Publications by authors named "Gary J Macfarlane"

Article Synopsis
  • - The research aimed to assess data collection practices for non-musculoskeletal manifestations (NMMs), comorbidities, and safety outcomes in patients with psoriatic arthritis (PsA) and axial spondyloarthritis (axSpA) across 17 European registries, emphasizing the need for international collaboration for better treatment strategies.
  • - A comprehensive survey with over 4,400 questionnaire items examined how 58 defined conditions were recorded in each registry, focusing on recording methods and the ability to link data to national registries.
  • - The study found that while many registries recorded a variety of conditions consistently, Nordic countries showed potential for data linkage but had limited recording practices, while other regions maintained thorough documentation, paving the way
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Article Synopsis
  • The study aimed to evaluate the retention rates and remission outcomes of patients with axial spondyloarthritis (axSpA) and psoriatic arthritis (PsA) who started treatment with secukinumab over 24 and 48 months.
  • Data was collected from 13 European registries, revealing that retention rates were around 51%-64%, and patients with no prior biologic treatments showed better outcomes compared to those with previous treatments.
  • The findings suggest that secukinumab remains effective over four years, with higher success rates in treatment-naïve patients compared to those who had already tried other therapies.
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Evidence linking adverse childhood experiences and chronic pain in adulthood is largely cross-sectional, potentially subject to recall bias and does not allow exploration of mediating pathways. We analysed a large population-based cohort (UK Biobank) using a causal framework, to determine if childhood maltreatment is related to chronic "all over" body pain in adulthood. We used doubly robust estimation with inverse probability weights to estimate the difference in risk of chronic pain "all over" between those exposed/not exposed to childhood maltreatment (abuse or neglect).

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HPV-positive and HPV-negative head and neck squamous cell carcinoma (HNSCC) are recognized as distinct entities. There remains uncertainty surrounding the causal effects of smoking and alcohol on the development of these two cancer types. Here we perform multivariable Mendelian randomization (MR) to evaluate the causal effects of smoking and alcohol on the risk of HPV-positive and HPV-negative HNSCC in 3431 cases and 3469 controls.

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Remote monitoring using electronic patient reported outcomes (ePROs) in axial spondyloarthritis (axSpA) may improve self-management and reduce the need for consultations. However, knowledge regarding patients' willingness to use remote care and adherence to reporting ePROs is scarce. The objective of this study was to assess axSpA patients' willingness to use remote care and adherence to reporting of ePROs.

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Objectives: To compare the treatment effectiveness of secukinumab in radiographic (r) versus non-radiographic (nr) axial spondyloarthritis (axSpA) patients treated in routine care across Europe.

Methods: Prospectively collected data on secukinumab-treated axSpA patients with known radiographic status were pooled from nine countries.Remission rates based on patient-reported outcomes (PROs; Numeric Rating Scale (0-10), for example, pain ≤2/Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) ≤2 and Ankylosing Spondylitis Disease Activity Score (ASDAS) inactive disease (ID) <1.

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The UK Antimicrobial Registry (UKAR) has been developed to capture data on real world usage of antimicrobial agents with an initial focus on those used to treat drug-resistant infections. Several industry partners have committed support for the study, which is included in the National Institute for Health and Care Research (NIHR) portfolio in England with similar arrangements in the three devolved UK nations. The two antimicrobials in the National Institute for Health and Care Excellence (NICE) subscription model pilot (cefiderocol and ceftazidime/avibactam) are included in the UKAR and future expansion of work in this area is planned.

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Every year at the Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA) annual meeting, new project ideas are presented and discussed with a view to obtaining feedback and support. Arising from previous work, a project proposal was presented at the 2023 meeting; the project aims to improve early diagnosis of psoriatic arthritis (PsA) by comparing a physician-based vs a patient questionnaire-based approach. This project has received the backing of the GRAPPA research committee, but additional funding will be required.

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  • The study aimed to determine whether the modified 28-joint disease activity index (DAPSA28) or the 28-joint disease activity score with C-reactive protein (DAS28-CRP) is better for monitoring disease activity in psoriatic arthritis (PsA) when the full joint count is unavailable.
  • Analysis of real-world data from over 3,000 European patients revealed that at the 6-month mark, DAPSA28 provided similar remission rates to DAPSA, but DAS28-CRP showed significantly higher rates of both remission and response.
  • The results suggest that DAPSA28 is preferable to DAS28-CRP when conducting assessments without a full joint count due to the
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Background: Head and neck cancer (HNC) incidence is on the rise, often diagnosed at late stage and associated with poor prognoses. Risk prediction tools have a potential role in prevention and early detection.

Methods: The IARC-ARCAGE European case-control study was used as the model development dataset.

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Chronic pain, defined as persistent or recurring pain or pain lasting longer than 3 months, is a common childhood problem. The objective of this study was to conduct an updated systematic review and meta-analysis on the prevalence of chronic pain (ie, overall, headache, abdominal pain, back pain, musculoskeletal pain, multisite/general pain, and other) in children and adolescents. EMBASE, PubMed, CINAHL, and PsycINFO were searched for publications between January 1, 2009, and June 30, 2023.

