Clinical and experimental rheumatology最新文献

{"title":"Clinical characteristics and prognostic analysis of concurrent Pneumocystis jirovecii pneumonia in patients with connective tissue diseases: a retrospective study.","authors":"Yujie Shi, Ruxuan Chen, Hongli Sun, Kai Xu, Zhiyi Li, Mengqi Wang, Chi Shao, Hui Huang","doi":"10.55563/clinexprheumatol/yyd4gm","DOIUrl":"https://doi.org/10.55563/clinexprheumatol/yyd4gm","url":null,"abstract":"<p><strong>Objectives: </strong>The incidence of Pneumocystis jirovecii pneumonia (PJP) in connective tissue diseases (CTD) patients is increasing and the mortality rate is high. We carried out this study to describe clinical characteristics in PJP patients with different underlying CTDs and identify prognostic risk factors in CTD-PJP patients.</p><p><strong>Methods: </strong>We retrospectively enrolled consecutive patients with CTD-PJP in our centre between January 2014 and December 2022. We included 248 participants who were classified according to underlying CTD or clinical outcomes.</p><p><strong>Results: </strong>In our study, there were 57 CTD-PJP patients (41, 66) years, 64.5% of whom were female, 108 (43.5%) of whom died. There were more interstitial lung disease (ILD) (p<0.001), pneumomediastinum (p=0.004), and a higher corticosteroid dosage (p=0.003) in the idiopathic inflammatory myopathy (IIM) group of patients. Patients in the IIM group had a significant highest mortality (65.5%), whereas those in the rheumatoid arthritis (RA) group had a lower mortality rate (30.4%) (p=0.006). Multivariate analysis indicated that IIM (HR=6.657, p<0.001, 95% CI: 2.883-15.368), hospital-acquired pneumonia (HAP) (HR=2.175, p<0.05, 95% CI: 1.028-4.601), lower minimal albumin (Alb) (HR=0.869, p<0.001, 95% CI: 0.802-0.942) and higher lactate dehydrogenase (LDH) (HR=1.002, p<0.001, 95% CI: 1.001-1.003) were independent risk factors for the survival of CTD-PJP patients. The optimal cut-off point of serum minimal Alb was 26.5 g/L and serum LDH was 612 U/L, respectively.</p><p><strong>Conclusions: </strong>CTD-PJP patients were mainly middle-aged female, with a high mortality rate. IIM patients had a relatively worse outcome, while RA patients had a relatively better survival rate. IIM, HAP, lower serum minimal Alb and higher LDH were independent survival risk factors for them.</p>","PeriodicalId":10274,"journal":{"name":"Clinical and experimental rheumatology","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145225081","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Modification of cardiovascular risk factors after viscosupplementation with hyaluronic acid in patients with symptomatic hip and knee osteoarthritis.","authors":"Agustín Miguel García-Bravo, Miguel Ángel Ruiz-Fernández, Alejandro Taboada Vázquez, Andrea Vizcaíno-Arzola, Olga Del Rey Echevarría, Marcos Rufino-Navarro, Lina Pérez-Méndez, Francisco J De León-García","doi":"10.55563/clinexprheumatol/tsa1u8","DOIUrl":"https://doi.org/10.55563/clinexprheumatol/tsa1u8","url":null,"abstract":"<p><strong>Objectives: </strong>We aimed to evaluate the modification of cardiovascular risk factor parameters after intra-articular injection with hyaluronic acid in patients with symptomatic hip and knee osteoarthrtitis. This was a retrospective cohort study of 101 patients meeting the clinical and radiological criteria of the American College of Rheumatology for hip and knee osteoarthritis, Kellgren-Lawrence grades I-IV.</p><p><strong>Methods: </strong>Patients received four intra-articular injections of hyaluronic acid in the knee and/or hip in the period of study. After the injections, changes in weight and BMI, pain using the visual analogue scale, consumption of pain medications, and physical activity were recorded at each follow-up visit. Analytical variations in blood glucose, HbA1c, total cholesterol, LDL, HDL, and triglycerides were also evaluated.</p><p><strong>Results: </strong>Over the 24-month study period, weight and BMI were stabilised. A reduction in pain of 1.2 points (p<0.001), a 20,76% reduction in analgesic consumption (p<0.001), and a 19.81% increase in physical activity (p<0.001) and a 21.8% increase in frequency (p=0.001) were observed. Total cholesterol (p=0.002), LDL (p=0.009), HDL (p=0.023), and triglycerides (p=0.021) showed a significant decrease in all cases when analysed in patients whose baseline levels were pathological.</p><p><strong>Conclusions: </strong>Intra-articular viscosupplementation with hyaluronic acid in symptomatic hip and knee osteoarthritis achieves a decrease in pain, potentially allowing patients to increase their physical activity levels, which helps control weight and BMI. Secondarily it could influence the improvement of CVRF analytical outcomes in the medium term in those patients who had altered levels.