Clinical Rheumatology最新文献

{"title":"CD3 + CD4 + T cells counts reflect the severity and prognosis of invasive pulmonary aspergillosis in patients with connective tissue disease-associated interstitial lung disease.","authors":"Shenyun Shi, Ruyi Zou, Rui Li, Tingting Zhao, Chao Wu, Yonglong Xiao, Xuebing Feng, Lulu Chen","doi":"10.1007/s10067-025-07425-9","DOIUrl":"10.1007/s10067-025-07425-9","url":null,"abstract":"<p><strong>Objectives: </strong>Invasive pulmonary aspergillosis (IPA) is a potentially fatal complication in patients with connective tissue disease-associated interstitial lung disease (CTD-ILD). The aim of this study is to investigate the clinical significance of CD3 + CD4 + T cells counts in CTD-ILD with IPA patients.</p><p><strong>Methods: </strong>This retrospective study included 152 CTD-ILD patients admitted to a single center in China between January 2018 and June 2020. A total of 54 CTD-ILD patients with IPA were assigned to the CTD-ILD with IPA group, while 98 uninfected CTD-ILD patients were assigned to the control group. Serum CD3 + CD4 + T cells counts were compared between the above-mentioned two groups, and the correlations between CD3 + CD4 + T cells counts and the clinical features, mortality of CTD-ILD with IPA were also evaluated.</p><p><strong>Results: </strong>CTD-ILD patients with IPA had significantly lower CD3 + CD4 + T cells counts than those with CTD-ILD without IPA (P < 0.001). The area under the receiver operating characteristic curve (AUROC) of discriminating CTD-ILD with IPA from CTD-ILD without IPA was 0.800 (95% CI, 0.722-0.878, P < 0.001). Correlation analyses showed that serum CD3 + CD4 + T cells counts were positively correlated with PaO2/FiO2 ratio(r = 0.317, P = 0.034) and negatively correlated with C reactive protein (CRP) (r = - 0.358, P = 0.009), erythrocyte sedimentation rate (ESR) (r = - 0.346, P = 0.014), and lactate dehydrogenase (LDH) (r = - 0.306, P = 0.026). In addition, 30 decedents with CTD-ILD infected IPA exhibited lower values of CD3 + CD4 + T cells compared with 24 survivors (P = 0.041). Furthermore, CD3 + CD4 + T cells counts were a prognostic factor and also associated with a higher mortality rate (log-rank test, P = 0.003).</p><p><strong>Conclusion: </strong>CD3 + CD4 + T cells counts could be a useful serum indicator associated with occurrence of IPA in CTD-ILD. Moreover, decreased CD3 + CD4 + T cells counts were associated with a poor survival of IPA in CTD-ILD patients. Key Points • CTD-ILD patients with IPA had significantly lower CD3+CD4+T cells counts than those with CTD-ILD without IPA. • Correlation analyses showed that serum CD3+CD4+T cells counts were positively correlated with PaO2/FiO2 ratio and negatively correlated with C reactive protein (CRP), erythrocyte sedimentation rate (ESR) and lactate dehydrogenase (LDH). • Decreased CD3+CD4+T cells counts were associated with a poor survival of IPA in CTD-ILD patients.</p>","PeriodicalId":10482,"journal":{"name":"Clinical Rheumatology","volume":" ","pages":"2421-2430"},"PeriodicalIF":2.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143810661","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":"Effects of telitacicept in SLE patients with antiphospholipid antibody positivity: a retrospective self-controlled case series.","authors":"Liling Zhou, Yong You, Shaozhe Cai, Cong Ye, Lingli Dong","doi":"10.1007/s10067-025-07411-1","DOIUrl":"10.1007/s10067-025-07411-1","url":null,"abstract":"<p><strong>Objectives: </strong>Antiphospholipid antibody (aPL) is closely related to the manifestation of antiphospholipid syndrome (APS) and an increased risk of thrombosis in systemic lupus erythematosus (SLE) patients. Telitacicept is a new dual B cell inhibitor which has been approved in China to treat SLE, but its application in APS or aPL-positive patients is still lacking. This study aimed to observe the effects of telitacicept in SLE patients with aPL positivity.</p><p><strong>Methods: </strong>It is a retrospective self-controlled case series study on SLE patients with aPL positivity who received telitacicept at a Chinese medical center during June 2021 to March 2023. Demographical information, clinical and immunological characteristics, and aPL profiles were gleaned from the electronic medical records system, and response of aPL profiles to telitacicept treatment was analyzed.