Advances in Rheumatology最新文献

{"title":"Systemic lupus erythematosus and risk factors for adverse outcomes in pregnancy: a single center retrospective cohort study in Northern Brazil.","authors":"Sérgio Henrique Oliveira Dos Santos, Juliana Bühring, Luiz Fernando de Souza Passos, Bárbara Seabra Carneiro, Domingos Sávio Nunes de Lima, Sandra Lúcia Euzébio Ribeiro","doi":"10.1186/s42358-025-00467-2","DOIUrl":"10.1186/s42358-025-00467-2","url":null,"abstract":"<p><strong>Background: </strong>Systemic lupus erythematosus (SLE) directly impacts pregnancy outcomes, and few studies have analyzed the related risk factors for maternal and fetal/perinatal complications in Brazil. We described and analyzed the risk factors for maternal and fetal complications in SLE pregnancies at an outpatient clinic in the State of Amazonas, Northern Brazil.</p><p><strong>Methods: </strong>Pregnancies that occurred after the SLE diagnosis between 2001 and 2020 were analyzed. Risk factors for adverse outcomes were determined using logistic regression.</p><p><strong>Results: </strong>A total of 155 pregnancies from 109 women were included; the mean age was 28.2 (±5.5) years, the median disease duration was 72 [36; 108] months, 56 (36.1%) had active disease prior to pregnancy, 39 (26.5%) had nephritis, 30 (20.3%) had cutaneous manifestations, and the incidence of disease activity during pregnancy was 29.7%; there was a 12.3% (95% CI, [4.2; 20.4]) increase in the proportion of patients with active disease, there were 35 (22.9%) fetal deaths, 26 (16.8%) cases of preeclampsia, 44 (37.3%) preterm births, 16 (16.2%) cases of low birth weight for gestational age, and 18 (18.8%) cases of intrauterine growth restriction. Risk factors for maternal events included immunological alterations (OR=3.02; 95% CI [1.11; 8.21]), renal involvement (OR=3.74; 95% CI [1.25; 11.21]), and disease activity before pregnancy (OR=1.30; 95% CI [1.04; 1.64]); the use of hydroxychloroquine before pregnancy was protective (OR=0.23; 95% CI [0.08; 0.67]). Risk factors for fetal events included the use of acetylsalicylic acid (ASA) during pregnancy (OR=5.22; 95% CI [1.33; 20.54]) and disease activity during pregnancy (OR=1.31; 95% CI [1.14; 1.52]); the use of antimalarials before and during pregnancy was protective (OR=0.14; 95% CI [0.04; 0.44]). According to the post-hoc analysis, the probability of a Type S error in the ASA association was 100%. The retrospective nature and the presence of missing data about laboratory tests are the main limitations of this study.</p><p><strong>Conclusion: </strong>Pregnancy management in SLE presents a unique set of challenges that require a comprehensive and multidisciplinary approach. Careful monitoring of disease activity, appropriate medication management, and psychosocial support are essential for optimizing maternal and fetal health outcomes.</p>","PeriodicalId":48634,"journal":{"name":"Advances in Rheumatology","volume":"65 1","pages":"35"},"PeriodicalIF":2.1,"publicationDate":"2025-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144734439","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of interventions with resistance exercises on muscle strength, physical disability, and quality of life in systemic sclerosis patients: a systematic review with meta-analysis.","authors":"André Luiz Silveira Mallmann, Daniel Nóbrega de Moraes, Lucas Denardi Dória, Leonardo Peterson Dos Santos, Stephanie Pilotti, Mayra Angélica de Souza Antunes, Laura Fontana Steinmetz, Thauan Júnior Santos de Souza, Vanessa Hax, Jerri Luiz Ribeiro, Ricardo Machado Xavier, Rafael Mendonça da Silva Chakr","doi":"10.1186/s42358-025-00468-1","DOIUrl":"10.1186/s42358-025-00468-1","url":null,"abstract":"<p><strong>Introduction: </strong>Systemic sclerosis (SSc) often leads to decreased muscle strength and mass, impairing physical performance and causing disability. Interventions with resistance exercise (RE) is an effective non-pharmacological approach to mitigate these issues. This systematic review aims to evaluate the effects of interventions with RE on muscle strength, muscle mass, physical performance, physical disability, and quality of life (QOL) in SSc patients, as well as to assess its adherence and safety.