Modern Rheumatology最新文献

{"title":"The serum amyloid A to C-reactive protein ratio is lower in men than in women because of higher C-reactive protein concentrations in men.","authors":"Hiroshi Uda, Michihito Katayama, Keiji Maeda, Osamu Saiki","doi":"10.1093/mr/roaf004","DOIUrl":"10.1093/mr/roaf004","url":null,"abstract":"<p><strong>Objectives: </strong>We previously found that discrepancy between serum amyloid A (SAA) and C-reactive protein (CRP) levels linked to the difference of SAA/CRP ratio in patients with early rheumatoid arthritis, and the ratio varied among different patients. This study aimed to determine why the SAA/CRP ratio differed among different patients.</p><p><strong>Methods: </strong>The patients (n = 466) with most of inflammatory diseases were enrolled. After examined CRP and SAA concentrations, we compared the SAA/CRP ratio, and SAA and CRP concentrations in men and women.</p><p><strong>Results: </strong>The SAA/CRP ratio varied dramatically among different patients (33.6-0.140). The 10 highest SAA/CRP ratios were all in women, and half of the 10 lowest ratios were found in men. The loge SAA/CRP ratio was significantly higher in women than in men (P < .0001). The loge SAA concentration was not different between women and men (P = .174), but the loge CRP concentration was significantly higher in men (P < .0001).</p><p><strong>Conclusions: </strong>The SAA/CRP ratio varies considerably among different patients. The SAA/CRP ratio in women is higher than in men because loge CRP but not SAA concentrations in men are higher than in women. The finding is against the conventional view and suggests that the reference range of CRP concentrations in women should be assessed lower than in men.</p>","PeriodicalId":18705,"journal":{"name":"Modern Rheumatology","volume":" ","pages":"677-682"},"PeriodicalIF":1.8,"publicationDate":"2025-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143008493","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":"Anti-arthritic effects of polyunsaturated fatty acid-rich supplementation combined with selective soluble epoxide hydrolase inhibitors in a collagen-induced arthritis mouse model.","authors":"Akiko Yoshida, Kosaku Murakami, Hirotake Tsukamoto, Yunhong Hotta, Yoichi Nakayama, Rintaro Saito, Mirei Shirakashi, Hideaki Tsuji, Ryosuke Hiwa, Shuji Akizuki, Ran Nakashima, Hajime Yoshifuji, Akira Onishi, Masao Tanaka, Tsuneyo Mimori, Akio Morinobu","doi":"10.1093/mr/roaf019","DOIUrl":"10.1093/mr/roaf019","url":null,"abstract":"<p><strong>Objectives: </strong>Polyunsaturated fatty acids (PUFAs) are healthy fats that contain a double carbon bond. They are made up of omega (ω)-3 and ω-6 PUFAs, where ω-3 PUFAs exhibit beneficial effects, such as the suppression of cardiovascular events and the improvement of abnormal lipid metabolism. However, their effects on rheumatoid arthritis (RA) are unclear. Epoxy fatty acids, which are intermediate metabolites of ω-6 and ω-3 PUFAs, are formed through the action of cytochrome P and possess anti-inflammatory properties. However, they are quickly converted into their inactive forms by soluble epoxide hydrolase.</p><p><strong>Methods: </strong>The protective effects of ω-3 and ω-6 PUFAs on arthritic symptoms with or without soluble epoxide hydrolase inhibitors (sEHis) were investigated in a collagen-induced arthritis mouse model.</p><p><strong>Results: </strong>The group treated with a combination of ω-3 PUFAs and sEHi showed a marked inhibition of arthritis compared to the other groups. Analysis of the faecal flora before the onset of arthritis showed an inverse correlation between the arthritis score and the relative abundance of Lactococcus, suggesting that changes in the intestinal flora in the preclinical stage may influence the onset of arthritis.</p><p><strong>Conclusions: </strong>This study highlights the potential of ω-3 PUFAs combined with sEHi as the novel protective effect for RA.