Therapeutic Advances in Musculoskeletal Disease最新文献

{"title":"Non-pharmacological interventions for patients with axial spondyloarthritis: a meta-analysis.","authors":"Lidong Hu, Xingkang Liu, Xiaojian Ji, Yiwen Wang, Jiaxin Zhang, Lulu Zeng, Yangqin Xun, Jianglin Zhang, Jian Zhu, Feng Huang","doi":"10.1177/1759720X251329696","DOIUrl":"10.1177/1759720X251329696","url":null,"abstract":"<p><strong>Background: </strong>Non-pharmacological interventions (NPIs) are recommended in current international clinical practice guidelines for the management of axial spondyloarthritis (axSpA) as a complementary therapy.</p><p><strong>Objectives: </strong>To assess the comparative impact of different NPIs on the clinical outcomes of patients with axSpA.</p><p><strong>Design: </strong>Network meta-analysis and traditional meta-analysis of randomized controlled trials (RCTs).</p><p><strong>Data sources and methods: </strong>We searched systematically PubMed, EMBASE, the Cochrane Library, Web of Science, and Chinese Biological Medical Database up to May 2023, and included these RCTs of patients with axSpA receiving the managements of NPIs. The risk of bias of individual RCT was assessed through a modified version of the Cochrane Risk of Bias Tool. Bayesian random-effects network meta-analysis and traditional meta-analysis were performed to calculate the mean difference.</p><p><strong>Results: </strong>A total of 51 RCTs involving 3457 patients with axSpA were included in this study. Both supervised combined exercises and neuromuscular training showed a significant reduction in disease activity (Bath Ankylosing Spondylitis Disease Activity Index (BASDAI): 1.13 lower, 1.17 lower, respectively), physical function (Bath Ankylosing Spondylitis Functional Index (BASFI): 1.0 lower, 0.88 lower, respectively), and spinal mobility (Bath Ankylosing Spondylitis Metrology Index (BASMI): 0.7 lower, 1.35 lower, respectively), compared to standard care. Both supervised combined exercises and neuromuscular training also presented more significant improvement than conventional exercises in disease activity (BASDAI: 0.91 lower, 0.95 lower, respectively), physical function (BASFI: 0.67 lower, 0.56 lower, respectively), and spinal mobility (BASMI: 0.18 lower, 0.82 lower, respectively). A traditional meta-analysis demonstrated that supervised combined exercise and neuromuscular training could significantly reduce BASDAI, BASFI, and BASMI scores when compared to unsupervised exercise or standard care. Aerobic exercise, supervised combined exercise, and conventional exercise could significantly reduce pain scores, compared to standard care.</p><p><strong>Conclusion: </strong>Compared to either standard care or conventional exercises, supervised combined exercises and neuromuscular training were more beneficial for ameliorating disease activity, physical function, and spinal mobility in patients with axSpA. The choice of exercise modalities may depend on patient values and preferences.</p><p><strong>Trial registration: </strong>PROSPRO: CRD42021251219.</p>","PeriodicalId":23056,"journal":{"name":"Therapeutic Advances in Musculoskeletal Disease","volume":"17 ","pages":"1759720X251329696"},"PeriodicalIF":3.4,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11967214/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143781215","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":"Primary non-response in inflammatory arthritis treated with biologics and targeted therapies in daily clinical practice.","authors":"Leticia Leon, Dalifer Freites-Nuñez, Esther Toledano, Gloria Candelas, Cristina Martinez, María Rodríguez-Laguna, Benjamín Fernández-Gutiérrez, Lydia Abasolo","doi":"10.1177/1759720X251325665","DOIUrl":"10.1177/1759720X251325665","url":null,"abstract":"<p><strong>Background: </strong>Switching between therapies is a recommended strategy for rheumatoid arthritis (RA) and psoriatic arthritis (PsA) patients who experience treatment failure; moreover, data on switching due to primary non-response and subsequent failures are limited.