Rheumatology最新文献

{"title":"A case with systemic juvenile idiopathic arthritis treated with tofacitinib and rapamycin.","authors":"Veysel Çam, Erdal Sağ, Yelda Bilginer, Seza Özen","doi":"10.1093/rheumatology/keae637","DOIUrl":"https://doi.org/10.1093/rheumatology/keae637","url":null,"abstract":"","PeriodicalId":21255,"journal":{"name":"Rheumatology","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2024-11-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142695885","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"68Ga-FAPI and 18F-NaF PET/CT in psoriatic arthritis: a comparative study.","authors":"Fan Yang, Chaofan Lu, Qingqing Pan, Rui Zhang, Meng Yang, Qian Wang, Mengtao Li, Xiaofeng Zeng, Yaping Luo, Xiaomei Leng","doi":"10.1093/rheumatology/keae577","DOIUrl":"https://doi.org/10.1093/rheumatology/keae577","url":null,"abstract":"<p><strong>Objectives: </strong>As fibroblast-like synoviocyte activation and bone formation are associated with psoriatic arthritis (PsA), positron emission tomography (PET) using the tracers of 68Ga-fibroblast activation protein inhibitor (FAPI) and 18F-sodium fluoride (NaF) may sensitively detect the disease. In this prospective study, we aimed to evaluate the performance of 68Ga-FAPI PET/CT in PsA and to compare it with 18F-NaF PET/CT.</p><p><strong>Methods: </strong>Sixteen participants (female 7/16, age 42.31 ± 10.66 years) with PsA were prospectively enrolled and underwent dual-tracer PET/CT, clinical assessment and ultrasonography. PET/CT images were scored for PET-positive lesions at the peripheral joints, entheses, and axial joints.</p><p><strong>Results: </strong>The positivity rate of 68Ga-FAPI in peripheral joints is higher than that in entheses and axial joints (21.84% vs 12.15% vs 0%), whereas high positivity rates of 18F-NaF in peripheral joints, entheses, and axial joints were observed (85.23%, 78.13%, and 75%, respectively). The disease activity score 28 was higher in the PET-positive than in the PET-negative group with 68Ga-FAPI (5.25 ± 1.84 vs 2.55 ± 0.94, p= 0.037), but not with 18F-NaF. Besides, the PET joint count at 68Ga-FAPI PET/CT was positively correlated with the TJC (r = 0.604, p= 0.017), SJC (r = 0.773, p= 0.001), DAS28-CRP (r = 0.556, p= 0.032), PASDAS (r = 0.540, p= 0.038) and PsASon13 (r = 0.701, p= 0.005), while no correlation was observed in 18F-NaF PET/CT.</p><p><strong>Conclusion: </strong>The positivity rates of 68Ga-FAPI- and 18F-NaF PET/CT were different in patients with PsA in peripheral joints, entheses, and axial joints. The extent of joint involvement at 68Ga-FAPI PET/CT correlated with clinical and ultrasound variables as well as disease activity.</p>","PeriodicalId":21255,"journal":{"name":"Rheumatology","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2024-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142686780","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Do SMS/e-mail reminders increase influenza vaccination of rheumatoid arthritis patients under anti-TNF: a nested randomized controlled trial in the ART e-cohort.","authors":"Yann Nguyen, Gabriel Baron, Naima Hamamouche, Rakiba Belkhir, Sylvie Miconnet, Martin Soubrier, Camille Hostachy, Pascale Thevenot, André Basch, Marie-Elise Truchetet, Pascal Claudepierre, Emmanuelle Dernis, Hubert Marotte, René-Marc Flipo, Olivier Brocq, Jacques Morel, Bruno Fautrel, Carine Salliot, Alain Saraux, Charles Leske, Thierry Schaeverbeke, Philippe Ravaud, Xavier Mariette, Adeline Ruyssen-Witrand, Raphaèle Seror","doi":"10.1093/rheumatology/keae599","DOIUrl":"https://doi.org/10.1093/rheumatology/keae599","url":null,"abstract":"<p><strong>Objectives: </strong>To evaluate the effectiveness of short message service (SMS) and/or email reminders in improving influenza vaccination coverage rates among rheumatoid arthritis (RA) patients treated with anti-TNF therapies, and to identify factors associated with vaccination.</p><p><strong>Methods: </strong>A nested randomized controlled trial in the ART e-cohort, an ongoing French nationwide multicentre prospective cohort of RA patients treated with anti-TNF therapy. Patients were 1:1 randomized, with stratification on age. The intervention consisted in regular reminders via SMS and/or emails to get vaccinated against influenza during the vaccination campaign. After the end, all participants received a questionnaire. The primary outcome was the influenza vaccination coverage. Secondary outcomes included the vaccination coverage before and after COVID-19 pandemic, and factors associated with vaccination.