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  1. Article ; Online: Pain in autoimmune inflammatory myopathies: a scoping review.

    Leclair, Valérie / Tsui, Harmony / Hudson, Marie

    RMD open

    2023  Volume 9, Issue 1

    Abstract: Background: Pain is considered a priority for research by adult patients with autoimmune inflammatory myopathy (AIM) and their families. Our aim was to review the literature for studies reporting on pain in adult AIM and to summarise their findings.: ... ...

    Abstract Background: Pain is considered a priority for research by adult patients with autoimmune inflammatory myopathy (AIM) and their families. Our aim was to review the literature for studies reporting on pain in adult AIM and to summarise their findings.
    Methods: A scoping review was conducted searching for studies in PubMed and MEDLINE including more than five adult patients with AIM and assessing pain using a patient-reported outcome measure. Study population characteristics, pain measurement and clinical correlates of pain were extracted using a standardised protocol.
    Results: The search strategy identified 2831 studies with 33 meeting inclusion criteria. Most studies used visual analogue scales (n=14) and/or the Medical Outcomes Study 36-Item Short Form Bodily Pain Scale (n=17). Frequency of pain and/or myalgias ranged from 64% to 100%. Subjects with AIM had significantly more pain than the general population and comparable pain to other chronic rheumatic diseases. Insufficient results were available to identify significant clinical correlates of pain in AIM.
    Conclusion: This review suggests that the burden of pain in AIM is considerable. Still, due to the heterogeneity and low quality of the evidence, significant knowledge gaps persist. Studies are needed to characterise pain trajectories of patients with AIM.
    MeSH term(s) Adult ; Humans ; Pain/etiology ; Myositis/complications ; Autoimmune Diseases
    Language English
    Publishing date 2023-01-10
    Publishing country England
    Document type Journal Article ; Review
    ZDB-ID 2812592-7
    ISSN 2056-5933 ; 2056-5933
    ISSN (online) 2056-5933
    ISSN 2056-5933
    DOI 10.1136/rmdopen-2022-002591
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Treatment of Vascular Complications in Systemic Sclerosis: What Is the Best Approach to Diagnosis and Management of Renal Crisis and Digital Ulcers?

    Hughes, Michael / Herrick, Ariane L / Hudson, Marie

    Rheumatic diseases clinics of North America

    2022  Volume 49, Issue 2, Page(s) 263–277

    Abstract: Vasculopathy as exemplified by scleroderma renal crisis (SRC) and digital ulcers (DUs) is a cardinal feature of systemic sclerosis (SSc) and is associated with significant morbidity, including in patients with early disease. Prompt recognition and ... ...

    Abstract Vasculopathy as exemplified by scleroderma renal crisis (SRC) and digital ulcers (DUs) is a cardinal feature of systemic sclerosis (SSc) and is associated with significant morbidity, including in patients with early disease. Prompt recognition and management is required to alleviate potentially irreversible damage from SSc-associated vasculopathy. Both SRC and DUs share many etiopathogenic drivers which inform the therapeutic strategy. The aim of our review was to describe the diagnosis and management of SRC and DUs in SSc, and to discuss unmet needs for future research.
    MeSH term(s) Humans ; Skin Ulcer/diagnosis ; Skin Ulcer/etiology ; Skin Ulcer/therapy ; Fingers/blood supply ; Fingers/pathology ; Scleroderma, Systemic/complications ; Scleroderma, Systemic/diagnosis ; Scleroderma, Systemic/therapy ; Vascular Diseases/diagnosis ; Vascular Diseases/etiology ; Vascular Diseases/therapy
    Language English
    Publishing date 2022-07-16
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 92118-x
    ISSN 1558-3163 ; 0889-857X
    ISSN (online) 1558-3163
    ISSN 0889-857X
    DOI 10.1016/j.rdc.2023.01.004
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  3. Article ; Online: Scleroderma renal crisis.

    Hudson, Marie

    Current opinion in rheumatology

    2015  Volume 27, Issue 6, Page(s) 549–554

    Abstract: Purpose of review: There are important knowledge gaps concerning scleroderma renal crisis (SRC), in large part because its rarity has hampered research. Many studies to date share limitations, in particular small samples, prevalent cases, and ... ...

