Reumatologia Clinica最新文献

{"title":"Weight change patterns in rheumatoid arthritis patients treated with leflunomide: A real-world comparative study","authors":"Asadullah Khan,&nbsp;Syed Nazeer Ahmed,&nbsp;Rabbey Raza Khan,&nbsp;Fazila Nazeer,&nbsp;Hamid Ali Khan,&nbsp;Sakina Kazmi","doi":"10.1016/j.reuma.2026.502211","DOIUrl":"10.1016/j.reuma.2026.502211","url":null,"abstract":"<div><h3>Background</h3><div>Leflunomide is a widely used conventional synthetic disease-modifying antirheumatic drug (csDMARD) in rheumatoid arthritis (RA), particularly in low- and middle-income countries where biologics are cost-prohibitive. Weight loss is a recognised but understudied adverse effect. This study aimed to characterise the prevalence, magnitude, and temporal patterns of leflunomide-associated weight change in a real-world RA cohort.</div></div><div><h3>Methods</h3><div>This prospective longitudinal observational study was conducted at a rheumatology department using an exposure-defined prospective comparative cohort design. Patients newly initiated on leflunomide 20<!--> <!-->mg/day at enrollment (cases, <em>n</em> <!-->=<!--> <!-->206) were compared with RA patients not receiving leflunomide (controls, <em>n</em> <!-->=<!--> <!-->92) over 12 months. Body weight was recorded in the morning on a standardised scale by the same nurse at baseline and at 3, 6, 9, and 12 months. Primary outcomes included any weight loss, clinically significant weight loss (≥5%), severe weight loss (≥10%), and rapid weight loss (≥5% by 3 months). Multivariable logistic regression was performed, adjusting for age, gender, baseline weight, disease activity, and disease duration.</div></div><div><h3>Results</h3><div>At 6 months, 56.8% of leflunomide-treated patients experienced any weight loss, with clinically significant weight loss (≥5%) in 31.1% and severe weight loss (≥10%) in 8.3%. Rapid weight loss occurred in 17.0% of cases. Leflunomide-exposed patients showed a progressive, stepwise mean weight decline (−0.94<!--> <!-->kg at 3 months, −1.44<!--> <!-->kg at 6 months, −2.23<!--> <!-->kg at 9 months), while controls remained stable. At 12 months, severe weight loss was significantly more frequent in cases than controls (19.6% vs 8.8%; <em>p</em> <!-->=<!--> <!-->0.042). Sustained clinically significant weight loss was observed in 21.7% of cases. On multivariable analysis, leflunomide exposure was independently associated with more than twofold higher odds of ≥5% weight loss (OR 2.46, 95% CI 1.21–5.03).</div></div><div><h3>Conclusions</h3><div>Leflunomide is independently associated with clinically meaningful and often progressive weight loss in patients with RA. These findings support routine weight monitoring in leflunomide-treated patients and underscore the importance of distinguishing drug-related weight reduction from other causes to avoid unnecessary diagnostic investigations and optimise patient counselling.</div></div>","PeriodicalId":47115,"journal":{"name":"Reumatologia Clinica","volume":"22 7","pages":"Article 502211"},"PeriodicalIF":1.5,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148660832","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A patient-centered journal club for health education in women with fibromyalgia: A pilot study","authors":"Iván Cuyul-Vásquez,&nbsp;Josefa Molina,&nbsp;Diego Quidequeo,&nbsp;Alfredo Paiva,&nbsp;Rocío Vásquez,&nbsp;Carolina Roa,&nbsp;Javier Meneses-Pinto,&nbsp;Joaquín Salazar-Méndez,&nbsp;Felipe Ponce-Fuentes","doi":"10.1016/j.reuma.2026.502204","DOIUrl":"10.1016/j.reuma.2026.502204","url":null,"abstract":"<div><h3>Background</h3><div>This study evaluated the effects of a patient journal club educational program on quality of life, cyberchondria, and key pain-related variables (intensity, catastrophizing, acceptance, self-efficacy) in women with fibromyalgia.