Seminars in arthritis and rheumatism最新文献

{"title":"Semi-quantitatively scored apical extent of disease predicts change in total lung capacity in patients with systemic sclerosis and early interstitial lung disease.","authors":"K.M.C. van Doorn-Hogervorst ,&nbsp;E.R. (Emiel) Marges ,&nbsp;A.A. (Anne) Schouffoer ,&nbsp;L.J.M. (Lucia) Kroft ,&nbsp;T.W.J. (Thomas) Huizinga ,&nbsp;J.J.M. (Miranda) Geelhoed ,&nbsp;J.K. (Jeska) de Vries-Bouwstra ,&nbsp;M.K. (Maarten) Ninaber","doi":"10.1016/j.semarthrit.2025.152650","DOIUrl":"10.1016/j.semarthrit.2025.152650","url":null,"abstract":"<div><h3>Background</h3><div>Pulmonary function tests (PFTs) and extent of ILD on HRCT predict mortality in systemic sclerosis associated interstitial lung disease (SSc-ILD). It is not known whether location and type in addition to extent of affected lung parenchyma are associated with PFTs changes.</div></div><div><h3>Methods</h3><div>SSc patients from a targeted healthcare program were included when PFTs and visually scored concomitant chest HRCT and PFTs at one year follow-up were available. Lung parenchyma of SSc patients was semi-quantitatively scored by visual assessment (reticulation, ground glass opacities, emphysema and disease extent) at five levels from apex to base. Regression analysis after linearity check and excluding multicollinearity was used to predict changes in PFT parameters (TLC, total lung capacity; FVC, forced vital capacity; DLCO, diffusion capacity for carbon monoxide).</div></div><div><h3>Results</h3><div>A total of 185 patients were included (85% female, mean age at first symptoms 40 years). All HRCT variables correlated with PFT parameters cross-sectionally. Disease extent and reticulation at the apices (level 1), reticulation at level 2, disease extent and reticulation at level 3 all correlated significantly with TLC (r 0.151–0.17, <em>p</em> &lt; 0.05). Of these HRCT variables disease extent at level 1 predicted change in TLC (adjusted R² 0.024, p 0.021) and when excluding patients with emphysema or pulmonary hypertension, reticulation at level 3 predicted change in TLC (adjusted R² 0.026, p 0.020).</div></div><div><h3>Conclusions</h3><div>In patients with systemic sclerosis and lung involvement, disease extent and reticulation at the mid-upper zones predicted change in TLC which may be of clinical importance.</div></div>","PeriodicalId":21715,"journal":{"name":"Seminars in arthritis and rheumatism","volume":"71 ","pages":"Article 152650"},"PeriodicalIF":4.6,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143290936","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":"Management of disease progression after autologous hematopoietic stem cell transplantation in systemic sclerosis: Results from an international questionnaire-based study","authors":"Julia Spierings ,&nbsp;Giulia Bandini ,&nbsp;Yannick Allanore ,&nbsp;Nicoletta Del Papa ,&nbsp;Christopher P Denton ,&nbsp;Oliver Distler ,&nbsp;Daniel E. Furst ,&nbsp;Raffaella Greco ,&nbsp;Dinesh Khanna ,&nbsp;Masataka Kuwana ,&nbsp;Marco Matucci-Cerinic ,&nbsp;Mandana Nikpour ,&nbsp;Anna van Rhenen ,&nbsp;Jacob M van Laar ,&nbsp;Michael Hughes","doi":"10.1016/j.semarthrit.2025.152638","DOIUrl":"10.1016/j.semarthrit.2025.152638","url":null,"abstract":"<div><h3>Objective</h3><div>Autologous stem cell transplantation (AHSCT) is an established treatment in diffuse cutaneous systemic sclerosis (dcSSc). Optimal management of disease progression after AHSCT in dcSSc has not been defined. The aim of this study was to explore the experience and preferences of SSc experts on post-AHSCT management.</div></div><div><h3>Methods</h3><div>An online questionnaire study was conducted containing 17 questions concerning respondent demographics, definition of SSc progression after AHSCT, diagnostic work-up and treatment preferences.