    Abstract Purpose of review: There are important knowledge gaps concerning scleroderma renal crisis (SRC), in large part because its rarity has hampered research. Many studies to date share limitations, in particular small samples, prevalent cases, and retrospective study designs. This review features some of the most recent studies that attempt to shed new insights into SRC while trying to overcome those limitations.
    Recent findings: The most important recent progress in the understanding of the pathophysiology of SRC includes identification of novel genetic and serological biomarkers. Outcomes of SRC remain poor and there are also ongoing efforts to identify novel therapeutic strategies, in particular targeting the endothelin-1 pathway.
    Summary: Meaningful improvement in outcomes of SRC will be predicated on greater understanding of the underlying mechanisms of disease and identification of novel therapeutic and preventive strategies. Some efforts are ongoing but ultimately, international cooperation will be necessary to achieve this for a rare complication of a rare disease.
    MeSH term(s) Endothelin-1/metabolism ; Humans ; Kidney Diseases/diagnosis ; Kidney Diseases/etiology ; Kidney Diseases/physiopathology ; Kidney Diseases/therapy ; Risk Factors ; Scleroderma, Systemic/diagnosis ; Scleroderma, Systemic/etiology ; Scleroderma, Systemic/physiopathology ; Scleroderma, Systemic/therapy
    Chemical Substances Endothelin-1
    Language English
    Publishing date 2015-11
    Publishing country United States
    Document type Journal Article ; Research Support, Non-U.S. Gov't ; Review
    ZDB-ID 1045317-9
    ISSN 1531-6963 ; 1040-8711
    ISSN (online) 1531-6963
    ISSN 1040-8711
    DOI 10.1097/BOR.0000000000000221
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  4. Article ; Online: Allopurinol and Cardiovascular Events: Time-Related Biases in Observational Studies.

    Suissa, Samy / Suissa, Karine / Hudson, Marie

    Arthritis care & research

    2022  Volume 74, Issue 5, Page(s) 858–865

    Abstract: Objective: Several observational studies reported that allopurinol, an effective treatment for gout, was associated with important reductions in cardiovascular (CV) events, with calls for large, randomized trials, although some results were conflicting. ...

    Abstract Objective: Several observational studies reported that allopurinol, an effective treatment for gout, was associated with important reductions in cardiovascular (CV) events, with calls for large, randomized trials, although some results were conflicting. The present study was undertaken to assess the extent of time-related biases in these observational studies.
    Methods: We searched the literature for all observational studies reporting on allopurinol and CV events, focusing on 2 time-related biases. Time-related confounding bias results from studies using cohorts of patients all exposed to allopurinol, with comparisons based on episodes of allopurinol discontinuation, where confounding factors are not updated over follow-up time. Immortal time bias arises from the exposure misclassification of periods of cohort follow-up during which the outcome under study cannot occur.
    Results: We identified 12 studies, of which 8 were affected by time-related confounding bias or immortal time bias, while the remaining 4 studies avoided these biases. The studies affected by time-related confounding bias resulted in significant reductions in the incidence of CV events with allopurinol use (pooled hazard ratio [HR] 0.88 [95% confidence interval (95% CI) 0.85-0.92]), as did the studies affected by immortal time bias (pooled HR 0.79 [95% CI 0.72-0.87]). The 4 studies that avoided these biases resulted in a pooled HR of 1.07 (95% CI 0.91-1.25).
    Conclusion: Observational studies reporting significantly reduced incidence of CV events with allopurinol use were affected by time-related biases. Overall, studies that avoided these biases did not find a protective effect. The ALL-HEART randomized trial will provide important and accurate evidence on the potential effectiveness of allopurinol on CV outcomes.
    MeSH term(s) Allopurinol/adverse effects ; Bias ; Cardiovascular Diseases/diagnosis ; Cardiovascular Diseases/epidemiology ; Cardiovascular Diseases/prevention & control ; Gout/complications ; Gout/drug therapy ; Gout/epidemiology ; Gout Suppressants/adverse effects ; Humans ; Observational Studies as Topic
    Chemical Substances Gout Suppressants ; Allopurinol (63CZ7GJN5I)
    Language English
    Publishing date 2022-03-03
    Publishing country United States
    Document type Journal Article
    ZDB-ID 645059-3
    ISSN 2151-4658 ; 0893-7524 ; 2151-464X
    ISSN (online) 2151-4658
    ISSN 0893-7524 ; 2151-464X
    DOI 10.1002/acr.24713
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  5. Article ; Online: Glucosamine and lower mortality and cancer incidence: Selection bias in the observational studies.

