JCR: Journal of Clinical Rheumatology最新文献

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The Lupus Foundation of America Rapid Evaluation of Activity in Lupus Patient-Reported Outcome Predicts Health-Related Quality of Life, Fatigue, and Work Productivity Impairment: Data From the Almenara Lupus Cohort.
IF 2.4 4区 医学
JCR: Journal of Clinical Rheumatology Pub Date : 2025-02-03 DOI: 10.1097/RHU.0000000000002204
Manuel F Ugarte-Gil, Rocío V Gamboa-Cárdenas, Victor R Pimentel-Quiroz, Cristina Reátegui-Sokolova, Claudia Elera-Fitzcarrald, Samira García-Hirsh, César Pastor-Asurza, Zoila Rodriguez-Bellido, Risto Perich-Campos, Graciela S Alarcón
{"title":"The Lupus Foundation of America Rapid Evaluation of Activity in Lupus Patient-Reported Outcome Predicts Health-Related Quality of Life, Fatigue, and Work Productivity Impairment: Data From the Almenara Lupus Cohort.","authors":"Manuel F Ugarte-Gil, Rocío V Gamboa-Cárdenas, Victor R Pimentel-Quiroz, Cristina Reátegui-Sokolova, Claudia Elera-Fitzcarrald, Samira García-Hirsh, César Pastor-Asurza, Zoila Rodriguez-Bellido, Risto Perich-Campos, Graciela S Alarcón","doi":"10.1097/RHU.0000000000002204","DOIUrl":"https://doi.org/10.1097/RHU.0000000000002204","url":null,"abstract":"<p><strong>Objective: </strong>The study aims to evaluate the impact of patient-reported disease activity in other patient-reported outcomes (PROs) in systemic lupus erythematosus (SLE) patients.</p><p><strong>Methods: </strong>SLE patients from the Almenara Lupus Cohort were included, and visits were performed every 6 months. Disease activity was assessed with the Lupus Foundation of America Rapid Evaluation of Activity in Lupus (LFA-REAL) PRO, health-related quality of life (HRQoL) with the LupusQoL, fatigue with the Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-F), and work productivity impairment with the work productivity and activity impairment (WPAI). Generalized estimating equations were performed for each domain of the LupusQoL, the FACIT-F, and the WPAI. The LFA-REAL PRO measured at the previous visit; multivariable models were adjusted for possible confounders measured at the same visit as the LFA-REAL PRO. The Β (regression unstandardized coefficient) is reported per an increase of 10 units of the LFA-REAL PRO.</p><p><strong>Results: </strong>A total of 316 patients and 1116 visits were included. Mean (SD) LFA-REAL PRO at baseline was 240.9 (182.1). LFA-REAL PRO predicted a worse HRQoL in all domains of the LupusQoL, the WPAI, and the FACIT-F, even after adjustment for confounders.</p><p><strong>Conclusions: </strong>A higher patient-reported disease activity predicted a worse HRQoL and fatigue as well as a higher work productivity impairment in SLE patients. Patient-reported disease activity should be included in the evaluation of SLE patients on a regular basis as such provides the patients' own perception of their disease. This may have an impact on their adherence to treatment and may result in better outcomes.</p>","PeriodicalId":14745,"journal":{"name":"JCR: Journal of Clinical Rheumatology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143122763","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}
引用次数: 0
Not All Lupus With Nephritis Is Lupus Nephritis.
IF 2.4 4区 医学
JCR: Journal of Clinical Rheumatology Pub Date : 2025-02-03 DOI: 10.1097/RHU.0000000000002187
Timyra Lister, Stephen Soloway
{"title":"Not All Lupus With Nephritis Is Lupus Nephritis.","authors":"Timyra Lister, Stephen Soloway","doi":"10.1097/RHU.0000000000002187","DOIUrl":"https://doi.org/10.1097/RHU.0000000000002187","url":null,"abstract":"","PeriodicalId":14745,"journal":{"name":"JCR: Journal of Clinical Rheumatology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143122760","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}
引用次数: 0
Discrepancies in Temporal Artery Biopsy Positivity Rate Among White and Black Patients Suspected of Having Giant Cell Arteritis.
