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See detailEnergy expenditure of nursing home residents and participation in exercise classes: an analysis of the SENIOR cohort
Charles, Alexia ULiege; Buckinx, Fanny ULiege; Mouton, Alexandre ULiege et al

in Journal of the American Medical Directors Association (in press)

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See detailImpact of frailty status on the cost of drugs and dietary supplements prescribed to nursing home residents: the SENIOR cohort.
Buckinx, Fanny ULiege; Charles, Alexia ULiege; Quabron, A. et al

in Aging Clinical and Experimental Research (2019), 31

Background The financial impact associated with drug consumption has been poorly investigated among frail subjects and, specifically, in nursing home settings. Aims To determine the association of the ... [more ▼]

Background The financial impact associated with drug consumption has been poorly investigated among frail subjects and, specifically, in nursing home settings. Aims To determine the association of the average monthly cost of the drugs and dietary supplements consumed by nursing home residents with their frailty status. Methods This is an analysis of the first follow-up year of the SENIOR cohort. All participants were classified into “frail” or “non-frail” categories according to Fried’s criteria at baseline. Monthly bills from the pharmacy were analysed to determine the association between the average monthly cost of the drugs and dietary supplements consumed and frailty status. Results A sample of 87 residents (83.8 ± 9.33 years and 75.9% women) from the SENIOR cohort was included. The prevalence of frailty was 28%. The median number of medications consumed each day was 9 (6–12) (no difference between frail and non-frail subjects; p = 0.15). The overall median monthly cost was € 109.6, of which 49% was covered by Belgian social security and the remaining balance was paid by the patient. When comparing the drug expenses of the frail subjects and the non-frail subjects, the overall average monthly cost did not differ between the 2 groups (p = 0.057). Nevertheless, the expenditure remaining to be paid by the residents, after the Belgian social security intervention, was significantly higher among the frail residents (€ 65.7) than among the non-frail residents (€ 47.6; p = 0.017). Conclusions Frailty status has an impact on the expenditures related to the consumption of drugs. [less ▲]

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See detailSafety of intra-articular hyaluronic acid injections in osteoarthritis: outcomes of a systematic review and meta-analysis.
Honvo, Germain ULiege; Reginster, Jean-Yves ULiege; Rannou, F. et al

in Drugs and Aging (2019), 36(suppl 1), 101-127

Background: Some controversy exists regarding the safety of intra-articular hyaluronic acid (IAHA) in the management of osteoarthritis (OA). Objective : The objective of this study was to re-assess the ... [more ▼]

Background: Some controversy exists regarding the safety of intra-articular hyaluronic acid (IAHA) in the management of osteoarthritis (OA). Objective : The objective of this study was to re-assess the safety profile of IAHA in patients with OA, through a comprehensive meta-analysis of randomized, placebo-controlled trials. Methods A comprehensive literature search was undertaken in the databases MEDLINE, Cochrane Central Register of Controlled Trials (CENTRAL), and Scopus. Randomized, double-blind, placebo-controlled, parallel-group trials that assessed adverse events (AEs) with IAHA in patients with OA were eligible for inclusion. Authors and/or study sponsors were contacted to obtain the full report of AEs. The primary outcomes were overall severe and serious AEs, as well as the following MedDRA System Organ Class (SOC)-related AEs: gastrointestinal, cardiac, vascular, respiratory, nervous system, skin and subcutaneous tissue disorders, musculoskeletal, renal and urinary disorders, infections and infestations, and hypersensitivity reaction. Results: Database searches initially identified 1481 records. After exclusions according to the selection criteria, 22 studies were included in the qualitative synthesis, and nine studies having adequate data were ultimately included in the metaanalysis. From the studies excluded according to the pre-specified selection criteria, 21 with other pharmacological OA treatments permitted during the trials were a posteriori included in a parallel qualitative synthesis, from which eight studies with adequate data were finally included in a parallel meta-analysis. Since this meta-analysis was designed to assess safety, the exclusion criterion on concomitant anti-OA medication was crucial. However, due to the high number of studies that allowed mainly concomitant oral non-steroidal anti-inflammatory drugs (NSAIDs), we decided to include them in a post hoc parallel analysis in order to compare the results from the two analyses. No statistically significant difference in odds was found between IAHA and placebo for all types of SOC-related disorders, except for infections and infestations, for which significantly lower odds were found with IAHA compared with placebo, both overall (odds ratio [OR] = 0.61, 95% confidence interval [CI] 0.40–0.93; I2 = 0%) and in studies without concomitant anti-OA medication (OR = 0.49, 95% CI 0.27–0.89). There were significant increased odds of reporting serious AEs with IAHA compared with placebo, both overall (OR = 1.78, 95% CI 1.21–2.63; I2 = 0%) and in studies with concomitant anti-OA medication (OR = 1.78, 95% CI 1.10–2.89), but not in studies without concomitant anti-OA medication (OR = 1.78, 95% CI 0.92–3.47). Conclusions: Using the available data on studies without any concomitant anti-OA medication permitted during clinical trials, IAHA seems not to be associated with any safety issue in the management of OA. However, this evidence was associated with only a “low” to “moderate” certainty. A possible association with increased risk of serious AEs, particularly when used with concomitant OA medications, requires further investigation. [less ▲]

