Collection and management of selected comorbidities and their risk factors in chronic inflammatory rheumatic diseases in daily practice in France

Gossec, Laure; Baillet, Athan; Dadoun, Sabrina; Daïen, C.; Bérenbaum, Francis; Dernis, Emmanuelle; Fayet, Françoise; Hudry, Christophe; Mezieres, Maryse; Pouplin, Sophie; Richez, Christophe; Saraux, Alain; Savel, Carine; Senbel, Éric; Soubrier, Martin; Sparsa, L.; Wendling, Daniel; Dougados, Maxime

doi:10.1016/j.jbspin.2016.05.012

Cited by 43 publications

(30 citation statements)

References 48 publications

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“…Cancer monitoring in patients with RA receiving DMARDs. Routine safety monitoring for signs and symptoms of cancer was mentioned in 14 recommendations (42%) (4,6,11,12,17,26,27,(32)(33)(34)(35)37,42,43); most referred to bDMARDs (see Supplementary Table 3, available on the Arthritis Care & Research web site at http://onlin elibr ary.wiley.com/doi/10.1002/acr.23865/ abstract). The overall agreement was to watch for symptoms, but very few recommendations detailed which symptoms should be watched for, or which screening tests should be used or when.…”

Section: Quality Of Reportingmentioning

confidence: 99%

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Systematic Review of Recommendations on the Use of Disease‐Modifying Antirheumatic Drugs in Patients With Rheumatoid Arthritis and Cancer

López-Olivo

Colmegna

Matusevich

et al. 2020

Arthritis Care & Research

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Objective To evaluate consensus recommendations regarding management of rheumatoid arthritis (RA) in patients with cancer. Methods We searched electronic databases, guideline registries, and relevant web sites for cancer‐specific recommendations on RA management. Reviewers independently selected and appraised the recommendations according to the Appraisal of Guidelines for Research and Evaluation (AGREE) II instrument. We identified similarities and discrepancies among recommendations. Results Of 4,077 unique citations, 39 recommendations were identified, of which half described their consensus process. Average scores for the AGREE II domains ranged from 33% to 87%. Cancer risk in RA was addressed in 79% of recommendations, with acknowledgement of increased overall cancer risk. Recommendations did not agree on the safety of using disease‐modifying antirheumatic drugs (DMARDs) in RA patients with cancer, except for the contraindication of tumor necrosis factor inhibitors in patients at risk for lymphoma. Most recommendations agreed that RA treatment should be stopped and re‐evaluated with a new diagnosis of cancer. Recommendations for patients with a history of cancer differed depending on the drug, cancer type, and time since cancer diagnosis. Few recommendations addressed all issues. Conclusion Recommendations for the treatment of RA in patients with cancer often fail to meet expected methodologic criteria. There was agreement on the need for caution when prescribing DMARDs to these patients. However, several areas continue to lack consensus, and given the paucity of evidence, there is an urgent need for research and expert opinion to guide and standardize the management of RA in patients with cancer.

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Section: Quality Of Reportingmentioning

confidence: 99%

“…Patients with rheumatoid arthritis (RA) have a high prevalence of comorbidities, which are often suboptimally managed (1)(2)(3)(4). Among them, a person diagnosed with RA is more likely than the general population to have a history of cancer (5,6).…”

Section: Introductionmentioning

confidence: 99%

Systematic Review of Recommendations on the Use of Disease‐Modifying Antirheumatic Drugs in Patients With Rheumatoid Arthritis and Cancer

López-Olivo

Colmegna

Matusevich

et al. 2020

Arthritis Care & Research

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“…Specific guidelines recommendations have been published to enhance detection and management of specific comorbidities associated to RA. 3 Objectives: To identify the prevalence of unknown cardiometabolic risk factors in a Mexican-mestizo cohort with RA.…”

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confidence: 99%

AB1315 Medication use among pregnant women with rheumatic diseases in korea based on the national health insurance service-national sample cohort

