Modern Rheumatology最新文献

{"title":"Prevalence of systemic lupus erythematosus and age-stratified treatment trends in the Japanese population: A cross-sectional study based on the National Database of Health Insurance Claims.","authors":"Masakazu Matsushita, Ryoko Sakai, Naoto Yokogawa, Masaki Shimizu, Yuzaburo Inoue, Eisuke Inoue, Ken Yamaji, Masaaki Mori, Takako Miyamae","doi":"10.1093/mr/roaf020","DOIUrl":"10.1093/mr/roaf020","url":null,"abstract":"<p><strong>Objectives: </strong>The aim of this article is to investigate the prevalence of systemic lupus erythematosus (SLE) in Japan and explore its treatment regimens in different age groups.</p><p><strong>Methods: </strong>We identified patients with SLE from the National Database of Health Insurance Claims of anonymized health insurance-related information; they had disease names associated with SLE and were treated with glucocorticoids, hydroxychloroquine, or immunosuppressants. These data were used to investigate disease prevalence and profiles in Japan.</p><p><strong>Results: </strong>Of 74,277 patients with SLE, 12,816 were men (16.6%) and 61,961 were women (83.4%). Oral glucocorticoids were administered to 89.1% of patients and hydroxychloroquine to 21.4%. Regarding immunosuppressants, mycophenolate mofetil was prescribed for 49.2% of patients aged ≤14 years and tacrolimus for 35.5% of those aged 20-39 years; these rates were higher than those observed in other age groups.</p><p><strong>Conclusions: </strong>The high proportion of patients receiving treatment for comorbidities may be partially explained by the high rate of glucocorticoid use, as approval of hydroxychloroquine for the treatment of SLE was delayed in Japan. This is the first study to ascertain the prevalence of SLE and its treatment status in Japan using the National Database, thus providing useful basic data to improve the management of the disease.</p>","PeriodicalId":18705,"journal":{"name":"Modern Rheumatology","volume":" ","pages":"850-858"},"PeriodicalIF":1.9,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143605650","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 study of clinical features of atrophic gastritis in patients with Sjögren's disease.","authors":"Susumu Nishiyama, Keiji Ohashi, Tetsushi Aita, Yasuhiko Yoshinaga","doi":"10.1093/mr/roaf031","DOIUrl":"10.1093/mr/roaf031","url":null,"abstract":"<p><strong>Objectives: </strong>Patients with Sjogren's disease (SjD) are known to develop atrophic gastritis. Our aim is to examine the prevalence rate of atrophic gastritis in patients with SjD and its association with Helicobacter pylori infection and autoantibodies.</p><p><strong>Methods: </strong>We collected data of 103 patients with SjD, who underwent upper endoscopy at our hospital from January 2004 to June 2024. Helicobacter pylori infection was determined by at least one of the following methods, the urease test, the 13C-urea breath test, and the blood test for H. pylori antibody.</p><p><strong>Results: </strong>The prevalence rate of atrophic gastritis in patients with SjD was 68.0%. Around half of the patients (56.1%) with atrophic gastritis were positive for H. pylori tests. Primary SjD patients with atrophic gastritis had significantly higher positive rates of anti-La/SSB antibody than those with other gastric findings (38.5% vs. 5.9%, P < .05). There was no difference in anti-La/SSB antibody prevalence between H. pylori positive and negative group.</p><p><strong>Conclusion: </strong>Anti-La/SSB antibody, other than H. pylori may contribute to develop atrophic gastritis in patients with primary SjD.</p>","PeriodicalId":18705,"journal":{"name":"Modern Rheumatology","volume":" ","pages":"872-877"},"PeriodicalIF":1.9,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143677111","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":"Association between hydroxychloroquine concentrations and its efficacy and safety in Japanese patients with rheumatoid arthritis.","authors":"Hiroshi Takei, Masayuki Hashiguchi, Satoshi Takanashi, Hironari Hanaoka, Jun Kikuchi, Keiko Yoshimoto, Tsuyoshi Shiga, Mikiko Shimizu, Tsutomu Takeuchi, Yuko Kaneko","doi":"10.1093/mr/roaf033","DOIUrl":"10.1093/mr/roaf033","url":null,"abstract":"<p><strong>Objectives: </strong>This study aims to evaluate the association between serum concentrations of hydroxychloroquine (HCQ) and its derivatives and clinical efficacy in Japanese patients with rheumatoid arthritis (RA).