RMD Open最新文献

{"title":"Getting prepared for the silver wave: challenges in conducting rheumatic and musculoskeletal disease research in older adults.","authors":"Saskia Truijen, Shennah Austen, Fabienne Magdelijns, Annelies Boonen, Marloes van Onna","doi":"10.1136/rmdopen-2024-005280","DOIUrl":"10.1136/rmdopen-2024-005280","url":null,"abstract":"<p><p>Research in older adults diagnosed with rheumatic and musculoskeletal diseases (RMDs) comes with unique challenges, as these patients often face consequences of ageing, such as multimorbidity, polypharmacy, and geriatric syndromes (eg, frailty). In this viewpoint, we highlight various clinical, ethical, regulatory and logistical challenges, including, among others, issues with the decision-making capacity of older adults regarding study participation. We emphasise the need for feasible strategies and protocols to enhance research inclusivity in order to ultimately improve evidence-based care for the growing population of older adults with RMDs.</p>","PeriodicalId":21396,"journal":{"name":"RMD Open","volume":"11 1","pages":""},"PeriodicalIF":5.1,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11873332/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143531412","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":"EducAR: implementing a multicomponent strategy to improve therapeutic adherence in rheumatoid arthritis.","authors":"María Ahijón Lana, Francisca Sivera Mascaró, Antonio Fernández-Nebro, Sara Muntadas Castelló, Marina Pérez, Teresa Otón, María Jesús García de Yébenes, Loreto Carmona","doi":"10.1136/rmdopen-2024-004989","DOIUrl":"10.1136/rmdopen-2024-004989","url":null,"abstract":"<p><strong>Introduction: </strong>The EULAR points to consider (PtC) for reducing non-adherence need implementation.</p><p><strong>Objectives: </strong>To design, implement and evaluate a strategy based on the PtC to improve treatment adherence in rheumatoid arthritis (RA).</p><p><strong>Methods: </strong>A multidisciplinary panel cocreated an intervention that was subsequently tested in a cluster trial, where centres were randomised to access the developed intervention or follow the standard of care (SOC). 6-month initiation and implementation adherence were measured in consecutive patients with <2 years of RA. The results were discussed among the centres assigned to the intervention to explore barriers and facilitators to implementation.</p><p><strong>Results: </strong>The intervention was a two-sided website. The items on the patient site mainly addressed disease and treatment education, self-management and peer support. The healthcare professional site has tutorials on communication to improve trust and adherence, plus shared decision-making aids. It was tested in 141 RA patients (67 control and 74 intervention). Both groups increased adherence at 6 months, mainly in the control group (48% to 67% vs 42% to 47% in the intervention group). Implementation had been very low in relation to barriers identified as lack of time, inadequate focus (exclusively for nurses) and consideration of the current SOC as adequate.</p><p><strong>Conclusion: </strong>Despite designing an intervention based on the best evidence, the results were inconclusive; the lack of a detected effect could be explained by the limited implementation, which was insufficient for the complexity of the changes required (change of culture).</p><p><strong>Trial register number: </strong>ClinicalTrials.gov ID NCT05425485.