المؤلفون: Vina, Ernest R., Ran, Di, Ashbeck, Erin L., Kaur, Manjinder, Kwoh, C. Kent

مرشدي الرسالة: University of Arizona Arthritis Center, University of Arizona; Tucson

الوصف: Objective: To determine if severity of osteoarthritis-related knee pain is associated with a willingness to undergo total knee replacement (TKR) and whether this association is confounded or modified by components of socioeconomic status and health care coverage. MethodsCross-sectional analysis was conducted among 3,530 Osteoarthritis Initiative study participants. Logistic regression models were used to assess the effect of knee pain severity (where 0=none, 1-3=mild, 4-7=moderate, and 8-10=severe) on willingness to undergo TKR. Stratified analyses were conducted to evaluate whether socioeconomic status and health care coverage modify the effect of knee pain severity on willingness. Results: Participants with severe knee pain, compared to participants without pain, were less willing to undergo TKR (odds ratio [OR] 0.73, 95% confidence interval [95% CI] 0.57-0.93). This association was attenuated when adjusted for age, sex, comorbidity, depression, health insurance coverage, prescription medicine coverage, health care source, education, income, employment, race, and marital status (adjusted OR 0.92, 95% CI 0.68-1.24). The odds of willingness to undergo TKR were significantly lower in those with the highest level of pain, compared to those without pain, among participants without health insurance (adjusted OR 0.08, 95% CI 0.01-0.56), but not among those with health insurance (adjusted OR 1.03, 95% CI 0.73-1.38), when adjusted for demographic, clinical, health care access, and socioeconomic factors (P=0.015). However

الإتاحة: http://hdl.handle.net/10150/622660Test
http://arizona.openrepository.com/arizona/handle/10150/622660Test

المؤلفون: Roemer, Frank W., Guermazi, Ali, Collins, Jamie E., Losina, Elena, Nevitt, Michael C., Lynch, John A., Katz, Jeffrey N., Kwoh, C. Kent, Kraus, Virginia B., Hunter, David J.

مرشدي الرسالة: Univ Arizona, Coll Med, Arthrit Ctr, Univ Arizona, Coll Med, Div Rheumatol

مصطلحات موضوعية: Osteoarthritis, MRI, Progression, Scoring, Biomarkers

الوصف: Background: To describe the scoring methodology and MRI assessments used to evaluate the cross-sectional features observed in cases and controls, to define change over time for different MRI features, and to report the extent of changes over a 24-month period in the Foundation for National Institutes of Health Osteoarthritis Biomarkers Consortium study nested within the larger Osteoarthritis Initiative (OAI) Study. Methods: We conducted a nested case-control study. Cases (n = 406) were knees having both radiographic and pain progression. Controls (n = 194) were knee osteoarthritis subjects who did not meet the case definition. Groups were matched for Kellgren-Lawrence grade and body mass index. MRIs were acquired using 3 T MRI systems and assessed using the semi-quantitative MOAKS system. MRIs were read at baseline and 24 months for cartilage damage, bone marrow lesions (BML), osteophytes, meniscal damage and extrusion, and Hoffa- and effusion-synovitis. We provide the definition and distribution of change in these biomarkers over time. Results: Seventy-three percent of the cases had subregions with BML worsening (vs. 66 % in controls) (p = 0.102). Little change in osteophytes was seen over 24 months. Twenty-eight percent of cases and 10 % of controls had worsening in meniscal scores in at least one subregion (p < 0.001). Seventy-three percent of cases and 53 % of controls had at least one area with worsening in cartilage surface area (p < 0.001). More cases experienced worsening in Hoffa- and effusion synovitis than controls (17 % vs. 6 % (p < 0.001); 41 % vs. 18 % (p < 0.001), respectively). Conclusions: A wide range of MRI-detected structural pathologies was present in the FNIH cohort. More severe changes, especially for BMLs, cartilage and meniscal damage, were detected primarily among the case group suggesting that early changes in multiple structural domains are associated with radiographic worsening and symptomatic progression.

