RMD Open最新文献

{"title":"Is AI-assisted active learning software able to reliably speed-up systematic literature reviews in rheumatology? A real-time comparison of AI-assisted and manual abstract selection.","authors":"Joy Ardjuna van der Pol, Tom Wj Huizinga, Sytske Anne Bergstra","doi":"10.1136/rmdopen-2024-005024","DOIUrl":"10.1136/rmdopen-2024-005024","url":null,"abstract":"","PeriodicalId":21396,"journal":{"name":"RMD Open","volume":"10 4","pages":""},"PeriodicalIF":5.1,"publicationDate":"2024-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11624811/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142780994","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of employees living with an 'arthritis' on sickness absence and transitions out of employment: a comparative observational study in the UK.","authors":"William Whittaker, James Higgerson, Martin Eden, Katherine Payne, Ross Wilkie, Suzanne Mm Verstappen","doi":"10.1136/rmdopen-2024-004817","DOIUrl":"10.1136/rmdopen-2024-004817","url":null,"abstract":"<p><strong>Purpose: </strong>To assess sickness absence and transitions from employment for employees with arthritis compared with employees without arthritis over time.</p><p><strong>Methods: </strong>We use 10 waves of the UK Household Longitudinal Survey (2009-2019). The sample (n=38 928) comprises employees aged 50 years to state retirement age. Arthritis was self-reported and could refer to people with conditions under the umbrella term 'inflammatory arthritis' or osteoarthritis (hereafter 'arthritis'). Weighted random-effects multivariable linear probability models were estimated for two employment-related measures (1) sickness absence and (2) transitions from employment to: (a) unemployment; (b) long-term sick; (c) early retirement. These were regressed against a variable for arthritis and confounding factors (age, socioeconomic job classification, employing sector, year and additional health conditions). Additional analyses examined an interaction between the variable arthritis and these factors to test whether the effect of arthritis differs between these groups.</p><p><strong>Results: </strong>Employees reporting having arthritis were more likely to have sickness absence (1.35 percentage points greater rate (95% CI (0.92, 1.78)) and to transition to long-term sick (0.79 percentage points (0.46, 1.13)) and early retirement (0.58 percentage points (0.05, 1.11)). No effect was found for transitions to unemployment. There was limited evidence that the effects of arthritis vary for employees in different socioeconomic classifications.</p><p><strong>Conclusions: </strong>Employees living with arthritis have higher rates of sickness absence and greater rates of transitions from employment to long-term sick and early retirement. Further work could look at ways to quantify the implications for individuals, employers and the state and ways to alleviate the effects of living with arthritis on work participation.</p>","PeriodicalId":21396,"journal":{"name":"RMD Open","volume":"10 4","pages":""},"PeriodicalIF":5.1,"publicationDate":"2024-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11624701/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142772134","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"NSAID exposure delays time-to-pregnancy in patients with spondyloarthritis: an analysis of the GR2 prospective cohort.","authors":"Sabrina Hamroun, Marion Couderc, René-Marc Flipo, Jérémie Sellam, Christophe Richez, Emanuelle Dernis, Aline Frazier, Laure Gossec, Elisabeth Gervais, Hubert Marotte, Laetitia Dunogeant, Cédric Lukas, Alban Deroux, Gaëlle Guettrot-Imbert, Véronique Le Guern, Nathalie Costedoat-Chalumeau, Anna Molto","doi":"10.1136/rmdopen-2024-004745","DOIUrl":"10.1136/rmdopen-2024-004745","url":null,"abstract":"<p><strong>Background: </strong>The impact of disease activity and treatment on fertility outcomes in patients with spondyloarthritis (SpA) has been little explored. This study aimed to describe median time to pregnancy (TTP) in women with SpA and the factors influencing TTP in this population.</p><p><strong>Methods: </strong>This prospective observational multicentre (63 centres) French cohort (GR2 study-NCT02450396) included consecutive women with a diagnosis of SpA (according to their rheumatologist) who wanted to become pregnant between 2015 and 2021. TTP (in months) was the main outcome criterion, prospectively calculated from the date of study inclusion to the date of conception. Data on demographics, disease characteristics, disease activity, severity and treatment were prospectively collected at inclusion and each year thereafter until pregnancy occurred. TTP and its associated factors were estimated by survival analysis (Shared Frailty Cox models), with a random centre effect and multiple imputation to address missing data.