</p>","PeriodicalId":21396,"journal":{"name":"RMD Open","volume":"11 1","pages":""},"PeriodicalIF":5.1,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11873333/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143531281","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":"Validation of a semi-quantitative method to assess interstitial lung disease severity and progression in systemic sclerosis by standard and low-dose HRCT scans.","authors":"Lucas Tschalèr, Suzana Jordan, Trond Mogens Aaløkken, Mike Becker, Cathrine Brunborg, Cosimo Bruni, Christian Clarenbach, Rucsandra Dobrota, Michael Thomas Durheim, Muriel Elhai, Thomas Frauenfelder, Håvard Fretheim, Torhild Garen, Oyvind Midtvedt, Carina Mihai, Øyvind Molberg, Oliver Distler, Anna-Maria Hoffmann-Vold","doi":"10.1136/rmdopen-2024-004938","DOIUrl":"10.1136/rmdopen-2024-004938","url":null,"abstract":"<p><strong>Background: </strong>While the presence of distinct imaging abnormalities by high-resolution CT (HRCT) defines interstitial lung disease (ILD), there is a relative lack of validated methods to quantify these abnormalities in clinical practice, limiting ILD severity and progression assessments. We aimed to validate a semi-quantitative method for lung fibrosis assessment in patients with systemic sclerosis associated ILD (SSc-ILD) by standard and low-dose HRCT, considering lung structure and function as integral components of ILD evaluation.</p><p><strong>Methods: </strong>SSc patients from Oslo and Zurich with HRCT images, pulmonary function tests, including forced vital capacity (FVC), diffusing capacity for carbon monoxide (DLCO) and the 6-minute walk test with oxygen (O₂) desaturation were enrolled. We validated the semi-quantitative fibrosis extent method by HRCT using criteria for content and construct validity, discrimination, sensitivity to change and feasibility, as well as inter- and intra-rater variability.</p><p><strong>Results: </strong>65 SSc patients from Zurich and 90 from Oslo were included. Significant correlations were observed between the extent of fibrosis on HRCT and FVC (r=-0.517, p<0.001), DLCO (r=-0.400, p<0.001) and O₂ desaturation (r=-0.500, p<0.001), indicating content, construct and criterion validity. Discrimination and sensitivity to change assessments showed moderate correlation with DLCO (r=-0.377, p=0.003) but not with FVC or O₂ desaturation. Inter- and intra-rater variability demonstrated excellent reliability (κ=0.891 and κ=0.996, respectively), with HRCT quantification averaging 9-15 min, indicating high feasibility.</p><p><strong>Conclusion: </strong>This study confirms that semi-quantitative fibrosis assessment of HRCT for SSc-ILD meets most validation criteria, supporting its use in clinical practice and showing additive value of structural to functional ILD assessment.</p>","PeriodicalId":21396,"journal":{"name":"RMD Open","volume":"11 1","pages":""},"PeriodicalIF":5.1,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11873339/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143531428","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":"Association of peripheral CD8⁺ T cell activation with disease activity and treatment resistance in systemic lupus erythematosus.","authors":"Yuya Fujita, Shingo Nakayamada, Satoshi Kubo, Yusuke Miyazaki, Koshiro Sonomoto, Hiroaki Tanaka, Yoshiya Tanaka","doi":"10.1136/rmdopen-2024-005122","DOIUrl":"10.1136/rmdopen-2024-005122","url":null,"abstract":"<p><strong>Objective: </strong>Various immune-cell subsets intricately mediate the pathogenesis of systemic lupus erythematosus (SLE). However, the role of CD8⁺ T cells in SLE remains unclear. We investigated the proportions and characteristics of peripheral CD8⁺ T cells and their association with clinical manifestations of SLE.</p><p><strong>Methods: </strong>We retrospectively enrolled 211 patients with SLE and 48 age- and sex-matched healthy controls (HCs). Peripheral CD8⁺ T cells were analysed using flow cytometry. The primary endpoint was the comparison of peripheral CD8⁺ T cell subset characteristics between patients and HCs.