العلاقة: http://bmcmusculoskeletdisord.biomedcentral.com/articles/10.1186/s12891-016-1310-6Test

الإتاحة: http://hdl.handle.net/10150/623126Test
http://arizona.openrepository.com/arizona/handle/10150/623126Test

المؤلفون: Hunter, David J, Deveza, Leticia A, Collins, Jamie E, Losina, Elena, Katz, Jeffrey N, Nevitt, Michael C, Lynch, John A, Roemer, Frank W, Guermazi, Ali, Bowes, Michael A, Dam, Erik B, Eckstein, Felix, Kwoh, C Kent, Hoffmann, Steve, Kraus, Virginia B

المصدر: Arthritis Care & Research. 74(7)

مصطلحات موضوعية: Biomedical and Clinical Sciences, Clinical Sciences, Prevention, Biomedical Imaging, Pain Research, Arthritis, Aging, Chronic Pain, Clinical Research, Musculoskeletal, Biomarkers, Cartilage, Articular, Disease Progression, Humans, Knee Joint, Magnetic Resonance Imaging, National Institutes of Health (U.S.), Osteoarthritis, Knee, Synovitis, United States, Public Health and Health Services, Psychology, Clinical sciences, Allied health and rehabilitation science

الوصف: ObjectiveTo determine the optimal combination of imaging and biochemical biomarkers for use in the prediction of knee osteoarthritis (OA) progression.MethodsThe present study was a nested case-control trial from the Foundation of the National Institutes of Health OA Biomarkers Consortium that assessed study participants with a Kellgren/Lawrence grade of 1-3 who had complete biomarker data available (n = 539 to 550). Cases were participants' knees that had radiographic and pain progression between 24 and 48 months compared to baseline. Radiographic progression only was assessed in secondary analyses. Biomarkers (baseline and 24-month changes) that had a P value of

وصف الملف: application/pdf

الوصول الحر: https://escholarship.org/uc/item/64n63926Test

المؤلفون: Moradi, Kamyar, Mohajer, Bahram, Guermazi, Ali, Kwoh, C. Kent, Bingham, Clifton O., Mohammadi, Soheil, Cao, Xu, Wan, Mei, Roemer, Frank W., Demehri, Shadpour

المساهمون: National Institutes of Health, National Institute on Aging, National Institute of Arthritis and Musculoskeletal and Skin Diseases

المصدر: Journal of Cachexia, Sarcopenia and Muscle ; ISSN 2190-5991 2190-6009

الوصف: Background Preclinical rheumatoid arthritis (Pre‐RA) is defined as the early stage before the development of clinical RA. While cachexia is a well‐known and potentially modifiable complication of RA, it is not known if such an association exists also in the Pre‐RA stage. To investigate such issue, we aimed to compare the longitudinal alterations in the muscle composition and adiposity of participants with Pre‐RA with the matched controls. Methods In this observational cohort study, the Osteoarthritis Initiative (OAI) participants were categorized into Pre‐RA and propensity score (PS)‐matched control groups. Pre‐RA was retrospectively defined as the absence of RA from baseline to year‐2, with progression to physician‐diagnosed clinical RA between years 3–8 of the follow‐up period. Using a validated deep learning algorithm, we measured MRI biomarkers of thigh muscles and adiposity at baseline and year‐2 follow‐ups of the cohort. The outcomes were the differences between Pre‐RA and control groups in the 2‐year rate of change for thigh muscle composition [cross‐sectional area (CSA) and intramuscular adipose tissue (Intra‐MAT)] and adiposity [intermuscular adipose tissue (Inter‐MAT) and subcutaneous adipose tissue (SAT)]. Linear mixed‐effect regression models were used for comparison. Results After 1:3 PS‐matching of the groups for confounding variables (demographics, risk factors, co‐morbidities, and knee osteoarthritis status), 408 thighs (102 Pre‐RA and 306 control) of 322 participants were included (age mean ± SD: 61.7 ± 8.9 years; female/male: 1.8). Over a 2‐year period, Pre‐RA was associated with a larger decrease in total thigh muscle CSA [estimate, 95% confidence interval (CI): −180.13 mm 2 /2‐year, −252.80 to −107.47, P ‐value < 0.001]. Further examination of thigh muscle composition showed that the association of the presence of Pre‐RA with a larger decrease in muscle CSA over 2 years was noticeable in the quadriceps, flexors, and sartorius muscle groups ( P ‐values < 0.05). Comparison of ...

