Seminars in arthritis and rheumatism最新文献

{"title":"Impairment of white matter microstructure and structural network in patients with systemic lupus erythematosus","authors":"Ru Bai ,&nbsp;Yifan Yang ,&nbsp;Shuang Liu ,&nbsp;Shu Li ,&nbsp;Ruotong Zhao ,&nbsp;Xiangyu Wang ,&nbsp;Yuqi Cheng ,&nbsp;Jian Xu","doi":"10.1016/j.semarthrit.2024.152620","DOIUrl":"10.1016/j.semarthrit.2024.152620","url":null,"abstract":"<div><h3>Objective</h3><div>The study aimed to investigate the damage of white matter (WM) microstructure and structural network in patients with systemic lupus erythematosus (SLE) using diffusion tensor imaging.</div></div><div><h3>Methods</h3><div>Tract-based spatial statistics (TBSS) were used to compare the difference in WM fractional anisotropy (FA) between SLE and HCs groups. The differences in WM networks between groups are compared using graph theory. The correlation between clinical data and SLE abnormal WM structure and network was analysed.</div></div><div><h3>Results</h3><div>The sample included 140 SLE patients and 111 healthy controls (HCs). Due to data missing, excessive head movement amplitude, failure of quality control and other reasons, 127 cases of SLE (103 females, mean age 29.84 years (SD 7.00), median years of education 12.00, interquartile range(9.00,15.00) and a median course of disease (month) 12.00, interquartile range (3.00,24.00)) and 102 cases of HCs (76 females, mean age 30.63 years (SD 7.24), median years of education 15.00, interquartile range(12.00,16.00)) were finally included in the study. The FA values of 5 clusters involving the right retrolenticular part of the internal capsule (RLIC), the genu of corpus callosum (GCC), the body of corpus callosum, the splenium of corpus callosum (SCC), were significantly lower in the SLE group compared to the HCs (<em>P</em> &lt; 0.05 with threshold-free cluster enhancement corrected). The SLEDAI showed a negative correlation with FA in GCC, and HAMD showed a negative correlation with FA in SCC and right RLIC (<em>P</em> &lt; 0.05). Regarding network indicators, Cp, E_glob, and E_loc were significantly decreased, while Lp was significantly increased in the SLE group. The degree centrality (DC) of 6 brain regions and the E_nodal of 17 regions were significantly lower in the SLE group. SLEDAI showed a negative correlation with the area under the curve (AUC) of DC and E_nodal in the left inferior frontal gyrus triangular (<em>q</em> &lt; 0.05 with false discovery rate corrected), while MMSE showed a positive correlation with the E_nodal in the left hippocampus (<em>P</em> &lt; 0.05).</div></div><div><h3>Conclusion</h3><div>The study concludes that changes in WM microstructure and its structural network may contribute to the development of severe neuropsychiatric symptoms in SLE patients. These changes may be the basis of brain damage that leads to the development of NPSLE from SLE without major neuropsychiatric manifestations.</div></div>","PeriodicalId":21715,"journal":{"name":"Seminars in arthritis and rheumatism","volume":"71 ","pages":"Article 152620"},"PeriodicalIF":4.6,"publicationDate":"2024-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142897118","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":"Established and novel insights to guide cancer assessment in patients with idiopathic inflammatory myopathies","authors":"Angela Ceribelli ,&nbsp;Antonio Tonutti ,&nbsp;Natasa Isailovic ,&nbsp;Maria De Santis ,&nbsp;Carlo Selmi","doi":"10.1016/j.semarthrit.2024.152619","DOIUrl":"10.1016/j.semarthrit.2024.152619","url":null,"abstract":"<div><h3>Objective</h3><div>Older age, dermatomyositis, and specific serum autoantibodies such as anti-TIF1-γ are associated with higher cancer risk in patients with myositis. We evaluated a vast cohort of patients with myositis for the prevalence of cancer, the association to disease features, and the performance of the recent IMACS guidelines.