Showing papers by "Olivier Bruyère published in 2023"

Sarcopenia and health‐related quality of life: A systematic review and meta‐analysis

Abstract: The decrease of physical abilities and functional decline that can be caused by musculoskeletal conditions such as sarcopenia, can lead to higher levels of dependency and disability. Therefore, it may influence patient reported outcome measures (PROM), such as the health‐related quality of life (HRQoL). The purpose of this systematic review and meta‐analysis is to provide a comprehensive overview of the relationship between sarcopenia and HRQoL. Preferred Reporting Items for Systematic Reviews and Meta‐Analyses (PRISMA) were followed throughout the whole process of this work. A protocol was previously published on PROSPERO. The electronic databases MEDLINE, Scopus, Allied and Complementary Medicine (AMED), EMB Review – ACP Journal Club, EBM Review ‐ Cochrane Central of Register of Controlled Trials and APA PsychInfo were searched until October 2022 for observational studies reporting a HRQoL assessment in both sarcopenic and non‐sarcopenic individuals. Study selection and data extraction were carried out by two independent researchers. Meta‐analysis was performed using a random effect model, reporting an overall standardized mean difference (SMD) and its 95% confidence interval (CI) between sarcopenic and non‐sarcopenic individuals. Study quality was measured using the Newcastle‐Ottawa Scale and the strength of evidence was assessed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) tool. The search strategy identified 3725 references from which 43 observational studies were eligible and included in this meta‐synthesis study. A significantly lower HRQoL was observed for sarcopenic individuals compared with non‐sarcopenic ones (SMD −0.76; 95% CI −0.95; −0.57). Significant heterogeneity was associated with the model (I2 = 93%, Q test P‐value <0.01). Subgroup analysis showed a higher effect size when using the specific questionnaire SarQoL compared with generic questionnaires (SMD −1.09; 95% CI −1.44; −0.74 with the SarQoL versus −0.49; 95% CI −0.63; −0.36 with generic tools; P‐value for interaction <0.01). A greater difference of HRQoL between sarcopenic and non‐sarcopenic was found for individuals residing in care homes compared with community‐dwelling individuals (P‐value for interaction <0.001). No differences were found between age groups, diagnostic techniques, and continents/regions. The level of evidence was rated as moderate using the GRADE assessment. This systematic review and meta‐analysis combining 43 observational studies shows that HRQoL is significantly reduced in sarcopenic patients. The use of disease‐specific HRQoL instruments may better discriminate sarcopenic patients with respect to their quality of life.

Conversion to belatacept after lung transplantation: Report of 10 cases

Abstract: Background Calcineurin inhibitors (CNIs) remain the cornerstone of maintenance immunosuppression (IS) after lung transplantation (LTx), although CNI-related life-threatening toxic effects may occur. Belatacept, a novel immunosuppressant that blocks a T-cell co-stimulation pathway, is a non-nephrotoxic drug indicated as an alternative to CNIs in kidney Tx. In LTx, there are only a few reports of belatacept conversion as a CNI-free or CNI-sparing IS treatment. Methods We reviewed a series of 10 LTx recipients with conversion to a CNI-free belatacept IS regimen within the first year post-LTx (n = 7) or a belatacept/low-dose CNI combination after the first year (n = 3). Results Use of belatacept was triggered by severe renal failure in 9 patients and under-IS with previous other IS-related toxicities in 1 patient. Mean estimated glomerular filtration rate after starting belatacept significantly improved at 6 months after initiation and at the last-follow-up (p = 0.006, and p = 0.002 respectively). The incidence of recurrent and/or severe acute cellular rejection (ACR) episodes was high in patients with CNI-free belatacept-based IS (n = 4/7). Chronic graft allograft dysfunction developed in 2 of 9 recipients under belatacept IS. Belatacept was stopped in 6 patients because of recurrent/severe ACR (n = 3), recurrent opportunistic infections (n = 1), center modified policy (n = 1), or other cause (n = 1). Conclusion Early conversion to CNI-free belatacept-based IS improved renal function in this series but was counterbalanced by a high incidence of recurrent ACR, including life-threatening episodes. Other studies are needed to better determine the indications for its use after LTx, possibly with lower immunological risk IS regimens, such as CNI-sparing belatacept.

