Rheumatology Advances in Practice最新文献

{"title":"Perception of recurrence risk in patients with IgG4-related disease: a descriptive phenomenological study.","authors":"Kai Yu, Hui Gao, Shibo Liu, Haihong Yao, Xiaoqing Wang, Chenghua Luo, Qian Guo, Yuexian Shi","doi":"10.1093/rap/rkae148","DOIUrl":"10.1093/rap/rkae148","url":null,"abstract":"<p><strong>Objective: </strong>About 40% of IgG4-related disease (IgG4-RD) patients face recurrence, severely impacting their quality of life. We aimed to explore the characteristics of the perception of recurrence risk in patients with IgG4-RD.</p><p><strong>Methods: </strong>A qualitative study design with a descriptive phenomenological approach was used. Fourteen patients with IgG4-RD were recruited via purposive sampling, including six patients with first onset and eight patients experiencing recurrence. Semi-structured interviews were conducted to collect data, and transcripts were analysed by two independent researchers using Colaizzi's descriptive analysis framework. The COREQ checklist was followed.</p><p><strong>Results: </strong>Data analysis identified nine subthemes falling into four themes: (a) perception of differential susceptibility to recurrence; (b) perception of crucial recurrence risk factors; (c) perception of recurrence warning signs and medical behaviours; (d) perception of multiple recurrence outcomes. We found that susceptibility perception formed the basis of recurrence risk perception. For patients with first onset, the main manifestations were misconception or evasion of the risk of recurrence, whereas patients experienced recurrence demonstrated a clear perception of recurrence risk and feelings of fear. Based on this, other themes emerged.</p><p><strong>Conclusions: </strong>Since the absence of accurate knowledge related to recurrence, the perception of recurrence risk in patients with IgG4-RD primarily manifested as misconception, evasion or feeling fear. Ultimately, they couldn't take appropriate actions to prevent recurrence. Healthcare professionals should develop comprehensive interventions for patients with IgG4-RD, integrating health education, disease consultation and psychological support, with the aim of enhancing awareness of recurrence risk and empowering them to manage their conditions in the long term.</p>","PeriodicalId":21350,"journal":{"name":"Rheumatology Advances in Practice","volume":"9 1","pages":"rkae148"},"PeriodicalIF":2.1,"publicationDate":"2024-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11665928/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142882913","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Transient negativity for the anti-TIF1γ antibody before treatment in juvenile dermatomyositis.","authors":"Yuji Fujita, Takashi Matsushita, Megumi Sato, Shigemi Yoshihara","doi":"10.1093/rap/rkae146","DOIUrl":"10.1093/rap/rkae146","url":null,"abstract":"","PeriodicalId":21350,"journal":{"name":"Rheumatology Advances in Practice","volume":"8 4","pages":"rkae146"},"PeriodicalIF":2.1,"publicationDate":"2024-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11634673/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142819034","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Quality of life and clinical gout assessments during pegloticase with and without methotrexate co-therapy: MIRROR randomized controlled trial exploratory findings.","authors":"John Botson, Katie Obermeyer, Brian LaMoreaux, Lissa Padnick-Silver, Supra Verma, Michael E Weinblatt, Jeff Peterson","doi":"10.1093/rap/rkae145","DOIUrl":"10.1093/rap/rkae145","url":null,"abstract":"<p><strong>Objectives: </strong>Pegloticase lowers serum urate (SU) but is limited by anti-drug antibodies. Methotrexate (MTX) co-administration increases urate-lowering response rate and decreases infusion reaction risk. This is of importance in uncontrolled gout patients who have few treatment options and highly impacted quality of life (QOL). Here, we report exploratory QOL/clinical endpoints of MIRROR RCT (NCT03994731).</p><p><strong>Methods: </strong>Patients with uncontrolled gout (sUA ≥ 7 mg/dl, urate-lowering tehraoy (ULT) failure/intolerance, and ≥1 gout sign/symptom [≥1 tophus, ≥2 flares in past year, chronic gouty arthritis]) were administered pegloticase (biweekly 8 mg infusion; 52 weeks) with oral MTX (15 mg/week) or placebo co-therapy. Key exploratory outcomes included change from baseline (CFB) in Physician Global Assessment of Gout [PhGA, score: 0-10], CFB in tender/swollen joint counts [TJC/SJC, score: 0-68/0-66], and gout chronic response rate (GCR50, GCR70; 50%/70% reduction in ≥3 of TJC, SJC, HAQ-Health, HAQ-Pain). Least-square mean (±S.E.) CFB to week 52 was estimated using a mixed model for repeated measures.