Reumatismo最新文献

{"title":"Retention rate and predictor factors of drug discontinuation in axial spondyloarthritis: a focus on certolizumab and secukinumab.","authors":"Ebru Atalar, Hatice Ecem Konak, Pınar Akyüz Dağlı, Bahar Özdemir Ulusoy, Özlem Karakaş, Kevser Orhan, Rezan Koçak Ulucaköy, Esra Kayacan Erdoğan, Serdar Can Güven, Orhan Küçükşahin, İsmail Doğan, Hakan Babaoğlu, Yüksel Maraş, Şükran Erten, Ahmet Omma, Berkan Armağan","doi":"10.4081/reumatismo.2025.1792","DOIUrl":"10.4081/reumatismo.2025.1792","url":null,"abstract":"<p><strong>Objective: </strong>Drug survival rate and time are important to demonstrate the effectiveness of treatment in patients with axial spondyloarthritis (axSpA) in real life. Therefore, we aimed to evaluate drug survival rate and predictors of discontinuation of certolizumab and secukinumab in axSpA patients.</p><p><strong>Methods: </strong>This single-center retrospective cohort study included patients treated with certolizumab (n=239) and secukinumab (n=64) among axSpA patients followed up at the rheumatology clinic. Clinical, laboratory, and imaging findings, treatment duration, and reasons for discontinuation were evaluated between April 2019 and December 2022. Drug survival rate and time were analyzed using Kaplan-Meier analysis, and predictive factors associated with drug discontinuation were analyzed using multivariable Cox regression analysis.</p><p><strong>Results: </strong>At 12 months, drug retention rates were 76% in the secukinumab group and 73% in the certolizumab group. The overall retention rate was similar in both groups (p=0.641). The median survival time was 66.0 months in the secukinumab group vs. 62.8 months in the certolizumab group. A comparison of the patients who discontinued certolizumab treatment with those who continued showed that patients who discontinued certolizumab treatment had a higher frequency of female sex, peripheral arthritis, and inflammatory bowel disease. Comparison of the patients who discontinued secukinumab treatment with those who continued revealed that patients who discontinued secukinumab treatment only had a higher frequency of male sex. Multivariable Cox regression showed that male sex was independently associated with a lower risk of certolizumab discontinuation [hazard ratio (HR): 0.634, 95% confidence interval (CI): 0.41-0.97, p=0.036] and with a higher risk of secukinumab discontinuation (HR: 2.77, 95% CI: 1.18-6.49, p=0.018).</p><p><strong>Conclusions: </strong>Our data showed that the drug survival rate of certolizumab and secukinumab was similar in patients with AxSpA. There was a lower risk of certolizumab discontinuation and a higher risk of secukinumab discontinuation in males.</p>","PeriodicalId":21222,"journal":{"name":"Reumatismo","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144529476","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":"Real-life effectiveness of rituximab in different subsets of idiopathic inflammatory myopathies.","authors":"Stefano Stano, Fabio Cacciapaglia, Laura Coladonato, Giuseppe Lopalco, Florenzo Iannone, Marco Fornaro","doi":"10.4081/reumatismo.2025.1817","DOIUrl":"10.4081/reumatismo.2025.1817","url":null,"abstract":"<p><strong>Objective: </strong>Idiopathic inflammatory myopathies (IIM) are heterogeneous autoimmune diseases including dermatomyositis (DM), polymyositis (PM), immune-mediated necrotizing myopathy (IMNM), and anti-synthetase syndrome (ASS). Treatment typically involves high-dose corticosteroids (CCS) and conventional synthetic disease-modifying antirheumatic drugs (csDMARD). Rituximab (RTX) has shown effectiveness in refractory cases. Our real-life study aimed to assess the safety and effectiveness of RTX treatment in IIM patients.</p><p><strong>Methods: </strong>We conducted a retrospective study including patients with IIM refractory to both high-dose CCS and csDMARD. Patients were treated with a full RTX dose (2 g every 6 months). Laboratory and clinical data, along with the total improvement score (TIS), were assessed to evaluate RTX effectiveness and safety. Data were analyzed using GraphPad Prism (v. 9.5.1).</p><p><strong>Results: </strong>A total of 41 patients received the full RTX dose (15 DM, 15 ASS, 5 PM, and 6 IMNM). This treatment regimen significantly reduced daily CCS usage from 15 mg [interquartile range (IQR) 12.5-25 mg] at baseline to 5 mg (IQR 5-5 mg) after 1 year of treatment (p<0.001). Additionally, over 90% of patients achieved at least a minimal TIS at 12 months, which was maintained at 24 months. At 1 year, RTX persistence was 68.3%. Although reductions in serum immunoglobulins (Ig)A and IgM levels were observed, no cases of severe hypogammaglobulinemia (IgG<400 mg/dL) occurred. The most common reason for treatment interruption was an adverse skin reaction (6 cases) during RTX infusion, while infections most frequently involved the respiratory tract (5 cases).