    Suissa, Karine / Hudson, Marie / Suissa, Samy

    Pharmacoepidemiology and drug safety

    2022  Volume 31, Issue 12, Page(s) 1272–1279

    Abstract: Background: Glucosamine is a widely used supplement to treat joint pain and osteoarthritis despite inconclusive randomized trial results on its effectiveness. In contrast, observational studies associate glucosamine with significant reductions in ... ...

    Abstract Background: Glucosamine is a widely used supplement to treat joint pain and osteoarthritis despite inconclusive randomized trial results on its effectiveness. In contrast, observational studies associate glucosamine with significant reductions in mortality and cancer incidence. We evaluated the extent of bias, particularly selection bias, to explain these surprising beneficial effects.
    Methods: We searched the literature to identify all observational studies reporting on the effect of glucosamine use on major outcomes.
    Results: We identified 11 observational studies, reporting a mean 16% reduction in all-cause mortality (hazard ratio [HR] 0.84, 95% CI: 0.81-0.87) with glucosamine use, as well as significant reductions in cancer incidence and other major diseases including cardiovascular, respiratory and diabetes. We show that these significant effects can result from selection bias due to collider stratification, as all studies used "prevalent" cohorts, where glucosamine use started before cohort entry, and where subjects agreed to join the cohorts. Our illustration of the bias using the UK Biobank publication involving a half-million subjects shows how a true rate ratio of mortality of 1.0 in the population can result in a biased rate ratio of 0.82 in the prevalent cohort.
    Conclusions: The observational studies reporting significant reductions in mortality, cancer incidence and other outcomes with glucosamine were affected by selection bias from collider stratification. In the absence of properly conducted observational studies that circumvent this bias by considering "new users", the studies to date cannot support the prescription of this supplement as a preventive measure for mortality, cancer, and other chronic diseases.
    MeSH term(s) Humans ; Glucosamine/therapeutic use ; Selection Bias ; Bias ; Cohort Studies ; Neoplasms/epidemiology
    Chemical Substances Glucosamine (N08U5BOQ1K)
    Language English
    Publishing date 2022-09-09
    Publishing country England
    Document type Journal Article
    ZDB-ID 1099748-9
    ISSN 1099-1557 ; 1053-8569
    ISSN (online) 1099-1557
    ISSN 1053-8569
    DOI 10.1002/pds.5535
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    Zs.A 3395: Show issues Location:
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  6. Article ; Online: Effectiveness of Allopurinol in Reducing Mortality: Time-Related Biases in Observational Studies.

    Suissa, Samy / Suissa, Karine / Hudson, Marie

    Arthritis & rheumatology (Hoboken, N.J.)

    2021  Volume 73, Issue 9, Page(s) 1749–1757

    Abstract: Objective: The treatment of gout with allopurinol is effective at reducing urate levels and the frequency of flares. Several observational studies have shown important reductions in mortality with allopurinol use, with wide variations in results. We ... ...

    Abstract Objective: The treatment of gout with allopurinol is effective at reducing urate levels and the frequency of flares. Several observational studies have shown important reductions in mortality with allopurinol use, with wide variations in results. We undertook this review to assess the extent of bias in these studies, particularly time-related biases such as immortal time bias.
    Methods: We searched the literature to identify all observational studies describing the effect of allopurinol use versus nonuse on all-cause mortality.
    Results: We identified 12 observational studies, of which 3 were affected by immortal time bias and 3 by immeasurable time bias, while the remaining 6 studies avoided these time-related biases. Reductions in all-cause mortality with allopurinol use were observed among the studies with immortal time bias, with a pooled hazard ratio (HR) of death associated with allopurinol of 0.71 (95% confidence interval [95% CI] 0.50-1.01), as well as in those with immeasurable time bias (pooled HR 0.62 [95% CI 0.56-0.67]). The 6 studies that avoided these biases demonstrated a null effect of allopurinol on mortality (pooled HR 0.99 [95% CI 0.87-1.11]), though the lack of an analysis based on treatment adherence may have attenuated the effect.
    Conclusion: Observational studies are important to provide real-world data on medication effects. The observational studies showing significantly decreased mortality with allopurinol treatment cannot be used as evidence, however, mainly due to time-related biases that tend to greatly exaggerate the potential benefit of treatments. The ALL-HEART randomized trial, which is currently underway and evaluates the effect of adding allopurinol to usual care (compared to no added treatment), will provide reliable evidence on mortality.
    MeSH term(s) Allopurinol/therapeutic use ; Bias ; Cause of Death ; Gout/blood ; Gout/drug therapy ; Gout Suppressants/therapeutic use ; Humans ; Hyperuricemia/blood ; Hyperuricemia/drug therapy ; Mortality ; Observational Studies as Topic ; Proportional Hazards Models ; Time Factors ; Uric Acid/blood
    Chemical Substances Gout Suppressants ; Uric Acid (268B43MJ25) ; Allopurinol (63CZ7GJN5I)
    Language English
    Publishing date 2021-07-27
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 2756371-6
    ISSN 2326-5205 ; 2326-5191
    ISSN (online) 2326-5205
    ISSN 2326-5191
    DOI 10.1002/art.41710
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  7. Article ; Online: Screening and management of subclinical interstitial lung disease in systemic sclerosis: an international survey.