</p><p><strong>Methods: </strong>A systematic review and meta-analysis were conducted based on a PICOS framework: Patient = Systemic Sclerosis; Intervention = Resistance exercise; Study design = Randomized clinical trials. Searches were performed across MEDLINE (PubMed), PMC, Web of Science, Cochrane Library, LILACS, and EMBASE up to January 2025.</p><p><strong>Results: </strong>Ten randomized clinical trials, including 422 participants (~85% female), were eligible for analysis. Participants' ages ranged from 42 to 64 years, with body mass indices between 22.5 and 28.0 kg/m². The intervention period was standardized to 12 weeks. Interventions with RE significantly improved muscle strength (SMD = 2.76 kg; 95% CI, 1.32 to 4.20; p = 0.0002) and functional disability (SMD = -0.47; 95% CI, -0.93 to -0.00; p = 0.05) compared to controls. Interventions with RE also showed superiority in the physical component of QOL (SMD = 0.42; 95% CI, 0.04 to 0.81; p = 0.03). Although enhanced physical performance was observed, statistical pooling was not possible due to limited data. Interventions with RE had a low incidence of adverse events, but data on disease progression and adherence were insufficient.</p><p><strong>Conclusion: </strong>Interventions with RE benefits muscle strength, physical function, and QOL in SSc patients, though optimal protocols and adherence strategies need further investigation. More robust studies are required to refine training methods and enhance clinical trial designs.</p>","PeriodicalId":48634,"journal":{"name":"Advances in Rheumatology","volume":"65 1","pages":"34"},"PeriodicalIF":2.1,"publicationDate":"2025-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144734438","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction: Brazilian recommendations for the management of tuberculosis infection in immune-mediated inflammatory diseases.","authors":"Viviane Angelina de Souza, Ana Luiza Mendes Amorim Caparroz, Virginia Fernandes Moça Trevisani, Anna Carolina Faria Moreira Gomes Tavares, Ana Karla Guedes de Melo, Anete Trajman, Ana Cristina de Medeiros-Ribeiro, Marcelo de Medeiros Pinheiro, Ricardo Machado Xavier, Odirlei Andre Monticielo, Maria Fernanda Brandão de Resende Guimarães, Flavio Sztajnbok, Sidney Bombarda, Liliana Andrade Chebli, Adriana Maria Kakehasi, Ana Luiza Bierrenbach, Ana Paula Monteiro Gomides Reis, Blanca Elena Rios Gomes Bica, Claudia Diniz Lopes Marques, Cristina Flores, Denise Silva Rodrigues, Eduardo Dos Santos Paiva, Eliana Dias Matos, Fernanda Dockhorn Costa Johansen, Helio Arthur Bacha, Joana Starling de Carvalho, José Roberto Provenza, Ketty Lysie Libardi Lira Machado, Licia Maria Henrique da Mota, Lilian David de Azevedo Valadares, Marco Antônio Araújo da Rocha Loures, Margareth Maria Pretti Dalcolmo, Maria Cecilia de Carvalho Bortoletto, Max Igor Banks Ferreira Lopes, Rejane Maria Rodrigues de Abreu Vieira, Ricardo Romiti, Rogerio Saad-Hossne, Rozana Mesquita Ciconelli, Valderilio Feijó Azevedo, Valéria Maria Augusto, Vitor Alves Cruz, Gecilmara Cristina Salviato Pileggi","doi":"10.1186/s42358-025-00466-3","DOIUrl":"https://doi.org/10.1186/s42358-025-00466-3","url":null,"abstract":"","PeriodicalId":48634,"journal":{"name":"Advances in Rheumatology","volume":"65 1","pages":"33"},"PeriodicalIF":2.0,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144683482","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of rheumatologists' knowledge of biosimilars.","authors":"Thayane Furtado Rolim Lima, Lia Poti Gomes Cordeiro, Kirla Wagner Poti Gomes, Carlos Ewerton Maia Rodrigues","doi":"10.1186/s42358-025-00465-4","DOIUrl":"https://doi.org/10.1186/s42358-025-00465-4","url":null,"abstract":"<p><strong>Introduction: </strong>Biosimilars reduce the cost of biologic therapy without compromising safety and effectiveness. In this study we evaluated Brazilian rheumatologists' knowledge and perceptions of biosimilars.</p><p><strong>Methods: </strong>Cross-sectional and descriptive study based on a questionnaire containing 17 items on familiarity, knowledge and perceptions of biosimilars.