Rheumatology最新文献

{"title":"Evaluating the therapeutic potential of tofacitinib in Sjögren's disease: a comprehensive clinical and immunological assessment.","authors":"Qinghong Liu, Yuqing Zeng, Xiaoyan Xing, Bo Huang, Ruiling Feng, Yifan Wang, Naidi Wang, Xia Zhang, Yuhui Li, Linchong Su, Alexander Jacob, Julian L Ambrus, Long Shen, Lakshmanan Suresh, Di Yu, Xiang Lin, Jing He","doi":"10.1093/rheumatology/keaf173","DOIUrl":"https://doi.org/10.1093/rheumatology/keaf173","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the efficacy, safety, and immunological effects of tofacitinib in patients with Sjögren's Disease (SjD), focusing on its impact on disease activity and immune cell modulation.</p><p><strong>Methods: </strong>Two independent cohort studies, one retrospective (Cohort I) and one prospective (Cohort II), were conducted to investigate the efficacy of oral tofacitinib treatment in patients diagnosed with SjD. All participants were evaluated for changes in disease activity and lab parameters. Circulating T cells were analyzed, focusing on follicular helper T (Tfh) cells and peripheral helper T (Tph) cells.</p><p><strong>Results: </strong>In cohort ǀ, 112 patients treated with tofacitinib showed a significant improvement in the ESSDAI score (median [IQR], 8.00 (4.25, 15.75) vs 6.50 (2.25, 12.75), p < 0.001). In cohort ‖, ten patients completed the 12-month treatment period. There was a significant reduction in ESSDAI scores at the 6th month compared with baseline (p = 0.001). 80% (8/10) of patients achieved a decrease of at least one point or 15% in ESSPRI scores. A significant reduction in the proportion of Th17 cells was observed (mean ± SD, 14.84 ± 7.70 vs 7.74 ± 4.24, p = 0.008). A decrease in Tfh and Tph cells was also observed, along with decreased pSTAT-3 levels in CD4+ T cells and disease activity scores. No serious adverse events were observed in the two cohorts.</p><p><strong>Conclusions: </strong>Tofacitinib effectively improves disease activity and immune regulation in SjD, and it is associated with suppressing Tfh and Tph cells, suggesting its potential as a treatment option.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov Identifier: NCT05087589.</p>","PeriodicalId":21255,"journal":{"name":"Rheumatology","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143731426","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":"Vascular MRI also depicts musculoskeletal manifestations in GCA-PMR spectrum disease patients.","authors":"Daria Kern, Thorsten A Bley, Lukas Riedling, Matthias Fröhlich, Jost Hillenkamp, Michael Gernert, Marc Schmalzing, Rudolf A Werner, Konstanze V Guggenberger","doi":"10.1093/rheumatology/keaf169","DOIUrl":"https://doi.org/10.1093/rheumatology/keaf169","url":null,"abstract":"<p><strong>Objectives: </strong>To evaluate the incremental value of contrast-enhanced vascular MRI for also detecting inflammatory musculoskeletal manifestations in patients with GCA-PMR spectrum disease (GPSD).</p><p><strong>Methods: </strong>T1-weighted contrast-enhanced VIBE (Volume Interpolated Breath-hold Examination)-sequences of the torso of 78 patients with clinically confirmed GPSD, acquired for vessel wall imaging of the aorta, were retrospectively evaluated for signs of inflammation in the glenohumeral synovium, long biceps and subscapularis tendons, supra-/interspinous ligaments, and for shoulder joint effusion. Two experienced radiologists and two inexperienced readers assessed the images independently. Interrater reliability between experienced and inexperienced readers was calculated.</p><p><strong>Results: </strong>49% of the patients were diagnosed with GCA only, 28% with PMR only, and 23% with both GCA and PMR (GCA-PMR). Musculoskeletal inflammation was predominantly bilaterally symmetrical. Glenohumeral synovitis was found in 35% of all patients, shoulder joint effusion in 6%, long biceps tendon enhancement in 26%, subscapularis tendon enhancement in 42%, and supra-/interspinous ligament enhancement in 29%. Patients with PMR showed inflammatory signs at a higher percentage compared with those with GCA or GCA-PMR. Fleiss' kappa indicated almost perfect agreement among readers for supra-/interspinous ligament and subscapularis tendon assessments.