Current opinion in rheumatology最新文献_第10页

Sacroiliitis in inflammatory bowel disease. 炎症性肠病中的骶髂关节炎。

IF 5.2 2区医学

Current opinion in rheumatology Pub Date : 2024-07-01 Epub Date: 2024-04-30 DOI: 10.1097/BOR.0000000000001017

Fardina Malik, Michael H Weisman

{"title":"Sacroiliitis in inflammatory bowel disease.","authors":"Fardina Malik, Michael H Weisman","doi":"10.1097/BOR.0000000000001017","DOIUrl":"10.1097/BOR.0000000000001017","url":null,"abstract":"Purpose of review: This review summarizes the recent evidence regarding the epidemiology of inflammatory bowel disease (IBD) associated sacroiliitis, including the prevalence, pathogenesis, role of imaging, and therapeutic challenges.Recent findings: Sacroiliitis is an underappreciated musculoskeletal manifestation of IBD, a chronic inflammatory condition of the gut affecting the younger population. Untreated sacroiliitis can lead to joint destruction and chronic pain, further adding to morbidity in IBD patients. Recent publications suggest sacroiliitis can be detected on abdominal imaging obtained in IBD patients to study bowel disease, but only a small fraction of these patients were seen by rheumatologists. Early detection of IBD-associated sacroiliitis could be achieved by utilization of clinical screening tools in IBD clinics, careful examination of existing computed tomography and MRI studies, and timely referral to rheumatologist for further evaluation and treatment. Current treatment approaches for IBD and sacroiliitis include several targeted biologic therapies, but IBD-associated sacroiliitis has limited options, as these therapies may not overlap in both conditions.Summary: With the advances in imaging, sacroiliitis is an increasingly recognized comorbidity in IBD patients. Future studies focusing on this unique patient population will expand our understanding of complex pathophysiology of IBD-associated sacroiliitis and lead to identification of novel targeted therapies for this condition.","PeriodicalId":11145,"journal":{"name":"Current opinion in rheumatology","volume":" ","pages":"274-281"},"PeriodicalIF":5.2,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140853003","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Navigating the complexity of pain in psoriatic arthritis and axial spondyloarthritis. 了解银屑病关节炎和轴性脊柱关节炎疼痛的复杂性。

IF 5.2 2区医学

Current opinion in rheumatology Pub Date : 2024-07-01 Epub Date: 2024-05-01 DOI: 10.1097/BOR.0000000000001023

Philip J Mease

{"title":"Navigating the complexity of pain in psoriatic arthritis and axial spondyloarthritis.","authors":"Philip J Mease","doi":"10.1097/BOR.0000000000001023","DOIUrl":"10.1097/BOR.0000000000001023","url":null,"abstract":"Purpose of review: Pain is the most common and often most troublesome feature of chronic autoimmune diseases such as psoriatic arthritis (PsA) and axial spondyloarthritis (AxSpA). A predominant concept is that the main source of pain is from disease-induced tissue inflammation and structural damage, activating peripheral nerve fibers which relay to the central nervous system. This mechanism is nociceptive pain and the presumption has been that controlling inflammation will be sufficient to reduce this form of pain. However, despite control of inflammation, patients may still have significant residual pain.Recent findings: We are learning that there are additional pain mechanisms, neuropathic and nociplastic, that are often operative in patients with rheumatologic conditions, that can significantly influence pain experience, quantitation of disease activity, and may benefit from therapeutic approaches distinct from immunotherapy. Neuropathic pain arises from diseased or damaged nerve tissue and nociplastic pain reflects sensitization of the central nervous system due to multiple genetic, neurobiologic, neural network dysregulation, and psychosocial factors. Pain arising from these mechanisms influence assessment of disease activity and thus needs to be factored into decision-making about immunotherapy efficacy.Summary: This review addresses the importance of accurately assessing the complex mechanisms of pain experience in patients with PsA and AxSpA to more appropriately manage immunomodulatory, neuromodulatory, and nonpharmacologic therapies.","PeriodicalId":11145,"journal":{"name":"Current opinion in rheumatology","volume":" ","pages":"282-288"},"PeriodicalIF":5.2,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140864333","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Artificial intelligence and machine learning in axial spondyloarthritis. 人工智能和机器学习在轴性脊柱关节炎中的应用。

