Journal of Rheumatology最新文献

{"title":"Nintedanib in rheumatoid arthritis related interstitial lung disease: real-world safety profile and risk of side effects and discontinuation.","authors":"Marco Sebastiani, Gemma Lepri, Claudia Iannone, Emanuele Bozzalla Cassione, Giuliana Guggino, Andrea Lo Monaco, Roberta Foti, Marco Fornaro, Maria Sole Chimenti, Angelo Fassio, Simona Truglia, Francesca Cozzini, Antonio Carletto, Alessandro Giollo, Addolorata Corrado, Chiara Bazzani, Serena Guiducci, Ennio Favalli, Serena Bugatti, Florenzo Iannone, Roberto Caporali, Andreina Manfredi","doi":"10.3899/jrheum.2024-0976","DOIUrl":"https://doi.org/10.3899/jrheum.2024-0976","url":null,"abstract":"<p><strong>Objective: </strong>Some concerns remain about the safety of nintedanib in patients with interstitial lung disease (ILD) related to rheumatoid arthritis (RA-ILD), such as in presence of comorbidities or in combination with biologic, targeted synthetic and/or conventional synthetic disease modifying antirheumatic drugs (DMARDs). In this multicentre study, we retrospectively evaluated the safety of nintedanib in a real-world population of RA-ILD patients from Italian GISEA registry and the possible role of comorbidities and DMARDs on drug safety and withdrawal. Secondary aim was to investigate the causes of nintedanib discontinuation.</p><p><strong>Methods: </strong>Sixty-five patients treated with nintedanib according to the current therapeutic indications were enrolled in the study. Nintedanib was prescribed in combination with DMARDs and/or steroids in 62 patients (95.4%).</p><p><strong>Results: </strong>Twelve-month retention rate of nintedanib was 76.7% and the drug was effective on about 80% of patients with at least 6 months of follow-up. Adverse events were recorded in 36 subjects (55.3%), mainly gastroenteric. Thirty-one subjects required a reduction of the nintedanib dose; among them, a transient or permanent reduction of the daily dose of nintedanib allowed to continue the treatment in 22, while 15 (23.1%) withdrew the drug, in all cases for treatment-related adverse events. Comorbidities were significantly associated to side effects at multivariate analysis, while adverse events of nintedanib were the main cause of discontinuation.</p><p><strong>Conclusion: </strong>Combination therapy with DMARDs didn't reduce safety and effectiveness of nintedanib, while adverse events were the main cause of drug withdrawal or reduction of the dose of drug, mainly due to comorbidities.</p>","PeriodicalId":50064,"journal":{"name":"Journal of Rheumatology","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2024-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142840056","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":"Cancer incidence and outcome for patients with Rheumatoid Arthritis: a long-term population study in Western Australia.","authors":"Johannes Nossent, Helen I Keen, David B Preen, Charles A Inderjeeth","doi":"10.3899/jrheum.2024-0724","DOIUrl":"https://doi.org/10.3899/jrheum.2024-0724","url":null,"abstract":"<p><strong>Objective: </strong>To compare malignancy incidence and impact between hospitalized patients with Rheumatoid Arthritis (RA) and controls.</p><p><strong>Methods: </strong>Population-level observational study of patients with RA identified (ICD-9CM 714, ICD10-AM M05-M06) in the Hospital Morbidity Data Collection (HDMC) in Western Australia (WA) between 1985 and 2015 and non-exposed hospitalised controls matched on gender, age and year of index admission. HDMC data were linked to WA Cancer and WA Death Registry data and cancer incidence rates (CIR) per 1000 person years (PY) , incidence rate ratio ratios (IRR) with 95% CI and Kaplan Meier survival estimated.</p><p><strong>Results: </strong>Among 14.041 patients with RA (67.56 % female, age 65 years) and 33.785 controls (65.16% female, age 65 years), preexisting cancer in RA patients was less prevalent than in controls (7.6% vs 14.2%, p<0.01). In participants without prior cancer, the overall post index CIR was lower in RA (19.68 vs 24.77, IRR 0.79 , CI 0.76-0.83) and stable over three study decades. CIR was higher in RA patients for lung (1.17 , CI 1.04-1.34) and haematological cancer (1.21 , CI 1.03-1.43) but lower for most other cancer types. Median survival was lower for RA patients than controls (overall 3.3 vs 5.3 years, p<0.01) with increased mortality rates observed for most cancer subtypes.</p><p><strong>Conclusion: </strong>Overall CIR in RA patients was stably lower over time than in matched controls. CIR was only increased for lung and haematological cancer. Despite the overall lower CIR, post cancer mortality was higher for patients with RA in most cancer subtypes.