Relapse in rheumatoid arthritis patients undergoing dose reduction and withdrawal of biologics: are predictable factors more relevant than predictive parameters? An observational prospective real-life study

International audienc

Multidisciplinary team intervention to reduce the nocebo effect when switching from the originator infliximab to a biosimilar

Objectives To evaluate an intervention to reduce the nocebo effect (NE) when switching from the originator infliximab (OI) to the infliximab biosimilar SB2 in chronic inflammatory rheumatic disease (CIRD).Methods An intervention was built with healthcare professionals (HPs) and a patient representative, based on a systematic review of interventions reducing the NE in musculoskeletal diseases and semi-directed questioning of five patients. Our strategy consisted of training HPs, switch information given by the nurses, a consistent vocabulary. All CIRD patients switched from OI to SB2 were included for the intervention. The primary outcome was the SB2 retention rate (RR) at 34 weeks. Secondary outcomes were the SB2 RR at 12 months, discontinuation rates due to a possible NE and comparison with a historical cohort of CIRD patients receiving the OI and 6 published European cohorts.Results 45 patients were included from March 2018 (rheumatoid arthritis, n=17, spondylarthritis, n=28). After 34 weeks, the SB2 RR was 91.2%, similar to the historical cohort RR (p=0.41) but higher than the 3 European cohort RRs (p<0.05). At 12 months, the SB2 RR was 84.5% vs 88.4% for the historical cohort (p=0.52). SB2 discontinuation due to a possible NE was 6.6% after 12 months.Conclusions A tailored communication with a prominent role of nurses reduced the NE in non-medical switches from the OI to SB2 as compared to published results. The RR was similar to the historical cohort RR. The methodology used to construct this intervention may help improve the outcomes of switches with upcoming biosimilars

Impact of assessment of bone status before corrective surgery of lumbar spine in patients over 50 years old

International audienc

Dietary Recommendations of the French Society for Rheumatology for Patients with Chronic Inflammatory Rheumatic Diseases

International audienceCet article présente le 1er ensemble de recommandations diététiques de la Société française de rhumatologie pour les patients atteints de rhumatismes inflammatoires chroniques (IRD) réalisé par un groupe de travail composé de 12 experts rhumatologues, 3 médecins spécialistes en nutrition, 1 médecin spécialiste en médecine interne, 1 diététicien diplômé. et 3 représentants d'associations de patients. Ce groupe s'est appuyé sur une revue systématique de la littérature et sur des avis d'experts, en prenant en compte non seulement les effets articulaires de l'alimentation dans la DRI mais aussi les effets extra-articulaires. Huit principes généraux et neuf recommandations ont été établis. Les principes généraux soulignent que le conseil nutritionnel ne se substitue pas au traitement pharmacologique de la MRI et qu'il fait partie intégrante de la prise en charge globale du patient, qui pourraient aider le patient à participer activement à ses soins. Les recommandations proposent d'accompagner la perte de poids chez les sujets en surpoids ou obèses, un régime de type méditerranéen et une supplémentation en acides gras polyinsaturés, principalement oméga-3. A l'inverse, les régimes sans gluten (en l'absence de maladie cœliaque), les régimes végétariens/végétaliens, le jeûne et l'élimination des produits laitiers ne doivent pas être proposés. La supplémentation en vitamines ou en oligo-éléments n'est pas indiquée pour contrôler l'activité chronique de l'IRD, tandis que l'utilisation de probiotiques ou d'épices n'est pas recommandée compte tenu des données limitées ou disparates. les régimes sans gluten (en l'absence de maladie coeliaque), les régimes végétariens/végétaliens, le jeûne et l'élimination des produits laitiers ne doivent pas être proposés. La supplémentation en vitamines ou en oligo-éléments n'est pas indiquée pour contrôler l'activité chronique de l'IRD, tandis que l'utilisation de probiotiques ou d'épices n'est pas recommandée compte tenu des données limitées ou disparates. les régimes sans gluten (en l'absence de maladie coeliaque), les régimes végétariens/végétaliens, le jeûne et l'élimination des produits laitiers ne doivent pas être proposés. La supplémentation en vitamines ou en oligo-éléments n'est pas indiquée pour contrôler l'activité chronique de l'IRD, tandis que l'utilisation de probiotiques ou d'épices n'est pas recommandée compte tenu des données limitées ou disparates

Development and real-life use assessment of a self-management smartphone application for patients with inflammatory arthritis. A user-centred step-by-step approach

International audienceBackground Mobile health applications (apps) are increasing in interest to enhance patient self-management. Few apps are actually used by patients and have been developed for patients with inflammatory arthritis (IA) treated with disease-modifying anti-rheumatic drugs which use entails risk of adverse effects such as infections. Objective To develop Hiboot, a self-management mobile app for patients with IA, by using a user-centred step-by-step approach and assess its real-life use. Methods The app development included first a qualitative study with semi-guided audiotaped interviews of 21 patients to identify the impact of IA on daily life and patient treatments practices and an online cross-sectional survey of 344 patients to assess their health apps use in general and potential user needs. A multidisciplinary team developed the first version of the app via five face-to-face meetings. After app launch, a second qualitative study of 21 patients and a users’ test of 13 patients and 3 rheumatologists led to the app’s current version. The number of app installations, current users and comments were collected from the Google Play store and the Apple store. Results The qualitative study revealed needs for counselling, patient–health professional partnership, and skills to cope with risk situations; 86.8% participants would be ready to use an app primarily on their rheumatologist’s recommendation. Six functionalities were implemented: a safety checklist before treatment administration, aids in daily life situations based on the French academic recommendations, treatment reminders, global well-being self-assessment, periodic counselling messages, and a diary. The Hiboot app was installed 20,500 times from September 2017 to October 2020, with 4300 regular current users. Scores were 4.4/5 stars at Android and iOS stores. Conclusion Hiboot is a free self-management app for patients with IA developed by a step-by-step process including patients and health professionals. Further evaluation of the Hiboot benefit is needed

HIBOOT home page.

Republished from a screenshot of the application home page under a CC BY license, with permission from the French society of rheumatology original copyright 2022.</p

Qualitative studies.

(DOCX)</p

Quantitative study: Smartphone use, difficulties encountered and information needs in daily life (n = 344).

Quantitative study: Smartphone use, difficulties encountered and information needs in daily life (n = 344).</p

Information on daily situations/symptoms and patient queries from the app from March to November 2020.

Data collected in Google analytics.</p

Hiboot features and content examples.

(DOCX)</p