Rheumatology最新文献

{"title":"Systemic lupus erythematosus-disease activity score remission and low disease activity were similarly associated with patient-reported outcomes compared with definition of remission in systemic lupus erythematosus remission and lupus low disease activity state.","authors":"Emi Nakanishi,Masakazu Matsushita,Kentaro Minowa,Kurisu Tada,Toshio Kawamoto,Makio Kusaoi,Hirofumi Amano,Takayuki Kon,Shinji Morimoto,Keigo Ikeda,Satoshi Suzuki,Kazuhisa Nozawa,Kwang-Seok Yang,Ran Matsudaira,Akira Katagiri,Hiroshi Tsushima,Wataru Urasaki,Shuko Nojiri,Ken Yamaji,Naoto Tamura","doi":"10.1093/rheumatology/keaf349","DOIUrl":"https://doi.org/10.1093/rheumatology/keaf349","url":null,"abstract":"OBJECTIVESThe treat-to-target (T2T) approach for systemic lupus erythematosus (SLE) has recently been proposed. However, the most suitable criterion for determining remission or low disease activity (LDA) using patient-reported outcomes (PROs) remains unknown. This study aimed to compare the relationship between PROs and various remission criteria, including the definition of remission in SLE (DORIS), SLE disease activity score (SLE-DAS) remission, lupus low disease activity state (LLDAS), and SLE-DAS LDA.METHODSA multicentre prospective study was conducted involving patients with SLE who visited Juntendo University and its affiliated hospitals between 2018 and 2024. A cross-sectional analysis was performed using surveys completed by physicians and patients. Multivariate analyses were performed to explore the relationship between PROs and remission/LDA criteria. Quality of life was evaluated using the medical outcomes study 36-item short-form health survey (SF-36) and EuroQol-5D.RESULTSThis study included 334 patients. All remission and LDA criteria were significantly associated with the SF-36 physical component summary, with SLE-DAS remission demonstrating superior accuracy metrics compared with DORIS remission. No associations were observed with the mental component summary for any remission or LDA criteria. Regarding the EuroQol-5D, no correlations were identified with DORIS remission; however, correlations were observed with other remissions and LDA criteria.CONCLUSIONRemission and LDA criteria based on the safety of estrogens in lupus erythematosus national assessment SLE disease activity index and SLE-DAS exhibited similar associations with PROs. SLE-DAS remission and LDA represent valid treatment targets in a T2T approach, comparable to DORIS remission and LLDAS in terms of PROs.","PeriodicalId":21255,"journal":{"name":"Rheumatology","volume":"90 1","pages":""},"PeriodicalIF":5.5,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144478925","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":"Novel location of IgG4-related disease in the anterior mediastinum.","authors":"Hideki Oka,Shuji Sumitomo,Junnosuke Yamakawa,Daisuke Yamashita,Koichiro Ohmura","doi":"10.1093/rheumatology/keaf351","DOIUrl":"https://doi.org/10.1093/rheumatology/keaf351","url":null,"abstract":"","PeriodicalId":21255,"journal":{"name":"Rheumatology","volume":"7 1","pages":""},"PeriodicalIF":5.5,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144478633","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":"Sex differences in serum proteomic profiles in psoriatic arthritis.","authors":"Steven Dang,Xianwei Li,Liqun Diao,Vincent Piguet,David Croitoru,Joan Wither,Igor Jurisica,Vinod Chandran,Lihi Eder","doi":"10.1093/rheumatology/keaf311","DOIUrl":"https://doi.org/10.1093/rheumatology/keaf311","url":null,"abstract":"OBJECTIVESSex-related differences exist in the clinical presentation and treatment outcomes of patients with psoriatic arthritis (PsA). The biological pathways driving these differences remain unknown. We conducted an untargeted proteomic study to identify sex-specific serum proteins and biological pathways in males and females with PsA.METHODSWe used an aptamer-based panel to measure 6402 serum proteins in 50 male and 50 female patients with active PsA and 50 age- and sex-matched non-psoriatic controls. Differential expression and pathway enrichment analysis identified differentially expressed proteins (DEPs) and enriched pathways between male and female PsA patients. Machine learning classifiers were used to develop sex-specific multi-biomarker models to distinguish PsA patients from controls. Proteins with the highest predictive performances were highlighted from random forest models.RESULTSThe differential analysis revealed over 20 times more sex-specific DEPs in PsA males vs controls (n = 741) than in PsA females vs controls (n = 31). The enriched pathways among DEPs in PsA males vs PsA females were related to intracellular signalling, vascular function, cytokine signalling, and immune cell functions. All models discriminated PsA from controls for both sexes with an area under the curve of 0.85-0.99. Variable importance analysis identified leukotriene A-4 hydrolase as a significant predictor in PsA females vs controls, whereas interleukin-36 alpha, NEK7, and PIK3CA/PIK3R1 were significant in PsA males vs controls.CONCLUSIONSignificantly more dysregulated proteins and biological pathways were found in males than in females with PsA. The identified proteins and pathways offer potential new targets for sex-based research in PsA.","PeriodicalId":21255,"journal":{"name":"Rheumatology","volume":"147 