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  1. Article ; Online: Does patient-reported bath ankylosing spondylitis disease activity index correlate with inflammatory back pain and extra-articular manifestations in axial spondyloarthropathy?

    Patel, Roshni / Byravan, Swetha / Moorthy, Arumugam

    Musculoskeletal care

    2023  Volume 21, Issue 4, Page(s) 1429–1433

    MeSH term(s) Humans ; Spondylitis, Ankylosing/complications ; Spondylarthropathies/complications ; Back Pain ; Patient Reported Outcome Measures ; Severity of Illness Index
    Language English
    Publishing date 2023-09-26
    Publishing country England
    Document type Journal Article
    ZDB-ID 2171452-6
    ISSN 1557-0681 ; 1478-2189
    ISSN (online) 1557-0681
    ISSN 1478-2189
    DOI 10.1002/msc.1824
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    Zs.A 6046: Show issues Location:
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  2. Article ; Online: Cannabinoids in rheumatology: Friend, foe or a bystander?

    Jain, Nibha / Moorthy, Arumugam

    Musculoskeletal care

    2022  Volume 20, Issue 2, Page(s) 416–428

    Abstract: Objectives: Cannabinoids have gained popularity recently with special emphasis on their use for chronic pain. Although NICE guidelines advise against their usage for management of chronic pain, almost all rheumatologists encounter a few patients in ... ...

    Abstract Objectives: Cannabinoids have gained popularity recently with special emphasis on their use for chronic pain. Although NICE guidelines advise against their usage for management of chronic pain, almost all rheumatologists encounter a few patients in their daily practice who either use them or are curious about them. We reviewed the mechanism of action of cannabinoids, current knowledge about their role in rheumatology and potential drug interactions with common drugs used in Rheumatology. We attempted to answer the question "If cannabinoids are friend, foe or just a mere bystander?"
    Methods: We adhered to a search strategy for writing narrative reviews as per available guidelines. We searched PubMed with the search terms "Cannabinoids", "Rheumatology" and "Chronic pain" for published articles and retrieved 613 articles. The abstracts and titles of these articles were screened to identify relevant studies focusing on mechanism of actions, adverse effects and drug interactions. We also availed the services of a musculoskeletal librarian.
    Results: Despite the NHS guidelines against the usage of cannabinoids and associated significant stigma, cannabinoids are increasingly used for the management of pain in rheumatology without prescription. Cannabinoids act through two major receptors CB1 and CB2, which are important modulators of the stress response with potential analgesic effects. Their role in various rheumatological diseases including Rheumatoid arthritis, Osteoarthritis and Fibromyalgia have been explored with some benefits. However, in addition to the adverse effects, cannabinoids also have some potential interactions with common drugs used in rheumatology, which many users are unaware of.
    Conclusion: While the current studies and patient reported outcomes suggest cannabinoids to be a "friend" of rheumatology, their adverse events and drug interactions prove to be a "Foe". We were unable to arrive at a definite answer for our question posed, however on the balance of probabilities we can conclude cannabinoids to be a "foe". Under these circumstances, a disease and drug focussed research is need of the hour to answer the unresolved question.
    MeSH term(s) Arthritis, Rheumatoid ; Cannabinoids/adverse effects ; Chronic Pain/drug therapy ; Fibromyalgia ; Humans ; Rheumatology
    Chemical Substances Cannabinoids
    Language English
    Publishing date 2022-04-27
    Publishing country England
    Document type Journal Article ; Review
    ZDB-ID 2171452-6
    ISSN 1557-0681 ; 1478-2189
    ISSN (online) 1557-0681
    ISSN 1478-2189
    DOI 10.1002/msc.1636
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    Zs.A 6046: Show issues Location:
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  3. Article ; Online: Clinical efficacy of JAK inhibitors on enthesitis in spondyloarthropathy: A scoping literature review.

    Jubber, Ameen / Tahir, Hasan / Moorthy, Arumugam

    Musculoskeletal care

    2023  Volume 21, Issue 4, Page(s) 1195–1203

    Abstract: Background: Enthesitis is a key feature of spondyloarthropathy (SpA). In recent years, JAK inhibitors have emerged as efficacious drugs in the landscape of advanced therapies for patients with SpA.: Method: The aim of this scoping literature review ... ...

