Rheumatology最新文献_第2页

Baricitinib for Takayasu arteritis refractory to TNF-α inhibitors: a multi-centre, single-arm trial Baricitinib治疗TNF-α抑制剂难治性高松动脉炎：一项多中心单组试验

IF 5.5 2区医学

Rheumatology Pub Date : 2025-05-24 DOI: 10.1093/rheumatology/keaf286

Jiachen Li, Weiyi Xia, Huijuan Ji, Xiaoxin Gong, Qi Dong, Yanan Wu, Longjun Wang, Meixia Peng, Jingxuan Liu, Ke Ma, Qi Yu, Xinglei Cui, Yuanyuan Luo, Wenhua Zhu, Shumin Zhang, Shi Chen, Yuhui Li, Zhanguo Li, Tian Liu

{"title":"Baricitinib for Takayasu arteritis refractory to TNF-α inhibitors: a multi-centre, single-arm trial","authors":"Jiachen Li, Weiyi Xia, Huijuan Ji, Xiaoxin Gong, Qi Dong, Yanan Wu, Longjun Wang, Meixia Peng, Jingxuan Liu, Ke Ma, Qi Yu, Xinglei Cui, Yuanyuan Luo, Wenhua Zhu, Shumin Zhang, Shi Chen, Yuhui Li, Zhanguo Li, Tian Liu","doi":"10.1093/rheumatology/keaf286","DOIUrl":"https://doi.org/10.1093/rheumatology/keaf286","url":null,"abstract":"Objective This study aimed to assess the efficacy and safety of baricitinib in Takayasu arteritis (TAK) refractory to TNF-α inhibitors. Methods We conducted a multicentre, single-arm trial between February 2021 and August 2023. Patients with TAK unresponsive to at least 6 months of TNF-α inhibitors were treated with baricitinib 4 mg daily for up to 48 weeks, while continuing of immunosuppressants and glucocorticoids. Clinical features, inflammatory parameters, imaging changes, and treatment data were collected during follow-up. The primary end point was the overall response (ORR) (complete response [CR] plus partial response [PR]) at 24 weeks. Results A total of ten patients (9 female and 1 male) patients were enrolled, with median age of 29 years (26.0, 35.3) and a median disease duration of 56.5 months (31.8, 88.5). The ORR at 24 weeks was 80%, with six patients achieving CR and two achieving PR. Disease progression was noted in the remaining two patients. Disease activity, erythrocyte sedimentation rate, and C-reactive protein at 24 weeks were significantly decreased compared with those at baseline. The median glucocorticoid dosage decreased from 20.0 mg/day (15.0, 26.3) at baseline (p&lt; 0.001)–6.3 mg/day (4.4, 10.6) at 24 weeks. No relapse was observed in the eight patients who achieved a response. The adverse effects (AEs) included upper respiratory tract infection (n = 2) and diarrhoea (n = 1), with no serious AEs reported. Conclusion Baricitinib is effective in patients with TAK resistant to conventional treatments and anti-TNF-α therapy and demonstrates a notable steroid-sparing effect. Trial registration ClinicalTrials.gov; NCT06662721","PeriodicalId":21255,"journal":{"name":"Rheumatology","volume":"34 1","pages":""},"PeriodicalIF":5.5,"publicationDate":"2025-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144133587","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

Performance of the new PREVENT Score for indicating subclinical atherosclerosis in rheumatoid arthritis 新的预防评分在类风湿关节炎亚临床动脉粥样硬化中的表现

