Lancet Rheumatology最新文献

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Research in Brief 研究简介
IF 16.4 1区 医学
Lancet Rheumatology Pub Date : 2025-09-22 DOI: 10.1016/S2665-9913(25)00261-9
Jennifer Thorley
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引用次数: 0
Patient outcomes from implementing a shared decision-making aid for systemic lupus erythematosus: a prospective implementation study. 实施系统性红斑狼疮共同决策辅助的患者结果:一项前瞻性实施研究。
IF 16.4 1区 医学
Lancet Rheumatology Pub Date : 2025-09-17 DOI: 10.1016/S2665-9913(25)00130-4
Jasvinder A Singh, Larry R Hearld, Seth Eisen, W Winn Chatham, Sonali Narain, Narender Annapureddy, Diane L Kamen, Kimberly Trotter, Vikas Majithia, Cathy Lee Ching, Zineb Aouhab, Swamy Venuturupalli, Daniel J Wallace, Rosalind Ramsey-Goldman, Alfred H J Kim, Maureen McMahon, S Sam Lim, Kalpana Bhairavarasu, Alexa Meara, Kenneth Kalunian, Mark Beasley
{"title":"Patient outcomes from implementing a shared decision-making aid for systemic lupus erythematosus: a prospective implementation study.","authors":"Jasvinder A Singh, Larry R Hearld, Seth Eisen, W Winn Chatham, Sonali Narain, Narender Annapureddy, Diane L Kamen, Kimberly Trotter, Vikas Majithia, Cathy Lee Ching, Zineb Aouhab, Swamy Venuturupalli, Daniel J Wallace, Rosalind Ramsey-Goldman, Alfred H J Kim, Maureen McMahon, S Sam Lim, Kalpana Bhairavarasu, Alexa Meara, Kenneth Kalunian, Mark Beasley","doi":"10.1016/S2665-9913(25)00130-4","DOIUrl":"https://doi.org/10.1016/S2665-9913(25)00130-4","url":null,"abstract":"<p><strong>Background: </strong>Data on patient decision making for people with systemic lupus erythematosus (SLE) are scarce. We previously showed that an evidence-based SLE patient decision aid was more effective than the SLE information pamphlet provided by the American College of Rheumatology in reducing decisional conflict for the choice of immunosuppressive medications in women with lupus nephritis, with higher acceptability and feasibility. The aim of this study was to assess patient outcomes from the implementation of this SLE patient decision aid on disease management in people with SLE.</p><p><strong>Methods: </strong>This prospective implementation study was done in 15 geographically diverse rheumatology clinics across the USA. Adults aged 18 years or older with a diagnosis of SLE identified based on a medical record review were included. There were no exclusion criteria. Participants were invited to view the computerised SLE patient decision aid, provided through a touchscreen tablet, a website, or a smartphone app during a regular clinic visit with their rheumatologist at baseline (viewing at follow-up visits was optional). Participants viewed either the full or abbreviated (lite) version, based on SLE disease activity and treatment, as recommended by their rheumatologist. Participants completed validated computerised surveys at each of the baseline, 3-month, and 6-month clinic visits on touchpad computers or their mobile phone (depending on patient preference). These surveys included questions related to patient decisional conflict, shared decision making, patient-physician communication, and perceived acceptability and feasibility of the decision aid. The main outcome of this study was to assess the impact of the SLE patient decision aid (both full and lite versions) on patient decisional conflict, shared decision making, patient-provider communication, and perceived acceptability and feasibility. The study had a multistakeholder committee that included people with lived experience of SLE. This study was registered at ClinicalTrials.gov, NCT03735238.