Rudy Hidayat
Division of Rheumatology, Department of Internal Medicine, Faculty of Medicine, Universitas Indonesia/Dr Cipto Mangunkusumo General Hospital, Jakarta, Indonesia

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Validity And Reliability Of Lupus Quality Of Life Questionnaire In Patients With Systemic Lupus Erythematosus In Indonesia Anindito, Bagus; Hidayat, Rudy; Koesnoe, Sukamto; Dewiasty, Esthika
Indonesian Journal of Rheumatology Vol 8, No 2 (2016)
Publisher : Indonesian Rheumatology Association

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Abstract

Background: The development of Systemic Lupus Erythematosus (SLE) treatment has led the increased of patients survival. Quality of life has became a value based medicine component that should be evaluated in treating SLE. One standardized questionnaire to asses the quality of life in SLE patients is Lupus Quality of Life (Lupus QoL). Currently, in Indonesia, there has not been any spesific questionnaire to asses the quality of life in SLE patients. This study aims to prove that Lupus QoL is valid and reliable to asses the quality of life in SLEpatients in Indonesia.Methods: This study used cross sectional study method. Firstly, we translated the Lupus QoL into Indonesian language, then we tested to 10 respondents. Then, we continued the study with larger sample size. We analyzed the reliability of the test and the re-test result using the interclass coefficient correlation and the internal consistency of the tests using cronbach alpha. Construct validity was evaluated using multi trait scaling analysis and the extrenal validity was evaluated using correlation between domains in short form 36 (SF 36)with Lupus QoL and with disease activity.Results: Data collection was done to 65 SLE patients between October – November 2015 in RSCM. The test has good external validity SF 36 (r=0.38-0.66, p<0.05) and good construct validity (r >0.4; range: 0.44-0.93). The ICC value in one week >0.7 and Cronbach α was>0.7 in each domain. The correlation between lupus QoL and the disease activity was weak and consistentwith other studies.Conclusion: Lupus QoL questionnaire is valid and reliable to asses the quality of life in SLE patients inIndonesia.Key words: Quality of Life, Systemic Lupus Erythematosus, Lupus QoL, Validity, Reliability
Tophi which develop years before the first attack of acute gouty arthritis Hidayat, Rudy; Kasjmir, Yoga I
Indonesian Journal of Rheumatology Vol 1, No 1 (2009)
Publisher : Indonesian Rheumatology Association

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Gout is a clinical disease associated with hyperuricemia and caused by the deposition ofmonosodium urate crystals in and around the tissue of joints. The course of classic gout passes through three distinct stages: asymptomatic hyperuricemia, acute intermittent gout, and advanced gout/chronic tophaceous gout.1,2 Tophi; described as accumulation of articular, osseus, soft tissue, and cartilaginous crystalline deposits; is one of clinical manifestation of chronic tophaceous gout stage, and usually developedafter 10 or more years of acute intermittent gout.1,2 Although patients have been reported with tophias their initial clinical manifestation
Risk of cardiovascular disease in rheumatoid arthritis patients Utari, A P; Hidayat, Rudy; Setiyohadi, Bambang
Indonesian Journal of Rheumatology Vol 3, No 1 (2011)
Publisher : Indonesian Rheumatology Association

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Abstract

Despite rheumatoid arthritis (RA) therapy development has been in advance level today, its mortality remains increasing in general population. The mortality is mainly caused by early-manifested atherosclerosis and other cardiovascular complications. Available evidences showthis condition appears in early stage of the disease. Thus, early detection and management of cardiovascular risk, followed by control of these factors are necessaryto reduce morbidity and mortality of RA patients
Diagnostic values of DAS28 and DAS28-squeeze in evaluating Rheumatoid Arthritis disease Santosa, David; Hidayat, Rudy; Prasetyo, Marcel; Nugroho, Pringgodigdo
Indonesian Journal of Rheumatology Vol 8, No 2 (2016)
Publisher : Indonesian Rheumatology Association

