Open Access Rheumatology-Research and Reviews最新文献

{"title":"Prevalence and Associated Risk Factors of Fibromyalgia Among Schoolteachers in The Eastern Region of Saudi Arabia.","authors":"Manal A Hasan, Safia M H Al Abbas, Rana K Almuqati, Hawra Alwan Alsalem, Marwan J Alwazzeh, Safi G Alqatari, Abdullah A Al-Abdulwahab, Hajer M AlZuhair, Danya Y Al Nujaidi, Mohammed D Al Shubbar","doi":"10.2147/OARRR.S575504","DOIUrl":"10.2147/OARRR.S575504","url":null,"abstract":"<p><strong>Purpose: </strong>Fibromyalgia (FMS) is a chronic pain syndrome characterized by widespread pain, fatigue, sleep disturbance, and cognitive dysfunction. It is more common in women, often underdiagnosed, and may be shaped by lifestyle and occupational factors. Teachers experience high physical and psychosocial demands, yet FMS prevalence in this group in Saudi Arabia remains unclear. This study assessed FMS prevalence among schoolteachers in the Eastern Province, identified risk factors, and explored its impact on work performance.</p><p><strong>Patients and methods: </strong>A cross-sectional study was conducted among 850 teachers aged ≥25 years from private and governmental schools. Participants completed a self-administered online survey including demographics, lifestyle, occupational, and health data, along with the validated Fibromyalgia Survey Diagnostic Criteria (FSDC, 2010 ACR). FMS prevalence and its associations with demographic and lifestyle factors were analyzed using chi-square and <i>t</i>-tests. Work performance was evaluated through self-reported measures of motivation, concentration, punctuality, absenteeism, and workplace relationships.</p><p><strong>Results: </strong>Mean age was 44.8 (±8.7) years; 64% were female and 92.8% Saudi nationals. FMS prevalence was 14.4%, with only 4.5% previously diagnosed. FMS was significantly associated with female gender, divorced/widowed status, physical inactivity, and poor sleep, while BMI and age showed no significant association. Teachers with FMS reported lower motivation and concentration, but no differences were found in punctuality, absenteeism, or workplace relationships.</p><p><strong>Conclusion: </strong>FMS affects approximately one in seven schoolteachers in the Eastern Province of Saudi Arabia, with the majority of cases remaining undiagnosed. Female gender, physical inactivity, and poor sleep were significantly associated with FMS. Teachers with FMS reported reduced work motivation and concentration. These findings highlight the need for increased awareness of FMS among educators and healthcare providers.</p>","PeriodicalId":45545,"journal":{"name":"Open Access Rheumatology-Research and Reviews","volume":"18 ","pages":"575504"},"PeriodicalIF":3.4,"publicationDate":"2026-02-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12922953/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147272366","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Herpes Zoster Risk in Rheumatoid Arthritis Patients on Janus Kinase Inhibitors: A 17-Year Experience from Rheumatoid Arthritis Saudi Database (RASD).","authors":"Ola Abudaowd, Suzan M Attar, Muhammad Irfanullah Siddiqui, Fida Merghani Ahmed, Alhussain Asiri, Mohammed M Alomair, Ayda Rahma Ali, Mona Alsharaif, Hanan AlMalki, Sami Bahlas, Yasser Bawazir, Gamal Salama, Albadr Hussain, Reham Kaki, Hani M Almoallim","doi":"10.2147/OARRR.S571893","DOIUrl":"10.2147/OARRR.S571893","url":null,"abstract":"<p><strong>Background/purpose: </strong>The advent of targeted therapies, such as biologic disease-modifying anti-rheumatic drugs (bDMARDs) and Janus kinase inhibitors (JAKi), has revolutionized the treatment of rheumatoid arthritis (RA) patients who do not respond adequately to conventional disease-modifying anti-rheumatic drugs (csDMARDs). Concerns have been raised about the increased risk of infections, especially herpes zoster (HZ). The association between JAKi treatment and HZ remains complex. The objective of this study was to assess the risk of HZ among RA patients in our Rheumatoid Arthritis Saudi Database (RASD) receiving JAKi and other DMARDs.</p><p><strong>Patients and methods: </strong>A 17-year retrospective multicenter chart review study was conducted in Saudi Arabia using RASD. We included patients diagnosed with RA according to the American College of Rheumatology criteria who were 18 years of age and above, on different modalities of treatment: csDMARDs, bDMARDs, targeted synthetic DMARDs (tsDMARDs) with or without concomitant GC. The following information was collected: demographics, comorbidities, medications, HZ occurrence, and vaccination history.