Jang Woo Ha, Jason Jungsik Song, Yong-Beom Park, Sang-Won Lee
{"title":"Validation of the 2022 ACR/EULAR classification criteria for giant cell arteritis in Koran patients with giant cell arteritis.","authors":"Jang Woo Ha, Jason Jungsik Song, Yong-Beom Park, Sang-Won Lee","doi":"10.1093/mr/roae110","DOIUrl":"https://doi.org/10.1093/mr/roae110","url":null,"abstract":"<p><strong>Objectives: </strong>We applied the 2022 American College of Rheumatology (ACR)/European Alliance of Association for Rheumatology (EULAR) criteria to Korean patients previously diagnosed with giant cell arteritis (GCA) according to the 1990 ACR criteria and validated its clinical efficiency.</p><p><strong>Methods: </strong>Nine patients with GCA were included in this study. The proportion of patients meeting each item of the 1990 ACR criteria and the 2022 ACR/EULAR criteria were assessed. fluorodeoxyglucose-positron emission tomography (FDG-PET), and temporal artery biopsy were performed in eight, and four of the nine patients, respectively.</p><p><strong>Results: </strong>The median age was 65.0 years, and 77.8% of the patients were women. Seven (77.8%) patients had polymyalgia rheumatica. All nine patients were reclassified as having GCA according to the 2022 ACR/EULAR criteria. Among the 10 items of the 2022 ACR/EULAR criteria, the item contributing the most to the reclassification was elevated acute-phase reactant levels (100%), followed by new temporal headache (77.8%), and FDG-PET activity throughout the aorta (77.5%). Positive temporal artery biopsy findings were observed in 75.0% of the patients; however, only four patients underwent biopsy, which was insufficient to assess its efficacy. An item of sudden visual loss did not make a considerable contribution to the reclassification of GCA because of its rare frequency (11.1%).</p><p><strong>Conclusion: </strong>In this study, for the first time, we demonstrated a concordance rate of 100% between the two criteria in Korean patients previously diagnosed with GCA. Moreover, we also clarified the major contributors to the reclassification according to the 2022 ACR/EULAR criteria.</p>","PeriodicalId":18705,"journal":{"name":"Modern Rheumatology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142951781","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":"Late-onset rheumatoid arthritis: Justifying the need for international practice guidelines and classification criteria.","authors":"Chokan Baimukhamedov, Marina Baimukhamedova","doi":"10.1093/mr/roae117","DOIUrl":"https://doi.org/10.1093/mr/roae117","url":null,"abstract":"","PeriodicalId":18705,"journal":{"name":"Modern Rheumatology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2024-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142951779","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 association between difficult-to-treat rheumatoid arthritis and probable sarcopenia.","authors":"Yoshifumi Ohashi, Mochihito Suzuki, Yasumori Sobue, Kenya Terabe, Shuji Asai, Nobunori Takahashi, Shiro Imagama","doi":"10.1093/mr/roae116","DOIUrl":"https://doi.org/10.1093/mr/roae116","url":null,"abstract":"<p><strong>Objectives: </strong>To identify factors associated with probable sarcopenia in patients with rheumatoid arthritis (RA).</p><p><strong>Methods: </strong>Probable sarcopenia was diagnosed using the SARC-F questionnaire. Patients with difficult-to-treat RA (D2T-RA) were defined as those with a history of using ≥2 biological/targeted synthetic (b/ts) disease-modifying antirheumatic drugs (b/tsDMARDs) who had moderate or high disease activity. Among 486 patients, 101 were classified into the probable sarcopenia group (SARC-F ≥4), and 385 were classified into the non-probable sarcopenia group (SARC-F <4). Factors associated with probable sarcopenia were examined using multiple logistic regression analysis. Additionally, patients were divided into the D2T-RA (n = 38) and non-D2T-RA (n = 448) groups, and the proportion of probable sarcopenia and RA treatment status were compared.