</p><p><strong>Objectives: </strong>To obtain information from clinical practice regarding failures due to primary non-response in patients on biologic and target synthetic disease-modifying antirheumatic drugs (ts/bDMARDs), assessing the incidence rate (IR) of switching due to primary non-response and risk of subsequent treatment failure by cycling compared to swapping.</p><p><strong>Design: </strong>A longitudinal retrospective study, spanning from 2007 to 2022, was conducted on patients with RA or PsA treated with ts/bDMARDs at an outpatient rheumatology clinic.</p><p><strong>Methods: </strong>The main outcomes were as follows: (1) ts/bDMARD failure due to primary non-response and (2) subsequent discontinuation of prescribed ts/bDMARD due to lack of efficacy. The independent variable was switching between classes compared to switching within class. As covariates, clinical, sociodemographic, clinical, and treatments were considered. To estimate ts/bDMARDs switching rates, survival techniques were used, expressing the IR per 100 patients * year with their 95% confidence interval. Cox multivariate regression analyses were run to assess the role of switching between/within class in the subsequent treatment failure.</p><p><strong>Results: </strong>In total, 327 patients were included. Of these, 50 patients in 77 treatment courses developed primary non-response with an IR of 4.25 (3.4-5.3). The IR was quite similar between RA and PsA, higher in women, and in those who started ts/bDMARDs after 2018. In those with primary non-response, there were 42 subsequent treatment failures with an IR of 26.38 (19.49-35.69). The multivariate model showed that cycling increased the risk of subsequent failure compared to swapping (hazard ratio: 2 (1.1-3.77), <i>p</i> = 0.03).</p><p><strong>Conclusion: </strong>This study provides support to consider swapping a better alternative rather than cycling after primary non-response.</p>","PeriodicalId":23056,"journal":{"name":"Therapeutic Advances in Musculoskeletal Disease","volume":"17 ","pages":"1759720X251325665"},"PeriodicalIF":3.4,"publicationDate":"2025-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11956518/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143754521","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":"Tofacitinib in early active axial spondyloarthritis: protocol of a randomized double-blind, placebo-controlled, multicenter phase IV study, FASTLANE.","authors":"Valeria Rios Rodriguez, Lidia Sánchez-Riera, Hildrun Haibel, Caroline Höppner, Murat Torgutalp, Fabian Proft, Judith Rademacher, Elke Binder, Annette Diehl, Ivana Vranic, Yuxi Zhao, Rajiv Mundayat, Arne Yndestad, Denis Poddubnyy","doi":"10.1177/1759720X251324429","DOIUrl":"10.1177/1759720X251324429","url":null,"abstract":"<p><strong>Background: </strong>Early treatment initiation is one of the strongest predictors of good treatment response in axial spondyloarthritis (axSpA). Recently, the Assessment in SpondyloArthritis International Society (ASAS) defined early axSpA as a diagnosis of axSpA with a duration of axial symptoms equal to or less than 2 years. Tofacitinib is a Janus kinase (JAK) inhibitor for the treatment of ankylosing spondylitis.</p><p><strong>Objectives: </strong>Compare the efficacy and safety of tofacitinib versus placebo (both on non-steroidal anti-inflammatory drug (NSAID) background) in patients with active early axSpA and inadequate response to at least one NSAID.</p><p><strong>Design: </strong>This is a phase IV, randomized, double-blind, placebo-controlled, multicenter clinical trial.</p><p><strong>Methods and analysis: </strong>The study will recruit 104 patients aged ⩾18 and ⩽45 years with active early axSpA (chronic back pain ⩽2 years), inadequate response to at least one NSAID, and objective signs of active inflammation (on magnetic resonance imaging (MRI) of sacroiliac joints (SIJs) or elevated C-reactive protein). Patients will be randomized 1:1 to receive tofacitinib 5 mg twice daily or placebo, with background naproxen 500 mg twice daily for 16 weeks. Patients not meeting early treatment response criteria at week 4 will receive open-label tofacitinib until week 16. Primary and key secondary endpoints at week 16 will be the proportion of patients achieving disease remission (Axial Spondyloarthritis Disease Activity Score <1.3) and change from baseline in MRI SIJ Spondyloarthritis Research Consortium of Canada osteitis score, respectively. Safety will be monitored up to 4 weeks after the last study drug dose.