</div></div><div><h3>Methods</h3><div>A pre–post study design was employed. Twenty women with fibromyalgia (mean age 50.8<!--> <!-->±<!--> <!-->7.5 years) participated in a three-week patient journal club educational program. The journal club included collaborative planning, material preparation, and individual reading of adapted scientific articles. The sessions were moderated in person by a speech-language pathologist with six years of university teaching experience but no prior specialized training in chronic pain, ensuring a neutral facilitation of the group discussions. Outcome measures assessed were quality of life, pain intensity, pain catastrophizing, pain self-efficacy, pain acceptance and cyberchondria.</div></div><div><h3>Results</h3><div>Significant improvements were observed in quality of life (<em>p</em> <!-->=<!--> <!-->0.001, <em>d</em> <!-->=<!--> <!-->−0.85), pain intensity (<em>p</em> <!-->=<!--> <!-->0.005, <em>d</em> <!-->=<!--> <!-->−0.74), pain catastrophizing (<em>p</em> <!-->&lt;<!--> <!-->0.001, <em>d</em> <!-->=<!--> <!-->−1.11), pain acceptance (<em>p</em> <!-->=<!--> <!-->0.028, <em>d</em> <!-->=<!--> <!-->0.53) and cyberchondria (<em>p</em> <!-->=<!--> <!-->0.003, <em>d</em> <!-->=<!--> <!-->−0.75). Pain self-efficacy showed no statistically significant change (<em>p</em> <!-->=<!--> <!-->0.083, <em>d</em> <!-->=<!--> <!-->0.41).</div></div><div><h3>Conclusions</h3><div>These findings suggest that the patient journal club is a promising tool for improving quality of life, and reducing pain intensity, pain catastrophizing and cyberchondria in women with fibromyalgia. Given the study's small sample size and lack of a control group, further research with larger, controlled trials is necessary to validate these results.</div></div>","PeriodicalId":47115,"journal":{"name":"Reumatologia Clinica","volume":"22 7","pages":"Article 502204"},"PeriodicalIF":1.5,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148660831","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Actualización de recomendaciones Sociedad Española de Reumatología de uso de terapia biológica en el lupus eritematoso sistémico","authors":"Íñigo Rúa-Figueroa,&nbsp;Noé Brito García,&nbsp;María Galindo Izquierdo,&nbsp;Jaime Calvo Alén,&nbsp;Irene Altabás González,&nbsp;Beatriz Tejera Segura,&nbsp;Tarek Carlos Salman Monte,&nbsp;José María Pego-Reigosa,&nbsp;Enrique Morales Ruiz,&nbsp;Ignacio García Doval,&nbsp;Julio Suarez Cuba,&nbsp;Leyre Riancho Zarrabeitia,&nbsp;Ariadna Auladell Rispau,&nbsp;Janet Puñal Riobóo","doi":"10.1016/j.reuma.2026.502201","DOIUrl":"10.1016/j.reuma.2026.502201","url":null,"abstract":"<div><div>The significant growth of information in the field of biologic therapies (BT) for the treatment of systemic lupus erythematosus (SLE) has made it necessary an update of the previous SER recommendation document. Three BTs have been approved for use in SLE. The first BT available was belimumab, with an already abundant and solid body of evidence regarding its efficacy and safety. More recently, anifrolumab has been added, also backed with a robust body of evidence but with a less practical application experience. Finally, the emergence of obinutuzumab, a second-generation anti-CD20 monoclonal antibody that is more effective than rituximab and has demonstrated efficacy in lupus nephritis, has revitalized ablative therapy in SLE, although more safety data are needed before it can widely replace rituximab. Despite the lack of direct comparisons between the various biologic agents available, certain differences regarding their efficacy across different disease domains, as well as in the speed of action and safety-related aspects, must be taken into account when tailoring therapeutic decisions. Overall, biologics have been increasingly incorporated into the treatment algorithm at earlier stages of SLE, based on their capacity to improve outcomes compared to standard therapy, and are now first-line treatments for certain manifestations such as lupus nephritis.