Rheumatology最新文献

{"title":"Enhanced surveillance for the detection of psoriatic arthritis in a UK primary care psoriasis population: results from the TUDOR trial.","authors":"Neil McHugh, William Tillett, Philip Helliwell, Jonathan Packham, Howard Collier, Claire Davies, Myka Ransom, Laura Coates, Sarah T Brown","doi":"10.1093/rheumatology/keae374","DOIUrl":"10.1093/rheumatology/keae374","url":null,"abstract":"<p><strong>Objectives: </strong>Our objective was to determine whether early detection of undiagnosed PsA in a primary care psoriasis population improves outcome in physical function at 24 months post-registration.</p><p><strong>Methods: </strong>A multicentre, prospective, parallel group cluster randomized controlled trial in patients with psoriasis was conducted. Participants with suspected inflammatory arthritis on screening were referred for an assessment of PsA [enhanced surveillance (ES) arm: at baseline, and 12 and 24 months; standard care (SC) arm: at 24 months]. The primary outcome measure was the HAQ Disability Index (HAQ-DI) at 24 months post-registration in participants diagnosed with PsA.</p><p><strong>Results: </strong>A total of 2225 participants across 135 general practitioner practices registered: 1123 allocated to ES and 1102 to SC. The primary analysis population consisted of 87 participants with a positive diagnosis of PsA: 64 in ES, 23 in SC. The adjusted odds ratio (OR) for achieving a HAQ-DI score of 0 at 24 months post-registration in ES compared with SC was 0.64 [95% CI (0.17, 2.38)], and the adjusted OR of achieving a higher (non-zero) HAQ-DI score at 24 months post-registration in ES relative to SC arm was 1.12 (95% CI 0.67, 1.86), indicating no evidence of a difference between the two treatment groups (P = 0.66).</p><p><strong>Conclusion: </strong>The trial was underpowered for demonstrating the prespecified treatment effect; in patients with psoriasis there was no evidence that early diagnosis of PsA by ES in primary care changes physical function at 24 months compared with SC.</p><p><strong>Clinical trial registration: </strong>The TUDOR trial is registered as ISRCTN38877516.</p>","PeriodicalId":21255,"journal":{"name":"Rheumatology","volume":" ","pages":"1750-1759"},"PeriodicalIF":4.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11962868/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141749036","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}

{"title":"Low incidence of late-onset giant cell arteritis during the first year in patients with polymyalgia rheumatica-a repeated imaging study.","authors":"Andreas Wiggers Nielsen, Ellen-Margrethe Hauge, Ib Tønder Hansen, Berit Dalsgaard Nielsen, Søren Geill Kjær, Jesper Blegvad, Kate Rewers, Christian Møller Sørensen, Lars Christian Gormsen, Kresten Krarup Keller","doi":"10.1093/rheumatology/keae463","DOIUrl":"10.1093/rheumatology/keae463","url":null,"abstract":"<p><strong>Objective: </strong>The objective was to investigate the incidence of late-onset giant cell arteritis (GCA) within the first year in patients diagnosed with polymyalgia rheumatica (PMR).</p><p><strong>Methods: </strong>In this prospective study, treatment-naïve individuals with a new clinical diagnosis of PMR and without GCA symptoms underwent baseline assessments, including vascular ultrasonography and 2-[18F]fluoro-2-deoxy-D-glucose positron emission tomography computed tomography (FDG-PET/CT). To prevent biased inclusion, rapid referral clinics were established for all patients suspected of PMR. Additionally, the patients underwent GCA monitoring during clinical visits at weeks 8 and 10, which involved vascular ultrasonography and FDG-PET/CT scans. After one year, a follow-up visit was performed to confirm the PMR diagnosis and perform vascular ultrasonography.</p><p><strong>Results: </strong>A final PMR diagnosis was assigned to 62 patients, excluding two patients with concurrent subclinical GCA and PMR at baseline, corresponding to a baseline prevalence of subclinical GCA of 3%. During the one-year follow-up, two PMR patients developed late-onset GCA corresponding to an incidence rate of 32 per 1000 person-years. One patient developed GCA 14 weeks after the PMR diagnosis, exhibiting cranial symptoms and positive vascular ultrasonography. The other patient presented with subclinical large vessel GCA at the one-year visit detected with vascular ultrasonography and confirmed by FDG-PET/CT.