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See detailSafety of topical non-steroidal anti-inflammatory drugs in osteoarthritis: outcomes of a systematic review and meta-analysis.
Honvo, Germain ULiege; Leclercq, Victoria ULiege; Geerinck, Anton ULiege et al

in Drugs and Aging (2019), 36(suppl 1), 45-64

Objective: We aimed to assess the safety of topical non-steroidal anti-inflammatory drugs (NSAIDs) in the management of osteoarthritis (OA) in a systematic review and meta-analysis of randomized, placebo ... [more ▼]

Objective: We aimed to assess the safety of topical non-steroidal anti-inflammatory drugs (NSAIDs) in the management of osteoarthritis (OA) in a systematic review and meta-analysis of randomized, placebo-controlled trials. Methods: A comprehensive literature search was undertaken in the MEDLINE, Cochrane Central Register of Controlled Trials (CENTRAL), and Scopus electronic databases. Randomized, double-blind, placebo-controlled, parallel-group trials that assessed adverse events (AEs) with topical NSAIDs in patients with OA were eligible for inclusion. Authors and/or study sponsors were contacted to obtain the full report of AEs. The primary outcomes were overall severe and serious AEs, as well as the following MedDRA System Organ Class (SOC)-related AEs: gastrointestinal, vascular, cardiac, nervous system, skin and subcutaneous tissue, musculoskeletal and connective tissue. Results The search strategy identified 1209 records, from which 25 papers were included in the qualitative synthesis and 19 were included in the meta-analysis, after exclusions. Overall, more total AEs (odds ratio [OR] 1.16, 95% confidence interval [CI] 1.04–1.29; I2 = 0.0%) and more withdrawals due to AEs (OR 1.49, 95% CI 1.15–1.92; I2 = 0.0%) were observed with topical NSAIDs compared with placebo. The same results were achieved with topical diclofenac, largely driven by an increase in skin and subcutaneous tissue disorders (OR 1.73, 95% CI 0.96–3.10), although the difference was not statistically significant compared with placebo. No significant difference in the odds for gastrointestinal disorders was observed between topical NSAIDs and placebo (OR 0.96, 95% CI 0.73–1.27). Conclusions Topical NSAIDs may be considered safe in the management of OA, especially with regard to low gastrointestinal toxicity. The use of topical NSAIDs in OA should be considered, taking into account their risk: benefit profile in comparison with other anti-OA treatments. [less ▲]

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See detailApports de la cohorte liégeoise SENIOR dans l’étude de la fragilité en maison de repos.
Buckinx, Fanny ULiege; Charles, Alexia ULiege; Reginster, Jean-Yves ULiege et al

in Revue Médicale de Liège (2019), 74(4), 212-217

Au cours des deux dernières décennies, la documentation traitant de la fragilité s’est faite de plus en plus abondante. Toutefois, il n’existe toujours pas de définition opérationnelle et de critères ... [more ▼]

