International Journal of Rheumatic Diseases最新文献

{"title":"Cutaneous Infarct in IgA Vasculitis","authors":"Jagannath De, G. S. R. S. N. K. Naidu, Aman Sharma, Sanjay Jain","doi":"10.1111/1756-185x.70376","DOIUrl":"https://doi.org/10.1111/1756-185x.70376","url":null,"abstract":"","PeriodicalId":14330,"journal":{"name":"International Journal of Rheumatic Diseases","volume":"28 7","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144657650","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Incidence and Risk of Malignancy in Japanese Patients With Rheumatoid Arthritis in the National Database of Rheumatic Diseases in Japan (NinJa Database)","authors":"Toshihiro Matsui,&nbsp;Aosa Kamezaki-Nakagawa,&nbsp;Masato Hoshi,&nbsp;Hiroshi Hirano,&nbsp;Naonobu Sugiyama,&nbsp;Toshitaka Hirano,&nbsp;Miwa Enami,&nbsp;Shigeyuki Toyoizumi,&nbsp;Fujio Matsuyama,&nbsp;Tatsunori Murata,&nbsp;Yukitomo Urata,&nbsp;Kimito Kawahata,&nbsp;Shigeto Tohma","doi":"10.1111/1756-185x.70363","DOIUrl":"https://doi.org/10.1111/1756-185x.70363","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>The study aimed to evaluate the incidence rate and potential risk factors of malignancies in Japanese patients with rheumatoid arthritis (RA).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This retrospective observational study analyzed data of adult patients with RA from April 2013 to March 2019 using the NinJa database. Patients were categorized into the overall RA cohort and sub-cohorts: biologic disease-modifying antirheumatic drug (bDMARDs) or Janus kinase inhibitors (JAKi-s)-exposed, bDMARDs exposed, and bDMARDs or JAKi-s naïve conventional synthetic DMARDs exposed. The incidence of overall and each type of malignancy was calculated, and the associated risk factors were analyzed using multivariate logistic regression.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Overall, 26 607 patients were included in the overall RA cohort (mean age: 64.16 ± 13.29 years; female: 78.87%) with 1018 malignancies. The incidence of malignancies was similar to that in the general population, with a standardized incidence ratio (SIR) of 0.97 (95% confidence interval [CI]: 0.91–1.03). It was consistent across the sub-cohorts and each year. The most frequent malignancies were lung cancer (<i>n</i> = 158), lymphoma (<i>n</i> = 151) and colorectal cancer (<i>n</i> = 145). The incidence of lymphoma and skin cancer was higher than the general population, with SIRs of 4.00 (3.39–4.68) and 1.70 (1.25–2.30), respectively. Multivariate analysis showed older age, male sex, smoking, Steinbrocker stage score 2 versus 1, 4 versus 1, and higher Disease Activity Score 28 using C-reactive protein as potential risk factors for malignancies.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Japanese patients with RA did not have an elevated risk of overall malignancies, whereas the incidence of lymphoma and skin cancer was higher in patients with RA than in the general population.</p>\u0000 </section>\u0000 </div>","PeriodicalId":14330,"journal":{"name":"International Journal of Rheumatic Diseases","volume":"28 7","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144635369","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Case Report: Sarcoid Reaction Induced by Anti-TNF Therapy","authors":"Ana Catarina Moniz,&nbsp;Sónia Mota Faria,&nbsp;Madalena Silveira Machado,&nbsp;Manuela Zita Veiga,&nbsp;Mariana Teixeira,&nbsp;Tiago Saldanha,&nbsp;Miguel Cordeiro,&nbsp;Fernando Pimentel-Santos,&nbsp;Carina Lopes","doi":"10.1111/1756-185x.70366","DOIUrl":"https://doi.org/10.1111/1756-185x.70366","url":null,"abstract":"","PeriodicalId":14330,"journal":{"name":"International Journal of Rheumatic Diseases","volume":"28 7","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144606486","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Taiwan's National Health Insurance Research Database: A Silent Force Behind Global Changes in Clinical Practice and Guidelines","authors":"Ting-Chun Tseng,&nbsp;Renin Chang,&nbsp;Jin-Shuen Chen,&nbsp;James Cheng-Chung Wei","doi":"10.1111/1756-185x.70365","DOIUrl":"https://doi.org/10.1111/1756-185x.70365","url":null,"abstract":"&lt;p&gt;The Taiwan National Health Insurance Research Database (NHIRD) stands as one of the world's most comprehensive healthcare information systems. Emerging from Taiwan's universal National Health Insurance program in 1995, the NHIRD systematically captures claims data from beneficiaries who represent over 99.5% of the population. Since 2000, this repository has documented an extensive range of healthcare interactions, encompassing patient demographics, outpatient and inpatient claims, prescription records, and detailed medical facility information. Following its transition in 2016 to management by Taiwan's Ministry of Health and Welfare Data Science Centre, the NHIRD now supports advanced cross-database linkages, incorporating key clinical variables such as laboratory results, cancer staging, disability assessments, and socioeconomic indicators [&lt;span&gt;1&lt;/span&gt;], representing a key strength when compared to other national health insurance databases (Table 1).