</p><p><strong>Results: </strong>Sixteen SLE patients were included. Eight of them were definite APS, and the other eight patients were aPL carriers. After 6 months of telitacicept administration, significant improvements were observed in parameters representing SLE disease activity, including SLEDAI-2 K, anti-dsDNA antibody levels, and complement levels. Meanwhile, we observed significant decreases in aPL levels that had not been previously reported. LAC normalized ratios significantly decreased from baseline after telitacicept treatment for 6 months (dRVVT: 1.86 (1.24, 2.80) vs. 1.44 (1.11, 1.94), P = 007; SCT: 1.76 (1.28, 3.23) vs. 1.36 (1.06, 2.01), P = 0.010). The titer of aCL IgG decreased from 196.6 (54.58, 328.85) to 90.20 (15.6, 202.20) CU, and anti-β2GPI IgG decreased from 828.70 (51.60, 2490.80) to 211.10 (18.40, 422.50) CU after 6 months of telitacicept treatment (P-value 0.005 and 0.013, respectively). Interestingly, a rebound tendency in aPL titers was observed after telitacicept withdrawal. No thrombosis events or pregnancy morbidities occurred, and no serious adverse events or death happened during treatment.</p><p><strong>Conclusions: </strong>Telitacicept may be an effective and safe option for patients with persistent aPL. Further well-designed prospective cohort studies are needed to confirm these findings. Key Points • Telitacicept is effective to lower aPL titers and promote aPL seroconversion, which may provide potential for the application of telitacicept in APS by reducing aPL-related events. • No thrombosis events and serious adverse events happened in aPL-positive patients during telitacicept treatment.</p>","PeriodicalId":10482,"journal":{"name":"Clinical Rheumatology","volume":" ","pages":"2287-2297"},"PeriodicalIF":2.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143981607","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":"Comparisons of [⁶⁸ Ga]Ga-FAPI-04 PET/CT with X-ray imaging in the assessment of patients with rheumatoid arthritis.","authors":"Dan Yang, Jiana Chen, Guangyuan He, Ziyue Zhou, Jiaqi Xu, Yezi Peng, Xiangyi Shen, Xu Jiang, Qingqing Pan, Lidan Zhao, Yunyun Fei, Yaping Luo, Huaxia Yang","doi":"10.1007/s10067-025-07414-y","DOIUrl":"10.1007/s10067-025-07414-y","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to compare the value of [⁶⁸ Ga]Ga-FAPI-04 PET/CT with X-ray imaging in assessing disease activity and treatment response in patients with rheumatoid arthritis (RA).</p><p><strong>Method: </strong>All patients underwent clinical and laboratory assessments, [⁶⁸ Ga]Ga-FAPI-04 PET/CT, and X-ray imaging, with a 6-month follow-up to assess disease activity and treatment response. Bland-Altman analysis assessed the agreement between PET/CT and X-ray parameters. Correlation analyses were performed between clinical characteristics and imaging parameters. Receiver operating characteristic (ROC) curve analyses were used to predict treatment response.</p><p><strong>Results: </strong>We prospectively enrolled 17 patients with RA (14 females and 3 males; median age, 55.0 yr [IQR: 50.0-58.5 yr]). [⁶⁸ Ga]Ga-FAPI-04 PET/CT showed strong agreement with X-ray in evaluating the number of joints involved. PET/CT imaging-derived parameters, including PET joint count (PJC_FAPI), PET articular index (PAI_FAPI), total synovitis uptake (TSU_FAPI), and metabolic synovitis volume (MSV_FAPI) were significantly correlated with C-reactive protein levels. Moreover, PJC_FAPI and PAI_FAPI were associated with tender or swollen joint count (TJC/SJC), disease activity score with 28-joint counts (DAS28), and Simplified Disease Activity Index (SDAI), respectively. No correlations were observed between the X-ray findings and disease activity parameters. The baseline PAI_FAPI > cutoff values could discriminate responders and non-responders at the 6-month follow-up according to the Clinical Disease Activity Index (CDAI) and SDAI response criteria, while X-ray could not predict treatment response.</p><p><strong>Conclusions: </strong>[⁶⁸ Ga]Ga-FAPI-04 PET/CT was superior to X-ray imaging in evaluating disease activity and predicting treatment response in patients with RA.</p><p><strong>Trial registration: </strong>ClinicalTrials. NCT04514614. Registered 13 August 2020, https://register.</p><p><strong>Clinicaltrials: </strong>gov/prs/app/action/SelectProtocol?sid=S000A4PN&selectaction=Edit&uid=U0001JRW&ts=2&cx=-×9t7p.