</p><p><strong>Results: </strong>A total of 614 patients diagnosed with RA were enrolled in the study of whom 87.6% (n=538) were female and 98.2% (n = 603) were of Arab ethnicity with a mean age was 48.79 ± 13.35 years. Herpes zoster (HZ) occurred in only 1.1% (n = 7) of patients. JAKi therapy was not associated with an increased risk of HZ (p = 0.454). However, Asian ethnicity (p = 0.010) and cumulative GC exposure ≥60 mg (p = 0.035) were significantly associated with higher HZ risk.</p><p><strong>Conclusion: </strong>We did not detect any association between JAKi and HZ infection in our RASD. On the other hand, cumulative GC of 60 mg or more and Asian ethnicity were identified as significant risk factors. These findings provide a basis for future nationwide studies aimed to deliver personalized preventive strategies against HZ.</p>","PeriodicalId":45545,"journal":{"name":"Open Access Rheumatology-Research and Reviews","volume":"18 ","pages":"571893"},"PeriodicalIF":3.4,"publicationDate":"2026-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12911962/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146221493","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"From Nerve to Autoimmunity: Acute Guillain-Barré Syndrome in a 4-Year-Old with Early-Onset Pediatric Systemic Lupus Erythematosus.","authors":"Mu'ath Kanan, Hamzah A Hasan, Aya M Hassan, Lana Sbitan","doi":"10.2147/OARRR.S578137","DOIUrl":"10.2147/OARRR.S578137","url":null,"abstract":"<p><strong>Objective: </strong>To report an unusual pediatric case of Guillain-Barré Syndrome (GBS) presented as the first manifestation of Systemic Lupus Erythematosus (SLE), highlighting diagnostic and clinical considerations.</p><p><strong>Methods: </strong>We document the clinical presentation, laboratory findings, diagnostic investigations, and management of a 4-year-old boy who presented with progressive weakness and sensory deficits. Initial Electrophysiology and cerebrospinal fluid analysis reveal GBS diagnosis while, autoimmune and renal workup revealed an underlying SLE.</p><p><strong>Results: </strong>We report a case of a 4-year-old boy who presented with progressive bilateral lower-limb weakness, absent deep tendon reflexes, sensory loss, and muscle weakness, confirmed as GBS through electrophysiological studies and cerebrospinal fluid analysis. Further investigations revealed thrombocytopenia, elevated antinuclear antibody titers, double-stranded DNA antibodies, proteinuria, and hematuria, leading to the diagnosis of SLE with GBS as the initial manifestation. The patient was referred for rheumatology and nephrology management and recovered from GBS but was diagnosed with SLE, complicated by membranous lupus nephritis (class V).</p><p><strong>Conclusion: </strong>GBS can rarely present as the first neurological manifestation of pediatric SLE. Early recognition and a multidisciplinary approach are critical for effective management and improved outcomes.</p>","PeriodicalId":45545,"journal":{"name":"Open Access Rheumatology-Research and Reviews","volume":"18 ","pages":"578137"},"PeriodicalIF":3.4,"publicationDate":"2026-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13033419/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147595492","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Antioxidant and Anti-Inflammatory Effects of Turmeric Fermentation Liquid in Knee Osteoarthritis.","authors":"Chun-Wen Lan, Hsin-Hung Chen, Jim Jinn-Chyuan Sheu","doi":"10.2147/OARRR.S578197","DOIUrl":"10.2147/OARRR.S578197","url":null,"abstract":"<p><strong>Background: </strong><i>Curcuma longa</i> L. (turmeric) is a widely used medicinal plant with potent antioxidant and anti-inflammatory properties. It has been traditionally employed to manage inflammatory diseases such as osteoarthritis. This study explored the therapeutic potential of turmeric fermentation liquid (TF) in reducing oxidative stress, inflammation, and cartilage degradation in a monosodium iodoacetate-induced rat model of knee osteoarthritis (KOA).</p><p><strong>Methods: </strong>Fresh turmeric was washed, sliced, and fermented using <i>Lactobacillus</i> strains under controlled conditions to enhance its bioavailability and produce TF. Male Wistar rats were divided into four groups: Control, MIA, MIA+glucosamine hydrochloride, and MIA+TF. TF was administered orally for four weeks, and its effects were assessed through ELISA, histological staining, and immunohistochemistry to measure oxidative stress markers, inflammatory cytokines, and cartilage integrity.