</div></div>","PeriodicalId":47115,"journal":{"name":"Reumatologia Clinica","volume":"22 7","pages":"Article 502201"},"PeriodicalIF":1.5,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148660834","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comment on “Knowledge, intentions, and practices of breastfeeding among women with systemic lupus erythematosus: A cross-sectional survey”","authors":"Deepti M. Sati,&nbsp;Vanashri Dhananjay Shinde,&nbsp;Chhaya Agarwal","doi":"10.1016/j.reuma.2026.502223","DOIUrl":"10.1016/j.reuma.2026.502223","url":null,"abstract":"","PeriodicalId":47115,"journal":{"name":"Reumatologia Clinica","volume":"22 7","pages":"Article 502223"},"PeriodicalIF":1.5,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148660823","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neurolupus como primera manifestación de lupus eritematoso sistémico de inicio en la infancia: experiencia clínica en un hospital de tercer nivel","authors":"Rodolfo Enrique Rangel Ayón,&nbsp;Enrique Cuevas Orta,&nbsp;Jorge Luis García Ramírez,&nbsp;Jorge Guillermo Reyes Vaca,&nbsp;Antonio Bravo Oro","doi":"10.1016/j.reuma.2026.502210","DOIUrl":"10.1016/j.reuma.2026.502210","url":null,"abstract":"<div><h3>Background and objective</h3><div>Pediatric-onset systemic lupus erythematosus presents a diagnostic and therapeutic challenge, particularly when the initial presentation is neurological or neuropsychiatric. The objective of this study is to describe the clinical characteristics, neuroimaging findings, therapeutic approach, and outcomes of a cohort of pediatric patients presenting with neurolupus as the first manifestation of the disease.</div></div><div><h3>Patients</h3><div>Nine pediatric patients, aged 4 to 17 years, were treated at a tertiary care hospital in Mexico.</div></div><div><h3>Results</h3><div>Females predominated (77.8%), with a mean age of onset of 10.8 years. Initial manifestations were heterogeneous: cerebrovascular events in 66.7%, chorea in 22.2%, psychosis and seizures in 11.1% each, and cerebellar syndrome in one case. In most cases, neuroimaging showed findings of ischemia, vasculitis, or arterial irregularities, while the electroencephalogram was abnormal in two-thirds of the available studies. All patients had positive antinuclear antibodies, and 44.4% presented with antiphospholipid antibodies, a finding associated with a higher risk of recurrence. Treatment included high-dose steroids in all cases, with immunosuppressants such as methotrexate (55.6%) and mycophenolate (44.4%) being the most frequently used. Cyclophosphamide was used in only one case. Anticoagulant therapy was indicated only in patients with antiphospholipid syndrome or thrombotic events.</div></div><div><h3>Discussion and conclusions</h3><div>The prognosis was variable. Patients with psychosis and seizures showed a favorable recovery, while those with extensive cerebrovascular events presented with permanent motor and cognitive sequelae. This series highlights the high frequency of vascular involvement and antiphospholipid antibodies as key factors in pediatric neurolupus, providing novel evidence in the Mexican population and underscoring the need for early screening protocols and a multidisciplinary approach.