Journal of Rheumatology最新文献

{"title":"Degenerative Disc Disease in Young Adults With Psoriatic Arthritis.","authors":"Fadi Kharouf, Shangyi Gao, Daniel Pereira, Richard J Cook, Vinod Chandran, Dafna D Gladman","doi":"10.3899/jrheum.2024-1148","DOIUrl":"10.3899/jrheum.2024-1148","url":null,"abstract":"<p><strong>Objective: </strong>We aimed to explore the prevalence of degenerative disc disease (DDD) in patients with psoriatic arthritis (PsA) aged < 50 years and to describe the factors associated with its development. We also examined the association between radiographic axial imaging findings and inflammatory back pain (IBP) and mechanical back pain.</p><p><strong>Methods: </strong>We included patients with PsA aged < 50 years who were followed at our prospective observational cohort. We defined DDD as intervertebral disc space narrowing, spur formation, facet joint arthrosis, and spondylolisthesis on anteroposterior and lateral plain radiographs of the cervical and thoracolumbar spine. To identify factors associated with the development of DDD, we used multivariate Cox regression analysis. We used generalized estimating equations (GEEs) to test the association between imaging findings (isolated DDD, isolated axial disease, and both) and the type of back pain.</p><p><strong>Results: </strong>Of 814 patients included in the study, 316 (38.8%) were observed to have DDD on plain radiographs of the spine. Factors associated with the development of DDD included older age (hazard ratio [HR] 1.08, <i>P</i> < 0.01), male sex (HR 1.52, <i>P</i> = 0.03), diabetes mellitus (HR 2.35, <i>P</i> = 0.045), and IBP (HR 2.03, <i>P</i> < 0.01). Being employed (vs unemployed), higher BMI, calcaneal spurs, and targeted disease-modifying antirheumatic drug use showed a trending association with DDD. In the GEE analysis, none of the abnormal imaging findings were significantly associated with back pain or IBP.</p><p><strong>Conclusion: </strong>DDD is common in young patients with PsA, and its development may be associated with demographic features, comorbidities, and disease-related factors. IBP does not reliably distinguish between axial PsA and DDD.</p>","PeriodicalId":50064,"journal":{"name":"Journal of Rheumatology","volume":" ","pages":"583-589"},"PeriodicalIF":3.6,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143425988","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":"Improving Systemic Sclerosis Quality of Care.","authors":"Aos Aboabat, Samar Aboulenain, Hila Jazayeri, Zareen Ahmad, Medha Soowamber, Dalage Morris, Sindhu R Johnson","doi":"10.3899/jrheum.2024-0752","DOIUrl":"10.3899/jrheum.2024-0752","url":null,"abstract":"<p><strong>Objective: </strong>Systemic sclerosis (SSc) is a multisystemic autoimmune disease with high morbidity and healthcare costs. Inconsistent quality of care delivery, including inadequate screening and monitoring, necessitates improvement. This study aimed to enhance the uptake of validated quality indicators (QIs) for SSc.</p><p><strong>Methods: </strong>An interrupted time series study was conducted at 4 scleroderma clinics across 2 hospitals using the Model for Improvement methodology, employing Plan-Do-Study-Act (PDSA) cycles. A retrospective chart review assessed baseline frequencies of selected QIs. The primary aim was to increase rates of 7 baseline and 5 follow-up QIs to 80%. Root-cause analysis identified barriers to QI uptake, leading to interventions including provider education, equipment procurement, and care standardization with reminder systems. Real-time data tracking was facilitated through run charts.</p><p><strong>Results: </strong>The average completion rate for baseline QIs increased from 48% to 83% over 8 months, with sustained improvements post-PDSA cycle 3. Monitoring and treatment QI completion improved from 40% to 77%. Process measures saw increases in completion rates: baseline spirometry and diffusing lung capacity for carbon monoxide rates improved from 63.5% to 92%, documented counseling to perform weekly blood pressure self-measurement increased from 19% to 86.6%, referrals to hand range-of-motion exercise programs rose from 54% to 92%, baseline creatine kinase measurement rates increased from 52% to 88%, and oxygen saturation documentation rose from 31% to 65%. Stakeholders reported high satisfaction (median rating of 4), with minimal additional time per patient (median 2.5 minutes).</p><p><strong>Conclusion: </strong>This QI study significantly improved SSc care through low-cost, applicable interventions, setting a precedent for future work on long-term sustainability and broader application in chronic disease management.