</div></div><div><h3>Results</h3><div>In total, 69 respondents from 21 countries completed the questionnaire. The majority (89.7 %) works at a university hospital, and were involved in decisions regarding AHSCT in patients with SSc (71 %). Most have 1 to 5 patients who underwent AHSCT under their care. They defined failure to improve after AHSCT as: an increase in mRSS, new onset or worsening of interstitial lung disease (ILD), new onset scleroderma renal crisis (SRC) or inflammatory arthritis. Progression after initial response was defined as: increase in mRSS, new or worsening of ILD, new SRC, inflammatory arthritis, new pulmonary arterial hypertension, digital vasculopathy or impaired physical functioning. The most frequent therapy in case of AHSCT failure was mycophenolate mofetil (<em>N</em> = 55, 88.7 %), rituximab (<em>N</em> = 54, 87.1 %), nintedanib (<em>N</em> = 39, 62.9 %) or/and tocilizumab (<em>N</em> = 36, 58.1 %). Combination therapy with more than one of these agents was considered by most respondents (<em>N</em> = 61, 88.4 %).</div></div><div><h3>Conclusion</h3><div>Our study benchmarks the unique combined experiences of post-AHSCT management among SSc experts. We summarize preferences regarding definition of AHSCT failure and progression after response, as well as approach to diagnostic work-up and treatment.</div></div>","PeriodicalId":21715,"journal":{"name":"Seminars in arthritis and rheumatism","volume":"71 ","pages":"Article 152638"},"PeriodicalIF":4.6,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143139224","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":"The effects of menopausal hormone therapy for the risk of systemic lupus erythematosus: A nationwide cohort study in Korea","authors":"Ji Hyoun Kim ,&nbsp;Yo Han Im ,&nbsp;Ji Hyun Noh ,&nbsp;Jin-Sung Yuk","doi":"10.1016/j.semarthrit.2025.152632","DOIUrl":"10.1016/j.semarthrit.2025.152632","url":null,"abstract":"<div><h3>Objectives</h3><div>This retrospective cohort study aimed to investigate the influence of menopausal hormone therapy (MHT) on the occurrence of systemic lupus erythematosus (SLE) in postmenopausal women. Additionally, the study aimed to examine the specific effects of individual MHT drugs.</div></div><div><h3>Methods</h3><div>In this population-based cohort study conducted in Korea, a total of 452,124 women aged &gt;40 years seeking healthcare for menopause were assessed from January 1, 2011, to December 31, 2014. After employing propensity score matching, 139,331 pairs were included in the MHT and non-MHT groups. Follow-up of participants continued until December 31, 2020. The diagnosis of SLE was based on the International Classification of Diseases 10th edition criteria.</div></div><div><h3>Results</h3><div>The median follow-up in the study was 7.9 [6.9–8.9] years. SLE developed in 134 (0.1 %) of the 139,197 participants in the MHT group and 143 (0.1 %) of the 139,188 of the non-MHT group, individually. The risk of SLE in the MHT group did not show a significant increase compared to the non-MHT group {hazard ratio (HR) 1.114, 95 % confidence interval (CI) 0.88–1.41}. Subgroup analysis results indicated no significant differences based on the type of MHT or the duration of MHT use, except tibolone. In the group that used tibolone within 3 years, the HR for SLE risk was 1.45 (95 % confidence interval: 1.051–2.001).</div></div><div><h3>Conclusion</h3><div>The utilization of MHT did not demonstrate a substantial impact on the development of SLE in postmenopausal women. Caution is required in the early stages of tibolone use.</div></div>","PeriodicalId":21715,"journal":{"name":"Seminars in arthritis and rheumatism","volume":"71 ","pages":"Article 152632"},"PeriodicalIF":4.6,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143290927","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":"Associations of local bone involvement with disease activity, damage and functional disability in Sjögren's disease: A cross-sectional study","authors":"Andre S. Franco,&nbsp;Igor H. Murai,&nbsp;Thomas H. Yang,&nbsp;Liliam Takayama,&nbsp;Virginia L.N. Bonoldi,&nbsp;Valeria F. Caparbo,&nbsp;Lissiane K.N. Guedes,&nbsp;Diogo S. Domiciano,&nbsp;Sandra G. Pasoto,&nbsp;Camille P. Figueiredo,&nbsp;Rosa M.R. Pereira","doi":"10.1016/j.semarthrit.2025.152644","DOIUrl":"10.1016/j.semarthrit.2025.152644","url":null,"abstract":"<div><h3>Background</h3><div>Sjögren's disease (SjD) arthritis is non-erosive, but joint involvement in this disease remains unclear. This study investigated the association between bone erosions and clinical parameters using high-resolution peripheral quantitative computed tomography (HR-pQCT) in patients with SjD.