Seminars in arthritis and rheumatism最新文献

{"title":"Taper versus discontinuation of tocilizumab in patients with giant cell arteritis: Real-world experience from a tertiary center","authors":"Marc K. Nielsen ,&nbsp;Andreas W. Nielsen ,&nbsp;Agnete O. Donskov ,&nbsp;Ib T. Hansen ,&nbsp;Berit D. Nielsen ,&nbsp;Christoffer Mørk ,&nbsp;Ellen M. Hauge ,&nbsp;Kresten K. Keller","doi":"10.1016/j.semarthrit.2024.152508","DOIUrl":"10.1016/j.semarthrit.2024.152508","url":null,"abstract":"<div><h3>Introduction</h3><p>Following the approval of tocilizumab (TCZ) for giant cell arteritis (GCA), recent studies have shown a high relapse frequency after abrupt discontinuation of TCZ. However, a thorough exploration of TCZ tapering compared to abrupt discontinuation has never been undertaken. Likewise, adverse events have only been scarcely investigated in routine care. This study aimed to compare the incidence of relapses in GCA patients undergoing TCZ tapering compared to abrupt discontinuation.</p></div><div><h3>Methods</h3><p>We performed a single-center retrospective cohort study from 2012 to 2022. Data from GCA patients treated with TCZ was obtained from the Electronic Patients Record. Relapse-free survival is reported in Kaplan-Meier plots and tapering versus abrupt discontinuation were compared using a Wilcoxon-Brewlos-Gehan test.</p></div><div><h3>Results</h3><p>We included 155 patients receiving TCZ treatment for GCA, of which 104 discontinued TCZ. Among the 104 patients discontinuing TCZ, 42 (40 %) experienced a relapse within the first year. A total of 57 patients underwent taper with 6/38 (16 %) and 2/19 (11 %) relapsing while receiving TCZ every second or third week, respectively. In comparison, 59 patients underwent abrupt discontinuation with 27 (46 %) relapsing during follow-up. The patients undergoing abrupt TCZ discontinuation demonstrated a significantly shorter time to relapse compared to all tapered patients (<em>p</em> = 0.02) as well as patients tapered from weekly TCZ treatment to every second week (<em>p</em> &lt; 0.01). Furthermore, 15 % of patients discontinued TCZ due to adverse events.</p></div><div><h3>Conclusion</h3><p>This is the first study indicating that TCZ taper induced longer relapse-free survival than abrupt discontinuation, implying that taper may be favored over discontinuation in patients with GCA.</p></div>","PeriodicalId":21715,"journal":{"name":"Seminars in arthritis and rheumatism","volume":"68 ","pages":"Article 152508"},"PeriodicalIF":4.6,"publicationDate":"2024-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0049017224001483/pdfft?md5=84ee41d18aa0d41e781f6c2d660917a5&pid=1-s2.0-S0049017224001483-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141564257","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":"Mortality risk in patients with anti-MDA5 antibody-positive dermatomyositis: A risk assessment","authors":"Tomoyuki Kawada","doi":"10.1016/j.semarthrit.2024.152511","DOIUrl":"10.1016/j.semarthrit.2024.152511","url":null,"abstract":"","PeriodicalId":21715,"journal":{"name":"Seminars in arthritis and rheumatism","volume":"69 ","pages":"Article 152511"},"PeriodicalIF":4.6,"publicationDate":"2024-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141545187","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prognostic factors and the value of radiographic osteoarthritis for persistent complaints after referral for ankle radiography","authors":"S.E.(Sabine) Kloprogge ,&nbsp;R.M.M.(Roshni) Lachmipersad ,&nbsp;N.(Nienke) Katier ,&nbsp;A.K.E.(Adinda) Mailuhu ,&nbsp;J.(Jeanette) van Vooren ,&nbsp;J.M.(John) van Ochten ,&nbsp;P.J.E.(Patrick) Bindels ,&nbsp;S.M.A.(Sita) Bierma-Zeinstra ,&nbsp;M.