Summer publications roundup

Summer publications roundup

The group has continued throughout the summer to maintain a healthy publication record. Here are some of the most recent publication highlights for the months of July-September.

Predictors of extra-articular manifestations in axial spondyloarthritis and their influence on TNFi prescribing patterns

Extra-articular manifestations (EAMs), such as uveitis (eye disease), psoriasis (skin disease), and inflammatory bowel disease, are common features of axial spondyloarthritis (axSpA).  The presence of these conditions may influence the choice of medication for some patients. This paper examines the occurrence of, and factors associated with EAMs among patients with axSpA, and whether they influenced treatment decisions regarding biologic therapy.

We found that 1 in 3 patients with axSpA have at least one EAM – although most commonly, only one.  Patients with uveitis are more likely to be HLA-B27 positive, whereas those with psoriasis and inflammatory bowel disease have lower rates of HLA-B27 positivity than the overall cohort.  The presence of an EAM does not appear to influence the likelihood of being prescribed biologic therapy, although there was some evidence that it does influence choice of specific drug.

Future analysis will determine whether EAMs influence the likelihood of staying on biologic medication and/or whether it protects patients from incident episodes or flares of existing EAMs.

You can read the full article here.

“No one wants to look after the fibro patient”; understanding models and patient perspectives of care for fibromyalgia

Fibromyalgia is a common and complex long-term pain condition. Despite advancements in our understanding and treatment of fibromyalgia, patients report patchy health care provision and frustrating journeys through the health care system. To inform how best to deliver care, this study undertook two narrative reviews examining existing evidence on models of care for fibromyalgia and patients' experiences, preferences, and unmet needs regarding their health care.

For thus study seven databases were systematically searched with quantitative data narratively synthesised and qualitative data thematically analysed. No evidence-based model of care covering the patient journey through the healthcare system was identified. Limited evidence suggests no clear benefit for ongoing care in secondary care settings. Patients with fibromyalgia reported difficult interactions with the healthcare system that might equally be expressed by those with other long-term conditions, such as inconsistent and poorly coordinated care. However, they also face unique problems; fibromyalgia was often not viewed as a real condition, resulting in difficult encounters with healthcare staff such as patients not feeling believed or listened to and significant delays in diagnosis were commonplace. Positive care experiences such as being listened to and shared decision-making made patients feeling better informed, well supported, and more satisfied.

There is little evidence to inform how best to organise health care for patients with fibromyalgia and ensure care is delivered in a coordinated and consistent way. These findings provide a strong rationale for developing a new model of care for fibromyalgia.

You can read the full article here.

Digestive side effects of tapentadol in patients with chronic pain (confidence evaluation in network meta-analysis)

In addition to exploring non-pharmacological strategies in pain, rational prescribing is an important area of research. A confidence evaluation helps to make informed decisions about any results obtained from meta-analyses. This paper uses recently developed techniques to better describe the best way to characterize the (un)certainties about the digestive side effects of tapentadol, an atypical opioid, in patients with chronic pain.

Using an updated search in PubMed/Medline and Web of Science (until March 2020) pairwise meta-analyses were performed using random-effect models and confidence in network meta-analysis (CiNeMA) for the confidence analysis.

The results on the effect of tapentadol compared to other opioids in chronic pain showed possible imprecision, heterogeneity and/or incoherence. However, with a high level of confidence, tapentadol was associated with a lower incidence of constipation than oxycodone. 

You can read the full article here.

Mining whole genome sequence data to efficiently attribute individuals to source populations

Whole genome sequence (WGS) data could transform our ability to attribute individuals to source populations. However, methods that efficiently mine these data are yet to be developed.

This paper presents a computational method (minimal multilocus distance (MMD)), implemented in R, which rapidly deals with these large data sets. The MMD method was applied on WGS data to determine the source of human Campylobacter disease, the geographical origin of diverse biological species including humans and proteomic data to classify breast cancer tumours. The method is generic, easy to use, provides a highly accurate attribution and it is computationally efficient for large genotypes. MMD is relevant for multiple applications in the life sciences, aiming to characterise populations, and where dealing with big genome data represents a real computational challenge.

You can read the full article here.

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