</p>","PeriodicalId":50064,"journal":{"name":"Journal of Rheumatology","volume":" ","pages":"598-603"},"PeriodicalIF":3.6,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143426192","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":"Dr. Yoshida et al reply.","authors":"Yusuke Yoshida, Hiroki Kobayashi, Takashi Kida, Nobuyuki Yajima, Toshiko Ito-Ihara, Takashi Kawaguchi, Yutaka Kawahito, Shintaro Hirata","doi":"10.3899/jrheum.2025-0142","DOIUrl":"10.3899/jrheum.2025-0142","url":null,"abstract":"","PeriodicalId":50064,"journal":{"name":"Journal of Rheumatology","volume":" ","pages":"625-626"},"PeriodicalIF":3.6,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143765463","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":"Inflammation as a treatment target in hand osteoarthritis: A review of previous studies and future perspectives.","authors":"Ida Kristin Haugen, Marthe Gløersen, Elisabeth Mulrooney, Alexander Mathiessen","doi":"10.3899/jrheum.2025-0206","DOIUrl":"https://doi.org/10.3899/jrheum.2025-0206","url":null,"abstract":"<p><p>Historically, osteoarthritis (OA) was considered a non-inflammatory joint disease, distinct from systemic inflammatory diseases such as rheumatoid arthritis and psoriatic arthritis. However, observational studies on hand OA have shown that synovitis is common and is associated with both pain and disease progression. Hence, targeting synovitis in hand OA could provide clinical benefits in terms of symptom relief and disease modification. Conflicting results have been found in several previous studies that have tested the efficacy of various anti-inflammatory treatments, including oral and topical non-steroidal anti-inflammatory drugs (NSAIDs), oral and intra-articular corticosteroids, colchicine, synthetic and biological disease-modifying drugs (DMARDs). To date, prednisolone and methotrexate have shown the most promising results. Several ongoing studies, especially those investigating intraarticular anti-inflammatory therapies, are expected to provide valuable insights for clinical practice.</p>","PeriodicalId":50064,"journal":{"name":"Journal of Rheumatology","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144200709","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":"Role of CD19 Chimeric Antigen Receptor T Cell Therapy in Idiopathic Inflammatory Myopathies.","authors":"Anushka Aggarwal, Maha Almackenzie, Rohit Aggarwal","doi":"10.3899/jrheum.2024-1115","DOIUrl":"10.3899/jrheum.2024-1115","url":null,"abstract":"<p><p>Idiopathic inflammatory myopathies (IIMs) comprise a spectrum of autoinflammatory disease characterized primarily by muscle inflammation, with secondary involvement of diverse organs including joints, skin, lungs, heart, and the gastrointestinal system. Managing these conditions poses considerable challenges, often inflicting profound distress on the afflicted individuals. Encouragingly, the deployment of chimeric antigen receptor (CAR) T cell therapy has demonstrated promising efficacy across various autoimmune diseases, extending hope for ameliorating the burden of IIM. This review provides an overview of the role of B cells in IIM pathogenesis, currently available B cell-depleting therapies, reasons for their lack of efficacy, and the application of CD19 CAR T cell therapy in the management of IIM, encompassing indications, efficacy, and tolerability profiles in these patient populations. Through this comprehensive review, we propose clinical trial design, target population, response criteria, and long-term follow-up measures for future clinical trials focusing on CD19 CAR T cell therapy in IIM. This overview aims to streamline research efforts and enhance the efficacy of therapeutic interventions in challenging cases.</p>","PeriodicalId":50064,"journal":{"name":"Journal of Rheumatology","volume":" ","pages":"532-542"},"PeriodicalIF":3.6,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143634790","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 Systematic Review of Clinical Trial Designs and Outcome Measures in Sjögren Disease Randomized Controlled Trials.","authors":"Maxime Beydon, Yann Nguyen, Rachael Gordon, Nathan Foulquier, Coralie Bouillot, Katherine M Hammitt, Simon J Bowman, Xavier Mariette, Divi Cornec, Sara S McCoy, Raphaèle Seror","doi":"10.3899/jrheum.2024-1012","DOIUrl":"10.3899/jrheum.2024-1012","url":null,"abstract":"<p><strong>Objective: </strong>To systematically review all existing Sjögren disease (SjD)-related instruments reported in clinical trials for SjD.