Adipokines and Associations with Incident Osteoporotic Fracture in Patients with Rheumatoid Arthritis.

Purpose: We assessed whether circulating adipokines are associated with incident fractures in patients with rheumatoid arthritis (RA).

Methods: Three adipokines (adiponectin, leptin, fibroblast growth factor [FGF]-21) were measured using banked enrollment serum from participants in a longitudinal RA cohort. Adipokine levels were dichotomized as high/low using median values.

Weight loss, disease activity, and patient reported outcomes in patients with musculoskeletal and autoimmune diseases taking weight loss medications: a retrospective cohort study.

Introduction: Given potential impacts of adiposity on pain and inflammation, we evaluated if weight loss was associated with improvements in disease activity and patient reported outcomes (PROs) in people with rheumatic and musculoskeletal disease (RMD) using weight loss therapies.

Methods: Participants with RMDs enrolled in the FORWARD Databank and reporting weight loss medication use were included in this retrospective cohort study. Linear models using generalized estimating equations assessed the association with ≥5 % weight loss and changes in PROs and disease activity over a 6-month period, clustering by participant and adjusting for the prior 6-month PRO, BMI, diabetes status, age, and sex.

Evaluating the Longitudinal Association of Rheumatoid Arthritis Disease Activity with Phenotypic Frailty: Evidence for Secondary Frailty?

Introduction: The cross-sectional association between rheumatoid arthritis (RA) disease activity and frailty has been described, however the longitudinal relationship is less well understood. We evaluated the association between disease activity and frailty over time.

Methods: We utilized a longitudinal RA cohort established at the VA Puget Sound Health Care System.

Development and External Validation of a Genetic Risk Score for Pain in Rheumatoid Arthritis.

Objective: Several single-nucleotide polymorphisms (SNPs) have been associated with chronic pain syndromes. Our objective was to determine whether genetic variants are associated with pain and disease activity in rheumatoid arthritis (RA).

Methods: Participants were included from two independent RA cohorts: FORWARD (National Databank for Rheumatic Diseases, training dataset) and VARA (Veterans Affairs RA registry, validation dataset).

Improving High-Risk Osteoporosis Medication Adherence and Safety With an Automated Dashboard.

Background: Osteoporosis medications, notably anabolic therapies, necessitate careful oversight due to their high cost and laboratory monitoring requirements, precise dosing in clinics, and strategic sequencing. These challenges were exacerbated by the COVID-19 pandemic. To address this, we created an automated clinic dashboard to aid in population health management at a US Department of Veterans Affairs osteoporosis clinic.

Prevalence of Frailty and Associated Factors in a US-Wide Cohort of Rheumatic Diseases.

Objective: We quantified the prevalence of self-reported frailty and identified associated factors in a US-wide cohort of people with rheumatic and musculoskeletal diseases (RMDs).

Methods: Frailty was measured using the FRAIL scale, a patient-reported frailty instrument, in FORWARD, The US-based National Databank for Rheumatic Diseases. Frailty prevalence was determined overall and by individual RMD, which included rheumatoid arthritis, connective tissue diseases (CTDs), osteoarthritis (OA), fibromyalgia, spondyloarthritis (SpA), and vasculitis.

Agreement of Administrative Pharmacy Dispensing With Self-Reported Use of Oral Prednisone in US Veterans With Rheumatoid Arthritis.

Objective: Administrative claims are used to evaluate oral glucocorticoid use in rheumatoid arthritis (RA), despite limited evidence to support accuracy. We aimed to evaluate the performance of claims-based algorithms for glucocorticoid use compared to self-report in an RA population.

Methods: Participants with RA enrolled at seven Veterans Affairs Rheumatoid Arthritis (VARA) Registry sites were asked six questions as part of clinical care assessing current prednisone use and dose, recent use, "stockpiling," and receiving prednisone outside the Department of Veterans Affairs (VA).

Genetically-determined variation in CRP impacts disease activity assessment in rheumatoid arthritis.