    Hoa, Sabrina / Baron, Murray / Hudson, Marie

    Rheumatology (Oxford, England)

    2021  Volume 61, Issue 8, Page(s) 3401–3407

    Abstract: Objective: Interstitial lung disease (ILD) is the leading cause of mortality in SSc. Experts now recommend high-resolution CT (HRCT) screening in all SSc patients and treatment of subclinical ILD in SSc patients with high-risk phenotypes. We undertook ... ...

    Abstract Objective: Interstitial lung disease (ILD) is the leading cause of mortality in SSc. Experts now recommend high-resolution CT (HRCT) screening in all SSc patients and treatment of subclinical ILD in SSc patients with high-risk phenotypes. We undertook an international survey to understand current screening and treatment practices in subclinical SSc-ILD.
    Methods: An electronic REDCap survey was distributed to 611 general rheumatologists, 348 national and international SSc experts, 285 general respirologists and 57 ILD experts.
    Results: One hundred and ninety-eight participants responded to the survey, including 135 (68%) rheumatologists and 54 (27%) respirologists. Over half (59%) of respondents routinely ordered HRCTs in all newly diagnosed SSc patients, although this practice was more common in Europe (83%), the USA (68%), Asia (73%) and Latin America (100%) compared with Canada (40%) and Australia (40%). Nearly half (48%) of respondents would not treat subclinical SSc-ILD, whereas 52% would treat or consider treatment. At least 70% would likely treat subclinical ILD in the setting of diffuse SSc, anti-topoisomerase-I autoantibodies, disease duration below 18 months, ground-glass opacities, oxygen desaturation, or significant ILD progression on imaging or pulmonary function tests. The majority (67%) of respirologists would not treat subclinical ILD. MMF was the preferred first-line drug for the treatment of subclinical SSc-ILD.
    Conclusion: This international survey highlights important regional variations in SSc-ILD screening and significant heterogeneity among rheumatologists and respirologists in the treatment of subclinical SSc-ILD. High-quality research addressing these questions is needed to produce evidence-based guidelines and harmonize the approach to identification and treatment of subclinical SSc-ILD.
    MeSH term(s) Autoantibodies ; Humans ; Lung ; Lung Diseases, Interstitial/diagnosis ; Lung Diseases, Interstitial/drug therapy ; Lung Diseases, Interstitial/etiology ; Respiratory Function Tests/adverse effects ; Scleroderma, Systemic ; Surveys and Questionnaires
    Chemical Substances Autoantibodies
    Language English
    Publishing date 2021-12-13
    Publishing country England
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 1464822-2
    ISSN 1462-0332 ; 1462-0324
    ISSN (online) 1462-0332
    ISSN 1462-0324
    DOI 10.1093/rheumatology/keab929
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  8. Article ; Online: Occupation as a gendered-role and outcome in systemic sclerosis.

    Alkhamees, Fatema / Hoi Yun Yu, Oriana / Wang, Mianbo / Hudson, Marie

    Journal of scleroderma and related disorders

    2022  Volume 8, Issue 2, Page(s) 131–136

    Abstract: Objective: Sex and gender are of growing scientific interest in disease onset and course. While sex differences have been shown to exist in systemic sclerosis, there is a paucity of data on gender. Our objective was to examine the association between ... ...

