Modern Rheumatology最新文献_第3页

Challenges nurses face in providing care to older patients with rheumatoid arthritis: A qualitative study. 护士在为类风湿关节炎老年患者提供护理时面临的挑战：定性研究。

IF 1.8 4区医学

Modern Rheumatology Pub Date : 2025-02-21 DOI: 10.1093/mr/roae087

Mie Fusama, Hideko Nakahara, Yukitomo Urata, Kimito Kawahata, Yutaka Kawahito, Masayo Kojima, Takahiko Sugihara, Motomu Hashimoto, Takako Miyamae, Atsuko Murashima, Masaaki Mori, Nobuyuki Yajima, Toshihiro Matsui

{"title":"Challenges nurses face in providing care to older patients with rheumatoid arthritis: A qualitative study.","authors":"Mie Fusama, Hideko Nakahara, Yukitomo Urata, Kimito Kawahata, Yutaka Kawahito, Masayo Kojima, Takahiko Sugihara, Motomu Hashimoto, Takako Miyamae, Atsuko Murashima, Masaaki Mori, Nobuyuki Yajima, Toshihiro Matsui","doi":"10.1093/mr/roae087","DOIUrl":"10.1093/mr/roae087","url":null,"abstract":"Objectives: This study aims to identify challenges nurses face in providing care to older patients with rheumatoid arthritis (RA) in Japan.Methods: Nurses certified by the Japan Rheumatism Foundation were requested via mail to describe challenges in providing care to older RA patients. Qualitative content analysis was used.Results: One hundred and eighty-two issues were identified from 152 responses. Twenty categories were grouped into seven components, five of which focused on patients: (1) lack of patient understanding, (2) lack of understanding and support from surrounding people, (3) numerous comorbidities and complications, (4) challenges related to physical strength, and (5) financial issues. Two focused on nurses: (6) lack of knowledge of nurses and (7) inadequate systems and environment in the workplace. Various difficulties, such as polypharmacy due to multimorbidity, lifestyle issues due to aged couples or those living alone, and inadequate decision-making and informed consent due to cognitive decline, were also identified.Conclusions: Nurses experienced numerous medical and nonmedical difficulties in providing care to older RA patients. Assessing patients' comprehension and self-management and grasping their situations at home are necessary. Along with the improvement of nurses' knowledge and skills, support from their workplace and multidisciplinary team care, including families, are crucial.","PeriodicalId":18705,"journal":{"name":"Modern Rheumatology","volume":" ","pages":"256-264"},"PeriodicalIF":1.8,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142133195","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

Screening for familial disease presence in first-degree relatives of Behçet's disease patients: Is measurement of common femoral vein wall thickness valuable for the diagnosis? 筛查贝赫切特病患者一级亲属中是否存在家族性疾病：测量股总静脉壁厚度对诊断有价值吗？

IF 1.8 4区医学

Modern Rheumatology Pub Date : 2025-02-21 DOI: 10.1093/mr/roae061

Ayşe Elif Boncukcuoğlu, Erhan Topal, Rabia Ergelen, Dilara Kaş, Elifnur Alkan, Gamzenur Kaya, Şevket Girgin, Tülin Ergun, Haner Direskeneli, Fatma Alibaz-Oner

