Rheumatology最新文献

{"title":"An exploratory trial of a single dose of CAM2043 (treprostinil subcutaneous depot) in systemic sclerosis-related Raynaud’s phenomenon","authors":"Ariane L Herrick, Andrea Murray, Graham Dinsdale, Joanne Manning, Chukwuma Chukwu, Marcia Alvarez Fernandez, Ulrika Axling, James R Seibold, Fredrik Tiberg","doi":"10.1093/rheumatology/keaf291","DOIUrl":"https://doi.org/10.1093/rheumatology/keaf291","url":null,"abstract":"Objectives Our aim was to explore the effect of a single subcutaneous dose of CAM2043, a novel extended-release subcutaneous formulation of treprostinil, on finger temperature in patients with systemic sclerosis (SSc)-related Raynaud’s phenomenon (RP). Methods This was an exploratory, open-label, single-dose Phase 2 trial. Ten female patients (median age 54.0 years) attended on 6 occasions: screening, baseline (day 1), Days 2, 3, 8 and 15. On day 1, patients received a single subcutaneous injection of 2.5 mg CAM2043. A standard cold challenge test of the hands was performed pre-dose and at 3, 6, 24, 72, 168 and 336 h post-dose, with temperature response over the subsequent 15 min measured by infrared thermography. The primary end point was the mean change in area under the temperature-time curve (AUCtherm) for rewarming (8 fingers) at 6 h vs baseline. Results AUCtherm increased 6 h post-dose (mean increase 192.7 °C×sec [95% confidence interval (CI): -727.1,1112.6]) and was significantly greater at 24 h than at baseline (mean increase 1175.8 °C×sec [95% CI: 127.3,2224.3]), returning to baseline values by day 15. Maximum temperature after rewarming increased significantly from baseline at 24 h, by 1.4 °C (95% CI: 0.1,2.7). Mean (standard deviation [SD]) Raynaud’s Condition Score (3.7[1.3] units at baseline) improved significantly post-dosing, including day 8 (mean reduction 1.6 units [95% CI: -2.68,-0.52]). Adverse events were reported by all 10 patients: all reported erythema and pain at the injection site. Conclusion The positive outcome indicates that CAM2043 could be further investigated in clinical trials of RP. Trial registration www.clinicaltrialsregister.eu/, EudraCT number 2019–002444-24.","PeriodicalId":21255,"journal":{"name":"Rheumatology","volume":"244 1","pages":""},"PeriodicalIF":5.5,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144177001","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":"Interferon-γ release assay as an emergent powerful biomarker in systemic lupus erythematosus","authors":"Yves Renaudineau, Emmanuel Treiner, Fabrice Herin, Stanislas Faguer, Gregory Pugnet, Laurent Sailler","doi":"10.1093/rheumatology/keaf186","DOIUrl":"https://doi.org/10.1093/rheumatology/keaf186","url":null,"abstract":"Objectives To investigate the ex vivo IFN-γ release assay (IGRA) as a biomarker of SLE activity and disease outcome. Methods This retrospective study, conducted between 2008 and 2024 at a single tertiary care center, included 145 SLE patients at various disease stages. Data were collected on spontaneous IFN-γ levels (IGRA-nil) and on phytohemagglutinin-induced IFN-γ levels (IGRA-PHA, after subtracting the IGRA-nil result). Results The ex vivo spontaneous IFN-γ release was increased (IGRA-nil; p= 0.0004) and the PHA-induced IFN-γ release was decreased in active SLE patients (IGRA-PHA; p< 1 0 −4), regardless of treatment, including glucocorticoids. Nephritis, serositis, constitutional symptoms, mucocutaneous, and musculoskeletal manifestations were associated with impaired IGRA-PHA release (p < 0.05 for each association). An IGRA-PHA ≥ 8.0 IU/ml, corresponding to the optimal Youden index, predicted clinically inactive SLE better than IGRA-nil (AUC= 0.853 vs 0.722), and IGRA-PHA <1.6 IU/ml indicated 100% specificity for active disease. Moreover, IGRA-PHA ≥ 8.0 IU/ml was an independent predictor of clinically inactive SLE in multivariate regression analysis (OR = 10.6 [95% CI: 3.72–30.17]; p = 9.7x10−6), and IGRA-PHA ≤1.6 IU/ml was associated with a longer time to achieve remission in a log-rank test (p = 2.4x10−6). Conclusion The