Current opinion in rheumatology最新文献_第2页

SGLT-2 inhibitors: new horizons for rheumatologists. SGLT-2 抑制剂：风湿病学家的新视野。

IF 5.2 2区医学

Current opinion in rheumatology Pub Date : 2024-09-01 Epub Date: 2024-07-24 DOI: 10.1097/BOR.0000000000001030

Katherine Chakrabarti, W Joseph McCune

{"title":"SGLT-2 inhibitors: new horizons for rheumatologists.","authors":"Katherine Chakrabarti, W Joseph McCune","doi":"10.1097/BOR.0000000000001030","DOIUrl":"10.1097/BOR.0000000000001030","url":null,"abstract":"Purpose of review: Sodium glucose cotransporter 2 (SGLT2) inhibitors are a class of medications initially developed for the treatment of diabetes, although their cardiac and renal protective benefits are far reaching. There has been marked interest in the rheumatology community to adopt these medications into our clinical practice, particularly for chronic kidney disease with persistent proteinuria.Recent findings: SGLT2 inhibitors have been approved for patients with type 2 diabetes mellitus, heart failure with reduced or preserved ejection fraction, atherosclerotic cardiovascular disease in the setting of type 2 diabetes mellitus, as well as chronic kidney disease with proteinuria. Large studies on SGLT2 inhibitors have largely excluded patients with proteinuric chronic kidney disease due to autoimmune glomerulonephritis due to concerns for confounding from immunosuppression. The Dapagliflozin and Prevention of Adverse Outcomes in CKD Trial (DAPA-CKD) showed that SGLT2 inhibition decreased progression of renal disease in patients with IgA nephropathy. Expanding this to other autoimmune glomerulonephropathies, several small studies have shown improvements in proteinuria in patients with lupus nephritis treated with SGLT2 inhibitors. A study evaluating safety of SGLT2 inhibitors in patients with lupus identified no specific concerns even with concomitant use of immunosuppression.Summary: Small studies have shown that SGLT2 inhibitors can been utilized safely and efficaciously in patients with lupus nephritis. Additional research is needed to identify where these medications fit into the rheumatology treatment armamentarium.","PeriodicalId":11145,"journal":{"name":"Current opinion in rheumatology","volume":null,"pages":null},"PeriodicalIF":5.2,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11296270/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141616079","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

Renal disease in pediatric rheumatology. 小儿风湿病学中的肾脏疾病。

IF 5.2 2区医学

Current opinion in rheumatology Pub Date : 2024-09-01 Epub Date: 2024-05-16 DOI: 10.1097/BOR.0000000000001027

Ellen Cody, Hermine I Brunner

引用次数: 0

Current management of giant cell arteritis and its complications. 巨细胞动脉炎及其并发症的治疗现状。

IF 5.2 2区医学

Current opinion in rheumatology Pub Date : 2024-09-01 Epub Date: 2024-06-26 DOI: 10.1097/BOR.0000000000001029

Elena Galli, Francesco Muratore, Kenneth J Warrington

{"title":"Current management of giant cell arteritis and its complications.","authors":"Elena Galli, Francesco Muratore, Kenneth J Warrington","doi":"10.1097/BOR.0000000000001029","DOIUrl":"10.1097/BOR.0000000000001029","url":null,"abstract":"Purpose of review: This review provides an update on current management strategies for giant cell arteritis (GCA), emphasizing the need for alternative therapies to reduce disease relapses and mitigate glucocorticoid (GC)-related morbidity.Recent findings: The standard of care for GCA has traditionally involved prolonged use of GC, and recent studies are exploring faster GC tapering regimens in an effort to reduce adverse effects while maintaining disease control. Randomized clinical trials have highlighted the efficacy of tocilizumab (TCZ), an interleukin-6 receptor inhibitor, in reducing disease flares and sparing GCs. However, the optimal treatment duration with TCZ is unknown and patients remain at risk of relapse after treatment discontinuation. An unmet therapeutic need persists for patients who are not candidates for TCZ, and for those who have inadequate response to this biologic. Therefore, investigations into alternative therapies such as targeting interleukin-17A, blocking T-cell activation or inhibiting the Janus kinase-signal transducer and activator of transcription pathway, showcase potential avenues for tailored treatments.Summary: While GCs remain the cornerstone of therapy, TCZ emerges as a promising GC-sparing agent. Ongoing research targeting different pathways implicated in GCA pathogenesis have led to encouraging results. However, the preliminary nature of these findings necessitates larger randomized controlled trials to establish their efficacy conclusively.","PeriodicalId":11145,"journal":{"name":"Current opinion in rheumatology","volume":null,"pages":null},"PeriodicalIF":5.2,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141450040","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

Updates in the care and management of children and adolescents with systemic lupus erythematosus. 系统性红斑狼疮儿童和青少年患者的最新护理和管理方法。

IF 5.2 2区医学

Current opinion in rheumatology Pub Date : 2024-09-01 Epub Date: 2024-05-15 DOI: 10.1097/BOR.0000000000001026

