Rheumatology最新文献

{"title":"Can the dose of belimumab be reduced in patients with systemic lupus erythematosus?","authors":"Iñigo Rua-Figueroa, Irene Altabás-González, Coral Mouriño, Karen Roberts, Andrea Hernández-Martín, Ivette Casafont-Solé, Judit Font-Urgelles, Jose A Román-Ivorra, Marta de la Rubia Navarro, Maria Galindo-Izquierdo, Tarek C Salman-Monte, Javier Narváez, Paola Vidal-Montal, Maria Jesús García-Villanueva, Sandra Garrote-Corral, Maria Angeles Blazquez-Canamero, Carlos Marras Fernandez-Cid, Maria Piqueras-García, Julia Martínez-Barrio, Marina Sánchez-Lucas, Josefina Cortés-Hernández, Eleonora Penzo, Jaime Calvo-Alén, Juan Ramón de Dios, Belén Alvarez-Rodríguez, Margarida Vasques-Rocha, Eva Tomero, Raul Menor-Almagro, Myriam Gandía, José A Gómez-Puerta, Beatriz Frade-Sosa, Consuelo Ramos-Giráldez, Carmen Trapero-Pérez, Elvira Diez, Clara Moriano, Alejandro Muñoz-Jiménez, José María Pego-Reigosa","doi":"10.1093/rheumatology/keae270","DOIUrl":"10.1093/rheumatology/keae270","url":null,"abstract":"<p><strong>Objectives: </strong>The aims of this study were to investigate the prevalence of dose reduction in patients with SLE treated with belimumab (BEL) in Spain, analyse treatment modalities, and determine impact on control of disease activity.</p><p><strong>Methods: </strong>Retrospective longitudinal and multicentre study of SLE patients treated with BEL. Data on disease activity, treatments and outcomes were recorded before and after reduction (6-12 months), and they were compared.</p><p><strong>Results: </strong>A total of 324 patients were included. The dose was reduced in 29 patients (8.9%). The dosing interval was increased in nine patients receiving subcutaneous BEL and in six patients receiving intravenous BEL. The dose per administration was reduced in 16 patients. Pre-reduction status was remission (2021 DORIS) in 15/26 patients (57.7%) and LLDAS in 23/26 patients (88.5%). After reduction, 2/24 patients (8.3%) and 3/22 patients (13.6%) lost remission at 6 months and 12 months, respectively [not statistically significant (NS)]. As for LLDAS, 2/23 patients (8.7%) and 2/21 patients (9.5%) lost their status at 6 and 12 months, respectively (NS). Significantly fewer patients were taking glucocorticoids (GCs) at their 12-month visit, although the median dose of GCs was higher at the 12-month visit (5 [0.62-8.75] vs 2.5 [0-5] at baseline).</p><p><strong>Conclusion: </strong>Doses of BEL can be reduced with no relevant changes in disease activity-at least in the short term-in a significant percentage of patients, and most maintain the reduced dose. However, increased clinical or serologic activity may be observed in some patients. Consequently, tighter post-reduction follow-up is advisable.</p>","PeriodicalId":21255,"journal":{"name":"Rheumatology","volume":" ","pages":"1220-1224"},"PeriodicalIF":4.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140916792","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: Extended ultrasound examination identifies more large vessel involvement in patients with giant cell arteritis.","authors":"","doi":"10.1093/rheumatology/keae345","DOIUrl":"10.1093/rheumatology/keae345","url":null,"abstract":"","PeriodicalId":21255,"journal":{"name":"Rheumatology","volume":" ","pages":"1534"},"PeriodicalIF":4.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141604075","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":"Biopsy vs imaging for the diagnosis of giant cell arteritis. Viewpoint 2: in favour of biopsy.","authors":"Georgina Espígol-Frigolé, Sergio Prieto-González, Javier Marco-Hernández, Marc Corbera-Bellalta, Maria C Cid","doi":"10.1093/rheumatology/keae474","DOIUrl":"https://doi.org/10.1093/rheumatology/keae474","url":null,"abstract":"<p><strong>Objectives: </strong>Both temporal artery biopsy (TAB) and imaging are widely used to support the diagnosis of giant cell arteritis (GCA). The objective of this study was to compare the use of TAB and imaging.