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Alani Q, Yassir M, Mansoor R, Flayyih R, Ali Saifuddin Yaqoob N, Rafeeq H, Farghaly S, Abd El Aziz S. Knowledge, Attitude, and Practices Towards Osteoporosis Among Adults in the United Arab Emirates (UAE) in 2023. Cureus 2024; 16:e56084. [PMID: 38618442 PMCID: PMC11011242 DOI: 10.7759/cureus.56084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/13/2024] [Indexed: 04/16/2024] Open
Abstract
BACKGROUND Osteoporosis, the silent epidemic, is defined as a systemic skeletal disease characterized by low mineral bone mass and micro-architectural deterioration of bone tissue. Osteoporosis is considered a burden to global economic, social, and health development. Osteoporosis exerts a substantial global influence, markedly influencing rates of illness and death on a broad scale. Clinical features of osteoporosis can include chronic back pain, loss of height, and a stooped posture, as well as an increased risk of fractures in the spine, hip, and wrist. Accurate identification and monitoring of these clinical features are essential for effective management and treatment of osteoporosis. This study aims to identify the knowledge, attitudes, and practices (KAP) of adults (over 18 years) about osteoporosis and identify relations between knowledge, attitudes, and practices with demographic data. Furthermore, to assess the risk factors and preventive measures for osteoporosis. METHODOLOGY Data from 446 responders were collected using a Google Forms questionnaire, including questions to assess knowledge, attitudes, and practice levels among adults 18 years and above in the United Arab Emirates (UAE). The collected data and statistical analysis were done through the IBM® SPSS® Statistics. Chi-Square was used in SPSS Statistics; the chi-square test was used for the relation between categorical variables, and P less than 0.05 was the cut-off level of significance. RESULTS The research revealed that 41.9% of the participants had good knowledge, 38.8% had a positive attitude, and 45.3% had poor practices. The results also showed that there is a statistically significant correlation between gender and knowledge, attitudes, and practices. CONCLUSION Our research demonstrates that there's a statistically significant correlation between gender variables with knowledge, attitudes, and practices. These findings have important implications in assessing the correlation between variables in our research that could be used to prevent osteoporosis further, target the specific demographic group, and provide the required education. Overall, our research contributes to a better understanding of the knowledge, attitude, and practices towards Osteoporosis among adults in the UAE and underscores the importance of further awareness in this area.
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Affiliation(s)
- Quds Alani
- Research, Dubai Medical College for Girls, Dubai, ARE
| | | | | | - Raya Flayyih
- Research, Dubai Medical College for Girls, Dubai, ARE
| | | | - Hessa Rafeeq
- Research, Dubai Medical College for Girls, Dubai, ARE
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Alnaqbi KA, Al Zeyoudi J, Aljaberi AK. Cardiac Arrhythmia and Heart Failure Shortly After Starting Romosozumab for Osteoporosis: A Case-Based Review. Cureus 2023; 15:e50303. [PMID: 38089947 PMCID: PMC10714059 DOI: 10.7759/cureus.50303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/11/2023] [Indexed: 12/23/2023] Open
Abstract
Romosozumab is a humanized monoclonal antibody that targets the sclerostin protein, which regulates bone formation and resorption. It is a novel therapy in the treatment of post-menopausal women with osteoporosis. The evidence regarding romosozumab's cardiovascular safety is conflicting. We report the first post-marketing case demonstrating cardiac events (i.e., atrial fibrillation and congestive heart failure) in a female patient with osteoporosis likely triggered by romosozumab. A literature review on romosozumab and cardiovascular disease is discussed extensively. For osteoporotic patients with cardiovascular risk factors (e.g., hypertension, coronary artery disease, and stroke), the benefits of fracture prevention should be weighed against potential cardiovascular risks before prescribing romosozumab. Real-world data on post-marketing surveillance will shed light on the potential safety signals of romosozumab.
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Affiliation(s)
- Khalid A Alnaqbi
- Internal Medicine, College of Medicine and Health Sciences, United Arab Emirates (UAE) University, Al Ain, ARE
- Internal Medicine/Rheumatology, Tawam Hospital, Al Ain, ARE
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Liang G, Zhao J, Zhao D, Dou Y, Huang H, Yang W, Zhou G, Gu Z, Pan J, Liu J. Longbie capsules reduce bone loss in the subchondral bone of rats with comorbid osteoporosis and osteoarthritis by regulating metabolite alterations. Front Med (Lausanne) 2023; 10:1256238. [PMID: 37915330 PMCID: PMC10616798 DOI: 10.3389/fmed.2023.1256238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Accepted: 09/25/2023] [Indexed: 11/03/2023] Open
Abstract
Background and objective With the development of global population aging, comorbidity (≥2 diseases) is a common health problem among elderly people. Osteoarthritis (OA) and osteoporosis (OP) are common in elderly individuals. There is a lack of drug therapy for OA and OP comorbidities. The purpose of this study was to explore the efficacy and mechanism of Longbie capsule (LBJN), which contains various plant herbs, in treating OA and OP comorbidities (OA + OP) in rats using metabolomics techniques. Methods We created an OA + OP rat model through bilateral oophorectomy combined with meniscus instability surgery. Thirty SD rats were randomly divided into five groups (six in each group), namely, the sham group, OA group, OA + OP group, LBJN low-dose group (0.625 g/kg, OA + OP+LB-L group) and LBJN high-dose group (1.25 g/kg, OA + OP+LB-H group). After 8 weeks of intervention, we used micro-CT to detect bone microstructure status, ELISA to measure bone metabolism indicators, and UPLC-MS technology for metabolomics analysis. Finally, the screened differentially expressed metabolites were subjected to Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway and functional enrichment analysis. Results The micro-CT results showed that LBJN significantly improved the bone mineral density (BMD) and bone quality of subchondral bone in OA + OP rats, and LBJN regulated the expression of bone alkaline phosphatase (BALP), osteoprotegerin (OPG), and tartrate-resistant acid phosphatase (TRACP) in serum to maintain bone metabolism balance. Metabolomics analysis showed that the metabolic trajectory of OA + OP rats after intervention in the OA + OP+LB-H group showed significant changes, and 107 potential biomarkers could be identified. Among them, 50 metabolites were upregulated (such as zeranol) and 57 were downregulated (such as vanillactic acid). The KEGG functional enrichment results indicated that the differentially expressed metabolites are mainly involved in amino acid metabolism, lipid metabolism, and carbohydrate metabolism. The KEGG pathway enrichment results indicated that LBJN may exert therapeutic effects on OA + OP rats by regulating the cAMP signaling pathway, and the FoxO signaling pathway. Conclusion LBJN can maintain bone metabolism balance by regulating serum lipid metabolism, amino acid metabolism, carbohydrate metabolism, and estrogen, thereby reducing bone loss in subchondral bone, which may be a potential mechanism through which LBJN treats OA + OP.