</p><p><strong>Results: </strong>Factors associated with probable sarcopenia included age [adjusted odds ratio (OR): 1.03], body mass index (OR: 1.16), D2T-RA (OR: 3.39), and Health Assessment Questionnaire-Disability Index (OR: 1.38), and diabetes mellitus (OR: 2.77). The proportion of probable sarcopenia was significantly higher (60.5% vs. 17.4%), and the rate of methotrexate use was significantly lower (34.2% vs. 64.1%), in the D2T-RA group than in the non-D2T-RA group. Moreover, in the D2T-RA group, most patients used two or three b/tsDMARDs (two: 68.4%, three: 21.1%).</p><p><strong>Conclusions: </strong>D2T-RA was associated with probable sarcopenia. Tight control by treatment enhancement may help overcome sarcopenia.</p>","PeriodicalId":18705,"journal":{"name":"Modern Rheumatology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2024-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142951780","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}
Atsushi Takayama, Toshiki Fukasawa, Masato Takeuchi, Koji Kawakami
{"title":"Comparative renoprotective effectiveness of allopurinol and febuxostat among hyperuricemic patients with preserved kidney function.","authors":"Atsushi Takayama, Toshiki Fukasawa, Masato Takeuchi, Koji Kawakami","doi":"10.1093/mr/roae115","DOIUrl":"https://doi.org/10.1093/mr/roae115","url":null,"abstract":"<p><strong>Objective: </strong>Early initiation of xanthine oxidase inhibitors (XOIs) may benefit patients with preserved kidney function. However, a direct comparison between the impact of allopurinol and those of febuxostat on long-term kidney function among this population is lacking.</p><p><strong>Methods: </strong>We conducted a retrospective cohort study with a new-user, active-comparator design among patients with eGFR within the reference range and no proteinuria. The primary outcome was a composite incidence of significant eGFR decline (≥ 40% decline from baseline) and all-cause death at 5 years. Adjusted hazard ratios (HRs) were estimated using Cox's proportional hazard models with inverse probability of treatment and censoring weighting.</p><p><strong>Results: </strong>We analyzed 1,142 patients (287 with allopurinol and 855 with febuxostat). The adjusted HRs (95% confidence intervals) for allopurinol initiators compared to febuxostat initiators for the composite outcome at 5 years were 0.84 (0.74-0.95). The cause-specific adjusted HRs for allopurinol initiators relative to febuxostat initiators were 0.82 (0.70-0.94) for significant eGFR decline over 5 years, and 1.08 (0.91-1.24) for all-cause death over 5 years.</p><p><strong>Conclusion: </strong>Allopurinol initiators preserved kidney function better than febuxostat over 5 years. Clinicians should exercise caution not only when prescribing but also when selecting XOIs, even for patients with preserved kidney function.</p>","PeriodicalId":18705,"journal":{"name":"Modern Rheumatology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2024-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142895798","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":"Risk factors for adverse drug reactions to sulfamethoxazole-trimethoprim prophylaxis in patients with rheumatic and musculoskeletal diseases.","authors":"Kazuoto Hiramoto, Mitsuhiro Akiyama, Yuko Kaneko","doi":"10.1093/mr/roae059","DOIUrl":"10.1093/mr/roae059","url":null,"abstract":"<p><strong>Objectives: </strong>Risk factors for adverse drug reactions (ADRs) associated with prophylactic sulfamethoxazole-trimethoprim (SMX/TMP) in patients with rheumatic and musculoskeletal diseases undergoing immunosuppressive therapy remain unclear; we aimed to identify the risk factors associated with ADRs.