</p>","PeriodicalId":50064,"journal":{"name":"Journal of Rheumatology","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2024-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142840026","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":"Drs. Weber and Liao reply.","authors":"Brittany N Weber, Katherine P Liao","doi":"10.3899/jrheum.2024-1186","DOIUrl":"https://doi.org/10.3899/jrheum.2024-1186","url":null,"abstract":"","PeriodicalId":50064,"journal":{"name":"Journal of Rheumatology","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2024-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142840039","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":"Drs. Lo and Driban reply.","authors":"Grace H Lo, Jeffrey B Driban","doi":"10.3899/jrheum.2024-1166","DOIUrl":"https://doi.org/10.3899/jrheum.2024-1166","url":null,"abstract":"","PeriodicalId":50064,"journal":{"name":"Journal of Rheumatology","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2024-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142840031","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 Single-Arm Observational Data for Causal Inference: The Case of GLA:D for Hip and Knee Osteoarthritis.","authors":"Daniel L Riddle, Ian A Harris, Robin Christensen","doi":"10.3899/jrheum.2024-0880","DOIUrl":"https://doi.org/10.3899/jrheum.2024-0880","url":null,"abstract":"","PeriodicalId":50064,"journal":{"name":"Journal of Rheumatology","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2024-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142840064","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. Roberts et al reply.","authors":"Janet H Roberts, Cheri Gunn, Jennifer E Mackinnon, Susan Parlee, Volodko Bakowsky, Trudy Taylor, Claire E H Barber, John G Hanly, Alexandra Legge","doi":"10.3899/jrheum.2024-1091","DOIUrl":"https://doi.org/10.3899/jrheum.2024-1091","url":null,"abstract":"","PeriodicalId":50064,"journal":{"name":"Journal of Rheumatology","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2024-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142840029","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 Stratification Approach Based on Salivary Gland Ultrasonography for Assessing Secretory Function in Sjögren Disease.","authors":"Wenke Huang, Shaoyun Hao, Zhiming Ouyang, Liqin Peng, Xinghuan Chen, Wenjing Yang, Wenjing Zhong, Junsheng Chen, Lie Dai, Yingqian Mo","doi":"10.3899/jrheum.2024-0711","DOIUrl":"10.3899/jrheum.2024-0711","url":null,"abstract":"<p><strong>Objective: </strong>Our aim was to develop an ultrasonographic scoring model for staging hypofunction of salivary glands (SGs) in patients with Sjögren disease (SjD).</p><p><strong>Methods: </strong>The assessment of SG secretory hypofunction was conducted by measuring whole salivary flows. B-mode ultrasonography was performed bilaterally on the parotid and submandibular glands to quantitatively evaluate the gland score and Outcome Measures in Rheumatology (OMERACT) score. The correlation between these scores and SG secretory function in patients with SjD was analyzed, leading to the development of an ultrasonographic scoring model for staging SG hypofunction.</p><p><strong>Results: </strong>A 1-center derivation cohort comprising 164 patients with SjD and a double-center validation cohort consisting of 107 patients with SjD were included. Both ultrasonographic scores demonstrated excellent discriminatory ability between patients with SjD with hypofunction and those with normal function (area under the curve > 0.8 for both; <i>P</i> < 0.001). A novel ultrasonographic scoring model revealed that low total OMERACT scores (< 5) indicated initial-stage SG hypofunction, whereas high scores (> 9) suggested end-stage hypofunction. Conversely, patients with moderate-level total OMERACT scores (5-9) required further stratification using total gland scores. The incidence of SG hypofunction among all 271 patients with SjD was found to be 18% in the initial stage, 58% in the progressive stage, and 100% in the end stage (<i>P</i> < 0.01). Further, the incidence of lacrimal gland involvement and hyperglobulinemia (IgG > 16 IU/mL) was significantly lower in the initial-stage patients compared to those at other stages (all <i>P</i> < 0.01).</p><p><strong>Conclusion: </strong>The novel ultrasonographic scoring model incorporates precise definitions for each stage of SG hypofunction, providing a robust and clinically significant approach to stratification of SG secretory hypofunction in SjD.