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Affiliation(s)
- Guihong Liang
- The Second Clinical College of Guangzhou University of Chinese Medicine, Guangzhou, China
- Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China
- The Research Team on Bone and Joint Degeneration and Injury of Guangdong Provincial Academy of Chinese Medical Sciences, Guangzhou, China
| | - Jinlong Zhao
- The Second Clinical College of Guangzhou University of Chinese Medicine, Guangzhou, China
- Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China
- The Research Team on Bone and Joint Degeneration and Injury of Guangdong Provincial Academy of Chinese Medical Sciences, Guangzhou, China
| | - Di Zhao
- The Second Clinical College of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Yaoxing Dou
- The Second Clinical College of Guangzhou University of Chinese Medicine, Guangzhou, China
- Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China
- The Research Team on Bone and Joint Degeneration and Injury of Guangdong Provincial Academy of Chinese Medical Sciences, Guangzhou, China
| | - Hetao Huang
- Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China
| | - Weiyi Yang
- Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China
| | - Guanghui Zhou
- The Second Clinical College of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Zhuoxu Gu
- The Second Clinical College of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Jianke Pan
- The Second Clinical College of Guangzhou University of Chinese Medicine, Guangzhou, China
- Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China
- The Research Team on Bone and Joint Degeneration and Injury of Guangdong Provincial Academy of Chinese Medical Sciences, Guangzhou, China
| | - Jun Liu
- The Research Team on Bone and Joint Degeneration and Injury of Guangdong Provincial Academy of Chinese Medical Sciences, Guangzhou, China
- The Fifth Clinical College of Guangzhou University of Chinese Medicine, Guangzhou, China
- Guangdong Second Chinese Medicine Hospital (Guangdong Province Enginering Technology Research Institute of Traditional Chinese Medicine), Guangzhou, China
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Al Rayes H, Salah H, Hamad T, Soliman M, Bedaiwi M. The Impact of Spondyloarthritis on Health-Related Quality of Life and Healthcare Resource Utilization in Saudi Arabia: A Narrative Review and Directions for Future Research. Open Access Rheumatol 2023; 15:161-171. [PMID: 37705696 PMCID: PMC10497044 DOI: 10.2147/oarrr.s414530] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Accepted: 07/04/2023] [Indexed: 09/15/2023] Open
Abstract
Spondylarthritis (SpA) is an umbrella term that encompasses a wide range of rheumatological disorders. Several studies demonstrated that SpA is associated with increased healthcare resource utilization (HCRU) and a lower health-related quality of life (HRQoL). This review aimed to summarize the current literature regarding the multidimensional impact of SpA on HRQoL and HCRU in Saudi Arabia and explore the correlation of the extent of severity of SpA with HRQoL and HCRU. Although the prevalence of SpA varies across different populations and is correlated with HLA-B27 prevalence, the magnitude of SpA in the Saudi population has not been extensively evaluated. Few studies have investigated the impact of SpA on HRQoL and HCRU in Saudi Arabia and the Middle East. There is a need to study the cost-effectiveness of various SpA treatment strategies, including biologic disease-modifying anti-rheumatic drugs (bDMARDs), to prioritize healthcare spending in the Saudi healthcare system. Data on SpA in Saudi Arabia and the Middle East region are mainly based on expert views, with few population-based studies compared to other regions. Therefore, there is an imperative need to develop high-quality, national-level epidemiological studies that assess the following: (1) more accurate estimates of the current prevalence of SpA in Saudi Arabia, including the prevalence of axial SpA and psoriatic arthritis; (2) the phenotypes/clinical characteristics of SpA, including disease severity and extra-articular involvement; (3) the impact of SpA on the HRQoL of the patients and the factors that can predict the extent of impaired HRQoL in such population, which can represent the first step in developing psychological interventions that should be personalized to this patient population; (4) the impact of implementing formal assessment of disease activity on the management of the patients and, subsequently, their HRQoL; and (5) the HCRU and costs for patients with SpA, and how treatment patterns can affect this cost.
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Affiliation(s)
- Hanan Al Rayes
- Division of Rheumatology, Department of Internal Medicine, Prince Sultan Military Medical City, Riyadh, Saudi Arabia
| | - Hany Salah
- Therapeutic Area Lead Rheumatology, Intercontinental, AbbVie Biopharmaceuticals GmbH, Dubai, United Arab Emirates
| | - Tharwat Hamad
- Medical Manager, Immunology, AbbVie Biopharmaceuticals GmbH, Jeddah, Saudi Arabia
| | - Mohab Soliman
- Medical Advisor, Rheumatology, AbbVie Biopharmaceuticals GmbH, Riyadh, Saudi Arabia
| | - Mohamed Bedaiwi
- Division of Rheumatology, College of Medicine, King Saud University Medical City, King Saud University, Riyadh, Saudi Arabia
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Singh S, Singh S, Nachimuthu M, Kassim AF, Bhullar AK, Veerakumaran R, Kol GN, Roslan NAM. Effectiveness of Ultrasound-guided versus Anatomical Landmark-guided Genicular Nerve Block to Treat Chronic Knee Osteoarthritis: A Retrospective Cohort Study. Oman Med J 2023; 38:e550. [PMID: 38225997 PMCID: PMC10788927 DOI: 10.5001/omj.2023.103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2023] [Accepted: 03/26/2023] [Indexed: 01/17/2024] Open
Abstract
Objectives There is limited data on the relative effectiveness of different techniques used for administering genicular nerve block (GNB) for pain management of chronic knee osteoarthritis (OA) in the Malaysian population. This study aims to determine and compare the effectiveness of GNB administered using two pain management techniques?"anatomical landmark-guided (ALG) and ultrasound-guided (USG)?"for chronic knee OA in this population. Methods This retrospective cohort study included 40 patients with chronic knee OA who received GNB, 20 of whom underwent treatment with the USG technique and the other 20 with the ALG technique. Pain, stiffness, and functional limitation scores were assessed using the Western Ontario and McMaster Universities Osteoarthritis Index Questionnaire (WOMAC) and Numeric Rating Scale (NRS-11) at baseline and post-treatment day one, three weeks, and six weeks. Results Both groups reported a significant reduction in WOMAC and NRS-11 scores as per their feedback on day one, three weeks, and six weeks post-treatment. Greater reductions in WOMAC and NRS-11 scores were reported by patients who received GNB via USG than by ALG technique, the difference achieving statistical significance at six weeks after treatment (p =0.026). Conclusions GNB administration using USG and ALG techniques are both effective in significantly reducing pain, stiffness, and functional limitation in patients suffering from chronic knee OA. Among the two techniques, USG appears to be more effective. Nevertheless, GNB guided by ALG continues to be a viable treatment modality, especially in healthcare settings with limited to no USG facilities.
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Affiliation(s)
- Sarbhjit Singh
- Department of Orthopedics, Hospital Sultanah Bahiyah, Kedah, Malaysia
| | - Sarbhan Singh
- Institute for Medical Research, National Institutes of Health, Ministry of Health Malaysia, Setia Alam, Malaysia
| | | | | | | | | | - Goh Ni Kol
- Department of Orthopedics, Hospital Raja Permaisuri Bainun, Perak, Malaysia
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Al-Omari B, Farhat J, Khan M, Grancharov H, Zahr ZA, Hanna S, Alrahoomi A. Exploring patient treatment decision making for osteoarthritis in the UAE: a cross-sectional adaptive choice-based conjoint study. BMC Public Health 2023; 23:1542. [PMID: 37573337 PMCID: PMC10423421 DOI: 10.1186/s12889-023-16490-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Accepted: 08/09/2023] [Indexed: 08/14/2023] Open
Abstract
OBJECTIVE To assess osteoarthritis (OA) patients' preferences for pharmaceutical treatment via Adaptive Choice-Based Conjoint (ACBC) method. METHODS A United Arab Emirates (UAE) based Patient and Public Involvement (PPI) group designed the ACBC questionnaire with 10 attributes and 34 levels. The questionnaire was developed using Sawtooth Software and analyzed through Hierarchical Bayesian (HB). Results were standardized using Z-score via SPSS. RESULTS Study participants were 1030 OA patients, 83.6% aged 50 or older and 83.4% female. The avoidance of medication's side effects accounted for 66% relative importance compared to 6% relative importance for the medication's benefits. The "way of taking the medicine" attribute had the highest coefficient of variation (70%) and the four side effect attributes "risk of gastric ulcer, addiction, kidney and liver impairment, and heart attacks and strokes" had a coefficient of variation from 18 to 21%. CONCLUSIONS Arab OA patients are similar to other ethnic groups in trading-off benefits and side effects and consistently prioritizing the avoidance of medications' side effects. Although the "Way of taking medicine" was the least important attribute it was associated with the highest variation amongst patients. OA patients also prefer prescribed medications to internet-purchased and over-the-counter options.
