Clinical and experimental rheumatology最新文献

{"title":"Epstein-Barr virus infection and prognosis in haemophagocytic lymphohistiocytosis patients with underlying rheumatic diseases: a single-centre retrospective study.","authors":"Deli Song, Jingshi Wang, Hang Zhou, Lin Wu, Jia Zhang, Zhao Wang","doi":"10.55563/clinexprheumatol/7l4od4","DOIUrl":"https://doi.org/10.55563/clinexprheumatol/7l4od4","url":null,"abstract":"<p><strong>Objectives: </strong>Haemophagocytic lymphohistiocytosis (HLH) with underlying rheumatic diseases (rHLH) is a lethal disease, in which Epstein-Barr virus (EBV) infection is a causative factor. Whether EBV infection is associated with treatment response and prognosis of patients with rHLH remains unclear. This study explored the clinical features of patients with Epstein-Barr virus-positive rHLH.</p><p><strong>Methods: </strong>In this retrospective study, we included 137-patients and divided them into EBV-negative (n=116) and EBV-positive (n=21) groups. We compared the clinical characteristics, treatment responses, and prognoses between the two groups. Propensity score matching (PSM) was used to match patients between groups. Kaplan-Meier analysis was used to elucidate the relationship between the EBV-infected cell type and prognosis.</p><p><strong>Results: </strong>EBV-positive patients were more likely to have relapsed or refractory rHLH. The survival time of the EBV-negative group was significantly longer than that of the EBV-positive group (p=0.012). Further analysis of EBV-infected lymphocyte subsets revealed a significant decrease in survival in the NK and/or T lymphocyte groups compared to the other cell types (p<0.01).</p><p><strong>Conclusions: </strong>Patients with EBV-positive rHLH are more likely to experience relapse or refractoriness. For patients with rHLH, prompt testing of EBV-infected lymphocyte subsets should be performed upon EBV infection. An etoposide-based regimen is recommended for patients with EBV-positive rHLH, and rituximab may be effective in patients with refractory or relapsed rHLH with EBV-infected B lymphocytes. However, for patients with EBV-infected NK and/or T lymphocytes, treatment should be aligned with that for EBV-HLH.</p>","PeriodicalId":10274,"journal":{"name":"Clinical and experimental rheumatology","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143983551","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":"Reply to the comment on: The great challenge: bone fragility and environment.","authors":"Giammarco De Mattia, Maurizio Mazzantini","doi":"10.55563/clinexprheumatol/fikslq","DOIUrl":"https://doi.org/10.55563/clinexprheumatol/fikslq","url":null,"abstract":"","PeriodicalId":10274,"journal":{"name":"Clinical and experimental rheumatology","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143961288","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":"Characterising infusion/injection-related reactions in patients with rheumatoid arthritis treated with biologic agents.","authors":"Ji-Won Kim, Sun-Kyung Lee, Kichul Shin, Ju-Yang Jung, Chang-Hee Suh, Jinhyun Kim, Hyoun-Ah Kim","doi":"10.55563/clinexprheumatol/z9894l","DOIUrl":"https://doi.org/10.55563/clinexprheumatol/z9894l","url":null,"abstract":"<p><strong>Objectives: </strong>Biologic disease-modifying anti-rheumatic drugs (bDMARDs) have transformed the management of rheumatoid arthritis (RA), but their efficacy can be limited by infusion/injection-related reactions (IRRs). This study investigated demographic and clinical factors associated with IRRs in patients with RA using data from the Korean College of Rheumatology Biologics & Targeted Therapy (KOBIO) Registry.</p><p><strong>Methods: </strong>We analysed 1,832 patients with RA, categorising them into IRR and non-IRR groups. Demographic, disease characteristics, and treatment histories were compared. A Sankey plot visualised bDMARD switching patterns, and multivariable logistic regression identified IRR-independent predictors.</p><p><strong>Results: </strong>IRRs occurred in 9.7% of patients and were significantly associated with younger age (mean 49.9 vs. 54.9 years; OR=1.793, p=0.014), secondary Sjögren's syndrome (OR=2.175, p=0.035), and prior leflunomide use (OR=1.497, p=0.015). Abatacept (OR=0.263, p<0.001), tocilizumab (OR=0.419, p<0.001), and golimumab (OR=0.345, p=0.006) were associated with reduced IRR risk compared to infliximab. Following IRRs, use of etanercept, infliximab, and adalimumab declined, while tocilizumab and Janus kinase (JAK) inhibitors increased.</p><p><strong>Conclusions: </strong>IRRs are common among RA patients receiving bDMARDs, particularly in younger individuals or those with prior leflunomide use. Abatacept, tocilizumab, and JAK inhibitors represent safer alternatives, underscoring the need for individualised treatment strategies.</p>","PeriodicalId":10274,"journal":{"name":"Clinical and experimental rheumatology","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143979292","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":"Application of the 2023 ACR/EULAR antiphospholipid syndrome classification criteria to patients fulfilling the 2006 revised Sapporo criteria.","authors":"Oh Chan Kwon, Jang Woo Ha, Min-Chan Park, Yong-Beom Park, Sang-Won Lee","doi":"10.55563/clinexprheumatol/r0irbn","DOIUrl":"https://doi.org/10.55563/clinexprheumatol/r0irbn","url":null,"abstract":"<p><strong>Objectives: </strong>The American College of Rheumatology (ACR) and the European Alliance of Associations for Rheumatology (EULAR) developed new classification criteria for antiphospholipid syndrome (APS) in 2023. Although the new criteria yielded high specificity, further validation is needed in Asia, as the clinical characteristics of APS differ across ethnicities. We applied the 2023 ACR/EULAR criteria to Korean patients classified as having APS by the 2006 revised Sapporo criteria and assessed the concordance rate between the criteria.