Clinical Rheumatology最新文献

{"title":"Electroacupuncture delays the progression of juvenile collagen-induced arthritis via regulation NLRP3/ NF-κB signaling pathway -mediated pyroptosis and its influence on autophagy.","authors":"Fater A Khadour, Younes A Khadour, Tao Xu","doi":"10.1007/s10067-025-07354-7","DOIUrl":"https://doi.org/10.1007/s10067-025-07354-7","url":null,"abstract":"<p><strong>Background: </strong>Juvenile idiopathic arthritis (JIA) can lead to synovial inflammation. JIA is a chronic autoimmune inflammatory condition that primarily affects children. It is recognized as the most prevalent form of arthritis in the pediatric population and is associated with significant impairment and disability. Electroacupuncture (EA) effectively treats various synovium-related conditions, including symptoms of synovial inflammation, in both human and animal models. However, the specific mechanism by which EA protects against JIA remains unclear. Therefore, we conducted a comprehensive study to investigate the protective mechanisms of EA in a rat model. We aimed to examine the impact of EA on pathological changes in synovial tissue of juvenile collagen-induced arthritis (CIA) rats.</p><p><strong>Methods: </strong>The CIA model was established using Sprague‒Dawley (SD) rats aged 2-3 weeks. In this study, we investigated the potential role of EA on JIA by regulating the NLRP3-NF-κB axis in juvenile CIA rats and its influence on autophagy. To verify the effect of EA on juvenile CIA, the expression of NLRP3 was overexpressed by an adeno-associated virus injected into the knee joint of the CIA rats.</p><p><strong>Results: </strong>In this study, we observed that NLRP3 plays an important role in developing juvenile CIA and that NLRP3 overexpression exacerbates inflammation and increases synovium inflammation. We also demonstrated that the expression of NLRP3 was increased in synovial tissue, and NLRP3 could upregulate the NF-κB signal pathway and influence inflammation. Moreover, we also found increases in the expression of NLRP3 by impairing autophagy capacity and activation of the pyroptosis pathway in the synovium of the juvenile CIA rats.</p><p><strong>Conclusion: </strong>Moreover, we also discovered that EA decreased the expression of NLRP3 by restoring the impaired autophagy capacity and inhibiting the NLRP3-NF-κB axis, thereby delaying the progression of juvenile CIA. These results showed that EA is effective in inhibiting inflammation and synovial degeneration and alleviating the progression of juvenile CIA. As a result, our results provide new insight into the mechanism by which EA delays the development of juvenile CIA, offering a novel therapeutic regimen for JIA. This trial was registered with ClinicalTrials.gov, number NCT10203935. Registered October 07, 2023. Key Points • NLRP3 plays a critical role in juvenile collagen-induced arthritis (CIA), with its overexpression linked to increased inflammation in synovial tissue. • Electroacupuncture (EA) reduces NLRP3 expression and inhibits the NLRP3-NF-κB axis, mitigating inflammatory responses and delaying juvenile CIA progression. • EA restores impaired autophagy in juvenile CIA rats, promoting cellular health and inflammation management. • EA alleviates synovial degeneration, improving joint health and function in juvenile CIA models.</p>","PeriodicalId":10482,"journal":{"name":"Clinical Rheumatology","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143603759","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":"Knowledge, attitude, and practice towards knee osteoarthritis: a regional study in Chinese patients.","authors":"Tao Liu, Chao Lin, Hui Shi, Qiang Ren, Xinmei Lin","doi":"10.1007/s10067-025-07385-0","DOIUrl":"https://doi.org/10.1007/s10067-025-07385-0","url":null,"abstract":"<p><strong>Introduction: </strong>Given the chronic nature of knee osteoarthritis and its reliance on self-management, patients' knowledge, attitudes, and practice (KAP) significantly influence their ability to effectively manage knee osteoarthritis. This study aimed to investigate patients' KAP towards knee osteoarthritis.</p><p><strong>Methods: </strong>This cross-sectional survey was conducted among patients with knee osteoarthritis, using a self-designed questionnaire.</p><p><strong>Results: </strong>A total of 764 (96.47%) valid questionnaires enrolled, including 451 (59.03%) females, with a mean age of 48.28 ± 7.08 years. Their mean KAP scores were 8.10 ± 3.67 (possible range 0-16), 26.40 ± 4.492 (possible range 9-45), and 20.67 ± 5.156 (possible range 7-35), respectively. Structural equation modelling showed that knowledge had direct effects on attitude and practice. Attitude was found to exert a direct impact on practice. Moreover, multivariate logistic regression showed that employment, family's monthly income, duration of knee osteoarthritis, and medication were independently associated with knowledge. Age, sex, employment, and coachfellow were independently associated with attitude. Sex, employment, and marital status were independently associated with practice (all P < 0.05).