(Marienke) van Middelkoop","doi":"10.1016/j.semarthrit.2024.152487","DOIUrl":"https://doi.org/10.1016/j.semarthrit.2024.152487","url":null,"abstract":"<div><h3>Background</h3><p>Ankle symptoms are a common reason to consult the general practitioner and often persist for years. In a population referred for ankle radiography, the prevalence of radiographic osteoarthritis (OA) is substantial, but its additional predictive value for persistent symptoms is unknown. Therefore, we examined the prognosis of symptoms 2–3 years after referral for ankle radiography, assessed clinical prognostic factors, and the additional predictive value of radiographic OA for persistent ankle complaints.</p></div><div><h3>Methods</h3><p>We included 893 adults referred for ankle radiography and studied the following candidate prognostic factors at baseline: age, sex, body mass index (BMI), referral for chronic complaints (&gt;3 months), pain during activity (NRS-11) and presence of stiffness and functional loss as predominant symptom. X-rays were scored for radiographic OA. After 2–3 years participants were invited for a follow-up questionnaire including persistence of ankle complaints. To assess prognostic factors for persistent complaints, uni- and multivariable logistic regression were used.</p></div><div><h3>Results</h3><p>Of the 194 responders at follow-up, ankle complaints persisted in 71(36.6 %). BMI (OR 1.08; 95 % CI 1.01–1.15), stiffness as predominant symptom (OR 1.69; 95 % CI 0.89–3.21), and chronic complaints (OR 2.84; 95 % CI 1.45–5.57) were in the initial model for persistent complaints (AUC=0.69). After adding radiographic OA (OR 2.36; 95 % CI 1.01–5.50), the AUC of the final model became 0.70.</p></div><div><h3>Conclusion</h3><p>Ankle complaints persist in a considerable proportion of patients 2–3 years after referral for ankle radiography. BMI, chronic complaints and radiographic OA are prognostic factors for persistent complaints, but the additional predictive value of radiographic OA on top of clinical factors is negligible.</p></div>","PeriodicalId":21715,"journal":{"name":"Seminars in arthritis and rheumatism","volume":"68 ","pages":"Article 152487"},"PeriodicalIF":4.6,"publicationDate":"2024-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141592950","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Modelling long-term outcomes for patients with systemic lupus erythematosus","authors":"Z. Touma ,&nbsp;S. Kayaniyil ,&nbsp;A. Parackal ,&nbsp;D. Bonilla ,&nbsp;J. Su ,&nbsp;A. Johnston ,&nbsp;J. Gahn ,&nbsp;E.D. Hille ,&nbsp;R. Ohsfeldt ,&nbsp;S. Chandran","doi":"10.1016/j.semarthrit.2024.152507","DOIUrl":"10.1016/j.semarthrit.2024.152507","url":null,"abstract":"<div><h3>Background</h3><p>New treatments for systemic lupus erythematosus (SLE) aim to improve tolerability and disease activity control over standard of care (SoC) treatment. SoC typically includes daily glucocorticoid (GC) which carries a risk of organ damage over time. This study sought to develop natural history models to identify predictors of long-term outcomes with current SoC SLE treatment.</p></div><div><h3>Methods</h3><p>Generalized linear and parametric accelerated failure time survival models (GLM) and parametric accelerated failure time (AFT) survival models were designed to identify predictors of disease activity, flare rate, GC use, organ damage, and mortality beyond the first year of treatment in patients with SLE. Models were run using a longitudinal retrospective analysis of prospectively collected Toronto Lupus Cohort (TLC) study data, collected between 1997 and 2020. Covariates of clinical and statistical significance were selected by bivariate- then multi-variate regression to find the model of best fit.</p></div><div><h3>Findings</h3><p>Of the 1255 subjects included, 89 % were female 89 % and 65 % Caucasian. Mean follow-up was 10·5 years. At first visit, 51 % of patients had moderate-to-severe disease activity (SLEDAI-2 K score ≥ 6). Mean organ damage scores gradually increased over the years following diagnosis. Median survival of the cohort was ∼35 years from study entry. In the GLM models, SLEDAI-2 K yearly average, and average GC dose were key for predicting change in SLEDAI-2 K, GC use/ dose, and flare (any/rate). Together, adjusted mean SLEDAI-2 K and GC dose were shown to be predictors of mortality and damage in at least 9 of 12 organ systems considered.