Rheumatology最新文献

{"title":"Membranous Lupus Nephritis: Too Little, Too Much!","authors":"Fadi Kharouf,Pankti Mehta,Dafna D Gladman,Laura P Whittall Garcia,Zahi Touma","doi":"10.1093/rheumatology/keaf514","DOIUrl":"https://doi.org/10.1093/rheumatology/keaf514","url":null,"abstract":"","PeriodicalId":21255,"journal":{"name":"Rheumatology","volume":"18 1","pages":""},"PeriodicalIF":5.5,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145140126","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":"Low serum folic acid is a potential predictor of psoriatic arthritis in patients with psoriasis.","authors":"Yi-Hsuan Shen,Yu-Chen Huang","doi":"10.1093/rheumatology/keaf509","DOIUrl":"https://doi.org/10.1093/rheumatology/keaf509","url":null,"abstract":"","PeriodicalId":21255,"journal":{"name":"Rheumatology","volume":"3 1","pages":""},"PeriodicalIF":5.5,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145140180","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":"PASDAS test-retest reliability in early, untreated PsA: data from the GOLMePsA clinical trial.","authors":"Gabriele De Marco,Elizabeth M A Hensor,Dennis McGonagle,Ai Lyn Tan,Laura C Coates,Paul Emery,Philip S Helliwell,Helena Marzo-Ortega","doi":"10.1093/rheumatology/keaf507","DOIUrl":"https://doi.org/10.1093/rheumatology/keaf507","url":null,"abstract":"","PeriodicalId":21255,"journal":{"name":"Rheumatology","volume":"41 1","pages":""},"PeriodicalIF":5.5,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145133939","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":"PROMIS displays strong construct validity in pediatric and adult patients with idiopathic inflammatory myopathies.","authors":"Emma M Austenfeld,Sara E Sabbagh,Melodee Liegl,Ke Yan,Vy Do,Julie Fuller,Kelly Rouster-Stevens,Lisa G Rider,Adam Schiffenbauer","doi":"10.1093/rheumatology/keaf502","DOIUrl":"https://doi.org/10.1093/rheumatology/keaf502","url":null,"abstract":"OBJECTIVESWe assessed the validity of Patient-Reported Outcome Measurement Information System (PROMIS) for juvenile and adult-onset idiopathic inflammatory myopathies (JIIM/IIM) and determined associations with disease characteristics and assessments.METHODSPROMIS-49 or -57 questionnaires were completed by parents (n = 70) and pediatric (n = 49) or adult patients with IIM (n = 61). Construct validity was evaluated using legacy health-related quality of life (HRQoL) instruments and associations with disease assessments and clinical characteristics.RESULTSAll groups reported decreased Physical Function (PF) (39.9-44.3, p< 0.001-0.002) compared with the reference population. All groups also reported significantly increased pain interference (49.6-55.8, p< 0.001), fatigue (49.5-55.1, p< 0.001-0.004), and anxiety (47.0-52.5, p< 0.001-0.043). PROMIS demonstrated excellent internal consistency (α > 0.9) and construct validity with legacy HRQoL instruments. Parents reported worse PF (39.7 vs 42.9, p< 0.001), more Fatigue (52.4 vs 48.5, p= 0.023), and higher Anxiety (49.6 vs 46.8, p= 0.032) than their children. PROMIS PF correlated best with disease activity measures (|r|=0.022-0.636), whereas Social Role, Anxiety, and Depression correlated poorly with disease activity measures. Multiple PROMIS domains correlated with Patient and Parent Global Damage, but only parent PF correlated with Physician Global Damage (|r|=0.414). Several PROMIS domains had better correlations with disease assessments than the Medical Outcomes Study Short Form-36 (SF-36).CONCLUSIONPROMIS offers a nuanced view of HRQoL that traditional disease assessments do not adequately capture. PROMIS has good construct validity, and it may be more sensitive than legacy HRQoL measures. These findings support the incorporation of PROMIS into the assessment of IIM/JIIM to address comprehensive patient well-being.","PeriodicalId":21255,"journal":{"name":"Rheumatology","volume":"59 1","pages":""},"PeriodicalIF":5.5,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145133911","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":"High prevalent early damage independently predicts future mortality in an inception cohort of Takayasu arteritis.","authors":"Durga Prasanna Misra,Upendra Rathore,Tooba Qamar,Kritika Singh,Deeksha Singh,Ranjeet Singh Chauhan,Sara Abid,Rudrarpan Chatterjee,Able Lawrence,Amita Aggarwal,Manas Ranjan Behera,Roopali Khanna,Neeraj Jain,Manish Ora","doi":"10.1093/rheumatology/keaf508","DOIUrl":"https://doi.org/10.1093/rheumatology/keaf508","url":null,"abstract":"OBJECTIVESTo evaluate early damage, its evolution, and prognostic relevance in an inception cohort of Takayasu arteritis (TAK) using the Large Vessel Vasculitis Index of