</div></div><div><h3>Methods</h3><div>A retrospective cohort analysis was performed and in all cases serum autoantibodies were tested using HEp-2, immunoassays, RNA- and protein-immunoprecipitation. Myositis was defined as cancer-associated if malignancy occurred within 3 years prior to or after the onset of myositis.</div></div><div><h3>Results</h3><div>Ninety-five patients with IIM were followed-up for a median of 6 years (interquartile range 3–11), the majority were classified as ‘high-risk’ or ‘intermediate-risk’ of cancer based on IMACS guidelines. A diagnosis of cancer was made in 22/95 (23 %) of cases and, based on the timing of the diagnosis, 14 % patients were cancer-associated myositis, with no significant differences compared to patients without cancer. Both groups of patients with overall cancer and cancer-associated myositis had more respiratory comorbidities, anemia, and hypergammaglobulinemia, and dermatomyositis phenotype. Anti-TIF1-γ antibody positivity predicted cancer-associated myositis but not the overall cancer rate; malignancy was observed in particular in patients with isolated anti-TIF1-γ antibodies, while a lower prevalence occurred in case of additional specificities identified by immunoprecipitation.</div></div><div><h3>Conclusions</h3><div>Recent IMACS guidelines perform well in the interception of cancer, yet adjunctive history and laboratory features should be considered. Patients with anti-TIF1-γ antibodies are at risk of cancer-associated myositis, but concurrent autoantibodies negatively correlate with malignancy and warrant characterization.</div></div>","PeriodicalId":21715,"journal":{"name":"Seminars in arthritis and rheumatism","volume":"71 ","pages":"Article 152619"},"PeriodicalIF":4.6,"publicationDate":"2024-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142972045","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":"The history of ankylosing spondylitis/axial spondyloarthritis – what is the driving force of new knowledge?","authors":"Braun J․ ,&nbsp;Sieper J․ ,&nbsp;Dougados M․","doi":"10.1016/j.semarthrit.2024.152611","DOIUrl":"10.1016/j.semarthrit.2024.152611","url":null,"abstract":"<div><div>The history of (axial) spondyloarthritis has started several centuries ago. Since the end of the 19th century major achievements have been made. This historical review tries to show how closely the advances in clinical medicine in rheumatology have been related to advances made in basic sciences.</div></div>","PeriodicalId":21715,"journal":{"name":"Seminars in arthritis and rheumatism","volume":"71 ","pages":"Article 152611"},"PeriodicalIF":4.6,"publicationDate":"2024-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143011074","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 operational definition of old age and impact on outcomes in DMARD-treated patients with rheumatoid arthritis: A systematic literature review","authors":"Saskia P.M. Truijen ,&nbsp;Jerome P.R. Schreurs ,&nbsp;Annelies Boonen ,&nbsp;Marloes van Onna","doi":"10.1016/j.semarthrit.2024.152607","DOIUrl":"10.1016/j.semarthrit.2024.152607","url":null,"abstract":"<div><h3>Objective</h3><div>To systematically review operational definitions of old(er) age in rheumatoid arthritis (RA) patients and investigate differences in disease-modifying anti-rheumatic drug (DMARD) efficacy, safety and drug survival between young(er) and old(er) patients.</div></div><div><h3>Methods</h3><div>A systematic review was performed on studies conducting research in an old(er) RA patient population. Two reviewers independently performed data extraction and risk of bias assessment. Operational definitions of old(er) age were described using frequency statistics. For studies comparing effects of DMARDs, random effects meta-analyses estimated pooled odds ratios (ORs) of young(er) vs. old(er) patients reaching remission, experiencing adverse events (AEs) and discontinuing drug treatment due to unfavourable events.