Reumatologia Clinica最新文献

{"title":"Frailty assessment in patients with Behçet's syndrome: A cross-sectional monocentric study","authors":"Hakan Apaydin ,&nbsp;Serdar Can Güven ,&nbsp;Rezan Koçak Ulucaköy ,&nbsp;Hakan Babaoğlu ,&nbsp;Esra Kayacan Erdoğan ,&nbsp;Kevser Orhan ,&nbsp;Berkan Armağan","doi":"10.1016/j.reuma.2024.04.004","DOIUrl":"10.1016/j.reuma.2024.04.004","url":null,"abstract":"<div><h3>Aims</h3><div>Evidence evaluating the association between pre-frailty and frailty, and risk of adverse health outcomes in patients with Behçet's syndrome (BS) is limited in the literature. The aim of this study was to characterize the prevalence of frailty and associated factors in a single-centre cohort of patients with BS.</div></div><div><h3>Methods</h3><div>Based on the International Study Group's criteria, this was a monocentric cross-sectional study of BS patients. The Fried frailty criteria were used to define frailty. The Turkish version of the Behçet's Disease Current Activity Form was used to measure the disease activity of BS. Damage index was assessed with the Behçet's Syndrome Overall Damage Index.</div></div><div><h3>Results</h3><div>Forty-four patients were enrolled. According to Fried frailty criteria, patients were classified as 13.6% frail, 59% pre-frail, and 27.2% robust, respectively. Compared to pre-frail and robust patients, frail patients had higher levels of inflammatory markers at the time of diagnosis. CRP levels at time of diagnosis and at the last visit were higher in the frail group than in the pre-frail and robust groups (<em>p</em> <!-->=<!--> <!-->0.039 and <em>p</em> <!-->=<!--> <!-->0.023, respectively). When active drugs for BS were evaluated, systemic glucocorticoid (50%, <em>p</em> <!-->=<!--> <!-->0.030) and cyclophosphamide (33.3%, <em>p</em> <!-->=<!--> <!-->0.006) treatments were higher in the frail group.</div></div><div><h3>Conclusions</h3><div>Frailty and pre-frailty are commonly detected even in younger patients with BS. Inflammation can be described as potential determinants of frailty status.</div></div>","PeriodicalId":47115,"journal":{"name":"Reumatologia Clinica","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142357999","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 del Documento de Consenso de la Sociedad Española de Reumatología sobre el uso de terapias biológicas y sintéticas dirigidas en la artritis reumatoide","authors":"José María Álvaro-Gracia Álvaro ,&nbsp;Petra Díaz del Campo Fontecha ,&nbsp;José Luis Andréu Sánchez ,&nbsp;Alejandro Balsa Criado ,&nbsp;Rafael Cáliz Cáliz ,&nbsp;Isabel Castrejón Fernández ,&nbsp;Hèctor Corominas ,&nbsp;José A. Gómez Puerta ,&nbsp;Sara Manrique Arija ,&nbsp;Natalia Mena Vázquez ,&nbsp;Ana Ortiz García ,&nbsp;Chamaida Plasencia Rodríguez ,&nbsp;Lucía Silva Fernández ,&nbsp;Jesús Tornero Molina","doi":"10.1016/j.reuma.2024.05.007","DOIUrl":"10.1016/j.reuma.2024.05.007","url":null,"abstract":"<div><h3>Objective</h3><div>To update the consensus document of the Spanish Society of Rheumatology (SER) regarding the use of targeted biological and synthetic therapies in rheumatoid arthritis (RA) with the aim of assisting clinicians in their therapeutic decisions.</div></div><div><h3>Methods</h3><div>A panel of 13 experts was assembled through an open call by SER. We employed a mixed adaptation-elaboration-update methodology starting from the 2015 Consensus Document of the Spanish Society of Rheumatology on the use of biological therapies in RA. Starting with systematic reviews (SR) of recommendations from EULAR 2019, American College of Rheumatology 2021, and GUIPCAR 2017, we updated the search strategies for the PICO questions of GUIPCAR. An additional SR was conducted on demyelinating disease in relation to targeted biological and synthetic therapies. Following the analysis of evidence by different panelists, consensus on the wording and level of agreement for each recommendation was reached in a face-to-face meeting.