</p><p><strong>Methods: </strong>This article was based on a debate presented at the 21st Vasculitis Meeting, discussing the advantages and disadvantages of using TAB with histology vs imaging for the diagnosis of suspected GCA.</p><p><strong>Results: </strong>TAB is the diagnostic procedure with the highest specificity. Its sensitivity may be improved by removing an appropriate artery length, practice, examining multiple sections at various levels, and by recognizing incomplete histological findings (which may lead to a more definitive diagnosis by further sectioning or imaging or be related to other inflammatory diseases). TAB may provide histopathological clues useful for diagnosing GCA mimics that may produce similar imaging abnormalities. TAB is a useful research resource, and our current understanding of GCA physiopathology mostly relies on tissue immunopathology studies.</p><p><strong>Conclusion: </strong>A suspected diagnosis of GCA should be supported by an objective test. TAB is the procedure with the highest specificity, and its sensitivity may be improved by training. Histopathologic examination provides data for an alternative diagnosis, when diseases other than GCA involve the temporal artery. Imaging is essential for the assessment of large-vessel involvement and allows follow-up studies.</p>","PeriodicalId":21255,"journal":{"name":"Rheumatology","volume":"64 Supplement_1","pages":"i74-i78"},"PeriodicalIF":4.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143606238","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":"Highlights from the breakout session: genetic and environmental conditionings of vasculitis.","authors":"Maria Cid, Neil Basu","doi":"10.1093/rheumatology/keae527","DOIUrl":"https://doi.org/10.1093/rheumatology/keae527","url":null,"abstract":"","PeriodicalId":21255,"journal":{"name":"Rheumatology","volume":"64 Supplement_1","pages":"i104-i105"},"PeriodicalIF":4.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143606323","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":"Uptake and safety of pneumococcal vaccination in adults with immune-mediated inflammatory diseases: a UK wide observational study.","authors":"Georgina Nakafero, Matthew J Grainge, Tim Card, Christian D Mallen, Jonathan S Nguyen Van-Tam, Abhishek Abhishek","doi":"10.1093/rheumatology/keae160","DOIUrl":"10.1093/rheumatology/keae160","url":null,"abstract":"<p><strong>Objective: </strong>The uptake and safety of pneumococcal vaccination in people with immune-mediated inflammatory diseases (IMIDs) is poorly understood. We investigated the UK-wide pneumococcal vaccine uptake in adults with IMIDs and explored the association between vaccination and IMID flare.</p><p><strong>Methods: </strong>Adults with IMIDs diagnosed on or before 1 September 2018, prescribed steroid-sparing drugs within the last 12 months and contributing data to the Clinical Practice Research Datalink Gold, were included. Vaccine uptake was assessed using a cross-sectional study design. Self-controlled case series analysis investigated the association between pneumococcal vaccination and IMID flare. The self-controlled case series observation period was up to 6 months before and after pneumococcal vaccination. This was partitioned into a 14-day pre-vaccination induction, 90 days post-vaccination exposed and the remaining unexposed periods.</p><p><strong>Results: </strong>We included 32 277 patients, 14 151 with RA, 13 631 with IBD, 3804 with axial SpA and 691 with SLE. Overall, 57% were vaccinated against pneumococcus. Vaccine uptake was lower in those younger than 45 years old (32%), with IBD (42%) and without additional indication(s) for vaccination (46%). In the vaccine safety study, data for 1067, 935 and 451 vaccinated patients with primary-care consultations for joint pain, autoimmune rheumatic disease flare and IBD flare, respectively, were included. Vaccination against pneumococcal pneumonia was not associated with primary-care consultations for joint pain, autoimmune rheumatic disease flare and IBD flare in the exposed period, with incidence rate ratios (95% CI) 0.95 (0.83-1.09), 1.05 (0.92-1.19) and 0.83 (0.65-1.06), respectively.