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Affiliation(s)
- Basem Al-Omari
- Department of Epidemiology and Population Health, College of Medicine and Health Sciences, Khalifa University, P.O. Box 127788, Abu Dhabi, United Arab Emirates.
| | - Joviana Farhat
- Department of Epidemiology and Population Health, College of Medicine and Health Sciences, Khalifa University, P.O. Box 127788, Abu Dhabi, United Arab Emirates
| | - Mumtaz Khan
- Department of Epidemiology and Population Health, College of Medicine and Health Sciences, Khalifa University, P.O. Box 127788, Abu Dhabi, United Arab Emirates
- Department of Rheumatology, Sheikh Shakhbout Medical City (SSMC), P.O. Box 11001, Abu Dhabi, United Arab Emirates
| | - Hristo Grancharov
- Department of Epidemiology and Population Health, College of Medicine and Health Sciences, Khalifa University, P.O. Box 127788, Abu Dhabi, United Arab Emirates
- Department of Orthopedics & Sports Medicine, Healthpoint Hospital, P.O. Box 112308, Abu Dhabi, United Arab Emirates
| | - Zaki Abu Zahr
- Department of Rheumatology, Healthpoint Hospital, P.O. Box 112308, Abu Dhabi, United Arab Emirates
| | - Sammy Hanna
- Department of Epidemiology and Population Health, College of Medicine and Health Sciences, Khalifa University, P.O. Box 127788, Abu Dhabi, United Arab Emirates
- Department of Orthopedics & Sports Medicine, Healthpoint Hospital, P.O. Box 112308, Abu Dhabi, United Arab Emirates
- Barts and the London School of Medicine and Dentistry, Queen Mary University of London, Whitechapel, London, E1 2AD, UK
| | - Abdulla Alrahoomi
- Department of Epidemiology and Population Health, College of Medicine and Health Sciences, Khalifa University, P.O. Box 127788, Abu Dhabi, United Arab Emirates
- Department of Orthopedics & Sports Medicine, Healthpoint Hospital, P.O. Box 112308, Abu Dhabi, United Arab Emirates
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徐 健, 王 文, 范 雪, 王 露, 张 萌. [Correlation Between Osteoarthritis and Osteoporosis in Men]. SICHUAN DA XUE XUE BAO. YI XUE BAN = JOURNAL OF SICHUAN UNIVERSITY. MEDICAL SCIENCE EDITION 2023; 54:439-443. [PMID: 36949712 PMCID: PMC10409179 DOI: 10.12182/20230360504] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Indexed: 03/24/2023]
Abstract
Objective To investigate the influence of osteoarthritis (OA) at different sites and of different degrees on the prevalence of osteoporosis (OP) and lumbar bone mineral density (L-BMD) in men, and thereby to analyze the relationship between OA and OP. Methods We collected information on the age, height, body mass, the course of pain, smoking status, exercise status, and history of hypertension and diabetes of 1206 male patients who received treatment for bone and joint pain at the Department of Osteoporosis and Rheumatology, West China Fourth Hospital, Sichuan University between January 2017 and December 2020. The patients' L-BMD was determined with dual-energy X-ray absorptiometry. The sites and the degrees of OA were evaluated by digital radiography and CT or MRI. χ 2 test was performed to compare the OP prevalence of different groups. Analysis of covariance was carried out to compare the L-BMD of different groups. Binary logistic regression was conducted to analyze the risk factors of OP. Results OP prevalence of the OA group was significantly lower than that of the non-OA group ( P<0.05). OP prevalence of the lumbar vertebra OA group was significantly lower than that of the non-OA group ( P<0.05). In addition, OP prevalence of the mild OA group and moderate OA group was significantly lower than of the non-OA group ( P<0.05). The L-BMD of the OA group was significantly higher than that of the non-OA group ( P<0.05). In addition, there were significant differences in L-BMD between groups with OA at different sites ( P<0.05). Furthermore, the L-BMD of the lumbar vertebra OA group and the multi-site OA group was significantly higher than that of the non-OA group ( P<0.05). There were significant differences in L-BMD between groups with different degrees of OA ( P<0.05). Furthermore, the L-BMD of the mild OA group and moderate OA group was significantly higher than that of the non-OA group ( P<0.05). OA and exercise were found to be protective factors for OP (odds ratio [ OR]=0.715 and 0.625, 95% confidence interval [ CI]: 0.550-0.928 and 0.481-0.814, P<0.05). Age and BMI were found to be risk factors for OP in men ( OR=1.018 and 1.081, 95% CI: 1.008-1.028 and 1.042-1.122, P<0.05). Conclusion Lumbar vertebra OA and mild and moderate OA decrease OP prevalence in men, while lumbar vertebra OA, multi-site OA, and mild and moderate OA increase L-BMD in men. OA and exercise decrease the occurrence of OP in men, while age and BMI increase the risk of OP in men.
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Affiliation(s)
- 健 徐
- 四川大学华西公共卫生学院/四川大学华西第四医院 骨质疏松与风湿免疫科 (成都 610041)Department of Osteoporosis and Rheumatology, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu 610041, China
| | - 文志 王
- 四川大学华西公共卫生学院/四川大学华西第四医院 骨质疏松与风湿免疫科 (成都 610041)Department of Osteoporosis and Rheumatology, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu 610041, China
| | - 雪 范
- 四川大学华西公共卫生学院/四川大学华西第四医院 骨质疏松与风湿免疫科 (成都 610041)Department of Osteoporosis and Rheumatology, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu 610041, China
| | - 露 王
- 四川大学华西公共卫生学院/四川大学华西第四医院 骨质疏松与风湿免疫科 (成都 610041)Department of Osteoporosis and Rheumatology, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu 610041, China
| | - 萌 张
- 四川大学华西公共卫生学院/四川大学华西第四医院 骨质疏松与风湿免疫科 (成都 610041)Department of Osteoporosis and Rheumatology, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu 610041, China
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Al Saleh J, Almoallim H, Elzorkany B, Al Belooshi A, Batouk O, Fathy M, Vainstein N, Kaki AM. Assessing the Burden of Osteoarthritis in Africa and the Middle East: A Rapid Evidence Assessment. Open Access Rheumatol 2023; 15:23-32. [PMID: 36945659 PMCID: PMC10024869 DOI: 10.2147/oarrr.s390778] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Accepted: 02/28/2023] [Indexed: 03/17/2023] Open
Abstract
Introduction/Objectives This rapid evidence assessment (REA) was conducted to assess the burden of weight-bearing joint osteoarthritis in the developing countries of Africa and the Middle East. Methods Our REA methodology used a standardized search strategy to identify observational studies, published between January 1, 2010, and April 23, 2020, reporting on outcomes pertaining to the epidemiology and humanistic or economic burden of weight-bearing osteoarthritis. Relevant data from the included studies were used for qualitative analysis. Results Among the 20 publications reporting on knee osteoarthritis in 10 countries in Africa and the Middle East, 2 also reported on hip, and 1 on foot osteoarthritis. Prevalence of symptomatic/radiographic knee OA was 9-14% among rheumatology outpatients and 31-34% among those with mixed etiology osteoarthritis. Prevalence of knee OA diagnosed by magnetic resonance imaging was 70% among patients ≥40 years of age attending a hospital in Saudi Arabia. Quality-of-life outcomes were reported in 16 publications and suggested a substantial humanistic burden of osteoarthritis, including worse pain, function, and quality of life, and more depression; comparisons between studies were hampered by the variety of tools and scoring scales used, however. No studies reported on economic outcomes. Conclusion This REA indicates a substantial burden of osteoarthritis in weight-bearing joints in Africa and the Middle East, consistent with publications from other regions of the world.