</p><p><strong>Results: </strong>Between October 2021 and April 2022, 446 participants were randomized (224 in the intervention group, 222 in the control group). Among them, 325 (73%) reported their vaccination status and 221 (68%) were vaccinated against influenza: 116/158 (73%) in the intervention group, vs 105/167 (63%) in the control group (RR 1.08; 95% CI 0.95-1.23). The vaccination coverage before and after COVID-19 pandemic did not differ (72% vs 72%; 95% CI -8% to8%). Age ≥65 years (OR 6.25; 95% CI 2.88-13.60), and previous influenza vaccination in the years before inclusion (OR 7.81; 95% CI 4.36-14.02) were associated with higher rates of vaccination.</p><p><strong>Conclusion: </strong>SMS and/or e-mails reminders did not significantly improve influenza vaccination rates in our cohort. COVID-19 pandemic did not substantially impact the influenza vaccination coverage. Our results might be counterbalanced by an already high vaccination coverage.</p><p><strong>Trial registration number: </strong>www.clinicaltrials.gov; NCT05220423; NCT03062865.</p>","PeriodicalId":21255,"journal":{"name":"Rheumatology","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2024-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142688464","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A mobile app to support self-management and remotely monitor disease impact in rheumatoid arthritis: the randomised controlled AEGORA trial.","authors":"Michaël Doumen, Elias De Meyst, Delphine Bertrand, Sofia Pazmino, Marine Piessens, Johan Joly, Mieke Devinck, René Westhovens, Patrick Verschueren","doi":"10.1093/rheumatology/keae638","DOIUrl":"https://doi.org/10.1093/rheumatology/keae638","url":null,"abstract":"<p><strong>Objectives: </strong>We aimed to study if smartphone applications could support the self-management of RA, while investigating engagement and potential negative psychological effects with app-use.</p><p><strong>Methods: </strong>App-based Education and GOal-setting in RA (AEGORA) was a multicentre randomised controlled trial with 2:1:1-allocation to usual care or two versions of an app-based self-management intervention for RA. The 16-week programme involved patient education, goal-setting, and remote monitoring of the Rheumatoid Arthritis Impact of Disease (RAID) instrument, either weekly or monthly depending on randomisation. The primary end point was improvement in the Arthritis Self-Efficacy Scale (ASES) after 16 weeks. Secondary endpoints included non-inferiority regarding the Pain Catastrophizing Scale (PCS) and superiority regarding patient-reported physical activity, sleep quality and RAID. App engagement and RAID-scores were analysed descriptively.</p><p><strong>Results: </strong>Overall, 122 patients were included: mean (SD) disease duration 12 (9) years, mean (SD) age 58(11), 68% female, mean (SD) DAS28-CRP 2.4(0.9). The intervention did not improve the ASES-score over usual care (β: 0.44, p= 0.87). Non-inferiority was established for the PCS (β -0.95 [95% CI -3.30 to + 1.40] favouring the intervention). Other predefined outcomes did not differ. App retention steadily declined to 43% by 16 weeks. Although the RAID remained stable over time overall, 35% of app users reported ≥1 episode of clinically relevant worsening over 16 weeks.</p><p><strong>Conclusion: </strong>This app-based self-management intervention was not superior to usual care regarding self-efficacy improvement. However, remote symptom monitoring provided valuable insight and did not increase pain catastrophising, alleviating concerns regarding the psychological impact of remote monitoring with apps.</p><p><strong>Trial registration number: </strong>clinicaltrials.gov, NCT05888181.