Rheumatology Advances in Practice最新文献

{"title":"Navigating antiphospholipid syndrome: from personalized therapies to cutting-edge research.","authors":"Karen Kortright-Maldonado, Bruno Eduardo Reyes-Torres, Lilian Stephany Cabrera-Lopez, Pedro Rodríguez-Henríquez, Erika Karina Tenorio-Aguirre, Froylan D Martínez-Sánchez","doi":"10.1093/rap/rkaf005","DOIUrl":"10.1093/rap/rkaf005","url":null,"abstract":"<p><p>APS is an autoimmune disorder characterized by thrombosis and pregnancy complications, primarily driven by aPLs such as LA, aCL and anti-β2 glycoprotein I (a-β2GPI). Despite advances in anticoagulation therapies, managing refractory APS cases remains challenging. Emerging therapies, including rituximab, eculizumab and HCQ, show potential in addressing the underlying mechanisms of APS. Additionally, research into genetic and environmental factors, particularly the gut microbiome's role through molecular mimicry, suggests new therapeutic pathways. Diagnostic advancements, such as the adjusted Global Antiphospholipid Syndrome Score (aGAPSS), metabolomic profiling and MRI, have improved risk stratification and early detection. Non-traditional biomarkers like anti-phosphatidylserine/prothrombin (aPS/PT) and anti-Domain I antibodies further enhance risk assessment. Future research should aim to validate these approaches, optimizing patient outcomes and minimizing long-term APS complications.</p>","PeriodicalId":21350,"journal":{"name":"Rheumatology Advances in Practice","volume":"9 1","pages":"rkaf005"},"PeriodicalIF":2.1,"publicationDate":"2025-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11751690/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143024605","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":"Impact of disease manifestations on first biologic drug survival in axial spondyloarthritis: a real-life Canadian study.","authors":"Raphaël Hurtubise, Sherry Rohekar, Nigil Haroon, Zeynep Baskurt, Tina Chim, Michel Zummer, Robert D Inman, Nicolas Richard","doi":"10.1093/rap/rkaf004","DOIUrl":"10.1093/rap/rkaf004","url":null,"abstract":"<p><strong>Objectives: </strong>The primary objective of this study was to assess the impact of extramusculoskeletal manifestations (EMMs) and peripheral musculoskeletal features on first biologic drug survival in subjects with axial spondyloarthritis (axSpA). The secondary objective was to evaluate the impact of reasons for treatment discontinuation.</p><p><strong>Methods: </strong>A total of 593 axSpA patients from the SpondyloArthritis Research Consortium of Canada initiating a first biologic drug were identified between 2003 and 2023. Drug survival was presented using Kaplan-Meier curves for each disease manifestation and compared using the logrank test. A Cox proportional hazards model was used to analyse independent predictors of discontinuation. The impact of reasons for treatment discontinuation was assessed using a competing risk analysis.</p><p><strong>Results: </strong>The presence of psoriasis, nail psoriasis, dactylitis, at least one EMM or at least one peripheral musculoskeletal manifestation was associated with prolonged drug survival compared with subjects without these disease manifestations. In multivariable analysis, psoriasis [hazard ratio (HR) 0.53 (95% CI 0.33, 0.86)] and at least one peripheral musculoskeletal manifestation [HR 0.65 (95% CI 0.47, 0.92)] were independently associated with a lower risk for biologic discontinuation. The presence of psoriasis or dactylitis was associated with reduced treatment discontinuation in patients who stopped their biologic medication for ineffectiveness but not when treatment was discontinued due to adverse events.</p><p><strong>Conclusions: </strong>This study showed that the presence of some axSpA disease manifestations were associated with prolonged biologic drug survival. Psoriasis and peripheral musculoskeletal manifestations were the most significant predictors of treatment retention. Future research will be needed to further refine treatment strategies according to specific disease manifestations.</p>","PeriodicalId":21350,"journal":{"name":"Rheumatology Advances in Practice","volume":"9 1","pages":"rkaf004"},"PeriodicalIF":2.1,"publicationDate":"2025-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11780884/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143067875","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":"Kawasaki disease preceded by acute appendicitis treated with intravenous immunoglobulin without surgery.","authors":"Megumi Sato, Yuji Fujita, Junko Naganuma, Kaori Sekine, Shun Watanabe, Kei Ogino, Kan Suzuki, Shigemi Yoshihara","doi":"10.1093/rap/rkaf003","DOIUrl":"10.1093/rap/rkaf003","url":null,"abstract":"<p><p>Graphical Abstract.