</p><p><strong>Conclusion: </strong>Patients had inadequate knowledge, negative attitude, and inactive practice towards knee osteoarthritis. Age, gender, employment, and marital status, monthly income, duration of knee osteoarthritis, medication, and coachfellow might be associated with their KAP. It is recommended to enhance clinical practice through patient education, personalized exercise plans, and tailored care based on individual patient profiles for improved knee osteoarthritis management. Key Points • Patients show inadequate KAP towards knee osteoarthritis. • Factors affecting KAP include age, gender, and income. • Need for patient education and personalized care in management.</p>","PeriodicalId":10482,"journal":{"name":"Clinical Rheumatology","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143603828","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":"Inverse L-shaped association of triglyceride glucose index with all-cause and cerebral cardiovascular-related mortality in osteoarthritis patients: a cohort of 4145 patients.","authors":"Zitian Zheng, Meng Yang, Zhiyu Zhang, Yucheng Zhu, Hongjie Huang, Jianquan Wang","doi":"10.1007/s10067-025-07376-1","DOIUrl":"https://doi.org/10.1007/s10067-025-07376-1","url":null,"abstract":"<p><strong>Background: </strong>Currently, osteoarthritis (OA) is recognized as a systemic disease, wherein metabolic disturbances play a part in joint degeneration and elevated risk of mortality. This study investigates the prognostic value of the triglyceride-glucose (TyG) index in determining all-cause and cerebral cardiovascular mortality among OA patients, accentuating the necessity for customized interventions.</p><p><strong>Methods: </strong>A cohort of osteoarthritis patients from the 1999-2018 NHANES was linked to the 2019 National Death Index (NDI) for mortality confirmation. TyG index correlation with all-cause and cerebral cardiovascular mortality was assessed using Cox regression and Kaplan-Meier curves. Non-linear associations were examined with restricted cubic splines, and a two-piecewise Cox model was built around the inflection point.</p><p><strong>Results: </strong>A total of 4145 OA patients were followed for a median of 89 months, during which 1109 all-cause deaths and 427 cerebral cardiovascular-related deaths were observed. Restricted cubic splines showed an inverse L-shaped relationship between the TyG index and both types of mortality. The critical point was identified as 9.48, with a 1-unit increase associated with a 71% and 91% rise in adjusted all-cause and cerebral cardiovascular mortality, respectively (HR 1.71; 95% CI 1.30, 2.26 and HR 1.91; 95% CI 1.28, 2.86). Subgroup analyses revealed significant associations between the TyG index and elevated mortality risks among non-white OA patients and those with concurrent diabetes.</p><p><strong>Conclusion: </strong>In OA patients, the TyG index and mortality (both all-cause and cerebral cardiovascular) share an inverse L-shaped relationship, with identified thresholds at 9.48. This threshold offers valuable insight for risk assessment, thus promoting a shift towards personalized healthcare strategies founded on metabolic status for enhanced outcomes within OA populations. Key points • The TyG index predicts all-cause and cerebral cardiovascular mortality in OA patients. • An inverse L-shaped relationship between the TyG index and mortality was found, with a critical threshold of 9.48. • Non-white OA patients and those with diabetes show significant associations with elevated mortality risks, highlighting the importance of personalized care.</p>","PeriodicalId":10482,"journal":{"name":"Clinical Rheumatology","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143603805","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":"Anti-CD74 autoantibodies in axial spondyloarthritis as biomarkers for activity and severity of disease but not for tumour necrosis factor inhibitor retention: data from the Swiss Clinical Quality Management in rheumatic diseases cohort.","authors":"Annik Steimer, Andrea Götschi, Torsten Witte, Almut Scherer, Jonas Brändli, Michael J Nissen, Burkhard Möller, Simon Grosswiler, Diego Kyburz, Diana Dan, Andrea Rubbert-Roth, Sabine Adler, Oliver Distler, Xenofon Baraliakos, Adrian Ciurea","doi":"10.1007/s10067-025-07393-0","DOIUrl":"https://doi.org/10.1007/s10067-025-07393-0","url":null,"abstract":"<p><strong>Objectives: </strong>Anti-CD74 antibodies (Abs) have been proposed as a diagnostic biomarker in axial spondyloarthritis (axSpA). The aims of this study were to evaluate the association of these Abs with disease activity parameters in axSpA and to assess their predictive value for tumour necrosis factor inhibitor (TNFi) treatment effectiveness.