A general practice perspective on early rheumatoid arthritis management: A qualitative study from Flanders

Meyfroidt, Sabrina; Stevens, Judith; Lepeleire, Jan De; Westhovens, René; Cock, Diederik De; Elst, Kristien Van der; Vanhaecht, Kris; Verschueren, Patrick

doi:10.3109/13814788.2015.1084279

Cited by 21 publications

(34 citation statements)

References 31 publications

(41 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…GP have previously self‐reported potential causes of delayed referral in early RA. These include the symptoms of early RA being insufficiently clear, the time‐intensive nature of examining the condition, a lack of self‐confidence in the condition, diagnostic uncertainty and inconclusive tests, low RA incidence in the community and confusion with other rheumatic diseases, such as osteoarthritis and gout . Although patient delay exerted the largest influence on overall delay, GP delay did independently predict overall delay in this cohort.…”

Section: Discussionmentioning

confidence: 89%

Treatment delays for patients with new‐onset rheumatoid arthritis presenting to an Australian early arthritis clinic

Ison

Duggan

Mehdi

et al. 2018

Internal Medicine Journal

View full text Add to dashboard Cite

show abstract

Section: Discussionmentioning

confidence: 89%

Treatment delays for patients with new‐onset rheumatoid arthritis presenting to an Australian early arthritis clinic

Ison

Duggan

Mehdi

et al. 2018

Internal Medicine Journal

View full text Add to dashboard Cite

show abstract

“…International guidelines recommend the involvement of general practitioners (GPs) in the RA multidisciplinary team [ 9 ]. Various studies have investigated the relationship between GPs and rheumatologists regarding the referral of patients with inflammatory rheumatic diseases from primary care to rheumatology clinics [ 79 – 82 ]. According to the results of a survey among Flemish GPs, decisions about intensive treatment initiation in early RA should be made by rheumatologists [ 79 ].…”

Section: Resultsmentioning

confidence: 99%

Multidisciplinary Management of Spondyloarthritis-Related Immune-Mediated Inflammatory Disease

et al. 2018

View full text Add to dashboard Cite

IntroductionImmune-mediated inflammatory diseases (IMIDs) are chronic autoimmune conditions that share common pathophysiologic mechanisms. The optimal management of patients with IMIDs remains challenging because the coexistence of different conditions requires the intervention of several specialists. The aim of this study was to develop a series of statements defining overarching principles that guide the implementation of a multidisciplinary approach for the management of spondyloarthritis (SpA)-related IMIDs including SpA, psoriasis, psoriatic arthritis, Crohn’s disease, ulcerative colitis and uveitis.MethodsA Delphi consensus-based approach was used to identify a core set of statements. The process included development of initial questions by a steering committee, an exhaustive search of the literature using complementary approaches to identify potential statements and two Delphi voting rounds for finalization of the statements.ResultsConsensus was achieved on the related nature of IMIDs, the existence of a high prevalence of multiple IMIDs in a single patient and the fact that a multidisciplinary approach can result in a more extensive evaluation and comprehensive approach to treatment. The goals of a multidisciplinary team should be to increase diagnosis of concomitant IMIDs, improve the decision-making process, and increase patient satisfaction and adherence. Early referral and diagnosis, early recognition of concomitant IMIDs and optimizing treatment to improve patient quality of life are some of the advantages of using multidisciplinary teams. To be effective, a multidisciplinary team should be equipped with the appropriate tools for diagnosis and follow-up, and at a minimum the multidisciplinary team should include a dermatologist, gastroenterologist and rheumatologist; providing psychologic support via a psychologist and involving an ophthalmologist, general practitioners and nurses in multidisciplinary care is also important.ConclusionThe present Delphi consensus identified a set of overarching principles that may be useful for implementation of a multidisciplinary approach for the management of SpA-related IMIDs.FundingAristea and Hippocrates.

show abstract

“…A non-responsive treatment population can be found for csDMARDS treatment regimens [86], and despite their high effectiveness in many patients, bDMARDS such as TNF-α inhibitors also give variable therapy responses and still a considerable number of patients do not respond [87,88]. Of course the remaining important delay in diagnosis and appropriate treatment initiation [89][90][91], difficulties with the implementation of sufficiently intensive treatment schedules [82][83][84] as well as adverse reactions to DMARDs, comorbidities, discrepancies in treatment goals between patients and health professionals [89] and psychosocial factors can be held partly responsible for this, but the leading cause of the unmet need remains insufficient biological disease control with current therapeutics. It might be that current therapies are simply not sufficiently potent to deal with the particular pathophysiological processes responsible for persistent disease activity in certain individuals or that they fail to hit the right targets.…”

Section: Lack Of Treatment Response For Patient Subpopulationmentioning

confidence: 99%

“…This was the case for 42,9 % of the 5'UTR fusions and 50% of the fusions to the coding region. The clones that had an in-frame fusion to the 5'UTR contained part of the translated 5'UTR followed by the full length protein, which could range in size between 91 donors. Ferritin has been found to be specifically upregulated in RA synovium [133,134].…”

Section: Construction Of a Novel Ra Cdna Phage Display Librarymentioning

confidence: 99%

cDNA phage display for the discovery of theranostic autoantibodies in rheumatoid arthritis

et al. 2016

Self Cite

View full text Add to dashboard Cite

Rheumatoid arthritis (RA) is the world's most common autoimmune disease mainly characterized by a chronic inflammation of multiple synovial joints. Rheumatologists now have a whole range of treatment options including glucocorticoids (GCs), classical synthetic and biological disease-modifying antirheumatic drugs (cs- and bDMARDS), resulting in a tremendous improvement in treatment outcomes for RA patients over the last two decades. Despite this progress, the choice of treatment regimen to achieve stable remission at the individual patient level still largely depends on trial and error. In this review, the need for novel theranostic markers that can predict a patient's response to methotrexate, the standard first-line csDMARD treatment, is discussed. Like in many autoimmune diseases, the majority of RA patients form a whole range of autoantibodies. We aim to find novel theranostic autoantibody markers using serological antigen selection, a high-throughput technique that uses cDNA phage display to identify novel antigen targets. We have constructed a barcoded cDNA phage display library from the synovial tissue of three RA patients by fusing cDNA products to the filamentous phage minor coat protein VI. This library contains a large proportion of full-length genes and gene fragments that are cloned in frame with the phage gene VI. By screening this library for antibody reactivity in serum samples of patients from the CareRA trial, which compared different intensive treatment strategies based on csDMARDs and a step-down GC schedule, our cDNA phage display library has great potential for the discovery of novel theranostic autoantibody biomarkers.

show abstract

A general practice perspective on early rheumatoid arthritis management: A qualitative study from Flanders

Cited by 21 publications

References 31 publications

Treatment delays for patients with new‐onset rheumatoid arthritis presenting to an Australian early arthritis clinic

Treatment delays for patients with new‐onset rheumatoid arthritis presenting to an Australian early arthritis clinic

Multidisciplinary Management of Spondyloarthritis-Related Immune-Mediated Inflammatory Disease

cDNA phage display for the discovery of theranostic autoantibodies in rheumatoid arthritis

Contact Info

Product

Resources

About