Modern Rheumatology最新文献_第9页

Rheumatologists' Perceptions of Nurse-led Telephone Consultations for Patients with Rheumatoid Arthritis in Japan. 日本风湿病学家对护士主导的类风湿性关节炎患者电话咨询的看法。

IF 1.9 4区医学

Modern Rheumatology Pub Date : 2026-05-28 DOI: 10.1093/mr/roag049

Mie Fusama, Hideko Nakahara, Izumi Kobayashi, Toshihiro Matsui, Misuzu Gregg

{"title":"Rheumatologists' Perceptions of Nurse-led Telephone Consultations for Patients with Rheumatoid Arthritis in Japan.","authors":"Mie Fusama, Hideko Nakahara, Izumi Kobayashi, Toshihiro Matsui, Misuzu Gregg","doi":"10.1093/mr/roag049","DOIUrl":"https://doi.org/10.1093/mr/roag049","url":null,"abstract":"Objectives: To examine rheumatologists' perceptions of nurse-led telephone consultations in rheumatoid arthritis patients, including differences in those working with and without rheumatology care nurses.Methods: Rheumatologists completed a web-based questionnaire on nurse-led telephone consultations.Results: 129 rheumatologists responded: 49 with rheumatology care nurses, 73 without, and 7 unknown. Regarding telephone consultations, 35.7% reported nurses handled them, and 34.9% either physicians or nurses did. Most agreed with nurse handling (87.6%) and its contribution to patient satisfaction (89.9%), with higher agreement among those with rheumatology care nurses (p< 0.001 both). High agreement was also observed for nurse management of daily life (93.0%), psychological issues (92.3%), and self-injection techniques (91.4%). Rheumatologists with rheumatology care nurses showed higher agreement across many items, including whether patients should self-inject biological agents (p = 0.001) and management of drug side effects (p = 0.011). Reported challenges included insufficient nurse knowledge and lack of reimbursement. Qualitative analysis indicated that nurse-led telephone consultations facilitate access, enable appropriate triage and prompt responses, and reduce unnecessary visits. Expected benefits included patient information gathering, clear explanations, psychological support, and complementing rheumatologists' work.Conclusions: Most rheumatologists agreed nurses handle telephone consultations, which were perceived to facilitate person-centered care, appropriate triage, and economic benefits.","PeriodicalId":18705,"journal":{"name":"Modern Rheumatology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148042798","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

Real-World Implementation of Treatment Intensification After Methotrexate in Rheumatoid Arthritis in the Context of Treat-to-Target Recommendations: Insights From Japan's Claims Data. 在治疗目标推荐的背景下，甲氨蝶呤治疗类风湿关节炎后强化治疗的实际实施：来自日本索赔数据的见解。