{"title":"Screening for familial disease presence in first-degree relatives of Behçet's disease patients: Is measurement of common femoral vein wall thickness valuable for the diagnosis?","authors":"Ayşe Elif Boncukcuoğlu, Erhan Topal, Rabia Ergelen, Dilara Kaş, Elifnur Alkan, Gamzenur Kaya, Şevket Girgin, Tülin Ergun, Haner Direskeneli, Fatma Alibaz-Oner","doi":"10.1093/mr/roae061","DOIUrl":"10.1093/mr/roae061","url":null,"abstract":"Objectives: We aimed to assess first-degree relatives (FDRs) of Behçet's disease (BD) patients for the presence of clinical symptoms and signs of BD and evaluate common femoral vein (CFV) wall thickness measurement for the diagnosis.Methods: Patients with BD (n = 129) and FDRs (n = 230) of these patients were included. FDRs were questioned in terms of BD symptoms by phone. Pathergy test and CFV wall thickness measurement were performed among 111 FDRs who accepted the clinical assessment. Clinical assessment groups were classified according to the criteria sets for BD. FDRs who did not meet the criteria sets and had at least one clinical finding in addition to oral aphthae (OA) were categorized as the 'suspected BD'.Results: : We observed increased frequency of isolated BD manifestations in FDRs. Ten FDRs were diagnosed with BD during clinical evaluation. A significantly increased CFV wall thickness was observed in FDRs of BD patients fulfilling diagnostic BD criteria (P < .001 for both sides) and also in those with suspected BD group (P < .05 for both sides). The presence of OA, genital ulcer, folliculitis, or erythema nodosum was associated with increased CFV wall thickness (P < .05).Conclusion: Our results suggest that the CFV wall thickness measurement can be used in the diagnosis of familial BD.","PeriodicalId":18705,"journal":{"name":"Modern Rheumatology","volume":" ","pages":"371-377"},"PeriodicalIF":1.8,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141889751","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

Serum creatinine is more strongly associated with hyperuricemia than eGFR in males but not in females. 在男性中，血清肌酐与高尿酸血症的关系比肾小球滤过率与高尿酸血症的关系更密切，而在女性中则不然。

IF 1.8 4区医学

Modern Rheumatology Pub Date : 2025-02-21 DOI: 10.1093/mr/roae083

Yukana Chihara, Ichiro Wakabayashi, Yuki Kataoka, Tetsuya Yamamoto

{"title":"Serum creatinine is more strongly associated with hyperuricemia than eGFR in males but not in females.","authors":"Yukana Chihara, Ichiro Wakabayashi, Yuki Kataoka, Tetsuya Yamamoto","doi":"10.1093/mr/roae083","DOIUrl":"10.1093/mr/roae083","url":null,"abstract":"Objectives: Serum creatinine and estimated glomerular filtration ratio (eGFR) are factors associated with hyperuricemia, though which is more closely associated with hyperuricemia remains unclear.Subjects and methods: This retrospective cross-sectional study examined the associations of serum creatinine and eGFR with hyperuricemia using health check-up findings. Enrolled were 6020 individuals (3509 males, 2511 females) who underwent health check-ups from 2017 to 2021. The subjects were divided based on serum uric acid level into the normuricemia (males 1.5-7.0 mg/dl, females 1.5-< 6.0 mg/dl) and hyperuricemia (males >7.0 mg/dl, female ≥ 6.0 mg/dl) groups. Matched-pair analysis was used to evaluate the association between hyperuricemia and variables related to serum uric acid.Results: Matched-pair analysis results showed a significant association of serum creatinine with hyperuricemia in male subjects but not in females. Furthermore, propensity score obtained by binominal logistic regression demonstrated that serum creatinine had a greater association with hyperuricemia than eGFR in the males but not in females.Conclusions: The present findings indicate an association of serum creatinine with hyperuricemia in males not only because of reduced renal function but other factors related to greater muscle mass, such as increased intake of protein-rich foods containing purines and increased uric acid production induced by accelerated creatinine metabolism.","PeriodicalId":18705,"journal":{"name":"Modern Rheumatology","volume":" ","pages":"378-385"},"PeriodicalIF":1.8,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142350227","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

The use of biologic disease-modifying antirheumatic drugs does not increase surgical site infection or delayed wound healing after orthopaedic surgeries for rheumatoid arthritis. 类风湿性关节炎骨科手术后，使用生物制剂改变病情抗风湿药不会增加手术部位感染或延迟伤口愈合。

IF 1.8 4区医学

Modern Rheumatology Pub Date : 2025-02-21 DOI: 10.1093/mr/roae089

Yohei Kiso, Keiichiro Nishida, Ryozo Harada, Yoshihisa Nasu, Ryuichi Nakahara, Yoshifumi Hotta, Shuichi Naniwa, Toshifumi Ozaki