</p><p><strong>Methods: </strong>Patients diagnosed with axSpA in the Swiss Clinical Quality Management registry with available biosamples and a measurement of IgA anti-CD74 Abs were included in this cohort study. We used a cut-off of 15 U/ml to define anti-CD74 Abs elevation. Associations of important disease characteristics with anti-CD4 Abs elevation and anti-CD74 Abs levels were evaluated using logistic and linear regression, respectively. For patients with an available biosample before TNFi initiation, we evaluated drug retention and estimated the hazard ratio of treatment discontinuation depending on anti-CD74 Abs elevation.</p><p><strong>Results: </strong>Elevated IgA anti-CD74 Abs were found in 383/722 (53%) patients with axSpA and were significantly associated with older age, male sex, and elevated C-reactive protein (CRP). Among 310 patients starting TNFi treatment, no significant difference in drug retention was found between patients with and without elevated anti-CD74 Abs (HR 0.91, 95% CI 0.66 to 1.25). An increased Bath Ankylosing Spondylitis Disease Activity Index was found to be associated with a reduced TNFi retention whereas an elevated CRP was associated with a prolonged retention.</p><p><strong>Conclusions: </strong>Although elevated IgA anti-CD74 Abs are associated with CRP elevation, we could not demonstrate an additional value of this biomarker for predicting response to treatment with TNFi beyond CRP measurement.</p>","PeriodicalId":10482,"journal":{"name":"Clinical Rheumatology","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143596367","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":"Comparative analysis of clinical profile, therapeutic management, and clinical prognosis of patients with seropositive or seronegative rheumatoid arthritis following the introduction of a first targeted therapy in a real-life setting.","authors":"Léonard Angelozzi, André Gillibert, Pauline Brevet, Julien Grosjean, Stefan Darmoni, Fabienne Jouen, Thierry Lequerré, Olivier Vittecoq","doi":"10.1007/s10067-025-07390-3","DOIUrl":"https://doi.org/10.1007/s10067-025-07390-3","url":null,"abstract":"<p><strong>Objectives: </strong>To evaluate clinical prognosis following the introduction of a first targeted therapy (TT) according to the serological profile of rheumatoid arthritis (RA) and to analyze differences in efficacy of TT.</p><p><strong>Method: </strong>This single-center retrospective study included patients with RA who received a first TT between 2000 and 2020. Patients were seropositive (IgM and/or IgA rheumatoid factors plus anti-CCP) or seronegative (without autoantibodies). Various data were collected at baseline and during follow-up. The primary endpoint was remission (assessed by DAS28) at one and two years.</p><p><strong>Results: </strong>Among 259 patients, 164 (63.3%) were seropositive and presented higher disease activity and more frequent erosive involvement than seronegative patients at TT introduction. The most prescribed first TTs were etanercept for seronegative RA (47 ([49.5%) versus 41 (25%), p < 0.001) and abatacept for seropositive RA (41 (25%) versus 6 (6.3%), p < 0.001). Remission rates and TT switches were not significantly different between groups. Initial DAS28-CRP and number of painful joints were independent prognostic factors associated with absence of remission at one year (OR 0.46 (0.26, 0.80), p = 0.007) and two years (OR 0.90 (0.82, 0.98), p = 0.027) respectively. Among seropositive patients, the two-year remission rate was not significantly different according to the therapeutic class received (cellular- versus cytokine-targeted).</p><p><strong>Conclusions: </strong>Patients with seropositive RA showed more active and severe disease than patients with seronegative RA at the introduction of a first TT. Although the choice of the first TT varied according to serological profile and time of analysis, clinical prognosis at one and two years was similar between groups. Key Points • Seropositive versus seronegative RA was more active at start of first targeted therapy. • First-line TTs were etanercept for seronegative RA and abatacept for seropositive RA. • Rate of targeted therapy switches was comparable between both groups. • Remission rates at 1 and 2 years were similar in seropositive and seronegative RA. • Remission rates were similar for cellular and cytokine inhibitors in seropositive RA.