</p>","PeriodicalId":10274,"journal":{"name":"Clinical and experimental rheumatology","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145225087","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Serum NLRC3 levels in systemic lupus erythematosus: correlation with clinical characteristics.","authors":"Wengen Li, Xiaodong Gu, Sudong Liu, Chao Chen, Xianghui He, Biyao Huang","doi":"10.55563/clinexprheumatol/h3m8hl","DOIUrl":"https://doi.org/10.55563/clinexprheumatol/h3m8hl","url":null,"abstract":"<p><strong>Objectives: </strong>The role of nucleotide oligomerisation domain (NOD)-like receptor with a caspase activation and recruitment domain 3 (NLRC3) in systemic lupus erythematosus (SLE) remains unclear. This study aims to investigate serum NLRC3 levels and their correlations with disease characteristics in SLE.</p><p><strong>Methods: </strong>This cross-sectional study included 60 newly diagnosed active SLE patients hospitalised at Meizhou People's Hospital between January 2023 and May 2024. An additional 60 SLE patients in the lupus low disease activity state (LLDAS) and 50 healthy controls (HCs) served as control groups. Clinical data were extracted from electronic medical records. Spearman correlation was used to investigate the relationships between NLRC3 and clinical characteristics. Receiver operating characteristic (ROC) curve analysis was used to evaluate the diagnostic performance of NLRC3.</p><p><strong>Results: </strong>Serum NLRC3 levels in active SLE patients were lower than those in LLDAS SLE patients (p=0.014) and HCs (p=0.004), while no notable difference was observed between LLDAS SLE patients and HCs (p=0.631). Active SLE patients with fever, rash, or haematological involvement showed significantly lower NLRC3 levels (p=0.029 for fever; p=0.034 for rash, and p=0.032 for haematological involvement). NLRC3 levels were negatively correlated with fever, rash, leukopenia, and serum BAFF levels (p=0.028; p=0.033; p=0.028 and p=0.017, respectively); positively linked to complement C3 (p=0.044). ROC analysis showed an AUC of 0.665 (p=0.003) for discriminating active SLE from LLDAS SLE.</p><p><strong>Conclusions: </strong>Serum NLRC3 levels are significantly reduced in active SLE patients and are associated with clinical disease activity parameters. NLRC3 could be a promising biomarker for active SLE identification.</p>","PeriodicalId":10274,"journal":{"name":"Clinical and experimental rheumatology","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145225100","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"SHP2 inhibitor mitigated renal tubular epithelial cell injury in lupus nephritis via ERK/NF-κB pathway.","authors":"Yu Chen, Shumin Wang, Shuhui Tan, Tingting Jiang, Xiaojing Li, Genhong Yao, Lingyun Sun","doi":"10.55563/clinexprheumatol/csqb0j","DOIUrl":"https://doi.org/10.55563/clinexprheumatol/csqb0j","url":null,"abstract":"<p><strong>Objectives: </strong>The Src homology phosphatase 2 (SHP2) has been shown to be associated with systemic lupus erythematosus (SLE). However, its role and specific mechanisms in lupus nephritis (LN) remains unknown. In this study, we aimed to explore the efficacy and mechanism of targeting SHP2 for treatment of LN.</p><p><strong>Methods: </strong>The SHP2 was detected in renal tissues of MRL/lpr mice by western blot and immunohistochemistry. The MRL/lpr mice were divided into control group, PBS group and treatment group. The treatment group received SHP099 (SHP2 inhibitor) intraperitoneally daily for 4 weeks. The lupus-like symptoms and renal histopathological changes of mice in the PBS and SHP099 groups were evaluated. The expression of inflammation and fibrosis-related genes in renal tissues was detected by RT-qPCR. The renal tubular epithelial cell (HK-2) injury was induced by lipopolysaccharide (LPS). The effects of SHP099 and ERK/NF-κB signalling pathway on LPS-treated-HK-2 cells were assessed.</p><p><strong>Results: </strong>SHP2 was activated in kidney tissues of MRL/lpr mice. After treatment with SHP099, renal pathology was alleviated, inflammation- and fibrosis-related gene expression levels were reduced, and ERK/NF-κB signalling pathway-related protein was reduced in MRL/lpr mice. SHP099 inhibited LPS-induced inflammatory activation in HK-2 cells. SHP099 regulated ERK/NF-κB signalling pathway in HK-2 cells.</p><p><strong>Conclusions: </strong>Our findings suggested that inhibition of SHP2 mitigated renal tubular epithelial cell injury in LN through regulating the ERK/NF-κB signalling pathway. Our study elucidated the mechanism of the beneficial effects of SHP2 inhibitor on LN and provided a promising therapeutic strategy to treat LN.