</p><p><strong>Results: </strong>TF enhanced antioxidant capacity and significantly reduced lipid peroxidation. It suppressed pro-inflammatory cytokines (TNF-α, IL-1β) and increased anti-inflammatory IL-10 levels. Histological analysis revealed cartilage preservation, reduced proteoglycan loss, and decreased synovitis severity. Safranin O staining confirmed higher proteoglycan retention in TF-treated cartilage, while immunohistochemistry showed reduced IL-6 and IL-1β expression. Furthermore, TF improved synovial fluid quality and decreased chondrocyte apoptosis, resulting in better joint mobility and reduced pain behavior in KOA rats.</p><p><strong>Conclusion: </strong>Turmeric fermentation liquid exhibits potential as a natural therapy for KOA by addressing oxidative stress and inflammation. The fermentation process enhances bioavailability, providing a novel approach for preserving joint health and function. Further clinical studies are needed to confirm its efficacy and safety in humans.</p>","PeriodicalId":45545,"journal":{"name":"Open Access Rheumatology-Research and Reviews","volume":"18 ","pages":"578197"},"PeriodicalIF":3.4,"publicationDate":"2026-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13021379/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147575822","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring the Toxicological Effects of Acetyl Tributyl Citrate Exposure on Osteoarthritis Based on Machine Learning, Network Toxicology and Molecular Docking Analysis.","authors":"Yifang Zhu, Lin Deng, Junxiang Xia, Jing Yang, Dan Zhao, Min Li","doi":"10.2147/OARRR.S560636","DOIUrl":"10.2147/OARRR.S560636","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the potential toxicological effects of acetyl tributyl citrate (ATBC) on osteoarthritis (OA) and elucidate the underlying mechanisms using bioinformatics, machine learning, and network toxicology.</p><p><strong>Methods: </strong>ATBC targets were identified from multiple databases, and OA-associated differentially expressed genes (DEGs) were sourced from GSE51588. Intersection analysis identified common targets. Functional enrichment and protein-protein interaction (PPI) network analysis were performed. Machine learning algorithms (LASSO, Random Forest and SVM) validated core targets, with ROC curves assessing diagnostic potential. Immune infiltration differences were analyzed via Cibersort. Molecular docking confirmed ATBC binding to core targets, and an adverse outcome pathway (AOP) framework was developed to elucidate ATBC's role in exacerbating OA through key genes and pathways.</p><p><strong>Results: </strong>Intersection analysis identified 40 common targets related to both ATBC and OA. Functional enrichment analysis revealed that these targets were significantly involved in calcium signaling pathways and neuroactive ligand-receptor interactions, both of which are implicated in OA pathogenesis. The PPI network analysis identified TNF, MMP8, CXCR4, and SLC2A1 as core targets. Machine learning algorithms further validated these core targets. ROC curve analysis showed that these genes have diagnostic potential, with AUC values ranging from 0.762 to 0.970. Immune infiltration analysis using Cibersort revealed significant differences in immune cell infiltration between OA and control groups, with core targets showing distinct correlations with various immune cells. Molecular docking confirmed strong binding affinities between ATBC and the core targets, with binding energies less than -5 kcal/mol. A novel adverse outcome pathway (AOP) framework was established, suggesting that ATBC may influence the expression of TNF, CXCR4, MMP8, and SLC2A1, with the calcium signaling and neuroactive ligand-receptor interaction pathways potentially contributing to immune dysregulation and OA progression.</p><p><strong>Conclusion: </strong>The identification of key targets (TNF, MMP8, CXCR4, and SLC2A1) and molecular docking results elucidates potential mechanisms by which ATBC exposure may exacerbate OA progression. The AOP provides evidence for joint-health risk assessment of plasticizers and offers readily measurable biomarkers for regulatory toxicology and future therapeutic development.