Modern Rheumatology最新文献

{"title":"Real-world use of biologics for non-systemic juvenile idiopathic arthritis: Information from a Japanese hospital claims database.","authors":"Takashi Funatogawa, Kazuma Mii, Saki Katayama, Yuka Aoki, Yasuaki Matsubara, Kazuki Kojima, Mariko Hoshiba","doi":"10.1093/mr/roag025","DOIUrl":"10.1093/mr/roag025","url":null,"abstract":"<p><strong>Objectives: </strong>Limited information is available on patients with non-systemic juvenile idiopathic arthritis (nsJIA) receiving biologics in Japan. The types of biologics, treatment duration, prior and concomitant treatments, administration routes (intravenous [IV] or subcutaneous [SC] injection), and patient characteristics were investigated.</p><p><strong>Methods: </strong>We investigated nsJIA, excluding psoriatic arthritis and ankylosing spondylitis, using data from a Japanese hospital claims database (2008-2024).</p><p><strong>Results: </strong>Of the 4191 nsJIA patients in the database, 965 (23.0%) received one or more biologics. For the first biologic, the most common were antitumour necrosis factor (anti-TNF) drugs (55.3% overall; adalimumab SC, 32.1%; etanercept SC, 9.8%; infliximab IV, 9.2%; others, < 2.1% each), followed by anti-interleukin-6 (anti-IL-6) drugs (39.9% overall; tocilizumab, 39.1% [IV, 32.4%; SC, 6.6%]; others, ≤ 0.7%), abatacept IV or SC (3.7%), and canakinumab SC (1.0%). Of the patients receiving anti-TNF and anti-IL-6 drugs, 40% and 58% continued treatment for ≥1 year, respectively. The most common conventional synthetic disease-modifying antirheumatic drug (csDMARD) administered prior to anti-TNF and anti-IL-6 drugs was methotrexate [39.0% (anti-TNF) and 33.5% (anti-IL-6)], with others at ≤ 3.6%. The most common csDMARD used concomitantly was also methotrexate [66.9% (anti-TNF) and 50.4% (anti-IL-6)], with others < 8.6%.</p><p><strong>Conclusions: </strong>Our study describes the real-world usage of biologics for nsJIA in Japan.</p>","PeriodicalId":18705,"journal":{"name":"Modern Rheumatology","volume":" ","pages":"826-836"},"PeriodicalIF":2.1,"publicationDate":"2026-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147444326","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":"Effectiveness and safety of rituximab for remission maintenance therapy in microscopic polyangiitis and granulomatosis with polyangiitis in Japan: A retrospective multicentre cohort study (J-CANVAS).","authors":"Motoki Takeuchi, Yoshiyuki Abe, Ayako Makiyama, Masahiro Kogami, Satoshi Omura, Daiki Nakagomi, Masatoshi Kadoya, Naoho Takizawa, Atsushi Nomura, Yuji Kukida, Naoya Kondo, Yasuhiko Yamano, Takuya Yanagida, Koji Endo, Shintaro Hirata, Kiyoshi Matsui, Tohru Takeuchi, Kunihiro Ichinose, Ryo Yanai, Yusuke Matsuo, Yasuhiro Shimojima, Ryo Nishioka, Ryota Okazaki, Tomoaki Takata, Takafumi Ito, Mayuko Moriyama, Ayuko Takatani, Yoshia Miyawaki, Yutaka Kawahito, Toshiko Ito-Ihara, Takashi Kida, Nobuyuki Yajima, Takashi Kawaguchi, Ken Yamaji, Naoto Tamura","doi":"10.1093/mr/roag014","DOIUrl":"10.1093/mr/roag014","url":null,"abstract":"<p><strong>Objectives: </strong>Rituximab (RTX) is a standard maintenance therapy for antineutrophil cytoplasmic antibody-associated vasculitis. Its efficacy in Japan remains unclear, where microscopic polyangiitis (MPA) predominates and clinical characteristics differ from Western-dominated randomized controlled trial (RCT) populations.</p><p><strong>Methods: </strong>Japanese patients with MPA or granulomatosis with polyangiitis (GPA) enrolled in a nationwide registry were included. Exposure was RTX use during maintenance therapy. The primary endpoint was major relapse-free survival at 104 weeks. The secondary endpoint was any relapse-free survival (major or minor) at 104 weeks. Baseline differences were adjusted using inverse probability of treatment weighting based on key demographic and disease-related covariates.