</p><p><strong>Methods: </strong>We systematically searched Medline (PubMed) and EMBASE between January 2002 and March 2023 to identify all randomized controlled trials (RCTs) using both a manual approach and artificial intelligence software (Bibliography BOT). We extracted all the instruments used as primary or secondary outcomes and assessed whether the study succeeded in improving the outcome. We also classified the instruments according to the recently defined preliminary outcome domains.</p><p><strong>Results: </strong>Among 5420 references, 60 RCTs were included, focusing either on overall disease manifestations (53%) or on a single organ/symptom (eg, dry eyes [17%], xerostomia [15%], fatigue [12%], or pulmonary function [3%]). Primary outcomes included measures of oral or ocular dryness, patient-reported outcomes (PROs), systemic activity, and other outcomes. Common instruments used were European Alliance of Associations for Rheumatology (EULAR) Sjögren Syndrome Disease Activity Index (ESSDAI), EULAR Sjögren Syndrome Patient-Reported Index, Schirmer-I test for unstimulated salivary flow, and IgG levels. ESSDAI was a primary outcome in 11 studies, with 45% of studies reaching significance, whereas none of the 16 studies with ESSDAI as a secondary outcome reached significance. PROs were the primary outcome in 34 studies. Glandular function measurements varied, with unstimulated salivary flow as the most commonly measured outcome. Life impact was assessed more frequently as a secondary outcome. Only 2 studies focused on biological activity.</p><p><strong>Conclusion: </strong>Our review highlighted the heterogeneity of SjD RCTs in both the study designs and outcomes. The use of PROs and composite outcomes has increased in recent years, highlighting a shift from objective dryness measures to more holistic patient-centered outcomes.</p>","PeriodicalId":50064,"journal":{"name":"Journal of Rheumatology","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143764383","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":"Seasonal Variations and Their Influence on Antineutrophil Cytoplasmic Antibody-Associated Vasculitis Relapse.","authors":"Gang Wang, Zhichun Liu","doi":"10.3899/jrheum.2024-1325","DOIUrl":"10.3899/jrheum.2024-1325","url":null,"abstract":"","PeriodicalId":50064,"journal":{"name":"Journal of Rheumatology","volume":" ","pages":"624"},"PeriodicalIF":3.6,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143765473","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":"Long-term effectiveness and safety of denosumab for osteoporosis in patients with rheumatic diseases.","authors":"Karin Furukawa, Kaichi Kaneko, Mai Kawazoe, Kotaro Shikano, Takahiko Sugihara, Toshihiro Nanki","doi":"10.3899/jrheum.2024-1321","DOIUrl":"https://doi.org/10.3899/jrheum.2024-1321","url":null,"abstract":"<p><strong>Objective: </strong>The long-term effectiveness of denosumab, an anti-RANKL monoclonal antibody, for increasing bone mineral density (BMD) and reducing fracture risk in postmenopausal women with osteoporosis has been demonstrated. However, its long-term effectiveness and safety in patients with rheumatic diseases remain unclear. Therefore, the present study investigated the long-term effectiveness and safety of denosumab for osteoporosis in patients with rheumatic diseases.</p><p><strong>Methods: </strong>This retrospective study included patients who received denosumab between August 2013 and August 2022. We evaluated BMD at the lumbar spine for up to 7 years and at the femur for up to 3 years. The effects of glucocorticoid (GC) usage, age, and renal function on BMD in patients receiving denosumab were assessed. The retention rate and adverse events were also evaluated.</p><p><strong>Results: </strong>One hundred and sixty-five patients with rheumatic diseases were enrolled (median age 66.5 years, 92.1% female, and 68.5% on GC therapy). Lumbar spine BMD significantly increased over 7 years (p < 0.001), while femoral neck, trochanter, and total hip BMD significantly increased for up to 3 years (p < 0.001). Lumbar spine BMD significantly increased regardless of the GC dose, age, or renal dysfunction. The retention rate of denosumab at 7 years was 68.1%. The most common serious adverse event was infection. Two cases of osteonecrosis of the jaw and 10 new fractures were observed during treatment with denosumab.</p><p><strong>Conclusion: </strong>The present study suggests that the long-term use of denosumab is an effective and generally safe option for increasing BMD in patients with rheumatic diseases.