</p>","PeriodicalId":45545,"journal":{"name":"Open Access Rheumatology-Research and Reviews","volume":"18 ","pages":"560636"},"PeriodicalIF":3.4,"publicationDate":"2026-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13021556/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147575793","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of miR-145-5p, miR-143-3p and miR-146a-5p with Simplified Disease Activity Index in Rheumatoid Arthritis.","authors":"Beatriz Teresita Martín Márquez, Fernanda Isadora Corona Meraz, Andrea Aguilar-Vázquez, Itzel Yoselin Arteaga Gallegos, Judith Alejandra Esparza Michel, Alvaro Jovanny Tovar-Cuevas, Milton Omar Guzmán-Ornelas, Roberto Carlos Rosales Gómez, Flavio Sandoval García, Oscar Pizano Martínez, Edy David Rubio Arellano, Gabriela Paola García-Ordoñez, Christian Juarez-Gomez, Mónica Vázquez-Del Mercado","doi":"10.2147/OARRR.S561973","DOIUrl":"10.2147/OARRR.S561973","url":null,"abstract":"<p><strong>Purpose: </strong>MicroRNAs (miR) have emerged as key regulatory molecules in immune response and inflammation. This study investigated the association between the plasma expression levels of miR-146a-5p, miR-143-3p, miR-145-5p and rheumatoid arthritis (RA) clinical activity measured by standard tools such as the Simplified Disease Activity Index (SDAI).</p><p><strong>Patients and methods: </strong>Forty-eight RA patients fulfilling the EULAR/ACR 2010 criteria and 39 clinical apparently healthy subjects (HS) were included. Patients were categorized based on disease clinical activity using standard scores. Expression levels of miR were determined by RT-qPCR to be analyzed in the context of disease clinical activity, serum inflammation markers and autoantibodies such as rheumatoid factor (RF) and anti-cyclic citrullinated peptide antibodies (anti-CCP). Bioinformatic analysis was performed to assess gene interactions and signaling pathways.</p><p><strong>Results: </strong>The expression of miR-146a-5p showed higher expression in patients with low or moderate clinical disease activity. In addition, miR-145-5p was negatively correlated with both RF and anti-CCP antibodies. Bioinformatic analysis revealed that the miRs could simultaneously regulate myosin VI (<i>MYO6</i>) and connective tissue growth factor (<i>CTGF</i>) genes.</p><p><strong>Conclusion: </strong>Our findings suggest that the plasma levels of the analyzed miR are associated with key serological markers and low to moderate disease clinical activity in RA patients according to SDAI score. The bioinformatics data supports the potential for these miRs to regulate genes involved in RA pathology.</p>","PeriodicalId":45545,"journal":{"name":"Open Access Rheumatology-Research and Reviews","volume":"17 ","pages":"251-264"},"PeriodicalIF":1.7,"publicationDate":"2025-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12719922/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145821429","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring Antifibrotic Strategies for Interstitial Lung Disease in Rheumatoid Arthritis: A Narrative Review.","authors":"Narjes Sadat Farizani Gohari, Farahnaz Hoseinzadeh, Amirmohammad Khalaji, Samaneh Mirzaei, Mohsen Gholinataj Jelodar","doi":"10.2147/OARRR.S561159","DOIUrl":"10.2147/OARRR.S561159","url":null,"abstract":"<p><p>Rheumatoid arthritis (RA) is an autoimmune disease that primarily affects the joints, although extra-articular involvement, including interstitial lung disease (ILD), is also seen. Usual interstitial pneumonia and nonspecific interstitial pneumonia (NSIP) are the most common ILD in RA, which may be associated with the development of fibrotic changes in the lungs and a poorer prognosis for patients. However, the precise mechanism of ILD in RA remains unclear. A combination of environmental triggers, genetic predisposition, and enhanced immune system activity contributes to the formation of a chronic inflammatory process in the lungs, leading to uncontrolled fibroblast activity, which is ultimately associated with progressive fibrosis. Although currently available treatments for RA are effective for joint involvement, the efficacy of these anti-inflammatory treatments in progressive pulmonary fibrosis has not been encouraging. In recent years, the use of antifibrotic agents, which have been well-tested in the treatment of idiopathic pulmonary fibrosis (IPF), has been tested in the treatment of fibrotic and interstitial lung involvement in other diseases. In this study, we compared the pulmonary fibrotic developmental process of RA with IPF. Given the similarities in the pathogenesis and inflammatory pathways of these two entities, the use of antifibrotic drugs may offer a suitable and potentially promising strategy for treating fibrotic changes in RA. Currently, we face the challenge of a lack of sufficient studies with an appropriate sample size in this area. Therefore, the design and implementation of appropriate trials in the future should be considered a policy.