</p><p><strong>Ethics: </strong>The study will be performed according to the ethical principles of the Declaration of Helsinki and will be approved by independent ethics committees of each center.</p><p><strong>Discussion: </strong>This is one of the first randomized clinical trials designed to evaluate the efficacy and safety of a JAK inhibitor in the recently ASAS-defined \"early\" axSpA population. <b><i>Trial registration</i>:</b> ClinicalTrials.gov: NCT06112665; CTIS: 2023-505050-18-00.</p>","PeriodicalId":23056,"journal":{"name":"Therapeutic Advances in Musculoskeletal Disease","volume":"17 ","pages":"1759720X251324429"},"PeriodicalIF":3.4,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11898075/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143617191","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":"Major adverse cardiovascular events or venous thromboembolism in patients with rheumatoid arthritis initiating biological or targeted synthetic disease-modifying antirheumatic drugs: a nationwide, population-based cohort study.","authors":"Chung-Mao Kao, Yen-Ju Chen, Yi-Ming Chen, Der-Yuan Chen, Hsin-Hua Chen","doi":"10.1177/1759720X251321917","DOIUrl":"10.1177/1759720X251321917","url":null,"abstract":"<p><strong>Background: </strong>Rheumatoid arthritis (RA) is complicated by a high risk of cardiovascular disease and requires the initiation of biological or targeted synthetic disease-modifying antirheumatic drugs (b/tsDMARDs) for persistently active disease despite first-line therapies. The influence of b/tsDMARDs, especially tsDMARDs, on cardiovascular risk in Taiwanese patients with RA remains unclear.</p><p><strong>Objectives: </strong>To compare the risk of major cardiovascular adverse events (MACEs) or venous thromboembolism (VTE) amongst RA patients initiating approved b/tsDMARDs for up to 5 years.</p><p><strong>Design: </strong>A nationwide, population-based, retrospective cohort study.</p><p><strong>Methods: </strong>Using Taiwan National Health Insurance (NHI) Research Database, we identified patients with RA initiating NHI-reimbursed b/tsDMARDs indicated for RA between 2001 and 2020. Study outcomes were newly developed MACEs or VTE within 5 years of the first b/tsDMARD initiation. Time-dependent Cox regression analysis was performed to determine the association between b/tsDMARDs and MACEs or VTE and independently associated or protective factors. Subgroup analyses by age at b/tsDMARD initiation and cardiovascular risk levels, as well as sensitivity analyses of b/tsDMARD initiation after 2012, were performed.</p><p><strong>Results: </strong>We enrolled 12,332 adults with RA initiating the first b/tsDMARD during pre-determined period. The incidence rates of MACE and VTE were 894 and 283 per 100,000 person-years, respectively. After adjustment, other b/tsDMARDs were not associated with a higher risk of MACEs or VTE than tumour necrosis factor inhibitors (TNFis) up to 5 years after initiation. Subgroup analyses by age at b/tsDMARD initiation and cardiovascular risk levels revealed consistent findings. Factors associated with or protective against MACEs or VTE were identified.</p><p><strong>Conclusion: </strong>No non-TNFi b/tsDMARD had a higher risk of MACEs or VTE than TNFis up to 5 years after initiation amongst patients with RA, and this remained consistent for those initiating their b/tsDMARD at age 65 years and older or with high cardiovascular risk.