</div></div><div><h3>Results</h3><div>This review included 324 studies. The operational definition for old(er) age ranged from 40.0 to 77.3 years. The most frequent definition was 65 (45.1 %), followed by 60 years or older (20.4 %). Fifty-eight percent of studies reported no reason for using a specific age-threshold. Seventy-nine studies evaluated DMARD efficacy, safety and/or survival, with 37 eligible for meta-analysis. No statistically significant difference in reaching remission was observed between old(er) and young(er) patients (OR=0.76 (95 %-CI: 0.57–1.02)) (<em>n</em> = 11 studies). AEs and drug discontinuation were experienced more often in old(er) patients (OR=1.33 (95 %-CI: 1.01–1.74) (<em>n</em> = 19 studies) and OR=1.12 (95 %-CI: 1.02–1.23) (<em>n</em> = 25 studies), respectively).</div></div><div><h3>Conclusion</h3><div>Definitions of old(er) age vary across studies including RA patients. Old(er) age appears to affect DMARD safety and discontinuation. To ensure meaningful comparisons across studies, studies should justify the chosen definition and report and account for potential impacts of indicators of ageing, such as multimorbidity, polypharmacy, and geriatric syndromes.</div></div>","PeriodicalId":21715,"journal":{"name":"Seminars in arthritis and rheumatism","volume":"71 ","pages":"Article 152607"},"PeriodicalIF":4.6,"publicationDate":"2024-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142927893","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 effect of biological treatment on female fertility: A cohort study of women with rheumatoid arthritis and psoriatic arthritis","authors":"Einat Haikin Herzberger ,&nbsp;Tzipi Hornik-Lurie ,&nbsp;Yair Levi ,&nbsp;Netanella Miller ,&nbsp;Amir Wiser ,&nbsp;Anat Hershko-Klement","doi":"10.1016/j.semarthrit.2024.152608","DOIUrl":"10.1016/j.semarthrit.2024.152608","url":null,"abstract":"<div><h3>Objectives</h3><div>To investigate female fertility in patients with rheumatoid arthritis (RA) exposed to biological drugs.</div></div><div><h3>Methods</h3><div>In this retrospective cohort study, based on an electronic health record database, 4517 women with RA were compared to 1415 patients with psoriatic arthritis (PsA). Patients were 18–40 years-of-age at diagnosis. Biological treatments included tumor necrosis factor inhibitors, anti-CD-20 monoclonal antibodies, interleukin blockers and T-cell inhibitors. Main outcome measure was positive pregnancy test rate. Secondary outcome measures were pregnancy attempts and use of in vitro fertilization (IVF)</div></div><div><h3>Results</h3><div>Mean age at diagnosis and at initiation of biological treatments was not statistically different between RA and PsA (30.7 ± 6.3 vs. 30.9 ± 6; p = 0.260 and 34.2 ± 8 vs. 34.2 ± 7.5 years; p = 0.729, respectively). Both groups demonstrated lower rates of positive beta hCG after diagnosis, as compared to baseline rates before diagnosis. However, exposure to biological treatment did not negatively affect the likelihood of conception in either group. Beta hCG testing increased in both groups after initiation of biological treatments (RA p &lt; 0.01, PsA p = 0.07). Use of fertility medications before diagnosis was about 8 % in both groups (p &gt; 0.5). After diagnosis, before exposure, this percentage dropped to approximately 4 % in both groups (p &gt; 0.5) but recovered to baseline values. Post-exposure IVF rate among RA patients was lower (p &lt; 0.01) than the pretreatment state but was not significantly different in the PsA group.</div></div><div><h3>Conclusions</h3><div>This large cohort study provides reassuring data regarding spontaneous and medicated fertility in patients exposed to biological medications. Further studies, as well as data on live birth rates are required to consolidate these findings.