JCR: Journal of Clinical Rheumatology最新文献

{"title":"Anti-RA33 Antibodies Are Present in Patients With Lyme Disease.","authors":"John B Miller, Ting Yang, Alison W Rebman, Laura Cappelli, Clifton O Bingham, Marcia Daniela Villegas de Flores, Erika Darrah, John N Aucott","doi":"10.1097/RHU.0000000000002176","DOIUrl":"10.1097/RHU.0000000000002176","url":null,"abstract":"<p><strong>Background/objective: </strong>To determine if anti-RA33 antibodies, which can be seen in early forms of inflammatory arthritis, are present in patients with Lyme arthritis (LA).</p><p><strong>Methods: </strong>Anti-RA33 antibodies were tested using a commercially available assay in patients with LA (n = 47) and compared with patients with erythema migrans who returned to health (EM RTH, n = 20) and those with post-treatment Lyme disease (PTLD) (n = 50), characterized by noninflammatory arthralgia, as an observational comparative study utilizing Lyme-exposed patients from various original cohorts.</p><p><strong>Results: </strong>We found that anti-RA33 was present in higher proportions of patients with LA (23.4% vs. 0%, p = 0.001) and PTLD (12.0% vs. 0%, p = 0.040) than healthy controls. There was also a trend toward a higher percentage of anti-RA33 positivity in patients with EM RTH versus controls (10.0% vs. 0%, p = 0.080). There were no statistically significant differences among groups of patients with LA, PTLD, and EM RTH ( p ≥ 0.567). There was also no difference in the proportion of patients with antibiotic-responsive LA compared with those with persistent synovitis after antibiotics, termed post-infectious LA, and there were no differences in clinical manifestations, musculoskeletal ultrasound evaluation (synovial hypertrophy, power Doppler, tendinopathy), or patient-reported outcomes based on anti-RA33 status.</p><p><strong>Conclusions: </strong>This is the first study to identify anti-RA33 antibodies in patients with LA, though these antibodies did not identify a unique clinical subset of patients in this cohort. Unexpectedly, we found anti-RA33 antibodies at similar levels in patients with PTLD and EM RTH; further study is needed to determine the relevance of this finding.</p>","PeriodicalId":14745,"journal":{"name":"JCR: Journal of Clinical Rheumatology","volume":" ","pages":"65-70"},"PeriodicalIF":2.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11902579/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142687050","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":"Risk of Malignancy Related to Ixekizumab 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":"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":"53-59"},"PeriodicalIF":2.4,"publicationDate":"2025-03-01","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":"A Cross-Disciplinary Study of Facial Asymmetry in a Pre-Hispanic Mesoamerican Sculpture: Some Cultural and Rheumatological Insights.","authors":"Josefina Mansilla-Lory, Hugo Sandoval, Arturo Talavera, Iván Pérez-Neri, Carlos Pineda","doi":"10.1097/RHU.0000000000002182","DOIUrl":"10.1097/RHU.0000000000002182","url":null,"abstract":"<p><strong>Background/historical perspective: </strong>Facial asymmetry has been recognized and represented in Mesoamerican and South American pre-Hispanic cultures.</p><p><strong>Summary: </strong>This study aims to describe and contextualize an ancient pre-Hispanic stone face carving from the Early Postclassic Period (1200-1500 AD) discovered during excavations for the construction of what is now the National Rehabilitation Institute in Mexico City. The remarkable facial asymmetry of the artifact, suggesting facial paralysis, is a focal point for an interdisciplinary study combining bioarchaeology, anthropology, paleopathology, and rheumatology.</p><p><strong>Conclusions: </strong>Although most causes of facial paralysis are idiopathic and pre-Hispanic Mesoamerican populations may have had a higher incidence of infections that could be the leading triggering cause, the potential connection between facial paralysis and rheumatic diseases in pre-Hispanic or pre-Columbian contexts is still a topic of ongoing investigation. This task remains highly relevant for rheumatologists who have traced the history and evolution of rheumatic diseases.</p><p><strong>Future research: </strong>To understand the potential causes of disabilities in ancient societies, a comprehensive, holistic, and transdisciplinary approach is needed, including evidence-based reviews to analyze the relationship between facial paralysis and rheumatic diseases.</p>","PeriodicalId":14745,"journal":{"name":"JCR: Journal of Clinical Rheumatology","volume":" ","pages":"87-91"},"PeriodicalIF":2.