</p>","PeriodicalId":10482,"journal":{"name":"Clinical Rheumatology","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143596379","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":"Neonatal lupus erythematosus presenting with congenital heart block: clinical characteristics and follow-up.","authors":"Wenqiang Sun, Minqian Zhou, Yihui Li, Zexi Sun, Xueping Zhu","doi":"10.1007/s10067-025-07381-4","DOIUrl":"10.1007/s10067-025-07381-4","url":null,"abstract":"<p><strong>Objective: </strong>Congenital heart block (CHB) in patients with neonatal lupus erythematosus (NLE) is usually irreversible. Our study aimed to investigate the clinical characteristics and prognostic follow-up results of patients with NLE presenting with CHB and to provide a reference for the clinical treatment and management of such patients.</p><p><strong>Methods: </strong>Six patients with NLE and CHB at the Children's Hospital of Soochow University between January 1, 2011, and December 31, 2023, were retrospectively analyzed. Prenatal maternal data, clinical characteristics, laboratory investigations, treatments, and follow-ups were analyzed using descriptive statistics.</p><p><strong>Results: </strong>Six patients with NLE and CHB-four females, two males, and five preterm infants-were included. Three patients had degree III CHB, one had degree II CHB, and two had degree I CHB. The diagnostic gestational age for CHB was 23.6 ± 2.7 weeks. Four patients experienced varying degrees of bradycardia during the fetal period. Of the six pregnant mothers, three had systemic lupus erythematosus, one had Sjogren's syndrome, and one was positive for the anti-SSA/Ro autoantibody after the postpartum patient was seropositive. All pregnant mothers with autoimmune diseases were in remission and stable before delivery. One case of mildly active lupus in early pregnancy resolved after low-dose oral steroid hormone administration. All six patients with NLE-related manifestations, except CHB, showed improvement in systemic symptoms within 6 months. One patient was implanted with a pacemaker for exercise intolerance and complete atrioventricular block (CAVB) at the age of 1 year and 5 months and is now tolerating activity well without abnormal cardiac rhythms. One of the six patients had a global developmental delay, and two had a motor developmental delay.</p><p><strong>Conclusions: </strong>Fetal echocardiography should be performed in high-risk pregnancies between 16 weeks of gestation and 1 month after birth. Patients with NLE and CHB are prone to varying degrees of growth retardation. Pacemaker implantation is an effective treatment for children with CAVB. Key Points • CHB in patients with NLE is usually irreversible. • Patients with NLE and CHB are prone to varying degrees of growth retardation. • Implantation of a pacemaker is an effective treatment for children with CAVB.</p>","PeriodicalId":10482,"journal":{"name":"Clinical Rheumatology","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-03-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143582227","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":"Association between rheumatoid arthritis and hyperuricemia among adults: a cross-sectional study based on NHANES data.","authors":"Chanjing Zhao, Qian Xiao, Wen Huang, Yushun Chen, Xuran Yang","doi":"10.1007/s10067-025-07386-z","DOIUrl":"https://doi.org/10.1007/s10067-025-07386-z","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to explore the relationship between rheumatoid arthritis (RA) and hyperuricemia among adults.</p><p><strong>Method: </strong>All the data were from the National Health and Nutrition Examination Survey (NHANES 1997-2018) database. Linear regression, logistic regression, and restricted cubic spline (RCS) analyses were used to investigate the association between RA and hyperuricemia. Subgroup analysis and interaction tests were conducted to assess the influence of various subgroups on their association.</p><p><strong>Results: </strong>This study included 41,460 patients, among whom 2603 had RA. The RA group had higher uric acid levels compared with the non-RA group (P < 0.001). Linear regression showed that RA was significantly related to uric acid levels among several adjusted models (all P < 0.05). Logistic regression analysis also indicated the independent association between RA and hyperuricemia in a positive relationship (P < 0.05). Subgroup analysis revealed significant association in the subgroups of females, age ≥ 60 years, non-Hispanics, individuals with hypertension and antihypertensive drugs use, and those with BMI ≥ 30 kg/m² (all P < 0.05). The interaction test showed that there was no interaction effect between baseline features and RA (all interaction P > 0.05). RCS analysis further found that the course of RA, rather than the age of diagnosis, was related to hyperuricemia (P < 0.05). Furthermore, we found that the association between RA and hyperuricemia was mainly observed in populations with 15-30-year course of RA (P < 0.05).