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Affiliation(s)
- Jamal Al Saleh
- Department of Rheumatology, Dubai Hospital, Dubai Health Authority, Dubai, United Arab Emirates
| | - Hani Almoallim
- Department of Medicine, Medical College, Umm Al-Qura University, Makkah, Saudi Arabia
| | | | - Ali Al Belooshi
- Mediclinic City Hospital, Department of Surgery, UAE University, Dubai, United Arab Emirates
| | - Omar Batouk
- King Saud bin Abdulaziz University for Health Sciences, National Guard Health Affairs, Jeddah, Saudi Arabia
| | | | | | - Abdullah M Kaki
- Department of Anesthesia and Critical Care, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
- Correspondence: Abdullah M Kaki, MD, FRCPC, Professor of Anesthesiology and Pain Medicine, Faculty of Medicine, King Abdulaziz University, PO Box 2907, Jeddah, 21461, Saudi Arabia, Tel/Fax +966126408335, Email ;
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Muacevic A, Adler JR, Almalki H, Alameer M, Ali N, Alomani N, Alyusuf Z, Hasan W, Maki R, Al Mail S. Osteoporosis Among Bahraini Women Based on Bone Mineral Density Measurements: A Retrospective Study. Cureus 2022; 14:e31368. [PMID: 36514635 PMCID: PMC9741857 DOI: 10.7759/cureus.31368] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/11/2022] [Indexed: 11/13/2022] Open
Abstract
Objectives The objective is to estimate the prevalence of osteoporosis among women in Bahrain who are aged ≥18 years. Methods In this retrospective study conducted at Salmaniya Medical Complex, a total of 590 Bahraini women were enrolled. Their bone mineral density measurements were obtained through dual-energy x-ray absorptiometry (DEXA) performed between January 2017 and December 2017. Six sites were chosen as the measurement targets. Patients were diagnosed with osteoporosis if their T-score was > -2.5 according to the World Health Organization guidelines. Results Osteoporosis was diagnosed in 27.1% of the patients; 53.2% had osteopenia, 0.3% had severe osteoporosis, and 19.3% had normal bone conditions. The prevalence of osteopenia as well as osteoporosis increased with age. Conclusion Osteoporosis and osteopenia are common among Bahraini women. This study provides useful information on the prevalence of osteoporosis among Bahraini women. Major steps by health authorities in the country are needed to reduce morbidity and improve the quality of life.
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Alnaqbi KA, Hannawi S, Namas R, Alshehhi W, Badsha H, Al‐Saleh J. Consensus statements for pharmacological management, monitoring of therapies, and comorbidity management of psoriatic arthritis in the United Arab Emirates. Int J Rheum Dis 2022; 25:1107-1122. [PMID: 35916205 PMCID: PMC9804226 DOI: 10.1111/1756-185x.14406] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Revised: 06/28/2022] [Accepted: 07/17/2022] [Indexed: 01/05/2023]
Abstract
OBJECTIVE Psoriatic arthritis (PsA), a chronic inflammatory disease characterized by heterogeneous clinical manifestations, substantially impacts the quality of life of affected individuals. This article aims at developing consensus recommendations for the management of PsA and associated comorbidities and screening and monitoring requirements of PsA therapies in the United Arab Emirates (UAE) population. METHODS An extensive review of present international and regional guidelines and publications on the pharmacological management, monitoring of therapies in the context of PsA was performed. Key findings from guidelines and literature were reviewed by a panel of experts from the UAE at several meetings to align with current clinical practices. Consensus statements were formulated based on collective agreement of the experts and members of Emirates Society for Rheumatology. RESULTS The consensus recommendations were developed to aid practitioners in clinical decision-making with respect to dosage recommendations for pharmacological therapies for PsA, including conventional drugs, non-biologic, and biologic therapies. Consensus recommendations for therapeutic options for the treatment of PsA domains, including peripheral arthritis, axial disease, enthesitis, dactylitis, psoriasis, and nail disease, were developed. The panel emphasized the importance of monitoring PsA therapies and arrived at a consensus on monitoring requirements for PsA therapies. The expert panel proposed recommendations for the management of common comorbidities associated with PsA. CONCLUSION These consensus recommendations can guide physicians and healthcare professionals in the UAE in making proper treatment decisions, as well as efficiently managing comorbidities and monitoring therapies in patients with PsA.
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Affiliation(s)
- Khalid A. Alnaqbi
- Department of RheumatologyTawam HospitalAl AinUAE,College of Medicine and Health SciencesUAE UniversityAl AinUAE
| | - Suad Hannawi
- Emirates Health Services (EHS)DubaiUAE,Ministry of Health and PreventionDubaiUAE
| | - Rajaie Namas
- Division of Rheumatology, Department of Internal MedicineCleveland Clinic Abu DhabiUAE
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Alnaqbi KA, Hannawi S, Namas R, Alshehhi W, Badsha H, Al‐Saleh J. Consensus statements for evaluation and nonpharmacological Management of Psoriatic Arthritis in UAE. Int J Rheum Dis 2022; 25:725-732. [PMID: 35678066 PMCID: PMC9544782 DOI: 10.1111/1756-185x.14357] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Revised: 03/23/2022] [Accepted: 05/17/2022] [Indexed: 12/13/2022]
Abstract
OBJECTIVE Psoriatic arthritis (PsA), a chronic inflammatory arthropathy, is often underdiagnosed in Middle Eastern countries, substantially impacting the treatment of affected individuals. This article aims to highlight current unmet clinical needs and provide consensus recommendations for region-specific evaluation methods and nonpharmacological therapies in the United Arab Emirates (UAE). METHOD An extensive literature review was conducted, focusing especially on global and regional guidelines for the evaluation and treatment of PsA. These form the basis of the consensus statements formulated. Additionally, an expert panel of key opinion leaders from the UAE reviewed these guidelines and available literature at an advisory board meeting to identify unmet needs, bridge clinical gaps in the UAE, and develop consensus statements for the evaluation and treatment of PsA. RESULT The consensus statements were developed based on overarching principles for the management of PsA, evaluation of patients with PsA, and nonpharmacological approaches for the management of PsA. The overarching principles included adopting a targeted, multidisciplinary approach, along with collaboration between rheumatologists and dermatologists in cases of clinically significant skin involvement. The panel also highlighted the value of composite disease severity measures for characterizing clinical manifestations of PsA. In terms of nonpharmacological management approaches, lifestyle modification (comprising dietary change, exercise, and cessation of smoking) and psychotherapy were recommended. CONCLUSION The consensus statements will aid healthcare professionals in clinical decision-making in the context of PsA.