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142818015","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":"Axial Tophaceous Gout Diagnosed by Dual-Energy CT.","authors":"Shay Brikman, Amir Bieber","doi":"10.1097/RHU.0000000000002170","DOIUrl":"10.1097/RHU.0000000000002170","url":null,"abstract":"","PeriodicalId":14745,"journal":{"name":"JCR: Journal of Clinical Rheumatology","volume":" ","pages":"e6"},"PeriodicalIF":2.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143005528","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":"Severe Refractory Tophaceous Gout.","authors":"Eaman Alhassan","doi":"10.1097/RHU.0000000000002184","DOIUrl":"10.1097/RHU.0000000000002184","url":null,"abstract":"","PeriodicalId":14745,"journal":{"name":"JCR: Journal of Clinical Rheumatology","volume":" ","pages":"e10"},"PeriodicalIF":2.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142813274","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":"Allopurinol Adherence in US Patients With Gout: Analysis of the Medical Expenditure Panel Survey, 2018-2021.","authors":"Kevin R Riggs, Joshua S Richman, Andrea L Cherrington, Jasvinder A Singh","doi":"10.1097/RHU.0000000000002177","DOIUrl":"10.1097/RHU.0000000000002177","url":null,"abstract":"<p><strong>Background/objective: </strong>Gout is the most common inflammatory arthritis, and its morbidity can be substantially reduced through urate-lowering therapy. However, adherence to allopurinol-the most common urate-lowering therapy-is notoriously poor. Prior studies have not fully elucidated factors associated with allopurinol adherence, particularly psychosocial factors.</p><p><strong>Methods: </strong>We used 2018-2021 data from the Medical Expenditure Panel Survey, a national longitudinal survey on health care expenditures and utilization. We calculated the medication possession ratio (MPR) for allopurinol for participants with gout and categorized each as follows: no allopurinol fills, low adherence (MPR ≤0.8), or high adherence (MPR >0.8) to allopurinol. We used multivariable logistic regression to identify factors associated with high adherence, using person-year as the unit of measure and accounting for clustering for participants who contributed more than 1 person-year.</p><p><strong>Results: </strong>The analyses included 919 respondents (1453 person-years), representing a weighted total of 15,084,439 person-years. Across all years, 27.4% had no allopurinol fills, 37.4% had low adherence, and 35.2% had high adherence. In multivariable models for high adherence, Black race (odds ratio, 0.49; 95% confidence interval, 0.33-0.73, compared with White) and residence in the South US region (odds ratio, 0.54; 95% confidence interval, 0.35-0.82, compared with Northeast) were negatively associated with high adherence.</p><p><strong>Conclusions: </strong>Black race and residing in the Southern US were associated with lower allopurinol adherence among gout patients. Interventions to improve adherence, particularly among Black patients in the South, are needed to maximize the potential benefits of allopurinol.</p>","PeriodicalId":14745,"journal":{"name":"JCR: Journal of Clinical Rheumatology","volume":" ","pages":"83-86"},"PeriodicalIF":2.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142739507","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":"Calciphylaxis in Coexistent Primary and Secondary Hyperparathyroidism.","authors":"Yujia Wang, Yanfang Xu","doi":"10.1097/RHU.0000000000002173","DOIUrl":"10.1097/RHU.0000000000002173","url":null,"abstract":"","PeriodicalId":14745,"journal":{"name":"JCR: Journal of Clinical Rheumatology","volume":" ","pages":"e7-e8"},"PeriodicalIF":2.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143005529","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":"Neuro-IgG4-Related Inflammatory Pseudotumor.","authors":"Hirotaka Yamamoto, Yoshinori Taniguchi","doi":"10.1097/RHU.0000000000002158","DOIUrl":"10.1097/RHU.0000000000002158","url":null,"abstract":"","PeriodicalId":14745,"journal":{"name":"JCR: Journal of Clinical Rheumatology","volume":" ","pages":"e5"},"PeriodicalIF":2.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142620732","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":"Higher Mortality Risk From Ovarian Carcinomas, Small Bowel Neoplasms, and B-Cell and Mucosa-Associated Lymphoid Tissue Lymphomas in Sjögren Syndrome Patients.","authors":"José Manuel Vázquez-Comendador, María Mateos Seirul-Lo, María Martínez-Urbistondo, Nuria Miguel-Ontañón, Antonio González-Guzmán, Román Fernández-Guitián, Raquel Castejón, Pedro Durán-Del Campo, Pablo Tutor, Susana Mellor-Pita, Víctor Moreno-Torres","doi":"10.1097/RHU.0000000000002169","DOIUrl":"10.1097/RHU.0000000000002169","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the impact of the different types of neoplasms and lineages on Sjögren syndrome (SjS) patient mortality.