IF 5.2 2区医学

Current opinion in rheumatology Pub Date : 2024-07-01 Epub Date: 2024-03-27 DOI: 10.1097/BOR.0000000000001015

Lisa C Adams, Keno K Bressem, Denis Poddubnyy

{"title":"Artificial intelligence and machine learning in axial spondyloarthritis.","authors":"Lisa C Adams, Keno K Bressem, Denis Poddubnyy","doi":"10.1097/BOR.0000000000001015","DOIUrl":"10.1097/BOR.0000000000001015","url":null,"abstract":"Purpose of review: To evaluate the current applications and prospects of artificial intelligence and machine learning in diagnosing and managing axial spondyloarthritis (axSpA), focusing on their role in medical imaging, predictive modelling, and patient monitoring.Recent findings: Artificial intelligence, particularly deep learning, is showing promise in diagnosing axSpA assisting with X-ray, computed tomography (CT) and MRI analyses, with some models matching or outperforming radiologists in detecting sacroiliitis and markers. Moreover, it is increasingly being used in predictive modelling of disease progression and personalized treatment, and could aid risk assessment, treatment response and clinical subtype identification. Variable study designs, sample sizes and the predominance of retrospective, single-centre studies still limit the generalizability of results.Summary: Artificial intelligence technologies have significant potential to advance the diagnosis and treatment of axSpA, providing more accurate, efficient and personalized healthcare solutions. However, their integration into clinical practice requires rigorous validation, ethical and legal considerations, and comprehensive training for healthcare professionals. Future advances in artificial intelligence could complement clinical expertise and improve patient care through improved diagnostic accuracy and tailored therapeutic strategies, but the challenge remains to ensure that these technologies are validated in prospective multicentre trials and ethically integrated into patient care.","PeriodicalId":11145,"journal":{"name":"Current opinion in rheumatology","volume":" ","pages":"267-273"},"PeriodicalIF":5.2,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140293083","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Investigating gout flares: beyond a definition. 痛风发作的调查：超越定义。

IF 5.1 2区医学

Current opinion in rheumatology Pub Date : 2024-05-03 DOI: 10.1097/bor.0000000000001024

Charles Sutherland, Angelo L Gaffo

引用次数: 0

Autoantibodies in rheumatoid arthritis - rheumatoid factor, anticitrullinated protein antibodies and beyond. 类风湿性关节炎的自身抗体--类风湿因子、抗瓜氨酸蛋白抗体及其他。

IF 5.2 2区医学

Current opinion in rheumatology Pub Date : 2024-05-01 Epub Date: 2024-02-26 DOI: 10.1097/BOR.0000000000001006