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Abstract

Background : In recent years, rheumatoid arthritis (RA) uses a “treat to target”  treatment strategy. This strategy requires a valid and accurate tool for assessing disease activity. The most widely used tool is DAS28, which was developed from DAS with the omission of ankle and foot joints. There has been many critization aboutthe accuracy of DAS28 in classifying the state of RA disease. Most importantly, when an active disease state was misclassified as an inactive state (false negative)which lead to under treat and subsequently to disability. The difference between DAS28 and DAS lies mainly in the exclusion of ankle and foot joints, thus DAS28-squeeze, a new and simple tool has been proposed. It comprises the same 28 joints in DAS28 added with a sqeeze test on both metatarsophalangeal joints. However, this new tool has never been validated with any imaging techniques.Objective : To assess the diagnostic values of DAS28 and DAS28-squeeze.Methods : This study comprised a cross-sectional diagnostic study, using Power Doppler sonography as a standard reference in evaluating the diagnostic value ofDAS28 and DAS28-squeeze. This study uses the most sringent sonography criteria of active disease which is an active Doppler signal with a moderate synovial hypertrophy on B-mode. Results : Over the study period, 56 subjects underwent diagnostic tests using DAS28, DAS28-squeeze and Power Doppler sonography. There were 4 false negativecases in DAS28 and 1 case in DAS28-squeeze. The sensitivities of DAS28 and DAS28-squeeze to identify active disease using Power Doppler sonography as reference standard were 73.3% (95%CI ± 11.59) and 93.3% (95%CI ± 6.55), respectively. While the specificities of DAS28 and DAS28-squeeze were 36.6% (95%CI ± 12.62) and 34.1% (95%CI ± 12.42), respectively. Furthermore the negative likelihood ratioof DAS28 and DAS28-squeeze were 0.73 and 0.19, respectively.Conclusion : This study is the first to validate DAS28- squeeze using imaging techniques. From this study the false negative rate of DAS28-squeeze is lower thanDAS28. DAS28-squeeze has a better sensitivity and negative likelihood ratio than DAS28 in identifying RA disease state.Keywords : Rheumatoid Arthritis, DAS28, DAS28-squeeze, treat to target, Power Doppler, squeeze test
Correlation between Interleukin-6 and E-Selectin as a Marker of Endothelial Dysfunction in Rheumatoid Arthritis Patient without Traditional Cardiovascular Risk Factor Jerry Eddya Putra Boer; Rudy Hidayat; Ika Prasetya Wijaya; Ikhwan Rinaldi
Indonesian Journal of Rheumatology Vol. 10 No. 2 (2018): Indonesian Journal of Rheumatology
Publisher : Indonesian Rheumatology Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (228.443 KB) | DOI: 10.37275/ijr.v10i2.98

Abstract

Rheumatoid arthritis (RA) is an autoimmune disease which has recently been recognized to manifest as not only intraarticular but also extraarticular symptoms. Cardiovascular events, presented either subclinically or clinically, were discovered more in AR patients. Atherogenic inflammatory mediator in AR including interleukin-6 (IL-6) was thought to be one of nontraditional cardiovascular risk factor contributing to increase the endothelial dysfunction biomarker such as E-Selectin. This study was purposed to determine the correlation between inflammatory mediator and endothelial dysfunction event, especially between IL-6 and E-Selectin, in RA patient without traditional cardiovascular risk factor. A cross-sectional study was performed to 40 RA patients of Rheumatology Clinic of Cipto Mangunkusumo National General Hospital, Indonesia from September to November 2017. Measurement of the level of IL-6 and E-Selectin were performed using enzyme-linked immunosorbent assay (ELISA). Bivariate correlation analysis was performed to determine the correlation between those two biomarkers. The mean age of this study subjects was 44.9 (13.1) years and median of disease duration was 36 months. This study showed weak correlation between IL-6 and E-Selectin level, but not statistically significant.232, p=0.149). There is weak correlation between IL-6 and sE-Selectin in rheumatoid arthritis patient without traditional risk factor cardiovascular Keywords: traditional risk factor cardiovascular, E-Selectin, interleukin-6, pro inflammatory mediator, rheumatoid arthritis
Serum Nerve Growth Factor in the Occurrence of Peripheral Neuropathy in Rheumatoid Arthritis Patients Rudy Hidayat; Ridho Adriansyah; Ahmad Yanuar Safri; Sukamto Koesnoe
Indonesian Journal of Rheumatology Vol. 12 No. 1 (2020): Indonesian Journal of Rheumatology
Publisher : Indonesian Rheumatology Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/ijr.v12i1.149