Objectives: In patients with RA, we evaluated a single-nucleotide variant previously associated with lower CRP to assess if this impacts clinical disease activity assessments including the disease activity score-28 with CRP (DAS28(CRP)).

Methods: Patients from three observational cohorts were evaluated-the United Kingdom Biobank (UKB), the Veterans Affairs RA Registry (VARA) and the FORWARD Databank. The effect of rs1205 genotype on log-adjusted serum CRP concentrations was assessed using linear regression adjusted for sex, age and population structure.

Peripheral Biomarker Signatures in Rheumatoid Arthritis-Associated Interstitial Lung Disease.

Objective: Rheumatoid arthritis-associated interstitial lung disease (RA-ILD) is a significant cause of morbidity and mortality among patients with RA, yet effective risk stratification for RA-ILD is lacking. We sought to characterize unique peripheral blood biomarker signatures in RA that could improve RA-ILD discrimination beyond clinical and genetic risk factors.

Methods: We performed a cross-sectional study of participants in the Veterans Affairs Rheumatoid Arthritis Registry.

Frailty integration in medical specialties: Current evidence and suggested strategies from the Clin-STAR frailty interest group.

Frailty is a syndrome that can inform clinical treatments and interventions for older adults. Although implementation of frailty across medical subspecialties has the potential to improve care for the aging population, its uptake has been heterogenous. While frailty assessment is highly integrated into certain medical subspecialties, other subspecialties have only recently begun to consider frailty in the context of patient care.

Frailty and rheumatic diseases: evidence to date and lessons learned.

Frailty represents a dynamic multisystem state of reduced physiological reserve that increases vulnerability to adverse health outcomes. Frailty occurs prematurely in adults with immune-mediated rheumatic diseases and is emerging as an important risk factor for adverse outcomes in these conditions. In this Series paper, we present a conceptual overview of frailty and its prevalence among patients with immune-mediated rheumatic diseases.

MUC5B Promoter Variant and Survival in Rheumatoid Arthritis-Associated Interstitial Lung Disease.

Objective: Investigate the association between the MUC5B rs35705950 promoter variant and survival in RA-associated interstitial lung disease (RA-ILD).

Methods: We studied participants in the Veteran Affairs Rheumatoid Arthritis (VARA) registry with validated ILD diagnoses. Participants were followed until death or end of study period.

Escalation to Biologics After Methotrexate Among US Veterans With Rheumatoid Arthritis Grouped by Rural Versus Urban Areas.

Objective: Racial and ethnic disparities in rheumatoid arthritis (RA) outcomes are well recognized. However, whether disparities in RA treatment selection and outcomes differ by urban versus rural residence, independent of race, have not been studied. Our objective was to evaluate whether biologic disease-modifying antirheumatic drug (bDMARD) initiation after methotrexate administration differs by rural versus urban residence among veterans with RA.

Antibodies to Malondialdehyde-Acetaldehyde Adduct Are Associated With Prevalent and Incident Rheumatoid Arthritis-Associated Interstitial Lung Disease in US Veterans.

Objective: The objective of this study is to determine the associations of protein-specific anti-malondialdehyde-acetaldehyde (MAA) antibodies with prevalent and incident rheumatoid arthritis-interstitial lung disease (RA-ILD).

Methods: Within a multicenter, prospective cohort of US veterans with RA, RA-ILD was validated by medical record review of clinical diagnoses, chest imaging, and pathology. Serum antibodies to MAA-albumin, MAA-collagen, MAA-fibrinogen, and MAA-vimentin (IgA, IgM, and IgG) were measured by a standardized enzyme-linked immunosorbent assay.

Plasma Matrix Metalloproteinase Concentrations and Risk of Interstitial Lung Disease in a Prospective Rheumatoid Arthritis Cohort.

Objective: To evaluate the associations of plasma matrix metalloproteinases (MMPs) with prevalent and incident interstitial lung disease (ILD) in people with rheumatoid arthritis (RA).

