Reumatismo最新文献

{"title":"Antisynthetase syndrome with anti-glycyl tRNA synthetase antibodies in a patient with axial spondyloarthritis treated with tumor necrosis factor-α inhibitors.","authors":"Maria Iacovantuono, Chiara Bonini, Ernesto Di Biase, Vinicio Magliacani, Gian Domenico Sebastiani","doi":"10.4081/reumatismo.2025.1756","DOIUrl":"10.4081/reumatismo.2025.1756","url":null,"abstract":"<p><p>We present a case of interstitial lung disease arising in the course of antisynthetase syndrome (ASSD) in a patient with axial spondyloarthritis (ax-SpA) undergoing tumor necrosis factor-α (TNF-α) inhibitor therapy. Only two cases of ASSD in ax-SpA patients have been described in the literature, although with a different autoantibody profile. Only in one case, ASSD manifested with lung involvement, without the possible implication of TNF-α inhibitors in the pathogenesis, as it occurred concurrently with spondyloarthritis. Our case is the first to emphasize the coexistence of ASSD with anti-glycyl tRNA synthetase antibodies and ax-SpA, reminding us of the possible, although rare, adverse effects on the lungs with TNF-α inhibitors.</p>","PeriodicalId":21222,"journal":{"name":"Reumatismo","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143391661","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Inflammatory back pain as an unusual manifestation of Takayasu arteritis: a case report.","authors":"Faiq Gorial, Nabaa Awadh, Ali Al-Shakarchi, Ghaith Al-Gburi","doi":"10.4081/reumatismo.2024.1678","DOIUrl":"10.4081/reumatismo.2024.1678","url":null,"abstract":"<p><p>Takayasu arteritis and spondyloarthritis are two rheumatological diseases whose co-existence is well-documented in the literature. Data on the presence of inflammatory back pain in Takayasu arteritis without a diagnosis of spondyloarthritis, however, is scarce. Here, we present a 33-year-old man who was admitted to the emergency department with acute-onset chest pain associated with left carotidynia, carotid bruit, and left arm claudication, normal electrocardiogram and computed tomography angiographic features suggesting Takayasu arteritis, including stenosis and occlusion of the aorta and its branches. Two years prior, he had undergone a clinical work-up for inflammatory back pain accompanied by alternating buttocks pain, morning stiffness lasting more than half an hour, and heel pain. HLA-B27 status and magnetic resonance imaging of the sacroiliac joints were both negative. He was prescribed non-steroidal anti-inflammatory drugs and was placed on adalimumab 40 mg subcutaneously every 2 weeks but had to switch to etanercept 2 months before his emergency admission due to supply issues. Oral prednisolone was initiated at a dose of 60 mg/day with symptomatic improvement in both his inflammatory back pain and his chest pain, but he had to be switched to methotrexate and infliximab due to steroid side effects. Inflammatory aortitis should be considered as a possibility during the assessment of inflammatory back pain to mitigate the risks of delayed diagnosis.</p>","PeriodicalId":21222,"journal":{"name":"Reumatismo","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142547063","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The holistic management of peripheral spondyloarthritis: focus on articular involvement in patients with inflammatory bowel disease.","authors":"Ennio Lubrano, Alessandro Armuzzi, Silvia Scriffignano, Carla Felice, Fabio Massimo Perrotta, Vincenzo Venerito, Sergio Del Vescovo, Roberta Ramonda, Giulia Cassone, Fabiola Atzeni, Roberto Caporali, Fabrizio Conti, Elisa Gremese, Florenzo Iannone, Marco Sebastiani, Ennio Giulio Favalli","doi":"10.4081/reumatismo.2024.1688","DOIUrl":"10.4081/reumatismo.2024.1688","url":null,"abstract":"<p><strong>Objective: </strong>To provide a comprehensive overview of peripheral spondyloarthritis (pSpA), focusing specifically on its occurrence and management in patients with inflammatory bowel disease (IBD).</p><p><strong>Methods: </strong>An exhaustive literature search was conducted in PubMed, Embase, Cochrane Database of Systematic Reviews, and Google Scholar to identify relevant studies on pSpA in IBD patients. Titles, abstracts, and full-text articles were screened for relevance. Data on study design, patient characteristics, diagnostic criteria, main findings, and conclusions were extracted from selected articles. Study quality was assessed using appropriate checklists. Information was synthesized narratively to summarize current understanding.