{"title":"The use of biologic disease-modifying antirheumatic drugs does not increase surgical site infection or delayed wound healing after orthopaedic surgeries for rheumatoid arthritis.","authors":"Yohei Kiso, Keiichiro Nishida, Ryozo Harada, Yoshihisa Nasu, Ryuichi Nakahara, Yoshifumi Hotta, Shuichi Naniwa, Toshifumi Ozaki","doi":"10.1093/mr/roae089","DOIUrl":"10.1093/mr/roae089","url":null,"abstract":"Objective: To investigate the effect of the use of biologic disease-modifying antirheumatic drugs (bDMARDs) on surgical site infection (SSI) and delayed wound healing (DWH) in rheumatoid arthritis (RA) patients undergoing orthopaedic surgery.Methods: We retrospectively reviewed the records of 965 elective orthopaedic procedures undertaken in RA patients. The incidences of SSI and DWH were compared between the bDMARDs user and nonuser groups. Subsequently, univariate and multivariate logistic regression analyses were performed to evaluate risk factors for SSI and DWH after propensity score matching. The incidence of postoperative flare-up was also examined.Results: In 965 procedures, SSI and DWH were identified in 12 and 28 cases, respectively. SSI and DWH were identified in 3 and 17 of 414 procedures treated with bDMARDs, respectively. Flare-up occurred in 21 cases. Propensity score matching identified 315 cases in both groups, with no significant difference in incidence between the two groups. No risk factors for SSI were identified, whereas age, diabetes mellitus, foot and ankle surgery, and a history of musculoskeletal-related infection were identified as risk factors for DWH.Conclusion: The use of bDMARDs was not associated with an increased incidence of SSI or DWH, with the incidence of flare-up being relatively low.","PeriodicalId":18705,"journal":{"name":"Modern Rheumatology","volume":" ","pages":"265-272"},"PeriodicalIF":1.8,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142350229","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

Efficacy and safety of Janus kinase inhibitors in patients with difficult-to-treat rheumatoid arthritis. Janus 激酶抑制剂对难以治疗的类风湿关节炎患者的疗效和安全性。

IF 1.8 4区医学

Modern Rheumatology Pub Date : 2025-02-21 DOI: 10.1093/mr/roae077

Shohei Anno, Tadashi Okano, Kenji Mamoto, Yutaro Yamada, Koji Mandai, Kazuki Orita, Takahiro Iida, Masahiro Tada, Kentaro Inui, Tatsuya Koike, Hiroaki Nakamura

{"title":"Efficacy and safety of Janus kinase inhibitors in patients with difficult-to-treat rheumatoid arthritis.","authors":"Shohei Anno, Tadashi Okano, Kenji Mamoto, Yutaro Yamada, Koji Mandai, Kazuki Orita, Takahiro Iida, Masahiro Tada, Kentaro Inui, Tatsuya Koike, Hiroaki Nakamura","doi":"10.1093/mr/roae077","DOIUrl":"10.1093/mr/roae077","url":null,"abstract":"Objectives: This study evaluated the effectiveness of Janus kinase inhibitors (JAKi) in patients with difficult-to-treat rheumatoid arthritis (D2T RA).Methods: This study included 220 patients with RA who were treated with JAKi. Sixty-two patients were naïve to biological disease-modifying antirheumatic drugs (bDMARDs)/JAKi (1st group), 57 patients were failure to one bDMARDs/JAKi (2nd group), and 101 patients were failure to ≥ 2 bDMARDs/JAKi. Of these 101 patients, 25 did not meet the D2T RA criteria (non-D2T RA group) and 76 met the D2T RA criteria (D2T RA group).Results: : DAS28-ESR was improved in all groups at 24 weeks (1st: P < .01, 2nd: P < .01, non-D2T RA: P = .01, D2TRA: P = .02), and improvement ratio of DAS28-ESR was not different between DT2RA group and 2nd (P = .73) or non-D2T RA group (P = .68). Glucocorticoid use [odds ratios: 8.67; 95% confidence interval (CI): 1.23-60.90; P = .03] and number of past bDMARD/JAKi uses ≥ 3 (odds ratios: 10.55; 95% CI: 1.39-80.30; P = .02) were risk factors for DAS28-ESR ≥ 3.2 at 24 weeks in the D2T RA group.Conclusions: Clinical efficacy of JAKi in D2T RA group did not differ from that in 2nd and non-D2T RA groups. Glucocorticoid use and multiple bDMARD/JAKi failure were poor prognostic factors for D2T RA.","PeriodicalId":18705,"journal":{"name":"Modern Rheumatology","volume":" ","pages":"225-233"},"PeriodicalIF":1.8,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142109567","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

