Rheumatology Advances in Practice最新文献

{"title":"Single-camera motion capture of finger joint mobility as a digital biomarker for disease activity in rheumatoid arthritis.","authors":"Vincenzo Venerito, Tobias Manigold, Marco Capodiferro, Deborah Markham, Marc Blanchard, Florenzo Iannone, Thomas Hügle","doi":"10.1093/rap/rkae143","DOIUrl":"https://doi.org/10.1093/rap/rkae143","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the association between hand motion tracking features obtained through computer vision from smartphone cameras and disease activity in patients with RA.</p><p><strong>Methods: </strong>The PyPI package of MediaPipe (version 0.9.0.1) was used for key landmark detection. Finger joint angles were calculated in each frame using the normalized dot product of the vectors (equations). RA patients were instructed to perform a rapid repetition of five fist closures. Hand movements were captured using standard smartphone cameras. Kinetic features time to maximum flexion for MCP, PIP and DIP joints were correlated with RA disease activity and disability outcomes. Logistic regression was used to investigate associations of range of motion and kinetic features with 28-joint DAS (DAS28) low disease activity/remission.</p><p><strong>Results: </strong>Our model showed promising performance in predicting low disease activity/remission in RA patients. Internal validation using 5-fold cross-validation on the training dataset (<i>n</i> = 81) yielded a mean accuracy of 0.72 (s.d. 0.09), specificity of 0.65 (s.d. 0.17), recall of 0.86 (s.d. 0.05) and area under the receiver operating characteristics curve (AUROC) of 0.80 (s.d. 0.09). External validation on the test dataset (<i>n</i> = 19) demonstrated improved performance with an accuracy of 0.84, specificity of 0.75, recall of 0.91 and AUROC of 0.89. Greater PIP and DIP joint angle changes, along with faster time to maximal flexion, were associated with lower disease activity. Significant correlations were observed between kinetic metrics and standard clinical measures, including DAS28, swollen joint count, tender joint count and HAQ Disability Index.</p><p><strong>Conclusion: </strong>Single-camera motion capture of repeated fist closure may serve as an accessible digital biomarker for disease activity in RA.</p>","PeriodicalId":21350,"journal":{"name":"Rheumatology Advances in Practice","volume":"9 2","pages":"rkae143"},"PeriodicalIF":2.1,"publicationDate":"2025-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12007596/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144043940","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":"Artificial intelligence in rheumatology: days of a future past.","authors":"Vincenzo Venerito","doi":"10.1093/rap/rkaf022","DOIUrl":"10.1093/rap/rkaf022","url":null,"abstract":"","PeriodicalId":21350,"journal":{"name":"Rheumatology Advances in Practice","volume":"9 2","pages":"rkaf022"},"PeriodicalIF":2.1,"publicationDate":"2025-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12007593/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143995950","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":"External validation of the polymyalgia rheumatica impact scale: a prospective cohort study.","authors":"Lien Moreel, Michaël Doumen, Albrecht Betrains, Ellen De Langhe, Daniel Blockmans, Steven Vanderschueren","doi":"10.1093/rap/rkaf046","DOIUrl":"10.1093/rap/rkaf046","url":null,"abstract":"<p><strong>Objectives: </strong>To externally validate the PMR impact scale (PMR-IS).</p><p><strong>Methods: </strong>We conducted a prospective cohort study at the University Hospitals Leuven, Leuven, Belgium. Recently diagnosed PMR patients were included between July 2022 and December 2023 and followed until 1 year after diagnosis. All patients completed the PMR-IS, HAQ Disability Index, 36-item Short Form and a visual analogue scale for pain at every visit. Internal consistency, floor and ceiling effects, construct validity, responsiveness and discriminatory power for detecting relapse on the PMR-IS were assessed.</p><p><strong>Results: </strong>Fifty-five PMR patients (mean age 71 years, 47% female) were included, who had a total of 246 visits. Internal consistency, construct validity and responsiveness met the quality criteria for the symptoms, function and emotional and psychological well-being subdomains. The internal consistency of the glucocorticoid side effects subdomain was insufficient and only one of the three hypotheses for construct validity were met. The function and emotional and psychological well-being subdomains showed a floor effect, while no ceiling effect was observed. The symptoms, function and emotional and psychological well-being subdomains had a good discriminatory power for detecting relapse [area under the curve (AUC) 0.89, 0.86 and 0.72, respectively], but the PMR activity score performed better (AUC 0.94, <i>P</i> < 0.05 for all subdomains).