</p><p><strong>Results: </strong>A total of 389 patients were analysed, with 85 in the RTX group. The RTX group included a higher proportion of GPA cases (37/85 vs. 74/304), resulting in baseline imbalance. After inverse probability of treatment weighting, no major relapses were observed in the RTX group, whereas the major relapse-free survival at 104 weeks was 94.8% in the non-RTX group. The RTX group showed significantly higher any relapse-free survival at 104 weeks (95.4% versus 83.3%; HR for any relapse, 0.27; 95% CI, 0.09-0.74; P = .02).</p><p><strong>Conclusions: </strong>Our findings suggest that RTX may be an effective option for remission maintenance in Japanese patients with MPA or GPA.</p>","PeriodicalId":18705,"journal":{"name":"Modern Rheumatology","volume":" ","pages":"786-793"},"PeriodicalIF":2.1,"publicationDate":"2026-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146227523","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":"Real-World Outcomes of Baricitinib in Patients with Rheumatoid Arthritis: A Two-Year Observational Study of Overall and Difficult-to-Treat Patients in Japan.","authors":"Kei Ikeda, Taisuke Kojima, Naoto Tsujimoto, Izumi Sato, Yuko Kaneko","doi":"10.1093/mr/roag074","DOIUrl":"https://doi.org/10.1093/mr/roag074","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to evaluate real-world effectiveness and long-term retention of baricitinib in Japanese patients with rheumatoid arthritis (RA), including those classified as difficult-to-treat (D2T).</p><p><strong>Methods: </strong>This 24-month observational study enrolled patients initiating baricitinib, stratified by prior use of biological/targeted synthetic disease-modifying antirheumatic drugs (b/tsDMARDs) and baseline Clinical Disease Activity Index (CDAI) scores. Key endpoints included time-to-discontinuation, achievement of and time to low disease activity (LDA) or remission. Data were analysed using logistic regression models adjusted for demographic and clinical variables.</p><p><strong>Results: </strong>Baricitinib demonstrated sustained effectiveness, with 58.2% of overall patients (N=353) and 42.0% of patients with D2T RA (N=88) remaining on treatment at 24 months. CDAI remission was achieved in 36.4% of overall patients and 22.9% patients with D2T RA. Discontinuation was mainly due to primary non-response (11.0%). Mean (SD) changes in patient-reported outcomes (PROs) from baseline scores were: patient global assessment of disease activity (-21.7 [28.4] mm), Health Assessment Questionnaire-Disability Index (-0.360 [0.601]), and pain visual analogue scale (-24.9 [26.8] mm). Among baseline glucocorticoid users retained on baricitinib at 24 months, 55.9% discontinued glucocorticoids.</p><p><strong>Conclusion: </strong>Baricitinib showed sustained effectiveness and retention, including in patients with D2T RA; early improvements in pain and fatigue were predictive of CDAI disease remission during the 24-month follow-up.</p>","PeriodicalId":18705,"journal":{"name":"Modern Rheumatology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148857321","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 Results of Unlinked-type Total Elbow Arthroplasty for Stiff Elbows in Patients with Rheumatoid Arthritis.","authors":"Yasuhiro Kiyota, Takuji Iwamoto, Taku Suzuki, Noboru Matsumura, Kazuki Sato, Masaya Nakamura","doi":"10.1093/mr/roag077","DOIUrl":"https://doi.org/10.1093/mr/roag077","url":null,"abstract":"<p><strong>Objectives: </strong>Total elbow arthroplasty is a common treatment for elbow stiffness due to rheumatoid arthritis. Although linked prostheses are often preferred, unlinked implants may reduce prosthetic stress and loosening risk. This study evaluated the clinical outcomes of unlinked total elbow arthroplasty in patients with rheumatoid arthritis presenting with stiff elbows.