</p>","PeriodicalId":10482,"journal":{"name":"Clinical Rheumatology","volume":" ","pages":"2191-2199"},"PeriodicalIF":2.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143993925","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 the clinical efficacy and pharmacoeconomics of tofacitinib and adalimumab in Chinese patients with rheumatoid arthritis: An analysis based on propensity score matching.","authors":"Qin-Yao Xu, Ya-Qian Liu, Wan-Qiu Tong, Yan-Ran Yin-Ruo, Sheng-Qian Xu, Zong-Wen Shuai","doi":"10.1007/s10067-025-07431-x","DOIUrl":"10.1007/s10067-025-07431-x","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to investigate the clinical efficacy and pharmacoeconomics of tofacitinib versus adalimumab in treating patients with rheumatoid arthritis (RA).</p><p><strong>Methods: </strong>Propensity score matching was used to obtain matched cohorts of 116 RA patients treated with tofacitinib or adalimumab. Clinical and laboratory indicators were compared before and after treatment between the two groups. A Markov model was used to assess cost-effectiveness, incorporating direct and indirect costs. Sensitivity analyses validated model stability, with a 6-month cycle simulating lifelong disease progression (27 years).</p><p><strong>Results: </strong>Both the tofacitinib-treated group and the adalimumab-treated group showed significant improvements in terms of swollen and tender joint counts, duration of morning stiffness, VAS and HAQ scores, and ESR, CRP, and DAS28 levels (P < 0.05). Adalimumab treatment resulted in reductions in rheumatoid factor levels (P < 0.05). ACR20 (χ² = 0.240, P = 0.624), ACR50 (χ² = 0.321, P = 0.571), and ACR70 (χ² = 0.222, P = 0.637) response rates did not differ significantly between groups. Adverse events included tuberculosis, leukopenia, mild liver dysfunction in the adalimumab group, and herpes zoster and mild liver dysfunction in the tofacitinib group, with gastrointestinal reactions observed in both groups (P > 0.05). Cost-effectiveness analysis indicated that tofacitinib was more cost-effective than adalimumab. Univariate sensitivity analysis identified ACR50 and ACR70 response rates as key influencing factors, while probabilistic sensitivity analysis showed a 99.38% probability of tofacitinib being cost-effective relative to adalimumab.</p><p><strong>Conclusion: </strong>Tofacitinib combined with methotrexate demonstrated comparable clinical efficacy and safety to adalimumab combined with methotrexate, with better cost-effectiveness, supporting its use as a favorable treatment strategy. Key Points • Our research indicates that tofacitinib exhibits a more favorable pharmacoeconomic profile for treating rheumatoid arthritis, characterized by reduced treatment costs and increased quality-adjusted life years. • Tofacitinib consistently demonstrated its cost-effectiveness superiority over adalimumab across various sensitivity analyses, exhibiting a 99.38% likelihood of being more cost-effective.</p>","PeriodicalId":10482,"journal":{"name":"Clinical Rheumatology","volume":" ","pages":"2153-2162"},"PeriodicalIF":2.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12141396/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143961798","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Letter to the editor: ''Radiographic entheseal lesions of the pelvic region are more prevalent in radiographic axSpA than in age- and sex-matched controls and are associated with more severe spinal disease''.","authors":"Özge Tezen","doi":"10.1007/s10067-025-07472-2","DOIUrl":"10.1007/s10067-025-07472-2","url":null,"abstract":"","PeriodicalId":10482,"journal":{"name":"Clinical Rheumatology","volume":" ","pages":"2587-2588"},"PeriodicalIF":2.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143969438","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 potential of semi-quantitative and quantitative methods in predicting progression in rheumatoid arthritis-associated interstitial lung disease.","authors":"Duygu Temiz Karadag, Sevtap Dogan, Ozgur Cakir, Yusuf Altıntas, Seyma Yilmaz, Neslihan Gökcen, Ayten Yazici, Ayse Cefle","doi":"10.1007/s10067-025-07443-7","DOIUrl":"10.1007/s10067-025-07443-7","url":null,"abstract":"<p><strong>Introduction: </strong>Rheumatoid arthritis-associated interstitial lung disease (RA-ILD) presents with variable severity and progression, highlighting the need for effective tools to identify patients at risk. Although CT imaging plays a vital role in the management of RA-ILD, there is a lack of objective methods to predict disease progression. This study investigates the association between semi-quantitative and quantitative CT scoring methods and disease progression in early-stage RA-ILD.