</p>","PeriodicalId":21350,"journal":{"name":"Rheumatology Advances in Practice","volume":"9 1","pages":"rkaf003"},"PeriodicalIF":2.1,"publicationDate":"2025-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11751686/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143024602","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":"Correction to: OA20 Differentiating Lupus Nephritis from Pre-eclampsia-A Diagnostic Dilemma.","authors":"","doi":"10.1093/rap/rkae156","DOIUrl":"https://doi.org/10.1093/rap/rkae156","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.1093/rap/rkae117.020.].</p>","PeriodicalId":21350,"journal":{"name":"Rheumatology Advances in Practice","volume":"9 1","pages":"rkae156"},"PeriodicalIF":2.1,"publicationDate":"2025-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11700574/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142932622","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":"Determinants of physical function, as measured using PROMIS PF-10a, in patients with rheumatoid arthritis: results from the international COVID-19 Vaccination in Autoimmune Diseases (COVAD) study.","authors":"Saadia Sasha Ali, Christiana Demetriou, Ioannis Parodis, Ai Lyn Tan, Abraham Edgar Gracia-Ramos, Mrudula Joshi, Carlo V Caballero-Uribe, Sreoshy Saha, James B Lilleker, Arvind Nune, John D Pauling, Chris Wincup, Kshitij Jagtap, Dzifa Dey, Marcin Milchert, Oliver Distler, Hector Chinoy, Vikas Agarwal, Latika Gupta, Elena Nikiphorou","doi":"10.1093/rap/rkae154","DOIUrl":"10.1093/rap/rkae154","url":null,"abstract":"<p><strong>Objectives: </strong>Physical function in RA is largely influenced by multiple clinical factors, however, there is a growing body of evidence that psychological state and other comorbidities also play an essential role. Using data obtained in the COVID-19 Vaccination in Autoimmune Diseases study, an international self-reported e-survey, we aimed to explore the predictive ability of sociodemographic and clinical variables on Patient-Reported Outcomes Measurement Information System Physical Function Short Form 10a (PROMIS PF-10a) in RA and to investigate variation in disease activity and functional outcomes based on country-level socio-economic parameters.</p><p><strong>Methods: </strong>Patient demographics, disease characteristics including current symptom status, functional status and treatment variables, as well as income level of the country of residence, were extracted from survey responses. PROMIS PF-10a scores were compared across country income levels. The influence of extracted variables on reversed PROMIS PF-10a scores were investigated using negative binomial univariable- and multivariable regression.</p><p><strong>Results: </strong>A total of 1342 RA patients were included in this analysis. In the optimised parsimonious predictive model for reversed PROMIS PF-10a, older age, female gender, disease duration, fatigue and pain levels were independently associated with worse physical function, whereas Asian ethnicity, higher overall physical health ratings, ability to carry out everyday activities and residing in a country with an upper-middle or high-income level were independently associated with better physical function.</p><p><strong>Conclusion: </strong>Our study highlights that clinical factors remain strong predictors of physical function in RA, irrespective of individual and country-level socio-economic differences. Interestingly, high country-level income was associated with better physical function, irrespective of individual sociodemographic and clinical factors.</p>","PeriodicalId":21350,"journal":{"name":"Rheumatology Advances in Practice","volume":"9 1","pages":"rkae154"},"PeriodicalIF":2.1,"publicationDate":"2024-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11751688/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143024601","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":"Rapidly progressive digital necrosis in polyarteritis nodosa.","authors":"Soichiro Kubota, Yoshiaki Kobayashi, Shunichiro Hanai, Daiki Nakagomi","doi":"10.1093/rap/rkae153","DOIUrl":"https://doi.org/10.1093/rap/rkae153","url":null,"abstract":"","PeriodicalId":21350,"journal":{"name":"Rheumatology Advances in Practice","volume":"9 1","pages":"rkae153"},"PeriodicalIF":2.1,"publicationDate":"2024-12-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11709451/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142954217","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 Scleroderma and Raynaud's UK (SRUK) national survey to explore rheumatologists' awareness, approaches to diagnosis and management and training needs within systemic sclerosis.","authors":"Emma Blamont, Sue Farrington, Nina Glover-Southworth, Gemma Cornwell, Laura Gibson, Melanie Sloan, Michael Hughes","doi":"10.1093/rap/rkae152","DOIUrl":"10.1093/rap/rkae152","url":null,"abstract":"<p><strong>Objectives: </strong>Patients' outcomes and experiences can be affected by rheumatologist knowledge and awareness of systemic sclerosis (SSc). Our survey, directed at UK-based rheumatologists, aimed to expand our understanding of the above points along with their ability to keep up to date with guidelines defining best practice.