Annette van der Helm-van Mil's research while affiliated with Leiden University Medical Centre and other places

... The prevalence of depression is significantly higher in RA patients as compared to general population; a number of factors are associated with increased risk of depression including RA-specific factors such as patients reported outcomes including level of pain, fatigue, disability, but also disease activity [3]. In addition, inconsistent associations have been found between pro-inflammatory cytokines such as TNF and depression in RA [27]. In our study, 4.98% patients were diagnosed with concomitant depression. ...

... Rheumatoid arthritis (RA) is a chronic inflammatory disease that causes progressive joint destruction if not appropriately treated [1]. However, recent advances in treatment, particularly the advent of biological disease-modifying antirheumatic drugs (bDMARDs) and targeted synthetic DMARDs (tsDMARDs), have made it a feasible therapeutic goal to control joint destruction [2]. RA is prevalent among women aged in their 40s to 50s. ...

... The UA as a population has undoubtedly changed over the years. Patients with UA according to the contemporary definition (neither meeting the 1987 nor 2010 RA criteria and having no other clinical diagnosis) are different compared with the larger group with a conventional UA diagnosis (not meeting the 1987 RA criteria and having no other clinical diagnosis), and risk factors are only partly similar [22]. Consequently, a new paradigm for treating UA is needed, based on the discovery of potential novel therapeutic targets that could in the future lead to better patient stratification and proper clinical trials to determine which treatments work in this UA population. ...

... Though concerns such as a reduced ability to conceive, impaired fertility and erectile dysfunction are raised by the male patients with many autoimmune rheumatic diseases, the data are scarce on pregnancy outcomes when the father is suffering from an inflammatory arthritis (IA). In this issue of Rheumatology, Perez-Garcia et al. have addressed this unmet need in their study describing pregnancy outcomes of partners of men diagnosed with IA [1]. ...

... There are different recognised populations considered at-risk of RA, notably as most recently redefined by a EULAR taskforce. 42 These include seropositive arthralgia, clinically suspected arthralgia (CSA), first degree relatives of RA patients and ACPA+individuals with non-specific MSK symptoms. In Leeds, we chose to recruit the later, as at-risk individuals often initially present to primary care clinicians while CSA requires specialist assessment (ie, secondary care). ...

... У АЦЦП-негативных пациентов с артралгиями при МРТ выявляются признаки субклинического синовита [149]. Обнаружение при МРТ эрозий (ДЧ=68%; ДС=78%), синовитов (ДЧ=91%) и теносиновитов (ДЧ=82%) у пациентов с НДА помогает установить диагноз АЦЦП-негативного РА на ранней стадии [150,151]. По данным МРТ, образование эрозий связано с персистирующим остеитом и не зависит от локального синовита [152]. У негативных и позитивных по АЦЦП пациентов количество синовитов и теносиновитов сопоставимо, но остеиты при АЦЦП-негативном РА встречаются реже и после назначения терапии купируются быстрее, чем при серопозитивном, что подтверждает меньшая активность эрозивного процесса [153,154]. ...

... Herein we found that seropositive patients who received concomitant MTX showed longer TNFi median survival time than those found for patients who were treated without MTX. This result would be in agreement with observations recently published by both Greenwood et al. and van Mulligen et al. (10,23). In addition, we found that the use of concomitant MTX in seropositive patients resulted in a 41% smaller likelihood of discontinuing TNFi therapy when compared with patients who did not receive it. ...

... A costeffectiveness analysis of the trial showed that tapering either the TNFi or the csDMARD first is equally cost-effectivewhile medication costs were significantly lower in patients who tapered their TNFi first, indirect costs were higher due to more productivity loss. 55 56 Evidence on recapturing LDA or remission after treatment reinduction was also confirmed in patients who experienced a flare. 57 Overall, disease activity-guided tapering appeared beneficial compared with stopping DMARDs abruptly. ...

... As an outcome, these individuals have fewer complications and receive earlier and more effective treatments that decrease the progression of the disease and the need for surgical interventions for joint damage. [24][25][26][27] Ensuring attention by the rheumatologist is also related to reducing gaps in inequity. For example, a study conducted in Canada showed 30% less likelihood of being diagnosed in rural populations promptly because of the lack of this specialty. ...

... However, absenteeism and presenteeism were higher leading to higher productivity costs (€25 826 ± €46 289 vs €16 349 ± €38 277 for tapering TNFi first vs tapering csDMARDs first). 55 57 AVERT-2 (conference abstract) investigated early RA patients who received ABA 125 mg weekly+MTX for 52 weeks and achieved SDAI remission (≤3.3) at week 40 and 52. Patients were then randomised to continuation of ABA+MTX; or ABA dose reduction (125 mg Q2W) + MTX for 24 weeks followed by ABA withdrawal (placebo treatment) + MTX for another 24 weeks; or ABA 125 mg weekly and MTX stopping (without withdrawal). ...