Rheumatology最新文献

{"title":"Treatment-emergent major adverse cardiovascular and thromboembolic events were infrequent during clinical trials of pegloticase.","authors":"Orrin M Troum, Mai Duong, Katie Obermeyer, Lissa Padnick-Silver, Brian LaMoreaux","doi":"10.1093/rheumatology/keaf017","DOIUrl":"10.1093/rheumatology/keaf017","url":null,"abstract":"<p><strong>Objectives: </strong>Long-term maintenance of serum urate levels <6 mg/dl reduces gout flare frequency. However, urate-lowering therapy (ULT) initiation can induce gout flare. The incidence of thromboembolic (TE) and cardiovascular (CV) events has been shown to increase in the 30 and 120 days following gout flare, respectively; therefore, the question of ULT initiation increasing patient risk for CV/TE events has been raised. Here, we investigate CV/TE event incidence following pegloticase initiation in clinical trials.</p><p><strong>Methods: </strong>This post hoc analysis of pooled data from four trials examined treatment-emergent gout flare and CV/TE events in patients with uncontrolled gout. Studies included two phase 3 trials (NCT00325195), the MIRROR open-label trial (NCT03635957), and the MIRROR randomized controlled trial (NCT03994731). Per protocol, pegloticase (8 mg) was administered every 2 (all trials) or 4 weeks (phase 3 trials); data from the first 24 weeks of therapy were included in this analysis. Some MIRROR patients received MTX (15 mg/week) as co-therapy. Based on prior studies, the high-risk window for CV/TE events was defined as 120 days following flare onset.</p><p><strong>Results: </strong>Overall, 5/328 (1.5%) patients experienced ≥1 CV/TE event during pegloticase treatment, including 3/244 (1.2%) patients who received on-label (biweekly) dosing (35.4 events/1000 person-years). All events occurred within the 120-day gout flare exposure window.</p><p><strong>Conclusions: </strong>CV/TE event incidence during pegloticase treatment was similar to the general gout population (31.7 events/1000 person-years). These findings suggest that pegloticase initiation does not put patients at a higher risk for CV/TE events.</p>","PeriodicalId":21255,"journal":{"name":"Rheumatology","volume":" ","pages":"3328-3333"},"PeriodicalIF":4.7,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12107073/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142954154","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":"Barriers to and facilitators of sustaining a systemic lupus erythematosus (SLE) patient decision aid in regular rheumatology outpatient care in the USA.","authors":"Erin E Blanchard, Allyson G Hall, Ezra Gore, Parvaneh Yaghoubi Jami, Aizhan Karabukayeva, Larry R Hearld, Shelby Gontarz, Jasvinder A Singh","doi":"10.1093/rheumatology/keaf043","DOIUrl":"10.1093/rheumatology/keaf043","url":null,"abstract":"<p><strong>Objective: </strong>This study investigates the barriers to and facilitators of sustaining a decision aid (DA) tool for patients with SLE in routine rheumatology outpatient care across the USA. The DA was initially developed for assisting patients with SLE in making informed medication choices by providing personalized information on their treatment process.</p><p><strong>Methods: </strong>We conducted semi-structured interviews with clinicians, administrators, and information technology (IT) professionals from 15 geographically diverse rheumatology clinics that participated in a large-scale DA implementation trial. Interviews were transcribed and analysed using NVivo, with thematic coding to identify key factors influencing DA sustainability.</p><p><strong>Results: </strong>The analysis identified several facilitators, including the DA's user-friendly design and its effectiveness in simplifying complex medical information, aiding informed decision-making for patients with SLE. Challenges affecting DA sustainability included inconsistent staff knowledge about the DA, difficulties integrating the DA into clinical workflows, a lack of executive and physician champions, and a lack of structured training and communication strategies. Additionally, concerns were raised about the availability of staff support and the technological capabilities required to maintain use of the DA.