updated systemic sclerosis criteria improve disease classification

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CLINICAL NEWS BritishJournalofHospitalMedicine,November2013,Vol74,No11 609 ©2013MAHealthcareLtd Arterial hardening may contribute to Alzheimer’s in older people Older people with hardening of the arteries are more likely to have a build-up of beta-amyloid plaques in the brain, even if they have no visible signs of dementia, according to research published in Neurology. New hepatitis C injection device A new injection device, ViraferonPeg Clearclick, has launched for hepatitis C patients to accurately titrate and self-administer their weekly dose of peginterferon alfa- 2b (ViraferonPeg). The device has been designed to maintain dosing flexibility across five dosage strengths, helping patients to deliver the optimal dose and help maximize patient outcomes. Nab-paclitaxel shows survival advantage in metastatic pancreatic cancer Nab-paclitaxel (Abraxane) plus gemcitabine demonstrated clinically meaningful results across primary and key secondary end points and patient subgroups compared with gemcitabine alone, according to a study published in the New England Journal of Medicine. New,moresensitive,classifica- tioncriteriaforsystemicsclero- sis have been published, ena- bling earlier identification and treatment of this disabling autoimmunedisease. The criteria were developed by a joint committee commis- sionedbytheAmericanCollege of Rheumatology (ACR) and European League Against Rheumatism (EULAR) (van denHoogenetal,2013). Systemic sclerosis, also knownasscleroderma,isacon- nectivetissuediseasecharacter- ized by sclerodermatous skin changes, Raynaud’s phenome- nonandinternalorganfibrosis. The ACR estimates that sys- temic sclerosis affects 49000 adultsintheUSA. The joint ACR-EULAR committeewasledbyDrJanet Pope from Western University, St.Joseph’sHealthCareLondon in Ontario, Canada, and Dr Frank van den Hoogen from St. Maartenskliniekin The Netherlands. The committee’s intent was to improvetheclassi- fication of system- icsclerosisbyclus- tering items and simplifying the weighting of the differentcriteria. Thenewcriteriasetwastest- edforspecificityandsensitivity by comparing scleroderma cases with controls (patients withdisorderssimilartosclero- derma), and validated by expertsviewingcaseswithand withoutthedisease. Thevalidationtestingshows that sensitivity and specificity werebothgreaterthan90%for the2013systemic sclerosis classifica- tion criteria com- pared to 75% for the 1980 ACR criteria. ‘The new sys- temic sclerosis classification cri- teria should cor- rectly classify more patients with the disease,’ concluded Dr Pope. ‘Criteria thataremorespecificwillallow for earlier identification and bettertreatmentforthosewith systemicsclerosis.’ vandenHoogenF,KhannaD, FransenJetal(2013)2013 classificationcriteriaforsystemic sclerosis:anAmericanCollegeof Rheumatology/EuropeanLeague AgainstRheumatismcollaborative initiative.Arthritis Rheum3 October(Epubaheadofprint) (doi:10.1002/art.38098) Anappthatenablesdoctorsto quickly and accurately assess the extent of a burn and so deliverthebestpossibletreat- ment to patients has emerged as the overall winner of the EHI Awards 2013 in associa- tionwithCGI. TheMerseyBurnsAppwas developed by a PhD student, Chris Seaton, and two plastic surgeonsatStHelen’sand Knowsley NHS Trust, Rowan Pritchard Jones and Professor Paul McArthur, with further support from the Knowsley Health InformaticsService. Traditionally, doctors sketchaburnonpaperto assessitsextentanddecide whatfluidstogivetoapatient. Theappenablesthemtoshade theareaofaburnonaplanof the human body, does the fluid calculations for them, and collects patient details that can be forwarded to a specialistunit. The app is also the first UK healthcare app to carry a CE mark from the Medicines and HealthcareProductsRegulatory Agency, making it the first, regulatedphoneappintheUK. EHI director Linda Davidsonsaid:‘Improvingthe working lives of their clinical colleagues and helping them toimprovethecaretheydeliv- er to patients is what moti- vates the healthcare IT teams and the suppliers who enter theEHIAwardseachyear. Sheadded:‘TheMersey BurnsAppisawonderful example of how modern technologycanbeusedto makecarebetterandfast- er,andsoisaveryfitting winner of this year’s awards.Wewouldliketo congratulate the team behindit.’ Mersey Burns App wins top EHI Award Updated systemic sclerosis criteria improve disease classification Dr Janet Pope, Professor and Chair of the Division of Rheumatology, Western University, St. Joseph’s Health Care London, Ontario, Canada itish Journal of Hospital Medicine.Downloaded from magonlinelibrary.com by ${IPAddress} on August 15, 2014. For personal use only. No other uses without permission. . All rights reserve

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Page 1: Updated systemic sclerosis criteria improve disease classification

CliniCal news

British�Journal�of�Hospital�Medicine,�November�2013,�Vol�74,�No�11� 609

©�2

013�

MA�

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lthca

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td

Arterial hardening may contribute to Alzheimer’s in older peopleOlder people with hardening of the arteries are more likely to have a build-up of beta-amyloid plaques in the brain, even if they have no visible signs of dementia, according to research published in Neurology.

