Journal of Rheumatology最新文献

{"title":"Association of Past Smoking Status With Gout in Māori People in Aotearoa New Zealand.","authors":"Niamh C Fanning, John F Pearson, Nicola Dalbeth, Huti Watson, Tony R Merriman, Lisa K Stamp","doi":"10.3899/jrheum.2024-0239","DOIUrl":"https://doi.org/10.3899/jrheum.2024-0239","url":null,"abstract":"<p><strong>Objective: </strong>Evidence for an association of smoking with gout is conflicting. We assessed associations of current and past smoking with gout in an Aotearoa New Zealand (NZ) population.</p><p><strong>Methods: </strong>Multivariable logistic regression analysis was performed on cross-sectional data from participants of NZ Māori (from 2 studies: Genetics of Gout in Aotearoa [GGA] study of 293 participants with gout and 431 without; and Ngāti Porou Hauora [NPH] study of 111 participants with gout and 42 without), Pacific people (257 participants with gout and 357 without), and European (694 participants with gout and 688 without) ancestry.</p><p><strong>Results: </strong>Current smoking was not associated with gout in NZ Māori (GGA: adjusted odds ratio [aOR] 1.54, <i>P</i> = 0.13; NPH: aOR 3.02, <i>P</i> = 0.10), Pacific people (aOR 0.64, <i>P</i> = 0.21), or European (aOR 0.92, <i>P</i> = 0.80) cohorts. Ex-smoker status was associated with higher gout prevalence in Māori cohorts (GGA: aOR 1.71, <i>P</i> = 0.02; NPH: aOR 7.95, <i>P</i> < 0.001), but not in Pacific people (aOR 1.10, <i>P</i> = 0.69) or European (aOR 1.18, <i>P</i> = 0.22) cohorts. Associations were independent of age, sex, BMI, alcohol intake, kidney function, hypertension, diabetes, physical activity, sugary drink consumption, education, and employment. No association of smoker status with serum urate concentrations was observed in participants without gout.</p><p><strong>Conclusion: </strong>Ex-smoker status was associated with higher gout prevalence in people of NZ Māori ancestry. No association of current smoking with gout was observed across ancestral groups, raising uncertainties about the relevance of an association specific to ex-smokers.</p>","PeriodicalId":50064,"journal":{"name":"Journal of Rheumatology","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2024-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142640134","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":"Broadening the Landscape for Treatment Recommendations in the Management of Axial Spondyloarthritis.","authors":"Wilson Bautista-Molano","doi":"10.3899/jrheum.2024-1041","DOIUrl":"https://doi.org/10.3899/jrheum.2024-1041","url":null,"abstract":"","PeriodicalId":50064,"journal":{"name":"Journal of Rheumatology","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2024-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142640135","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":"The evaluation of myocarditis in patients with Still's disease; clinical findings from the multicentre international AIDA Network Still's Disease Registry.","authors":"Piero Ruscitti, Ilenia Di Cola, Antonio Vitale, Valeria Caggiano, Pierpaolo Palumbo, Ernesto Di Cesare, Jiram Torres-Ruiz, Guillermo Arturo Guaracha-Basañez, Eduardo Martín-Nares, Francesco Ciccia, Daniela Iacono, Flavia Riccio, Maria Cristina Maggio, Samar Tharwat, Soad Hashad, Donato Rigante, Augusta Ortolan, Henrique A Mayrink Giardini, Isabele Parente de Brito Antonelli, Rafael Alves Cordeiro, Roberto Giacomelli, Luca Navarini, Onorina Berardicurti, Alessandro Conforti, Daniela Opris-Belinski, Jurgen Sota, Carla Gaggiano, Giuseppe Lopalco, Fiorenzo Iannone, Francesco La Torre, Violetta Mastrorilli, Marcello Govoni, Francesca Ruffilli, Giacomo Emmi, Edoardo Biancalana, Petros P Sfikakis, Maria Tektonidou, José Hernández-Rodríguez, Verónica Gómez-Caverzaschi, Özgül Soysal Gündüz, Giovanni Conti, Serena Patroniti, Antonio Gidaro, Arianna Bartoli, Alma Nunzia Olivieri, M Francesca Gicchino, Antonio Luca Brucato, Lorenzo Dagna, Alessandro Tomelleri, Corrado Campochiaro, Amato De Paulis, Ilaria Mormile, Francesca