</div></div><div><h3>Results</h3><div>The panel established 5 general principles and 15 recommendations on the management of RA. These encompassed crucial aspects such as the importance of early treatment, therapeutic goals in RA, monitoring frequency, the use of glucocorticoids, the application of conventional synthetic disease-modifying antirheumatic drugs (csDMARDs), biological DMARDs (bDMARDs), and targeted synthetic DMARDs. Additionally, recommendations on dose reduction of these drugs in stable patients were included. This update also features recommendations on the use of bDMARDs and Janus Kinase inhibitors in some specific clinical situations, such as patients with lung disease, a history of cancer, heart failure, or demyelinating disease.</div></div><div><h3>Conclusions</h3><div>This update provides recommendations on key aspects in the management of RA using targeted biological and synthetic therapies.</div></div>","PeriodicalId":47115,"journal":{"name":"Reumatologia Clinica","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141688982","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":"Multicentric reticulohistiocytosis: A 20-year diagnosis beneath the surface","authors":"David Fernández-Fernández ,&nbsp;Ivonne Lourdes Mamani-Velarde ,&nbsp;Maritza Tatiana Segarra-Ortega ,&nbsp;José María Pego-Reigosa","doi":"10.1016/j.reuma.2024.07.005","DOIUrl":"10.1016/j.reuma.2024.07.005","url":null,"abstract":"","PeriodicalId":47115,"journal":{"name":"Reumatologia Clinica","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142357986","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":"Efficacy of psychological interventions to reduce anxiety and depression in patients with lupus. A systematic review and meta-analysis","authors":"Jose Luis Vicente-Escudero","doi":"10.1016/j.reuma.2024.06.006","DOIUrl":"10.1016/j.reuma.2024.06.006","url":null,"abstract":"<div><div>The presence of anxiety and depression symptoms in patients with lupus is common, and some research reports that psychological interventions can reduce them, therefore we conducted a systematic review and meta-analysis of the efficacy of psychological interventions in adults with systemic lupus erythematosus. Randomized and non-randomized clinical trials with adult population diagnosed with lupus, treated with psychological intervention, and compared with similar groups were selected. Several databases were searched in July 2023. Fourteen studies were included in the meta-analysis, with moderate effect sizes for anxiety and depression in group intervention modalities. Factors such as percentage of sample with lupus, gender, medication, and interventions with relaxation components influenced the results. Group psychological intervention programs are effective in reducing symptoms in patients with lupus, although further research on treatment modulating variables is needed.</div></div>","PeriodicalId":47115,"journal":{"name":"Reumatologia Clinica","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142357984","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":"Adalimumab treatment of resistant chondrocalcinosis","authors":"Fatih Tastekin,&nbsp;Kenan Aksu","doi":"10.1016/j.reuma.2024.06.003","DOIUrl":"10.1016/j.reuma.2024.06.003","url":null,"abstract":"<div><div>In this article, we present a case of resistant chondrocalcinosis who had a good response with 40<!--> <span>mg subcutaneous adalimumab<span><span>. To our knowledge, this is the first report using adalimumab successfully in severe CPDD. Anti-TNF therapy can be a good therapeutic option for second line therapy in </span>CPPD.</span></span></div></div>","PeriodicalId":47115,"journal":{"name":"Reumatologia Clinica","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141848226","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":"Carta al editor en respuesta a: «Neumomediastino espontáneo: una manifestación extramuscular de la dermatomiositis anti-MDA5. Reporte de 2 casos»","authors":"Santiago Campbell-Silva ,&nbsp;Iyuleisa Castro-González ,&nbsp;Santiago Campbell-Quintero ,&nbsp;Sebastián Campbell-Quintero","doi":"10.1016/j.reuma.2024.05.008","DOIUrl":"10.1016/j.reuma.2024.05.008","url":null,"abstract":"","PeriodicalId":47115,"journal":{"name":"Reumatologia Clinica","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142357985","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":"Gastrointestinal symptoms in patients using methotrexate: A cross-sectional study in a sample with rheumatoid arthritis","authors":"Carina Albuquerque Roberto,&nbsp;Isabela Stachevski,&nbsp;Barbara Stadler Kahlow,&nbsp;Renato Nisihara,&nbsp;Thelma Skare","doi":"10.1016/j.reuma.2024.03.006","DOIUrl":"10.1016/j.reuma.2024.03.006","url":null,"abstract":"<div><h3>Background</h3><div>Gastrointestinal intolerance is common in rheumatoid arthritis (RA) patients using methotrexate and may lead to treatment discontinuation.