Therapeutic Advances in Musculoskeletal Disease最新文献

{"title":"Correlation of changes in inflammatory and collagen biomarkers with durable guselkumab efficacy through 2 years in participants with active psoriatic arthritis: results from a phase III randomized controlled trial.","authors":"Stefan Siebert, Georg Schett, Siba P Raychaudhuri, Monica Guma, Warner Chen, Sheng Gao, Soumya D Chakravarty, Frederic Lavie, Proton Rahman","doi":"10.1177/1759720X241283536","DOIUrl":"10.1177/1759720X241283536","url":null,"abstract":"<p><strong>Background: </strong>Guselkumab (human monoclonal antibody) selectively inhibits the interleukin (IL)-23p19 subunit.</p><p><strong>Objectives: </strong>Assess the longer-term pharmacodynamic effects of guselkumab and explore associations between such effects and clinical responses in patients with active psoriatic arthritis (PsA).</p><p><strong>Design: </strong>DISCOVER-2 randomized 739 biologic-naïve patients with active PsA (swollen/tender joint counts each ⩾5, C-reactive protein (CRP) ⩾0.6 mg/dL) to guselkumab (100 mg every 4 weeks (Q4W) or at Weeks 0, 4, and then Q8W) or placebo. Guselkumab-randomized participants with available serum biomarker data (randomly selected to reflect demographic and disease characteristics of the DISCOVER-2 population) comprised inflammatory (<i>N</i> = 100) and collagen (<i>N</i> = 178) biomarker cohorts.</p><p><strong>Methods: </strong>Pharmacodynamic effects of guselkumab through 2 years on inflammatory and collagen biomarker levels (general linear model) and associations between biomarkers and improvements in composite measures of joint, skin, and overall disease activity (Spearman linear regression) through 2 years were assessed. The relationship between the pharmacodynamic effects of guselkumab and achieving ⩾50% improvement in the American College of Rheumatology response criteria (ACR50) was assessed using a general linear model.</p><p><strong>Results: </strong>With guselkumab, pharmacodynamic effects on inflammatory (CRP, IL-6, serum amyloid A (SAA), IL-17A, IL-17F, IL-22, and beta-defensin 2 (BD-2)) and collagen (matrix metalloproteinase-degradation type I, III, IV, and VI collagen (C1M, C3M, C4M, and C6M)) biomarker levels were sustained or enhanced through Week 100. Throughout follow-up timepoints (Week 24/52/100), decreases in CRP, IL-6, C1M, and C6M levels correlated (<i>r</i> = 0.26-0.30; <i>p</i> < 0.05) with improved joint disease activity (Disease Activity in Psoriatic Arthritis); decreases in IL-17A, IL-17F, IL-22, and BD-2 levels correlated (<i>r</i> = 0.34-0.58; <i>p</i> < 0.05) with improved skin disease (Psoriasis Area and Severity Index); and decreases in C1M, C3M, C4M, and C6M correlated (<i>r</i> = 0.27-0.31; <i>p</i> < 0.05) with improved overall disease activity (Psoriatic Arthritis Disease Activity Score). Significantly (<i>p</i> < 0.05) greater reductions from baseline at Week 100 in CRP, IL-6, SAA, and C1M levels were observed in participants improving from Week 24 ACR50 nonresponse to Week 100 ACR50 response and were accompanied by a significant decrease in C1M from Week 24 to Week 100 versus nonresponders at both Weeks 24 and 100.</p><p><strong>Conclusion: </strong>In biologic-naïve participants with active PsA, guselkumab elicited substantial and enduring reductions in biomarkers that were associated with durable improvements in joint, skin, and overall disease activity through 2 years of DISCOVER-2.</p><p><strong>Trial registration: </strong>NCT03158285 (clinicaltrials","PeriodicalId":23056,"journal":{"name":"Therapeutic Advances in Musculoskeletal Disease","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-10-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11528637/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142567436","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":"What have we learnt from the inhibition of IL-6 in RA and what are the clinical opportunities for patient outcomes?","authors":"Peter C Taylor, Eugen Feist, Janet E Pope, Peter Nash, Jean Sibilia, Roberto Caporali, Alejandro Balsa","doi":"10.1177/1759720X241283340","DOIUrl":"https://doi.org/10.1177/1759720X241283340","url":null,"abstract":"<p><p>Rheumatoid arthritis (RA) is an autoimmune disease characterised by persistent inflammation of the synovial joints as well as other tissues and organs. Left untreated, it can lead to joint damage, disability and even increased mortality. The disease is driven by inflammatory cytokines that contribute to the chronic inflammation seen in RA. Interleukin-6 (IL-6) is a key pathological cytokine and a target for treatments aiming to alleviate local and systemic inflammation. Despite advances in understanding RA and the introduction of new treatments, achieving sustained remission remains challenging. This review explores the role of IL-6 in RA pathogenesis, its potential as a treatment target and the significance of personalised medicine in RA management. IL-6 has a dual signalling mechanism, classical