</p><p><strong>Methods: </strong>Rheumatologists were invited to participate in an online survey, with the results analysed and presented descriptively and graphically by SRUK.</p><p><strong>Results: </strong>Of the 150 UK rheumatologists surveyed, 2% reported that they had not heard of SSC and 18.7% reported having a limited understanding of the condition. A total of 44% of respondents reported that they were fully versed in the signs and symptoms of SSc. The majority of those surveyed shared the broad view that all aspects of SSc, including services (63.4%), specialist positions (64.7%), research (73.1%) and training and education (70%), are either completely or somewhat underfunded. Most respondents (87.4%) reported that their workload allowed them to 'somewhat' (48.74%) or 'completely' (38.66%) keep up to date with official guidelines. Scleroderma and Raynaud's UK (SRUK) (47.9%), followed by NICE (43.7%), were the most highly used sources of information utilized among those surveyed.</p><p><strong>Conclusion: </strong>Our survey reveals a serious gap in the awareness and the signs and symptoms of SSc among some UK rheumatologists, in addition to a perception that services, training and education in this area are underfunded. Our findings indicate that there is a role for the provision of further education and training as part of continued professional development.</p>","PeriodicalId":21350,"journal":{"name":"Rheumatology Advances in Practice","volume":"9 1","pages":"rkae152"},"PeriodicalIF":2.1,"publicationDate":"2024-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11739612/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143010859","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":"Analysis of risk factors for abnormal renal function in patients with gout in Southwest China: a cross-sectional study.","authors":"Ting Zhang, Ziqian Zeng, Dan Xu, Wantai Dang","doi":"10.1093/rap/rkae151","DOIUrl":"10.1093/rap/rkae151","url":null,"abstract":"<p><strong>Objective: </strong>To analyse the associations between renal function and clinical laboratory indicators and explore the renal function abnormality risk factors for gout patients in Southwest China.</p><p><strong>Methods: </strong>Outpatient and hospitalized gout patients (<i>n</i> = 4384) at the First Affiliated Hospital of Chengdu Medical College between January 2017 and December 2020 were divided into normal (<i>n</i> = 2393) and abnormal (<i>n</i> = 1991) renal function groups according to their eGFR. The relationships between clinical laboratory indicators and the eGFR were analysed, and a logistic regression model was fit to identify significant risk factors.</p><p><strong>Results: </strong>Sex, age, absolute lymphocyte count (ALC), cystatin C (CysC), homocysteine (Hcy) and thyroid stimulating hormone (TSH) were associated with renal function abnormalities (<i>P</i> < 0.05), whereas age [odds ratio (95% CI) = 1.06 (1.05-1.08), <i>P</i> < 0.001], Hcy [1.02 (1.00-1.04), <i>P</i> = 0.028], CysC [1.72 (1.54-1.92), <i>P</i> < 0.001], ALC [0.71 (0.52-0.97), <i>P</i> = 0.03] and TSH [1.08 (1.00-1.17), <i>P</i> = 0.049] were abnormal renal function risk factors for gout patients. After stratification by UA, binary logistic regression analysis identified the following risk factors: Q1 age [1.06 (1.02-1.11), <i>P</i> = 0.003], CysC [1.67 (1.30-2.16), <i>P</i> < 0.001]; Q2 age [1.09 (1.06-1.12), <i>P</i> < 0.001], CysC [1.55 (1.28-1.88), <i>P</i> < 0.001], FT3 [0.66 (0.46-0.96), <i>P</i> = 0.029]; Q3 age [1.06 (1.03-1.09), <i>P</i> < 0.001], CysC [1.75 (1.41-2.18), <i>P</i> < 0.001], Hcy [1.04 (1.00-1.08), <i>P</i> = 0.047], ALC [0.35 (0.18-0.69), <i>P</i> = 0.002]; Q4 age [1.05 (1.02-1.09), <i>P</i> = 0.004], CysC [1.79 (1.40-2.30), <i>P</i> < 0.001].</p><p><strong>Conclusion: </strong>ALC and levels of TSH and serum Cys could be used for monitoring for abnormal renal function in patients with gout.</p>","PeriodicalId":21350,"journal":{"name":"Rheumatology Advances in Practice","volume":"9 1","pages":"rkae151"},"PeriodicalIF":2.1,"publicationDate":"2024-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11696702/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142932620","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 comparison of the efficacy of intramuscular tetracosactide and subacromial triamcinolone injection in rotator cuff tendinitis: a randomized trial.","authors":"Amir Hossein Orandi, Amirpasha Mansour, Nima Bagheri, Hossein Majedi, Seyed Ali Emami Meibodi, Seyed Khalil Pestehei, Peyman Saberian","doi":"10.1093/rap/rkae150","DOIUrl":"10.1093/rap/rkae150","url":null,"abstract":"<p><strong>Objectives: </strong>Rotator cuff tendinitis (RCT) is a tendon inflammation often following subacromial impingement syndrome. One of the non-surgical management modalities for RCT is subacromial injection of corticosteroids. Some studies have claimed a correlation between ACTH (Adrenocorticotropic Hormone) deficiency and rotator cuff lesions; hence, intramuscular ACTH analogue injection has been recommended as an option. This research aimed to compare the effectiveness of these two treatment methods.