</p><p><strong>Results: </strong>Patients with SLE (mean age, 42.3 years; women, 89% and mean disease duration, 112.8 months) had significantly higher proportions of naïve CD8⁺ T cells (CCR7⁺CD45RA⁺), CD8⁺ terminally differentiated effector memory cells (CCR7^-CD45RA⁺) and activated CD8⁺ T cells (CD38⁺HLA-DR⁺) in peripheral blood mononuclear cells than HCs (p<0.001). Activated CD8 <b>⁺</b> T cells produced granzyme B and interferon-γ, which correlated with serum double-stranded (ds) DNA antibodies (rs=0.3146, p<0.0001) and 50% haemolytic unit of complement (rs=-0.3215, p=0.0003), and were significantly increased in patients with active systemic, renal or haematological involvement (p<0.05). Cluster analysis-based subgroup classification based on CD8 cell differentiation and activation revealed a group with high numbers of activated CD8⁺ T cells, highly active SLE and organ damage, including active nephritis and persistently high cell counts after a 24-week treatment, indicating treatment resistance (high anti-dsDNA antibody titres and high glucocorticoid doses).</p><p><strong>Conclusion: </strong>In SLE, greater proportions of highly cytotoxic and proinflammatory activated CD8⁺ T cells in peripheral blood-modulated disease activity, organ damage and residual treatment resistance, presenting a potential treatment target.</p>","PeriodicalId":21396,"journal":{"name":"RMD Open","volume":"11 1","pages":""},"PeriodicalIF":5.1,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11865784/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143516621","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":"Impact of an intervention for osteoarthritis based on exercise and education on metabolic health: a register-based study using the SOAD cohort.","authors":"Simone Battista, Filippo Recenti, Ali Kiadaliri, Stefan Lohmander, Thérése Jönsson, Allan Abbott, Johanna Vinblad, Ola Rolfson, Martin Englund, Andrea Dell'Isola","doi":"10.1136/rmdopen-2024-005133","DOIUrl":"10.1136/rmdopen-2024-005133","url":null,"abstract":"<p><strong>Objective: </strong>This study evaluated the effects of a 6-week osteoarthritis (OA) exercise and education intervention on metabolic health markers, including blood pressure (BP), glycated haemoglobin (HbA1c), high-density lipoprotein (HDL), cholesterol levels and weight in individuals with both OA and diabetes.</p><p><strong>Methods: </strong>Data originated from the Swedish Osteoarthritis and Diabetes cohort, which is composed of the Swedish Osteoarthritis Register (SOAR) and National Diabetes Register. We included individuals diagnosed with OA and diabetes who underwent the intervention between January 2008 and December 2019, matched with controls with diabetes who did not based on birth year, sex, OA site (hip/knee) and OA diagnosis year. Outcomes included BP, HbA1c, HDL, total cholesterol levels and weight measured up to 3 years before and after SOAR enrolment. Statistical analyses used two-way fixed-effect models.</p><p><strong>Results: </strong>The study included 4571 individuals with OA and diabetes (mean age: 69.5, SD: 7.8; women: 52.7%; knee OA: 71.2%) and 7925 controls. The intervention group showed a systolic BP decrease of approximately 1.0 mm Hg at 6 and 12 months compared with the control group. HDL levels increased by about 0.02 mmol/L at 12, 18 and 24 months. Weight decreased by approximately 0.5 kg at 6, 18 and 30 months. HbA1c levels increased by approximately 0.5 mmol/mol at 6 months. No essential differences were found in the total cholesterol levels.</p><p><strong>Conclusion: </strong>An OA exercise and education intervention designed following OA clinical practice guidelines led to small and unlikely clinically relevant improvements in metabolic health markers in individuals with OA and diabetes.</p>","PeriodicalId":21396,"journal":{"name":"RMD Open","volume":"11 1","pages":""},"PeriodicalIF":5.1,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11865791/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143516622","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":"Lung ultrasound outperforms symptom-based screening to detect interstitial lung disease associated with rheumatoid arthritis.","authors":"Marie Vermant, Alexandros Kalkanis, Joseph Jacob, Tinne Goos, Emanuela Elsa Cortesi, Heleen Cypers, Nico De Crem, Tine Follet, Stefan Gogaert, Barbara Neerinckx, Veerle Taelman, Nathalie Veyt, Laurens J De Sadeleer, Patrick Verschueren, Wim Wuyts","doi":"10.1136/rmdopen-2024-005283","DOIUrl":"10.1136/rmdopen-2024-005283","url":null,"abstract":"<p><strong>Objectives: </strong>Interstitial lung disease associated with rheumatoid arthritis (RA-ILD) is linked to high mortality. Currently, effective screening tools are lacking. We assessed the role of symptoms and lung ultrasound (LUS) as potential screening tools.