</p><p><strong>Results: </strong>Answers were received from 135 rheumatologists, of whom 97.8% were familiar with biosimilars and 92.5% had at some time prescribed them, but only 47.7% felt comfortable prescribing them to stable patients and 62.2% strongly disagreed with automatic substitution. In addition, 51.9% preferred naive patients when starting treatment with biosimilars.</p><p><strong>Conclusion: </strong>Despite the growing acceptance of biosimilars, many physicians remain reluctant. Evidence-based continuing education is essential to clarify these issues.</p>","PeriodicalId":48634,"journal":{"name":"Advances in Rheumatology","volume":"65 1","pages":"32"},"PeriodicalIF":2.0,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144660849","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence of metabolic syndrome in low-income childhood-onset systemic lupus erythematosus patients.","authors":"Natalia Gomes Iannini, Carlos Ewerton Maia Rodrigues","doi":"10.1186/s42358-025-00464-5","DOIUrl":"https://doi.org/10.1186/s42358-025-00464-5","url":null,"abstract":"<p><strong>Objective: </strong>To determine the prevalence of metabolic syndrome (MetS) in patients with childhood onset Systemic Lupus Erithematosus (cSLE) and controls from Northeastern Brazil and to verify its association with specific SLE parameters and cardiovascular risk factors.</p><p><strong>Methods: </strong>The prevalence of MetS was assessed cross-sectionally in 58 patients with cSLE and 33 age -matched controls. Information was collected by clinical examination and standardized questionnaires, investigating personal and family history of cardiovascular disease and obesity and socioeconomic and demographic characteristics.</p><p><strong>Results: </strong>The prevalence of MetS was higher in cSLE patients than in controls according to both ABRAN criteria (8.6% vs. 0%; p = 0.083) and IDF criteria (10,3% vs. 3.0%; p = 0.208), but without statistical significance. Importantly, 91.4% of patients were from a low-income household. Patients with MetS according to ABRAN also had lower ESR levels (p = 0.039), higher total cholesterol (p = 0.013), HDL-c (p = 0.007) and triglycerides (p = 0.001) and a lower albumin level (p = 0.016). Patients with MetS according to IDF had higher SDI scores (p = 0.039) and higher C3 and C4 levels (p < 0.001 and p < 0.001, respectively). The multivariate logistic regression identified higher levels C4 (OR = 32.6; 95% CI = 1.0-544.0; p = 0.015) and increase in the number of leukocytes (OR = 1.9, 95%CI = 1.1-3.2; p = 0.022) as independent risk factors for MetS in patients with cSLE.</p><p><strong>Conclusion: </strong>The prevalence of Mets in the patients with cSLE seems to be low in this population. There was association of MetS with higher cumulative damage indices and levels of complement. We did not observe any association with clinical manifestations, autoantibody profile and dose of corticosteroids.</p>","PeriodicalId":48634,"journal":{"name":"Advances in Rheumatology","volume":"65 1","pages":"31"},"PeriodicalIF":2.0,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144585315","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictive value of total CSVD burden scores in cognitive impairment among SLE patients on the basis of MRI evaluation.","authors":"Lei Wang, Guimin Zheng, Xiuchuan Jia, Yingmin Chen","doi":"10.1186/s42358-025-00463-6","DOIUrl":"https://doi.org/10.1186/s42358-025-00463-6","url":null,"abstract":"<p><strong>Background: </strong>Cognitive impairment (CI) is a significant problem in systemic lupus erythematosus (SLE) patients. In recent years, total cerebral small vessel disease (CSVD) burden scores have had substantial value in predicting cognitive impairment. However, its application in treating concurrent cognitive impairment in SLE patients is unclear. To explore the relationship between total CSVD burden scores and cognitive dysfunction in SLE patients and to analyze its predictive value.</p><p><strong>Methods: </strong>The Montreal Cognitive Assessment (MoCA) score was used to evaluate the cognitive function of 50 patients with SLE, and the total load score of patients with CSVD was analyzed via magnetic resonance imaging (MRI). Multivariate regression was used to evaluate the relationship between total CSVD burden scores and cognitive dysfunction, and the predictive value of total CSVD burden scores was assessed.