Clovis A Silva, Nadia E Aikawa, Eloisa Bonfa

{"title":"Updates in the care and management of children and adolescents with systemic lupus erythematosus.","authors":"Clovis A Silva, Nadia E Aikawa, Eloisa Bonfa","doi":"10.1097/BOR.0000000000001026","DOIUrl":"10.1097/BOR.0000000000001026","url":null,"abstract":"Purpose of review: This narrative review offers an update of the most important recent articles published in the previous year of childhood-onset systemic lupus erythematosus (cSLE), focusing on care and management.Recent findings: Age-related disparities may play a significant role in the clinical and laboratory characteristics of cSLE, as well as its performance in distinct classification criteria. Monogenic lupus is associated with higher disease damage scores and mortality rate compared to sporadic cSLE. Adolescent face unique challenges, with comorbid psychiatric diagnosis, low resilience and nonadherence posing relevant challenges. A recent international task force has outlined pivotal principles and points-to-consider for treat-to-target (T2T) in cSLE patients. While the past year did yield new randomized controlled trial for cSLE treatment, publications focused on broader management strategies, including the impact of ultraviolet radiation exposure, immunization, and strict blood pressure control. Additionally, case reports and series have evaluated the efficacy/safety profiles of both available and emerging treatments.Summary: Current studies highlighted the various facets of cSLE, epidemiology, clinical, laboratory, classification criteria, adolescent issues, prognosis, surveillance, T2T approach and drug management. Despite notable progress, the scarcity of randomized trials emphasizes the need to delineate safer and more efficacious treatment modalities in cSLE.","PeriodicalId":11145,"journal":{"name":"Current opinion in rheumatology","volume":null,"pages":null},"PeriodicalIF":5.2,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140921333","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

Editorial introduction. 编辑介绍。

IF 5.2 2区医学

Current opinion in rheumatology Pub Date : 2024-09-01 Epub Date: 2024-08-01 DOI: 10.1097/BOR.0000000000001031

引用次数: 0

Novel therapies in juvenile idiopathic arthritis. 幼年特发性关节炎的新疗法。

IF 5.2 2区医学

Current opinion in rheumatology Pub Date : 2024-09-01 Epub Date: 2024-05-22 DOI: 10.1097/BOR.0000000000001028

Anne M Sage, Sarah L N Clarke, Athimalaipet V Ramanan

引用次数: 0

Update on antineutrophil cytoplasmic autoantibody vasculitis in children. 儿童抗中性粒细胞胞浆自身抗体血管炎的最新进展。

IF 5.2 2区医学

Current opinion in rheumatology Pub Date : 2024-09-01 Epub Date: 2024-07-10 DOI: 10.1097/BOR.0000000000001033

Jessica L Bloom, Eveline Y Wu

{"title":"Update on antineutrophil cytoplasmic autoantibody vasculitis in children.","authors":"Jessica L Bloom, Eveline Y Wu","doi":"10.1097/BOR.0000000000001033","DOIUrl":"10.1097/BOR.0000000000001033","url":null,"abstract":"Purpose of review: Antineutrophil cytoplasmic autoantibody (ANCA)-associated vasculitis (AAV) is often organ- or life-threatening in children and impacts them during important periods of psychosocial and physical development. This review covers recent advances in the pathophysiology, diagnosis, management, and outcomes of AAV in children and highlights the ongoing need for funding and increased research collaboration.Recent findings: Recent work has improved our understanding of AAV disease pathogenesis, potentially identifying new biomarkers and therapeutic targets. Collaborative clinical studies have also highlighted the variable manifestations in children and identified potential factors associated with poorer outcomes. Consensus-based treatment guidelines are also appearing, but clinical trials are still essential to better understanding treatment efficacy and safety in children affected by AAV. New, validated outcome measures, including those that are patient-reported, will facilitate these much-needed clinical trials in pediatric AAV.Summary: There is a continued need for more rigorous study in pediatric AAV, however, there is certainly excitement with the increase in recent research relevant to the pediatric population.","PeriodicalId":11145,"journal":{"name":"Current opinion in rheumatology","volume":null,"pages":null},"PeriodicalIF":5.2,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141579188","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

Calcinosis in systemic sclerosis. 系统性硬化症中的钙化。

IF 5.2 2区医学

Current opinion in rheumatology Pub Date : 2024-09-01 Epub Date: 2023-10-10 DOI: 10.1097/BOR.0000000000000900