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Affiliation(s)
- Khalid A. Alnaqbi
- Department of RheumatologyTawam HospitalAl AinUAE
- College of Medicine and Health SciencesUAE UniversityAl AinUAE
| | - Suad Hannawi
- Emirates Health Services (EHS)DubaiUAE
- Ministry of Health and PreventionDubaiUAE
| | - Rajaie Namas
- Division of Rheumatology, Department of Internal MedicineCleveland ClinicAbu DhabiUAE
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RISK FACTORS FOR THE DEVELOPMENT OF PATHOLOGICAL PROCESSES IN THE STRUCTURES OF THE HIP JOINT. WORLD OF MEDICINE AND BIOLOGY 2022. [DOI: 10.26724/2079-8334-2022-1-79-108-112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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13
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Hamood R, Tirosh M, Fallach N, Chodick G, Eisenberg E, Lubovsky O. Prevalence and Incidence of Osteoarthritis: A Population-Based Retrospective Cohort Study. J Clin Med 2021; 10:4282. [PMID: 34575394 PMCID: PMC8468886 DOI: 10.3390/jcm10184282] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Revised: 09/12/2021] [Accepted: 09/14/2021] [Indexed: 01/06/2023] Open
Abstract
While trends data of osteoarthritis (OA) are accumulating, primarily from Western Europe and the US, a gap persists in the knowledge of OA epidemiology in Middle Eastern populations. This study aimed to explore the prevalence, incidence, correlations, and temporal trends of OA in Israel during 2013-2018, using a nationally representative primary care database. On 31 December 2018, a total of 180,126 OA patients were identified, representing a point prevalence of 115.3 per 1000 persons (95% CI, 114.8-115.8 per 1000 persons). Geographically, OA prevalence was not uniformly distributed, with the Southern and Northern peripheral districts having a higher prevalence than the rest of the Israeli regions. OA incidence increased over time from 7.36 per 1000 persons (95% CI 6.21-7.50 per 1000 persons) in 2013 to 8.23 per 1000 persons (95% CI 8.09-8.38 per 1000 persons) in 2017 (p-value for trend = 0.02). The incidence was lowest in patients under 60 years (in both sexes) and peaked at 60-70 years. In older ages, the incidence leveled off in men and declined in women. The growing risk of OA warrants a greater attention to timely preventive and therapeutic interventions. Further population-based studies in the Middle East are needed to identify modifiable risk factors for timely preventive and therapeutic interventions.
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Affiliation(s)
- Rola Hamood
- Medical Affairs Pfizer Inc., Herzliya 4672509, Israel;
| | | | - Noga Fallach
- Kahn-Sagol-Maccabi Research and Innovation Institute, Maccabi Healthcare Services, Tel Aviv 6812509, Israel; (N.F.); (G.C.)
| | - Gabriel Chodick
- Kahn-Sagol-Maccabi Research and Innovation Institute, Maccabi Healthcare Services, Tel Aviv 6812509, Israel; (N.F.); (G.C.)
- Sackler School of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel
| | - Elon Eisenberg
- The Ruth and Bruce Rappaport Faculty of Medicine, Technion—Israel Institute of Technology, Rambam Health Care Campus, Haifa 3525433, Israel;
| | - Omri Lubovsky
- Barzilai Medical Center Ashkelon Israel, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva 8410501, Israel;
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Almoallim H, Al Saleh J, Badsha H, Ahmed HM, Habjoka S, Menassa JA, El-Garf A. A Review of the Prevalence and Unmet Needs in the Management of Rheumatoid Arthritis in Africa and the Middle East. Rheumatol Ther 2021; 8:1-16. [PMID: 33226566 PMCID: PMC7991016 DOI: 10.1007/s40744-020-00252-1] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Accepted: 10/31/2020] [Indexed: 02/07/2023] Open
Abstract
Estimates of the global prevalence of rheumatoid arthritis (RA) range from 0.24 to 1%, but vary considerably around the globe. A variation in RA prevalence is also expected across Africa and the Middle East, due to ethnic, climate, and socioeconomic differences. To assess the prevalence of RA in Africa and the Middle East, we searched Medline (via PubMed) and databases of major rheumatology conferences. Seventeen journal articles and 0 abstracts met the inclusion criteria. Estimated prevalence ranged from 0.06 to 3.4%. Most studies reported values near or below 0.25%. Consistent with data from other regions, RA was more prevalent among urban than rural populations, and among women than men. The women:men prevalence ratio ranged from 1.3:1 to 12.5:1, which suggests notable differences from the global average of 2:1. Relative increases in prevalence were observed in North Africa and the Middle East (13% since 1990) and Western Sub-Saharan Africa (14%), whereas rates in Eastern, Central, and Southern Sub-Saharan Africa show decreases (4-12%). Low disease awareness, delays to visit rheumatologists, and socioeconomic factors appear to hinder early diagnosis and aggressive treatment. Few countries have developed RA-specific treatment guidelines, and many physicians and patients face limited access to even basic treatments. An improved understanding of the epidemiology and management of RA, and the related socioeconomic consequences is necessary, so that targeted attempts can be made to encourage early diagnosis and treatment.
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Affiliation(s)
- Hani Almoallim
- Faculty of Medicine, Umm-Al-Qura University, Makkah, Saudi Arabia.
| | | | - Humeira Badsha
- Dr Humeira Badsha Medical Center, Dubai, United Arab Emirates
| | | | - Sara Habjoka
- Pfizer Biopharmaceutical Group, Emerging Markets, Dubai, United Arab Emirates
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15
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Fréz AR, Alouche SR, Binda AC, Vieira GW, Bueno BAM, Cabral CMN. Development of a Core Set for Knee Dysfunction Based on the International Classification of Functioning, Disability and Health: A Cross-sectional Study. Arch Phys Med Rehabil 2020; 102:571-581. [PMID: 33278366 DOI: 10.1016/j.apmr.2020.10.139] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Accepted: 10/28/2020] [Indexed: 11/15/2022]
Abstract
OBJECTIVE To develop an International Classification of Functioning, Disability and Health core set for patients with knee dysfunction. DESIGN Cross-sectional study. SETTING The study was conducted at all levels of care (general community, primary care units, rehabilitation clinics/centers, hospital). PARTICIPANTS Participants (N=388) with knee dysfunction with or without clinical diagnosis of knee pathology, with or without complaint of pain, with or without instability, and/or with or without knee movement restriction of any type. INTERVENTIONS Not applicable. MAIN OUTCOME MEASURES Participants were assessed using the core sets for acute and postacute musculoskeletal conditions, the subjective form from the International Knee Documentation Committee scale, the self-report of general health and functionality, and the general health and functionality classified by the researcher. To identify the categories that best explain knee dysfunction, linear regression analyses were performed. RESULTS Twenty-four categories were identified from the 75 core set categories for acute and postacute musculoskeletal conditions. Eleven categories belong to the component body functions, 3 represent body structures, 7 represent activities and participation, and 3 represent environmental factors. CONCLUSIONS A core set for knee dysfunction that can be used at all levels of health care was proposed, which offers a system for disability assessment related to knee dysfunction, including environmental and social factors. These factors are important for a broad assessment because they include the multiple aspects of functionality, usually not considered in other knee dysfunction assessment instruments. Further analysis of the content and construct validity of the core set is required.
