Publications by authors named "Harald Vonkeman"

Objectives: To evaluate the experiences of patients with spondyloarthritis (SpA) and their healthcare providers (HCPs) with patient-initiated follow-up (PIFU) supported by asynchronous telemedicine (TM) compared with their previous experiences with usual care, and to identify prerequisites for sustainable implementation of PIFU/TM.

Methods: Individual, semi-structured interviews were conducted with purposefully selected patients (n = 21) and HCPs (n = 9) who previously participated in the 'TeleSpA' randomised controlled trial and thematically analysed. PIFU/TM consisted of a once-yearly pre-planned physical visit with in-between remote monitoring at 6 months.

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Background: With rising health-care expenditures and workforce shortages, sustainable alternatives to traditional outpatient follow-up strategies are required to optimise care efficiency. We aimed to investigate the cost-effectiveness and clinical effectiveness of patient-initiated follow-up (PIFU) supported by asynchronous telemedicine for patients with spondyloarthritis compared with usual care in daily practice.

Methods: TeleSpA was a multicentre, pragmatic, open-label, randomised controlled trial.

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Insight into the daily life experiences of patients with post-COVID-19 syndrome is lacking. The current study explored temporal fluctuations of and associations between positive and negative affect and symptoms throughout the day in previously hospitalised post-COVID-19 patients using an experience sampling methodology. Ten participants (age: median = 60, interquartile range = 9 years; 50% women; 80% ≥1 comorbidity; 8-12 months since hospital discharge) filled out brief online questionnaires, six times a day for 14 consecutive days.

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Article Synopsis
  • Many COVID-19 survivors experience long-lasting impacts on their health-related quality of life (HRQoL), particularly after hospitalization, with distinct patterns of recovery observed over a year.
  • The study followed 500 patients and identified three physical HRQoL trajectories ('stable high', 'improving', 'stable low') and four mental HRQoL trajectories ('stable high', 'improving', 'middle declining', 'low').
  • Factors like age, obesity, and education level were linked to lower HRQoL, highlighting the need for ongoing assessments and interventions for those affected.
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Objectives: Central pain mechanisms may be prominent in a considerable subset of rheumatology patients with persistent pain. Several self-report instruments have been used in previous research to infer the presence and severity of central sensitization (CS) that stem from different definitions or approaches of CS. The current study aimed to evaluate and quantify the overlap of actual symptoms measured among self-report measures of CS in rheumatology.

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Objectives: To compare inflammatory and structural differences in active Psoriatic Arthritis (PsA) between disease-modifying antirheumatic drug (DMARD)-naive and DMARD-failure patients using diverse imaging approaches for future analyses. Additionally, to explore the influence of patient characteristics (clinical and demographic variables) on imaging findings.

Methods: Of the 80 patients included from the first cohort of the ongoing multicentre TOFA-PREDICT trial, 40 were DMARD-naive and 40 were DMARD-failure (csDMARD failure; 1 prior bDMARD excluding etanercept was allowed), all meeting classification criteria for PsA with a minimum disease duration of eight weeks.

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Background: We aimed to describe the burden of adverse drug reactions (ADRs) reported by patients participating in the Dutch ADR Monitor using a multifactorial burden measurement instrument.

Methods: The Dutch ADR Monitor is a cohort event monitoring system that collects information on ADR experiences, including burden. This study includes the initial data (November 2022 until May 2023).

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Background: There is a lack of knowledge on patient perspectives on adverse drug reactions (ADRs) attributed to the use of biologics. The aim of this study is to quantify the burden over time of ADRs attributed to TNF-α inhibitors in patients with inflammatory rheumatic diseases (IRDs) and investigate whether the burden over time differs between different types of ADRs.

Research Design And Methods: Data were used from the Dutch Biologic Monitor (DBM), an observational prospective cohort study for patient-reported ADRs attributed to biologics.

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Objectives: To determine whether patient reported outcome measures (PROMs) capturing activity limitations, health impact, pain, fatigue and work ability are responsive and sensitive to changes in disease activity status in patients with early and established rheumatoid arthritis (RA).

Methods: All early RA patients (n = 557) from the tREACH-trial and established RA patients (n = 188) from the TARA-trial were included. Both studies were multicentre, single-blinded trials with a treat-to-target management approach.

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Background: Patients with psoriatic arthritis (PsA) have an increased risk of cardiovascular disease, possibly due to a chronic inflammatory state.

Objectives: The main objective of this study was to investigate the difference in vascular inflammation, measured with 18-fluorodeoxyglucose positron emission tomography/CT (PET/CT), in PsA patients and controls. We conducted a secondary analysis to assess the association between clinical parameters of disease activity with vascular inflammation in PsA.

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Objective: Understanding preferences of patients with rheumatoid arthritis (RA) can facilitate tailored patient-centric care. This study elicited trade-offs that patients with RA were willing to make during treatment selection.

Methods: Patients with RA completed an online discrete choice experiment, consisting of a series of choices between hypothetical treatments.

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Introduction: Generalized pain hypersensitivity is a characteristic feature in many different types of chronic pain. Recently, a 7-item self-reported Generalized Pain Questionnaire (GPQ) was developed to evaluate the presence and severity of generalized pain hypersensitivity in chronic pain patients. Here, we evaluate the test-retest reliability of the GPQ and report on preliminary reference values for various patient groups and healthy subjects.