Telemedicine as an alternative to in-person care in the field of rheumatic diseases: A systematic scoping review. 在风湿病领域，远程医疗可替代亲诊：系统性范围界定综述。

IF 1.8 4区医学

Modern Rheumatology Pub Date : 2025-02-13 DOI: 10.1093/mr/roaf012

Ken-Ei Sada, Shigeru Iwata, Yuzaburo Inoue, Eiichi Tanaka, Keiichiro Nishida, Yutaka Kawahito, Asami Abe, Atsushi Kawakami, Takako Miyamae

{"title":"Telemedicine as an alternative to in-person care in the field of rheumatic diseases: A systematic scoping review.","authors":"Ken-Ei Sada, Shigeru Iwata, Yuzaburo Inoue, Eiichi Tanaka, Keiichiro Nishida, Yutaka Kawahito, Asami Abe, Atsushi Kawakami, Takako Miyamae","doi":"10.1093/mr/roaf012","DOIUrl":"https://doi.org/10.1093/mr/roaf012","url":null,"abstract":"Objective: The COVID-19 pandemic prompted the widespread adoption of telemedicine as an alternative to in-person care. This systematic scoping review evaluated the effectiveness, cost-efficiency, and challenges of telemedicine for patients with rheumatic diseases.Methods: A comprehensive search of the MEDLINE database was conducted using specific terms related to rheumatoid or juvenile arthritis, and telemedicine. The literature search included studies published up to March, 2024. In this review, we only considered studies assessing telemedicine as an alternative to in-person care.Results: The search, conducted on March 15, 2024, generated 258 references. Eight reports from three randomized controlled trials (RCTs) and three observational studies were included. RCTs have shown that the outcomes of telemedicine intervention are comparable to those of in-person care in terms of disease activity, functional status, and quality of life, while enabling fewer outpatient visits and cost-effectiveness. However, the high dropout rates highlight the importance of patient preferences and comprehensive education. Observational studies revealed similar findings but were limited by a high confounding bias.Conclusion: Telemedicine offers economic advantages and maintains clinical outcomes comparable to those of in-person care. Its success depends on structured patient education and alignment with patient preferences. Further research is required, particularly in the context of healthcare in Japan.","PeriodicalId":18705,"journal":{"name":"Modern Rheumatology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143409176","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

Correction to: Central sensitization in axial spondyloarthritis: An explorative study with quantitative sensory testing and clinical scales.

IF 1.8 4区医学

Modern Rheumatology Pub Date : 2025-02-08 DOI: 10.1093/mr/roaf013

引用次数: 0

Antinuclear Antibodies Staining Patterns and Titers in Juvenile Idiopathic Arthritis.

IF 1.8 4区医学

Modern Rheumatology Pub Date : 2025-02-04 DOI: 10.1093/mr/roaf011

Seher Sener, Ezgi Deniz Batu, Emil Aliyev, Ozge Basaran, Zeynep Saribas, Yelda Bilginer, Burcin Sener, Seza Ozen

