Current opinion in rheumatology最新文献_第6页

Clinical endpoints in myositis: challenges and ways forward. 肌炎的临床终点：挑战与前进之路。

IF 5.2 2区医学

Current opinion in rheumatology Pub Date : 2024-11-01 Epub Date: 2024-08-22 DOI: 10.1097/BOR.0000000000001044

Cristina Ricco, Caroline J Stone, Victoria P Werth

{"title":"Clinical endpoints in myositis: challenges and ways forward.","authors":"Cristina Ricco, Caroline J Stone, Victoria P Werth","doi":"10.1097/BOR.0000000000001044","DOIUrl":"10.1097/BOR.0000000000001044","url":null,"abstract":"Purpose of review: This review addresses the challenges and advances in clinical endpoints for myositis, with a particular focus on ensuring comprehensive assessment of both muscle and skin disease activity. The relevance of this review stems from recent developments in outcome measures and their implications for clinical trial design and patient inclusivity. While quality of life (QoL) and lung involvement are also important aspects of myositis, they are beyond the scope of this review and need to be addressed in future studies.Recent findings: Traditional outcome measures like the Total Improvement Score (TIS) have limitations, especially for patients with skin-predominant dermatomyositis (DM). Recent studies highlight the importance of incorporating skin-specific measures such as the Cutaneous Disease Area and Severity Index (CDASI) and the novel composite measure, Dermatomyositis Outcomes for Muscle and Skin (DMOMS). These measures provide a more balanced assessment of disease activity. Clinical trial data analyzed using these measures have demonstrated significant benefits for patients with both classic and amyopathic DM, emphasizing the need for their broader adoption.Summary: Advancements in outcome measures are crucial for inclusive and effective myositis clinical trials. Incorporating comprehensive tools like the DMOMS can enhance the assessment of both muscle and skin disease activities, potentially leading to better therapeutic strategies and improved patient outcomes. This shift is essential for addressing the needs of all Idiopathic inflammatory myopathy patients, including those with skin-predominant DM.","PeriodicalId":11145,"journal":{"name":"Current opinion in rheumatology","volume":" ","pages":"430-437"},"PeriodicalIF":5.2,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142016684","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

Current efforts and historical perspectives on classification of idiopathic inflammatory myopathies. 特发性炎症性肌病分类的当前努力和历史展望。

IF 5.2 2区医学

Current opinion in rheumatology Pub Date : 2024-11-01 Epub Date: 2024-08-12 DOI: 10.1097/BOR.0000000000001042

Stefanie Glaubitz, Didem Saygin, Ingrid E Lundberg

{"title":"Current efforts and historical perspectives on classification of idiopathic inflammatory myopathies.","authors":"Stefanie Glaubitz, Didem Saygin, Ingrid E Lundberg","doi":"10.1097/BOR.0000000000001042","DOIUrl":"10.1097/BOR.0000000000001042","url":null,"abstract":"Purpose of review: The classification of idiopathic inflammatory myopathies is challenging due to the large number of clinical, serological, histopathological and genetic findings, as well as the latest findings and developments in the field of myositis research. The latest official classification criteria are the 2017 European Alliance of Associations for Rheumatology (EULAR)/American College of Rheumatology (ACR) classification criteria for adult and juvenile idiopathic inflammatory myopathies, which have been extensively reviewed in recent years for their applicability, sensitivity and specificity.Recent findings: The sensitivity and specificity of the 2017 ACR/EULAR criteria are sometimes performing better, but usually at the same level as the previous criteria. A large number of further suggestions for amendments to the criteria have been made. In particular there is a need to revise the criteria with regard to the addition of new myositis-specific autoantibodies, newly defined subgroups (especially antisynthetase syndrome, immune medicated necrotizing myopathy and overlap myositis) and possibly the addition of further diagnostic procedures (for instance, muscle MRI or PET CT) to improve the accuracy and timeliness of the criteria.Summary: Efforts to optimize the myositis classification criteria have been extensive in recent years and a new global interdisciplinary collaboration of clinicians is currently taking place based on the previous results with the aim of revising the 2017 EULAR/ACR classification criteria.","PeriodicalId":11145,"journal":{"name":"Current opinion in rheumatology","volume":" ","pages":"473-480"},"PeriodicalIF":5.2,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141916350","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

Juvenile Behçet syndrome: a contemporary view and differential diagnosis in pediatric practice. 青少年贝赫切特综合征：儿科实践中的当代观点和鉴别诊断。

IF 5.1 2区医学

Current opinion in rheumatology Pub Date : 2024-09-19 DOI: 10.1097/bor.0000000000001057

Mehmet Yildiz,Oya Koker,Ozgur Kasapcopur

{"title":"Juvenile Behçet syndrome: a contemporary view and differential diagnosis in pediatric practice.","authors":"Mehmet Yildiz,Oya Koker,Ozgur Kasapcopur","doi":"10.1097/bor.0000000000001057","DOIUrl":"https://doi.org/10.1097/bor.0000000000001057","url":null,"abstract":"PURPOSE OF REVIEWThis review aims to provide a comprehensive and contemporary overview of juvenile Behçet syndrome (jBS), highlighting its clinical manifestations, diagnostic challenges, and treatment strategies.RECENT FINDINGSBehçet syndrome, with its intricate etiopathogenesis and diverse clinical phenotypes, is more aptly classified as a syndrome than a single disease. Its heterogeneous nature requires a broad diagnostic approach and sophisticated differential diagnosis capabilities. The relatively rare occurrence of Behçet syndrome, combined with incomplete clinical presentations and overlapping differential diagnoses, presents significant diagnostic challenges, particularly in pediatric cases. Nevertheless, substantial progress has been made in treatment, especially in managing inflammatory components and preventing complications. Juvenile patients, given their developmental stage, require distinct therapeutic strategies compared to adults, with careful consideration of treatment side effects on growth and psychosocial development.SUMMARYTo ensure early identification of jBS, it is imperative to refine and develop diagnostic criteria specifically tailored to pediatric populations. With a deeper understanding of the disease mechanisms, treatment protocols should be designed to address the developmental, psychosocial, and individual needs of patients, aiming to minimize long-term side effects. Additionally, comprehensive studies considering age, sex, and ethnic differences are necessary to fill gaps in the literature and resolve existing inconsistencies.","PeriodicalId":11145,"journal":{"name":"Current opinion in rheumatology","volume":"17 1","pages":""},"PeriodicalIF":5.1,"publicationDate":"2024-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142250187","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

The role of neutrophil extracellular traps in inflammatory rheumatic diseases. 中性粒细胞胞外捕获器在炎症性风湿病中的作用。

IF 5.1 2区医学

Current opinion in rheumatology Pub Date : 2024-09-12 DOI: 10.1097/bor.0000000000001054

Norio Hanata,Mariana J Kaplan

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":" ","pages":"344-350"},"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

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":" ","pages":"351-359"},"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

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":" ","pages":"315-321"},"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