Rheumatology最新文献_第10页

Frequency and characteristics of severe relapses in giant cell arteritis. 巨细胞动脉炎严重复发的频率和特点。

IF 4.7 2区医学

Rheumatology Pub Date : 2025-03-01 DOI: 10.1093/rheumatology/keae174

Nicolas Lozachmeur, Anael Dumont, Samuel Deshayes, Jonathan Boutemy, Gwénola Maigné, Nicolas Martin Silva, Alexandre Nguyen, Sophie Gallou, Rémi Philip, Achille Aouba, Hubert de Boysson

{"title":"Frequency and characteristics of severe relapses in giant cell arteritis.","authors":"Nicolas Lozachmeur, Anael Dumont, Samuel Deshayes, Jonathan Boutemy, Gwénola Maigné, Nicolas Martin Silva, Alexandre Nguyen, Sophie Gallou, Rémi Philip, Achille Aouba, Hubert de Boysson","doi":"10.1093/rheumatology/keae174","DOIUrl":"10.1093/rheumatology/keae174","url":null,"abstract":"Objectives: To assess the frequency and characteristics of severe relapse in patients with GCA in a real-life setting.Methods: In a monocentric database of 530 patients, we retrospectively analysed patients who experienced at least one relapse and distinguished severe from non-severe relapses. Severe relapse was defined by the occurrence of an ischaemic event (ophthalmologic, neurologic, digestive, limb ischaemia), the occurrence of an aortic complication (i.e. new or worsening of aortic dilation, aortic dissection), or new or worsening vascular stenosis.Results: From the cohort of 530 patients, 242 (45.7%) patients experienced relapse at least once, including 13 (2.5% of the cohort) who experienced severe relapse. Among the 464 recorded relapses, 14 (3% of all relapses) were severe. Severe relapse corresponded to the following vascular events: a peripheral limb ischaemia in six patients, a visual event in three patients (including two acute anterior ischaemic anterior neuropathies), an aortic complication in three patients, a mesenteric ischaemia in one patient and an ischaemic stroke in one patient. When compared with the 229 patients who experienced non-severe relapses, severe relapse patients were younger at diagnosis (P = 0.02), and showed more frequently limb claudication at baseline (P < 0.0001) and fewer GCA-related cranial signs (P < 0.0001). At diagnosis, more large-vessel vasculitis on imaging (82% vs 36%, P = 0.002) were observed in patients with severe relapse. The death rate did not differ between patients with severe and non-severe relapses.Conclusion: In a real-life setting, relapse affects nearly half of GCA patients, but severe relapse is rare.","PeriodicalId":21255,"journal":{"name":"Rheumatology","volume":" ","pages":"1386-1391"},"PeriodicalIF":4.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140158948","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}

引用次数: 0

Polyarticular juvenile idiopathic arthritis has a distinct co-inhibitor receptor profile. 多关节幼年特发性关节炎具有独特的共抑制剂受体特征。

IF 4.7 2区医学

Rheumatology Pub Date : 2025-03-01 DOI: 10.1093/rheumatology/keae306

Erdal Sag, Zeynep Balik, Selcan Demir, Ummusen Akca Kaya, Seher Sener, Muserref Kasap Cuceoglu, Erdal Atalay, Sena Bocutcu, Tayfun Vural, Nur Kubra Tasdemir, Busra Aydin, Yelda Bilginer, Bent Deleuran, Seza Ozen