</p><p><strong>Methods: </strong>Patients with active RA despite conventional synthetic disease-modifying antirheumatic drugs were recruited, and HCQ was administered for 24 weeks in addition to the prior treatment. Serum concentrations of HCQ, desethylhydroxychloroquine (DHCQ), desethylchloroquine (DCQ), and bisdesethylchloroquine (BCQ) were measured at weeks 0, 4, 8, 12, 24, and 32. The association between each serum concentration and achievement of American College of Rheumatology (ACR) 20/50/70 was analysed.</p><p><strong>Results: </strong>Forty-nine patients whose sera were available were included in the analysis. The serum concentrations of HCQ, DHCQ, DCQ, and BCQ reached a plateau at Week 4 and remained at the stable levels during the 24 weeks. The concentrations of HCQ, DHCQ, DCQ, and BCQ at Week 24 were higher in patients who achieved ACR20 than in those who did not. Furthermore, higher serum concentrations of DHCQ and BCQ were also associated with the achievement of ACR50 and ACR70, while those of HCQ and DCQ were not.</p><p><strong>Conclusions: </strong>Serum concentrations of HCQ and its derivatives are associated with the clinical effectiveness of HCQ in Japanese patients with RA.</p>","PeriodicalId":18705,"journal":{"name":"Modern Rheumatology","volume":" ","pages":"801-807"},"PeriodicalIF":1.9,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143701058","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 effect of hypoxia on rheumatoid arthritis.","authors":"Anting Liu, Shuang Li, Chenlu Huo, Tingting Qian, Yan Zhu, Tao Jiang","doi":"10.1093/mr/roaf046","DOIUrl":"10.1093/mr/roaf046","url":null,"abstract":"<p><p>Rheumatoid arthritis (RA) is a chronic autoimmune disease with synovitis as the main pathologic change, and acute exacerbation severely affects patients' quality of life, but its specific pathogenesis has not been clarified. The effects of low-pressure hypoxia brought on by high-altitude surroundings and intestinal hypoxia have received comparatively less attention, even though hypoxia is a distinct state in the synovium of RA. In an effort to offer fresh approaches and ideas for treating RA, reducing pain, and enhancing quality of life, this review updates the mechanism of synovial hypoxia on RA in recent years. It also advances the theory that intestinal hypoxia and low-pressure hypoxia in the external environment aggravate arthritis.</p>","PeriodicalId":18705,"journal":{"name":"Modern Rheumatology","volume":" ","pages":"787-800"},"PeriodicalIF":1.9,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144199617","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":"Oral health-related quality of life in Sjögren's disease patients with unstimulated whole salivary flows ≥0.1 ml/min for whom no therapeutic approaches are provided in the EULAR recommendations.","authors":"Naoto Azuma, Maki Iwatani, Yuichi Yokoyama, Naoaki Hashimoto, Masao Tamura, Teppei Hashimoto, Mai Morimoto, Aki Nishioka, Masayasu Kitano, Shinichiro Tsunoda, Takashi Yamane, Kiyoshi Matsui, Hajime Sano","doi":"10.1093/mr/roaf023","DOIUrl":"10.1093/mr/roaf023","url":null,"abstract":"<p><strong>Objectives: </strong>To assess the oral health-related quality of life (OHRQoL) in Sjögren's disease (SjD) patients with unstimulated whole salivary flow (UWSF) ≥0.1 ml/min for whom no preferred therapeutic approaches are provided in the European League Against Rheumatism recommendations.</p><p><strong>Methods: </strong>Thirty-four SjD patients and 23 controls were enrolled in this study. The UWSF was measured using the spitting method. OHRQoL was quantitatively evaluated using the short-form Oral Health Impact Profile (OHIP-14).</p><p><strong>Results: </strong>In SjD patients, 26 (76.5%) had a UWSF <0.1 ml/min, and 8 (23.5%) had ≥0.1 ml/min. The OHIP-14 scores were significantly higher in both the ≥0.1 and <0.1 ml/min groups than in the non-SjD group. Among the OHIP-14 questions, the ≥0.1 ml/min group scored significantly higher than the non-SjD group for 'uncomfortable to eat foods', 'self-conscious', 'diet unsatisfactory', 'difficult to relax', 'felt life less satisfying', and 'unable to function'.