</p><p><strong>Results: </strong>pSpA is the most common extraintestinal manifestation of IBD, with a median prevalence of 16%. It worsens quality of life and requires collaboration between gastroenterologists and rheumatologists for optimal diagnosis and treatment. Several \"red flags\" guide appropriate specialist referral of IBD patients with suspected pSpA. Once the diagnosis is confirmed, the choice of therapy depends on IBD phenotype and patterns of articular/axial involvement. Anti-tumor necrosis factor (TNF) drugs are first-line biologics, with interleukin (IL)-12/23 and IL-23 inhibitors as alternatives for anti-TNF failure. Small molecules like apremilast and Janus kinase inhibitors also have utility. Recommended treatment algorithms exist, but more randomized controlled trials are needed.</p><p><strong>Conclusions: </strong>Early identification of pSpA is crucial in IBD patients to enable timely intervention, prevent structural damage, and minimize disability. A multidisciplinary, holistic approach addressing musculoskeletal and extra-musculoskeletal manifestations is key to optimal patient outcomes.</p>","PeriodicalId":21222,"journal":{"name":"Reumatismo","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142625536","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Baricitinib in polymyalgia rheumatica and giant cell arteritis: report of six cases.","authors":"Dario Camellino, Christian Dejaco, Franco Martini, Renzo Cosso, Gerolamo Bianchi","doi":"10.4081/reumatismo.2024.1796","DOIUrl":"10.4081/reumatismo.2024.1796","url":null,"abstract":"<p><p>The objective of this case series is to describe the efficacy and safety of baricitinib (BARI) in a group of patients with polymyalgia rheumatica (PMR) and/or giant cell arteritis (GCA). These patients were treated with BARI due to either a refractory disease course or the unavailability of tocilizumab because of the pandemic. A total of six patients (five females and one male, median age 64 years, range 50-83) were treated with BARI. Two of them had isolated PMR, two had PMR with associated large vessel (LV)-GCA, one had LV-GCA presenting as fever of unknown origin, and one had cranial-GCA. All patients reported improvement with BARI. At the time of starting BARI, patients were taking a median prednisone dose of 8.75 mg/day (range 0-25), and the four patients with PMR had a median PMR-activity score of 23.3 (indicating high disease activity), which decreased to 1.58 after 6 months of treatment with BARI. Two of them could stop glucocorticoids (GC) and continue BARI monotherapy. One patient suffered from pneumonia, and BARI was therefore stopped. No other adverse events attributable to BARI were detected. Our case series supports previous reports suggesting the efficacy of Janus kinase inhibitors as a GC-sparing strategy in PMR and GCA.</p>","PeriodicalId":21222,"journal":{"name":"Reumatismo","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142522858","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Alfonse T. Masi.","authors":"Maurizio Cutolo","doi":"10.4081/reumatismo.2025.1892","DOIUrl":"10.4081/reumatismo.2025.1892","url":null,"abstract":"<p><p>Alfonse T. Masi (born October 1930) passed away peacefully and comfortably in his home in March 2025 at the age of 94 years after a prestigious career...</p>","PeriodicalId":21222,"journal":{"name":"Reumatismo","volume":"77 1","pages":""},"PeriodicalIF":1.2,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143674621","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Italian Society for Rheumatology guidelines on reproductive health in patients with rheumatic diseases.","authors":"Chiara Crotti, Nicola Ughi, Emanuela Beretta, Antonio Luca Brucato, Greta Carrara, Maria Sole Chimenti, Paola Conigliaro, Francesca Crisafulli, Giovanna Cuomo, Emma Di Poi, Khadija El Auofy, Micaela Fredi, Maria Chiara Gerardi, Maria Gerosa, Ariela Hoxa, Aurora Ianniello, Maddalena Larosa, Danila Morano, Marta Mosca, Mario Motta, Martina Orlandi, Melissa Padovan, Davide Rozza, Savino Sciascia, Silvia Tonolo, Simona Truglia, Maria Letizia Urban, Anna Zanetti, Sonia Zatti, Angela Tincani","doi":"10.4081/reumatismo.2025.1752","DOIUrl":"10.4081/reumatismo.2025.1752","url":null,"abstract":"<p><strong>Objective: </strong>To date, there is no shared national guideline in Italy for the management of reproductive health in rheumatic diseases (RHRD). The Italian Society for Rheumatology (SIR) has committed to developing clinical practice recommendations to provide guidance on both management and treatment regarding RHRD in Italy.</p><p><strong>Methods: </strong>Using the GRADE-ADOLOPMENT methodology, a systematic literature review was conducted to update the scientific evidence that emerged after the publication of the reference recommendations from the American College of Rheumatology. A multidisciplinary group of 18 clinicians with specialist experience in rheumatology, allergy and clinical immunology, internal medicine, nephrology, gynecology and obstetrics, and neonatology, a professional nurse, a clinical psychologist, and a representative from the National Association of Rheumatic Patients discussed the recommendations in collaboration with the evidence review working group. Subsequently, a group of stakeholders was consulted to examine and externally evaluate the developed recommendations.