''Usefulness of routine hepatitis C and hepatitis B serology in the diagnosis of recent-onset arthritis. Systematic prospective screening in all patients seen by the rheumatologists of a defined area - Brief report''

Ansemant, Thiphaine | Ornetti, Paul | Garrot, Jean-Francois | Pascaud, Francoise | Tavernier, Christian | Maillefert, Jean-FrancisInternational audience''Objective: Previous studies evaluating the usefulness of systematic screening for hepatitis B and C in patients with recent-onset arthritis suffered from a major bias since they were conducted in hospitals. The objective of the present study was to evaluate the relevance of such screening, performed by hospital and office-based rheumatologists of a defined area, in the diagnosis of arthritis or inflammatory polyarthralgia of less than 1 year duration. Methods: The CRRRI is a network which includes most hospital and office-based rheumatologists of an area with a population of 506,755 inhabitants. All patients seen by the CRRRI participants in their usual practice between March 2008 and December 2010 for inflammatory polyarthralgia, mono-, oligo-, or polyarthritis of less than 1 year duration were included. Patients' serum samples were screened for the presence of anti-hepatitis C virus (HCV) antibodies, with positive samples further evaluated for HCV-RNA with a reverse transcriptase-polymerase chain reaction, and for the presence of hepatitis B virus (HBV) infection. Results: Two hundred and thirty-three patients were included (162 women, 71 men; mean age of 50.6 +/- 15.8 years). Patients were evaluated for inflammatory polyarthralgia (n = 51), monoarthritis (n = 21), oligoarthritis (n = 35) or polyarthritis (n = 126) lasting for a mean 19.8 +/- 29.8 weeks. No new HCV or HBV infection diagnosis was done. Conclusion: In this study not suffering from a hospital-selection bias, screening for hepatitis C and B infection was not helpful in the diagnosis process of recent-onset arthritis. Key messages: Systematic hepatitis B and C serology is not relevant in patients with recent-onset (< 1 year) arthritis. (C) 2011 Societe francaise de rhumatologie. Published by Elsevier Masson SAS. All rights reserved.'

Study of professional practices among rheumatologists in Burgundy: initial corticotherapy in polymyalgia rheumatica

Import JabRef | WosArea RheumatologyInternational audienceTo study the initial dose of corticoids prescribed by rheumatologists in the Cote d'Or, a French department of Burgundy, in the treatment of polymyalgia rheumatica (PMR), the clinical and biological data of patients who consulted rheumatologists of the Cote d'Or between March 2006 and December 2008 for PMR were collected. The statistical analyses concerned the initially prescribed dose of prednisone: the median, mean, and standard deviation were calculated cumulatively and then for individual rheumatologists; the Mann-Whitney test was used to compare the mean initial doses prescribed with regard to (a) the main practice of the practitioner (private-practice or hospital rheumatologist), (b) the presence of clinical signs of severity, (c) severity of the inflammatory syndrome, and (d) the presence of clinical relapse with the decrease in corticoids. Ninety-nine patients were included (age=72 +/- 8.6 years, 59% women). The mean dose of prednisone prescribed was 27.4 +/- 12.4 mg/day. Considerable inter- and intra-individual variabilities in the doses prescribed were noted. There was no significant difference concerning the dose prescribed according to the clinical severity or the type of practice. However, the dose was significantly higher (34.3 +/- 14.7 vs. 25.5 +/- 11.1 mg/day) in patients with a high sedimentation rate. Clinical relapse was not statistically linked to the initial dose of corticoids. This evaluation of professional practices among French rheumatologists shows that the initial dose of prednisone prescribed in PMR varies considerably and is higher than the dose currently recommended in the literature (15 mg/day)