JCR: Journal of Clinical Rheumatology最新文献

{"title":"Association of Klotho and Gout in Middle-Aged and Older Adults: National Health and Nutrition Survey (2007-2016).","authors":"Chaolan Wang, Ke Lin, Yan Jiang, Kangrong Wu, Hong Zhang, Jian Chen, Na Li, Wanpei Luo, Tianbao Liu, Shuang Du","doi":"10.1097/RHU.0000000000002192","DOIUrl":"https://doi.org/10.1097/RHU.0000000000002192","url":null,"abstract":"<p><strong>Background: </strong>Klotho, which is known to negatively regulate metabolic disorders and kidney disease, has a role in gout that remains unclear. This research explored how klotho levels correlate with the prevalence of gout.</p><p><strong>Methods: </strong>Participants aged 40 to 79 from the National Health and Nutrition Examination Survey (2007-2016) were examined in both lines. The connection between klotho levels and gout was analyzed through weighted multivariate logistic regression. Restricted cubic splines were used to assess linearity and investigate the dose-response relationship. To ensure the stability of the results, subgroup and sensitivity analyses were conducted.</p><p><strong>Results: </strong>In total, 9660 individuals participated, with the weighted sample size calculated at 88,892,738.77. The group included 47.79% males (4793), with the median age being 57.00 years. Upon adjusting for all covariates, the multivariate analysis indicated an odds ratio of 0.51 (95% confidence interval [CI]: 0.33~0.78, p = 0.003) for the likelihood of occurrence of gout. When compared with the lowest klotho quartile Q1 (≥151.3, <655.3 pg/mL), the adjusted odds ratios for the subsequent quartiles Q2 (≥655.5, <800.9 pg/mL), Q3 (≥801.0, <991.6 pg/mL), and Q4 (≥991.7, ≤3998.5 pg/mL) were 0.97 (95% CI: 0.68~1.38), 0.78 (95% CI: 0.50~1.21), and 0.48 (95% CI: 0.32~0.73), respectively. Analyses focusing on subgroups and sensitivity confirmed these results.</p><p><strong>Conclusions: </strong>This research found a negative correlation between serum α-klotho concentrations and the occurrence of gout. Those with the highest levels of klotho exhibited the lowest likelihood of gout, indicating potential importance for future studies and clinical uses.</p>","PeriodicalId":14745,"journal":{"name":"JCR: Journal of Clinical Rheumatology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2024-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142807256","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":"Childhood Familial Mediterranean Fever in the United States: Spectrum of Clinical Phenotypes and MEFV Genotypes in a Cohort From Southeast Michigan.","authors":"Basil M Fathalla, Ronald Thomas","doi":"10.1097/RHU.0000000000002183","DOIUrl":"10.1097/RHU.0000000000002183","url":null,"abstract":"<p><strong>Objectives: </strong>The aim of this study was to report the spectrum of Familial Mediterranean Fever (FMF) in children living in Southeast Michigan.</p><p><strong>Methods: </strong>We reviewed prerecorded data in medical records of FMF patients. Statistical analysis of the data included Fisher exact test, Pearson χ 2 procedure, parametric independent samples t test, and parametric analysis of variance using SPSS Version 29.0, IBM Inc.</p><p><strong>Results: </strong>The study included 29 males and 21 females. The mean age at presentation was 4.63 ± 3.66 years, and the mean time to diagnosis was 2.1 ± 2.18 years. A slight majority presented in the first 3 years of age (54%). Family history of FMF was reported in only 58% of patients. Clinical manifestations included fever (84%), gastrointestinal (84%), musculoskeletal (64%; including chronic arthritis, sacroiliitis, and nonbacterial osteomyelitis), chest (28%), cutaneous (14%), and other manifestations (16%). Fever without other manifestations was reported only in patients presenting at ≤3 years of age ( p = 0.016), whereas older patients reported more gastrointestinal manifestations ( p = 0.04). Reported MEFV variants included p.M694V (n = 26), p.V726A (n = 23), p.M694I (n = 13), and others (n = 10). Homozygote and compound heterozygote patients had more gastrointestinal manifestations ( p < 0.001), whereas fever was more common in the heterozygote patients ( p = 0.04). The mean follow-up period was 5.34 ± 4.13 years with no renal disease.