IF 5.5 2区医学

Rheumatology Pub Date : 2025-05-24 DOI: 10.1093/rheumatology/keaf267

J Alex B Gibbons, Joan M Bathon, Jon T Giles

{"title":"Performance of the new PREVENT Score for indicating subclinical atherosclerosis in rheumatoid arthritis","authors":"J Alex B Gibbons, Joan M Bathon, Jon T Giles","doi":"10.1093/rheumatology/keaf267","DOIUrl":"https://doi.org/10.1093/rheumatology/keaf267","url":null,"abstract":"Objectives Patients with rheumatoid arthritis (RA) are at increased risk of atherosclerotic cardiovascular disease (ASCVD), yet traditional 10-year CVD risk calculators—such as the 2013 Pooled Cohort Equations (PCE)—underperform in RA. Our objective was to determine the performance of the PCE vs the updated PREVENT algorithm in indicating presence of subclinical coronary and carotid atherosclerosis in RA. Methods Patients with RA without known CVD underwent chest CT to quantify a coronary artery calcium (CAC) score and carotid artery ultrasound to determine presence of carotid artery plaque. The PCE score and three 10-year PREVENT scores—Total CVD, ASCVD, and Total CVD with urine albumin-to-creatinine ratio (uACR)—were calculated; scores were compared in their performance to indicate CAC and presence of carotid plaque. Results The PCE score was significantly different from each of the PREVENT scores (p&lt; 0.001). The PCE and the PREVENT scores were significantly associated with all levels of CAC and carotid plaque. In predicting CAC &gt;0, the PREVENT ASCVD score area under the receiver operating characteristic curve (AUROC) was 0.723—lower than the PCE AUROC of 0.775 (p= 0.034). For carotid plaque, there was no difference in AUROC between the PCE and the PREVENT ASCVD, PREVENT Total CVD score, or PREVENT Total CVD + uACR score. Conclusion The newly updated PREVENT scores is not better than the prior PCE for indicating subclinical coronary and carotid atherosclerosis in RA. Because the PCE score already underperforms in RA patients, it is unlikely that the PREVENT algorithm will adequately predict CVD event risk in this population.","PeriodicalId":21255,"journal":{"name":"Rheumatology","volume":"80 1","pages":""},"PeriodicalIF":5.5,"publicationDate":"2025-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144133591","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

Myositis specific autoantibody subtypes are associated with response to Janus kinase inhibitors in patients with juvenile dermatomyositis 肌炎特异性自身抗体亚型与青少年皮肌炎患者对Janus激酶抑制剂的反应相关

IF 5.5 2区医学

Rheumatology Pub Date : 2025-05-24 DOI: 10.1093/rheumatology/keaf214

Brigitte Bader-Meunier, Thomas R J Moreau, Florence A Aeschlimann, François-Jérome Authier, Jean Luc Charuel, Fabienne Jouen, Olivier Boyer, Christine Bodemer, Anne Welfringer-Morin, Vincent Bondet, Benjamin Fournier, Pierre Quartier, Marie-Louise Frémond, Anne-Perrine Foray, Carlos Sanchez, Darragh Duffy, Cyril Gitiaux, Mathieu P Rodero

{"title":"Myositis specific autoantibody subtypes are associated with response to Janus kinase inhibitors in patients with juvenile dermatomyositis","authors":"Brigitte Bader-Meunier, Thomas R J Moreau, Florence A Aeschlimann, François-Jérome Authier, Jean Luc Charuel, Fabienne Jouen, Olivier Boyer, Christine Bodemer, Anne Welfringer-Morin, Vincent Bondet, Benjamin Fournier, Pierre Quartier, Marie-Louise Frémond, Anne-Perrine Foray, Carlos Sanchez, Darragh Duffy, Cyril Gitiaux, Mathieu P Rodero","doi":"10.1093/rheumatology/keaf214","DOIUrl":"https://doi.org/10.1093/rheumatology/keaf214","url":null,"abstract":"Objectives To evaluate the efficacy and safety of Janus kinase inhibitors (JAKi) in a monocentric series of patients with juvenile dermatomyositis (JDM) and to identify factors associated with the achievement of clinically inactive disease (CID). Methods Single-centre retrospective study of 39 JDM patients treated with JAKi fot at least 6 months. The proportion of patients achieving CID within 6 months after initiation of JAKi was assessed using the PRINTO criteria and the Skin Disease Activity Score. Type 1 interferon (IFN) gene signature, serum IFN-α and IFN-β protein titres were measured as potential response biomarkers. Results 39 patients with JDM were included. Partial or complete CID was achieved in 32/39 (82%) patients after 6 months of treatment. In responders, the mean steroid dose decreased from 1 to 0 mg/kg/d (p= 0.001) and all other medications were withdrawn. In multivariable analysis, the presence of anti-TIF-1γ antibodies was the only factor at JDM onset associated with the absence of CID (p&lt; 0,001. A significant decrease in the median Type 1 IFN score and serum IFN- α from the diagnosis of JDM to the 6-months follow-up was observed only in patientswith CID. JAKi-related adverse events consisted of infections in 9 patients (including 5 herpes zoster infections) and weight gain in 3 patients. Conclusions JAKi induced CID in the majority of new-onset and refractory JDM patients, except in a subset of patients with refractory TIF-1γ positive JDM. Overall tolerance was acceptable. These results need to be validated in a larger prospective international cohort study.","PeriodicalId":21255,"journal":{"name":"Rheumatology","volume":"135 1","pages":""},"PeriodicalIF":5.5,"publicationDate":"2025-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144133618","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