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Objective: To investigate which factors are associated with treatment intensification (TI) in axial spondylarthritis (axSpA) patients with high disease activity (HDA).

Methods: Patients with axSpA and HDA (Ankylosing Spondylitis Disease Activity Score [ASDAS]≥2.1) from the Dutch SpA-Net registry were included.

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Objective: A high discrepancy between the number of tender and swollen joints (e.g. ΔTSJ ≥ 7) has previously been used as an indication for the presence of changes in central mechanisms in patients with moderate-to-high disease activity.

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Introduction: There is a need for more extensive information about adverse drug reactions (ADRs) for patients than currently available, including information on the course of ADRs. Aspects characterising the course of ADRs from the patient perspective have not been identified before.

Objective: We aimed to develop a framework based on common themes in the course of ADRs identified from patient descriptions in patient-reported ADRs.

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To assess the effect of pharmacotherapeutic interventions commonly employed in the management of COVID-19 hospitalized patients on the development of post-COVID-19 syndrome. This study employed two distinct databases, the Medisch Spectrum Twente (MST) clinical database comprising electronic health records of COVID-19 patients hospitalized at MST, and the Post-COVID cohort database which contains follow-up information on the same patients. These databases were integrated to establish the potential relationship between the administration of corticosteroids, antibiotics, or anticoagulants during hospitalization and the occurrence of post-COVID-19 syndrome after a 6-month interval following discharge.

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Objective: To explore residual disease, defined as substantial symptoms and disease burden despite a remission or low disease activity (LDA) state, in patients with axial spondyloarthritis (axSpA), and to determine which factors are associated with residual disease.

Methods: For this cross-sectional observational study, 1 timepoint per patient was used from SpA-Net, a web-based monitoring registry for SpA. Patients with an Ankylosing Spondylitis Disease Activity Score (ASDAS) < 2.

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Background: Fatigue is a common problem in immune-mediated inflammatory disease (IMID) patients, significantly impacting their quality of life.

Objectives: In this study, we describe the pattern and characteristics of fatigue as a patient-reported adverse drug reaction (ADR) of biologics, and compared patient and treatment characteristics with patients reporting other ADRs or no ADRs.

Methods: In this cohort event monitoring study, the description and characteristics of fatigue reported as a possible ADR in the Dutch Biologic Monitor were assessed and analysed for commonly recurring themes or patterns.

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Background: Several patient characteristics may be of influence on treatment pathways of rheumatoid arthritis (RA) patients in clinical practice. The aim of this study is to analyze treatment pathways of early RA patients stratified for gender and adverse drug reaction (ADR) occurrence.

Research Design And Methods: Treatment pathways of patients included in the DREAM-RA treat-to-target cohort I between 16th of July 2006-30th of April 2020 were assessed.

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Objective: The aim of this study was to explore the longitudinal associations between health literacy profiles and disease activity and medication prescription in patients with RA.

Methods: Patients with RA who previously completed the Health Literacy Questionnaire (HLQ) and were assigned 1 of 10 distinct health literacy profiles based on cluster analysis were further aggregated into three groups: 'several health literacy limitations', 'some health literacy limitations' and 'good health literacy'. Linear mixed modelling (LMM) was used to analyse the association between health literacy groups and disease activity over the course of 1 year.

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Introduction: During the COVID-19 pandemic, an accelerated uptake of remote monitoring strategies, replacing traditional face-to-face care, has been observed. However, data on the effects of remote care interventions for patients with rheumatic and musculoskeletal diseases remain scarce and interpretation is hampered by study heterogeneity and research quality concerns. High-quality evidence is required to guide future implementation in clinical practice, with health economic analyses identified as an important knowledge gap.

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Article Synopsis
  • A study examined sex differences in adverse drug reactions (ADRs) reported by patients with inflammatory rheumatic diseases, focusing on those using etanercept or adalimumab.
  • A total of 748 patients participated, revealing that 55% of women reported at least one ADR compared to 38% of men, with significant differences in the types of ADRs reported.
  • While women reported more injection site reactions, the overall burden of ADRs was similar between sexes, highlighting important considerations for clinical counseling and ADR investigations.
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Article Synopsis
  • This study compares adverse drug reactions (ADRs) and treatment discontinuation rates between adalimumab (ADA) and etanercept (ETN) in real-world rheumatoid arthritis (RA) patients over a period from 2003 to 2020.
  • It analyzes data from 416 patients, finding that 22.1% experienced ADRs, with ADA having a higher rate of discontinuation compared to ETN over time.
  • The results indicate that while both drugs have ADRs as a significant reason for stopping treatment, ETN shows better long-term drug survival than ADA, particularly at the 2-, 5-, and 10-year marks.
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Article Synopsis
  • The study aimed to evaluate the effects and safety of switching from the brand adalimumab (Humira®) to the biosimilar Amgevita® in rheumatoid arthritis patients, focusing on disease activity, quality of life, and patient satisfaction over time.
  • Researchers conducted a retrospective analysis of 52 RA patients over one year to monitor their disease activity and well-being before and after the switch, finding no significant changes in health outcomes.
  • Overall, most patients reported satisfaction with the switch, and only a small percentage (7.9%) stopped the biosimilar due to side effects, suggesting that the transition was safe and effective for patients.
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