Abstract

Abstract Background Peripheral neuropathy (PN) is an extraarticular manifestation in rheumatoid arthritis (RA). In type-2 diabetes mellitus (DM) patients, Nerve Growth Factor (NGF) is associated with PN. The correlation between NGF level and PN among RA has not been concluded yet. This study aimed to determine the mean levels of NGF blood serum and its relationship to PN among RA patients. Method A cross sectional study using consecutive sampling method including patient of rheumatology clinic Cipto Mangunkusumo Hospital was performed between July 2015 to March 2016. The NGF level measurement and Electromyography-Nerve Conduction Velocities (EMG-NCV) were examined to the subjects. Patients were classified into 2 groups; PN positive and PN negative. Bivariate analysis was done to investigate the relationship between NGF and PN among groups. Secondary data such as age, sex, Erythrocyte Sedimentation Rate (ESR), CRP, Disease Activity Score (DAS)28-ESR and CRP are obtained from medical record. Result Among 132 subjects, PN was found in 60 subjects. The median of NGF level in RA patients was 4.11 pg/mL (0.0-24.5). The median of NGF level of RA patients with PN was 4.11 pg/mL (1.1-20.83) and without PN was 3.89 pg/mL (0.0-24.5). Types of neuropathy among patients were polyneuropathy (21.97%), mononeuropathy multiplex (15.15%) and Carpal Tunnel Syndrome (11.36%). In this study we found no association between NGF serum level and PN among RA patients (p = 0.716). Conclusion The median of serum NGF level among PN group was higher than without PN. There was no relationship between serum NGF level and PN among patients with RA. Keywords :rheumatoid arthritis, peripheral neuropathy, nerve growth factor
Characteristics of Patients with Autoimmune Rheumatic Disease in the Era of COVID-19 Pandemic in Indonesia Rudy Hidayat; Harry Isbagio; Anna Ariane; Faisal Parlindungan; Laniyati Hamijoyo; I Nyoman Suarjana; Dwi Budi Darmawati; Rakhma Yanti Hellmi; Gede Kambayana; IA Ratih Wulansari Manuaba; Awalia Awalia
Indonesian Journal of Rheumatology Vol. 12 No. 1 (2020): Indonesian Journal of Rheumatology
Publisher : Indonesian Rheumatology Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/ijr.v12i1.159

Abstract

Background Coronavirus Disease 2019 (COVID-19) could be fatal in high-risk patient including autoimmune rheumatic patients. Nowadays, the management of these patients becomes dilemma because the use of steroids and disease-modifying anti-rheumatic drugs could suppress the immune system however, poor control of the underlying disease increases the infection risk. Understanding the characteristics of these patients in the COVID-19 pandemic is essentials to establish management guidelines and identify patients who are more susceptible to COVID-19. This study aimed to determine the characteristics of autoimmune rheumatic patients in the era of COVID-19 pandemic in Indonesia. MethodA descriptive study using national scale survey method was conducted. The subjects were autoimmune rheumatic patients in Indonesia and recruited using consecutive sampling. The variables evaluated in this study were demographic data, history of disease, current medications taken, daily activities in the COVID-19 pandemic, and also data related to COVID-19. The surveys distributed in online form to patients with autoimmune rheumatic disease in Indonesia. ResultTotal participants in this study were 570 patients, mostly women (93.9%), aged <60 years old (97.2%), and diagnosed with systemic lupus erythematosus (62.8%). Glucocorticoid (70.2%) especially low dose glucocorticoid (52.6%) is the most medication taken by patients. A 30.5% of patients is taking hydroxychloroquine/chloroquine and 88.1% of them have good compliance. During COVID-19 pandemic, 76.5% respondents still do normal activities/work and only 53.2% use personal protective equipment. Eleven of 541 respondents had positive PCR test and confirmed to COVID-19. The risk of COVID-19 infection based on British Society of Rheumatology (BSR) scoring system showed that 57.9%, 28.6%, and 13.5% patients in high, moderate and low risk, respectively. ConclusionPatients with autoimmune rheumatic diseases might be more susceptible to COVID-19 than the general population. Interplay of aging, therapies and disease-specific factors, comorbidities and the proper use of personal protective equipment seem to contribute. Keywords :autoimmune rheumatic disease, characteristic, COVID-19, Indonesia
Should Patient with Autoimmune Inflammatory Rheumatic Diseases (AIIRD) be vaccinated with COVID-19 Vaccines? Cesarius Singgih Wahono; Perdana Aditya; Faisal Parlindungan; RM. Suryo Anggoro KW; Anna Ariane; Herlina Yani; Andi Raga Ginting; Lisa Kurnia Sari; Pande Ketut Kurniari; Ratih Manuaba; Ika Vemilia; Rudy Hidayat; Sumariyono Sarmidi; Harry Isbagjo
Indonesian Journal of Rheumatology Vol. 13 No. 1 (2021): Indonesian Journal of Rheumatology
Publisher : Indonesian Rheumatology Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/ijr.v13i1.167