</p>","PeriodicalId":23056,"journal":{"name":"Therapeutic Advances in Musculoskeletal Disease","volume":"17 ","pages":"1759720X251321917"},"PeriodicalIF":3.4,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11898041/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143617183","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":"Capsular stem cell function and tissue composition are associated with symptoms and radiographic severity in people with knee osteoarthritis.","authors":"T Mark Campbell, Robert Feibel, Jeffrey Dilworth, Odette Laneuville, Guy Trudel","doi":"10.1177/1759720X251321941","DOIUrl":"10.1177/1759720X251321941","url":null,"abstract":"<p><strong>Background: </strong>Osteoarthritis (OA) is associated with lost range of motion in the affected joint(s). Evidence suggests that this may be due to increased activity of posterior capsule fibroblasts, cells in turn derived from mesenchymal stromal cells (MSCs).</p><p><strong>Objectives: </strong>To test the hypotheses that (1) MSCs are more numerous in the posterior capsule of patients with knee flexion contracture (FC) and (2) in OA participants with knee FC, the MSC population in the posterior capsule differentiates toward a fibrotic phenotype. In order to complete these objectives, we looked for associations between capsule histologic and MSC outcomes with clinical outcomes.</p><p><strong>Design: </strong>Cross-sectional translational research design using data from the Ottawa Knee Osteoarthritis (OKOA) database.</p><p><strong>Methods: </strong>A total of 71 OKOA database participants and their relevant clinical and laboratory outcomes were included. Associations were first tested with bivariate correlation, then for <i>p</i> < 0.10, tested using a linear model.</p><p><strong>Results: </strong>No lab-based differences between FC and no-FC groups we discovered. In the posterior capsule, there was an association between knee flexion and adipogenic capacity (<i>p</i> = 0.001), osteogenic capacity (<i>p</i> < 0.001), KL grade and percent \"other\" (mainly neurovascular) tissue (<i>p</i> = 0.039), visual analog scale pain, and percent fibrous tissue (<i>p</i> = 0.014). For the anterior capsule, there was an association between knee flexion (<i>p</i> = 0.002) and extension (<i>p</i> = 0.005) with MSC enumeration, KL grade with MSC fibrogenic capacity (<i>p</i> = 0.002), and Knee Injury and Osteoarthritis Outcome Score quality of life with chondrogenic capacity (<i>p</i> < 0.001).</p><p><strong>Conclusion: </strong>Joint capsule composition, MSC enumeration, and function were associated with important clinical OA outcomes. These findings suggest that the entire joint capsule may play an important role in OA-related morbidity and progression and could represent an underappreciated target for OA treatment.</p>","PeriodicalId":23056,"journal":{"name":"Therapeutic Advances in Musculoskeletal Disease","volume":"17 ","pages":"1759720X251321941"},"PeriodicalIF":3.4,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11877474/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143557615","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":"Incidence rate of and risk factors for glomerulonephritis in patients with axial spondyloarthritis: a nationwide population-based study.","authors":"Subin Hwang, Ye-Jee Kim, Soo Min Ahn, Bon San Koo","doi":"10.1177/1759720X251320328","DOIUrl":"10.1177/1759720X251320328","url":null,"abstract":"<p><strong>Background: </strong>Although extramusculoskeletal manifestations, such as uveitis and psoriasis, in patients with axial spondyloarthritis (SpA) are well-documented, studies on the occurrence of glomerulonephritis in this population are scarce.</p><p><strong>Objectives: </strong>This study aimed to assess the incidence rate and risk factors for glomerulonephritis in patients with axial SpA using a nationwide population-based cohort in Korea.</p><p><strong>Design: </strong>Nationwide population-based study.</p><p><strong>Methods: </strong>This study included patients diagnosed with axial SpA between 2016 and 2019 from Korea's National Health Insurance Database. Patients with a diagnosis of preexisting kidney disease prior to their axial SpA diagnosis and those diagnosed with glomerulonephritis within 1 year of their axial SpA diagnosis were excluded. For the remaining patients, the incidence rates of glomerulonephritis and Cox proportional hazard ratios were analyzed.