IF 1.9 4区医学

Modern Rheumatology Pub Date : 2026-05-22 DOI: 10.1093/mr/roag046

Tsutomu Takeuchi, Hisaaki Isaji, Yi Piao, Susan Song, Mahiro Tani

{"title":"Real-World Implementation of Treatment Intensification After Methotrexate in Rheumatoid Arthritis in the Context of Treat-to-Target Recommendations: Insights From Japan's Claims Data.","authors":"Tsutomu Takeuchi, Hisaaki Isaji, Yi Piao, Susan Song, Mahiro Tani","doi":"10.1093/mr/roag046","DOIUrl":"https://doi.org/10.1093/mr/roag046","url":null,"abstract":"Objectives: To describe real-world treatment patterns in Japanese patients with rheumatoid arthritis, focusing on intensification after methotrexate and prescribing patterns of methotrexate and glucocorticoids, in the context of treat-to-target strategy.Methods: This was a retrospective cohort study using claims database. Adults with rheumatoid arthritis who initiated methotrexate were included and classified by treatment intensification within 210 days (6 months, as per the guideline, plus a 30-day grace period) into three groups: (1) intensified to conventional synthetic disease-modifying antirheumatic drugs, (2) intensified to biologic or targeted synthetic disease-modifying antirheumatic drugs, or (3) remained on methotrexate monotherapy. Methotrexate and glucocorticoid dose transitions were visualised using Sankey diagrams.Results: Of 21,734 patients, 13,784 (63.4%) remained on methotrexate monotherapy and 4,949 (22.8%) received intensification (63.8% intensified with synthetic disease-modifying antirheumatic drugs and 34.8% with biologic or targeted synthetic disease-modifying antirheumatic drugs). In the intensified subgroups, 40% used glucocorticoids for >90 days, and 80% had a daily dose >5 mg; approximately 30% received a methotrexate dose <6 mg when transitioned to second-line therapy.Conclusions: The low intensification rate within 6 months, predominance of synthetic disease-modifying drugs, insufficient methotrexate dose escalation, and long-term use of glucocorticoids suggest a gap between real-world clinical practice and guideline recommendations.","PeriodicalId":18705,"journal":{"name":"Modern Rheumatology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147988284","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

Development of the Japan College of Rheumatology guidance on musculoskeletal ultrasound scanning protocol in rheumatology practice (revised edition). 制定日本风湿病学会风湿病实践中肌肉骨骼超声扫描协议指南（修订版）。

IF 1.9 4区医学

Modern Rheumatology Pub Date : 2026-05-18 DOI: 10.1093/mr/roag045

Takehisa Ogura, Kei Ikeda, Shin-Ya Kawashiri, Michihiro Ogasawara, Tadashi Okano, Makoto Wada, Tatsunori Horie, Ryusuke Yoshimi, Ryuichi Nakahara, Ryota Hara, Asami Abe, Masahiro Ayano, Koji Funahashi, Chihiro Imaizumi, Natsuko Nakagawa, Atsushi Kawakami

{"title":"Development of the Japan College of Rheumatology guidance on musculoskeletal ultrasound scanning protocol in rheumatology practice (revised edition).","authors":"Takehisa Ogura, Kei Ikeda, Shin-Ya Kawashiri, Michihiro Ogasawara, Tadashi Okano, Makoto Wada, Tatsunori Horie, Ryusuke Yoshimi, Ryuichi Nakahara, Ryota Hara, Asami Abe, Masahiro Ayano, Koji Funahashi, Chihiro Imaizumi, Natsuko Nakagawa, Atsushi Kawakami","doi":"10.1093/mr/roag045","DOIUrl":"https://doi.org/10.1093/mr/roag045","url":null,"abstract":"Objectives: To describe the methodological framework and consensus-based decision rules that underpin the revised guidance on musculoskeletal ultrasound scanning protocols in rheumatology practice.Methods: A systematic literature search of musculoskeletal ultrasound imaging and assessment methods was conducted to extract candidate anatomical structures and the corresponding scanning techniques from the included articles. A Delphi survey of the Guidance Development Panel selected the sites for inclusion. Iterative consensus meetings defined standardised scanning procedures for each structure, including patient positioning, limb orientation, probe placement, scanning direction, and key anatomical landmarks to be captured on the ultrasound images.Results: A total of 3 168 unique records were identified, of which 36 were included after screening. Based on the included articles and the first edition, a list of 159 candidate anatomical structures across the seven regions was compiled (including two structures added during the consensus process). Through the Delphi process, 50 structures were endorsed for inclusion in the guidance. An image atlas was produced presenting the standardised views used in routine practice and the scanning procedures for the recommended structures.Conclusions: This revised guidance provides standardised musculoskeletal ultrasound scanning methods for rheumatic diseases based on a systematic literature search and structured consensus process.","PeriodicalId":18705,"journal":{"name":"Modern Rheumatology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-05-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147973704","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

Optimal glucocorticoid tapering in anti-synthetase syndrome-associated interstitial lung disease: A multicentre MYKO cohort study. 抗合成酶综合征相关间质性肺病的最佳糖皮质激素减量：一项多中心MYKO队列研究