</p><p><strong>Methods: </strong>116 adult patients with RA presenting to the rheumatology outpatient clinic underwent high-resolution CT (HRCT) scans, pulmonary function tests, LUS (72 zones) and completed a Visual Analogue Scale (VAS) for cough and modified Medical Research Council dyspnoea scale (mMRC). Kruskal-Wallis (KW) tests evaluated the correlation between clinical-radiological HRCT score (no ILD, non-specific abnormalities, subclinical ILD or ILD) and the B-lines on LUS, diffusion capacity (DLCO%pred), forced vital capacity (FVC%pred), VAS Cough and mMRC. Sensitivity and specificity analyses were performed to assess symptom-based questionnaires and the number of B-lines to detect RA-ILD. Area under the receiver operating characteristics (AUROC) for detecting clinical ILD and subclinical ILD were calculated.</p><p><strong>Results: </strong>In 11.8% of patients, an ILD was detected on HRCT. Additionally, in 5%, a diagnosis of subclinical interstitial lung changes was made. The number of B-lines was most strongly associated with the clinical-radiological score (KW χ²=41.2, p=<0.001). DLCO%pred was also significantly correlated with the clinical-radiological score (KW χ²=27.4, p=<0.001), but FVC%pred, mMRC and VAS cough were not. Cough and dyspnoea only weakly predicted the ILD score in the sensitivity-specificity analyses, while B-lines showed AUROCs>0.9 for predicting subclinical and clinical ILD.</p><p><strong>Conclusion: </strong>LUS is a promising tool for early detection of RA-ILD, outperforming symptom-based questionnaires or the presence of dyspnoea or cough.</p>","PeriodicalId":21396,"journal":{"name":"RMD Open","volume":"11 1","pages":""},"PeriodicalIF":5.1,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12083264/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143516623","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":"Targeting the IL-17A pathway for therapy in early-stage tendinopathy.","authors":"Neal L Millar, Iain B McInnes, Frank Kolbinger, Friedrich Raulf, Moeed Akbar, Yufei Li, Nicolau Beckmann, Nathalie Accart, Olivier Leupin, Claudio Calonder, Matthias Schieker, Michaela Kneissel, Christian Bruns, Richard M Siegel, Eckhard Weber","doi":"10.1136/rmdopen-2024-004729","DOIUrl":"10.1136/rmdopen-2024-004729","url":null,"abstract":"<p><strong>Objectives: </strong>Tendinopathy is a frequent clinical problem and represents an extraordinary health economic and socioeconomic burden with high unmet medical needs. Recent clinical evidence suggests blockade of interleukin 17A (IL-17A) for tendinopathy therapy. The present preclinical study elucidates the biological mechanisms of IL-17A pathway stimulation and blockade in tendinopathy.</p><p><strong>Methods: </strong>We explored whether IL-17A and other IL-17 family members are differentially expressed in biopsies of healthy, early-stage and late-stage tendinopathic human rotator cuff tendons using RT-qPCR. IL-17 pathway signature genes in healthy human tendon-derived cells were identified following IL-17A stimulation using AmpliSeq RNA. The molecular, structural and functional consequences of IL-17A pathway stimulation were explored in healthy human tendon-derived cells and in a rat tendon fascicle model ex vivo. The effects of IL-17A pathway blockade were investigated in a rat model of rotator cuff tendinopathy in vivo.</p><p><strong>Results: </strong>We provide evidence of differential expression of IL-17A mRNA (<i>IL17A</i>) versus other IL-17 family members in human rotator cuff early-stage tendinopathy. In human tendon-derived cells, stimulation with IL-17A induced the expression of the selected IL-17A pathway signature genes <i>NFKBIZ, ZC3H12A, CXCL1, IL6, MMP3</i>. Expression was inhibited by IL-17A blockade. In the rat ex vivo and in vivo models, IL-17A blockade alleviated inflammatory immune effector release, tendon structural degeneration, tendon inflammation and impaired tendon function.