{"title":"Antinuclear Antibodies Staining Patterns and Titers in Juvenile Idiopathic Arthritis.","authors":"Seher Sener, Ezgi Deniz Batu, Emil Aliyev, Ozge Basaran, Zeynep Saribas, Yelda Bilginer, Burcin Sener, Seza Ozen","doi":"10.1093/mr/roaf011","DOIUrl":"https://doi.org/10.1093/mr/roaf011","url":null,"abstract":"Objective: The importance of antinuclear antibodies (ANA) patterns and titers in juvenile idiopathic arthritis (JIA) patients is not clearly determined in the literature. In our study, we evaluated the ANA staining patterns and titers in JIA patients.Methods: JIA patients were retrospectively assessed. ANA was identified by using indirect immunofluorescence assay on HEp-2 cells, with a positivity threshold set at a titer of 1/100 or higher.Results: Eight hundred-five patients with JIA were evaluated (oligoarticular JIA [OJIA, n=396], enthesitis-related arthritis [ERA, n=195], polyarticular JIA [PJIA, n=132], systemic JIA [SJIA, n=53], psoriatic arthritis [PsA, n=20], unclassified JIA [n=9]). Their median (min-max) age at diagnosis was 7.9 (4.6-12.1) years (F/M=1.2). The most frequently observed ANA nuclear staining patterns were AC-4/5 (fine or large speckled) in 29.7% of patients and AC-1 (homogeneous) in 25.9%. The most common ANA cytoplasmic staining pattern was AC-19 (dense fine speckled) (17.6%). Most SJIA and unclassified JIA patients were ANA negative. The most frequently detected ANA titer in OJIA and ERA patients was 1/160 (p=0.026 and p=0.018, respectively), while in PsA patients, it was 1/320 (p<0.001). In addition, uveitis and inflammatory bowel disease, which were comorbidities associated with JIA, were most frequently associated with the nuclear AC-4/5 pattern and the cytoplasmic AC-19 pattern, as well as with an ANA titer of 1/160 (all p<0.001).Conclusion: Our study showed that many JIA subtypes and JIA-related comorbidities were associated with the AC-4/5, AC-1, and AC-19 patterns of ANA. However, multicenter studies in larger cohorts are needed to generalize these results.","PeriodicalId":18705,"journal":{"name":"Modern Rheumatology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143123378","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

Frequent detection of anti-nuclear antibodies and low-titer rheumatoid factor in female patients with undifferentiated peripheral spondyloarthritis in Japan: a prospective observational study.

IF 1.8 4区医学

Modern Rheumatology Pub Date : 2025-02-04 DOI: 10.1093/mr/roaf010

Sho Mokuda, Hiroki Kobayashi, Kei Araki, Michinori Ishitoku, Hirofumi Watanabe, Tomohiro Sugimoto, Yusuke Yoshida, Shintaro Hirata

{"title":"Frequent detection of anti-nuclear antibodies and low-titer rheumatoid factor in female patients with undifferentiated peripheral spondyloarthritis in Japan: a prospective observational study.","authors":"Sho Mokuda, Hiroki Kobayashi, Kei Araki, Michinori Ishitoku, Hirofumi Watanabe, Tomohiro Sugimoto, Yusuke Yoshida, Shintaro Hirata","doi":"10.1093/mr/roaf010","DOIUrl":"https://doi.org/10.1093/mr/roaf010","url":null,"abstract":"Objectives: Studies on the clinical features of undifferentiated peripheral spondyloarthritis (upSpA) are limited. This study explores sex-based manifestations of upSpA and compares upSpA with rheumatoid arthritis (RA) under conditions of low human leukocyte antigen B27 positivity in Japan.Methods: In this multicenter prospective observational study, physical and laboratory findings from 29 upSpA cases (19 females, 10 males) were collected to investigate sex differences. Fourteen patients with RA were also enrolled as a control group to evaluate clinical parameters distinguishing upSpA and RA.Results: Tenderness at the humeral epicondyles and the Achilles tendon were more common in female patients with upSpA than in males. Serum C-reactive protein (CRP) levels were lower in female patients with upSpA than in male patients. Serum rheumatoid factor (RF) levels were lower in upSpA cases than in RA, with a cut-off value of 84 IU/mL differentiating RA from upSpA. An anti-nuclear antibodies (ANA) test at a dilution of ≥1:160 was detected in about half of the female upSpA cases but not in male cases.Conclusions: Among upSpA and RA cases, female patients with upSpA frequently present with multiple enthesitis, low serum CRP levels, low-titer RF positivity, and a high incidence of ANA positivity.","PeriodicalId":18705,"journal":{"name":"Modern Rheumatology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143123379","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

Risk Factors for Cytomegalovirus Reactivation during the Treatment of ANCA-Associated Vasculitis: A retrospective cohort study of the J-CANVAS study.