</p><p><strong>Methods: </strong>Medical records review study based on the Spanish Hospital Discharge Database and the International Classification of Diseases, Tenth Revision, Clinical Modification coding list. The neoplasm-related deaths in SjS patients with the general population during the period 2016-2019 were compared. A binary logistic regression analysis considering age, sex, tobacco use, and alcohol use was performed to determine the impact of SjS on the risk of dying from each neoplasm group and lineage.</p><p><strong>Results: </strong>In the period studied, 705,557 in-hospital deaths were certified in Spain, 139,531 (19.8%) from neoplasms. Neoplasms surpassed SjS activity as a cause of mortality in primary SjS patients (11.3% vs. 1.6%, p < 0.001). SjS patients presented higher mortality rates from small bowel carcinoma (0.3% vs. 1.8%; odds ratio [OR], 5.41; 95% confidence interval [CI], 1.33-22) and gynecological neoplasms (6.4% vs. 3%; OR, 2.13; 95% CI, 1.01-4.58), related to ovarian carcinomas (4.6% vs. 1.3%; OR, 3.65; 95% CI, 1.48-8.97), than the general population. Hematological neoplasm-related deaths were more prevalent in SjS patients than in the non-SjS population (18.3% vs. 8.9%; OR, 2.04; 95% CI, 1.25-3.31), mostly attributable to the higher proportion of deaths from B-cell non-Hodgkin lymphoma (8.3% vs. 2.5%; OR, 3.04; 95% CI, 1.54-6.03) and mucosa-associated lymphoid tissue lymphoma (1.8% vs. 0.1%; OR, 70.17; 95% CI, 16.61-296.36).</p><p><strong>Conclusion: </strong>SjS patients face an elevated risk of mortality from small bowel neoplasms, ovarian carcinomas, and B-cell and mucosa-associated lymphoid tissue lymphoma compared with the general Spanish population. Apart from developing approaches to mitigate their occurrence, it is crucial to explore thoroughly and consider the implementation of targeted early-detection programs for these specific conditions.</p>","PeriodicalId":14745,"journal":{"name":"JCR: Journal of Clinical Rheumatology","volume":" ","pages":"78-82"},"PeriodicalIF":2.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11902581/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143005575","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":"Accuracy and Performance Characteristics of Administrative Codes for the Diagnosis of Autoinflammatory Syndromes: A Discovery and Validation Study.","authors":"Saeyun Lee, Sujin Kim, Suzanne Segerstrom, Polly J Ferguson, Aleksander Lenert","doi":"10.1097/RHU.0000000000002172","DOIUrl":"10.1097/RHU.0000000000002172","url":null,"abstract":"<p><strong>Objective: </strong>The aim of this study was to evaluate and validate the accuracy and performance characteristics of administrative codes in diagnosing autoinflammatory syndromes (AISs).</p><p><strong>Methods: </strong>We identified potential AIS patients from the electronic medical records at the University of Iowa Hospital and Clinics and the Stead Family Children's Hospital using a screening filter based on the 10th edition of the International Classification of Diseases ( ICD-10 ) codes and interleukin-1 antagonists. Diagnostic criteria for adult-onset Still disease, systemic juvenile idiopathic arthritis, Behçet disease (BD), familial Mediterranean fever (FMF), cryopyrin-associated periodic syndrome (CAPS), and SAPHO (synovitis, acne, pustulosis, hyperostosis, and osteitis) syndrome and chronic nonbacterial osteomyelitis (SAPHO-CNO) were reviewed for each patient. Patients who did not meet the diagnostic criteria were categorized as non-AIS. In this cross-sectional study, we calculated the sensitivity, specificity, positive predictive value, negative predictive value, and area under the receiver operating characteristic curve for the ICD codes in diagnosing AIS.</p><p><strong>Results: </strong>Out of the 502 patients with potential AIS, 338 patients (67%) had a true AIS diagnosis. Sensitivity ranged from 80% (SAPHO-CNO) to 100% (BD and FMF), and positive predictive value ranged from 15% (FMF) to 80% (SAPHO-CNO). Specificity ranged from 81% (FMF) to 99% (CAPS and SAPHO-CNO), whereas negative predictive value ranged from 98% (adult-onset Still disease) to 100% (systemic juvenile idiopathic arthritis, BD, FMF, and CAPS). All ICD codes or code combinations for the diagnosis of specific AIS subtypes showed high accuracy with areas under the receiver operating characteristic curve ≥0.89.</p><p><strong>Conclusions: </strong>This study validated the accuracy of administrative codes for diagnosing AIS, supporting their use in constructing AIS cohorts for clinical outcomes research.</p>","PeriodicalId":14745,"journal":{"name":"JCR: Journal of Clinical Rheumatology","volume":" ","pages":"60-64"},"PeriodicalIF":2.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143005526","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}