</p><p><strong>Conclusions: </strong>We report the largest childhood FMF cohort in the United States. A negative family history should not preclude consideration of FMF as a cause of periodic fever. Recurrent fever can be the only manifestation, particularly in young patients with FMF. The absence of fever and chronic progressive musculoskeletal manifestations can uncommonly occur.</p>","PeriodicalId":14745,"journal":{"name":"JCR: Journal of Clinical Rheumatology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2024-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142769117","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":"Unveiling Uric Acid in Tendons: Dual-Energy Computed Tomography Imaging Insight.","authors":"Fatima K Alduraibi","doi":"10.1097/RHU.0000000000002181","DOIUrl":"https://doi.org/10.1097/RHU.0000000000002181","url":null,"abstract":"","PeriodicalId":14745,"journal":{"name":"JCR: Journal of Clinical Rheumatology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2024-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142769121","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":"Risk of Malignancy Related to Ixekizumab in Patients in Patients With Psoriatic Arthritis or Axial Spondyloarthropathy: Systematic Review and Meta-analysis.","authors":"José Ramón Maneiro, Julia Carmona, Antonio Mera, Eva Pérez-Pampín","doi":"10.1097/RHU.0000000000002175","DOIUrl":"https://doi.org/10.1097/RHU.0000000000002175","url":null,"abstract":"<p><strong>Background: </strong>We aimed to estimate the risk of malignancy associated with ixekizumab in randomized controlled trials (RCTs) and long-term extension studies (LTEs) in patients with rheumatological indications.</p><p><strong>Methods: </strong>A systematic review of the literature up to June 2024 was performed to analyze the risk of malignancy associated with ixekizumab use in patients with psoriatic arthritis and axial spondyloarthritis. The primary endpoint was overall malignancy risk in RCTs and LTEs. Meta-analyses of RCTs were performed when at least 3 studies had comparable outcome measures using Peto odds ratios. For LTEs, meta-analyses were performed using random-effects computing incidence rates (IRs) per 100 patient-years.</p><p><strong>Results: </strong>Twelve articles, 4 LTEs and 8 pooled analyses, were included. Meta-analyses of RCTs for malignancy risk at week 24 showed a Peto odds ratio of 0.45 (0.11-1.86), with an I2 of 43.0%. When stratified according to the comparator, heterogeneity decreased. Malignancy risk comparing ixekizumab with placebo was 1.43 (0.18-11.53), with an I2 of 39.6%. Malignancy risk comparing ixekizumab with adalimumab was 0.11 (0.01-0.77), with an I2 of 0%. At week 52, the IR of all malignancies with ixekizumab was 0.31 (0.07-0.72), with an I2 of 18.9%. At 156 weeks, the IR of all malignancies with ixekizumab was 0.58 (0.29-0.96), with an I2 of 0%.</p><p><strong>Conclusion: </strong>Ixekizumab appears to confer a low malignancy risk in patients treated for rheumatological indications. Patients with psoriatic arthritis and axial spondyloarthritis appeared to be at similar risk, except for those with nonmelanoma skin cancer.</p>","PeriodicalId":14745,"journal":{"name":"JCR: Journal of Clinical Rheumatology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2024-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142769119","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":"Two-Year Mortality Predictors in Fragility Fractures-A Medical Records Review Study: Erratum.","authors":"","doi":"10.1097/RHU.0000000000002174","DOIUrl":"https://doi.org/10.1097/RHU.0000000000002174","url":null,"abstract":"","PeriodicalId":14745,"journal":{"name":"JCR: Journal of Clinical Rheumatology","volume":"30 8","pages":"354"},"PeriodicalIF":2.4,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143005611","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":"Feasibility and Acceptability of a REDCap-Embedded HIPAA-Compliant Text Messaging Application to Track Medication Adherence in Adolescents