</div></div>","PeriodicalId":21715,"journal":{"name":"Seminars in arthritis and rheumatism","volume":"71 ","pages":"Article 152608"},"PeriodicalIF":4.6,"publicationDate":"2024-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142903439","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":"Prioritising domains of glucocorticoid therapy to measure in trials: Results from a modified delphi exercise from the OMERACT glucocorticoid impact working group.","authors":"Joanna Tieu, Jonathan Tl Cheah, Suellen Lyne, Kevin Yip, Nilasha Ghosh, Pamela Richards, Robin Christensen, Rachel J Black, Joanna C Robson, Sarah L Mackie, Catherine L Hill, Susan M Goodman","doi":"10.1016/j.semarthrit.2024.152602","DOIUrl":"https://doi.org/10.1016/j.semarthrit.2024.152602","url":null,"abstract":"<p><strong>Introduction: </strong>There is no consensus amongst patients and healthcare professionals about how to measure important adverse effects of glucocorticoids (GCs) that includes the patient's perspective. The OMERACT GC Impact working group sought to identify the domains of greatest importance to both patients and healthcare professionals for use in a proposed core outcome set.</p><p><strong>Methods: </strong>Patients and healthcare professionals participated in a Delphi consensus exercise to rate the importance of previously identified candidate domains. Those deemed critical to include by at least 70% in both groups, after three rounds of a Delphi exercise were identified as meeting consensus. All participants were asked which additional domains should be measured in all trials in a final survey; those domains selected by more than 70% of all participants were added, resulting in a final list of potential core domains.</p><p><strong>Results: </strong>In total, 363 people (295 patients and 68 healthcare professionals) participated in the Delphi process. The final list of potential core domains included: bone fragility, diabetes, eye problems and/or changes in vision, high blood pressure, infection, osteonecrosis, mood disturbance, fatigue, sleep disturbance, weight.</p><p><strong>Conclusion: </strong>The 10 domains identified through this exercise informed the proposed core domain set of GC effects to be considered for use in future clinical trials involving GCs. This core domain set was endorsed at the OMERACT 2020 virtual workshop.</p>","PeriodicalId":21715,"journal":{"name":"Seminars in arthritis and rheumatism","volume":" ","pages":"152602"},"PeriodicalIF":4.6,"publicationDate":"2024-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142795108","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":"Quantification of coronary artery calcification in systemic sclerosis using visual ordinal and deep learning scoring: Association with systemic sclerosis clinical features","authors":"Yiming Luo ,&nbsp;Daniel Hanuska ,&nbsp;Jiehui Xu ,&nbsp;Mary M Salvatore ,&nbsp;Elana J Bernstein","doi":"10.1016/j.semarthrit.2024.152598","DOIUrl":"10.1016/j.semarthrit.2024.152598","url":null,"abstract":"<div><h3>Objective</h3><div>To investigate the association between systemic sclerosis (SSc) clinical features and the extent and progression of coronary artery calcifications.</div></div><div><h3>Methods</h3><div>We conducted a single-center retrospective cohort study of patients with SSc. In our primary aim, we investigated the association between SSc clinical features and the annual progression of coronary artery calcium (CAC) scores quantified using the visual ordinal scoring method. In our secondary aim, we utilized DeepCAC, a deep learning-based method, to quantify coronary artery calcifications (“deep learning CAC score”), and explored its association with SSc clinical features.</div></div><div><h3>Results</h3><div>Eighty-six SSc patients were included in the primary aim and 171 in the secondary aim. SSc disease duration was inversely associated with annual ordinal CAC score progression in the demographics-adjusted model (coefficient = -0.004, 95 % CI -0.006 to -0.001, p-value = 0.01) and the demographics- and cardiovascular (CV) risk factor-adjusted model (coefficient = -0.004, 95 % CI -0.008 to -0.0004, p-value = 0.03). The presence of \"fingertip ischemic ulcers or digital pitting scars\" (demographics-adjusted model: coefficient = 1.07, 95 % CI 0.29 to 1.85, <em>p</em> &lt; 0.01; demographics- and CV risk factor-adjusted model: coefficient = 1.39, 95 % CI 0.43 to 2.34, <em>p</em> &lt; 0.01) and Group 1 pulmonary hypertension (demographics-adjusted model: coefficient = 1.34, 95 % CI 0.34 to 2.35, <em>p</em> &lt; 0.01; demographics- and CV risk factor-adjusted model: coefficient = 1.52, 95 % CI 0.38 to 2.65, <em>p</em> &lt; 0.01) were both associated with the deep learning CAC score.