Modern Rheumatology最新文献

{"title":"Efficacy and safety of canakinumab in patients with adult-onset Still's disease: Results from an open-label phase III study in Japan.","authors":"Tatsuya Atsumi, Yohei Kirino, Mitsumasa Kishimoto, Shunsuke Furuta, Yuko Kaneko, Yasunori Iwata, Keishi Fujio, Toshihide Mimura, Satoshi Kawaai, Ryota Wakabayashi, Noriko Seko, Wataru Hongo, Manmath Patekar, Atsushi Kawakami","doi":"10.1093/mr/roag026","DOIUrl":"10.1093/mr/roag026","url":null,"abstract":"<p><strong>Objectives: </strong>To evaluate the efficacy and safety of canakinumab 4 mg/kg every 4 weeks administered subcutaneously in Japanese adult-onset Still's disease patients.</p><p><strong>Methods: </strong>Fourteen participants were included in this open-label, single-arm, active-treatment study. The primary endpoint was the adapted ACR30 response, with a predefined 95% CI lower limit requirement of 40% at Week 8. Secondary endpoints included glucocorticoid tapering from Weeks 8 to 28; adapted ACR30/50/70/90/100 responses over time; and the systemic feature score over time.</p><p><strong>Results: </strong>The primary endpoint was not met [6/11 patients (54.5%); 95% CI: 20.6-88.5; one-sided P = 0.249]. From Weeks 8 to 28, 6/11 patients (54.5%) successfully tapered oral glucocorticoids. At Week 28, among the 11 patients assessed, 70% achieved adapted ACR30 and adapted ACR50, 60% achieved adapted ACR70 and adapted ACR90, and 40% achieved adapted ACR100. At Week 28, the mean (SD) change from baseline in the systemic feature score was -4.3 (2.06). All 14 patients had at least one treatment-emergent adverse event. Six participants (42.9%) had serious adverse events. Three patients had serious infections; all were considered treatment-related and all recovered.</p><p><strong>Conclusion: </strong>Although the primary endpoint was not met, the Week 28 analysis showed that canakinumab treatment led to improvements in various efficacy outcome measures in Japanese patients with adult-onset Still's disease, with no unexpected safety signals.</p>","PeriodicalId":18705,"journal":{"name":"Modern Rheumatology","volume":" ","pages":"809-816"},"PeriodicalIF":2.1,"publicationDate":"2026-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147504415","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":"Serum calprotectin elevation and interferon-α-induced neutrophil priming in macrophage activation syndrome associated with systemic lupus erythematosus: Clinical and experimental insights.","authors":"Yohei Hosokawa, Yusuke Yoshida, Sho Mokuda, Naoya Oka, Hiroki Kobayashi, Genki Kidoguchi, Michinori Ishitoku, Tomohiro Sugimoto, Shintaro Hirata","doi":"10.1093/mr/roag012","DOIUrl":"10.1093/mr/roag012","url":null,"abstract":"<p><strong>Objectives: </strong>To clarify the diagnostic utility of serum calprotectin and gene expression in interferon (IFN)-α-activated neutrophils in macrophage activation syndrome (MAS) in patients with systemic lupus erythematosus (SLE).</p><p><strong>Methods: </strong>This single-centre, cross-sectional study analysed serum calprotectin levels in 47 patients with SLE (including eight with MAS) and 7 patients with adult-onset Still's disease (AOSD) complicated with MAS as a reference population. In neutrophil-based experiments, mRNA expression levels of S100A8 and S100A9 were measured following stimulation with IFN-α or interleukin (IL)-1β.</p><p><strong>Results: </strong>Serum calprotectin levels were significantly elevated in patients with SLE-MAS compared to those with SLE without MAS and comparable to those in patients with AOSD-MAS. Calprotectin levels correlated with serum ferritin levels (rs = 0.49, P = .004), but not with anti-dsDNA antibodies or complement levels. At a cut-off value of 9184.4 ng/ml, serum calprotectin demonstrated sensitivity of 62.5% and specificity of 94.9% for identifying MAS. Recombinant IFN-α2a induced a dose-dependent increase in S100A8 and S100A9 expression in neutrophils, whereas recombinant interleukin-1β had no effect. Pre-treatment with an anti-IFN-α2 neutralising antibody effectively suppressed the IFN-α2a-induced expression of S100A8 and S100A9.</p><p><strong>Conclusions: </strong>Serum calprotectin, upregulated by IFN-α, may serve as a useful biomarker for diagnosing MAS in SLE.</p>","PeriodicalId":18705,"journal":{"name":"Modern Rheumatology","volume":" ","pages":"778-785"},"PeriodicalIF":2.1,"publicationDate":"2026-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147276617","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":"Clinical performance of three anti-dsDNA antibody immunoassays in systemic lupus erythematosus.","authors":"Kenichi Uto, Natsuki Yoshida, Takaichi Okano, Mai Yamashita, Nobuhide Hayashi, Takamitsu Imanishi, Yoshihiko Yano, Jun Saegusa, Sho Sendo","doi":"10.1093/mr/roag018","DOIUrl":"10.1093/mr/roag018","url":null,"abstract":"<p><strong>Objectives: </strong>To evaluate the clinical performance of three commercially available anti-double-stranded DNA (dsDNA) antibody immunoassays in Japan.