Bifidobacterium ameliorates lupus nephritis and modulates aberrant differentiation of lymphocyte subsets 双歧杆菌改善狼疮性肾炎和调节淋巴细胞亚群的异常分化

IF 5.5 2区医学

Rheumatology Pub Date : 2025-05-24 DOI: 10.1093/rheumatology/keaf271

Lihua Wu, Zhirong Guan, Xiaoyu Zhang, Yanan Liu, Shuhong Chi, Xiangguo Duan, Chunxia Su

{"title":"Bifidobacterium ameliorates lupus nephritis and modulates aberrant differentiation of lymphocyte subsets","authors":"Lihua Wu, Zhirong Guan, Xiaoyu Zhang, Yanan Liu, Shuhong Chi, Xiangguo Duan, Chunxia Su","doi":"10.1093/rheumatology/keaf271","DOIUrl":"https://doi.org/10.1093/rheumatology/keaf271","url":null,"abstract":"Objectives The gut microbiota is crucial in the progression of lupus nephritis (LN), and probiotics have emerged as a potential therapeutic approach. This study investigates the role of Bifidobacterium in LN pathogenesis and its effects on immune cell populations. Methods Clinical samples were collected from 61 systemic lupus erythematosus (SLE) patients, and flow cytometry was used to analyze changes in CD4+ T and B cell subsets. ELISA quantified cytokine secretion and autoantibodies in both human and murine models. Additionally, 16S rRNA sequencing identified variations in gut microbiota abundance among patients and helped screen for potential probiotics. Histopathological examination and immunofluorescence staining assessed kidney injury improvements in MRL/lpr mice treated with Bifidobacterium, its total metabolites, and short-chain fatty acids (SCFAs). Results SLE patients showed decreased gut microbiota abundance and diversity, particularly a reduction in Bifidobacterium. Clinical data revealed lower proportions of memory B cells, central memory T cells, Treg cells, and IL-2, alongside increased effector memory T cells, Th1 and Th17 cells, IL-10, and IFN-γ in LN patients. Supplementation with Bifidobacterium, its metabolites, and SCFAs corrected the imbalances in CD4+ T and B cell subsets and cytokine levels, reduced autoantibody levels in mice, and alleviated kidney damage. Conclusions Bifidobacterium is significantly diminished in SLE patients, influencing kidney injury and immune cell balance in LN. Moreover, Bifidobacterium, its total metabolites and SCFAs’ supplementation in MRL/lpr mice notably improved kidney damage and restored immune cell equilibrium in MRL/lpr mice.","PeriodicalId":21255,"journal":{"name":"Rheumatology","volume":"12 1","pages":""},"PeriodicalIF":5.5,"publicationDate":"2025-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144133413","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

