Reumatologia Clinica最新文献

{"title":"Nailfold capillaroscopy in inflammatory bowel disease: A shared approach in gastroenterology and rheumatology","authors":"Maha S.I. Abdelrahman ,&nbsp;Doaa Abdeltawab ,&nbsp;Rasha Hamed Shehata","doi":"10.1016/j.reuma.2025.501998","DOIUrl":"10.1016/j.reuma.2025.501998","url":null,"abstract":"<div><h3>Introduction and objectives</h3><div>Inflammatory bowel disease (IBD) has systemic consequences that extend beyond the gastrointestinal tract. While nailfold capillaroscopy (NFC) is widely utilized in many rheumatological disorders, its significance in evaluating microvascular changes in IBD remains unknown. This study aimed to standardize NFC use in IBD patients and relate NFC results to clinical and laboratory criteria.</div></div><div><h3>Methods</h3><div>This observational case–control study included histology- and colonoscopy-diagnosed IBD patients. We performed NFC on eight fingers of each subject using a Dino-Lite digital microscope, adhering to European Alliance of Associations for Rheumatology guidelines. Capillary characteristics, including density, morphology, and dimensions, as well as microhemorrhages, were assessed at 200×.</div></div><div><h3>Results</h3><div>The study included 50 IBD patients and 30 healthy controls. IBD patients had significantly lower capillary density (7.52<!--> <!-->±<!--> <!-->0.68<!--> <!-->capillaries/mm) than controls (8.18<!--> <!-->±<!--> <!-->0.63<!--> <!-->capillaries/mm, <em>p</em> <!-->&lt;<!--> <!-->0.001), with 26% of IBD patients exhibiting densities below seven capillaries/mm. In IBD patients, microhemorrhages were more prevalent than in controls (<em>p</em> <!-->=<!--> <!-->0.032). Raynaud's phenomenon was more commonly detected in patients with low mean capillary density (<em>p</em> <!-->=<!--> <!-->0.04).</div></div><div><h3>Conclusion</h3><div>IBD patients had reduced mean capillary density and increased microhemorrhages. These changes suggested that NFC could be a non-invasive way provides unique insights into IBD microvascular health.</div><div>.</div></div>","PeriodicalId":47115,"journal":{"name":"Reumatologia Clinica","volume":"21 10","pages":"Article 501998"},"PeriodicalIF":1.3,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145645935","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":"Asociación de índices hematológicos, actividad y daño orgánico en el lupus eritematoso sistémico: análisis multicéntrico de 319 casos","authors":"Beatriz Tejera Segura,&nbsp;Adrián Quevedo Rodriguez,&nbsp;María García González,&nbsp;Judith Hernández Sánchez,&nbsp;Marta Hernández Díaz,&nbsp;Íñigo Rua-Figueroa de Larrinoa","doi":"10.1016/j.reuma.2025.501969","DOIUrl":"10.1016/j.reuma.2025.501969","url":null,"abstract":"<div><h3>Introduction</h3><div>Systemic lupus erythematosus (SLE) is a chronic autoimmune disease with a variable course. There is a need for simple and accessible biomarkers to assess disease activity and prognosis.</div></div><div><h3>Objectives</h3><div>To analyze the relationship between hematological indices NLR (neutrophil-to-lymphocyte ratio) and PLR (platelet-to-lymphocyte ratio) with disease activity and organ damage in patients with SLE.</div></div><div><h3>Materials and methods</h3><div>A multicenter retrospective study including 319 patients with SLE. Associations between NLR and PLR with disease activity (SLEDAI-2K), organ damage (SLICC/SDI), hypocomplementemia, mortality, and clinical manifestations were evaluated.</div></div><div><h3>Results</h3><div>Both indices showed a significant association with disease activity, even after adjusting for confounding factors. No associations were found with organ damage or specific clinical manifestations. NLR was associated with hypocomplementemia, and both indices were linked to mortality.</div></div><div><h3>Conclusions</h3><div>NLR and PLR may serve as useful, low-cost, and complementary tools for monitoring disease activity in SLE. Prospective studies are needed to confirm their value as independent biomarkers.