IF 1.9 4区医学

Modern Rheumatology Pub Date : 2026-05-17 DOI: 10.1093/mr/roag044

Hirofumi Miyake, Takuya Kotani, Takayasu Suzuka, Shogo Matsuda, Katsumasa Oe, Mahiro Yamamoto, Chifumi Akiyama, Takahiro Seno, Takashi Kida, Tomoya Sagawa, Hironori Inoue, Junya Kitai, Yuki Shimada, Keisuke Hirobe, Kazuma Yoshida, Atsubumi Ogawa, Yuto Nakakubo, Yoichi Nakayama, Yasuhiro Nohda, Tsuneo Sasai, Hideaki Tsuji, Ran Nakashima

{"title":"Optimal glucocorticoid tapering in anti-synthetase syndrome-associated interstitial lung disease: A multicentre MYKO cohort study.","authors":"Hirofumi Miyake, Takuya Kotani, Takayasu Suzuka, Shogo Matsuda, Katsumasa Oe, Mahiro Yamamoto, Chifumi Akiyama, Takahiro Seno, Takashi Kida, Tomoya Sagawa, Hironori Inoue, Junya Kitai, Yuki Shimada, Keisuke Hirobe, Kazuma Yoshida, Atsubumi Ogawa, Yuto Nakakubo, Yoichi Nakayama, Yasuhiro Nohda, Tsuneo Sasai, Hideaki Tsuji, Ran Nakashima","doi":"10.1093/mr/roag044","DOIUrl":"https://doi.org/10.1093/mr/roag044","url":null,"abstract":"Objectives: To explore glucocorticoid (GC) tapering target in patients with acute/subacute anti-synthetase syndrome-associated interstitial lung disease (ASyS-ILD).Methods: We retrospectively analysed 86 patients with newly diagnosed acute/subacute ASyS-ILD from the MYKO cohort. Patients were grouped using prednisolone-equivalent dose thresholds of 15, 12.5, and 10 mg/day at 6 months. Exploratory three-group analyses categorised patients into ≤12.5, 12.5-15, and >15 mg/day. Matching weights adjusted for baseline confounders. Cox proportional-hazards models evaluated 5-year all-cause mortality and event-free survival for disease flares and infections requiring hospitalisation. A multivariable logistic regression assessed factors associated with achieving ≤15 mg/day at 6 months.Results: In two-group analyses, the ≤15 mg/day group had a lower infection risk (hazard ratio (HR) 0.18, 95% confidence interval (CI) 0.04-0.81), whereas analyses using other thresholds showed no clear differences. In the three-group analyses, patients receiving 12.5-15 mg/day tended to have the lowest flare risk. Female sex was associated with achieving ≤15 mg/day at 6 months (odds ratio 3.29, 95% CI 1.09-10.13).Conclusions: Tapering to a prednisolone-equivalent dose of 12.5-15 mg/day at 6 months may represent a reasonable target to balance risks of flares and infections in patients with acute/subacute ASyS-ILD.","PeriodicalId":18705,"journal":{"name":"Modern Rheumatology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147963824","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

Consolidation Volume Assessed by Quantitative Computed Tomography Predicts the Prognosis of Pneumocystis Pneumonia in Rheumatic Diseases. 定量计算机断层扫描评估实变体积预测风湿疾病肺囊虫性肺炎的预后。

IF 1.9 4区医学

Modern Rheumatology Pub Date : 2026-05-15 DOI: 10.1093/mr/roag043

Kodai Sakiyama, Ryo Hisada, Mitsutaka Yasuda, Maria Tada, Yotaro Oki, Masanari Sugawara, Yuka Shimizu, Shuhei Shimoyama, Shuhei Takeyama, Tetsuya Horita, Masaru Yoshimura, Michihito Kono, Yuichiro Fujieda, Olga Amengual, Masaru Kato, Tatsuya Atsumi