</p><p><strong>Conclusion: </strong>This study validates the good measurement properties of the symptoms, function and emotional and psychological well-being subdomains of the PMR-IS. In contrast, the glucocorticoid side effects subdomain did not show adequate internal consistency and construct validity, necessitating further validation and possibly refinement of its items prior to application in clinical trials or daily practice.</p>","PeriodicalId":21350,"journal":{"name":"Rheumatology Advances in Practice","volume":"9 2","pages":"rkaf046"},"PeriodicalIF":2.1,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12080742/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144079861","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":"Variation in blood test monitoring practices for patients treated with conventional and biologic DMARDs.","authors":"Joanne Ablewhite, Amy Fuller, Abdullah Almayahi, Abhishek Abhishek","doi":"10.1093/rap/rkaf044","DOIUrl":"https://doi.org/10.1093/rap/rkaf044","url":null,"abstract":"","PeriodicalId":21350,"journal":{"name":"Rheumatology Advances in Practice","volume":"9 2","pages":"rkaf044"},"PeriodicalIF":2.1,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12077759/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144079920","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":"Nailfold capillary abnormalities as useful clues in an atypical case suggestive of cancer-associated dermatomyositis sine dermatitis.","authors":"Hiroki Kohno, Namiho Irie, Ai Yamane, Tomoko Koura, Kenta Kaneyoshi, Takamichi Sugimoto, Yu Yamazaki, Tomohiro Sugimoto","doi":"10.1093/rap/rkaf043","DOIUrl":"10.1093/rap/rkaf043","url":null,"abstract":"","PeriodicalId":21350,"journal":{"name":"Rheumatology Advances in Practice","volume":"9 2","pages":"rkaf043"},"PeriodicalIF":2.1,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12098259/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144143482","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":"A psychometric evaluation of the Musculoskeletal Health Questionnaire (MSK-HQ): validation and measurement invariance in inflammatory arthritis.","authors":"Nikita Arumalla, James B Galloway, Joanna Ledingham, Toby Garrood, Sam Norton","doi":"10.1093/rap/rkaf041","DOIUrl":"10.1093/rap/rkaf041","url":null,"abstract":"<p><strong>Objectives: </strong>The Musculoskeletal Health Questionnaire (MSK-HQ) is a patient reported outcome measure (PROM) co-produced for use across musculoskeletal diseases. This study analyses the validity, reliability, sensitivity to change and measurement invariance of the MSK-HQ in inflammatory arthritis (IA).</p><p><strong>Methods: </strong>A total of 5106 patients recruited to the National Early Inflammatory Arthritis Audit (NEIAA) between May 2018 and March 2020 with a diagnosis of IA were included. Patients completed PROMs at baseline and 3 and 12 months alongside clinic visits. Convergent validity was assessed in relation to the HAQ-II, Patient Health Questionnaire 4 (PHQ-4) and 28-item DAS (DAS28). Construct validity was assessed using confirmatory factor analysis (CFA). Hierarchical tests for configural, metric and scalar invariance determined measurement invariance in item CFAs.</p><p><strong>Results: </strong>The MSK-HQ total score correlated well with the HAQ-II (<i>r</i> = -0.79) and PHQ-4 (<i>r</i> = -0.66) and moderately with the DAS28 (<i>r</i> = -0.42). A unidimensional structure for the MSK-HQ was confirmed only when two items relating to illness perception were excluded. The MSK-HQ total score demonstrated good sensitivity to change. Reliability was high (α = 0.93). The minimum clinically important difference was 4 points across the IA subtypes. Significance was noted in tests of DIF for a few MSK-HQ items, but the level of bias was small.</p><p><strong>Conclusion: </strong>This study provides evidence for the validity and sensitivity to change of the MSK-HQ in patients with IA, with a change of >4 points likely to be clinically meaningful. The MSK-HQ has high convergent and construct validity and is sensitive to change, providing a valuable tool for clinical care and research studies.