</p><p><strong>Methods: </strong>This observational study analyzed baseline and the first technically evaluable follow-up CT scans of patients who met the 2010 ACR/EULAR classification criteria for RA and were diagnosed with ILD. Only patients with ≤ 5 years between baseline and follow-up scans were included. Semi-quantitative assessments were conducted using the Goh and Warrick scoring systems, while quantitative analyses utilized Vitrea software to measure mean lung attenuation (MLA) and low-, medium-, and high-density lung volumes. Progression risk factors were evaluated using binary logistic regression, with progression defined by changes in CT parameters over time.</p><p><strong>Results: </strong>A total of 77 RA-ILD patients (45 females, 32 males) were included, with a median follow-up period of 20 months (interquartile range: 7.4-46 months). Disease progression was observed in 34 patients (44.2%). Baseline medium-density volume (MDV), follow-up mean lung attenuation (MLA), and low-density volume (LDV) differed significantly between the progression and non-progression groups (p < 0.05). Quantitative CT parameters demonstrated strong correlations with both the Goh and Warrick scoring systems. Binary logistic regression analysis identified the usual interstitial pneumonia (UIP) pattern on baseline imaging as the only independent predictor of disease progression (odds ratio: 3.1; 95% confidence interval: 1.1-12.4).</p><p><strong>Conclusion: </strong>In this study of early-stage RA-ILD patients, only the usual interstitial pneumonia (UIP) pattern on baseline HRCT independently predicted disease progression. Neither semi-quantitative scores nor quantitative CT parameters were predictive of progression. However, quantitative CT metrics demonstrated strong correlations with traditional scoring systems, supporting their utility in objectively assessing disease extent.</p>","PeriodicalId":10482,"journal":{"name":"Clinical Rheumatology","volume":" ","pages":"2213-2223"},"PeriodicalIF":2.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12141109/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144074996","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Identification of serum exosomal miRNA biomarkers in patients with lupus nephritis.","authors":"Fei Chen, Jia Gao, Bo Shi, Wenjing Liu, Jianmin Gong, Adeel Khan, Yifan Sun, Ping Yang, Zhiyang Li","doi":"10.1007/s10067-025-07447-3","DOIUrl":"10.1007/s10067-025-07447-3","url":null,"abstract":"<p><strong>Introduction: </strong>Characterized by glomerulonephritis, lupus nephritis (LN) worsens the prognosis of patients with systemic lupus erythematosus (SLE) and contributes to its increased mortality rate. Here, we investigated whether serum exosomal microRNAs (miRNAs) are promising new biomarkers of LN.</p><p><strong>Methods: </strong>Serum exosomes were initially isolated using a reagent-based kit, and total RNA was extracted with the Trizol method. Small RNA sequencing was subsequently performed to identify differentially expressed exosomal miRNAs. Validation of these miRNAs was conducted via real-time quantitative polymerase chain reaction (RT-qPCR) on individual samples from both the training and validation cohorts, leading to the identification of candidate small RNAs specifically associated with LN. Receiver operating characteristic (ROC) curve analysis was employed to evaluate the diagnostic performance of the identified candidates. To further investigate the immune landscape, 12 types of cytokines were quantified using flow cytometry, and their correlations with the candidate miRNAs were analyzed via Spearman rank correlation. Additionally, the biological functions of these miRNAs were explored through enrichment analyses based on Gene Ontology (GO) terms and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathways.