Publications by authors named "Philip Conaghan"

Background: Midfoot pain is common but poorly understood, with radiographs often indicating no anomalies. This study aimed to describe bone, joint and soft tissue changes and to explore associations between MRI-detected abnormalities and clinical symptoms (pain and disability) in a group of adults with midfoot pain, but who were radiographically negative for osteoarthritis.

Methods: Community-based participants with midfoot pain underwent an MRI scan of one foot and scored semi-quantitatively using the Foot OsteoArthritis MRI Score (FOAMRIS).

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Introduction: Persistent knee pain often due to knee osteoarthritis (OA) is a highly prevalent and disabling condition. Electronic-rehabilitation (e-rehab) programmes have the potential to support self-management of knee OA. This study aimed to evaluate user engagement and acceptability of two e-rehab programmes, Group e-rehab, a remote physiotherapy-led programme and My Knee UK, a self-directed web-based exercise programme.

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Objectives: Explore a newly defined composite measure of symptom progression for knee osteoarthritis (KOA) in a large, randomized study of a potential disease-modifying osteoarthritis drug (DMOAD).

Design: Using longitudinal KOA studies, a potential composite endpoint of time to symptom progression was defined as the first occurrence of worsening of Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) Pain of ≥10 points with no improvement (≤9 point decrease) in WOMAC Function (0-100 scale). A post hoc analysis explored discrimination and association with structural outcomes in the sprifermin FORWARD trial through Years 3 and 5.

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Objective: Neuroimaging investigations are critical to provide a more direct assessment of brain disturbances associated with osteoarthritis (OA)-related pain, and to better understand its pathophysiology to develop new treatment strategies. This viewpoint aims to summarize the importance of the brain in OA pain.

Method: A European working group on pain in osteoarthritis GO-PAIN (Going Inside Osteoarthritis-related Pain Phenotyping) has been created to work on a global assessment of the OA-related pain.

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Objective: To propose a new definition for SLEDAI arthritis informed by imaging.

Methods: We performed a planned secondary analysis of observational data from a multicentre study evaluating SLE patients with inflammatory joint pain (swelling not required) using various clinical instruments, laboratory tests and ultrasound. For SLEDAI arthritis, assessors (blinded to ultrasound) were asked which of the glossary terms for arthritis in any version of the SLEDAI drove their decision to score for arthritis.

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Background: Certain groups are commonly under-served by health research due to exclusionary models of research design/delivery. Working in partnership with under-served groups is key to improving inclusion. This project aimed to explore the use of a knowledge mobilisation approach to start building partnerships with under-served groups based on trust and mutual understanding.

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Background: The EULAR recommendations for the treatment of systemic sclerosis (SSc) were updated in 2017, informed by a systematic literature review (SLR) completed in 2014.

Objectives: The aim of this new SLR was to provide the most up-to-date literature to underpin contemporary EULAR recommendations for the management of SSc.

Methods: 30 searches for 30 interventions (including several outcomes/clinical questions), and 1 dedicated search (with several interventions) for calcinosis were prioritised by the task force.

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Background: There is considerable diversity in arthroplasty follow-up pathways. This qualitative study aimed to understand healthcare professionals' practice and attitude to follow-up, their motivation for change and what evidence they considered before implementing new pathways.

Methods: The main UKSAFE study enroled 38 centres providing revision procedures across the United Kingdom.

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Background And Objective: Using graph theory, Electronic Health Records (EHRs) can be represented graphically to exploit the relational dependencies of the multiple information formats to improve Machine Learning (ML) prediction models. In this systematic qualitative review, we explore the question: How are graphs used on EHRs, to predict diagnosis and health outcomes?

Methodology: The search strategy identified studies that used patient-level graph representations of EHRs to utilise ML to predict health outcomes and diagnoses. We conducted our search on MEDLINE, Web of Science and Scopus.

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Introduction: The growing prevalence and lack of effective pain therapies for knee osteoarthritis (KOA) results in a substantial unmet need for novel analgesic therapies. The transient receptor potential vanilloid 1 (TRPV1) receptor is expressed in subsets of nociceptive sensory neurons and has major roles in pain transmission and regulation. In the structures of the knee joint, nociceptors are present in abundance.

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Background: Corticosteroids are among the few effective treatments for knee osteoarthritis, but short duration of action limits their utility. EP-104IAR, a long-acting formulation of fluticasone propionate for intra-articular injection, optimises the action of fluticasone propionate through novel diffusion-based extended-release technology. The SPRINGBOARD trial assessed the efficacy, safety, and pharmacokinetics of EP-104IAR in people with knee osteoarthritis.