IF 2.4 4区 医学
JCR: Journal of Clinical Rheumatology Pub Date : 2025-01-31 DOI: 10.1097/RHU.0000000000002205
Raj Vachhani, Peng Li, Mehdi Tavakoli, Lanning Kline, Angelo Gaffo
{"title":"Discrepancies in Temporal Artery Biopsy Positivity Rate Among White and Black Patients Suspected of Having Giant Cell Arteritis.","authors":"Raj Vachhani, Peng Li, Mehdi Tavakoli, Lanning Kline, Angelo Gaffo","doi":"10.1097/RHU.0000000000002205","DOIUrl":"10.1097/RHU.0000000000002205","url":null,"abstract":"<p><strong>Objective: </strong>Our hypothesis is that biopsy-positive giant cell arteritis (GCA) is infrequent among Black patients. To evaluate this, we compared the temporal artery biopsy (TAB) positivity rates among White and Black patients.</p><p><strong>Methods: </strong>This is a case-control study review from all patients who underwent TAB at our institution from 2012 until 2021. The main study outcome was the TAB positivity rate. The main independent variable was race/ethnicity. Clinical and demographic features of patients undergoing TAB were compared between those with positive and negative biopsies with t tests, Wilcoxon rank sum test, χ 2 test, or Fisher exact test where appropriate. A multiple logistic regression with Firth correction was performed with factors found to be significant in bivariate analysis to evaluate for independent associations with a positive biopsy.</p><p><strong>Results: </strong>Three hundred eighty-five patients who underwent TAB for suspected GCA were included (290 White, 95 Black). Mean sedimentation rate was higher in Black patients, but otherwise, both groups had similar demographic and clinical characteristics. Positivity rate of TAB in White patients was 20.3% and 8.4% in Black patients. White race was associated with higher likelihood of TAB positivity compared with Black race (odds ratio, 3.47). Patients with positive TAB were more likely to have jaw claudication, constitutional symptoms, and higher inflammatory markers. Other factors significant in the logistic regression model included age, and inversely with decreased visual acuity.</p><p><strong>Conclusions: </strong>Our study results support the hypothesis that there is a discrepancy in the frequency of biopsy-confirmed GCA in patients referred for TAB, with Black patients having lower rates than their White counterparts.</p>","PeriodicalId":14745,"journal":{"name":"JCR: Journal of Clinical Rheumatology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143074343","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}
引用次数: 0
Generalized Edema in Anti-NXP2 Antibody-Positive Dermatomyositis.
IF 2.4 4区 医学
JCR: Journal of Clinical Rheumatology Pub Date : 2025-01-31 DOI: 10.1097/RHU.0000000000002207
Yuki Koshida, Takashi Yamane
{"title":"Generalized Edema in Anti-NXP2 Antibody-Positive Dermatomyositis.","authors":"Yuki Koshida, Takashi Yamane","doi":"10.1097/RHU.0000000000002207","DOIUrl":"https://doi.org/10.1097/RHU.0000000000002207","url":null,"abstract":"","PeriodicalId":14745,"journal":{"name":"JCR: Journal of Clinical Rheumatology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143074346","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}
引用次数: 0
Lupus Nephritis Renal Response in a Real-World Setting in Argentina. 狼疮性肾炎在阿根廷真实世界的肾脏反应。
IF 2.4 4区 医学
JCR: Journal of Clinical Rheumatology Pub Date : 2025-01-20 DOI: 10.1097/RHU.0000000000002196
Alvaro Andres Reyes Torres, Valeria Scaglioni, Enrique R Soriano, Javier Eduardo Rosa, Marina Scolnik
