B Hanna, C L Polte, E Sakiniene, J von Brömsen, E Bollano, R Pullerits, T Jin
{"title":"Cardiovascular risk and cardiac involvement in idiopathic inflammatory myopathies: insights from a cross-sectional Swedish single-centre study.","authors":"B Hanna, C L Polte, E Sakiniene, J von Brömsen, E Bollano, R Pullerits, T Jin","doi":"10.1080/03009742.2025.2470011","DOIUrl":"10.1080/03009742.2025.2470011","url":null,"abstract":"<p><strong>Objective: </strong>We aimed to investigate the cardiovascular profile, including risk factors and cardiovascular abnormalities, in patients with idiopathic inflammatory myopathies (IIMs).</p><p><strong>Method: </strong>In this cross-sectional study, 109 IIM patients and 20 age- and gender-matched healthy controls were enrolled and underwent electrocardiographic and transthoracic echocardiographic examinations. We analysed blood levels of cardiac troponin I (cTnI) and N-terminal pro-brain natriuretic peptide (NT-proBNP), assessed IIM disease-specific features, and evaluated the medical history of cardiovascular risk factors. IIM patients were stratified into two groups: those with previous cardiac involvement and those without.</p><p><strong>Results: </strong>IIM patients had a higher body mass index (BMI) and a greater prevalence of diabetes mellitus and dyslipidaemia than healthy controls (p = 0.023, p = 0.024, and p = 0.042, respectively). They also showed significantly higher rates of arrhythmia, cardiac axis deviation, negative T-waves, and suspected pulmonary hypertension, along with elevated NT-proBNP levels (p = 0.041, p = 0.004, p = 0.041, p = 0.012, and p = 0.034, respectively). A significantly higher proportion (p = 0.037) of immune-mediated necrotizing myopathy (IMNM) subtype (50%) was found among IIM with previous cardiac involvement compared to those without (20%). cTnI levels were significantly higher in IIM with cardiac involvement than in IIM without cardiac involvement (p = 0.009).</p><p><strong>Conclusions: </strong>Cardiovascular complications in patients with IIM may result from an increased prevalence of traditional cardiovascular risk factors, such as higher BMI, diabetes mellitus, and dyslipidaemia, and/or from direct cardiac involvement, such as previous myocarditis. Cardiac involvement in IIM is notably associated with the IMNM subtype.</p>","PeriodicalId":21424,"journal":{"name":"Scandinavian Journal of Rheumatology","volume":" ","pages":"272-281"},"PeriodicalIF":2.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143624630","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
K B Lauridsen, K S Duch, A S Mortensen, R Cordtz, S Kristensen, M L Lund, L W Dreyer
{"title":"Sex differences in treatment response in patients with rheumatoid arthritis treated with tumour necrosis factor inhibitor: a cohort study from the DANBIO registry.","authors":"K B Lauridsen, K S Duch, A S Mortensen, R Cordtz, S Kristensen, M L Lund, L W Dreyer","doi":"10.1080/03009742.2025.2471713","DOIUrl":"10.1080/03009742.2025.2471713","url":null,"abstract":"<p><strong>Objective: </strong>The aim of this study was to investigate associations between sex and treatment response and persistence in patients with rheumatoid arthritis (RA) initiating their first tumour necrosis factor inhibitor (TNFi).</p><p><strong>Method: </strong>This Danish nationwide cohort study included RA-patients starting their first TNFi treatment between 2006 and 2022. Overall and age-specific treatment response was compared across sexes at 4 and 12 months. Treatment persistence was investigated using survival analysis.</p><p><strong>Results: </strong>In total, 7789 RA-patients were identified; 75% were females. Females had slightly smaller ∆DAS28-CRP compared to males after 12 months, mainly due to less reduction of swollen joint count (SJC) and CRP. At 12 months the crude proportion of males with good response was higher (62%) than in females (55%), adjusted RR 1.14 (95% confidence interval (CI) 1.06; 1.23). The adjusted hazard ratio for treatment termination within first year was 0.82 (95% CI 0.73; 0.92) in males versus females. The median treatment persistence for individuals aged <50 years was 1.6 years (95% CI 1.4; 1.8) in females and 3.2 years (95% CI 2.6; 4.0) in males. The same difference was not seen in patients aged > 50 years.