Sarcopenia is associated with a greater risk of polypharmacy and number of medications: a systematic review and meta‐analysis

Abstract: Polypharmacy in older adults is associated with multiple negative consequences that may affect muscular function, independently from the presence of medical conditions. The aim of this systematic review and meta‐analysis was to investigate the association of sarcopenia with polypharmacy and higher number of medications. A systematic literature search of observational studies using PubMed, Web of Science, Scopus and Cochrane Library databases was conducted from inception until June 2022. To determine if sarcopenia is associated with a higher risk of polypharmacy and increased number of medications, a meta‐analysis using a random‐effects model was used to calculate the pooled effects (CRD42022337539). Twenty‐nine studies were included in the systematic review and meta‐analysis. Sarcopenia was associated with a higher prevalence of polypharmacy (odds ratio [OR]: 1.65, 95% confidence interval [CI] [1.23, 2.20], I2 = 84%, P < 0.01) and higher number of medications (mean difference: 1.39, 95% CI [0.59, 2.19], I2 = 95%, P < 0.01) compared with individuals without sarcopenia. Using meta‐regression, a high variance was observed due to different populations (i.e., community‐dwelling, nursing home residents, inpatients, outpatients) for both outcomes of polypharmacy (r = −0.338, SE = 0.1669, 95% CI [−0.67, −0.01], z = −2.03, P = 0.04) and number of medications (r = 0.589, SE = 0.2615, 95% CI [0.08, 1.10], z = 2.25, P = 0.02). This systematic review and meta‐analysis reported a significantly increased risk of polypharmacy and higher number of medications in people with sarcopenia compared with individuals without this condition. Future research should clarify whether the specificity and number of medications is a direct contributor in accelerating the progression of muscle wasting and dysfunction contributing to sarcopenia in older adults.

Recent sarcopenia definitions—prevalence, agreement and mortality associations among men: Findings from population‐based cohorts

Abstract: The 2019 European Working Group on Sarcopenia in Older People (EWGSOP2) and the Sarcopenia Definitions and Outcomes Consortium (SDOC) have recently proposed sarcopenia definitions. However, comparisons of the performance of these approaches in terms of thresholds employed, concordance in individuals and prediction of important health‐related outcomes such as death are limited. We addressed this in a large multinational assembly of cohort studies that included information on lean mass, muscle strength, physical performance and health outcomes.

Systematic Review of the Key Factors Influencing the Indoor Airborne Spread of SARS-CoV-2

Abstract: The COVID-19 pandemic due to the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) has been plaguing the world since late 2019/early 2020 and has changed the way we function as a society, halting both economic and social activities worldwide. Classrooms, offices, restaurants, public transport, and other enclosed spaces that typically gather large groups of people indoors, and are considered focal points for the spread of the virus. For society to be able to go “back to normal”, it is crucial to keep these places open and functioning. An understanding of the transmission modes occurring in these contexts is essential to set up effective infection control strategies. This understanding was made using a systematic review, according to the Preferred Reporting Items for Systematic reviews and Meta-Analyses statement (PRISMA) 2020 guidelines. We analyze the different parameters influencing airborne transmission indoors, the mathematical models proposed to understand it, and discuss how we can act on these parameters. Methods to judge infection risks through the analysis of the indoor air quality are described. Various mitigation measures are listed, and their efficiency, feasibility, and acceptability are ranked by a panel of experts in the field. Thus, effective ventilation procedures controlled by CO2-monitoring, continued mask wearing, and a strategic control of room occupancy, among other measures, are put forth to enable a safe return to these essential places.

Comment on: The Effect of Intra-articular Hyaluronic Acid Injections and Payer Coverage on Total Knee Arthroplasty Procedures: Evidence From Large US Claims Database

