Scandinavian Journal of Rheumatology最新文献

{"title":"Is the decision maker a key determinant of colchicine withdrawal success in paediatric heterozygous familial Mediterranean fever patients?","authors":"G Özomay Baykal, Ş Türkmen, S Atamyıldız Uçar, E Tunce, N Kara Çanlıoğlu, B Sözeri","doi":"10.1080/03009742.2025.2602228","DOIUrl":"10.1080/03009742.2025.2602228","url":null,"abstract":"<p><strong>Objective: </strong>To examine the demographic and clinical features of paediatric familial Mediterranean fever (FMF) patients with a heterozygous Mediterranean fever (<i>MEFV</i>) gene mutation, focusing on colchicine discontinuation and factors linked to sustained remission.</p><p><strong>Method: </strong>This retrospective study included 2325 paediatric FMF patients followed at a tertiary rheumatology clinic between August 2016 and February 2024. Of these, 1246 carried a heterozygous <i>MEFV</i> mutation, and 87 had stopped colchicine. Discontinuation was either physician decision (PD) or initiated by family/patient decision (FD). Demographic data, clinical symptoms, colchicine use, and <i>MEFV</i> variants were recorded. Patients were monitored after discontinuation to assess remission and the need for retreatment.</p><p><strong>Results: </strong>Of 87 patients, 47 (54%) were discontinued under PD and 40 (46%) under FD. The median discontinuation age was 10.8 years in PD and 11.7 years in FD. Colchicine was reinitiated in 25 patients (28.7%): 11 (4.0%) from PD and 14 (56.0%) from FD. Drug-free remission was maintained in 62 patients (71.3%), including 36 PD (58.1%) and 26 FD (41.9%) (p = 0.45). The pre-discontinuation asymptomatic period was significantly longer in PD (p < 0.01). PD patients also had a lower risk of reinitiating treatment than FD patients (p = 0.046). Older age at discontinuation was associated with sustained remission (p = 0.01).</p><p><strong>Conclusion: </strong>Colchicine withdrawal under physician supervision and at older ages is associated with a lower risk of relapse and greater likelihood of maintaining drug-free remission.</p>","PeriodicalId":21424,"journal":{"name":"Scandinavian Journal of Rheumatology","volume":" ","pages":"191-196"},"PeriodicalIF":1.5,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145959363","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":"Annual trends of chronic opioid use in patients with inflammatory bowel disease and spondyloarthritis in Denmark between 2000 and 2023.","authors":"R S Dalal, K E Zeiss, J Nielsen, S D Madsen, J Ermann, B M Nørgård","doi":"10.1080/03009742.2026.2657653","DOIUrl":"https://doi.org/10.1080/03009742.2026.2657653","url":null,"abstract":"<p><strong>Objective: </strong>Patients with inflammatory bowel disease (IBD) and concomitant spondyloarthritis (SpA) experience substantial pain burden. We examined long-term trends in chronic opioid use (COU) among patients with IBD with and without SpA in Denmark.</p><p><strong>Method: </strong>Using nationwide Danish health registers, we identified patients with Crohn's disease or ulcerative colitis between 2000 and 2023. SpA was defined using validated International Classification of Diseases, 10th Revision (ICD-10) codes. COU was defined as the dispensing of three or more opioid prescriptions within a 12 month period, with prescriptions separated by at least 30 days. Annual proportions of COU were calculated for patients with IBD with SpA (IBD + SpA) and IBD without SpA. A subgroup analysis evaluated chronic use of strong opioids exclusively. Temporal trends were assessed descriptively and comparisons between groups were performed using logistic regression with robust variance.</p><p><strong>Results: </strong>The IBD population increased from 13 417 patients in 2000 to 51 230 in 2023, while the proportion with SpA increased from 1.6% to 5.5%. COU declined over time in both groups. Among patients without SpA, COU decreased from 9.8% in 2000 to 5.7% in 2023. In contrast, COU remained substantially higher in IBD + SpA patients, declining from 27.0% to 13.7% over the same period (p < 0.001). Chronic strong opioid use remained stable in patients without SpA but increased in IBD + SpA patients from 3.6% to 6.2% (p < 0.001).