Rheumatology Advances in Practice最新文献

{"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To investigate the relapse rate of SLE patients after glucocorticoids (GCs) withdrawn, assess the risk factors associated with disease relapse and clarify the outcome of patients with relapse.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}

{"title":"Concurrence of bird-related hypersensitivity pneumonitis and systemic sclerosis-associated interstitial lung disease.","authors":"Mai Miyahara, Kazuki M Matsuda, Hirohito Kotani, Tomomi Miyake, Asako Yoshizaki-Ogawa, Ayumi Yoshizaki, Shinichi Sato","doi":"10.1093/rap/rkaf037","DOIUrl":"10.1093/rap/rkaf037","url":null,"abstract":"","PeriodicalId":21350,"journal":{"name":"Rheumatology Advances in Practice","volume":"9 2","pages":"rkaf037"},"PeriodicalIF":2.1,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11985381/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143995929","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":"Ustekinumab merits further exploration in Takayasu arteritis despite a failed randomized controlled trial.","authors":"Durga Prasanna Misra","doi":"10.1093/rap/rkaf038","DOIUrl":"10.1093/rap/rkaf038","url":null,"abstract":"","PeriodicalId":21350,"journal":{"name":"Rheumatology Advances in Practice","volume":"9 2","pages":"rkaf038"},"PeriodicalIF":2.1,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12000531/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144051233","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":"Clinical predictors of immediate response to a multimodal inpatient programme for chronic refractory musculoskeletal pain syndromes-a cross-sectional study.","authors":"Tiffany Pretat, Thomas Hügle, Johanna Mettler, Marc Suter, Sandy Jean-Scherb, Pedro Ming-Azevedo","doi":"10.1093/rap/rkaf024","DOIUrl":"10.1093/rap/rkaf024","url":null,"abstract":"<p><strong>Objectives: </strong>Chronic pain (CP) affects approximately 20% of the global population, leading to significant disability and economic burden. Multimodal programmes (MMPs) are the most effective short-term interventions for managing musculoskeletal chronic pain syndromes (MCPS). However, patient characteristics influence treatment response, requiring personalized approaches. This study aims to identify clinical, social and psycho-behavioural predictors of immediate response to a 2-week inpatient MMP for refractory MCPS.</p><p><strong>Methods: </strong>A cross-sectional study analysed 207 MCPS patients who completed an MMP at CHUV Lausanne, Switzerland, from March 2018 to November 2022. Validated questionnaires assessed pain severity, impact, kinesiophobia, catastrophizing and other factors before and after the programme. Univariate and multivariate analyses identified predictors of treatment response.</p><p><strong>Results: </strong>Significant improvements were observed in 9 out of 12 outcomes, including pain severity (<i>P</i> = 0.01), pain impact (<i>P</i> < 0.01), disability (<i>P</i> = 0.14), kinesiophobia (<i>P</i><0.001) and catastrophizing (<i>P</i> < 0.001). Non-specific low-back pain, catastrophizing at entry, biomechanical disorders and psychiatric conditions were identified as key predictors of treatment response, respectively influencing 4, 3, 3 and 2 over 9 outcome measures in multivariable analysis. Non-specific low-back pain was linked to worse outcomes, whereas reductions in catastrophizing correlated with improved pain severity and kinesiophobia. Socioeconomic factors, such as disputes over disability financial aid, also influenced outcomes.</p><p><strong>Conclusion: </strong>This study confirms a modest yet significant immediate benefit of MMP for patients with refractory MCPS and provided a deeper insight into the predictors of treatment outcomes and their influence on various outcome measures. Further longitudinal studies are needed to confirm these findings and explore underlying mechanisms.</p>","PeriodicalId":21350,"journal":{"name":"Rheumatology Advances in Practice","volume":"9 2","pages":"rkaf024"},"PeriodicalIF":2.1,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12033028/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144009918","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":"Building a stronger future together: a message from the new Editor-in-Chief.","authors":"Mwidimi Ndosi","doi":"10.1093/rap/rkaf021","DOIUrl":"https://doi.org/10.1093/rap/rkaf021","url":null,"abstract":"","PeriodicalId":21350,"journal":{"name":"Rheumatology Advances in Practice","volume":"9 2","pages":"rkaf021"},"PeriodicalIF":2.1,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11913324/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143650111","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":"Skeletal mastocytosis as a cause of chronic widespread pain.","authors":"Nabihah Malik, Richard Porter, Sahena Haque, Naila Tazeen","doi":"10.1093/rap/rkaf026","DOIUrl":"10.1093/rap/rkaf026","url":null,"abstract":"","PeriodicalId":21350,"journal":{"name":"Rheumatology Advances in Practice","volume":"9 2","pages":"rkaf026"},"PeriodicalIF":2.1,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12060711/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143995930","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":"WORKWELL process evaluation: qualitative data analyses of the participant interviews at 12- and 36-month follow-ups.","authors":"Simone Battista, Jennifer Parker, Angela Ching, June Culley, Sarah Long, Alison Heard, Alison Hammond, Kathryn Radford, Paula Holland, Terence O'Neill, Karen Walker-Bone, Yeliz Prior","doi":"10.1093/rap/rkaf034","DOIUrl":"10.1093/rap/rkaf034","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to qualitatively examine the delivery of the WORKWELL trial, a job retention vocational rehabilitation (JRVR) programme designed to help individuals with inflammatory arthritis (IA) maintain employment. A qualitative process evaluation used the Normalization Process Theory (NPT) to understand participant experiences and identify factors influencing implementation and outcomes.