</p>","PeriodicalId":10274,"journal":{"name":"Clinical and experimental rheumatology","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145225156","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison and clinical analysis of tissue-specific autoantibodies levels in primary Sjögren's disease and other connective tissue diseases.","authors":"Zhi Min Wang, Yu Shu Yang, Xuan Qi, Yue Zhang, Xiao Ping Wang, Jin Long Li, Zi Zhe Huang, Hui Fang Guo, Li Xia Gao","doi":"10.55563/clinexprheumatol/tt1e0x","DOIUrl":"https://doi.org/10.55563/clinexprheumatol/tt1e0x","url":null,"abstract":"<p><strong>Objectives: </strong>This study investigates serum levels of anti-parotid secretory protein (PSP), anti-salivary gland protein 1 (SP1), and anti-carbonic anhydrase 6(CA6) antibodies in primary Sjögren's disease (pSjD) and other connective tissue diseases (CTDs), further to evaluate their clinical relevance.</p><p><strong>Methods: </strong>The study enrolled 60 patients diagnosed with pSjD, along with 30 disease controls (DC) suffering from various CTDs and 30 healthy controls (HC) for comparison. The serum levels of anti-PSP, anti-SP1, and anti-CA6 antibodies were measured using chemiluminescent immunoassays. Statistical analyses were performed using SPSS 27.0, including ANOVA, nonparametric tests (Kruskal-Wallis H and Mann-Whitney U), and Spearman correlation.</p><p><strong>Results: </strong>The Patients with pSjD showed significantly higher serum levels of anti-CA6 immunoglobulin G (IgG), anti-PSP IgG/IgA, and anti-SP1 IgG than the DC and HC groups (p<0.05). These antibodies have a certain predictive accuracy in pSjD. The IgG subtype of anti-CA6, anti-PSP and anti-SP1 had a positive correlation with the erythrocyte sedimentation rate (ESR) and IgG in clinical correlations aspect. The levels of anti-CA6 IgG and anti-PSP IgG increased significantly with the severity of labial gland pathology (p<0.05). The subgroups that were positive for anti-SSA52KD(Ro52)/SSA60KD(Ro60)/SSB(La) exhibited higher levels of anti-CA6 IgG and anti-PSP IgG than their seronegative counterparts (p<0.05), while positivity for anti-centromere antibody (ACA)was linked to lower levels of anti-CA6 and anti-PSP IgG.</p><p><strong>Conclusions: </strong>Anti-CA6, anti-PSP and anti-SP1 antibodies show diagnostic value in pSjD, with elevated IgG levels reflecting disease progression, histopathological damage, and distinct autoantibody interactions, implicating their pathogenic contributions.</p>","PeriodicalId":10274,"journal":{"name":"Clinical and experimental rheumatology","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145225140","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The impact of first-line tumour necrosis factor inhibitor treatment on anti-infective use in patients with axial spondyloarthritis: a nationwide retrospective cohort study.","authors":"Hlin Thorhallsdottir, Aron H Bjornsson, Thorvardur J Love, Bjorn Gudbjornsson","doi":"10.55563/clinexprheumatol/o4irbr","DOIUrl":"https://doi.org/10.55563/clinexprheumatol/o4irbr","url":null,"abstract":"<p><strong>Objectives: </strong>To investigate the use of anti-infective prescriptions (AIPs) in axial spondyloarthritis (axSpA) patients treated with tumour necrosis factor α inhibitors (TNFi) therapy and determine factors associated with increased risk of anti-infective use.</p><p><strong>Methods: </strong>In this nationwide matched cohort study, we extracted information on all adult biologic-naive patients with axSpA initiating treatment with a TNFi in 2003-2018 from ICEBIO. Each patient was matched on age, sex, and calendar time to five individuals from the general population. AIPs were collected from nationwide registers two years before and after TNFi initiation. Prescription incidence rates (IR) were calculated, and multivariable analysis was conducted.</p><p><strong>Results: </strong>The study identified data on 378 axSpA patients. The axSpA patients had higher IR per patient-year (py) of AIPs than comparators (1.12 (1.04-1.20) vs. 0.40 (0.38-0.42), p<0.001) before TNFi treatment. After TNFi initiation, the IR per py of AIP increased to 1.43 ((1.35-1.52), p<0.001), with a significant increase for antibiotics (1.04 (0.97-1.12) to 1.29 (1.21-1.38), p<0.001) and antivirals (0.03 (0.2-0.04) vs. 0.07 (0.06-0.1), p<0.001). Prior AIPs, female sex, and higher HAQ score were associated with increased AIPs after TNFi initiation, while age, smoking, and the use of glucocorticoids or methotrexate were not.