{"title":"Polyarticular juvenile idiopathic arthritis has a distinct co-inhibitor receptor profile.","authors":"Erdal Sag, Zeynep Balik, Selcan Demir, Ummusen Akca Kaya, Seher Sener, Muserref Kasap Cuceoglu, Erdal Atalay, Sena Bocutcu, Tayfun Vural, Nur Kubra Tasdemir, Busra Aydin, Yelda Bilginer, Bent Deleuran, Seza Ozen","doi":"10.1093/rheumatology/keae306","DOIUrl":"10.1093/rheumatology/keae306","url":null,"abstract":"Objectives: JIA is the most common rheumatic disease of childhood; the pathogenesis is associated with T-cell activation. T-cell activation can be counterbalanced by signals generated by inhibitory receptors (IRs) such as CTLA-4, PD-1, LAG-3 and TIM-3. Here, we identify the role of IRs in the pathogenesis of different JIA subtypes.Methods: In total, we included 67 oligoarticular JIA, 12 IgM-RF negative polyarticular JIA, 17 enthesitis-related arthritis, 11 systemic JIA patients and 10 healthy controls. We collected plasma (and SF) samples from the patients either at the onset or during a flare of their disease. We measured the soluble levels of co-IRs (IL-2Rα, 4-1BB, CD86, TGF-β1, CTLA-4, PD-L1, PD-1, TIM-3, LAG- 3, Galectin-9) by cytometric bead array kits and their cellular expression (PD-1, CTLA-4, TIM-3, LAG-3) by flow cytometry. We compared the plasma levels and cellular expressions of different co-IRs within different JIA subgroups.Results: The polyarticular JIA group was different from the three other examined JIA subgroups, having higher levels of plasma sCTLA-4 (P < 0.001), sPD-1 (P < 0.05) and s4-1BB (P < 0.05) when compared with the other JIA subgroups and healthy controls. We analysed the cellular surface expression of different co-IRs on the peripheral blood mononuclear cells of different JIA subtypes. Similar to plasma levels, both the percentage (P < 0.05) and the mean fluorescence intensity (P < 0.01) of CTLA4 expression were higher in the polyarticular JIA subgroup.Conclusion: This is the first report studying the expression profile of different co-IRs in different subtypes of JIA. Polyarticular JIA patients had a different co-IR profile, having more CTLA-4, PD-1 and 4-1BB in their plasma than the other subtypes of JIA.","PeriodicalId":21255,"journal":{"name":"Rheumatology","volume":" ","pages":"1424-1430"},"PeriodicalIF":4.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141088397","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}

引用次数: 0

Comment on: Longitudinal study of patients with anti-SAE antibody-positive dermatomyositis: a multicenter cohort study in China. 评论抗SAE抗体阳性皮肌炎患者的纵向研究：一项在中国进行的多中心队列研究。

IF 4.7 2区医学

Rheumatology Pub Date : 2025-03-01 DOI: 10.1093/rheumatology/keae405

Yuta Yamashita, Yoshinao Muro, Haruka Koizumi, Satoshi Kamiya, Norika Akashi, Mariko Ogawa-Momohara, Takuya Takeichi, Masashi Akiyama

引用次数: 0

A double-blind, placebo-controlled, randomized multiple dose phase 1b trial of a CDK4/6 inhibitor, TCK-276, in patients with active rheumatoid arthritis. 一项针对活动性类风湿性关节炎患者的 CDK4/6 抑制剂 TCK-276 的双盲、安慰剂对照、随机多剂量 1b 期试验。

IF 4.7 2区医学

Rheumatology Pub Date : 2025-03-01 DOI: 10.1093/rheumatology/keae357

Daisuke Tasaki, Kazuoki Tsuruda, Shosho Sun, Yoshinori Tsumura, Satoshi Asano, Yuki Suzuki, Shunsuke Tsujimoto, Daishiro Miura, Hiroaki Sato

{"title":"A double-blind, placebo-controlled, randomized multiple dose phase 1b trial of a CDK4/6 inhibitor, TCK-276, in patients with active rheumatoid arthritis.","authors":"Daisuke Tasaki, Kazuoki Tsuruda, Shosho Sun, Yoshinori Tsumura, Satoshi Asano, Yuki Suzuki, Shunsuke Tsujimoto, Daishiro Miura, Hiroaki Sato","doi":"10.1093/rheumatology/keae357","DOIUrl":"10.1093/rheumatology/keae357","url":null,"abstract":"Objective: The purpose of this study was to evaluate the safety, tolerability, pharmacokinetics and efficacy (as an exploratory endpoint) of TCK-276, a novel CDK4/6 inhibitor, after multiple oral doses for 7 days in patients with active RA.Methods: This multicentre, randomized, placebo-controlled, dose-ascending, double-blind, phase 1b, multiple-dose study included 32 patients with active RA in four cohorts of 8 patients (6 active and 2 matching placebo), each receiving an oral dose of TCK-276 or matching placebo for 7 days (once daily). The doses of TCK-276 were 10, 25, 75 and 175 mg/day. Safety and pharmacokinetic endpoints, and exploratory disease activity parameters for RA were assessed.Results: There were no deaths, serious adverse events, notable clinically meaningful laboratory findings (including haematological changes), clinically meaningful vital sign changes or clinically meaningful ECG or cardiac telemetry changes. TCK-276 was rapidly absorbed and the half-life time ranged approximately from 6 to 12 h. No obvious accumulation was observed, and the increase in TCK-276 exposure was dose proportional. At day 7, DAS28-CRP responses (EULAR good or moderate responses) were observed in 40%, 80% and 66.7% at 25, 75 and 175 mg/day TCK-276, respectively, vs 12.5% in placebo; ACR20 responses were 33.3%, 60% and 50%, respectively, vs none in placebo.Conclusion: TCK-276 (≤175 mg) was well tolerated with no clinically meaningful safety signals in patients with active RA. Together with the preliminary efficacy (≥25 mg/day), these data warrant further study of TCK-276 for the treatment of active RA.Trial registration: ClinicalTrails.gov, NCT05437419.","PeriodicalId":21255,"journal":{"name":"Rheumatology","volume":" ","pages":"1036-1044"},"PeriodicalIF":4.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141604073","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}