</p><p><strong>Results: </strong>Among the 11,796 patients, 58 had glomerulonephritis, resulting in an incidence rate of 1.82 per 1000 person-years. After adjusting for age and sex, the hazard ratio for patients with a Charlson Comorbidity Index score of ⩾1 was 2.03 (confidence interval (CI), 1.14-3.63; <i>p</i> = 0.017). When adjusting for age, sex, and comorbidities, the hazard ratio for patients with hypertension was 2.37 (CI, 1.20-4.69; <i>p</i> = 0.014). Among the 58 patients, 4 (6.9%) were diagnosed with glomerulonephritis, as confirmed via kidney biopsy.</p><p><strong>Conclusion: </strong>The incidence rate of glomerulonephritis in Korean patients with axial SpA is lower than that in patients with other musculoskeletal manifestations. In addition, the presence of comorbidities, including hypertension, is a significant risk factor for glomerulonephritis in patients with axial SpA. Despite the low occurrence, careful monitoring for glomerulonephritis in patients with axial SpA is essential.</p>","PeriodicalId":23056,"journal":{"name":"Therapeutic Advances in Musculoskeletal Disease","volume":"17 ","pages":"1759720X251320328"},"PeriodicalIF":3.4,"publicationDate":"2025-02-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11831623/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143442078","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":"Advanced imaging techniques in crystal arthritis.","authors":"Victor Laurent, Georgios Filippou, Silvia Sirotti, Tristan Pascart","doi":"10.1177/1759720X251316097","DOIUrl":"10.1177/1759720X251316097","url":null,"abstract":"<p><p>Gout and calcium pyrophosphate deposition (CPPD) disease are the most common causes of crystal arthritis. Identifying the pathogenic crystal deposition is the cornerstone of the diagnosis, but also prognosis and monitoring of the diseases. Conventional radiography has been for decades the only imaging technique used, with its very restricted sensitivity in both diseases. Advanced techniques, namely ultrasound and dual-energy computed tomography (DECT), are being increasingly used in the diagnosis and management of gout and CPPD diseases, and their role is now well recognized in classification criteria and in recommendations for the diagnosis and management. In gout, ultrasound elementary lesions of monosodium urate deposition are well defined and have been shown to be sensitive to change and can be monitored, while direct quantification of these deposits can be performed with DECT. In CPPD disease, the definition of elementary lesions and their scoring has been well established for ultrasound, while the proof of concept that DECT can help discriminate calcium pyrophosphate crystal deposits among other calcium-containing structures has been shown. The aim of this narrative review is to provide an overview of the use of advanced imaging techniques in crystal-induced arthropathies.</p>","PeriodicalId":23056,"journal":{"name":"Therapeutic Advances in Musculoskeletal Disease","volume":"17 ","pages":"1759720X251316097"},"PeriodicalIF":3.4,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11792016/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143190168","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":"Efficacy and retention rate of secukinumab in psoriatic arthritis across different clinical phenotypes: insights from the Italian GISEA Registry.","authors":"Giuseppe Lopalco, Maria Morrone, Fabiola Atzeni, Chiara Bazzani, Francesco Paolo Bianchi, Francesco Paolo Cantatore, Roberto Caporali, Antonio Carletto, Alberto Cauli, Maria Sole Chimenti, Sergio Colella, Fabrizio Conti, Addolorata Corrado, Ennio Giulio Favalli, Alberto Floris, Marco Fornaro, Rosario Foti, Roberta Foti, Elena Fracassi, Bruno Frediani, Stefano Gentileschi, Roberto Gorla, Elisa Gremese, Emanuela Praino, Roberta Ramonda, Cinzia Rotondo, Marco Sebastiani, Angelo Semeraro, Gianfranco Ferraccioli, Giovanni Lapadula, Florenzo Iannone","doi":"10.1177/1759720X251315138","DOIUrl":"10.1177/1759720X251315138","url":null,"abstract":"<p><strong>Background: </strong>Randomized clinical trials have demonstrated the efficacy of secukinumab (SECU) in reducing disease activity in psoriatic arthritis (PsA), while real-world studies prove a broader perspective on SECU's usefulness in everyday clinical practice.