20 patients enrolled immediately in Rheum iCMP

Selected iCMP nurses will receive a 4-hour training using unique educational materials already developed by our team that specifically address lupus-related racial, ethnic and socioeconomic disparities, as well as clinical information about lupus. These iCMP nurses will then reach out to high-risk lupus patients to ensure that patients attend scheduled rheumatology appointments, fill prescriptions for lupus-specific medications, and obtain recommended lupus screening labs and preventive care.

Rheum iCMP

20 patients enrolled in Rheum iCMP after 4 months; will receive monthly lupus educational materials mailed to their home during the first 4 months

Participants enrolled in the control group will be recommended national exercise recommendations pertianing to engaging in 150 minutes a week of moderate intensity exercise five times per week.

Apart from these exercise sessions participants in this group will complete 3 separate evaluation sessions at the beginning, interim, and end of the study where they will be walking on a standard-of care treadmill for 30 minutes with blood draws at 0 and 30 minutes (only during beginning and end session), kinematic measure of gait parameters, measures of different cardiovascular parameters and cardiometabolic markers followed by thigh muscle strength testing.

Patients in this group will receive available exercise recommendations of 150 minutes of moderate intensity exercise per week (30 minutes per day).

Exercise for Knee Osteoarthritis Recommendations (Control group)

Participants enrolled in the Lower-body positive-pressure (LBPP) supported low-load treadmill walking exercise will complete a total of two walking exercise sessions per week for a total of eight consecutive weeks (i.e. 16 exercise sessions in all). Each walking session will include 30-minute walking on a G-Trainer (AlterG Inc., Fremont, CA) under low-load walking conditions.

Apart from these exercise sessions participants in this group will complete 3 separate evaluation sessions at the beginning, interim, and end of the study where they will be walking on a standard-of care treadmill for 30 minutes with blood draws at 0 and 30 minutes (only during beginning and end session), kinematic measure of gait parameters, measures of different cardiovascular parameters and cardiometabolic markers followed by thigh muscle strength testing.

Lower-body positive-pressure (LBPP) supported low-load treadmill walking exercise

Exercise for Knee Osteoarthritis -(LBPP supported low-load treadmill Walking)

Participants enrolled in the aquatic exercise program will complete a total of two aquatic walking exercise sessions per week for a total of eight consecutive weeks (i.e. 16 exercise sessions in all). Each aquatic exercise program will include walking in the pool for 30 minutes at self-selected speeds under the guidance of an aquatic therapy instructor.

Apart from these exercise sessions participants in this group will complete 3 separate evaluation sessions at the beginning, interim, and end of the study where they will be walking on a standard-of care treadmill for 30 minutes with blood draws at 0 and 30 minutes (only during beginning and end session), kinematic measure of gait parameters, measures of different cardiovascular parameters and cardiometabolic markers followed by thigh muscle strength testing.

Exercise for Knee Osteoarthritis - (Aquatic Walking)

류마티스 관절염 환자에게 실로스타졸이 증상 개선과 삶의 질 향상에 도움되는지 6개월간 살펴보는 임상시험입니다.

35 patients receiving conventional synthetic disease modifying antirheumatic drugs in addition to Cilostazol 100 mg twice daily for 6 months.

An antiplatelet agent used for intermittent claudication , it has an anti-inflammatory effect which will help control patients with Rheumatoid arthritis

Cilostazol 100 MG

methotrexate 7.5-15 mg once weekly hydroxychloroquine 200 mg twice daily sulfasalazine 500 mg to 3 g once daily leflunomide 20 mg once daily

conventional synthetic antirheumatic drugs

35 patients receiving conventional synthetic disease modifying antirheumatic drugs for 6 months.

35명의 환자에게 기존의 합성 항류마티스제 외에 실로스타졸 100mg을 1일 2회 6개월 동안 투여했습니다.

실로스타졸 100mg

기존의 합성 항류마티스 약물

35명의 환자에게 6개월 동안 기존의 합성 항류마티스제를 투여했습니다.

실로스타졸이 류마티스 관절염 환자에게 미치는 영향

This intervention will help people with RA get tested for hyperlipidemia so that they can later discuss with their physician how to better treat their increased risk for cardiovascular disease.

Cardiovascular Risk Assessment for Patients with Rheumatoid Arthritis

Participants in this group will not receive peer coaches calls. They will receive additional educational materials about CVD risk and the regular care provided by their doctors.

