Clinical and experimental rheumatology最新文献

{"title":"Allogeneic stem cell transplantation in difficult-to-treat rheumatoid arthritis.","authors":"Kevin Van Compernolle, Dominik Selleslag, Glen S Hazlewood, Jan Storek, Jacob M van Laar, Yves Piette","doi":"10.55563/clinexprheumatol/qonstg","DOIUrl":"10.55563/clinexprheumatol/qonstg","url":null,"abstract":"","PeriodicalId":10274,"journal":{"name":"Clinical and experimental rheumatology","volume":" ","pages":"545"},"PeriodicalIF":3.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142496173","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 charter to improve care for systemic lupus erythematosus.","authors":"Marta Mosca, Jeanette Andersen, Patrick Wildman, Susan Manzi, Zahir Amoura, Irene Bultink, Odirlei Andre Monticielo, Sandra Navarra, Susanne Pettersson","doi":"10.55563/clinexprheumatol/my79eu","DOIUrl":"10.55563/clinexprheumatol/my79eu","url":null,"abstract":"<p><strong>Objectives: </strong>To develop evidenced recommendations to allow the global systemic lupus erythematosus (SLE) advocacy community to effectively advocate for change and improve care for patients with SLE.</p><p><strong>Methods: </strong>A Global Working Group consisting of representatives from patient advocacy groups, professional organisations, and the SLE healthcare community defined key areas of unmet need in patients with SLE. Targeted principles for each area of unmet need guided a literature review to investigate the current global situation, pre-existing advocacy efforts, and best practices from other therapy areas. The results from this literature review allowed the Working Group to develop recommendations to improve care for patients with SLE.</p><p><strong>Results: </strong>Barriers faced by patients with SLE can stem from poor recognition of symptoms, which leads to delays in accurate diagnosis, cycling between different healthcare professionals, and inconsistencies in receiving optimal care. Patient access to approved treatments for SLE also remains limited. This Patient Charter, co-developed with a group of internationally recognised clinicians and patient advocates, sets out the minimum standard of care people living with SLE should expect and receive under 4 principles with distinct recommendations for change.</p><p><strong>Conclusions: </strong>The intention is to improve health outcomes by uniting and empowering patients, caregivers, patient groups, and healthcare professionals to advocate for reforms to healthcare practices for people living with SLE.</p>","PeriodicalId":10274,"journal":{"name":"Clinical and experimental rheumatology","volume":" ","pages":"517-525"},"PeriodicalIF":3.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142616025","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":"C-reactive protein thresholds for discriminating active disease in psoriatic arthritis may be different in early versus established disease.","authors":"Marta Loredo, Pablo González Del Pozo, Paula Alvarez, Norma Calleja, Rubén Queiro","doi":"10.55563/clinexprheumatol/8dazct","DOIUrl":"10.55563/clinexprheumatol/8dazct","url":null,"abstract":"<p><strong>Objectives: </strong>Inflammatory biomarkers such as C-reactive protein (CRP) lack discriminatory capacity to detect active disease in psoriatic arthritis (PsA). Our aim was to find CRP thresholds capable of discriminating active disease in both early and established PsA.</p><p><strong>Methods: </strong>We included a total of 345 PsA patients (215 early-onset not exposed to high-impact therapies and 130 with established disease under biologics and oral targeted therapies). Discriminative CRP thresholds were determined by the Youden index, while their sensitivity/specificity balance was evaluated by the area under the receiver-operating characteristic (AUROC) curve.</p><p><strong>Results: </strong>Cohort I (recent-onset PsA) included 215 consecutive patients, mean age 49.8 ± 13.9 years, 145 men (67.4%) and 70 women (32.6%). Cohort II (established PsA: mean duration 9.2 ± 7.1 years) included 130 consecutive patients, mean age 55.6 ± 11.2 years, 64 men (49.2%) and 66 women (50.8%). In cohort II, a CRP value around 0.20 mg/dl resulted discriminative for active disease (AUROC 0.71, OR 4.7, p<0.001). Among patients not exposed to anti-TNF drugs in cohort II, a CRP ≥0.22 mg/dl was highly discriminative for active disease (AUROC 0.86). In cohort I, no CRP values ​​ with good discriminative performance were obtained in any scenario. The standard inflammatory CRP value (≥0.5 mg/dl) did not provide discriminative advantage above the previous thresholds in either cohort.</p><p><strong>Conclusions: </strong>Our results suggest the adoption of lower than standard CRP cut-off values ​​ for a better assessment of PsA in clinical practice. This seems to be more applicable in established than in recent-onset PsA.</p>","PeriodicalId":10274,"journal":{"name":"Clinical and experimental rheumatology","volume":" ","pages":"467-471"},"PeriodicalIF":3.