</p><p><strong>Results: </strong>We analysed 88 women included before conception. Among them, 56 (63.6%) became pregnant during follow-up. Median TTP was 16.1 (95% CI (12.2 to 25.3)) months. Mean preconceptional Bath Ankylosing Spondylitis Disease Activity Index at inclusion was 2.9 (±SD 2.1). Patients were treated with TNF inhibitors, non-steroidal anti-inflammatory drugs (NSAIDs), conventional synthetic disease-modifying antirheumatic drugs and glucocorticoids in 61 (69.3%), 23 (26.1%), 12 (13.6%) and 8 (9.1%) cases, respectively. The multivariate model found a significant association between TTP and age (HR) (per year) 1.22 95% CI (1.08 to 1.40); p<0.001) and the use of NSAIDs during preconception (HR 3.01 95% CI (2.15 to 3.85); p=0.01).</p><p><strong>Conclusion: </strong>Age and NSAID use during preconception were significantly associated with a longer TTP, after adjustment for other confounding factors. These findings warrant caution in the use of NSAIDs in SpA patients trying to conceive.</p>","PeriodicalId":21396,"journal":{"name":"RMD Open","volume":"10 4","pages":""},"PeriodicalIF":5.1,"publicationDate":"2024-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11624830/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142772136","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Relationship between high-resolution computed tomography quantitative imaging analysis and physiological and clinical features in antisynthetase syndrome-related interstitial lung disease.","authors":"Sangmee Sharon Bae, Fereidoun Abtin, Grace Kim, Daniela Markovic, Cato Chan, Siamak Moghadam-Kia, Chester V Oddis, Daniel Sullivan, Galina Marder, Swamy Venuturupalli, Paul F Dellaripa, Tracy J Doyle, Gary Matt Hunninghake, Jeremy Falk, Christina Charles-Schoeman, Donald P Tashkin, Jonathan Goldin, Rohit Aggarwal","doi":"10.1136/rmdopen-2024-004592","DOIUrl":"10.1136/rmdopen-2024-004592","url":null,"abstract":"<p><strong>Objectives: </strong>To explore the association between the extent of CT abnormalities by quantitative imaging analysis (QIA) and clinical/physiological disease parameters in patients with antisynthetase syndrome associated interstitial lung disease (ARS-ILD).</p><p><strong>Methods: </strong>We analysed 20 patients with antisynthetase antibodies and active ILD enrolled in the Abatacept in Myositis-Associated Interstitial Lung Disease study. High-resolution chest CT was obtained at weeks 0, 24 and 48 and QIA scored the extent of ground glass (quantitative score for ground glass), fibrosis (quantitative score for lung fibrosis, QLF) and total ILD (quantitative ILD, QILD). Mixed-effects models estimated longitudinal QIA scores over time. Associations between QIA scores with clinical/physiological parameters were analysed longitudinally using repeated-measures mixed-effects models.</p><p><strong>Results: </strong>Patients were median age 57 years, 55% males and 85% white. Higher (worse) baseline QIA scores correlated with lower baseline forced vital capacity (FVC) and diffusing capacity adjusted for haemoglobin (DLCO). Longitudinal QIA trajectories trended towards improving scores during the trial, and patients on O₂ at baseline had worsening QIA trajectories which were different from patients who were not on O₂. Longitudinal QIA scores demonstrated strong associations with both FVC and DLCO over time. Higher QILD scores over time were also associated with worse dyspnoea scores, pulmonary visual analogue scale, physician and patient global disease activity, health status in 6/8 domains of the Short Form-36 and higher oxygen requirements. Patients with significant radiographic improvement at 48 weeks had higher baseline QLF, QILD and worse DLCO.</p><p><strong>Conclusions: </strong>Longitudinal QIA scores associate with lung physiology, patient perception of respiratory status, overall disease activity and quality of life over time in ARS-ILD. QIA may allow reproducible monitoring of disease progression and response to therapy over time.</p><p><strong>Trial registration number: </strong>NCT03215927.