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Affiliation(s)
- Andersom Ricardo Fréz
- Physical Therapy Department, Universidade Estadual do Centro-Oeste, Guarapuava, Paraná; Master's and Doctoral Program in Physical Therapy, Universidade Cidade de São Paulo, São Paulo, Brazil.
| | - Sandra Regina Alouche
- Master's and Doctoral Program in Physical Therapy, Universidade Cidade de São Paulo, São Paulo, Brazil
| | - Aline Cristiane Binda
- Physical Therapy Department, Universidade Estadual do Centro-Oeste, Guarapuava, Paraná
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Cui A, Li H, Wang D, Zhong J, Chen Y, Lu H. Global, regional prevalence, incidence and risk factors of knee osteoarthritis in population-based studies. EClinicalMedicine 2020; 29-30:100587. [PMID: 34505846 PMCID: PMC7704420 DOI: 10.1016/j.eclinm.2020.100587] [Citation(s) in RCA: 445] [Impact Index Per Article: 111.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Revised: 09/22/2020] [Accepted: 09/23/2020] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Knee osteoarthritis (OA) is a major cause of disability in the elderly, however, there are few studies to estimate the global prevalence, incidence, and risk factors of knee OA. METHODS For this study, we searched PUBMED, EMBASE and SCOPUS from inception to April 4, 2020, without language restriction. We identified eligible studies with information on the prevalence or incidence of knee OA in population-based observational studies and extracted data from published reports. We did random-effects meta-analysis to generate estimates. This study was registered with PROSPERO (CRD42020181035). FINDINGS Out of 9570 records identified, 88 studies with 10,081,952 participants were eligible for this study. The pooled global prevalence of knee OA was 16⋅0% (95% CI, 14⋅3%-17⋅8%) in individuals aged 15 and over and was 22⋅9% (95% CI, 19⋅8%-26⋅1%) in individuals aged 40 and over. Correspondingly, there are around 654⋅1 (95% CI, 565⋅6-745⋅6) million individuals (40 years and older) with knee OA in 2020 worldwide. The pooled global incidence of knee OA was 203 per 10,000 person-years (95% CI, 106-331) in individuals aged 20 and over. Correspondingly, there are around annual 86⋅7 (95% CI, 45⋅3-141⋅3) million individuals (20 years and older) with incident knee OA in 2020 worldwide. The prevalence and incidence varied substantially between individual countries and increased with age. The ratios of prevalence and incidence in females and males were 1⋅69 (95% CI, 1⋅59-1⋅80, p<0⋅00) and 1⋅39 (95% CI, 1⋅24-1⋅56, p<0⋅00), respectively. INTERPRETATION Our study provides the global prevalence (16⋅0% [95% CI, 14⋅3%-17⋅8%]) and incidence (203 per 10,000 person-years [95% CI, 106-331]) of knee OA. These findings can be used to better assess the global health burden of knee OA. Further prospective cohort studies are warranted to identify modifiable risk factors for providing effectively preventive strategies in the early stages of the disease. FUNDING This work was supported by grants from the National Natural Science Foundation of China (nos. 81772384 and 81572174).
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Affiliation(s)
| | | | - Dawei Wang
- Department of Orthopaedics, The Fifth Affiliated Hospital of Sun Yat-Sen University, Zhuhai 519000, Guangdong, China
| | - Junlong Zhong
- Department of Orthopaedics, The Fifth Affiliated Hospital of Sun Yat-Sen University, Zhuhai 519000, Guangdong, China
| | - Yufeng Chen
- Department of Orthopaedics, The Fifth Affiliated Hospital of Sun Yat-Sen University, Zhuhai 519000, Guangdong, China
| | - Huading Lu
- Department of Orthopaedics, The Fifth Affiliated Hospital of Sun Yat-Sen University, Zhuhai 519000, Guangdong, China
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Shawashi TO, Darawad M. Osteoporosis Knowledge, Beliefs and Self-efficacy Among Female University Students: A Descriptive Study. Open Nurs J 2020. [DOI: 10.2174/1874434602014010211] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
Abstract
Aim:
This study aimed to investigate female university students' knowledge, beliefs and self-efficacy regarding osteoporosis.
Methods:
This is a descriptive cross-sectional study conducted amongst 260 female university students in Jordan. This study utilized a package of instruments to measure different variables of the study, including demographic data, Osteoporosis Knowledge Assessment Tool (OKAT), Osteoporosis Health Belief Scale (OHBS) and Osteoporosis Self-Efficacy Scale (OSES).
Results:
Participants had a relatively low level of knowledge regarding osteoporosis (M=8.1/20, 40.5%). In general, they had fairly positive beliefs towered osteoporosis with a percentage of 70% (M=3.5/5, SD=0.3) and moderate self-efficacy in practicing osteoporosis recommended practices. No significant differences were observed in participants’ knowledge, beliefs, and self-efficacy of osteoporosis based on their demographic variables except their college specialty.
Conclusion:
The current study confirmed that female university students had inadequate knowledge about osteoporosis. There is a gap between the participants' beliefs, self-efficacy about osteoporosis and their daily lifestyle. In view of such lack of knowledge of osteoporosis, efforts should be made to raise the level of osteoporosis awareness among university students through health education intervention programs for all-female university students regardless of their college, specialty or academic program.
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18
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Al-Saleh Y, Al-Daghri NM, Sabico S, Alessa T, Al Emadi S, Alawadi F, Al Qasaabi S, Alfutaisi A, Al Izzi M, Mukhaimer J, Suhaili AR, Reginster JY, Sulimani R. Diagnosis and management of osteoporosis in postmenopausal women in Gulf Cooperation Council (GCC) countries: consensus statement of the GCC countries' osteoporosis societies under the auspices of the European Society for Clinical and Economic Aspects of Osteoporosis and Osteoarthritis (ESCEO). Arch Osteoporos 2020; 15:109. [PMID: 32700153 DOI: 10.1007/s11657-020-00778-5] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Accepted: 06/25/2020] [Indexed: 02/03/2023]
Abstract
UNLABELLED A consensus platform is provided by the experts of the Gulf Cooperation Council (GCC) countries' respective osteoporosis societies, on which specific guidelines can be developed further for regional use on the assessment and treatment of postmenopausal women at risk from fractures due to osteoporosis. INTRODUCTION Guidance is provided in a Gulf Cooperation Council (GCC) country setting on the assessment and treatment of postmenopausal women at risk from fractures due to osteoporosis, which is an adaptation of the European guidance by Kanis et al., jointly published by the International Osteoporosis Foundation and the European Society for Clinical and Economic Aspects of Osteoporosis and Osteoarthritis (ESCEO). The respective osteoporosis societies of the Gulf Cooperation Council (GCC) countries assembled for a unifying consensus on the diagnosis and management of osteoporosis in postmenopausal women for the region. METHODS The Chair for Biomarkers of Chronic Diseases (CBCD) in King Saud University (KSU), Riyadh, Kingdom of Saudi Arabia (KSA), in cooperation with the Saudi Osteoporosis Society (SOS), hosted regional experts and respective leaders from different GCC osteoporosis societies, together with an adviser from the ESCEO. An assembly of experts representing the different osteoporosis societies from Saudi Arabia, the UAE, Bahrain, Oman, and Kuwait gathered on February 15-16, 2019 in Riyadh, KSA for the formulation of a general osteoporosis consensus for the region. RESULTS The following areas were covered: diagnosis of osteoporosis and assessment of fracture risk; general and pharmacological management of osteoporosis; and hip fractures, vitamin D, recommendation on which FRAX tool to follow, and the importance of country-specific FRAX® and fracture liaison services for secondary fracture prevention. CONCLUSIONS A platform is provided on which specific guidelines can be developed for regional use in GCC.
