Patient and physician satisfaction with rofecoxib in osteoarthritis: Results of the EVA (Experience with VIOXX in Arthritis) survey

A nationwide survey was undertaken among 74192 patients with osteoarthritis (OA) and 5986 physicians (including 5265 general practitioners [GPs]) in Belgium to evaluate satisfaction with the selective cyclo-oxygenase 2 inhibitor rofecoxib (12.5 or 25 mg, given once a day for an average of 30 days). Rofecoxib was considered by patients to be a very effective treatment for OA, with satisfaction scores of good or very good in the domains of pain, mobility and general satisfaction. More than 80% of GP-treated patients expressed a wish to continue rofecoxib therapy. Preference for rofecoxib was especially strong in patients (n = 45453) who had previously been treated with conventional non-steroidal anti-inflammatory drugs (NSAIDs), notably patients who had used diclofenac, ibuprofen and nimesulide. Physicians also expressed high satisfaction with rofecoxib, with more than 80% of surveyed physicians indicating a wish to continue prescribing the drug. The results of this large survey demonstrate a clear preference for rofecoxib over conventional NSAIDs in a substantial majority of OA patients. The satisfactory pain relief and excellent gastrointestinal safety profile of rofecoxib demonstrated in earlier controlled trials are likely to have been factors in patients' preferences for rofecoxib over NSAIDs.SCOPUS: ar.jinfo:eu-repo/semantics/publishe

Vroegtijdige verwijzing van patiënten met vermoeden van axiale spondyloartritis in eerste lijn : de Belgische resultaten van de RADAR-studie

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Dual energy X-ray absorptiometry-based assessment of male patients using standardized bone density values and a national reference database

Dual energy X-ray absorptiometry (DXA) measurements from different manufacturers provide different bone mineral density (BMD) values and derived T-scores and Z-scores. These differences result partly from technical differences in the algorithms for the determination of bone mineral content and bone area and partly from the use of different manufacturer-derived reference databases. The present study was to implement a uniforrn expression of BNID in all male patients by using standardized BMD (sBMD) values and referring to a newly established national male reference sample. In 8 bone densitometry centers throughout Belgium 229 young healthy men were measured on Hologic (Bedford, MA) or GE-Lunar (Madison, WI) bone densitometers. Quality control procedures were implemented and site cross-calibration performed using the European Spine Phantom. Absolute BMD values were converted to standardized values by validated formulas (sBMD). Clinically acceptable between-center differences were noted. No discrepancy was observed in terms of mean sBMD and standard deviations at the lumbar spine and proximal femur between the Belgian and the US reference populations. Region-specific sBMD thresholds for the diagnosis of male osteoporosis were calculated. The current data provide a basis to implement a nation-wide, uniform expression of BMD in male patients and allow harmonization of the BMD-based diagnosis and treatment of osteoporosis in men

Fast Track Algorithm: How To Differentiate A “Scleroderma Pattern” From A “Non-Scleroderma Pattern”

Objectives: This study was designed to propose a simple “Fast Track algorithm” for capillaroscopists of any level of experience to differentiate “scleroderma patterns” from “non-scleroderma patterns” on capillaroscopy and to assess its inter-rater reliability. Methods: Based on existing definitions to categorise capillaroscopic images as “scleroderma patterns” and taking into account the real life variability of capillaroscopic images described standardly according to the European League Against Rheumatism (EULAR) Study Group on Microcirculation in Rheumatic Diseases, a fast track decision tree, the “Fast Track algorithm” was created by the principal expert (VS) to facilitate swift categorisation of an image as “non-scleroderma pattern (category 1)” or “scleroderma pattern (category 2)”. Mean inter-rater reliability between all raters (experts/attendees) of the 8th EULAR course on capillaroscopy in Rheumatic Diseases (Genoa, 2018) and, as external validation, of the 8th European Scleroderma Trials and Research group (EUSTAR) course on systemic sclerosis (SSc) (Nijmegen, 2019) versus the principal expert, as well as reliability between the rater pairs themselves was assessed by mean Cohen's and Light's kappa coefficients. Results: Mean Cohen's kappa was 1/0.96 (95% CI 0.95-0.98) for the 6 experts/135 attendees of the 8th EULAR capillaroscopy course and 1/0.94 (95% CI 0.92-0.96) for the 3 experts/85 attendees of the 8th EUSTAR SSc course. Light's kappa was 1/0.92 at the 8th EULAR capillaroscopy course, and 1/0.87 at the 8th EUSTAR SSc course. C Conclusion: For the first time, a clinical expert based fast track decision algorithm has been developed to differentiate a “non-scleroderma” from a “scleroderma pattern” on capillaroscopic images, demonstrating excellent reliability when applied by capillaroscopists with varying levels of expertise versus the principal expert and corroborated with external validation.Wo