IF 1.8 4区医学

Modern Rheumatology Pub Date : 2025-01-31 DOI: 10.1093/mr/roaf008

Kazutaka Kawamori, Nao Oguro, Kunika Shimizu, Takashi Kida, Satoshi Omura, Daiki Nakagomi, Yoshiyuki Abe, Masatoshi Kadoya, Naoho Takizawa, Atsushi Nomura, Yuji Kukida, Naoya Kondo, Yasuhiko Yamano, Takuya Yanagida, Koji Endo, Shintaro Hirata, Kiyoshi Matsui, Tohru Takeuchi, Kunihiro Ichinose, Masaru Kato, Ryo Yanai, Yusuke Matsuo, Yasuhiro Shimojima, Ryo Nishioka, Ryota Okazaki, Tomoaki Takata, Takafumi Ito, Mayuko Moriyama, Ayuko Takatani, Yoshia Miyawaki, Toshiko Ito-Ihara, Takashi Kawaguchi, Yutaka Kawahito, Nobuyuki Yajima

{"title":"Risk Factors for Cytomegalovirus Reactivation during the Treatment of ANCA-Associated Vasculitis: A retrospective cohort study of the J-CANVAS study.","authors":"Kazutaka Kawamori, Nao Oguro, Kunika Shimizu, Takashi Kida, Satoshi Omura, Daiki Nakagomi, Yoshiyuki Abe, Masatoshi Kadoya, Naoho Takizawa, Atsushi Nomura, Yuji Kukida, Naoya Kondo, Yasuhiko Yamano, Takuya Yanagida, Koji Endo, Shintaro Hirata, Kiyoshi Matsui, Tohru Takeuchi, Kunihiro Ichinose, Masaru Kato, Ryo Yanai, Yusuke Matsuo, Yasuhiro Shimojima, Ryo Nishioka, Ryota Okazaki, Tomoaki Takata, Takafumi Ito, Mayuko Moriyama, Ayuko Takatani, Yoshia Miyawaki, Toshiko Ito-Ihara, Takashi Kawaguchi, Yutaka Kawahito, Nobuyuki Yajima","doi":"10.1093/mr/roaf008","DOIUrl":"https://doi.org/10.1093/mr/roaf008","url":null,"abstract":"Objectives: Cytomegalovirus (CMV) reactivation during immunosuppressive therapy poses a risk of severe infections. This study aimed to investigate the risk factors of CMV reactivation in patients with microscopic polyangiitis and granulomatosis with polyangiitis using a nationwide cohort in Japan.Methods: This retrospective cohort study used data from the Japan Collaborative Registry of anti-neutrophil cytoplasmic antibody-associated vasculitis. The outcome was as CMV reactivation up to 48 weeks after treatment initiation. We explored the risk factors for CMV reactivation by comparing the two groups.Results: Of the 454 patients, CMV reactivation occurred in 89 (19.6%). The univariate analysis showed that patients with CMV reactivation were older (p<0.001), had higher Birmingham Vasculitis Activity Scores (BVAS) (p=0.004) and BVAS renal scores (p<0.001), and had received glucocorticoid pulse (p=0.004). The logistic regression analysis showed that hypoalbuminemia (odds ratio [OR]: 0.55, 95% confidence interval [CI]: 0.31-0.98), and low serum IgG (OR: 0.94, 95% CI: 0.89-1.00) were risk factors for CMV reactivation.Conclusions: Hypoalbuminemia and low serum IgG levels were risk factors for CMV reactivation. It is necessary to accurately identify high-risk patients and closely monitor their condition.","PeriodicalId":18705,"journal":{"name":"Modern Rheumatology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143066737","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