Therapeutic Advances in Musculoskeletal Disease最新文献

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Bone marrow edema in children: chronic nonbacterial osteomyelitis and its mimickers
IF 4.2 2区 医学
Therapeutic Advances in Musculoskeletal Disease Pub Date : 2024-09-19 DOI: 10.1177/1759720x241278438
Chiara Giraudo, Giulia Fichera, Anna Michielin, Francesco Zulian, Roberto Stramare, Winston J. Rennie
{"title":"Bone marrow edema in children: chronic nonbacterial osteomyelitis and its mimickers","authors":"Chiara Giraudo, Giulia Fichera, Anna Michielin, Francesco Zulian, Roberto Stramare, Winston J. Rennie","doi":"10.1177/1759720x241278438","DOIUrl":"https://doi.org/10.1177/1759720x241278438","url":null,"abstract":"Bone marrow is a highly cellular tissue undergoing significant developmental and physiologic changes with age. Indeed, with maturation from pediatric to the adult age there is a progressive, centrifugal conversion from red to yellow bone marrow. Histological characteristics of bone marrow are reflected in MR image signal. MR is therefore extremely sensitive in detecting pathological changes which are mostly characterized by increased free water causing high signal intensity on T2. Among the numerous diseases causing bone marrow edema in children chronic nonbacterial osteomyelitis (CNO) certainly has to be mentioned. This idiopathic inflammatory disorder is characterized by nonspecific migrating symptoms like skeletal pain with phases of exacerbations and relapses with alternating acute and chronic MR signs and it is often a diagnosis of exclusion. Hence, with bone marrow edema, various features at imaging should be considered to differentiate malignancies such as osseous lymphoma, osteosarcoma, and Ewing’s sarcoma as well as benign lesions like osteomyelitis, post-traumatic, or post-treatment bone marrow edema. The aim of this review is to recall the main characteristics of CNO and provide an overview of its main mimickers highlighting similarities and differences.","PeriodicalId":23056,"journal":{"name":"Therapeutic Advances in Musculoskeletal Disease","volume":null,"pages":null},"PeriodicalIF":4.2,"publicationDate":"2024-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142269496","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}
引用次数: 0
Monotherapy or combination therapy in PsA: current aspects
IF 4.2 2区 医学
Therapeutic Advances in Musculoskeletal Disease Pub Date : 2024-09-19 DOI: 10.1177/1759720x241274055
Elpida Skouvaklidou, Paraskevi Avgerou, Konstantinos D. Vassilakis, George E. Fragoulis, Nikolaos Kougkas
{"title":"Monotherapy or combination therapy in PsA: current aspects","authors":"Elpida Skouvaklidou, Paraskevi Avgerou, Konstantinos D. Vassilakis, George E. Fragoulis, Nikolaos Kougkas","doi":"10.1177/1759720x241274055","DOIUrl":"https://doi.org/10.1177/1759720x241274055","url":null,"abstract":"Psoriatic arthritis (PsA) is an immune-mediated inflammatory disease with heterogeneity regarding its clinical features, mainly affecting the skin and the musculoskeletal system; additionally, extra-musculoskeletal manifestations and comorbidities are common, adding complexity to its treatment. In the last decades, a plethora of therapeutic options have been available, including conventional synthetic disease-modifying anti-rheumatic drugs (DMARDs), biological DMARDs (bDMARDs), and targeted synthetic DMARDs (tsDMARDs), and many recommendations have been published regarding the proper use of them in patients with PsA. In rheumatoid arthritis, the combination of conventional with bDMARDs or tsDMARDs is a common and recommended practice, whereas in PsA there is scarce data about the benefit of this combination. This review summarizes all the available data from randomized clinical trials, observational studies, and registries about the value of this therapeutic strategy.","PeriodicalId":23056,"journal":{"name":"Therapeutic Advances in Musculoskeletal Disease","volume":null,"pages":null},"PeriodicalIF":4.2,"publicationDate":"2024-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142258728","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}