</p><p><strong>Conclusions: </strong>RA was associated with hyperuricemia and their association was still stable even after adjusting for several variables, suggesting that uric acid levels should be routinely tested to detect hyperuricemia at an early stage in patients with RA. Key Points • Revealing association between rheumatoid arthritis (RA) and hyperuricemia risk: This study initially explored the association between RA and hyperuricemia, finding that RA was positively related to the higher uric acid levels and hyperuricemia risk. • Reflecting the role of RA course on their association: Our study found that their association was mainly observed in population with RA course of 15-30 years.</p>","PeriodicalId":10482,"journal":{"name":"Clinical Rheumatology","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143566276","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":"The association between dyslipidemia and hand osteoarthritis: a systematic review and meta-analysis.","authors":"Tai-Yuan Hsueh, Yu-Pin Chen","doi":"10.1007/s10067-025-07384-1","DOIUrl":"https://doi.org/10.1007/s10067-025-07384-1","url":null,"abstract":"<p><strong>Background: </strong>Hand osteoarthritis (HOA) is a prevalent degenerative joint disease, with emerging evidence suggesting metabolic factors, including dyslipidemia, play a role in its pathogenesis. Dyslipidemia components, including low-density lipoprotein (LDL), high-density lipoprotein (HDL), and triglycerides, may contribute to cartilage damage and inflammation in hand joints, though robust evidence is limited.</p><p><strong>Method: </strong>A systematic review and meta-analysis were conducted using PubMed, Embase, and Web of Science to identify case-control and cohort studies examining the association between dyslipidemia and HOA. Dyslipidemia was assessed as a binary variable, while LDL, HDL, and triglycerides were analyzed as continuous variables. The quality of the included studies was assessed using the Newcastle-Ottawa Scale. Random effects model was used to calculate standardized mean differences (SMDs) and odds ratios (ORs). This study adhered to PRISMA guidelines for transparent reporting and was registered with the International Prospective Register of Systematic Reviews (CRD42024616873).</p><p><strong>Results: </strong>For dyslipidemia (binary), the pooled OR was 1.40 (95% CI = 1.19-1.66, P < 0.0001) with negligible heterogeneity (I² = 0%, P = 0.82). Triglycerides showed a mean difference of 14.48 (95% CI = 5.37 to 23.60, P = 0.002) with low heterogeneity (I² = 0%, P = 0.46). HDL yielded a pooled SMD of 0.48 (95% CI =  - 1.50 to 2.46, P = 0.63) with low heterogeneity (I² = 9%, P = 0.35). For LDL, the SMD was 4.78 (95% CI =  - 0.53 to 10.09, P = 0.08) with moderate-to-high heterogeneity (I² = 68%, P = 0.02).</p><p><strong>Conclusion: </strong>This meta-analysis reveals a moderate association between dyslipidemia, especially elevated triglycerides, and HOA. While lipid abnormalities may play a role in HOA development, the evidence for LDL and HDL is less clear. Limitations in study definitions and populations suggest the need for further research to better understand these relationships and their implications for prevention and management strategies in HOA.</p>","PeriodicalId":10482,"journal":{"name":"Clinical Rheumatology","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143566281","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":"Patient perspectives on rheumatic and musculoskeletal diseases: insights from a large-scale survey.","authors":"Khalid A Alnaqbi, Mohammed Alaswad, Shaima Alasfour","doi":"10.1007/s10067-025-07388-x","DOIUrl":"https://doi.org/10.1007/s10067-025-07388-x","url":null,"abstract":"<p><strong>Introduction/objectives: </strong>Rheumatic and musculoskeletal diseases (RMD) are prevalent among Arabic-speaking patients in the Middle East and North Africa (MENA), yet their perspectives remain underexplored. This study examines patient experiences and perspectives.</p><p><strong>Method: </strong>A cross-sectional survey was developed using pilot testing with clinimetric sensibility assessment to ensure clarity and relevance, and the Open-Source Metric for Measuring Arabic Narratives (OSMAN) to assess readability. The Checklist for Reporting Internet E-Surveys (CHERRIES) was used to enhance the quality of the survey. The survey was distributed via social media to Arabic-speaking patients with self-reported RMDs. Collected data included demographics, disease characteristics, medication use, treatment satisfaction factors, perceived causes, and patient concerns.