</p><p><strong>Methods: </strong>This retrospective study included 9 women with 10 stiff elbows due to rheumatoid arthritis who underwent primary total elbow arthroplasty using an unlinked implant. Stiffness was defined as a range of motion of less than 60°. Mean age was 58 years and mean follow-up was 59 months. Outcomes included range of motion, Mayo Elbow Performance Score, pain during movement assessed with a visual analogue scale, complications, and implant loosening.</p><p><strong>Results: </strong>Extension improved from -59° to -38°, flexion from 101° to 123° and arc of motion from 42° to 85°. Mayo Elbow Performance Score improved from 53 to 93, and pain score from 36 to 1. Two cases of transient ulnar neuropathy resolved without treatment. No implant loosening, dislocation, or revision surgery occurred.</p><p><strong>Conclusions: </strong>Unlinked total elbow arthroplasty improved clinical outcomes without major complications and may be a viable option for stiff elbows in patients with rheumatoid arthritis.</p>","PeriodicalId":18705,"journal":{"name":"Modern Rheumatology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148857359","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 Characteristics of Enthesitis-Related Arthritis and Outcomes of Treatment with Salazosulfapyridine.","authors":"Yuko Akutsu, Yuko Hayashi, Masaaki Mori, Masaki Shimizu","doi":"10.1093/mr/roag075","DOIUrl":"https://doi.org/10.1093/mr/roag075","url":null,"abstract":"<p><strong>Objectives: </strong>Enthesitis-related arthritis (ERA), characterized by chronic arthritis and/or enthesitis, is a relatively rare subtype of juvenile idiopathic arthritis (JIA). Achieving sustained disease control can be challenging. We aimed to characterize ERA and to evaluate the efficacy of salazosulfapyridine (SASP) treatment.</p><p><strong>Methods: </strong>We retrospectively reviewed 23 patients with ERA treated in our institute between 2015 and 2025. Clinical characteristics, laboratory findings, and treatment courses were analyzed descriptively. Patients were categorized into three groups based on treatment escalation following NSAID therapy.</p><p><strong>Results: </strong>The median age at onset was 10 years, and median disease duration before diagnosis was 11 months; 47.8% were females. Axial involvement was present in 65.2%, and psychological comorbidities in 52.2%. Nineteen patients received SASP; four who were younger at onset and had lower CRP levels at diagnosis were maintained on SASP monotherapy without treatment escalation. Active joint and enthesitis counts generally improved during follow-up, although some patients had persistent disease activity at 12 months. No severe adverse events were observed.</p><p><strong>Conclusions: </strong>Diagnostic delay and psychological comorbidities were characteristic of ERA. SASP may be beneficial in selected patients with lower inflammatory activity at diagnosis; prospective studies are needed to better define its role in ERA management.</p>","PeriodicalId":18705,"journal":{"name":"Modern Rheumatology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148857295","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":"Retraction of: Avacopan, a selective C5a receptor antagonist, for anti-neutrophil cytoplasmic antibody-associated vasculitis.","authors":"","doi":"10.1093/mr/roag060","DOIUrl":"https://doi.org/10.1093/mr/roag060","url":null,"abstract":"","PeriodicalId":18705,"journal":{"name":"Modern Rheumatology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148813508","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 rheumatoid arthritis-interstitial lung disease and lung cancer: a two -sample Mendelian randomization study with East Asian genetic instruments.","authors":"Chueh-Hsuan Hsu, Shuo-Chueh Chen, Yung-Luen Yu","doi":"10.1093/mr/roag068","DOIUrl":"https://doi.org/10.1093/mr/roag068","url":null,"abstract":"<p><strong>Objectives: </strong>Epidemiological studies consistently report an increased risk of lung cancer among rheumatoid arthritis patients. Proposed risk factors include male sex, smoking, and rheumatoid arthritis-associated interstitial lung disease. However, whether a direct genetic causal link exists between rheumatoid arthritis-associated interstitial lung disease and lung cancer remains unexplored. We used Mendelian randomization with East Asian genetic instruments to evaluate this relationship.