and trans-signalling, which influences various intracellular pathways. While several targeted therapies have emerged, no single mechanism-based therapy is universally effective due to the diversity and complexity of the disease. Different approaches to targeting IL-6 have been tested, including biologic blockade of receptors or ligands, and inhibition of IL-6 signalling. IL-6 receptor inhibitors have been validated as RA therapeutics, either alone or in combination with other treatments. Tocilizumab, the first approved IL-6 inhibitor, blocks both soluble and membrane-bound IL-6 receptors, reducing the inflammatory cascade. Clinical trials confirm the efficacy and safety of tocilizumab and its role as a treatment option for patients unresponsive to conventional therapies. The benefits of IL-6 inhibition extend beyond reduced joint inflammation to the amelioration of comorbidities like anaemia, cardiovascular disease, depression and osteoporosis. Tailoring treatment to patients' profiles and comorbidities is essential for optimal outcomes. A 'treat-to-profile' approach, focusing on a holistic view of the patient, could improve personalised medicine strategies. Biosimilars - lower-cost alternatives to biologics - further enhance the accessibility and cost-effectiveness of treatment. IL-6 inhibitors present a valuable treatment option for RA management, particularly for patients with specific comorbidities.</p>","PeriodicalId":23056,"journal":{"name":"Therapeutic Advances in Musculoskeletal Disease","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11497505/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142508538","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":"Imaging in psoriatic arthritis: established methods and emerging techniques.","authors":"Yingzhao Jin, Isaac T Cheng, Dongze Wu, Xianfeng Yan, Sze-Lok Lau, Nga Sze Wong, Vivian W Hung, Ling Qin, Ryan Ka Lok Lee, James F Griffith, Cheuk-Chun Szeto, Ho So, Lai-Shan Tam","doi":"10.1177/1759720X241288060","DOIUrl":"https://doi.org/10.1177/1759720X241288060","url":null,"abstract":"<p><p>Psoriatic arthritis (PsA) is a heterogeneous, chronic, inflammatory musculoskeletal disease that can lead to peripheral and axial damage and loss of function. A clear difference between PsA and other forms of inflammatory arthritis is the different forms of bone remodeling seen in PSA which incorporates not only increased bone resorption with bone erosions, osteolysis, and loss of bone mineral density but also increased bone formation with periostitis, syndesmophytes, enthesiophytes, and ankylosis. PsA, if diagnosed late, will lead to significant structural damage, the most severe form of which is known as arthritis mutilans, and loss of physical function. Imaging plays a crucial role in diagnosing and monitoring both peripheral and axial conditions associated with PsA. Radiography is currently the main modality used to monitor structural damage in PsA though commonly used scoring systems do not include bony proliferation as a criterion. Besides, radiography is limited in determining the presence and cause of periarticular soft tissue thickening, which may arise from tendinosis, tenosynovitis, synovial proliferation, bursitis, or enthesitis. Recently, much more attention has been paid to determining the imaging characteristics of PsA, which enables more precise identification of disease and severity assessment. Newer imaging technologies also enable variations in normal bone microstructure to be distinguished from disease-related abnormality. This review discusses the current state of innovative imaging modalities in PsA, specifically concentrating on their roles in PsA diagnosis and treatment, improving the early detection of PsA, and identifying patients with skin psoriasis at risk of developing psoriatic arthritis.</p>","PeriodicalId":23056,"journal":{"name":"Therapeutic Advances in Musculoskeletal Disease","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11483715/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142475465","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":"Infections in psoriatic arthritis: association with treatment.","authors":"Athanasios Vassilopoulos, Konstantinos Thomas, Dimitrios Vassilopoulos","doi":"10.1177/1759720X241289201","DOIUrl":"10.1177/1759720X241289201","url":null,"abstract":"<p><p>Serious infections (SIs) remain one of the most significant comorbidities in patients with inflammatory arthritides including psoriatic arthritis (PsA). Apart from methotrexate (MTX) and biologics such as tumor necrosis factor (TNFi), interleukin-12/23 (IL-12/23i), and IL-17 inhibitors (IL-17i), traditionally used for the treatment of PsA, recently biologics such as IL-23i and targeted synthetic agents like JAK inhibitors (JAKi) have been introduced in the daily clinical practice for the treatment of this disease. Although overall the incidence of SIs in patients with PsA treated with these agents is lower compared to patients