</p><p><strong>Conclusion: </strong>This study is the first to demonstrate a low incidence rate of late-onset GCA in PMR patients within the first year, employing repeated imaging to exclude GCA at baseline and diagnose GCA during follow-up. Additionally, it provides evidence of a low prevalence of subclinical GCA across the entire PMR population.</p><p><strong>Trial registration: </strong>ClinicalTrials.Gov, NCT04519580.</p>","PeriodicalId":21255,"journal":{"name":"Rheumatology","volume":" ","pages":"2193-2198"},"PeriodicalIF":4.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142047113","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 use of intravenous methylprednisolone in giant cell arteritis: a population-based study.","authors":"Hampus Henningson, Björn Hammar, Aladdin J Mohammad","doi":"10.1093/rheumatology/keae459","DOIUrl":"10.1093/rheumatology/keae459","url":null,"abstract":"<p><strong>Objectives: </strong>To determine clinical characteristics, outcome and occurrence of comorbidities in patients with biopsy-confirmed giant cell arteritis (GCA) treated with intravenous methylprednisolone (IVMP) vs those receiving oral glucocorticoids (OGC) only.</p><p><strong>Methods: </strong>A retrospective study included patients with GCA diagnosed from 2004 through 2019. Clinical and laboratory characteristics, and cumulative GC dose were compared in patients receiving IVMP vs OGCs. Changes in visual acuity (VA), occurrence of comorbidities after GCA diagnosis, and mortality were analysed.</p><p><strong>Results: </strong>A total of 419 patients (69% female) were included. In total, 111 patients were initially treated with IVMP, 104 (94%) of whom showed visual manifestations at onset and 308 received OGCs only. Ninety patients (21.5%) exhibited visual involvement at onset, verified by an ophthalmologist. Compared with OGC, patients receiving IVMP exhibited lower inflammatory response at presentation. There was a tendency for improvement in VA with the use of IVMP, but the results were not statistically significant (OR 1.19, 95% CI 0.35-4.01). Patients treated with IVMP had a higher risk of newly diagnosed diabetes mellitus within a year of GCA diagnosis (OR 2.59, 95% CI 1.19-5.63). This risk remained elevated after adjusting for cumulative OGC dose at three months (adjusted OR 3.30, 95% CI 1.29-8.43). There was no difference in survival between treatment groups.</p><p><strong>Conclusions: </strong>Our study found no evidence supporting any benefit of using IVMP in improving VA or survival. IVMP may increase diabetes risk within a year of GCA diagnosis. Further studies are needed to evaluate the value of IVMP in GCA.</p>","PeriodicalId":21255,"journal":{"name":"Rheumatology","volume":" ","pages":"2083-2090"},"PeriodicalIF":4.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11962881/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142073805","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}

{"title":"Diagnostic accuracy of hip joint ultrasound for detection of calcium pyrophosphate deposition.","authors":"Carina Soto-Fajardo, Fabián Carranza-Enríquez, Raúl Pichardo-Bahena, Denise Clavijo-Cornejo, Víctor Manuel Ilizaliturri-Sánchez, Paola Flores-Ordoñez, Abish Ángeles-Acuña, Sinthia Solórzano-Flores, Georgios Filippou, Hugo Sandoval, Carlos Pineda","doi":"10.1093/rheumatology/keae515","DOIUrl":"10.1093/rheumatology/keae515","url":null,"abstract":"<p><strong>Objective: </strong>CPPD disease is a chronic and disabling arthropathy. US has been shown to be a tool with high sensitivity and specificity for the diagnosis of CPPD disease, but its value at the hip joint has not yet been determined. Therefore, our objective was to evaluate the diagnostic accuracy of US for the identification of CPP crystals in the hip joint as compared with histopathology.</p><p><strong>Methods: </strong>Diagnostic test study involving patients over 50 years of age with osteoarthritis, scheduled for hip replacement surgery. US was performed on the affected hip. Acetabular fibrocartilage (FC) and hyaline cartilage (HC) of the femoral head were assessed, and a dichotomous score was used for the presence/absence of CPP crystals. SF was obtained from the affected hip and examined using polarized light microscopy. Histopathological examination was performed by an experienced pathologist in search of CPP crystals in FC and HC samples.