</p>","PeriodicalId":21255,"journal":{"name":"Rheumatology","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2024-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142687672","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Enhancing Gout Diagnosis with Deep Learning in Dual-energy Computed Tomography: A Retrospective Analysis of Crystal and Artifact Differentiation","authors":"Yunjung Choi, Riel Castro-Zunti, Daewoo Lee, Jae Sung Yun, Younhee Choi, Seok-bum Ko, Eun Jung Choi, Gong Yong Jin, Wan-Hee Yoo, Eun Hae Park","doi":"10.1093/rheumatology/keae523","DOIUrl":"https://doi.org/10.1093/rheumatology/keae523","url":null,"abstract":"Objectives To evaluate whether the application of deep learning (DL) could achieve high diagnostic accuracy in differentiating between green colour coding, indicative of tophi, and clumpy artifacts observed in dual-energy computed tomography (DECT) scans. Methods A comprehensive analysis of 18 704 regions of interest (ROIs) extracted from green foci in DECT scans obtained from 47 patients with gout and 27 gout-free controls was performed. The ROIs were categorized into three size groups: small, medium, and large. Convolutional neural network (CNN) analysis on a per-lesion basis and support vector machine (SVM) analysis on a per-patient basis were performed. The area under the receiver operating characteristic curve, sensitivity, specificity, positive predictive value, and negative predictive value of the models were compared. Results For small ROIs, the sensitivity and specificity of the CNN model were 81.5% and 96.1%, respectively; for medium ROIs, 82.7% and 96.1%, respectively; for large ROIs, 91.8% and 86.9%, respectively. Additionally, the DL algorithm exhibited accuracies of 88.5%, 88.6%, and 91.0% for small, medium, and large ROIs, respectively. In the per-patient analysis, the SVM approach demonstrated a sensitivity of 87.2%, a specificity of 100%, and an accuracy of 91.8% in distinguishing between patients with gout and gout-free controls. Conclusion Our study demonstrates the effectiveness of the DL algorithm in differentiating between green colour coding indicative of crystal deposition and clumpy artifacts in DECT scans. With high sensitivity, specificity, and accuracy, the utilization of DL in DECT for diagnosing gout enables precise lesion classification, facilitating early-stage diagnosis and promoting timely intervention approaches.","PeriodicalId":21255,"journal":{"name":"Rheumatology","volume":"8 1","pages":""},"PeriodicalIF":5.5,"publicationDate":"2024-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142679143","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comment on: \"Real-world outcomes of a dedicated fast-track polymyalgia rheumatica clinic\".","authors":"Agnete Overgaard Donskov, Christoffer Søvsø Våben, Elisabeth Lindrup Nielsen, Andreas Wiggers Nielsen, Ellen Margrethe Hauge, Kresten Krarup Keller","doi":"10.1093/rheumatology/keae633","DOIUrl":"10.1093/rheumatology/keae633","url":null,"abstract":"","PeriodicalId":21255,"journal":{"name":"Rheumatology","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2024-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142668955","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Type I interferon biomarker in idiopathic inflammatory myopathies: associations of Siglec-1 with disease activity and treatment response.","authors":"Renske G Kamperman, Saskia R Veldkamp, Sanne W Evers, Johan Lim, Ivo van Schaik, Annet van Royen-Kerkhof, Femke van Wijk, Anneke J van der Kooi, Marc Jansen, Joost Raaphorst","doi":"10.1093/rheumatology/keae630","DOIUrl":"https://doi.org/10.1093/rheumatology/keae630","url":null,"abstract":"<p><strong>Objectives: </strong>Novel biomarkers are needed to guide therapy in idiopathic inflammatory myopathies (IIM). Expression of Siglec-1, a type I interferon biomarker, was examined in adult patients with IIM in relation to disease activity and treatment response.</p><p><strong>Methods: </strong>We analysed PBMC samples from 19 newly diagnosed adult IIM patients who participated in a phase-2 pilot study on efficacy of intravenous immunoglobulin (IVIG) monotherapy, and from 9 healthy controls. Siglec-1 expression on monocytes was measured by flow cytometry before and after treatment, and was evaluated in relation to IIM subtype, physician global activity (PhGA) scores, manual muscle strength (MMT) and the Total Improvement Score (TIS).</p><p><strong>Results: </strong>Diagnoses included dermatomyositis (DM; n = 9), immune-mediated necrotizing myopathy (IMNM; n = 5), non-specific/overlap myositis (NSM/OM; n = 4), and antisynthetase syndrome (ASyS; n = 1). All patients showed increased Siglec-1 expression at baseline. Relative median fluorescence intensity of Siglec-1 was highest in patients with DM. After 9 weeks, follow-up samples were available for 15 patients of whom 10 patients showed a decline in Siglec-1 expression. In DM, Siglec-1 correlated with disease activity (MMT; rs = -0.603, p= 0.013 and PhGA; rs = 0.783, p< 0.001) and with the TIS (rs = -0.786, p= 0.036).