Rheumatology最新文献

{"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}

{"title":"Cell-integrated serum-induced signalling patterns can differentiate between hand and knee osteoarthritis patients.","authors":"Margot Neefjes, Bas A C Housmans, Charlotte Kaffa, Nathalie G M Thielen, Leo A B Joosten, Cornelia H M van den Ende, Elly L Vitters, Guus G H van den Akker, Tim J M Welting, Arjan P M van Caam, Peter M van der Kraan","doi":"10.1093/rheumatology/keae555","DOIUrl":"10.1093/rheumatology/keae555","url":null,"abstract":"<p><strong>Objective: </strong>OA is a very heterogeneous disease. Here, we aimed to differentiate OA patients based on their serum-induced cell-integrated signalling patterns.</p><p><strong>Design: </strong>In order to monitor the activity of different cellular homeostasis-regulating pathways in response to patient serum, we analysed the response of human OA serum samples to sixteen cell-based transcription factor luciferase reporter assays. In this study we compared serum samples from 55 patients with knee OA, 56 patients with hand OA and 42 healthy controls.</p><p><strong>Results: </strong>Differential serum-induced pathway activity was observed between samples from healthy controls, knee OA and hand OA patients: Serum of hand OA patients induced high MAPK-related AP1 activity whereas serum of knee OA patients induced more SRE, ISRE and SOX9 activity, which is related to ELK1-SRF, STAT1-STAT2 and SOX9 activity respectively. Principal component analysis revealed that these differences differentiate hand OA from knee OA. Both hand and knee OA clustered clearly in 2 different endotypes each, but no principle component could be identified of these subtypes within either the hand OA or the knee OA sample group.</p><p><strong>Conclusion: </strong>This study demonstrates that serum from hand OA and knee OA patients evokes diverse cellular signalling patterns that differentiates hand OA, knee OA and healthy controls. This underlines that the pathomolecular mechanisms of OA are likely significantly different between hand and knee OA, a finding that could lead to new insight into the pathobiology of OA endotypes and joint-specific therapies.</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":"142668953","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":"Clinical course of pediatric-onset Behçet's Disease in young adulthood","authors":"Tugce Bozkurt, Mehmet Yıldız, Rabia Deniz, Ayten Yazıcı, Murat Karabacak, Hakan Karataş, Seda Kutluğ-Ağaçkıran, Aybüke Günalp, Elif Kılıç Könte, Sezgin Şahin, Oya Köker, Kenan Barut, Cemal Bes, Ayşe Cefle, Tulin Ergun, Haner Direskeneli, Özgür Kasapçopur, Fatma Alibaz-Oner","doi":"10.1093/rheumatology/keae624","DOIUrl":"https://doi.org/10.1093/rheumatology/keae624","url":null,"abstract":"Objectives Although Behçet's disease (BD) typically manifests in the second or third decade of life, initial symptoms may appear at a younger age. It may also take a longer time for the full disease phenotype to develop after the first symptom onset in pediatric patients. In this study we aimed to assess the clinical course of pediatric-onset BD in adulthood period. Methods The files of 112 patients diagnosed with BD before the age of 18, selected from five tertiary clinics, were retrospectively examined. Patients with a follow-up of less than six months were excluded. Results The study comprised 93 patients with pediatric-onset BD, of whom 64.5% (n = 60) were male. The median age of diagnosis was 15 years (13–17). Major organ involvement was present in 49 (52.5%) patients. The most commonly affected organ was the eye (29%). Sixty-eight (73.1%) patients had follow-up data in adulthood. Fourty patients had only mucocutaneous manifestations in the pediatric period. During follow-up in adulthood, 15 (53.3% were male) had new major organ involvement with a mean of 10.1 (SD: 7.9) years after diagnosis. Twenty-eight patients (41.1%) experienced major organ involvement during the pediatric period. In adulthood follow-up, 12 (42.8%) developed new major organ involvement and/or relapse of the same organ. Eighteen (26.5%) of 68 pediatric-onset BD patients had new major organ involvement, and 9 (13.2%) had a relapse during adulthood follow-up. Conclusion Our results showed that nearly one-third of pediatric BD patients have a new major organ involvement or a relapse in adulthood. Regular follow-up of pediatric BD patients in adulthood is essential to prevent long-term damage in this disease subset.","PeriodicalId":21255,"journal":{"name":"Rheumatology","volume":"1 1","pages":""},"PeriodicalIF":5.5,"publicationDate":"2024-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142610463","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: Association between colchicine use and adverse cardiovascular events in patients with gout: a nationwide nested case-control study: Reply.","authors":"Hyung Woo Kim, Tae Ik Chang, Seung Hyeok Han","doi":"10.1093/rheumatology/keae626","DOIUrl":"https://doi.org/10.1093/rheumatology/keae626","url":null,"abstract":"","PeriodicalId":21255,"journal":{"name":"Rheumatology","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2024-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142625929","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}