Lancet Rheumatology最新文献

{"title":"Allogeneic umbilical cord-derived mesenchymal stromal cells as treatment for systemic lupus erythematosus: a single-centre, open-label, dose-escalation, phase 1 study","authors":"Prof Dominique Farge MD , Lucie Biard PhD , Ben Weil EngD , Virginie Girault PhD , Pauline Lansiaux PhD , Ingrid Munia MSc , Séverine Loisel PhD , Catney Charles BSc , Judikael Saout PhD , Prof Matthieu Resche-Rigon PhD , Prof Anne Sophie Korganow MD , Clément Beuvon MD , Prof Grégory Pugnet MD , Carlotta Cacciatore MD , Noémie Abisror MD , Prof Jean Luc Taupin PhD , Audrey Cras PhD , Prof Mark W Lowdell PhD , Prof Karin Tarte PhD","doi":"10.1016/S2665-9913(24)00298-4","DOIUrl":"10.1016/S2665-9913(24)00298-4","url":null,"abstract":"<div><h3>Background</h3><div>Patients with systemic lupus erythematosus (SLE) with inadequate responses to standard therapies have unmet therapeutic needs. The immunomodulatory, proangiogenic, and antifibrotic properties of mesenchymal stromal cells support their use in treating patients with SLE. We aimed to assess the safety of a single intravenous infusion of allogeneic umbilical cord-derived mesenchymal stromal cells in patients with severe SLE.</div></div><div><h3>Methods</h3><div>This prospective, single-centre, open-label, dose-escalation, Bayesian phase 1 study was done at the Saint-Louis University Hospital (Paris, France). Eligible patients were aged 18–70 years, were diagnosed with SLE according to American College of Rheumatology criteria with positive antinuclear antibodies, had a baseline Safety of Estrogens in Lupus Erythematosus National Assessment–SLE Disease Activity Index (SELENA-SLEDAI) score of 6 or more, and had disease that was refractory to first and second line SLE therapies. Patients were to receive a single intravenous infusion of 1 × 10<sup>6</sup>, 2 × 10<sup>6</sup>, or 4 × 10<sup>6</sup> umbilical cord-derived mesenchymal stromal cells per kg (manufactured from a single umbilical cord) in cohorts of five patients per dose, starting at 2 × 10<sup>6</sup> cells per kg. The primary endpoint was the rate of treatment-related severe adverse events (grade ≥3) in the first 10 days after infusion of umbilical cord-derived mesenchymal stromal cells. People with lived experience were involved in study design, patient enrolment, and dissemination of the study findings. This study is registered with <span><span>ClinicalTrials.gov</span><svg><path></path></svg></span>, <span><span>NCT03562065</span><svg><path></path></svg></span>, and the EU Clinical Trials Register, EudraCT2017-001400-29.</div></div><div><h3>Findings</h3><div>From May 14, 2019, to March 6, 2023, 29 patients were screened for eligibility, eight of whom were enrolled in the study. Enrolment was terminated early after inclusion of eight patients and no patients received the 1 × 10<sup>6</sup> dose of umbilical cord-derived mesenchymal stromal cells. Seven (88%) of eight participants were cisgender women and one (13%) was a cisgender man. The median age was 35 years (range 26–57) and the median SLE disease duration was 12 years (5–19). All patients received at least 2 × 10<sup>6</sup> cells per kg (range 2 × 10<sup>6</sup> to 4 × 10<sup>6</sup>). No severe adverse events and three infusion-related adverse events (two grade 1 and one grade 2) occurred in two patients in the first 10 days after infusion. After 12·4 months (range 12–13) of follow-up, no treatment-related severe adverse events and three non-treatment-related severe adverse events occurred in one patient after relapse.</div></div><div><h3>Interpretation</h3><div>Our results suggest that a single infusion of 2 × 10<sup>6</sup> cells per kg or 4 × 10<sup>6</sup> cells per kg of allogeneic umbilical cord-d","PeriodicalId":48540,"journal":{"name":"Lancet Rheumatology","volume":"7 4","pages":"Pages e261-e273"},"PeriodicalIF":15.0,"publicationDate":"2024-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142873192","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}