</p><p><strong>Conclusion: </strong>To sustain the DA in clinical practice, there is a need for enhanced training programs, better workflow integration, in-clinic physician champions, and effective use of electronic medical records for DA dissemination. Addressing these challenges would improve the impact of the DA on patient education and decision-making, ensuring its continued use in routine care.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov, NCT03735238.</p>","PeriodicalId":21255,"journal":{"name":"Rheumatology","volume":" ","pages":"3580-3586"},"PeriodicalIF":4.7,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143053208","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 2025 British Society for Rheumatology guideline for the treatment of axial spondyloarthritis with biologic and targeted synthetic DMARDs.","authors":"Sizheng Steven Zhao, Stephanie R Harrison, Ben Thompson, Max Yates, Joe Eddison, Antoni Chan, Nick Clarke, Nadia Corp, Charlotte Davis, Lambert Felix, Kalveer Flora, William J Gregory, Gareth T Jones, Christopher A Lamb, Helena Marzo-Ortega, Daniel J Murphy, Harry Petrushkin, Virinderjit Sandhu, Raj Sengupta, Stefan Siebert, Danielle A Van Der Windt, Dale Webb, Zenas Z N Yiu, Karl Gaffney","doi":"10.1093/rheumatology/keaf089","DOIUrl":"10.1093/rheumatology/keaf089","url":null,"abstract":"","PeriodicalId":21255,"journal":{"name":"Rheumatology","volume":" ","pages":"3242-3254"},"PeriodicalIF":4.7,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12107049/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143811959","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":"Correction to: Five-year follow-up of patients with difficult-to-treat rheumatoid arthritis.","authors":"","doi":"10.1093/rheumatology/keae354","DOIUrl":"10.1093/rheumatology/keae354","url":null,"abstract":"","PeriodicalId":21255,"journal":{"name":"Rheumatology","volume":" ","pages":"4061"},"PeriodicalIF":4.7,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12107050/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141604076","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":"Towards the definition of disease phenotypes in paediatric SAPHO syndrome: a national multicentric study.","authors":"Caterina Matucci-Cerinic, Anna Attico, Clara Malattia, Alessandro Consolaro, Silvia Rosina, Luciana Breda, Saverio La Bella, Marco Cattalini, Francesca Ricci, Giovanni Conti, Adele Civino, Letizia Baldini, Francesco Licciardi, Antonella Insalaco, Francesco La Torre, Serena Pastore, Giovanni Filocamo, Gisella Beatrice Beretta, Francesca Biscaro, Angela Miniaci, Gabriele Simonini, Edoardo Marrani, Angela Pistorio, Nicolino Ruperto, Stefano Volpi, Roberta Caorsi, Gianmaria Viglizzo, Marco Gattorno","doi":"10.1093/rheumatology/keaf065","DOIUrl":"10.1093/rheumatology/keaf065","url":null,"abstract":"<p><strong>Objectives: </strong>The objective of this study was to confirm the presence of different disease phenotypes of paediatric SAPHO syndrome (pSAPHO) based on their skin manifestations in a large cohort of Italian patients.</p><p><strong>Methods: </strong>Patients with pSAPHO were enrolled in the Eurofever Registry and the data retrospectively analysed. The patients were categorized according to their skin manifestations into an acne - hidradenitis suppurativa (Acne-HS) group and a palmoplantar pustulosis - psoriasis vulgaris (PPP-PV) group and were compared with patients without skin manifestations (chronic non-bacterial osteomyelitis, CNO). Comparisons of frequencies between groups were performed using the χ2 test or the Fischer's exact test.