Au cours des deux dernières décennies, la documentation traitant de la fragilité s’est faite de plus en plus abondante. Toutefois, il n’existe toujours pas de définition opérationnelle et de critères universellement reconnus pour décrire la fragilité. Les critères cliniques de fragilité doivent être prédictifs du risque de déclin fonctionnel et d’événements péjoratifs de santé. Dans cette optique, identifier précocement les sujets fragiles permet d’agir sur les facteurs de risque et d’éviter les évolutions défavorables. La cohorte SENIOR, une étude longitudinale de personnes âgées résidant en maison de repos initiée en 2013, a pour objectif de contribuer à la compréhension des facteurs de risque, des conséquences et de la trajectoire de la fragilité. Elle a aussi pour but d’apporter des pistes de prise en charge. Cette cohorte suscite beaucoup d’intérêt dans le monde de la recherche scientifique. En effet, grâce aux nombreuses données démographiques, cliniques et anamnestiques récoltées annuellement, elle permet d’apporter des éléments de réponses aux problématiques liées à la fragilité des personnes âgées. [less ▲]

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See detailSafety of symptomatic slow-acting drugs for osteoarthritis: outcomes of a systematic review and meta-analysis.
Honvo, Germain ULiege; Reginster, Jean-Yves ULiege; Rabenda, Véronique ULiege et al

in Drugs and Aging (2019), 36(suppl 1), 65-99

Background: Symptomatic slow-acting drugs for osteoarthritis (SYSADOAs) are an important drug class in the treatment armamentarium for osteoarthritis (OA). Objective: We aimed to re-assess the safety of ... [more ▼]

Background: Symptomatic slow-acting drugs for osteoarthritis (SYSADOAs) are an important drug class in the treatment armamentarium for osteoarthritis (OA). Objective: We aimed to re-assess the safety of various SYSADOAs in a comprehensive meta-analysis of randomized placebocontrolled trials, using, as much as possible, data from full safety reports. Methods : We performed a systematic review and random-effects meta-analyses of randomized, double-blind, placebocontrolled trials that assessed adverse events (AEs) with various SYSADOAs in patients with OA. The databases MEDLINE, Cochrane Central Register of Controlled Trials (Ovid CENTRAL) and Scopus were searched. The primary outcomes were overall severe and serious AEs, as well as AEs involving the following Medical Dictionary for Regulatory Activities (MedDRA) system organ classes (SOCs): gastrointestinal, cardiac, vascular, nervous system, skin and subcutaneous tissue, musculoskeletal and connective tissue, renal and urinary system. Results Database searches initially identified 3815 records. After exclusions according to the selection criteria, 25 studies on various SYSADOAs were included in the qualitative synthesis, and 13 studies with adequate data were included in the meta-analyses. Next, from the studies previously excluded according to the protocol, 37 with mainly oral nonsteroidal anti-inflammatory drugs (NSAIDs) permitted as concomitant medication were included in a parallel qualitative synthesis, from which 18 studies on various SYSADOAs were included in parallel meta-analyses. This post hoc parallel inclusion was conducted because of the high number of studies allowing concomitant anti-OA medications. Indeed, primarily excluding studies with concomitant anti-OA medications was crucial for a meta-analysis on safety. The decision for parallel inclusion was made for the purpose of comparative analyses. Glucosamine sulfate (GS), chondroitin sulfate (CS) and avocado soybean unsaponifiables (ASU; Piascledine ®) were not associated with increased odds for any type of AEs compared with placebo. Overall, with/without concomitant OA medication, diacerein was associated with significantly increased odds of total AEs (odds ratio [OR] 2.22; 95% confidence interval [CI] 1.58–3.13; I2 = 52.8%), gastrointestinal disorders (OR 2.85; 95% CI 2.02–4.04; I2 = 62.8%) and renal and urinary disorders (OR 3.42; 95% CI 2.36–4.96; I2 = 17.0%) compared with placebo. In studies that allowed concomitant OA medications, diacerein was associated with significantly more dermatological disorders (OR 2.47; 95% CI 1.42–4.31; I2 = 0%) and more dropouts due to AEs (OR 3.18; 95% CI 1.85–5.47; I2 = 13.4%) than was placebo. No significant increase in serious or severe AEs was found with diacerein versus placebo. Conclusions: GS and CS can be considered safe treatments for patients with OA. All eligible studies on ASU included in our analysis used the proprietary product Piascledine® and allowed other anti-OA medications; thus, the safety of ASU must be confirmed in future studies without concomitant anti-OA medications. Given the safety concerns with diacerein, its usefulness in patients with OA should be assessed, taking into account individual patient characteristics. [less ▲]