</p><p><strong>Results: </strong>The levels of hsa-miR-497-5p and hsa-miR-6515-5p were significantly higher in the LN group compared to the SLE without LN group, with a combined area under the ROC curve (AUC) of 0.798. Notably, these two miRNAs demonstrated exceptional discriminative performance in identifying LN patients with mild proteinuria, achieving an AUC of 0.844. Furthermore, flow cytometry analysis revealed markedly elevated serum levels of interferon (IFN)-γ, interleukin (IL)-8, and IL-17 in the LN group compared to healthy controls (HCs). Additionally, IL-6 and IL-17 levels were significantly higher in the LN group compared to the SLE without LN group. Hsa-miR-6515-5p exhibited a strong positive correlation with IL-8 and IFN-γ. Bioinformatic analyses indicated that these exosomal miRNAs may contribute to the progression of LN by regulating key signaling pathways, with the MAPK signaling pathway being prominently implicated.</p><p><strong>Conclusions: </strong>Our study demonstrated that serum exosomal miRNAs, specifically hsa-miR-497-5p and hsa-miR-6515-5p, show significant potential as biomarkers for the early detection and prognosis of LN.</p>","PeriodicalId":10482,"journal":{"name":"Clinical Rheumatology","volume":" ","pages":"2299-2310"},"PeriodicalIF":2.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143969437","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":"CCR5 + T cells as a potential biomarker for primary Sjögren's disease based on bioinformatics analysis.","authors":"Huixin Dou, Ruiqing Wu, Hao Wang, Xiaoyan Wang, Yingying Su","doi":"10.1007/s10067-025-07460-6","DOIUrl":"10.1007/s10067-025-07460-6","url":null,"abstract":"<p><strong>Objective: </strong>To identify and verify potential biomarkers for primary Sjögren's disease (pSjD) using bioinformatics analysis and explore the molecular immune mechanisms of biomarkers.male-to-female ratio of 1:9 METHODS: The pSjD datasets were downloaded from the Gene Expression Omnibus (GEO) database. Differential expression analysis, weighted gene co-expression network analysis (WGCNA) and functional analysis were conducted. PPI network analysis was performed and the hub genes were screened by Cytoscape software. The diagnostic value was assessed by receiver operating characteristic (ROC) analysis. To explore biomarker-immune cell relations, we used CIBERSORT for cell-type identification, combined with scRNA-seq data. Lastly, we validated the expression of the biomarker in human samples.</p><p><strong>Results: </strong>A total of 96 overlapping genes, including 1 downregulated and 95 upregulated genes, were obtained. Based on the enrichment analysis, these overlapping genes were mapped to terms related to the functions and regulation of the immune system. CCR5 was identified as a critical biomarker and demonstrated high diagnostic accuracy for pSjD. From CIBERSORT analysis, CCR5 was significantly associated with diverse immune cells. Further scRNA-seq analysis indicated that CCR5 was specifically upregulated in T cells of pSjD salivary gland tissues, which was confirmed in pSjD patients.</p><p><strong>Conclusion: </strong>Our findings show the role of CCR5 in pSjD, mediated by immune mechanisms. CCR5 is localized in T cells of pSjD salivary glands. Elevated CCR5 expression may be a key biomarker, and increased CCR5 + T cells could aid future diagnosis, prognosis, and treatment of pSjD.</p>","PeriodicalId":10482,"journal":{"name":"Clinical Rheumatology","volume":" ","pages":"2387-2401"},"PeriodicalIF":2.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143981688","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":"Severe infection risk in triple and quadruple therapy for anti-MDA5 antibody-positive dermatomyositis.","authors":"Yoshitaka Ueda, Naofumi Chinen, Kota Shimada, Naoto Yokogawa","doi":"10.1007/s10067-025-07445-5","DOIUrl":"10.1007/s10067-025-07445-5","url":null,"abstract":"<p><strong>Introduction: </strong>Anti-melanoma differentiation-associated gene 5 (MDA5) antibody-positive dermatomyositis (MDA5-DM) can be refractory to treatment, and a triple combination therapy (TCT) consisting of a glucocorticoid, cyclophosphamide, and a calcineurin inhibitor is widely used in induction therapy. For progressive or severe disease despite TCT, another immunosuppressive agent, such as a Janus kinase (JAK) inhibitor, may be added to the induction regimen.