引用次数: 0
Knee osteoarthritis: disease burden, available treatments, and emerging options
IF 4.2 2区 医学
Therapeutic Advances in Musculoskeletal Disease Pub Date : 2024-09-17 DOI: 10.1177/1759720x241273009
Michael Langworthy, Vinod Dasa, Andrew I. Spitzer
{"title":"Knee osteoarthritis: disease burden, available treatments, and emerging options","authors":"Michael Langworthy, Vinod Dasa, Andrew I. Spitzer","doi":"10.1177/1759720x241273009","DOIUrl":"https://doi.org/10.1177/1759720x241273009","url":null,"abstract":"Osteoarthritis (OA) is a prevalent condition that affects nearly 528 million people worldwide, including 23% of the global population aged ⩾40, and is characterized by progressive damage to articular cartilage, which often leads to substantial pain, stiffness, and reduced mobility for affected patients. Pain related to OA is a barrier to maintaining physical activity and a leading cause of disability, accounting for 2.4% of all years lived with disability globally, reducing the ability to work in 66% of US patients with OA and increasing absenteeism in 21% of US patients with OA. The joint most commonly involved in OA is the knee, which is affected in about 60%–85% of all OA cases. The aging population and longer life expectancy, coupled with earlier and younger diagnoses, translate into a growing cohort of symptomatic patients in need of alternatives to surgery. Despite the large number of patients with knee OA (OAK) worldwide, the high degree of variability in patient presentation can lead to challenges in diagnosis and treatment. Multiple society guidelines recommend therapies for OAK, but departures from guidelines by healthcare professionals in clinical settings reflect a discordance between evidence-based treatment algorithms and routine clinical practice. Furthermore, disease-modifying pharmacotherapies are limited, and treatment for OAK often focuses solely on symptom relief, rather than underlying causes. In this narrative review, we summarize the patient journey, analyze current disease burden and nonsurgical therapy recommendations for OAK, and highlight emerging and promising therapies—such as cryoneurolysis, long-acting corticosteroids, and gene therapies—for this debilitating condition.","PeriodicalId":23056,"journal":{"name":"Therapeutic Advances in Musculoskeletal Disease","volume":null,"pages":null},"PeriodicalIF":4.2,"publicationDate":"2024-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142258729","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}
引用次数: 0
Cardiovascular comorbidities in psoriatic arthritis: state of the art
IF 4.2 2区 医学
Therapeutic Advances in Musculoskeletal Disease Pub Date : 2024-09-14 DOI: 10.1177/1759720x241274537
Mrinalini Dey, Elena Nikiphorou
{"title":"Cardiovascular comorbidities in psoriatic arthritis: state of the art","authors":"Mrinalini Dey, Elena Nikiphorou","doi":"10.1177/1759720x241274537","DOIUrl":"https://doi.org/10.1177/1759720x241274537","url":null,"abstract":"Psoriatic arthritis (PsA) is a complex multi-system immune-mediated condition, characterised by a high comorbidity burden, one of the most prevalent of which is cardiovascular disease (CVD), affecting up to 80% of patients. This narrative review explores the current understanding of cardiovascular comorbidities in PsA, focusing on mechanistic pathways, risk assessment, and the impact of treatment choices on cardiovascular health. Here, we outline the role of inflammatory cytokines, immune system dysregulation, and genetic predispositions in PsA, not only as drivers of musculoskeletal manifestations but also atherosclerosis and endothelial dysfunction, giving rise to cardiovascular pathology. Given these insights, accurately assessing and predicting cardiovascular risk in PsA patients is a critical challenge. This review evaluates traditional risk calculators as well as innovative biomarkers and imaging techniques, emphasising their utility and limitations in capturing the true cardiovascular risk profile of PsA patients. There are multiple complexities surrounding the treatment of PsA in the context of