With Lupus.","authors":"Onengiya Harry, Brittany Richard, Alysha Taxter, Joseph Skelton","doi":"10.1097/RHU.0000000000002142","DOIUrl":"10.1097/RHU.0000000000002142","url":null,"abstract":"<p><strong>Background/objective: </strong>Despite advances in clinical care and treatment options, adolescents with lupus continue to experience adverse health outcomes. Poor adherence to medication regimens is a major contributor to these negative outcomes. The utility of short message service (SMS) in tracking barriers to adherence prospectively remains untested for adolescents with lupus. Our objectives were (1) feasibility of incorporating a Health Insurance Portability and Accountability Act (HIPAA)-compliant SMS text messaging application into REDCap and (2) acceptability of using SMS text messaging to track barriers to medication adherence in adolescents with lupus.</p><p><strong>Methods: </strong>This study is a 12-week pilot cohort study of adolescents with SLE per the 1997 revised American College of Rheumatology. A REDCap-embedded HIPAA-compliant text messaging application was used to send biweekly messages with survey link to track medication adherence. Measures were completed. Descriptive statistics were used to summarize demographics, medical, and acceptability data. Response to text messages and survey completion rates were reported as a measure of feasibility.</p><p><strong>Results: </strong>Most eligible adolescents approached agreed to participate (n = 17, 71% enrollment rate). The cellphone ownership rate among adolescents eligible for participation was 92%. Nine subjects responded to all text messages sent (53% response and completion rate). Eleven subjects (65%) responded to two thirds of the text messages. Overall, 77% of enrolled subjects completed at least half of the surveys sent. Reminders to complete surveys were sent to 30% of enrolled adolescents.</p><p><strong>Conclusions: </strong>This study shows that embedding a HIPAA-compliant SMS text message application in REDCap is feasible and can be used to engage adolescents with chronic conditions in monitoring between clinic visits.</p>","PeriodicalId":14745,"journal":{"name":"JCR: Journal of Clinical Rheumatology","volume":" ","pages":"332-335"},"PeriodicalIF":2.4,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11747896/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142347001","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":"Multiple Conjunctival Ulcers in Behçet Disease.","authors":"Masaki Shimizu, Yuko Baba","doi":"10.1097/RHU.0000000000002133","DOIUrl":"10.1097/RHU.0000000000002133","url":null,"abstract":"","PeriodicalId":14745,"journal":{"name":"JCR: Journal of Clinical Rheumatology","volume":" ","pages":"e185"},"PeriodicalIF":2.4,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142347002","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":"Comparative Analysis of Coagulation Activation in Rheumatoid Arthritis Patients Treated With TNF Inhibitors Versus JAK Inhibitors: A Longitudinal Study.","authors":"Romy Hansildaar, Reinder Raadsen, Martijn Gerritsen, Magdolna Nagy, Bas Dijkshoorn, H M H Spronk, Hugo Ten Cate, M T Nurmohamed","doi":"10.1097/RHU.0000000000002136","DOIUrl":"10.1097/RHU.0000000000002136","url":null,"abstract":"<p><strong>Objectives: </strong>This study aims to investigate the activation of the coagulation system of RA patients and assess changes during anti-inflammatory treatment with tumor necrosis factor blockers (anti-TNF) and Janus kinase inhibitors (JAKi).</p><p><strong>Methods: </strong>Biomarkers for the coagulation system, including D-dimer, fibrinogen, prothrombin time, activated partial thrombin time, prothrombin fragment 1 + 2, thrombin-antithrombin complex (TAT), activated factor IX, antithrombin complex, and von Willebrand factor (vWF), were longitudinally measured in 83 RA patients treated with anti-TNF and 38 RA patients with JAKi. Data were collected at baseline, after 1, 3, and 6 months.