</p><p><strong>Conclusion: </strong>Uptake of pneumococcal vaccination in UK patients with IMIDs was suboptimal. Vaccination against pneumococcal disease was not associated with IMID flare.</p>","PeriodicalId":21255,"journal":{"name":"Rheumatology","volume":" ","pages":"962-968"},"PeriodicalIF":4.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11879285/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140120527","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":"Anti-FHL1 autoantibodies in adult patients with myositis: a longitudinal follow-up analysis.","authors":"Angeles S Galindo-Feria, Karin Lodin, Begum Horuluoglu, Sepehr Sarrafzadeh-Zargar, Edvard Wigren, Susanne Gräslund, Olof Danielsson, Marie Wahren-Herlenius, Maryam Dastmalchi, Ingrid E Lundberg","doi":"10.1093/rheumatology/keae317","DOIUrl":"10.1093/rheumatology/keae317","url":null,"abstract":"<p><strong>Objectives: </strong>To determine prevalence and clinical associations of anti-Four-and-a-half-LIM-domain 1 (FHL1) autoantibodies in patients with idiopathic inflammatory myopathies (IIM) and to evaluate autoantibody levels over time.</p><p><strong>Methods: </strong>Sera at the time of diagnosis from patients with IIM (n = 449), autoimmune disease controls (DC, n = 130), neuromuscular diseases (NMDs, n = 16) and healthy controls (HC, n = 100) were analysed for anti-FHL1 autoantibodies by enzyme-linked immunosorbent assay (ELISA). Patients with IIM FHL1+ and FHL1- were included in a longitudinal analysis. Serum levels were correlated to disease activity.</p><p><strong>Results: </strong>Autoantibodies to FHL1 were more frequent in patients with IIM (122/449, 27%) compared with DC (autoimmune DC and NMD, 13/146, 9%, P < 0.001) and HC (3/100.3%, P < 0.001). Anti-FHL1 levels were higher in IIM [median (IQR)=0.62 (0.15-1.04)] in comparison with DC [0.22 (0.08-0.58)], HC [0.35 (0.23-0.47)] and NMD [0.48 (0.36-0.80)] P < 0.001. Anti-FHL1+ patients with IIM were younger at the time of diagnosis compared with the anti-FHL1- group (P = 0.05) and were seronegative for other autoantibodies in 25%.In the first follow-up, anti-FHL1+ sample 20/33 (60%) positive at baseline had turned negative for anti-FHL1 autoantibodies. Anti-FHL1 autoantibodies rarely appeared after initiating treatment. Anti-FHL1 autoantibody levels correlated with CK (r = 0.62, P= 0.01), disease activity measured using the Myositis Disease Activity Assessment Tool (MYOACT) (n = 14, P = 0.004) and inversely with Manual Muscle Test-8 (r = -0.59, P = 0.02) at baseline.</p><p><strong>Conclusion: </strong>Anti-FHL1 autoantibodies were present in 27% of patients with IIM; of these, 25% were negative for other autoantibodies. Other autoimmune diseases had lower frequencies and levels. Anti-FHL1 levels often decreased with immunosuppressive treatment, correlated with disease activity measures at diagnosis and rarely appeared after start of treatment.</p>","PeriodicalId":21255,"journal":{"name":"Rheumatology","volume":" ","pages":"1482-1492"},"PeriodicalIF":4.