</div></div><div><h3>Methods</h3><div>In this cross-sectional study at a quaternary hospital in Brazil, 106 female patients with SjD, aged 18–65 years, who met ACR/EULAR 2016 criteria were evaluated. Exclusion criteria were the use of osteoporosis medication and other bone or autoimmune diseases. Disease activity, damage, functional disability, and laboratory tests were assessed. HR-pQCT was used to identify bone erosions and osteophytes in the 2nd and 3rd metacarpophalangeal and proximal interphalangeal joints, and functional impairment was measured by the handgrip test. Associations between bone erosions, osteophytes, and clinical indices were analysed using logistic regression and generalised linear models.</div></div><div><h3>Findings</h3><div>Between July 2022 and October 2023, 368 patients were screened, and 106 were included. Bone erosions were present in 56.7 % of patients, predominantly in the 3rd metacarpal head, with a mean volume of 5.71 mm³. Osteophytes were identified in 7.2 % of cases. Erosion volume was significantly higher in older and postmenopausal women, in those with greater damage and in those with osteophytes. Erosion volume increased by 7 % per year of age, and postmenopausal women had a 3.54-fold increase in erosion volume compared to premenopausal women. No significant associations were observed between erosions and disease indices or clinical outcomes.</div></div><div><h3>Interpretation</h3><div>This study shows a higher prevalence of bone erosions in SjD than previously described, particularly in older, postmenopausal women. These findings highlight the potential of HR-pQCT as a sensitive tool to detect joint damage in SjD, challenging its non-erosive classification.</div></div>","PeriodicalId":21715,"journal":{"name":"Seminars in arthritis and rheumatism","volume":"71 ","pages":"Article 152644"},"PeriodicalIF":4.6,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143123474","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":"Comparative analysis of disease outcomes: Early vs. late transition from psoriasis to psoriatic arthritis","authors":"Fadi Kharouf ,&nbsp;Pankti Mehta ,&nbsp;Shangyi Gao ,&nbsp;Daniel Pereira ,&nbsp;Richard Cook ,&nbsp;Dafna D Gladman ,&nbsp;Vinod Chandran","doi":"10.1016/j.semarthrit.2025.152639","DOIUrl":"10.1016/j.semarthrit.2025.152639","url":null,"abstract":"<div><h3>Objectives</h3><div>Psoriasis typically precedes psoriatic arthritis (PsA). We explored whether the interval between the two diagnoses is associated with PsA phenotype and outcomes.</div></div><div><h3>Methods</h3><div>We constructed an inception (PsA duration ≤2 years) cohort of patients who developed PsA after psoriasis from a prospective observational cohort. All patients were diagnosed with PsA prior to or at their presentation to the clinic (baseline). We divided the cohort into early and late transition groups based on the median transition period between the diagnoses of psoriasis and PsA of nine years. Features associated with early and late transition at baseline were studied using logistic regression. The impact of early versus late transition on disease activity was assessed using multivariate linear regression, with the 5-year adjusted mean swollen joint count (SJC) as the outcome. The influence on damage was evaluated using Cox regression, with time to radiographic progression as the outcome.</div></div><div><h3>Results</h3><div>We included 702 patients. Late transition patients were observed to have a younger age at diagnosis of psoriasis and older age at diagnosis of PsA. At baseline, they had higher BMI and PASI and less frequent use of conventional synthetic DMARDs. There was a trend for lower disease activity over time in the late transition group. Radiographic progression was not significantly different.</div></div><div><h3>Conclusion</h3><div>There were no significant differences in the PsA features at baseline between the two groups. However, on follow-up, there was a trend for lower cumulative disease activity but not in the rate of radiographic progression in the late transition group.