</p><p><strong>Results: </strong>One hundred patients were enrolled, of whom 62% were found to have hyperechoic areas suggestive of CPP deposition on US examination. Pathological evaluation revealed a prevalence of 61% of CPP crystals. The sensitivity, specificity and the positive predictive and the negative predictive values were 90%, 82%, 89%, and 84%, respectively. The area under the curve for US compared with histopathology for the diagnosis of hip CPPD was 0.86 (95% CI: 0.78-0.94).</p><p><strong>Conclusion: </strong>US is a valid imaging modality with good diagnostic accuracy for the detection of hip CPPD.</p>","PeriodicalId":21255,"journal":{"name":"Rheumatology","volume":" ","pages":"1783-1790"},"PeriodicalIF":4.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142308549","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 haemorrhage 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>Objective: </strong>To assess the association of aPL and diffuse alveolar haemorrhage (DAH) in patients with 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 APS.</p><p><strong>Results: </strong>Out of 454 screened studies, nine were included in meta-analysis, encompassing 7746 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 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>Conclusion: </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":"1598-1608"},"PeriodicalIF":4.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11962882/pdf/","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":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A case with systemic juvenile idiopathic arthritis treated with tofacitinib and rapamycin.","authors":"Veysel Cam, Erdal Sag, Yelda Bilginer, Seza Ozen","doi":"10.1093/rheumatology/keae637","DOIUrl":"10.1093/rheumatology/keae637","url":null,"abstract":"","PeriodicalId":21255,"journal":{"name":"Rheumatology","volume":" ","pages":"2315-2316"},"PeriodicalIF":4.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11962887/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142695885","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}

{"title":"Epidemiology of ANCA vasculitis in northern Spain.","authors":"Fabricio Benavides-Villanueva, Alba Herrero-Morant, Diana Prieto-Peña, Salma Al Fazazi, Vanesa Calvo-Río, Mónica Renuncio-García, Adrián Martín-Gutierrez, María Del Amparo Sánchez-Lopez, Claudia Poo-Fernandez, Clara Escagedo-Cagigas, María Rodríguez-Vidriales, Ricardo Blanco","doi":"10.1093/rheumatology/keae413","DOIUrl":"10.1093/rheumatology/keae413","url":null,"abstract":"<p><strong>Objectives: </strong>The incidence of anti-neutrophil cytoplasmic antibodies (ANCA)-associated vasculitis (AAV) shows disparate results due to variable classification criteria and heterogeneous population series. We aimed to estimate the incidence of AAV in a well-defined population with standardized classification criteria.</p><p><strong>Methods: </strong>This was a population-based study of AAV patients diagnosed from January 2000 to December 2023 in Cantabria, northern Spain. Patients were classified according to ACR/EULAR 2022 into granulomatosis with polyangiitis (GPA), microscopic polyangiitis (MPA), or unclassified vasculitis if the criteria were not met. Eosinophilic granulomatosis with polyangiitis patients were not included. The annual incidence rates were estimated by cases over 1 000 000 (106) (95% CI) including overall AVV, type of AAV, sex and year of diagnosis. A literature review was also performed.</p><p><strong>Results: </strong>We included 152 patients [80M/72F; mean age 70.6 (13.18) years]. They were classified as MPA (67; 44%), GPA (64; 42.2%), and unclassified vasculitis (21; 13.8%). Annual incidence was 13.4 (95% CI: 10, 16.8)/106 [male 14.5 (95% CI: 10.5, 18.5); female 12.1 (95% CI: 8.7, 15.6)]. The Annual incidence of MPA was 5.9 (95% CI: 4, 7.8)/106 and GPA 5.6 (95% CI: 3.9, 7.3)/106. The mean annual incidence increased from 6.1 (95% CI: 4.5, 7.7)/106 to 16.5 (595% CI: .6, 27.4)/106 in the last 3 years, particularly in GPA from 2.3 (95% CI: 0.3, 4.9)/106 to 8.2 (95% CI: 2, 14.5)/106. The prevalence of AAV was 184.7 (95% CI: 181, 188)/106.