</div></div>","PeriodicalId":47115,"journal":{"name":"Reumatologia Clinica","volume":"22 7","pages":"Article 502210"},"PeriodicalIF":1.5,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148661155","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Respuesta a carta al editor: «Tuberculosis latente en pacientes reumatológicos bajo terapia biológica: consideraciones metodológicas y perspectiva desde la atención primaria»","authors":"Luis Francisco Valdés Corona,&nbsp;Ana González Andrade,&nbsp;Aylin Luna Salazar,&nbsp;David Vega-Morales,&nbsp;Jiram Torres-Ruiz,&nbsp;Iris Jazmín Colunga-Pedraza,&nbsp;Sandra Sicsik,&nbsp;Ángel Castillo Ortiz,&nbsp;Miguel A. Saavedra Salinas,&nbsp;Guillermo Guaracha-Basáñez,&nbsp;Dafhne Guadalupe Miranda Hernández,&nbsp;Fedra Irazoque-Palazuelos,&nbsp;Sandra Carrillo Vazquez,&nbsp;Julio Cesar Casasola Vargas,&nbsp;Omar Eloy Muñoz-Monroy,&nbsp;Javier Merayo-Chalico,&nbsp;Estefanía Torres Valdez,&nbsp;Sergio Duran Barragán,&nbsp;Erick Adrián Zamora-Theozol,&nbsp;Daniel Xavier Xibille Friedmann,&nbsp;Vijaya Rivera Terán","doi":"10.1016/j.reuma.2026.502215","DOIUrl":"10.1016/j.reuma.2026.502215","url":null,"abstract":"","PeriodicalId":47115,"journal":{"name":"Reumatologia Clinica","volume":"22 7","pages":"Article 502215"},"PeriodicalIF":1.5,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148660822","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Manifestaciones reumatológicas y retraso diagnóstico del raquitismo carencial: experiencia en una unidad de reumatología pediátrica","authors":"Adrián Mayo-Juanatey,&nbsp;Rosa Bou Torrent,&nbsp;Joan Calzada-Hernández,&nbsp;Silvia Marín del Barrio,&nbsp;María Navallas Irujo,&nbsp;Jordi Antón","doi":"10.1016/j.reuma.2026.502161","DOIUrl":"10.1016/j.reuma.2026.502161","url":null,"abstract":"","PeriodicalId":47115,"journal":{"name":"Reumatologia Clinica","volume":"22 7","pages":"Article 502161"},"PeriodicalIF":1.5,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148660827","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Vogt–Koyanagi–Harada disease: Beyond ophthalmology, an important condition for the Latin American Rheumatology Community","authors":"Ignacio Javier Gandino,&nbsp;Ramiro Adrian Gómez,&nbsp;José Maximiliano Martínez Pérez,&nbsp;Cristhian A. Urzua","doi":"10.1016/j.reuma.2026.502166","DOIUrl":"10.1016/j.reuma.2026.502166","url":null,"abstract":"","PeriodicalId":47115,"journal":{"name":"Reumatologia Clinica","volume":"22 7","pages":"Article 502166"},"PeriodicalIF":1.5,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148660828","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Aracnodactilia y contracturas congénitas en una paciente con artrosis nodular: sospecha de síndrome de Beals","authors":"Julia Ulier Bellmunt,&nbsp;Yedra Usón Rodríguez,&nbsp;Pilar Martínez Vallés,&nbsp;Marina Soledad Moreno García","doi":"10.1016/j.reuma.2026.502206","DOIUrl":"10.1016/j.reuma.2026.502206","url":null,"abstract":"","PeriodicalId":47115,"journal":{"name":"Reumatologia Clinica","volume":"22 7","pages":"Article 502206"},"PeriodicalIF":1.5,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148661157","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":"Tuberculosis latente en pacientes reumatológicos bajo terapia biológica: consideraciones metodológicas y perspectiva desde la atención primaria","authors":"Juan Sebastián Therán León,&nbsp;Liliana Cristina Díaz Cruz,&nbsp;Gustavo Andrés Díaz Cruz","doi":"10.1016/j.reuma.2026.502173","DOIUrl":"10.1016/j.reuma.2026.502173","url":null,"abstract":"","PeriodicalId":47115,"journal":{"name":"Reumatologia Clinica","volume":"22 7","pages":"Article 502173"},"PeriodicalIF":1.5,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148660829","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}