</div></div>","PeriodicalId":21715,"journal":{"name":"Seminars in arthritis and rheumatism","volume":"71 ","pages":"Article 152639"},"PeriodicalIF":4.6,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143080981","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":"Renal outcomes and survival in amyloidosis associated with familial Mediterranean fever: A longitudinal study","authors":"David J Ozeri ,&nbsp;Danielle Bar ,&nbsp;Bar Somech Safran ,&nbsp;Amit Druyan ,&nbsp;Olga Lesya Kukuy ,&nbsp;Eitan Giat ,&nbsp;Merav Lidar ,&nbsp;Avi Livneh","doi":"10.1016/j.semarthrit.2025.152642","DOIUrl":"10.1016/j.semarthrit.2025.152642","url":null,"abstract":"<div><h3>Objectives</h3><div>Long-term outcomes of Familial Mediterranean fever (FMF)-associated amyloidosis (FMF-amyloidosis) have been rarely evaluated. This study aimed to investigate renal and overall survival in patients with FMF-amyloidosis and define the factors affecting outcomes.</div></div><div><h3>Methods</h3><div>We retrospectively analyzed patients with FMF-amyloidosis treated between 2000 and 2022. The primary outcome was the rate of end-stage renal disease or death during the study period. Patients not achieving this outcome served as references to identify factors affecting the outcome.</div></div><div><h3>Results</h3><div>The study included 61 patients with FMF-amyloidosis, of whom 82% attained the primary outcome within a mean of 10.8 ± 9.6 years from the diagnosis of amyloid nephropathy. Lower estimated glomerular filtration rate (eGFR) and increased concomitant medication usage at the time of amyloidosis diagnosis were significant outcome determinants. Maximally selected rank statistics followed by survival analysis determined that an optimal eGFR cutoff &lt;67 mL/min/1.73 m² at amyloidosis diagnosis was significantly associated with a shorter time to endpoint, with a 10-year kidney or overall survival of 17% versus 59% below or above this cutoff, respectively. Kaplan–Meier analysis revealed that treatment with interleukin-1 (IL-1) blockers, administered to 13 timely relevant patients, had no impact on outcomes.</div></div><div><h3>Conclusions</h3><div>FMF-amyloidosis generally has poor long-term prognosis, significantly influenced by the amyloid burden at diagnosis. IL-1 blocker efficacy in altering these outcomes remains uncertain owing to the small sample size.</div></div>","PeriodicalId":21715,"journal":{"name":"Seminars in arthritis and rheumatism","volume":"71 ","pages":"Article 152642"},"PeriodicalIF":4.6,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143139225","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":"Are participants in gout medication registration clinical trials representative of people with gout in the general population?","authors":"Jendy Liu ,&nbsp;Gregory D. Gamble ,&nbsp;Nicola Dalbeth","doi":"10.1016/j.semarthrit.2025.152647","DOIUrl":"10.1016/j.semarthrit.2025.152647","url":null,"abstract":"<div><h3>Background</h3><div>Ensuring clinical trial participants are representative of the target population is important for the generalizability of trial findings. This study aimed to determine if phase 3 clinical trials of gout medications approved by the US Food and Drug Administration (FDA) included participants representative of the US general population with gout.</div></div><div><h3>Methods</h3><div>Gout therapeutics were identified by searching the FDA and CenterWatch websites. Data from phase 3 clinical trials of FDA approved gout medications between 2009 and 2023 were analyzed. Demographic variables (sex, age, and ethnicity) and comorbidities (hypertension, myocardial infarction, heart failure, nephrolithiasis, chronic kidney disease, BMI ≥30 kg/m², and diabetes) were extracted and compared with published data from the 2007–2008 and 2015–2016 US National Health and Nutrition Examination Survey (NHANES). Data were pooled using a random effects model and presented as a percentage with a 95 % confidence interval.</div></div><div><h3>Results</h3><div>Twelve phase 3 clinical trials were included, covering febuxostat, colchicine, pegloticase, lesinurad, and canakinumab. Compared to the NHANES gout population, clinical trials over-represented men, younger individuals, and White ethnicity participants. Under-representation was observed for clinical trial participants with hypertension, prior myocardial infarction, nephrolithiasis, and diabetes, while those with a BMI ≥30 kg/m² were over-represented.