Publications by authors named "Tien-Tsai Cheng"

Aim: To evaluate real-world abatacept retention and clinical outcomes in patients with rheumatoid arthritis in Taiwan.

Methods: This prospective, observational study enrolled patients with rheumatoid arthritis aged ≥20 years who received abatacept in real-world practice. The primary endpoint was the abatacept retention rate at 24 months.

View Article and Find Full Text PDF

The Fracture Risk Assessment Tool (FRAX®) is a widely utilized country-specific calculator for identifying individuals with high fracture risk; its score is calculated from 12 variables, but its formulation is not publicly disclosed. We aimed to decompose and simplify the FRAX® by utilizing a nationwide community survey database as a reference module for creating a local assessment tool for osteoporotic fracture community screening in any country. Participants ( = 16384; predominantly women (75%); mean age = 64.

View Article and Find Full Text PDF

Long-term Glucocorticoid (GC) use results in compromised bone strength and fractures, and several treatment recommendations have been developed to prevent fractures, but none have been validated in a real-world setting. This study aims to create a treatment decision tool and compares this tool to the treatment suggestions from the American College of Rheumatology (ACR), International Osteoporosis Foundation and European Calcified Tissue Society (IOF-ECTS), and GC-adjusted Fracture Risk Assessment Tool (GC-FRAX), above the intervention threshold. We utilized registry data gathered at Chang Gung Memorial Hospital at Kaohsiung, Taiwan, between September 2014 and April 2021.

View Article and Find Full Text PDF

Background: Rheumatoid arthritis (RA) is a systemic inflammatory disease in which TNF-α plays an important role. Fibroblast growth factor receptor 3 (FGFR3) is reportedly involved in RA by regulating the expression of inflammatory cytokines.

Objective: This study examined the expression profile of FGFR3 in human synovial biopsy tissues and evaluated its gene-silencing effects on behaviors of synovial cells.

View Article and Find Full Text PDF

Unlabelled: While FRAX with BMD could be more precise in estimating the fracture risk, DL-based models were validated to slightly reduce the number of under- and over-treated patients when no BMD measurements were available. The validated models could be used to screen for patients at a high risk of fracture and osteoporosis.

Purpose: Fracture risk assessment tool (FRAX) is useful in classifying the fracture risk level, and precise prediction can be achieved by estimating both clinical risk factors and bone mineral density (BMD) using dual X-ray absorptiometry (DXA).

View Article and Find Full Text PDF
Article Synopsis
  • Patients with rheumatoid arthritis have an increased risk of developing diabetes, which can lead to serious health issues like cardiovascular diseases.
  • This study analyzed data from over 5,500 rheumatoid arthritis patients to see how different treatments (like DMARDs) affect the risk of diabetes onset.
  • Results indicated that using biological DMARDs, methotrexate combinations, and certain other conventional DMARDs significantly reduced the risk of diabetes compared to methotrexate monotherapy, with hydroxychloroquine being particularly effective.
View Article and Find Full Text PDF

Background: Osteoporotic vertebral fractures may predict the future occurrence of fractures and increase mortality. Treating underlying osteoporosis may prevent second fractures. However, whether anti-osteoporotic treatment can reduce the mortality rate is not clear.

View Article and Find Full Text PDF

Osteoporosis greatly increases the risk of fractures. Osteoporotic fractures negatively impact quality of life, increase the burden of care, and increase mortality. Taiwan is an area with a high prevalence of osteoporosis.

View Article and Find Full Text PDF
Article Synopsis
  • The study investigated the impact of adalimumab on health-related quality of life in Taiwanese patients with moderate-to-severe rheumatoid arthritis over a 24-week period.
  • 100 biologic-naive patients received adalimumab injections every two weeks, with significant improvements observed in the Health Assessment Questionnaire-Disability Index (HAQ-DI) and other quality of life measures by weeks 12 and 24.
  • Findings indicated that 60% of patients experienced meaningful improvements in their condition, suggesting adalimumab therapy positively affects overall well-being in this population.
View Article and Find Full Text PDF

Background: Osteoporosis increases the risk of fractures. Visceral fat is associated with cardiovascular disease (CVD). There is inadequate knowledge on the relationship between osteoporosis and visceral fat.

View Article and Find Full Text PDF

Danazol is a treatment option for autoimmune hemolytic anemia (AIHA) and immune thrombocytopenia (ITP). Three patients with AIHA and eight patients with ITP between 2008 and 2022 were enrolled in the Rheumatology Outpatient Clinic of Chang Gung Memorial Hospital, Kaohsiung. Those patients were refractory or intolerant to conventional therapy and were treated with danazol.

View Article and Find Full Text PDF

Shared decision making (SDM) is an interactive process that involves patients and their healthcare professionals reaching joint decisions about medical care through negotiation. As the initiators of medical decision-making in daily routine, physicians should be aware of and concerned about the SDM process. Thus, professional competency development for SDM has become increasingly critical for physicians' training.