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142876342","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":"Survival and early outcomes following lung transplantation for interstitial lung disease associated with non-scleroderma connective tissue disease: a national cohort study.","authors":"Caikang Luo, Jiang Shi, Jiaqin Zhang, Yanwei Lin, Yining Pan, Jie Zhang, Chao Yang, Guilin Peng, Jianxing He, Xin Xu","doi":"10.55563/clinexprheumatol/tjnyz5","DOIUrl":"10.55563/clinexprheumatol/tjnyz5","url":null,"abstract":"<p><strong>Objectives: </strong>The progressive decline in interstitial lung disease associated with non-scleroderma connective tissue disease (ILD-NSCTD) is linked to poor prognosis and frequently results in respiratory failure. Lung transplantation (LTx) offers a viable treatment option, yet its outcomes in ILD-NSCTD remain contentious, particularly across different subtypes.</p><p><strong>Methods: </strong>This retrospective cohort study included patients with idiopathic pulmonary fibrosis (IPF) (n=11,610) and ILD-NSCTD (n=610) listed in the United Network for Organ Sharing (UNOS) database who underwent lung transplantation between May 5, 2005, and December 31, 2022. We used the Kaplan-Meier method to evaluate cumulative survival rates and logistic regression to assess the risk of post-operative complications.</p><p><strong>Results: </strong>Compared to IPF patients, those with ILD-NSCTD are generally younger, with a lower proportion of male and white patients. After propensity matching, overall survival rates remained similar between the groups (log-rank, p=0.953). However, ILD-NSCTD was associated with a significantly higher risk of post-operative stroke (adjusted OR 1.75, 95% CI 1.12-2.74, p=0.015) and longer post-operative hospital stays (p<0.001). Subgroup analyses yielded consistent results. Finally, infection was identified as the leading cause of death.</p><p><strong>Conclusions: </strong>Compared to IPF, patients with ILD-NSCTD have a significantly higher risk of post-operative stroke and extended hospital stays, potentially due to complications inherent to ILD-NSCTD. However, the underlying causes of these outcomes remain unclear. Despite these differences, short-term and long-term survival rates are comparable between the two groups, with consistent findings across various ILD-NSCTD subgroups. Therefore, ILD-NSCTD should not be regarded as a relative contraindication for lung transplantation. Nonetheless, the influence of extra-pulmonary complications in ILD-NSCTD patients requires further investigation.</p>","PeriodicalId":10274,"journal":{"name":"Clinical and experimental rheumatology","volume":" ","pages":"477-485"},"PeriodicalIF":3.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142977852","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":"Integrated analysis of genome-wide copy number variation and exome-wide rare variation identified novel loci for rheumatoid arthritis.","authors":"Shiqiang Cheng, Ke Xu, Weikun Hou, Xiaoyue Qin, Li Liu, Xuena Yang, Bolun Cheng, Chuyu Pan, Peilin Meng, Yan Wen, Yumeng Jia, Huan Liu, Feng Zhang, Peng Xu","doi":"10.55563/clinexprheumatol/dvpnbx","DOIUrl":"https://doi.org/10.55563/clinexprheumatol/dvpnbx","url":null,"abstract":"<p><strong>Objectives: </strong>The genetic underpinnings of RA remain partially elucidated, motivating our exploration of copy number variations (CNV) and rare variations in the pathogenesis of RA.</p><p><strong>Methods: </strong>We conducted an integrated analysis of the genome-wide landscape of CNV and exome-wide rare variation associations with RA in the UK Biobank. To strengthen our findings, we corroborated the results by the differentially expressed genes identified from gene expression profiles of synovial tissue of RA patients and health controls. Furthermore, we leveraged the Drug-Gene Interaction Database to explore potential drugs that could be repurposed to target genes found to be associated with RA.</p><p><strong>Results: </strong>After adjusted for the covariates, genome-wide CNV association study identified 92 significant signals and the gene-based burden test of the exonic variants identified 94 genome-wide significant associations for RA. Integrating genome-wide CNV and exome-wide rare variation analysis identified 3 common loci for RA, such as GPER1. Two overlapped genes were detected by CNV findings and gene expression profiles for RA, such as HLA-DQB1. Utilising a gene-drug interaction database, we identified novel pharmacological agents that could modulate the activity of these common genes.</p><p><strong>Conclusions: </strong>This study provides valuable insights into deciphering the genetic basis of RA and offers potential precision medicine strategies for RA.</p>","PeriodicalId":10274,"journal":{"name":"Clinical and experimental rheumatology","volume":"43 3","pages":"459-466"},"PeriodicalIF":3.