Abstract: We read with great interest the article recently published in your journal, entitled “The Effect of Intra-articular Hyaluronic Acid Injections and Payer Coverage on Total Knee Arthroplasty Procedures: Evidence From Large US Claims Database”. [[1]Molloy I.B. Holte A.J. Zhao Y. Parker D.J. Werth P.M. Jevsevar D.S. The Effect of intra-articular hyaluronic acid injections and payer coverage on total knee arthroplasty procedures: evidence from large US Claims Database.Arthroplasty Today. 2023; 19: 101080Abstract Full Text Full Text PDF Scopus (0) Google Scholar] Even if the interest in intra-articular hyaluronic acid in the treatment of knee osteoarthritis (OA) is of clinical importance, we sincerely believe this work presents some important limitations. The first important limitation is that no idea of the severity of knee OA [[2]Veronese N. Honvo G. Bruyère O. Rizzoli R. Barbagallo M. Maggi S. et al.Knee osteoarthritis and adverse health outcomes: an umbrella review of meta-analyses of observational studies.Aging Clin Exp Res. 2022; 35: 245-252Crossref Scopus (1) Google Scholar], at the time of diagnosis or when the Intraarticular Hyaluronic Acid (IAHA) administrations were initiated, was reported. On the contrary, several guidelines based on high-quality articles, clearly reported that IAHA should be recommended only as a second-line treatment, that is, for patients who do not respond to background therapy with symptomatic slow-acting drug for OA or to Non Steroidal Anti-Inflammatory Drugs. [[3]Bruyère O. Honvo G. Veronese N. Arden N.K. Branco J. Curtis E.M. et al.An updated algorithm recommendation for the management of knee osteoarthritis from the European Society for clinical and Economic aspects of Osteoporosis, Osteoarthritis and Musculoskeletal Diseases (ESCEO).Semin Arthritis Rheum. 2019; 49: 337-350Crossref PubMed Scopus (260) Google Scholar,[4]Bannuru R.R. Osani M. Vaysbrot E. et al.OARSI guidelines for the non-surgical management of knee, hip, and polyarticular osteoarthritis.Osteoarthritis Cartilage. 2019; 27: 1578-1589Abstract Full Text Full Text PDF PubMed Scopus (1191) Google Scholar] In other words, the patients included in the study of Molloy et al. [[1]Molloy I.B. Holte A.J. Zhao Y. Parker D.J. Werth P.M. Jevsevar D.S. The Effect of intra-articular hyaluronic acid injections and payer coverage on total knee arthroplasty procedures: evidence from large US Claims Database.Arthroplasty Today. 2023; 19: 101080Abstract Full Text Full Text PDF Scopus (0) Google Scholar] might have a greater level of severity than people who might be handled by nonpharmacological approaches or with a background treatment. Therefore, it seems quite obvious that those patients have a higher rate of total knee arthroplasty or a quicker need for total knee arthroplasty, finally leading to an important selection bias. Moreover, since these authors used administrative data, they were not able to differentiate important characteristics of the IAHA, namely the number of injections, the molecular weight of hyaluronic acid, and/or the number of injections that, on the contrary, play a significant role in the benefits that we can obtain from the IAHA. [[5]Bannuru R.R. Vaysbrot E.E. Sullivan M.C. McAlindon T.E. Relative efficacy of hyaluronic acid in comparison with NSAIDs for knee osteoarthritis: a systematic review and meta-analysis.Semin Arthritis Rheum. 2014; 43: 593-599Crossref PubMed Scopus (131) Google Scholar,[6]Veronese N. Cooper C. Bruyère O. et al.Multimodal multidisciplinary management of patients with moderate to severe pain in knee osteoarthritis: a need to meet patient expectations.Drugs. 2022; 82: 1347-1355Crossref Scopus (5) Google Scholar] Other important flaws in the study of Molloy et al. [[1]Molloy I.B. Holte A.J. Zhao Y. Parker D.J. Werth P.M. Jevsevar D.S. The Effect of intra-articular hyaluronic acid injections and payer coverage on total knee arthroplasty procedures: evidence from large US Claims Database.Arthroplasty Today. 2023; 19: 101080Abstract Full Text Full Text PDF Scopus (0) Google Scholar] are the limited consideration of important potential confounders, including pain severity, quality of life, or disability that, on the contrary, may affect the response to IAHA [[7]Bowman E.N. Hallock J.D. Throckmorton T.W. Azar F.M. Hyaluronic acid injections for osteoarthritis of the knee: predictors of successful treatment.Int Orthop. 2018; 42: 733-740Crossref PubMed Scopus (37) Google Scholar]. Finally, we would like to take into consideration a recent commentary stating that seven published reviews representing more than 65,200 patients have confirmed the efficacy of IAHA. [[8]Spitzer A.I. Bert J.M. Compliance with the AAOS guidelines for treatment of osteoarthritis of the knee: a survey of the American association of hip and knee surgeons.J Am Acad Orthop Surg. 2018; 26: e358-e359Crossref PubMed Scopus (0) Google Scholar] In conclusion, even if we thank Molloy et al. [[1]Molloy I.B. Holte A.J. Zhao Y. Parker D.J. Werth P.M. Jevsevar D.S. The Effect of intra-articular hyaluronic acid injections and payer coverage on total knee arthroplasty procedures: evidence from large US Claims Database.Arthroplasty Today. 2023; 19: 101080Abstract Full Text Full Text PDF Scopus (0) Google Scholar] for their contribution, we believe that their findings should be considered very cautiously since several important biases are present and since these data are not representative of the entire population affected by knee OA, which probably requires a step by step approach, based on a tailored therapy that includes the use of IAHA in some cases in which oral therapy failed. N. Veronese reports personal fees from IBSA, Mylan, Viatris, Fidia, MSD; J. Y. Reginster was consultant with IBSA France and received a fee for speech from IBSA Italy; O. Bruyère reports consulting or lecture fees from Amgen, Aptissen, Biophytis, IBSA, Mylan, Novartis, Orifarm, Sanofi, UCB and Viatris; F. Pegreffi did not report any conflict of interest for this work. For full disclosure statements refer to https://doi.org/10.1016/j.artd.2023.101128. Download .pdf (.11 MB) Help with pdf files Conflict of Interest Statement for Pegreffi Download .pdf (.06 MB) Help with pdf files Conflict of Interest Statement for Veronese Download .pdf (.06 MB) Help with pdf files Conflict of Interest Statement for Bruyère Download .pdf (.2 MB) Help with pdf files Conflict of Interest Statement for Reginster Patient-optimizing enhanced recovery pathways for total knee and hip arthroplasty in Medicare patients: implication for transition to ambulatory surgery centersArthroplasty TodayVol. 5Issue 4PreviewMedicare-insured patients may be candidates for outpatient total knee and hip arthroplasty (TKA/THA) because postsurgical complications are often age unrelated. We evaluated an opioid-minimizing enhanced recovery after surgery (ERAS) pathway in an inpatient setting designed to presurgically optimize and prepare patients to reduce risk of avoidable postsurgical complications and maximize feasibility of same-day discharge. Full-Text PDF Open AccessComment on: The Effect of Intra-articular Hyaluronic Acid Injections and Payer Coverage on Total Knee Arthroplasty Procedures: Evidence From Large U.S. Claims DatabaseArthroplasty TodayVol. 21PreviewWe appreciate the response from Pegreffi et al. (F. Pegreffi et al., unpublished data) to the article “The Effect of Intra-articular Hyaluronic Acid Injections and Payer Coverage on Total Knee Arthroplasty Procedures: Evidence From Large U.S. Claims Database.” We agree there are several limitations associated with the use of administrative data, as stated within the article and noted by Pegreffi et al. We are unable to comment on noncoded factors that may influence the utilization of viscosupplementation, including severity of the disease, previous nonoperative management, the patient mindset toward treatment, and the operative provider’s practice model. Full-Text PDF Open Access