</p></div><div><h3>Interpretation</h3><p>These comprehensive, longitudinal, predictive models show that disease activity and GC use are significant predictors of organ damage and mortality in a patient population with predominantly moderate to severe SLE. This deepens understanding of SLE natural history and underscores the need for new treatment approaches that reduce disease activity and GC use with an aim to improve long-term SLE outcomes.</p></div><div><h3>Funding</h3><p>This study was funded by AstraZeneca.</p></div>","PeriodicalId":21715,"journal":{"name":"Seminars in arthritis and rheumatism","volume":"68 ","pages":"Article 152507"},"PeriodicalIF":4.6,"publicationDate":"2024-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0049017224001471/pdfft?md5=ad77581972ce52f3f9a657deb50dc9f7&pid=1-s2.0-S0049017224001471-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141637280","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":"Brain white matter microstructural alterations in Behcet's syndrome correlate with cognitive impairment and disease severity: A diffusion tensor imaging study","authors":"Osman Aykan Kargin ,&nbsp;Serdar Arslan ,&nbsp;Bora Korkmazer ,&nbsp;Sabriye Guner ,&nbsp;Ayse Ozdede ,&nbsp;Nursena Erener ,&nbsp;Elif Burcu Ersungur Celik ,&nbsp;Gulcin Baktiroglu ,&nbsp;Rauf Hamid ,&nbsp;Ahmet Oz ,&nbsp;Burc Cagri Poyraz ,&nbsp;Ugur Uygunoglu ,&nbsp;Emire Seyahi ,&nbsp;Osman Kizilkilic","doi":"10.1016/j.semarthrit.2024.152509","DOIUrl":"https://doi.org/10.1016/j.semarthrit.2024.152509","url":null,"abstract":"<div><h3>Objectives</h3><p>To evaluate the microstructural integrity of brain white matter tracts in patients with Neuro-Behcet's syndrome (NBS) and Behcet's syndrome (BS) without neurological manifestations using diffusion tensor imaging (DTI) and to investigate potential utility of DTI as a surrogate biomarker of neurocognitive functioning and disease severity.</p></div><div><h3>Methods</h3><p>This cross-sectional study comprised 34 NBS patients and 32 BS patients without neurological involvement, identified based on the International Study Group of the Behcet's disease (ISGBD) and the International Consensus Recommendation (ICR) criteria, as well as 33 healthy controls. Cognitive functions, including attention, memory, language, abstraction, executive control, visuospatial skills, and sensorimotor performance were assessed using standardized questionnaires. DTI data were analyzed using tract-based spatial statistics (TBSS) and automated probabilistic tractography to investigate inter-group differences. Subsequently, correlations between tensor-derived parameters of white matter tracts, neurocognitive test scores, and disease severity measures were examined.</p></div><div><h3>Results</h3><p>DTI revealed decreased fractional anisotropy and increased radial diffusivity, mean diffusivity, and axial diffusivity in both supratentorial and infratentorial white matter in NBS patients, indicating widespread loss of microstructural integrity. Moreover, this loss of integrity was also observed in BS patients without neurological manifestations, albeit to a lesser extent. In NBS patients, certain white matter tracts, including cingulum bundle, were associated with poor cognitive performance across multiple domains and disease severity.</p></div><div><h3>Discussion</h3><p>DTI findings might potentially serve as a neuroimaging marker to predict the extent of neurocognitive impairment and disease severity associated with central nervous system involvement in BS.