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143613758","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":"Matrix metalloproteinase-12, an indicator potentially contributing to the differential diagnosis and activity assessment of retroperitoneal fibrosis.","authors":"Tong Zheng, Xiaoying Zhang, Jun Gao, Xiaoying Zhang, Jinxia Zhao, Shibo Liu, Hui Gao","doi":"10.55563/clinexprheumatol/ys972g","DOIUrl":"https://doi.org/10.55563/clinexprheumatol/ys972g","url":null,"abstract":"<p><strong>Objectives: </strong>We aimed to find a diagnostic indicator that contributed to differential diagnosis and activity assessment of retroperitoneal fibrosis (RPF).</p><p><strong>Methods: </strong>We analysed the expression of MMP-12 in pathological tissues and peripheral blood, and explored their correlations with clinical, laboratory, radical and pathological parameters.</p><p><strong>Results: </strong>The positive rate of MMP-12 in pathological tissues was significantly higher than that in the healthy controls. It was positively correlated with the positive rates of mTOR, CXCR5, IL-13 in the germinal centres (GCs) and MMP-12, IL-13 in the periphery. The parametric estimate of the area under the ROC curve of the positive rate and its 95% confidence interval were 0.875 and 0.673 ~1.000. The cut-off value and sensitivity and specificity were 16.395%, 0.938 and 0.750. Thickness of RPF mass was more severe in MMP-12 positive group based on this cut-off value. Although the concentration of MMP-12 in peripheral blood did not increase significantly, it was positively correlated with time before treatment and the positive rate of CXCR5 in the GCs.</p><p><strong>Conclusions: </strong>The positive rate of MMP-12 in the GCs of pathological tissues is a potential marker that contributes to the differential diagnosis of RPF and might be associated with the degree of fibrosis, although MMP-12 in the peripheral blood was not very helpful for disease diagnosis and monitoring of treatment effects. MMP-12 had the potential to become an indicator for the differential diagnosis RPF and monitoring the disease process.</p>","PeriodicalId":10274,"journal":{"name":"Clinical and experimental rheumatology","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143457054","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":"Tixagevimab-cilgavimab for the prevention of COVID-19: real-world experience in patients with rheumatic diseases receiving rituximab.","authors":"Chi Chiu Mok, Moon Ho Leung, Ka Man Chan, King Yee Ying, Tse Kwan Ho, Weng Nga Lao, Ka Lai Lee, Ho So, Woon Leung Ng, Ling Yin Ho, Kit Yu Young, Chi Hung To","doi":"10.55563/clinexprheumatol/rd87jm","DOIUrl":"https://doi.org/10.55563/clinexprheumatol/rd87jm","url":null,"abstract":"<p><strong>Objectives: </strong>To study the safety and efficacy of tixagevimab-cilgavimab (TIX-CIL) in reducing COVID-19 in patients with rheumatic diseases receiving rituximab.</p><p><strong>Methods: </strong>Patients with rheumatic diseases who were receiving rituximab for ≥12 months were invited for an injection of TIX-CIL (300 mg/300 mg) between November and December 2022. The occurrence of SARS-CoV2 infection in the subsequent 6 months was compared between those who did or did not receive TIX-CIL, adjusting for demographic characteristics, previous SAR2-CoV2 infection, COVID-19 vaccination and other factors by multivariate analyses.</p><p><strong>Results: </strong>A total of 330 patients were studied: 142 received TIX-CIL (age 55.8 ±14.7 years, 80% women) and 188 refused TIX-CIL (age 54.3 ±14.3 years; 84% women). There were fewer SLE patients in the TIX-CIL group (27% vs. 39%; p=0.02) and patients in this group had received a significantly greater number of COVID-19 vaccine doses (2.9 ±0.9 vs. 2.6±1.2; p=0.02). At month 3 post-injection, significantly fewer patients who received TIX-CIL developed COVID-19 (7.7% vs. 19.1%; p=0.003). However, the incidence of COVID-19 at month 6 was not significantly lower in the TIX-CIL group (23.2% vs. 27.2%; p=0.42). Severe COVID-19 developed in 11(3.3%) patients by month 6 and there was no difference between the two groups. Logistic regression revealed that TIX-CIL injection (OR 0.35[0.17-0.73]), female sex (OR 0.40[0.18-0.87]) and previous COVID-19 (OR 0.26[0.12-0.59]) were independent factors protective against COVID-19 at month 3. Adverse events to TIX-CIL were exclusively mild and self-limiting, with musculoskeletal pain, headache and dizziness being the most common.</p><p><strong>Conclusions: </strong>TIX-CIL was well tolerated and effective in reducing the incidence of COVID-19 in the subsequent 3 months.