    Abstract Background: Enthesitis is a key feature of spondyloarthropathy (SpA). In recent years, JAK inhibitors have emerged as efficacious drugs in the landscape of advanced therapies for patients with SpA.
    Method: The aim of this scoping literature review was to search the published literature for studies on JAK inhibitors and their effects on enthesitis in patients with SpA and evaluate the data and summarise the findings. The clinical trials reviewed used the Leeds Enthesitis Index, Spondyloarthritis Research Consortium of Canada Enthesitis Index, and Maastrich Ankylosing Spondylitis Enthesitis Score as outcome measures.
    Results: Tofacitinib, upadacitinib, and filgotinib had numerically greater reductions in the enthesitis scores when compared with placebo.
    Conclusion: While the JAK inhibitors are therapeutic options for enthesitis in SpA, head-to-head studies are needed to compare the JAK inhibitors against the biological drugs (targeting TNF, IL-17, and IL-12/23) as well as studies showing the effects of JAK inhibitors on enthesitis imaging.
    MeSH term(s) Humans ; Janus Kinase Inhibitors/pharmacology ; Janus Kinase Inhibitors/therapeutic use ; Spondylarthropathies/drug therapy ; Spondylarthritis/drug therapy ; Spondylitis, Ankylosing/drug therapy ; Treatment Outcome ; Antirheumatic Agents/therapeutic use
    Chemical Substances Janus Kinase Inhibitors ; Antirheumatic Agents
    Language English
    Publishing date 2023-07-28
    Publishing country England
    Document type Journal Article ; Review
    ZDB-ID 2171452-6
    ISSN 1557-0681 ; 1478-2189
    ISSN (online) 1557-0681
    ISSN 1478-2189
    DOI 10.1002/msc.1802
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    Zs.A 6046: Show issues Location:
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  4. Article ; Online: Ethnicity and patient reported outcome BASDAI in the monitoring of axial spondyloarthropathy: Does it matter?

    Byravan, Swetha / Jothimurugan, Sindhuja / Moorthy, Arumugam

    Musculoskeletal care

    2022  Volume 21, Issue 1, Page(s) 97–101

    MeSH term(s) Humans ; Ethnicity ; Spondylarthropathies ; Spondylitis, Ankylosing ; Patient Reported Outcome Measures ; Severity of Illness Index
    Language English
    Publishing date 2022-07-06
    Publishing country England
    Document type Journal Article
    ZDB-ID 2171452-6
    ISSN 1557-0681 ; 1478-2189
    ISSN (online) 1557-0681
    ISSN 1478-2189
    DOI 10.1002/msc.1669
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    Zs.A 6046: Show issues Location:
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  5. Article ; Online: Rheumatology patients on immunosuppressive treatment and their perioperative management: Review of recommendations.

    Khader, Shafeeqa Gulam / Hussain, Wajith Hussain Zahir / Moorthy, Arumugam

    Musculoskeletal care

    2022  Volume 21, Issue 2, Page(s) 571–575

    MeSH term(s) Humans ; Rheumatology ; Immunosuppressive Agents/therapeutic use ; Arthritis, Rheumatoid
    Chemical Substances Immunosuppressive Agents
    Language English
    Publishing date 2022-12-03
    Publishing country England
    Document type Journal Article
    ZDB-ID 2171452-6
    ISSN 1557-0681 ; 1478-2189
    ISSN (online) 1557-0681
    ISSN 1478-2189
    DOI 10.1002/msc.1721
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    Zs.A 6046: Show issues Location:
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  6. Article ; Online: Venous thromboembolism risk with Janus kinase inhibitors: Is it a class wide effect?

    Jubber, Ameen / Woodward, Jonathan / Tahir, Hasan / Moorthy, Arumugam

    Expert opinion on drug safety

    2022  Volume 21, Issue 8, Page(s) 1005–1007

    MeSH term(s) Humans ; Janus Kinase Inhibitors/adverse effects ; Risk Factors ; Venous Thromboembolism/chemically induced
    Chemical Substances Janus Kinase Inhibitors
    Language English
    Publishing date 2022-07-13
    Publishing country England
    Document type Editorial
    ZDB-ID 2088728-0
    ISSN 1744-764X ; 1474-0338
    ISSN (online) 1744-764X
    ISSN 1474-0338
    DOI 10.1080/14740338.2022.2100343
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    Zs.A 6096: Show issues Location:
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  7. Article ; Online: Reactive arthritis: a clinical review.