</p><p><strong>Results: </strong>A total of 54 pSAPHO patients with skin manifestations (35 Acne-HS, 19 PPP-PV) were enrolled and compared with 167 patients with chronic recurrent multifocal osteomyelitis (CRMO). In the Acne-HS group, 82.9% were males, in the PPP-PV, 84.2% were females, while in the chronic non-bacterial osteomyelitis (CNO) group, no gender differences were observed (P < 0.0001). The three groups differed significantly with respect to age at disease onset: Acne-HS median 13.3 years, PPP-PV median 10.2 years, CNO median 9.5 years (P = 0.0001). An axial pattern was more frequent in the Acne-HS (91.4%) group and the PPP-PV group (89.4%) compared with in the CNO group (46%) (P < 0.0001). Both the Acne-HS (82.9%) and the PPP-PV (63.2%) groups required a biologic therapy more frequently than the CNO group (36.8%), but patients with Acne-HS presented with a refractory skin disease requiring steroids and other lines of treatment, while PPP-PV responded well to biologics.</p><p><strong>Conclusion: </strong>Our data have identified two different phenotypes of pSAPHO based on skin manifestations, with different age of onset, gender, and response to treatments. These two groups have peculiar clinical features that differ from those of the CNO group. A new classification encompassing these phenotypes is warranted.</p>","PeriodicalId":21255,"journal":{"name":"Rheumatology","volume":" ","pages":"3777-3786"},"PeriodicalIF":4.7,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143256061","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 characteristics of primary SS- and overlap SS-associated pulmonary arterial hypertension: a multicentre retrospective study.","authors":"Xiaoxuan Sun, Yixin Zhang, Ting Liu, Hang Zhang, Beibei Zu, Lei Zhou, Qiang Wang, Miaojia Zhang","doi":"10.1093/rheumatology/keaf013","DOIUrl":"10.1093/rheumatology/keaf013","url":null,"abstract":"<p><strong>Objective: </strong>The objective of this study was to explore the clinical characteristics and risk factors for adverse outcomes in patients with SS-associated pulmonary arterial hypertension (SS-PAH).</p><p><strong>Methods: </strong>A retrospective analysis was conducted on SS-PAH patients diagnosed by right heart catheterization (RHC) between March 2013 and March 2024 across four Chinese medical centres. Patients were categorized into primary SS-PAH (pSS-PAH) and overlap SS-PAH groups, based on the presence of additional autoimmune diseases. We compared clinical and demographic data, echocardiographic and haemodynamic parameters, treatment strategies, and event-free survival between the groups. The statistical analyses included t-tests, Wilcoxon rank-sum tests, χ2 tests, Fisher's exact tests, and Kaplan-Meier survival analysis.</p><p><strong>Results: </strong>Overlap SS-PAH was most commonly associated with SLE. Compared with pSS-PAH, overlap SS-PAH patients had a lower proportion categorized as having WHO functional class III-IV, lower pulmonary vascular resistance (PVR), and higher cardiac index. They also showed higher treatment success rates and better event-free survival. However, overlap SS-PAH patients with primary biliary cholangitis (PBC) or autoimmune hepatitis (AIH) had significantly lower 1-year event-free survival rates, older age, and elevated ALP levels.</p><p><strong>Conclusion: </strong>Overlap SS-PAH generally has a better prognosis than pSS-PAH, with improved exercise capacity and milder haemodynamic abnormalities. However, overlap with PBC/AIH is associated with a poorer prognosis. These findings highlight the heterogeneity of SS-PAH and the need for tailored treatment based on underlying autoimmune conditions.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov, https://clinicaltrials.gov, NCT05980728.</p>","PeriodicalId":21255,"journal":{"name":"Rheumatology","volume":" ","pages":"3618-3625"},"PeriodicalIF":4.7,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142954149","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":"Total-body positron emission tomography: a tool for systemic, quantitative evaluation of the inflammatory burden of psoriatic arthritis.","authors":"Siba P Raychaudhuri, Yasser G Abdelhafez, Dario F Mazza, Smriti K Raychaudhuri, Simon R Cherry, Lorenzo Nardo, Ramsey D Badawi, Abhijit J Chaudhari","doi":"10.1093/rheumatology/keae702","DOIUrl":"10.1093/rheumatology/keae702","url":null,"abstract":"<p><strong>Objectives: </strong>To test the hypothesis that recently-developed total body-positron emission tomography (TB-PET) imaging with integrated computed tomography (CT) will enable low-dose, quantitative, domain-specific evaluation of the total inflammatory burden of psoriatic arthritis (PsA) and associate with established outcome measures of the clinical domains of PsA.