{"title":"Lupus Nephritis Renal Response in a Real-World Setting in Argentina.","authors":"Alvaro Andres Reyes Torres, Valeria Scaglioni, Enrique R Soriano, Javier Eduardo Rosa, Marina Scolnik","doi":"10.1097/RHU.0000000000002196","DOIUrl":"https://doi.org/10.1097/RHU.0000000000002196","url":null,"abstract":"<p><strong>Objective: </strong>To identify the percentage of patients with incident lupus nephritis who achieved primary efficacy renal response (PERR) and complete renal response (CRR) after 2 years of treatment at a university hospital.</p><p><strong>Methods: </strong>An observational study including patients with lupus with a first renal biopsy with nephritis class III, IV, or V, or combined, performed between years 2000 and 2018 and follow-up for over 2 years at a university hospital in Argentina. The proportion of patients with PERR and CRR at 1 and 2 years and the proportion of patients requiring rescue therapy were calculated. Comparison with clinical trials and observational studies was done through literature search.</p><p><strong>Results: </strong>Seventy-five patients were included; 85.3% were female and 36.5 years in average at the time of biopsy, with lupus nephritis class III (n = 7), class IV (n = 59), combination of IV + V (n = 4), and pure V (n = 5). At 1 and 2 years, PERR was achieved in 57 patients (76.0%; 95% confidence interval [CI], 64.8%-84.5%), whereas CRR was achieved in 44 patients (58.7%; 95% CI, 46.9%-69.4%). A proteinuria level <0.7 g/24 hours was observed in 80.0% (95% CI, 69.2%-87.7%) of patients at 2 years and <0.5 g/24 hours in 76.0% (95% CI, 64.8%-84.5%). Fifteen patients (20.0%; 95% CI, 12.3%-30.8%) needed rescue therapy during the first 2 years after biopsy.</p><p><strong>Conclusion: </strong>We found higher PERR (76.0%) and CRR (58.7%) at 2 years after the first renal biopsy than those reported in many randomized trials, similar to those reported in observational studies.</p>","PeriodicalId":14745,"journal":{"name":"JCR: Journal of Clinical Rheumatology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143005589","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}
引用次数: 0
Clinical Experience with TNF Inhibition and Longitudinal Image Monitoring in Osseous Sarcoidosis. 骨结节病肿瘤坏死因子抑制及纵向影像监测的临床经验。
IF 2.4 4区 医学
JCR: Journal of Clinical Rheumatology Pub Date : 2025-01-20 DOI: 10.1097/RHU.0000000000002190
Seth J VanDerVeer, Erica M Hill
{"title":"Clinical Experience with TNF Inhibition and Longitudinal Image Monitoring in Osseous Sarcoidosis.","authors":"Seth J VanDerVeer, Erica M Hill","doi":"10.1097/RHU.0000000000002190","DOIUrl":"https://doi.org/10.1097/RHU.0000000000002190","url":null,"abstract":"<p><strong>Background: </strong>In this case series, we present longitudinal imaging surveillance of 6 cases of osseous sarcoidosis, each of which was effectively treated with tumor necrosis factor (TNF) inhibition.</p><p><strong>Methods: </strong>We identified 6 patients from Brooke Army Medical Center with osseous sarcoidosis, who were treated with TNF inhibition and followed with longitudinal imaging studies. Cases of osseous sarcoidosis were defined as having pathologic evidence of noncaseating granulomas on bone biopsy and evidence of osseous lesions on imaging attributable to sarcoidosis by the radiologist, treating clinician, and reviewer. Clinical data were obtained through review of the military electronic medical record.</p><p><strong>Results: </strong>Longitudinal imaging with positron emission tomography/computed tomography, magnetic resonance imaging, and bone scintigraphy assisted in the identification of active disease and clinical remission. Imaging progression of asymptomatic lesions was associated with the eventual development of bone pain 1 to 3 years later. Clinical remission was achieved in all six cases of osseous sarcoidosis and effective doses for TNF inhibition were adalimumab 40 mg subcutaneously every 1 to 2 weeks and infliximab 5 mg/kg every 6 to 8 weeks. Time to complete imaging response ranged from 3 to 8 months.</p><p><strong>Conclusions: </strong>Longitudinal imaging with bone scintigraphy, positron emission tomography/computed tomography, and magnetic resonance imaging demonstrated several benefits including evaluation for occult disease, surveillance of asymptomatic lesions, and evaluation of treatment response. TNF inhibition with adalimumab or infliximab was successful in all cases, and complete resolution of osseous lesions was demonstrated in 5 of 6 patients. Discontinuation of TNF inhibition led to disease recurrence in 2 cases, which prompted the use of long-term immunosuppressive therapy in all treated patients.</p>","PeriodicalId":14745,"journal":{"name":"JCR: Journal of Clinical Rheumatology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143005580","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}