</p><p><strong>Conclusions: </strong>Even with UWSF ≥0.1 ml/min, SjD patients had lower OHRQoL. The normal range of salivary flow rates is wide, exhibiting high interindividual variability. Even if the salivary flow rate is preserved in a single measurement, the possibility of having oral dryness due to a decrease in the salivary flow rate from the normal value for that patient should be considered.</p>","PeriodicalId":18705,"journal":{"name":"Modern Rheumatology","volume":" ","pages":"866-871"},"PeriodicalIF":1.9,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143634284","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":"Imaging assessment of malignancy screening using computed tomography and diffusion-weighted whole-body imaging with background body signal suppression in rheumatoid arthritis.","authors":"Takeshi Mochizuki, Koichiro Yano, Katsunori Ikari, Naoko Otani, Ryo Hiroshima, Ken Okazaki","doi":"10.1093/mr/roaf030","DOIUrl":"10.1093/mr/roaf030","url":null,"abstract":"<p><strong>Objectives: </strong>To investigate differences in information obtained from plain computed tomography (CT) and diffusion-weighted whole-body imaging with background body signal suppression (DWIBS) during malignancy screening in patients with rheumatoid arthritis.</p><p><strong>Methods: </strong>We enrolled 524 patients with RA who underwent plain CT from the chest to the pelvis and DWIBS. CT and DWIBS were performed within 3 months of each other. Rheumatologists, radiologists, and pulmonologists interpreted the plain CT and DWIBS images.</p><p><strong>Results: </strong>The prevalence of malignancy was 3.1%. Prostate, lung, breast, uterine, ovarian, and fallopian tube cancers were detected in 7, 4, 2, 1, 1, and 1 patient, respectively. The sensitivities of CT and DWIBS were 75.0% and 93.8%, respectively (P = .333). The specificities of CT and DWIBS were 76.0% and 85.8%, respectively (P < .001). The prevalence rates of interstitial lung disease, colonic diverticula, and kidney stones on CT were 17.6%, 27.1%, and 19.1%, respectively. The prevalence of lymphadenopathy in patients who underwent DWIBS was 3.6%.</p><p><strong>Conclusion: </strong>This study suggests that DWIBS is superior to or equivalent to CT for malignancy screening. Our findings have important implications for imaging-based screening and can help address cancer-related issues in rheumatoid arthritis treatment.</p>","PeriodicalId":18705,"journal":{"name":"Modern Rheumatology","volume":" ","pages":"837-842"},"PeriodicalIF":1.9,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143677114","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":"Characterization of patients with rheumatoid arthritis not using biologic/targeted synthetic disease-modifying drugs despite insufficient disease control: Another difficult-to-treat RA.","authors":"Hisakata Yamada, Ryosuke Tsurui, Masakazu Kondo, Jun-Ichi Fukushi, Koji Sakuraba, Tomoya Miyamura, Motoko Ishida, Masataka Nakamura, Yasushi Inoue, Tomomi Tsuru, Toshihide Shuto, Seiji Yoshizawa, Masanobu Ohishi, Kenta Kamo, Akihisa Haraguchi, Akiza Maeyama, Yojiro Arinobu, Hiroki Mitoma, Masahiro Ayano, Nobuyuki Ono, Yukio Akasaki, Toshifumi Fujiwara, Daisuke Hara, Shinkichi Arisumi, Keitaro Yasumoto, Takahiro Natori, Hiroaki Niiro, Yasuharu Nakashima","doi":"10.1093/mr/roaf037","DOIUrl":"10.1093/mr/roaf037","url":null,"abstract":"<p><strong>Objectives: </strong>To understand the prevalence and characteristics of rheumatoid arthritis (RA) patients not using biologic/targeted synthetic disease-modifying drugs (b/tsDMARDs) despite insufficient disease control.</p><p><strong>Methods: </strong>The data from 3172 RA patients in the FRANK (Fukuoka RA NetworK) registry, a Japanese registry of RA patients, were analysed. The patients were divided into groups based on the use of b/tsDMARDs and the reasons for not using them. Age, disease duration, drug use, activity of daily living (ADL) and quality of life (QOL) measures, the frequency of workers, and satisfaction with treatment were compared among the groups.