</p><p><strong>Conclusion: </strong>Despite overall reductions in opioid prescribing, COU, particularly strong opioid use, remains disproportionately high among patients with IBD + SpA. These findings suggest persistent unmet needs in pain management for this high-risk population.</p>","PeriodicalId":21424,"journal":{"name":"Scandinavian Journal of Rheumatology","volume":" ","pages":"1-6"},"PeriodicalIF":2.1,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147820060","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":"Subcutaneous panniculitis-like T-cell lymphoma in a patient with dermatomyositis and rheumatoid arthritis.","authors":"D Fujimori, H Shoda, M Kitahara, S Igari, Y Yamamoto, H Hayashi, K Tahara, T Sawada","doi":"10.1080/03009742.2025.2569157","DOIUrl":"10.1080/03009742.2025.2569157","url":null,"abstract":"","PeriodicalId":21424,"journal":{"name":"Scandinavian Journal of Rheumatology","volume":" ","pages":"221-223"},"PeriodicalIF":2.1,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145597165","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":"Limit of the detection of hip joint synovitis using ultrasound in a patient with polymyalgia rheumatica.","authors":"D Nakagomi, S Kubota, S Hanai","doi":"10.1080/03009742.2025.2576958","DOIUrl":"10.1080/03009742.2025.2576958","url":null,"abstract":"","PeriodicalId":21424,"journal":{"name":"Scandinavian Journal of Rheumatology","volume":" ","pages":"224-225"},"PeriodicalIF":2.1,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145452873","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":"Assessing cervical rotation in ankylosing spondylitis: iPhone Compass versus traditional tools.","authors":"G Kenar Artin, H Yarkan Tugsal, B Akin, P Cetin, I Sari, N Akkoc","doi":"10.1080/03009742.2025.2580770","DOIUrl":"10.1080/03009742.2025.2580770","url":null,"abstract":"<p><strong>Objective: </strong>The aim of the study was to assess the reliability of using the iPhone's built-in Compass application for measuring cervical rotation (CR) degrees in patients with ankylosing spondylitis (AS), compared to traditional methods using an inclinometer and a universal goniometer.</p><p><strong>Method: </strong>Patients diagnosed with AS and receiving care at our rheumatology outpatient clinic were enrolled in this study. Two examiners measured CR using the iPhone 4 Compass application, an inclinometer, and a universal goniometer. Each measurement was performed twice. Intrarater and interrater reliability were assessed using intraclass correlation coefficients (ICCs), while agreement between methods was analysed by the Bland-Altman method.</p><p><strong>Results: </strong>The study sample included 30 AS patients (73% male). Excellent intrarater and interrater reliability were observed across all three measurement methods in the entire sample. Bland-Altman analysis showed good agreement between the iPhone and inclinometer, with a mean difference (bias) of -5.6 for Examiner 1 [95% confidence interval (CI) -7.6 to -3.6] and -6.3 for Examiner 2 (95% CI -8.8 to -3.8). The mean differences between the iPhone and universal goniometer measurements were 2.3 for Examiner 1 (95% CI -0.4 to 5.2) and 4.1 for Examiner 2. Similarly, between the universal goniometer and inclinometer, mean differences were -8.0 for Examiner 1 (95% CI -11.2 to -4.8) and -10.4 for Examiner 2.</p><p><strong>Conclusion: </strong>Through the integration of everyday smartphone technology for clinical use, the iPhone Compass application can be considered a practical and accessible tool for measuring CR in patients with AS, offering potential benefits for clinical practice.