引用次数: 0
Evaluation of the Reliability of ChatGPT to Provide Guidance on Recombinant Zoster Vaccination for Patients With Rheumatic and Musculoskeletal Diseases. ChatGPT为风湿病和肌肉骨骼疾病患者重组带状疱疹疫苗接种提供指导的可靠性评价
IF 2.4 4区 医学
JCR: Journal of Clinical Rheumatology Pub Date : 2025-01-15 DOI: 10.1097/RHU.0000000000002198
Akhil Sood, Amanda Moyer, Pegah Jahangiri, Diane Mar, Prachaya Nitichaikulvatana, Nitya Ramreddy, Liya Stolyar, Janice Lin
{"title":"Evaluation of the Reliability of ChatGPT to Provide Guidance on Recombinant Zoster Vaccination for Patients With Rheumatic and Musculoskeletal Diseases.","authors":"Akhil Sood, Amanda Moyer, Pegah Jahangiri, Diane Mar, Prachaya Nitichaikulvatana, Nitya Ramreddy, Liya Stolyar, Janice Lin","doi":"10.1097/RHU.0000000000002198","DOIUrl":"https://doi.org/10.1097/RHU.0000000000002198","url":null,"abstract":"<p><strong>Introduction: </strong>Large language models (LLMs) such as ChatGPT can potentially transform the delivery of health information. This study aims to evaluate the accuracy and completeness of ChatGPT in responding to questions on recombinant zoster vaccination (RZV) in patients with rheumatic and musculoskeletal diseases.</p><p><strong>Methods: </strong>A cross-sectional study was conducted using 20 prompts based on information from the Centers for Disease Control and Prevention (CDC), the Advisory Committee on Immunization Practices (ACIP), and the American College of Rheumatology (ACR). These prompts were inputted into ChatGPT 3.5. Five rheumatologists independently scored the ChatGPT responses for accuracy (Likert 1 to 5) and completeness (Likert 1 to 3) compared with validated information sources (CDC, ACIP, and ACR).</p><p><strong>Results: </strong>The overall mean accuracy of ChatGPT responses on a 5-point scale was 4.04, with 80% of responses scoring ≥4. The mean completeness score of ChatGPT response on a 3-point scale was 2.3, with 95% of responses scoring ≥2. Among the 5 raters, ChatGPT unanimously scored with high accuracy and completeness to various patient and physician questions surrounding RZV. There was one instance where it scored with low accuracy and completeness. Although not significantly different, ChatGPT demonstrated the highest accuracy and completeness in answering questions related to ACIP guidelines compared with other information sources.</p><p><strong>Conclusions: </strong>ChatGPT exhibits promising ability to address specific queries regarding RZV for rheumatic and musculoskeletal disease patients. However, it is essential to approach ChatGPT with caution due to risk of misinformation. This study emphasizes the importance of rigorously validating LLMs as a health information source.</p>","PeriodicalId":14745,"journal":{"name":"JCR: Journal of Clinical Rheumatology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143005585","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}
引用次数: 0
Prevalence and Associated Factors of Sarcopenia in Thai Rheumatoid Arthritis Patients: A Cross-Sectional Study. 泰国类风湿性关节炎患者肌肉减少症的患病率及相关因素:一项横断面研究。
IF 2.4 4区 医学
JCR: Journal of Clinical Rheumatology Pub Date : 2025-01-06 DOI: 10.1097/RHU.0000000000002194
Wanitcha Gumtorntip, Phichayut Phinyo, Nuntana Kasitanon, Worawit Louthrenoo
{"title":"Prevalence and Associated Factors of Sarcopenia in Thai Rheumatoid Arthritis Patients: A Cross-Sectional Study.","authors":"Wanitcha Gumtorntip, Phichayut Phinyo, Nuntana Kasitanon, Worawit Louthrenoo","doi":"10.1097/RHU.0000000000002194","DOIUrl":"https://doi.org/10.1097/RHU.0000000000002194","url":null,"abstract":"<p><strong>Background/objectives: </strong>Sarcopenia associates with poor health-related quality of life (HRQoL). This study aimed to determine prevalence and factors associated with sarcopenia in rheumatoid arthritis (RA) patients. The HRQoL between RA patients with and without sarcopenia also was compared.