</p><p><strong>Results: </strong>In total, 100 patients were randomized to pegloticase + MTX; 52 to pegloticase + PBO. At baseline, patients had poor overall health (HAQ-Health [MTX, PBO]: 44.9 ± 28.6, 39.1 ± 27.4; PhGA: 5.5 ± 2.1, 5.4 ± 2.2) and many affected joints (TJC: 5.4 ± 7.8, 6.7 ± 8.4; SJC: 8.3 ± 12.2, 11.0 ± 15.9). QOL progressively improved during treatment, with similar CFB at week 52 in MTX vs. PBO groups in PhGA (-4.2 ± 0.2 vs. -3.8 ± 0.3) and TJC/SJC (-6.1 ± 0.5 vs. -7.0 ± 0.8/-5.1 ± 0.4 vs. -6.0 ± 0.6). However, at week 52, more MTX patients met GCR50 (58.0% vs. 38.5%) and GCR70 (52.0% vs. 30.8%) criteria.</p><p><strong>Conclusion: </strong>In the MIRROR RCT, pegloticase treatment with or without MTX co-therapy led to meaningful clinical/QOL improvements in uncontrolled gout patients. However, patients receiving MTX co-therapy had greater benefits because of a higher sustained SU-lowering rate (60.0% vs. 30.8% in the PBO group at week 52).</p><p><strong>Trial registration: </strong>ClinicalTrials.gov, http://clinicaltrials.gov, NCT03994731.</p>","PeriodicalId":21350,"journal":{"name":"Rheumatology Advances in Practice","volume":"8 4","pages":"rkae145"},"PeriodicalIF":2.1,"publicationDate":"2024-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11646119/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142829841","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Current usage of and perspectives on the use of MRI to assess treatment non-response in axial spondyloarthritis: a UK-based survey.","authors":"Jake Weddell, Timothy J P Bray, Raj Sengupta, Dennis McGonagle, Pedro M Machado, Helena Marzo-Ortega","doi":"10.1093/rap/rkae139","DOIUrl":"10.1093/rap/rkae139","url":null,"abstract":"","PeriodicalId":21350,"journal":{"name":"Rheumatology Advances in Practice","volume":"8 4","pages":"rkae139"},"PeriodicalIF":2.1,"publicationDate":"2024-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11645469/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142829837","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pain management in people with inflammatory arthritis: British Society for Rheumatology guideline scope.","authors":"Ian C Scott, Opeyemi Babatunde, Christopher Barker, Rebecca Beesley, Richard Beesley, Hollie Birkinshaw, Mel Brooke, Hema Chaplin, Lara Chapman, Coziana Ciurtin, James Dale, Dervil Dockrell, Emma Dures, Kathyrn Harrison, Meghna Jani, Charlotte Lee, Maura McCarron, Christian D Mallen, Assie O'Connor, Claire Pidgeon, Tamar Pincus, Dee Pratt, Yeliz Prior, Karim Raza, Zoe Rutter-Locher, Seema Sharma, Katie Shaw, Samantha Small, Tilli Smith, Lesley Tiffin, Jordan Tsigarides, Mikalena Xenophontos, Nicholas G Shenker","doi":"10.1093/rap/rkae128","DOIUrl":"10.1093/rap/rkae128","url":null,"abstract":"<p><p>Pain is a common symptom in people with inflammatory arthritis (IA), which has far-reaching impacts on their lives. Recent electronic health record studies demonstrate that UK-based pain care in people with IA commonly involves the prescribing of long-term opioids and gabapentinoids, despite an absence of trial evidence for their efficacy. Patient surveys suggest that non-pharmacological pain management is underused. A UK-specific guideline on pain management for people with IA is required to resolve this. This scoping document outlines the context and prioritized clinical questions for the first British Society for Rheumatology (BSR) guideline on pain management for people with IA. The guideline aims to provide evidence-based recommendations on how pain can be best managed in people with IA (including its assessment, and pharmacological and non-pharmacological treatments), ensuring that people with IA in the UK are offered evidence-based pain management strategies. The guideline is for healthcare professionals involved in the care of people with IA of all ages and genders, people with IA and their families and carers, NHS managers and healthcare commissioners, and other relevant stakeholders such as patient organizations. It will be developed using the methods outlined in the BSR's 'Creating Clinical Guidelines' protocol.</p>","PeriodicalId":21350,"journal":{"name":"Rheumatology Advances in Practice","volume":"8 4","pages":"rkae128"},"PeriodicalIF":2.1,"publicationDate":"2024-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11573413/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142676780","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The frequency and clinical associations of opioid use in systemic sclerosis.","authors":"Jessica L Fairley, Dylan Hansen, Susanna Proudman, Joanne Sahhar, Gene-Siew Ngian, Diane Apostolopoulos, Jennifer Walker, Lauren V Host, Wendy Stevens, Nava Ferdowsi, Maryam Tabesh, Mandana Nikpour, Laura Ross","doi":"10.1093/rap/rkae144","DOIUrl":"10.1093/rap/rkae144","url":null,"abstract":"<p><strong>Objective: </strong>To define the frequency and associations of opioid use in SSc.