</p><p><strong>Methods: </strong>We compared the reactivity and diagnostic accuracy of three commercially available anti-dsDNA antibody immunoassays (radioimmunoassay, chemiluminescence enzyme immunoassay, and fluorescence enzyme immunoassay). We evaluated how well the three anti-dsDNA antibody immunoassays reflected disease activity and individual organ involvement in systemic lupus erythematosus.</p><p><strong>Results: </strong>Three anti-dsDNA antibody immunoassays demonstrated moderate to substantial correlation and concordance, while some patients exhibited different reactivity because of assay principles and detection systems. The diagnostic accuracies of the three immunoassays were comparable based on the receiver operating characteristic analyses and optimal cutoff values. Among the three anti-dsDNA antibody immunoassays, a fully automated chemiluminescence enzyme immunoassay-specific detection system demonstrated high sensitivity that reflects disease activity. The combined results of the titers and positivity rates of the three anti-dsDNA antibody immunoassays showed that nephritis was significantly associated with the chemiluminescence enzyme immunoassay and arthritis with the radioimmunoassay, and weak or no associations with other organ involvement were observed.</p><p><strong>Conclusions: </strong>We confirmed that the clinical performances of the three dsDNA immunoassays are comparable. Our findings suggest that selecting an optimal anti-dsDNA immunoassay will be useful for clinical decision-making in systemic lupus erythematosus.</p>","PeriodicalId":18705,"journal":{"name":"Modern Rheumatology","volume":" ","pages":"768-777"},"PeriodicalIF":2.1,"publicationDate":"2026-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147308033","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":"Assessment of residual symptoms using the Okomarigoto Sheet can complement evaluation of the patient acceptable symptom state in patients with rheumatoid arthritis.","authors":"Kensuke Koyama, Tetsuro Ohba, Ryousuke Koizumi, Koki Watabe, Chikako Sugita, Hirotaka Haro","doi":"10.1093/mr/roag027","DOIUrl":"10.1093/mr/roag027","url":null,"abstract":"<p><strong>Objectives: </strong>Although clinical remission is the primary treatment goal in rheumatoid arthritis (RA), many patients continue to experience residual symptoms that impair quality of life. This study examined whether the complete absence of residual symptoms, assessed using the Okomarigoto Sheet (OS), is associated with achieving the Patient Acceptable Symptom State (PASS), including among patients in Simplified Disease Activity Index (SDAI)-defined remission.</p><p><strong>Methods: </strong>This cross-sectional, single-center study included 260 consecutive patients with RA. Residual symptoms were evaluated using the OS, with particular emphasis on whether an OS score of zero was associated with PASS achievement. Clinical characteristics were compared between groups, and factors associated with PASS non-achievement were analysed using univariate and multivariate logistic regression analyses.</p><p><strong>Results: </strong>Of the 260 patients, 196 achieved PASS. An OS score of zero was strongly associated with PASS achievement (odds ratio [OR], 11.02; 95% confidence interval [CI], 4.06-29.2; P < .001). Among patients in SDAI remission, none of the PASS nonachievers had an OS score of zero. PASS nonachievement was associated with higher disease activity, greater functional impairment, and persistent residual symptoms. Multivariate analysis identified Steinbrocker class, C-reactive protein, and total OS score (OR, 1.27; 95% CI, 1.13-1.43; P < .001) as independent predictors of PASS nonachievement. In patients in SDAI remission, OS-assessed pain independently predicted PASS nonachievement.</p><p><strong>Conclusions: </strong>The complete absence of residual symptoms, as measured by the OS, was strongly associated with achieving PASS, even among patients in SDAI-defined remission. Systematic evaluation and targeted management of residual symptoms may improve patient satisfaction and facilitate shared decision-making in RA care.