</p>","PeriodicalId":21350,"journal":{"name":"Rheumatology Advances in Practice","volume":"9 2","pages":"rkaf041"},"PeriodicalIF":2.1,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12064166/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144034676","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 and future advances in practice: arboviral arthritides.","authors":"Ashish Sharma, Vinod Ravindran","doi":"10.1093/rap/rkaf029","DOIUrl":"https://doi.org/10.1093/rap/rkaf029","url":null,"abstract":"<p><p>Arboviral arthritides are a group of viral infections affecting the musculoskeletal system. Mosquitoes are vectors for some of the arboviral febrile diseases such as due to chikungunya, dengue and Zika viruses, which constitute a major proportion of arboviral arthritide syndromes in humans. They have gained epidemiological importance as the natural habitats of these mosquitoes are in the vicinity of human dwellings. Chikungunya virus infection frequently leads to post-infectious chronic musculoskeletal syndromes including erosive inflammatory arthritis, which resembles RA. Clinical features of the chronic phase result from the chronic persistence of the virus in certain tissues after the acute infection has resolved. In addition, the triggering of autoimmunity has also been implicated in musculoskeletal syndromes. Due to the diversity of clinical presentations and overlapping features with other viral illnesses and inflammatory arthritides, diagnosis and management are challenging. Poor prognostic factors for predicting evolution to chronic arthritides are not well delineated. There is no universal agreement regarding when to start immunomodulatory agents and the duration of such therapy. The lack of specific antiviral agents adds to the complexity of the situation. A live-attenuated vaccine has been recently approved by the US Food and Drug Administration for the prevention of chikungunya virus infection. This review discusses the musculoskeletal syndromes related to arboviral infections, with a major focus on chikungunya virus-related arthritis to provide practical guidance to clinicians involved in managing patients with chikungunya and its sequelae.</p>","PeriodicalId":21350,"journal":{"name":"Rheumatology Advances in Practice","volume":"9 2","pages":"rkaf029"},"PeriodicalIF":2.1,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11992517/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144036753","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":"Kinesiophobia as part of the psychological burden in Spondyloarthritis: a case-control study.","authors":"Eugenio Capparelli, Maria Iacovantuono, Sergio Del Vescovo, Benedetta Monosi, Chiara Bonini, Luigi Fiannacca, Elisabetta Greco, Eneida Cela, Paola Conigliaro, Greta Giulia Dipietrangelo, Florenzo Iannone, Giuseppe Lopalco, Maria Sole Chimenti","doi":"10.1093/rap/rkaf040","DOIUrl":"10.1093/rap/rkaf040","url":null,"abstract":"<p><strong>Objectives: </strong>Psychological distress is commonly reported by patients affected by Spondyloarthritis (SpA), with >50% experiencing concomitant depression or anxiety. This case-control study aimed to investigate the psychological dimensions of SpA by assessing and comparing levels of kinesiophobia, depression and health-related quality of life (HRQoL) between SpA patients and a healthy control (HC) group.</p><p><strong>Methods: </strong>This cross-sectional case-control study included patients with SpA classified by Assessment of SpondyloArthritis international Society classification criteria and a group of HCs matched by sex and age. Inclusion criteria were age ≥18 years and stable therapy for at least 6 consecutive months. Data collection involved interviews and medical records. Psychological assessments were conducted using the Italian version of the Tampa Scale of Kinesiophobia-13 (TSK-IV), Beck's Depression Inventory (BDI) and the 36-item Short Form (SF-36) Health Survey. Statistical analyses included <i>t</i>-test or Mann-Whitney U-test, chi-squared test, correlation analysis and multiple linear regression models.</p><p><strong>Results: </strong>Among 172 SpA patients and 94 HCs, SpA patients had significantly higher kinesiophobia (<i>P</i> < 0.001) and depression scores (<i>P</i> < 0.01). HRQoL was lower across all SF-36 domains except perceived health change. Axial SpA and peripheral SpA differed in diagnostic and therapeutic delay. Females showed greater kinesiophobia and depressive symptoms than males. Undergoing to second- or subsequent-line biologic therapy was linked to higher kinesiophobia and poorer HRQoL. BDI scores and diagnostic delay were key predictors of kinesiophobia in the SpA population.</p><p><strong>Conclusion: </strong>Kinesiophobia has a significant impact on psychological well-being in SpA patients. These findings highlight the need for targeted interventions that address not only the physical but also the psychological dimension of SpA.