</p><p><strong>Methods: </strong>This cross-sectional study recruited RA patients, aged ≥20 years, at Chiang Mai University Hospital between May and November 2023. Their skeletal muscle mass (bioelectrical impedance analysis), grip strength (hand dynamometer), and physical performance (gait speed test) were evaluated. Sarcopenia was defined according to the Asian Working Group for Sarcopenia. Patient characteristics, disease activity, physical disability (HAQ-DI), HRQoL (SF-36), nutrition (mini nutrition assessment), and medications were recorded.</p><p><strong>Results: </strong>Of 299 patients (89.0% female; age 61.3 ± 11.6 years; disease duration 13.9 ± 8.6 years), 37.5% had sarcopenia (27.4% severe sarcopenia). In multivariable analysis, body mass index (odds ratio [95% confidence interval] 1.46/1 unit decrease [1.27, 1.68], p < 0.001), disease duration (1.89/10 years increase [1.27, 2.83], p = 0.002), deformity of hands/feet (3.80 [1.50, 9.61], p = 0.005), mini nutritional assessment score (1.21/1 score decrease [1.04, 1.40], p = 0.012), and high C-reactive protein (CRP) (1.94 [1.02, 3.69], p = 0.044) were independent factors associated with sarcopenia. There was no relationship between sarcopenia and disease activity (DAS-28-ESR or CRP) or medication use. RA patients with sarcopenia had higher HAQ score than those without, but potentially lower scores in physical function domain of SF-36 with adjusted mean difference of 0.2 (95% confidence interval 0.03, 0.32, p = 0.022) and -5.9 (-12.24, 0.38, p = 0.066), respectively.</p><p><strong>Conclusions: </strong>About one third of the Thai RA patients in this center had sarcopenia. Low body mass index, long disease duration, joint deformity, malnutrition, and high CRP were independent factors associated with sarcopenia. Sarcopenia affects physical capabilities and the physical function domain of the HRQoL.</p>","PeriodicalId":14745,"journal":{"name":"JCR: Journal of Clinical Rheumatology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142931852","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}
引用次数: 0
Rituximab Treatment in Adult Patients With Idiopathic Inflammatory Myositis: A Systematic Review and Meta-analysis. 利妥昔单抗治疗特发性炎症性肌炎成人患者:系统回顾与元分析》。
IF 2.4 4区 医学
JCR: Journal of Clinical Rheumatology Pub Date : 2025-01-01 Epub Date: 2024-11-11 DOI: 10.1097/RHU.0000000000002151
Lilian Otalora Rojas, Karishma Ramsubeik, Luis Sanchez-Ramos, Shastri Motilal, Jasvinder A Singh, Gurjit S Kaeley
{"title":"Rituximab Treatment in Adult Patients With Idiopathic Inflammatory Myositis: A Systematic Review and Meta-analysis.","authors":"Lilian Otalora Rojas, Karishma Ramsubeik, Luis Sanchez-Ramos, Shastri Motilal, Jasvinder A Singh, Gurjit S Kaeley","doi":"10.1097/RHU.0000000000002151","DOIUrl":"10.1097/RHU.0000000000002151","url":null,"abstract":"<p><strong>Objective: </strong>This systematic review and meta-analysis assess the efficacy and safety of rituximab (RTX) in treating idiopathic inflammatory myositis (IIM).</p><p><strong>Methods: </strong>PubMed and Embase were systematically searched for trials and observational studies involving RTX use in IIM. Data were analyzed using a random-effects model to generate pooled estimates for overall response, complete remission, partial response, and adverse events, with subgroup analyses by myositis type and RTX dosage (PROSPERO registered number CRD42022353740). Risk of bias assessments were done using the Newcastle-Ottawa Scale for observational studies and risk of bias 1 tool for trials.</p><p><strong>Results: </strong>Seventeen studies (1 randomized controlled trial and 16 observational studies), encompassing 362 patients, were included. The overall pooled response rate was 70% (95% confidence interval [CI]: 57%-82%; I2 = 74%, p < 0.001). Complete remission occurred in 13% (95% CI: 3%-25%; I2 = 79%, p < 0.001) and partial response in 48% (95% CI: 30%-67%; I2 = 87%, p < 0.001), both with significant heterogeneity. Subgroup analysis revealed high response rates across all myositis types: polymyositis 69%, dermatomyositis 67%, antisynthetase syndrome 70%, juvenile dermatomyositis 60%, and immune-mediated necrotizing myopathy 86%. Response rates were similar between RTX induction doses of 1 g IV on days 0 and 14 (68%) and 375 mg/m 2 weekly for 4 weeks (71%). Reported adverse events totaled 120, including infusion reactions (18.5%) and infections (12.4%).