</p><p><strong>Results: </strong>Recommendations were formulated for each area of interest: contraception, assisted reproductive technology, preconception counseling, and use of drugs before, during, and after pregnancy and during breastfeeding, considering both paternal and maternal exposure.</p><p><strong>Conclusions: </strong>The new SIR recommendations provide the rheumatology community with a practical guide based on updated scientific evidence for the management of RHRD.</p>","PeriodicalId":21222,"journal":{"name":"Reumatismo","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143410396","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Retrospective evaluation of the efficacy of ultrasound-guided intra-articular hyaluronic-acid-based injections (Hyalubrix^®) in patients with glenohumeral osteoarthritis.","authors":"Lorenzo Monti, Emanuele Franchi, Francesco Verde, Stefano Sgherzi, Filippo Maria Anghilieri","doi":"10.4081/reumatismo.2024.1699","DOIUrl":"10.4081/reumatismo.2024.1699","url":null,"abstract":"<p><strong>Objective: </strong>Intra-articular injections of hyaluronic acid (HA) have been reported to alleviate pain, reduce disability, and improve joint function in glenohumeral osteoarthritis (GH-OA). This retrospective study aimed to evaluate the effectiveness of a HA-based formulation (Hyalubrix®) in reducing the pain of patients with GH-OA and improving both patient's shoulder functions and quality of life (QoL).</p><p><strong>Methods: </strong>Data collected during the standard clinical practice of the center was retrospectively analyzed. The Simple Shoulder Test (SST) questionnaire reported data on the patient's ability to perform daily activities; the Euro-Quality of Life Health Assessment (EQ-5D) collected evidence on QoL; and changes in pain were evaluated through the Visual Analog Scale (VAS). SST and EQ-5D scores were analyzed comparing baseline values with those at the last follow-up, while VAS was investigated for all the available visits. Continuous values were summarized as mean ± standard deviation, median, and 25-75th percentiles. The Shapiro-Wilk test assessed normality, with significance set at p<0.05, and no adjustments for multiple comparisons were made.</p><p><strong>Results: </strong>All scores showed a significant improvement: VAS decreased from 55.4±13.8 to 16.2±16.3 (p<0.001), the SST increased from 38.0 to 65.5 (p<0.001), as did the EQ-5D (from 41.7 to 76.7; p<0.001).</p><p><strong>Conclusions: </strong>GH-OA treatment with Hyalubrix® proved to be highly beneficial, leading to complete pain reduction in more than 50% of patients and a significant reduction in 27.5% of cases. This resulted in improved joint function and QoL.</p>","PeriodicalId":21222,"journal":{"name":"Reumatismo","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142838440","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictors of poor outcomes in juvenile dermatomyositis: what do we know? A narrative review.","authors":"Ana Martins, Sara Ganhão, Francisca Aguiar, Mariana Rodrigues, Iva Brito","doi":"10.4081/reumatismo.2024.1640","DOIUrl":"10.4081/reumatismo.2024.1640","url":null,"abstract":"<p><strong>Objective: </strong>Juvenile dermatomyositis (JDM) is a rare chronic systemic inflammatory disorder with a highly variable clinical course. It is important to identify the patients at risk of developing more severe disease. However, based on the existing literature, there is a lack of data regarding predictors of poor outcomes. Obtaining knowledge about clinical and laboratory risk factors for disease progression and severity at an earlier stage of the disease could potentially lead to a better long-term prognosis for patients with JDM.</p><p><strong>Methods: </strong>A narrative review to identify risk factors for poor outcomes in patients with JDM, such as death, severe disease, refractory disease, and functional impairment, was conducted. A total of 27 articles were included.</p><p><strong>Results: </strong>Certain clinical manifestations and immunology features appear to worsen the prognosis in children with JDM. The recognition of these risk factors is essential for all pediatric rheumatologists as it allows the earlier identification of patients with potentially worse outcomes. These patients should receive closer follow-up and aggressive and individualized therapy to reduce their morbimortality.</p><p><strong>Conclusions: </strong>Additional research is needed not only to identify more predictors of worse outcomes but also more effective treatment approaches targeted toward these patients.