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Introduction: Fatigue is an important and distressing symptom for many people living with chronic musculoskeletal (MSK) conditions. Many non-pharmacological interventions have been investigated in recent years and some have been demonstrated to be effective in reducing fatigue and fatigue impact, however, there is limited guidance for clinicians to follow regarding the most appropriate management options. The objective of this scoping review is to understand and map the extent of evidence in relation to the factors that relate to the outcome of non-pharmacological interventions on MSK condition-related fatigue across the lifespan.

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Objective: Ankylosing Spondylitis Disease Activity Score based on C-reactive protein (ASDAS-CRP) is recommended over ASDAS based on erythrocyte sedimentation rate (ASDAS-ESR) to assess disease activity in axial spondyloarthritis (axSpA). Although ASDAS-CRP and ASDAS-ESR are not interchangeable, the same disease activity cut-offs are used for both. We aimed to estimate optimal ASDAS-ESR values corresponding to the established ASDAS-CRP cut-offs (1.

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Article Synopsis
  • The study looked at patients with PsA (psoriatic arthritis) who started a 2nd or 3rd TNFi (a type of medicine) and how many continued taking it after a year.
  • Out of the patients studied, about 68% stayed on their 2nd TNFi and 66% on their 3rd TNFi after a year.
  • The results showed that effectiveness of the new medicine depended on why they stopped taking the previous one, with better outcomes for those who stopped because the first medicine didn’t work as well after some time.
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Objectives: Previous attempts to pool prevalence studies in PsA have failed to take account of important methodological differences between studies which may have created biased estimates. The aim of this review is to estimate the prevalence of PsA within the adult general population worldwide, considering potential differences between population-based and health administrative studies separately.

Methods: Four electronic databases were systematically searched for articles reporting the prevalence of PsA.

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Article Synopsis
  • Researchers looked at studies to find out all the ways chronic pain affects work, not just the usual ones.
  • They found that there are many factors involved, like how people feel at work, their relationships, and what happens outside of work, which means they need a better way to ask about these issues.
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Objectives: In patients with axial spondyloarthritis (axSpA) or psoriatic arthritis (PsA) initiating secukinumab, we aimed to assess and compare the proportion of patients achieving 6-, 12- and 24-month patient-reported outcomes (PRO) remission and the 24-month retention rates.

Patients And Methods: Patients with axSpA or PsA from 16 European registries, who initiated secukinumab in routine care were included. PRO remission rates were defined as pain, fatigue, Patient Global Assessment (PGA) ≤2 (Numeric Rating Scale (NRS) 0-10) and Health Assessment Questionnaire (HAQ) ≤0.

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Background: Patients with chronic inflammatory joint diseases such as axial spondyloarthritis have traditionally received regular follow-up in specialist health care to maintain low disease activity. The follow-up has been organized as prescheduled face-to-face visits, which are time-consuming for both patients and health care professionals. Technology has enabled the remote monitoring of disease activity, allowing patients to self-monitor their disease and contact health care professionals when needed.

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  • The study investigates pain management strategies used by community-dwelling adults in the U.S. and Canada, focusing on the types of treatments and combinations employed, as well as their correlations with individual characteristics and country context.
  • Data from a 2020 online survey with over 4,000 respondents revealed that common pain treatments include over-the-counter medications, living with pain, and exercise, with cannabis being a notable self-reported treatment.
  • Participants were grouped into five clusters based on their treatment preferences, revealing varying reliance on medication, exercise, and self-care, with pain levels being a significant factor in treatment frequency.
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Background: In European axial spondyloarthritis (axSpA) and psoriatic arthritis (PsA) clinical registries, we aimed to investigate commonalities and differences in (1) set-up, clinical data collection; (2) data availability and completeness; and (3) wording, recall period, and scale used for selected patient-reported outcome measures (PROMs).

Methods: Data was obtained as part of the EuroSpA Research Collaboration Network and consisted of (1) an online survey and follow-up interview, (2) upload of real-world data, and (3) selected PROMs included in the online survey.

Results: Fifteen registries participated, contributing 33,948 patients (axSpA: 21,330 (63%), PsA: 12,618 (37%)).

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A growing proportion of head and neck cancer (HNC), especially oropharyngeal cancer (OPC), is caused by human papillomavirus (HPV). There are several markers for HPV-driven HNC, one being HPV early antigen serology. We aimed to investigate the diagnostic accuracy of HPV serology and its performance across patient characteristics.

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  • Walk With Ease (WWE) is a 6-week walking program from the US designed for adults with arthritis, and it can be done either with a teacher or on your own.
  • A study was done to see if WWE would work well in the UK, where it is not very known.
  • Most people liked the program and found it helpful, with many saying they would tell their friends and family about it, showing it could help more people in the UK stay healthy.
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Background: The past decade has seen an explosion of research in causal mediation analysis. However, most analytic tools developed so far rely on frequentist methods which may not be robust in the case of small sample sizes. In this paper, we propose a Bayesian approach for causal mediation analysis based on Bayesian g-formula, which will overcome the limitations of the frequentist methods.

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Article Synopsis
  • The study aimed to identify baseline predictors for remission and drug retention in bio-naïve patients with Psoriatic Arthritis (PsA) starting TNF inhibitors, analyzing data from 13 European registries.
  • In a pooled cohort of 13,369 patients, results showed that 25% achieved remission and 34% had a moderate response at 6 months, while 63% retained their medication at 12 months.
  • Five common baseline predictors, including age, disease duration, sex, CRP levels, and fatigue score, were identified as significant for all three outcomes, suggesting these findings are applicable across different populations.
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