&lt;/p&gt;&lt;p&gt;The NHIRD's strength lies in its well-validated data across a spectrum of health conditions, from common ailments to severe diseases including ischemic stroke, atrial fibrillation (AF), hypertension, diabetes, hyperlipidemia, and cancer. With demonstrated modest to high sensitivity and positive predictive values, this database serves as an invaluable resource for understanding disease burden, optimizing treatment strategies, and evaluating outcomes [&lt;span&gt;1, 2&lt;/span&gt;].&lt;/p&gt;&lt;p&gt;To demonstrate the NHIRD's influence on clinical practice, we looked into its contributions to the 2024 European Society of Cardiology (ESC) Guidelines for Atrial Fibrillation (AF) Management. Of the 1248 references screened from the guideline, approximately 1% (12 studies) originated from NHIRD analyses (Table 2), each providing significant insights into AF management strategies [&lt;span&gt;15&lt;/span&gt;]. Several studies identified high-risk populations at elevated risk for thromboembolic events and stroke among Taiwanese patients [&lt;span&gt;3, 4, 7, 8, 11&lt;/span&gt;]. A particularly influential study by Hsu et al. found that patients with concurrent hypertrophic cardiomyopathy (HCM) and AF experienced a high incidence of stroke, regardless of their CHA2DS2-VASc score. This finding directly influenced current practice, leading to a Class IB recommendation for non-vitamin K antagonist oral anticoagulants (NOACs) in HCM patients with AF [&lt;span&gt;4, 15&lt;/span&gt;].&lt;/p&gt;&lt;p&gt;Further research enhanced our understanding of risk assessment strategies. Two studies demonstrated that dynamic monitoring of CHA2DS2-VASc and HAS-BLED scores provided superior risk prediction compared to static baseline measurements [&lt;span&gt;5, 6&lt;/span&gt;]. This evidence supported the current Class IB recommendation for periodic reassessment of both thromboembolic and bleeding risks in AF management.&lt;/p&gt;&lt;p&gt;The database also yielded important insights into therapeutic approaches. Three studies investigating antidiabetic agents revealed potential protective effects against AF o","PeriodicalId":14330,"journal":{"name":"International Journal of Rheumatic Diseases","volume":"28 7","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1756-185x.70365","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144606567","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Classification in Idiopathic Inflammatory Myopathies: Where Are We Now?","authors":"Keeran Shivakumar,&nbsp;Ian Teh,&nbsp;Latika Gupta,&nbsp;Jessica Day","doi":"10.1111/1756-185X.70295","DOIUrl":"https://doi.org/10.1111/1756-185X.70295","url":null,"abstract":"&lt;p&gt;The classification of idiopathic inflammatory myopathies (IIMs) remains a significant challenge in the field of rheumatology and neuromuscular medicine. Despite advances in our understanding of these rare and heterogeneous diseases, the establishment of universally accepted classification criteria remains elusive. We recently highlighted substantial heterogeneity in the application of classification criteria, underscoring the need for unified frameworks [&lt;span&gt;1&lt;/span&gt;].&lt;/p&gt;&lt;p&gt;This editorial examines the current landscape of IIM classification, highlighting the proliferation of competing frameworks, the evolving role of biomarkers, and the broader implications for clinical practice and research. We explore the key barriers to achieving consensus and highlight opportunities to balance scientific rigor with clinical utility, ultimately enhancing patient care and accelerating therapeutic innovation.&lt;/p&gt;&lt;p&gt;Idiopathic inflammatory myopathies (IIMs) represent a heterogeneous group of systemic autoimmune disorders and include polymyositis (PM), dermatomyositis (DM), clinically amyopathic dermatomyositis (CADM), immune-mediated necrotising myopathy (IMNM), anti-synthetase syndrome (ASyS), overlap myositis (OM), and inclusion body myositis (IBM). These conditions are characterized by a predilection for skeletal muscle inflammation, although amyopathic forms exist. Additionally, these conditions often present with a spectrum of extra-muscular manifestations such as distinctive cutaneous lesions, interstitial lung disease, myocarditis, and arthritis. Variations in the clinical spectrum, prognosis, and therapeutic responses suggest distinct underlying pathophysiological mechanisms.&lt;/p&gt;&lt;p&gt;The rarity of IIM adds another layer of complexity to the classification dilemma. With limited patient populations available for study, generating robust data to support detailed subtyping is challenging, and the statistical power of many studies remains constrained. The scarcity of cases often necessitates lumping diverse clinical entities into broader categories to ensure sufficient cohort sizes for research, even if this oversimplifies the nuanced differences between subtypes. Historically, DM and PM have been studied together; however, contemporary literature indicates DM itself to be a highly heterogeneous condition characterized by distinct antibody-defined subtypes. Additionally, many conditions traditionally classified as PM have now been redefined into more precise subtypes such as IMNM and ASyS, rendering true PM extremely rare.