Developing a Video Game as an Awareness and Research Tool Based on SARS-CoV-2 Epidemiological Dynamics and Motivational Perspectives

Abstract: In mid-2020, the University of Liège (ULiège, Belgium) commissioned the ULiège Video Game Research Laboratory (Liège Game Lab) and the AR/VR Lab of the HEC-Management School of ULiège to create a serious game to raise awareness of preventive measures for its university community. This project has its origins in two objectives of the institutional policy of ULiège in response to the crisis caused by SARS-CoV-2 to raise awareness among community members of various preventive actions that can reduce the spread of the virus and to inform about the emergence and progression of a pandemic. After almost two years of design, the project resulted in the creation of SARS Wars, a decision-making management game for browsers and smartphones. This article presents the creative process of the game, specifically the integration of an adapted SEIR (susceptible-exposed-infectious-recovered) model, as well as the modeling of intercompartmental circulation dynamics in the game’s algorithm, and the various limitations observed regarding the game’s original missions and possibilities for future work. The SARS-CoV-2 video game project may be considered an innovative way to translate epidemiology into a language that can be used in the scope of citizen sciences. On the one hand, it provides an engaging tool and encourages active participation of the audience. On the other hand, it allows us to have a better understanding of the dynamic changes of a pandemic or an epidemic (crisis preparedness, monitoring, and control) and to anticipate potential consequences in the given parameters at set time (emerging risk identification), while offering insights for impact on some parameters on motivation (social science aspect).