</p>","PeriodicalId":21424,"journal":{"name":"Scandinavian Journal of Rheumatology","volume":" ","pages":"177-183"},"PeriodicalIF":2.1,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145482768","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":"KLF15 deficiency accelerates cartilage destruction in inflammatory arthritis.","authors":"K Anjiki, S Hayashi, K Kikuchi, Y Takashima, K Ikuta, K Wada, S Tachibana, Y Onoi, Y Suda, A Saito, T Maeda, T Kamenaga, M Tsubosaka, Y Kuroda, N Nakano, T Matsumoto, T Hosooka, W Ogawa, R Kuroda","doi":"10.1080/03009742.2026.2654265","DOIUrl":"https://doi.org/10.1080/03009742.2026.2654265","url":null,"abstract":"<p><strong>Objective: </strong>Kruppel-like factor 15 (KLF15) is a transcription factor that promotes anabolic pathways and suppresses catabolic signalling in joint tissues. KLF15 regulates adipocyte differentiation through peroxisome proliferator-activated receptor-γ (PPARγ), which suppresses inflammation via the nuclear factor-κB pathway. This study aimed to clarify the effects of KLF15 in a mouse model of collagen antibody-induced arthritis (CAIA).</p><p><strong>Method: </strong>Tamoxifen-induced cartilage-specific <i>KLF15</i> knockout (KO) mice were generated. Ten-week-old male KO mice (KO group) and wild-type mice (WT group) were treated intraperitoneally with anti-type II collagen antibody to create CAIA mice. At 0, 1, 2, and 4 weeks after antibody administration, the knee joints were collected for histological (safranin-O, haematoxylin-eosin) and immunohistological [PPARγ, phosphor-IκB kinase complex (pIKK) α/β, interleukin-1β (IL-1β), matrix metalloproteinase-3 (MMP3) and MMP13] evaluation and compared. Chondrocytes from <i>KLF15 </i>KO and WT mice were evaluated for KLF15, PPARγ, MMP3, and MMP13 mRNA expression by quantitative polymerase chain reaction, and for pIKKα/β by Western blotting.</p><p><strong>Results: </strong>The arthropathy score was significantly higher in the KO group at 4 weeks, while the synovitis score showed no difference. Positive cell ratios for PPARγ were decreased in the KO group, and pIKKα/β, IL-1β, MMP3, and MMP13 were significantly increased. Western blotting showed significantly increased pIKKα/β expression in KO cells compared to WT cells.</p><p><strong>Conclusion: </strong>Arthritis induced in cartilage-specific <i>KLF15</i> KO mice may cause articular cartilage destruction by decreasing PPARγ expression and increasing inflammatory cytokines and MMPs via IKKα/β. Modulation of KLF15 could be a potential therapeutic strategy for the treatment of arthritis, including rheumatoid arthritis.</p>","PeriodicalId":21424,"journal":{"name":"Scandinavian Journal of Rheumatology","volume":" ","pages":"1-12"},"PeriodicalIF":2.1,"publicationDate":"2026-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147779763","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":"Treatment outcomes and predictors of macrophage activation syndrome in adult-onset Still's disease: a 24 year single-centre experience.","authors":"B Acar, O O Kizilkaya, B Aktas, O C Kılınc, S Ugurlu","doi":"10.1080/03009742.2026.2656045","DOIUrl":"https://doi.org/10.1080/03009742.2026.2656045","url":null,"abstract":"<p><strong>Objective: </strong>Adult-onset Still's disease (AOSD) is a rare systemic autoinflammatory disorder with heterogeneous presentation and treatment responses. This study describes real-world treatment outcomes in AOSD and evaluates factors associated with macrophage activation syndrome (MAS).</p><p><strong>Method: </strong>This retrospective cohort included 93 adult patients diagnosed with AOSD between 2000 and 2024 according to Yamaguchi criteria. Clinical and laboratory data, treatments, and outcomes were analysed. MAS predictors were evaluated using multivariable logistic regression, receiver operating characteristics (ROC) curve analysis was performed.</p><p><strong>Results: </strong>Treatment involved glucocorticoids, methotrexate, and interleukin-1 (IL-1) or IL-6-targeting biologics. Anakinra and tocilizumab showed similar responses (55.3% vs 58.3%). Among 17 anakinra-unresponsive patients, 16 received tocilizumab, and 11 achieved complete remission. Diagnostic delay, defined as the interval between symptom onset and diagnosis, was linked to poorer methotrexate response (p = 0.0457) and lower rates of glucocorticoid discontinuation (p < 0.01). Higher baseline ferritin [odds ratio (OR) 2.18, 95% confidence interval (CI) 1.12-4.24] and systemic scores (OR 2.52, 95% CI 1.28-4.96) were independently associated with MAS. Baseline ferritin demonstrated discriminatory ability for MAS [area under the curve (AUC) 0.82], with a cut-off of 2000 ng/mL (95% CI 0.68-0.95; p < 0.001). A systemic score ≥ 7 showed association with MAS (OR 18.27, 95% CI 4.25-78.47).