</p><p><strong>Conclusions: </strong>RTX demonstrated effectiveness in various subsets of IIMs, often leading to clinical improvement and significantly reducing the CCS dose.</p>","PeriodicalId":21222,"journal":{"name":"Reumatismo","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143796241","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":"Intimate partner violence in reproductive-age and pregnant-postpartum women with autoimmune rheumatic diseases: a comparative cross-sectional study.","authors":"Mara Alejandra Ponce-Santillán, Anahí Carrazco-Chapa, Andres Manuel Ortiz-Rios, Maria Eugenia Corral-Trujillo, Jesus Alberto Cardenas-de la Garza, Cassandra Michele Skinner-Taylor, Dionicio Angel Galarza-Delgado, Lorena Perez-Barbosa","doi":"10.4081/reumatismo.2025.1850","DOIUrl":"10.4081/reumatismo.2025.1850","url":null,"abstract":"<p><strong>Objective: </strong>We aimed to describe the frequency of intimate partner violence (IPV) in reproductive-age women and pregnant-postpartum women with autoimmune rheumatic diseases (ARDs) and compare it with those without ARDs (controls).</p><p><strong>Methods: </strong>A descriptive, cross-sectional, and comparative study was conducted among pregnant-postpartum patients and reproductive-age women (18-45 years) with and without ARDs who attended the Hospital Universitario in Monterrey, Mexico, and answered the survey Hurt-Insult-Threaten-Scream (HITS) scale in the validated Spanish version, from June 2023 to May 2024.</p><p><strong>Results: </strong>A total of 120 women were included: 60 with ARDs and 60 controls. In both groups, 30 patients were reproductive-age women and 30 were pregnant-postpartum women. A total of 44 (36%) women reported being victims of IPV. No significant differences were found in reported IPV between the control group and the group of women with ARDs (n=21, 35% vs. n=23, 38%, p=0.85). There was no statistically significant difference between the ARD group compared to the control group in the HITS score (p=0.537), nor between the pregnant-postpartum subgroups (p=0.356) or the reproductive-age subgroups (p=0.972). These findings indicate that IPV rates did not significantly differ by ARD status or reproductive stage in this sample.</p><p><strong>Conclusions: </strong>Nearly one in every three women experienced IPV, but our research showed that there was no difference in the frequency of IPV between the ARD group and the control group. Pregnant and postpartum women were more likely to report IPV than women of reproductive age. These findings highlight that IPV is a significant concern for all women in Mexico and the need for increased attention and support for them.</p>","PeriodicalId":21222,"journal":{"name":"Reumatismo","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144286404","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":"Coexisting rheumatoid arthritis and sickle cell disease: case series and literature review.","authors":"Abdallah Alqethami, Sabri Alsaeedi, Samera Felemban, Abdulelah Qadi","doi":"10.4081/reumatismo.2025.1682","DOIUrl":"10.4081/reumatismo.2025.1682","url":null,"abstract":"<p><p>Rheumatoid arthritis (RA) is rarely reported among patients with sickle cell disease (SCD). RA treatment in these patients is believed to be more challenging due to the fear of increasing the risk of infection and complications of SCD. We are reporting 7 patients with concurrent SCD and RA. The average age at the time of the diagnosis of RA was 33.3±12.6 years (ranging from 16 to 53 years), and most were women (5/7). Most of the patients were positive for rheumatoid factor (6/7) or anticyclic citrullinated peptide (6/7). Four patients were treated with hydroxyurea. The most used antirheumatic drugs were methotrexate (7/7), biologic agents (5/7), and prednisone (4/7). Two patients were in remission, four had low and one had high disease activity. Four patients (4/7) had avascular necrosis, two in the shoulders and two in the hip joints. Four patients had emergency visits or hospitalizations within one year of the diagnosis of RA, but none had blood transfusions, infections, or death. The start of antirheumatic medications was not associated with an increased risk of infection, blood transfusions, emergency visits, or hospitalizations, nor with a worsening of laboratory measures. The findings suggest that the treatment of RA in patients with SCD should follow the same strategy as in patients without SCD. However, treatment should be individualized according to the individual patient's risk of infection and SCD complications.