Rheumatology最新文献

{"title":"Correction to: Peripheral manifestations are major determinants of disease phenotype and outcome in new onset spondyloarthritis.","authors":"","doi":"10.1093/rheumatology/kead529","DOIUrl":"10.1093/rheumatology/kead529","url":null,"abstract":"","PeriodicalId":21255,"journal":{"name":"Rheumatology","volume":" ","pages":"886"},"PeriodicalIF":4.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41109820","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":"Efficacy and safety of belimumab in patients with lupus nephritis: a real-world retrospective observational study.","authors":"Sishi Lin, Ji Zhang, Xiaohan You, Bo Chen, Yan Liang, Yin Zhou, Xiaokai Ding, Yinqiu Lv, Huidi Zhang, Bofeng Su, Yongheng Bai, Chaosheng Chen","doi":"10.1093/rheumatology/kead707","DOIUrl":"10.1093/rheumatology/kead707","url":null,"abstract":"<p><strong>Objectives: </strong>To evaluate the differences in efficacy and safety between lupus nephritis (LN) patients who received belimumab plus standard therapy and those who received only standard therapy in real world practice.</p><p><strong>Methods: </strong>Patients diagnosed with LN at the First Affiliated Hospital of Wenzhou Medical University from November 2012 to July 2023 were identified, and eligible cases were divided into two groups according to whether they received additional treatment with belimumab during the course of the disease.</p><p><strong>Results: </strong>A total of 1169 LN patients were identified from our follow-up database. In total, 112 patients receiving add-on treatment with belimumab (BLM group) and 112 control patients matched for relevant baseline characteristics were enrolled in this study. The median duration of treatment with belimumab was 13.82 [7.24, 20.29] months. Compared with the control group, the BLM group had more significant improvement in disease activity indicators such as serum albumin and complement levels, significantly lower B-cell count, immunoglobulin, and earlier first attainment of renal remission, but there was no significant improvement in renal function and kidney-related events or death during the 2-year follow-up period. In the BLM group, the treatment effect of belimumab was more prominent in patients with lower levels of proteinuria. The safety profile of belimumab treatment was favorable, with a lower incidence of respiratory tract infection in the BLM group than in the control group during the follow-up period (P = 0.015).</p><p><strong>Conclusions: </strong>This real-world study revealed that add-on treatment with belimumab provided better disease remission, and the therapeutic effect was more significant in patients with lower proteinuria levels. In addition, it had a favorable safety profile and reduced the risk of respiratory tract infection.</p>","PeriodicalId":21255,"journal":{"name":"Rheumatology","volume":" ","pages":"614-622"},"PeriodicalIF":4.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139037956","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":"Short-term and long-term outcomes of patients with anti-melanoma differentiation-associated gene 5 antibody-positive dermatomyositis.","authors":"Tomoaki Ida, Shunsuke Furuta, Michio Fujiwara, Masaki Hiraguri, Koichi Hirose, Kei Ikeda, Taro Iwamoto, Shin-Ichiro Kagami, Yoshihisa Kobayashi, Kazuhiro Kurasawa, Daiki Nakagomi, Yoshihiro Oya, Yoshie Sanayama, Toshimasa Shimizu, Tomohiro Tamachi, Takeshi Umibe, Masahiro Yasui, Hiroshi Nakajima","doi":"10.1093/rheumatology/keae011","DOIUrl":"10.1093/rheumatology/keae011","url":null,"abstract":"<p><strong>Objectives: </strong>Anti-melanoma differentiation-associated gene 5 (MDA5) antibody-positive dermatomyositis (MDA5-DM) is a subtype of dermatomyositis characterized by frequent interstitial lung disease and reduced muscle involvement. This study aimed to determine the short-term and long-term outcomes of patients with MDA5-DM.</p><p><strong>Methods: </strong>Information on baseline characteristics, treatments and short-term and long-term outcomes of patients with MDA5-DM including survival, relapse and the titre of anti-MDA5 antibody, was retrospectively collected. Descriptive statistics regarding clinical outcomes were calculated, and a comparison of clinical parameters between patients with and without relapse was performed. The short-term survival according to the use of Janus kinase inhibitors (JAKi) was also assessed.