</p>","PeriodicalId":18705,"journal":{"name":"Modern Rheumatology","volume":" ","pages":"665-676"},"PeriodicalIF":1.8,"publicationDate":"2025-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143573637","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":"Frequent detection of antinuclear antibodies and low-titre 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":"10.1093/mr/roaf010","url":null,"abstract":"<p><strong>Objectives: </strong>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.</p><p><strong>Methods: </strong>In this multicentre 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.</p><p><strong>Results: </strong>Tenderness at the humeral epicondyles and the Achilles tendon were more common in female patients with upSpA than in males. Serum C-reactive protein levels were lower in female patients with upSpA than in male patients. Serum rheumatoid factor levels were lower in upSpA cases than in RA, with a cut-off value of 84 IU/ml differentiating RA from upSpA. An antinuclear antibodies (ANA) test at a dilution of ≥1:160 was detected in about half of the female upSpA cases but not in male cases.</p><p><strong>Conclusions: </strong>Among upSpA and RA cases, female patients with upSpA frequently present with multiple enthesitis, low serum C-reactive protein levels, low-titre rheumatoid factor positivity, and a high incidence of antinuclear antibodies positivity.</p>","PeriodicalId":18705,"journal":{"name":"Modern Rheumatology","volume":" ","pages":"753-761"},"PeriodicalIF":1.8,"publicationDate":"2025-07-05","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}

{"title":"Comparative renoprotective effectiveness of allopurinol and febuxostat among hyperuricaemic patients with preserved kidney function.","authors":"Atsushi Takayama, Toshiki Fukasawa, Masato Takeuchi, Koji Kawakami","doi":"10.1093/mr/roae115","DOIUrl":"10.1093/mr/roae115","url":null,"abstract":"<p><strong>Objectives: </strong>Early initiation of xanthine oxidase inhibitors may benefit patients with preserved kidney function. However, a direct comparison between the impact of allopurinol and that 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 estimated glomerular filtration rate (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 were estimated using Cox's proportional hazard models with inverse probability of treatment and censoring weighting.</p><p><strong>Results: </strong>We analysed 1142 patients (287 with allopurinol and 855 with febuxostat). The adjusted hazard ratios (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 hazard ratios for allopurinol initiators relative to febuxostat initiators were 0.82 (0.70-0.94) for significant eGFR decline >5 years and 1.08 (0.91-1.24) for all-cause death >5 years.</p><p><strong>Conclusions: </strong>Allopurinol initiators preserved kidney function better than febuxostat >5 years. Clinicians should exercise caution not only when prescribing but also when selecting xanthine oxidase inhibitors, even for patients with preserved kidney function.</p>","PeriodicalId":18705,"journal":{"name":"Modern Rheumatology","volume":" ","pages":"767-776"},"PeriodicalIF":1.8,"publicationDate":"2025-07-05","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":"Real-world treatment persistence in csDMARD-IR and bDMARD-IR patients with rheumatoid arthritis in Japan: A large claims database study.","authors":"Tsutomu Takeuchi, Craig Pfeifer, Yan Zhong, Yi Piao, Toshihiko Kaise, Mahiro Tani","doi":"10.1093/mr/roaf007","DOIUrl":"10.1093/mr/roaf007","url":null,"abstract":"<p><strong>Objectives: </strong>To investigate treatment persistence for biologic disease-modifying antirheumatic drugs (bDMARDs) and Janus kinase inhibitors (JAKis), including filgotinib, in Japanese patients with rheumatoid arthritis (RA) who have an inadequate response (IR) to conventional synthetic DMARDs (csDMARD-IR) and bDMARDs (bDMARD-IR), and to identify characteristics associated with treatment discontinuation.