</div></div>","PeriodicalId":47115,"journal":{"name":"Reumatologia Clinica","volume":"21 9","pages":"Article 501969"},"PeriodicalIF":1.3,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145365706","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":"Juvenile systemic lupus erythematosus: Challenge for equity in Latin America","authors":"Ana Victoria Villarreal-Treviño ,&nbsp;Claudia Saad-Magalhãnes ,&nbsp;Marcela Álvarez ,&nbsp;Nadina Rubio-Pérez ,&nbsp;Fernando García Rodríguez","doi":"10.1016/j.reuma.2025.501973","DOIUrl":"10.1016/j.reuma.2025.501973","url":null,"abstract":"<div><div>Juvenile-onset systemic lupus erythematosus (jSLE) is an autoimmune disease that presents with greater severity and higher mobility than adult-onset SLE. In Latin America, data on its incidence, prevalence and clinical phenotypes are limited. Specialized care is available only in a few centers with trained pediatric rheumatologists leading to substantial diagnostic delays and barriers to timely treatment. This review highlights the urgent need for region-specific strategies to improve early diagnosis, expand access to specialized care and reduce disparities in outcomes for children and adolescents with jSLE in Latin America.</div></div>","PeriodicalId":47115,"journal":{"name":"Reumatologia Clinica","volume":"21 9","pages":"Article 501973"},"PeriodicalIF":1.3,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145365707","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":"Impact of the IL18 −137 G/C (rs187238) polymorphism on susceptibility and clinical manifestations in women systemic lupus erythematosus","authors":"Danton Magri ,&nbsp;Clisten Fátima Staffen ,&nbsp;Ticiana Della Justina Farias ,&nbsp;Ilíada Rainha de Souza ,&nbsp;Yara Costa Netto Muniz ,&nbsp;Ivânio Alves Pereira ,&nbsp;Lia Kubelka de Carlos Back ,&nbsp;Luciano Santos Pinto Guimarães ,&nbsp;Juliana Dal-Ri Lindenau","doi":"10.1016/j.reuma.2025.501972","DOIUrl":"10.1016/j.reuma.2025.501972","url":null,"abstract":"<div><h3>Introduction and objectives</h3><div>Systemic lupus erythematosus (SLE) is a chronic autoimmune disease characterized by the production of autoantibodies, inflammation processes, and tissue damage. There are several genetic factors associated with the disease, many of them single nucleotide polymorphisms (SNPs). Interleukin-18 is a pro-inflammatory cytokine encoded by the <em>IL18</em> gene, and the SNP <em>−137 G/C (rs187238)</em> has been studied in several populations. This case control study analyzed whether <em>rs187238</em> is associated with SLE susceptibility and its clinical manifestations in a Brazilian population.</div></div><div><h3>Materials and methods</h3><div>153 patients fulfilling the American College of Rheumatology classification criteria for SLE were recruited, as well as 147 controls. Genotyping was performed by sequence-specific polymerase chain reaction (SSP-PCR). To assess SLE susceptibility a logistic regression test was conducted. Clinical aspects were tested through Poisson regression and clustered by Principal Component Analysis.</div></div><div><h3>Results</h3><div>An association between the <em>rs187238*C_</em> carriers genotypes and SLE was found, these genotypes were associated with a 127% increased chance of developing the disease (OR<!--> <!-->=<!--> <!-->2.27, 95% CI<!--> <!-->=<!--> <!-->1.32–3.98, <em>p</em> <!-->=<!--> <!-->0.003). The <em>*C_</em> genotypes were also associated with photosensitivity (PR<!--> <!-->=<!--> <!-->1.39, 95% CI<!--> <!-->=<!--> <!-->1.1–1.8, <em>p</em> <!-->=<!--> <!-->0.017), malar rash (PR<!--> <!-->=<!--> <!-->1.37, 95% CI<!--> <!-->=<!--> <!-->1.1–1.8, <em>p</em> <!-->=<!--> <!-->0.014) and Raynaud phenomenon (PR<!--> <!-->=<!--> <!-->1.37, 95% IC<!--> <!-->=<!--> <!-->1.1–1.8, <em>p</em> <!-->=<!--> <!-->0.015).</div></div><div><h3>Discussion and conclusions</h3><div>These findings suggest the potential of rs187238 as a genetic marker for SLE risk and clinical stratification in admixed Latin American populations.