</p>","PeriodicalId":18705,"journal":{"name":"Modern Rheumatology","volume":" ","pages":"753-759"},"PeriodicalIF":2.1,"publicationDate":"2026-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147444264","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":"Impact of anti-drug antibodies and neutralising antibodies on safety and efficacy of ozoralizumab in rheumatoid arthritis.","authors":"Masafumi Kawanishi, Tsutomu Takeuchi, Nobuko Horiuchi, Hironori Yamasaki, Shunsuke Okamoto, Yusuke Miyazaki, Yoko Mano, Masanao Kyuuma, Rumiko Matsumoto, Yoshiya Tanaka","doi":"10.1093/mr/roag008","DOIUrl":"10.1093/mr/roag008","url":null,"abstract":"<p><strong>Objectives: </strong>To evaluate the induction of antidrug antibodies (ADAs) and the expression of neutralising antibodies (NAbs) during ozoralizumab treatment, a trivalent anti-TNFα NANOBODY® compound for rheumatoid arthritis, and their impact on safety and efficacy.</p><p><strong>Methods: </strong>Data from a phase II/III trial of ozoralizumab co-administered with methotrexate (OHZORA) and a phase III trial without methotrexate (NATSUZORA) were analysed. Participants were stratified by ADA and NAb status. Safety and efficacy outcomes were compared across subgroups.</p><p><strong>Results: </strong>ADA induction was observed in 29.2 (OHZORA) and 44.3% (NATSUZORA) of participants; NAb expression was observed in 7.5 and 19.3%, respectively. ADA induction was not associated with treatment continuation or safety. In NATSUZORA, reduced efficacy was observed in the NAb-positive participants, although approximately half of those participants maintained low disease activity through week 52. In OHZORA, NAb expression showed no significant impact on efficacy. Several NAb-positive participants in either trial showed sustained disease control in the long-term extension (HOSHIZORA).</p><p><strong>Conclusions: </strong>ADA induction had no apparent impact on safety. The effect of NAb expression on efficacy was limited particularly in OHZORA, suggesting that methotrexate co-administration may reduce NAb development and contribute to the optimal preservation of efficacy and safety in clinical practice.</p>","PeriodicalId":18705,"journal":{"name":"Modern Rheumatology","volume":" ","pages":"737-746"},"PeriodicalIF":2.1,"publicationDate":"2026-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146227587","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":"Evaluation of 334 paediatric chronic non-bacterial osteomyelitis cases: A multicentre cohort study defining clusters.","authors":"Özge Başaran, Yağmur Bayındır, Selcan Demir, Adalet Elcin Yildiz, Emil Aliyev, Kadir Ulu, Eda Kayhan, Fatih Haşlak, Özlem Akgün, Elif Arslanoğlu Aydın, Rana İsgüder, Zahide Ekici Tekin, Hülya Köse, Özge Baba, Nihal Karaçayır, Semra Ayduran, Elif Gümüşsoy Ay, Ümmüşen Kaya Akça, Hatice Adıgüzel Dündar, Müşerref Kasap Cüceoğlu, Şengül Çağlayan, Aydan Yekedüz Bülbül, Şevki Erdem Varol, Ezgi Deniz Batu, Balahan Bora, Hafize Emine Sönmez, Kübra Öztürk, Metin Kaya Gürgöze, Selçuk Yüksel, Mukaddes Kalyoncu, Sevcan Azime Bakkaloğlu, Sara Sebnem Kilic, Mustafa Çakan, Rabia Miray Kışla Ekinci, Erbil Ünsal, Semanur Özdel, Banu Çelikel Acar, Nuray Aktay Ayaz, Özgür Kasapçopur, Ayşenur Paç Kısaarslan, Betül Sözeri, Yelda Bilginer, Seza Özen","doi":"10.1093/mr/roag019","DOIUrl":"10.1093/mr/roag019","url":null,"abstract":"<p><strong>Objectives: </strong>This multicentre cohort study aimed to describe the clinical and demographic features of paediatric patients diagnosed with chronic non-bacterial osteomyelitis in Turkey and to identify patient clusters based on bone involvement.</p><p><strong>Methods: </strong>A total of 334 paediatric chronic non-bacterial osteomyelitis patients from 21 paediatric rheumatology centres were included. Data on clinical presentation, imaging, and biopsy results were collected. A two-step cluster analysis was performed to classify patients by bone-site involvement, resulting in four distinct clusters.</p><p><strong>Results: </strong>Axial-thoracic cluster, involving the vertebra, clavicle, and sternum, was more common in female patients and showed higher rates of skin involvement. Lower-extremity cluster, characterized by lower extremity bone involvement, included the largest number of patients. Unlike previous reports, the Turkish cohort had a higher proportion of male patients and a lower frequency of skin involvement. At a median follow-up of 42.4 months, 77.3% of patients achieved remission, while 22% experienced a relapse. Mandibular involvement, additional rheumatologic diseases, and localized bone pain were associated with an increased relapse risk.</p><p><strong>Conclusions: </strong>This study highlights the clinical profile of paediatric chronic non-bacterial osteomyelitis in Turkey, marked by male predominance and low skin involvement. The identified bone-site clusters may help guide prognosis and should be validated in other populations.