Methods: Within a multicenter, prospective cohort of US veterans with RA, we performed a cross-sectional study of prevalent ILD and cohort study of incident ILD. ILD diagnoses were validated by medical record review of provider diagnoses and chest imaging and/or pathology reports.

Development and internal validation of a clinical and genetic risk score for rheumatoid arthritis-associated interstitial lung disease.

Objective: Although clinical and genetic risk factors have been identified for rheumatoid arthritis-associated interstitial lung disease (RA-ILD), there are no current tools allowing for risk stratification. We sought to develop and validate an ILD risk model in a large, multicentre, prospective RA cohort.

Methods: Participants in the Veterans Affairs RA (VARA) registry were genotyped for 12 single nucleotide polymorphisms (SNPs) associated with idiopathic pulmonary fibrosis.

Associations Between Adiponectin and the Development of Diabetes in Rheumatoid Arthritis.

Purpose: We evaluated associations between adiponectin and the risk of diabetes among patients with rheumatoid arthritis (RA), a systemic inflammatory disease associated with metabolic disturbance.

Methods: This prospective cohort study included adults with RA from the Veterans Affairs Rheumatoid Arthritis Registry. Adiponectin and inflammatory cytokines/chemokines were measured at enrollment on stored serum samples.

Frailty and Risk of Serious Infections in Patients With Rheumatoid Arthritis Treated With Biologic or Targeted-Synthetic Disease-Modifying Antirheumatic Drugs.

Objective: It remains unknown whether frailty status portends an increased risk of adverse outcomes in patients with rheumatoid arthritis (RA) initiating biologic or targeted-synthetic (b/ts) disease-modifying antirheumatic drugs (DMARDs). The objective of our study was to evaluate the association between frailty and serious infections in a younger population of patients (<65 years old) with RA who initiated b/tsDMARDs.

Methods: Using MarketScan data, we identified new users of tumor necrosis factor inhibitors (TNFi), non-TNFi biologic DMARDs, or Janus kinase inhibitors (JAKi) between 2008 and 2019 among those with RA.

Psychometric Properties of Frailty Instruments in Adults With Rheumatoid Arthritis: A Systematic Review.

Objective: Examine psychometric properties of frailty instruments used in adults with rheumatoid arthritis (RA) to inform selection of frailty instruments for clinical and research use.

Methods: A systematic review was registered in PROSPERO. Studies measuring frailty in adults with RA published before May 25, 2022, were searched in six electronic databases.

Serum alarmins and the risk of incident interstitial lung disease in rheumatoid arthritis.

Objectives: To quantify associations of serum alarmins with risk of rheumatoid arthritis-associated interstitial lung disease (RA-ILD).

Methods: Using serum collected at enrolment, three alarmins (IL-33, thymic stromal lymphopoietin [TSLP] and IL-25) were measured in a multicentre prospective RA cohort. ILD was classified using systematic medical record review.

2023 American College of Rheumatology and American Association of Hip and Knee Surgeons Clinical Practice Guideline for the Optimal Timing of Elective Hip or Knee Arthroplasty for Patients With Symptomatic Moderate-to-Severe Osteoarthritis or Advanced Symptomatic Osteonecrosis With Secondary Arthritis for Whom Nonoperative Therapy Is Ineffective.

Objective: To develop evidence-based consensus recommendations for the optimal timing of hip and knee arthroplasty to improve patient-important outcomes including, but not limited to, pain, function, infection, hospitalization, and death at 1 year for patients with symptomatic and radiographic moderate-to-severe osteoarthritis or advanced symptomatic osteonecrosis with secondary arthritis of the hip or knee who have previously attempted nonoperative therapy, and for whom nonoperative therapy was ineffective, and who have chosen to undergo elective hip or knee arthroplasty (collectively referred to as TJA).

Methods: We developed 13 clinically relevant population, intervention, comparator, outcomes (PICO) questions. After a systematic literature review, the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach was used to rate the quality of evidence (high, moderate, low, or very low), and evidence tables were created.