with rheumatoid arthritis, still a number of unresolved issues regarding their safety remain. Current evidence is reassuring regarding the safety profile of conventional synthetic disease-modifying anti-rheumatic drugs, such as MTX. The increased risk for reactivation of latent infections, such as tuberculosis and hepatitis B virus (HBV) with the use of TNFi, is well described; nevertheless, it is significantly ameliorated with the appropriate screening and prophylaxis. Regarding IL-12/23i and IL-17i, there are no significant safety signals, except from an increased incidence of usually mild <i>Candida</i> infections with the latter class. Newer biologics such as IL-23i and targeted synthetic agents like JAKi have been recently introduced in the daily clinical practice for the treatment of this disease. While IL-23i has not been shown to increase the risk for common or opportunistic infections, a well-established association of JAKi with herpes zoster warrants the attention of rheumatologists. In this narrative review, we summarize the infectious complications of available treatment options by drug class in patients with PsA.</p>","PeriodicalId":23056,"journal":{"name":"Therapeutic Advances in Musculoskeletal Disease","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11487508/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142475466","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":"Serum transthyretin levels and disease activity in patients with primary Sjögren's syndrome.","authors":"You-Fan Peng, Fei-Yan Lu, Yi-Bin Deng","doi":"10.1177/1759720X241283528","DOIUrl":"https://doi.org/10.1177/1759720X241283528","url":null,"abstract":"<p><strong>Background: </strong>A strong association has been demonstrated between serum transthyretin (TTR) levels and autoimmune diseases. However, there is limited information regarding the role of serum TTR in patients with primary Sjögren's syndrome (pSS).</p><p><strong>Objectives: </strong>This study was designed to explore the association between serum TTR and disease activity in patients with pSS.</p><p><strong>Design: </strong>This study was a retrospective observational study.</p><p><strong>Methods: </strong>This study included 84 patients with pSS and 135 age- and sex-matched healthy controls retrospectively, and collected data were analyzed. The European League Against Rheumatism (EULAR) Sjögren's Syndrome Disease Activity Index (ESSDAI) and Clinical ESSDAI (ClinESSDAI) scores were used to assess the disease activity in patients with pSS.</p><p><strong>Results: </strong>Serum TTR levels were significantly lower in patients with pSS than those in healthy controls (181.9 ± 69.2 vs 241.8 ± 48.9 mg/L, <i>p</i> < 0.001). Serum TTR levels were significantly and negatively correlated with ESSDAI (<i>r</i> = -0.385, <i>p</i> < 0.001) and ClinESSDAI (<i>r</i> = -0.340, <i>p</i> = 0.002) scores in patients with pSS, respectively. Multivariable linear regression analysis showed that serum TTR was significantly associated with ESSDAI (Beta = -0.248, <i>p</i> = 0.017) and ClinESSDAI (Beta = -0.215, <i>p</i> = 0.036) scores in patients with pSS, respectively.</p><p><strong>Conclusion: </strong>Serum TTR is a potential marker for assessing disease activity in patients with pSS, which may contribute to the clinical management of pSS.</p>","PeriodicalId":23056,"journal":{"name":"Therapeutic Advances in Musculoskeletal Disease","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11483703/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142475467","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":"Counting the costs: a nationwide study on healthcare use following an adalimumab biosimilar switch in >1300 inflammatory arthritis patients.","authors":"Hafsah Nabi, Rikke Ibsen, Michael Ibsen, Jakob Kjellberg, Merete Lund Hetland, Bente Glintborg","doi":"10.1177/1759720X241289391","DOIUrl":"10.1177/1759720X241289391","url":null,"abstract":"<p><strong>Background: </strong>In Denmark, cost savings motivate mandatory biosimilar switches. In 2018, patients switched from originator to biosimilar adalimumab, that is, to GP2017 in Eastern and to SB5 in Western Denmark. However, concerns were raised about additional costs covering, that is, an increased number of outpatient visits due to patient education, treatment monitoring, and patient concerns.</p><p><strong>Objectives: </strong>To investigate whether the switch led to increased total healthcare costs, defined as costs related to in- and outpatient contacts in hospitals and the primary sector and use of prescription medicine (excluding biological treatment).</p><p><strong>Design: </strong>Observational cohort study with geographical cluster pseudo-randomization.</p><p><strong>Methods: </strong>Patients with rheumatoid arthritis, psoriatic arthritis (PsA), and axial spondyloarthritis (AxSpA), who switched were identified in the nationwide DANBIO registry. Total healthcare costs 9 months before and after the switch were captured from the National Patient and Prescription registries. The difference between pre- and post-switch costs was estimated by a generalized estimation equations (GEE) model.