Hydroxychloroquine: Another Battle Lost in the Campaign to Find Effective Therapies for Hand Osteoarthritis
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Editorials20 March 2018Hydroxychloroquine: Another Battle Lost in the Campaign to Find Effective Therapies for Hand OsteoarthritisElena Losina, PhD and Jeffrey N. Katz, MD, MScElena Losina, PhDBrigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts (E.L., J.N.K.)Search for more papers by this author and Jeffrey N. Katz, MD, MScBrigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts (E.L., J.N.K.)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/M18-0035 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Symptomatic hand osteoarthritis affects 1 in 12 older adults (1) and typically involves the distal and proximal interphalangeal (DIP and PIP) joints and the carpometacarpal joint of the thumb. Symptoms affect a person's ability to perform basic activities of daily living, including eating, cooking, and dressing, as well as more complex occupational and recreational tasks. No therapies modify or arrest the progression of damage to cartilage and bone. Hence, treatment of hand osteoarthritis is focused on symptom relief (2). Patients with symptomatic hand osteoarthritis are typically prescribed acetaminophen, nonsteroidal anti-inflammatory drugs, and—if these agents do not provide sufficient relief—opioids. Identification ...References1. Dillon CF, Hirsch R, Rasch EK, Gu Q. Symptomatic hand osteoarthritis in the United States: prevalence and functional impairment estimates from the third U.S. National Health and Nutrition Examination Survey, 1991-1994. Am J Phys Med Rehabil. 2007;86:12-21. [PMID: 17304684] CrossrefMedlineGoogle Scholar2. Zhang W, Doherty M, Leeb BF, Alekseeva L, Arden NK, Bijlsma JW, et al. EULAR evidence based recommendations for the management of hand osteoarthritis: report of a Task Force of the EULAR Standing Committee for International Clinical Studies Including Therapeutics (ESCISIT). Ann Rheum Dis. 2007;66:377-88. [PMID: 17046965] CrossrefMedlineGoogle Scholar3. Berenbaum F. Osteoarthritis as an inflammatory disease (osteoarthritis is not osteoarthrosis!). Osteoarthritis Cartilage. 2013;21:16-21. [PMID: 23194896] doi:10.1016/j.joca.2012.11.012 CrossrefMedlineGoogle Scholar4. Vlychou M, Koutroumpas A, Malizos K, Sakkas LI. Ultrasonographic evidence of inflammation is frequent in hands of patients with erosive osteoarthritis. Osteoarthritis Cartilage. 2009;17:1283-7. [PMID: 19447214] doi:10.1016/j.joca.2009.04.020 CrossrefMedlineGoogle Scholar5. Mathiessen A, Slatkowsky-Christensen B, Kvien TK, Hammer HB, Haugen IK. Ultrasound-detected inflammation predicts radiographic progression in hand osteoarthritis after 5 years. Ann Rheum Dis. 2016;75:825-30. [PMID: 25834142] doi:10.1136/annrheumdis-2015-207241 CrossrefMedlineGoogle Scholar6. Gaujoux-Viala C, Smolen JS, Landewé R, Dougados M, Kvien TK, Mola EM, et al. Current evidence for the management of rheumatoid arthritis with synthetic disease-modifying antirheumatic drugs: a systematic literature review informing the EULAR recommendations for the management of rheumatoid arthritis. Ann Rheum Dis. 2010;69:1004-9. [PMID: 20447954] doi:10.1136/ard.2009.127225 CrossrefMedlineGoogle Scholar7. Canadian Hydroxychloroquine Study Group. A randomized study of the effect of withdrawing hydroxychloroquine sulfate in systemic lupus erythematosus. N Engl J Med. 1991;324:150-4. [PMID: 1984192] CrossrefMedlineGoogle Scholar8. Kingsbury SR, Tharmanathan P, Keding A, Ronaldson SJ, Grainger A, Wakefield RJ, et al. Hydroxychloroquine effectiveness in reducing symptoms of hand osteoarthritis. A randomized trial. Ann Intern Med. 2018;168:385-95. doi:10.7326/M17-1430 LinkGoogle Scholar9. Punzi L, Bertazzolo N, Pianon M, Michelotto M, Todesco S. Soluble interleukin 2 receptors and treatment with hydroxychloroquine in erosive osteoarthritis [Letter]. J Rheumatol. 1996;23:1477-8. [PMID: 8856633] MedlineGoogle Scholar10. Kortekaas MC, Kwok WY, Reijnierse M, Wolterbeek R, Bøyesen P, van der Heijde D, et al. Magnetic resonance imaging in hand osteoarthritis: intraobserver reliability and criterion validity for clinical and structural characteristics. J Rheumatol. 2015;42:1224-30. [PMID: 25979715] doi:10.3899/jrheum.140338 CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts (E.L., J.N.K.)Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M18-0035.Corresponding Author: Elena Losina, PhD, Policy Innovation eValuations in Orthopedic Treatments (PIVOT) Center, Department of Orthopaedic Surgery, Brigham and Women's Hospital, 60 Fenwood Road, BTM 5-016, Boston, MA 02115; e-mail, [email protected]harvard.edu.Current Author Addresses: Drs. Losina and Katz: Policy Innovation eValuations in Orthopedic Treatments (PIVOT) Center, Department of Orthopaedic Surgery, Brigham and Women's Hospital, 60 Fenwood Road, BTM 5-016, Boston, MA 02115.This article was published at Annals.org on 20 February 2018. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoHydroxychloroquine Effectiveness in Reducing Symptoms of Hand Osteoarthritis Sarah R. Kingsbury , Puvan Tharmanathan , Ada Keding , Sarah J. Ronaldson , Andrew Grainger , Richard J. Wakefield , Catherine Arundel , Fraser Birrell , Michael Doherty , Tonia Vincent , Fiona E. Watt , Krysia Dziedzic , Terence W. O'Neill , Nigel K. Arden , David L. Scott , John Dickson , Toby Garrood , Michael Green , Ajit Menon , Tom Sheeran , David Torgerson , and Philip G. Conaghan Metrics 20 March 2018Volume 168, Issue 6Page: 442-443KeywordsDrugsHydroxychloroquineInflammationMagnetic resonance imagingOrthopedicsOsteoarthritisPathogenesisPhenotypesRheumatoid arthritisUltrasound imaging ePublished: 20 February 2018 Issue Published: 20 March 2018 Copyright & PermissionsCopyright © 2018 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,006 | 0,026 |
| Méta-épidémiologie (sens strict) | 0,002 | 0,001 |
| Méta-épidémiologie (sens large) | 0,002 | 0,002 |
| Bibliométrie | 0,004 | 0,001 |
| Études des sciences et des technologies | 0,002 | 0,002 |
| Communication savante | 0,006 | 0,005 |
| Science ouverte | 0,002 | 0,001 |
| Intégrité de la recherche | 0,008 | 0,009 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,042 | 0,023 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».