Ultrasound findings in knee of patients of osteoarthritis and their correlation with pain

Background: Osteoarthritis (OA) is a common joint disorder, with the knee being one of the most frequently involved sites. Conventional radiography (CR), hitherto the primary imaging tool in OA, shows late and indirect findings. Ultrasound (US), on the other hand, offers the possibility to depict different structures within the knee. The main objectives of this study is to asses correlation of Ultrasonography (USG) findings of OA knees and pain assessed in each knee using a numerical rating scale (NRS) from 0 to 10.Methods: This study was a single center cross sectional observational study. Patients presenting to rheumatology clinic between February 2017 to March 2017 and satisfying ACR clinical criteria for osteoarthritis of knees were taken. Pain assessed in each knee using NRS. USG evaluation of painful knee was done using standard protocols.Results: In this study, 9 patients and 17 knees were examined. The mean age was 65.7 yrs with more females (66%) as compared to males (33.3%), mean disease duration was 6 yrs with majority of patients (88%) on pain reliever medications (NSAIDS). Ultrasound showed that synovitis and osteophytes has negative correlation with pain score (r=-0.06, r-.09). Presence of cartilage loss had slightly higher correlation with pain score (r=0.18). The meniscal protrusion (r value 0.15) is associated slight correlation with pain score.Conclusions: Ultrasound can assess many soft tissue pathologies which cannot be seen on conventional radiography, however the importance of these soft tissue pathologies is uncertain and remains to be determined. In this study we could not find any significant correlation between pain and ultrasound findings

Biosimilar etanercept: a real world safety and patient related outcomes from a single centre

Background: Biosimilars are expected to provide affordable and quality treatment equivalent to the biologics in various rheumatic disorders. Presently, the data available on the safety and effectiveness of biosimilars is very scarce. The objective of the present study was to assess the safety profile of intended biosimilar of etanercept developed by Intas pharmaceuticals Ltd. (Intacept) in Rheumatoid arthritis (RA), spondyloarthropathy (SpA), ankylosing Spondylitis (AS), juvenile idiopathic arthritis (JIA) and psoriatic arthritis (PsA).Methods: In single center, retrospective observational study, all patients were enrolled in routine clinical practice     who received Intended biosimilar of Etanercept (Intacept) and the following data was collected. Basic demographic profile, disease and duration of therapy, any adverse event, patient’s global assessment of disease activity on visual analogue scale (0 to 100), patient’s overall experience with Intended biosimilar etanercept (Intacept).Results: Total 70 patients were enrolled (41males and 29 females) having RA (42), AS (11), SpA (13), JIA (2) AND PsA (2). The mean duration of follow up was 8±1.7 months. 10% patients reported adverse events like injection site pain (4.29%), fever (2.86%), redness (1.42%) and weight gain (1.42%). 45% patients had LTBI screen positive and were initiated on chemoprophylaxis with Rifampicin and INH 4weeks prior to Intacept. About 24% of patients dropped due to various reasons like affordability issue (5.7%), inadequate response (8.6%), no response (10%) and side effects (5.7%). 51.4% patients observed more than 50% improvement in global disease activity with Intacept while 10% patients did not get any response with the treatment. 77.2% patients perceived the overall therapy with Intacept as excellent, very good, good or OK while 22.8% patients rated Intacept therapy as non-satisfactory.Conclusions: The study leads to the conclusion that Intended biosimilar of etanercept (Intacept) was safe and well tolerated in various rheumatic disorders in a real-world scenario