Clinical Rheumatology最新文献

{"title":"A rebuttal to \"The ineffectiveness of stretching exercises in patients with fibromyalgia: A systematic review discussion\" - comments on \"The effectiveness of stretching exercises in patients with fibromyalgia\".","authors":"Morten Pallisgaard Støve, Anne Mette Lücke Dissing, Janus Laust Thomsen, Stig Peter Magnusson, Allan Riis","doi":"10.1007/s10067-024-07223-9","DOIUrl":"https://doi.org/10.1007/s10067-024-07223-9","url":null,"abstract":"","PeriodicalId":10482,"journal":{"name":"Clinical Rheumatology","volume":null,"pages":null},"PeriodicalIF":2.9,"publicationDate":"2024-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142603629","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical characteristics and risk factors analysis of abdominal symptoms in IgA vasculitis patients: a retrospective cohort study.","authors":"Yuhan Gu, Yu Zhang, Zhixin Zheng, Ping Zhu","doi":"10.1007/s10067-024-07226-6","DOIUrl":"https://doi.org/10.1007/s10067-024-07226-6","url":null,"abstract":"<p><p>About 50% of children with IgA vasculitis (IgAV) have abdominal symptoms, usually colic mimic to acute abdomen. Since signs and symptoms of vasculitis may appear in any order, this may affect the diagnosis of children whose abdominal symptoms precede the appearance of purpura. It is necessary to identify the risk factors, pathogenesis, and specific biomarkers to improve the prevention and management of IgAV patients with abdominal symptoms. All the 278 patients were children who had been diagnosed with IgAV in Nanyang Central Hospital between January 2018 and December 2018. The patient's age, gender, clinical manifestations, laboratory examination, and medical history were retrospectively collected. All the patients were divided into two groups based on whether they had abdominal symptoms. Ridge regression and multivariate logistic regression model were used to find risk factors of IgAV patients with abdominal symptoms. Of the 278 patients, 54 patients had abdominal symptoms, and the remaining 224 patients had no abdominal symptoms. Patients with abdominal symptoms had a lower proportion of infections and higher IgM concentrations than patients with other symptoms. For patients over 12 years of age, platelet counts were lower in patients with abdominal symptoms. In addition, basophil count was identified as a protective factor, while IgM was identified as a risk factor. Infections, platelet counts, basophil count, and IgM concentration may be associated with abdominal symptoms in IgAV patients. Basophils and IgM may be involved in the pathological mechanism of abdominal symptoms.</p>","PeriodicalId":10482,"journal":{"name":"Clinical Rheumatology","volume":null,"pages":null},"PeriodicalIF":2.9,"publicationDate":"2024-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142602124","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cardiovascular risk according to biological agent exposure in patients with ankylosing spondylitis: a nationwide population-based study.","authors":"Oh Chan Kwon, Hye Sun Lee, Juyeon Yang, Min-Chan Park","doi":"10.1007/s10067-024-07225-7","DOIUrl":"https://doi.org/10.1007/s10067-024-07225-7","url":null,"abstract":"<p><strong>Objectives: </strong>Patients with ankylosing spondylitis (AS) have a higher risk of cardiovascular events than controls. Although biological disease-modifying anti-rheumatic drugs (bDMARDs) are efficacious in treating AS, their effect on cardiovascular risk remains unclear. This study evaluated the effect of tumour necrosis factor inhibitors (TNFis) and interleukin-17 inhibitors (IL-17is) on cardiovascular risk in patients with AS.</p><p><strong>Methods: </strong>Data of 43,502 patients diagnosed with AS from 2010 onwards and without prior history of cardiovascular events were extracted from the Korean nationwide database. Cardiovascular events were defined as incident myocardial infarctions or strokes. Patients were followed-up through 2021. The risk of cardiovascular events was compared between TNFis exposure (vs. bDMARDs non-exposure), IL-17is exposure (vs. bDMARDs non-exposure), and IL-17is exposure (vs. TNFis exposure), using time-dependent Cox models.</p><p><strong>Results: </strong>The incidence rates of cardiovascular events during bDMARDs non-exposure, TNFis exposure, and IL-17is exposure were 18.66, 8.92, and 12.87 per 10,000 person-years, respectively. TNFis exposure (vs. bDMARDs non-exposure) was significantly associated with a lower risk of cardiovascular events (adjusted hazard ratio [aHR] = 0.697, 95% confidence interval [CI] = 0.499-0.973), whereas IL-17is exposure (vs. bDMARDs non-exposure) was not (aHR = 0.962, 95% CI = 0.134-6.920). The risk of cardiovascular events did not differ between IL-17is and TNFis exposures (aHR = 1.381, 95% CI = 0.189-10.087).