</p><p><strong>Results: </strong>About 10% of RA patients in the FRANK registry are non-users of b/tsDMARDs despite disease activity. The three major reasons for not using were the presence of comorbidity, economic reasons, and the patient's intent except for economic reasons. Patients with comorbidity and/or older age have low ADL/QOL but are mostly satisfied with the treatment. Intriguingly, patients not using b/tsDMARDs due to economic reasons are the youngest and have the highest proportion of workers.</p><p><strong>Conclusions: </strong>We revealed the status of RA patients, non-users of b/tsDMARDs despite disease activity, who are not included in the European Alliance of Associations for Rheumatology (EULAR)-defined difficult-to-treat RA. About half of them might benefit from b/tsDMARD by patient education and socioeconomic support.</p>","PeriodicalId":18705,"journal":{"name":"Modern Rheumatology","volume":" ","pages":"830-836"},"PeriodicalIF":1.9,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144008289","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 retrospective chart review to explore the efficacy and safety of switching to peficitinib in Japanese patients with rheumatoid arthritis and inadequate response to biologic disease-modifying antirheumatic drugs.","authors":"Kunihiro Yamaoka, Junichi Kondo, Toshinori Furuya, Yusuke Tanaka, Tadatsura Koshika, Yoshiaki Morita, Kenji Oku","doi":"10.1093/mr/roaf043","DOIUrl":"10.1093/mr/roaf043","url":null,"abstract":"<p><strong>Objectives: </strong>This retrospective, observational study examined the safety and efficacy of the Janus kinase inhibitor peficitinib in Japanese patients with rheumatoid arthritis who switched to peficitinib due to inadequate response to biologic disease-modifying antirheumatic drugs.</p><p><strong>Methods: </strong>We included patients aged ≥ 20 years with rheumatoid arthritis who switched to peficitinib between 10 July 2019 and 31 March 2022 and were enrolled in peficitinib post-marketing surveillance. The primary endpoint was change in disease activity score in 28 joints with erythrocyte sedimentation rate (DAS28-ESR) from index date to 24 weeks. Secondary endpoints included change in Clinical Disease Activity Index and adverse event incidence.</p><p><strong>Results: </strong>Of 76 enrolled patients, efficacy data were available for 67; 56 completed 24 weeks of treatment. One-quarter (19/76) of patients reported adverse events; 16 (21.1%) had drug-related adverse events with one (streptococcal infection) considered serious. From index date to 24 weeks, mean (standard deviation) change in DAS28-ESR was -0.95 (1.24) (95% confidence interval [CI]: -1.26, -0.65; P < .0001) and in Clinical Disease Activity Index was -7.82 (8.52) (95% CI: -9.90, -5.74; P < .0001). Improvements in DAS28-ESR and Clinical Disease Activity Index by 12 and 24 weeks were statistically significant regardless of prior number of biologic disease-modifying antirheumatic drugs.</p><p><strong>Conclusions: </strong>Peficitinib could be an effective treatment option for patients with rheumatoid arthritis refractory to biologic disease-modifying antirheumatic drugs.</p>","PeriodicalId":18705,"journal":{"name":"Modern Rheumatology","volume":" ","pages":"808-819"},"PeriodicalIF":1.9,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144225894","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":"Polyangiitis overlap syndrome is a high-risk clinical phenotype for relapse: Case series from the KEIO-vasculitis cohort.","authors":"Hiroki Tabata, Mitsuhiro Akiyama, Yuki Imai, Koji Suzuki, Kanako Shimanuki, Koichi Saito, Hiroshi Takei, Yasushi Kondo, Jun Kikuchi, Yuko Kaneko","doi":"10.1093/mr/roaf041","DOIUrl":"10.1093/mr/roaf041","url":null,"abstract":"<p><strong>Background: </strong>Polyangiitis overlap syndrome, characterized by the coexistence of giant cell arteritis (GCA) and anti-neutrophil cytoplasmic antibody-associated vasculitis (AAV), is a rare and poorly understood condition. Clinical features, treatment responses, and long-term prognosis of this entity remain unclear. This study aimed to elucidate clinical characteristics, relapse patterns, and potential therapeutic strategies for polyangiitis overlap syndrome.</p><p><strong>Methods: </strong>We retrospectively analysed consecutive patients with GCA or AAV at our institution between January 2012 and September 2024 and identified cases of polyangiitis overlap syndrome. Clinical data, including symptoms, laboratory findings, treatment regimens, and outcomes, were extracted from medical records and analysed descriptively.