引用次数: 0

Potential impact of European Medicines Agency measures to minimize risk of serious side effects on JAKi prescribing and utilization in the UK. 欧洲药品管理局降低严重副作用风险的措施对英国 JAKi 处方和使用的潜在影响。

IF 4.7 2区医学

Rheumatology Pub Date : 2025-03-01 DOI: 10.1093/rheumatology/keae279

Zixing Tian, Lianne Kearsley-Fleet, James Galloway, Kath Watson, Mark Lunt, Kimme L Hyrich

{"title":"Potential impact of European Medicines Agency measures to minimize risk of serious side effects on JAKi prescribing and utilization in the UK.","authors":"Zixing Tian, Lianne Kearsley-Fleet, James Galloway, Kath Watson, Mark Lunt, Kimme L Hyrich","doi":"10.1093/rheumatology/keae279","DOIUrl":"10.1093/rheumatology/keae279","url":null,"abstract":"Objective: Janus kinase inhibitors (JAKis) or targeted synthetic (ts) disease-modifying antirheumatic drugs (DMARDs) effectively treat rheumatoid arthritis (RA). However, due to safety concerns, the European Medicines Agency (EMA) published risk-minimization measures limiting JAKi prescription to certain at-risk patients unless no suitable alternative is available. This analysis included patients who had started their first-ever JAKi (before EMA measures were published) in a large national cohort study to investigate the potential impact of these measures on JAKi prescribing and utilization in the UK.Method: RA patients starting first-ever JAKi therapy in BSRBR-RA between 13 February 2017 and 31 May 2022 were included. The percentages of patients meeting the EMA risk criteria were presented. For the at-risk patients, their previous numbers of distinct biologic (b) DMARD classes prescribed were described.Result: A total of 1341 patients were included, and 80% (N = 1075) met ≥1 EMA risk criterion. Of those who met ≥1 risk criterion, 529 patients (49%) had received JAKi as their first or second b/tsDMARD class, whereas 299 (28%) had received ≥3 prior bDMARD classes.Conclusion: Four-fifths of RA patients who had commenced a JAKi before the EMA advisory were considered 'at-risk', with prescribing only advised if there was no suitable alternative. Almost a third of those patients had already received ≥3 bDMARDs classes, and alternative therapies would be very limited for them; however, suitable alternatives might have existed for the remaining proportion, especially for those who received a JAKi as their first or second b/tsDMARD, and re-evaluation of the suitability of their treatment may be needed.","PeriodicalId":21255,"journal":{"name":"Rheumatology","volume":" ","pages":"1453-1458"},"PeriodicalIF":4.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11879295/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140945916","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Long-term clinical outcomes in early rheumatoid arthritis that was treated-to-target in the BeSt and IMPROVED studies. 在 BeSt 和 IMPROVED 研究中接受靶向治疗的早期类风湿关节炎患者的长期临床疗效。

IF 4.7 2区医学

Rheumatology Pub Date : 2025-03-01 DOI: 10.1093/rheumatology/keae212

Sascha Louise Heckert, Johanna M Maassen, Isabell Nevins, Paul Baudoin, Gerda M Steup-Beekman, Tom W J Huizinga, Sytske Anne Bergstra, Cornelia F Allaart