</p><p><strong>Methods: </strong>We conducted a two-sample Mendelian randomization in which genetic instruments for rheumatoid arthritis-associated interstitial lung disease were derived from an East Asian GWAS (358 RA-ILD cases, 4 550 RA controls), and lung cancer associations were obtained from a cross-ancestry GWAS meta-analysis (20 378 cases, 18 696 controls). Causal effects were estimated using inverse-variance weighted, Mendelian randomization-Egger, and weighted median methods.</p><p><strong>Results: </strong>Ten single nucleotide polymorphisms were identified as genetic instruments. Inverse-variance weighted analysis revealed no significant causal association between genetically predicted rheumatoid arthritis-associated interstitial lung disease and lung cancer (odds ratio = 1.00; 95% confidence interval: 0.99-1.01; p-value = 0.78). Sensitivity analyses showed no horizontal pleiotropy or heterogeneity.</p><p><strong>Conclusions: </strong>Our findings suggest that the severe lung complications of rheumatic arthritis do not inherently share a direct, genetically driven pathway with malignancy. The observed clinical risk may be explained by shared environmental factors, such as smoking, or chronic immune dysregulation, rather than inherent genetic pleiotropy, although further investigation is needed to clarify these mechanisms.</p>","PeriodicalId":18705,"journal":{"name":"Modern Rheumatology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148795356","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 remission definitions on residual symptom burden assessed using the Okomarigoto Sheet in rheumatoid arthritis: a comparison between Boolean 1.0 and Boolean 2.0.","authors":"Kensuke Koyama, Tetsuro Ohba, Ryousuke Koizumi, Koki Watabe, Hirotaka Haro","doi":"10.1093/mr/roag069","DOIUrl":"https://doi.org/10.1093/mr/roag069","url":null,"abstract":"<p><strong>Objectives: </strong>This study examined whether adopting the Boolean 2.0 remission criteria results in the inclusion of patients with a higher burden of residual symptoms (RS) in rheumatoid arthritis (RA). It also aimed to characterize differences in RS burden across remission definitions.</p><p><strong>Methods: </strong>This cross-sectional, single-center study included 400 consecutive patients with RA. RSs were assessed using the Okomarigoto Sheet (OS), which evaluates pain, morning stiffness, and fatigue. Clinical remission was defined using the Disease Activity Score in 28 joints with C-reactive protein (DAS28-CRP), Clinical Disease Activity Index (CDAI), Simplified Disease Activity Index (SDAI), and Boolean 1.0 and 2.0 criteria. The primary outcome was the proportion of patients achieving OS = 0. Mixed-effects logistic regression and subgroup analyses were conducted to compare RS burden across remission definitions.</p><p><strong>Results: </strong>The proportion of patients achieving complete absence of RSs differed across remission definitions, with the highest rate observed in Boolean 1.0 remission (52.7%), followed by Boolean 2.0 (45.0%) and DAS28-CRP (37.5%). Compared with Boolean 1.0 remission, patients meeting Boolean 2.0 but not Boolean 1.0 criteria had significantly higher total and domain-specific OS scores (all p < 0.001). Similar findings were observed among patients achieving DAS28-CRP remission but not Boolean 1.0 remission. Mixed-effects logistic regression indicated no significant difference between Boolean 1.0 and Boolean 2.0 remission in achieving OS = 0.</p><p><strong>Conclusions: </strong>RS burden in RA varies depending on the remission definition. Boolean 2.0 remission expands the classification of remission and is associated with higher multidimensional residual symptom scores than Boolean 1.0 remission.