</p><p><strong>Methods: </strong>Seventy-one adult participants (40 with PsA, 16 with rheumatoid arthritis (RA), and 15 with osteoarthritis (OA)) underwent 20-min TB-PET/CT scans using [18F]FDG, a glucose analogue radiotracer. [18F]FDG uptake was assessed qualitatively and quantitatively. Rheumatological examinations were performed prior to the scan. For both evaluations, domain-specific assessments included 68 joints, 6 entheses, 20 nails, axial disease and dactylitis.</p><p><strong>Results: </strong>[18F]FDG PET uptake consistent with joint involvement and enthesitis was noted in 100% of participants with PsA. Other features included nail matrix pathology (53%), spinal involvement (60%), active sacroiliitis (13%) and dactylitis (10%). Patterns of [18F]FDG uptake in PsA differed from those in participants with RA or OA. There was a high concordance between TB-PET measures and the domain-specific assessments of the joint (75%), entheseal (79%) and nail (65%) pathology. TB-PET was positive for an additional 15% of joints, 20% of entheses and 13% of nails that were negative on clinical assessments.</p><p><strong>Conclusion: </strong>TB-PET/CT identified inflammatory pathologies characteristic to all clinical domains of PsA and thus provided an in vivo evaluation of systemic PsA inflammatory burden. This promising tool may further contribute to identifying pathologies that may be occult, provide biomarkers to diagnose and differentiate PsA at an early stage, and to monitor early treatment response.</p>","PeriodicalId":21255,"journal":{"name":"Rheumatology","volume":" ","pages":"3483-3491"},"PeriodicalIF":4.7,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12107055/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142877832","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":"Association between large vessel vasculitis and inflammatory bowel disease: a case-control study.","authors":"François Maillet, Yann Nguyen, Olivier Espitia, Laurent Perard, Carlo Salvarani, Etienne Rivière, Dieynaba Ndiaye, Cécile-Audrey Durel, Philippe Guilpain, Luc Mouthon, Anna Kernder, Javier Loricera, Pascal Cohen, Isabelle Melki, Claire de Moreuil, Nicolas Limal, Arsène Mékinian, Nathalie Costedoat-Chalumeau, Nathalie Morel, Jonathan Boutemy, Loïc Raffray, Jean-Sébastien Allain, Valérie Devauchelle, Isabelle Kone-Paut, Marc Fabre, Marie Durel, Antoine Dossier, Sébastien Abad, Marcella Visentini, Adrien Bigot, Halil Yildiz, Olivier Fain, Maxime Samson, Guillaume Gondran, Vered Abitbol, Benjamin Terrier","doi":"10.1093/rheumatology/keaf030","DOIUrl":"10.1093/rheumatology/keaf030","url":null,"abstract":"<p><strong>Objectives: </strong>To describe the characteristics and outcome of patients with the association of large vessel vasculitis (LVV, Takayasu arteritis [TA] or GCA) and IBD.</p><p><strong>Methods: </strong>An observational, multicentre, retrospective case-control study. Cases were LVV-IBD patients from European countries, whereas controls had isolated LVV (iLVV).</p><p><strong>Results: </strong>A total of 39 TA-IBD and 12 GCA-IBD cases were enrolled, compared with 52 isolated GCA (iGCA) and 93 isolated TA (iTA) controls. LVV occurred after IBD in 56% in TA-IBD and 75% in GCA-IBD, with a median interval of 1 year (interquartile range [IQR] 1-7) in TA-IBD and 8.6 years (IQR 1-17.7) in GCA-IBD. Crohn's disease was more common in TA-IBD (67%), whereas ulcerative colitis was more common in GCA-IBD (58%). Compared with iTA, TA-IBD were significantly younger at diagnosis of TA (median age 27 vs 37 years, P < 0.001) and had more upper limb claudication (36% vs 12%, P = 0.006). GCA-IBD patients had more frequent arterial thickening or stenosis than controls (75% vs 30%, respectively, P = 0.044) and tended to more frequently involve gastrointestinal arteries (20% vs 0%, respectively, P = 0.06). LVV occurred in IBD patients despite treatment with glucocorticoids (36%), azathioprine (25%) or TNF-alpha blockers (29%). The presence of the IBD was not associated with a higher LVV relapse rate in multivariate analysis (adjusted hazard ratio [aHR] 0.62 [0.13-2.83] for GCA and aHR 0.92 [0.44-1.89] for TA).