</p><p><strong>Results: </strong>Multivariate logistic regression analysis revealed that years of education (OR = 0.975, 95% CI [0.952-0.998], P = 0.035), neuropsychiatric systemic lupus erythematosus (NPSLE) (OR = 4.152, 95% CI [2.158-7.990], P < 0.001), and the CSVD total burden score (OR = 3.884, 95% CI [0.840-0.928], P < 0.001) were independently associated with cognitive impairment in SLE patients. The results of the ROC curve analysis revealed that the area under the curve (AUC) of the CSVD total burden score for the prediction of cognitive impairment in SLE patients was 0.885.</p><p><strong>Conclusions: </strong>Years of education, NPSLE score, and total CSVD burden score are closely related to the occurrence of cognitive impairment in SLE patients. In particular, the total CSVD burden score is beneficial for the prediction of cognitive impairment.</p><p><strong>Clinical trial number: </strong>Not applicable.</p><p><strong>Trial registration: </strong>Not applicable.</p>","PeriodicalId":48634,"journal":{"name":"Advances in Rheumatology","volume":"65 1","pages":"30"},"PeriodicalIF":2.0,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144555458","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Brazilian guidelines for the management of tuberculosis infection in immune-mediated inflammatory diseases: is retesting in latent tuberculosis screening appropriate and Safe?","authors":"Carlos Brito, Rita Moraes de Brito","doi":"10.1186/s42358-025-00462-7","DOIUrl":"10.1186/s42358-025-00462-7","url":null,"abstract":"<p><p>The article \"Brazilian Recommendations for the Management of Tuberculosis Infection in Immune-Mediated Inflammatory Diseases\" by Viviane de Souza et al. presents important discussions on the subject; however, the recommendation for annual repetition of the TST/IGRA test for three years and after medication changes raises considerable concerns. This approach may lead to overdiagnosis and overtreatment of latent tuberculosis infection (LTBI). Frequent false-positive results in retests can result in unnecessary antibiotic use, contributing to bacterial resistance, a problem of global significance. The recommendation, considered to have a moderate level of evidence, is subject to criticism. Arguments used to support retesting, such as high conversion rates of tests after one year, reports of tuberculosis cases despite negative screenings being attributed to false negatives, and reliance on other sources with lower levels of evidence, do not constitute sufficient evidence to confirm tuberculosis infection or justify the recommendation. On the other hand, there is evidence that has not been considered in the discussion against the recommendation for retesting, indicating that this practice may increase the risk of diagnosing false-positive infections, leading to overtreatment without clinically proven benefits. Potentially harmful interventions should not be implemented without solid evidence to support them. In this letter to the editor, we briefly discuss this recommendation and the arguments against its implementation, highlighting its associated risks.</p>","PeriodicalId":48634,"journal":{"name":"Advances in Rheumatology","volume":"65 1","pages":"29"},"PeriodicalIF":2.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144545702","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Determinants of myocardial fibrosis in patients with immune-mediated inflammatory diseases.","authors":"Nicholas Black, Joshua Bradley, Fardad Soltani, John P Farrant, Josephine H Naish, Matthias Schmitt, Maya H Buch, Christopher A Miller","doi":"10.1186/s42358-025-00451-w","DOIUrl":"10.1186/s42358-025-00451-w","url":null,"abstract":"<p><strong>Background: </strong>Myocardial fibrosis is an important adverse prognostic marker, however; determinants of myocardial fibrosis in immune-mediated inflammatory diseases (IMIDs) remain poorly defined. We aimed to identify determinants of myocardial fibrosis in patients with IMIDs, as measured by cardiovascular magnetic resonance (CMR) extracellular volume (ECV).