</p><p><strong>Methods: </strong>Data were collected via one-to-one telephone interviews with trial participants at 12 and 36 months. An inductive reflexive thematic analysis was followed by a deductive analysis based on NPT's four constructs (coherence, cognitive participation, collective action and reflexive monitoring).</p><p><strong>Results: </strong>Sixty-two participants (mean age 51.0; 82.3% female) were interviewed, most diagnosed with RA (75.8%). Four secondary themes were generated under NPT constructs. For 'Coherence', themes included 'Exploring the Purpose and Impact of Taking Part in WORKWELL' and 'Questionnaires as Instrument for Reflection'. In 'Cognitive Participation', the theme was 'Commitment and Investment to WORKWELL'. For 'Collective Action', we identified 'Key Actions for Successful WORKWELL', and under 'Reflexive Monitoring', the theme was 'Suggestions for Improving WORKWELL'. These themes reflected participants' mixed feelings about the intervention, finding value in the intervention but highlighting the need for more tailored, timely and relevant content. Workplace support was crucial but often insufficient. Follow-up calls from researchers to ensure questionnaire completion were seen as a way to reflect and monitor their conditions. The pandemic's impact on work environments also influenced outcomes.</p><p><strong>Conclusion: </strong>Findings suggest that WORKWELL provided work support for participants, though its impact could be enhanced through greater customization, early intervention and stronger workplace engagement.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov NCT03942783. Registered on 8 May 2019. ISRCTN Registry ISRCTN61762297. Registered on 13 May 2019. Retrospectively registered.</p>","PeriodicalId":21350,"journal":{"name":"Rheumatology Advances in Practice","volume":"9 2","pages":"rkaf034"},"PeriodicalIF":2.1,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11930348/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143693205","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":"Osteoarthritis after major combat trauma: the Armed Services Trauma Rehabilitation Outcome Study.","authors":"Fearghal P Behan, Alexander N Bennett, Fraje Watson, Susie Schofield, Eleanor F Miller, Oliver O'Sullivan, Christopher J Boos, Nicola T Fear, Paul Cullinan, Philip G Conaghan, Anthony M J Bull","doi":"10.1093/rap/rkaf033","DOIUrl":"10.1093/rap/rkaf033","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the differences in clinical and radiographic knee OA markers between injured and uninjured UK service personnel.</p><p><strong>Methods: </strong>This study was a cross-sectional analysis, 8 years post-injury, of a prospective cohort study. The Knee Injury and Osteoarthritis Outcome Scores (KOOS), radiographic Kellgren and Lawrence (KL) scores and Osteoarthritis Research Society International scores (joint space narrowing, sclerosis, osteophytes) were obtained from 565 uninjured and 579 matched (on sex, age, rank, regiment and role on deployment) major combat injured participants from the Armed Services Trauma Rehabilitation Outcome study; 35 had a knee injury and 142 had an amputation without knee injury. Kruskal-Wallis tests were used to compare between groups for KOOS and radiographic measures. A multiple logistic regression was performed on the effects of injury on radiographic features.</p><p><strong>Results: </strong>The mean age at injury was 25.7 years (s.d. 5.2). Injured participants demonstrated worse KOOS values for pain {median 89 [interquartile range (IQR) 72-100] <i>vs</i> 94 [83-100]} and symptoms [median 80 (IQR 60-90) <i>vs</i> 85 (70-95), <i>P</i> < 0.001] and higher scores for radiographic variables than uninjured participants. Injured non-amputated/non-knee-injured participants had worse KOOS values than uninjured participants [pain: 92 (IQR 75-100) <i>vs</i> 94 (83-100); symptoms: 80 (IQR 60-90) <i>vs</i> 85 (70-95), <i>P</i> < 0.01]. Knee-injured participants had worse KOOS values [pain: 67 (IQR 55-85), symptoms: 55 (IQR 35-73), <i>P</i> < 0.001] than all subgroups and worse radiographic measures than injured non-amputated participants. KL score (≥1) and sclerosis were worse for amputees than injured non-amputated participants. Amputees had 4.04-fold increased odds (95% CI 2.45, 6.65) <i>vs</i> uninjured participants and knee-injured participants had 4.06-fold increased odds (95% CI 1.89-8.74) than uninjured participants of knee osteoarthritis (KOA; KL ≥1). Injured participants (without knee injury/amputation) had 1.74-fold (95% CI 1.27, 2.69) increased odds of KOA than uninjured participants.</p><p><strong>Conclusion: </strong>Major combat trauma (in addition to knee injury or amputation) has a substantial effect on the development of KOA.