</p>","PeriodicalId":21350,"journal":{"name":"Rheumatology Advances in Practice","volume":"9 2","pages":"rkaf040"},"PeriodicalIF":2.1,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12065625/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144044847","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, prolonged opioid use, initiated anti-rheumatic treatment and psychiatric morbidity in new-onset psoriatic arthritis.","authors":"Anna Laine, Paula Muilu, Hannu Kautiainen, Kari Puolakka, Vappu Rantalaiho","doi":"10.1093/rap/rkaf039","DOIUrl":"10.1093/rap/rkaf039","url":null,"abstract":"<p><strong>Objectives: </strong>To explore the use of DMARDs and painkillers in incident PsA patients.</p><p><strong>Methods: </strong>From the Finnish Social Insurance Institution register we collected all adult patients granted a special reimbursement (SR) for DMARDs for PsA from 1 January 2010 to 31 December 2014 (<i>N</i> = 2678). For each case, three general population controls were matched. The purchases of painkillers, antidepressants, anxiolytics and hypnotics were analysed 1 year before and after the index date (ID; the date the SR was granted) and DMARDs at the ID and 1 year before it.</p><p><strong>Results: </strong>The year preceding the ID, 51% of the patients purchased any DMARDs, with 31% being MTX. Nevertheless, on the ID the respective percentages increased to 95% and 71%. PsA patients purchased all painkillers significantly more often than their controls before the ID and the purchases peaked at the ID. After that, the purchases of paracetamol and NSAIDs decreased but those of opioids remained at almost the same level. PsA patients purchased antidepressants and hypnotics more often than their controls. The use of the antidepressants, anxiolytics, hypnotics and opioids before the ID was associated with the risk of prolonged opioid use.</p><p><strong>Conclusion: </strong>A substantial proportion of incident PsA patients are purchasing DMARDs before the ID, which may reflect the difficulty of setting a PsA diagnosis or may represent the treatment of severe skin psoriasis. PsA patients use more painkillers than their matched controls 1 year preceding the diagnosis. Prolonged opioid use is particularly evident among patients using psychiatric medications.</p>","PeriodicalId":21350,"journal":{"name":"Rheumatology Advances in Practice","volume":"9 2","pages":"rkaf039"},"PeriodicalIF":2.1,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12064172/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143992499","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":"Glucocorticoids discontinuation in systemic lupus erythematosus: a single-centre study.","authors":"Yaqi Zhang, Hanyin Deng, Daidi Chen, Yujiao Wang, Mian Liu, Guangcai Chen, Wenqian Yi, Ziyi Jin, Renju Xu, Xuebing Feng","doi":"10.1093/rap/rkaf036","DOIUrl":"10.1093/rap/rkaf036","url":null,"abstract":"<p><strong>Objectives: </strong>To investigate the relapse rate of SLE patients after glucocorticoids (GCs) withdrawn, assess the risk factors associated with disease relapse and clarify the outcome of patients with relapse.</p><p><strong>Methods: </strong>Data of SLE patients who discontinued GC during 2017-2022 were included. Cox regression model was used to estimate the hazard ratio for different factors contributing to lupus relapse. Kaplan-Meier model was used to assess the cumulative relapse rate. For those who relapsed, the proportion of patients regaining remission or lupus low disease activity state (LLDAS) was tracked, and factors associated with remission were analysed.</p><p><strong>Results: </strong>Totally 217 SLE patients were included, of whom 166 experienced disease relapse. The non-relapse rates were 57.3% at 1 year, 19.6% at 3 years and only 7.8% at 5 years after GC withdrawal. Multivariable Cox regression analysis showed self-discontinuation, prior renal or pulmonary impairment or positive anti-dsDNA antibody were independent predictors of SLE relapse. Of the relapsed patients, 21.1% had achieved remission and 54.2% had achieved LLDAS at 12 months of follow-up. Those with high SLEDAI-2K score, anaemia, hypocomplementaemia as well as positive anti-dsDNA or anti-Sm antibody had lower remission rates.</p><p><strong>Conclusions: </strong>Most SLE patients have difficulty maintaining prolonged stabilization after discontinuing GC and regain remission within a year of relapse. Before discontinuing GC, risk factors associated with recurrence of SLE need to be assessed.</p>","PeriodicalId":21350,"journal":{"name":"Rheumatology Advances in Practice","volume":"9 2","pages":"rkaf036"},"PeriodicalIF":2.1,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12060718/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144036801","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}