Damage (LVVID).METHODSLVVID was scored in an inception cohort of TAK within 3 months of cohort entry, at one year, and the last follow-up at or after one year. Association between initial LVVID scores and demographic characteristics, disease activity, and angiographic subtypes were evaluated. Hazard ratios (HR) for mortality per point/quartile increase in baseline LVVID scores were calculated using Cox proportional hazards regression. Damage evolution from baseline to one year or last follow-up was compared using paired Student's t test. Pre-treatment predictors of progression were assessed using logistic regression.RESULTSAmong 199 patients (141 females, pediatric-onset 54), 192/199 (96.5%) had damage (most often cardiovascular) scored on LVVID at presentation, 112/114 (98.2%) at one year, and 126/130 (96.9%) at last follow-up. Initial LVVID was greater with active disease, Hata's type V, or Goel's cluster 1 angiographic subtypes. Higher baseline LVVID was associated with increased mortality [crude HR per point increase 1.49 (95%CI 1.24-1.80) or per quartile increase in LVVID 1.92 (1.21-3.05)] consistent despite adjustment for disease activity or angiographic subtype. Significant progression of LVVID was observed at 1 year (3.49 ± 2.01 vs 3.27 ± 1.86, p< 0.001) or at the last follow-up (3.73 ± 2.18 vs 3.28 ± 1.88 p< 0.001), predicted by active disease at presentation (OR 2.89) and glucocorticoid (OR 3.53) or immunosuppressant use (OR 3.52).CONCLUSIONMost patients with TAK had recordable early damage which predicted future mortality.","PeriodicalId":21255,"journal":{"name":"Rheumatology","volume":"319 1","pages":""},"PeriodicalIF":5.5,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145133912","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 and outcomes related to clinical inertia in systemic lupus erythematosus: a multicentre LUNA cohort study.","authors":"Hirofumi Miyake,Takashi Kida,Ryusuke Yoshimi,Yuta Michizu,Keisuke Nishimura,Ken-Ei Sada,Yoshia Miyawaki,Yusuke Matsuo,Shigeru Ohno,Hiroshi Kajiyama,Shuzo Sato,Yasuhiro Shimojima,Michio Fujiwara,Ayuko Takatani,Takahisa Onishi,Masao Katsushima,Tomoaki Ida,Kunihiko Umekita,Hiroto Nakano,Kei Ikeda,Kunihiro Ichinose,Akira Onishi","doi":"10.1093/rheumatology/keaf504","DOIUrl":"https://doi.org/10.1093/rheumatology/keaf504","url":null,"abstract":"OBJECTIVESThis study aimed to identify predictors of clinical inertia in systemic lupus erythematosus (SLE) management and to evaluate its impact on clinical outcomes.METHODSA historical cohort study was conducted using data from the multicentre LUNA cohort in Japan. The 365 patients with active disease 1 year before baseline (SLE Disease Activity Index score >4 or active gastrointestinal lesions or haemolytic anaemia) were classified by baseline disease activity and treatment intensification status over 1 year into non-intensification (n = 247) vs intensification (n = 118) groups. Furthermore, the clinical inertia group (n = 116), defined as sustained active disease without intensification, was compared with the non-clinical inertia group (n = 249), which comprised all other patients. Regression analyses assessed predictors and outcomes, including damage accrual, disease activity, quality of life (QoL), and patient satisfaction.RESULTSNon-intensification was associated with larger increases in glucocorticoid-related damage, while clinical inertia was linked to greater increases in overall and glucocorticoid-related damage. Non-intensification and clinical inertia correlated with a tendency towards reduced QoL across several domains. Hydroxychloroquine use and fewer concomitant immunosuppressants predicted non-intensification of treatment, whereas female sex and greater damage accrual predicted clinical inertia; older age showed similar but non-significant trends for both outcomes.CONCLUSIONBecause clinical inertia can drive damage accrual and QoL deterioration, avoiding clinical inertia is a therapeutic priority. Regular reassessment of treatment strategy is essential for older patients, women, and those with greater damage. Proactive tailoring of treatment to individual risk profiles can arrest clinical inertia and improve long-term outcomes.","PeriodicalId":21255,"journal":{"name":"Rheumatology","volume":"50 1","pages":""},"PeriodicalIF":5.5,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145103486","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":"Phenotypic clusters of patients with Takayasu arteritis predict disease activity at presentation, damage and future vascular complications","authors":"Aysegul Avcu, Augustine Jose, Sachit Ganapathy, Fatma Alibaz-Oner, Chengappa