</p>","PeriodicalId":10274,"journal":{"name":"Clinical and experimental rheumatology","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143457072","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":"Frailty assessment in patients with systemic sclerosis.","authors":"Claudia Barison, Elda Piovani, Liala Moschetti, Eleonora Pedretti, Maria Grazia Lazzaroni, Franco Franceschini, Paolo Airò","doi":"10.55563/clinexprheumatol/h04798","DOIUrl":"https://doi.org/10.55563/clinexprheumatol/h04798","url":null,"abstract":"<p><strong>Objectives: </strong>To evaluate the prevalence of frailty, a clinical syndrome characterised by reduced physiological reserve which exposes affected individuals to the worst consequences of acute clinical episodes, in SSc patients, and to identify associated demographic and clinical factors.</p><p><strong>Methods: </strong>Frailty, comorbidities, SSc-related-activity, -organ damage and -overall patient-reported impact were assessed in 169 consecutive outpatients with SSc aged over 60 years by Primary Care Frailty Index (PC-FI), age-adjusted Charlson Comorbidity index (CCI), revised EUSTAR activity index, Scleroderma Clinical Trials Consortium Damage Index (SCTC-DI), and Sclero-ID, respectively. Information and data on hospitalisations were recorded during follow-up visits, scheduled according to clinical necessity, in 85 patients.</p><p><strong>Results: </strong>Frailty was observed in 51.3% of patients, with 31.9% classified as mildly frail, 10.7% as moderately frail, and 7.7% as severely frail. Frail SSc patients, as compared with non-Frail, were older, had a longer disease duration, higher CCI, SCTC-DI, Sclero-ID and exhibited more severe SSc complications. Multivariate analysis identified that disease duration and SSc-related organ damage as independent factors associated with PC-FI scores. Patients who died or required hospitalisation during follow-up were older, with higher PC-FI and CCI than the other SSc patients, though their SSc disease activity and damage did not differ significantly.</p><p><strong>Conclusions: </strong>Over half of SSc patients exhibited frailty, which correlated with both SSc-related organ damage and comorbidities. PC-FI appears to predict death and hospitalisations in SSc patients, highlighting frailty assessment as a potential tool for health program planning.</p>","PeriodicalId":10274,"journal":{"name":"Clinical and experimental rheumatology","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143457045","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":"Clinical value of diagnosing ischaemic stroke in patients with Takayasu's arteritis combining multiple arterial occlusion and high-grade enhancement.","authors":"Liuping Cui, Ran Liu, Yi Zhao, Bing Tian, Yingqi Xing","doi":"10.55563/clinexprheumatol/za3z36","DOIUrl":"https://doi.org/10.55563/clinexprheumatol/za3z36","url":null,"abstract":"<p><strong>Objectives: </strong>To determine the vascular ultrasound and contrast-enhanced ultrasound characteristics of ischaemic stroke in patients with Takayasu's arteritis (TAK) and explore the diagnostic value of ultrasound characteristics for diagnosing ischaemic stroke in such patients.</p><p><strong>Methods: </strong>We retrospectively analysed 80 patients with TAK who underwent vascular ultrasound and contrast-enhanced ultrasound on admission. We analysed the ultrasound characteristics of ischaemic stroke in these patients and performed multiple logistic regression analyses to determine the independent risk factors for ischaemic stroke in the patient cohort. The value of ultrasound characteristics in patients with TAK and ischaemic stroke was evaluated using the net reclassification and integrated discrimination improvement indices.</p><p><strong>Results: </strong>Among 80 patients, 22 (27.5%) had ischaemic stroke. Fourteen patients had anterior circulation infarction, two had posterior circulation infarction, and six had both. Multivariate analysis showed that the number of occluded arteries (odds ratio (OR), 2.01; p=0.005), high-grade enhancement (grade ≥2, OR, 6.52; p=0.016), and revascularisation (OR, 0.05; p=0.002) were independent influencing factors for ischaemic stroke in patients with TAK. The area under the curve indicated that the number of occluded arteries (≥3) and high-grade enhancement (grade ≥2) can be used to identify patients with TAK at high risk for ischaemic stroke.</p><p><strong>Conclusions: </strong>A higher number of cervical artery occlusions and high-grade enhancement (grade ≥2) are independent risk factors for ischaemic stroke in patients with TAK. The combination of these factors can facilitate the diagnosis of ischaemic stroke in these patients.</p>","PeriodicalId":10274,"journal":{"name":"Clinical and experimental rheumatology","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143457038","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 7th International Congress on Controversies in Fibromyalgia.","authors":"Jacob N Ablin, Piercarlo Sarzi-Puttini","doi":"10.55563/clinexprheumatol/zol8zo","DOIUrl":"10.55563/clinexprheumatol/zol8zo","url":null,"abstract":"","PeriodicalId":10274,"journal":{"name":"Clinical and experimental rheumatology","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143457059","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}