</p><p><strong>Conclusion: </strong>Despite similar baseline disease activity, females had a lower chance than males of achieving good response 4 and 12 months after starting treatment with first TNFi. The sex difference in DAS28-CRP improvement is caused by a greater decrease in CRP and SJC among males. Further, females had an increased risk of discontinuation, especially among patients aged < 50 years.</p>","PeriodicalId":21424,"journal":{"name":"Scandinavian Journal of Rheumatology","volume":" ","pages":"252-262"},"PeriodicalIF":2.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143664481","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
B I Nce, M Bektas, Ü A Gülseren, E Ük, B Çelik, S Yüce, S Dadin, H Yazici, Y Yalçinkaya, B Artim-Esen, A Gül, S Kalayoglu-Bes Is Ik, M I Nanç
{"title":"Evaluation of therapeutic plasma exchange in anti-neutrophil cytoplasmic antibody-associated vasculitis in real-life settings: long-term results of propensity score matching analysis in high-risk patients.","authors":"B I Nce, M Bektas, Ü A Gülseren, E Ük, B Çelik, S Yüce, S Dadin, H Yazici, Y Yalçinkaya, B Artim-Esen, A Gül, S Kalayoglu-Bes Is Ik, M I Nanç","doi":"10.1080/03009742.2025.2470517","DOIUrl":"10.1080/03009742.2025.2470517","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the prognostic significance and safety of therapeutic plasma exchange (TPE) in patients with anti-neutrophil cytoplasmic antibody-associated vasculitis (AAV) with severe organ or system involvement.</p><p><strong>Method: </strong>Data of patients diagnosed with AAV between 2011 and 2021 were evaluated retrospectively. Patients with baseline estimated glomerular filtration rate (eGFR) ≤ 50 mL/min/1.73m<sup>2</sup> or diffuse alveolar haemorrhage (DAH) were included in the analysis (n = 71). Patients who underwent TPE were compared with others in the groups formed after two models of propensity score matching (PSM). Initial PSM was performed according to the presence of DAH, age, gender, eGFR, and BVAS. A data-driven approach was conducted for the second model.</p><p><strong>Results: </strong>In the initial PSM cohort (n = 48), the remission rate at 6 months was lower in the TPE group (p = 0.04). There were no significant differences in mortality and improvement of eGFR at 6 and 12 months. No severe complications due to TPE were observed. Rates of serious infections (SIs) and end-stage renal disease (ESRD) at 12 months were higher in the TPE group (p = 0.016 and 0.02, respectively). Data-driven PSM analysis (n = 44) revealed no significant differences between groups.</p><p><strong>Conclusion: </strong>We did not demonstrate a positive effect of TPE on remission, ESRD, and mortality in AAV in this study. Despite low short-term complication rates, the increased risk of SIs possibly associated with ESRD was remarkable. The limited long-term benefits of TPE should be carefully weighed against its associated risks when selecting patients for treatment.</p>","PeriodicalId":21424,"journal":{"name":"Scandinavian Journal of Rheumatology","volume":" ","pages":"282-291"},"PeriodicalIF":2.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143692903","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Q Zang, F Li, Y Ju, J Wang, J Luo, W Liu, T Ding, L He, L Mo
{"title":"Dysregulated serum lipid profile and atherosclerosis in untreated female Takayasu arteritis patients: a propensity score-matched analysis.","authors":"Q Zang, F Li, Y Ju, J Wang, J Luo, W Liu, T Ding, L He, L Mo","doi":"10.1080/03009742.2025.2488096","DOIUrl":"10.1080/03009742.2025.2488096","url":null,"abstract":"<p><strong>Objective: </strong>Recent studies suggest that dyslipidaemia may play a critical role in the progression of cardiovascular disease in Takayasu arteritis (TA), although the exact relationship between dyslipidaemia and TA disease activity remains unclear, which is the focus of this study.