</p><p><strong>Results: </strong>A total of 154 patients with MDA5-DM were included in the study. Forty patients (26.0%) died during the remission induction phase, with respiratory failure being the most common cause of mortality. Among the 114 patients who survived the remission induction phase, the 5-year cumulative survival and relapse-free survival rates were 96.8% and 77.4%, respectively, and 7.9% of patients achieved complete drug-free remission. Fifty-four patients achieved normalization of anti-MDA5 antibody titres and only two of them relapsed after normalization. In the severe patients, the 6-month survival rate became significantly higher after the emergence of the JAKi treatment compared with before its existence (P = 0.03).</p><p><strong>Conclusion: </strong>Although relapse often occurs, the long-term survival of MDA5-DM patients who survived the remission induction phase is generally favourable. The status of the anti-MDA5 antibody is associated with relapse. JAKi may improve the survival of refractory patients with severe MDA5-DM.</p>","PeriodicalId":21255,"journal":{"name":"Rheumatology","volume":" ","pages":"756-762"},"PeriodicalIF":4.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139432938","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":"IgA vasculitis nephritis-outcomes in adult-onset disease.","authors":"James Stanway, Nina Brown, Afeera Pervez, Els Van de Perre, James Tollitt, Nikolaos Marketos, Nikki Wong, Ajay Dhaygude, Arvind Ponnusamy, Ed O'Riordan, Michael Venning, Mårten Segelmark, Matthew Morgan, David Jayne, Patrick Hamilton, Charles D Pusey, Louise Oni, Alan D Salama","doi":"10.1093/rheumatology/keae030","DOIUrl":"10.1093/rheumatology/keae030","url":null,"abstract":"<p><strong>Objectives: </strong>IgA vasculitis (IgAV) in adults has been relatively under-investigated. Since outcomes are worse in other forms of vasculitis with increasing age, we investigated the outcomes of IgAV comparing younger adults (18-34), middle-aged adults (35-64) and elderly patients (≥64 years) focusing on kidney outcomes.</p><p><strong>Methods: </strong>We identified patients with renal biopsy-confirmed IgAV nephritis and collected data regarding clinical features and progression to end stage kidney disease (ESKD). The relationship between patient factors and ESKD was analysed by regression.</p><p><strong>Results: </strong>We identified 202 cases, 34% aged 18-34, 43% aged 35-64 and 23% elderly (>64 years). Median follow-up was 44 months. Elderly patients were more likely to present with ESKD (23.9%) compared with middle-aged (13.7%) and younger adults (2.9%) (χ2 11.6, P = 0.002). In patients with independent kidney function at biopsy, there was no difference in outcomes between age groups. Male gender, Black ethnicity, diabetes, histological evidence of chronic renal damage and estimated glomerular filtration rate < 30 ml/min were risk factors for development of ESKD. In this observational study 68.3% of patients received glucocorticoids and 56.9% additional immunosuppression.</p><p><strong>Conclusion: </strong>Elderly patients with IgAV are more likely to have ESKD at presentation, but there is no difference in renal survival between age groups, among those presenting with independent renal function. Renal impairment at biopsy is an independent risk factor for subsequent development of ESKD. There is significant variability in the timing of kidney biopsy and management of these patients among specialist centres. Young adults have outcomes more in keeping with childhood IgAV.</p>","PeriodicalId":21255,"journal":{"name":"Rheumatology","volume":" ","pages":"690-696"},"PeriodicalIF":4.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139563848","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 of disease activity with depression and anxiety in systemic lupus erythematosus: a comparison of SLEDAI-2K and SLE-DAS.","authors":"Leilei Yang, Bingjie Gu, Xiaoqin Wang, Qijie Ren, Minning Shen, Dinglei Su","doi":"10.1093/rheumatology/keae070","DOIUrl":"10.1093/rheumatology/keae070","url":null,"abstract":"<p><strong>Objective: </strong>To explore the association of disease activity, as evaluated by both the Systemic Lupus Erythematosus Disease Activity Score (SLE-DAS) and the SLEDAI-2000 (SLEDAI-2K), with depression and anxiety in patients with SLE.</p><p><strong>Methods: </strong>A cross-sectional study was conducted among 85 Chinese patients with SLE. Disease activity was measured using SLEDAI-2K and SLE-DAS scoring systems. Depression and anxiety were assessed using Patient Health Questionnaire-9 and Generalized Anxiety Disorder Scale-7, respectively. Multivariate logistic regression analysis was performed to evaluate the association of disease activity scores, as well as specific clinical and laboratory items, with depression and anxiety.