Cross-cultural adaptation of the Dutch version of the Functional Index for Hand Osteoarthritis (FIHOA) and a study on its construct validity

SummaryObjectiveTo validate a cross-culturally translated and adapted Dutch version of the Functional Index for Hand Osteoarthritis (FIHOA) in patients with osteoarthritis (OA) of the hands and to evaluate its construct validity by comparing with the Australian/Canadian Osteoarthritis Hand Index (AUSCAN).MethodsThe FIHOA was translated into Dutch and cross-culturally adapted. The questionnaire was administered to 72 patients with hand OA (female/male ratio: 64/8, handedness: right: 62/left: 7/both: 3). A visual analogue scale (VAS) pain scale (100mm) and the AUSCAN questionnaire were also recorded. An item–item analysis was performed. Test–retest reliability (time interval: 5 days) was assessed in 21 patients with intraclass correlation coefficient (ICC) and Bland and Altman graphical method. Construct validity was assessed by Spearman rank correlation coefficient between the FIHOA and AUSCAN.ResultsInternal consistency was high (Cronbach's alpha=0.89). All items, except for one (‘Are you able to clench the fist?’), and the mean total FIHOA scores were statistically different between the subgroups based on the VAS (mean total score=7.46 and 14.19, in a-/mild symptomatic and symptomatic group, respectively (P<0.001)).The Spearman's correlation between all subscales of the AUSCAN (pain, stiffness, functionality) and the FIHOA was good, especially with the subscale functionality (r=0.81, P<0.01). Test–retest reliability was excellent with an ICC of 0.96 for the total score and the Bland and Altman plot showing a homogeneous distribution of the differences.ConclusionThe psychometric properties of the Dutch version of the FIHOA are excellent. There is a good correlation between the FIHOA and all subscales of the AUSCAN, especially the subscale functionality

The Belgian MIRA (MabThera In Rheumatoid Arthritis) registry: clues for the optimization of rituximab treatment strategies

This study describes the results of the Belgian 'MabThera In Rheumatoid Arthritis (MIRA)' registry: effectiveness, safety and evaluation of the current retreatment practice on the background of the Belgian reimbursement criteria for rituximab

Comparison of performance of the Assessment of Spondyloarthritis International Society, the European Spondyloarthropathy Study Group and the modified New York criteria in a cohort of Chinese patients with spondyloarthritis

Early diagnosis of spondyloarthritis (SpA) is essential as anti-tumor necrosis factor therapy can achieve significant symptomatic relief and control of disease activity. This study aims to compare the clinical characteristics, disease activity, and functional status of a Chinese cohort of SpA patients who were re-classified into ankylosing spondylitis (AS) patients fulfilling the modified New York (MNY) criteria, those with undifferentiated SpA (USpA) fulfilling the European Spondyloarthropathy Study Group (ESSG) classification criteria only (USpA/ESSG) and those who fulfill Assessment of SpondyloArthritis International Society (ASAS) only (USpA/ASAS). Disease activity was evaluated by Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), severity of morning stiffness, patient global assessment, and C-reactive protein. Functional status was evaluated by Bath Ankylosing Spondylitis Functional Index (BASFI), modified Schober index, and dimension of chest expansion. One hundred and twenty-eight patients with disease duration of 16.3 ± 10.4 years were recruited. Patients in USpA/ESSG and USpA/ASAS were significantly younger (p = 0.01), had shorter disease duration (p < 0.01), and lower BASFI (p = 0.03) than established AS patients. All three groups have active disease with comparable BASDAI >3. BASFI correlated inversely with dimension of chest expansion and negatively modified Schober index in AS patients (p < 0.01) and modestly with BASDAI (r = 0.25, p < 0.01). BASFI correlated moderately with BASDAI in USpA/ESSG (r = 0.61, p < 0.01) but not with chest expansion or modified Schober index. Compared with established AS patients recognized by MNY criteria, patients fulfilling USpA defined by ESSG or ASAS criteria had earlier disease, as active disease and less irreversible functional deficit

Infliximab: 12 years of experience

Rheumatoid arthritis (RA), ankylosing spondylitis (AS) and psoriatic arthritis (PsA) are immune-mediated conditions that share an inflammatory mechanism fuelled by excessive cytokines, particularly TNF. Control of inflammation and rapid suppression of cytokines are important in treating these diseases. With this understanding and the corresponding advent of TNF inhibitors, RA patients, AS patients and PsA patients have found more choices than ever before and have greater hope of sustained relief. As a widely used TNF inhibitor, infliximab has a deep and established record of efficacy and safety data. Extensive evidence - from randomised controlled clinical trials, large registries and postmarketing surveillance studies - shows that infliximab effectively treats the signs and symptoms, provides rapid and prolonged suppression of inflammation, prevents radiologically observable disease progression and offers an acceptable safety profile in RA, AS and PsA. In very recent studies, investigators have observed drug-free remission in some patients. Additionally, infliximab may interfere with rapidly progressing disease in RA by early addition to methotrexate in patients with signs of an aggressive course. Finally, infliximab has been shown to reduce PsA clinical manifestations such as nail involvement. With our current understanding, substantial data and increasing confidence regarding use in practice, infliximab can be considered a well-known drug in our continued campaign against inflammatory rheumatic diseases