</p><p><strong>Conclusions: </strong>RTX shows a favorable clinical response in IIM treatment, though response rates vary. There was a significant heterogeneity in treatment effect estimates that are based on a small number of patients. The incidence of infusion reactions and infections highlights the need for careful monitoring. Further controlled trials are essential to refine treatment protocols and evaluate long-term outcomes for RTX's role in IIM.</p>","PeriodicalId":14745,"journal":{"name":"JCR: Journal of Clinical Rheumatology","volume":" ","pages":"33-39"},"PeriodicalIF":2.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142620688","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}
引用次数: 0
Scleroderma Renal Crisis and Musculoskeletal Corticosteroid Injections. 硬皮病肾危象与肌肉骨骼皮质类固醇注射。
IF 2.4 4区 医学
JCR: Journal of Clinical Rheumatology Pub Date : 2025-01-01 Epub Date: 2024-11-11 DOI: 10.1097/RHU.0000000000002168
Maheswari Muruganandam, Eyerusalem B Akpan, Matthew K McElwee, N Suzanne Emil, Meredith C Keller, Adarsh S Vangala, Fatmah Dihowm, Sharon E Nunez, James I Gibb, Frank X O'Sullivan, Roderick A Fields, Wilmer L Sibbitt
{"title":"Scleroderma Renal Crisis and Musculoskeletal Corticosteroid Injections.","authors":"Maheswari Muruganandam, Eyerusalem B Akpan, Matthew K McElwee, N Suzanne Emil, Meredith C Keller, Adarsh S Vangala, Fatmah Dihowm, Sharon E Nunez, James I Gibb, Frank X O'Sullivan, Roderick A Fields, Wilmer L Sibbitt","doi":"10.1097/RHU.0000000000002168","DOIUrl":"10.1097/RHU.0000000000002168","url":null,"abstract":"<p><strong>Background/objective: </strong>Inflammatory arthritis frequently affects patients with systemic sclerosis (SSc) but musculoskeletal corticosteroid (MSKC) injections are often avoided due to concerns of scleroderma renal crisis (SRC). This study investigated the incidence of SRC following MSKC injections.</p><p><strong>Methods: </strong>In a 136-SSc cohort, 46 subjects underwent a total of 330 MSKC injections each receiving a significant dosage of triamcinolone acetonide (mean, 95.2 ± 44.2 mg per injection session). Data on blood pressure (BP), serum creatinine and glucose, urine protein, and complications were obtained before and after injection from the patients' medical records.</p><p><strong>Results: </strong>MSKC and control subjects were similar in age (MSKC: 58.9 ± 12.1 vs. 55.5 ± 14.9 years), female (MSKC: 97.8% [45/46] vs. 89.9% [81/90]), antinuclear antibody (MSKC: 71.7% [33/46] vs. 81.1% [73/90]), anti-centromere antibody (MSKC: 47.8% [22/46] vs. 37.8% [34/90]), anti-topoisomerase antibody (MSKC: 26.1% [12/46] vs. 26.7% [24/90]), and anti-RNA polymerase III antibody (MSKC: 17.4.1% [8/46] vs. 24.4% [22/90]) (all p > 0.05). Pre- and post-MSKC demonstrated nonsignificant changes in systolic BP (pre: 127 ± 22 vs. post: 127 ± 21 mm Hg, p = 1.0), diastolic BP (pre: 71 ± 13 vs. post: 71 ± 11 mm Hg, p = 1.0), creatinine (pre: 0.78 ± 0.56 vs. post: 0.76 ± 0.20 mg/dL, p = 0.64), glucose (pre: 100 ± 21 vs. post: 99 ± 24 mg/dL, p = 0.67), and urine protein-creatinine ratio (pre: 0.14 ± 0.12 vs. post: 0.12 ± 0.11 mg/mg, p = 0.41). One case of SRC with mortality occurred in the controls and none in the MSKC group. No infections, hematologic abnormalities, or tendon rupture were noted.</p><p><strong>Conclusion: </strong>MSKC injections in established SSc are generally safe with low incidences of SRC and complications. However, it is still prudent to monitor high-risk individuals and recent-onset SSc post-MSKC injection.</p>","PeriodicalId":14745,"journal":{"name":"JCR: Journal of Clinical Rheumatology","volume":" ","pages":"12-19"},"PeriodicalIF":2.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142620695","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}
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