Srijana Davuluri, Christian Lood, Lorinda Chung

{"title":"Calcinosis in systemic sclerosis.","authors":"Srijana Davuluri, Christian Lood, Lorinda Chung","doi":"10.1097/BOR.0000000000000900","DOIUrl":"10.1097/BOR.0000000000000900","url":null,"abstract":"Purpose of review: To provide updated information on the prevalence, pathogenesis, diagnostics, and therapeutics of calcinosis cutis associated with systemic sclerosis (SSc).Recent findings: Observational studies show ethnic and geographical differences in the prevalence of calcinosis. In addition to clinical and serological associations, biochemical studies and in-vivo models have attempted to explain theories behind its pathogenesis, including prolonged state of inflammation, mechanical stress, hypoxia, and dysregulation in bone and phosphate metabolism. Long-term use of proton pump inhibitors may increase the risk for calcinosis in SSc. Few single center observational studies have shown mild benefit with minocycline and topical sodium thiosulfate.Summary: Calcinosis cutis is the deposition of insoluble calcium in the skin and subcutaneous tissues. It affects up to 40% of SSc patients and causes significant morbidity. Long disease duration, features of vascular dysfunction, and osteoporosis have been associated with calcinosis. Altered levels of inorganic pyrophosphate and fibroblast growth factor-23 have been implicated in dysregulated phosphate metabolism that may lead to calcinosis in SSc. Plain radiography can help with diagnosis and quantifying the calcinosis burden. Surgical treatment remains the most effective therapy when feasible. At present, no medical therapies have proven efficacy in large randomized controlled trials.","PeriodicalId":11145,"journal":{"name":"Current opinion in rheumatology","volume":null,"pages":null},"PeriodicalIF":5.2,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41194417","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

Gastrointestinal disease in systemic sclerosis: the neglected organ system? 系统性硬化症的胃肠道疾病：被忽视的器官系统？

IF 5.2 2区医学

Current opinion in rheumatology Pub Date : 2024-08-29 DOI: 10.1097/BOR.0000000000001052

Zsuzsanna McMahan, John Pandolfino, Harris Perlman, Francesco Del Galdo, Monique Hinchcliff

{"title":"Gastrointestinal disease in systemic sclerosis: the neglected organ system?","authors":"Zsuzsanna McMahan, John Pandolfino, Harris Perlman, Francesco Del Galdo, Monique Hinchcliff","doi":"10.1097/BOR.0000000000001052","DOIUrl":"https://doi.org/10.1097/BOR.0000000000001052","url":null,"abstract":"Purpose of review: Identifying outcomes and clinical trial endpoints enabled the discovery of new inflammatory bowel disease (IBD) treatments. Herein, we describe efforts to advance the study of gastrointestinal (GI) manifestations in systemic sclerosis (SSc).Recent findings: Insights into the scope of the problem, as well as advancements in the measurement and treatment of SSc-GI, are underway. Proposed SSc esophageal endophenotypes are now defined, risk stratification methods are growing, and imaging and functional studies are now employed to guide therapeutic interventions. Additional progress is being made in characterizing the gut microbiome in patients with SSc. Research into the role of the immune response in the pathogenesis of SSc-GI disease is also ongoing, evolving simultaneously with the development of methods to facilitate data collection with real-time capture of diet, exercise, and medication data.Summary: Multidisciplinary teams are working to deepen our understanding of SSc-GI disease pathogenesis, to identify biomarkers for risk stratification and the assessment of disease activity, and to develop and validate outcomes and clinical trial endpoints to pave the way toward effective therapy for SSc-GI disease.","PeriodicalId":11145,"journal":{"name":"Current opinion in rheumatology","volume":null,"pages":null},"PeriodicalIF":5.2,"publicationDate":"2024-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142079590","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

Treatment of interstitial lung disease in systemic sclerosis: guidelines and new clinical trial results. 系统性硬化症间质性肺病的治疗：指南和新的临床试验结果。

IF 5.2 2区医学

Current opinion in rheumatology Pub Date : 2024-08-28 DOI: 10.1097/BOR.0000000000001049

Sindhu R Johnson, Elana J Bernstein

{"title":"Treatment of interstitial lung disease in systemic sclerosis: guidelines and new clinical trial results.","authors":"Sindhu R Johnson, Elana J Bernstein","doi":"10.1097/BOR.0000000000001049","DOIUrl":"https://doi.org/10.1097/BOR.0000000000001049","url":null,"abstract":"Purpose of review: Interstitial lung disease (ILD) is the leading cause of death in patients with systemic sclerosis-associated interstitial lung disease (SSc-ILD). The American College of Rheumatology (ACR), in conjunction with the American College of Chest Physicians (CHEST), recently published clinical practice guidelines for the treatment of adults with systemic autoimmune rheumatic disease-associated ILD, including SSc-ILD. Herein, we summarize evidence from randomized trials evaluating the safety and efficacy of pharmacologic therapies for the treatment of SSc-ILD.Recent findings: In this review, we present findings from recent randomized controlled trials in SSc-ILD. The pharmacologic therapies discussed include immunosuppressive medications (mycophenolate, cyclophosphamide, rituximab, and tocilizumab) and antifibrotic medications (nintedanib and pirfenidone).Summary: Randomized trials provide an evidence base for the SSc-ILD treatment recommendations put forth in the ACR/CHEST Guidelines for the treatment of ILD in people with systemic autoimmune rheumatic diseases. These guidelines will help inform clinical practice and highlight areas in which further research is needed.","PeriodicalId":11145,"journal":{"name":"Current opinion in rheumatology","volume":null,"pages":null},"PeriodicalIF":5.2,"publicationDate":"2024-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142079591","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