</p><p><strong>Results: </strong>Among 60 GCA and 151 AAV cases, we identified six cases of polyangiitis overlap syndrome. The median age at onset was 68 years (range: 54-75), and 33% were female. Microscopic polyangiitis was the most common AAV subtype (50%). Fever was the predominant symptom (83%), and kidney involvement was observed in 83%, followed by pulmonary involvement (67%). All patients received high-dose glucocorticoids; four received cyclophosphamide, and two received tocilizumab as induction therapy. Over a median follow-up of 32 months (range: 5-122), four of six patients (67%) experienced relapse, all due to AAV-related activity. Notably, two patients who received tocilizumab as maintenance therapy remained in remission with minimal glucocorticoid exposure.</p><p><strong>Conclusion: </strong>Polyangiitis overlap syndrome represents a high-risk phenotype for relapse, driven by AAV activity. Our findings suggest that IL-6 receptor blockade is a potential therapeutic option, highlighting the need for further research to establish optimal maintenance strategies in this complex disease entity.</p>","PeriodicalId":18705,"journal":{"name":"Modern Rheumatology","volume":" ","pages":"878-883"},"PeriodicalIF":1.9,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144151168","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":"Recommendations for the treatment of juvenile idiopathic arthritis with oligoarthritis or polyarthritis from the 2024 update of the Japan College of Rheumatology Clinical Practice Guidelines for the management of rheumatoid arthritis including juvenile idiopathic arthritis with oligoarthritis or polyarthritis - secondary publication.","authors":"Takako Miyamae, Nami Okamoto, Yuzaburo Inoue, Tomohiro Kubota, Takasuke Ebato, Hitoshi Irabu, Hideto Kameda, Yuko Kaneko, Hiroshi Kubo, Kanako Mitsunaga, Masaaki Mori, Ayako Nakajima, Kenichi Nishimura, Naoaki Ohkubo, Tomomi Sato, Yuko Sugita, Satoshi Takanashi, Takayuki Tanaka, Hiroaki Umebayashi, Masato Yashiro, Shingo Yamanishi, Mie Fusama, Shintaro Hirata, Mitsumasa Kishimoto, Masataka Kohno, Masayo Kojima, Toshihisa Kojima, Akio Morinobu, Takahiko Sugihara, Eiichi Tanaka, Nobuyuki Yajima, Ryo Yanai, Yutaka Kawahito, Masayoshi Harigai","doi":"10.1093/mr/roaf042","DOIUrl":"10.1093/mr/roaf042","url":null,"abstract":"<p><strong>Objectives: </strong>To conduct systematic reviews (SRs) and develop clinical practice guidelines (CPGs) for managing juvenile idiopathic arthritis (JIA) with oligoarthritis or polyarthritis.</p><p><strong>Methods: </strong>The Grading of Recommendations, Assessment, Development, and Evaluation methodology was employed to carry out SRs and formulate the CPGs. An expert panel, including patients, paediatric and nonpaediatric rheumatologists, guideline specialists, and patient representatives, used the Delphi method to discuss and agree on the recommendations.</p><p><strong>Results: </strong>Six clinical questions (CQs) on the efficacy and safety of medical treatments were evaluated. These included CQ1 on methotrexate (MTX), CQ2 on non-MTX conventional synthetic disease-modifying antirheumatic drugs, CQ3 on glucocorticoids, CQ4 on tumour necrosis factor inhibitors, CQ5 on interleukin-6 inhibitors, and CQ6 on Janus kinase inhibitors. Two randomized controlled trials were identified for CQ1, three for CQ2, two for CQ3, eight for CQ4, two for CQ5, and two for CQ6. Based on these evaluations, three strong and three conditional recommendations were established. The CPGs have been endorsed by the Japan College of Rheumatology and the Pediatric Rheumatology Association of Japan.</p><p><strong>Conclusions: </strong>The SRs provided the necessary evidence to develop the CPGs, which are intended to guide not only paediatric but also nonpaediatric rheumatologists, caregivers, patients, and their families in treatment decision-making.</p>","PeriodicalId":18705,"journal":{"name":"Modern Rheumatology","volume":" ","pages":"894-908"},"PeriodicalIF":1.9,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144208974","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}