</p>","PeriodicalId":21222,"journal":{"name":"Reumatismo","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142625417","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"PASSing to the patient side: early achieving of an acceptable symptom state in patients with rheumatoid arthritis treated with Janus kinase inhibitors.","authors":"Cristina Garufi, Silvia Mancuso, Fulvia Ceccarelli, Letizia Caruso, Cristiano Alessandri, Manuela Di Franco, Roberta Priori, Valeria Riccieri, Rossana Scrivo, Simona Truglia, Fabrizio Conti, Francesca Romana Spinelli","doi":"10.4081/reumatismo.2024.1725","DOIUrl":"10.4081/reumatismo.2024.1725","url":null,"abstract":"<p><strong>Objective: </strong>Patients Acceptable Symptom State (PASS) is a single dichotomized question assessing health satisfaction. We aimed to investigate PASS achievement within 4 weeks of treatment with Janus kinase (JAK) inhibitors (Jakinibs) and its association with treatment response after 4 and 12 weeks in rheumatoid arthritis (RA) patients.</p><p><strong>Methods: </strong>We recruited consecutive RA patients starting baricitinib or tofacitinib. At baseline, 4 and 12 weeks, we calculated disease activity [Disease Activity Score on 28 joints (DAS28), Clinical Disease Activity Index, Simplified Disease Activity Index], disease status [remission and low-disease activity (LDA)], percentage of patients achieving PASS, and the time to attain PASS. We assessed the impact of clinically relevant variables on PASS achievement by logistic regression analysis.</p><p><strong>Results: </strong>We enrolled 113 patients [98 (86.7%) females; median age 59.6 (interquartile range 16.9), median disease duration 144 (132) months]. 90 (79.6%) patients achieved PASS after 10 (8) days. A similar percentage of PASS achievers and non-achievers was in remission/LDA at weeks 4 and 12, but the reduction of disease activity was significantly greater in PASS achievers. All patients achieving Boolean remission at weeks 4 and 12 had achieved PASS within 4 weeks. The impact of Patients Global Assessment (PGA) on DAS28 was significantly greater in PASS non-achievers compared to PASS achievers; inversely, the impact of C-reactive protein was more relevant in PASS achievers. At multivariate analysis, pain and PGA were significantly associated with PASS.</p><p><strong>Conclusions: </strong>In our cohort, Jakinibs allowed an early achievement of PASS in a great percentage of RA patients. PASS is strictly dependent on PGA and pain and could suggest, early in the management of RA patients, therapeutic success.</p>","PeriodicalId":21222,"journal":{"name":"Reumatismo","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142584247","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Conventional radiography and correlated factors of enthesopathies of the Achilles tendon and plantar fascia in patients with axial spondyloarthritis.","authors":"Ebru Yılmaz, Özge Pasin","doi":"10.4081/reumatismo.2024.1709","DOIUrl":"10.4081/reumatismo.2024.1709","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to investigate the correlated risk factors and presence of radiological enthesopathies of the Achilles tendon and plantar fascia in patients with axial spondyloarthropathy (axSpA).</p><p><strong>Methods: </strong>242 patients (121 female and 121 male) with axSpA were included in this study. The Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), the Bath Ankylosing Spondylitis Functional Index (BASFI), the Ankylosing Spondylitis Disease Activity Score with C-reactive protein (ASDAS-CRP), the Bath Ankylosing Spondylitis Radiology Index (BASRI), the Maastricht Ankylosing Spondylitis Enthesitis Score (MASES), and CRP were evaluated in all patients. The lateral foot X-rays of the patients were assessed for enthesopathies of the Achilles tendon and plantar fascia attachments.</p><p><strong>Results: </strong>Calcaneal spur and Achilles enthesopathies were present in 57.4% of the patients. 39.3% of patients had enthesopathies in both regions. The male and female groups differed statistically in terms of weight, height, body mass index (BMI), positive family history, and duration since diagnosis (p<0.05). The presence of calcaneal spur and Achilles enthesopathies was found to be significantly correlated with age, weight, BMI, symptom duration, and the scores of BASDAI, BASFI, ASDAS-CRP, BASRI, and MASES (p<0.05).</p><p><strong>Conclusions: </strong>The presence of enthesopathies appears to be associated with age, weight, BMI, symptom duration, and disease activity. Conventional radiography can be used as an auxiliary tool in the evaluation of entheseal abnormalities in patients with SpA, especially in patients with advanced age, long symptom duration, and high BMI.</p>","PeriodicalId":21222,"journal":{"name":"Reumatismo","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142522859","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}