concurrent CVD, and therapeutic choices must carefully balance efficacy in managing PsA symptoms with the potential cardiovascular implications. A multidisciplinary approach, integrating dermatological, rheumatological, and cardiological perspectives, amongst others, to optimise patient outcomes, is key. Overall, a heightened clinical awareness and research focus on cardiovascular comorbidities in PsA is warranted, aiming to refine risk assessment strategies and therapeutic interventions that holistically address the multifaceted needs of patients with PsA.","PeriodicalId":23056,"journal":{"name":"Therapeutic Advances in Musculoskeletal Disease","volume":null,"pages":null},"PeriodicalIF":4.2,"publicationDate":"2024-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142258730","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}
引用次数: 0
The socioeconomic status of patients with ankylosing spondylitis and its association with the burden of the disease and permanent disability: a cross-sectional cluster analysis. 强直性脊柱炎患者的社会经济状况及其与疾病负担和永久性残疾的关系:横断面聚类分析。
IF 3.4 2区 医学
Therapeutic Advances in Musculoskeletal Disease Pub Date : 2024-09-05 eCollection Date: 2024-01-01 DOI: 10.1177/1759720X241272947
Desirée Ruiz-Vilchez, Lourdes Ladehesa-Pineda, María Ángeles Puche-Larrubia, María Carmen Ábalos-Aguilera, Pilar Font-Ugalde, Alejandro Escudero-Contreras, Eduardo Collantes-Estévez, Clementina López-Medina
{"title":"The socioeconomic status of patients with ankylosing spondylitis and its association with the burden of the disease and permanent disability: a cross-sectional cluster analysis.","authors":"Desirée Ruiz-Vilchez, Lourdes Ladehesa-Pineda, María Ángeles Puche-Larrubia, María Carmen Ábalos-Aguilera, Pilar Font-Ugalde, Alejandro Escudero-Contreras, Eduardo Collantes-Estévez, Clementina López-Medina","doi":"10.1177/1759720X241272947","DOIUrl":"https://doi.org/10.1177/1759720X241272947","url":null,"abstract":"<p><strong>Background: </strong>Few studies have been conducted to investigate the socioeconomic profiles of patients with ankylosing spondylitis (AS) and their associations with disease severity and disability.</p><p><strong>Objectives: </strong>The objectives of this study were to identify clusters of patients with AS according to their socioeconomic characteristics and to evaluate the associations between these clusters and the severity of the disease and permanent disability.</p><p><strong>Design: </strong>This was a cross-sectional and multicentre study.</p><p><strong>Methods: </strong>Patients with AS from the REGISPONSER study were included in this analysis. A cluster analysis was conducted using information on sociodemographic (age, sex, race, marital status, education) and socioeconomic (employment, profession, housing conditions and social level) characteristics. Disease burden and permanent disability were compared between the different clusters using logistic regression adjusted for disease duration and disease activity.</p><p><strong>Results: </strong>A total of 866 patients with AS were included. Two clusters were identified according to socioeconomic characteristics: Cluster 1 (<i>n</i> = 476), with a predominantly low socioeconomic profile, and Cluster 2 (<i>n</i> = 390), with a predominantly high socioeconomic profile. After adjusting for disease duration, patients in Cluster 1 had a longer diagnosis delay, greater body mass index and greater structural damage than those in Cluster 2. Access to biologic disease-modifying anti-rheumatic drugs (bDMARDs) was similar for both groups. However, patients in Cluster 1 had a greater prevalence of permanent disability than those in Cluster 2 after adjusting for disease duration and disease activity (30.8% vs 13.2%, odds ratio 2.58 (95% confidence interval 1.76-3.83)).</p><p><strong>Conclusion: </strong>This study suggests that the socioeconomic status of patients with AS may have implications for disease severity and permanent disability, despite the similar use of bDMARDs.</p>","PeriodicalId":23056,"journal":{"name":"Therapeutic Advances in Musculoskeletal Disease","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11378180/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142154999","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}