</p><p><strong>Methods: </strong>For this study, 126 patients with APS were included. Clinical and laboratory data were reviewed, and the fulfilment of the 2023 ACR/EULAR criteria was assessed for each patient.</p><p><strong>Results: </strong>Of the 126 patients classified by the 2006 revised Sapporo criteria, 107 had APS according to the 2023 ACR/EULAR criteria, accounting for a concordance rate of 84.9%. The concordance rate differed according to the index event. Patients with venous thromboembolism had the highest concordance rate (100%), followed by those with arterial thrombosis (76.4%). Patients with obstetric events had the lowest concordance rate (45.5%), attributable to the stricter obstetric criterion in the 2023 ACR/EULAR criteria than in the 2006 revised Sapporo criteria.</p><p><strong>Conclusions: </strong>In Korean patients with APS, the concordance rate between the 2023 ACR/EULAR criteria and the 2006 revised Sapporo criteria was high. The concordance rate was considerably lower when confined to patients with obstetric APS. The 2023 ACR/EULAR criteria are stricter, particularly for obstetric events; its emphasis on specificity may result in the exclusion of patients with clinically significant obstetric APS.</p>","PeriodicalId":10274,"journal":{"name":"Clinical and experimental rheumatology","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143961567","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":"Comment on: The great challenge: bone fragility and environment.","authors":"George M Weisz","doi":"10.55563/clinexprheumatol/zufilb","DOIUrl":"https://doi.org/10.55563/clinexprheumatol/zufilb","url":null,"abstract":"","PeriodicalId":10274,"journal":{"name":"Clinical and experimental rheumatology","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143979077","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 hidden burden of fibromyalgia: exploring work impairment and quality of life in caregivers.","authors":"Demet Ferahman, Ömer Faruk Bucak, Soner Arik, Tuğba Şahbaz","doi":"10.55563/clinexprheumatol/obdrlt","DOIUrl":"https://doi.org/10.55563/clinexprheumatol/obdrlt","url":null,"abstract":"<p><strong>Objectives: </strong>Fibromyalgia (FM) syndrome is a chronic musculoskeletal disorder that profoundly impacts not only patients but also their informal caregivers, affecting their quality of life and work productivity. This study aims to investigate the impact of FM on the work productivity and quality of life of informal caregivers.</p><p><strong>Methods: </strong>This cross-sectional study included FM patients who applied to our Physical Medicine and Rehabilitation clinic and their informal caregivers. FM was diagnosed using the revised 2016 American College of Rheumatology (ACR) criteria. A healthy control group and their cohabiting relatives were also included. FM patients completed the Revised Fibromyalgia Impact Questionnaire (FIQR), while caregivers and control group relatives completed the Work Productivity and Activity Impairment Questionnaire-General Health (WPAI-GH) and the World Health Organization Quality of Life Scale-Short Form (WHOQoL-BREF).</p><p><strong>Results: </strong>The study included 68 FM caregivers and 68 control group relatives. WPAI scores revealed significant differences in presenteeism, overall work productivity loss, and activity impairment between FM caregivers and controls (p<0.05), though no difference in absenteeism was observed. WHOQoL-BREF scores showed significant reductions across all quality-of-life domains for FM caregivers compared to controls, with a notable correlation between the FIQR scores of FM patients and the social relationships domain of their caregivers (p=0.026, r=-0.269).</p><p><strong>Conclusions: </strong>FM poses substantial burdens on both patients and their informal caregivers, reducing caregivers' work productivity and quality of life. Given the chronic nature of FM and the resulting long-term caregiving responsibilities, interventions that support both patients and caregivers, such as integrated healthcare and psychotherapy, may be beneficial. Further longitudinal studies are needed to examine these effects over time and support the development of comprehensive caregiver support strategies.</p>","PeriodicalId":10274,"journal":{"name":"Clinical and experimental rheumatology","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143967853","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":"Regarding the pain of men: characteristics of fibromyalgia in male patients.","authors":"Lian Bannon, Omer Shlezinger, Mark Berman, Laurence Mangel, Jacob Nadav Ablin, Valerie Aloush","doi":"10.55563/clinexprheumatol/s5e2km","DOIUrl":"https://doi.org/10.55563/clinexprheumatol/s5e2km","url":null,"abstract":"<p><strong>Objectives: </strong>Fibromyalgia (FM) is a chronic pain disorder with a female predominance. The impact of gender on the epidemiologic and clinical characteristics, as well as therapeutic strategies for FM patients, remains incompletely understood. This study aims to outline the clinical and epidemiologic profiles of male FM patients in comparison to female patients.