</p><p><strong>Methods: </strong>Consecutive patients with rheumatic and musculoskeletal diseases, who were admitted to Keio University Hospital and received prophylactic administration of SMX/TMP, were included. Data regarding ADRs to SMX/TMP were collected to identify the associated risk factors using multivariable analysis.</p><p><strong>Results: </strong>Of 438 patients included in the analysis, 82 (18.7%) experienced ADRs. Patients in the ADR group were significantly older, had chronic kidney disease, and exhibited lower lymphocyte and platelet counts, lower albumin levels, lower estimated glomerular filtration rates, higher aspartate aminotransferase levels, and higher ferritin levels than those in the non-ADR group. Regarding the underlying rheumatic and musculoskeletal diseases, adult-onset Still's disease (ASD) was associated with a significantly higher incidence of ADRs (67%) than other diseases. Multivariable analysis identified the presence of ASD and low lymphocyte counts as independent risk factors for allergic ADRs and older age and use of angiotensin-converting enzyme inhibitors/angiotensin receptor blockers for nonallergic ADRs.</p><p><strong>Conclusions: </strong>Risk factors for ADRs associated with prophylactic SMX/TMP treatment in patients with rheumatic and musculoskeletal diseases were identified.</p>","PeriodicalId":18705,"journal":{"name":"Modern Rheumatology","volume":" ","pages":"94-101"},"PeriodicalIF":1.8,"publicationDate":"2024-12-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141889750","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 features of juvenile onset ankylosing spondylitis in Japanese patients.","authors":"Kenji Kishimoto, Shuji Asai, Mochihito Suzuki, Ryo Sato, Junya Hasegawa, Kenya Terabe, Shiro Imagama","doi":"10.1093/mr/roae065","DOIUrl":"10.1093/mr/roae065","url":null,"abstract":"<p><strong>Objectives: </strong>This retrospective study aimed to examine the clinical features of juvenile onset ankylosing spondylitis (JoAS) in Japanese patients.</p><p><strong>Methods: </strong>We examined clinical symptoms (including initial symptoms) and the progression to diagnosis of AS in 17 Japanese JoAS patients at Nagoya university hospital between January 2004 and May 2023. Initial symptoms considered were pain at axial joints and/or extra-axial joints.</p><p><strong>Results: </strong>Mean ages (± standard deviation) at onset and diagnosis of AS were 12.9 (± 2.0) and 19.6 (± 9.6) years, respectively. The back was the most common site of initial symptoms (7 patients; 41.2%), followed by the hip (5 patients; 29.4%) and knees (5 patients; 29.4%). Initial symptoms were limited to extra-axial joints and axial joints in 9 (52.9%) and 7 (41.2%) patients, respectively. Nine patients (52.9%) were recognised as a musculoskeletal disease other than AS, such as oligoarticular juvenile idiopathic arthritis.</p><p><strong>Conclusions: </strong>Sites of initial symptoms frequently were the back, hip, and knees, with 52.9% of patients having initial symptoms limited to extra-axial joints. More than half of the patients recognised musculoskeletal diseases other than AS.</p>","PeriodicalId":18705,"journal":{"name":"Modern Rheumatology","volume":" ","pages":"144-150"},"PeriodicalIF":1.8,"publicationDate":"2024-12-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142109565","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 importance of anti-Ro52 antibody in polymyositis and dermatomyositis.","authors":"Toshiki Sugita, Hiroto Tsuboi, Naoki Sugita, Rai Akiyoshi, Yuki Kuroda, Akira Kawashima, Fumina Kawashima, Daiki Tabuchi, Fumika Honda, Ayako Ohyama, Saori Abe, Ayako Kitada, Hiromitsu Asashima, Haruka Miki, Shinya Hagiwara, Yuya Kondo, Isao Matsumoto","doi":"10.1093/mr/roae052","DOIUrl":"10.1093/mr/roae052","url":null,"abstract":"<p><strong>Objectives: </strong>To clarify the clinical features of anti-Ro52 antibody (Ab)-positive polymyositis (PM)/dermatomyositis (DM).