{"title":"Consolidation Volume Assessed by Quantitative Computed Tomography Predicts the Prognosis of Pneumocystis Pneumonia in Rheumatic Diseases.","authors":"Kodai Sakiyama, Ryo Hisada, Mitsutaka Yasuda, Maria Tada, Yotaro Oki, Masanari Sugawara, Yuka Shimizu, Shuhei Shimoyama, Shuhei Takeyama, Tetsuya Horita, Masaru Yoshimura, Michihito Kono, Yuichiro Fujieda, Olga Amengual, Masaru Kato, Tatsuya Atsumi","doi":"10.1093/mr/roag043","DOIUrl":"https://doi.org/10.1093/mr/roag043","url":null,"abstract":"Objective: To investigate the prognostic value of quantitative computed tomography (QCT) analysis in pneumocystis pneumonia (PCP) patients with rheumatic diseases, specifically relating abnormal lung volumes (ALV) to major clinical events (MCE).Methods: This multicentre, retrospective study included 83 PCP patients with rheumatic diseases. QCT automatically quantified ALV, categorised into consolidation (≥ -300 HU) and ground-glass opacities (< -300 HU). The primary outcome was MCE, including intubation, intensive care unit admission and death. Logistic regression and survival analyses assessed associations between QCT-derived volumes and MCE.Results: MCE occurred in 17 patients (20%). Patients with MCE had significantly larger consolidation volumes than those without MCE (median, 5.7% vs 0.4%, p < 0.001). Logistic regression analysis identified lactate dehydrogenase, C-reactive protein, and beta-D-glucan as risk factors; however, consolidation volume remained independently associated with MCE after adjustment (odds ratio: 1.33, 95% confidence interval 1.11-1.59, p < 0.001). Receiver operating characteristic analysis of consolidation volume for predicting MCE showed an area under the curve of 0.89 (p < 0.001). Kaplan-Meier analysis revealed significantly lower MCE-free survival in patients with consolidation volumes ≥ 1.4% (p < 0.001; log-rank test).Conclusion: In PCP patients with rheumatic diseases, QCT-derived consolidation volume is a strong predictor of severe outcomes.","PeriodicalId":18705,"journal":{"name":"Modern Rheumatology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147949015","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

Medical pre-training and fine-tuning improve large-language-model prediction of rheumatoid-arthritis disease activity. 医学预训练和微调改进了类风湿关节炎疾病活动的大语言模型预测。

IF 1.9 4区医学

Modern Rheumatology Pub Date : 2026-05-15 DOI: 10.1093/mr/roag039

Suguru Honda, Katsunori Ikari, Mayuko Fujisaki, Eiichi Tanaka, Masayoshi Harigai

{"title":"Medical pre-training and fine-tuning improve large-language-model prediction of rheumatoid-arthritis disease activity.","authors":"Suguru Honda, Katsunori Ikari, Mayuko Fujisaki, Eiichi Tanaka, Masayoshi Harigai","doi":"10.1093/mr/roag039","DOIUrl":"https://doi.org/10.1093/mr/roag039","url":null,"abstract":"Objective: To evaluate whether medical-domain pre-training and parameter-efficient fine-tuning improve the ability of locally deployable large language models (LLMs) to predict long-term disease activity and disability in rheumatoid arthritis (RA), and to benchmark their performance against established tabular machine-learning models.Methods: We trained on-premises Llama-2 (70B) models with and without medical pre-training (Meditron) and applied QLoRA fine-tuning using structured data from 11 865 patients in the IORRA cohort. Models predicted eight binary outcomes of RA disease activity and disability at 2 years. Performance was compared with logistic regression, random forest, and XGBoost using ROC-AUC, Brier score, calibration plots, and decision-curve analysis.Results: Medical pre-training and QLoRA fine-tuning both improved discrimination and calibration, with effects varying by endpoint. Fine-tuned LLMs achieved the highest or comparable ROC-AUCs for most DAS-based outcomes and matched conventional models for remission tasks. In low-prevalence outcomes, LLMs showed more stable calibration and small but consistent net-benefit advantages, while some tabular models exhibited clinically harmful decision curves.Conclusions: Endpoint-specific, privacy-preserving LLMs can complement or replace conventional tabular models for RA disease-activity prediction, providing reliable, locally deployable decision support without sacrificing data privacy.","PeriodicalId":18705,"journal":{"name":"Modern Rheumatology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147949020","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 of 90-Day Readmission for Heart Failure among Patients with Rheumatoid Arthritis: A Retrospective Cohort Study. 类风湿关节炎患者因心力衰竭再入院90天的风险：一项回顾性队列研究