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11879316/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141247513","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":"Plasma interferon-alpha protein levels during pregnancy are associated with lower birth weight in systemic lupus erythematosus.","authors":"Marit Stockfelt, Agnes Torell, Iva Gunnarsson, Elisabet Svenungsson, Agneta Zickert, Maria Majcuk Sennström, Estelle Trysberg, Anders A Bengtsson, Andreas Jönsen, Helena Strevens, Christopher Sjöwall, Muna Saleh, Sofia Pihl, Dag Leonard, Lars Rönnblom, Tansim Akhter, Kaj Blennow, Henrik Zetterberg, Bo Jacobsson, Anna-Carin Lundell, Anna Rudin","doi":"10.1093/rheumatology/keae332","DOIUrl":"10.1093/rheumatology/keae332","url":null,"abstract":"<p><strong>Objectives: </strong>Adverse pregnancy outcomes are more common in women with SLE compared with healthy women, but we lack prognostic biomarkers. Plasma IFN-α protein levels are elevated in a subgroup of pregnant women with SLE, but whether this is associated with pregnancy outcomes is unknown. We investigated the relationship between IFN-α, adverse pregnancy outcomes and the presence of autoantibodies in SLE pregnancy.</p><p><strong>Methods: </strong>We followed 76 women with SLE prospectively. Protein levels of IFN-α were quantified in plasma collected in the second and third trimester with single-molecule array. Positivity for ANA and aPL antibodies was assessed during late pregnancy with multiplexed bead assay. Clinical outcomes included the adverse pregnancy outcomes small for gestational age (SGA), preterm birth and preeclampsia.</p><p><strong>Results: </strong>During SLE pregnancy, women with SGA infants compared with those without had higher levels of plasma IFN-α protein, and IFN-α positivity was associated with lower birth weight of the infant. Preterm birth was associated with autoantibodies against chromatin. IFN-α protein levels associated positively with autoantibodies against chromatin, Smith/RNP (SmRNP) and RNP, but negatively with aPL antibodies.</p><p><strong>Conclusion: </strong>Elevated IFN-α protein in plasma of women with SLE is a potential risk factor for lower birth weight of their infants. The association between IFN-α and lower birth weight warrants further investigation regarding the pathophysiological role of IFN-α during SLE pregnancy.</p>","PeriodicalId":21255,"journal":{"name":"Rheumatology","volume":" ","pages":"1469-1475"},"PeriodicalIF":4.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11879350/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141321517","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":"Extrarenal symptoms associate with worse quality of life in patients enrolled in the AMP RA/SLE Lupus Nephritis Network.","authors":"Philip M Carlucci, Katherine Preisinger, Kristina K Deonaraine, Devyn Zaminski, Maria Dall'Era, Heather T Gold, Kenneth Kalunian, Andrea Fava, H Michael Belmont, Ming Wu, Chaim Putterman, Jennifer Anolik, Jennifer L Barnas, Richard Furie, Betty Diamond, Anne Davidson, David Wofsy, Diane Kamen, Judith A James, Joel M Guthridge, William Apruzzese, Deepak Rao, Michael H Weisman, Peter M Izmirly, Jill Buyon, Michelle Petri","doi":"10.1093/rheumatology/keae189","DOIUrl":"10.1093/rheumatology/keae189","url":null,"abstract":"<p><strong>Objective: </strong>Lupus nephritis (LN) can occur as an isolated component of disease activity or be accompanied by diverse extrarenal manifestations. Whether isolated renal disease is sufficient to decrease health-related quality of life (HRQOL) remains unknown. This study compared Patient-Reported Outcomes Measurement Information System 29-Item (PROMIS-29) scores in LN patients with isolated renal disease to those with extrarenal symptoms to evaluate the burden of LN on HRQOL and inform future LN clinical trials incorporating HRQOL outcomes.</p><p><strong>Methods: </strong>A total of 181 LN patients consecutively enrolled in the multicentre multi-ethnic/racial Accelerating Medicines Partnership completed PROMIS-29 questionnaires at the time of a clinically indicated renal biopsy. Raw PROMIS-29 scores were converted to standardized T scores.