Recapitulation of clinical features in a patient-derived xenograft mouse model of VEXAS Syndrome. 患者来源的异种移植小鼠VEXAS综合征模型的临床特征概述。

IF 4.7 2区医学

Rheumatology Pub Date : 2025-05-24 DOI: 10.1093/rheumatology/keaf284

Liliana Arede, Rita Coutinho, Tiago L Duarte, Marta Lopes, Rui V Simões, Susana Silva, Pedro Baptista, José Manuel Lopes, Raquel Faria, Delfim Duarte

引用次数: 0

Association between steatotic liver disease and risk of incident systemic sclerosis: a nationwide cohort study 脂肪变性肝病与系统性硬化症发生风险之间的关系：一项全国性队列研究

IF 5.5 2区医学

Rheumatology Pub Date : 2025-05-24 DOI: 10.1093/rheumatology/keaf278

Oh Chan Kwon, Kyu-Na Lee, Kyungdo Han

{"title":"Association between steatotic liver disease and risk of incident systemic sclerosis: a nationwide cohort study","authors":"Oh Chan Kwon, Kyu-Na Lee, Kyungdo Han","doi":"10.1093/rheumatology/keaf278","DOIUrl":"https://doi.org/10.1093/rheumatology/keaf278","url":null,"abstract":"Objective Antinuclear antibody (ANA) positivity has been observed in patients with steatotic liver disease (SLD); however, the link between SLD and ANA-positive connective tissue diseases remains unexplored. We aimed to evaluate the association between SLD and risk of systemic sclerosis (SSc), a representative ANA-positive connective tissue disease. Methods A longitudinal population-based cohort study using a Korean nationwide database was conducted. The analysis included 4,413 719 individuals who participated in a national health screening program in 2012, with a mean follow-up period of 9.21 ± 1.05 years. Participants were categorized based on SLD status into four groups: no SLD, metabolic dysfunction-associated liver disease (MASLD), metabolic dysfunction and alcohol-related liver disease (MetALD), and alcohol-related liver disease (ALD). The main outcome measure was incident SSc. Multivariable Cox proportional hazard models were used to evaluate the association between SLD and risk of incident SSc. Results Among the 4,413 719 individuals, 2,827 907 (64.07%) had no SLD, 1,344 494 (30.46%) had MASLD, 165 475 (3.75%) had MetALD, and 75 843 (1.72%) had ALD. Compared with individuals without SLD, those with MASLD (adjusted hazard ratio [HR]: 1.612 [1.276, 2.038]), MetALD (adjusted HR: 1.575 [0.816, 3.040]), and ALD (adjusted HR: 3.063 [1.635, 5.739]) had a higher risk of incident SSc, with MASLD and ALD reaching statistical significance. The risk was the highest among individuals with ALD. Conclusion SLD was linked to an increased risk of incident SSc. These findings underscore the need for effective monitoring and management of SLD, particularly by reducing excessive alcohol consumption, to lower the risk of incident SSc.","PeriodicalId":21255,"journal":{"name":"Rheumatology","volume":"46 1","pages":""},"PeriodicalIF":5.5,"publicationDate":"2025-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144133588","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

Exploring the impact of conventional and targeted disease modifying anti-rheumatic drugs on body weight in patients with psoriatic arthritis 探讨常规和靶向抗风湿药物对银屑病关节炎患者体重的影响

IF 5.5 2区医学

Rheumatology Pub Date : 2025-05-23 DOI: 10.1093/rheumatology/keaf277

Pankti Mehta, Fadi Kharouf, Virginia Carrizo Abarza, Shangyi Gao, Richard J Cook, Denis Poddubnyy, Dafna D Gladman, Vinod Chandran

