Seminars in arthritis and rheumatism最新文献

{"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}

{"title":"Relapses in giant cell arteritis treated with tocilizumab. Retrospective multicenter study of 407 patients in clinical practice","authors":"Adrián Martín-Gutiérrez ,&nbsp;Javier Loricera ,&nbsp;Vicente Aldasoro ,&nbsp;Olga Maiz ,&nbsp;Eugenio de Miguel ,&nbsp;Eva Galíndez-Agirregoikoa ,&nbsp;Iván Ferraz-Amaro ,&nbsp;Santos Castañeda ,&nbsp;Ricardo Blanco ,&nbsp;Tocilizumab in Giant Cell Arteritis Spanish Collaborative Group","doi":"10.1016/j.semarthrit.2025.152640","DOIUrl":"10.1016/j.semarthrit.2025.152640","url":null,"abstract":"<div><h3>Objective</h3><div>Tocilizumab (TCZ) is the only biologic approved in Giant Cell Arteritis (GCA). In clinical trials around a quarter of patients relapse during TCZ treatment. We assess the frequency, features and factors associated with relapses in a wide series of GCA patients in a real-world setting.</div></div><div><h3>Methods</h3><div>National multicenter observational study of GCA patients treated with TCZ between 2016 and 2021. The variables collected at TCZ initiation were demographic, clinical, laboratory, temporal artery biopsy, and imaging findings, corticosteroids dose, previous therapies and TCZ therapeutic schedule. We perform a comparative study between patients with/ without relapses (bivariate analysis) and a study of factors associated with relapse (multivariate logistic).</div></div><div><h3>Results</h3><div>We study 407 patients (295 women; mean age 73.6 ± 8.9 years). After a mean follow-up of 25.3 ± 21.7 months, relapses were observed in 63 of 407 (15.5 %) patients. At TCZ initiation, no differences were observed between both groups (with/without relapses) in demographic, clinical and laboratory features or corticosteroid dose. The median time to the first relapse was 12 [6–24] months being the most frequent manifestations polymyalgia rheumatica (47.6 %), and headache (12.7 %). In multivariate logistic regression analysis, the set of variables associated with GCA relapses were TCZ initiation later than 6 weeks (OR 3.446 [1.196- 9.931]), optimization (OR 2.803 [1.507–5.215]) and administration of IV TCZ (OR 2.327 [1.244–4.353]) and previous therapies to TCZ (OR 5.062[2.402–10.665]).</div></div><div><h3>Conclusion</h3><div>In this series, GCA relapses were observed in 15 % of patients, all of them non-severe. Relapses were associated with TCZ therapeutic schedule, such as IV administration, optimization, delayed initiation and previous therapies to TCZ.</div></div>","PeriodicalId":21715,"journal":{"name":"Seminars in arthritis and rheumatism","volume":"71 ","pages":"Article 152640"},"PeriodicalIF":4.6,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143122644","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":"An analysis of the first relapse in giant cell arteritis using ultrasonography","authors":"Chetan B Mukhtyar,&nbsp;Shruti Alanoor,&nbsp;Georgina Ducker","doi":"10.1016/j.semarthrit.2025.152646","DOIUrl":"10.1016/j.semarthrit.2025.152646","url":null,"abstract":"<div><h3>Objectives</h3><div>To compare the nature of the first relapse of giant cell arteritis to baseline disease using ultrasonography</div></div><div><h3>Methods</h3><div>Patients with suspected new and relapsing giant cell arteritis between January 2017 and December 2023 underwent protocolised ultrasonography to examine the superficial temporal and axillary arteries plus other areas as clinically indicated. The nature of disease was categorised as affecting superficial temporal, axillary or mixed disease. Patients where other arteries were needed for diagnosis or relapse were categorised separately. Patients with clinically and sonological evidence of polymyalgia rheumatica were distinctly categorised.</div></div><div><h3>Results</h3><div>66 patients were included. At diagnosis and first relapse, 48/66 and 20/66 patients respectively had superficial temporal artery involvement. At diagnosis and first relapse, 23/66 and 40/66 respectively patients had axillary artery involvement. Patients without superficial temporal artery disease at diagnosis did not relapse in the superficial temporal artery. 7/66 patients suffered a polymyalgia rheumatica relapse. 5 of those 7 had superficial temporal arterial involvement at diagnosis.</div></div><div><h3>Conclusion</h3><div>This is the first study that reports on the nature of relapsing giant cell arteritis using sonological appearances. Relapsing disease is more common in the extracranial arteries and may be mistaken for polymyalgia rheumatica. True polymyalgia rheumatica relapses are uncommon. Relapses in patients with giant cell arteritis should be assessed using ultrasonography and should include the imaging of the axillary artery.