</p><p><strong>Results: </strong>Seventy-five (41%) patients had extrarenal disease (mean age 34, 85% female) and 106 (59%) had isolated renal (mean age 36, 82% female). Rash (45%), arthritis (40%) and alopecia (40%) were the most common extrarenal manifestations. Compared with isolated renal, patients with extrarenal disease reported significantly worse pain interference, ability to participate in social roles, physical function, and fatigue. Patients with extrarenal disease had PROMIS-29 scores that significantly differed from the general population by >0.5 SD of the reference mean in pain interference, physical function, and fatigue. Arthritis was most strongly associated with worse scores in these three domains.</p><p><strong>Conclusion: </strong>Most patients had isolated renal disease and extrarenal manifestations associated with worse HRQOL. These data highlight the importance of comprehensive disease management strategies that address both renal and extrarenal manifestations to improve overall patient outcomes.</p>","PeriodicalId":21255,"journal":{"name":"Rheumatology","volume":" ","pages":"1193-1200"},"PeriodicalIF":4.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11879353/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140294383","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":"Comment on: 'Hepatitis B reactivation in PsA patients: an SLR and meta-analysis for IL-17, IL-23 and JAK inhibitors': reply.","authors":"Theodoros Androutsakos, Konstantinos Dimitriadis, Maria-Loukia Koutsompina, Konstantinos D Vassilakis, Avraam Pouliakis, George E Fragoulis","doi":"10.1093/rheumatology/keae646","DOIUrl":"10.1093/rheumatology/keae646","url":null,"abstract":"","PeriodicalId":21255,"journal":{"name":"Rheumatology","volume":" ","pages":"1570-1571"},"PeriodicalIF":4.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142740306","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":"Osteoporosis is associated with anti-topoisomerase I positivity and glucocorticoids use in patients with systemic sclerosis.","authors":"Charles Midol, Edgar Wiebe, Elise Siegert, Dörte Huscher, Hélène Béhal, David Launay, Eric Hachulla, Eric L Matteson, Frank Buttgereit, Vincent Sobanski","doi":"10.1093/rheumatology/keae142","DOIUrl":"10.1093/rheumatology/keae142","url":null,"abstract":"<p><strong>Objectives: </strong>Patients with systemic sclerosis (SSc) are at increased risk for osteoporosis (OP) and associated fragility fractures. This study aimed to identify underlying risk factors for these conditions in patients with SSc.</p><p><strong>Methods: </strong>This cross-sectional study was based on a large prospective cohort of patients with SSc using retrospectively collected bone health data. OP was defined as the presence of a T-score below -2.5 at the femoral neck or lumbar spine, a previous major osteoporotic fracture, or the prescription of anti-osteoporotic therapy.</p><p><strong>Results: </strong>A total of 485 patients fulfilling the ACR/EULAR 2013 diagnostic criteria for SSc, followed in the Lille University Hospital, were included in the study. The prevalence of OP was 23%; fragility fractures occurred in 18% of patients. OP was associated with higher age, diffuse cutaneous subset, interstitial lung disease (ILD), anti-topoisomerase I positivity, treatment with glucocorticoids (GC) and DMARDs in univariable analysis. Multivariable analysis indicated that higher age (OR 1.06 [95%CI 1.04-1.08]), anti-topoisomerase I antibody positivity (OR 2.22 [1.18-4.16]) and treatment with GC (OR 4.48 [2.42-8.26]) were significantly and independently associated with OP.</p><p><strong>Conclusion: </strong>Our study shows that OP risk in patients with SSc is determined by age, disease-related factors such as diffuse cutaneous subset, ILD and anti-topoisomerase I antibody positivity, but also treatment with GC independently of other factors.</p>","PeriodicalId":21255,"journal":{"name":"Rheumatology","volume":" ","pages":"1270-1276"},"PeriodicalIF":4.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140060396","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}