</p><p><strong>Conclusions: </strong>Filled AIPs among axSpA patients increased after TNFi initiation in contrast to what has been documented in prior studies on severe infections. This indicates an increase in non-severe infections or a lower threshold for AIPs among physicians after treatment initiation. Furthermore, axSpA patients were prescribed more AIPs before TNFi treatment compared to the general population, suggesting elevated baseline infection risk.</p>","PeriodicalId":10274,"journal":{"name":"Clinical and experimental rheumatology","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145225165","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The utility of machine learning-based decision support system in referral of suspected rheumatic disease.","authors":"Hakan Babaoğlu, Hasan Satiş, Yasin Kavak, Abdurrahman Tufan","doi":"10.55563/clinexprheumatol/31phae","DOIUrl":"https://doi.org/10.55563/clinexprheumatol/31phae","url":null,"abstract":"<p><strong>Objectives: </strong>The rising prevalence of rheumatic diseases (RD), coupled with a global shortage of rheumatologists, creates significant challenges for timely and accurate diagnosis. This study aimed to develop and evaluate an adaptive machine learning (ML)-based decision support system for facilitating accurate referral of patients with suspected RD to rheumatology clinics.</p><p><strong>Methods: </strong>Participants attending a rheumatology outpatient clinic for the first time were enrolled in this study. A web-based survey, designed for patient accessibility, collected data on clinical symptoms associated with various rheumatic diseases. At the end of a 6-month follow-up, the rheumatologic disease status (correct referral/unnecessary referral) of the patients was added to the database. A fivefold cross-validation approach was employed to assess model performance. The reported results are the average of these five-fold models, reporting sensitivity, specificity, and area under the curve (AUC).</p><p><strong>Results: </strong>During the 6-month follow-up period involving 843 participants, 574 were diagnosed with a rheumatologic disease. Overall, 31.9% of participants were found to have been referred unnecessarily. The ML model accurately identified patients who were appropriately referred, achieving a mean AUC of 77.9% (95% CI: 74.9%-80.9%), with a mean sensitivity of 87.1% (95% CI: 84.4%-89.8%), and a mean specificity of 67.8% (95% CI: 62.2%-73.3%) across five folds. The best-performing fold reached an AUC of 81.34% (95% CI: 78.58%-84.22%) with the sensitivity of 81.74% (78.58%- 4.90%) and a specificity of 80.95% (76.26%-85.64%). The addition of four questions (n=245) significantly improved performance metrics, with an AUC of 90.77% (95% CI 87.20-94.34), sensitivity of 89.74% (95% CI 85.14-94.34), and specificity of 92.05% (95% CI 86.05-98.05) for best fold.</p><p><strong>Conclusions: </strong>This ML-based triage tool demonstrates strong potential for accurately identifying appropriate referrals, reducing unnecessary consultations, and enhancing resource utilisation in rheumatology clinics. Our results show that performance improved through an iterative, patient-feedback-driven refinement process. Future multicentre studies are needed for validation, and collaborative efforts will be essential to maximise its impact.</p>","PeriodicalId":10274,"journal":{"name":"Clinical and experimental rheumatology","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145225262","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Behçet's syndrome: one year in review 2025.","authors":"Gülen Hatemi, Emire Seyahi, Izzet Fresko, Rosaria Talarico, Didar Uçar, Vedat Hamuryudan","doi":"10.55563/clinexprheumatol/8xuim0","DOIUrl":"https://doi.org/10.55563/clinexprheumatol/8xuim0","url":null,"abstract":"<p><p>Behçet's syndrome (BS) is a variable-vessel vasculitis with multiorgan involvement and heterogeneous clinical manifestations. A list of studies were published on BS last year including studies that explore the epidemiology of BS in different parts of the world, role of potential immunological biomarkers in major organ involvement phenotypes, genome wide association studies, studies on micro RNAs, toll like receptors, neutrophil function and epigenetics that added to our understanding of the pathogenesis, studies on imaging and clinical findings that aim to improve diagnosis, differential diagnosis, and monitoring of each organ involvement, as well as studies on management, especially focusing on the role of TNF inhibitors compared to conventional immunosuppressives. The aim of this review is to provide a critical digest of the studies on BS published during 2024.