</div></div>","PeriodicalId":21715,"journal":{"name":"Seminars in arthritis and rheumatism","volume":"71 ","pages":"Article 152646"},"PeriodicalIF":4.6,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143080973","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":"Calcium pyrophosphate deposition is associated with an increased risk for nephrolithiasis: A cohort study","authors":"Mahum Mirza,&nbsp;Alison Fernandes,&nbsp;Katherine Sherman,&nbsp;Ann K Rosenthal","doi":"10.1016/j.semarthrit.2025.152641","DOIUrl":"10.1016/j.semarthrit.2025.152641","url":null,"abstract":"<div><h3>Background/Objective</h3><div>Calcium pyrophosphate deposition disease (CPPD) is a type of arthritis affecting aging adults that presents with chronic and acute inflammatory and non-inflammatory joint disease. While the etiology of CPPD is not fully understood, recent work suggests that it may be associated with other mineralization disorders. In this retrospective cohort study, we investigated the hypothesis that the prevalence of nephrolithiasis is increased in patients with CPPD.</div></div><div><h3>Methods</h3><div>We used the National VA Corporate Data Warehouse to identify CPPD patients with at least one inpatient or outpatient ICD9 code for CPPD between January 1, 2010 and December 31, 2014. This disease cohort was age-, sex-, and date-matched to up to four controls. The presence of independent risk factors for nephrolithiasis was noted for both cohorts, including hyperparathyroidism, renal tubular acidosis, inflammatory bowel disease, short gut syndrome, and obesity (BMI &gt; 30).</div></div><div><h3>Results</h3><div>A total of 18,761 CPPD patients were identified who were matched by age and sex to 75,043 controls, for a total sample size of 93,804 individuals. The average age of the cohorts was 68.5 years, with a predominant male demographic (94.3 %). The prevalence of nephrolithiasis was significantly higher in the CPPD cohort (8.6 %) compared to controls (5.1 %, <em>P</em> &lt; .0001). Adjusted analyses revealed an odds ratio of 1.659 (95 % CI 1.560, 1.764) for nephrolithiasis in CPPD patients which remained significant after removal of patients with hyperparathyroidism.</div></div><div><h3>Conclusions</h3><div>These data suggest that CPPD is an independent risk factor for kidney stone formation and provide further support for the hypothesis that CPPD is a systemic disorder of mineralization with extra-articular implications.</div></div>","PeriodicalId":21715,"journal":{"name":"Seminars in arthritis and rheumatism","volume":"71 ","pages":"Article 152641"},"PeriodicalIF":4.6,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143080979","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":"Disease characteristics, co-morbidities and treatment response in a contemporary axial spondyloarthritis cohort: Analysis of 717 patients from the Greek AxSpA registry","authors":"Charalampos Papagoras ,&nbsp;George E. Fragoulis ,&nbsp;Nikolaos Fytanidis ,&nbsp;Michael Krikelis ,&nbsp;Evangelia Mole ,&nbsp;Sousana Gazi ,&nbsp;Vasileios Skepastianos ,&nbsp;Nikolaos Kougkas ,&nbsp;Theodoros Dimitroulas ,&nbsp;Nikolaos Koletsos ,&nbsp;Evripidis Kaltsonoudis ,&nbsp;Paraskevi V. Voulgari ,&nbsp;Anastasios Karamanakos ,&nbsp;Maria Pappa ,&nbsp;Maria G. Tektonidou ,&nbsp;Petros P. Sfikakis ,&nbsp;Kalliopi Klavdianou ,&nbsp;Eleni Kalavri ,&nbsp;Konstantinos Kottas ,&nbsp;Gkikas Katsifis ,&nbsp;Dimitrios Vassilopoulos","doi":"10.1016/j.semarthrit.2025.152645","DOIUrl":"10.1016/j.semarthrit.2025.152645","url":null,"abstract":"<div><h3>Background</h3><div>Significant advances have recently reshaped the management of axial spondyloarthritis (AxSpA). Real-world data from contemporary cohorts are important to capture the current landscape in AxSpA.</div></div><div><h3>Methods</h3><div>A prospective multicenter observational study of patients with AxSpA was undertaken supported by the Greek Rheumatology Society. Here we analyze disease characteristics, comorbidities and treatment patterns at baseline.</div></div><div><h3>Results</h3><div>717 patients (64.9% males) with a mean age of 50 years and a median disease duration of 13 years were included. Two thirds of patients had r-AxSpA. The prevalence of peripheral arthritis ever (45%) equaled that of enthesitis, with hip involvement affecting 28% of patients. The leading comorbidities were increased BMI (60%), dyslipidemia (30%) hypertension (30%), depression (14%) and osteoporosis (10%). Most patients (78%) received a bDMARD, while 12% received no treatment at all. Inactive disease or low disease activity was attained by 65% of patients. ASDAS, BASDAI and BASFI were comparable between r-AxSpA and nr-AxSpA, but nr-AxSpA patients reported higher Global and Pain VAS scores. In multivariable analyses, predictors of high ASDAS were dactylitis ever, current smoking and the number of previous bDMARDs, while HLA B27 positivity and low alcohol intake were associated with a lower ASDAS. Male sex, HLA B27 positivity, high CRP at diagnosis, older age and longer diagnosis delay independently predicted the presence of syndesmophytes.