</p><p><strong>Methods: </strong>We conducted a study with 86 patients suffering from RCT. The patients were randomly divided into two groups of 43; one group received a subacromial injection of 40 mg of triamcinolone acetonide, while the other group received 1 mg of intramuscular tetracosactide injection. We recorded the Constant-Murley (CM) and visual analogue scale (VAS) scores for each patient before and 4 weeks after injections to measure pain acuity and joint functionality. Later, we compared and analysed the two scores in each group.</p><p><strong>Results: </strong>Based on the statistical analysis, the mean ages of the participants in the triamcinolone and tetracosactide groups were 53.21 ± 11.37 and 54.56 ± 11.98, respectively. Both groups demonstrated an improvement in VAS for pain and CM scores (<i>P</i> < 0.05). However, the VAS for pain score decreased, and the CM score increased more significantly in the triamcinolone group than in the tetracosactide group (<i>P</i> < 0.05).</p><p><strong>Conclusion: </strong>Although both treatment methods exhibit promise for pain relief, subacromial injection of triamcinolone appears more efficacious than intramuscular injection of tetracosactide in patients with RCT, based on a 4-week follow-up.</p><p><strong>Trial registration: </strong>Iranian Registry of Clinical Trials, https://irct.behdasht.gov.ir, IRCT20240110060673N1.</p>","PeriodicalId":21350,"journal":{"name":"Rheumatology Advances in Practice","volume":"9 1","pages":"rkae150"},"PeriodicalIF":2.1,"publicationDate":"2024-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11703363/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143415086","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 pattern of anti-IL-6 versus non-anti-IL-6 biologic disease modifying anti-rheumatic drugs use in patients with rheumatoid arthritis in Wales, UK: a real-world study using electronic health records.","authors":"Roxanne Cooksey, Jonathan Kennedy, Muhammad Rahman, Sinead Brophy, Ernest Choy","doi":"10.1093/rap/rkae140","DOIUrl":"10.1093/rap/rkae140","url":null,"abstract":"<p><strong>Objective: </strong>Investigating factors associated with drug initiation and discontinuation in patients treated with anti-IL-6 biologic DMARDs (bDMARDs) (tocilizumab or sarilumab) <i>vs</i> non-anti-IL-6 (anti-TNF, B or T cell therapies) bDMARDs for RA.</p><p><strong>Methods: </strong>A retrospective cohort study of patients with the diagnosis of RA in the Secure Anonymised Information Linkage Databank, comprising primary and secondary care and specialist rheumatology clinic records for >90% of the population in Wales, UK. Patients initiated on first bDMARD treatment, discontinuation and clinical outcomes including infection and hospitalisation were analysed using Cox regression analysis.</p><p><strong>Results: </strong>Of patients identified with RA in their primary care records, 95.7% (4691/4922) received conventional synthetic DMARDs (csDMARDs). More than one-third (36.2%) were treated with bDMARDs (1784/4922). Of these biologic-naïve patients, 6.5% (116) were treated with anti-IL-6 bDMARDs; this treatment was associated with a previous history of infection [difference 8.8% (95% CI 1.1, 17.8)] and kidney disease [14.3% (95% CI 8.0, 22.5)]. Treatment discontinuation was significantly higher in the non-anti-IL-6 bDMARD-treated patients (23.1%) compared with the anti-IL-6 bDMARD-treated individuals (18.1%) [difference 9.4% (95% CI 1.1, 15.7)]. For those discontinuing a first line of treatment, 385 patients (23%) and 21 patients (18%) switched to an alternative bDMARD from the non-anti-IL-6 and anti-IL-6 groups, respectively.</p><p><strong>Conclusion: </strong>Comorbidities, history of infection and kidney disease were associated with choosing anti-IL-6 bDMARDs in biologic-naïve RA patients in Wales. Anti-IL-6 bDMARD-treated biologic-naïve patients were more likely to continue treatment than non-IL-6 bDMARD-treated patients.</p>","PeriodicalId":21350,"journal":{"name":"Rheumatology Advances in Practice","volume":"9 1","pages":"rkae140"},"PeriodicalIF":2.1,"publicationDate":"2024-12-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11651880/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142855130","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}