New hepatitis C injection deviceA new injection device, ViraferonPeg Clearclick, has launched for hepatitis C patients to accurately titrate and self-administer their weekly dose of peginterferon alfa-2b (ViraferonPeg). The device has been designed to maintain dosing flexibility across five dosage strengths, helping patients to deliver the optimal dose and help maximize patient outcomes.

Nab-paclitaxel shows survival advantage in metastatic pancreatic cancerNab-paclitaxel (Abraxane) plus gemcitabine demonstrated clinically meaningful results across primary and key secondary end points and patient subgroups compared with gemcitabine alone, according to a study published in the New England Journal of Medicine.

New,�more�sensitive,�classifica-tion�criteria�for�systemic�sclero-sis� have� been� published,� ena-bling� earlier� identification� and�treatment� of� this� disabling�autoimmune�disease.�

The� criteria� were� developed�by�a� joint�committee�commis-sioned�by�the�American�College�of� Rheumatology� (ACR)� and�European� League� Against�Rheumatism� (EULAR)� (van�den�Hoogen�et�al,�2013).

Systemic� sclerosis,� also�known�as�scleroderma,�is�a�con-nective�tissue�disease�character-ized� by� sclerodermatous� skin�changes,� Raynaud’s� phenome-non�and�internal�organ�fibrosis.�The� ACR� estimates� that� sys-temic� sclerosis� affects� 49�000�adults�in�the�USA.

The� joint� ACR-EULAR�committee�was�led�by�Dr�Janet�Pope� from� Western� University,�St.�Joseph’s�Health�Care�London�

in� Ontario,�Canada,� and� Dr�Frank� van� den�Hoogen� from� St.�Maartenskliniek�in�The� Netherlands.�The� committee’s�intent� was� to�improve�the�classi-fication�of� system-ic�sclerosis�by�clus-tering� items� and�simplifying� the�weighting� of� the�different�criteria.�

The�new�criteria�set�was�test-ed�for�specificity�and�sensitivity�by� comparing� scleroderma�cases� with� controls� (patients�with�disorders�similar�to�sclero-derma),� and� validated� by�experts�viewing�cases�with�and�without�the�disease.

The�validation�testing�shows�that� sensitivity� and� specificity�were�both�greater�than�90%�for�

the�2013�systemic�sclerosis�classifica-tion� criteria� com-pared� to� 75%� for�the� 1980� ACR�criteria.�

‘The� new� sys-temic� sclerosis�classification� cri-teria� should� cor-rectly� classify�more� patients�with� the� disease,’�concluded� Dr�Pope.� ‘Criteria�

that�are�more�specific�will�allow�for� earlier� identification� and�better�treatment�for�those�with�systemic�sclerosis.’van�den�Hoogen�F,�Khanna�D,�

Fransen�J�et�al�(2013)�2013�classification�criteria�for�systemic�sclerosis:�an�American�College�of�Rheumatology/European�League�Against�Rheumatism�collaborative�initiative.�Arthritis Rheum�3�October�(Epub�ahead�of�print)�(doi:�10.1002/art.38098)

An�app�that�enables�doctors�to�quickly� and� accurately� assess�the� extent� of� a� burn� and� so�deliver�the�best�possible�treat-ment� to�patients�has�emerged�as� the� overall� winner� of� the�EHI� Awards� 2013� in� associa-tion�with�CGI.

The�Mersey�Burns�App�was�developed� by� a� PhD� student,�Chris�Seaton,� and� two�plastic�surgeons�at�St�Helen’s�and�Knowsley� NHS� Trust,�Rowan� Pritchard� Jones�and� Professor� Paul�McArthur,� with� further�support� from� the�Knowsley� Health�Informatics�Service.

Traditionally,� doctors�sketch�a�burn�on�paper�to�assess�its�extent�and�decide�

what�fluids�to�give�to�a�patient.�The�app�enables�them�to�shade�the�area�of�a�burn�on�a�plan�of�the� human� body,� does� the�fluid� calculations� for� them,�and� collects� patient� details�that� can� be� forwarded� to� a�specialist�unit.

The�app�is�also�the�first�UK�healthcare� app� to� carry� a� CE�mark� from� the� Medicines� and�

Healthcare�Products�Regulatory�Agency,� making� it� the� first,�regulated�phone�app�in�the�UK.�

EHI� director� Linda�Davidson�said:�‘Improving�the�working� lives� of� their� clinical�colleagues� and� helping� them�to�improve�the�care�they�deliv-er� to� patients� is� what� moti-vates� the� healthcare� IT� teams�and� the� suppliers� who� enter�

the�EHI�Awards�each�year.She�added:�‘The�Mersey�

Burns�App�is�a�wonderful�example� of� how� modern�technology�can�be�used�to�make�care�better�and�fast-er,�and�so�is�a�very�fitting�winner� of� this� year’s�awards.�We�would� like� to�congratulate� the� team�behind�it.’

Mersey Burns App wins top EHI Award

Updated systemic sclerosis criteria improve disease classification

Dr Janet Pope, Professor and Chair of the Division of Rheumatology, Western University, St. Joseph’s Health Care London, Ontario, Canada

British Journal of Hospital Medicine.Downloaded from magonlinelibrary.com by ${IPAddress} on August 15, 2014. For personal use only. No other uses without permission. . All rights reserved.