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Affiliation(s)
- Yousef Al-Saleh
- Chair for Biomarkers of Chronic Diseases, College of Science, King Saud University, PO Box 2455, Riyadh, 11451, Kingdom of Saudi Arabia.,College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, 22490, Saudi Arabia.,King Abdullah International Medical Research Center, Riyadh, 11481, Saudi Arabia.,Department of Medicine, King Abdulaziz Medical City, Ministry of National Guard-Health Affairs, Riyadh, 14611, Saudi Arabia
| | - Nasser M Al-Daghri
- Chair for Biomarkers of Chronic Diseases, College of Science, King Saud University, PO Box 2455, Riyadh, 11451, Kingdom of Saudi Arabia.
| | - Shaun Sabico
- Chair for Biomarkers of Chronic Diseases, College of Science, King Saud University, PO Box 2455, Riyadh, 11451, Kingdom of Saudi Arabia
| | - Thamer Alessa
- Division of Endocrinology, Diabetes and Metabolism, Jaber Al-Ahmad Hospital, Kuwait City, Kuwait
| | - Samar Al Emadi
- Department of Medicine, Hamad General Hospital, Doha, Qatar
| | | | | | | | | | | | | | - Jean-Yves Reginster
- Chair for Biomarkers of Chronic Diseases, College of Science, King Saud University, PO Box 2455, Riyadh, 11451, Kingdom of Saudi Arabia.,Department of Public Health, Epidemiology and Health Economics, University of Liège, 4000, Liège, Belgium
| | - Riad Sulimani
- College of Medicine, King Saud University, Riyadh, Saudi Arabia
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Dehlin M, Jacobsson L, Roddy E. Global epidemiology of gout: prevalence, incidence, treatment patterns and risk factors. Nat Rev Rheumatol 2020; 16:380-390. [PMID: 32541923 DOI: 10.1038/s41584-020-0441-1] [Citation(s) in RCA: 528] [Impact Index Per Article: 132.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/11/2020] [Indexed: 12/12/2022]
Abstract
Gout is the most common inflammatory arthritis and occurs when hyperuricaemia, sustained elevation of serum urate levels resulting in supersaturation of body tissues with urate, leads to the formation and deposition of monosodium urate crystals in and around the joints. Recent reports of the prevalence and incidence of gout vary widely according to the population studied and methods employed but range from a prevalence of <1% to 6.8% and an incidence of 0.58-2.89 per 1,000 person-years. Gout is more prevalent in men than in women, with increasing age, and in some ethnic groups. Despite rising prevalence and incidence, suboptimal management of gout continues in many countries. Typically, only a third to half of patients with gout receive urate-lowering therapy, which is a definitive, curative treatment, and fewer than a half of patients adhere to treatment. Many gout risk factors exist, including obesity, dietary factors and comorbid conditions. As well as a firmly established increased risk of cardiovascular disease and chronic kidney disease in those with gout, novel associations of gout with other comorbidities have been reported, including erectile dysfunction, atrial fibrillation, obstructive sleep apnoea, osteoporosis and venous thromboembolism. Discrete patterns of comorbidity clustering in individuals with gout have been described. Increasing prevalence and incidence of obesity and comorbidities are likely to contribute substantially to the rising burden of gout.
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Affiliation(s)
- Mats Dehlin
- Department of Rheumatology and Inflammation Research, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Lennart Jacobsson
- Department of Rheumatology and Inflammation Research, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Edward Roddy
- Primary Care Centre Versus Arthritis, School of Primary, Community and Social Care, Keele University, Keele, UK. .,Haywood Academic Rheumatology Centre, Haywood Hospital, Midlands Partnership NHS Foundation Trust, Stoke-on-Trent, UK.
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20
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Harnanik T, Soeroso J, Suryokusumo MG, Juliandhy T. Effects of Hyperbaric Oxygen on T helper 17/regulatory T Polarization in Antigen and Collagen-induced Arthritis: Hypoxia-inducible Factor-1α as a Target. Oman Med J 2020; 35:e90. [PMID: 31993228 PMCID: PMC6982795 DOI: 10.5001/omj.2020.08] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2019] [Accepted: 05/02/2019] [Indexed: 12/17/2022] Open
Abstract
Objectives We sought to investigate and prove the effect of hyperbaric oxygen therapy (HBOT) on T helper 17 (Th17)/regulatory T (Treg) cell polarization through changes in the expression of hypoxia-inducible factor-1 alpha (HIF-1α) in rheumatoid arthritis (RA) animal model. Methods We used antigen and collagen-induced arthritis (ACIA) as a RA animal model. Sixteen male BALB/c models of ACIA mice were divided into two groups, the non-HBOT group as the control group and the HBOT group as the treatment group. Expression of HIF-1α, Th17 anti-cluster differentiation 196 (CD196), and Treg anti-interleukine 2 receptor β-chain cells (IL-2Rβ) in tissue from the left knee joint tissue were determined histologically. Oxidative stress and systemic inflammation were assessed by levels of superoxide dismutase (SOD), interleukin 17a (IL-17a), C-reactive protein (CRP), and rheumatoid factor (RF) using the enzyme-linked immune-sorbent assay. The degree of arthritis was assessed by clinical scoring of paw swelling and the diameter of paw swelling. Results We found a significant decrease (p < 0.050) in the expression of HIF-1α, Th17 (CD196), IL-17a, RF levels, and the clinical scores and the diameter of paw swelling when comparing both groups. There was no significant decrease in the level of CRP in the treatment group compared to the control group. The expression of Treg (IL-2Rβ) increased significantly (p < 0.050) and the level of SOD increased but not significantly (p > 0.050) in the treatment group compared to the control group. Conclusions HBOT has effects on the polarization of Th17 to Treg through a decrease in expression of HIF-1α in mice with ACIA. HBOT is recommended for use as a support therapy for RA in combination with drug therapy.