</p><p><strong>Conclusion: </strong>This study identifies specific clinical and imaging characteristics of LVV-IBD patients, in particular a more severe vascular presentation of GCA-IBD patients compared with iGCA patients.</p>","PeriodicalId":21255,"journal":{"name":"Rheumatology","volume":" ","pages":"3724-3732"},"PeriodicalIF":4.7,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143079873","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: Impact of incident rheumatoid arthritis on earnings: a nationwide sibling comparison study.","authors":"","doi":"10.1093/rheumatology/keae712","DOIUrl":"10.1093/rheumatology/keae712","url":null,"abstract":"","PeriodicalId":21255,"journal":{"name":"Rheumatology","volume":"64 6","pages":"4062"},"PeriodicalIF":4.7,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12107080/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144161776","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":"Belimumab concentrations and immunogenicity in relation to drug effectiveness and safety in SLE within a Swedish real-world setting.","authors":"Alvaro Gomez, Tomas Walhelm, Floris C Loeff, Andreas Jönsen, Dionysis Nikolopoulos, Bryan van den Broek, Anders A Bengtsson, Annick de Vries, Theo Rispens, Christopher Sjöwall, Ioannis Parodis","doi":"10.1093/rheumatology/keaf128","DOIUrl":"10.1093/rheumatology/keaf128","url":null,"abstract":"<p><strong>Objectives: </strong>Studies supporting therapeutic drug monitoring to biopharmaceuticals in SLE are scarce. We aimed to assess anti-drug antibody (ADA) occurrence in belimumab-treated SLE patients and associations between belimumab concentrations and clinical response, serological outcomes and adverse events.</p><p><strong>Methods: </strong>We included 100 patients treated with intravenous belimumab. Clinical data and biological samples were collected at baseline and months 3, 6, 12 and 24. Belimumab levels were determined by quantitative sandwich ELISA, and ADA by an acid-dissociation radioimmunoassay. Clinical activity was evaluated with the SLEDAI-2000 (SLEDAI-2K), revised SLE activity measure (SLAM-R) and physician's global assessment (PhGA). Serological markers included C3, C4 and anti-dsDNA. We performed cross-sectional Spearman's rank correlation analyses, and longitudinal analyses using generalized estimating equations.</p><p><strong>Results: </strong>Belimumab concentrations varied widely (median: 25.8; interquartile range [IQR]: 20.9-43.5 μg/ml) but were stable over time at the group level. Pre-existing ADA was detected in two patients, but no patient developed ADA during follow-up. Belimumab levels moderately correlated with SLEDAI-2K (ρ: -0.37; P = 0.003) and PhGA (ρ: -0.41; P = 0.005) at month 6, while longitudinal analysis revealed a very weak association with SLEDAI-2K (β: -0.10; SE: 0.05; P = 0.031) and a weak association with SLAM-R (β: -0.32; SE: 0.13; P = 0.014). Despite moderate correlations between belimumab levels and serological markers at month 6, there were no associations in longitudinal analysis. There was no relationship between belimumab levels and adverse events.</p><p><strong>Conclusion: </strong>Belimumab yielded no immunogenicity. Belimumab levels were modestly associated with clinical activity but not with serological activity or adverse events.</p>","PeriodicalId":21255,"journal":{"name":"Rheumatology","volume":" ","pages":"3797-3805"},"PeriodicalIF":4.7,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12107032/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143557828","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}