</p><p><strong>Conclusions: </strong>TNFis exposure (vs. bDMARDs non-exposure) was associated with approximately 30% lower risk of cardiovascular events in patients with AS. IL-17is exposure had no significant association with the risk of cardiovascular events compared with bDMARDs non-exposure or TNFis exposure. Key Points • TNFis exposure was associated with a 30% lower cardiovascular risk in patients with AS. • IL-17is exposure had no significant association with cardiovascular risk in patients with AS. • TNFis could be the preferred bDMARD with regard to cardiovascular risk in patients with AS.</p>","PeriodicalId":10482,"journal":{"name":"Clinical Rheumatology","volume":null,"pages":null},"PeriodicalIF":2.9,"publicationDate":"2024-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142603630","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dactylitis in Melanoma Differentiation-Associated protein 5 (MDA5)-associated amyopathic dermatomyositis: clue or conundrum?","authors":"Sukdev Manna","doi":"10.1007/s10067-024-07224-8","DOIUrl":"https://doi.org/10.1007/s10067-024-07224-8","url":null,"abstract":"","PeriodicalId":10482,"journal":{"name":"Clinical Rheumatology","volume":null,"pages":null},"PeriodicalIF":2.9,"publicationDate":"2024-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142582592","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Interplay of calcium pyrophosphate crystals, oxidative stress, and clinical features on knee osteoarthritis severity.","authors":"Javier Fernández-Torres, Karina Martínez-Flores, Indira Xiomara Puerta-Escalante, Nathalie Montaño-Armendariz, Carlos Suárez-Ahedo, Víctor Ilizaliturri-Sánchez, Rolando Espinosa-Morales, Carlos Alberto Lozada-Pérez, Yessica Zamudio-Cuevas","doi":"10.1007/s10067-024-07220-y","DOIUrl":"https://doi.org/10.1007/s10067-024-07220-y","url":null,"abstract":"<p><strong>Background: </strong>Deposition of calcium pyrophosphate (CPP) crystals is observed in most joints affected by severe osteoarthritis (OA). CPP may cause local damage by inducing an inflammatory process and oxidative stress (OS).</p><p><strong>Objectives: </strong>To evaluate inflammation and OS induced by CPP deposition and their association with the degree of knee OA.</p><p><strong>Methods: </strong>Synovial fluid (SF) from patients with OA classified as grade 3 and 4 (ACR criteria) was analyzed. Reactive oxygen species (ROS) and H₂O₂ levels were quantified, and inflammation by white blood cell (WBC) count. CPPs were detected by polarized light microscopy. Multifactorial dimensionality reduction (MDR) was used to visualize possible interactive effects between variables.</p><p><strong>Results: </strong>Fifty-six SF were analyzed, 22 (39.28%) were in moderate OA and 34 (60.71%) in severe OA. CPPs were identified in 17 moderate OA and 18 severe OA samples. In the moderate OA, ROS levels were significantly higher in the CPP + group (5.0% vs 2.0%, P = 0.03). Body mass index and CPP were significantly correlated (r =  - 0.439, P = 0.041). In the severe OA group, there were significant correlations of age with WBC (r =  - 0.431, P = 0.011), WBC with H₂O₂ (r = 0.454, P = 0.007), and ROS with H₂O₂ (r = 0.387, P = 0.024). MDR analysis revealed strong synergistic interactions between H₂O₂ and sex (6.68%) for moderate OA, while for severe OA, there were interactions between sex and ROS (6.99%) and between sex and inflammation (4.39%).</p><p><strong>Conclusion: </strong>ROS and inflammation may be factors that potentiate damage in knee OA, and this may help in the development of antioxidant interventions for CPP-associated OA. Key Points • This study evaluated CPP crystal-induced oxidative stress and inflammation and their effect on OA severity. • In the moderate OA phenotype, CPP crystals modify ROS levels. • ROS and inflammation are factors that increase damage in knee OA, especially when CPP crystals are present.