</div></div>","PeriodicalId":47115,"journal":{"name":"Reumatologia Clinica","volume":"21 9","pages":"Article 501972"},"PeriodicalIF":1.3,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145365779","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":"Effectiveness of subcutaneous methotrexate in patients with rheumatoid arthritis and its long-term persistence","authors":"Pedro Santos-Moreno ,&nbsp;Rosmery V. Barroso-Parra ,&nbsp;María Carrasquilla-Sotomayor ,&nbsp;Nelson Rafael Alvis-Zakzuk ,&nbsp;Lina Moyano-Tamara ,&nbsp;Nelson J. Alvis-Zakzuk ,&nbsp;Josefina Zakzuk","doi":"10.1016/j.reuma.2025.501971","DOIUrl":"10.1016/j.reuma.2025.501971","url":null,"abstract":"<div><h3>Background and objective</h3><div>Methotrexate has been used as the gold-standard therapy in patients with rheumatoid arthritis (RA) for more than 30 years. However, there is limited information on long-term effectiveness. The aim of this study was to describe the effectiveness of subcutaneous methotrexate (MTX SC) and its long-term persistence in real life in patients diagnosed with RA.</div></div><div><h3>Patients and methods</h3><div>We conducted an analytical retrospective cohort study of patients with RA treated at a reference center in Colombia. We included participants older than 18 years-old with a minimum of one year of follow-up using MTX SC. The main endpoint was to evaluate the changes in the level of disease activity through the DAS28 index from 6 to 48 months of follow-up. Survival curves were estimated using the Kaplan–Meier method to compare different therapies with MTX SC. A <em>p</em>-value<!--> <!-->&lt;<!--> <!-->0.05 was considered statistically significant.</div></div><div><h3>Results</h3><div>877 patients with RA were included, with a median age of 65 [RIQ: 57–73] years, 84% of whom were women. Therapeutic success was achieved in 83% of the population considering those who were maintained in low activity or remission during the follow-up period.</div></div><div><h3>Discussion and conclusions</h3><div>This study shows the proportion of those who started with active disease, meanwhile those in remission and low activity increased from 6 months to the end of follow-up when MTX SC is used appropriately. Effectiveness and persistence of MTX SC over time can be extended up to 48 months during follow-up.</div></div>","PeriodicalId":47115,"journal":{"name":"Reumatologia Clinica","volume":"21 9","pages":"Article 501971"},"PeriodicalIF":1.3,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145365778","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":"Bone involvement in Gaucher disease: Data from a North African registry","authors":"Zeineb Meddeb ,&nbsp;Nour Ben Younes ,&nbsp;Houssem Abida ,&nbsp;Hela Boudabous ,&nbsp;Mouna Zribi ,&nbsp;Cherifa AbdelKefi ,&nbsp;Amira El Ouni ,&nbsp;Sana Toujani ,&nbsp;Safa Khatrouch ,&nbsp;Amel Ben Chehida ,&nbsp;Kamel Bouslama ,&nbsp;Abdelmoula Mohamed Slim ,&nbsp;Saloua B’Chir Hamzaoui ,&nbsp;Thara Larbi","doi":"10.1016/j.reuma.2025.501996","DOIUrl":"10.1016/j.reuma.2025.501996","url":null,"abstract":"<div><h3>Introduction and objectives</h3><div>Gaucher disease (GD) is characterized by an abnormal accumulation of glucocerebroside in the phagocytic cells due to an enzymatic deficiency in glucocerebrosidase. It is a systemic condition frequently associated with skeletal involvement. Our aim was to evaluate bone involvement (BI) in GD and to assess the impact of specific therapies for GD including enzyme replacement therapy (ERT) and substrate reduction therapy (SRT).</div></div><div><h3>Patients and methods</h3><div>Data at diagnosis and at the final post-treatment follow-up was extracted from the Tunisian GD registry.</div></div><div><h3>Results</h3><div>Among the 74 included patients 48 had BI (65%), being the third most frequent disease feature. Seventeen patients reported experiencing bone pain crises (23%). Twenty-two patients had elevated alkaline phosphatases (30%), among which, 14 had BI (19%). Standard skeletal X-rays revealed femur deformity in Erlenmeyer flask shape in 4 patients and lytic bone lesions in 2 other patients for whom screening for malignancies was negative. Magnetic resonance imaging of the spine and lower limbs revealed bone marrow infiltration in 19 patients. Aseptic osteonecrosis was identified in 6 patients on MRI (22%). Bone mineral density demonstrated osteoporosis in 7 cases (14%) and osteopenia in 17 others (35%). Specific therapies for GD showed a trend towards improvement of bone pain (velaglucerase alfa) and bone densitometry parameters (velaglucerase alfa and eliglustat) at the final post-treatment follow-up, although formal statistical testing was not feasible due to small and heterogeneous subgroups.