</div></div><div><h3>Conclusions</h3><div>FDA approved gout medication trials since 2009 have not enrolled a study population that is representative of the US general population with gout, particularly regarding age, ethnicity, and cardiometabolic comorbidities. For broader applicability, future phase 3 trials should ensure the greater inclusion of women, older individuals, diverse ethnicities, and those with common gout-associated comorbid conditions.</div></div>","PeriodicalId":21715,"journal":{"name":"Seminars in arthritis and rheumatism","volume":"71 ","pages":"Article 152647"},"PeriodicalIF":4.6,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143290938","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":"Use of biologic drug in the treatment of localized scleroderma and systemic sclerosis in children: A scoping review","authors":"Seher Sener ,&nbsp;Ezgi Deniz Batu","doi":"10.1016/j.semarthrit.2025.152634","DOIUrl":"10.1016/j.semarthrit.2025.152634","url":null,"abstract":"<div><h3>Objective</h3><div>Biologic drugs are a potential treatment option in resistant cases of juvenile scleroderma. In this review, we aimed to examine previous studies regarding biologic drug use in pediatric patients with localized scleroderma and systemic sclerosis.</div></div><div><h3>Methods</h3><div>We performed a search on MEDLINE and Scopus for articles involving pediatric localized scleroderma and systemic sclerosis patients treated with biologic drugs.</div></div><div><h3>Results</h3><div>We identified 17 articles describing 58 pediatric patients with localized scleroderma treated with biologic drugs and 12 articles describing 29 pediatric patients with systemic sclerosis treated with biologic drugs during our literature search. The most frequently used biologic drug in localized scleroderma treatment was abatacept (55.2 %), followed by tocilizumab (48.3 %). These biologic drugs were mainly preferred for treating resistant/progressive skin disease in pediatric patients with localized scleroderma (58.5 % and 68.8 %, respectively). The improvement rates associated with abatacept and tocilizumab were 92.9 % and 77.4 %, respectively. Adverse events were observed in 23.5 % of all localized scleroderma patients. The most frequently used biologic drug in systemic sclerosis treatment was rituximab (51.7 %), followed by tocilizumab (44.8 %). Rituximab was predominantly favored for managing cardiac involvement (45.5 %), whereas tocilizumab was preferred for pulmonary involvement (50 %) in pediatric patients with systemic sclerosis. The improvement rates associated with rituximab and tocilizumab were 72.7 % and 94.1 %, respectively. Adverse events were reported in 40 % of all systemic sclerosis patients.</div></div><div><h3>Conclusion</h3><div>Our results showed that abatacept and tocilizumab were more frequently used in patients with localized scleroderma, while rituximab and tocilizumab were the predominantly used biologics in patients with systemic sclerosis. The improvement rate with these biologics were quite high with acceptable safety profile.</div></div>","PeriodicalId":21715,"journal":{"name":"Seminars in arthritis and rheumatism","volume":"71 ","pages":"Article 152634"},"PeriodicalIF":4.6,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143378284","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":"Tender joints in early autoantibody-negative rheumatoid arthritis: Should they be included in the scoring of joint involvement of the 2010 ACR/EULAR classification criteria?","authors":"Ludovico De Stefano ,&nbsp;Emanuele Bozzalla Cassione ,&nbsp;Garifallia Sakellariou ,&nbsp;Federica Sabatelli ,&nbsp;Emmanuele Guadalupi ,&nbsp;Clelia Zampaglione ,&nbsp;Andrea Nicrosini ,&nbsp;Antonio Manzo ,&nbsp;Carlomaurizio Montecucco ,&nbsp;Serena Bugatti","doi":"10.1016/j.semarthrit.2025.152637","DOIUrl":"10.1016/j.semarthrit.2025.152637","url":null,"abstract":"<div><h3>Objectives</h3><div>The interpretation of joint tenderness as a sign of inflammation in patients with autoantibody-negative rheumatoid arthritis (RA) is uncertain. This may hinder disease classification and create selection bias for patient enrollment in clinical trials. Here we tested whether reclassifying the pattern of joint involvement based on swollen joints increases specificity for persistent arthritis in autoantibody-negative early RA.