Della Casa, Haner Direskeneli, Fatma Alibaz-Oner, Anastasios Karamanakos, Aikaterini Dimouli, Gaafar Ragab, Ayman Abdelmonem Mahmoud Ahmed, Abdurrahman Tufan, Hamit Kucuk, Riza Kardas, Ezgi D Batu, Seza Ozen, Ewa Wiesik-Szewczyk, Andrea Hinojosa-Azaola, Alberto Balistreri, Claudia Fabiani, Bruno Frediani, Luca Cantarini","doi":"10.3899/jrheum.2024-0683","DOIUrl":"https://doi.org/10.3899/jrheum.2024-0683","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the cardiac involvement in patients with Still's disease with a focus on myocarditis included in the multicenter AIDA (AutoInflammatory Disease Alliance) network Still's disease registry. To exploit the predictive factors for myocarditis in deriving a clinical risk patient profile for this severe manifestation.</p><p><strong>Methods: </strong>A multicenter observational study was built up assessing consecutive patients with Still's disease characterized by the cardiac involvement among those included in the AIDA Network Still's Disease Registry. The cardiac involvement was defined according to the presence of pericarditis, tamponade, myocarditis, and/or aseptic endocarditis.</p><p><strong>Results: </strong>In total, 73 patients with Still's disease and cardiac involvement were assessed (mean age 36.3±19.9 years, 42.5% male sex); out of them, 21.9% were children. The most common cardiac manifestation was the pericarditis in 90.4% of patients, 26.0% presented with myocarditis, and less frequently endocarditis (2.7%) and tamponade (1.4%). Comparing clinical features of patients with myocarditis than others, significantly increased frequencies of skin rash, and pleuritis as well as higher values of systemic score were recognised. Furthermore, an enhanced mortality rate was registered in patients with myocarditis. In regression models, the skin rash and the systemic score independently predicted the myocarditis.</p><p><strong>Conclusion: </strong>The characteristics of patients with Still's disease and cardiac involvement were assessed in the AIDA network. The most common feature was the pericarditis but also a more severe clinical picture was reported in patients with myocarditis. The latter was associated with increased mortality rate and with higher systemic score, identifying patients to be carefully managed.</p>","PeriodicalId":50064,"journal":{"name":"Journal of Rheumatology","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2024-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142640141","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":"Patient profiles in randomised controlled trials versus a real-world study, in psoriatic arthritis: scoping review and meta-analysis.","authors":"Gelsomina Alle, Clementina Lopez-Medina, Stefan Siebert, Frédéric Lavie, Wim Noel, Josef S Smolen, Laure Gossec","doi":"10.3899/jrheum.2024-0653","DOIUrl":"https://doi.org/10.3899/jrheum.2024-0653","url":null,"abstract":"<p><strong>Objective: </strong>Patients with psoriatic arthritis (PsA) in randomised controlled trials (RCTs) may not reflect patients in clinical practice. The objective was to perform a meta-analysis of PsA patients' characteristics in RCTs of biologic disease-modifying antirheumatic drugs (bDMARDs), and to compare them to patient profiles in a real-world study.</p><p><strong>Methods: </strong>Data sources: (a) Scoping literature review of phase III RCTs of bDMARDs in PsA published 2015-2020; (b) International observational study of PsA patients starting a bDMARD enrolled in 2015-2018 (PsABio: NCT02627768). Data collected at baseline included swollen and tender joint counts (SJC/TJC), enthesitis, skin involvement (body surface area -BSA-), C-reactive protein (CRP), physician global assessment (PhGA) and patient-reported outcomes (HAQ, pain). Univariate random-effects meta-analysis was conducted to calculate pooled means and proportions.