Standard of care

Weill Medical College of Cornell University

Continue with usual RA care in their rheumatologist's office

RA patients will be randomized to receive their RA care via their established PCP who completed a structured training course in RA and who has monthly case review/consultation sessions with the rheumatology team in this study

Primary Care Treatment in lieu of Rheumatologist

McKailey Lyndaker

Eyal Kedar, MD

Each participant is assigned a coordinating rheumatology nurse. Based on an initial bio-psycho-social assessment, the nurse and the participant define up to five activities using the Patient Specific Functional Scale (PSFS) and agree on goals based on shared decision-making. The coordinating nurse provides self-management support in face-to-face, telephone or online consultations depending on the participant's needs during the following six months. At each face-to-face consultation with the nurse, the PSFS activities and the goals are evaluated. Each participant can get up to 2.5 hours of support from the nurse, up to 4 hours a physiotherapist and or occupational therapist, and 1 hour from a social worker. In addition, the coordinating nurse helps identify relevant offers in the participant's municipality. The coordinating nurse can plan up to two conferences with involved professionals. A final consultation with the coordinating nurse is held after the six-month intervention.

A coordinating rheumatology nurse who follows the participant for six months, goal setting and action planning with the nurse, opportunity for needs based support from a physiotherapist, an occupational therapist and a social worker, opportunity for interdisciplinary conferences to coordinate support to achieve the agreed upon goals and a final status consultation.

Interdisciplinary Nurse-coordinated self-management support for people with inflammatory arthritis and substantial disease impact

Usual care consists of planned consultations every 6-12 months by a rheumatologist or a rheumatology nurse and access to support from a rheumatology nurse by telephone. The planned consultations encompass review of blood tests, joint examinations, review of completed answers to questionnaires in DANBIO, adherence and evaluation of whether pharmacological adjustment is necessary. In addition, the planned nursing consultations sporadically encompass education in relation to management of the disease, symptoms and the pharmacological treatment. At the outpatient departments at the Danish Hospital for Rheumatic Diseases, Rigshospitalet-Glostrup and Frederiksberg Hospital, patients who have specific challenges can be offered an additional nursing consultation for non-pharmacological support. At Rigshospitalet-Glostrup it is also possible to refer a patient to see a physiotherapist and/ or an occupational therapist in the outpatient department.

The Danish Center for Expertise in Rheumatology

Bente A Esbensen, PhD

Luise H Lindgren, PhD

Jette Primdahl, PhD

Berit F Petersen, MPQM

An individualized rheumatoid arthritis self-management program for managing RA patients' physical behavioral problems was applied for the intervention group. The program was based on the self-efficacy theory and the four resources were incorporated to emphasize patients' knowledge, skill, and responsibility in managing their RA situations.

The intervention group received the rheumatoid arthritis self-management program which was based on Bandura's theory of self-efficacy and proposes that self-efficacy is influenced by four information sources: mastery of experience, social modeling, social persuasion and one's physical and emotional states. To enhance participants' self-management skill, the following strategies were employed: peer story-telling, assessment, family involvement, goal setting, self-monitoring, self-evaluation, and phone calls consultation.

rheumatoid arthritis self-management program

The control group received general information on rheumatoid arthritis care and follow-up.

The following investigations and treatments will be offered as associated with a comprehensive comorbidity clinic appointment with the primary care rheumatology family physician: Blood pressure, heart rate, height and weight measurement. Blood work (standard lipid panel, fasting plasma glucose or glycated hemoglobin (A1C), eGFR, and Lipoprotein a, Bone densitometry (if applicable to the patient/participant).

Vaccinations will be offered if applicable to the patient/participant according to Health Canada guidelines (Vaccination with Pneu-P-23, Pneu-C-13, herpes zoster and COVID-19 vaccine).

The participant will be booked with a primary care rheumatology family physician for rheumatoid arthritis comorbidity screening. They will complete weight, height, blood pressure measurement, assess for risk factors for dyslipidemia, type 2 diabetes, hypertension, bone mineral density loss and vaccine preventable infectious diseases.

Primary Care Rheumatology Family Physician Consultation

Cassandra Schulz, MD

Yan Yeung, MD

Sabrina Lue, MD

중등도에서 중증 류마티스 관절염 환자를 대상으로 두 가지 약물 조합의 효과를 비교하는 시험입니다.

This intervention is open label. Both patient and investigator will know about the intervention. Participants are allocated according to block randomization. Total two groups with each contain 48 patients. One group will be given Tofacitinib, Methotrexate and another group will be given Upadacitinib, Methotrexate

To see the efficacy of Upadacitinib, Methotrexate versus Tofacitinib, Methotrexate in moderate to severe Rheumatoid arthritis

중등도에서 중증 류마티스 관절염에서 우파다시티닙, 메토트렉세이트와 토파시티닙, 메토트렉세이트의 효능을 비교하려면

Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh

중등도에서 중증 류마티스 관절염에서 토파시티닙과 메토트렉세이트 병용 요법의 효능과 우파다시티닙과 메토트렉세이트 병용 요법의 효능 비교

The Arthritis Self-Management Program (ASMP) will be administered to 15 African American lupus patients participating in an ongoing "SLE Clinic Database Project" at the Medical University of South Carolina (MUSC). Fifteen other patients will serve as controls and receive usual care.