</p><p><strong>Method: </strong>We evaluated dyslipidaemia and atherosclerosis in a cohort of untreated female patients. Fifty untreated female patients with TA (median age 30 years) and 98 healthy controls matched for age and body mass index (median age 30 years) were assessed for lipid profiles [total cholesterol (TC), triglycerides (TG), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), apolipoprotein A1 (ApoA1), ApoB, ApoE, lipoprotein(a)], inflammatory markers [C-reactive protein (CRP), erythrocyte sedimentation rate (ESR)], and atherosclerotic plaque frequency.</p><p><strong>Results: </strong>TA patients exhibited significantly higher levels of TG and the non-HDL-C/HDL-C ratio than the control group, whereas TC, HDL-C, LDL-C, and ApoA1 levels were significantly lower. Pearson's correlation analysis indicated a positive correlation between CRP and ApoB, as well as the non-HDL-C/HDL-C ratio, and negative correlations with TG, HDL-C, and ApoA1. Atherosclerotic plaques were detected in 14.3% of the TA patients. Multivariate regression analysis revealed that the presence of atherosclerotic plaques was associated only with age, independent of inflammatory markers and lipoprotein levels.</p><p><strong>Conclusion: </strong>The results of this study indicate that untreated female TA patients exhibit a markedly dysregulated serum lipid profile. Atherosclerosis in early TA was not related to lipids or markers of inflammation.</p>","PeriodicalId":21424,"journal":{"name":"Scandinavian Journal of Rheumatology","volume":" ","pages":"302-310"},"PeriodicalIF":2.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144009876","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Baricitinib for skin vasculitis in primary Sjögren's disease: report of two cases.","authors":"G Hernández-Molina","doi":"10.1080/03009742.2025.2488098","DOIUrl":"10.1080/03009742.2025.2488098","url":null,"abstract":"","PeriodicalId":21424,"journal":{"name":"Scandinavian Journal of Rheumatology","volume":" ","pages":"316-318"},"PeriodicalIF":2.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144044226","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Late-onset Raynaud's phenomenon in a 90-year-old male with polymyalgia rheumatica.","authors":"A Nigro","doi":"10.1080/03009742.2025.2491875","DOIUrl":"10.1080/03009742.2025.2491875","url":null,"abstract":"","PeriodicalId":21424,"journal":{"name":"Scandinavian Journal of Rheumatology","volume":" ","pages":"319-321"},"PeriodicalIF":2.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143992636","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Non-inflammatory macrophages phagocytose and hydrolyse monosodium urate crystals in different stages of gout.","authors":"Y-J Huang, L-C Wang, C-P Wang, K-H Yu, C-F Kuo","doi":"10.1080/03009742.2025.2491176","DOIUrl":"10.1080/03009742.2025.2491176","url":null,"abstract":"<p><strong>Objective: </strong>Macrophages play a crucial role in gouty arthritis; however, the relationship between non-inflammatory macrophages (M0) and different stages of gout remains unclear. This study aimed to investigate the phagocytosis, hydrolysis, and subsequent cytokine secretion of monosodium urate (MSU) by non-inflammatory macrophages in patients in different stages of gout.</p><p><strong>Method: </strong>Non-inflammatory macrophages were derived from monocytes through stimulation with macrophage colony-stimulating factor (M-CSF) for a duration of 10 days. The study included patients with asymptomatic hyperuricaemia, intercritical gout, tophaceous gout, and a normal control group. The phagocytic and hydrolytic capabilities of non-inflammatory macrophages were measured using flow cytometry based on the increase in side-scatter area. In addition, to evaluate the relationship between the hydrolysis capability of non-inflammatory macrophages and subsequent inflammation, we cultured them with lipopolysaccharide (LPS) and/or MSU.