    Jubber, Ameen / Moorthy, Arumugam

    The journal of the Royal College of Physicians of Edinburgh

    2021  Volume 51, Issue 3, Page(s) 288–297

    Abstract: Reactive arthritis (ReA) is a form of inflammatory arthritis triggered by a remote antecedent infection, usually in the genitourinary or gastrointestinal tract. It is part of the spondyloarthropathy (SpA) spectrum, an umbrella term for a group of ... ...

    Abstract Reactive arthritis (ReA) is a form of inflammatory arthritis triggered by a remote antecedent infection, usually in the genitourinary or gastrointestinal tract. It is part of the spondyloarthropathy (SpA) spectrum, an umbrella term for a group of distinct conditions with shared clinical features. Typically, it presents with an asymmetric oligoarthritis of the lower limb joints, and patients may also have sacroiliitis, enthesitis and dactylitis. Other features often seen include anterior uveitis, urethritis and skin manifestations such as pustular lesions on the plantar areas. Although ReA was characterised initially as a sterile arthritis, the detection of metabolically active Chlamydia species in the joint fluid of some affected patients has generated further questions on the pathophysiology of this condition. There are no formal diagnostic criteria, and the diagnosis is mainly clinical. HLA-B27 can support the diagnosis in the correct clinical context, and serves as a prognostic indicator. The majority of patients have a self-limiting course, but some develop chronic SpA and require immunomodulatory therapy.
    MeSH term(s) Arthritis, Reactive/diagnosis ; Arthritis, Reactive/etiology ; Diagnosis, Differential ; Humans ; Prognosis
    Language English
    Publishing date 2021-09-15
    Publishing country Scotland
    Document type Journal Article ; Review
    ZDB-ID 2866363-9
    ISSN 2042-8189 ; 0953-0932
    ISSN (online) 2042-8189
    ISSN 0953-0932
    DOI 10.4997/JRCPE.2021.319
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    Zs.A 3088 -Suppl.-: Show issues Location:
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  8. Article ; Online: From bench to bedside- is there a role of IL-17 drugs in rheumatoid arthritis?

    Byravan, Swetha / Samarasinghe, Harini / Yuan, Jack Shi Jie / Tahir, Syed Haider / Moorthy, Arumugam / Tahir, Hasan

    Expert opinion on investigational drugs

    2024  

    Abstract: Introduction: IL-17 has been described as a pro-inflammatory cytokine that is relevant in the seronegative spondylarthritides with IL-17 targeted therapies being licensed for their treatment.There is evidence to demonstrate that IL-17 is found in RA ... ...

    Abstract Introduction: IL-17 has been described as a pro-inflammatory cytokine that is relevant in the seronegative spondylarthritides with IL-17 targeted therapies being licensed for their treatment.There is evidence to demonstrate that IL-17 is found in RA joints and contributes to the pro-inflammatory cascade. This results in synovial hyperplasia and osteoclastogenesis thus causing joint destruction and bony erosions.
    Areas covered: This review article summarizes trials that have studied the use of IL-17 targeted therapies in RA patients who have failed conventional synthetic disease-modifying therapy (C-DMARDS) and biologic DMARDS.
    Expert opinion: The trials that have studied IL-17 inhibitors in RA patients have only shown a modest improvement in disease activity. In several trials, the primary endpoint was not achieved whilst in others, when comparing with existing licensed biologics for RA, did not demonstrate any superiority.Tissue Necrosis Factor-alpha (TNF-α) likely plays more of a pivotal role in the pathogenesis of RA with IL-17 having a synergistic effect. Therefore, in our opinion, IL-17 inhibitors as an independent therapy for RA are less likely to provide a cost-effective benefit. There may be scope to potentially combine it with TNF-α-inhibitors (TNF-i), but this requires further research especially with the potential concerns related to increased immunosuppression.
    Language English
    Publishing date 2024-05-02
    Publishing country England
    Document type Journal Article ; Review
    ZDB-ID 1182884-5
    ISSN 1744-7658 ; 0967-8298 ; 1354-3784
    ISSN (online) 1744-7658
    ISSN 0967-8298 ; 1354-3784
    DOI 10.1080/13543784.2024.2351505
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    Zs.A 3739: Show issues Location:
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  9. Article: An Ethnic Variation in the Acceptance of Biological Disease-Modifying Therapies: A University Hospital Experience.