引用次数: 0
Meibomian gland dropout of upper eyelids as a novel biomarker for early diagnosis of primary Sjögren's syndrome: a pilot study. 上眼睑睑板腺脱落作为早期诊断原发性斯约格伦综合征的新型生物标志物:一项试验研究。
IF 3.4 2区 医学
Therapeutic Advances in Musculoskeletal Disease Pub Date : 2024-09-02 eCollection Date: 2024-01-01 DOI: 10.1177/1759720X241274726
Jing Wu, Yongying Liang, Fanjun Shi, Xianghong Tu, Jingfa Zhang, Qinghua Qiu
{"title":"Meibomian gland dropout of upper eyelids as a novel biomarker for early diagnosis of primary Sjögren's syndrome: a pilot study.","authors":"Jing Wu, Yongying Liang, Fanjun Shi, Xianghong Tu, Jingfa Zhang, Qinghua Qiu","doi":"10.1177/1759720X241274726","DOIUrl":"10.1177/1759720X241274726","url":null,"abstract":"<p><strong>Background: </strong>Early diagnosis of primary Sjögren's syndrome (pSS) remains difficult due to its insidious onset.</p><p><strong>Objectives: </strong>To identify whether meibomian gland dropout (MGD) is a sensitive and noninvasive predictor of pSS by studying its association with histopathology in labial salivary gland biopsy in patients with clinically suspected pSS.</p><p><strong>Design: </strong>Prospective, randomized, multicenter, comparative effectiveness study.</p><p><strong>Methods: </strong>The study was conducted from July 2022 to July 2023. In all, 56 eligible participants with clinically suspected pSS were recruited from three combined ophthalmology medicine/rheumatology SS clinics. All participants with suspected pSS were evaluated and diagnosed by ophthalmology and rheumatology consultants and underwent infrared imaging of the meibomian glands using Keratograph 5M and histopathological evaluation of labial salivary gland biopsies. The length, width, and tortuosity of the meibomian glands were measured; the dropout rate in the nasal, temporal, and total eyelids was analyzed; and the dropout score was calculated using meibography grading scales.</p><p><strong>Results: </strong>Among the 56 participants, 34 were identified with pSS, and 22 were diagnosed with non-SS dry eye (NSSDE) and served as the control group. We recorded significant differences in the temporal and total MGD rates of the upper eyelids between the pSS and NSSDE groups (all <i>p</i> < 0.01). Improved prediction accuracy was achieved with the temporal and total MGD rates in the upper eyelids, with area under the curve values of 0.94 and 0.91, and optimal cutoff points of 0.78 and 0.75, respectively.</p><p><strong>Conclusion: </strong>MGD in the upper eyelids, especially in the temporal portion, is strongly associated with the histopathological outcome of labial salivary gland biopsy in pSS and is proposed as a highly predictive and noninvasive biomarker for the early diagnosis of pSS.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov identifier: ChiCTR2000038911.</p>","PeriodicalId":23056,"journal":{"name":"Therapeutic Advances in Musculoskeletal Disease","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11369872/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142126739","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}
引用次数: 0
Switching related to inefficacy in biologics and targeted synthetic therapies for psoriatic arthritis: a comparative real-life study. 与银屑病关节炎生物制剂和合成靶向疗法无效有关的转换:一项真实生活比较研究。
IF 3.4 2区 医学
Therapeutic Advances in Musculoskeletal Disease Pub Date : 2024-08-31 eCollection Date: 2024-01-01 DOI: 10.1177/1759720X241273083
Dalifer Freites-Nuñez, Leticia Leon, Esther Toledano, Gloria Candelas, Cristina Martinez, Maria Rodriguez-Laguna, Daniel Rubio, Benjamin Fernandez-Gutierrez, Lydia Abasolo