</p><p><strong>Results: </strong>There was a robust correlation between SLEDAI-2K and SLE-DAS scores in overall patient population (Spearman's r = 0.764, 95% CI 0.655-0.842; P < 0.001) and in those with moderate-to-high disease activity (Spearman's r = 0.792, 95% CI 0.616-0.892; P < 0.0001). However, the correlation weakened for patients with mild disease activity or remission (Spearman's r = 0.450, 95%CI 0.188-0.652; P = 0.001). Multivariate logistic regression analysis did not show a significant correlation between SLEDAI-2K and SLE-DAS scores and depression/anxiety. The presence of mucosal ulcer/serositis significantly increased the risk of depression (odds ratio = 4.472, 95% CI 1.035-19.328; P = 0.045) and anxiety (odds ratio = 3.978, 95% CI 1.051-15.049; P = 0.042).</p><p><strong>Conclusion: </strong>The SLE-DAS scoring system demonstrated a comparable ability to assess disease activity in SLE compared with SLEDAI-2K. Though neither scoring system showed significant associations with depression and anxiety, the presence of mucosal ulcer/serositis markedly heightened the risk of both among SLE patients.</p>","PeriodicalId":21255,"journal":{"name":"Rheumatology","volume":" ","pages":"632-638"},"PeriodicalIF":4.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139672547","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":"Comparative effectiveness of tofacitinib and tumour necrosis factor inhibitors in patients with rheumatoid arthritis in real-world practice: a prospective observational study.","authors":"Soo-Kyung Cho, Yeo-Jin Song, Hye Won Kim, Eunwoo Nam, Ja-Young Jeon, Hyun-Jeong Yoo, Yoon-Kyoung Sung","doi":"10.1093/rheumatology/keae109","DOIUrl":"10.1093/rheumatology/keae109","url":null,"abstract":"<p><strong>Objective: </strong>The objective of this study was to assess the effectiveness of tofacitinib vs TNF inhibitors (TNFis) in Korean patients with RA.</p><p><strong>Methods: </strong>The study used data from a single academic referral hospital's registries of biologic DMARDs (bDMARDs) and tofacitinib and examined remission rates based on the DAS28-ESR after 12 months. Multivariable logistic regression analysis was used to estimate the odds ratio (OR) for achieving remission with tofacitinib compared with TNFi, adjusting for potential confounders.</p><p><strong>Results: </strong>This analysis included 665 patients (200 on tofacitinib and 455 on TNFis) who were followed up for at least 12 months. Of these, 96 patients in the tofacitinib group (48.0%) and 409 patients in the TNFi group (89.9%) were treatment-naïve to bDMARDs. Intention-to-treat analysis revealed no significant difference in the remission rates between the two groups (18.0% vs 19.6%, P = 0.640). Multivariable analysis demonstrated comparable remission rates with tofacitinib and TNFi (OR 1.204, 95% CI 0.720-2.013). In the subpopulation naïve to Janus kinase inhibitors (JAKis) and bDMARDs, tofacitinib showed better remission rates than TNFis (OR 1.867, 95% CI 1.033-3.377). Tofacitinib had more adverse events but similar rates of serious adverse events to TNFis.</p><p><strong>Conclusion: </strong>In real-world settings, there was no significant difference in remission rates at 12 months between the tofacitinib and TNFi groups. In terms of safety, tofacitinib exhibited a higher incidence of adverse events compared with TNFis, while the occurrence of serious adverse events was comparable between the groups.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov, https://clinicaltrials.gov, NCT02602704.</p>","PeriodicalId":21255,"journal":{"name":"Rheumatology","volume":" ","pages":"541-547"},"PeriodicalIF":4.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139747328","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":"Rheumatoid arthritis and atrial fibrillation: bridging the gap in ischaemic stroke prevention.","authors":"Deshire Alpizar-Rodriguez, Marco U Martinez-Martinez","doi":"10.1093/rheumatology/keae548","DOIUrl":"10.1093/rheumatology/keae548","url":null,"abstract":"","PeriodicalId":21255,"journal":{"name":"Rheumatology","volume":" ","pages":"391-392"},"PeriodicalIF":4.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142473619","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":"Executive summary: British Society for Rheumatology guideline on management of adult and juvenile onset Sjögren disease.","authors":"Elizabeth J Price, Stuart Benjamin, Michele Bombardieri, Simon Bowman, Sara Carty, Coziana Ciurtin, Bridget Crampton, Annabel Dawson, Benjamin A Fisher, Ian Giles, Peter Glennon, Monica Gupta, Katie L Hackett, Genevieve Larkin, Wan-Fai Ng, Athimalaipet V Ramanan, Saad Rassam, Saaeha Rauz, Guy Smith, Nurhan Sutcliffe, Anwar Tappuni, Stephen B Walsh","doi":"10.1093/rheumatology/keae218","DOIUrl":"10.1093/rheumatology/keae218","url":null,"abstract":"","PeriodicalId":21255,"journal":{"name":"Rheumatology","volume":" ","pages":"396-408"},"PeriodicalIF":4.