</p><p><strong>Methods: </strong>Cross-sectional study of 116 patients with IMIDs undergoing clinical CMR at Manchester University NHS Foundation Trust. IMIDs included rheumatoid arthritis, systemic lupus erythematosus, systemic sclerosis (SSc), ankylosing spondylitis, psoriatic arthritis and vasculitis. CMR included pre- and post-contrast T1 mapping to measure myocardial ECV, with same day blood sampling. Determinants of ECV were investigated with univariable and multivariable linear regression.</p><p><strong>Results: </strong>ECV varied significantly according to IMID diagnosis (ANOVA F statistic 2.80, P = 0.015); ECV was higher in patients with SSc compared to other IMIDs. Major determinants of ECV as a continuous variable were SSc, smoking and body mass index (BMI); regression coefficients 3.33 (95% confidence interval 0.82-5.84), 3.08 (0.73-5.43), and - 0.19 (-0.29 - -0.09) respectively, P < 0.01 (SSc, smoking and lower BMI were associated with increased ECV). Approximately a quarter of the variability in ECV could be explained by these predictors (optimism adjusted R² 0.265).</p><p><strong>Conclusion: </strong>SSc is associated with a higher burden of myocardial fibrosis compared to other IMIDs. In patients with IMIDs, independent determinants of myocardial fibrosis were presence of SSc, smoking and BMI. Importantly, participants underwent CMR for clinical indications and may not be representative of IMID populations in the community.</p>","PeriodicalId":48634,"journal":{"name":"Advances in Rheumatology","volume":"65 1","pages":"28"},"PeriodicalIF":2.0,"publicationDate":"2025-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12167332/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144295081","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fibromyalgia with concomitant immune-mediated rheumatic diseases: an evaluation of clinical characteristics, diagnostic criteria and multimodal treatment outcomes.","authors":"Johanna Mettler, Pedro Ming-Azevedo, Thomas Hügle","doi":"10.1186/s42358-025-00457-4","DOIUrl":"https://doi.org/10.1186/s42358-025-00457-4","url":null,"abstract":"<p><strong>Objectives: </strong>Fibromyalgia (FM) is a relevant comorbidity in immune-mediated rheumatic diseases (IMRD). Immune mechanisms have been postulated to trigger FM, potentially leading to distinct clinical features compared to FM occurring without IMRDs. This study aims to provide a comprehensive comparison of FM characteristics in patients with and without concomitant IMRD and to evaluate the differences in diagnostic FM criteria between the two groups.</p><p><strong>Methods: </strong>A comprehensive dataset of clinical, psychosocial, and sleep variables, along with validated questionnaires, was prospectively collected from 341 patients with chronic musculoskeletal pain syndromes who participated in a rheumatology-led, two-week multimodal inpatient program at the University Hospital of Lausanne between 2018 and 2024. Participants were included if they met either the Fibromyalgia Rapid Screening Tool (FiRST) or the American College of Rheumatology (ACR) 2010 criteria for FM. The disease activity of the underlying IMRD was assessed by two rheumatologists. Data were separately analyzed in two cohorts: one fulfilling the FiRST criteria and the other fulfilling the ACR 2010 criteria.</p><p><strong>Results: </strong>Among the participants, 153 patients met the FiRST criteria, of whom 34 also had a history of clinically diagnosed IMRD. Similarly, 149 patients fulfilled the ACR 2010 criteria, with 32 of them also having IMRD. The most common IMRDs were HLA-B27-negative spondyloarthritis (53%), Sjögren's syndrome (16%), HLA-B27-positive spondyloarthritis (9%), psoriatic arthritis (9%), seronegative rheumatoid arthritis (9%), and seropositive rheumatoid arthritis (3%). In 88% of patients with IMRD, the disease was considered inactive. No significant clinical or epidemiological differences were found between FM patients with or without IMRD in either the FiRST or ACR 2010 cohorts, except for a higher prevalence of enthesopathies and childhood pain in patients with concomitant IMRD. FM patients with IMRD had slightly lower FiRST scores, and FiRST-positive IMRD patients showed a better short-term response to the multimodal program, particularly in FABQ-work, BPI-interference, and Pain Catastrophizing Scale scores. However, no significant difference was observed in the Pain Disability Index (PDI) three months post-program.