الإتاحة: https://doi.org/10.1002/jcsm.13533Test

المؤلفون: Wilson, Debbie L., Zhou, Lili, Sudano, Dominick G., Ashbeck, Erin L., Kwoh, C. Kent, Krebs, Lindy, Sheer, Amy, Smith, James, Tudeen, Michael, Lo‐Ciganic, Wei‐Hsuan

المصدر: ACR Open Rheumatology ; ISSN 2578-5745 2578-5745

الوصف: Objective The study objective was to examine associations between the use of biologic response modifiers (BRMs), corticosteroids, and oral small molecules (OSMs) and subsequent coccidioidomycosis infection risk among US Medicare beneficiaries with rheumatic or autoimmune diseases. Methods This retrospective cohort study used US 2011 to 2016 Medicare claims data. We identified geographic areas with endemic coccidioidomycosis (≥25 cases per 10,000 beneficiaries). Among beneficiaries having any rheumatic/autoimmune diseases, we identified those initiating BRMs, corticosteroids, and OSMs. Based on refill days supplied, we created time‐varying exposure variables for BRMs, corticosteroids, and OSMs with a 90‐day lag period after drug cessation. We examined BRMs, corticosteroids, and OSMs and subsequent coccidioidomycosis infection risk using multivariable Cox proportional hazard regression. Results Among 135,237 beneficiaries (mean age: 67.8 years; White race: 83.1%; Black race: 3.6%), 5,065 had rheumatic or autoimmune diseases, of which 107 individuals were diagnosed with coccidioidomycosis during the study period (6.1 per 1,000 person‐years). Increased risk of coccidioidomycosis was observed among beneficiaries prescribed any BRMs (17.7 per 1,000 person‐years; adjusted hazard ratio [aHR] 3.94; 95% confidence interval [CI] 1.18–13.16), followed by individuals treated with only corticosteroids (12.2 per 1,000 person‐years; aHR 2.29; 95% CI 1.05–5.03) compared to those treated with only OSMs (4.2 per 1,000 person‐years). The rate of those treated with only OSMs was the same as that of beneficiaries without these medications. Conclusion Incidence of coccidioidomycosis was low among 2011 to 2016 Medicare beneficiaries with rheumatic or autoimmune diseases. BRM and corticosteroid users may have higher risks of coccidioidomycosis compared to nonusers, warranting consideration of screening for patients on BRMs and corticosteroids in coccidioidomycosis endemic areas.

الإتاحة: https://doi.org/10.1002/acr2.11654Test

المؤلفون: Wilson, Debbie L., Kollampare, Shubha, Kwoh, C. Kent, Zhou, Lili, Ashbeck, Erin L., Sudano, Dominick, Lupi, Maria, Miller, Andrew, Smith, Kristy, Lo‐Ciganic, Wei‐Hsuan

المصدر: ACR Open Rheumatology ; ISSN 2578-5745 2578-5745

الوصف: Objective We aimed to estimate Coccidioides serologic screening rates before initiation of biologic disease‐modifying antirheumatic drugs including tofacitinib (b/tsDMARDs), conventional synthetic disease‐modifying antirheumatic drugs (csDMARDs), and/or noninhaled corticosteroids. Methods This retrospective cohort study used 2011 to 2016 US Medicare claims data and included beneficiaries with rheumatic or autoimmune disease residing in regions within Arizona, California, and Texas endemic for Coccidioides spp. with ≥1 prescription for a b/tsDMARD, csDMARD, and/or noninhaled corticosteroid. We estimated prior‐year serologic screening incidence before initiating b/tsDMARDs, csDMARD, and/or noninhaled corticosteroid. Results During 2012 to 2016, 4,331 beneficiaries filled 64,049 prescriptions for b/tsDMARDs, csDMARDs, and noninhaled corticosteroids. Arizona's estimated screening rate was 20.1% (95% confidence interval [95% CI] 14.5–25.7) in the year before prescription initiation for b/tsDMARDs, 8.1% (95% CI 6.5–9.7) before csDMARDs, and 6.9% (95% CI: 5.6–8.2) before corticosteroids. Screening rates for b/tsDMARDs (2.8%, 95% CI 0.0–6.7), csDMARDs (1.0%, 95% CI 0.0–2.0), and corticosteroids (0.8%, 95% CI: 0.4–1.1) were negligible in California and undetected in Texas. Adjusted screening rate before prescription for b/tsDMARDs in Arizona increased from 14.5% (95% CI 7.5–21.5) in 2012 to 26.7% (95% CI 17.6–35.8) in 2016. Rheumatologists prescribing b/tsDMARDs in Arizona screened more than other providers (20.9% [95% CI 13.9–27.9] vs 12.9% [95% CI 5.9–20.0]). Conclusion Coccidioides serologic screening rates among Medicare beneficiaries with rheumatic/autoimmune diseases on b/tsDMARDs, csDMARDs, and noninhaled corticosteroids was low in Coccidioides spp.–US endemic regions between 2012 and 2016. Alignment of screening recommendations and clinical practice is needed.

