Therapeutic Advances in Musculoskeletal Disease最新文献

{"title":"Inflammatory activity levels on patients with anti-TNF therapy: most important factors and a decision tree model based on REGISPONSER and RESPONDIA registries.","authors":"David Castro Corredor, Luis Ángel Calvo Pascual, Eduardo Collantes-Estévez, Clementina López-Medina","doi":"10.1177/1759720X251332224","DOIUrl":"https://doi.org/10.1177/1759720X251332224","url":null,"abstract":"<p><strong>Background: </strong>The effectiveness of anti-tumour necrosis factor (TNF) therapy in spondyloarthritis is traditionally associated with factors such as age, obesity and disease subtypes. However, less-explored aspects, such as mental health, socioeconomic status and work type may also play a crucial role in determining inflammatory activity and therapeutic response.</p><p><strong>Objectives: </strong>To identify the most significant factors explaining inflammatory activity levels in patients treated with anti-TNF therapy and to develop an interpretable machine-learning model with good performance and minimal overfitting.</p><p><strong>Design: </strong>This is an observational, cross-sectional and multicentre study with socio-demographical and clinical data extracted from the Registry of Spondyloarthritis of Spanish Rheumatology (REGISPONSER) and Ibero-American Registry of Spondyloarthropathies (RESPONDIA) registries.</p><p><strong>Methods: </strong>We selected patients receiving anti-TNF therapy and applied five feature selection methods to identify key factors. We evaluated these factors using 182 machine learning models, and, finally, we selected a decision tree model that offered comparable performance with reduced overfitting.</p><p><strong>Results: </strong>Activity levels appear strongly influenced by quality-of-life indicators, particularly the SF-12 physical and mental components and Ankylosing Spondylitis Quality of Life scores. While factors such as age, weight, years of treatment and age at diagnosis have relevance, they are not necessary to obtain a pruned tree with similar cross-validated mean accuracy.</p><p><strong>Conclusion: </strong>Recognizing the central role of physical and mental well-being in managing disease activity can lead to better therapeutic strategies for chronic disease management.</p>","PeriodicalId":23056,"journal":{"name":"Therapeutic Advances in Musculoskeletal Disease","volume":"17 ","pages":"1759720X251332224"},"PeriodicalIF":3.4,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12078959/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144080367","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":"Muscle health in ankylosing spondylitis: effects of disease duration, inflammation, education level, and spinal mobility on skeletal muscle atrophy.","authors":"Jiawen Hu, Yiwen Wang, Zhimeng Yu, Yinan Zhang, Xiaojian Ji, Lulu Zeng, Jiaxin Zhang, Shiwei Yang, Kunpeng Li, Jian Zhu, Jianglin Zhang, Yinghua Liu, Feng Huang","doi":"10.1177/1759720X251335591","DOIUrl":"https://doi.org/10.1177/1759720X251335591","url":null,"abstract":"<p><strong>Background: </strong>Ankylosing spondylitis (AS) is a progressive chronic disease that primarily affects the axial skeleton, leading to significant musculoskeletal impairment. This condition may extend its inflammatory impact to peripheral muscles, potentially resulting in muscle wasting.</p><p><strong>Objectives: </strong>The study aimed to investigate the prevalence of sarcopenia among AS patients, to determine the specific cutoff values for muscle status, and to identify risk factors that may impact muscle status in AS patients.</p><p><strong>Design: </strong>A cross-sectional study was conducted involving consecutive AS patients attending the Department of Rheumatology and Immunology at the First Medical Center of the Chinese PLA General Hospital. Clinical characteristics and body composition were evaluated.</p><p><strong>Methods: </strong>Based on the Asian Working Group for Sarcopenia criteria, the prevalence of sarcopenia among AS patients were calculated. Additionally, specific cutoff values for muscle mass and muscle strength in AS patients were analyzed. Univariable and multivariable logistic regression analyses were employed to scrutinize risk factors impacting muscle status in AS patients, including appendicular skeletal muscle mass index (ASMI) and grip strength.