</div></div><div><h3>Conclusion</h3><div>Our results suggest that the progression of coronary artery calcification accelerates early during the SSc disease course and that severe microvasculopathy may be a risk factor for atherosclerotic CVD.</div></div>","PeriodicalId":21715,"journal":{"name":"Seminars in arthritis and rheumatism","volume":"70 ","pages":"Article 152598"},"PeriodicalIF":4.6,"publicationDate":"2024-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142744215","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":"High prevalence and incidence of systemic sclerosis in Reunion Island, a French multi-ethnical and tropical territory","authors":"Arthur Dubernet ,&nbsp;Céline Roussin ,&nbsp;Nathalie Sultan-Bichat ,&nbsp;Aurélie Foucher ,&nbsp;Cécile Saint-Pastou Terrier ,&nbsp;Patrice Poubeau ,&nbsp;Julien Klisnick ,&nbsp;Antoine Bertolotti ,&nbsp;Loraine Gaüzère ,&nbsp;Frédéric Renou ,&nbsp;Anne Gerber ,&nbsp;Kelly Bagny ,&nbsp;Sophie Osdoit-Médart ,&nbsp;Tannvir Desroche ,&nbsp;Quentin Richier ,&nbsp;Nathalie Allou ,&nbsp;Stéphane Lecoules ,&nbsp;Stéphanie Fayeulle ,&nbsp;Damien Vagner ,&nbsp;Maïssa Safieddine ,&nbsp;Loïc Raffray","doi":"10.1016/j.semarthrit.2024.152594","DOIUrl":"10.1016/j.semarthrit.2024.152594","url":null,"abstract":"<div><h3>Objectives</h3><div>Systemic sclerosis’ (SSc) prevalence varies according to geographical location, presumably in link with environmental and genetic factors. We sought to determine SSc prevalence and incidence on Reunion Island, a southern hemisphere territory characterised by multi-ethnic background.</div></div><div><h3>Methods</h3><div>We conducted a retrospective review of SSc cases defined according to ACR/EULAR 2013 classification criteria. Cases were retrieved over the 2005–2021 period through multiple sources, mainly community and hospital follow-up. Patients were assigned to three clinical subsets: sine scleroderma (normal skin) (ss), limited cutaneous (lc) or diffuse cutaneous (dc) SSc. Prospective submission of questionnaires to patients in 2021 enabled determination of patients’ self-declared ethnicity and physician-assessed phototype group. Prevalence was calculated for 2021 and mean annual incidence between 2005 and 2021 after adjustment with WHO's standards.</div></div><div><h3>Results</h3><div>Overall, 207 patients were included in the retrospective cohort, including 175 SSc (108 lcSSc, 58 dcSSc and 9 ssSSc) and 32 mixed connective tissue disease. Prevalence and mean annual incidence were estimated to be 30.9 (95 %IC: 26.1–35.8) per 100,000 inhabitants in 2021 and 2.13 (95 %IC: 1.81–2.45) per 100,000 inhabitants/year respectively. The 5- and 10-year survival rates after diagnosis were 0.93 and 0.82 respectively. Phototypes and ethnicity were determined in 102 and 86 patients, respectively. Darker phototypes presented more frequently with pulmonary hypertension, while lighter phototypes had more severe gastro-intestinal manifestations and anti-centromere antibodies positivity.</div></div><div><h3>Conclusion</h3><div>Our study revealed high prevalence and incidence of SSc in Reunion Island which is consistent with the frequently described higher frequency among patients of African origin.