{"title":"Long-term clinical outcomes in early rheumatoid arthritis that was treated-to-target in the BeSt and IMPROVED studies.","authors":"Sascha Louise Heckert, Johanna M Maassen, Isabell Nevins, Paul Baudoin, Gerda M Steup-Beekman, Tom W J Huizinga, Sytske Anne Bergstra, Cornelia F Allaart","doi":"10.1093/rheumatology/keae212","DOIUrl":"10.1093/rheumatology/keae212","url":null,"abstract":"Objectives: To assess disease outcomes after 20 and 12 years of patients with RA or undifferentiated arthritis (UA), treated-to-target in the BeSt and IMPROVED trials.Methods: In BeSt (inclusion 2000-02, duration 10 years), 508 patients with early RA were randomized to: 1. sequential monotherapy, 2. step-up combination therapy, 3. initial csDMARD combination therapy, 4. initial bDMARD/csDMARD combination therapy. The treatment target was low disease activity (DAS ≤ 2.4).In IMPROVED (inclusion 2007-10, duration 5 years), 610 patients with early RA/UA started MTX with prednisone bridging. The treatment target was remission (DAS < 1.6). Patients not in early remission were randomized to 1. csDMARD combination therapy or 2. bDMARD/csDMARD combination therapy.Between 2019 and 22, these patients were invited for long-term follow-up.Results: One-hundred-fifty-three ex-Best and 282 ex-IMPROVED patients participated in the follow-up study after a median of 12 and 20 years since the study started.In ex-BeSt and ex-IMPROVED patients, the rate of low disease activity was 91%, and 68% were in DAS remission. Median SHS was 14.0 in ex-BeSt (IQR 6.0-32.5; progression since end BeSt 6.0, IQR 2.0-12.5) and 8 in ex-IMPROVED participants (IQR 3-16; progression since end IMPROVED 4, IQR 2-9). Mean HAQ was 0.8 ± 0.6 in ex-BeSt (change since end BeSt: 0.3 ± 0.5) and 0.6 ± 0.6 in ex-IMPROVED participants (change since end IMPROVED: 0.06 ± 0.5).Conclusion: At 12/20 years after treatment started, the majority of RA and UA patients who had been treated to target low DAS or DAS remission were in DAS remission and had limited functional disability. Radiographic damage progression was mild although not completely suppressed.","PeriodicalId":21255,"journal":{"name":"Rheumatology","volume":" ","pages":"1052-1059"},"PeriodicalIF":4.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11879312/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140336687","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Imaging findings in polymyalgia rheumatica.

IF 4.7 2区医学

Rheumatology Pub Date : 2025-03-01 DOI: 10.1093/rheumatology/keae473

Claire E Owen, Octavia Nakos

引用次数: 0

Highlights from the breakout session: other forms of vasculitis.

IF 4.7 2区医学

Rheumatology Pub Date : 2025-03-01 DOI: 10.1093/rheumatology/keae386

Tanaz A Kermani, Kenneth J Warrington

引用次数: 0

Highlights from the breakout session: vasculitis in paediatric rheumatology.

IF 4.7 2区医学

Rheumatology Pub Date : 2025-03-01 DOI: 10.1093/rheumatology/keae406

Yagmur Bayindir, Marija Jelusic, Seza Ozen

{"title":"Highlights from the breakout session: vasculitis in paediatric rheumatology.","authors":"Yagmur Bayindir, Marija Jelusic, Seza Ozen","doi":"10.1093/rheumatology/keae406","DOIUrl":"https://doi.org/10.1093/rheumatology/keae406","url":null,"abstract":"The 21st International Vasculitis Workshop, held in Barcelona, Spain, from April 7 to 10, 2024, highlighted advances in pediatric vasculitis, focusing on a holistic, multidisciplinary approach. Common childhood vasculitides, including IgA Vasculitis (IgAV) and Kawasaki Disease (KD), were discussed. The Ankara 2008 criteria for IgAV, endorsed by EULAR and PReS, were evaluated for their performance in adults, showing high sensitivity but necessitating further refinement for improved specificity. Studies on genetic associations, such as Human Leukocyte Antigen (HLA) polymorphisms in IgAV, and biomarkers like S100A8/A9, HMGB1, and RAGE, were presented. Kawasaki disease research included novel anti-apolipoprotein A-2 antibodies, showing promise in reducing coronary arteritis. Monogenic vasculitides, such as deficiency of ADA2, were addressed with new consensus-driven recommendations. The workshop underscored the importance of continued research and tailored therapeutic strategies to improve outcomes in pediatric vasculitis, paving the way for advancements in diagnosis, management, and understanding of these complex diseases.","PeriodicalId":21255,"journal":{"name":"Rheumatology","volume":"64 Supplement_1","pages":"i131-i133"},"PeriodicalIF":4.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143606333","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}

引用次数: 0

Comment on: Hepatitis B reactivation in PsA patients: an SLR and meta-analysis for IL-17, IL-23 and JAK inhibitors. PsA患者的乙肝再激活：IL-17、IL-23和JAK抑制剂的SLR和荟萃分析

IF 4.7 2区医学

Rheumatology Pub Date : 2025-03-01 DOI: 10.1093/rheumatology/keae645

Rachana Mehta, Ashok Kumar Balaraman, Sanjit Sah, Ganesh Bushi

引用次数: 0