الإتاحة: https://doi.org/10.1002/acr2.11663Test

المؤلفون: Lo, Grace H, Ikpeama, Uzoh E, Driban, Jeffrey B, Kriska, Andrea M, McAlindon, Timothy E, Petersen, Nancy J, Storti, Kristi L, Eaton, Charles B, Hochberg, Marc C, Jackson, Rebecca D, Kwoh, C Kent, Nevitt, Michael C, Suarez‐Almazor, Maria E

المصدر: PM&R. 12(6)

مصطلحات موضوعية: Public Health, Biomedical and Clinical Sciences, Clinical Sciences, Health Sciences, Chronic Pain, Osteoarthritis, Pain Research, Arthritis, Aging, Clinical Research, Musculoskeletal, Good Health and Well Being, Adolescent, Adult, Aged, Child, Cross-Sectional Studies, Female, Humans, Knee Joint, Male, Middle Aged, Osteoarthritis, Knee, Prospective Studies, Retrospective Studies, Swimming, United States, Young Adult, Clinical sciences, Allied health and rehabilitation science

الوصف: BackgroundTo date, there have not been any epidemiologic studies that have evaluated the association between swimming over a lifetime and knee health.ObjectiveThe study aimed to evaluate the relationship of a history of swimming with knee pain, radiographic knee OA (ROA), and symptomatic knee OA (SOA).DesignCross-sectional retrospective study.SettingFour academic centers in the United States.ParticipantsRespondents to the historical physical activity survey within the Osteoarthritis Initiative with knee radiographs and symptom assessments.MethodsIn this retrospective study nested within the Osteoarthritis Initiative, researchers performed logistic regression with the predictor being swimming over a lifetime and over particular age ranges.Main outcome measurementsPerson-based definitions of frequent knee pain, ROA, and SOA.ResultsA total of 2637 participants were included, with a mean age of 64.3 years (SD 8.9), body mass index of 28.4 kg/m2 (SD 4.9), and 44.2% male. Over a lifetime, the adjusted prevalence measures for frequent knee pain, ROA, and SOA for any versus no history of swimming were 36.4% (33.4% - 39.5%) v. 39.9% (37.4% - 42.5%), 54.3% (51.0% - 57.6%) v. 61.1% (58.4% - 63.7%), and 21.9% (19.4% - 24.7%) v. 27.0% (24.7% - 29.4%) respectively.ConclusionsThis is the first epidemiologic study to indicate that swimming is potentially beneficial toward knee health, particularly when performed earlier in life (before age 35). Future prospective studies are needed to confirm these findings and to better scrutinize the associations in older age groups.

وصف الملف: application/pdf

الوصول الحر: https://escholarship.org/uc/item/8jf5z9mcTest

المؤلفون: Lo, Grace H, McAlindon, Timothy E, Kriska, Andrea M, Price, Lori Lyn, Rockette-Wagner, Bonny J, Mandl, Lisa A, Eaton, Charles B, Hochberg, Marc C, Jackson, Rebecca D, Kwoh, C Kent, Nevitt, Michael C, Driban, Jeffrey B

المصدر: Medicine & Science in Sports & Exercise. 52(4)