</p><p><strong>Conclusions: </strong>51% of the GPSD patients showed signs of inflammation in at least one of the evaluated musculoskeletal structures on contrast-enhanced MRI, with the subscapularis tendon being the most frequently affected. A contrast-enhanced T1-weighted VIBE sequence provides a fast one-stop solution for assessing inflammatory wall changes of the aorta while simultaneously visualizing inflammation-suspect changes in the musculoskeletal structures of the torso within a reasonable examination time.</p>","PeriodicalId":21255,"journal":{"name":"Rheumatology","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143710136","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":"The effect of prednisolone initiation and short-term discontinuation on the clinical assessment of polymyalgia rheumatica.","authors":"Christoffer S Våben, Andreas W Nielsen, Marc K Nielsen, Line T Moll, Christoffer Mørk, Emil B Dalgaard, Tue K Rasmussen, René D Østgård, Ib T Hansen, Berit D Nielsen, Christian M Sørensen, Jesper Blegvad-Nissen, Søren G Kjær, Ellen-Margrethe Hauge, Kresten K Keller","doi":"10.1093/rheumatology/keaf170","DOIUrl":"https://doi.org/10.1093/rheumatology/keaf170","url":null,"abstract":"<p><strong>Objectives: </strong>Approximately half of individuals with suspected polymyalgia rheumatica (PMR) initiate prednisolone before rheumatological evaluation, but it is unknown if prednisolone reduces the ability to diagnose PMR. This study evaluated the clinical assessment of a PMR diagnosis before and after prednisolone initiation and after short-term prednisolone discontinuation.</p><p><strong>Methods: </strong>Data from a prospective cohort of treatment-naïve patients with PMR (n = 66) and non-PMR (n = 27) were used to create case report forms (CRFs). All patients were assessed at baseline and patients with PMR were reassessed after 8 weeks of prednisolone treatment (n = 57) and after short-term prednisolone discontinuation at week 10 (n = 48). In total, 198 CRFs were created containing patient demographics, current symptoms, physical examination, and blood test results. Six rheumatologists, blinded to diagnosis, prednisolone treatment, and visit timing, assessed each CRF, rating the probability of a PMR diagnosis from 0-10 and classifying them as PMR or non-PMR.</p><p><strong>Results: </strong>At baseline, CRF assessors effectively distinguished PMR from non-PMR, demonstrating median probabilities of PMR of 7.8 and 2.8, respectively, and a sensitivity/specificity of 85.9%/82.7% for the PMR diagnosis. After prednisolone initiation, the median probability of PMR was 1.0 and sensitivity was 3.5%, followed by a median probability of PMR of 2.3 and a sensitivity of 25% after short-term prednisolone discontinuation.</p><p><strong>Conclusion: </strong>This study shows that clinically assessing PMR becomes challenging after prednisolone initiation, and that short-term prednisolone discontinuation does not improve clinical assessment to pre-treatment levels. Consequently, the study supports recommendations of deferring prednisolone initiation until after specialist evaluation in individuals suspected of having PMR.</p>","PeriodicalId":21255,"journal":{"name":"Rheumatology","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143711136","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":"Intracranial giant cell arteritis: a comprehensive systematic review.","authors":"Sagar Patel, Iva Okaj, Jessica Scott, Sukhreet Atwal, Colin Stark, Rabia Tahir, Nader Khalidi, Mats Junek","doi":"10.1093/rheumatology/keaf162","DOIUrl":"https://doi.org/10.1093/rheumatology/keaf162","url":null,"abstract":"<p><strong>Objectives: </strong>Giant cell arteritis (GCA) is increasingly recognized to occur in intracranial vessels with unknown clinical ramifications. We identified all reported cases of intracranial GCA (ICGCA) in the literature to describe common presentations, investigations, treatments, and outcomes.