</p><p><strong>Conclusion: </strong>Siglec-1 was increased in treatment-naive IIM patients and showed a decline after IVIG monotherapy. In DM, Siglec-1 expression correlated with relevant clinical measures. This underlines the dynamic role of type I IFN in IIM and the biomarker potential of Siglec-1, in particular in DM. These findings should be further validated in larger cohorts with longer follow-up.</p>","PeriodicalId":21255,"journal":{"name":"Rheumatology","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2024-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142676779","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comment on: Real-world outcomes of a dedicated fast-track polymyalgia rheumatica clinic reply.","authors":"Sharon Cowley, Patricia Harkins, Colm Kirby, Danielle Molloy, Richard Conway, David Kane","doi":"10.1093/rheumatology/keae634","DOIUrl":"10.1093/rheumatology/keae634","url":null,"abstract":"","PeriodicalId":21255,"journal":{"name":"Rheumatology","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2024-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142668957","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Anti-PTX3 antibodies: towards a new concept of pain in rheumatoid arthritis?","authors":"Cátia Duarte, Luís S Inês","doi":"10.1093/rheumatology/keae636","DOIUrl":"https://doi.org/10.1093/rheumatology/keae636","url":null,"abstract":"","PeriodicalId":21255,"journal":{"name":"Rheumatology","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2024-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142676778","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association Between Antiphospholipid Antibodies and Diffuse Alveolar Hemorrhage Risk in Systemic Lupus Erythematosus: A Systematic Review and Meta-Analysis.","authors":"Mariana González-Treviño, Gabriel Figueroa-Parra, Jeffrey X Yang, Larry J Prokop, Sherif M Gamal, Mercedes A García, Judith A James, Jason S Knight, M Hassan Murad, Javier Narvaez, Bernardo A Pons-Estel, Rosana M Quintana, Ulrich Specks, Xuwei Yang, Alí Duarte-García","doi":"10.1093/rheumatology/keae632","DOIUrl":"10.1093/rheumatology/keae632","url":null,"abstract":"<p><strong>Objectives: </strong>To assess the association of antiphospholipid antibodies (aPL) and diffuse alveolar hemorrhage (DAH) in patients with systemic lupus erythematosus (SLE) by performing a systematic review and meta-analysis.</p><p><strong>Methods: </strong>Multiple databases were systematically searched from inception to February 2024. Studies were eligible if they included patients with SLE (population), reported aPL status (exposure), and DAH (outcome). We pooled the estimates as odds ratio (OR) using fixed-effect models. We examined the association between aPL and DAH, as well as associations based on aPL subtypes or concomitant antiphospholipid syndrome (APS).</p><p><strong>Results: </strong>Out of 454 screened studies, nine were included in meta-analysis, encompassing 7,746 patients with SLE, of whom 2016 (26.0%) were aPL positive and 163 (2.1%) had DAH. Patients with SLE and positive aPL (any) were more likely to develop DAH than aPL-negative patients (OR = 1.76, 95% CI 1.24-2.49; I2= 0%). Patients with SLE and positive lupus anticoagulant (LA; OR = 1.76, 95% CI 1.06-2.93, I2= 35%) or positive anticardiolipin IgG (OR = 1.62, 95% CI 1.13-2.34, I2=0%) had a higher likelihood of developing DAH compared with patients that were negative for these aPL. An APS diagnosis was associated with a 2.5-fold increased likelihood of DAH compared with subjects without APS (OR = 2.46, 95% CI 1.23-4.92, I2=0%). Positivity of anti-β2 glycoprotein I IgG was not significantly associated with DAH among patients with SLE (OR = 0.78, 95% CI 0.45-1.36, I2=0%).</p><p><strong>Conclusions: </strong>In patients with SLE, aPL positivity increases the risk of DAH compared with aPL-negative patients, particularly in those positive for LA and anticardiolipin IgG.</p>","PeriodicalId":21255,"journal":{"name":"Rheumatology","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2024-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142668861","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}