</div></div><div><h3>Conclusion</h3><div>In this sizable contemporary AxSpA cohort, one third of patients still miss treatment targets. Additional to cardiovascular risk factors, depression and osteoporosis are considerably prevalent. Smoking predicts a higher ASDAS, while HLA B27 positivity predicts syndesmophyte formation, but also better ASDAS responses.</div></div>","PeriodicalId":21715,"journal":{"name":"Seminars in arthritis and rheumatism","volume":"71 ","pages":"Article 152645"},"PeriodicalIF":4.6,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143080984","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":"Age of onset of rheumatoid arthritis and radiographic changes","authors":"Masaru Shimizu ,&nbsp;Misti L Paudel ,&nbsp;Nancy Shadick ,&nbsp;Michael Weinblatt ,&nbsp;Daniel H Solomon","doi":"10.1016/j.semarthrit.2025.152635","DOIUrl":"10.1016/j.semarthrit.2025.152635","url":null,"abstract":"<div><h3>Objectives</h3><div>The association between age of rheumatoid arthritis (RA) onset and joint erosions remains unclear. We investigated the effects of age of RA onset on incident joint erosion and the progression of radiographic findings.</div></div><div><h3>Methods</h3><div>Patients diagnosed with RA within 2 years of enrollment in a large single-center RA registry were included. The age of RA onset was categorized into young- (≤44 years of age), middle- (45–65), and late-onset (≥66). Modified total Sharp scores (mTSS) were obtained at baseline, year 2, and year 5, and incident joint erosion was defined as an erosion score &gt;0. Adjusted odds ratio (aOR) of incident joint erosions and adjusted change in mTSS by age category were evaluated over a 5-year follow-up period.</div></div><div><h3>Results</h3><div>Among 1,581 participants with RA, 284 patients within 2 years of RA diagnosis were identified. The mean mTSS were 0.54 in the young-, 3.12 in the middle-, and 4.77 in the late-onset group. The aOR of incident joint erosion in the middle-, aOR 4.0 (95 % CI 2.2 - 7.5), and the late-onset groups, 8.2 (95 % CI 3.6 - 19.2), were elevated compared with the young-onset group. Compared with the young-onset group, the adjusted changes in mTSS in the middle- group, 2.8 (95 % CI 0.20 – 5.4), and the late-onset groups, 1.9 (95 % CI -0.26 – 4.1), were elevated.</div></div><div><h3>Conclusion</h3><div>The odds of incident joint erosion and change in the mTSS were increased among patients with later RA onset. Age of RA onset should be considered when determining optimal management strategies.</div></div>","PeriodicalId":21715,"journal":{"name":"Seminars in arthritis and rheumatism","volume":"71 ","pages":"Article 152635"},"PeriodicalIF":4.6,"publicationDate":"2025-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143075368","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":"ANCA-associated vasculitis in patients with rheumatoid arthritis: A single-center cohort study","authors":"Daniel Bolotin ,&nbsp;Courtney O'Brien ,&nbsp;Veena K Ranganath ,&nbsp;Tanaz A. Kermani","doi":"10.1016/j.semarthrit.2025.152648","DOIUrl":"10.1016/j.semarthrit.2025.152648","url":null,"abstract":"<div><h3>Aim</h3><div>To evaluate characteristics of antineutrophil cytoplasmic antibody (ANCA) associated vasculitis (AAV) in patients with rheumatoid arthritis (RA) and positive ANCA, and, to compare patients with RA+ANCA and RA+AAV.</div></div><div><h3>Methods</h3><div>This retrospective study included patients with RA and +ANCA. Patients with AAV were identified and data abstracted. RA+AAV were compared to RA+ANCA to evaluate factors associated with AAV.</div></div><div><h3>Results</h3><div>The study included 77 patients with RA+ANCA, mean (±SD) age 62.1 (17.2) years, 79 % female, 65 % seropositive. p-ANCA positivity was noted in 45 % and myeloperoxidase-positivity in 42 %. AAV was diagnosed in 29 %; granulomatosis with polyangiitis (GPA) (45 %), microscopic polyangiitis (36 %), eosinophilic granulomatosis with polyangiitis (5 %), unclassifiable (14 %). Renal (41 %) and upper airway involvement (36 %) were most frequently observed. Diagnosis of RA preceded AAV in 59 %. Positive rheumatoid factor (RhF), myeloperoxidase (MPO)-ANCA, rheumatoid nodules and inflammatory eye disease were more frequent in RA+AAV than RA+ANCA while positive ANCA via immunofluorescence alone and positive dsDNA were more frequent in RA+AAV (<em>p</em> &lt; 0.05). Treatment exposure for RA did not differ between the two groups.</div></div><div><h3>Conclusions</h3><div>RA often preceded the diagnosis of AAV and GPA was the most frequently observed AAV. The interplay of +RhF and +MPO antibodies and AAV in patients with RA+ANCA warrants further investigation.</div></div>","PeriodicalId":21715,"journal":{"name":"Seminars in arthritis and rheumatism","volume":"71 ","pages":"Article 152648"},"PeriodicalIF":4.6,"publicationDate":"2025-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143080976","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}