</p>","PeriodicalId":10482,"journal":{"name":"Clinical Rheumatology","volume":null,"pages":null},"PeriodicalIF":2.9,"publicationDate":"2024-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142582535","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of group versus individual patient education for promoting safety skills of patients with autoimmune rheumatic diseases treated with biologics: a multicentre randomised controlled trial.","authors":"Francoise Fayet, Catherine Beauvais, Bruno Pereira, Martine Béranger, Malory Rodere, Béatrice Pallot-Prades, Patricia Peyrard, Sophie Pouplin, Marine Grandjean, Delphine Chu Miow Lin, Marc Ardizzone, Marie Sophie Cherillat, Anne Tournadre, Angélique Fan, Martin Soubrier","doi":"10.1007/s10067-024-07218-6","DOIUrl":"https://doi.org/10.1007/s10067-024-07218-6","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the effectiveness of a nurse-led intervention combining face-to-face and group education sessions for the acquisition of safety skills by patients with autoimmune rheumatic diseases treated with biologics.</p><p><strong>Methods: </strong>This multicentre randomised controlled trial compared two individual patient education sessions against a combination of an individual session at baseline and a group session 3 months later. The primary outcome was a validated questionnaire (BioSecure) scored at 6 and 12 months that assessed competencies and problem-solving abilities to deal with fever, infection, vaccination, and daily situations. Secondary outcomes were fear of disease, anxiety, depression, and arthritis helplessness.</p><p><strong>Results: </strong>A total of 120 patients with rheumatoid arthritis and spondyloarthritis were included (60 in each arm) from 7 French rheumatology departments; 99 patients completed the study at 6 months and 83 at 12 months. The BioSecure score improved at 6 months in both arms (delta from baseline 14.9 ± 16.3 in face-to-face education and 16.0 ± 17.9 in combined education) and was maintained for 12 months but no significant difference was found between arms at 6 and 12 months (p = 0.35 and p = 0.13, respectively). Fear of disease, arthritis helplessness, and anxiety were improved at 6 and 12 months with no difference between arms.</p><p><strong>Conclusion: </strong>Educating patients using individual nurse-led sessions or a combination of individual and group sessions increased their safety skills on biologics, with no superiority shown for the combined format. Given the time and resources required to educate patients, these results could lead to potential cost savings.</p><p><strong>Trial registration: </strong>Clinical Trials: NCT03838939. Key Points • Face-to-face patient education has been shown effective in promoting safety skills of patients treated with biologics compared to information provided by the rheumatologist in usual care. • This randomised controlled trial showed that a patient education format combining one individual and one group session was not superior to two individual sessions regarding safety skills assessed at 6 and 12 months • Safety skills, fear of disease, arthritis helplessness, and anxiety were improved in both arms. • As the most common barriers to the implementation of patient education are constraints in time and resources, these results could lead to potential cost savings.</p>","PeriodicalId":10482,"journal":{"name":"Clinical Rheumatology","volume":null,"pages":null},"PeriodicalIF":2.9,"publicationDate":"2024-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142582530","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Weight-adjusted waist index associated with bone mineral density in rheumatoid arthritis patients: a cross-sectional study.","authors":"Qian Lyu, Linxiao Ma, Huijie Liu, Haiyan Shao","doi":"10.1007/s10067-024-07179-w","DOIUrl":"https://doi.org/10.1007/s10067-024-07179-w","url":null,"abstract":"<p><p>The research examined the association between weight-adjusted waist index (WWI) and bone mineral density (BMD) in individuals with rheumatoid arthritis, considering the impact of obesity on bone health. The association between WWI and BMD was examined utilizing weighted linear regression and smoothed curve fitting with data from NHANES 2005-2010, 2013-2014, and 2017-2018. Subgroup analysis verified the stability of the results. The study included a cohort of 983 rheumatoid arthritis patients. A significant negative correlation was found between WWI and BMD at the total femur, femoral neck, and lumbar spine (β = -0.03, 95% CI (-0.04, -0.02), p < 0.001; β = -0.02, 95% CI (-0.04, -0.01), p = 0.001; β = -0.04, 95% CI (-0.06, -0.02), p < 0.001). This negative association was not significantly influenced by factors like age, gender, race, education, PIR, diabetes, hypertension, sleep disorders, alcohol consumption, or smoking status (p > 0.05 for interaction). The findings indicate a negative correlation between WWI and BMD in the rheumatoid arthritis population. Key Points •A negative correlation was found between WWI and BMD at the total femur, femoral neck, and lumbar spine in the rheumatoid arthritis population.