    Abstract Objective: Sex and gender are of growing scientific interest in disease onset and course. While sex differences have been shown to exist in systemic sclerosis, there is a paucity of data on gender. Our objective was to examine the association between occupation, a gender-related role and outcomes in systemic sclerosis.
    Methods: An occupation score ranging from 0 to 100, with lower scores representing occupations traditionally held by men and higher scores traditionally held by women, was constructed using the National Occupational Classification 2016 and data from Statistics Canada. Subjects in the Canadian Scleroderma Research Group registry were assigned an occupation score based on self-reported occupation. Multivariate models, adjusted for sex, age, smoking and education were used to estimate the independent effect of occupation score on systemic sclerosis outcomes.
    Results: We included 1104 subjects, of which 961 were females (87%) and 143 (13%) males. There were differences between females versus males: disease duration (9.9 vs 7.6 years,
    Conclusion: We did not find independent associations between an occupation score, a gender-related role and outcomes in systemic sclerosis. These results should be interpreted with caution as occupation may be a poor measure of gender. Future research using a validated measure of gender will be needed to generate robust data on the effect of gender in systemic sclerosis.
    Language English
    Publishing date 2022-12-19
    Publishing country England
    Document type Journal Article
    ISSN 2397-1991
    ISSN (online) 2397-1991
    DOI 10.1177/23971983221143599
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  9. Article ; Online: Scleroderma renal crisis.

    Hudson, Marie / Ghossein, Cybele / Steen, Virginia

    Presse medicale (Paris, France : 1983)

    2021  Volume 50, Issue 1, Page(s) 104063

    Abstract: Scleroderma renal crisis (SRC) is a rare but life-threatening complication of systemic sclerosis (SSc) characterized by malignant hypertension and acute kidney injury. Historically, SRC was the leading cause of death in SSc. However, with the advent of ... ...

    Abstract Scleroderma renal crisis (SRC) is a rare but life-threatening complication of systemic sclerosis (SSc) characterized by malignant hypertension and acute kidney injury. Historically, SRC was the leading cause of death in SSc. However, with the advent of angiotensin converting enzyme (ACE) inhibitors, mortality rates have decreased significantly. Nevertheless, one-year outcomes remain poor, with over 30% mortality and 25% of patients remaining dialysis-dependent. There is an urgent need to improve early recognition and treatment, and to identify novel treatments to improve outcomes of SRC. In this chapter, the clinical features, classification, pathophysiology, differential diagnosis, management and outcomes of SRC are presented. Specific issues relating to pregnancy, prophylactic ACE inhibition and management of essential hypertension are also discussed.
    MeSH term(s) Acute Kidney Injury/etiology ; Acute Kidney Injury/mortality ; Acute Kidney Injury/pathology ; Acute Kidney Injury/therapy ; Angiotensin-Converting Enzyme Inhibitors/therapeutic use ; Diagnosis, Differential ; Female ; Humans ; Hypertension, Malignant/etiology ; Hypertension, Malignant/mortality ; Hypertension, Malignant/pathology ; Hypertension, Malignant/therapy ; Pregnancy ; Pregnancy Complications/etiology ; Renal Dialysis ; Scleroderma, Systemic/complications
    Chemical Substances Angiotensin-Converting Enzyme Inhibitors
    Language English
    Publishing date 2021-02-03
    Publishing country France
    Document type Journal Article ; Review
    ZDB-ID 120943-7
    ISSN 2213-0276 ; 0032-7867 ; 0755-4982 ; 0301-1518
    ISSN (online) 2213-0276
    ISSN 0032-7867 ; 0755-4982 ; 0301-1518
    DOI 10.1016/j.lpm.2021.104063
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  10. Article ; Online: Reply.

    Suissa, Samy / Suissa, Karine / Hudson, Marie

    Arthritis & rheumatology (Hoboken, N.J.)

    2021  Volume 73, Issue 12, Page(s) 2349

    Language English
    Publishing date 2021-10-28
    Publishing country United States
    Document type Letter ; Comment
    ZDB-ID 2756371-6
    ISSN 2326-5205 ; 2326-5191
    ISSN (online) 2326-5205
    ISSN 2326-5191
    DOI 10.1002/art.41884
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