</p>","PeriodicalId":21396,"journal":{"name":"RMD Open","volume":"10 4","pages":""},"PeriodicalIF":5.1,"publicationDate":"2024-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11603737/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142751494","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Identification of a machine learning-based diagnostic model for axial spondyloarthritis in rheumatological routine care using a random forest approach.","authors":"Imke Redeker, Styliani Tsiami, Jan Eicker, Uta Kiltz, David Kiefer, Ioana Andreica, Philipp Sewerin, Xenofon Baraliakos","doi":"10.1136/rmdopen-2024-004702","DOIUrl":"10.1136/rmdopen-2024-004702","url":null,"abstract":"<p><strong>Objectives: </strong>In axial spondyloarthritis (axSpA), early diagnosis is crucial, but diagnostic delay remains long and diagnostic criteria do not exist. We aimed to identify a diagnostic model that distinguishes patients with axSpA from patients without axSpA with chronic back pain based on clinical data in routine care.</p><p><strong>Methods: </strong>Clinical data from patients with chronic back pain were used, with information on rheumatological examinations based on clinical indications. The total dataset was randomly divided into training and test datasets at a 7:3 ratio. A machine learning-based model was built to distinguish axSpA from non-axSpA using the random forest algorithm. Overall accuracy, sensitivity, specificity and the area under the receiver operating characteristic curve-area under the curve (ROC-AUC) in the test dataset were calculated. The contribution of each variable to the accuracy of the model was assessed.</p><p><strong>Results: </strong>Data from 939 randomly selected patients were available: 659 diagnosed with axSpA and 280 with non-axSpA. In the test dataset, the model reached an accuracy of 0.9234, a sensitivity of 0.9586, a specificity of 0.8438 and a ROC-AUC of 0.9717. Human leucocyte antigen B27 (HLA-B27) contributed most to the accuracy of the model; that is, the accuracy would suffer most from not using HLA-B27, followed by insidious onset of back pain and erosions in the sacroiliac joint.</p><p><strong>Conclusions: </strong>We provide a machine learning-based model that reveals high performance in diagnosing patients with chronic back pain with axSpA versus without axSpA based on information from a tertiary rheumatology practice. This model has the potential to improve diagnostic delay in patients with axSpA in daily routine settings.</p>","PeriodicalId":21396,"journal":{"name":"RMD Open","volume":"10 4","pages":""},"PeriodicalIF":5.1,"publicationDate":"2024-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11603692/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142751486","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Performance of the EULAR Systemic sclerosis Impact of Disease (ScleroID) questionnaire as a patient-reported outcome measure for patients with diffuse systemic sclerosis.","authors":"Rucsandra Dobrota, Alexandru Garaiman, Kim Fligelstone, Ann Tyrrell Kennedy, Annelise Roennow, Yannick Allanore, Patricia E Carreira, László Czirják, Chris Denton, Roger Hesselstrand, Gunnel Sandqvist, Otylia Kowal-Bielecka, Cosimo Bruni, Marco Matucci-Cerinic, Carina Mihai, Ana Maria Gherghe, Ulf Mueller-Ladner, Tore Kvien, Turid Heiberg, Oliver Distler, Mike Oliver Becker","doi":"10.1136/rmdopen-2024-004653","DOIUrl":"10.1136/rmdopen-2024-004653","url":null,"abstract":"<p><strong>Objective: </strong>Systemic sclerosis Impact of Disease (ScleroID) is the first comprehensive patient-reported outcome measure (PROM) specifically developed for systemic sclerosis (SSc). We investigated the performance of ScleroID in patients with diffuse cutaneous SSc (dcSSc), as a prerequisite for its use in randomised controlled trials (RCTs) testing potentially disease-modifying drugs.</p><p><strong>Methods: </strong>All patients with dcSSc from the large, multicentric, ScleroID cohort were included. SSc-Health Assessment Questionnaire (HAQ), EuroQol-5 Dimensions and 36-item Short Form Health Survey (SF-36) were used as comparators. The study includes a longitudinal arm with a reliability visit at 7±3 days and a 12 months follow-up visit. The performance of ScleroID in dcSSc was assessed according to the Outcome Measures in Rheumatology filter.</p><p><strong>Results: </strong>In total, 152 dcSSc patients were analysed (29% male, median age 54 years). ScleroID reflected well the disease impact of dcSSc, showing a good construct validity with high Spearman's correlation coefficients with comparators (SSc-HAQ, 0.79, 95% CI (0.69, 0.86); HAQ-Disability Index, 0.72 95% CI (0.60, 0.80); SF-36 physical score, -0.69 95% CI (-0.77, -0.60)). The internal consistency was strong (Cronbach's alpha 0.87, split-half reliability coefficient 0.88).In the longitudinal arm, 44 patients had a reliability visit and 113 had a follow-up visit, of whom 19/113 (17%) reported a significant change (11 improved, 8 worsened). ScleroID showed a good consistency and discriminative ability with excellent test-retest reliability (intraclass correlation coefficient 0.89, 95% CI (0.84, 0.92)) and moderate sensitivity to change (standardised response mean -0.63 in the improved subgroup and 0.48 in the worsened subgroup), but superior to the comparators.