</p>","PeriodicalId":50064,"journal":{"name":"Journal of Rheumatology","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144200710","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":"Development of the Australian Rheumatology Association Clinical Care Standard for the diagnosis and management of rheumatoid arthritis in adults.","authors":"Maria B Sukkar, Rosemary Ainley, Claire Barrett, Stephanie Bond, Linda A Bradbury, Andrew M Briggs, Angela Brown, Courtney Brown, Rachelle Buchbinder, Lisa Carroll, Jessica Cheers, Rebecca Grainger, Pauline Habib, Louise Hardy, Justin J Holland, Tony Hollins, Rebecca James, Donna Knapp, David Fl Liew, Lyn March, David Martens, Carol McCrum, Dennis R Neuen, Jonathan Ong, Susanna M Proudman, Debra Rowett, Tracey Rudd, Sabina Schot, Marline L Squance, Deborah E Turner, Samuel L Whittle, Shirani A Wright, Helen Keen, Catherine L Hill","doi":"10.3899/jrheum.2024-1034","DOIUrl":"https://doi.org/10.3899/jrheum.2024-1034","url":null,"abstract":"<p><strong>Objective: </strong>To develop a quality standard, termed a Clinical Care Standard, for the diagnosis and management of rheumatoid arthritis (RA).</p><p><strong>Methods: </strong>A Working Group with consumer representation co-created guiding principles and quality statements for RA care through a series of workshops. The process was informed by consumer recommendations, clinical practice guidelines, and international quality criteria. A national survey of healthcare professionals and consumers was conducted to establish consensus. For each quality statement, respondents were asked to indicate on a scale of 1 to 9 (i) if this is a priority area for improvement in RA care and (ii) their agreement with the content of the statement. For (i) and (ii), respectively, scores between 1 and 4 indicated it was not a priority and disagreement; 5 and 6 indicated it was important but not critical and moderate agreement; 7 and 9 indicated it was high priority and agreement. Criteria for inclusion were a mean score ≥ 7.00 for priority and a mean score ≥ 7.00 for content.</p><p><strong>Results: </strong>The working group formulated 13 quality statements and established 7 guiding principles for RA care. The survey was completed by 605 consumers and 308 healthcare professionals. The pre-defined criteria for inclusion were met by 12 of 13 quality statements.</p><p><strong>Conclusion: </strong>The Australian Rheumatology Association has developed the first Clinical Care Standard for RA in Australia. This Standard will serve as an important lever for healthcare professionals and services, consumer organisations and policy makers to improve the quality of care for adults with RA.</p>","PeriodicalId":50064,"journal":{"name":"Journal of Rheumatology","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144200707","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":"Understanding Psoriasis Phenotype Associated with Psoriatic Arthritis using 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":"https://doi.org/10.3899/jrheum.2024-1202","url":null,"abstract":"<p><strong>Objective: </strong>To describe the psoriatic phenotype associated with psoriatic arthritis (PsA) METHODS: Based on the previously published PURE 4 validation study, this work aims to describe the sociodemographic and clinical characteristics, as well as the PURE-4 questionnaire outcomes, of psoriasis patients who completed the study. It compares those diagnosed with PsA during the study to those with only psoriasis . The variables compared were age, gender, time since diagnosis of psoriasis, psoriasis location, psoriasis treatment, Psoriasis Area and Severity Index (PASI), and Dermatology Life Quality Index (DLQI).</p><p><strong>Results: </strong>The study included 253 psoriasis patients, from whom 46 developed PsA (28 [60.9%] male; mean age 48.9 [11.1]) during the study. At baseline, patients who developed PsA had more involvement of psoriasis in the neck (13.0% vs. 3.4%, p<0.01), knees (71.4% vs. 50.0%, p=0.02), hands (40.0% vs. 17.7%, p<0.01), and feet (22.9% vs. 9.8%, p=0.03) as well as high impact areas. PASI (8.7 [5.6] vs. 6.8 [5.0], p=0.03) and DLQI (9.9 [6.9] vs. 7.6 [6.7], p=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% in Assessment I to 91.7% in Assessment II (91.7% vs. 45.4%, p<0.01).</p><p><strong>Conclusion: </strong>Greater psoriasis involvement in neck, knees, hands, and feet as well as high impact areas of patients who developed PsA suggests additional information on arthritogenic phenotype of psoriasis in our study population compared to locations generally linked to arthritis risk (nail or scalp).</p>","PeriodicalId":50064,"journal":{"name":"Journal of Rheumatology","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-06-01","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}