</p><p><strong>Methods: </strong>We conducted a systematic review using MEDLINE, Embase and Pubmed databases to identify studies that reported cases of ICGCA. The study was registered on a systematic review database (PROSPERO 42023412373). We defined intracranial involvement as any vessel cranial to the dura mater that was confirmed by either histopathology or imaging. Data was summarized using descriptive statistics.</p><p><strong>Results: </strong>Of 1554 studies identified, 102 studies underwent full-text review. These studies included 340 patients with ICGCA. The median age was 73.7 (interquartile range (IQR) 71.9-77.3) and 46.9% patients were female. Presentations of ICGCA included stroke in 240 (70.6%) patients and isolated intracranial imaging or histologic changes in 67 (19.7%) patients. The most common vessels involved were 180 (52.9%) vertebrobasilar, 166 (48.8%) internal carotid and 49 (14.4%) ophthalmic arteries. Treatment was reported in 214 individuals. Glucocorticoids were administered to 210 (98.1%); tocilizumab, cyclophosphamide and methotrexate were the most common adjunctive medications. Of the 181 patients with reported follow-up outcomes, relapse occurred in 40 (22.1%) patients and 59 (32.6%) individuals died.</p><p><strong>Conclusion: </strong>Our findings suggest that ICGCA is not a rare entity and may represent a more severe manifestation of GCA. Optimal therapy for ICGCA is unknown. Structured prospective evaluation is needed to better understand this manifestation of GCA.</p>","PeriodicalId":21255,"journal":{"name":"Rheumatology","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143711123","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":"Prostaglandin E1 restores endothelial progenitor cell function in systemic sclerosis.","authors":"Judith Potjewijd, Rachid Tobal, Steven J Arends, Lucienne Debrus-Palmans, Jan G M C Damoiseaux, Pieter van Paassen","doi":"10.1093/rheumatology/keaf174","DOIUrl":"https://doi.org/10.1093/rheumatology/keaf174","url":null,"abstract":"<p><strong>Objectives: </strong>Systemic sclerosis (SSc) is a chronic autoimmune disease characterized by microvascular injury and impaired angiogenesis, with endothelial progenitor cells (EPCs) playing a key role in vascular repair. EPC subsets, including endothelial colony-forming cells (ECFCs) and colony-forming unit-endothelial cells (CFU-ECs), are known to be dysfunctional in SSc, contributing to disease-associated vasculopathy. Prostaglandin E1 (PGE1) is a vasodilator with potential pro-angiogenic effects, but its impact on EPC numbers and function in SSc remains unexplored. This study aimed to investigate whether PGE1 treatment can modulate EPC numbers, specifically CFU-ECs and ECFCs, in patients with SSc and Raynaud's phenomenon (RP), and evaluate its potential role in promoting vascular repair. Methods: This study evaluated the effect of PGE1 on EPC levels in 12 SSc patients with Raynaud's phenomenon (RP) and 5 healthy controls (HCs). CFU-EC and ECFC clusters were quantified before and after PGE1 treatment using standardized culture methods. PGE1 was administered intravenously over 8-9 days. Statistical analyses compared EPC counts between groups and time points.</p><p><strong>Results: </strong>Baseline CFU-EC and ECFC cluster counts were significantly reduced in SSc patients compared to HCs (p = 0.02 and p < 0.01, respectively). Following PGE1 treatment, both CFU-EC and ECFC clusters significantly increased in SSc patients (p = 0.02 and p = 0.001, respectively), reaching levels comparable to HCs. No significant changes were observed in HCs across two time points. A significant delta in cluster counts was observed in SSc patients versus HCs (CFU-EC: p = 0.03; ECFC: p = 0.01).</p><p><strong>Conclusion: </strong>PGE1 treatment restores CFU-EC and ECFC levels in SSc patients, suggesting a potential role in repairing vascular damage. These findings highlight PGE1's therapeutic benefits beyond vasodilation, supporting its use in SSc-associated microvasculopathy.