</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":"142954111","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":"Tuberculosis infection in patients with dermatomyositis.","authors":"Luis Carlos Palomino Romero, Alfredo Vargas Caselles, Natalia Soledad Rius, Enrique Soriano, Javier Rosa, Marina Scolnik","doi":"10.4081/reumatismo.2025.1631","DOIUrl":"10.4081/reumatismo.2025.1631","url":null,"abstract":"<p><p>Patients with dermatomyositis (DM) are particularly susceptible to opportunistic infections due to immunosuppression induced by the disease itself and its treatment. We describe three patients who met the diagnostic criteria for DM and developed tuberculous myositis. The first case, a 54-year-old woman, had a positive polymerase chain reaction (PCR) for Mycobacterium tuberculosis detected in a post-mortem muscle biopsy. A second patient was diagnosed with a positive Ziehl-Neelsen stain in bronchoalveolar lavage, and a third patient, with multiple collections in the thorax and lower limbs, had positive Ziehl-Neelsen stain and PCR for Mycobacterium tuberculosis. In inflammatory myopathies, muscle and soft tissue infection by tuberculosis may produce symptoms similar to the underlying disease. The differential diagnosis of tuberculosis superinfection can be difficult.</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":"143606284","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":"After what time interval are we justified to diagnose immune checkpoint inhibitor-mediated polymyalgia rheumatica?","authors":"Ciro Manzo, Marco Isetta","doi":"10.4081/reumatismo.2025.1823","DOIUrl":"10.4081/reumatismo.2025.1823","url":null,"abstract":"<p><p>Dear Editor, The number of cases of cancer patients diagnosed as having immune checkpoint inhibitor-mediated polymyalgia rheumatica is increasing...</p>","PeriodicalId":21222,"journal":{"name":"Reumatismo","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143543367","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":"Small molecules in idiopathic inflammatory myopathies: a systematic review and a multicenter case series about Janus kinase inhibitors and apremilast.","authors":"Chiara Rizzo, Silvia Grazzini, Edoardo Conticini, Hector Chinoy, Roberto D'Alessandro, Federica Camarda, Luca Cantarini, Bruno Frediani, Giuliana Guggino, Lidia La Barbera","doi":"10.4081/reumatismo.2025.1718","DOIUrl":"10.4081/reumatismo.2025.1718","url":null,"abstract":"<p><strong>Objective: </strong>Idiopathic inflammatory myopathies (IIM) are rare autoimmune diseases that primarily affect striated muscles; skin, joints, and lungs may be involved with different degrees of severity. Traditional treatment relies on high-dose glucocorticoids and conventional synthetic disease-modifying antirheumatic drugs.</p><p><strong>Methods: </strong>A growing amount of evidence is demonstrating the potential role of novel treatments in the management of IIM. We report our experience with Janus kinase inhibitors (JAKi) in these conditions and review the current evidence for the use of small molecules in real-life clinical practice.</p><p><strong>Results: </strong>A total of 41 papers were retrieved from PubMed, 37 papers concerning IIM and JAKi, and 4 papers concerning IIM and apremilast.</p><p><strong>Conclusions: </strong>An overall good efficacy was evidenced in IIM-associated skin lesions, including rash, ulcers, and calcinosis. If present, muscle and joint involvement demonstrated a good response to therapy, while it was not possible to draw any conclusion about dysphagia. No life-threatening adverse events were reported.</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":"142984652","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":"Janus kinase inhibitors in rheumatoid arthritis-associated interstitial lung disease: where do we stand and what may be the future?","authors":"Beatrice Maranini, Roberta Foti, Moustapha Taha, Veronica Venturelli, Andrea Lo Monaco, Marcello Govoni","doi":"10.4081/reumatismo.2025.1754","DOIUrl":"10.4081/reumatismo.2025.1754","url":null,"abstract":"<p><strong>Objective: </strong>Interstitial lung disease (ILD) is rare, but it is one of the most frequent extra-articular manifestations and a relevant cause of morbidity and mortality in rheumatoid arthritis (RA). Over the past few years, Janus kinase inhibitors (JAKis) have been reported to have promising efficacy in the treatment of active RA, but recent concerns have been raised about their safety profile, namely, malignancy and cardiovascular disease, limiting their use to certain patient categories.</p><p><strong>Methods: </strong>The objective of this narrative review is to summarize the current evidence of the efficacy and safety of JAKis in RA-ILD management, investigating a possible emerging role for this drug class in such a subset of patients.</p><p><strong>Results: </strong>Current studies focusing on JAKis in RA-ILD are scarce, but they globally report an overall stabilization of respiratory symptoms, functional data, and radiographic extension of ILD. In some cohorts, JAKis determined even an encouraging improvement in lung disease, and few reports presented good tolerability of JAKis in combination with antifibrotics. Concerning the safety profile, no significant increased risk of pulmonary infection has been reported.