مصطلحات موضوعية: Biomedical and Clinical Sciences, Clinical Sciences, Health Sciences, Aging, Pain Research, Osteoarthritis, Chronic Pain, Arthritis, Clinical Research, Musculoskeletal, Aged, Arthralgia, Football, Humans, Longitudinal Studies, Male, Middle Aged, Osteoarthritis, Knee, Prevalence, Prospective Studies, Radiography, Risk Factors, United States, FOOTBALL, KNEE, OSTEOARTHRITIS, KNEE PAIN, Human Movement and Sports Sciences, Medical Physiology, Public Health and Health Services, Sport Sciences, Clinical sciences, Medical physiology, Sports science and exercise

الوصف: IntroductionMale youth in the United States commonly participate in gridiron (American) football. There are little data substantiating current popular opinion that it is associated with knee pain or osteoarthritis (OA) later in life. We aimed to evaluate the relationship of football with these outcomes in the Osteoarthritis Initiative (OAI).MethodsThis is a study of male OAI participants with knee x-ray readings, symptom assessments, and completed surveys on lifetime physical activity. The OAI is a multicenter, observational cohort recruited from the community not based on football participation status. A history of exposure to American football was ascertained via self-report. Knee radiographs were scored for Kellgren-Lawrence grade (0-4). Radiographic OA (ROA) was defined as Kellgren-Lawrence ≥ 2 in at least one knee. Frequent knee pain meant at least one knee with frequent knee pain. Symptomatic ROA required at least one knee with both ROA and frequent knee pain.ResultsA total of 1166 men had a mean age of 63.7 (SD, 9.2) yr and body mass index of 28.6 (SD, 4.2) kg·m. Thirty-one percent (365/1166) played football at some point in their lives, 95% of whom participated from ages 12 to 18 yr. The ORs for symptomatic ROA from the lowest to highest football participation were 1.2, 1.5, and 2.2, respectively (P for trend = 0.004). Findings were similar for football from ages 12 to 18 yr and for outcomes of knee pain and ROA.ConclusionThis is the first large epidemiologic study to suggest that football participation, including in the teen years, may be detrimental toward knee health. Prospective studies evaluating football players are warranted.

وصف الملف: application/pdf

الوصول الحر: https://escholarship.org/uc/item/5ff482twTest

المؤلفون: Kolasinski, Sharon L, Neogi, Tuhina, Hochberg, Marc C, Oatis, Carol, Guyatt, Gordon, Block, Joel, Callahan, Leigh, Copenhaver, Cindy, Dodge, Carole, Felson, David, Gellar, Kathleen, Harvey, William F, Hawker, Gillian, Herzig, Edward, Kwoh, C Kent, Nelson, Amanda E, Samuels, Jonathan, Scanzello, Carla, White, Daniel, Wise, Barton, Altman, Roy D, DiRenzo, Dana, Fontanarosa, Joann, Giradi, Gina, Ishimori, Mariko, Misra, Devyani, Shah, Amit Aakash, Shmagel, Anna K, Thoma, Louise M, Turgunbaev, Marat, Turner, Amy S, Reston, James

المصدر: Arthritis & Rheumatology. 72(2)

مصطلحات موضوعية: Clinical Research, Behavioral and Social Science, Chronic Pain, Complementary and Integrative Health, Osteoarthritis, Arthritis, Pain Research, Mind and Body, Rehabilitation, Prevention, Aging, Musculoskeletal, Hand Joints, Humans, Osteoarthritis, Hip, Osteoarthritis, Knee, Clinical Sciences, Immunology, Public Health and Health Services, Arthritis & Rheumatology