{"title":"The projected burden of arthritis among adults and children in Australia to the year 2040: a population-level forecasting study","authors":"Prof Ilana N Ackerman PhD , Alexandra Gorelik MSc , Danielle Berkovic PhD , Prof Rachelle Buchbinder PhD","doi":"10.1016/S2665-9913(24)00247-9","DOIUrl":"10.1016/S2665-9913(24)00247-9","url":null,"abstract":"<div><h3>Background</h3><div>Understanding how many people could be living with arthritis in the future is essential for planning health service needs and national health workforce requirements, and for arthritis advocacy and policy development. This study aimed to forecast the size of different populations with arthritis in Australia and associated health system expenditure, up to the year 2040.</div></div><div><h3>Methods</h3><div>In this population-level forecasting study for Australia, prevalence data for arthritis, osteoarthritis, and rheumatoid arthritis were obtained from the Australian Bureau of Statistics 2022 National Health Survey. Prevalence rates for juvenile idiopathic arthritis were sourced from 2021 Census data. Overall, age-specific and sex-specific prevalence data were applied to national population projections to forecast arthritis, osteoarthritis, rheumatoid arthritis, and juvenile idiopathic arthritis populations for 2025, 2030, 2035, and 2040. The base case analysis considered medium population growth; sensitivity analyses considered low and high growth scenarios. Health system expenditure data from the Australian Institute of Health and Welfare were extrapolated to base case projections for the years 2025, 2030, 2035, and 2040, and were then inflated to future dollars. To understand the broader context and implications of our projections through the lens of lived experience, an arthritis consumer researcher and members of the Arthritis Australia Consumer Advisory Panel reviewed the arthritis burden estimates.</div></div><div><h3>Findings</h3><div>With population growth and ageing, 5·39 million (95% CI 5·19–5·58) people are projected to have arthritis in Australia in 2040, representing an increase of 31% from 4·11 million (3·95–4·27) in 2025. By 2040, 3·11 million (2·99–3·23) people are expected to have osteoarthritis, 749 000 (652 000–846 000) are expected to have rheumatoid arthritis, and about 8500 children and adolescents are expected to have juvenile idiopathic arthritis. The age-standardised rate of osteoarthritis is forecast to increase for males from 6·28% in 2025 to 7·03% in 2040, and for females from 10·82% to 12·18% over this period. The age-standardised rate of rheumatoid arthritis is forecast to increase for males from 1·56% in 2025 to 1·75% in 2040, and for females from 2·62% in 2025 to 2·94% in 2040. Little change is anticipated in the number of children and adolescents with juvenile idiopathic arthritis (estimated at 8500 individuals in 2040). Based on current spending levels of AU$2100 per person with osteoarthritis and $1918 per person with rheumatoid arthritis, annual health system expenditure for osteoarthritis and rheumatoid arthritis is conservatively forecast to exceed AU$11·92 billion by 2040.</div></div><div><h3>Interpretation</h3><div>Using the latest national-level data, this study has generated contemporary projections of the substantial burden of arthritis (both population size and health-care co","PeriodicalId":48540,"journal":{"name":"Lancet Rheumatology","volume":"7 3","pages":"Pages e187-e196"},"PeriodicalIF":15.0,"publicationDate":"2024-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142796397","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}

{"title":"Arthritis burden projections: a call to action in Australia and beyond","authors":"Cesar A Hincapié","doi":"10.1016/S2665-9913(24)00349-7","DOIUrl":"10.1016/S2665-9913(24)00349-7","url":null,"abstract":"","PeriodicalId":48540,"journal":{"name":"Lancet Rheumatology","volume":"7 3","pages":"Pages e149-e151"},"PeriodicalIF":15.0,"publicationDate":"2024-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142796435","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}

{"title":"A disseminated gonococcal infection with spinal locations.","authors":"Monika Klimek, Esther Ebstein, Augustin Gaudemer, Laurène Deconinck, Marie Péan de Ponfilly, Leslie Benattar, Sébastien Ottaviani, Marine Forien, Philippe Dieudé, Pierre-Antoine Juge","doi":"10.1016/S2665-9913(24)00339-4","DOIUrl":"https://doi.org/10.1016/S2665-9913(24)00339-4","url":null,"abstract":"","PeriodicalId":48540,"journal":{"name":"Lancet Rheumatology","volume":" ","pages":""},"PeriodicalIF":15.0,"publicationDate":"2024-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142796431","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}