Kavadichanda, Upendra Rathore, Rahul Joseph Rajeev, Molly Mary Thabah, Manas Ranjan Behera, Neeraj Jain, Manish Ora, Haner Direskeneli, Durga Prasanna Misra","doi":"10.1093/rheumatology/keaf505","DOIUrl":"https://doi.org/10.1093/rheumatology/keaf505","url":null,"abstract":"Objective To identify clusters of Takayasu arteritis (TAK) based on clinical features and their prognostic relevance. Methods Using agglomerative hierarchical clustering, clusters were defined on phenotype at presentation from 564 patients with TAK from three cohorts from India and Türkiye. Angiographic involvement, disease activity and Vasculitis Damage Index (VDI) at presentation, initiation of glucocorticoids or immunosuppressive agents, requirement for vascular procedures, and new-onset vascular complications were compared between clusters [unpaired Student’s t test or odds ratios (OR with 95%CI)]. Mortality rates [hazard ratios (HR) with 95%CI] were computed using Cox regression. Results Three clusters were identified (1 and 2, with sub-clusters 2A and 2B). Cluster 2 was younger and comprised relatively fewer women than cluster 1. Clinical features and angiography in cluster 1 reflected more frequent involvement of the arch of aorta and its branches as opposed to a greater involvement of the abdominal aorta and its branches in cluster 2. Cluster 2B more often had pan-aortic disease and left subclavian involvement than 2A. Fewer patients in cluster 2A were initiated on glucocorticoids [OR adjusted for center (aOR) 0.51 (0.31-0.83)] or immunosuppressants [aOR 0.35 (0.20-0.60)] or developed new-onset vascular complications [aOR 0.22 (0.07-0.74)] than cluster 1. Cluster 2B had higher VDI (3.98) than clusters 1(3.50) or 2A (2.46) and required more frequent vascular interventions than Cluster 1 or 2A (aOR 1.73-1.88, p &amp;lt; 0.05). Survival was similar across clusters [HR 2A vs 1 0.99 (0.43-2.29), 2B vs 1 1.20 (0.84-1.70)]. Conclusion Phenotypic clusters of TAK reflected distinct angiographic involvement with prognostic implications.","PeriodicalId":21255,"journal":{"name":"Rheumatology","volume":"5 1","pages":""},"PeriodicalIF":5.5,"publicationDate":"2025-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145089726","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":"Modified lung ultrasound score to assess extent and prognosis in systemic autoimmune rheumatic disease-associated interstitial lung disease","authors":"Yanran Chen, Zirui Zhou, Qin Huang, Siju Lin, Xia Ye, Jingyi Xie, Cuilian Liu, Tiantian Yu, Zhenyu Yang, Yukai Wang, Dongzhou Liu, Xiaoping Hong","doi":"10.1093/rheumatology/keaf501","DOIUrl":"https://doi.org/10.1093/rheumatology/keaf501","url":null,"abstract":"Objectives Lung ultrasound (LUS) assesses lung lesion severity in systemic autoimmune rheumatic disease-associated interstitial lung disease (SARD-ILD). The ultrasound manifestations of SARD-ILD include pleural line (PL) abnormalities and heterogeneous B-line (BL) distribution. We aimed to investigate the feasibility of a modified ultrasound scoring system based on refined grading of BL and PL features in patients with SARD-ILD, to determine whether BLs and PLs can effectively reflect ILD patterns across different lung compartments. METHODS 195 Patients with nine SARD-ILDs underwent LUS-chest high-resolution computed tomography (HRCT) pairing was used to determine BLs and PLs diagnostic performance for ILD patterns characterization. BL and PL scores for both were refined to obtain the modified LUS score. Correlations with the Warrick score, ILD-GAP, and severity based on forced vital capacity (FVC) were analyzed, receiver operating characteristic (ROC) were calculated. RESULTS Using HRCT as a criterion, BLs and PLs showed high concordance for diagnosing ground-glass opacity (kappa = 0.606) and reticular opacity (kappa = 0.743), respectively. Modified LUS scores were positively correlated with the Warrick score (r = 0.863; p&amp;lt; 0.001) and ILD-GAP (r = 0.613; p&amp;lt; 0.005). ROC analysis revealed optimal modified LUS score thresholds of 11.5 for identifying cases with high fibrosis burden (Warrick score &amp;gt;8), 18.5 for high mortality risk (ILD-GAP ≥2), and 9.5 for severe functional impairment (FVC% predicted &amp;lt;60%). CONCLUSION BLs and PLs have different diagnostic significances for different ILD patterns. The modified LUS scoring system reliably assesses lesion severity and suggesting poor prognosis in SARD-ILD compared with computed tomography scan.","PeriodicalId":21255,"journal":{"name":"Rheumatology","volume":"1 1","pages":""},"PeriodicalIF":5.5,"publicationDate":"2025-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145089725","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":"Relationship