</p><p><strong>Results: </strong>We discovered that M0 macrophages were capable of phagocytosing and hydrolysing MSU crystals in various stages of gout, including the control group. Patients with asymptomatic hyperuricaemia exhibited the most pronounced phagocytic and hydrolytic capabilities, surpassing even those of the normal control group. The presence of MSU alone did not induce the secretion of pro-inflammatory cytokines. However, in experiments where M0 macrophages were stimulated with LPS and/or MSU, the phagocytic and hydrolytic abilities of M0 macrophages were correlated with inflammatory cytokine elevation.</p><p><strong>Conclusion: </strong>The efficient phagocytosis and hydrolysis of MSU crystals by M0 macrophages suggest their role in maintaining the non-inflammatory stage of gout. Our findings suggest that non-inflammatory macrophages play a role in gout.</p>","PeriodicalId":21424,"journal":{"name":"Scandinavian Journal of Rheumatology","volume":" ","pages":"292-301"},"PeriodicalIF":2.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144010157","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
A-S Sjö, K Ulin, E Klingberg, U Bergsten, I Gjertsson, A Bilberg
{"title":"From confusion to acceptance: overcoming challenges using a fighting spirit and the power of support - a qualitative study of young adults' experiences in the first year after diagnosis in early onset of chronic inflammatory joint disease.","authors":"A-S Sjö, K Ulin, E Klingberg, U Bergsten, I Gjertsson, A Bilberg","doi":"10.1080/03009742.2025.2513108","DOIUrl":"https://doi.org/10.1080/03009742.2025.2513108","url":null,"abstract":"<p><strong>Objective: </strong>Becoming ill with a chronic disease during young adulthood is characterized by significant physical, psychological, and psychosocial transformations. These dynamic changes can add to the complexity of managing a newly diagnosed chronic disease. The aim of this study was to explore how young adults experienced and managed the disease and daily life during the first year after being diagnosed with a chronic inflammatory joint disease (IJD).</p><p><strong>Method: </strong>A qualitative interview study based on semi-structured interviews was conducted and then interpreted using qualitative content analysis, including both manifest content and interpretations of underlying latent meaning. A total of 14 young adults (eight women and six men), ranging in age from 18 to 25 years, participated in the study within 1 year of being diagnosed with a chronic IJD.</p><p><strong>Results: </strong>The analysis resulted in five categories and 12 subcategories that described the young adults' experiences during the first year after being diagnosed with chronic IJD. The five categories were: Processing towards diagnosis, Struggling with the consequences of the disease, Finding ways to manage the new situation, Needing received support, and Accepting the situation as a process.</p><p><strong>Conclusion: </strong>The young adults demonstrated a strong fighting spirit as they adapted to new circumstances and found solutions to problems related to the disease. Their fighting spirit, combined with support from their significant others and healthcare professionals, helped them in this challenging time when their lifeworld was changing.</p>","PeriodicalId":21424,"journal":{"name":"Scandinavian Journal of Rheumatology","volume":" ","pages":"1-9"},"PeriodicalIF":2.2,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144529464","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
T Fatima, M Dehlin, S Burgess, A M Mason, P M Nilsson, O Melander, Lth Jacobsson, M C Kapetanovic