{"title":"Switching related to inefficacy in biologics and targeted synthetic therapies for psoriatic arthritis: a comparative real-life study.","authors":"Dalifer Freites-Nuñez, Leticia Leon, Esther Toledano, Gloria Candelas, Cristina Martinez, Maria Rodriguez-Laguna, Daniel Rubio, Benjamin Fernandez-Gutierrez, Lydia Abasolo","doi":"10.1177/1759720X241273083","DOIUrl":"10.1177/1759720X241273083","url":null,"abstract":"<p><strong>Background: </strong>Switching between therapies is a recommended strategy for psoriatic arthritis (PsA) patients who experience treatment failure; however, studies including real-life data are scarce.</p><p><strong>Objectives: </strong>To assess the incidence rate (IR) of switching between biologics and targeted synthetic disease-modifying anti-rheumatic drugs (b/tsDMARDs) due to inefficacy in PsA, and to compare the risk of switching due to inefficacy across different b/tsDMARDs groups.</p><p><strong>Design: </strong>A longitudinal retrospective study, spanning from 2007 to 2022, was conducted on patients with PsA treated with b/tsDMARDs at an outpatient rheumatology clinic.</p><p><strong>Methods: </strong>The primary outcome was switching between b/tsDMARDs due to inefficacy. The independent variable was the exposure to b/tsDMARDs during follow-up. As covariates, clinical, treatment-related, and sociodemographic variables were considered. Survival techniques were run to estimate the IR of switching due to inefficacy per 100 patients*year and confidence interval at 95% (95% CI). Cox multivariate regression analyses were run to assess the risk of b/tsDMARDs switching due to inefficacy, expressed as hazard ratio (HR) and 95% CI.</p><p><strong>Results: </strong>In all, 141 patients were included, with 893.09 patients*year follow-ups. 52.48% of them were females in their fifties. In total, 262 courses of treatment were recorded. During the study period, 56 patients presented 121 switches and 103 related to inefficacy (IR: 11.53 (9.51-13.98)). Tumor necrosis factor-alpha inhibitors (TNFi) showed the lowest IR. In the bivariate analysis, all b/tsDMARDs had more risk of switching compared to TNFi (HR: anti-lL-17 vs TNFi: 2.26 (1.17-4.36); others vs TNFi: 3.21 (1.59-6.45)); however, this statistical significance was no longer present in the multivariate analysis once adjustments were made for the covariates. Still, the final model achieved statistical significance in the following variables: gender, clinical symptoms, prescription year, therapy courses, glucocorticoids, and sulfasalazine.</p><p><strong>Conclusion: </strong>In this study, we did not find differences in the rate of switching due to inefficacy among different groups of b/tsDMARDs. Other concomitant treatments, sociodemographic, and clinical variables were identified as risk factors for switching due to inefficacy.</p>","PeriodicalId":23056,"journal":{"name":"Therapeutic Advances in Musculoskeletal Disease","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11366104/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142112318","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}
引用次数: 0
Effects of acupuncture versus placebo on clinical status and potential specific effects in Fibromyalgia: an umbrella review of 11 meta-analyses. 针灸与安慰剂对纤维肌痛临床状态和潜在特异性效果的影响:对 11 项元分析的总体回顾。
IF 3.4 2区 医学
Therapeutic Advances in Musculoskeletal Disease Pub Date : 2024-08-20 eCollection Date: 2024-01-01 DOI: 10.1177/1759720X241271775
Felipe Araya-Quintanilla, Robinson Ramirez-Vélez, Guillermo Mendez-Rebolledo, Iván Cuyul-Vásquez, Alexis Arce-Álvarez, Yasmin Ezzatvar, Héctor Gutiérrez-Espinoza
{"title":"Effects of acupuncture versus placebo on clinical status and potential specific effects in Fibromyalgia: an umbrella review of 11 meta-analyses.","authors":"Felipe Araya-Quintanilla, Robinson Ramirez-Vélez, Guillermo Mendez-Rebolledo, Iván Cuyul-Vásquez, Alexis Arce-Álvarez, Yasmin Ezzatvar, Héctor Gutiérrez-Espinoza","doi":"10.1177/1759720X241271775","DOIUrl":"10.1177/1759720X241271775","url":null,"abstract":"<p><strong>Background: </strong>The use of acupuncture is related to patients' expectations, and the therapeutic interaction effect remains a topic of debate in the literature. Accordingly, it is still unclear whether acupuncture can generate positive clinical effects in patients with fibromyalgia (FM).</p><p><strong>Objective: </strong>To determine the effectiveness of acupuncture versus placebo for clinical outcomes and determine the overall effect not attributed to specific effects in patients with FM.