Journal of Rheumatology最新文献

{"title":"Understanding the Psoriasis Phenotype Associated With Psoriatic Arthritis Using the PURE-4 Questionnaire: Insights From Spanish Real-World Settings.","authors":"Rubén Queiro-Silva, Isabel Belinchón-Romero, Ana Venegas, Lara Gómez-Labrador","doi":"10.3899/jrheum.2024-1202","DOIUrl":"10.3899/jrheum.2024-1202","url":null,"abstract":"<p><strong>Objective: </strong>To describe the psoriatic phenotype associated with psoriatic arthritis (PsA).</p><p><strong>Methods: </strong>Based on the previously published 4-item Psoriatic Arthritis Uncluttered Screening Evaluation (PURE-4) validation study, this work aims to describe the sociodemographic and clinical characteristics, as well as the PURE-4 questionnaire outcomes, of patients with psoriasis (PsO) who completed the study. It compares those diagnosed with PsA during the study to those with PsO only. The variables compared were age, sex, time since diagnosis of PsO, PsO location, PsO treatment, Psoriasis Area and Severity Index (PASI), and Dermatology Life Quality Index (DLQI).</p><p><strong>Results: </strong>The study included 253 patients with PsO, from whom 46 developed PsA (28 [60.9%] male; mean age 48.9 [11.1] years) during the study. At baseline, patients who developed PsA had more involvement of PsO in the neck (13% vs 3.4%, <i>P</i> < 0.01), knees (71.4% vs 50%, <i>P</i> = 0.02), hands (40% vs 17.7%, <i>P</i> < 0.01), and feet (22.9% vs 9.8%, <i>P</i> = 0.03) as well as high-impact areas. PASI (8.7 [SD 5.6] vs 6.8 [SD 5.0], <i>P</i> = 0.03) and DLQI (9.9 [SD 6.9] vs 7.6 [SD 6.7], <i>P</i> = 0.09) values were higher among patients with PsA. Peripheral joint pain with swelling (item 4) was the most prevalent item of PURE-4 among patients with PsA, ranging from 67.6% (vs 47.1%; <i>P</i> = 0.03) in Assessment I to 91.7% (vs 45.4%; <i>P</i> < 0.01) in Assessment II.</p><p><strong>Conclusion: </strong>Greater PsO involvement in neck, knees, hands, and feet as well as in high-impact areas of patients who developed PsA provides additional information on the arthritogenic phenotype of PsO in our study population compared to locations generally linked to arthritis risk, such as the nails or scalp.</p>","PeriodicalId":50064,"journal":{"name":"Journal of Rheumatology","volume":" ","pages":"779-783"},"PeriodicalIF":3.4,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144200713","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tradition Versus Innovation: Conventional Radiography and Ultrasound in Calcium Pyrophosphate Deposition Identification. Instructions for Use.","authors":"Georgios Filippou, Silvia Sirotti, Luca Maria Sconfienza, Lene Terslev, Anna Zanetti, Davide Rozza, Esperanza Naredo, Ulrike Novo-Rivas, Pascal Zufferey, Carlos Pineda, Marwin Gutierrez, Antonella Adinolfi, Teodora Serban, Daryl MacCarter, Gael Mouterde, Annamaria Iagnocco, Anna Scanu, Ingrid Möller, Abhishek Abhishek, Nicola Dalbeth, Sara Tedeschi, Tristan Pascart, Maria-Antonietta D'Agostino, Fabio Becce","doi":"10.3899/jrheum.2024-1339","DOIUrl":"10.3899/jrheum.2024-1339","url":null,"abstract":"<p><strong>Objective: </strong>Conventional radiography (CR) and ultrasound (US) are used interchangeably for identification of calcium pyrophosphate deposition (CPPD). The aim of this study was to assess whether combining US and CR offers greater accuracy over either modality alone for the identification of CPPD.</p><p><strong>Methods: </strong>Consecutive patients scheduled for knee replacement surgery for osteoarthritis were enrolled. Before surgery, patients underwent CR and US of the knee. Menisci and hyaline cartilage were collected and analyzed using polarized light microscopy to confirm the presence of CPPD (gold standard). CR and US were assessed for absence/presence of CPPD by expert radiologists and sonographers. Diagnostic performance statistics were calculated. Poisson models with robust variance estimators were used to determine the likelihood of identifying CPPD.</p><p><strong>Results: </strong>Fifty-one patients (63% female, mean age 71.4 [SD 8] years) were enrolled. US demonstrated higher overall accuracy than CR for CPPD identification (0.78 vs 0.73). Sequential use of both modalities provided an advantage when only 1 knee site was positive in 1 of the 2 techniques; however, when 2 or 3 sites were positive, no additional advantage was observed. When US was negative, subsequent CR did not improve CPPD detection, but in cases of a negative CR, a positive US increased the likelihood of CPPD by 4.21 times, whereas a negative US substantially reduced the probability of CPPD, increasing the likelihood of its absence by 76%.