</p><p><strong>Conclusion: </strong>In this cohort, IL-1 and IL-6 blockade demonstrated similar effectiveness in AOSD, and biologic switching was followed by remission in several patients. Longer diagnostic delay was associated with less favourable treatment outcomes. Elevated baseline ferritin and systemic scores were associated with MAS.</p>","PeriodicalId":21424,"journal":{"name":"Scandinavian Journal of Rheumatology","volume":" ","pages":"1-9"},"PeriodicalIF":2.1,"publicationDate":"2026-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147779756","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":"Shoulder injection of platelet-rich plasma versus corticosteroids in rotator cuff tendinopathies.","authors":"S Bouden, C Jebali, S Ben Dhia, L Rouached, O Saidane, I Mahmoud, R Tekaya, A Ben Tekaya, L Abdelmoula","doi":"10.1080/03009742.2026.2620888","DOIUrl":"https://doi.org/10.1080/03009742.2026.2620888","url":null,"abstract":"<p><strong>Objective: </strong>To compare the efficacy of corticosteroid and platelet-rich plasma (PRP) injections on pain and function in chronic, non-ruptured rotator cuff tendinopathies.</p><p><strong>Method: </strong>In a 9 month prospective randomized trial, 52 patients were assigned to receive either corticosteroid (n = 26) or PRP (n = 26) injections. Pain was assessed using a visual analogue scale (VAS), and function was evaluated with shortened Disabilities of the Arm, Shoulder, and Hand questionnaire (QuickDASH) and Shoulder Pain and Disability Index (SPADI) scores at baseline, 1 week, and 3 months. Adverse events were documented.</p><p><strong>Results: </strong>The mean age was 62.3 ± 8.3 years, with 84.6% being female. Pain reduction was comparable between groups at 1 week (p = 0.49). At 3 months, corticosteroids achieved significantly greater pain relief (ΔVAS 3.35 vs 1.75; p = 0.02), confirmed by multivariate analysis (p = 0.01). Functional improvement was similar between groups; a non-significant trend favouring corticosteroids for QuickDASH was observed but not confirmed by multivariate analysis. Both treatments were well tolerated, with mild and transient adverse events: post-injection pain (PRP 73.1% vs CTC 53.8%) and local oedema (PRP 30.8% vs CTC 38.5%).</p><p><strong>Conclusion: </strong>Corticosteroids were more effective for pain reduction at 3 months, while PRP provided equivalent functional improvement. PRP may be an alternative for patients with corticosteroid contraindications.</p><p><strong>Trial registration: </strong>Clinicaltrials.gov (NCT07094178).</p>","PeriodicalId":21424,"journal":{"name":"Scandinavian Journal of Rheumatology","volume":" ","pages":"1-8"},"PeriodicalIF":2.1,"publicationDate":"2026-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147475121","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":"Myeloperoxidase-anti-neutrophil cytoplasmic antibody positivity and disease characteristics, treatment, and prognosis in eosinophilic granulomatosis with polyangiitis.","authors":"S Fukui, K Ichinose, H Ide, T Uchida, T Shimizu, M Umeda, R Sumiyoshi, T Koga, S-Y Kawashiri, N Iwamoto, T Origuchi, S Omura, D Nakagomi, Y Abe, M Wada, N Takizawa, A Nomura, Y Kukida, N Kondo, Y Yamano, H Takagi, K Endo, S Hirata, N Azuma, T Takeuchi, K Kamada, R Yanai, Y Matsuo, Y Shimojima, R Nishioka, R Okazaki, T Takata, M Moriyama, A Takatani, Y Miyawaki, T Shirai, H Dobashi, T Ito, I Matsumoto, T Takada, T Ito-Ihara, T Kida, N Yajima, T Kawaguchi, Y Kawahito, A Kawakami","doi":"10.1080/03009742.2025.2572885","DOIUrl":"10.1080/03009742.2025.2572885","url":null,"abstract":"<p><strong>Objectives: </strong>To evaluate the relationship between anti-neutrophil cytoplasmic antibody (ANCA) positivity and the disease characteristics, treatment, and prognosis of eosinophilic granulomatosis with polyangiitis (EGPA).</p><p><strong>Method: </strong>We conducted a retrospective cohort study of patients with new-onset or severely relapsing ANCA-associated vasculitis, enrolled in the J-CANVAS registry. The clinical characteristics at baseline, treatments, and prognoses of ANCA-positive and ANCA-negative patients were assessed.