</p>","PeriodicalId":18705,"journal":{"name":"Modern Rheumatology","volume":" ","pages":"845-851"},"PeriodicalIF":2.1,"publicationDate":"2026-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147317597","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":"Autologous chondrocyte implantation for the knee: Historical development, age-related outcomes, and future directions.","authors":"Kyohei Nakata, Akinori Nekomoto, Atsuo Nakamae, Nobuo Adachi","doi":"10.1093/mr/roag048","DOIUrl":"10.1093/mr/roag048","url":null,"abstract":"&lt;p&gt;&lt;p&gt;Articular cartilage defects of the knee remain a major clinical challenge because hyaline cartilage possesses a very limited intrinsic healing capacity. Untreated lesions often lead to pain, functional impairment, and progressive joint degeneration. Autologous chondrocyte implantation (ACI) was introduced in the 1990s as a transformative joint-preserving surgery designed to promote hyaline-like cartilage regeneration rather than simple repair. Since its inception, ACI has undergone significant technical evolution across three generations. First-generation ACI utilized a periosteal flap to cover injected chondrocytes, which demonstrated the feasibility of biological repair but was hindered by complications such as periosteal hypertrophy. To address these issues, second-generation techniques introduced collagen membranes, improving procedural safety. The third generation, matrix-assisted ACI, utilizes biodegradable scaffolds to ensure uniform cell distribution and simplify surgical workflows. In Japan, the development of atelocollagen-based scaffolds has further standardized these procedures, allowing for reliable clinical application. Historically, advanced age and early-stage osteoarthritis were considered relative or absolute contraindications for ACI due to concerns regarding diminished chondrocyte biological activity. However, contemporary clinical evidence indicates that chronological age alone is not a definitive predictor of treatment failure. While younger patients often achieve higher absolute clinical scores, middle-aged and older individuals frequently realize clinically meaningful improvements in pain relief and daily function. The success of ACI in these populations is increasingly linked to a comprehensive 'whole-joint' management strategy, where concomitant pathologies such as limb malalignment, meniscal deficiency, and ligamentous instability are addressed simultaneously. By optimizing the overall joint environment, ACI serves as a potential intervention to delay the necessity of total knee arthroplasty in patients over the age of 40 or 50. Future perspectives in cartilage repair focus on the potential for one-stage cell-based therapies to reduce donor-site morbidity and treatment complexity. One area of ongoing investigation involves the possible utilization of osteophyte-derived chondrocytes, which are typically discarded during surgery. Preliminary preclinical studies suggest that these cells may retain sufficient proliferative capacity and chondrogenic potential for therapeutic use. Integrating minced osteophyte cartilage with next-generation biomaterials could eventually offer a strategy that reduces the need for a healthy cartilage biopsy and cell culture, though further clinical validation remains essential. In conclusion, ACI has transitioned from an experimental treatment into a versatile joint-preserving procedure. As research continues to refine surgical indications and explore alternative cell sources, ACI remains","PeriodicalId":18705,"journal":{"name":"Modern Rheumatology","volume":" ","pages":"682-688"},"PeriodicalIF":2.1,"publicationDate":"2026-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148032638","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 evolutionary trade-off between immunosurveillance and self-tolerance: Insights from four rheumatologic themes.","authors":"Masaru Kato, Masatoshi Kawataka, Satoshi Yamaguchi, Reina Tsuda, Yoshitomo Morinaga, Tatsuhiko Ozawa, Shiho Fujisaka","doi":"10.1093/mr/roag047","DOIUrl":"10.1093/mr/roag047","url":null,"abstract":"<p><p>Host-pathogen interactions have shaped the evolution of the human immune system, sometimes resulting in genetic and acquired trade-offs between robust immunosurveillance and refined self-tolerance. This review examines four representative elements, HLA-B27, tyrosine kinase 2, IL-23 signalling, and anti-citrullinated protein antibodies, to illustrate how these immune components are balanced against the costs of autoimmune disorders. By tracing their evolutionary trajectories, molecular functions, and clinical implications, we aim to elucidate the double-edged nature of immune defence mechanisms and highlight therapeutic opportunities.