</p><p><strong>Results: </strong>Measurements of body composition, including ASM at 22.79 kg and ASMI at 7.69 kg/m², were significantly lower compared to the healthy control group (<i>p</i> < 0.05). The prevalence of sarcopenia, as identified by the sex-specific fifth percentile, is 8.66% in AS patients. In our study, the ASMI cutoffs were set at 7.48 kg/m² for males and 5.63 kg/m² for females. Logistic regression analysis revealed that AS patients who had a longer disease duration, lower level of education, elevated inflammatory markers, and a higher Bath Ankylosing Spondylitis Metrology Index (BASMI) were more likely to experience a decrease in ASMI. Regarding the muscle strength, lower education level and higher Bath Ankylosing Spondylitis Functional Index were correlated with a reduced grip strength in individuals with AS.</p><p><strong>Conclusion: </strong>Our study indicates that AS patients may have a diminished muscle status. Although the incidence of sarcopenia among AS patients is relatively low, a notable subset does suffer from muscle atrophy. Variables such as disease duration, education level, inflammatory markers, and BASMI are likely to influence muscle status in AS patients, warranting consideration in clinical management and intervention strategies.</p>","PeriodicalId":23056,"journal":{"name":"Therapeutic Advances in Musculoskeletal Disease","volume":"17 ","pages":"1759720X251335591"},"PeriodicalIF":3.4,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12062589/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144033138","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":"Plain language summary of publication to understand the ROSALIA study: a new biosimilar denosumab for bone health.","authors":"Richard Eastell, Sławomir Jeka, Maryam Lustberg, Colin Edgerton, Paweł Żuchowski, Barbara Vogg","doi":"10.1177/1759720X251335147","DOIUrl":"https://doi.org/10.1177/1759720X251335147","url":null,"abstract":"","PeriodicalId":23056,"journal":{"name":"Therapeutic Advances in Musculoskeletal Disease","volume":"17 ","pages":"1759720X251335147"},"PeriodicalIF":3.4,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12046156/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144033145","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":"RAGing ahead in rheumatology: new language model architectures to tame artificial intelligence.","authors":"Diego Benavent, Vincenzo Venerito, Xabier Michelena","doi":"10.1177/1759720X251331529","DOIUrl":"https://doi.org/10.1177/1759720X251331529","url":null,"abstract":"<p><p>Artificial intelligence (AI) is increasingly transforming rheumatology with research on disease detection, monitoring, and outcome prediction through the analysis of large datasets. The advent of generative models and large language models (LLMs) has expanded AI's capabilities, particularly in natural language processing (NLP) tasks such as question-answering and medical literature synthesis. While NLP has shown promise in identifying rheumatic diseases from electronic health records with high accuracy, LLMs face significant challenges, including hallucinations and a lack of domain-specific knowledge, which limit their reliability in specialized medical fields like rheumatology. Retrieval-augmented generation (RAG) emerges as a solution to these limitations by integrating LLMs with real-time access to external, domain-specific databases. RAG enhances the accuracy and relevance of AI-generated responses by retrieving pertinent information during the generation process, reducing hallucinations, and improving the trustworthiness of AI applications. This architecture allows for precise, context-aware outputs and can handle unstructured data effectively. Despite its success in other industries, the application of RAG in medicine, and specifically in rheumatology, remains underexplored. Potential applications in rheumatology include retrieving up-to-date clinical guidelines, summarizing complex patient histories from unstructured data, aiding in patient identification for clinical trials, enhancing pharmacovigilance efforts, and supporting personalized patient education. RAG also offers advantages in data privacy by enabling local data handling and reducing reliance on large, general-purpose models. Future directions involve integrating RAG with fine-tuned, smaller LLMs and exploring multimodal models that can process diverse data types. Challenges such as infrastructure costs, data privacy concerns, and the need for specialized evaluation metrics must be addressed. Nevertheless, RAG presents a promising opportunity to improve AI applications in rheumatology, offering a more precise, accountable, and sustainable approach to integrating advanced language models into clinical practice and research.</p>","PeriodicalId":23056,"journal":{"name":"Therapeutic Advances in Musculoskeletal Disease","volume":"17 ","pages":"1759720X251331529"},"PeriodicalIF":3.4,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12033461/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144019908","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":"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}