الوصف: ObjectiveTo develop an evidence-based guideline for the comprehensive management of osteoarthritis (OA) as a collaboration between the American College of Rheumatology (ACR) and the Arthritis Foundation, updating the 2012 ACR recommendations for the management of hand, hip, and knee OA.MethodsWe identified clinically relevant population, intervention, comparator, outcomes questions and critical outcomes in OA. A Literature Review Team performed a systematic literature review to summarize evidence supporting the benefits and harms of available educational, behavioral, psychosocial, physical, mind-body, and pharmacologic therapies for OA. Grading of Recommendations Assessment, Development and Evaluation methodology was used to rate the quality of the evidence. A Voting Panel, including rheumatologists, an internist, physical and occupational therapists, and patients, achieved consensus on the recommendations.ResultsBased on the available evidence, either strong or conditional recommendations were made for or against the approaches evaluated. Strong recommendations were made for exercise, weight loss in patients with knee and/or hip OA who are overweight or obese, self-efficacy and self-management programs, tai chi, cane use, hand orthoses for first carpometacarpal (CMC) joint OA, tibiofemoral bracing for tibiofemoral knee OA, topical nonsteroidal antiinflammatory drugs (NSAIDs) for knee OA, oral NSAIDs, and intraarticular glucocorticoid injections for knee OA. Conditional recommendations were made for balance exercises, yoga, cognitive behavioral therapy, kinesiotaping for first CMC OA, orthoses for hand joints other than the first CMC joint, patellofemoral bracing for patellofemoral knee OA, acupuncture, thermal modalities, radiofrequency ablation for knee OA, topical NSAIDs, intraarticular steroid injections and chondroitin sulfate for hand OA, topical capsaicin for knee OA, acetaminophen, duloxetine, and tramadol.ConclusionThis guideline provides direction for clinicians and patients making treatment decisions for the management of OA. Clinicians and patients should engage in shared decision-making that accounts for patients' values, preferences, and comorbidities. These recommendations should not be used to limit or deny access to therapies.

وصف الملف: application/pdf

الوصول الحر: https://escholarship.org/uc/item/9m7933mhTest

المؤلفون: Dunlop, Dorothy D, Song, Jing, Hootman, Jennifer M, Nevitt, Michael C, Semanik, Pamela A, Lee, Jungwha, Sharma, Leena, Eaton, Charles B, Hochberg, Marc C, Jackson, Rebecca D, Kwoh, C Kent, Chang, Rowland W

المصدر: American Journal of Preventive Medicine. 56(5)

مصطلحات موضوعية: Biomedical and Clinical Sciences, Allied Health and Rehabilitation Science, Public Health, Clinical Sciences, Health Sciences, Rehabilitation, Prevention, Behavioral and Social Science, Arthritis, Aging, Clinical Research, Brain Disorders, 3.1 Primary prevention interventions to modify behaviours or promote wellbeing, Prevention of disease and conditions, and promotion of well-being, Quality Education, Actigraphy, Aged, Disability Evaluation, Exercise, Exercise Tolerance, Female, Health Status, Humans, Knee Joint, Male, Middle Aged, Osteoarthritis, Knee, Predictive Value of Tests, Prospective Studies, Recovery of Function, Risk Factors, Sedentary Behavior, Self Report, Time Factors, Medical and Health Sciences, Education, Biomedical and clinical sciences, Health sciences

الوصف: INTRODUCTION:Physical activity guidelines recommend minimum thresholds. This study sought to identify evidence-based thresholds to maintain disability-free status over 4years among adults with lower extremity joint symptoms. METHODS:Prospective multisite Osteoarthritis Initiative accelerometer monitoring cohort data from September 2008 through December 2014 were analyzed. Adults (n=1,564) aged ≥49years at elevated disability risk because of lower extremity joint symptoms were analyzed for biennial assessments of disability-free status from gait speed ≥1meter/second (mobility disability-free) and self-report of no limitations in activities of daily living (activities of daily living disability-free). Classification tree analyses conducted in 2017-2018 identified optimal thresholds across candidate activity intensities (sedentary, light, moderate-vigorous, total light and moderate-vigorous activity, and moderate-vigorous accrued in bouts lasting ≥10 minutes). RESULTS:Minimal thresholds of 56 and 55 moderate-vigorous minutes/week best predicted disability-free status over 4years from mobility and activities of daily living disabilities, respectively, across the candidate measures. Thresholds were consistent across sex, BMI, age, and knee osteoarthritis presence. Mobility disability onset was one eighth as frequent (3% vs 24%, RR=0.14, 95% CI=0.09, 0.20) and activities of daily living disability onset was almost half (12% vs 23%, RR=0.55, 95% CI=0.44, 0.70) among people above versus below the minimum threshold. CONCLUSIONS:Attaining an evidence-based threshold of approximately 1-hour moderate-vigorous activity/week significantly increased the likelihood of maintaining disability-free status over 4years. This minimum threshold tied to maintaining independent living abilities has value as an intermediate goal to motivate adults to take action towards the many health benefits of a physically active lifestyle.

وصف الملف: application/pdf

الوصول الحر: https://escholarship.org/uc/item/3wt0r03zTest