</div></div><div><h3>Discussion and conclusions</h3><div>We presented descriptive data on BI derived from the Tunisian national Gaucher disease registry. This manifestation was common in our cohort. The limited size and heterogeneity of the treated subgroups precluded robust statistical comparisons. A major challenge in our setting is the delayed initiation of specific therapies, primarily due to late diagnosis and limited access to treatment.</div></div>","PeriodicalId":47115,"journal":{"name":"Reumatologia Clinica","volume":"21 9","pages":"Article 501996"},"PeriodicalIF":1.3,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145365780","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":"Exploring the prevalence of pulmonary involvement in juvenile-onset systemic lupus erythematosus: Data from the UK JSLE Cohort Study","authors":"Ayodele Faleye ,&nbsp;Kamran Mahmood ,&nbsp;Eslam Al-Abadi ,&nbsp;Kate Armon ,&nbsp;Kathryn Bailey ,&nbsp;Mary Brennan ,&nbsp;Coziana Ciurtin ,&nbsp;Janet Gardner-Medwin ,&nbsp;Kirsty Haslam ,&nbsp;Daniel Hawley ,&nbsp;Alice Leahy ,&nbsp;Heather Rostron ,&nbsp;Gulshan Malik ,&nbsp;Zoe McLaren ,&nbsp;Elena Moraitis ,&nbsp;Athimalaipet Ramanan ,&nbsp;Rangaraj Satyapal ,&nbsp;Philip Riley ,&nbsp;Ethan Sen ,&nbsp;Alison Kinder ,&nbsp;Eve Smith","doi":"10.1016/j.reuma.2025.501975","DOIUrl":"10.1016/j.reuma.2025.501975","url":null,"abstract":"<div><h3>Background</h3><div>Juvenile-onset systemic lupus erythematosus (JSLE) is a rare autoimmune disease with significant morbidity and mortality. Pulmonary manifestations in JSLE have not been comprehensively described in the literature to date.</div></div><div><h3>Objectives</h3><div>To report the frequency, clinical, and demographic characteristics of JSLE patients with pulmonary manifestations compared to those without.</div></div><div><h3>Methods</h3><div>United Kingdom (UK) JSLE Cohort Study participants aged<!--> <!-->&lt;<!--> <!-->18 years at diagnosis, with ≥4 American College of Rheumatology (ACR-1997) criteria for systemic lupus erythematosus (SLE), were eligible. Patients were grouped according to the presence or absence of pulmonary involvement. Pulmonary manifestations were described at diagnosis, 1-year, 2-year, and 5-year follow-up. Demographics and clinical characteristics of patients with/without pulmonary manifestations were compared.</div></div><div><h3>Results</h3><div>480 JSLE patients were included. Overall, 24.8% had pulmonary manifestations; 22.7% at diagnosis, 19.1% at 1 year, 17.2% at 2 years, and 22.4% patients at 5 years after diagnosis. Overall, the commonest manifestation was pulmonary serositis. Pulmonary involvement was associated with higher American College of Rheumatology (ACR)-1997 scores (<em>p</em> <!-->&lt;<!--> <!-->0.002) and higher pediatric version of British Isles Lupus Assessment Group (pBILAG) scores (<em>p</em> <!-->&lt;<!--> <!-->0.001) at diagnosis but there were no differences in Systemic Lupus International Collaborating Clinic Damage Index (SLICC-SDI) scores (<em>p</em> <!-->&gt;<!--> <!-->0.05). pBILAG defined pulmonary involvement was associated with increased frequency of constitutional (48.3 vs 26.1%), musculoskeletal (49.1 vs 26.1%), gastrointestinal (10.3 vs 3.8%), and hematological (37.9 vs 20.6%) involvement (all <em>p</em> <!-->&lt;<!--> <!-->0.05).</div></div><div><h3>Conclusion</h3><div>Pulmonary disease is common in JSLE. It is associated with wider organ involvement, suggesting a need for close monitoring and prompt treatment.