</p></div>","PeriodicalId":21715,"journal":{"name":"Seminars in arthritis and rheumatism","volume":"68 ","pages":"Article 152509"},"PeriodicalIF":4.6,"publicationDate":"2024-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141606426","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Corrigendum to “The Glucocorticoid Toxicity Index: Measuring Change in Glucocorticoid Toxicity Over Time” [Seminars in Arthritis and Rheumatism 55 (2022):152010]","authors":"John H. Stone ,&nbsp;P. Jane McDowell ,&nbsp;David R.W. Jayne ,&nbsp;Peter A. Merkel ,&nbsp;Joanna Robson ,&nbsp;Naomi J. Patel ,&nbsp;Yuqing Zhang ,&nbsp;Huibin Yue ,&nbsp;Pirow Bekker ,&nbsp;Liam G. Heaney","doi":"10.1016/j.semarthrit.2024.152496","DOIUrl":"https://doi.org/10.1016/j.semarthrit.2024.152496","url":null,"abstract":"","PeriodicalId":21715,"journal":{"name":"Seminars in arthritis and rheumatism","volume":"68 ","pages":"Article 152496"},"PeriodicalIF":4.6,"publicationDate":"2024-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0049017224001367/pdfft?md5=ca4533a61e8eedfb7ac6376804e74df0&pid=1-s2.0-S0049017224001367-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141485624","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":"TNFRSF11A variants contribute to systemic autoinflammatory diseases: A case series of 12 patients","authors":"Vasileios Papatheodorou ,&nbsp;Charalampos Gerodimos ,&nbsp;Antonios Dimitrakopoulos ,&nbsp;Efrosini Lada ,&nbsp;Maria G Tektonidou ,&nbsp;Anastasios Germenis ,&nbsp;Petros P Sfikakis ,&nbsp;Katerina Laskari","doi":"10.1016/j.semarthrit.2024.152505","DOIUrl":"https://doi.org/10.1016/j.semarthrit.2024.152505","url":null,"abstract":"<div><h3>Background</h3><p>Limited evidence suggests that variants in <em>TNFRSF11A</em> gene, encoding RANK, may contribute to systemic autoinflammatory disease (SAID).</p></div><div><h3>Aim/Methods</h3><p>To estimate the prevalence of <em>TNFRSF11A</em> variants in a cohort of patients with SAIDs screened for 26 related genes and describe the disease phenotypic expression.</p></div><div><h3>Results</h3><p>A total of 12 out of 167 patients, 7 males, aged (median) 38 years at disease onset, yielded at least one <em>TNFRSF11A</em> rare variant. All patients carried a coexisting variant in at least one other SAID-related gene, most frequently <em>MEFV</em> (6 patients), but also <em>TNFRSF1A, NOD2, NLRP3, NLRP7, MVK, IL36RN, RBCK1, PLCG2</em> and <em>PSMB8</em>. SAID episodes lasting (median) 9 days manifested with high grade fever (91%), myalgias (75%), malaise (67%), serositis (58%), arthralgias/arthritis (58%), gastrointestinal involvement (33%), and rash (25%), and responded to corticosteroids. The most common initial clinical diagnosis was TNF-associated periodic fever syndrome (TRAPS), which was, however, confirmed, in only one patient. The emergence of <em>MEFV</em> variations supported the diagnosis of atypical Familial Mediterranean Fever in two cases, whereas the diagnosis of Yao syndrome was speculated in two patients with <em>NOD2</em> variants. The presence of atypical disease and the inability of defining diagnosis in the remaining 7 patients, supported the possible involvement of <em>TNFRSF11A</em> variants in the phenotypic expression of SAIDs.</p></div><div><h3>Conclusion</h3><p><em>TNFRSF11A</em> variants, occurring in 7% of SAID patients always in combination with other SAID-related gene variants, contribute to the development of an autoinflammatory syndrome resembling to TRAPS. Additional studies to confirm novel pathogenic SAID pathways are clearly warranted.</p></div>","PeriodicalId":21715,"journal":{"name":"Seminars in arthritis and rheumatism","volume":"68 ","pages":"Article 152505"},"PeriodicalIF":4.6,"publicationDate":"2024-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141606427","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Advancing composite outcome measures: Insights on weighting components from OMERACT 2023","authors":"George A Wells ,&nbsp;Francis Guillemin ,&nbsp;Peter A. Merkel ,&nbsp;Maarten de Wit ,&nbsp;Sarah Mackie ,&nbsp;Lyn March ,&nbsp;Gunnar Tómasson ,&nbsp;Lauren K. King ,&nbsp;Sam Michel Cembalo ,&nbsp;Shawna Grosskleg ,&nbsp;Lara J. Maxwell ,&nbsp;Sara Monti ,&nbsp;Kaitlin A. Quinn ,&nbsp;Beverley J Shea ,&nbsp;Peter Tugwell ,&nbsp;Dorcas Beaton","doi":"10.1016/j.semarthrit.2024.152503","DOIUrl":"10.1016/j.semarthrit.2024.152503","url":null,"abstract":"<div><h3>Objective</h3><p>The OMERACT Composite Working Group hosted a workshop at OMERACT 2023 to explore the complexities of weighting components in the development of composite outcomes. This study presents the methodology and findings of this workshop, exploring the complexities of weighting the individual components of composite outcome measures.