</p><p><strong>Findings: </strong>Between May 23, 2019, and Dec 12, 2023, 2005 patients with SLE were assessed for eligibility and 1895 were included in the study. Study participants had a mean age of 44·7 years (SD 14·4); of the 1855 respondents with data on sex, 1731 (93·3%) were female and 124 (6·7%) were male; of the 1832 respondents with data on race, 827 (45·1%) were African American. Patient outcomes were either good or excellent at the baseline visit after viewing the SLE patient decision aid, including preparation for decision making. The mean Low Literacy Decisional Conflict Scale score was low at 19·5 (SD 23·8); 1351 (82·8%) of 1631 participants matched with their preferred role versus their actual role in treatment decision making (using the control preferences scale); the mean CollaboRATE score was 25·2 (SD 4·1; for patient involvement in shared decision making); the mean p","PeriodicalId":48540,"journal":{"name":"Lancet Rheumatology","volume":" ","pages":""},"PeriodicalIF":16.4,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145103032","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Enabling and supporting public and patient involvement in arthritis research. 允许和支持公众和患者参与关节炎研究。
IF 16.4 1区 医学
Lancet Rheumatology Pub Date : 2025-09-17 DOI: 10.1016/S2665-9913(25)00282-6
Talha Burki
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引用次数: 0
A diagnostic enigma: when arteries and muscles collide. 一个诊断难题:当动脉和肌肉碰撞时。
IF 16.4 1区 医学
Lancet Rheumatology Pub Date : 2025-09-16 DOI: 10.1016/S2665-9913(25)00230-9
Yu-Lan Chen, Shu Liang, Wei-Yue Li, Xiao-Ping Hong, Dong-Zhou Liu
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引用次数: 0
The global, regional, and national burden attributable to low bone mineral density, 1990-2020: an analysis of a modifiable risk factor from the Global Burden of Disease Study 2021. 1990-2020年低骨密度导致的全球、区域和国家负担:对《2021年全球疾病负担研究》中可改变风险因素的分析
IF 16.4 1区 医学
Lancet Rheumatology Pub Date : 2025-09-16 DOI: 10.1016/S2665-9913(25)00105-5
{"title":"The global, regional, and national burden attributable to low bone mineral density, 1990-2020: an analysis of a modifiable risk factor from the Global Burden of Disease Study 2021.","authors":"","doi":"10.1016/S2665-9913(25)00105-5","DOIUrl":"https://doi.org/10.1016/S2665-9913(25)00105-5","url":null,"abstract":"<p><strong>Background: </strong>Fractures related to osteoporosis and low bone mineral density lead to substantial morbidity, mortality, and cost to individuals and health systems. Here we present the most up-to-date global, regional, and national estimates of the contribution of low bone mineral density to the burden of fractures from falls and additional categories of injuries from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021.</p><p><strong>Methods: </strong>The burden of low bone mineral density was estimated from 1990 to 2020 in terms of years lived with disability (YLDs), disability-adjusted life years (DALYs), and deaths, for individuals aged 40 years and older, using data from population-based studies from 48 countries or territories (169 unique sources). Mean standardised femoral neck bone mineral density values were estimated by GBD location, age, and sex by meta-regression. Based on a separate meta-analysis of population-based studies from nine countries (12 unique sources), we also estimated the pooled relative risk of fractures per unit decrease in bone mineral density (g/cm<sup>2</sup>). The population-attributable fraction for low bone mineral density was calculated by comparing the observed distributions of standardised femoral neck bone mineral density to an age-specific and sex-specific counterfactual distribution, defined as the 99th percentile of five rounds of the National Health and Nutrition Examination Survey in the USA, by 5-year age group and sex. Hospital and emergency department data were used to derive the incidence of fractures for six categories of injury (road injuries, other transport injuries, falls, non-venomous animal contact, exposure to mechanical forces, and physical interpersonal violence) using ICD codes. Deaths due to fractures were estimated as the proportion of in-hospital deaths due to the specified injury causes for which a fracture (nature of injury code) was more severe than the cause of injury code. YLDs and DALYs attributable to low bone mineral density by cause of injury were also determined according to previous GBD methods.