</div></div><div><h3>Aim</h3><div>To study the prevalence of gastrointestinal symptoms in a sample of RA methotrexate users as well as its possible association with clinical and epidemiological variables.</div></div><div><h3>Methods</h3><div>Cross-sectional study of 192 patients with gastrointestinal symptoms using the MISS (methotrexate intolerance severity score). Clinical and epidemiological variables were collected through chart review and direct questioning. Patients’ adherence to methotrexate was evaluated through Moriski–Green–Levin questionnaire.</div></div><div><h3>Results</h3><div>The prevalence of gastrointestinal complaints was high with 55.7% of the sample classified as intolerant. Nausea and pain after drug ingestion were the most common reported complaints. This intolerance was associated with afro-descendant background (<em>p</em> <!-->=<!--> <!-->0.02); presence of associated fibromyalgia (<em>p</em> <!-->=<!--> <!-->0.04), concomitant use of glucocorticoids (<em>p</em> <!-->=<!--> <!-->0.03) and Jak inhibitors (0.03). A tendency towards association with leflunomide use was observed (<em>p</em> <!-->=<!--> <!-->0.06). Logistic regression was used to test drug associations with methotrexate intolerance, and showed that glucocorticoid use was independently associated with methotrexate intolerance OR<!--> <!-->=<!--> <!-->1.85; 95% CI<!--> <!-->=<!--> <!-->1.01–3.44; <em>p</em> <!-->=<!--> <!-->0.04. Route of administration, presence of previous gastric complaints, age and methotrexate dose did not interfere with MISS. MISS results were associated with moderate adherence to the drug.</div></div><div><h3>Conclusions</h3><div>There is a high rate of methotrexate intolerance that is more common in afro-descendants, those with associated fibromyalgia, glucocorticoid and Jak inhibitors users.</div></div>","PeriodicalId":47115,"journal":{"name":"Reumatologia Clinica","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142358072","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":"Cytokine storm in Chikungunya: Correspondence","authors":"H. Daungsupawong ,&nbsp;V. Wiwanitkit","doi":"10.1016/j.reuma.2024.06.001","DOIUrl":"10.1016/j.reuma.2024.06.001","url":null,"abstract":"","PeriodicalId":47115,"journal":{"name":"Reumatologia Clinica","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141951671","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":"Development of a core domain set for nailfold capillaroscopy reporting","authors":"Yasser El Miedany ,&nbsp;Sherif Ismail ,&nbsp;Mary Wadie ,&nbsp;Ulf Müller-Ladneru ,&nbsp;Roberto Giacomelli ,&nbsp;Vasiliki Liakouli ,&nbsp;Walter Hermann ,&nbsp;Nihal Fathy ,&nbsp;Maha El Gaafary ,&nbsp;Nermin A. Fouad ,&nbsp;Sally Saber ,&nbsp;Mohamed Hassan Abu-Zaid","doi":"10.1016/j.reuma.2024.04.001","DOIUrl":"10.1016/j.reuma.2024.04.001","url":null,"abstract":"<div><h3>Background</h3><p>The peripheral microangiopathy may be well evaluated and studied by nailfold capillaroscopy (NFC) which is a safe and non-invasive technique. NFC has been reported to have both diagnostic and prognostic values in patients presenting with Raynaud's phenomenon.</p></div><div><h3>Objective</h3><p>The overarching objective of this work was to make a consensus on what domains should be included in a capillaroscopy report and that it can be used in daily clinical practice and clinical research in the area of rheumatology.