</p><p><strong>Results: </strong>The mean age was 57 (±14) years; 76% was female. The mean DAS28-CRP was 3.6 (±1.3) for anti-TNF users and 4.1 (±1.4) for JAKi users at baseline and declined in both groups. Baseline coagulation markers levels were comparable between groups. In anti-TNF users, D-dimer and fibrinogen levels significantly declined (-0.31 mg/L, p = 0.01 and -0.71 g/L, p < 0.001, respectively), whereas TAT significantly increased after 6 months follow-up (1.46 μg/L, p = 0.03) and no effect on vWF ( p = 0.98). In JAKi users, vWF declined significantly during the 6 months follow-up (-37.41%, p < 0.001); additionally, there were reductions of D-dimer, fibrinogen, and TAT that did not reach significance (-0.17 mg/L, p = 0.59; -0.49 g/L, p = 0.12; and 0.68 μg/L, p = 0.27, respectively).</p><p><strong>Conclusions: </strong>The prothrombotic tendency in active RA declined during effective treatment with both anti-TNF and JAKi. Altogether, the biomarkers used in this study suggest that an increased VTE risk in the first 6 months due to either treatment with anti-TNF or JAKi is unlikely.</p>","PeriodicalId":14745,"journal":{"name":"JCR: Journal of Clinical Rheumatology","volume":" ","pages":"e166-e171"},"PeriodicalIF":2.4,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142346999","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":"Anticoagulant Treatment May Decrease the Relapse Rate of Pulmonary Arterial Involvement in Behçet's Disease.","authors":"Kerem Yiğit Abacar, Ayşe Elif Boncukcuoglu, Aysun Aksoy, Derya Kocakaya, Cagatay Cimsit, Haner Direskeneli, Fatma Alibaz-Oner","doi":"10.1097/RHU.0000000000002137","DOIUrl":"10.1097/RHU.0000000000002137","url":null,"abstract":"<p><strong>Objectives: </strong>Pulmonary arterial involvement (PAI) is one of the most common causes of mortality in Behçet's disease (BD). In this study, we aimed to evaluate the clinical features, course, and recurrence risk factors of BD-associated PAI.</p><p><strong>Methods: </strong>BD patients who were followed up in Marmara University BD outpatient clinic between 1990 and 2023 were included. All data were acquired from the patients' medical records. PAIs were classified according to the type of the vascular involvement as thrombosis or aneurysm. Factors affecting the risk of relapses were determined using multivariate Cox regression analysis.</p><p><strong>Results: </strong>Among 1350 BD patients, 110 (8.1%) had PAI. The mean age (SD) of patients with PAI was 42.4 (11.6) years, and the male/female ratio was 2.2 (76/34). Thirty-two (29.1%) of 110 patients were asymptomatic. Asymptomatic patients with PAI were significantly younger ( p = 0.031) than the symptomatic group. Also, a greater prevalence of females ( p = 0.001) and higher recurrence rates ( p = 0.019) were observed in the symptomatic group. Pulmonary arterial thrombosis was seen in 104 (94.5%) and aneurysms in 9 patients (6.6%). At least one PAI relapse was observed in 31 patients (28.2%). In multivariate analysis, the Cox regression model was significant ( p = 0.013), and not starting anticoagulants independently increased the PAI relapse risk (hazards ratio, 4.36; 95% confidence interval, 1.14-24.1; p = 0.042).</p><p><strong>Conclusions: </strong>Pulmonary arterial thrombosis is the main presentation type of PAI in BD, whereas aneurysmatic formation is rare. Despite immunosuppressive treatment, relapses occur during follow-up in one third of patients with PAI. When anticoagulant therapy is added to immunosuppressive therapy, the relapse rate in BD patients with PAI is significantly reduced.</p>","PeriodicalId":14745,"journal":{"name":"JCR: Journal of Clinical Rheumatology","volume":" ","pages":"303-308"},"PeriodicalIF":2.4,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142465901","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":"A Diagnostic Challenge: Toxoplasmosis Ophthalmopathy Co-occurring in Systemic Lupus Erythematosus.","authors":"Yonghong Yang, Fayou Li","doi":"10.1097/RHU.0000000000002156","DOIUrl":"10.1097/RHU.0000000000002156","url":null,"abstract":"","PeriodicalId":14745,"journal":{"name":"JCR: Journal of Clinical Rheumatology","volume":" ","pages":"e188"},"PeriodicalIF":2.4,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142545572","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}