Association Française de Lutte Anti-Rhumastismale

To establish French recommendations for the management of people living with hand osteoarthritis (OA) on behalf of the French Society of Rheumatology (SFR) and of the French Society of Physical and Rehabilitation Medicine (SOFMER). A systematic review of the literature, including systematic reviews, meta-analyses, and randomized controlled trials on pharmacological and non-pharmacological treatments, was conducted from inception until November 24, 2023. Based on this review and expert consensus, a multidisciplinary group of 25 healthcare professionals-including rheumatologists, physical and rehabilitation medicine physicians, hand surgeons, general practitioner, geriatrician, occupational therapists, physiotherapists, and patients-formulated the recommendations. Each statement was assigned a level of evidence, a grade of recommendation, and a level of agreement based on EULAR standardized procedures for recommendations. The group established four general principles and 11 specific recommendations. The general principles emphasize treatment objectives, individualized management, patient education, and a multimodal approach combining non-pharmacological and pharmacological therapies. Four specific recommendations address non-pharmacological strategies, including exercise, ergonomic advice, assistive devices, orthoses and heat applications. The group advises against the use of electromagnetic waves, laser therapy, acupuncture, or kinesiotaping. Seven specific recommendations cover pharmacological treatments, advocating for topical and oral NSAIDs, acetaminophen, chondroitin sulfate for symptom relief, low-dose oral corticosteroids for inflammatory flares, and intra-articular steroid injections for inflammatory painful interphalangeal OA. Given the current data, the group advises against the use of conventional synthetic or biological disease-modifying anti-rheumatic drugs (DMARDs). These recommendations provide a structured approach for the management of people living with hand OA in France, aligning with national healthcare practices and patient needs.

The effect of axial spondyloarthritis (axSpA) on patients' quality of life (QOL) has been well assessed in terms of body structures and functions, but literature is scarce in terms of social interactions and activities, work, and fears related to social interactions or activities.1.

AimTo assess the impact of the COVID-19 pandemic on patients with rheumatic and musculoskeletal diseases (RMDs).MethodsREUMAVID is a cross-sectional study using an online survey developed by an international multidisciplinary patient-led collaboration across seven European countries targeting unselected patients with RMDs. Healthcare access, daily activities, disease activity and function, well-being (WHO Five Well-Being Index (WHO-5)), health status, anxiety/depression (Hospital Anxiety and Depression Scale (HADS)) and access to information were evaluated. Data were collected in April–July 2020 (first phase).ResultsData from the first phase included 1800 patients with 15 different RMDs (37.2% axial spondyloarthritis, 29.2% rheumatoid arthritis, 17.2% osteoarthritis and others). Mean age was 53, 80% female and 49% had undertaken university studies. During the beginning of the pandemic, 58.4% had their rheumatology appointment cancelled and 45.6% reported not having received any information relating to the possible impact of SARS-CoV-2 infection in their RMDs, with the main source being patient organisations (27.6%).Regarding habits, 24.6% increased smoking, 18.2% raised their alcohol consumption, and 45.6% were unable to continue exercising. Self-reported disease activity was high (5.3±2.7) and 75.6% reported elevated pain. Half the patients (49.0%) reported poor well-being (WHO-5) and 46.6% that their health had changed for the worse during lockdown. According to HADS, 57.3% were at risk of anxiety and 45.9% of depression.ConclusionThroughout the first wave of the COVID-19 pandemic, patients with RMDs have experienced disruption in access to healthcare services, poor lifestyle habits and negative effects on their overall health, well-being and mental health. Furthermore, information on COVID-19 has not reached patients appropriately.

Abstract Background Mobile health applications (apps) are increasing in interest for enhancing patient self-management in rheumatology. However, few have been developed with the involvement of patients and health professionals and actually used by patients. Objective To develop and implement a mobile app for safety, self-assessment and medication adherence for patients with inflammatory arthritis treated with disease modifying anti-rheumatic drugs (DMARDs) and assess its real-life use. Methods A mixed qualitative-quantitative study including 42 and 344 patients, respectively, identified patients’ treatment practices and their use of health apps in general and their needs in terms of content and potential use. A multidisciplinary team including 7 rheumatologists, 3 patient association representatives and 4 members of a digital company developed the first version of the app with face-to-face meetings and patient feedback during the process. After the launch of the app, users’ feedback assessment included 7 patients and 3 rheumatologists. The number of app installations, current users, users’ requests and functionalities used were collected. Results Preliminary studies indicated numerous safety issues and needs for counselling, leading to the 6 functionalities of the app HIBOOT (OWL in English): a safety checklist before treatment administration, aid in daily life situations related to self-management and safety, treatment reminders, global well-being self-assessment, periodic counselling messages, and a diary to note comments and appointments. The app is free, with no personal data collection. The presentation is a friendly companion that interacts with the user. The content was based on the French recommendations for DMARD management, drug leaflets and public national health websites. HIBOOT was installed 20,500 times from 2017 to 2020, with 4300 regular current users and still increasing usage curves. The checklist, diary and queries on daily life situations were the most used functionalities. Overall, 18,000 requests were identified for information on safety or other patient matters over a 8-month period in 2020. Scores were 4.4/5 stars at Android and iOS stores. Conclusion HIBOOT is a free app for patients with inflammatory arthritis that was developed with a preliminary qualitative–quantitative study including patients during the process and has scientifically validated content. The number of current users is substantial. Future evaluation of the HIBOOT benefit is needed.

ObjectivesTo 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).MethodsAn 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.Results45 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.ConclusionsA 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.