</p><p><strong>Conclusion: </strong>The European Alliance of Associations for Rheumatology (EULAR) ScleroID performs well for patients with dcSSc. This supports its inclusion and regular assessment as PROM in RCTs.</p>","PeriodicalId":21396,"journal":{"name":"RMD Open","volume":"10 4","pages":""},"PeriodicalIF":5.1,"publicationDate":"2024-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11603699/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142751490","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Inflammatory biomarker analysis confirms reduced disease severity in heterozygous patients with familial Mediterranean fever.","authors":"Inès Elhani, Stefan Backes, Tilmann Kallinich, Gayane Amaryan, Alexandre Belot, Rainer Berendes, Thomas Berger, Frank Dressler, Dirk Foell, Sabrina Fühner, Arnd Giese, Claas Hinze, Anna Lisa Hitzegrad, Gerd Horneff, Annette Jansson, Jens Klotsche, Elke Lainka, Tim Niehues, Prasad Oommen, Johannes-Peter Haas, Christoph Rietschel, Katerina Theodoropoulo, Caroline Vinit, Elisabeth Weissbarth-Riedel, Véronique Hentgen, Helmut Wittkowski","doi":"10.1136/rmdopen-2024-004677","DOIUrl":"10.1136/rmdopen-2024-004677","url":null,"abstract":"<p><strong>Introduction: </strong>Familial Mediterranean fever (FMF) is a genetic disease leading to recurrent episodes of inflammation. Two pathogenic variants are required for classical disease, but the disease can occur in heterozygous patients. Patients are treated continuously with colchicine to prevent amyloid A (AA) amyloidosis, including heterozygous patients who display a moderate form of FMF and rarely develop AA amyloidosis. The need for lifelong colchicine treatment in heterozygous FMF is therefore controversial. We aimed to characterise genotype-specific levels of inflammatory biomarkers, and to focus on heterozygous patients who discontinued colchicine.</p><p><strong>Methods: </strong>All patients with FMF from the European databases AIDnet and JIRcohort who received colchicine during follow-up were included. Demographics, C reactive protein (CRP), serum amyloid A (SAA), S100A8/A9 and S100A12 levels, leucocyte and neutrophil counts were extracted. Visits were classified as active, subclinical or inactive according to symptoms, CRP and SAA levels.</p><p><strong>Results: </strong>Data from 747 patients were extracted (233 homozygous, 201 compound heterozygous, 224 heterozygous patients, 49 heterozygous with one class III variant and 40 compound heterozygous with two class III variants). During active visits, all biomarker levels were higher compared with inactive visits (p<0.001). Heterozygous patients showed lower levels of CRP, SAA, S100A8/A9 and S100A12 during inactive and subclinical visits than patients with two class IV-V variants. Colchicine was discontinued in 52 heterozygous patients and reintroduced in 23 of them (44%).</p><p><strong>Conclusion: </strong>S100A8/A9 and S100A12 proteins are biomarkers that can be used to assess disease activity. Heterozygous patients have lower levels of inflammatory biomarkers and some of them can sustainably discontinue colchicine treatment.</p>","PeriodicalId":21396,"journal":{"name":"RMD Open","volume":"10 4","pages":""},"PeriodicalIF":5.1,"publicationDate":"2024-11-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11590780/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142710368","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Stability of symptom-based subtypes in Sjogren's disease.","authors":"Joe Scott Berry, Jessica Tarn, John Casement, Dennis Lendrem, Kyle Thompson, Xavier Mariette, Jacques-Eric Gottenberg, Wan-Fai Ng","doi":"10.1136/rmdopen-2024-004914","DOIUrl":"10.1136/rmdopen-2024-004914","url":null,"abstract":"<p><strong>Objectives: </strong>The Newcastle Sjogren's Stratification Tool (NSST) stratifies Sjogren's disease patients into four subtypes. Understanding the stability of the subtypes is vital if symptom-based stratification is to be more broadly adopted. In this study, we stratify patients longitudinally to understand how symptom-based subtypes vary over time and factors influencing subtype change.</p><p><strong>Methods: </strong>274 patients from the United Kingdom Primary Sjögren's Syndrome Registry (UKPSSR) with data permitting NSST subtype assignment from two study visits were included. The French Assessment of Systemic Signs and Evolution of Sjogren's Syndrome (ASSESS) cohort (n=237) acted as an independent comparator. Group analyses of significant differences were performed, with logistic regression models used to assess covariates of subtype stability.