1","pages":""},"PeriodicalIF":5.5,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144478631","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":"Higher comorbidities associated with less improvement in disease activity in early rheumatoid arthritis: results from CATCH cohort.","authors":"Safoora Fatima,Janet E Pope,Lillian-Ruiheng Chen,Orit Schieir,Marie-France Valois,Susan J Bartlett,Gilles Boire,Glen Hazlewood,Carol Hitchon,Diane Tin,Carter Thorne,Bindee Kuriya,Hugues Allard-Chamard,Vivian P Bykerk,Louis Bessette,","doi":"10.1093/rheumatology/keaf350","DOIUrl":"https://doi.org/10.1093/rheumatology/keaf350","url":null,"abstract":"OBJECTIVESComorbidities negatively influence remission rates in rheumatoid arthritis (RA). This study estimated the effects of comorbidities on components of disease activity in early RA (ERA).METHODSUsing the Rheumatic Disease Comorbidity Index (RDCI), the influence of comorbidities on trajectories of components of the SDAI (Simple Disease Activity Index) was assessed in participants with ERA enrolled in Canadian Early Arthritis Cohort (CATCH) over the first year of treatment. Adjusted effects of RDCI scores categorized 0, 1, 2, and ≥ 3 on SDAI trajectories over time were analyzed using multivariable generalized estimating equations (GEE) models adjusted for multiple confounders.RESULTSERA participants (N = 2248) had a mean (SD) symptom duration of 5.7 (3) months; mean age 55 (15) years and 72% were female. Baseline SDAI was 29 (15), with 90% having moderate-high SDAI. Baseline RDCI scores were 0 in 888 (40%), 1 in 547 (24%), 2 in 451 (20%), and ≥3 in 362 (16%). While baseline disease activity was similar across comorbidity groups, patients with higher RDCI scores showed worse SDAI trajectories over the first year of RA treatment. Higher RDCI scores were independently associated with pain, patient and physician global assessments over time.CONCLUSIONThis large real-world analysis of ERA patients seen in routine rheumatology practice across Canada showed that while RA disease activity across comorbidity groups at diagnosis was similar, higher comorbidity was associated with slower improvement in RA disease activity over the first year of treatment, likely driven by independent associations with patient and physician global assessments and pain.","PeriodicalId":21255,"journal":{"name":"Rheumatology","volume":"54 1","pages":""},"PeriodicalIF":5.5,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144478921","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":"Correction to two papers to add a disclosure statement.","authors":"","doi":"10.1093/rheumatology/keaf295","DOIUrl":"https://doi.org/10.1093/rheumatology/keaf295","url":null,"abstract":"","PeriodicalId":21255,"journal":{"name":"Rheumatology","volume":"179 1","pages":""},"PeriodicalIF":5.5,"publicationDate":"2025-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144295813","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":"Serum cytokine levels towards precision medicine in Still's disease: a subanalysis of a randomized controlled trial of tocilizumab.","authors":"Koji Suzuki, Hideto Kameda, Kei Ikeda, Tomonori Ishii, Kosaku Murakami, Hyota Takamatsu, Yoshiya Tanaka, Takayuki Abe, Tsutomu Takeuchi, Yuko Kaneko","doi":"10.1093/rheumatology/keaf254","DOIUrl":"https://doi.org/10.1093/rheumatology/keaf254","url":null,"abstract":"<p><strong>Objectives: </strong>To predict the efficacy of IL-6 inhibition in patients with Still's disease by analysing inflammatory cytokine profiles before and during an IL-6 receptor inhibitor therapy.</p><p><strong>Methods: </strong>This is a subanalysis of the 52-week, randomized, double-blind, placebo-controlled trial of tocilizumab, an IL-6 receptor inhibitor, in patients with Still's disease. Multiple serum cytokine levels were measured regularly, and their pattern and profiles were analysed based on the response to tocilizumab.</p><p><strong>Results: </strong>A total of 26 patients (13 in the tocilizumab group and 13 in the placebo group) were enrolled. Before tocilizumab treatment, IL-6 levels were correlated with DAS with 28 joints (r = 0.67, P < 0.01), and IL-1β, IL-6 and IL-18 levels tended to be correlated with systemic feature score (r = 0.33, P = 0.09; r = 0.38, P = 0.05; r = 0.40, P = 0.04, respectively). IL-6 and IL-6 receptor levels were significantly elevated after tocilizumab initiation, while the other cytokines showed no significant difference compared with placebo. Baseline levels of IFN-γ and IL-1β were significantly higher in non-responders compared with responders (28.49 vs 5.65 pg/ml, P = 0.03; 0.26 vs 0.04 pg/ml, P = 0.048), and IFN-γ and IL-18 levels at week 52 remained high in non-responders (15.56 vs 7.03 pg/ml, P = 0.02; 5924 vs 392 pg/ml, P = 0.02).</p><p><strong>Conclusions: </strong>The effect of tocilizumab is limited to the IL-6 signalling pathway in Still's disease. Patients who did not respond to tocilizumab exhibited distinct cytokine profiles that pivot the IFN-γ axis. These findings highlight the role of IL-6 inhibition in Still's disease and shed light on its personalized treatment strategies.</p><p><strong>Clinical trial registration number: </strong>UMIN Clinical Trials Registry; UMIN000012987.