</p>","PeriodicalId":10274,"journal":{"name":"Clinical and experimental rheumatology","volume":"43 10","pages":"1699-1708"},"PeriodicalIF":3.4,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145353263","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Silent but significant: subclinical cardiovascular changes in paediatric Behçet's disease.","authors":"Ilyas Bingöl, Hafize Emine Sönmez, Sümeyra Doğan, Helen Bornaun","doi":"10.55563/clinexprheumatol/hepzdi","DOIUrl":"10.55563/clinexprheumatol/hepzdi","url":null,"abstract":"<p><strong>Objectives: </strong>Behçet's disease (BD) is a systemic, autoinflammatory vasculitis with recurrent mucocutaneous ulcerations, ocular involvement, and multisystemic manifestations, including cardiovascular complications. While extensively studied in adults, paediatric BD, particularly regarding cardiovascular involvement, remains underexplored. This study assesses cardiovascular manifestations in paediatric BD through echocardiographic, vascular, and microvascular evaluations.</p><p><strong>Methods: </strong>A total of 58 subjects were enrolled, including 29 paediatric BD patients and 29 healthy children. Exclusion criteria included comorbidities or prior cardiovascular diseases. Capillaroscopy assessed nailfold microvascular changes, and carotid artery intima-media thickness (CIMT) was measured via ultrasonography. Transthoracic echocardiography evaluated cardiac parameters, including ventricular function and indices of aortic stiffness and pulmonary vascular resistance.</p><p><strong>Results: </strong>The mean age of BD patients was 15.8 years, with disease onset at 12.4 years. Elevated left ventricular myocardial performance index (LV MPI), reduced right ventricular systolic function, and increased pulmonary arterial pressure. Aortic stiffness was also significantly higher, indicating early vascular remodelling. CIMT showed no significant differences. Mild capillary tortuosity was observed in some BD patients.</p><p><strong>Conclusions: </strong>The findings suggest early cardiovascular changes in paediatric BD, including diastolic dysfunction, increased pulmonary arterial pressure, and impaired aortic elasticity. These results highlight the need for routine cardiovascular screening, even without overt cardiac symptoms, to mitigate long-term cardiovascular risks. Further studies are needed to understand these abnormalities' progression and optimise interventions.</p>","PeriodicalId":10274,"journal":{"name":"Clinical and experimental rheumatology","volume":" ","pages":"1830-1835"},"PeriodicalIF":3.4,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145257665","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A single dose of anakinra for arresting familial Mediterranean fever attacks: a proof-of-concept study.","authors":"Eitan Giat, Avi Livneh, Ilan Ben-Zvi, Amit Druyan, Danielle Bar, David J Ozeri, Galit Almoznino, Merav Lidar","doi":"10.55563/clinexprheumatol/cj61ub","DOIUrl":"https://doi.org/10.55563/clinexprheumatol/cj61ub","url":null,"abstract":"<p><strong>Objectives: </strong>Familial Mediterranean fever (FMF) is characterised by painful inflammatory bouts, typically lasting one to three days. Analgesics, the only available treatment to alleviate acute attacks, are often ineffective in reducing pain and attack duration. This study evaluates the efficacy of a single dose of anakinra, administered at the onset of FMF attack, in arresting the attack.</p><p><strong>Methods: </strong>This prospective self-controlled case series involved patients receiving a single prefilled syringe with 100 mg anakinra for self-administration at attack onset. The primary outcome was the duration of anakinra-treated attacks compared to baseline attack duration. Additional attacks were treated with self-procured anakinra and analysed separately.</p><p><strong>Results: </strong>Twenty-three attacks experienced by 23 patients and treated with the furnished anakinra were analysed. Treated attacks were arrested within 5.4±6 hours from anakinra administration, and lasted 8.33±6.8 hours from onset, significantly shorter than the 56.3±16.8 hours reported at baseline (p=0.0001). Use of purchased anakinra (43 injections by 6 patients) attained equal outcome. Early administration of anakinra (within ≤4 hours of attack onset) resulted in attack termination within ≤4 hours from anakinra injection in 17 of 20 (85%) and 37 of 41 (90%) of the attacks treated with furnished and procured anakinra, respectively. Adverse events were limited to one patient experiencing an injection site reaction.</p><p><strong>Conclusions: </strong>Acute FMF attacks are highly responsive to early anakinra administration with low safety cost.</p>","PeriodicalId":10274,"journal":{"name":"Clinical and experimental rheumatology","volume":"43 10","pages":"1735-1741"},"PeriodicalIF":3.4,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145353276","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}