{"title":"Efficacy of combined immunomodulators in preventing uveitis relapses in patients with Behçet's disease on corticosteroids","authors":"Wei-Zhen Tang , Kang-Jin Huang , Tai-Hang Liu","doi":"10.1016/S2665-9913(24)00300-X","DOIUrl":"10.1016/S2665-9913(24)00300-X","url":null,"abstract":"","PeriodicalId":48540,"journal":{"name":"Lancet Rheumatology","volume":"6 12","pages":"Page e822"},"PeriodicalIF":15.0,"publicationDate":"2024-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142698879","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}

{"title":"Research in Brief","authors":"Jennifer Thorley","doi":"10.1016/S2665-9913(24)00344-8","DOIUrl":"10.1016/S2665-9913(24)00344-8","url":null,"abstract":"","PeriodicalId":48540,"journal":{"name":"Lancet Rheumatology","volume":"6 12","pages":"Page e825"},"PeriodicalIF":15.0,"publicationDate":"2024-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142698882","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}

{"title":"Patient-initiated follow-up: leave no one behind","authors":"The Lancet Rheumatology","doi":"10.1016/S2665-9913(24)00343-6","DOIUrl":"10.1016/S2665-9913(24)00343-6","url":null,"abstract":"","PeriodicalId":48540,"journal":{"name":"Lancet Rheumatology","volume":"6 12","pages":"Page e811"},"PeriodicalIF":15.0,"publicationDate":"2024-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142698881","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}

{"title":"Efficacy of combined immunomodulators in preventing uveitis relapses in patients with Behçet's disease on corticosteroids – Authors' reply","authors":"Zhenyu Zhong , Peizeng Yang","doi":"10.1016/S2665-9913(24)00301-1","DOIUrl":"10.1016/S2665-9913(24)00301-1","url":null,"abstract":"","PeriodicalId":48540,"journal":{"name":"Lancet Rheumatology","volume":"6 12","pages":"Pages e822-e823"},"PeriodicalIF":15.0,"publicationDate":"2024-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142698880","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}

{"title":"Understanding the spectrum from preclinical psoriatic arthritis to early diagnosis of the disease","authors":"Prof Francesco Ciccia MD PhD ,&nbsp;Saviana Gandolfo MD ,&nbsp;Prof Roberto Caporali MD PhD ,&nbsp;Prof Jose U Scher MD","doi":"10.1016/S2665-9913(24)00268-6","DOIUrl":"10.1016/S2665-9913(24)00268-6","url":null,"abstract":"<div><div>Psoriasis is a chronic inflammatory skin disease that often precedes the development of psoriatic arthritis. Advances over the past 10 years have deepened our understanding of the transition from skin inflammation to joint inflammation, revealing various phases during which genetic, environmental, and immunological factors can affect this transition. In 2023, a European Alliance of Associations for Rheumatology task force outlined key considerations for identifying individuals with subclinical disease from those with clinically stabilised disease. Discerning between subclinical psoriatic arthritis and very early disease is crucial and raises doubts and questions about when an individual transitions from being at risk to having established psoriatic arthritis. Labelling this stage as very early psoriatic arthritis rather than subclinical disease might have substantial clinical and therapeutic implications. This Viewpoint highlights the importance of precisely identifying the different stages of progression of psoriatic arthritis for timely interventions and better outcomes for patients.</div></div>","PeriodicalId":48540,"journal":{"name":"Lancet Rheumatology","volume":"7 3","pages":"Pages e208-e211"},"PeriodicalIF":15.0,"publicationDate":"2024-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142695921","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}

{"title":"Coronary polyarteritis nodosa.","authors":"Yi-Ning Yen, Hsien-Tzung Liao","doi":"10.1016/S2665-9913(24)00305-9","DOIUrl":"https://doi.org/10.1016/S2665-9913(24)00305-9","url":null,"abstract":"","PeriodicalId":48540,"journal":{"name":"Lancet Rheumatology","volume":" ","pages":""},"PeriodicalIF":15.0,"publicationDate":"2024-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142693754","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}