</p>","PeriodicalId":18705,"journal":{"name":"Modern Rheumatology","volume":" ","pages":"673-681"},"PeriodicalIF":2.1,"publicationDate":"2026-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147988398","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":"Upadacitinib monotherapy versus methotrexate monotherapy in methotrexate-naïve Japanese patients with rheumatoid arthritis: Long-term efficacy and safety through 5 years in the SELECT-EARLY study.","authors":"Tsutomu Takeuchi, Ronald van Vollenhoven, Yukitaka Ueki, Tatsuya Atsumi, Sebastian Meerwein, Xianwei Bu, Kazuya Hirata, Vibeke Strand","doi":"10.1093/mr/roag031","DOIUrl":"10.1093/mr/roag031","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the long-term (5-year) efficacy and safety of upadacitinib monotherapy compared with methotrexate (MTX) monotherapy in Japanese patients with rheumatoid arthritis who were included in the Phase 3 SELECT-EARLY study.</p><p><strong>Methods: </strong>Japanese patients were randomised 2:1:1:1 to upadacitinib 7.5, 15, or 30 mg daily, or MTX 7.5 mg/week (titrated to ≤15 mg/week). Efficacy assessments through Week 260 are reported as observed for patients receiving continuous upadacitinib or MTX, and by randomised group using non-responder imputation. Treatment-emergent adverse events were collected over 5 years and reported as events per 100 patient-years.</p><p><strong>Results: </strong>Of the 138 Japanese patients treated, 123 (89%) completed Week 48, and 121 (88%) entered the long-term extension on the study drug. Patients receiving upadacitinib had better overall long-term efficacy outcomes compared with patients receiving MTX. Similarly, treatment with upadacitinib resulted in numerically greater inhibition of structural joint progression through 5 years, relative to MTX. Higher treatment-emergent adverse event rates were observed in the 30 mg upadacitinib group compared with all other treatment groups, and no new safety signals were identified overall.</p><p><strong>Conclusion: </strong>This subanalysis of the SELECT-EARLY Japanese population corroborates findings from the global study population on the long-term clinical efficacy and safety of upadacitinib.</p>","PeriodicalId":18705,"journal":{"name":"Modern Rheumatology","volume":" ","pages":"705-715"},"PeriodicalIF":2.1,"publicationDate":"2026-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147675059","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":"Efficacy of low-dose aspirin in preventing hypertensive disorders of pregnancy in women with systemic lupus erythematosus: A single-center retrospective cohort study.","authors":"Chie Kohno, Akitsu Higuchi, Eiko Miyagawa, Shuko Mishima, Sawako Abe, Chinatsu Takai, Hisashi Noma, Atsuko Murashima, Kayoko Kaneko","doi":"10.1093/mr/roag028","DOIUrl":"10.1093/mr/roag028","url":null,"abstract":"<p><strong>Objectives: </strong>Low-dose aspirin (LDA) is widely recommended to prevent hypertensive disorders of pregnancy (HDP). However, the evidence of its effectiveness in pregnancies with systemic lupus erythematosus (SLE) remains limited. This study evaluated the efficacy of LDA in preventing HDP in women with SLE.</p><p><strong>Methods: </strong>We conducted a retrospective cohort study of 124 pregnancies with SLE managed at our hospital. Pregnancy outcomes were compared between women treated with LDA and those not treated, using propensity score and inverse probability weighting analyses to adjust for confounders.</p><p><strong>Results: </strong>LDA was used in 65 pregnancies and not used in 59. HDP occurred in 7/65 (10.8%) and 8/59 (13.6%), respectively. After adjusting for potential confounders, including antiphospholipid antibodies, lupus nephritis, chronic hypertension, chronic kidney disease, history of HDP, and hydroxychloroquine use, the risk ratio for HDP with LDA was 0.76 (95% confidence interval: 0.25-2.33; P = .64). Sensitivity analysis was consistent.</p><p><strong>Conclusions: </strong>LDA did not significantly reduce the incidence of HDP in women with SLE. This lack of effect may reflect the low event rate in a well-controlled cohort. These findings underscore the need for individualized risk assessment and careful monitoring, beyond reliance on LDA alone, in the management of pregnancies with SLE.</p>","PeriodicalId":18705,"journal":{"name":"Modern Rheumatology","volume":" ","pages":"760-767"},"PeriodicalIF":2.1,"publicationDate":"2026-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147444323","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}