</p>","PeriodicalId":21255,"journal":{"name":"Rheumatology","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143711135","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 \"ANA-Positive versus ANA-Negative Antiphospholipid Antibody-Positive Patients: Results from the APS ACTION Registry\". Reply.","authors":"Irene Cecchi, Doruk Erkan, Savino Sciascia","doi":"10.1093/rheumatology/keaf156","DOIUrl":"https://doi.org/10.1093/rheumatology/keaf156","url":null,"abstract":"","PeriodicalId":21255,"journal":{"name":"Rheumatology","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143711122","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 cardiovascular risk factors and the occurrence of giant cell arteritis: a systematic review and meta-analysis.","authors":"François Barde, Lucas Pacoureau, Alexis Elbaz, Raphaèle Seror, Yann Nguyen","doi":"10.1093/rheumatology/keaf164","DOIUrl":"https://doi.org/10.1093/rheumatology/keaf164","url":null,"abstract":"<p><strong>Objectives: </strong>We aimed to analyze the association between cardiovascular risks factors and the onset of giant cell arteritis (GCA) through a systematic review and meta-analysis of observational studies.</p><p><strong>Methods: </strong>Three databases (MEDLINE, EMBASE, WEB OF SCIENCE) were systematically reviewed. Epidemiological studies on the association between six cardiovascular risk factors (type 2 diabetes, hypertension, dyslipidaemia, smoking, overweight/obesity, history of a cardiovascular disease) and the risk of GCA were eligible. Risk of bias was assessed using the ROBINS-E scale. Pooled associations for studies assessing the same outcome were reported as odds ratios (OR) and their 95% confidence interval (CI).</p><p><strong>Results: </strong>The search strategy identified 4,210 references, of which 43 studies were analyzed and 17 were included in the meta-analysis (11 case-control studies, four cohort studies). An inverse association was found between type 2 diabetes and risk of GCA (OR = 0.75, 95% CI 0.61-0.93) and whereas history of cardiovascular disease was positively associated with GCA with risk (OR = 1.28, 95% CI 1.18-1.38). We found a trend towards a decreased risk of GCA in overweight participants (OR 0.64; 95% CI 0.41-1.00).</p><p><strong>Conclusion: </strong>Our study showed an inverse association of type 2 diabetes and a positive association of a history of cardiovascular disease with GCA risk. There is also a trend towards an inverse association with overweight. The pathophysiological mechanisms underlying these findings may involve an effect of cardiovascular risk factors themselves, a condition underlying these factors such as diet, or a condition following their diagnosis such as their treatment.</p>","PeriodicalId":21255,"journal":{"name":"Rheumatology","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143701394","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":"Exploring the relationship between skin severity and PASDAS in psoriatic arthritis: a cross-sectional study in the BSR-PsA and GRACE cohorts.","authors":"Michelle L M Mulder, Gareth T Jones, Ovidiu Rotariu, Philip S Helliwell","doi":"10.1093/rheumatology/keaf161","DOIUrl":"https://doi.org/10.1093/rheumatology/keaf161","url":null,"abstract":"<p><strong>Objectives: </strong>To explore the extent to which skin severity is reflected in the Psoriatic arthritis Disease Activity Score (PASDAS).</p><p><strong>Methods: </strong>Cross-sectional baseline data from the British Society for Rheumatology PsA register (BSR-PsA) and the GRAPPA Composite Exercise (GRACE) dataset was included. The body surface area score (BSA) and the Dermatology Life Quality Index (DLQI) were used to assess skin disease activity. BSA was categorized as none (0%), mild (<3%), moderate (3-10%), and severe (>10%) skin involvement. DLQI was categorized as no (0-1), small (2-5), moderate (6-10), large (11-20), and extreme (21-30) effect on quality of life. Mean and standard deviation PASDAS scores, physician and patient global VAS scores were calculated for each category of skin severity by both BSA and DLQI. Within each cohort, two groups were created based on the severity of skin disease (BSA cut-off of 10). Propensity score matching was applied to match groups for musculoskeletal disease activity and differences between the groups were assessed.