</p><p><strong>Methods: </strong>We analyzed 2020-2023 health claims data from adults with RA who received ≥1 prescription for bDMARDs or JAKis during the study period and ≥1 prescription for csDMARDs over the previous 6 months. Persistence rates were estimated for the csDMARD-IR (patients naïve to bDMARDs/JAKis) and bDMARD-IR (patients switching to bDMARDs/JAKis from an initial bDMARD) cohorts using the Kaplan-Meier method.</p><p><strong>Results: </strong>Overall, 7208 and 1581 patients were identified in the csDMARD-IR and bDMARD-IR cohorts, respectively. In the csDMARD-IR cohort, 1-year persistence rates were 59%-70% for JAKis (67% for filgotinib) and 53%-69% for bDMARDs. In the bDMARD-IR cohort, 1-year persistence rates were 57%-66% for JAKis (66% for filgotinib) and 19%-91% for bDMARDs. No clinical characteristics were consistently associated with the persistence of JAKi or bDMARD treatment.</p><p><strong>Conclusions: </strong>Rates of persistence among patients taking JAKis, including filgotinib, were approximately 60% or higher in csDMARD-IR and bDMARD-IR cohorts.</p>","PeriodicalId":18705,"journal":{"name":"Modern Rheumatology","volume":" ","pages":"626-636"},"PeriodicalIF":1.8,"publicationDate":"2025-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143492894","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":"Pearls and pitfalls in imaging of axial spondyloarthritis for rheumatologists.","authors":"Taiki Nozaki, Yuko Tsujioka, Hideharu Sugimoto, Yoshitake Yamada, Minoru Yamada, Youichi Yokoyama, Hitomi Fujishiro, Akimoto Nimura, Junya Tsuzaki, Manabu Hase, Masato Okada, Yuko Kaneko, Masahiro Jinzaki","doi":"10.1093/mr/roaf034","DOIUrl":"10.1093/mr/roaf034","url":null,"abstract":"<p><p>This review provides key insights into sacroiliitis imaging, covering anatomy, imaging techniques, and interpretation. It focuses on normal physiological changes in young to middle-aged women, children, and the elderly that can resemble sacroiliitis. We emphasize the importance of distinguishing between active and structural lesions, as highlighted in the recent ASAS-SPARTAN standardized magnetic resonance imaging protocol. Physicians should be aware that bone marrow oedema signals on magnetic resonance imaging, a hallmark of active inflammation in axial spondyloarthritis, can also be observed in young to middle-aged women, especially postpartum, even without spondyloarthritis. Paediatric sacroiliac joints may show changes mimicking inflammation due to ongoing bone growth. Furthermore, degenerative changes in the sacroiliac joint are common with advancing age and can be mistaken for sacroiliitis or interpreted as structural changes. The presence of accessory sacroiliac joints, prone to degeneration, further complicates diagnosis. Accurate interpretation requires considering these normal variations to avoid misdiagnosing spondyloarthritis. Collaboration between clinicians and radiologists is crucial, especially when encountering atypical or clinically inconsistent findings.</p>","PeriodicalId":18705,"journal":{"name":"Modern Rheumatology","volume":" ","pages":"612-625"},"PeriodicalIF":1.8,"publicationDate":"2025-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143971077","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":"Characteristics of patients with polymyalgia rheumatica based on glucocorticoid dose in Japan: A cohort study using routinely collected health data.","authors":"Yoshiya Tanaka, Toshiya Takahashi, Shoichiro Inokuchi, Hidetoshi Uenaka, Akiko Fujita, Kazuhito Sakamoto","doi":"10.1093/mr/roaf001","DOIUrl":"10.1093/mr/roaf001","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to describe the characteristics, inflammatory markers as surrogates for disease activity, and treatment of patients with polymyalgia rheumatica (PMR) in Japan.</p><p><strong>Methods: </strong>This cohort study analysed the data of 373 patients with PMR retrieved from an electronic medical record database in Japan. Patients were classified into quartiles, based on the daily glucocorticoid (GC) dose over the initial 90 days of treatment (Q1-Q4).