{"title":"Exploring the impact of conventional and targeted disease modifying anti-rheumatic drugs on body weight in patients with psoriatic arthritis","authors":"Pankti Mehta, Fadi Kharouf, Virginia Carrizo Abarza, Shangyi Gao, Richard J Cook, Denis Poddubnyy, Dafna D Gladman, Vinod Chandran","doi":"10.1093/rheumatology/keaf277","DOIUrl":"https://doi.org/10.1093/rheumatology/keaf277","url":null,"abstract":"Objectives To evaluate change in body weight with disease-modifying antirheumatic drugs (DMARD) in psoriatic arthritis (PsA). Methods We analyzed data from a large cohort of PsA patients with at least two weight measurements over follow-up. The absolute weight difference at one year from drug initiation was evaluated across—no medications or non-steroidal anti-inflammatory drugs (NSAIDs), conventional synthetic (cs) DMARDs, tumour necrosis factor inhibitors (TNFi), interleukin (IL)-12/23 inhibitor (i), IL-17i, IL-23i, Janus kinase inhibitors (JAKi), and apremilast classes. Two separate linear mixed models examined trends in weight change before and after treatment initiation with change point modeling and factors affecting weight over follow-up. Results Of 1754 patients, 473 were on NSAIDs or no medications, 571 on csDMARDs, 702 on bDMARDs, 42 on JAKi, and 70 on apremilast. Compared with weight at drug initiation, TNFi was associated with a weight gain at one year (1.54 kg, p&lt; 0.01), whereas no significant change was observed with other drug classes. On change-point modeling, a significant decrease in the rate of weight change was observed following IL-17i (slope 0.63 ± 0.20 vs -0.26 ± 0.25, p&lt; 0.01), IL-23i (0.82 ± 0.34 vs -0.56 ± 0.56, p&lt; 0.01), and csDMARDs (0.43 ± 0.24 vs -0.20 ± 0.26, p&lt; 0.01) compared with before treatment initiation. Factors associated with weight gain over follow-up included TNFi, IL12/23i use, male sex, follow-up duration, and higher baseline weight, while with weight loss were apremilast, older age, and diabetes mellitus. Conclusion The rate of weight gain significantly decreases following the initiation of IL-17i, IL-23i, and csDMARDs in PsA. Overall, TNFi and IL12/23i use is associated with weight gain, while apremilast with weight loss.","PeriodicalId":21255,"journal":{"name":"Rheumatology","volume":"138 1","pages":""},"PeriodicalIF":5.5,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144130385","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

Artificial intelligence-driven categorization of rheumatological disease subgroups. 人工智能驱动的风湿病亚群分类。

IF 5.5 2区医学

Rheumatology Pub Date : 2025-05-23 DOI: 10.1093/rheumatology/keaf273

Keerthi Talari,Vinod Ravindran

引用次数: 0

Pregnancy outcomes after maternal and paternal anti-IL-1 treatment exposure in cryopyrin associated periodic syndromes (CAPS) 母体和父亲暴露于抗il -1治疗后低温pyrin相关周期综合征（CAPS）的妊娠结局

IF 5.5 2区医学

Rheumatology Pub Date : 2025-05-23 DOI: 10.1093/rheumatology/keaf206

Özlem Satirer, Jörg Henes, Melanie Henes, Susanne M Benseler, Jasmin B Kuemmerle-Deschner