</p><p><strong>Method: </strong>A retrospective cohort study across two centers in Japan was undertaken between January 2016 and December 2024 evaluating patients with MDA5-DM receiving TCT or quadruple combination therapy (QCT) determining the presence of severe infection. The latter therapy consisted of the addition of a JAK inhibitor to the TCT. A severe infection was defined as Grade 3 or higher according to the Common Terminology Criteria for Adverse Events (CTCAE), version 5.0.</p><p><strong>Results: </strong>There were 24 patients were included; TCT: n = 19 and QCT: n = 5. In the former, three (3/19, 16%), two (2/19, 11%), and three (3/19, 16%) patients had a severe bacterial infection, invasive fungal infection, and a CMV infection, respectively. In the QCT group, two (2/5, 40%), two (2/5, 40%), and four (4/5: 80%) patients had a severe bacterial infection, invasive fungal infection, and a CMV infection, respectively. CMV infections were significantly more frequent in the QCT group (p = 0.014). Both TCT and QCT groups had five patients each with a severe infection (5/19, 26% and 5/5, 100%, respectively) (p = 0.006).</p><p><strong>Conclusion: </strong>While both TCT and QCT have infection, the QCT group may be at a higher risk, hence highlighting the need for vigilance and adequate prophylaxis.</p>","PeriodicalId":10482,"journal":{"name":"Clinical Rheumatology","volume":" ","pages":"2095-2100"},"PeriodicalIF":2.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143994478","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 intra-articular ozone and steroid injection in patients with adhesive capsulitis.","authors":"Ali Sahillioğlu, Aylin Ayyıldız, Tülay Şahin","doi":"10.1007/s10067-025-07471-3","DOIUrl":"10.1007/s10067-025-07471-3","url":null,"abstract":"<p><strong>Objective: </strong>Adhesive capsulitis is a disease characterized by a significant decrease in the active and passive range of motion(ROM) of the glenohumeral joint along with pain. Ozone therapy has demonstrated promising results in treating various diseases. This study aims to compare the efficacy of intraarticular ozone administration with steroid injection in treating adhesive capsulitis.</p><p><strong>Methods: </strong>Our study is a single-blind, prospective and comparative clinical trial. The study included 40 patients who were randomly assigned to one of two groups. The study group received 8 sessions of intra-articular ozone injection under ultrasound guidance, while the control group received a single intra-articular steroid injection. Patient evaluations were conducted before treatment, as well as 4 and 12 weeks after treatment. The study utilized three evaluation scales: the visual analog scale(VAS) for pain, the Shoulder Pain and Disability Index (SPADI), and ROM measurements.</p><p><strong>Results: </strong>Both treatment groups demonstrated a statistically significant improvement in range of motion, SPADI, and VAS scores compared to their values at baseline and weeks 4 and 12. However, no statistically significant difference was found between the two groups in the magnitude of improvement across these outcomes.</p><p><strong>Conclusion: </strong>The study results demonstrate that ozone injection repeated eight times led to improvements in pain, function, and range of motion that were not statistically different from those observed with a single corticosteroid injection in treating adhesive capsulitis. Although the study was not designed as a non-inferiority trial, the findings suggest that intra-articular ozone administration may be a potentially beneficial alternative treatment option. Key Points • This study demonstrates that intra-articular ozone (O₂-O₃) injection resulted in significant clinical improvements in pain, function, and range of motion in patients with primary adhesive capsulitis. • Despite differences in injection frequency, both ozone and corticosteroid injections led to improvements, with no statistically significant difference between groups. • This study contributes to the limited literature on ozone therapy for adhesive capsulitis and suggests its potential as an alternative to corticosteroid injection, particularly for patients who may not tolerate steroids. • Further research with longer follow-up periods is warranted to confirm the long-term efficacy and safety of ozone therapy in adhesive capsulitis management.</p>","PeriodicalId":10482,"journal":{"name":"Clinical Rheumatology","volume":" ","pages":"2517-2525"},"PeriodicalIF":2.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143971305","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}