</p><p><strong>Results: </strong>Overall, 1316 patients switched to GP2017 (<i>n</i> = 621) or SB5 (<i>n</i> = 695). Total healthcare costs were mainly driven by hospital costs. The monthly fluctuations of hospital costs 9 months before and after the switch were largely similar or decreased. In the adjusted analyses (GEE), hospital costs decreased after the switch (by approximately 15%) for GP2017 switchers, especially PsA (estimate = 0.83; 95% CI 0.75-0.92) and AxSpA patients (estimate = 0.85; 0.77-0.93), with no significant changes for SB5 switchers.</p><p><strong>Conclusion: </strong>We found no increase in total healthcare costs in 9 months following a nationwide mandatory adalimumab originator to biosimilar switch. Our findings were strengthened by similar results for GP2017 and SB5.</p>","PeriodicalId":23056,"journal":{"name":"Therapeutic Advances in Musculoskeletal Disease","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11526192/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142558861","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":"Computed tomography-current status and future directions for arthritis imaging.","authors":"Sevtap Tugce Ulas, Torsten Diekhoff","doi":"10.1177/1759720X241287373","DOIUrl":"https://doi.org/10.1177/1759720X241287373","url":null,"abstract":"<p><p>Applications of computed tomography (CT) in arthritis imaging have rapidly expanded in recent years due to ongoing technical developments. Dual-energy CT (DECT) has become indispensable in clinical practice, particularly for diagnosing gouty arthritis and assessing bony structural changes. Technological innovations such as low-dose CT and state-of-the-art reconstruction algorithms reduce radiation exposure while maintaining image quality and short acquisition times. This review explores the growing role of CT in arthritis imaging. Recent innovations have extended DECT's utility beyond gout diagnosis to the detection of inflammatory changes in various arthritic conditions. Postprocessing techniques such as the generation of subtraction images and iodine maps provide valuable insights into tissue perfusion and inflammatory activity, crucial for arthritis management. DECT can distinguish calcium from uric acid crystals, facilitating the differential diagnosis of various crystal arthropathies in a variety of clinical settings. This ability is particularly valuable in distinguishing between different clinical conditions in patients with inflammatory joint changes within a single imaging examination. Moreover, the advent of four-dimensional CT promises a better assessment of dynamic joint instabilities and ligament injuries, especially in the wrist. Overall, DECT offers a comprehensive approach to arthritis imaging, from the detection of structural changes to the assessment of active inflammation in joints and tendons. Continuous advances in CT technology, including photon-counting CT, hold promise for further improving diagnostic accuracy and expanding the role of CT in arthritis imaging and therapy monitoring.</p>","PeriodicalId":23056,"journal":{"name":"Therapeutic Advances in Musculoskeletal Disease","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11497529/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142508537","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":"An optimal deep learning model for the scoring of radiographic damage in patients with ankylosing spondylitis.","authors":"Yen-Ju Chen, Der-Yuan Chen, Haw-Chang Lan, An-Chih Huang, Yi-Hsing Chen, Wen-Nan Huang, Hsin-Hua Chen","doi":"10.1177/1759720X241285973","DOIUrl":"https://doi.org/10.1177/1759720X241285973","url":null,"abstract":"<p><strong>Background: </strong>Detecting vertebral structural damage in patients with ankylosing spondylitis (AS) is crucial for understanding disease progression and in research settings.</p><p><strong>Objectives: </strong>This study aimed to use deep learning to score the modified Stoke Ankylosing Spondylitis Spinal Score (mSASSS) using lateral X-ray images of the cervical and lumbar spine in patients with AS in Asian populations.</p><p><strong>Design: </strong>A deep learning model was developed to automate the scoring of mSASSS based on X-ray images.</p><p><strong>Methods: </strong>We enrolled patients with AS at a tertiary medical center in Taiwan from August 1, 2001 to December 30, 2020. A localization module was used to locate the vertebral bodies in the images of the cervical and lumbar spine. Images were then extracted from these localized points and fed into a classification module to determine whether common lesions of AS were present. The scores of each localized point were calculated based on the presence of these lesions and summed to obtain the total mSASSS score. The performance of the model was evaluated on both validation set and testing set.