</div></div>","PeriodicalId":47115,"journal":{"name":"Reumatologia Clinica","volume":"21 9","pages":"Article 501975"},"PeriodicalIF":1.3,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145365781","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":"Referral criteria from primary care to rheumatology: A qualitative study","authors":"Ana Urruticoechea-Arana ,&nbsp;Miguel Angel Abad-Hernandez ,&nbsp;Raquel Almodóvar ,&nbsp;Joan Miquel Nolla-Solé ,&nbsp;Juan Carlos Hermosa Hernán ,&nbsp;María Medina Abellán ,&nbsp;Concepción Fito Manteca ,&nbsp;José María Pego-Reinosa ,&nbsp;José Javier Pérez Venegas ,&nbsp;Paloma Vela ,&nbsp;Marcos Paulino ,&nbsp;Fernando León-Vazquez","doi":"10.1016/j.reuma.2025.501967","DOIUrl":"10.1016/j.reuma.2025.501967","url":null,"abstract":"<div><h3>Objectives</h3><div>To design referral criteria from primary care to rheumatology for patients with rheumatic and musculoskeletal diseases (RMDs).</div></div><div><h3>Methods</h3><div>Qualitative study. A panel of 13 expert rheumatologists and primary care physicians was convened. They defined the inclusion and exclusion criteria for a systematic review to analyse the efficacy and safety of primary care referral protocols/systems/criteria for patients with suspected or diagnosed RMDs. A survey was also launched in primary care setting to assess the level of knowledge of RMDs, available referral systems/criteria and the use of digital health tools for patient referral. The experts discussed the systematic review and survey results and defined and agreed on several referral criteria and other helpful educational materials to be included in a digital application (DerivaREUMA app).</div></div><div><h3>Results</h3><div>The systematic review identified 32 articles of moderate quality. The survey revealed that more than 60% of primary care physicians lacked standard referral protocols/systems/criteria to rheumatology. A consensus was reached on seven referral criteria, starting with one of the following that have more questions and sub-criteria afterwards: (1) arthritis &gt;3–4 weeks; (2) low-back pain &gt;3 months in patients aged &lt;45 years; (3) systemic autoimmune disease; (4) soft tissue rheumatism; (5) knee and hand osteoarthritis; (6) osteoporosis; (7) complications of rheumatological treatment. The app also contains informative and explanatory material.</div></div><div><h3>Discussion</h3><div>We have proposed referral criteria and other helpful materials aimed at promoting and improving efficiency in early referral of patients with RMDs from primary care to rheumatology.</div></div>","PeriodicalId":47115,"journal":{"name":"Reumatologia Clinica","volume":"21 9","pages":"Article 501967"},"PeriodicalIF":1.3,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145365827","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":"Telemedicine on the follow-up management of early referral patients with inflammatory arthritis in a limited-resource clinical setting","authors":"David Vega-Morales ,&nbsp;Valeria Alexsandra Fernández-Garza ,&nbsp;Lourdes Gil-Flores ,&nbsp;Delia Raquel López-Castillo ,&nbsp;Alondra Elizabeth Montoya-Montes ,&nbsp;Alain Nigel Michele Granados-Silva","doi":"10.1016/j.reuma.2025.501968","DOIUrl":"10.1016/j.reuma.2025.501968","url":null,"abstract":"<div><h3>Introduction and objectives</h3><div>Rheumatoid arthritis (RA) is a chronic inflammatory disease that requires continuous monitoring to optimize treatment outcomes and prevent long-term disability. Telemedicine has emerged as a promising strategy to improve access and continuity of care. This study aimed to evaluate the use of telemedicine as a follow-up tool in patients with newly diagnosed RA.</div></div><div><h3>Material and methods</h3><div>We conducted a prospective, observational study in patients with recent-onset RA recruited from an early arthritis detection program between May and November 2023. Following baseline in-person evaluation, patients were enrolled in a telemonitoring protocol consisting of two scheduled video consultations at 6 and 12 months. Clinical outcomes were assessed at each visit using the Health Assessment Questionnaire (HAQ), the Clinical Disease Activity Index (CDAI), and patient-reported joint counts.