</p><p><strong>Findings: </strong>In 2020, 8·32 million (95% UI 5·58-10·84) YLDs, 17·2 million (14·1-20·2) DALYs, and 477 000 (411 000-536 000) deaths were attributable to low bone mineral density globally in individuals aged 40 years and older. Between 1990 and 2020, global YLDs, DALYs, and deaths attributable to low bone mineral density increased by 91·8% (88·5-95·1), 89·8% (81·5-99·0), and 127·1% (108·5-144·5), respectively. Over this period, the age-standardised global rates of YLDs, DALYs, and deaths attributable to low bone mineral density showed modest decreases. In 2020, falls accounted for 76·2% (95% UI 74·2-78·3) of YLDs, 65·2% (62·9-67·6) of DALYs, and 71·0% (67·4-72·8) of deaths attributable to low bone mineral density, and road injuries largely accounted for the remaining amount: 12·4% (11·1-13·6) of YLDs, 24·6% (22·5-27·1) of DALYs, ","PeriodicalId":48540,"journal":{"name":"Lancet Rheumatology","volume":" ","pages":""},"PeriodicalIF":16.4,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145092803","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Unscientific vaccine policy endangers vulnerable patients 不科学的疫苗政策危及脆弱患者。
IF 16.4 1区 医学
Lancet Rheumatology Pub Date : 2025-09-12 DOI: 10.1016/S2665-9913(25)00262-0
The Lancet Rheumatology
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引用次数: 0
Correction to Lancet Rheumatol 2025; 7: e554-64. 《柳叶刀风湿病杂志2025》修正;7: e554 - 64。
IF 16.4 1区 医学
Lancet Rheumatology Pub Date : 2025-09-09 DOI: 10.1016/S2665-9913(25)00260-7
{"title":"Correction to Lancet Rheumatol 2025; 7: e554-64.","authors":"","doi":"10.1016/S2665-9913(25)00260-7","DOIUrl":"https://doi.org/10.1016/S2665-9913(25)00260-7","url":null,"abstract":"","PeriodicalId":48540,"journal":{"name":"Lancet Rheumatology","volume":" ","pages":""},"PeriodicalIF":16.4,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145056049","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Targeting B-cell activation to tackle both patient-reported and systemic disease outcomes in Sjögren's disease. 靶向b细胞活化以解决Sjögren疾病患者报告的和全身性疾病结果。
IF 16.4 1区 医学
Lancet Rheumatology Pub Date : 2025-09-09 DOI: 10.1016/S2665-9913(25)00219-X
Dewi Rijnenberg, Safae Hamkour, Frank Redegeld, Helen Leavis, Joël van Roon
{"title":"Targeting B-cell activation to tackle both patient-reported and systemic disease outcomes in Sjögren's disease.","authors":"Dewi Rijnenberg, Safae Hamkour, Frank Redegeld, Helen Leavis, Joël van Roon","doi":"10.1016/S2665-9913(25)00219-X","DOIUrl":"https://doi.org/10.1016/S2665-9913(25)00219-X","url":null,"abstract":"","PeriodicalId":48540,"journal":{"name":"Lancet Rheumatology","volume":" ","pages":""},"PeriodicalIF":16.4,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145056000","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Modelling allopurinol-induced severe adverse cutaneous reactions. 模拟别嘌呤醇引起的严重皮肤不良反应。
IF 16.4 1区 医学
Lancet Rheumatology Pub Date : 2025-09-04 DOI: 10.1016/S2665-9913(25)00220-6
Rebecca Grainger, Lisa K Stamp
{"title":"Modelling allopurinol-induced severe adverse cutaneous reactions.","authors":"Rebecca Grainger, Lisa K Stamp","doi":"10.1016/S2665-9913(25)00220-6","DOIUrl":"https://doi.org/10.1016/S2665-9913(25)00220-6","url":null,"abstract":"","PeriodicalId":48540,"journal":{"name":"Lancet Rheumatology","volume":" ","pages":""},"PeriodicalIF":16.4,"publicationDate":"2025-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145015212","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Development and validation of a prognostic model for predicting the risk of allopurinol-induced severe cutaneous adverse reactions: a retrospective new-user cohort study using linked primary care, hospitalisation, and mortality data. 别嘌呤醇诱导的严重皮肤不良反应风险预测模型的开发和验证:一项回顾性新用户队列研究,使用相关的初级保健、住院和死亡率数据。
IF 16.4 1区 医学