</p><p><strong>Design: </strong>Umbrella review of systematic reviews (SRs) and meta-analyses.</p><p><strong>Data sources and methods: </strong>An electronic search was performed in MEDLINE (via PubMed), Web of Science, CENTRAL, EMBASE, LILACS, CINAHL, PEDro, and SPORTDiscus databases from inception until December 2023. We selected studies with a clinical diagnosis of FM and that analyzed the effectiveness of acupuncture compared with a placebo. Pain intensity, functional status, fatigue, sleep quality, and depression symptoms were assessed. Effect sizes were calculated as the mean difference (MD) or standard mean difference (SMD). The quality of intervention reporting was assessed using the Grading of Recommendations Assessment, Development, and Evaluation approach.</p><p><strong>Results: </strong>Eleven SRs with 8399 participants were included. Compared with placebo, acupuncture was associated with reductions in pain intensity (MD = -1.13 cm, 95% CI -2.09 to -0.17, <i>p</i> < 0.001), physical function (SMD = -0.63, 95% CI -1.67 to 0.41, <i>p</i> = 0.06), sleep quality (SMD = -0.25, 95% CI -1.39 to 0.88, <i>p</i> = 0.06), and fatigue (SMD = 0.20, 95% CI = 0.17 to 0.22, <i>p</i> < 0.001). The proportion not attributable to specific effects (PCE) of acupuncture was 58% for pain intensity (PCE = 0.58, 95% CI 0.45 to 0.71), 57% for physical function (PCE = 0.57, 95% CI -0.07 to 1.20), and 69% for fatigue (PCE = 0.69, 95% CI 0.18 to 1.21).</p><p><strong>Conclusion: </strong>Acupuncture showed a statistically significant difference in decreased pain intensity and fatigue in women with FM. However, the certainty of evidence was low to very low; its effects are not clinically important, and more than 50% of the overall treatment effects were not attributed to the specific effects of acupuncture.</p><p><strong>Prospero registration number: </strong>CRD42023487315.</p>","PeriodicalId":23056,"journal":{"name":"Therapeutic Advances in Musculoskeletal Disease","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11334136/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142009503","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}
引用次数: 0
Metabolic syndrome and psoriatic arthritis: the role of weight loss as a disease-modifying therapy. 代谢综合征与银屑病关节炎:减肥作为疾病调节疗法的作用。
IF 3.4 2区 医学
Therapeutic Advances in Musculoskeletal Disease Pub Date : 2024-08-19 eCollection Date: 2024-01-01 DOI: 10.1177/1759720X241271886
Jacob Corum Williams, Ryan Malcolm Hum, Kira Rogers, Cristina Maglio, Uazman Alam, Sizheng Steven Zhao
{"title":"Metabolic syndrome and psoriatic arthritis: the role of weight loss as a disease-modifying therapy.","authors":"Jacob Corum Williams, Ryan Malcolm Hum, Kira Rogers, Cristina Maglio, Uazman Alam, Sizheng Steven Zhao","doi":"10.1177/1759720X241271886","DOIUrl":"10.1177/1759720X241271886","url":null,"abstract":"<p><p>Psoriatic arthritis (PsA) is an inflammatory joint and entheseal disease associated with significant personal and public health burden. PsA has a prevalence of up to 1%, affecting ~20% of people suffering with psoriasis. PsA is frequently accompanied by metabolic syndrome (MetS), and both conditions are characterised by a chronic pro-inflammatory state, with several key cytokines in PsA (interleukin (IL)-17 and IL-23) also elevated in those with MetS. This narrative review aims to provide an update on MetS in PsA, focusing on its prevalence, pathogenesis, prognosis, treatment interactions and future therapeutic options. MetS is particularly prevalent in PsA compared to other inflammatory arthritides. Cohort studies indicate a higher risk of PsA in individuals with obesity, while Mendelian randomization studies link childhood obesity, insulin resistance, and dyslipidaemia to PsA. Weight loss interventions have been shown to reduce disease activity in PsA. Additionally, MetS negatively impacts the efficacy of tumour necrosis factor inhibitor (TNFi) drugs in treating PsA. Drugs given for PsA may also affect the conditions constituting MetS. Leflunomide has been shown to