</div></div><div><h3>Methods</h3><div>From a prospective early arthritis cohort in the years 2005–2018, all autoantibody-negative patients fulfilling the 2010 ACR/EULAR RA criteria at enrollment were included. Patients were re-classified for the score of swollen joint involvement (1–3=score 2; 4–10=score 3; &gt;10=score 5). Groups were compared for baseline clinical and ultrasonographic (US) characteristics and outcomes after 12 and 36 months.</div></div><div><h3>Results</h3><div>Of a total of 354 autoantibody-negative patients with 2010-based RA, 39.5 % had a score of swollen joints=5, 47.5 % score=3, and 13 % score=2. We found equal signs of US synovitis and power Doppler of the wrists and metacarpophalangeal joints. Patients with lower swollen joint scores had similar requirements of treatment intensification within month 12 compared with patients with higher baseline inflammation. These latter had the most favourable outcomes, with lower need of second-line treatment strategies within month 36. Exclusion of patients with concomitant fibromyalgia did not modify the results.</div></div><div><h3>Conclusions</h3><div>Joint tenderness should be included in the evaluation of the pattern of joint involvement of the 2010 ACR/EULAR criteria to correctly classify patients with autoantibody-negative early RA. A score solely based on joint swelling may lead to the erroneous under-selection of patients with persistent arthritis.</div></div>","PeriodicalId":21715,"journal":{"name":"Seminars in arthritis and rheumatism","volume":"71 ","pages":"Article 152637"},"PeriodicalIF":4.6,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143080987","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":"Mortality and medical utilization in rheumatoid arthritis associated interstitial lung disease: A real-world, large-scale retrospective study comparing Janus kinase inhibitors and tumor necrosis factor inhibitors","authors":"Po-Cheng Shih ,&nbsp;Qing-Hua Zou ,&nbsp;Chih-Cheng Lai ,&nbsp;Shiow-Ing Wang ,&nbsp;Xiang-Yang Huang ,&nbsp;James Cheng Chung Wei","doi":"10.1016/j.semarthrit.2025.152636","DOIUrl":"10.1016/j.semarthrit.2025.152636","url":null,"abstract":"<div><h3>Objective</h3><div>The study is aimed to investigate the effectiveness of Janus kinase inhibitors (JAKi) on rheumatoid arthritis associated interstitial lung disease (RA-ILD) compared to tumor necrosis inhibitors (TNFi).</div></div><div><h3>Methods</h3><div>We applied a retrospective matched cohort analysis using the TriNetX database. The study included patients diagnosed with RA-ILD who received new prescriptions for JAKi or TNFi. The primary outcome was all-cause mortality, and secondary outcomes included medical utilizations. Hazard ratios (HRs) and Cox regression analyses were performed to assess these outcomes.</div></div><div><h3>Results</h3><div>Among 23,707 RA-ILD patients, 812 were selected for each treatment group (JAKi and TNFi) following propensity score matching. The JAKi group exhibited a higher all-cause mortality risk compared to the TNFi group (HR 1·458, 95 % CI: 1·136–1·870). JAKi group was also associated with a higher risk for hospitalization (HR 1·167, 95 % CI: 1·011–1·348), critical care services (HR 1·854, 95 % CI: 1·414–2·431), and mechanical ventilation (HR 2·609, 95 % CI: 1·718–3·962). Subgroup analysis indicated a heightened mortality risk in JAKi-treated patients aged over 65 years old (HR 1·815, 95 % CI: 1·316–2·503), and those with cardiovascular risk factors (HR 1·636, 95 % CI: 1·197–2·237). Sensitivity analysis yielded results that were not entirely consistent with the primary analysis, except for the subgroup aged over 65, where results remained aligned.</div></div><div><h3>Conclusion</h3><div>This real-world, large-scale cohort study indicated an association of higher mortality and medical utilizations in RA-ILD patients treated with JAKi compared to TNFi, especially among those over 65 years of age. These findings highlight the need for careful assessment when prescribing JAKi or TNFi for patients with RA-ILD.</div></div>","PeriodicalId":21715,"journal":{"name":"Seminars in arthritis and rheumatism","volume":"71 ","pages":"Article 152636"},"PeriodicalIF":4.6,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143140036","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}