Rheumatology Advances in Practice最新文献

{"title":"Successful combination therapy of mepolizumab and dupilumab in a patient with EGPA: a future therapeutic option?","authors":"Joana Martins-Martinho, Roberto Pereira da Costa, Tiago Abreu, Cristina Ponte","doi":"10.1093/rap/rkae093","DOIUrl":"10.1093/rap/rkae093","url":null,"abstract":"","PeriodicalId":21350,"journal":{"name":"Rheumatology Advances in Practice","volume":"8 3","pages":"rkae093"},"PeriodicalIF":2.1,"publicationDate":"2024-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11315680/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141917411","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 the association between circulating endothelial protein C receptor and disease activity of rheumatoid arthritis in a pilot study.","authors":"Meilang Xue, Haiyan Lin, Tom Lynch, Lara Bereza-Malcolm, Premarani Sinnathurai, Ranjeny Thomas, Helen Keen, Catherine Hill, Susan Lester, Mihir Wechalekar, Lyn March","doi":"10.1093/rap/rkae096","DOIUrl":"10.1093/rap/rkae096","url":null,"abstract":"<p><strong>Objectives: </strong>To investigate whether circulating endothelial protein C receptor (EPCR) is associated with disease activity and inflammatory markers in rheumatoid arthritis.</p><p><strong>Methods: </strong>Thirty-eight RA patients and 21 healthy controls (HC) were recruited via the A3BC biobank. Peripheral blood mononuclear cells and plasma were isolated from the blood of these participants. Plasma soluble (s)EPCR, IL-6, IL-17 and sCD14 were measured by enzyme-linked immunosorbent assay, cell membrane-associated (m)EPCR by flow cytometry; <i>EPCR</i> gene H3 single nucleotide polymorphism (SNP), which contributes to high plasma sEPCR levels, by PCR and DNA sequencing. Data were analysed using FlowJo10 and GraphPad Prism 10.</p><p><strong>Results: </strong>RA patients had higher levels of mEPCR on T cells and plasma sEPCR compared with HC. No difference in the <i>EPCR</i> gene H3 SNP G genotype frequency was found between RA and HC. This SNP was significantly correlated with higher sEPCR levels in HC but not in RA patients. In RA, plasma sEPCR levels were positively correlated with IL-6, IL-17, sCD14, anti-CCP and rheumatoid factor. In contrast, mEPCR levels on T cells and natural killer cells (NK) were inversely associated with disease activity measures including 28/66 swollen joint count, 28/68 tender joint count and/or DAS28-CRP/ESR scores, and positively correlated with <i>EPCR</i> gene H3 SNP, which was also correlated with lower disease activity measures in RA.</p><p><strong>Conclusion: </strong>Our findings suggest that EPCR may play an important role in RA, with plasma sEPCR being potentially associated with inflammatory markers and mEPCR and the <i>EPCR</i> gene H3 SNP possibly related to disease activity measures.</p>","PeriodicalId":21350,"journal":{"name":"Rheumatology Advances in Practice","volume":"8 3","pages":"rkae096"},"PeriodicalIF":2.1,"publicationDate":"2024-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11343369/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142056346","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 development of pGALSplus: evaluating feasibility and acceptability of an assessment to facilitate the identification and triage of children with musculoskeletal presentations.","authors":"Vicky Mercer, Nicola Smith, Michela Guglieri, Simon A Jones, Jeremy R Parr, Helen E Foster, Sharmila Jandial","doi":"10.1093/rap/rkae089","DOIUrl":"10.1093/rap/rkae089","url":null,"abstract":"<p><strong>Objectives: </strong>Healthcare professionals (HCPs) need to identify potentially serious musculoskeletal (MSK) presentations in children and refer them to specialists appropriately. Our aim was to develop 'pGALSplus' (paediatric gait, arms, legs and spine plus) to support clinical assessment, aid decision-making and assess feasibility and acceptability in exemplar MSK pathologies.</p><p><strong>Methods: </strong>We used a three-phase mixed methods approach: phase 1, preliminary stakeholder engagement and scoping review to propose pGALSplus; phase 2, iterative development of pGALSplus involving an expert working group; and phase 3, testing the feasibility of pGALSplus in exemplar MSK conditions [JIA, mucopolysaccharidoses (MPS), muscular dystrophy (MD), developmental coordination disorder (DCD) and healthy controls (HCs)]. The final pGALSplus was derived from analysis of phase 3 data and feedback from HCPs, families and expert consensus input from an international e-survey (<i>n</i> = 22) and virtual event (<i>n</i> = 13).</p><p><strong>Results: </strong>Feasibility was tested in 45 children (JIA, <i>n</i> = 10; MPS, <i>n</i> = 6; MD, <i>n</i> = 9; DCD, <i>n</i> = 10; HCs, <i>n</i> = 10). Overall the assessment was achievable in the target age range (2-10 years) and quick to complete [median 12 min (range 8-20)], with high acceptability from families. Expert feedback deemed pGALSplus to be very useful and of particular use to non-specialists in MSK paediatrics. The final pGALSplus comprises 26 clinical observations/skills with a colour-coding approach to aid decision-making and identification of more serious MSK presentations and additional resources to support its use in clinical practice.