</p><p><strong>Methods: </strong>Australian Scleroderma Cohort Study participants meeting ACR/EULAR criteria for SSc were included. Current or previous opioid use was recorded at each visit, with long-term use defined as use on two or more consecutive visits. Groups were compared using two-sample <i>t</i>-test, Wilcoxon rank sum test or chi-squared test. Generalised estimating equations were used to model longitudinal data.</p><p><strong>Results: </strong>Of 1951 participants with a mean age of 46.7 years (s.d. 14.4), 88% were female and 12% had ever received any opioids since SSc onset. Of these, 46% recorded opioid use across multiple consecutive study visits. Digital ulcers (63% <i>vs</i> 52%), synovitis (57% <i>vs</i> 38%), interstitial lung disease (37% <i>vs</i> 27%), gastrointestinal (GI) symptoms (upper 97% <i>vs</i> 88%, lower 90% <i>vs</i> 80%) and immunosuppression (59% <i>vs</i> 46%) were all more frequent in opioid-exposed groups (<i>P</i> < 0.05). In multivariable modelling, current opioid use at each study visit was associated with digital ulcers [odds ratio (OR) 1.5 (95% CI 1.1, 2.0), <i>P</i> = 0.01], synovitis [OR 1.5 (95% CI 1.1, 2.1), <i>P</i> = 0.02], lower GI symptoms [OR 1.8 (95% CI 1.3, 2.6), <i>P</i> < 0.01] and poorer physical [OR 1.8 (95% CI 1.3, 2.4), <i>P</i> < 0.01] and mental [OR 1.8 (95% CI 1.1, 3.0), <i>P</i> = 0.02] quality of life (QoL). Current opioid use was associated with worse fatigue [regression coefficient (RC) 3.0 units (95% CI 1.2, 4.8), <i>P</i> < 0.01], functional disability [RC 0.2 (95% CI 0.2, 0.3), <i>P</i> < 0.01], dyspnoea [RC 2.0 (95% CI 0.8, 3.1), <i>P</i> < 0.01], depression [RC 2.5 (95% CI 0.9, 4.0), <i>P</i> < 0.01] and anxiety [RC 2.5 (95% CI 0.9, 4.0), <i>P</i> < 0.01].</p><p><strong>Conclusions: </strong>Opioid use in SSc was associated with musculoskeletal, GI and lung involvement. Opioid prescription was associated with poorer QoL and physical function.</p>","PeriodicalId":21350,"journal":{"name":"Rheumatology Advances in Practice","volume":"8 4","pages":"rkae144"},"PeriodicalIF":2.1,"publicationDate":"2024-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11634672/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142819033","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hypereosinophilia and eosinophilic arterial aneurysm: not only eosinophilic granulomatosis with polyangiitis.","authors":"Elena Vanni, Chiara Marvisi, Carlo Salvarani","doi":"10.1093/rap/rkae138","DOIUrl":"10.1093/rap/rkae138","url":null,"abstract":"","PeriodicalId":21350,"journal":{"name":"Rheumatology Advances in Practice","volume":"8 4","pages":"rkae138"},"PeriodicalIF":2.1,"publicationDate":"2024-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11630549/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142807917","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rationale and concerns for using JAK inhibitors in axial spondyloarthritis.","authors":"Saad Ahmed, Rohan Yesudian, Hassan Ubaide, Laura C Coates","doi":"10.1093/rap/rkae141","DOIUrl":"10.1093/rap/rkae141","url":null,"abstract":"<p><p>Axial spondyloarthritis (axSpA) is a chronic illness with limited treatment options. The role of Janus kinase (JAK) inhibition as a therapeutic option has increasingly become a focus of research in recent years as they have brought a new mode of action to the clinical armamentarium. This review assesses the efficacy and safety profile of these drugs in axSpA. The current phase 2 and 3 clinical trials data are summarized across tofacitinib, upadacitinib and filgotinib. Moreover, the safety profiles of these drugs, in the context of emerging safety signals such as during the ORAL surveillance study, are reviewed. In summary, JAK inhibitors offer a novel therapeutic target for axSpA and appear to address some of the unmet needs for patients who have either failed to respond to current treatment options or in whom they are contraindicated. There is a relative lack of evidence in non-radiographic axSpA and longer-term trials are needed to establish true efficacy and safety profile in radiographic axSpA.</p>","PeriodicalId":21350,"journal":{"name":"Rheumatology Advances in Practice","volume":"8 4","pages":"rkae141"},"PeriodicalIF":2.1,"publicationDate":"2024-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11630911/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142807943","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Interrater reliability of RheuMetric checklist scales for physician global assessment, inflammation, damage and patient distress.","authors":"Juan Schmukler, Isabel Castrejon, Tengfei Li, Joel A Block, Theodore Pincus","doi":"10.1093/rap/rkae137","DOIUrl":"10.1093/rap/rkae137","url":null,"abstract":"<p><strong>Objective: </strong>To analyse interrater reliability of four RheuMetric checklist 0-10 visual numerical scales (VNSs) of physician global assessment (DOCGL), inflammation or reversible findings (DOCINF), organ damage or irreversible findings (DOCDAM) and patient distress or findings explained by fibromyalgia, depression or anxiety (DOCDIS).