</p><p><strong>Conclusion: </strong>During a 20-year period we found that the incidence of AAV (GPA and MPA) in northern Spain was higher than in southern Spain, but lower than northern European countries. An increase in the incidence was observed in the last years.</p>","PeriodicalId":21255,"journal":{"name":"Rheumatology","volume":" ","pages":"1999-2007"},"PeriodicalIF":4.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141898082","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":"Prevalence and prognostic relevance of electrocardiographic abnormalities among patients with ANCA-associated vasculitis.","authors":"Louis Nygaard, Caroline Hundborg Liboriussen, Nicholas Carlson, Karl Emil Nelveg-Kristensen, Salome Kristensen, Mikkel Porsborg Andersen, Helle Collatz Christensen, Kristian Kragholm, Claus Graff, Christian Torp-Pedersen, Per Ivarsen, My Svensson, Jon Waarst Gregersen, Christoffer Polcwiartek","doi":"10.1093/rheumatology/keae434","DOIUrl":"10.1093/rheumatology/keae434","url":null,"abstract":"<p><strong>Objectives: </strong>Current guidelines provide limited evidence for cardiovascular screening in ANCA-associated vasculitis (AAV). This study aimed to investigate the prevalence of ECG abnormalities and associations between no, minor or major ECG abnormalities with cardiovascular mortality in AAV patients compared with matched controls.</p><p><strong>Methods: </strong>Using a risk-set matched cohort design, patients diagnosed with granulomatosis with polyangiitis or microscopic polyangiitis with digital ECGs were identified from Danish registers from 2000 to 2021. Patients were matched 1:3 to controls without AAV on age, sex and year of ECG measurement. Associated hazards of cardiovascular mortality according to ECG abnormalities were assessed in Cox regression models adjusted for age, sex and comorbidities, with subsequent computation of 5-year risk of cardiovascular mortality standardized to the age- and sex-distribution of the sample.</p><p><strong>Results: </strong>A total of 1431 AAV patients were included (median age: 69 years, 52.3% male). Median follow-up was 4.8 years. AAV was associated with a higher prevalence of left ventricular hypertrophy (17.5% vs 12.5%), ST-T deviations (10.1% vs 7.1%), atrial fibrillation (9.6% vs 7.5%) and QTc prolongation (5.9% vs 3.6%). Only AAV patients with major ECG abnormalities demonstrated a significantly elevated risk of cardiovascular mortality [HR 1.99 (1.49-2.65)] compared with controls. This corresponded to a 5-year risk of cardiovascular mortality of 19.14% (16-22%) vs 9.41% (8-11%).</p><p><strong>Conclusion: </strong>Patients with AAV demonstrated a higher prevalence of major ECG abnormalities than controls. Notably, major ECG abnormalities were associated with a significantly increased risk of cardiovascular mortality. These results advocate for the inclusion of ECG assessment into routine clinical care for AAV patients.</p>","PeriodicalId":21255,"journal":{"name":"Rheumatology","volume":" ","pages":"2008-2018"},"PeriodicalIF":4.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141917409","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":"Factors associated with long-term opioid use among patients with axial spondyloarthritis or psoriatic arthritis who initiate opioids.","authors":"Yun-Ting Huang, David A Jenkins, Belay Birlie Yimer, Meghna Jani","doi":"10.1093/rheumatology/keae444","DOIUrl":"10.1093/rheumatology/keae444","url":null,"abstract":"<p><strong>Objective: </strong>Up to one in five patients with axial spondyloarthritis (AxSpA) or psoriatic arthritis (PsA) newly initiated on opioids transition to long-term use within the first year. This study aimed to investigate individual factors associated with long-term opioid use among opioid new users with AxSpA/PsA.</p><p><strong>Methods: </strong>Adult patients with AxSpA/PsA and without prior cancer who initiated opioids between 2006 and 2021 were included from Clinical Practice Research Datalink Gold, a national UK primary care database. Long-term opioid use was defined as having ≥3 opioid prescriptions issued within 90 days, or ≥90 days of opioid supply, in the first year of follow-up. Individual factors assessed included sociodemographic, lifestyle factors, medication use and comorbidities. A mixed-effects logistic regression model with patient-level random intercept was used to examine the association of individual characteristics with the odds of long-term opioid use.