</p><p><strong>Conclusions: </strong>pGALSplus is a novel evidence- and consensus-based assessment building on pGALS, with high acceptability and feasibility. As community-based MSK assessment in children becomes more established, we propose that pGALSplus will facilitate and inform decision-making to promote access to specialist care.</p>","PeriodicalId":21350,"journal":{"name":"Rheumatology Advances in Practice","volume":"8 3","pages":"rkae089"},"PeriodicalIF":2.1,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11319642/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141976523","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":"Muscular polyarteritis nodosa with fasciitis and upper extremity involvement.","authors":"Setsuko Oyama, Hiroyuki Yamashita, Misa Yamaji, Toshiaki Kobayashi, Akatsuki Kubota, Jun Shimizu, Tamiko Takemura, Hiroshi Kaneko","doi":"10.1093/rap/rkae088","DOIUrl":"10.1093/rap/rkae088","url":null,"abstract":"","PeriodicalId":21350,"journal":{"name":"Rheumatology Advances in Practice","volume":"8 3","pages":"rkae088"},"PeriodicalIF":2.1,"publicationDate":"2024-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11297502/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141891555","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":"Unusual reaction to a local corticosteroid injection to the heel: Tachon's syndrome?","authors":"Sidra Hussain, Ali S Jawad","doi":"10.1093/rap/rkae092","DOIUrl":"10.1093/rap/rkae092","url":null,"abstract":"","PeriodicalId":21350,"journal":{"name":"Rheumatology Advances in Practice","volume":"8 3","pages":"rkae092"},"PeriodicalIF":2.1,"publicationDate":"2024-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11319641/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141976524","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: The diagnosis and management of systemic autoimmune rheumatic disease-related interstitial lung disease: British Society for Rheumatology guideline scope.","authors":"","doi":"10.1093/rap/rkae085","DOIUrl":"https://doi.org/10.1093/rap/rkae085","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.1093/rap/rkae056.].</p>","PeriodicalId":21350,"journal":{"name":"Rheumatology Advances in Practice","volume":"8 3","pages":"rkae085"},"PeriodicalIF":2.1,"publicationDate":"2024-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11283306/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141789001","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: The influence of deprivation in the outcomes of psoriatic arthritis within the UK-utilizing Outcomes of Treatment in Psoriatic Arthritis Study Syndicate (OUTPASS) data.","authors":"","doi":"10.1093/rap/rkae079","DOIUrl":"10.1093/rap/rkae079","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.1093/rap/rkae051.].</p>","PeriodicalId":21350,"journal":{"name":"Rheumatology Advances in Practice","volume":"8 3","pages":"rkae079"},"PeriodicalIF":2.1,"publicationDate":"2024-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11246160/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141617060","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 prescription and monitoring of conventional synthetic disease-modifying anti-rheumatic drugs: British Society for Rheumatology guideline scope.","authors":"Louise Mercer, Abhishek Abhishek, Akhila Kavirayani, Alison Ahmed, Alan Davidson, Amy Foulkes, Claire Jones, Clare Nash, Emily Rose-Parfitt, Emmandeep Dhillon, Genevieve Zabate, Helen Twohig, Hope De Vere, Jennifer Scott, John Reynolds, Julia Holmes, Karen Hartley, Kishore Warrier, Kataryzna Nowak, Kate Parsons, Katie Bechman, Lisa Bray, Madura Adikari, Natasha Wood, Nicola Faithfull, Nicola Gullick, Pratyasha Saha, Rebecca Heaton, Samundeeswari Deepak, Samantha Hider, Sameena Khalid, Sanaa Suleiman Said, Sarah Ryan, Stuart Kyle, Subhra Raghuvanshi, Su-Yin Tan, Vinay Shivamurthy, James Galloway","doi":"10.1093/rap/rkae077","DOIUrl":"10.1093/rap/rkae077","url":null,"abstract":"<p><p>This guideline will provide up-to-date, evidence-based recommendations on the safe use of non-biologic DMARDs, also called conventional synthetic DMARDs (csDMARD), across the full spectrum of autoimmune rheumatic diseases. The guideline will update the guideline published in 2017 and will be expanded to include people of all ages. Updated information on the monitoring of DMARDs and vaccinations will be included. The guideline will be developed using the methods and processes described in the British Society for Rheumatology's 'Creating clinical guidelines: our protocol', updated 2023.