</p>","PeriodicalId":10482,"journal":{"name":"Clinical Rheumatology","volume":null,"pages":null},"PeriodicalIF":2.9,"publicationDate":"2024-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142582572","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Performance of the systemic lupus erythematosus risk probability index (SLERPI) in the Egyptian college of rheumatology (ECR) study cohort.","authors":"Nevin Hammam, Ahmed Elsaman, Esam Abualfadl, Soha Senara, Nada M Gamal, Mona H Abd-Elsamea, Abdelhfeez Moshrif, Osman Hammam, Tamer A Gheita, Samar Tharwat","doi":"10.1007/s10067-024-07210-0","DOIUrl":"https://doi.org/10.1007/s10067-024-07210-0","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to evaluate the performance of systemic lupus erythematosus Risk Probability Index (SLERPI) in Egyptian patients with SLE using a national rheumatology database.</p><p><strong>Methods: </strong>The Egyptian College of Rheumatology (ECR) database comprised of 1,162 patients with SLE and 4,327 with miscellaneous rheumatological diseases who were recruited from the Rheumatology Departments across the country. The diagnosis of SLE was established by expert rheumatologists. Variables of the SLERPI were extracted and recorded as present or absent for each patient. The absolute value for the SLERPI score was calculated for each patient, and the diagnosis of SLE was accounted for if the score was greater than 7 points.</p><p><strong>Results: </strong>Of 1,162 SLE patients evaluated, 1,031 (88.7%) patients were diagnosed with SLE according to the SLERPI, with an average score of 13.1 (3.8). Differences in the 14 SLERPI variables were significant between the SLE-SLERPI groups, except for the presence of leukopenia and positive ANA. As a score reduction item, the SLE-SLERPI > 7 group had lower interstitial lung diseases. Patients diagnosed with SLE according to SLERPI had significantly higher disease activity (p < 0.001), and this group more commonly received corticosteroids and mycophenolate mofetil. Compared to other miscellaneous rheumatological groups, all 14 SLERPI items are indeed more common in the SLE group. In terms of the overall performance of SLERPI in the diagnosis of SLE, the accuracy of SLERPI was 91.9% (95% CI 90.9%-92.9%), with a specificity of 96.95% and sensitivity of 86.9%. SLERPI showed that accuracy went up to 93.3% (95%CI 92.4%-94.2%), with a specificity of 94.9% and a sensitivity of 91.6% when patients with connective tissue diseases were taken out of the study.</p><p><strong>Conclusion: </strong>Using a large cohort of SLE, the SLERPI revealed excellent diagnostic efficacy and specificity. The use of SLERPI in clinical practice may contribute to improved patient diagnosis and prognosis. Key Points • SLERPI's performance has high diagnostic efficiency in Egyptian SLE patients. • SLERPI score can efficiently distinguish patients with SLE from other CTDs. • Within the SLERPI score, interstitial lung disease is the lowest predictor of SLE.</p>","PeriodicalId":10482,"journal":{"name":"Clinical Rheumatology","volume":null,"pages":null},"PeriodicalIF":2.9,"publicationDate":"2024-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142567567","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Relationship between SLCO1B1 polymorphisms and methotrexate intolerance in Mexican children with juvenile idiopathic arthritis.","authors":"Jimena Garcia-Silva, Beatriz Silva-Ramirez, Ana V Villarreal-Treviño, Viviana Mata-Tijerina, Nadina E Rubio-Perez, Fernando Garcia-Rodriguez","doi":"10.1007/s10067-024-07221-x","DOIUrl":"https://doi.org/10.1007/s10067-024-07221-x","url":null,"abstract":"<p><strong>Introduction: </strong>The most frequent adverse events (AEs) of methotrexate (MTX) are gastrointestinal symptoms and hepatotoxicity, which can affect its adherence, leading to reduced effectiveness. The SLCO1B1 gene codes for a liver protein (OATP1B1) responsible for drug transportation. Genetic variations within the SLCO1B1 gene locus impact drug transport, leading to altered pharmacokinetic profiles, delayed MTX clearance, and increased risk of toxicity. This study aimed to determine the association between single nucleotide polymorphisms (SNPs) in the SLCO1B1 gene (rs4149056, rs2306283) with the development of AEs in patients with juvenile idiopathic arthritis (JIA) treated with MTX.