View Article and Find Full Text PDF

Shared decision making (SDM) is a collaborative process involving patients and their healthcare workers negotiating to reach a shared decision about medical care. However, various physician stakeholders (attending physicians, medical residents, and doctors in post-graduate years) may have different viewpoints on SDM processes. The purpose of this study is to explore the core competence of physicians in performing SDM tasks and to investigate the significant competency development aspects/criteria by applying the literature research and expert interviews.

View Article and Find Full Text PDF

Objective: To explore the impact of seropositivity on systemic bone loss in rheumatoid arthritis (RA).

Methods: We conducted an interim analysis of the RA registry. Patients were examined with dual-energy X-ray absorptiometry at baseline and again 3 years later.

View Article and Find Full Text PDF
Article Synopsis
  • - The study aimed to create a FRAX®-based prediction model specifically for identifying fragility fractures in rheumatoid arthritis (RA) patients over a 3-year period.
  • - Data was collected from 493 RA patients, revealing that 23.5% experienced new fragility fractures, with the fixed intervention threshold (FITD) showing strong effectiveness compared to other models.
  • - The findings suggest that the FIT model can help healthcare providers make effective interventions to prevent fragility fractures in RA patients, offering a practical guideline for care.
View Article and Find Full Text PDF

Background: Rheumatoid arthritis (RA)-related comorbidities, including cardiovascular disease (CVD), osteoporosis (OP), and interstitial lung disease (ILD), are sub-optimally managed. RA-related comorbidities affect disease control and lead to impairment in quality of life. We aimed to develop consensus recommendations for managing RA-related comorbidities.

View Article and Find Full Text PDF
Article Synopsis
  • The study aimed to analyze the changes in bone mineral density (BMD) among rheumatoid arthritis (RA) patients treated with different medications over three years, specifically conventional synthetic disease-modifying anti-rheumatic drugs (csDMARDs), tumor necrosis factor-α inhibitors (TNFi), and abatacept.
  • A total of 752 RA patients were recruited, with 485 completing the study; results showed that BMD decreased significantly for those on csDMARDs and TNFi, while it remained stable in those receiving abatacept.
  • The findings suggest that abatacept may be more effective in preserving BMD compared to csDMARDs and TNFi, indicating the importance of anti-osteoporosis therapies in preventing bone
View Article and Find Full Text PDF
Article Synopsis
  • Researchers created the Male Osteoporosis Self-Assessment Tool for Taiwan (MOSTAi) to help identify Taiwanese men at risk for osteoporosis, as existing tools are seldom used for this demographic.
  • The tool is based on a questionnaire that assesses clinical risk factors, and its effectiveness was validated using a receiver operating characteristic (ROC) curve on data from 2,290 participants.
  • The final MOSTAi formula considers age and weight, with a cutoff score of 11 to determine risk, highlighting the need for region-specific assessment models for better osteoporosis detection.
View Article and Find Full Text PDF

In the intensive care unit (ICU), renal failure and respiratory failure are two of the most common organ failures in patients with systemic inflammatory response syndrome (SIRS). These clinical symptoms usually result from sepsis, trauma, hypermetabolism or shock. If this syndrome is caused by septic shock, the Surviving Sepsis Campaign Bundle suggests that vasopressin be given to maintain mean arterial pressure (MAP) > 65 mmHg if the patient is hypotensive after fluid resuscitation.

View Article and Find Full Text PDF
Article Synopsis
  • The study aimed to identify risk factors for fragility fractures in rheumatoid arthritis (RA) patients over a 3-year period through an observational cohort study at Chang Gung Memorial Hospital.
  • A total of 477 RA patients were tracked, with 103 having new fractures (Group A) and 206 not having any fractures (Group B), analyzing factors like co-morbidities and fracture history.
  • Findings indicated that the most significant risk factor for new fragility fractures in RA patients was a previous fracture, highlighting its role alongside other demographics and disease-related factors.
View Article and Find Full Text PDF

Background Cardiovascular disease is the most common cause of death in patients with rheumatoid arthritis. It is believed that using disease-modifying antirheumatic drugs (DMARDs) to control inflammation can reduce the risk of cardiovascular disease. In this study, we investigated whether patients who responded differently to DMARDs might sustain different cardiovascular events.

View Article and Find Full Text PDF
Article Synopsis
  • Rheumatoid arthritis (RA) is linked to decreased bone mineral density (BMD), and this study aimed to investigate how high disease activity affects long-term bone loss.
  • The research involved 477 RA patients categorized based on their disease activity levels and included BMD assessments at the start and after three years.
  • The findings indicated that patients in remission who used anti-osteoporosis treatment saw improved BMD, while those with moderate or high disease activity experienced significant bone loss, highlighting the importance of managing disease activity.
View Article and Find Full Text PDF

Background: Hormonal changes had been found in menopausal women. Muscle and bone mass decline after menopause and with aging, increasing the risk for sarcopenia and osteoporosis in later life. Only a few studies suggest that menopausal hormonal changes have an effect on the decline in muscle mass.

View Article and Find Full Text PDF