</p><p><strong>Results: </strong>UKPSSR and ASSESS cohorts showed a broadly similar proportion of subjects in each subtype and similar baseline clinical characteristics except body mass index (BMI). Several baseline characteristics differ significantly between the subtypes, most notably anti-Ro status and BMI. Subtype membership was reasonably stable in both cohorts with 60% and 57% retaining subtype. The high-symptom burden subtype was the most stable over time with 70% and 67% retaining subtype. Higher baseline probability score was the greatest predictor of subtype stability with higher C4 levels, antidepressant use, and a higher CCI score also predicting increased stability.</p><p><strong>Conclusion: </strong>NSST subtype membership remains stable over time in a large proportion of patients. When subtype transition is associated with factors at baseline, it is most strongly associated with an uncertain subtype allocation. Our findings support the hypothesis that symptom-based subtypes reflect genuine pathobiological endotypes and therefore maybe important to consider in trial design and clinical management.</p>","PeriodicalId":21396,"journal":{"name":"RMD Open","volume":"10 4","pages":""},"PeriodicalIF":5.1,"publicationDate":"2024-11-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11590857/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142710698","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction: Long-term safety and efficacy of anti-TNF multivalent VHH antibodies ozoralizumab in patients with rheumatoid arthritis.","authors":"","doi":"10.1136/rmdopen-2024-004480corr1","DOIUrl":"10.1136/rmdopen-2024-004480corr1","url":null,"abstract":"","PeriodicalId":21396,"journal":{"name":"RMD Open","volume":"10 4","pages":""},"PeriodicalIF":5.1,"publicationDate":"2024-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11590788/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142693146","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Biomechanical determinants of rheumatoid arthritis severity and excess cardiovascular disease: common origins of two complex diseases.","authors":"Stephen Philip Oakley, Samantha Stott, Kerri Gill, Lyanne Weston","doi":"10.1136/rmdopen-2024-004524","DOIUrl":"10.1136/rmdopen-2024-004524","url":null,"abstract":"<p><strong>Objectives: </strong>The determinants of rheumatoid arthritis (RA) severity and excess cardiovascular disease (CVD) are incompletely understood. Biomechanical factors are known to influence RA severity. Articular stiffness correlates with arterial and skin stiffness. This study explored the hypothesis that constitutional stiffness is a common determinant of RA severity and excess CVD.</p><p><strong>Methods: </strong>Fifty-eight patients with anti-CCP antibody (ACPA) positive RA and 57 controls were enrolled noting age, sex, body mass index, alcohol and tobacco exposure, Shared Epitope status and in RA disease duration, disease activity, ACPA titre and radiographic damage. Severe RA was defined as radiographic progression >1.3 mSharp points/year or requiring biological disease-modifying antirheumatic drugs (bDMARDs). Articular stiffness (Beighton Score and right 5th metacarpophalangeal (MCP) joint stress-strain responses), carotid-femoral pulse wave velocity and skin extensibility (percent increase distance two dots with manual traction dorsum right hand) were assessed.</p><p><strong>Results: </strong>Right 5th MCP stiffness correlated with Beighton Score and with arterial and skin stiffness. High radiographic rate was associated with greater MCP articular (t test p 0.014), arterial (p 0.044) and, in RA <5 years duration, greater skin stiffness (p 0.002) with similar trends in subjects requiring bDMARDs. In RA, arterial stiffness correlated with age (ß p<0.005), articular (ß p<0.001) and skin stiffness (ß p 0.037) and inversely with alcohol consumption (p 0.035).</p><p><strong>Conclusions: </strong>Articular, arterial and skin stiffness correlated with each other and with RA severity. As skin is not affected by RA, this association suggests that constitutional stiffness might be a common determinant of RA and CVD. Prospective studies of at-risk preclinical and early RA are required to determine if this relationship is causal.</p><p><strong>Trials registration number: </strong>ACTRN12617000170325.</p>","PeriodicalId":21396,"journal":{"name":"RMD Open","volume":"10 4","pages":""},"PeriodicalIF":5.1,"publicationDate":"2024-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11590849/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142693054","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}