</p></div><div><h3>Methods</h3><p>The workshop featured a multifaceted program, beginning with a plenary session that introduced the concept of composite outcomes, shared a patient's journey with rheumatic disease through a narrative, illustrated a composite outcome for Osteoarthritis Flares, and outlined the five domains selected for this composite outcome. A breakout exercise engaged participants in ranking and assigning weights to these domains, followed by group discussions to reach a consensus on weights. The workshop concluded with another plenary session that discussed various weighting approaches, including discrete choice and conjoint analysis from the ANCA-Associated Vasculitis working group, and outlined future directions for research on composite outcome methods.</p></div><div><h3>Results</h3><p>The breakout exercise revealed the challenges in assigning relative importance to different domains, highlighting the variability in participant perspectives. Consensus discussions highlighted the diversity in approaches to weighting, the need for appropriate methods to determine domain weights and the impact of such weights on the interpretation of composite scores.</p></div><div><h3>Conclusion</h3><p>The OMERACT 2023 workshop underscored the significance of a systematic approach to weighting components in composite outcome development. It highlighted the complexity of achieving consensus on the importance of domains and the role of incorporating the perspectives of patient research partners in this process. Future research directions include refining weighting methodologies, moving composites through the OMERACT Filter and enhancing understanding of their implications for clinical trials. The findings contribute to the ongoing discourse on optimizing composite outcome measures in rheumatology and beyond, advocating for a balanced integration of scientific rigour and patient-centeredness in their development.</p></div>","PeriodicalId":21715,"journal":{"name":"Seminars in arthritis and rheumatism","volume":"69 ","pages":"Article 152503"},"PeriodicalIF":4.6,"publicationDate":"2024-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142136783","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Primary central nervous system vasculitis with intracranial aneurysm","authors":"Carlo Salvarani ,&nbsp;Robert D. Brown Jr ,&nbsp;Teresa J.H. Christianson ,&nbsp;John Huston III ,&nbsp;Caterina Giannini ,&nbsp;Gene G. Hunder","doi":"10.1016/j.semarthrit.2024.152506","DOIUrl":"https://doi.org/10.1016/j.semarthrit.2024.152506","url":null,"abstract":"<div><h3>Background</h3><p>Unruptured intracranial aneurysms (UIAs) are rarely reported in primary central nervous system vasculitis (PCNSV). In this study we described the clinical findings, response to therapy, and outcomes of UIA in a large cohort of PCNSV patients.</p></div><div><h3>Methods</h3><p>We retrospectively studied 216 consecutive patients with PCNSV, selected by predetermined diagnostic criteria, who were seen during a 40-year period. UIAs were identified on cerebral angiography. The clinical, laboratory, radiologic and pathologic findings, management, and outcomes of patients with UIA were described and compared with those without UIA.