IGRA-PHA assay appears to be a powerful and independent biomarker for clinically active SLE, when performed at the initiation or intensification of therapy, and as a predictor of treatment-induced remission at therapy evaluation.","PeriodicalId":21255,"journal":{"name":"Rheumatology","volume":"3 1","pages":""},"PeriodicalIF":5.5,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144177000","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":"Ankylosed posterior spinal structures: the catalyst for syndesmophytes growth and impaired spinal mobility in axial spondyloarthritis.","authors":"Simin Liao, Jian Zhu, Liuquan Cheng, Zheng Zhao, Gui Luo, Chuan Song, Jiaxin Zhang, Feng Huang","doi":"10.1093/rheumatology/keaf199","DOIUrl":"https://doi.org/10.1093/rheumatology/keaf199","url":null,"abstract":"<p><strong>Objective: </strong>To identify risk factors for spinal structural progression and determine the most significant impact on syndesmophytes growth and impaired spinal mobility in axSpA.</p><p><strong>Methods: </strong>Baseline and 2-year follow-up clinical, thoracic and lumbar spine CT data of 94 patients were analyzed. Vertebral syndesmophytes unit (VSU) was defined as syndesmophytes anterior to vertebral body and its intervertebral disc space, with volumes calculated by Mimics software. Bilateral facet/costovertebral/costotransverse joints were assessed. Syndesmophytes growth was assessed with linear mixed-effects model, and posterior spinal structures progression were evaluated with generalized linear mixed-effects models. Influence of spinal changes on BASMI-change was analyzed with generalized linear model. Conditional R2 values quantified model fit, with coefficient percentage representing each variable's contribution.</p><p><strong>Results: </strong>Syndesmophytes growth occurred in 44.99% VSUs. Baseline facet joints ankylosis/erosion, costovertebral/costotransverse joints ankylosis were associated with syndesmophytes growth (p < 0.05). Contributing factors included changes of facet joints (56.84%), costotransverse joints (17.65%), costovertebral joints (16.26%), and age (6.08%). Structural progression was found in 8.79% (281/3196) of facet joints, among which 43.77% progressed to ankylosis, with age (6.56%) and baseline ankylosis/erosion (48.02%) driving this change. Besides, 16.31% of costovertebral joints progressed, with age (3.63%) and two-year costotransverse lesions progression (12.30%) as significant predictors. And 2.07% of costotransverse joints progressed, with costovertebral lesions (25.61%) and age (0.81%) correlating significantly. Ankylosed costovertebral joints (25.10%), facet joints (16.86%), costotransverse joints (12.72%), and syndesmophytes growth (4.45%) significantly contribute to BASMI-change.</p><p><strong>Conclusions: </strong>Ankylosed posterior spinal structures emerged as the paramount driver of syndesmophytes growth and a critical impediment to spinal mobility in axSpA.</p>","PeriodicalId":21255,"journal":{"name":"Rheumatology","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144174671","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":"Hospitalised with fever: worthy of serum ferritin.","authors":"Ian Harrowell, Randy Q Cron, Athimalaipet V Ramanan","doi":"10.1093/rheumatology/keaf294","DOIUrl":"https://doi.org/10.1093/rheumatology/keaf294","url":null,"abstract":"","PeriodicalId":21255,"journal":{"name":"Rheumatology","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144174672","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 safety of low-dose methotrexate for rheumatic diseases: looking beyond blood monitoring.","authors":"Sarah L Mackie, Catherine L Hill","doi":"10.1093/rheumatology/keaf257","DOIUrl":"https://doi.org/10.1093/rheumatology/keaf257","url":null,"abstract":"","PeriodicalId":21255,"journal":{"name":"Rheumatology","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144174745","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: Sustained drug-free remission in giant cell