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141088388","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":"Comparative risk of incident and recurrent acute anterior uveitis across different biological agents in patients with ankylosing spondylitis.","authors":"Oh Chan Kwon, Hye Sun Lee, Juyeon Yang, Min-Chan Park","doi":"10.1093/rheumatology/keae003","DOIUrl":"10.1093/rheumatology/keae003","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the comparative risk of incident and recurrent acute anterior uveitis (AAU) across different biological DMARDs (bDMARDs) in patients with AS.</p><p><strong>Methods: </strong>A retrospective nationwide cohort study was conducted on 34 621 patients with AS without a previous history of AAU using a national claims database. Patients were followed-up from 2010 to 2021. The comparative risk of incident and recurrent AAU across different bDMARDs was examined using multivariable time-dependent Cox models and counting process (Anderson-Gill) models, respectively.</p><p><strong>Results: </strong>The adjusted hazard ratios (aHRs) and 95% CIs for incident AAU (bDMARDs non-exposure as reference) were: adalimumab 0.674 (0.581-0.891), etanercept 1.760 (1.540-2.012), golimumab 0.771 (0.620-0.959), infliximab 0.891 (0.741-1.071) and secukinumab 1.324 (0.794-2.209). Compared with adalimumab exposure, etanercept [aHR 2.553 (2.114-3.083)], infliximab [aHR 1.303 (1.039-1.634)] and secukinumab [aHR 2.173 (1.273-3.710)] exposures showed a higher risk of incident AAU. The aHRs and 95% CIs for recurrent AAU (bDMARDs non-exposure as reference) were: adalimumab 0.798 (0.659-0.968), etanercept 1.416 (1.185-1.693), golimumab 0.874 (0.645-1.185), infliximab 0.926 (0.729-1.177) and secukinumab 1.257 (0.670-2.359). Compared with adalimumab exposure, etanercept exposure [aHR 1.793 (1.403-2.292)] was associated with a higher risk of recurrent AAU.</p><p><strong>Conclusion: </strong>Our data suggest preference for bDMARDs in the following order: adalimumab/golimumab > infliximab > secukinumab > etanercept (for incident AAU prevention) and adalimumab > golimumab/infliximab/secukinumab > etanercept (for recurrent AAU prevention).</p>","PeriodicalId":21255,"journal":{"name":"Rheumatology","volume":" ","pages":"588-596"},"PeriodicalIF":4.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139502809","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 of ankylosing spondylitis with the risk of cancer: a meta-analysis of cohort studies.","authors":"Lulin Yu, Yici Yan, Wenjing Liu, Siyu Huang, Leitao Sun, Shanming Ruan","doi":"10.1093/rheumatology/keae294","DOIUrl":"10.1093/rheumatology/keae294","url":null,"abstract":"<p><strong>Objectives: </strong>The potential impact of ankylosing spondylitis (AS) on cancer risk remains unclear. This study seeks to investigate the relationship between AS and different types of cancers.</p><p><strong>Methods: </strong>A literature search on PubMed, EMBASE and Cochrane Library up to 10 July 2023 was conducted. Two investigators selected eligible studies and extracted relevant data. The study used the random-effects model to explore the causality between AS and cancer, utilizing relative risk (RR) as a measure for the study.</p><p><strong>Results: </strong>A total of 20 cohorts with >330 000 participants were included. The pooling analysis shows AS being associated with a higher risk of cancers (RR = 1.16, 95% CI: 1.07-1.26, P = 0.001, I2 = 70.60%). In the subgroup analysis, AS has a higher cancer risk in Asia, but this association is not significant in Europe. Individual investigations indicate that AS is associated with an increased risk of bone cancer (RR = 3.41, 95% CI: 1.45-7.99, P = 0.005, I2 = 0.00%), thyroid gland cancer (RR = 1.76, 95% CI: 1.29-2.40, P < 0.001, I2 = 13.70%), multiple myeloma (RR = 1.74, 95% CI: 1.42-2.15, P < 0.001, I2 = 27.20%), leukaemia (RR = 1.52, 95% CI: 1.27-1.82, P < 0.001, I2 = 0.00%), kidney cancer (RR = 1.45, 95% CI: 1.08-1.94, P = 0.014, I2 = 0.00%), prostate cancer (RR = 1.43, 95% CI: 1.17-1.74, P < 0.001, I2 = 82.80%) and non-Hodgkin's lymphoma (RR = 1.42, 95% CI: 1.17-1.73, P < 0.001, I2 = 0.00%). However, there is no significant correlation with connective tissue cancer, brain cancer, testicular and other male cancers, bladder cancer, female cancers, skin cancer, and cancers of the digestive system and respiratory system.</p><p><strong>Conclusion: </strong>AS appears to be related to cancer development. The results highlighted the necessity for large-scale studies, considering influencing factors such as AS course, medication histories and potential biases when examining cancer risk.</p>","PeriodicalId":21255,"journal":{"name":"Rheumatology","volume":" ","pages":"440-454"},"PeriodicalIF":4.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141238138","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}