&lt;/p&gt;&lt;p&gt;These issues of rarity and heterogeneity are reflected in the classification criteria landscape. A fundamental dilemma is whether classification criteria should adopt a broad framework which incorporates subtyping, as in the EULAR-ACR 2017 classification model [&lt;span&gt;2&lt;/span&gt;] or whether IIM subtypes merit separate, detailed classification efforts, as exist for IMNM, IBM, CADM, and ASyS (Table 1). Over-arching IIM criteria promote ","PeriodicalId":14330,"journal":{"name":"International Journal of Rheumatic Diseases","volume":"28 7","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1756-185X.70295","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144598741","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"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: “Cerebral Perfusion Features in Takayasu Arteritis: Insights From pCASL MRI”","authors":"Bhaskar Kambhampati,&nbsp;Leelakrishna Ayanambakam,&nbsp;Ranjana Sah","doi":"10.1111/1756-185x.70361","DOIUrl":"https://doi.org/10.1111/1756-185x.70361","url":null,"abstract":"","PeriodicalId":14330,"journal":{"name":"International Journal of Rheumatic Diseases","volume":"28 7","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144582039","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Effects of Tocilizumab on Inflammatory and Differentiation Pathways in Primary Human Chondrocytes: A Bioinformatic and In Vitro Approaches","authors":"Bugrahan Regaip Kilinc,&nbsp;Feyza Kostak,&nbsp;Omer Faruk Yilmaz,&nbsp;Suray Pehlivanoglu,&nbsp;Duygu Yasar Sirin","doi":"10.1111/1756-185X.70336","DOIUrl":"https://doi.org/10.1111/1756-185X.70336","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>This study investigates the effects of Tocilizumab, an interleukin-6 (IL-6) receptor inhibitor, on human primary chondrocyte cells, focusing on bone morphogenetic protein 2 (BMP-2), hypoxia-inducible factor 1-alpha (HIF-1α), interleukin-1 beta (IL-1β), SRY-box transcription factor 9 (SOX-9), and IL-6 genes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Combining bioinformatic and experimental approaches, we assessed Tocilizumab's impact on inflammatory signaling pathways, cellular differentiation, and viability. Reactome and Gene Ontology (GO) enrichment analyses revealed the involvement of interleukin signaling, BMP, and mitogen-activated protein kinase (MAPK) pathways.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Protein–protein interaction (PPI) network analysis indicated strong interactions among the studied genes, with BMP-2 and SOX-9 identified as central nodes. Western blot analysis demonstrated a 71% reduction in SOX-9, a 55% reduction in HIF-1α, and an 81% reduction in BMP-2 expression levels by day 15. Conversely, IL-1β levels decreased by 67% after prolonged treatment. MTT assays showed a 27.7% reduction in cell viability at day 15 compared to controls. Despite these changes, staining analyses confirmed preserved cell membrane integrity and nuclear morphology, indicating minimal cytotoxic effects.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>These findings highlight Tocilizumab's role in modulating inflammation and differentiation pathways in human primary chondrocytes. Further studies should explore the long-term effects of IL-6 blockade on cartilage remodeling and regenerative capacity in chronic inflammatory settings.</p>\u0000 </section>\u0000 </div>","PeriodicalId":14330,"journal":{"name":"International Journal of Rheumatic Diseases","volume":"28 7","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1756-185X.70336","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144582041","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Producing an Anti-dsDNA Antibody Reference Reagents to Calibrate Different Quantitative Assays in China","authors":"Jiangfeng Zhao,&nbsp;Yuqing Zhu,&nbsp;Canchen Ma,&nbsp;Li Guo,&nbsp;Haiting Yang,&nbsp;Xueyu Zhang,&nbsp;Zhenghan Zhao,&nbsp;Shuang Ye,&nbsp;Kaiwen Wang","doi":"10.1111/1756-185x.70364","DOIUrl":"https://doi.org/10.1111/1756-185x.70364","url":null,"abstract":"","PeriodicalId":14330,"journal":{"name":"International Journal of Rheumatic Diseases","volume":"28 7","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144582040","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gamified Telerehabilitation in Oligoarticular Juvenile Idiopathic Arthritis: A Randomized Controlled, Single-Blind Trial","authors":"Gokce Leblebici,&nbsp;Eylul Pinar Kısa,&nbsp;Ela Tarakci,&nbsp;Iremnur Gunhan,&nbsp;Emine Nur Yenici,&nbsp;Ozgur Kasapcopur","doi":"10.1111/1756-185X.70342","DOIUrl":"https://doi.org/10.1111/1756-185X.70342","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>This study aimed to investigate the effect of the 6-week gamified exercise program, delivered via telerehabilitation, on pain, kinesiophobia, quality of life, and mobility in children with oligoarticular juvenile arthritis (JIA).