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See detailImpact of the frailty status on the cost of drugs consumed in nursing homes: results froim the Senior cohort.
Buckinx, Fanny ULiege; Charles, Alexia ULiege; Quabron, A. et al

in Osteoporosis International (2018, April 05), 29 S1

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See detailAgisme en maison de repos : résultats de la cohorte SENIOR
Buckinx, Fanny ULiege; Adam, Stéphane ULiege; Charles, Alexia ULiege et al

in Cahiers de l'Année Gérontologique (2018, April 05)

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See detailOwn attitude regarding aging among nursing home residents: results of the Senior cohort.
Buckinx, Fanny ULiege; Charles, Alexia ULiege; Rygaert, X. et al

in Osteoporosis International (2018, April), 29 S1

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See detailDynamic approach of the frailty status in nursing homes: 2-year prospective follow-up of the Senior cohort.
Buckinx, Fanny ULiege; Charles, Alexia ULiege; Rygaert, X. et al

in Osteoporosis International (2018, April), 29 S1

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See detailPlasma Klotho and Mortality Risk Among Nursing Home Residents: Results From the SENIOR Cohort
Buckinx, Fanny ULiege; Bruyère, Olivier ULiege; Reginster, Jean-Yves ULiege et al

in Journal of the American Medical Directors Association (2018), 19(12), 1139-1140

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See detailOwn attitude toward aging among nursing home residents: results of the SENIOR cohort
Buckinx, Fanny ULiege; Charles, Alexia ULiege; Rygaert, X. et al

in Aging Clinical and Experimental Research (2018), 10

Background: Stereotypes associated with aging are of great concern as extensive literature emphasizes its deleterious effects on physical and mental health of the elderly. Aim: To assess the relationship ... [more ▼]

Background: Stereotypes associated with aging are of great concern as extensive literature emphasizes its deleterious effects on physical and mental health of the elderly. Aim: To assess the relationship between the attitude toward aging and the frailty status of nursing homes residents. Methods: A cross-sectional analysis of the data collected at baseline in the SENIOR cohort was conducted. All subjects received a diagnosis of frailty based on the Fried’s criteria. They also responded to the Attitude to Aging Questionnaire (AAQ) and other questions assessing their subjective age, the age at which someone stops being considered young or is considered old and the open-ended Image-of-Aging question to evaluate the relationship between their perception of aging and their frailty status. Results: 272 nursing home residents (83.9 ± 8.19 years; 75% women) participated in this study. Out of them, 54 (19.9%) were frail, 182 (66.9%) were pre-frail, and 36 (13.2%) were robust. According to the AAQ questionnaire, frail subjects have a more negative perception of aging (score of 80.3 ± 10.2 points) than pre-frail subjects (83.6 ± 10.8) and robust subjects (86.5 ± 10.5) (p = 0.02). However, the three groups did not differ in the age that would mark, to their opinion, the end of youth (p = 0.93) or the beginning of old age (p = 0.98). The subjective age, rapported by nursing home residents, was not significantly different according to their frailty status. At least, based on the Open-Ended Image of Aging question, the residents’ vision of aging was not different according to the frailty status (p = 0.52). Conclusion: Based on the AAQ, frail subjects have more negative attitude to ageing compared to non-frail ones. © 2018, Springer Nature Switzerland AG. [less ▲]

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