IF 1.9 4区医学

Modern Rheumatology Pub Date : 2026-05-15 DOI: 10.1093/mr/roag040

Takano Toshio, Yamada Keiko, Ishida Ryo, Takeshima Taro

{"title":"Risk of 90-Day Readmission for Heart Failure among Patients with Rheumatoid Arthritis: A Retrospective Cohort Study.","authors":"Takano Toshio, Yamada Keiko, Ishida Ryo, Takeshima Taro","doi":"10.1093/mr/roag040","DOIUrl":"https://doi.org/10.1093/mr/roag040","url":null,"abstract":"Objectives: Patients with rheumatoid arthritis (RA) are at an increased risk of developing heart failure (HF); however, the risk of readmission due to HF in patients with RA remains unclear. This retrospective cohort study aimed to identify the risk of HF readmission among patients with RA.Methods: We included patients with RA aged ≥18 years who were hospitalized for the first time with HF and discharged between January 2012 and December 2019. The incidence of 90-day HF readmission was assessed. We reported the risk factors for HF readmission using the Fine-Gray model as adjusted subdistribution hazard ratios (aSHRs) and 95% confidence intervals (CIs).Results: The analysis included 1,274 patients (mean age, 76.4 years; 61.5% female; mean Charlson Comorbidity Index [CCI], 4.6). There were 146 (11.5%) cases of 90-day HF readmission in patients with RA who experienced HF complications, associated with the CCI (aSHR: 1.08, 95% CI: 1.01-1.15), diuretic use (aSHR: 1.48, 95% CI: 1.03-2.13), and opioid use (aSHR: 1.76, 95% CI: 1.11-2.77).Conclusions: Patients with RA appeared to have a higher incidence of 90-day HF readmission than the general HF registry population. HF readmission was associated with high CCI scores and the use of diuretics and opioids.","PeriodicalId":18705,"journal":{"name":"Modern Rheumatology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147949058","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

High Burden of Coinfection in Systemic Lupus Erythematosus with Bronchoalveolar Lavage Confirmed Pneumocystis jirovecii Pneumonia: A Single-Center Retrospective Study. 系统性红斑狼疮合并支气管肺泡灌洗确诊的乙氏肺囊虫肺炎并发感染的高负担：一项单中心回顾性研究

IF 1.9 4区医学

Modern Rheumatology Pub Date : 2026-05-15 DOI: 10.1093/mr/roag041

Kai-Chun Wang, Chien-Chih Lai, Wei-Sheng Chen, Hsien-Tzung Liao, Ming-Han Chen, De-Feng Huang, Chang-Youh Tsai, Ling-Ying Lu, Sheng-Jie Yu, Ming-Hong Tai, Yi-Syuan Sun