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Forty children with oligoarticular JIA (mean age: 11.86 ± 3.79 years) were randomly divided into two groups: Group I received game-based exercises via a telerehabilitation protocol, while Group II followed a home exercise program. The Wong Baker Pain Scale, Tampa Kinesiophobia Scale (TKS) and Pediatric Quality of Life Inventory (PedsQL) 3.0 Arthritis Module were completed by the patients. Patients' joint range of motion (ROM) and walking speed were measured by a blinded physiotherapist. The gamified exercises in the telerehabilitation program were supervised by another physiotherapist via WhatsApp video calls three times a week. Additionally, the exercise program was scheduled in the patients' calendars using Google Fit to provide reminders.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>There was a significant improvement in the ROM, walking speed, pain, kinesiophobia, and quality of life in the telerehabilitation group (<i>p</i> &lt; 0.05). After the intervention, the telerehabilitation group showed greater improvements compared to the control group in hip and ankle ROM values, walking speed, and quality of life scores for ages 13–18 (<i>p</i> &lt; 0.05).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The 6-week gamified telerehabilitation program reduced pain symptoms and kinesiophobia behaviors while improving the participants' quality of life and mobility.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Trial Registration</h3>\u0000 \u0000 <p>ClinicalTrials.gov NCT05837247</p>\u0000 </section>\u0000 </div>","PeriodicalId":14330,"journal":{"name":"International Journal of Rheumatic Diseases","volume":"28 7","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144582042","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring the Factors Associated With the Discontinuation of Tofacitinib in Patients With Rheumatoid Arthritis: A Retrospective Cohort Study","authors":"Li-Huei Chiang,&nbsp;Chia-Ling Yu,&nbsp;Tzu-Cheng Tsai,&nbsp;Yao-Fan Fang","doi":"10.1111/1756-185x.70356","DOIUrl":"https://doi.org/10.1111/1756-185x.70356","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Tofacitinib is the first oral targeted synthetic disease-modify anti-rheumatic drug for patients with moderate to severe rheumatoid arthritis. This study aimed to identify the factors associated with the discontinuation of tofacitinib in patients with RA in clinical practice.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>RA patients who received tofacitinib between 2015 and 2020 were included in this observational cohort study. The patients were followed for at least 1 year, ending on December 31, 2022. A tofacitinib non-responder was defined as a patient who required discontinuation or switch to another bDMARD. Conversely, tofacitinib responders were defined as those who could continue to receive tofacitinib without experiencing a loss of efficacy or severe adverse events. Univariate and multivariate Cox regression analyses and Kaplan–Meier survival curve analysis were used to investigate the factors associated with the discontinuation of tofacitinib.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 266 patients were enrolled. The average age of the patients was 57.07 ± 12.07 years, and 99 (37.2%) were tofacitinib non-responders. Univariate analysis revealed that the non-responders had a lower rate of concomitant hydroxychloroquine treatment and higher rates of leflunomide, biological disease-modifying antirheumatic drug (bDMARD), and tumor necrosis factor inhibitor (TNFi) treatment compared to the responders. Cox regression adjusted analysis indicated that prior bDMARD treatment (hazard ratio (HR) = 1.423, 95% confidence interval (CI) = 1.024, 1.976, <i>p</i> = 0.036), prior TNFi treatment (HR = 1.605, 95% CI = 1.165, 2.212, <i>p</i> = 0.004), and prior non-TNFi treatment (HR = 1.326, 95% CI = 1.012, 2.075, <i>p</i> = 0.048) were associated with a higher non-response rate. Moreover, Kaplan–Meier survival curve analysis revealed that the patients with prior bDMARD treatment had a higher non-response rate.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The RA patients who received tofacitinib in this study had a good response rate, and the average non-response rate was around 37% after 2 years of treatment. The main factor associated with an inadequate response to tofacitinib was prior bDMARD treatment. Prior TNFi treatment was the strongest factor associated with a non-response to tofacitinib. Patients with a non-response to tofacitinib may consider bDMARDs with other mechanisms if previous treatment with TNFis was unsuccessful.</p>\u0000 </section>\u0000 </div>","PeriodicalId":14330,"journal":{"name":"International Journal of Rheumatic Diseases","volume":"28 7","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144574111","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}