BSR and BHPR guideline for the prescription and monitoring of non-biologic disease-modifying anti-rheumatic drugs

Ledingham, Jo; Gullick, Nicola; Irving, Katherine; Gorodkin, Rachel; Aris, Melissa; Burke, Jean; Gordon, Patrick; Christidis, Dimitrios; Galloway, Sarah; Hayes, Eranga; Jeffries, Andrew; Mercer, Scott; Mooney, Janice; Leuven, Sander I. van; Galloway, James

doi:10.1093/rheumatology/kex389

Cited by 39 publications

(45 citation statements)

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“…Retinal toxicity, particularly with treatment duration 45 years, is a recognised complication. The British Society for Rheumatology (BSR) recently updated its screening guidelines: 1 'Patients should have baseline formal ophthalmic examination, ideally including objective retinal assessment for example using optical coherence tomography (OCT), within 1 year of commencing HCQ…… (and) annual eye assessment (ideally including optical coherence tomography) if continued for 45 years'…”

mentioning

confidence: 99%

Hydroxychloroquine use: the potential impact of new ocular screening guidelines

Yates

Malaiya

Stack

et al. 2017

Eye

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confidence: 99%

Hydroxychloroquine use: the potential impact of new ocular screening guidelines

Yates

Malaiya

Stack

et al. 2017

Eye

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“…Ahmad Abdullah 1 , Nancy Maltez 2 , Marie Hudson 3 , Aurore Fifi-Mah 4 , Shahin Jamal 5 , The Canadian Research Group of Rheumatology in Immuno-Oncology (CanRIO). 1 University of British Columbia, Rheumatology, Vancouver, Canada; 2 University of Ottawa, Rheumatology, Ottawa, Canada; 3 McGill Univeristy, Montreal, Canada; 4 University of Calgary, Calgary, Canada; 5 University of British Columbia, Vancouver, Canada Background: Immune checkpoint inhibitors (ICI) have revolutionized the treatment of cancer. However, enhanced immune activation from ICI has been associated with immune-related adverse events (irAE), including autoimmune rheumatologic diseases such as inflammatory arthritis, spondyloarthritis, polymyalgia rheumatica-like syndrome and inflammatory myositis, among many others.…”

Section: Ab1216 Checking In With Immune Checkpoint Inhibitors: Resultmentioning

confidence: 99%

Ab1217 why Do Patients Claim? Analysis of the Claims Made by Patients Through Customer Service

Navarro

Sánchez-Piedra

Nievas

et al. 2019

Abstracts Accepted for Publication

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Background:Analysis of the claims made by patients could be an indicator of quality and show strengths and aspects of improvement in the organization of a rheumatology departmentObjectives:The aims of the present study are to evaluate these claims, describe the sociodemographic and clinical characteristics of claiming patients and to determine the association between medical history and types of complaints. Methods: cross-sectional study. Claims made by patients treated by a Rheumatology department between 04/2016 and 12/2017 were analyzed. A descriptive analysis of these claims was carried out followed by a multivariate logistic regression model to determine the effect of the diagnosis of Fibromyalgia (FM)/Chronic Widespread Pain (CWP) on the type of claim and its association with clinical variables. A p <0.05 was considered significant.Results:One hundred and nine patients (mean age 54.7 ± 18.5 years, 78% women and 50.5% residents in rural areas) made 113 claims. The main reasons for claiming were: “advance medical evaluation and/or tests” (45.1%), ”request for evaluation by a specific physician” (24.8%) and ”rejection of evaluation by specific physician” (13, 3%). 67% of the claims were satisfied. The least satisfied claims were “request for evaluation by specific doctor” (39.3%) while claims for “cancellation of evaluation” were satisfied in 88% of the cases.Median time between claim and previous medical visit was 99 [34-203] days and between claim and the subsequent medical consultation was 44 [28-82] days. Patients whose claims were due to ”unpleasant attendance” were the first to complaint (median 28 [2-72] days) but waited for the longest time to be attended (median 103 [46-147] days). “Cancellation of evaluation” was attended after a median of 31.5 [28-33] days.The main reasons for medical evaluation were: inflammatory/systemic disease in 25 patients (22.15%), neck and low back pain in 23 patients (20.35%) and FM/CWP also in 20.35% of patients. As personal medical history, Psychiatric Disorders were present in 20.5% of patients and multiple comorbidities in 19.6% of patients. Twenty patients had no medical history of interest.Regarding the type of claims, differences were observed related to the diagnosis and the patient‘s medical history. The logistic regression model (FM as dependent variable) adjusted for sex, age, rural area, time to/after the claim and medical history showed that patients with FM/CWP requested more frequently to “be evaluated by other physician” (OR of 23.92 ( 95% CI, 1.4-409.06) and “reject to be evaluated by a specific physician” (OR of 8.48 (95% CI, 1.2-60.09) than rest of the patients and also presented more frequently with psychiatric history (OR of 22.39 (95% CI, 1.15-437.23) Conclusion: the present study reflects main reasons for claiming of patients treated in a rheumatology department. Reasons of claiming and comorbidities of patients with FM/CWP differ from those of the rest of patients. These findings may be of interest for the organization of resources in rheumatology dep...

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“…Our study reinforces the fact that it is important to discontinue MTX in the event of liver injury but it is equally important to do so accurately to avoid denying the children of a good therapeutic option. Children should be monitored according to the guidelines when on long‐term low‐dose MTX and liver biopsy considered in the event of frequent and persistent transaminitis in spite of MTX dose modification. This is helpful in ruling out any underlying cause of liver disease and to guide MTX therapy.…”

Section: Discussionmentioning

confidence: 99%

“…Regular liver biopsies are no longer recommended as studies have shown none to minimal liver injury if liver transaminases remain < 2 times upper limit of normal (ULN) with or without MTX dose modification. However, the guidance lacks clarity in children with elevated transaminases > 2 × ULN as the existing evidence fails to correlate biochemical abnormalities with histological injury . As the gold standard to assess liver injury is histology; we retrospectively reviewed records of children ≤ 16 years referred to us from 2002 to 2015 who had liver biopsy for suspected MTX induced liver injury.…”

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confidence: 99%