Intervention activities will consist of six weekly sessions of the Arthritis Self-Management Program (ASMP). Sessions will be administered in a group setting with the 15 African American lupus patients randomly assigned to the intervention arm of the study. Fifteen other patients will serve as controls and receive usual care. Patients participating in the stress intervention will receive six weeks of peer led sessions ranging in disease-specific and more general self-help content. The intervention will include homework assignments to practice and record use of session techniques and to complete worksheets regarding session-specific topics and activities. Usual care will include a brief explanation of the disease and relevant literature.

Arthritis Self Management Program

Sham ultrasound stimulation for 20 minutes once per day

Sham ultrasound stimulation (control)

All subjects will take at least one type of conventional synthetic DMARD at the same stable dose for at least 8 weeks prior to the treatment period and continuing through study close out

Conventional Synthetic DMARD

Subjects will receive daily noninvasive ultrasound stimulation of the spleen using Ultrasound Treatment Setting 1 for 20 minutes once per day

Non-invasive ultrasound stimulation of the spleen - Treatment Setting 1

Subjects will receive daily noninvasive ultrasound stimulation of the spleen using Ultrasound Treatment Setting 2 for 20 minutes once per day

Non-invasive ultrasound stimulation of the spleen - Treatment Setting 2

Nathaly Navarro, BS

Rosalia Tanory, MBBS

Adam Ramos

Samy Metyas, M.D.

Christina Chen, D.O.

Roshan Patel, M.D.

Yanisa Chuenkasamekul, PA-C

Jennifer Bui, PA-C

Ariel Bryant, PA-C

Ana Roup

Amal Mehta, M.D.

Chong Pedrick, RN

Panida Khuansanguan, MS

Kristen Demoruelle, M.D.

Erik Peterson, M.D.

류마티스 관절염 환자들에게 의사와의 소통을 돕는 프로그램이 질병 관리에 효과적인지 평가하는 시험입니다.

The clinician training is a generic, skills- and attitude-based approach for clinicians to acknowledge their decision making conversations with patients that 1) there is more than one option, and 2) patient's views matter in deciding what to do next. This tools-free approach can be used on the spot when needed and is termed fostering choice awareness (FCA). The one-hour training consists of 4 parts: 1) a knowledge session on evidence and guidelines on effective conversations and SDM, 2) video-review of behaviors which foster or hinder choice awareness, 3) clinical simulations in which clinicians practice fostering choice awareness behaviors, and 4) a reminder card for use in future clinic visits. Video clips will be of patient-clinician conversations around treatment decision making to prompt and probe clinicians' experiences, improve understanding, and improve practice.

Clinician communication training

The patient activation component consists of three questions patients can ask their clinician to help them become more involved: "1. What are my options?; 2. What are the possible benefits and harms of those options?; 3. How likely are each of those benefits and harms to happen to me?" These questions have been used in studies to promote improved communication in a number of conditions including cardiovascular disease, cancer, and women's health.

Patient activation

RA Choice presents information on FDA-approved RA treatments in a set of cards, which can be used alone or in combination based on a patient's preference, values, and the clinician's experience. The RA medication summary guide describes options for medication, physical therapy, occupational therapy, and ways to stay healthy with diet and exercise. Tool development followed key principles of creating low literacy materials that featured icons, short phrases written in plain language, and included topics of interest to RA patients faced with a medication decision. For the proposed study, we will include a paper-based version of the tool, or a web-based version available for telephone or VA Video Connect (VVC) visits. The tools will be updated to include new FDA-approved therapies (e.g., JAK inhibitors).

류마티스 iCMP

무릎 골관절염 운동 권장 사항(대조군), 무릎 골관절염 운동 - (LBPP 지원 저부하 트레드밀 걷기), 무릎 골관절염 운동 - (수중 걷기)

실로스타졸이 류마티스 관절염 환자에게 미치는 영향

류마티스 관절염 환자를 위한 심혈관 위험 평가, 표준 치료

류마티스 전문의 대신 1차 진료

염증성 관절염과 심각한 질병 영향을 가진 사람들을 위한 학제간 간호사가 조정하는 자기 관리 지원

류마티스 관절염 자가 관리 프로그램

1차 진료 류마티스 가정의학과 상담

중등도에서 중증 류마티스 관절염에서 토파시티닙과 메토트렉세이트 병용 요법의 효능과 우파다시티닙과 메토트렉세이트 병용 요법의 효능 비교

관절염 자가 관리 프로그램

비침습적 초음파를 이용한 비장 자극 - 치료 설정 1, 비침습적 초음파를 이용한 비장 자극 - 치료 설정 2, 가짜 초음파 자극(대조군), 기존 합성 항류마티스제

임상의 의사소통 교육, 환자 참여 증진, 류마티스 관절염약물 요약 안내서 및 류마티스 관절염 선택 가이드