</p>","PeriodicalId":50064,"journal":{"name":"Journal of Rheumatology","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2024-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142564924","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":"IgG4-Related Arterial Disease: An Unusual Case of Aortitis.","authors":"Martin Soubrier, Eric Hachulla","doi":"10.3899/jrheum.2024-0888","DOIUrl":"https://doi.org/10.3899/jrheum.2024-0888","url":null,"abstract":"","PeriodicalId":50064,"journal":{"name":"Journal of Rheumatology","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2024-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142840048","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":"Epidemiology of isolated Cutaneous Lupus Erythematosus in the multiethnic population of Reunion Island (France): a retrospective multicentric study.","authors":"Mathurin Maillet, Babacar Sakhir Tounkara, Damien Vagner, Kelly Bagny, Sébastien Duquenne, Céline Lartigau-Roussin, Anne Kolbe, Yves Lauret, Andry Randrianjohany, Serge Laureau, Nicole Denat, Aude Alquier, Nathalie Sultan-Bichat, Antoine Bertolotti, Loïc Raffray","doi":"10.3899/jrheum.2024-0661","DOIUrl":"10.3899/jrheum.2024-0661","url":null,"abstract":"<p><strong>Objective: </strong>Little data is available about the epidemiology of cutaneous lupus erythematosus (CLE) in South hemisphere and in multiethnic populations. We describe the prevalence and incidence of isolated CLE in the multiethnic population of Reunion Island (France), with its clinical characteristics.</p><p><strong>Methods: </strong>The study was performed in the public hospitals and private dermatology practices of Reunion Island. Cases were identified through informatics databases. Cases were defined as isolated CLE, meaning they did not fulfill the criteria for Systemic Lupus Erythematosus (SLE). Incident cases were collected from 2008 to 2021. Prevalence was calculated on January the 1st 2022. A capture-recapture analysis was performed to estimate both prevalence and incidence.</p><p><strong>Results: </strong>A total of 268 cases of CLE were identified and 218 were incident cases. The standardized prevalence of CLE was 43/100,000 persons and the average annual standardized incidence was 3.1/100,000 person-years. With a capture-recapture analysis, prevalence and annual incidence were estimated to be 99/100,000 persons [95%CI: 77.10-136.45] and 5.7/100,000 person-years [95%CI: 4.40-7.95] respectively. The mean age at diagnosis was 41.7 years old and female to male sex ratio of 4:1. Dark-skinned patients had a higher rate of discoid CLE and were more likely to receive immunosuppressants. Generalized discoid CLE, panniculitis and overlapping subtypes of CLE appeared as predictive markers of progression towards SLE.</p><p><strong>Conclusion: </strong>The prevalence and incidence of CLE in the multiethnic population of Reunion Island seem higher than in light-skinned populations. We highlighted new risk factors of evolution towards SLE that should be known by practitioners to adjust follow-up.</p>","PeriodicalId":50064,"journal":{"name":"Journal of Rheumatology","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2024-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142774195","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 Lived Experiences of Older Adults With Systemic Lupus Erythematosus: Patient Perspectives.","authors":"Sarah B Lieber, Sarah R Young, Yvonne Shea, Sarah P Gottesman, Robyn Lipschultz, Dongmei Sun, M Carrington Reid, Lisa A Mandl, Iris Navarro-Millán","doi":"10.3899/jrheum.2024-0478","DOIUrl":"10.3899/jrheum.2024-0478","url":null,"abstract":"<p><strong>Objective: </strong>Little is known about perceptions of aging among individuals with systemic lupus erythematosus (SLE). Gaining this knowledge could help to identify targets for future behavioral interventions aimed at successful aging with SLE. This qualitative study sought to elicit the lived experiences and essence of aging from older adults with SLE.</p><p><strong>Methods: </strong>We conducted semistructured interviews with adults aged ≥ 65 years with SLE seen at a single tertiary center. Qualitative data were analyzed thematically using a phenomenological approach. We collected data on sociodemographic characteristics and disease features prior to each qualitative interview.</p><p><strong>Results: </strong>Among 30 participants with a mean age of 71.3 years and mean SLE duration of 26.3 years (range 5-62 yrs), 4 overarching themes emerged to describe the essence of aging with SLE: SLE and comorbid conditions, cumulative effect of SLE symptoms, SLE disease trajectory, and self-perceptions of aging. Older adults with SLE shared variable aging experiences, including perspectives on multimorbidity and disease trajectory, as well as self-perceptions of aging.</p><p><strong>Conclusion: </strong>We identified both positive and negative self-perceptions of aging, often informed by participants' lived experiences of cumulative effects of SLE symptoms and SLE disease trajectory, and underscoring the diversity of their experiences. Understanding self-perceptions of aging in this population could inform the development of evidence-based strategies to empower older adults with SLE to harness their positivity and resilience, and thus improve health-related outcomes, including health-related quality of life.</p>","PeriodicalId":50064,"journal":{"name":"Journal of Rheumatology","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142564977","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}