</p><p><strong>Objectives: </strong>To assess the effectiveness of SECU by evaluating drug survival and identifying potential predictors of clinical response and treatment discontinuation in patients with moderate-to-severe PsA, using real-world data from the Italian Group for the Study of Early Arthritis (GISEA) registry.</p><p><strong>Design: </strong>This longitudinal retrospective study included PsA patients treated with SECU, spanning from May 2016 to November 2023.</p><p><strong>Methods: </strong>Data from 1045 PsA patients, including 783 with peripheral-only PsA (perPsA) and 262 with peripheral and axial involvement (mixed PsA) were analyzed. Drug survival was estimated by Kaplan-Meier analysis. Clinical outcomes, including Disease Activity Index for Psoriatic Arthritis (DAPSA), Psoriasis Area Severity Index (PASI), Ankylosing Spondylitis Disease Activity Score (ASDAS, C-Reactive Protein (CRP)-based), and Visual Analogue Scale (VAS) measures, were evaluated at baseline and at 6, 12, and 24 months. Adjusted hazard ratios (aHRs) for discontinuing SECU were determined using multivariate Cox regression models.</p><p><strong>Results: </strong>SECU survival at 24 months was 63.24%, significantly higher in mixed PsA compared to perPsA (<i>p</i> = 0.036). In the overall PsA population, DAPSA scores decreased significantly at 6 months, and further at 24 months (all <i>p</i> < 0.0001). In mixed PsA, ASDAS-CRP scores were significantly reduced at 6 months and remained stable through 24 months (all <i>p</i> < 0.0001). VAS pain scores also improved already at 6 months and continued to improve at 24 months (all <i>p</i> < 0.0001). Higher age (aHR = 0.98, 95% confidence interval (CI): 0.96-0.99, <i>p</i> = 0.007) and lower baseline DAPSA scores (aHR = 1.02, 95% CI: 1.01-1.03, <i>p</i> = 0.014) were associated with greater persistence of SECU treatment. SECU was well tolerated, with no serious adverse events.</p><p><strong>Conclusion: </strong>SECU showed sustained clinical improvements in both peripheral and axial involvement of PsA patients over 24 months, with higher persistence observed in mixed PsA patients. Our findings highlight the favorable clinical and safety profile of SECU in real world.</p>","PeriodicalId":23056,"journal":{"name":"Therapeutic Advances in Musculoskeletal Disease","volume":"17 ","pages":"1759720X251315138"},"PeriodicalIF":3.4,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11783553/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143079877","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":"Identification of clinical subgroups in anti-SRP positive immune-mediated necrotizing myopathy patients using cluster analysis.","authors":"Beibei Cui, Hongjiang Liu, Ruiting Liu, Geng Yin, Qibing Xie","doi":"10.1177/1759720X251314697","DOIUrl":"https://doi.org/10.1177/1759720X251314697","url":null,"abstract":"<p><strong>Background: </strong>Anti-signal recognition particle immune-mediated necrotizing myopathy (anti-SRP IMNM) is a rare autoimmune disorder characterized by muscle weakness and necrosis. Identifying clinical subgroups within this patient population could facilitate the management of the disease.</p><p><strong>Objectives: </strong>To identify distinct clinical subgroups of anti-SRP IMNM patients.</p><p><strong>Design: </strong>A retrospective study was conducted on anti-SRP IMNM patients treated at West China Hospital of Sichuan University between January 2010 and October 2023.</p><p><strong>Methods: </strong>Clinical data were collected. Unsupervised cluster analysis was conducted to classify patients into distinct subgroups based on their clinical features. Statistical analyses were performed to compare the clinical characteristics and outcomes among the identified clusters.