</p><p><strong>Methods: </strong>We retrospectively examined the clinical features and status of anti-Ro52 Abs in patients with PM/DM admitted to the University of Tsukuba Hospital between January 2019 and February 2023. We compared the anti-Ro52 Ab-positive and anti-Ro52 Ab-negative groups.</p><p><strong>Results: </strong>A total of 40 patients were selected and analysed. Twenty-three cases were PM, and 17 cases were DM (including six clinically amyopathic DM). Twenty-two cases were positive for anti-Ro52 Ab, 14 for anti-ARS Ab, and 6 for anti-MDA5 Ab. Interstitial lung disease was detected in 29 cases, nine of which were rapidly progressive. Glucocorticoid-resistant cardiomyopathy was detected in six cases. Of the 22 anti-Ro52 Ab-positive cases, only 3 were single-positive and the remaining 19 cases simultaneously had other autoantibodies. Comparing the anti-Ro52 Ab-positive and anti-Ro52 Ab-negative groups, the frequencies of anti-ARS Ab positivity (63.6% vs. 0%), interstitial lung disease (95.5% vs. 44.4%), glucocorticoid-resistant cardiomyopathy (27.3% vs. 0%), concomitant use of immunosuppressants (95.5% vs. 55.6%), and levels of C-reactive protein were significantly higher in the anti-Ro52 Ab-positive group (P < .05).</p><p><strong>Conclusions: </strong>Anti-Ro52 Abs were frequently positive in PM/DM, and may be useful as a severity marker.</p>","PeriodicalId":18705,"journal":{"name":"Modern Rheumatology","volume":" ","pages":"118-125"},"PeriodicalIF":1.8,"publicationDate":"2024-12-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141158188","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":"Diagnostic values and relevant factors of lumbar posterior lesions in axial spondyloarthritis.","authors":"Zhixiang Huang, Jiali Ding, Lixin Huang, Xuechan Huang, Yukai Huang, Xin Guo, Shuyang Chen, Weiming Deng, Tianwang Li","doi":"10.1093/mr/roae054","DOIUrl":"10.1093/mr/roae054","url":null,"abstract":"<p><strong>Objectives: </strong>To compare the lumbar posterior lesions between axial spondyloarthritis (axSpA) and lumbar disc herniation (LDH) patients, then their diagnostic value and related factors were evaluated.</p><p><strong>Methods: </strong>This cross-sectional study included axSpA patients from January 2020 to September 2023. They were classified as ankylosing spondylitis (AS) and non-radiographic axSpA (nr-axSpA) individuals. Canada-Denmark magnetic resonance imaging (MRI) scoring system was used to assess the defects of the lumbar spine. Receiver operating characteristic curve analysis was utilized to determine the value of distinguishing nr-axSpA. Linear regression analyses were adopted to find the relevant factors for lumbar posterior lesions.</p><p><strong>Results: </strong>Ninety-six AS, 98 nr-axSpA, and 108 LDH patients were included. The Canada-Denmark scores were greater in axSpA patients, AS in particular. Furthermore, lumbar posterior lesions can distinguish AS, nr-axSpA, and LDH. Besides, lumbar posterior lesions were positively related to the similar MRI changes in their adjacent structures, but were inversely associated with the other abnormalities.</p><p><strong>Conclusions: </strong>Lumbar posterior lesions were more serious in axSpA patients. These alterations had value in distinguishing axSpA. Lumbar posterior defects were related to their adjacent components, and they may not fully follow the MRI changing pattern of vertebral bodies and sacroiliac joints.</p>","PeriodicalId":18705,"journal":{"name":"Modern Rheumatology","volume":" ","pages":"151-161"},"PeriodicalIF":1.8,"publicationDate":"2024-12-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141173990","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":"Lung ultrasound in the assessment of interstitial lung disease in patients with connective tissue disease: Performance in comparison with high-resolution computed tomography.","authors":"Shinji Watanabe, Keina Yomono, Shintaro Yamamoto, Mikito Suzuki, Takahisa Gono, Masataka Kuwana","doi":"10.1093/mr/roae053","DOIUrl":"10.1093/mr/roae053","url":null,"abstract":"<p><strong>Objective: </strong>To investigate clinical relevance of performing lung ultrasound (LUS) in patients with connective tissue disease (CTD)-associated interstitial lung disease (ILD) in comparison with high-resolution computed tomography (HRCT).