</p><p><strong>Results: </strong>Three patients with positive proteinase-3 ANCA were excluded, and 166 patients with EGPA (new onset, 159; severe relapse, seven) were included. Sixty-two patients were myeloperoxidase (MPO)-ANCA positive and 104 patients were negative. No differences in age or sex were observed between the two groups. The MPO-ANCA-positive group had significantly more frequent mucous membrane and eye involvement, more frequent renal involvement, higher total Birmingham Vasculitis Activity Score, higher neutrophil counts, and higher C-reactive protein levels at baseline. Although rituximab was administered more frequently in the MPO-ANCA-positive group, no other differences in treatment were found. Both groups had comparable estimated glomerular filtration rates and prednisolone doses at weeks 24 and 48. The incidence rates of severe relapse, minor relapse, and serious infectious diseases were comparable. Cox regression analysis revealed that MPO-ANCA positivity was not a significant factor in serious infectious diseases and relapse.</p><p><strong>Conclusion: </strong>Patients with MPO-ANCA-positive EGPA demonstrated different baseline clinical characteristics from MPO-ANCA-negative patients. However, subsequent relapses and serious infectious diseases were comparable.</p>","PeriodicalId":21424,"journal":{"name":"Scandinavian Journal of Rheumatology","volume":" ","pages":"134-142"},"PeriodicalIF":2.1,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145439059","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":"Burden of disease and treatment patterns for psoriatic arthritis in Finland: a nationwide real-world evidence study.","authors":"L Ukkola-Vuoti, A Klåvus, I Toppila, P Elo, L Veijalainen, D Nordström","doi":"10.1080/03009742.2025.2576962","DOIUrl":"10.1080/03009742.2025.2576962","url":null,"abstract":"<p><strong>Objective: </strong>This study assessed the characteristics, concomitant medications, medication switches, sick leave, disability pensions, and healthcare resource utilization (HCRU) of patients with psoriatic arthritis (PsA) and biological disease-modifying anti-rheumatic drug (bDMARD) purchases in Finland using comprehensive follow-up data from four nationwide registry controllers.</p><p><strong>Method: </strong>Electronic healthcare data covering adult patients with PsA and reimbursed bDMARD purchases between 2013 and 2021 in Finland were used. Patients were followed from the first bDMARD purchase (first biological cohort) or switch (switcher cohort) to 2022 or until death/loss of follow-up. Patients with bDMARD purchases before 2013 and no switches afterwards were not included.</p><p><strong>Results: </strong>The study investigated 2546 patients with PsA and bDMARD purchases, with 458 (18.0%) in the switcher cohort and 2088 (82.0%) in the first biological cohort. In the first biological cohort, 22.4% (95% confidence interval 20.6-24.2) switched bDMARD after 12 months. Work absences accumulated before bDMARD initiation and decreased afterwards in the first biological cohort, while switchers maintained a modest linear accumulation. The proportion of under-65-year-old patients on disability pensions was higher in switchers compared to the first biological cohort. HCRU decreased after bDMARD initiation in the first biological cohort (annual cost per patient €5093 vs €4610), while it increased for switchers (€5246 vs €5596).</p><p><strong>Conclusion: </strong>Patients experienced increasing absenteeism before first bDMARD initiation, indicating an unmet need at treatment initiation. This suggests that earlier medication initiation could be beneficial, as a bDMARD switch with the bDMARD armamentarium available during the study period did not fully address growing absenteeism.</p>","PeriodicalId":21424,"journal":{"name":"Scandinavian Journal of Rheumatology","volume":" ","pages":"85-96"},"PeriodicalIF":2.1,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145513754","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}