</p><p><strong>Method: </strong>We performed an observational retrospective study to analyze the relationship between SNPs in the SLCO1B1 gene and the development of AEs in pediatric patients treated with MTX for JIA.</p><p><strong>Results: </strong>Thirty patients with JIA were included, 22 females (73.3%), with a median age of 11 years (IQR 8.3-15). The most frequent JIA subtype was rheumatoid factor-positive polyarthritis (36.7%). Twenty patients (66.7%) reported AEs. The *1B haplotype was the most frequent in this group (53.3%) and conferred a higher risk of developing AEs (OR = 3.89, 95% CI = 1.23 -12.29, p = 0.03).</p><p><strong>Conclusions: </strong>Patients with the allele *1B may benefit from lower doses of MTX. SLCO1B1 genotyping is a promising technique to identify patients at higher risk of AEs during treatment with MTX, thus requiring dose optimization.</p>","PeriodicalId":10482,"journal":{"name":"Clinical Rheumatology","volume":null,"pages":null},"PeriodicalIF":2.9,"publicationDate":"2024-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142567572","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of joint hypermobility on outcomes of children with juvenile idiopathic arthritis.","authors":"William R Black, Jade Singleton, Xing Wang, Julia G Harris, Jordan T Jones","doi":"10.1007/s10067-024-07130-z","DOIUrl":"10.1007/s10067-024-07130-z","url":null,"abstract":"<p><strong>Background: </strong>Juvenile idiopathic arthritis (JIA) is common in pediatric rheumatology. Despite treatment, many patients experience persistent disease activity. Joint hypermobility (JH), defined by an excessive range of motion across multiple joints, is prevalent in children and adolescents and may influence disease outcomes in JIA.</p><p><strong>Objective: </strong>This study examines the impact of JH on symptoms in youth and young adults with JIA.</p><p><strong>Methods: </strong>Data were obtained from the PR-COIN network and included patients under 21 years old with a diagnosis of JIA. Patients with JIA and JH were matched with those having JIA-only based on age, sex assigned at birth, JIA subtype, and medication exposure. Clinical data, including disease activity measures, patient well-being, and pain ratings, were collected at baseline and follow-up visits.</p><p><strong>Results: </strong>The sample included 420 patients with JIA + JH and 2100 with JIA only. The JIA + JH group exhibited higher disease activity at baseline, more active arthritis joints, elevated physician global assessment of disease activity scores, and worse patient-reported well-being. These differences persisted over time. The JIA + JH group had a 19-20% greater likelihood of maintaining high disease activity scores and worsening over subsequent visits, indicating a significant impact of JH on disease progression.</p><p><strong>Conclusion: </strong>JH in youth with JIA is associated with higher and persistent disease activity, suggesting that JH significantly contributes to the disease burden in patients with JIA and should be considered in treatment strategies. Future research should further explore the mechanisms by which JH influences disease activity and investigate comprehensive management approaches to improve outcomes for this population. Key Points • Children with JIA and joint hypermobility (JH) exhibit significantly higher disease activity at baseline compared to those with JIA only, including more active arthritis joints and elevated physician global assessment scores. • The presence of JH in JIA patients is associated with poorer patient-reported well-being and higher overall disease activity scores, which persist over time despite treatment. • JIA + JH patients have a 19-20% greater likelihood of maintaining high disease activity and worsening over subsequent visits, indicating a significant impact of JH on disease progression. • The study suggests that JH should be considered an important clinical factor in the management of JIA, with targeted interventions needed to address the increased disease activity and improve overall patient outcomes.</p>","PeriodicalId":10482,"journal":{"name":"Clinical Rheumatology","volume":null,"pages":null},"PeriodicalIF":2.9,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142125070","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}