{"title":"High Burden of Coinfection in Systemic Lupus Erythematosus with Bronchoalveolar Lavage Confirmed Pneumocystis jirovecii Pneumonia: A Single-Center Retrospective Study.","authors":"Kai-Chun Wang, Chien-Chih Lai, Wei-Sheng Chen, Hsien-Tzung Liao, Ming-Han Chen, De-Feng Huang, Chang-Youh Tsai, Ling-Ying Lu, Sheng-Jie Yu, Ming-Hong Tai, Yi-Syuan Sun","doi":"10.1093/mr/roag041","DOIUrl":"https://doi.org/10.1093/mr/roag041","url":null,"abstract":"Objectives: To assess coinfection burden and identify predictors of early mortality in systemic lupus erythematosus (SLE) with bronchoalveolar lavage fluid (BALF)-confirmed Pneumocystis jirovecii pneumonia (PJP).Methods: We retrospectively enrolled SLE patients with BALF-confirmed PJP. Clinical and microbiologic data from BALF and blood were reviewed. Predictors of 1-month mortality were analysed using univariable and multivariable logistic regression, with risk stratification and Kaplan-Meier analyses.Results: Twenty-four SLE patients with BALF-confirmed PJP were identified. BALF coinfection occurred in 15 (62.5%), most commonly cytomegalovirus (54.2%). Among those assessed, cytomegalovirus viremia was present in 55.0% and bacteremia in 29.2%. The 1-month and in-hospital mortality rates were 37.5% and 62.5%. Twenty patients (83.3%) required intubation. Given the limited number of events, the multivariable model was considered exploratory; concomitant bacteremia (p = .008) and glucocorticoid pulse therapy within 1 month (p = .036) were associated with 1-month mortality. Mortality increased stepwise with 0, 1, and 2 factors (18.8%, 66.7%, and 100%), and Kaplan-Meier analyses showed shorter survival with either factor.Conclusion: SLE patients with BALF-confirmed PJP have a high coinfection burden and substantial short-term mortality. Bacteremia and recent glucocorticoid pulse therapy identify a high-risk clinical context. Timely bronchoscopy supports coinfection detection and guides management.","PeriodicalId":18705,"journal":{"name":"Modern Rheumatology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147949060","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

Disentangling Temporal Factors in Organ Damage Accrual in Systemic Lupus Erythematosus: Onset-Age, Onset-Era, and Aging in the Japanese LUNA Registry. 解开系统性红斑狼疮器官损伤的时间因素：发病年龄，发病时代和年龄在日本LUNA登记处。

IF 1.9 4区医学

Modern Rheumatology Pub Date : 2026-05-15 DOI: 10.1093/mr/roag042

Risa Sagawa, Takashi Kida, Akira Onishi, Ken-Ei Sada, Kunihiro Ichinose, Ryusuke Yoshimi, Shigeru Ohno, Kazutaka Kawamori, Hiroshi Kajiyama, Shuzo Sato, Yasuhiro Shimojima, Michio Fujiwara, Yoshia Miyawaki, Yusuke Matsuo, Ayuko Takatani, Takahisa Onishi, Keisuke Nishimura, Tomoaki Ida, Takuya Yanagida, Aki Sakashita, Aiko Hirano, Kazuki Fujioka, Takahiro Seno, Masataka Kohno, Yutaka Kawahito