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Affiliation(s)
- Titut Harnanik
- Department of Hyperbaric, Drs. Med. R. Rijadi S., Phys. Naval Health Institute, Surabaya, Indonesia.,Department of Physiology, Hang Tuah University, Surabaya, Indonesia.,Department of Biochemistry, Unit of the Experimental Animal, Airlangga University, Surabaya, Indonesia
| | - Joewono Soeroso
- Department of Biochemistry, Unit of the Experimental Animal, Airlangga University, Surabaya, Indonesia
| | | | - Tedy Juliandhy
- Department of Electrical Engineering, Hang Tuah University, Surabaya, Indonesia
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Demographic and Clinical Patterns of Rheumatoid Arthritis in an Emirati Cohort from United Arab Emirates. Int J Rheumatol 2019; 2019:3057578. [PMID: 31662761 PMCID: PMC6778867 DOI: 10.1155/2019/3057578] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2019] [Revised: 07/22/2019] [Accepted: 08/01/2019] [Indexed: 01/09/2023] Open
Abstract
This retrospective cohort study aimed to assess the demographic and clinical characteristics of rheumatoid arthritis (RA) in Emirati patients attending Cleveland Clinic Abu Dhabi, a large tertiary center in the Middle East. In this study, 414 Emirati patients with RA were evaluated over a 3-year period from April 2015 to April 2018. All patients fulfilled the 2010 RA ACR/EULAR criteria and were assessed for demographic and clinical characteristics. The estimated RA prevalence rate in our population cohort was 2.72%. Females showed predominance (80%) with a higher body mass index (31.4 ± 6.61, P = 0.0001) compared to males (28.8 ± 6.03, P = 0.0001). The most frequent comorbidity observed was dyslipidemia (43.5%) followed by hypertension (37.9%), diabetes mellitus (34.5%), and gastroesophageal reflux disease (33.1%). Xerophthalmia was the most frequent extra-articular manifestation. Rheumatoid factor and anti-citrullinated peptide were detected in 63.3% and 41.5% patients, respectively, while both were present in 33.3% of patients. Methotrexate, adalimumab, and rituximab were the most frequently prescribed disease modifying agents. In this study, we describe disease features that are unique to United Arab Emirates (UAE) patients and demonstrate that RA has a significant disease burden. Our findings highlight the need for a RA national registry to improve the quality of care of these patients in UAE.
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Bedaiwi M, Al-Homood IA, El-Garf A, Uthman I, Sunna N, Nassier R, Mohamed H, Al Saleh J. Disease burden and treatment challenges of psoriatic arthritis in Africa and the Middle East. Rheumatol Int 2019; 39:1321-1329. [PMID: 31134289 DOI: 10.1007/s00296-019-04319-3] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2019] [Accepted: 05/03/2019] [Indexed: 01/17/2023]
Abstract
Psoriatic arthritis (PsA) is a chronic, inflammatory arthropathy occurring in up to 30% of patients with psoriasis, and is characterized by multiple manifestations including peripheral arthritis, enthesitis, dactylitis, spondylitis, and psoriatic skin and nail disease. This complex and heterogeneous disease is poorly understood and its diagnosis and treatment are suboptimal, particularly in Africa and the Middle East, where very few studies into the impact of PsA have been carried out. This article aims to highlight the disease burden of PsA in the region as well as to identify unmet clinical needs. A non-systematic review was carried out in the PubMed database and the most relevant publications were selected. Expert rheumatologists practicing in Africa and the Middle East provide an insight into the challenges of treating PsA in daily practice, along with recommendations for improvements.
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Affiliation(s)
- Mohamed Bedaiwi
- Division of Rheumatology, College of Medicine, King Saud University Medical City, King Saud University, Riyadh, Saudi Arabia.
| | - Ibrahim A Al-Homood
- Department of Medical Specialties, Rheumatology Section, King Fahad Medical City, Riyadh, Saudi Arabia
| | - Ayman El-Garf
- Rheumatology Department, Cairo University Hospitals, Cairo University, Cairo, Egypt
| | - Imad Uthman
- Division of Rheumatology, American University of Beirut Medical Center, Beirut, Lebanon
| | | | | | | | - Jamal Al Saleh
- Rheumatology Unit, Dubai Hospital, Dubai Health Authority, Dubai, United Arab Emirates
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A global perspective on the challenges and opportunities in learning about rheumatic and musculoskeletal diseases in undergraduate medical education. Clin Rheumatol 2019; 39:627-642. [DOI: 10.1007/s10067-019-04544-y] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2018] [Accepted: 04/01/2019] [Indexed: 10/26/2022]
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Nik Shafii NAH, Yaacob LH, Ishak A, Kadir AA. Traditional and Complementary Medicine Use in Knee Osteoarthritis and its Associated Factors Among Patients in Northeast Peninsular Malaysia. Oman Med J 2018; 33:148-153. [PMID: 29657684 DOI: 10.5001/omj.2018.27] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
Objectives We sought to determine the prevalence of traditional and complementary medicine (TCM) use for knee osteoarthritis and its associated factors among patients attending a referral hospital in an eastern coastal state of Malaysia. Methods This cross-sectional study included 214 patients with knee osteoarthritis. A universal sampling method was applied to patients who attended the outpatient clinic in Hospital Universiti Sains Malaysia from May 2013 to October 2013. Participants were given a questionnaire to determine their sociodemographic information and a validated Bahasa Malaysia version of the Western Ontario and McMaster Universities Arthritis Index (WOMAC). This questionnaire was used to assess the severity of knee osteoarthritis (i.e., pain, stiffness, and disturbances in daily activity). Results Over half (57.9%) of patients reported using TCM to treat knee osteoarthritis. Factors associated with TCM use were gender (odd ratio (OR) = 2.47; 95% confidence interval (CI): 1.28-4.77), duration of knee osteoarthritis (OR = 1.51; 95% CI: 1.03-2.23), and the severity of knee pain (OR = 2.56; 95% CI: 1.71-3.86). Conclusions The prevalence of TCM use among eastern Malaysian patients with knee osteoarthritis was high. Physicians caring for these patients should be aware of these findings so that inquiries regarding TCM use can be made and patients can be appropriately counseled.
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Affiliation(s)
- Nik Abdul Hafiz Nik Shafii
- Department of Family Medicine, School of Medical Sciences, Health Campus Universiti Sains Malaysia, Kubang Kerian Kelantan, Malaysia
| | - Lili Husniati Yaacob
- Department of Family Medicine, School of Medical Sciences, Health Campus Universiti Sains Malaysia, Kubang Kerian Kelantan, Malaysia
| | - Azlina Ishak
- Department of Family Medicine, School of Medical Sciences, Health Campus Universiti Sains Malaysia, Kubang Kerian Kelantan, Malaysia
| | - Azidah Abdul Kadir
- Department of Family Medicine, School of Medical Sciences, Health Campus Universiti Sains Malaysia, Kubang Kerian Kelantan, Malaysia
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Wahab KW, Sanya EO, Adebayo PB, Babalola MO, Ibraheem HG. Carpal Tunnel Syndrome and Other Entrapment Neuropathies. Oman Med J 2017; 32:449-454. [PMID: 29218119 DOI: 10.5001/omj.2017.87] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
Entrapment neuropathy is the result of pressure on a peripheral nerve as it passes through a narrow canal that is bounded by stiff tissues. In spite of their ubiquitous nature, they are underdiagnosed, underreported, and sometimes not properly managed, especially in developing countries. Entrapment neuropathies are of various types, but the most common type is carpal tunnel syndrome. Mechanisms involved in the pathophysiology of entrapment neuropathies include mechanical compression and nerve ischemia. A clear understanding of the various types and the underlying mechanisms of entrapment neuropathies are invaluable in the decision-making process involved in the management of every patient with the condition.
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Affiliation(s)
- Kolawole Wasiu Wahab
- Department of Medicine, Faculty of Clinical Sciences, University of Ilorin, Ilorin, Nigeria
| | - Emmanuel O Sanya
- Department of Medicine, Faculty of Clinical Sciences, University of Ilorin, Ilorin, Nigeria
| | - Philip B Adebayo
- Department of Medicine, Ladoke Akintola University of Technology, Ogbomoso, Nigeria
| | - Musbaudeen O Babalola
- Department of Surgery, Faculty of Clinical Sciences, University of Ilorin, Ilorin, Nigeria
| | - Hakeem G Ibraheem
- Department of Surgery, Faculty of Clinical Sciences, University of Ilorin, Ilorin, Nigeria
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