{"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}
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
{"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}
Anna Laine, Paula Muilu, Hannu Kautiainen, Kari Puolakka, Vappu Rantalaiho
{"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}
{"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}
Tiffany Pretat, Thomas Hügle, Johanna Mettler, Marc Suter, Sandy Jean-Scherb, Pedro Ming-Azevedo
{"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}
Nabihah Malik, Richard Porter, Sahena Haque, Naila Tazeen
{"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}
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
{"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}