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Vaccination is a very important measure for the prevention of various infections worldwide including the recent COVID-19 disease. However, until now the COVID-19 vaccine with various platforms has not been clinically tested on autoimmune inflammatory rheumatic disease (AIIRD) patients, due to caution against possible side effects and unknown efficacy. Several recent studies proved that there is increased risk of SARS-CoV-2 infection in AIIRD patients and moreover, those patients also have worse COVID-19 outcomes. Thus, patients with AIIRD should be prioritized for vaccination because they have an increased burden of infections, including COVID-19. Many studies showed that inactivated/non-live vaccine is safe for AIIRD patients and do not cause disease exacerbations. We conclude that benefits of vaccination greatly outweigh the risks of infection and therefore, COVID-19 vaccines can also be administered safely in stable AIIRD patients.
Indonesian Rheumatology Association (IRA) Recommendations for Diagnosis and Management of Rheumatoid Arthritis Rudy Hidayat; Bagus Putu Putra Suryana; Linda Kurniaty Wijaya; Anna Ariane; Rakhma Yanti Hellmi; Endy Adnan; Sumariyono
Indonesian Journal of Rheumatology Vol. 13 No. 1 (2021): Indonesian Journal of Rheumatology
Publisher : Indonesian Rheumatology Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/ijr.v13i1.173

Abstract

Introduction: Rheumatoid arthritis (RA) is an autoimmune rheumatic disease which often found in daily practice and requires certain considerations in recognizing clinical appearance also managing the disease as it often causes permanent joint damage, disability, even premature death. This recommendation is expected to become the latest reference for diagnosis and management of RA in Indonesia. Methods: The steering committee was formed by the Indonesian Rheumatology Association (IRA) to formulate key questions; conduct literature search, selection, and review; then formulate recommendation statements for diagnosis, therapy, and monitoring of RA. Furthermore, the steering committee determined the level of evidence and grades of the recommendations. After that, the level of agreement (LOA) was determined for each item by panelists including rheumatology consultants who have been appointed by IRA to represent Indonesia regions. Results: The steering committee established 30 recommendations including diagnosis, the role of laboratory and radiology tests, general treatment, the use of glucocorticoids, sDMARD, bDMARD, and tsDMARD. This recommendation also discusses guidelines on monotherapy, combination therapy, treatment strategies (treat-to-target), tapering, and continuous clinical remission. Treatment on co-morbidities and complications are also included in brief. Conclusion: IRA recommendations regarding the diagnosis and management of RA was made by considering various aspects such as the availability of drugs and supporting facilities, socioeconomic and cultural conditions in Indonesia, as well as the latest research that can be applied to Indonesian population.
Indonesian Rheumatology Association (IRA) Recommendations for Diagnosis and Management of Axial Spondyloarthritis 2021 Ayu Paramaiswari; R.M. Suryo Anggoro Kusumo Wibowo; Yulyani Werdiningsih; Arief Nurudhin; Surya Darma; Lita Diah Rahmawati; Sumartini Dewi; Rudy Hidayat; Sumariyono
Indonesian Journal of Rheumatology Vol. 13 No. 1 (2021): Indonesian Journal of Rheumatology
Publisher : Indonesian Rheumatology Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/ijr.v13i1.174

Abstract

Objective. Recommendations for spondyloarthritis are made to provide guidelines in diagnosis establishment, therapy, and monitoring of axial spondyloarthritis cases.Method. Literature searches were conducted online. The drafting team determines the levels of evidence (LOE) and grades of recommendation (GOR). After conducting a discussion, each recommendation that has been agreed upon by the drafting team is then classified based on the levels of evidence and grades of recommendation. The final step in the preparation of these recommendations is to determine the level of agreement (LOA) on each recommendation carried out by a team of panelists who have been appointed by IRA.Results. Twenty recommendations regarding axial spondyloarthritis were established. Strong recommendations or GOR A include: Ax-SpA diagnosis can be made according to the 2010 ASAS criteria, or the 1984 modified New York criteria specifically for the US; conventional radiographic examinations and MRI of the sacroiliac joints and vertebrae may be used as evaluators of disease activity and predictors of therapeutic response, as well as patients who do not respond to NSAIDs (within 4 weeks) can be administered a combination of NSAIDs and anti-TNF, and if it is not possible, a combination of NSAIDs and anti-IL-17A (Secukinumab, Ixekizumab).Conclusion. These recommendations provide a direction for clinicians to diagnose and manage spondyloarthritis.