Systems prediction of chronic lung allograft dysfunction: Results and perspectives from the Cohort of Lung Transplantation and Systems prediction of Chronic Lung Allograft Dysfunction cohorts

Abstract: Background Chronic lung allograft dysfunction (CLAD) is the leading cause of poor long-term survival after lung transplantation (LT). Systems prediction of Chronic Lung Allograft Dysfunction (SysCLAD) aimed to predict CLAD. Methods To predict CLAD, we investigated the clinicome of patients with LT; the exposome through assessment of airway microbiota in bronchoalveolar lavage cells and air pollution studies; the immunome with works on activation of dendritic cells, the role of T cells to promote the secretion of matrix metalloproteinase-9, and subpopulations of T and B cells; genome polymorphisms; blood transcriptome; plasma proteome studies and assessment of MSK1 expression. Results Clinicome: the best multivariate logistic regression analysis model for early-onset CLAD in 422 LT eligible patients generated a ROC curve with an area under the curve of 0.77. Exposome: chronic exposure to air pollutants appears deleterious on lung function levels in LT recipients (LTRs), might be modified by macrolides, and increases mortality. Our findings established a link between the lung microbial ecosystem, human lung function, and clinical stability post-transplant. Immunome: a decreased expression of CLEC1A in human lung transplants is predictive of the development of chronic rejection and associated with a higher level of interleukin 17A; Immune cells support airway remodeling through the production of plasma MMP-9 levels, a potential predictive biomarker of CLAD. Blood CD9-expressing B cells appear to favor the maintenance of long-term stable graft function and are a potential new predictive biomarker of BOS-free survival. An early increase of blood CD4 + CD57 + ILT2+ T cells after LT may be associated with CLAD onset. Genome: Donor Club cell secretory protein G38A polymorphism is associated with a decreased risk of severe primary graft dysfunction after LT. Transcriptome: blood POU class 2 associating factor 1, T-cell leukemia/lymphoma domain, and B cell lymphocytes, were validated as predictive biomarkers of CLAD phenotypes more than 6 months before diagnosis. Proteome: blood A2MG is an independent predictor of CLAD, and MSK1 kinase overexpression is either a marker or a potential therapeutic target in CLAD. Conclusion Systems prediction of Chronic Lung Allograft Dysfunction generated multiple fingerprints that enabled the development of predictors of CLAD. These results open the way to the integration of these fingerprints into a predictive handprint.

[Physical activity in nursing homes: contributions of the SENIOR cohort].

Abstract: The SENIOR ("Sample of Elderly Nursing homes Individuals: an Observational Research") study is a prospective follow-up of a cohort of more than 600 people living in nursing homes in Belgium. One of the objectives of this study is to investigate ways of managing frailty in order to prevent the occurrence of adverse health events. Thanks to the numerous demographic, clinical and anamnestic data collected annually, this study has shown the importance of promoting qualitative physical activity in nursing homes in order to improve the quality of life of residents. Specifically, our research showed the positive effect of physical activity programmes on weekly energy expenditure and improvement of functional abilities, motivation to engage in physical activity and quality of life. Furthermore, the possibilities to improve the motivational context of group physical activity sessions and the feasibility of innovative physical activity programmes, based on the development of a giant play mat or the organisation of competitions in nursing homes, were highlighted.

Efficacy of osteoporosis pharmacological treatments in men: a systematic review and meta-analysis.

Abstract: The objective of this systematic review and meta-analysis is to systematically identify and review the efficacy of pharmacological treatments in men with osteoporosis.Medline (via Ovid) and Cochrane CENTRAL were searched up to May 2023 for any randomized controlled trial (RCT) evaluating the efficacy of osteoporotic treatment on the evolution of Bone Mineral Density (BMD) and incidence of fractures of men suffering from primary osteoporosis. If at least two studies used the same pharmacological treatment and evaluated the same outcome, a random effect model meta-analysis was applied to reported pooled mean difference (MD) and 95% confidence interval (CI).From the 1,061 studies identified through bibliographic search, 21 RCTs fitted the inclusion criteria. Bisphosphonates (k = 10, n = 2992 men with osteoporosis) improved all three BMD sites compared to placebo; lumbar spine: MD + 4.75% (95% CI 3.45, 6.05); total hip: MD + 2.72% (95% CI 2.06; 3.37); femoral neck: MD + 2.26% (95% CI 1.67; 2.85). Denososumab (k = 2, n = 242), Teriparatide (k = 2, n = 309) and Abaloparatide (k = 2, n = 248) also produced significant improvement of all sites BMD compared to placebo. Romosozumab was only identified in one study and was therefore not meta-analysed. In this study, Romosozumab increased significantly BMD compared to placebo. Incident fractures were reported in 16 RCTs but only four reported fractures as the primary outcome. Treatments were associated with a lower incidence of fractures.Medications used in the management of osteoporosis in women appear to provide similar benefits in men with osteoporosis. Therefore, the algorithm for the management of osteoporosis in men could be similar to the one previously recommended for the management of osteoporosis in women.