Günter Steiner, René E M Toes

{"title":"Autoantibodies in rheumatoid arthritis - rheumatoid factor, anticitrullinated protein antibodies and beyond.","authors":"Günter Steiner, René E M Toes","doi":"10.1097/BOR.0000000000001006","DOIUrl":"10.1097/BOR.0000000000001006","url":null,"abstract":"Purpose of review: RA is characterized by the presence of autoantibodies among which rheumatoid factors (RFs) and antimodified protein antibodies (AMPA) are serological hallmarks of the disease. In recent years, several novel insights into the biology, immunogenetics and clinical relevance of these autoantibodies have been obtained, which deserve to be discussed in more detail.Recent findings: RFs from RA patients seem to target distinct epitopes which appear to be quite specific for RA. Determination of immunoglobulin A (IgA) isotypes of RF and anticitrullinated protein antibodies (ACPA) may provide prognostic information because their presence is associated with reduced therapeutic responses to TNF inhibitors. Furthermore, IgA levels are increased in RA patients and IgA immune complexes are more potent than immunoglobulin G (IgG) complexes in inducing NET formation. Concerning AMPAs, investigations on variable domain glycosylation (VDG) revealed effects on antigen binding and activation of autoreactive B cells. Studies on pathogenetic involvement of ACPA suggest Janus-faced roles: on the one hand, ACPA may be involved in joint destruction and pain perception while on the other hand protective anti-inflammatory effects may be attributed to a subset of ACPAs.Summary: The autoimmune response in RA is extremely complex and still far from being fully understood. Antibodies are not only valuable diagnostic biomarkers but also seem to play pivotal roles in the pathophysiology of RA.","PeriodicalId":11145,"journal":{"name":"Current opinion in rheumatology","volume":" ","pages":"217-224"},"PeriodicalIF":5.2,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11139241/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139971266","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Monogenic lupus: insights into disease pathogenesis and therapeutic opportunities. 单基因狼疮：洞察疾病发病机制和治疗机会。

IF 4.3 2区医学

Current opinion in rheumatology Pub Date : 2024-05-01 Epub Date: 2024-02-29 DOI: 10.1097/BOR.0000000000001008

Yuting Qin, Jianyang Ma, Carola G Vinuesa

引用次数: 0

New molecular targets in the treatment of rheumatoid arthritis. 治疗类风湿性关节炎的新分子靶点。

IF 5.2 2区医学

Current opinion in rheumatology Pub Date : 2024-05-01 Epub Date: 2024-01-02 DOI: 10.1097/BOR.0000000000001000

Beth I Wallace, Laura Cooney, David A Fox

引用次数: 0

Rheumatoid arthritis: prediction of future clinically-apparent disease, and prevention. 类风湿性关节炎：未来临床显现疾病的预测和预防。

IF 5.2 2区医学

Current opinion in rheumatology Pub Date : 2024-05-01 Epub Date: 2024-03-05 DOI: 10.1097/BOR.0000000000001013

Kevin D Deane

{"title":"Rheumatoid arthritis: prediction of future clinically-apparent disease, and prevention.","authors":"Kevin D Deane","doi":"10.1097/BOR.0000000000001013","DOIUrl":"10.1097/BOR.0000000000001013","url":null,"abstract":"Purpose of review: This review discusses updates in the prediction and prevention of future rheumatoid arthritis (RA).Recent findings: In individuals with musculoskeletal symptoms and elevated antibodies to citrullinated proteins (ACPA) without clinical inflammatory arthritis (IA), a 'simple' score has a positive predictive value (PPV) of ∼28% for clinical IA/RA within 1 year, and a comprehensive score (including ultrasound) has a PPV of ∼71% for clinical RA within 5 years. Controlled clinical trials in individuals at-risk for future RA have been performed using corticosteroids, rituximab, atorvastatin, methotrexate, hydroxychloroquine and abatacept. Abatacept modestly reduced rates of incident clinical RA and imaging inflammation within the trials, rituximab delayed clinical IA, and methotrexate improved function, symptoms and imaging inflammation. Vitamin D with or without omega 3 fatty acids reduced incidence of autoimmune diseases, including RA. While not proven in controlled clinical trials, observational studies suggest exercise, weight loss and smoking cessation may reduce progression to clinical RA.Summary: Prediction and prevention of RA is advancing although there are no currently approved interventions for prevention. Future studies should include deeper evaluation of the pathophysiology of RA development to improve prediction and identify key pathways to target in future clinical trials, as well as develop infrastructure to support prevention-related research.","PeriodicalId":11145,"journal":{"name":"Current opinion in rheumatology","volume":" ","pages":"225-234"},"PeriodicalIF":5.2,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10959682/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140027629","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Updates on interstitial lung disease and other selected extra-articular manifestations of rheumatoid arthritis. 类风湿关节炎间质性肺病及其他部分关节外表现的最新进展。