</p>","PeriodicalId":21350,"journal":{"name":"Rheumatology Advances in Practice","volume":"8 3","pages":"rkae077"},"PeriodicalIF":2.1,"publicationDate":"2024-07-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11239329/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141617061","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 relationship between obesity and patient-reported outcome measures in people with polymyalgia rheumatica.","authors":"Ian C Scott, Ram Bajpai, Samantha L Hider, Toby Helliwell, Christian D Mallen, Sara Muller","doi":"10.1093/rap/rkae081","DOIUrl":"10.1093/rap/rkae081","url":null,"abstract":"<p><strong>Objective: </strong>To examine the association between obesity and patient-reported outcome measures (PROMs) in a primary care-based cohort of people with PMR.</p><p><strong>Methods: </strong>The PMR Cohort Study recruited people with incident PMR from 382 general practices. Self-completed questionnaires (0, 12, 24 months) captured a range of PROMs for pain, stiffness, anxiety, depression, fatigue, function and quality of life, alongside data on BMI. People were categorized as underweight/normal weight (BMI < 25kg/m²), overweight (25-29.99 kg/m²) or obese (≥30 kg/m²). Piecewise, multilevel, linear mixed-effects regression models examined relationships between BMI categories and PROMs over time, adjusting for confounding variables. Chi-squared tests examined the relationship between obesity and glucocorticoid persistence.</p><p><strong>Results: </strong>644 people with PMR were included. At baseline, 33.9% were normal/underweight, 40.6% overweight and 25.5% obese. Compared with normal/underweight people, those with obesity had significantly worse scores for the following: pain and stiffness at 12 months; fatigue at 12 and 24 months; depression at baseline; physical function at all time points; and quality of life at baseline and 12 months. They also had significantly smaller improvements in stiffness (1.13 units on an 11-point numeric rating scale; <i>P </i>=<i> </i>0.001) and physical function (0.14 units measured using the modified Health Assessment Questionnaire; <i>P </i>=<i> </i>0.025) between 0 and 12 months. BMI categories did not relate to persistent glucocorticoid use at 12 months (<i>P </i>=<i> </i>0.110) or 24 months (<i>P </i>=<i> </i>0.166).</p><p><strong>Conclusion: </strong>Obesity associates with poorer outcomes for a range of PROMs in people with PMR. Consideration should be given to providing weight management support to people with PMR and obesity.</p>","PeriodicalId":21350,"journal":{"name":"Rheumatology Advances in Practice","volume":"8 3","pages":"rkae081"},"PeriodicalIF":2.1,"publicationDate":"2024-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11239789/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141616999","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":"Automated quantification of wrist bone marrow oedema, pre- and post-treatment, in early rheumatoid arthritis.","authors":"Chungwun Yiu, James Francis Griffith, Fan Xiao, Lin Shi, Bingjing Zhou, Su Wu, Lai-Shan Tam","doi":"10.1093/rap/rkae073","DOIUrl":"10.1093/rap/rkae073","url":null,"abstract":"<p><strong>Objective: </strong>Bone inflammation (osteitis) in early RA (ERA) manifests as bone marrow oedema (BME) and precedes the development of bone erosion. In this prospective, single-centre study, we developed an automated post-processing pipeline for quantifying the severity of wrist BME on T2-weighted fat-suppressed MRI.</p><p><strong>Methods: </strong>A total of 80 ERA patients [mean age 54 years (s.d. 12), 62 females] were enrolled at baseline and 49 (40 females) after 1 year of treatment. For automated bone segmentation, a framework based on a convolutional neural network (nnU-Net) was trained and validated (5-fold cross-validation) for 15 wrist bone areas at baseline in 60 ERA patients. For BME quantification, BME was identified by Gaussian mixture model clustering and thresholding. BME proportion (%) and relative BME intensity within each bone area were compared with visual semi-quantitative assessment of the RA MRI score (RAMRIS).</p><p><strong>Results: </strong>For automated wrist bone area segmentation, overall bone Sørensen-Dice similarity coefficient was 0.91 (s.d. 0.02) compared with ground truth manual segmentation. High correlation (Pearson correlation coefficient <i>r</i> = 0.928, <i>P</i> < 0.001) between visual RAMRIS BME and automated BME proportion assessment was found. The automated BME proportion decreased after treatment, correlating highly (<i>r</i> = 0.852, <i>P</i> < 0.001) with reduction in the RAMRIS BME score.</p><p><strong>Conclusion: </strong>The automated model developed had an excellent segmentation performance and reliable quantification of both the proportion and relative intensity of wrist BME in ERA patients, providing a more objective and efficient alternative to RAMRIS BME scoring.</p>","PeriodicalId":21350,"journal":{"name":"Rheumatology Advances in Practice","volume":"8 3","pages":"rkae073"},"PeriodicalIF":2.1,"publicationDate":"2024-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11194532/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141446914","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}