</p><p><strong>Methods: </strong>This single-centre study enrolled eligible patients with CTD-ILD from the prospective LUS registry. Total B-lines were detected by assessment at 14 sites via LUS. Forced vital capacity, diffusing lung capacity for carbon monoxide (DLCO), DLCO/alveolar volume, 6-minute walking distance, and the ILD-GAP index were used as ILD prognostic parameters. Correlations were examined using single and multiple regression analyses.</p><p><strong>Results: </strong>Sixty-seven patients were enrolled, including 29 with idiopathic inflammatory myopathy or anti-synthetase syndrome, 25 with systemic sclerosis (SSc), 10 with rheumatoid arthritis, and 3 with mixed CTD. The total number of B-lines correlated with ILD extent on HRCT in patients with CTD-ILD (r = 0.66; P < .001), particularly in patients with SSc-ILD (r = 0.78; P < .001). Total B-lines and ILD extent on HRCT showed comparable correlations with prognostic parameters, while multiple regression analysis revealed the limited benefit of performing LUS in addition to HRCT in predicting correlations with prognostic factors.</p><p><strong>Conclusions: </strong>LUS serves as an alternative tool for assessing the severity and prognosis of patients with CTD-ILD.</p>","PeriodicalId":18705,"journal":{"name":"Modern Rheumatology","volume":" ","pages":"79-87"},"PeriodicalIF":1.8,"publicationDate":"2024-12-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141174207","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 and safety of febuxostat in Japanese paediatric patients with hyperuricaemia including gout: Phase 2, single arm, open‒label, multicentre studies.","authors":"Shuichi Ito, Yo Morita, Makoto Nitami, Ryutaro Iwama, Akihiro Nakajima, Hisashi Yamanaka, Masataka Honda","doi":"10.1093/mr/roae056","DOIUrl":"10.1093/mr/roae056","url":null,"abstract":"<p><strong>Objectives: </strong>Urate-lowering efficacy and safety of febuxostat was evaluated in paediatric patients with hyperuricaemia including gout.</p><p><strong>Methods: </strong>A Phase 2 study of febuxostat in paediatric patients aged 6-18 years with hyperuricaemia including gout was conducted. We evaluated the proportion of patients achieving serum uric acid (sUA) level ≤6.0 mg/dl at Week 26, and long-term safety and efficacy at Week 52. We also considered efficacy stratified by renal function.</p><p><strong>Results: </strong>Thirty patients (10 at <40 kg and 20 at ≥40 kg) were enrolled. Twenty-four were males, 29 had asymptomatic hyperuricaemia, and 1 had gout. Age was 8 to 18 years. Of these, 63.3% (95% confidence interval 43.9-80.1%) achieved a sUA level of ≤6.0 mg/dl at Week 26. sUA level (mean ± standard deviation) was 5.55 ± 0.87 mg/dl, reduced from 9.01 ± 1.23 mg/dl at baseline. Febuxostat efficacy appeared similar for mild to moderate renal dysfunction and with normal renal function. There were no major safety issues.</p><p><strong>Conclusions: </strong>In paediatric patients with hyperuricaemia including gout, febuxostat showed long-term, well-controlled urate-lowering efficacy with no major safety issues. Findings suggest that no dose adjustment is required for paediatric patients with mild to moderate renal dysfunction.</p>","PeriodicalId":18705,"journal":{"name":"Modern Rheumatology","volume":" ","pages":"194-202"},"PeriodicalIF":1.8,"publicationDate":"2024-12-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142133196","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}