Lancet Rheumatology Pub Date : 2025-09-04 DOI: 10.1016/S2665-9913(25)00165-1
Edoardo Cipolletta, Georgina Nakafero, Davide Rozza, Satveer K Mahil, Catherine H Smith, Richard D Riley, Abhishek Abhishek
{"title":"Development and validation of a prognostic model for predicting the risk of allopurinol-induced severe cutaneous adverse reactions: a retrospective new-user cohort study using linked primary care, hospitalisation, and mortality data.","authors":"Edoardo Cipolletta, Georgina Nakafero, Davide Rozza, Satveer K Mahil, Catherine H Smith, Richard D Riley, Abhishek Abhishek","doi":"10.1016/S2665-9913(25)00165-1","DOIUrl":"https://doi.org/10.1016/S2665-9913(25)00165-1","url":null,"abstract":"<p><strong>Background: </strong>Allopurinol, the most prescribed urate-lowering drug, is a known cause of severe cutaneous adverse reactions. We aimed to develop and validate a model to assess the risk of allopurinol-induced severe cutaneous adverse reactions in adults newly prescribed allopurinol.</p><p><strong>Methods: </strong>In this retrospective new-user cohort study, we developed and validated a prognostic model using primary care, hospitalisation, and mortality data extracted from the UK Clinical Practice Research Datalink (CPRD) primary care database, for the period Jan 1, 2001, to March 29, 2021. Data from CPRD Aurum was used for model development and data from and CPRD GOLD was used for model validation. Adults (aged ≥18 years) residing in England who were newly prescribed allopurinol were followed up for 100 days to assess whether a severe cutaneous adverse reaction was recorded in hospitalisation or mortality records. Risk predictors included in the model were age, sex, ethnicity, chronic kidney disease stage, initial allopurinol dose, ischaemic heart disease, and heart failure. The primary outcome was to predict the 100-day risk of allopurinol-induced severe cutaneous adverse reactions in people newly prescribed allopurinol. We developed the model using multivariable Cox regression and pseudo-values, followed by penalisation and external validation. We assessed calibration, discrimination, and clinical utility in the risk range of 0·0001 to 0·003. People with lived experience of allopurinol use or gout were not involved in developing this research question, but will be involved in the dissemination of results.</p><p><strong>Findings: </strong>225 761 patients newly prescribed allopurinol were registered in the CPRD Aurum database (development cohort) and 173 812 were included in the study. 44 630 (25·7%) of 173 812 patients were female, 129 182 (74·3%) were male, 154 323 (88·8%) were White, and the mean age was 63·9 years (SD 15·0). Of the patients newly prescribed allopurinol with data in the CPRD GOLD database (validation cohort), 55 395 patients were screened and 41 610 were included in the study. 10 829 (26·0%) of 41 610 patients were female, 30 781 (74·0%) were male, 37 242 (89·5%) were White and the mean age was 64·4 years (SD 14·9). 63 (0·04%) severe cutaneous adverse events occurred in 173 812 patients in the development cohort and 16 (0·04%) occurred in 41 610 patients in the validation cohort. Age (adjusted hazard ratio 1·03 [95% CI 1·01-1·06]), chronic kidney disease stages 3, 4, and 5 (2·24 [1·20-4·17] for stage 3; 6·65 [2·90-15·23] for stage 4; 18·85 [6·32-56·19] for stage 5), initial allopurinol dose of 300 mg or higher (5·99 [3·56-0·08]), South Asian ethnicity (5·35 [2·37-12·07]), and other Asian ethnicity (5·63 [1·34-23·61]) were associated with the 100-day risk of allopurinol-induced severe cutaneous adverse reactions. In the development dataset, after optimism-adjustment, the model's explained variation (Royston an","PeriodicalId":48540,"journal":{"name":"Lancet Rheumatology","volume":" ","pages":""},"PeriodicalIF":16.4,"publicationDate":"2025-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145015309","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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