Outpatient Care Aspects of Rheumatic Patients in Latvia : Real Life Data in the Context of the First Month of the COVID-19 Pandemic

Publisher Copyright: © 2023 Julija Zepa et al., published by Sciendo.The aim of this study was to analyse the rheumatic disease profile and treatment aspects of the patients consulted in the outpatient department of Pauls Stradiņš Clinical University Hospital during the first month of the COVID-19 pandemic from 2020 March 13 till April 14. A total of 457 (76.04%) remote and 144 (23.96%) face-to-face consultations were analysed, totalling 601 patients: 434 (72.21%) females and 167 (27.79%) males with mean age 51.40 ± 14.73 years. Rheumatoid arthritis (223 (37.10%)), psoriatic arthritis (93 (15.47%)) and ankylosing spondylitis (80 (13.31%)) were the most frequently consulted conditions. Disease modifying antirheumatic drugs (DMARDs) or immunosuppressants (IS) were taken by 515 (85.69%) patients. These included synthetic DMARD (242 (46.99%)), mainly methotrexate; and biologic DMARD (156 (30.29%)), mainly tumour necrosis factor inhibitor. More than one-half of the cohort (427 (71.05%)) was not taking a glucocorticoid (GC). NSAIDs were used in 391 (65.08%) patients, mainly on demand (354 (90.54%)). Most patients (401 (66.72%)) had no comorbidities (hypertension, diabetes, malignancy and/or chronic respiratory disease). The profile of patients consulted in the outpatient department consisted mainly of middle-age females with autoimmune inflammatory arthritis treated by DMARD. Most of the patients did not use GCs, they did not regularly use NSAIDs and did not have comorbidities. Telemedicine is an acceptable way of care delivery for chronic rheumatic patients with previously known disease and treatment, especially during a pandemic.publishersversionPeer reviewe

The impact of body mass index on disease progression in ankylosing spondylitis

Publisher Copyright: © 2018 De Gruyter Open Ltd. All rights reserved.Obesity can be a factor that affects the course of chronic systemic inflammatory arthritis. The objective of this study was to characterise patients with ankylosing spondylitis (AS) according to an evaluation of their body mass index (BMI) and by exploring the link between the overweightness and obesity with routinely measured disease-specific variables, including disease activity (Bath Ankylosing Spondylitis Disease Activity Index BASDAI; Ankylosing Spondylitis Disease Activity Score, using CRP, ASDAScrp), spinal mobility (Bath Ankylosing Spondylitis Metrology Index, BASMI), functional capacity (BASFI), extraspinal manifestations like fatigue, uveitis, and peripheral arthritis present during the course of the disease. A total of 107 patients were included in the cross-sectional study fulfilling the modified New York criteria for AS. Patients were divided into three groups: with the evaluation of BMI 30.0 (obesity). The mean BMI was 25.13 (SD 4.07). 33% of patients were overweight and 15% were obese. The mean values of age, duration of AS, ASDAScrp, BASDAI, Bath Ankylosing Spondylitis Functional Index (BASFI), BASMI, pain in spine, and fatigue in the group with BMI < 24.9 were lower than in the other groups (p < 0.05). There was no difference between groups in age of AS onset, uveitis and peripheral arthritis. AS patients who were overweight or obese had a higher level of the disease activity, pain, fatigue, functional disability and spinal mobility impairment with worse values in the case of obesity.publishersversionPeer reviewe