</p><p><strong>Results: </strong>Of the 1050 responses received, 456 were complete and included in the analysis. Most respondents were female (81.4%) and between the ages of 25 and 44 (63.4%). The most frequently reported diseases were systemic lupus erythematosus, rheumatoid arthritis, and ankylosing spondylitis. Nearly all (97.1%) used medications within the previous three months, primarily hydroxychloroquine, glucocorticoids, and biologics. Key factors influencing treatment satisfaction were pain relief, laboratory result discussions, sleep quality, and mood improvement. Patients perceived immune system abnormalities (76.5%), psychological factors (54.8%), and genetics (41.7%) as primary disease causes. Main concerns included fear of disease complications, adverse drug reactions, and being a burden to others. Rheumatologists and internet search engines were the primary sources of information for patients. Most avoided alternative medicine, while 33.3% used it.</p><p><strong>Conclusion: </strong>This survey is the first and largest in the MENA region, providing valuable insights into patient perspectives on RMD. It highlights the need for holistic management, enhanced education, and supportive services to improve quality of life. Key Points • The most commonly perceived causes of rheumatic and musculoskeletal diseases among patients with RMD were immune system abnormalities, psychological factors, genetic/hereditary influences, and envy. • Patients' top concerns included fear of future complications, adverse drug reactions, becoming a burden to others, physical disability, and issues related to marriage and childbirth. • Key factors influencing treatment satisfaction included pain relief, discussions of laboratory results, sleep quality, and mood improvement. • Approximately one-third of patients had consulted practitioners of complementary and alternative medicine.</p>","PeriodicalId":10482,"journal":{"name":"Clinical Rheumatology","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143566280","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":"Characteristics and prognostic analysis of Pneumocystis jirovecii pneumonia in connective tissue diseases patients with interstitial lung disease: a retrospective study.","authors":"Yujie Shi, Ruxuan Chen, Hongli Sun, Kai Xu, Mengqi Wang, Zhiyi Li, Chi Shao, Hui Huang","doi":"10.1007/s10067-025-07392-1","DOIUrl":"https://doi.org/10.1007/s10067-025-07392-1","url":null,"abstract":"<p><strong>Introduction: </strong>Pneumocystis jirovecii pneumonia (PJP) is a common opportunistic infection. With the wide application of glucocorticosteroids and immunosuppressants, the incidence and mortality rates of PJP in connective tissue disease (CTD) patients with interstitial lung disease (ILD) are increasing.</p><p><strong>Methods: </strong>We retrospectively enrolled consecutive CTD-ILD patients with PJP in our center between January 2014 and December 2022. Cox regression models were constructed to explore prognostic factors in CTD-ILD-PJP patients.</p><p><strong>Results: </strong>There were 159 CTD-ILD patients [60 (51, 68) years, 61.0% female] with PJP, 78 (49.1%) of whom died. Compared with those in the CTD-non-ILD-PJP group, there were more pneumomediastinum cases (16.4% vs. 6.7%, p = 0.030) and significantly higher all-cause mortality rates (49.1% vs. 33.7%, p = 0.019) in the CTD-ILD-PJP group. Multivariate analysis indicated that IIM (HR = 2.635, 95% CI: 1.383-5.019), pneumomediastinum (HR = 2.877, 95% CI: 1.483-5.582), oral candidiasis infection (HR = 2.596, 95% CI: 1.229-5.483), aspergilli infection (HR = 2.886, 95% CI: 1.412-5.900), and lower minimal albumin (Alb) (HR = 0.872, 95% CI: 0.819-0.927) were independent risk factors associated with poor survival in CTD-ILD-PJP patients.</p><p><strong>Conclusions: </strong>CTD-ILD-PJP patients were mainly middle-aged females and had higher mortality rates than CTD-PJP patients without ILD. IIM, pneumomediastinum, oral candidiasis infection, aspergilli infection, and lower minimal Alb were independent risk factors associated with poor survival in CTD-ILD-PJP patients. Key Points • CTD-ILD-PJP patients had higher mortality rates than CTD-PJP patients without ILD. • IIM, pneumomediastinum, oral candidiasis infection, aspergilli infection, and lower minimal Alb were independent survival risk factors in CTD-ILD-PJP patients. • The study explored susceptibility and prognostic risk factors of CTD-ILD-PJP patients, to reduce the incidence and mortality.</p>","PeriodicalId":10482,"journal":{"name":"Clinical Rheumatology","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143566278","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}