</p><p><strong>Conclusion: </strong>Our data provide evidence that IL-17A is a key contributor to the pathogenesis of tendinopathy by promoting tendon inflammation and degeneration and that IL-17A blockade may represent a potential therapy in early-stage tendinopathy.</p>","PeriodicalId":21396,"journal":{"name":"RMD Open","volume":"11 1","pages":""},"PeriodicalIF":5.1,"publicationDate":"2025-02-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11881027/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143483954","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":"Incidence of rheumatoid arthritis in Austria: a prospective population-based cohort study in a federal province.","authors":"Rudolf Puchner, Judith Sautner, Valentin Ritschl, Herwig Pieringer, Alois Alkin, Lorenz Balcar, Yvonne Rammer, Sabine Schumacher, Tanja A Stamm","doi":"10.1136/rmdopen-2024-005331","DOIUrl":"10.1136/rmdopen-2024-005331","url":null,"abstract":"<p><strong>Objective: </strong>When it comes to prospective studies on the incidence of rheumatoid arthritis (RA), the Norfolk study from 1994 is still frequently cited as prospective incidence data by many countries lacking comprehensive RA registries, including Austria. The aim of this study was, therefore, to gather robust data on the incidence of RA among Austrian adults for the first time.</p><p><strong>Methods: </strong>All Upper Austrian rheumatologists reported newly diagnosed RA patients with symptom onset between 2016 and 2018, together with demographic data, laboratory and radiographic results. Cases still unclear at the end of 2018 were tracked in an extended observation period until 2023.</p><p><strong>Results: </strong>In total, 701 RA cases were reported. 583 complete patient datasets were analysed. In all 551 individuals with a mean age of 60.2 (±14.2) years, 359 (65.2%) being females, the diagnosis of RA was ascertained clinically by a rheumatologist, optionally applying RA-classification criteria. Across all 3 years, the annual RA incidence rate was 14.9/100 000 (95% CI 12.9 to 17.3), ranging from 20.0/100 000 (95% CI 17.6 to 22.7) in 2016 to 13.5/100 000 (95% CI 11.5 to 15.7) in 2017 and 11.3/100 000 (95% CI 9.5 to 13.3) in 2018. The incidence was highest in individuals >65 years (21.6/100 000, 95% CI 16.4 to 27.9). Women had a higher RA incidence (18.1/100 000, 95% CI 14.9 to 21.7) than men (10.4/100 000, 95% CI 8.0 to 13.3).</p><p><strong>Conclusions: </strong>This study provided prospective population-based data on the incidence of RA in Austrian adults for the first time. Incidence rates were comparable with other European countries. Compared with the Norfolk study, we found lower rates in both genders, more pronounced in females, however.</p>","PeriodicalId":21396,"journal":{"name":"RMD Open","volume":"11 1","pages":""},"PeriodicalIF":5.1,"publicationDate":"2025-02-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11848685/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143483952","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":"Continued nintedanib in patients with systemic sclerosis-associated interstitial lung disease: 3-year data from SENSCIS-ON.","authors":"Yannick Allanore, Madelon C Vonk, Oliver Distler, Arata Azuma, Maureen D Mayes, Alexandra James, Veronika Kohlbrenner, Margarida Alves, Dinesh Khanna, Kristin B Highland","doi":"10.1136/rmdopen-2024-005086","DOIUrl":"10.1136/rmdopen-2024-005086","url":null,"abstract":"<p><strong>Objective: </strong>We assessed adverse events and changes in forced vital capacity (FVC) in patients treated with open-label nintedanib over 148 weeks of SENSCIS-ON, the extension of the SENSCIS trial.