Objective: To estimate the burden of osteoarthritis (OA) among noninstitutionalized adults (!18 years of age) in the US. Design: Weighted nationally representative data from the 2015 Medical Expenditure Panel Survey were used to estimate OA prevalence in noninstitutionalized adults and compare adults with OA to those without OA for clinical (pain interference with activities [PIA], functional limitations), humanistic (health-related quality-of-life [HRQoL]) and economic outcomes (healthcare costs, wage loss). Productivity/wage loss was estimated among employed working-age adults (18e64 years). Multivariable regression analyses examined the associations between OA and outcomes. Results: In 2015, 10.5% (25.6 million) of noninstitutionalized US adults reported having any OA. Regression analyses indicated that adults with OA were significantly more likely than those without OA to report moderate (adjusted odds ratios [AOR] 1.99; 95% confidence interval [CI] 1.65e2.40] or severe PIA (AOR 2.59; 95% CI 2.21e3.04), any functional limitation (AOR 2.51; 95% CI 2.21e2.85), and poorer HRQoL on the SF-12 version 2 Physical Component Summary score (adjusted beta [standard error] À3.88

The influenza-related disease burden is highest among the elderly. We evaluated the relative vaccine effectiveness (rVE) of adjuvanted trivalent influenza vaccine (aTIV) compared to other egg-based influenza vaccines (high-dose trivalent (TIV-HD), quadrivalent (QIVe-SD), and standard-dose trivalent (TIVe-SD)) against influenza-related and cardio-respiratory events among subjects aged ≥65 years for the 2017–2018 influenza season. This retrospective cohort analysis used prescription claims, professional fee claims, and hospital charge master data. Influenza-related hospitalizations/ER visits and office visits and cardio-respiratory events were assessed post-vaccination. Inverse probability of treatment weighting (IPTW) and Poisson regression were used to evaluate the adjusted rVE of aTIV compared to other vaccines. In an economic analysis, annualized follow-up costs were compared between aTIV and TIV-HD. The study was composed of 234,313 aTIV, 1,269,855 TIV-HD, 212,287 QIVe-SD, and 106,491 TIVe-SD recipients. aTIV was more effective in reducing influenza-related office visits and other respiratory-related hospitalizations/ER visits compared to the other vaccines. For influenza-related hospitalizations/ER visits, aTIV was associated with a significantly higher rVE compared to QIVe-SD and TIVe-SD and was comparable to TIV-HD. aTIV was also associated with a significantly higher rVE compared to TIVe-SD against hospitalizations/ER visits related to pneumonia and asthma/COPD/bronchial events. aTIV and TIV-HD were associated with comparable annualized all-cause and influenza-related costs. Adjusted analyses demonstrated a significant benefit of aTIV against influenza- and respiratory-related events compared to the other egg-based vaccines.

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Background There has been significant improvement in the outcome of patients with MM. However, there has also been an increased risk of t-MN. Little is known about the characteristics and outcomes of patients with t-MN. Methods Patients with MM treated at our institution between 1993 and 2011 were reviewed. We identified 47 patients who were diagnosed with t-MN. The primary objective of this study was to evaluate the time to develop t-MN their response to treatment and overall survival. Results Median age of patients at diagnosis of MM was 65 years. Thirty two (68.0%) received initial treatment with conventional chemotherapeutic agents. Seven (14.9%) patients received treatment with novel agents such as lenalidomide, thalidomide or bortezomib. Eight (17.0%) patients were treated with a combination of novel and conventional agents. Twenty (42.6%) patients underwent high-dose chemotherapy and autologous hematopoietic stem cell transplantation (auto-HCT). Median time from the diagnosis of MM to t-MN was 7 years 95%CI [5.0 – 28.0]. Thirty-three (70.2%) patients developed t-MDS, 11 (23.4%) t-AML, and 3 (6.4%) t-CMML. Median age at diagnosis of t-MN was 65 years. Twenty-six (78.8%) patients with t-MDS, nine (81.8%) patients with t-AML and one (33.3%) patients with t-CMML had complex/high risk cytogenetics. Median OS for all 47 patients after diagnosis of t-MN was 6.3 months 95%CI [4.0 – 8.7]. Conclusion Development of t-MN in patients with MM is associated with poor outcomes. These patients in general have complex cytogenetic abnormalities, short CR and OS. Better understanding of disease biology and novel therapeutic approaches are warranted.

Introduction Arthritis and depression are two of the top disabling conditions. When arthritis and depression exist in the same individual, they can interact with each other negatively and pose a significant healthcare burden on the patients, their families, payers, healthcare systems, and society as a whole. Areas covered The primary objective of this review is to summarize, identify knowledge gaps and discuss the challenges in estimating the healthcare burden of depression among individuals with arthritis. Electronic literature searches were performed on PubMed, Embase, EBSCOhost, Scopus, the Cochrane Library, and Google Scholar to identify relevant studies. Expert Commentary Our review revealed that the prevalence of depression varied depending on the definition of depression, type of arthritis, tools and threshold points used to identify depression, and the country of residence. Depression exacerbated arthritis-related complications as well as pain and was associated with poor health-related quality of life, disability, mortality, and high financial burden. There were significant knowledge gaps in estimates of incident depression rates, depression attributable disability, and healthcare utilization, direct and indirect healthcare costs among individuals with arthritis.

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Introduction: Real-world data are sparse on longitudinal associations of opioid use with pain interference with activities (PIA) and daily function with osteoarthritis (OA) in the USA. Methods: Data from the 2010-2015 Medical Expenditure Panel Surveys were analyzed for community-dwelling adults with OA. Opioid use patterns were defined as persistent, intermittent, and no use. Evaluated outcomes were a change in PIA and functional limitations (activities of daily living [ADL], instrumental ADL [IADL], social and work activities, and cognitive function). Multivariable regression analyses explored the association of persistent/ Enhanced Digital Features To view enhanced digital features for this article go to https://doi.org/10.6084/ m9.figshare.11353643.