</div></div>","PeriodicalId":21715,"journal":{"name":"Seminars in arthritis and rheumatism","volume":"70 ","pages":"Article 152594"},"PeriodicalIF":4.6,"publicationDate":"2024-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142723012","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":"Smoking-related bias of standardized mortality ratios in rheumatoid arthritis: A modeling study","authors":"Michael M. Ward","doi":"10.1016/j.semarthrit.2024.152599","DOIUrl":"10.1016/j.semarthrit.2024.152599","url":null,"abstract":"<div><h3>Objective</h3><div>Standardized mortality ratios (SMRs) for rheumatoid arthritis (RA) are age- and sex-matched to the general population, but may be biased because smoking is more common in the RA group. This modeling study used national mortality data on smokers and non-smokers to estimate the effect on SMRs of the higher smoking prevalences typically found in RA.</div></div><div><h3>Methods</h3><div>Data from the United States National Health Interview Surveys 1999–2004 were used to create hypothetical cohorts with an age-sex composition typical of patients with RA (age 30 to 79; 70 % women). The reference cohort had the smoking prevalence of the general population (21.8 % current smokers). Additional cohorts were created that had higher proportions of smokers, approximating the prevalence of smoking commonly present in RA, with smoking relative risks of 1.25, 1.5, 1.75, and 2.0 compared to the reference cohort. SMRs were computed on 2000 replicate samples in which mortality over 10 years and 15 years was compared between the higher-smoking simulated RA cohorts and the reference cohort.</div></div><div><h3>Results</h3><div>The reference cohort had a prevalence of current smoking of 21.8 %. In a hypothetical RA cohort with a higher smoking prevalence, equal to a smoking relative risk of 2.0 compared to the general population, the median SMR for RA was 1.23 at 10 years and 1.17 at 15 years. At a smoking prevalence equivalent to a relative risk of 1.25, the median SMR for RA was 1.07 at 10 years and 1.04 at 15 years. Results were similar for SMRs based on relative risks that compared ever smokers to never smokers. Differences in smoking intensity between the hypothetical RA groups and reference cohorts had small effects on SMRs.</div></div><div><h3>Conclusions</h3><div>SMRs in RA may be inflated by even small increases in the prevalence of smoking relative to the general population. In these cases, an SMR benchmark of 1.0 to represent equal mortality outcomes would be too strict.</div></div>","PeriodicalId":21715,"journal":{"name":"Seminars in arthritis and rheumatism","volume":"70 ","pages":"Article 152599"},"PeriodicalIF":4.6,"publicationDate":"2024-11-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142699531","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":"The pathogenesis, diagnostic utility and clinical relevance of cutaneous telangiectasia in systemic sclerosis","authors":"Aishwarya Anilkumar ,&nbsp;Matthew Wells ,&nbsp;Robyn T Domsic ,&nbsp;Laura K Hummers ,&nbsp;Ami A Shah ,&nbsp;John D Pauling","doi":"10.1016/j.semarthrit.2024.152593","DOIUrl":"10.1016/j.semarthrit.2024.152593","url":null,"abstract":"<div><div>Cutaneous telangiectasia (Tel) are visible permanently dilated postcapillary dermal venules and are one of the most common disease-specific manifestations of systemic sclerosis (SSc). Telangiectasia have long been recognised for their utility in the diagnosis and classification of SSc, but the clinical and prognostic relevance of these aberrant cutaneous vascular manifestations has been somewhat neglected by clinicians. Similarly, the impact of SSc-Tel on body image dissatisfaction and social discomfort has been under-appreciated. The paucity of evidence-based approaches to management has limited access to potential effective treatments for SSc-Tel. The present review examines the pathogenesis, diagnostic value, impact and clinical relevance of telangiectasia in SSc. We highlight the potentially overlooked prognostic value and clinical utility of SSc-Tel, as part of a broader appraisal of areas of unmet research need.</div></div>","PeriodicalId":21715,"journal":{"name":"Seminars in arthritis and rheumatism","volume":"70 ","pages":"Article 152593"},"PeriodicalIF":4.6,"publicationDate":"2024-11-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142699532","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}