    Selvaskandan, Haresh / Moorthy, Arumugam

    Cureus

    2021  Volume 13, Issue 5, Page(s) e15270

    Abstract: Ethnic variations in the outcomes of rheumatological diseases are well documented. While physiological differences may account for these disparities, attitude to treatment is also likely to be a significant modifiable contributor. We sought to determine ... ...

    Abstract Ethnic variations in the outcomes of rheumatological diseases are well documented. While physiological differences may account for these disparities, attitude to treatment is also likely to be a significant modifiable contributor. We sought to determine if an ethnic variation exists in the uptake of biological disease-modifying anti-rheumatic drugs (DMARD) among a multi-ethnic cohort when offered in-person through a healthcare system free at the point of access. We conducted a retrospective cross-sectional study of patients seen in a biologic therapy counselling clinic between December 2016 and April 2017. Clinic letters from consultations were reviewed, and data including ethnicity, language spoken, and decision to accept or reject the therapy were extracted. We chose to measure uptake over adherence, as we believe it is an earlier, more direct marker of attitudes to joint saving medications. Ninety-one cases were included in the analysis. Over 13.2% (12/91) of the cohort declined a biologic treatment when it was offered as the standard of care for joint disease. Non-Caucasian patients accepted treatment less often than Caucasian (White British) patients (OR 0.265, CI 0.73-0.959, p = 0.043), as did those who did not speak English as a first language (OR 0.094, CI 0.18-0.497, p = 0.005). Age, sex, and diagnosis were well matched between those who accepted and declined therapy. We demonstrate a disparity in the uptake of biologic therapies between the White British population and patients from other ethnicities. The reasons for this are likely multifactorial and could be related to socio-economic factors, language barriers, and cultural differences. Addressing this discrepancy is a crucial first step to tackling preventable disparities in the outcomes of rheumatological disease between different ethnicities.
    Language English
    Publishing date 2021-05-27
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2747273-5
    ISSN 2168-8184
    ISSN 2168-8184
    DOI 10.7759/cureus.15270
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  10. Article ; Online: Ankle and Foot: Focus on Inflammatory Disease.

    Giraudo, Chiara / Fichera, Giulia / Ganguly, Sujata / Arumugam, Moorthy / Cecchin, Diego / Rennie, Winston J

    Seminars in musculoskeletal radiology

    2023  Volume 27, Issue 3, Page(s) 327–336

    Abstract: The ankle and foot have numerous bones and complex joints that can be affected by several types of inflammatory arthritis with different patterns and various radiologic signs, depending on the phase of the disease. Involvement of these joints is most ... ...

    Abstract The ankle and foot have numerous bones and complex joints that can be affected by several types of inflammatory arthritis with different patterns and various radiologic signs, depending on the phase of the disease. Involvement of these joints is most frequently seen in peripheral spondyloarthritis and rheumatoid arthritis in adults and juvenile idiopathic arthritis in children. Although radiographs are a mainstay in the diagnostic process, ultrasonography and especially magnetic resonance imaging allow early diagnosis and are crucial diagnostic tools. Some diseases have typical features based on target populations (e.g., adults versus children, men versus women), but others may have overlapping imaging characteristics. We highlight key diagnostic features and describe appropriate investigations to guide clinicians toward the correct diagnosis and provide support during disease monitoring.
    MeSH term(s) Male ; Child ; Adult ; Humans ; Female ; Ankle/diagnostic imaging ; Arthritis, Rheumatoid ; Arthritis, Juvenile ; Ankle Joint/diagnostic imaging ; Magnetic Resonance Imaging
    Language English
    Publishing date 2023-05-25
    Publishing country United States
    Document type Journal Article
    ZDB-ID 1360919-1
    ISSN 1098-898X ; 1089-7860
    ISSN (online) 1098-898X
    ISSN 1089-7860
    DOI 10.1055/s-0043-1766097
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    Zs.A 4887: Show issues Location:
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