</p></div><div><h3>Methods</h3><p>A Delphi questionnaire was developed regarding capillaroscopy report from a literature review and expert consensus. The first Delphi round included 14 core areas, its 18 domains with 50 subdomains, derived from a systematic literature review. The level of evidence was determined for each core set using the Oxford Centre for Evidence-based Medicine (CEBM) system. Nine response categories have been set per each item ranging between 1 and 9. Round 2, aimed to reach preliminary consensus “in” or “out” for domains. It included all items that were rated “critical” by at least 80% of the participants as well as any new domains proposed in round 1.</p></div><div><h3>Results</h3><p>The participants to the first, and second round were 11 experts. Fourteen domains were discussed in the two rounds. At the end of the survey, the final report template of NFC in rheumatology reached a consensus.</p></div><div><h3>Conclusion</h3><p>A nailfold capillaroscopy report template has been developed by this study, based on outcomes of a Delphi process, by international participants panel. All domains met the 80% voting threshold set in this work. The reporting template can be used for both clinical research as well as day to day practice to provide guidance and standardize the NFC reporting.</p></div>","PeriodicalId":47115,"journal":{"name":"Reumatologia Clinica","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141961684","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":"Can microvascular damage predict disease severity in patients with systemic sclerosis?","authors":"Ana Martins ,&nbsp;Sofia Pimenta ,&nbsp;Daniela Oliveira ,&nbsp;Raquel Miriam Ferreira ,&nbsp;Miguel Bernardes ,&nbsp;Lúcia Costa ,&nbsp;Georgina Terroso","doi":"10.1016/j.reuma.2024.05.004","DOIUrl":"10.1016/j.reuma.2024.05.004","url":null,"abstract":"<div><h3>Introduction</h3><p>Systemic sclerosis (SSc) is characterized by progressive fibrosis of the skin and internal organs, microvascular damage and cellular and humoral immunity abnormalities. Microvascular damage can be easily detected through nailfold videocapillaroscopy (NVC).</p></div><div><h3>Materials and methods</h3><p>A retrospective study of patients with SSc and a NVC performed within the first 6 months after diagnosis was conducted. Visceral involvement in the first 3 years of the disease and NVC findings were collected. The severity of microvascular damage was classified into four categories, according to the worsening of the NVC patterns. The severity of organ involvement was assessed by the disease severity scale of Medsger for each organ and as a global measure of disease severity, the simple summation was used.</p></div><div><h3>Results</h3><p>A total of 86 patients with SSc were included. A moderate correlation was found between the severity of microvascular damage and the global measure of disease severity (<em>r</em> <!-->=<!--> <!-->0.55, <em>p</em> <!-->&lt;<!--> <!-->0.001), the severity of peripheral vascular involvement (<em>r</em> <!-->=<!--> <!-->0.43, <em>p</em> <!-->&lt;<!--> <!-->0.001) and the severity of skin involvement (<em>r</em> <!-->=<!--> <!-->0.34, <em>p</em> <!-->=<!--> <!-->0.001).</p><p>The presence of a late scleroderma pattern in NVC were predictive in univariate analysis of digital ulcers (OR 6.03, 95% CI 1.52–23.86, <em>p</em> <!-->=<!--> <!-->0.01), muscular involvement (OR 13.09, 95% CI 1.09–156.78, <em>p</em> <!-->=<!--> <span>0.04), calcinosis (OR 27.22, 95% CI 5.56–133.33, </span><em>p</em> <!-->&lt;<!--> <!-->0.001) and worse global disease severity score (OR 1.67, 95% CI 1.17–2.38, <em>p</em> <!-->=<!--> <span>0.005). Multivariate analysis adjusted for disease duration and gender confirmed late pattern as an independent predictor of calcinosis (OR 42.89, 95% CI 5.53–332.85, </span><em>p</em> <!-->&lt;<!--> <!-->0.001).</p></div><div><h3>Discussion and conclusion</h3><p>In this study, the worsening of NVC pattern in SSc was associated with the overall disease severity, the severity of peripheral vascular involvement and extension of skin involvement. This study highlights the importance of NVC as a prognostic tool and a possible predictor of systemic visceral involvement.</p></div>","PeriodicalId":47115,"journal":{"name":"Reumatologia Clinica","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141961687","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}