</p><p><strong>Results: </strong>A total of 116 patients were included in the study, and 3 distinct clinical subgroups were identified: Cluster 3 (acute), Cluster 2 (subacute), and Cluster 1 (poor prognosis). Patients in Cluster 3 exhibited a short disease course (median 3 months), severe muscle weakness (78.38% with Medical Research Council (MRC) score ⩽3), high muscle enzyme levels, and a good response to treatment. Cluster 2 patients were younger (mean age 45.83 years), had a longer disease course (median 6.5 months), milder muscle damage, and lower autoantibody titers. Cluster 1 patients were older (mean age 58.10 years), predominantly male (70.97%), and had higher incidences of interstitial lung disease (70.97%) and cardiac injury (45.16%). In Cluster 1, 16.13% of cases were refractory, and the relapse rate was 38.71%, which was significantly higher compared to the other two clusters.</p><p><strong>Conclusion: </strong>This study highlights the clinical heterogeneity among anti-SRP IMNM patients and identifies three distinct clinical subgroups with unique characteristics. These findings provide insights for personalized management.</p>","PeriodicalId":23056,"journal":{"name":"Therapeutic Advances in Musculoskeletal Disease","volume":"17 ","pages":"1759720X251314697"},"PeriodicalIF":3.4,"publicationDate":"2025-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11775970/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143068087","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":"Impact of glucocorticoids on the therapeutic efficacy of denosumab against osteoporosis in patients with rheumatoid arthritis.","authors":"Jiwon Yang, Youngjae Park, Jennifer Jooha Lee, Seung-Ki Kwok, Ji Hyeon Ju, Wan-Uk Kim, Sung-Hwan Park","doi":"10.1177/1759720X251314712","DOIUrl":"https://doi.org/10.1177/1759720X251314712","url":null,"abstract":"<p><strong>Background: </strong>Rheumatoid arthritis (RA) and prolonged high-dose glucocorticoid (GC) treatment are established risk factors for osteoporosis.</p><p><strong>Objectives: </strong>In this study, we aimed to evaluate the therapeutic efficacy of denosumab according to the GC dose considered to increase the risk of glucocorticoid-induced osteoporosis (GIOP) in patients with RA.</p><p><strong>Design: </strong>A retrospective analysis of collected data on RA patients with osteoporosis starting denosumab.</p><p><strong>Methods: </strong>We included 418 patients with RA who were started on denosumab therapy and categorized them into those with and without GC intake ⩾2.5 mg/day for >3 months. The <i>T</i>-score and areal bone mineral density (aBMD) at the lumbar spine, total hip, and femur neck, as well as serum bone turnover markers, were measured at baseline and 12 months. We performed between-group and within-group comparisons of the BMD values at baseline and at 12 months.</p><p><strong>Results: </strong>Denosumab significantly increased the <i>T</i>-scores and aBMD at the lumbar spine, total hip, and femur neck after 12 months, regardless of GC intake. However, apart from the <i>T</i>-score at the lumbar spine, the other parameters did not show significant between-group differences. Similarly, in patients with anti-cyclic citrullinated peptide (CCP) antibody positivity or those treated with biologic or targeted synthetic disease-modifying antirheumatic drugs (DMARDs), although there were significant increases in the <i>T</i>-score and areal BMD at all sites in both groups, there were no significant between-group differences.</p><p><strong>Conclusion: </strong>Our findings suggest that the GC dose considered to increase the risk of GIOP did not significantly attenuate the therapeutic efficacy of denosumab in RA patients, including those positive for anti-CCP antibodies and users of biologic or targeted synthetic DMARDs.</p>","PeriodicalId":23056,"journal":{"name":"Therapeutic Advances in Musculoskeletal Disease","volume":"17 ","pages":"1759720X251314712"},"PeriodicalIF":3.4,"publicationDate":"2025-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11775979/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143068091","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}