reduce body weight but also increase blood pressure. TNFi drugs lead to weight gain but reduce cardiovascular risk. Janus kinase inhibitors increase lipid levels and cardiovascular risk among high-risk groups. Anti-IL-17 and anti-IL-12/IL-23 drugs may cause a short-term increase in cardiovascular risk, although the long-term effects have yet to be established. Weight loss represents an unexplored avenue for disease modification in PsA, alongside a plethora of general health benefits. Dietary and exercise modifications are the cornerstone of weight management but vary substantially across individuals. Novel therapies to treat weight loss, such as glucagon-like peptide 1 agonists and sodium-glucose cotransporter 2 inhibitors, may prove useful alongside disease-modifying therapies for those with PsA and MetS and should be investigated as potential therapeutic adjuncts.</p>","PeriodicalId":23056,"journal":{"name":"Therapeutic Advances in Musculoskeletal Disease","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11331474/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142005340","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}
引用次数: 0
The signature of the gut microbiota associated with psoriatic arthritis revealed by metagenomics. 元基因组学揭示了与银屑病关节炎相关的肠道微生物群特征。
IF 3.4 2区 医学
Therapeutic Advances in Musculoskeletal Disease Pub Date : 2024-08-10 eCollection Date: 2024-01-01 DOI: 10.1177/1759720X241266720
Wei Liu, Chunyan Li, Wenhui Xie, Yong Fan, Xiaohui Zhang, Yu Wang, Lei Li, Zhuoli Zhang
{"title":"The signature of the gut microbiota associated with psoriatic arthritis revealed by metagenomics.","authors":"Wei Liu, Chunyan Li, Wenhui Xie, Yong Fan, Xiaohui Zhang, Yu Wang, Lei Li, Zhuoli Zhang","doi":"10.1177/1759720X241266720","DOIUrl":"10.1177/1759720X241266720","url":null,"abstract":"<p><strong>Background: </strong>Gut microbiota is involved in the development of psoriatic arthritis (PsA), but until now, there has been a lack of understanding of the PsA host-bacteria interaction.</p><p><strong>Objectives: </strong>To reveal the labels of gut microbiota in PsA patients and the species and functions related to disease activity.</p><p><strong>Design: </strong>Observational research (cross-sectional) with an exploratory nature.</p><p><strong>Methods: </strong>Metagenomics sequencing was used to analyze stool samples from 20 treatment-naïve PsA patients and 10 age-matched healthy individuals. All samples were qualified for subsequent analysis.</p><p><strong>Results: </strong>Compared with the healthy group, α-diversity was reduced in the PsA group, and β-diversity could distinguish the two groups. Two bacteria with high abundance and correlation with PsA disease activity were identified, <i>Bacteroides sp. 3_1_19</i> and <i>Blautia AF 14-40</i>. In different functions, K07114 (calcium-activated chloride channel (CaCC) homolog) showed a positive correlation with PsA disease activity (disease activity in psoriatic arthritis, DAPSA) and Tet32 (an antibiotic-resistant gene), and carbohydrate-binding module family 50 was negatively correlated with erythrocyte sedimentation rate. A bacterial co-expression network associated with DAPSA was constructed. The network was centered on the bacteria in the <i>Bacteroides</i> genus, which formed a closely related network and were positively correlated with DAPSA. As another core of the network, K07114 was closely related to multiple bacteria in the <i>Bacteroides</i> genus and is also positively correlated with disease activity.</p><p><strong>Conclusion: </strong>The network composed of <i>Bacteroides</i> is associated with PsA disease activity, and its therapeutic value needs to be further explored. CaCCs may be a key channel for the interaction between <i>Bacteroides</i> and PsA-host.</p>","PeriodicalId":23056,"journal":{"name":"Therapeutic Advances in Musculoskeletal Disease","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11316960/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141917488","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}
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