</p><p><strong>Results: </strong>This study reviewed X-ray image data from 554 patients diagnosed with AS, which were then annotated by 3 medical experts for structural changes. The accuracy for judging various structural changes in the validation set ranged from 0.886 to 0.985, whereas the accuracy for scoring the single vertebral corner in the test set was 0.865.</p><p><strong>Conclusion: </strong>This study demonstrated a well-trained deep learning model of mSASSS scoring for detecting the vertebral structural damage in patients with AS at an accuracy rate of 86.5%. This artificial intelligence model would provide real-time mSASSS assessment for physicians to help better assist in radiographic status evaluation with minimal human errors. Furthermore, it can assist in a research setting by offering a consistent and objective method of scoring, which could enhance the reproducibility and reliability of clinical studies.</p>","PeriodicalId":23056,"journal":{"name":"Therapeutic Advances in Musculoskeletal Disease","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11459512/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142393610","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The incidence of vasculitides in Israel from 2007 to 2021 and during the COVID-19 pandemic.","authors":"Lior Zeller, Ran Ben David, Lena Novack, Ran Abuhasira, Mahmoud Abu-Shakra, Yuval Miskin, Iftach Sagy","doi":"10.1177/1759720X241274032","DOIUrl":"10.1177/1759720X241274032","url":null,"abstract":"<p><strong>Background: </strong>The incidence of various types of vasculitis conditions over time, specifically during coronavirus disease 2019 (COVID-19), is unknown.</p><p><strong>Objectives: </strong>We aimed to assess recent trends in vasculitides and the effect of the COVID-19 pandemic on these trends.</p><p><strong>Design: </strong>We conducted a retrospective analysis of Israel's largest Health Maintenance Organization, which covers over 4.7 million patients and represents 55% of the country.</p><p><strong>Methods: </strong>We calculated the age- and sex-adjusted incidence of giant cell arteritis (GCA), Takayasu, ANCA-associated vasculitis (AAV), IgA vasculitis, cryoglobulinemia, and Behcet's disease (BD) during 2007-2021. We analyzed associations of COVID-19 with the incidence of each of the examined conditions.</p><p><strong>Results: </strong>During 2007-2021, the adjusted annual incidence decreased from 7.9 (95% confidence interval (CI) 3.5-17.9) to 1.5 (95% CI 0.7-3.6) per 100,000 for GCA, from 5.2 (95% CI 2.7-11.1) to 1.5 (95% CI 0.7-3.3) per million for IgA vasculitis, and from 6.3 (95% CI 3.0-13.5) to 1.0 (0.5-2.5) per 100,000 for BD. The relative risks for these conditions decreased: 0.92 (95% CI 0.91-0.93), 0.93 (95% CI 0.89-0.98), and 0.90 (95% CI 0.85-0.94), respectively. The incidences of Takayasu, AAV, and cryoglobulinemia remained unchanged. The COVID-19 pandemic was not associated with changes in the incidence of any examined vasculitides.</p><p><strong>Conclusion: </strong>The incidences of GCA, IgA vasculitis, and BD decreased substantially in Israel during 15 years and were unaffected by the COVID-19 pandemic. Future studies should focus on possible environmental contributions to these findings.</p>","PeriodicalId":23056,"journal":{"name":"Therapeutic Advances in Musculoskeletal Disease","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11465294/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142401391","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":"Precision medicine in axial spondyloarthritis: current opportunities and future perspectives.","authors":"Jacqueline So, Lai-Shan Tam","doi":"10.1177/1759720X241284869","DOIUrl":"https://doi.org/10.1177/1759720X241284869","url":null,"abstract":"<p><p>Axial spondyloarthritis (axSpA) is a complex disease characterized by a diverse range of clinical presentations. The primary manifestation is inflammatory lower back pain, often accompanied by other clinical manifestations such as peripheral arthritis, enthesitis, uveitis, psoriasis, and inflammatory bowel disease. However, the presentation of axSpA can vary widely among patients. Despite extensive research, the precise pathogenesis of axSpA remains largely unknown. The lack of complete understanding poses challenges in subgrouping the disease, developing specific treatment approaches, and predicting treatment response. In this review, we will explore the limitations in diagnosing and treating axSpA. In addition, we will examine the current knowledge and potential opportunities provided by various omics and technological advancements in enhancing the diagnosis and personalized treatment of axSpA.</p>","PeriodicalId":23056,"journal":{"name":"Therapeutic Advances in Musculoskeletal Disease","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11457172/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142393611","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}