</p><p><strong>Results: </strong>Overall, 5654 patients from 10 RCTs were compared to 930 PsABio patients. Demographic data were similar. SJC/TJC were higher in RCTs than in PsABio (pooled means, 11.8/21.5 vs 5.7/11.9 respectively); enthesitis was more frequent in RCTs (64.7% vs 48.2%); as were patients with a BSA≥3% (62.2% vs 54.0%). PhGA was higher in RCTs (59.7mm vs 54.1mm). In contrast, patient-reported outcomes were similar, while CRP was significantly higher in PsABio (1.1 vs 1.4mg/dl).</p><p><strong>Conclusion: </strong>PsA patients starting a bDMARD in RCTs had highly active disease and a high patient-reported disease burden. In contrast, PsABio real-world patients starting a bDMARD had lower joint counts, skin disease and PhGA, but presented with similar patient-reported disease burden. The extrapolation of RCT data in clinical practice should take these elements into account.</p>","PeriodicalId":50064,"journal":{"name":"Journal of Rheumatology","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2024-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142640138","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":"Tocilizumab for Giant Cell Arteritis: Clinical Outcomes Following Relapses and Tocilizumab Discontinuation Due to Adverse Events.","authors":"Fumika N Nagase, Sho Fukui, Naoho Takizawa, Toshihiro Yamaguchi, Nobuhiro Oda, Hajime Inokuchi, Takanori Ito, Mitsuru Watanabe, Masei Suda, Yochiro Haji, Yasuhiro Suyama, Ryo Rokutanda, Masahiro Minoda, Atsushi Nomura, Eishi Uechi, Hiromichi Tamaki","doi":"10.3899/jrheum.2024-0612","DOIUrl":"https://doi.org/10.3899/jrheum.2024-0612","url":null,"abstract":"<p><strong>Objective: </strong>Tocilizumab (TCZ) is effective for giant cell arteritis (GCA). However, little is known regarding treatment modification and clinical outcomes after unfavorable events, such as GCA relapses or TCZ discontinuation due to adverse events (AEs).</p><p><strong>Methods: </strong>This multicenter retrospective study included GCA patients who initiated TCZ from 2008 to 2021 at five Japanese hospitals. GCA relapses and TCZ-related AEs were monitored for two years after TCZ initiation. In patients with GCA relapses, subsequent clinical courses, including relapse symptoms and treatment modification, were followed for 90 days after the relapses. Similarly, patients who discontinued TCZ due to AEs were additionally followed until one year after the TCZ discontinuation to evaluate AEs, relapses, and treatment changes.</p><p><strong>Results: </strong>Of 62 eligible patients, 10 patients (16%) relapsed after initiating TCZ therapy. Most relapses (8/10) occurred after extending TCZ intervals or discontinuing TCZ. Combinations of adjusting TCZ intervals, glucocorticoid (GC), and/or methotrexate (MTX) could manage the relapses without serious complications. In the entire cohort, AEs occurred in 28 patients (45%), and 8 patients (13%) discontinued TCZ due to AEs. After AE-related TCZ discontinuation, six patients attempted to taper GC without other immunosuppressive treatments, and four subsequently relapsed. In contrast, two patients who used other immunosuppressants or biological therapy could decrease GC without relapses.</p><p><strong>Conclusion: </strong>Although GCA relapses can occur after initiating TCZ therapy, most relapses can be safely managed by adjusting TCZ, GC, and/or MTX. Adding immunosuppressants or biological treatments may potentially be related to preventing relapses when patients discontinue TCZ due to AEs.</p>","PeriodicalId":50064,"journal":{"name":"Journal of Rheumatology","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2024-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142640142","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":"Cardiovascular Health and Adverse Pregnancy Outcomes in Autoimmune Rheumatic Diseases.","authors":"Vijaya Prasanna Parimi, Vinod Ravindran","doi":"10.3899/jrheum.2024-0828","DOIUrl":"https://doi.org/10.3899/jrheum.2024-0828","url":null,"abstract":"","PeriodicalId":50064,"journal":{"name":"Journal of