</p>","PeriodicalId":18705,"journal":{"name":"Modern Rheumatology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148795416","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":"Complete remission and relapse in the treatment of idiopathic inflammatory myopathies: a retrospective cohort study.","authors":"Naoki Kimura, Manami Nomura, Ryoichi Hanazawa, Akihiro Hirakawa, Mari Kihara, Hirokazu Sasaki, Natsuka Umezawa, Shinsuke Yasuda","doi":"10.1093/mr/roag067","DOIUrl":"https://doi.org/10.1093/mr/roag067","url":null,"abstract":"<p><strong>Objectives: </strong>To investigate the achievement of complete remission (CR) and the management for relapsed cases in the treatment of idiopathic inflammatory myopathies (IIM).</p><p><strong>Methods: </strong>A total of 132 patients were retrospectively analysed. CR was defined as no evidence of disease activity in all involved organs for a continuous period of six months. Relapse was defined as a dose increase of glucocorticoid (GC) more than 50% and an increase in prednisolone (PSL) equivalent to more than 0.4 mg/kg/day. Clinical data were collected by electrical chart review.</p><p><strong>Results: </strong>Eighty-eight (66.7%) patients achieved CR with an initial treatment. Forty-three patients experienced at least one relapse. Anti-ARS antibody was positively and achieving CR was negatively associated with relapse (HR 3.02 and OR 0.17, respectively). Re-induction therapies were classified into three groups: high-dose GC plus one immunosuppressant (IS)/biologics (H+1IS, n=12), moderate-dose GC plus two IS/biologics (M+2IS, n=12), and moderate-dose GC plus one IS/biologics (M+1IS, n=19). The frequency of second relapse was least in M+2IS regimen. Concomitant use of two IS/biologics did not increase the incidence of severe adverse events.</p><p><strong>Conclusions: </strong>CR was achieved in two-thirds of IIM patients. Achieving CR was protective for relapse. Combination therapy with two IS/biologics might be preferable in relapsed cases.</p>","PeriodicalId":18705,"journal":{"name":"Modern Rheumatology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148795421","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 Significance of Dysphagia in Idiopathic Inflammatory Myopathies: A Narrative Review of Survival and Functional Outcomes.","authors":"Shin-Ichiro Ohmura","doi":"10.1093/mr/roag071","DOIUrl":"https://doi.org/10.1093/mr/roag071","url":null,"abstract":"<p><p>Dysphagia is a common and clinically significant complication in idiopathic inflammatory myopathies (IIM), contributing to aspiration pneumonia, malnutrition, and reduced quality of life. However, its prognostic significance in terms of survival and swallowing outcomes remains unclear. A narrative review was conducted using PubMed to identify relevant studies published between January 2000 and April 2026. Dysphagia in IIM is associated with increased mortality, primarily due to aspiration-related complications and underlying disease severity. Emerging evidence indicates that this association may be modified by the presence of malignancy, particularly in dermatomyositis. Swallowing outcomes are heterogeneous: some patients show improvement with immunosuppressive therapy or intravenous immunoglobulin, whereas others experience persistent or progressive dysfunction, especially those with inclusion body myositis. Key prognostic factors include age, disease subtype, autoantibody status, and baseline severity of dysphagia. Dysphagia in IIM should be recognized as a clinically important manifestation associated with both survival and functional outcomes. Early identification and appropriate management are essential to improve patient prognosis. Further prospective studies are needed to establish standardized assessment and risk stratification strategies.</p>","PeriodicalId":18705,"journal":{"name":"Modern Rheumatology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148795339","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}