</p><p><strong>Results: </strong>In both the BSR-PsA (N = 1126) and GRACE (N = 588) datasets, PASDAS, VAS physician global, and VAS patient global scores increased with increasing skin scores. For the subjects grouped by severity of skin involvement, and matched for musculoskeletal activity, significant differences in PASDAS, physician global score and DLQI were observed for the BSR-PsA, and physician and patient global scores, DLQI and age for the GRACE dataset.</p><p><strong>Conclusion: </strong>These data suggest that psoriasis disease activity is represented in the composite PASDAS score, possibly through the global (patient and physician) VAS scores.</p>","PeriodicalId":21255,"journal":{"name":"Rheumatology","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143701396","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":"Immunosuppressant withdrawal versus glucocorticoid withdrawal in systemic lupus erythematosus: 2-year outcomes of a noninferiority randomized controlled trial.","authors":"Aishwarya Gopal, Chengappa Kavadichanda, Christina Mary Mariaselvam, K T Harichandrakumar, Molly Mary Thabah, Vir Singh Negi","doi":"10.1093/rheumatology/keaf163","DOIUrl":"https://doi.org/10.1093/rheumatology/keaf163","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to test whether immunosuppressant (IS) withdrawal is noninferior to glucocorticoid (GC) withdrawal in patients with Systemic Lupus Erythematosus (SLE) in remission.</p><p><strong>Methods: </strong>In this open-label, single-center, randomized (1:1) controlled trial, we compared flare occurrence in stable SLE patients undergoing GC or IS tapering. Patients aged >18, on stable GC (prednisolone ≤7.5 mg/day) and maintenance non-biological IS for ≥3 years, in clinical remission for ≥1 year, were enrolled and assigned to taper GC or IS over 3 months. The primary end point was the proportion of patients experiencing a flare, defined by the SELENA-SLEDAI Flare Index (SFI) at 52 weeks. Patients in remission beyond 52 weeks were followed up to the maximum available follow-up duration beyond 104 weeks.</p><p><strong>Results: </strong>Between May and December 2021, 121 patients were randomized, and 117 (GC withdrawal, n = 58; IS withdrawal, n = 59) were included in the primary analysis. Flare occurred in 31% of the GC withdrawal group and 20.3% in the IS withdrawal group (risk difference, 10.6%[95% CI, -26.5-5.1]; p= 0.18), demonstrating the noninferiority of IS withdrawal. At maximum follow-up, 44.8% in the GC withdrawal group and 32.2% in the IS withdrawal group experienced a flare (risk difference, -12.6%[95% CI, -30.1-4.9]; p= 0.11), confirming the noninferiority of IS withdrawal at 2 years. Damage accrual was similar between the two groups at both endpoints.</p><p><strong>Conclusion: </strong>IS withdrawal is noninferior to GC withdrawal in SLE patients in long-term clinical remission. Personalized tapering strategies based on baseline damage and steroid exposure may optimize outcomes.</p><p><strong>Trial registration: </strong>The trial was registered with https://ctri.nic.in/, CTRI/2020/07/026712.</p>","PeriodicalId":21255,"journal":{"name":"Rheumatology","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143701523","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":"Rituximab vs cyclophosphamide for cancer risk in ANCA-associated vasculitis.","authors":"Arjun Mahajan, Martin Viola, Jacob Ellen, Evan W Piette, Avery H LaChance, Jeffrey A Sparks","doi":"10.1093/rheumatology/keaf167","DOIUrl":"https://doi.org/10.1093/rheumatology/keaf167","url":null,"abstract":"","PeriodicalId":21255,"journal":{"name":"Rheumatology","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143700634","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}