of radiographic progression status to low disease activity in patients with psoriatic arthritis receiving secukinumab treatment for two years","authors":"Philip J Mease, Laura C Coates, Corine Gaillez, Alexis Shew, Weibin Bao, Christopher T Ritchlin","doi":"10.1093/rheumatology/keaf488","DOIUrl":"https://doi.org/10.1093/rheumatology/keaf488","url":null,"abstract":"Objective To examine relationships between radiographic progression and achievement of low disease activity (LDA) or remission at week 104 in patients with psoriatic arthritis (PsA) receiving secukinumab. Methods This post hoc analysis included data from patients with active PsA enrolled in the phase 3 FUTURE 5 study (NCT02404350). Patients were pooled by treatment received at week 104 (secukinumab 300 mg with loading dose [LD], secukinumab 150 mg with LD, or secukinumab 150 mg without LD) and grouped by radiographic progression status. Radiographic progression was defined as change from baseline to week 104 in van der Heijde modified Total Sharp Score &amp;gt;0.5. Efficacy was assessed by achievement of minimal disease activity (MDA), very low disease activity (VLDA), and Disease Activity Index for Psoriatic Arthritis (DAPSA) LDA or remission. Demographics and clinical characteristics associated with radiographic progression at week 104 were identified by logistic regression analyses. Results Of the 541 patients included in this analysis, 457 (84.5%) were radiographic nonprogressors and 84 (15.5%) were radiographic progressors. Higher proportions of nonprogressors achieved MDA, VLDA, and DAPSA LDA and remission at week 104 than progressors. Radiographic progression at week 104 was associated with older age and higher baseline high-sensitivity C-reactive protein level, whereas nonprogression was associated with 300 mg secukinumab (vs 150 mg secukinumab without LD), no prior exposure to tumour necrosis factor inhibitors, and lower body mass index. Conclusion Patients without radiographic progression through 2 years of secukinumab treatment had greater achievement of LDA states at week 104 than patients with radiographic progression. Trial registration ClinicalTrials.gov; NCT02404350","PeriodicalId":21255,"journal":{"name":"Rheumatology","volume":"41 1","pages":""},"PeriodicalIF":5.5,"publicationDate":"2025-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145089724","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":"Ten-year cardiovascular risk changes and major adverse events in gout patients","authors":"Byeongzu Ghang, Jinseok Kim, Taeuk Kang, Hyun Jung Kim","doi":"10.1093/rheumatology/keaf322","DOIUrl":"https://doi.org/10.1093/rheumatology/keaf322","url":null,"abstract":"Objective The long-term interaction between cardiovascular (CV) risk profiles and gout may influence the risk of cardiovascular events. However, the impact of gout and long-term changes in CV risk profile on CV events is unclear. Methods This was a nationwide cohort study based on the Korean National Health Insurance claims database and the National Health Screening Program. Patients aged 20–90 years newly diagnosed with gout after January 2012 and age- and sex-matched controls without gout were included. After adjusting for CV risk profiles measured 10 years before gout diagnosis and their long-term changes, the relative risks of incident CV events (myocardial infarction, cerebral infarction and cerebral haemorrhage) and all-cause death in the gout patients were assessed. Results In total, 113 853 patients with gout and 1 138 530 matched controls were studied. Multivariable analysis showed that gout was associated with increased risks for myocardial infarction (hazard ratio [HR]: 1.39, P &amp;lt; 0.001), cerebral infarction (HR: 1.36, P &amp;lt; 0.001), cerebral haemorrhage (HR: 1.50, P &amp;lt; 0.001), and all-cause death (HR: 1.07, P = 0.004). In addition, significant interactions were observed for myocardial infarction (Grade 1 aggravation over 10 years of diastolic blood pressure [DBP], P = 0.042), cerebral infarction (Grade 2 aggravation over 10 years of DBP, P = 0.037) and cerebral haemorrhage (Grade 2 aggravation over 10 years of total cholesterol, P = 0.057). Conclusions Gout patients had a high risk of incident CV events even after adjusting for CV risk profiles and their long-term changes. These long-term changes additively increase the risk of CV events in gout patients.","PeriodicalId":21255,"journal":{"name":"Rheumatology","volume":"21 1","pages":""},"PeriodicalIF":5.5,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145089410","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}