Rheumatology","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2024-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142640136","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":"Radiographic Axial Spondyloarthritis (Ankylosing Spondylitis) Commencing Late in Life.","authors":"Mark C Hwang, Karim Doughem, MinJae Lee, Lianne S Gensler, Mariko L Ishimori, Michael M Ward, Matthew A Brown, Amirali Tahanan, Michael H Weisman, Mohammad H Rahbar, John D Reveille","doi":"10.3899/jrheum.2024-0392","DOIUrl":"https://doi.org/10.3899/jrheum.2024-0392","url":null,"abstract":"","PeriodicalId":50064,"journal":{"name":"Journal of Rheumatology","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2024-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142640140","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":"Pursuing Gender Equity in Rheumatology: Thinking Beyond Gender Representation to Assess Gender Equality.","authors":"Laura Ross, Stephanie Bond, Jessica A Day","doi":"10.3899/jrheum.2024-0840","DOIUrl":"https://doi.org/10.3899/jrheum.2024-0840","url":null,"abstract":"","PeriodicalId":50064,"journal":{"name":"Journal of Rheumatology","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2024-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142640139","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":"Large Language Models in Rheumatologic Diagnosis: A Multimodal Performance Analysis.","authors":"Mahmud Omar, Reem Agbareia, Eyal Klang, Mohammad E Naffaa","doi":"10.3899/jrheum.2024-0975","DOIUrl":"https://doi.org/10.3899/jrheum.2024-0975","url":null,"abstract":"","PeriodicalId":50064,"journal":{"name":"Journal of Rheumatology","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2024-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142640137","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":"Disparities in time to diagnosis of Radiographic Axial Spondyloarthritis.","authors":"Renato Ferrandiz-Espadin, Gabriela Rabasa, Sarah Gasman, Brooke McGinley, Rachael Stovall, S Reza Jafarzadeh, Jean W Liew, Maureen Dubreuil","doi":"10.3899/jrheum.2024-0574","DOIUrl":"10.3899/jrheum.2024-0574","url":null,"abstract":"<p><strong>Objective: </strong>Radiographic axial spondyloarthritis (r-axSpA) has a 7-year average diagnostic delay. While the impact of sex or gender on time to diagnosis has been evaluated, the role of social determinants of health remains understudied. We assessed whether time from initial clinical documentation of r-axSpA symptoms to r-axSpA diagnosis (diagnostic delay) varies based on sex, race, ethnicity, or the presence of social needs.</p><p><strong>Methods: </strong>We studied patients with r-axSpA from a tertiary center from 2000 to 2022. The cohort was built with the Observational Health Data Sciences and Informatics (OHDSI) network. For the primary analysis, we assessed the time from back pain/spinal pain to r-axSpA diagnosis and secondarily, the time to r-axSpA from any other r-axSpA -related condition. To estimate differences in diagnostic delay, we employed a parametric survival model, accelerated failure time.</p><p><strong>Results: </strong>We included 404 patients (mean age 49, 37% female), with 25.5% identifying as Black, 31.1% as other or unknown race and 14.1% as Hispanic. Patients with a documented social need had a 21% increase in time from back pain to r-axSpA diagnosis (95% CI 0.93, 1.56). In patients with any r-axSpA related condition, time to diagnosis increased similarly by 21% (95% CI 0.92, 1.57). Considering an average time to diagnosis of 34 months, a social need increased time to diagnosis by 7 months.</p><p><strong>Conclusion: </strong>This study reveals a trend toward diagnostic delay in r-axSpA related to social need, sex, race, and ethnicity. Future studies should focus on referral strategies to enable prompt diagnosis and optimize care.</p>","PeriodicalId":50064,"journal":{"name":"Journal of Rheumatology","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2024-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142564934","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}