</p>","PeriodicalId":45545,"journal":{"name":"Open Access Rheumatology-Research and Reviews","volume":"17 ","pages":"233-250"},"PeriodicalIF":3.4,"publicationDate":"2025-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12707150/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145775896","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Expert Opinion Report on the Challenges in the Management of Psoriatic Arthritis in United Arab Emirates: A Focus on Interleukin-17 Inhibitors.","authors":"Ahmed Abogamal, Humeira Badsha, Suad Hannawi, Ghita Harifi, Bhavna Khan, Atheer Al Ansari, Khalid A Alnaqbi, Ahmed S Zayat, Shady Ibrahim, Mohamed Taher, Rajaie Namas","doi":"10.2147/OARRR.S540008","DOIUrl":"10.2147/OARRR.S540008","url":null,"abstract":"<p><strong>Purpose: </strong>To seek recommendations from a panel of experts in psoriatic arthritis (PsA) on the current management challenges, local practices, and role of interleukin (IL)-17 inhibitors in the United Arab Emirates (UAE) using evidence from phase III trials as background.</p><p><strong>Methods: </strong>Nine rheumatologists who treat PsA in the UAE completed a structured survey and attended a meeting to discuss topics/issues identified in the survey. A literature search was performed to identify phase III randomized trials of IL-17 inhibitors available in the UAE for PsA.</p><p><strong>Results: </strong>There was general agreement among the panel on the most common PsA domains presenting in patients (most commonly psoriasis [75-95% of patients], peripheral arthritis [50-90%], and enthesitis [40-90%]). In general, IL-17 inhibitors were among the preferred treatment options for managing PsA, particularly for patients with axial-, enthesitis-, or psoriasis-related symptoms. Current unmet needs and challenges included a lack of disease awareness among the general population and other healthcare professionals; the lack of a single medication to cover all domains/comorbidities; and lack of universal insurance coverage. The panel had experienced success with the IL-17 inhibitors ixekizumab and secukinumab, with many citing no preference for either agent. The literature search identified publications relating to 10 key phase III clinical trials of IL-17 inhibitors.</p><p><strong>Conclusion: </strong>The panel advocates for the use of the domain-based Group for Research and Assessment of Psoriasis and Psoriatic Arthritis treatment recommendations and generally considers IL-17 inhibitors (ixekizumab or secukinumab) as the preferred treatment options for managing PsA.</p>","PeriodicalId":45545,"journal":{"name":"Open Access Rheumatology-Research and Reviews","volume":"17 ","pages":"221-232"},"PeriodicalIF":1.7,"publicationDate":"2025-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12555017/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145393926","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring the Mediating Role of Insomnia in the Relationship Between Fibromyalgia, Depression, and Anxiety in Lebanese Adults.","authors":"Abdallah Chahine, Christian-Joseph El Zouki, Ghida Al Khoury, Sahar Obeid, Feten Fekih-Romdhane, Marielle Mansour, Jean-Claude Lahoud, Souheil Hallit","doi":"10.2147/OARRR.S530912","DOIUrl":"10.2147/OARRR.S530912","url":null,"abstract":"<p><strong>Background: </strong>Several studies have emerged to understand the relationship between insomnia and mental health issues like depression and anxiety from a causative perspective. Lebanon is a small country tormented by war, social insecurities and economic challenges, making it the fertile ground to understand the interaction between these variables in this population, especially with chronic pain. This study aims to better understand the relationship between insomnia, depression and anxiety in fibromyalgia patients in the Lebanese context.</p><p><strong>Methods: </strong>This cross-sectional study was conducted from October to November 2024 and involved participants from all over Lebanon. The questionnaire included sociodemographic questions and scales including the Widespread pain index (WPI), Symptom severity scale (SSS), Patient Health Questionnaire (PHQ-4) and Insomnia Severity Index (ISI).