arteritis.","authors":"","doi":"10.1093/rheumatology/keaf244","DOIUrl":"https://doi.org/10.1093/rheumatology/keaf244","url":null,"abstract":"","PeriodicalId":21255,"journal":{"name":"Rheumatology","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144161772","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":"Immunoadsorption as a novel therapy for refractory idiopathic inflammatory myopathies—a retrospective observational study","authors":"Kastriot Kastrati, Thomas Karonitsch, Hanien Rajab, Roman Reindl-Schwaighofer, Farsad Eskandary, Sahra Pajenda, Daniel Mrak, Peter Maximilian Heil, Hans Peter Kiener, Michael Bonelli, Kurt Derfler, Daniel Aletaha, Josef S Smolen, Helga Radner","doi":"10.1093/rheumatology/keaf289","DOIUrl":"https://doi.org/10.1093/rheumatology/keaf289","url":null,"abstract":"Objective Idiopathic inflammatory myopathies (IIM) are autoimmune disorders characterised by muscle inflammation, high creatine kinase (CK) levels, and disability. Despite immunomodulating therapies, patients often experience progressive disease, resulting in refractory conditions or dependence on glucocorticoids (GC). This study addresses the efficacy and safety of immunoadsorption (IAS) in refractory IIM. Methods A retrospective, monocentric study was conducted on patients with highly active IIM subjected to IAS between January 2000 and September 2021. Inclusion criteria were adult patients with confirmed IIM unresponsive to standard therapies, including GC and at least one disease-modifying antirheumatic drug. Primary end point was defined as minor improvement, requiring a ≥ 20% reduction in both daily GC-dosage and CK-levels at week 12, alongside patient comparative self-assessment (PCSA) rated as “no change” or “better.” Secondary endpoints included moderate (≥ 40%) and major (≥ 60%) improvements at weeks 4, 8, and 12. Relapse rates were assessed over a 3-month period following the last IAS procedure. Results The study included 23 refractory IIM patients treated with IAS. Primary end point was reached by 52.2% (n = 12) patients. Moderate improvement was observed in 8.7% (n = 2), 26.1% (n = 6), and 34.8% (n = 8) and major improvement in 8.7% (n = 2), 17.4% (n = 4), and 30.4% (n = 7) at weeks 4, 8, and 12, respectively. No unexpected adverse events were reported, with low relapse rates within 3 months post-IAS (18%). Conclusion IAS may be an effective adjunctive therapy in patients refractory to GC and conventional treatments, leading to rapid CK level reductions, decreased GC usage, and improvements in PCSA and muscle function.","PeriodicalId":21255,"journal":{"name":"Rheumatology","volume":"14 1","pages":""},"PeriodicalIF":5.5,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144165266","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":"Diffuse idiopathic skeletal hyperostosis as a marker for incident diabetes mellitus in cardiovascular disease patients.","authors":"Netanja I Harlianto, Wouter Foppen, Firdaus A A Mohamed Hoesein, Marjolein E Hol, Jorrit-Jan Verlaan, Pim A de Jong, Jan Westerink","doi":"10.1093/rheumatology/keaf268","DOIUrl":"https://doi.org/10.1093/rheumatology/keaf268","url":null,"abstract":"<p><strong>Objectives: </strong>Diffuse idiopathic skeletal hyperostosis (DISH) is a common incidental finding in medical imaging characterized by continuous vertebral ossification, which is associated with prevalent type 2 diabetes mellitus (T2DM). We hypothesized that incidental screen-detected DISH may be an actionable marker for incident diabetes screening and aimed to assess the absolute incidence rate (ratio) for T2DM in cardiovascular patients with and without DISH.</p><p><strong>Methods: </strong>Cardiovascular disease patients without diabetes (n = 3395) were included via the prospective Second Manifestation of ARTerial disease cohort. DISH was evaluated at baseline on chest radiographs using Resnick criteria. Incident T2DM was assessed by an adjudication committee. Adjusted incidence rate ratios (IRR) and numbers needed to screen were calculated.