{"title":"Genetically predicted serum urate and cancer risk: a Mendelian randomization study.","authors":"T Fatima, M Dehlin, S Burgess, A M Mason, P M Nilsson, O Melander, Lth Jacobsson, M C Kapetanovic","doi":"10.1080/03009742.2025.2512667","DOIUrl":"https://doi.org/10.1080/03009742.2025.2512667","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the causal effect of genetically predicted serum urate (SU) levels on the risk of overall and major site-specific cancers in individuals of European ancestry, using Mendelian randomization (MR) analysis.</p><p><strong>Method: </strong>Data from two population-based cohorts from southern Sweden, the Malmö Diet and Cancer Study (MDCS) and Malmö Preventive Project (MPP), and summary-statistics data from the Global Urate Genetic Consortium (GUGC) and UK Biobank cohort were used. A set of 26 SU-related variants was used as instrumental variables to perform a range of one- (using MDCS-MPP) and two-sample (using GUGC and UK Biobank) MR analyses. Causal relationships were assessed between genetically determined SU and 13 site-specific cancers (bladder, breast, color ectal, gastric, hepatic, lung, pancreatic, prostate, renal, skin, lymphatic, haematopoietic, and gynaecological cancers, and brain tumour) and 'any cancer'. We also performed epidemiological association analyses on individual-level data to determine SU-cancer relationships.</p><p><strong>Results: </strong>There was some suggestive evidence of an association between higher levels of genetically predicted SU and lower risk of brain (p = 0.04; one-sample MR) and colorectal (p = 0.02; two-sample MR) cancers, although these findings were not consistent across both MR approaches. No significant associations were observed between SU levels and the risk of other cancers (all p > 0.05).</p><p><strong>Conclusion: </strong>Our MR study found no consistent evidence of a causal effect of genetically predicted SU on overall or Q3 common site-specific cancers in European individuals.</p>","PeriodicalId":21424,"journal":{"name":"Scandinavian Journal of Rheumatology","volume":" ","pages":"1-11"},"PeriodicalIF":2.2,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144529465","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
T Sandström, O Kaipiainen-Seppänen, M Mali, M Kauppi, H Kautiainen, P Hannonen, T Yli-Kerttula, M Leirisalo-Repo, V Rantalaiho
{"title":"Limited reduction of bone mineral density in patients with early rheumatoid arthritis receiving aggressive treatment: 10 year results of the NEO-RACo study.","authors":"T Sandström, O Kaipiainen-Seppänen, M Mali, M Kauppi, H Kautiainen, P Hannonen, T Yli-Kerttula, M Leirisalo-Repo, V Rantalaiho","doi":"10.1080/03009742.2025.2515696","DOIUrl":"https://doi.org/10.1080/03009742.2025.2515696","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate whether rapid and sustained suppression of inflammation, using the NEO-RACo treatment, including prednisolone 7.5 mg/day for 2 years, in patients with early active rheumatoid arthritis (RA) can prevent the reduction of bone mineral density (BMD) in a 10 year follow-up.</p><p><strong>Method: </strong>In the NEO-RACo study, 99 patients, aged 18-60 years, with early RA and without earlier use of disease-modifying anti-rheumatic drugs (DMARDs), were treated with a triple combination of conventional synthetic DMARDs and 7.5 mg prednisolone daily for 2 years and double blindly randomized to receive either placebo or infliximab infusions for the first 6 months. After 2 years, the therapies could be modified, always aiming for strict remission. All patients also received 1000 mg calcium and 800 IU vitamin D<sub>3</sub> daily. BMD was measured by dual-energy X-ray absorptiometry at baseline, 2 years, 5 years, and 10 years. BMD Z-score ≤ -2.0 was considered to be below the expected value.</p><p><strong>Results: </strong>At baseline, two patients (2%) had a Z-score ≤ -2.0, including one patient with osteoporosis. At the time of the last BMD measurement, five patients (5%) had a Z-score ≤ -2.0, and no new-onset osteoporosis cases occurred. No significant differences emerged between the randomization groups.</p><p><strong>Conclusions: </strong>Both randomization groups were treated early and aggressively, and the decrease in BMD was low throughout the 10 year follow-up. The use of infliximab during the first 6 months provided no extra benefit regarding bone loss.Trial Registration: http://www.clintrials.gov (NCT00908089).</p>","PeriodicalId":21424,"journal":{"name":"Scandinavian Journal of Rheumatology","volume":" ","pages":"1-9"},"PeriodicalIF":2.2,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144476588","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}