</p></div><div><h3>Results</h3><p>12/216 (5.5 %) PCNSV patients had at least one UIA. Two patients underwent biopsies; one yielded negative results, while the other showed necrotizing vasculitis. Eleven patients had evidence of UIA on angiogram at diagnosis. One patient developed an aneurysm during the follow-up associated with a worsening of vasculitic radiological findings. The most common presenting symptom for PCNSV in the setting of UIA was headache (67 %), followed by persistent neurologic deficit or stroke (50 %). Most patients with UIA presented with multiple cerebral infarcts on MRI (67 %), one patient had subarachnoid hemorrhage, and one left parieto-occipital intracerebral hematoma, both unrelated to the aneurysm. Black blood imaging was performed in 4 patients and 2 showed segmental circumferential mural enhancement involving multiple vessels. Two patients had 2 UIAs, while the other 10 had 1. The most frequent UIA location was internal carotid artery (50 %), followed by anterior cerebral artery (21 %). Ten of the UIAs were &lt; 5 mm in diameter, and 3 were 5–7 mm in diameter; the size was not available for one. All UIAs were unchanged in size and configuration during follow-up (median: 18.5 months; range 1–151 months) and no new aneurysms were detected. Compared to the 204 patients with PCNSV without a UIA, no significant clinical differences were observed, except for a reduced disability at last follow-up (<em>p</em> = 0.038).</p></div><div><h3>Conclusions</h3><p>UIAs uncommonly occur in PCNSV.</p></div>","PeriodicalId":21715,"journal":{"name":"Seminars in arthritis and rheumatism","volume":"68 ","pages":"Article 152506"},"PeriodicalIF":4.6,"publicationDate":"2024-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141540400","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy and safety of culture-expanded mesenchymal stromal cell therapy in the treatment of 4 types of inflammatory arthritis: A systematic review and meta-analysis of 36 randomized controlled trials","authors":"Liuting Zeng ,&nbsp;Kailin Yang ,&nbsp;Ganpeng Yu ,&nbsp;Junpeng Chen ,&nbsp;Zhiyong Long ,&nbsp;Wang Xiang ,&nbsp;Shuman Liu ,&nbsp;Yaru Zheng ,&nbsp;Yexing Yan ,&nbsp;Moujia Hao ,&nbsp;Lingyun Sun","doi":"10.1016/j.semarthrit.2024.152498","DOIUrl":"https://doi.org/10.1016/j.semarthrit.2024.152498","url":null,"abstract":"<div><h3>Objective</h3><p>This study aims to assess the effectiveness and safety of mesenchymal stem cell (MSC) transplantation in the treatment of inflammatory arthritis.</p></div><div><h3>Methods</h3><p>Two researchers conducted a comprehensive search of Chinese and English databases from their inception until July 2023. The literature screening and data extraction were then performed. Statistical analysis was carried out using RevMan 5.4 software.</p></div><div><h3>Results</h3><p>A total of 36 relevant RCTs, involving 2,076 participants, were ultimately included in this study. These RCTs encompassed four types of inflammatory arthritis, namely rheumatoid arthritis (RA), osteoarthritis (OA), ankylosing spondylitis (AS), and systemic sclerosis (SSc). The results demonstrated that MSC therapy exhibited improvements in the Visual Analog Scale (VAS) for pain in OA patients (bone marrow: SMD=-0.95, 95 % CI: -1.55 to -0.36, <em>P</em> = 0.002; umbilical cord: SMD=-2.03, 95 % CI: -2.99 to -1.07, <em>P</em> &lt; 0.0001; adipose tissue: SMD=-1.26, 95 % CI: -1.99 to -0.52, <em>P</em> = 0.0009). Specifically, MSCs sourced from adipose tissue showed enhancements in Western Ontario and McMaster Universities Arthritis Index (WOMAC) pain (<em>P</em> = 0.0001), WOMAC physical function (<em>P</em> = 0.001), and total WOMAC scores (<em>P</em> = 0.0003). As for MSC therapy in RA, AS, and SSc, the current systematic review suggests a potential therapeutic effect of MSCs on these inflammatory arthritic conditions. Safety assessments indicated that MSC therapy did not increase the incidence of adverse events.</p></div><div><h3>Conclusion</h3><p>MSCs have the potential to alleviate joint pain and improve joint function in patients with inflammatory arthritis. Moreover, MSC therapy appears to be relatively safe and could be considered as a viable alternative treatment option for inflammatory arthritis.</p></div>","PeriodicalId":21715,"journal":{"name":"Seminars in arthritis and rheumatism","volume":"68 ","pages":"Article 152498"},"PeriodicalIF":4.6,"publicationDate":"2024-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141540401","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}