</p><p><strong>Methods: </strong>A retrospective cross-sectional observational study was conducted, encompassing all patients diagnosed with FM in the electronic medical record database of a tertiary hospital from 2010-2021. Each patient file was individually reviewed, and data was collected.</p><p><strong>Results: </strong>A total of 3044 patients were diagnosed with FM, of which 401 were male (13.2%). A random cohort of 438 female patients was created for comparison with the male cohort. The average age of male patients at the time of their FM diagnosis was notably higher than that of females (52.7 years vs. 44.9 years, p<0.001). Obesity was more prevalent among female patients (16% vs. 9.2% for males, p=0.003), while obstructive sleep apnoea was more common in males (6.7% vs. 1.8%, p<0.001). Male patients exhibited a significantly higher prevalence of post-traumatic stress disorder (PTSD) than females (14% vs. 5.7%, p<0.001). Among male patients, 48% were treated with medical cannabis compared to 34.6% of females (p<0.001).</p><p><strong>Conclusions: </strong>Distinct clinical gender-specific characteristics were identified in our real-world cohort of FM patients. PTSD and the use of medical cannabis were more prevalent among male patients, whereas obesity was more common in females. Further studies exploring the clinical and pathogenic mechanisms underlying these differences are recommended.</p>","PeriodicalId":10274,"journal":{"name":"Clinical and experimental rheumatology","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144062625","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":"Sacroiliitis and familial Mediterranean fever: unresolved questions.","authors":"Murat Emin Güveli, Hulya Güveli","doi":"10.55563/clinexprheumatol/8zi6z2","DOIUrl":"https://doi.org/10.55563/clinexprheumatol/8zi6z2","url":null,"abstract":"","PeriodicalId":10274,"journal":{"name":"Clinical and experimental rheumatology","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143986715","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":"Uncertainties in colchicine response criteria in elderly familial Mediterranean fever.","authors":"Murat Emin Güveli, Hulya Güveli","doi":"10.55563/clinexprheumatol/am59md","DOIUrl":"https://doi.org/10.55563/clinexprheumatol/am59md","url":null,"abstract":"","PeriodicalId":10274,"journal":{"name":"Clinical and experimental rheumatology","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143963700","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":"Correlation between nocturnal heart rate variability parameters and circulating neuropeptides in patients suffering from fibromyalgia.","authors":"María Carmen Navarro-Gonzalez, Claudia Lerma, Felipe-Israel López-Trejo, Evelyn Aranda-Cano, Alfonso Salgado-Aguayo, Daniel Paz-Gómez, María Isabel Barrera-Villalpando, Luis H Silveira, Violeta Higuera-Ortiz, Angélica Vargas-Guerrero, Manuel Martínez-Lavín, Laura Aline Martinez-Martinez","doi":"10.55563/clinexprheumatol/rfy9hb","DOIUrl":"https://doi.org/10.55563/clinexprheumatol/rfy9hb","url":null,"abstract":"<p><strong>Objectives: </strong>A consistent line of investigation proposes fibromyalgia (FM) as a stress-evoked, sympathetically maintained neuropathic pain syndrome. The purpose of this study was to measure dysautonomia-associated neuropeptide serum levels in women suffering from FM and to correlate these levels with heart rate variability parameters and disease severity.</p><p><strong>Methods: </strong>We studied 23 women suffering from FM without comorbid conditions and 15 age and body mass index-matched healthy women. At the time of the study, all participants were free from medications that could affect the autonomic nervous system. Time-domain parameters were extracted from nocturnal (00.00 to 06.00 hours) heart rate variability Holter recordings. The following 7 neuropeptide levels were measured via the 7-Plex Human Neuropeptide Magnetic Kit Milliplex MAP: alpha-melanocyte-stimulating hormone, beta-endorphin, cortisol, neurotensin, orexin, oxytocin and substance P.</p><p><strong>Results: </strong>The serum levels of beta-endorphin (669.24±186.28 vs. 541.71±146.26 pg/ml, p=0.028) and neurotensin (156.23±58.15 vs. 116.64±47.93 pg/ml, p=0.016) were significantly greater in patients with FM. Both neuropeptides were negatively correlated with the nocturnal heart rate R-R interval standard deviation (Rho=-0.52 p=0.025 and Rho=-0.6, p=0.003) and with the FIQR \"tenderness to touch\" (Rho -0.49 and Rho -0.41, p<0.05).</p><p><strong>Conclusions: </strong>The serum levels of beta-endorphin and neurotensin in women suffering from FM correlate with nocturnal heart rate variability parameters, revealing sympathetic hyperactivity. The unexpectedly increased circulating levels of these two analgesic neuropeptides in the FM group can be interpreted as a homeostatic attempt by the central nervous system to ease peripherally generated pain.</p>","PeriodicalId":10274,"journal":{"name":"Clinical and experimental rheumatology","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143966117","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}