</p><p><strong>Results: </strong>DISH was present in 263 (7.7%) patients. After a median follow-up of 11.1 years (IQR : 7.1-15.2), 317 patients developed T2DM. Patients with DISH had a higher incidence rate for T2DM compared with no-DISH patients (17.1 vs 7.8 T2DM per 1000 person-years). DISH was associated with incident T2DM in multivariate analyses (IRR : 1.47; 95%CI : 1.03-2.06), with the highest IRR in the DISH group with the most extensive ossification (IRR: 2.01; 95%CI : 1.15-3.29). The number needed to screen for T2DM in patients with screen detected DISH for 11.1 years was 7, similar to accepted risk markers overweight (n = 8), obesity (n = 5), hypertension (n = 9) and hyperlipidemia (n = 13).</p><p><strong>Conclusions: </strong>DISH is associated with higher rates of incident T2DM in cardiovascular disease patients, independent of accepted risk markers. DISH could be used as an imaging marker to identify cardiovascular disease patients with an increased risk for subsequent T2DM.</p>","PeriodicalId":21255,"journal":{"name":"Rheumatology","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144161773","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-imaging characteristics and management of anti-JO-1 and non-JO-1 anti-synthetase syndrome-associated interstitial lung disease","authors":"Wanqing Zhou, Ranxun Chen, Xi Chen, Weiwei Xie, Qingqing Xu, Yin Liu, Lulu Chen, Bi Chen, Jinghong Dai","doi":"10.1093/rheumatology/keaf287","DOIUrl":"https://doi.org/10.1093/rheumatology/keaf287","url":null,"abstract":"Objectives Given a substantial proportion of patients with ASS-ILD (anti-synthetase syndrome-associated interstitial lung disease) develop progressive pulmonary fibrosis (PPF), we aimed to investigate the clinical-radiographic characteristics and treatment in patients with or without anti-Jo-1 antibody. Methods Patients diagnosed with ASS-ILD from two centers were retrospectively reviewed and stratified into subgroups according to the anti-synthetase antibody. Demographic, clinical features, radiographic patterns, pulmonary function tests, management, and mortality were compared. Results In total, 377 patients were recruited, comprising 169 (44.8%) with anti-Jo-1 and 208 (55.2%) without, including 89 (23.6%) with anti-EJ, 72 (19.1%) with anti-PL-7, 39 (10.3%) with anti-PL-12 and 8 (2.1%) with anti-OJ. Patients with non-Jo-1 had significantly longer diagnostic durations (p= 0.037), hyperglobulinemia (p&amp;lt; 0.05), and more frequently combined with secondary Sjögren’s syndrome (p= 0.003) compared with those with anti-Jo-1. Regarding the radiographic patterns, patients with Anti-Jo-1 antibody frequently showed an organizing pneumonia pattern (15.6%) in chest high-resolution computed tomography (HRCT), while non-Jo-1 exhibited the fibrotic radiographic patterns, including usual interstitial pneumonia (UIP) (43.3%) and nonspecific interstitial pneumonia (NSIP) (52.2%). Moreover, patients with anti-Jo-1 had received an increased corticosteroids dose. Despite these, antifibrotic treatments and mortality were comparable between patients with anti-Jo-1 and non-anti-Jo-1. Conclusion Patients with ASS-ILD had distinctive clinical-imaging characteristics among the different antibodies, and non-anti-Jo-1 patients were susceptible to presenting a fibrotic phenotype. Further long-term study is needed to investigate the disease behaviour to guide optimal treatment strategy.","PeriodicalId":21255,"journal":{"name":"Rheumatology","volume":"42 1","pages":""},"PeriodicalIF":5.5,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144153344","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":"Interleukin-6 receptor blockade leads to low fibrinogen values as part of their effects on the acute phase.","authors":"Martin Achleitner, Oliver Tiebel, Nicolai Leuchten, Martin Aringer","doi":"10.1093/rheumatology/keaf195","DOIUrl":"https://doi.org/10.1093/rheumatology/keaf195","url":null,"abstract":"","PeriodicalId":21255,"journal":{"name":"Rheumatology","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144161774","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}