{"title":"Pregnancy outcomes after maternal and paternal anti-IL-1 treatment exposure in cryopyrin associated periodic syndromes (CAPS)","authors":"Özlem Satirer, Jörg Henes, Melanie Henes, Susanne M Benseler, Jasmin B Kuemmerle-Deschner","doi":"10.1093/rheumatology/keaf206","DOIUrl":"https://doi.org/10.1093/rheumatology/keaf206","url":null,"abstract":"Objectives To determine the effect of paternal and maternal anti-IL-1 treatment exposures on pregnancies and neonatal outcomes in CAPS. Methods A single-center study consecutive adult CAPS patients and their partners was performed between January 2012 and July 2024. All were screened for pregnancies and anti-IL-1 exposure before conception and/or during pregnancy; teratogenic co-therapies resulted in exclusion. Data included patient characteristics, disease activity, anti-IL-1 treatment, pregnancy complications, neonatal outcomes and child health trajectories. Results Among 112 patients 11 pregnancies were recorded including eight maternal and three paternal anti-IL-1 exposures. All patients had moderate CAPS, 43% had hearing loss. At conception, all patients received canakinumab. Among the eight maternal exposures, six switched to anakinra, one refused the switch and continued canakinumab, and one had to be switched back to canakinumab due to significant local injection reactions. Pregnancy complications included one miscarriage and one preterm birth, both associated with disease activity. Neonatal outcomes were favorable, with a mean gestational age of 37 + 6 weeks and an average birth weight of 3028 g. No congenital malformations were observed. Neonatal complications included one presumed sepsis (culture negative) requiring IV antibiotics and one mild RSV infection. CAPS was diagnosed in five of 11 offspring, all of whom achieved effective disease control early, with no cases of hearing loss or amyloidosis. Conclusion In summary, the benefit risk ratio of maternal and paternal anti-IL-1 exposure during conception and pregnancy in our CAPS patients was favourable. CAPS disease activity may have a significant impact on development of pregnancy complications.","PeriodicalId":21255,"journal":{"name":"Rheumatology","volume":"23 1","pages":""},"PeriodicalIF":5.5,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144133590","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

Does body composition matter in patients with systemic sclerosis? 身体成分对系统性硬化症患者有影响吗？

IF 5.5 2区医学

Rheumatology Pub Date : 2025-05-23 DOI: 10.1093/rheumatology/keaf283

Chiara Giraudo, Giulia Fichera, Marco Binda, Beatrice Moccaldi, Elisabetta Cocconcelli, Anna Cuberli, Anna Michielin, Andrea Doria, Roberto Stramare, Elisabetta Balestro, Elisabetta Zanatta

{"title":"Does body composition matter in patients with systemic sclerosis?","authors":"Chiara Giraudo, Giulia Fichera, Marco Binda, Beatrice Moccaldi, Elisabetta Cocconcelli, Anna Cuberli, Anna Michielin, Andrea Doria, Roberto Stramare, Elisabetta Balestro, Elisabetta Zanatta","doi":"10.1093/rheumatology/keaf283","DOIUrl":"https://doi.org/10.1093/rheumatology/keaf283","url":null,"abstract":"Objectives Body composition plays a significant role in various rheumatic and autoinflammatory diseases. The aim of our study was to assess the impact of muscle mass and subcutaneous adipose tissue quality and quantity in patients with systemic sclerosis (SSc). Methods Adults with SSc referring to our tertiary center who underwent high-resolution chest computed tomography (HRCT) to assess pulmonary involvement were included. A semi-automatic segmentation of the subcutaneous fat and paravertebral muscle was performed at the level of the 12th dorsal vertebra, and body composition metrics were collected (subcutaneous fat and paravertebral muscle area and density). Stepwise linear regression analysis was applied to evaluate if body composition, demographics, and pulmonary function tests acted as predictors of mortality. Considering patients with muscle Hu values &lt;30 as affected by myosteatosis, we used the odds-risk ratio to assess if it is associated with a higher risk of mortality. Results Eighty-seven SSc patients (77 females, age 60±15 years, 61% affected by limited cutaneous SSc) were included. The linear model demonstrated that lower DLCO (p = 0.047), higher BMI (p = 0.013), higher density of the subcutaneous fat (p = 0.005), and lower skeletal-muscle index (p &lt; 0.001) acted as predictors of mortality. Overall, 63 patients (72%) were affected by myosteatosis (ie, Hu &lt; 30 Hu) and patients affected by muscle fat infiltration at CT showed a 3.345 times higher mortality risk (95% CI 0.396–28.295). Conclusion Patients with systemic sclerosis are affected by myosteatosis and pre-sarcopenia and body composition seems to influence the overall outcome.","PeriodicalId":21255,"journal":{"name":"Rheumatology","volume":"22 1","pages":""},"PeriodicalIF":5.5,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144130383","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