</p><p><strong>Conclusion: </strong>US was more accurate than CR for identification of CPPD. Performing both exams can be an added value for CPPD identification only in a few specific cases.</p>","PeriodicalId":50064,"journal":{"name":"Journal of Rheumatology","volume":" ","pages":"817-822"},"PeriodicalIF":3.4,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144200711","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"<i>TREX1</i>-Associated Familial Chilblain Lupus With Cerebral Aneurysms Treated With Janus Kinase Inhibition.","authors":"Lindsay K Cho, Volodko Bakowsky, Alexandra Legge","doi":"10.3899/jrheum.2024-1231","DOIUrl":"10.3899/jrheum.2024-1231","url":null,"abstract":"","PeriodicalId":50064,"journal":{"name":"Journal of Rheumatology","volume":" ","pages":"840-841"},"PeriodicalIF":3.4,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143075677","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Use of Metagenomic Microbial Plasma Cell-Free DNA Next-Generation Sequencing Assay in Outpatient Rheumatology Practice.","authors":"Rachel A Jenkins, Matthew J Samec, Courtney A Arment, Kenneth J Warrington, John M Davis, Matthew J Koster","doi":"10.3899/jrheum.2024-1211","DOIUrl":"10.3899/jrheum.2024-1211","url":null,"abstract":"<p><strong>Objective: </strong>To assess the utility of a metagenomic microbial plasma cell-free DNA next-generation sequencing assay (Karius Test [KT]) in the evaluation of patients in an outpatient rheumatology practice.</p><p><strong>Methods: </strong>All patients with a KT ordered and obtained by a rheumatology provider in the outpatient setting from January 1, 2020, through December 31, 2022, were retrospectively identified. Demographic, clinical, laboratory, radiologic, histopathology, and microbial studies were abstracted. Indication for KT testing was categorized. KT results were defined based on positive result and clinical relevance regarding the symptoms under investigation at the time of the rheumatologic investigation. Review of cases 3 months after KT was undertaken to determine clinical outcome.</p><p><strong>Results: </strong>One hundred fifty patients with a KT were included (52.7% female, mean age 52 years). The reason for KT was evaluation of atypical presentation of rheumatic disease (80%), assessing flare vs infection in patients on immunosuppression (16.7%), and fever of unknown origin (3.3%). Twenty-four (16%) KTs were positive, 6 of which were considered clinically relevant and altered the final diagnosis and treatment. Of the 126 negative KTs, 5 (4%) were found to have a clinically relevant infection by conventional testing methodologies.</p><p><strong>Conclusion: </strong>In this large retrospective cohort study, the most frequent reason for KT utilization was an atypical presentation of rheumatic disease. One out of 4 positive KTs altered the final diagnosis and treatment. False negative rates were low. KT has utility in outpatient rheumatology assessments. Further delineation of which patients are best suited for KT testing remains to be defined.</p>","PeriodicalId":50064,"journal":{"name":"Journal of Rheumatology","volume":" ","pages":"823-828"},"PeriodicalIF":3.4,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144055128","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Novel Photon-Counting Computed Tomography for the Evaluation of Large-Vessel Giant Cell Arteritis.","authors":"Sehreen Mumtaz, Matthew J Koster, Kenneth J Warrington","doi":"10.3899/jrheum.2024-1156","DOIUrl":"10.3899/jrheum.2024-1156","url":null,"abstract":"","PeriodicalId":50064,"journal":{"name":"Journal of Rheumatology","volume":" ","pages":"842-843"},"PeriodicalIF":3.4,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143076043","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Dromedary Tale: A Tragi-Comedary on Science, Where Reliance Over Defiance Must Prevail.","authors":"Naomi Schlesinger, Elliot D Rosenstein, Richard S Panush","doi":"10.3899/jrheum.2025-0086","DOIUrl":"10.3899/jrheum.2025-0086","url":null,"abstract":"","PeriodicalId":50064,"journal":{"name":"Journal of Rheumatology","volume":" ","pages":"839"},"PeriodicalIF":3.4,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143425785","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Priority setting of physical activity barriers and facilitators among individuals with rheumatoid arthritis: a nominal group technique study.","authors":"Manuel Ester, Kiran Dhiman, Racheal Githumbi, Melissa Sipley, Kamala Adhikari Dahal, Claire Barber","doi":"10.3899/jrheum.2025-0191","DOIUrl":"https://doi.org/10.3899/jrheum.2025-0191","url":null,"abstract":"<p><strong>Objective: </strong>To (1) understand key physical activity (PA) determinants for individuals with rheumatoid arthritis (RA) and (2) map determinants using the behavior change wheel (BCW) to guide theory-driven intervention development.