</p>","PeriodicalId":21255,"journal":{"name":"Rheumatology","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2025-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144294863","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":"Glucocorticoid or immunosuppressives withdrawal in SLE in remission: that is the question… the only question?","authors":"Guillermo Ruiz-Irastorza","doi":"10.1093/rheumatology/keaf331","DOIUrl":"https://doi.org/10.1093/rheumatology/keaf331","url":null,"abstract":"","PeriodicalId":21255,"journal":{"name":"Rheumatology","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2025-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144294862","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":"Avacopan may not independently reduce ANCA titres in ANCA-Associated vasculitis: a retrospective analysis of 57 patients.","authors":"Motoki Takeuchi, Yoshiyuki Abe, Masahiro Kogami, Ayako Makiyama, Ken Yamaji, Naoto Tamura","doi":"10.1093/rheumatology/keaf339","DOIUrl":"https://doi.org/10.1093/rheumatology/keaf339","url":null,"abstract":"","PeriodicalId":21255,"journal":{"name":"Rheumatology","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2025-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144294861","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-HMGCR myopathy: observed ethnic differences in disease and disease outcomes in New Zealand","authors":"Hamish Anderson, Ke Li Chow, John O’Donnell","doi":"10.1093/rheumatology/keaf338","DOIUrl":"https://doi.org/10.1093/rheumatology/keaf338","url":null,"abstract":"Objectives Anti-HMGCR myopathy is an immune-mediated necrotizing myopathy strongly associated with statin use in adults. Polynesians have a higher incidence of anti-HMGCR myopathy in New Zealand (NZ), but ethnic differences in phenotype and outcome are not known. Methods 91 patients with anti-HMGCR myopathy were identified based on anti-HMGCR positivity by immunoprecipitation assay. Prioritised ethnicity data was used to identify 35 Polynesian and 48 NZ European patients to include in the cohort. Clinical records were accessed and information on disease phenotype, treatment, and outcome was obtained. Results Polynesian patients were younger than NZ European patients at presentation (median 64 vs 71 years p= 0.009). They were less likely to normalize their CK over the follow-up period (54.2% vs 79.2%, p= 0.016), even after controlling for length of follow-up. There were no other significant differences in disease phenotype or outcome found. Conclusion In addition to having higher incidence of anti-HMGCR myopathy, Polynesians are affected at a younger age and are less likely to achieve normal CK levels despite treatment over similar follow-up periods. The disproportionate burden of disease in this group should prompt early assessment of a Polynesian patient who presents with muscle symptoms while on a statin.","PeriodicalId":21255,"journal":{"name":"Rheumatology","volume":"63 1","pages":""},"PeriodicalIF":5.5,"publicationDate":"2025-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144288536","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":"Patients’ experiences of managing their rare rheumatic disease","authors":"Emma Dures, Celia Almeida, Sadia Janjua, Andrew Hunt, Jen Orme, Peter C Lanyon, Nicola Walsh, Joanna C Robson","doi":"10.1093/rheumatology/keaf330","DOIUrl":"https://doi.org/10.1093/rheumatology/keaf330","url":null,"abstract":"Objectives The rare autoimmune rheumatic diseases (RAIRDs) include systemic lupus erythematosus (lupus), systemic vasculitis, inflammatory myositis, systemic sclerosis, and Sjögren’s Disease. The objective of the study is to understand patients’ experiences of living with and managing their RAIRD. Methods Participants from the UK with a range of RAIRDs were recruited via social media including patient charity networks. Purposive sampling was used to include a range of participants with different conditions and demographic characteristics. A topic guide was developed with patient partners to guide discussions about health-related quality of life with RAIRDs, including support needs. Focus groups were conducted via online video conferencing, audio-recorded, transcribed, checked and anonymised. Data was analysed thematically by an academic psychologist and rheumatologist. Results Twenty-six patients with RAIRDs participated in six focus groups (between 3–6 people per focus group). The median age was 62 years (range 34–82), 21 (80%) were female, 21 (80%) had a diagnosis longer than the last two years. Five themes were identified: managing healthcare systems and health professionals; luck of the draw: variation in access and resources; trustworthy and reliable sources of support; support to live well: core care or an added extra; and dealing with the emotional fallout. Conclusion This study found that patients shared experiences regardless of their specific RAIRD suggesting that a combined intervention could meet their common support needs. Further large-scale work is required, including people who may not usually take part in research, to explore the potential content and structure of such an intervention.","PeriodicalId":21255,"journal":{"name":"Rheumatology","volume":"28 1","pages":""},"PeriodicalIF":5.5,"publicationDate":"2025-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144289868","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}