Measuring health-related quality of life in sarcopenia: summary of the SarQoL psychometric properties

Abstract: Patient perspectives are now widely recognized as a key element in the evaluation of health interventions. Therefore, the provision of specific and validated Patient Reported Outcome Measures that emphasize the lived experience of patients suffering from specific diseases is very important. In the field of sarcopenia, the only validated specific health-related quality of life (HRQoL) instrument available is the Sarcopenia Quality of Life questionnaire (SarQoL). This self-administrated HRQoL questionnaire, developed in 2015, consists of 55 items arranged into 22 questions and has currently been translated into 35 languages. Nineteen validation studies performed on SarQoL have consensually confirmed the capacity of SarQoL to detect difference in HRQoL between older people with and without sarcopenia, its reliability and its validity. Two further observational studies have also indicated its responsiveness to change. A short form SarQoL, including only 14 items has further been developed and validated to reduce the potential burden of administration. Research on the psychometric properties of SarQoL questionnaire is still encouraged as the responsiveness to change of SarQoL has not yet been measured in the context of interventional studies, as limited prospective data currently exist and as there is still not cut-off score to define a low HRQoL. In addition, SarQoL has mainly been used in community-dwelling older individuals with sarcopenia and would benefit to be studied in other types of populations. This review aims to provide to researchers, clinicians, regulators, pharmaceutical industries and other stakeholders a clear summary of comprehensive evidence on the SarQoL questionnaire published up to January 2023Query.

Results of Lung Transplantation for Cystic Fibrosis With Selected Donors Over 65 Years Old

Abstract: Lung transplantation is limited by the shortage of suitable donors. Many programs have begun to use extended criteria donors. Donors over 65 years old are rarely reported, especially for young cystic fibrosis recipients. This monocentric study was conducted for cystic fibrosis recipients from January 2005 to December 2019, comparing two cohorts according to lung donor age (<65 years or ≥65 years). The primary objective was to assess the survival rate at 3 years using a Cox multivariable model. Of the 356 lung recipients, 326 had donors under 65 years, and 30 had donors over 65 years. Donors’ characteristics did not differ significantly in terms of sex, time on mechanical ventilation before retrieval, and partial pressure of arterial oxygen/fraction of inspired oxygen ratio. There were no significant differences in post-operative mechanical ventilation duration and incidence of grade 3 primary graft dysfunction between the two groups. At 1, 3, and 5 years, the percentage of predicted forced expiratory volume in 1 s (p = 0.767) and survival rate did not differ between groups (p = 0.924). The use of lungs from donors over 65 years for cystic fibrosis recipients allows extension of the donor pool without compromising results. Longer follow-up is needed to assess the long-term effects of this practice. Graphical Abstract

Impact of COVID-19 Vaccination on Short-Term Perceived Change in Physical Performance among Elite Athletes: An International Survey

Abstract: COVID-19 vaccination raised concerns about its potential effects on physical performance. To assess the impact of COVID-19 vaccination on the perceived change in physical performance, we conducted an online survey among elite athletes from Belgium, Canada, France and Luxembourg, with questions about socio-demographics, COVID-19 vaccination, perceived impact on physical performance and perceived pressure to get vaccinated. Full vaccination was defined as two doses of mRNA or vector vaccine or a heterologous vaccine scheme. Among 1106 eligible athletes contacted, 306 athletes answered the survey and were included in this study. Of these, 72% perceived no change in their physical performance, 4% an improvement and 24% a negative impact following full COVID-19 vaccination. For 82% of the included athletes, the duration of the negative vaccine reactions was ≤3 days. After adjustment for potential confounding variables, practicing an individual sport, a duration of vaccine reactions longer than 3 days, a high level of vaccine reaction and the perceived pressure to get vaccinated were independently associated with a perceived negative impact on physical performance of more than 3 days after the vaccination. The perceived pressure to get vaccinated appears to be a parameter associated with the negative perceived change in the physical performance and deserves further consideration.