</p><p><strong>Results: </strong>In total, 10 300 opioid initiations were identified from 8212 patients (3037 AxSpA; 5175 PsA). The following factors were associated with long-term opioid use: being a current smoker (OR: 1.62; 95%CI: 1.38,1.90), substance use disorder (OR: 2.34, 95%CI: 1.05,5.21), history of suicide/self-harm (OR: 1.84; 95%CI: 1.13,2.99), co-existing fibromyalgia (OR: 1.62; 95%CI: 1.11,2.37), higher Charlson Comorbidity Index (OR: 3.61; 95%CI: 1.69,7.71 for high scores), high MME/day at initiation (OR: 1.03; 95%CI: 1.02,1.03) and gabapentinoid (OR: 2.35; 95%CI: 1.75,3.16) and antidepressant use (OR: 1.69; 95%CI: 1.45,1.98).</p><p><strong>Conclusions: </strong>In AxSpA/PsA patients requiring pain relief, awareness of lifestyle, sociodemographic and prescribing characteristics associated with higher risk of long-term opioid use can prompt timely interventions such as structured medication reviews and smoking cessation to promote safer prescribing and better patient outcomes.</p>","PeriodicalId":21255,"journal":{"name":"Rheumatology","volume":" ","pages":"1844-1852"},"PeriodicalIF":4.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11962957/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141988725","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}

{"title":"Multimodal imaging of structural damage and inflammation in psoriatic arthritis: a comparison of DMARD-naive and DMARD-failure patients.","authors":"Nağme Ö Renkli, Nienke J Kleinrensink, Julia Spierings, Simon Mastbergen, Harald E Vonkeman, Shasti C Mooij, Lydia G Schipper, Amin Herman, Iris Ten Katen, Frank J Nap, Marjolein E Hol, Pim A de Jong, Mylène P Jansen, Wouter Foppen","doi":"10.1093/rheumatology/keae450","DOIUrl":"10.1093/rheumatology/keae450","url":null,"abstract":"<p><strong>Objectives: </strong>To compare inflammatory and structural differences in active PsA between DMARD-naive and DMARD-failure patients using diverse imaging approaches for future analyses. Additionally, to explore the influence of patient characteristics (clinical and demographic variables) on imaging findings.</p><p><strong>Methods: </strong>Of the 80 patients included from the first cohort of the ongoing multicentre TOFA-PREDICT trial, 40 were DMARD-naive and 40 were DMARD-failure (csDMARD failure; one prior bDMARD excluding etanercept was allowed), all meeting classification criteria for PsA with a minimum disease duration of eight weeks. Baseline conventional radiographs of hands and feet, MRIs of both ankles, and whole-body [18F]-fluorodeoxyglucose PET/CT (18F-FDG PET/CT) were evaluated for inflammatory and structural imaging parameters, including Sharp-van der Heijde (SHS), Heel Enthesitis Magnetic Resonance Imaging Scoring System (HEMRIS) and Deauville synovitis scoring. Differences between groups and the influence of patient characteristics were examined with multiple linear regression.</p><p><strong>Results: </strong>At baseline, patient characteristics were similar between groups. Imaging parameters showed limited inflammation and structural damage. Inflammatory imaging parameters were not significantly different (P > 0.200). Among structural parameters, only HEMRIS Achilles tendon structural damage was significantly different (P = 0.024, R2 = 0.071) and SHS Joint Space Narrowing was not statistically significant (P = 0.050, R2 = 0.048) with higher values for both in DMARD failures. After correction of patient characteristics, these differences in imaging disappeared (both P > 0.600).</p><p><strong>Conclusion: </strong>At baseline, PsA patient groups were comparable concerning structural and inflammatory imaging parameters, especially after correcting for patient characteristics. Thus, DMARD-naive and DMARD-failure patient groups may be combined in future PsA progression and treatment decision studies.</p><p><strong>Trial registration: </strong>www.clinicaltrialsregister.eu. EudraCT: 2017-003900-28.</p>","PeriodicalId":21255,"journal":{"name":"Rheumatology","volume":" ","pages":"1760-1769"},"PeriodicalIF":4.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11962931/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141996351","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}