</p><p><strong>Methods: </strong>A patient-centered nominal group technique (NGT) approach was used, with recruitment via purposive sampling from past research participants. After self-reporting demographics and PA, participants attended NGT sessions consisting of idea generation, sharing, and refinement via discussion. Researchers combined PA determinant lists across sessions using content analysis. Using a survey, participants rated the importance of each determinant from 1-9. Theoretical mapping was completed with the most important 2/3 of determinants using the BCW.</p><p><strong>Results: </strong>Fourteen individuals participated across 3 sessions. Mean age was 58.1±13.4 years, 20.0±21.8 years with RA. Participants were 85.7% female, 78.6% white, and 85.7% had a university education. All participants were physically active, with a mean Leisure Score Index of 43.3±18.4 (<14 = insufficiently active, 14-24 = moderately active, >24 = active). The 22 PA barriers and 25 facilitators fell into 4 categories: personal, social, physical, and environmental. The top 3 barriers (importance: 7.1-7.4/9) were unpredictable fluctuations, fatigue, and lack of RA-specific PA knowledge. The top 3 facilitators (importance: 7.6-7.9/9) were motivation to maintain function, PA tailoring knowledge, and PA self-confidence. Theoretical mapping led to 3 capability-related, 6 opportunity-related, and 4 motivation-related determinants.</p><p><strong>Conclusion: </strong>Our study highlighted key PA determinants related to capability, opportunity, and motivation. Interventions may target skills (capability), social influences (opportunity), and beliefs about capabilities (motivation) to increase PA in RA.</p>","PeriodicalId":50064,"journal":{"name":"Journal of Rheumatology","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144719006","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk of Spondyloarthritis in Patients with Inflammatory Bowel Disease under Treatment with Biologics or Janus Kinase Inhibitors.","authors":"Young-Eun Kim, Soo Min Ahn, Ji Seon Oh, Yong-Gil Kim, Chang-Keun Lee, Bin Yoo, Sung Wook Hwang, Byong Duk Ye, Suk-Kyun Yang, Sang Hyoung Park, Seokchan Hong","doi":"10.3899/jrheum.2024-1279","DOIUrl":"https://doi.org/10.3899/jrheum.2024-1279","url":null,"abstract":"<p><strong>Objective: </strong>To detect spondyloarthritis (SpA) and evaluate risk factors in patients with inflammatory bowel disease (IBD) during biologic or Janus kinase inhibitor (JAKi) treatment.</p><p><strong>Methods: </strong>A retrospective cohort study of patients with IBD on biologics or JAKis, excluding prior SpA cases. We identified patients who developed musculoskeletal symptoms during IBD treatment. SpA was diagnosed after a clinical evaluation by a rheumatologist alongside imaging analysis of conventional radiographs and human leukocyte antigen B27 (HLA-B27) determination. Magnetic resonance imaging of the sacroiliac joints was performed only in cases where the CR was inconclusive.</p><p><strong>Results: </strong>Of 1,649 patients with IBD under biologic or JAKi treatment (Crohn's disease: 1,335; ulcerative colitis [UC]: 314), 96 (5.8%) were excluded due to a prior SpA diagnosis. Among the remaining 1,553 patients, 106 (6.8%) developed musculoskeletal symptoms during IBD treatment, and 30 (1.9%) were diagnosed with SpA (20: axial, 10: peripheral) during the follow-up (median: 5.2 [3.4-7.5] years). Risk factors for SpA in these patients included a partial Mayo score for UC at the time of onset of musculoskeletal symptoms (HR 1.57, P=0.03) and HLA-B27 positivity (HR 3.70, P=0.004). Alongside IBD treatment, 23/30 (77%) SpA patients used nonsteroidal anti-inflammatory drugs (NSAIDs); IBD disease activity did not worsen during treatment, regardless of NSAID use.</p><p><strong>Conclusion: </strong>During a median follow-up of 5.2 years, 6.8% of IBD patients undergoing biologic or JAKi treatment developed musculoskeletal symptoms, with a third subsequently diagnosed with SpA. HLA-B27 positivity and higher UC disease activity were associated with an increased risk of SpA.