</p><p><strong>Results: </strong>The analysis showed that Insomnia mediated the association between fibromyalgia and depression; higher fibromyalgia was significantly associated with higher insomnia severity, whereas higher insomnia severity was associated with higher depression. Also, Insomnia mediated the association between fibromyalgia and anxiety; higher fibromyalgia was significantly associated with higher insomnia severity, whereas higher insomnia severity was associated with higher anxiety. However, depression and anxiety did not mediate the association between fibromyalgia and insomnia severity.</p><p><strong>Conclusion: </strong>This study focused on the mediating role of insomnia between fibromyalgia and development of depression and anxiety on a sample of 641 Lebanese individual. With the use of specific scales and guidelines of the American College of Rheumatology, we were able to clearly elucidate the relationship between the selected variables. These findings underscore the importance of addressing issues such as insomnia in chronic pain as well as the associated comorbidities which have been proven to play an important role in the course of the disease. Future research should further explore targeted interventions that could enhance overall wellbeing in individuals with FM, considering the multiple factors influencing one's condition.</p>","PeriodicalId":45545,"journal":{"name":"Open Access Rheumatology-Research and Reviews","volume":"17 ","pages":"203-219"},"PeriodicalIF":3.4,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12439707/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145082110","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Treatment Patterns and Outcomes of Acthar Gel in Ankylosing Spondylitis and Psoriatic Arthritis: A Physician-Reported Chart Review.","authors":"Amit Patel, Priyanka P Shanbhag, Destri R Evans, Kyle Hayes, Mary Prince Panaccio, George J Wan","doi":"10.2147/OARRR.S538839","DOIUrl":"10.2147/OARRR.S538839","url":null,"abstract":"<p><strong>Purpose: </strong>To describe the characteristics of patients with ankylosing spondylitis (AS) or psoriatic arthritis (PsA) treated with Acthar Gel, medication utilization, and physicians' assessments of the effects of Acthar Gel on patients' health status.</p><p><strong>Patients and methods: </strong>A prospectively designed, cross-sectional, medical chart review study with a predefined protocol and analysis plan was conducted in November 2024, with data abstracted from patient records between April 2022 and November 2024. Eligible patients were aged ≥18 years, had AS or PsA, and had received Acthar Gel within ≤24 months.</p><p><strong>Results: </strong>On average, patients with AS were 44 years, and those with PsA were 51 years; patients were primarily Caucasian/non-Hispanic. Most patients with AS were male (67%, 42/63), whereas PsA had a similar gender distribution (49% [38/77] each). Common comorbidities included arthritis/osteoarthritis, chronic joint disease, and hypertension. Before receiving Acthar Gel, physicians reported 41% (26/63) of patients with AS and 44% (34/77) with PsA had fair-to-poor health status. Frequent symptoms in AS were back pain, lower back/hip stiffness, and fatigue, and in PsA were joint swelling and pain, reduced range of motion, and fatigue. Based on physician assessment, 95% (60/63) with AS and 88% (68/77) with PsA had improved health after Acthar Gel treatment. Improvements included reduction in overall symptoms (AS: 70% [42/60]; PsA: 63% [43/68]), decreased pain (AS: 68% [41/60]; PsA: 62% [42/68]), improved physical function (AS: 53% [32/60]; PsA: 54% [37/68], improved fatigue (AS: 35% [21/60]; PsA: 32% [22/68]), and reduced corticosteroid use (AS: 30% [18/60]; PsA: 31% [21/68]).</p><p><strong>Conclusion: </strong>Based on chart review, Acthar Gel may represent a potential treatment option for appropriate patients with AS or PsA. In this study, among patients with AS or PsA treated with Acthar Gel, physicians documented a reduction in overall symptoms, decreased pain, improved physical function, reduced corticosteroid use, improved strength, and improved fatigue using prespecified assessments.</p>","PeriodicalId":45545,"journal":{"name":"Open Access Rheumatology-Research and Reviews","volume":"17 ","pages":"193-202"},"PeriodicalIF":1.7,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12435518/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145076297","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}