Chung

Lee

et al. 2018

Epidemiology, Risk Factors for Disease or Disease Progression

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BackgroundMany rheumatic diseases (RD) predominantly affect women in their reproductive ages. Medication use during pregnancy is an important issue in women with RD since it may affect the health of both fetus and the mother.ObjectivesThis study aimed to characterise the status of medication dispensed for Korean women with RD in pre-gestational period and during pregnancy.MethodsWomen aged between 20–44 years and diagnosed as RD and had delivery after the diagnosis of RD were identified from National Health Insurance Service-National Sample Cohort (NHIC-NSC) (2009–2013). Rheumatoid arthritis (RA), systemic lupus erythematosus (SLE), and ankylosing spondylitis (AS) were included as RD. We analysed prevalence of RD related medication including disease-modifying antirheumatic drugs (DMARDs), NSAIDs, and corticosteroids (CSs) dispensed between the pre-gestational periods of 3 months before pregnancy until delivery. We also analysed prevalence of other medications and supplements which are commonly dispensed during pregnancy in women with RD and the age and sex matched controls.ResultsThere were 71 deliveries among 1059 women with RD. In RD pregnancies, 54.9% had taken at least 1 RD related medications. The prevalence of DMARDs dispensing during pregnancy was 23.9%, CSs 43.7%, and NSAIDs 38.0% in RD population. Although usage of antibiotics and medication for thyroid diseases during pregnancies were not different between the women with RD and the control, use of vitamin and iron supplements were significantly higher in the women with RD (38.0% vs 13.4%, p<0.0001).Abstract AB1315 – Table 1RD-related medication dispensing prevalence by pregnancy period (N=71)Pre-pregnancy1st Trimester2nd Trimester3rd Trimester cDMARDs17 (23.9)15 (21.1)14 (19.7)12 (16.9) Azathioprine1 (1.4)1 (1.4)1 (1.4)1 (1.4) Cyclosporin0 (0.0)0 (0.0)0 (0.0)0 (0.0) Hydroxychloroquine17 (23.9)14 (19.7)13 (18.3)10 (14.1) Sulfasalazine0 (0.0)0 (0.0)1 (1.4)2 (2.8) Tacrolimus1 (1.4)1 (1.4)0 (0.0)0 (0.0) Others0 (0.0)0 (0.0)0 (0.0)0 (0.0)bDMARDs0 (0.0)0 (0.0)0 (0.0)0 (0.0)Corticosteroids31 (43.7)24 (33.8)24 (33.8)22 (31.0)NSAIDs27 (38.0)13 (18.3)3 (4.2)1 (1.4)ConclusionsMedications are frequently required during pregnancies of women with RD. RD are a significant burden for pregnant women requiring increased number of medication use.References[1] Gotestam Skorpen C, Hoeltzenbein M, Tincani A, Fischer-Betz R, Elefant E, Chambers C, et al. The EULAR points to consider for use of antirheumatic drugs before pregnancy, and during pregnancy and lactation. Ann Rheum Dis. 2016;75(5):795–810.[2] Palmsten K, Simard JF, Chambers CD, Arkema EV. Medication use among pregnant women with systemic lupus erythematosus and general population comparators. Rheumatology (Oxford). 2017;56(4):561–9.Disclosure of InterestNone declared

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“…These EULAR points to consider were recently disseminated in France, using an evidence-based approach followed by expert consensus 9. In this initiative, Gossec et al clearly defined what part of the management of comorbidities is potentially within the remit of French rheumatologists.…”

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confidence: 99%

“…Thus, it was proposed to refer all patients with a risk >1% because the decision to perform carotid ultrasound and also the interpretation of this examination and subsequent treatment decisions should be made by a specialist. In this initiative,9 a visit to the dentist was recommended every year, in view of both the infectious risk represented by poor dental hygiene, and potential links between some CIRDs and periodontitis, as suggested by Castañeda et al 1…”

mentioning

confidence: 99%

Response to: ‘Additional proposals to reduce comorbidity in patients with chronic inflammatory rheumatic diseases’. Screening for comorbidities: what is the remit of rheumatologists?

Baillet

Gossec

Dougados

2016

Annals of the Rheumatic Diseases

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Collection and management of selected comorbidities and their risk factors in chronic inflammatory rheumatic diseases in daily practice in France

Cited by 43 publications

References 48 publications

Systematic Review of Recommendations on the Use of Disease‐Modifying Antirheumatic Drugs in Patients With Rheumatoid Arthritis and Cancer

Systematic Review of Recommendations on the Use of Disease‐Modifying Antirheumatic Drugs in Patients With Rheumatoid Arthritis and Cancer

AB1315 Medication use among pregnant women with rheumatic diseases in korea based on the national health insurance service-national sample cohort

Response to: ‘Additional proposals to reduce comorbidity in patients with chronic inflammatory rheumatic diseases’. Screening for comorbidities: what is the remit of rheumatologists?

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