{"title":"Disentangling Temporal Factors in Organ Damage Accrual in Systemic Lupus Erythematosus: Onset-Age, Onset-Era, and Aging in the Japanese LUNA Registry.","authors":"Risa Sagawa, Takashi Kida, Akira Onishi, Ken-Ei Sada, Kunihiro Ichinose, Ryusuke Yoshimi, Shigeru Ohno, Kazutaka Kawamori, Hiroshi Kajiyama, Shuzo Sato, Yasuhiro Shimojima, Michio Fujiwara, Yoshia Miyawaki, Yusuke Matsuo, Ayuko Takatani, Takahisa Onishi, Keisuke Nishimura, Tomoaki Ida, Takuya Yanagida, Aki Sakashita, Aiko Hirano, Kazuki Fujioka, Takahiro Seno, Masataka Kohno, Yutaka Kawahito","doi":"10.1093/mr/roag042","DOIUrl":"https://doi.org/10.1093/mr/roag042","url":null,"abstract":"Objectives: To disentangle the contributions of three temporal factors-onset-age, onset-era, and aging-to organ damage in systemic lupus erythematosus (SLE).Methods: We analyzed 1228 patients with SLE from a nationwide registry in Japan whose disease onset occurred between 1990-2019 at ≤50 years of age. Organ damage was assessed using the Systemic Lupus International Collaborating Clinics/American College of Rheumatology Damage Index (SDI) between 2020-2023. Negative binomial and logistic regression models estimated the independent associations of onset-age (<20 years [early-onset SLE: EOSLE] vs. 20-50 years), onset-era (5-year ordinal categories), and current age with SDI outcomes, adjusting for sex and comorbidities. Pairwise interactions among the temporal factors were examined.Results: EOSLE (count ratio 1.35; 95%CI 1.05-1.75), past onset-eras (count ratio 1.10; 95%CI 1.03-1.18), and older age (count ratio 1.02; 95%CI 1.01-1.03) were independently associated with higher SDI. EOSLE and older age were also associated with SDI ≥1, while past onset-eras were associated with greater 1-year increases in SDI. There was no evidence of interactions among the three temporal factors.Conclusions: Onset-age, onset-era, and aging each exert distinct impact on organ damage in SLE. Recognizing these temporal aspects may strengthen risk stratification and individualized long-term care.","PeriodicalId":18705,"journal":{"name":"Modern Rheumatology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147948993","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

Exploratory comparison of diffusion-weighted whole-body imaging with background body signal suppression and 18F-FDG PET/CT for assessing disease activity in large-vessel vasculitis. 带有背景信号抑制的弥散加权全身成像与18F-FDG PET/CT评估大血管炎疾病活动性的探索性比较

IF 1.9 4区医学

Modern Rheumatology Pub Date : 2026-05-08 DOI: 10.1093/mr/roag037

Yuji Nozaki, Atsuhiro Yamamoto, Daisuke Tomita, Tomoko Hyodo, Hayato Kaida, Kazunari Ishii, Koji Kinoshita

{"title":"Exploratory comparison of diffusion-weighted whole-body imaging with background body signal suppression and 18F-FDG PET/CT for assessing disease activity in large-vessel vasculitis.","authors":"Yuji Nozaki, Atsuhiro Yamamoto, Daisuke Tomita, Tomoko Hyodo, Hayato Kaida, Kazunari Ishii, Koji Kinoshita","doi":"10.1093/mr/roag037","DOIUrl":"https://doi.org/10.1093/mr/roag037","url":null,"abstract":"Objectives: To compare diffusion-weighted whole-body imaging with background body signal suppression (DWIBS) with ^18F-fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) for assessing disease activity in large-vessel vasculitis (LVV), and to evaluate whether segment-level analysis provides complementary information beyond global grading.Methods: We enrolled 25 patients with LVV (Takayasu arteritis [TAK], n = 11; giant cell arteritis [GCA], n = 14). Two blinded readers graded 11 arterial territories (18 segments) on a four-point visual scale for DWIBS and FDG-PET/CT. Global imaging grades were calculated as segment-averaged means. Correlations with serum C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) were assessed.Results: Global mean DWIBS grades correlated significantly with FDG-PET/CT grades (r = 0.72) and with CRP levels (r = 0.53). Territory-level mapping revealed diffuse central aortic involvement in GCA, whereas TAK showed more focal and segment-limited patterns. DWIBS demonstrated lower sensitivity in motion-prone regions but appeared to better reflect clinical activity and more frequently detected subclavian artery involvement in TAK compared with FDG-PET/CT. Residual vascular signals were also observed in some patients classified as being in clinical remission.Conclusions: DWIBS shows good agreement with FDG-PET/CT and provides a radiation- and contrast-free approach for assessing LVV. Global mean grades alone showed limited discriminatory power and may underestimate disease activity in focal or segment-limited involvement. Integrating segment-level imaging findings with clinical and laboratory markers may improve assessment of disease activity. Multicenter validation and longitudinal studies are warranted.","PeriodicalId":18705,"journal":{"name":"Modern Rheumatology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147856614","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}

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