</p>","PeriodicalId":50064,"journal":{"name":"Journal of Rheumatology","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144719007","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cumulative Incidence of Cancer Screening for Breast, Cervical, Prostate, and Colorectal Cancer in Patients with Rheumatoid Arthritis.","authors":"Rebecca T Brooks, Cassondra A Hulshizer, Andrew C Hanson, John M Davis, Vanessa L Kronzer, Elena Myasoedova, Cynthia S Crowson","doi":"10.3899/jrheum.2025-0190","DOIUrl":"10.3899/jrheum.2025-0190","url":null,"abstract":"<p><strong>Objective: </strong>To determine the incidence of breast, cervical, prostate, and colorectal cancer screening in patients with RA versus matched non-RA comparators.</p><p><strong>Methods: </strong>We performed a retrospective, matched cohort study of patients with and without RA living in an 8-county region of southern Minnesota on January 1, 2015. Through review of medical records, patients who fulfilled either the 1987 ACR or 2010 ACR/EULAR classification criteria for RA were identified. Patients with RA were matched 1:1 to non-RA comparators on age, sex, and county of residence. Cancer screening was determined from review of the U.S. Preventative Task Force recommendations. Cumulative incidence of cancer screening was estimated accounting for the competing risk of death, and Cox proportional hazard models adjusted for age, smoking and race assessed for the risk of delay.</p><p><strong>Results: </strong>The study included 1,614 patients with RA and 1,597 comparators without RA (mean age 63 years; 71% female). At 5-years of follow-up, 51.6% [95%CI:47.9-55.6%] of the RA cohort had cervical cancer screening compared to 58.2% [95%CI:54.5-62.2%] in the non-RA cohort. After adjusting for age, smoking, and race, RA was associated with decreased cervical cancer screening (aHR:0.83 [95%CI:0.72-0.96]). RA was not significantly associated with a decrease in breast (aHR:0.98 [95%CI:0.87-1.10]), prostate (aHR:0.99 [95%CI:0.74-1.34]), or colorectal (aHR:1.04 [95%CI:0.93-1.16]) cancer screening.</p><p><strong>Conclusion: </strong>Women with RA were more likely to experience delayed cervical cancer screening. Increased diligence by healthcare providers to ensure cervical cancer screening in RA patients is important to reduce the morbidity and mortality seen in patients with RA.</p>","PeriodicalId":50064,"journal":{"name":"Journal of Rheumatology","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12313206/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144719005","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Pediatric-Adult Provider Dyad Care Model Improves Transition From Pediatric to Adult Healthcare For Youth with Childhood-onset Systemic Lupus Erythematosus.","authors":"Tala El Tal, Amanda Steiman, Andrea Knight, Linda T Hiraki, Deborah M Levy, Alene Toulany, Earl D Silverman","doi":"10.3899/jrheum.2025-0046","DOIUrl":"https://doi.org/10.3899/jrheum.2025-0046","url":null,"abstract":"<p><strong>Background: </strong>Only 50% of pediatric rheumatology patients transition successfully to adult care. We developed a pediatric-adult provider dyad transition model for youth with childhood-onset systemic lupus erythematosus (cSLE). This model transitions patients from the SickKids Transition Clinic (STC) to the Young Adult SLE (YASLE) clinic at Mount Sinai Hospital (MSH) at age 18, where they receive combined pediatric-adult care for 4 years before transitioning to adult care.</p><p><strong>Objective: </strong>To evaluate the success of this transition model.</p><p><strong>Methods: </strong>A retrospective chart review was conducted for cSLE patients graduating from STC between August 2016 and September 2023. Transition success was assessed using three milestones: (1) initial follow-up at the YASLE clinic within one year, (2) subsequent follow-up with more than one YASLE visit, and (3) sustained follow-up at MSH. Data were reviewed as of September 2024.</p><p><strong>Results: </strong>Among 234 cSLE patients, 164 transitioned to the YASLE clinic. At STC, 20% had active disease (SLEDAI-2K >4), and 13% had SDI >1. The first milestone was achieved by 98.2%, with 96.2% attending their first YASLE visit within one year (median time: 3.5 months). The second milestone was met by 97.5% attending more than one visit. By the study end, 94.2% of patients maintained care at MSH with a median follow-up of 5.1 years [IQR 2.7-7.1], including 45.3% who graduated from YASLE.</p><p><strong>Conclusion: </strong>This transition model, incorporating 4 years of combined pediatric-adult care, demonstrated successful transition for youth with cSLE, with over 90% achieving key milestones of initial and sustained follow-up in adult care.</p>","PeriodicalId":50064,"journal":{"name":"Journal of Rheumatology","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144719003","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}