</p><p><strong>Conclusion: </strong>HLA-B27-negative spondyloarthritis and Sjögren's syndrome were the most common concomitant IMRDs in this FM cohort. FM patients with and without IMRD exhibited similar clinical and epidemiological features, suggesting a common pathophysiological background. The FiRST criteria, which emphasize central hypersensitization rather than diffuse pain, appear to be a suitable tool for detecting FM in IMRD patients. This may be particularly useful in cases where enthesial pain might interfere with FM diagnosis, and vice versa.</p>","PeriodicalId":48634,"journal":{"name":"Advances in Rheumatology","volume":"65 1","pages":"27"},"PeriodicalIF":2.0,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144286894","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A real-life study of juvenile idiopathic arthritis from two Brazilian referral centers for pediatric rheumatology.","authors":"Ana María Loroño Terrazas, Raúl Gutiérrez Suárez, Reinan Tavares Campos, Claudio Arnaldo Len, Nadia Emi Aikawa, Jade Dib Fernandez, Mayra Lisyer Dantas, Clóvis Artur Silva, Gleice Clemente, Maria Teresa Terreri","doi":"10.1186/s42358-025-00459-2","DOIUrl":"10.1186/s42358-025-00459-2","url":null,"abstract":"<p><strong>Background: </strong>Juvenile idiopathic arthritis (JIA) is the most common rheumatic disease in childhood, but its outcomes are still difficult to determine. We aimed to obtain outcome measurements of disease activity, functional capacity, disease damage, and therapeutic response, at one-year follow-up study on a real-life basis.</p><p><strong>Methods: </strong>An observational JIA cohort from two referral centers for pediatric rheumatology in Brazil Pediatric Rheumatology Centers was carried out over a period of one year. Clinimetric validated outcome measurements were applied over four visits. Multivariable logistic regression was performed to evaluate baseline variables associated with the following outcomes after one year of follow-up: disease activity, Minimal Disease Activity (MDA), disease flare, remission on medication and remission off medication.</p><p><strong>Results: </strong>A total of 127 patients were included in the study. Eighty-three (65.4%) were females, and median time to diagnosis was 6.0 months. JADAS71 and CHAQ improved during follow-up (mean Vbaseline 7.05 ± 9.3 vs. V52 3.52 ± 8.4; 0 ± 0.5 vs. 0.14 ± 0.4, p < 0.001, respectively) as well as JIA-ACR 30, 50, 70 and 90 (Vbaseline 79.8% vs. V52 88.8%; 71.4% vs. 84.1%; 59.7% vs. 77.6%; 49.6% vs. 69.2%, p < 0.05, respectively). Inactive disease was present in 33% of patients at baseline and in 67.9% at V52 (p < 0.001). Remission on medication, remission off medication and MDA were present in 46%, 11%, and 80.6% of patients at V52, respectively. Extra-articular and articular damage were not common at baseline (0.3 ± 0.7 and 1.1 ± 3.4 respectively) and did not decrease significantly during the period of the study. The presence of active joints 46/101 (45.5%) at baseline reduced the chance of the patient achieving remission off medication at the last visit by 84% (OR = 0.16; CI 95% from 0.03 to 0.91, p = 0.039).</p><p><strong>Conclusion: </strong>This study showed improvement in clinimetric outcome measurements and therapeutic responses in an inception cohort of JIA patients. The presence of active joints at baseline is related to not achieving remission at last visit. Long-term prospective and multicenter studies are needed to better assess the outcome of JIA and the differences among JIA subtypes.</p>","PeriodicalId":48634,"journal":{"name":"Advances in Rheumatology","volume":"65 1","pages":"26"},"PeriodicalIF":2.0,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144276271","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}