</div></div><div><h3>Results</h3><div>A total of 34 patients were included (94.1% female, mean age 48.2<!--> <!-->±<!--> <!-->8.9 years). At 6 and 12 months, 88.2% and 73.5% of patients completed their respective teleconsultations. Statistically significant improvements were observed in all clinical parameters: HAQ scores decreased from 0.87 to 0.50, CDAI from 23.5 to 12.0, TJC decreased from 10.5 to 3.4, SJC from 1.48 to 1.15, and EVA from 5.7 to 3.69.</div></div><div><h3>Discussion and conclusion</h3><div>Telemedicine proved to be an effective follow-up strategy for patients with newly diagnosed RA, showing significant improvements in functional status, pain, and disease activity over time. This approach may represent a valuable complement to in-person care in early RA management.</div></div>","PeriodicalId":47115,"journal":{"name":"Reumatologia Clinica","volume":"21 9","pages":"Article 501968"},"PeriodicalIF":1.3,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145365828","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":"Application of the DETECT algorithm in a cohort of patients with systemic sclerosis","authors":"Guillermo González-Arribas ,&nbsp;Mercedes Freire-González ,&nbsp;Lucía Silva-Fernández ,&nbsp;Javier de Toro Santos","doi":"10.1016/j.reuma.2025.501970","DOIUrl":"10.1016/j.reuma.2025.501970","url":null,"abstract":"<div><h3>Background</h3><div>Pulmonary hypertension (PH) is a severe complication of systemic sclerosis (SSc), with significant prognostic implications. The DETECT algorithm, is a two-step tool developed to facilitate early PH identification in high-risk SSc patients, although its performance in routine clinical practice, especially among patients with relatively preserved diffusing capacity for carbon monoxide (DLCO) remains underexplored.</div></div><div><h3>Objective</h3><div>To evaluate the clinical performance of the DETECT algorithm in a real-world cohort of SSc patients without a prior diagnosis of PH, and to identify variables associated with PH in this population.</div></div><div><h3>Methods</h3><div>We conducted a cross-sectional study including SSc patients meeting ACR/EULAR 2013 criteria. Patients with known PH, advanced chronic kidney disease, or severe heart failure were excluded. The DETECT algorithm was applied prospectively. Right heart catheterization (RHC) was performed in patients who met Step 2 criteria. Clinical, laboratory, functional and echocardiographic variables were collected. Logistic regression analyses were conducted to identify factors independently associated with PH.</div></div><div><h3>Results</h3><div>85 patients with SSc were included (90.58% women; mean age 67.36<!--> <!-->±<!--> <!-->11.75 years; mean disease duration 15.69<!--> <!-->±<!--> <!-->9.17 years). 31 patients (36.47%) met criteria for transthoracic echocardiography (TTE), and 21 (24.70%) underwent RHC. PH was confirmed in 11 patients (12.94%). Higher tricuspid regurgitation velocity (TRV) (OR<!--> <!-->=<!--> <!-->11.57; 95% CI: 1.29–103.98; <em>p</em> <!-->=<!--> <!-->0.029) was independently associated with PH. Conversely, higher DLCO was inversely associated with PH (OR<!--> <!-->=<!--> <!-->0.887; 95% CI: 0.797–0.987; <em>p</em> <!-->=<!--> <!-->0.028). PH was detected even in patients with DLCO<!--> <!-->&gt;<!--> <!-->60%.</div></div><div><h3>Conclusion</h3><div>The DETECT algorithm is a valuable tool for PH screening in SSc patients, with good correlation between its components and confirmed PH. Its applicability may be relevant even in patients with DLCO<!--> <!-->&gt;<!--> <!-->60%, broadening its clinical utility. Further research is warranted to validate its performance across diverse populations and to evaluate its long-term prognostic impact.</div></div>","PeriodicalId":47115,"journal":{"name":"Reumatologia Clinica","volume":"21 9","pages":"Article 501970"},"PeriodicalIF":1.3,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145365829","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}