</p><p><strong>Methods: </strong>Adverse events and changes in FVC over 148 weeks of SENSCIS-ON were assessed in patients who received nintedanib in SENSCIS and continued nintedanib in SENSCIS-ON ('continued nintedanib' group) and in patients who received placebo in SENSCIS or received nintedanib for ≤28 days in a drug-drug interaction study and then received nintedanib in SENSCIS-ON ('initiated nintedanib' group).</p><p><strong>Results: </strong>The continued nintedanib group comprised 197 patients, and the initiated nintedanib group comprised 247 patients (231 from SENSCIS). Diarrhoea was the most frequent adverse event, reported in 152 (77.2%) and 183 (74.1%) patients in the continued nintedanib and initiated nintedanib groups, respectively. Among patients in the continued and initiated nintedanib groups, respectively, 53 (26.9%) and 148 (59.9%) had ≥1 dose reduction, 72 (36.5%) and 131 (53.0%) had ≥1 treatment interruption and 29 (14.7%) and 72 (29.1%) had adverse events that led to treatment discontinuation. Mean (SE) changes in FVC (mL) at week 148 were -189.1 (29.5) in the continued nintedanib group and -126.4 (26.4) in the initiated nintedanib group.</p><p><strong>Conclusion: </strong>The safety profile of nintedanib over 148 weeks of SENSCIS-ON was consistent with that reported in SENSCIS. Changes in FVC during SENSCIS and SENSCIS-ON supported a continued effect of nintedanib on slowing the decline in lung function, but showed continued progression of SSc-ILD.</p>","PeriodicalId":21396,"journal":{"name":"RMD Open","volume":"11 1","pages":""},"PeriodicalIF":5.1,"publicationDate":"2025-02-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11848673/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143483950","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":"Comprehensive risk assessment for pulmonary manifestations in systemic lupus erythematosus: a large-scale Korean population-based longitudinal study.","authors":"Bo-Guen Kim, Jiyeong Kim, Yeonghee Eun, Dong Won Park, Sang-Heon Kim, Hyun Lee","doi":"10.1136/rmdopen-2024-005267","DOIUrl":"10.1136/rmdopen-2024-005267","url":null,"abstract":"<p><strong>Objectives: </strong>Pulmonary involvement is common in systemic lupus erythematosus (SLE), but the relative risk of pulmonary manifestations in SLE versus non-SLE subjects remains unclear. This study aimed to evaluate the risk of pulmonary manifestations in SLE subjects compared with matched controls.</p><p><strong>Methods: </strong>Using data from the Korean National Health Insurance Service (2009-2017), we identified 6074 individuals aged ≥20 years with newly diagnosed SLE and 60 740 matched controls by age and sex (1:10 ratio) who did not have prior pulmonary manifestations.</p><p><strong>Results: </strong>Over a mean follow-up of 9.3±2.7 years, the incidence of pulmonary manifestations was 15.2 per 1000 person-years in the SLE cohort and 4.5 per 1000 person-years in the matched cohort. The SLE cohort had a significantly higher risk of pulmonary manifestations (adjusted HR (aHR) 3.26; 95% CI 2.99 to 3.56). The highest risk was observed for pulmonary hypertension (aHR 14.66; 95% CI 9.43 to 22.80), followed by interstitial lung disease (aHR 9.58; 95% CI 7.99 to 11.49), pleural disorders (aHR 3.29; 95% CI 2.84 to 3.81), pulmonary embolism (aHR 2.66; 95% CI 2.06 to 3.43), tuberculosis (aHR 2.35; 95% CI 1.88 to 2.93), acute respiratory distress syndrome and haemorrhage (aHR 1.85; 95% CI 1.51 to 2.25) and lung cancer (aHR 1.41; 95% CI 1.02 to 1.95).</p><p><strong>Conclusions: </strong>Subjects with SLE have an approximately 3.3-fold higher risk of pulmonary manifestations compared with matched controls. Notably, the risks of pulmonary hypertension and interstitial lung disease are particularly elevated.</p>","PeriodicalId":21396,"journal":{"name":"RMD Open","volume":"11 1","pages":""},"PeriodicalIF":5.1,"publicationDate":"2025-02-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11848681/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143483948","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}