</p><p><strong>Methods: </strong>A retrospective study was performed of data from a rheumatology fellows' continuity clinic at Rush University. Each rheumatology patient seen in routine care with any diagnosis completed a multidimensional health assessment questionnaire (MDHAQ). Both the rheumatology fellow and attending rheumatologist independently completed RheuMetric estimates at the same visit for DOCGL, DOCINF, DOCDAM, DOCDIS and the proportion of DOCGL explained by each subglobal estimate (totalling 100%). Agreement between the two assessors was compared using paired <i>t</i>-tests, Spearman correlation coefficients, intraclass correlation coefficients (ICCs), Lin's concordance correlation coefficients (LCCCs) and Bland-Altman plots.</p><p><strong>Results: </strong>In 112 patients, mean levels of DOCINF were highest in inflammatory diseases, DOCDAM in osteoarthritis (OA) and DOCDIS in primary fibromyalgia (FM). However, mean DOCDAM was as high as DOCINF in inflammatory diseases. No statistically significant differences were seen between scores from attending rheumatologists and fellows. Agreement within 2/10 ranged from 60% for DOCGL to 71% for DOICINF and DOCDAM. Spearman correlations were 0.49-0.65, ICCs were 0.46-0.63 and LCCCs were 0.46-0.62 between rheumatologist and fellow, indicating moderate agreement; reliability was slightly higher for each subglobal VNS than for DOCGL.</p><p><strong>Conclusion: </strong>RheuMetric 0-10 DOCGL, DOCINF, DOCDAM and DOCDIS have moderate interrater reliability and are feasible in routine care to estimate patient status beyond DOCGL for improved management decisions.</p>","PeriodicalId":21350,"journal":{"name":"Rheumatology Advances in Practice","volume":"8 4","pages":"rkae137"},"PeriodicalIF":2.1,"publicationDate":"2024-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11630516/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142807844","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"CONTExT-RA: a cross-sectional study evaluating disease activity, quality of life and the socio-demographic profile of Irish patients with rheumatoid arthritis.","authors":"Grainne Murphy, Killian O'Rourke, Angela Camon, David Kane, Finbar O'Shea, Richard Conway, Claire Sheehy, Moneeb Saddiq, Deirdre Moran","doi":"10.1093/rap/rkae132","DOIUrl":"10.1093/rap/rkae132","url":null,"abstract":"<p><strong>Objectives: </strong>CONTExT-RA is a cross-sectional, non-interventional multicentre study which enrolled patients diagnosed with RA and receiving DMARD treatment in a secondary care setting. The study evaluated disease control and associated disease burden amongst this Irish population.</p><p><strong>Methods: </strong>Patients with RA attending six Irish rheumatology centres were invited to participate. Each consented patient attended a single routine study visit. Disease activity was assessed using Clinical Disease Activity Index (CDAI). The primary endpoint was EuroQol-5 dimensions (EQ-5D-5L) stratified by CDAI, compared using a non-parametric Wilcoxon Rank-Sum test.</p><p><strong>Results: </strong>130 patients were included. Using CDAI, 34 (26.2%) patients were in clinical remission (CR), 42 (32.3%) had low disease activity (LDA), 41 (31.5%) had moderate disease activity (MDA) and 13 (10.0%) had high disease activity (HDA). QoL (EQ-5D-5L index (median)) scores were significantly (<i>P</i> < 0.001) greater for patients in CR or CR/LDA than for those with MDA/HDA, 0.866 (0.920), 0.777 (0.822) vs 0.578 (0.691), respectively. Patients in CR reported higher levels of work productivity, mean (s.d.) rating of 1.7 (2.52) vs those in MDA/HDA of 4.2 (3.28) (higher rating indicates greater impairment). Similar findings were observed for non-work-related activities.</p><p><strong>Conclusion: </strong>Disease control for many patients with RA, treated in secondary care in Ireland, is sub-optimal with only 1 in 4 in CDAI remission. The impact of poor disease control on QoL is significant, and the superior outcomes for patients in CR provide compelling evidence that by achieving greater disease control, the burden of disease on patients can be greatly reduced.</p>","PeriodicalId":21350,"journal":{"name":"Rheumatology Advances in Practice","volume":"8 4","pages":"rkae132"},"PeriodicalIF":2.1,"publicationDate":"2024-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11588026/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142717017","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}