</p><p><strong>Results: </strong>The low GC dose group (Q1) had more patients aged ≥90 years (11.7%) and a higher prevalence of comorbidities. At 52 weeks, GC-free remission was achieved in 10% of patients and higher C-reactive protein levels were observed during the follow-up period. In contrast, the high GC dose group (Q4) exhibited a slower decline in C-reactive protein levels and more events of increased GC dose compared to Q1-Q3. The introduction of methotrexate was low, with 4.3-7.3% of patients. The incidence of osteoporosis and diabetes was higher in patients <75 years, whereas the incidence of hypertension was higher in patients ≥75 years.</p><p><strong>Conclusions: </strong>Patients refractory to high GC doses were identified. Patients receiving inadequately low doses of GCs were older with more comorbidities. This study highlights the unmet medical needs for PMR.</p>","PeriodicalId":18705,"journal":{"name":"Modern Rheumatology","volume":" ","pages":"722-730"},"PeriodicalIF":1.8,"publicationDate":"2025-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143008487","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":"Differences in the autoantibody phenotypes and long-term outcomes between juvenile- and adult-onset systemic sclerosis.","authors":"Hideaki Tsuji, Mirei Shirakashi, Ryosuke Hiwa, Shuji Akizuki, Ran Nakashima, Akira Onishi, Hajime Yoshifuji, Masao Tanaka, Akio Morinobu","doi":"10.1093/mr/roaf005","DOIUrl":"10.1093/mr/roaf005","url":null,"abstract":"<p><strong>Objective: </strong>To investigate differences in autoantibodies, clinical features, and long-term outcomes between juvenile- and adult-onset systemic sclerosis (SSc).</p><p><strong>Methods: </strong>Autoantibodies and survival rates over a maximum of 20 years were retrospectively analysed in 504 Japanese patients with SSc (juvenile-onset SSc, n = 17; adult-onset SSc, n = 487) using data from Kyoto University Registry.</p><p><strong>Results: </strong>: The autoantibodies observed were anti-topoisomerase-I (71% vs. 26%), anti-centromere (24% vs. 54%), and anti-RNA-polymerase-III (0% vs. 12%). A diffuse type and multiorgan involvement were observed in patients with anti-topoisomerase-I in both juvenile- and adult-onset SSc. In patients with anti-centromere, a diffuse type (juvenile-onset SSc vs. adult-onset SSc, 75% vs. 28%) and pulmonary fibrosis (50% vs. 17%) were more frequently observed in juvenile-onset SSc than in adult-onset SSc. Cox proportional hazard analyses showed that older onset (hazard ratio: 1.06, 95% confidence interval: 1.03-1.09) was associated with death, while autoantibodies were not significantly associated with death. Cumulative survival rates for 20 years were similar between juvenile- and adult-onset SSc when classified based on the presence of anti-centromere (100% vs. 89%, P = .20) and anti-topoisomerase-I (90% vs. 90%, P = .70).</p><p><strong>Conclusions: </strong>: Juvenile-onset SSc had more frequent diffuse-type and anti-topoisomerase-I. An older onset was slightly associated with mortality, whereas autoantibodies were not associated with mortality.</p>","PeriodicalId":18705,"journal":{"name":"Modern Rheumatology","volume":" ","pages":"683-690"},"PeriodicalIF":1.8,"publicationDate":"2025-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143008489","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":"MRI-based predictors of spinal ankylosis progression: ESSR framework for axial spondyloarthritis.","authors":"Yu Mori, Naoko Mori, Takuya Izumiyama, Ryuichi Kanabuchi, Hiroshi Hatakeyama, Toshimi Aizawa","doi":"10.1093/mr/roaf015","DOIUrl":"10.1093/mr/roaf015","url":null,"abstract":"<p><strong>Background: </strong>Magnetic resonance imaging (MRI), utilizing fat-saturated T2-weighted and short-tau inversion recovery sequences, is essential for the early diagnosis and monitoring of axial spondyloarthritis (axSpA). Recently, the European Society of Musculoskeletal Radiology proposed recommendations for the standardization of MRI findings for axSpA. However, the predictive value of specific MRI findings for spinal ankylosis progression remains unclear. This study investigates whether baseline MRI findings correlate with the progression of spinal ankylosis observed on radiographs over a 2-year period.