</p>","PeriodicalId":21350,"journal":{"name":"Rheumatology Advances in Practice","volume":"9 2","pages":"rkaf033"},"PeriodicalIF":2.1,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11985385/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144034679","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":"Intra-articular corticosteroid injections for the treatment of people with foot and ankle osteoarthritis: a systematic review.","authors":"Katherine Jones, Julie Bruce, Thomas L Lewis, Ciaran N Nolan, Shannon E Munteanu, Hylton B Menz, Michael R Backhouse","doi":"10.1093/rap/rkaf030","DOIUrl":"10.1093/rap/rkaf030","url":null,"abstract":"<p><strong>Objective: </strong>Intra-articular corticosteroid injections are commonly used in the management of foot and ankle OA. Although current clinical guidelines advocate the judicious use of corticosteroid injection as an adjunct therapy, none of these recommendations are specific to the foot and ankle. Therefore, the aim of this review is to examine the effectiveness of intra-articular corticosteroid injections in people with foot or ankle OA.</p><p><strong>Methods: </strong>Four databases (Cumulative Index to Nursing and Allied Health Literature [CINAHL], MEDLINE, EMBASE and CENTRAL) and one clinical trial register (International Clinical Trials Registry Platform [ICTRP]) were searched from inception to June 2024 for randomized control trials (RCTs) and quasi-RCTs evaluating corticosteroid injection in the treatment of foot or ankle OA on pre-specified outcomes: pain, function, quality of life, safety (adverse events) and/or cost-effectiveness. Two independent reviewers conducted record screening, data extraction (Cochrane data extraction tool) and assessment of methodological quality (Cochrane Risk of Bias tool [RoB 2.0]).</p><p><strong>Results: </strong>From 1711 citations, two RCTs (57 participants, 49% males) were identified. There were no differences in pain or function over 8 weeks after a single injection of intra-articular corticosteroid compared with prolotherapy for treatment of first metatarsal joint OA. Pain and function significantly improved in people having three corticosteroid injections combined with hyaluronic acid compared with corticosteroid injections alone for treatment of post-traumatic subtalar OA. Methodological quality was graded as some concerns in both trials.</p><p><strong>Conclusion: </strong>There is insufficient evidence to guide the use of intra-articular corticosteroid injections for OA of the foot or ankle. Future robust research is needed to provide reliable evidence for this commonly performed treatment.</p>","PeriodicalId":21350,"journal":{"name":"Rheumatology Advances in Practice","volume":"9 2","pages":"rkaf030"},"PeriodicalIF":2.1,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11928786/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143693204","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":"Exploring patient activation and self-management experiences in adults with fibromyalgia: a qualitative evidence synthesis.","authors":"Kit Yung, Durva Jadhav, Cheuk Ma, Sakshee Majgaonkar, Eya Manai, Jennifer Pearson","doi":"10.1093/rap/rkaf025","DOIUrl":"10.1093/rap/rkaf025","url":null,"abstract":"<p><strong>Objectives: </strong>Fibromyalgia syndrome (FMS) is a chronic pain condition that affects involvement in daily activities, including self-care and household responsibilities. Self-management strategies are a primary focus in treatment recommendations. However, their effectiveness depends on an individual's readiness and capacity to adopt health-promoting behaviours. This study aims to explore the experiences of adults in their self-management journey, focusing on the barriers and facilitators influencing patient activation (PA) and effective self-management.</p><p><strong>Methods: </strong>A qualitative evidence synthesis was conducted. An electronic search was performed using the following databases: CINAHL, PsycINFO, PubMed, Medline, ScienceDirect and AMED. The studies were screened against eligibility criteria to ensure their relevance. The quality of the included studies was assessed against the Critical Appraisal Skills Programme (CASP) questionnaire for qualitative studies and the Consolidated Criteria for Reporting Qualitative Research (COREQ) checklist. Findings from the papers were synthesized via the three-stage thematic synthesis process, and common themes were identified.</p><p><strong>Results: </strong>Nine studies with a total of 130 participants were included. Four major analytical themes were identified, including legitimizing FMS, the value of medical support, receiving peer and social support, and learning to self-manage.</p><p><strong>Conclusion: </strong>Self-management of FMS requires patients to be actively involved in managing their health. These findings highlight that support from HCPs, family members and peers helps patients learn how to self-manage and engage in health-promoting behaviours. Clinicians treating people with FMS should prioritize education, empathy and personalized support.</p>","PeriodicalId":21350,"journal":{"name":"Rheumatology Advances in Practice","volume":"9 2","pages":"rkaf025"},"PeriodicalIF":2.1,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11908766/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143650118","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}