Health Technology Assessment of Different Glucosamine Formulations and Preparations Currently Marketed in Thailand

Abstract: Objective: The aim of this study was to evaluate the cost-effectiveness of different glucosamine formulations and preparations used for the management of osteoarthritis in Thailand compared with placebo. Methods: We used a validated model to simulate the individual patient Utility score from aggregated data available from 10 different clinical trials. We then used the Utility score to calculate the quality-adjusted life year (QALY) over 3 and 6 months treatment period. We used the public costs of glucosamine products available in Thailand in 2019 to calculate the incremental cost-effectiveness ratio. We separated the analyses for prescription-grade crystalline glucosamine sulfate (pCGS) and other formulations of glucosamine. A cost-effectiveness cut-off of 3.260 USD/QALY was considered. Results: Irrespective of the glucosamine preparation (tablet or powder/capsule), the data show that pCGS is cost-effective compared with placebo over a 3 and 6 months. However, the other glucosamine formulations (e.g., glucosamine hydrochloride) never reached the breakeven point at any time. Conclusions: Our data show that pCGS is cost-effective for the management of osteoarthritis in the Thai context while other glucosamine formulations are not.

An update on the use of conventional and biological disease-modifying anti-rheumatic drugs in hand osteoarthritis

Abstract: Osteoarthritis (OA) is a highly prevalent condition worldwide associated with pain, progressive disability, reduced participation in social activities, and impaired quality of life. Despite its growing burden, the therapeutic options are still limited and almost exclusively addressed to symptoms’ management, while no disease-modifying OA drugs able to prevent or retard disease progression are actually available. For these reasons, in the last decades, relevant efforts to find new potential therapeutic targets in OA have been made and a number of existing conventional and biological disease-modifying anti-rheumatic drugs (DMARDs), including hydroxychloroquine (HCQ), methotrexate (MTX), tumor necrosis factor (TNF)-α, interleukin (IL)-1, and IL-6 inhibitors, commonly used to treat inflammatory rheumatic diseases, have been repurposed for the treatment of OA and explored also in hand osteoarthritis (HOA). The current narrative review was aimed to provide a comprehensive and updated understanding of the possibilities and the criticisms related to the treatment of HOA with conventional and biological DMARDs. Unfortunately, therapy with conventional and biologic drugs in HOA has not achieved the expected success, despite a rationale for their use exists. Thus, our findings outline the urgent need to enhance the exploration of HOA basic molecular mechanisms to find new potential therapeutic targets, personalized for each patient, and appropriate for the different subsets of HOA and for the different phases of disease.

Real-world evidence: new opportunities for osteoporosis research. Recommendations from a Working Group from the European Society for Clinical and Economic Aspects of Osteoporosis, Osteoarthritis and Musculoskeletal Diseases (ESCEO).

Abstract: This narrative review summarises the recommendations of a Working Group of the European Society for Clinical and Economic Aspects of Osteoporosis, Osteoarthritis and Musculoskeletal Diseases (ESCEO) for the conduct and reporting of real-world evidence studies with a focus on osteoporosis research.Vast amounts of data are routinely generated at every healthcare contact and activity, and there is increasing recognition that these real-world data can be analysed to generate scientific evidence. Real-world evidence (RWE) is increasingly used to delineate the natural history of disease, assess real-life drug effectiveness, understand adverse events and in health economic analysis. The aim of this work was to understand the benefits and limitations of this type of data and outline approaches to ensure that transparent and high-quality evidence is generated.A ESCEO Working Group was convened in December 2022 to discuss the applicability of RWE to osteoporosis research and approaches to best practice.This narrative review summarises the agreed recommendations for the conduct and reporting of RWE studies with a focus on osteoporosis research.It is imperative that research using real-world data is conducted to the highest standards with close attention to limitations and biases of these data, and with transparency at all stages of study design, data acquisition and curation, analysis and reporting to increase the trustworthiness of RWE study findings.