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Article Synopsis
  • A team updated the 2017 EULAR treatment recommendations for systemic sclerosis (SSc) to include new evidence and therapy options.
  • They conducted a systematic literature review and developed 22 recommendations across 8 clinical areas, focusing mainly on skin fibrosis and interstitial lung disease (ILD).
  • The updated guidelines now suggest new treatments like mycophenolate mofetil and rituximab and emphasize a research agenda for future therapies targeting various aspects of SSc.
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  • A study investigated the potential benefits of methotrexate, an antirheumatic drug, in treating knee osteoarthritis (KOA) pain through a multicenter, double-blind, placebo-controlled trial involving 207 participants.
  • Participants were randomly assigned to receive either methotrexate or a placebo for 12 months while continuing their usual pain relief medications, with a primary focus on assessing average knee pain at 6 months.
  • Results indicated that the methotrexate group experienced a significant decrease in knee pain compared to the placebo group, suggesting methotrexate may provide symptomatic relief for KOA.
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Objective: Limited data exist on the natural history of shoulder symptoms. We aimed to describe longitudinal patterns of shoulder symptoms and determine risk factors for incidence and persistence.

Methods: Data from Osteoarthritis Initiative participants observed annually for four years were used to describe shoulder symptom (yes/no, side) incidence and prevalence using descriptive analyses.

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Introduction: People living with a painful distal upper limb musculoskeletal disorder (DUL-MSD) often experience pain, difficulty in doing everyday tasks and a reduced quality of life. Currently, there are challenges in the treatment of DUL-MSDs, highlighting the need to develop innovative approaches to rehabilitation. A potential solution is to develop and implement a digital self-management rehabilitation programme focussing on optimising recovery, improving function and reducing pain.

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Establishing clinically meaningful changes in pain experiences remains important for clinical trials of chronic pain treatments. Regulatory guidance and pain measurement initiatives have recommended including patient-reported global assessment measures (eg, Patient-Global Impression of Change [PGIC]) to aid interpretation of within-patient differences in domain-specific clinical trial outcomes (eg, pain intensity). The objectives of this systematic review were to determine the frequency of global assessment measures inclusion, types of measures, domains assessed, number and types of response options, and how measures were analyzed.

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Background: Long-term health conditions can affect labour market outcomes. COVID-19 may have increased labour market inequalities, e.g.

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Background: Osteophytes are commonly used to diagnose and guide knee osteoarthritis (OA) treatment, but their causes are unclear. Although they are not typically the focus of knee arthroplasty surgeons, they can predict case difficulty and length. Furthermore, their extent and location may yield much information about the knee joint status.

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Objective: There are few effective osteoarthritis (OA) therapies. A novel injectable polyacrylamide hydrogel (iPAAG) previously demonstrated efficacy and safety up to week 26 in an open-label study of knee OA. Here we report longer-term effectiveness and safety data.

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Objective: Apocynin (AP) and paeonol (PA) are low molecular weight phenolic compounds with a broad array of anti-inflammatory and immunoregulatory effects. This study assessed of a fixed-dose combination of APPA in people with symptomatic knee osteoarthritis (OA).

Methods: A multi-center, randomized, placebo-controlled, double-blind phase 2a trial enrolled participants with radiographic knee OA (Kellgren-Lawrence, KL, grades 2-3) and pain ≥40/100 on WOMAC pain subscale, and evaluated the efficacy and safety of oral APPA over a 28-day period.

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Article Synopsis
  • The study investigates how different methods for calculating effect sizes (ES) can influence results, using data from three trials of tanezumab for osteoarthritis pain.
  • Three approaches for computing pooled standard deviation (SD) — Baseline, Endpoint, and Median — were compared, revealing significant differences in ES across these methods.
  • The researchers emphasize the need for transparency in reporting ES calculations, as these differences can impact treatment effect interpretations and sample size determinations for clinical trials.
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  • The study aimed to assess the effectiveness of ixekizumab vs. placebo and adalimumab in reducing spinal pain in patients with ankylosing spondylitis (AS) through objective inflammation measures like MRI and CRP levels.!
  • In a 52-week trial, ixekizumab showed greater reductions in spinal pain compared to placebo, particularly when inflammation was controlled, and continued to improve at week 52.!
  • The analysis suggests that ixekizumab not only helps lessen pain through inflammation reduction but may also work through additional mechanisms, indicating its potential as a more effective treatment for AS pain management.!
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Article Synopsis
  • The manuscript emphasizes the significance of increasing the adoption of Core Outcome Sets (COS) through collaboration and understanding the needs of various stakeholders.
  • A simulation format was used to engage eight Collaborator groups, highlighting the importance of COS and identifying barriers like lack of recommendations, inadequate patient involvement, and low awareness.
  • The findings advocate for COS development that includes patients and collaborators at all levels, calling for future research to investigate effective implementation and the role of validated instruments in improving COS uptake.
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