IF 5.1 2区医学

Current opinion in rheumatology Pub Date : 2024-05-01 Epub Date: 2024-02-23 DOI: 10.1097/BOR.0000000000001007

Elena Myasoedova, Eric L Matteson

{"title":"Updates on interstitial lung disease and other selected extra-articular manifestations of rheumatoid arthritis.","authors":"Elena Myasoedova, Eric L Matteson","doi":"10.1097/BOR.0000000000001007","DOIUrl":"10.1097/BOR.0000000000001007","url":null,"abstract":"Purpose of review: To discuss changes in epidemiology, recent advances in understanding of the pathogenesis and management of selected extraarticular manifestations of rheumatoid arthritis (ExRA).Recent findings: The incidence of ExRA overall and subcutaneous rheumatoid nodules in particular is declining after 2000. These trends reflect improved RA disease activity with early effective immunosuppressive treatments; changing environmental risk factors can be contributing. ExRA continues to carry a two-fold increased mortality risk. RA-associated interstitial lung disease (RA-ILD) is a major contributor to mortality, with no decline in incidence and scant therapeutic options. Individualized risk stratification for RA-ILD based on patient-level risk factors and biomarker profile is evolving with MUC5B as a major genetic risk factor. Clinical trials are underway to evaluate the benefits of novel antifibrotic therapies and targeted therapies for RA-ILD. The risk of cardiovascular disease in RA is generally amendable to treatment with disease-modifying antirheumatic drugs, although cardiovascular risk associated with JAK inhibition is not fully understood.Summary: Despite reduction in incidence of ExRA overall, the incidence of RA-ILD shows no significant decline and remains a major therapeutic challenge. The use of novel antifibrotics and immunosuppressive drugs shows promise in slowing the progression of RA-ILD.","PeriodicalId":11145,"journal":{"name":"Current opinion in rheumatology","volume":" ","pages":"203-208"},"PeriodicalIF":5.1,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139971268","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Management of postinfectious inflammatory arthritis. 感染后炎症性关节炎的治疗。

IF 5.1 2区医学

Current opinion in rheumatology Pub Date : 2024-05-01 Epub Date: 2024-02-21 DOI: 10.1097/BOR.0000000000001009

Hailey Baker, J Kennedy Amaral, Robert T Schoen

{"title":"Management of postinfectious inflammatory arthritis.","authors":"Hailey Baker, J Kennedy Amaral, Robert T Schoen","doi":"10.1097/BOR.0000000000001009","DOIUrl":"10.1097/BOR.0000000000001009","url":null,"abstract":"Purpose of review: Postinfectious inflammatory arthritis can result from various pathogens, including bacteria, viruses, fungi, and parasites. Prompt identification and treatment of acute infection is vital, but some cases progress to chronic arthritis despite successful treatment of infection. Postinfectious inflammatory arthritis varies from mild, self-limited arthralgia to severe, refractory arthritis, necessitating ongoing disease-modifying treatment. This review explores the spectrum of postinfectious inflammatory arthritis to provide insights into effective management.Recent findings: Research continues regarding the benefit of antimicrobial therapy, beyond treatment of the acute infection, to diminish the severity of postinfectious inflammatory arthritis. Following treatment of acute infection, most cases are self-limited so treatment is symptomatic. However, a difficult-to-predict fraction of cases develop chronic postinfectious inflammatory arthritis that can be challenging to manage. Recently, as more biologic, and targeted synthetic DMARDs have become available, treatment options have expanded.Summary: In this article, we use the term 'postinfectious inflammatory arthritis' rather than 'reactive arthritis' because it describes a broader spectrum of diseases and emphasizes the common pathogenesis of a postinfectious inflammatory process. We summarize the conventional therapies and recent management developments for the most frequently encountered postinfectious inflammatory arthritides.","PeriodicalId":11145,"journal":{"name":"Current opinion in rheumatology","volume":" ","pages":"155-162"},"PeriodicalIF":5.1,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139971267","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0