</p><p><strong>Conclusions: </strong>Thus far, evidence regarding the role of JAKis in the treatment of RA-ILD remains relatively limited, and additional prospective studies are needed to better understand the place of JAKis, if any, in preventing/stabilizing ILD in RA patients.</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":"143067656","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":"Prevalence of musculoskeletal disorders in patients referred for suspected deep vein thrombosis: insights from a rheumatologist-led clinic.","authors":"Nikoletta Svendsen, Philip Rask Lage-Hansen, Stavros Chrysidis","doi":"10.4081/reumatismo.2025.1828","DOIUrl":"10.4081/reumatismo.2025.1828","url":null,"abstract":"<p><strong>Objective: </strong>To assess the frequency of deep vein thrombosis (DVT) and alternative diagnoses in patients with suspected DVT when evaluated by a rheumatologist. Secondly, to describe the distribution of different diagnoses across three Wells score categories (low, moderate, and high).</p><p><strong>Methods: </strong>This is an observational study of patients evaluated at a DVT clinic for suspected DVT, with a rheumatologist-supervised evaluation, performing ultrasound scans on the affected limbs and assessing their results. The obtained diagnoses were noted along with the initial Wells scores performed by the rheumatologist.</p><p><strong>Results: </strong>649 patients were included. DVT was confirmed in 119/649 (18.3%) cases, with musculoskeletal (MSK) disorders, particularly arthritis and knee-related conditions, being the most common alternative diagnoses (166/649, 25.6%). 288/649 (44.4%) patients did not receive a definitive diagnosis. Higher Wells scores were more common in confirmed DVT cases, while patients with MSK disorders generally had lower Wells scores, likely due to clinical assessments that identified alternative diagnoses early.</p><p><strong>Conclusions: </strong>MSK disorders frequently present with symptoms mimicking DVT, underscoring the value of rheumatologist-led evaluations in suspected DVT cases. Further research is needed to refine diagnostic approaches for patients with DVT-like symptoms, particularly regarding the role of MSK expertise in both physical and ultrasound assessments.</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":"143606283","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":"Adherence to vaccination against SARS-CoV-2 and vaccine safety in patients with IgG4-related disease.","authors":"Linda Mastromanno, Federico Giardina, Angelica Gattamelata, Serena Colafrancesco, Simona Truglia, Francesca Romana Spinelli, Edoardo Simoncelli, Bruno Lucchino, Fabrizio Conti, Roberta Priori","doi":"10.4081/reumatismo.2025.1744","DOIUrl":"10.4081/reumatismo.2025.1744","url":null,"abstract":"<p><strong>Objective: </strong>To assess the adherence to the vaccination campaign against SARS-CoV-2 in patients with IgG4-related disease (IgG4-RD) and to evaluate the development of local and systemic adverse events (AEs) following vaccination. Additionally, to investigate the rate and outcome of SARS-CoV-2 infection in IgG4-RD patients.</p><p><strong>Methods: </strong>Patients with IgG4-RD in follow-up before the onset of the SARS-CoV-2 pandemic were contacted by telephone and asked to answer an ad hoc questionnaire regarding their vaccination status against SARS-CoV-2 and related AEs following vaccination. The occurrence and the outcome of SARS-CoV-2 infection were also recorded. The same questionnaire was proposed to healthy controls (HC).</p><p><strong>Results: </strong>20 patients and 40 HC were enrolled. In the patient's cohort, 90% were vaccinated with at least one dose; among them, 11 reported AEs: 61.1% systemic and 22.2% local. Within the HC group, 100% were vaccinated with at least one dose. 20 out of 40 HC had systemic AEs (50%), and 27 (67.5%) reported local AEs. Neither in IgG4-RD nor in HC, serious adverse reactions were observed. Among the patient's cohort, 60% contracted SARS-CoV-2 infection, and 41.67% were on immunosuppressants at the time of the infection. One patient presented with severe COVID-19. No disease flares following vaccination or infection were reported.</p><p><strong>Conclusions: </strong>Results from our study indicate good adherence to the vaccination campaign against SARS-CoV-2 in patients with IgG4-RD and support a relatively good safety profile of this vaccine. Compared to controls, patients with IgG4-RD reported slightly more systemic AEs and fewer local AEs. A similar rate of COVID-19 development was observed between IgG4-RD patients and HC.</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":"143029558","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}