</p><p><strong>Methods: </strong>Twenty-six axSpA patients who met Assessment of SpondyloArthritis International Society criteria and underwent baseline and 2-year follow-up imaging were included. MRI assessments of the lumbar spine and sacroiliac joint evaluated inflammatory and structural lesions, including Romanus and Anderson lesions. Radiographic progression was defined as a ≥2-point increase in the modified Stoke Ankylosing Spondylitis Spinal Score. Statistical analyses compared clinical and imaging parameters between progression (n = 9) and nonprogression (n = 17) groups.</p><p><strong>Results: </strong>Patients in the progression group had significantly higher baseline modified Stoke Ankylosing Spondylitis Spinal Score (P = .04) and modified-health assessment questionnaire scores (P = .04). Positive MRI findings of anterior and posterior corner inflammatory lesions and Anderson-central lesions were significantly associated with progression (P < .05). Romanus lesions, indicative of early structural changes, were more frequent in the progression group (P = .02). However, fat lesions and sacroiliac joint inflammation showed no significant predictive value.</p><p><strong>Conclusion: </strong>Baseline MRI findings, particularly inflammatory and Romanus lesions, are strong predictors of spinal ankylosis progression in axSpA. These results highlight the importance of incorporating MRI into personalized treatment strategies to mitigate disease progression. Further studies are needed to validate these findings in larger cohorts.</p>","PeriodicalId":18705,"journal":{"name":"Modern Rheumatology","volume":" ","pages":"738-743"},"PeriodicalIF":1.8,"publicationDate":"2025-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143572926","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 of spinal ankylosis with spinal mobility and functional impairment in radiographic axial spondyloarthritis: A computed tomography study.","authors":"Kenji Kishimoto, Shuji Asai, Mochihito Suzuki, Ryo Sato, Junya Hasegawa, Yusuke Ohno, Kenya Terabe, Shiro Imagama","doi":"10.1093/mr/roaf022","DOIUrl":"10.1093/mr/roaf022","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to examine relationships of the degree and level of spinal ankylosis with spinal mobility and functional impairment in patients with radiographic axial spondyloarthritis (r-axSpA) using computed tomography (CT).</p><p><strong>Methods: </strong>This retrospective study involving 27 patients examined the number of fused intervertebral segments in the whole, cervical, thoracic, and lumbar spine using CT as a measure of spinal ankylosis, Bath Ankylosing Spondylitis Metrology Index (BASMI) as a measure of spinal mobility, and Bath Ankylosing Spondylitis Functional Index (BASFI) as a measure of functional impairment.</p><p><strong>Results: </strong>Significant positive correlations were found between both BASMI and BASFI and the number of fused intervertebral segments in the whole, cervical, thoracic, and lumbar spine. 'Tragus to wall distance', a BASMI item, was significantly positively correlated with the number of intervertebral segments in the lumbar spine (r = 0.46, P = .02). 'Looking over your shoulder', a BASFI item, was strongly negatively correlated with the number of fused intervertebral segments in the cervical spine (r = 0.804, P < .01).</p><p><strong>Conclusions: </strong>The number of fused intervertebral segments was associated with impaired spinal mobility and functional impairment. Impaired spinal motion and functional impairment in daily living varied depending on the level of spinal ankylosis.</p>","PeriodicalId":18705,"journal":{"name":"Modern Rheumatology","volume":" ","pages":"744-752"},"PeriodicalIF":1.8,"publicationDate":"2025-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143582324","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}