Journal of Rheumatology最新文献

{"title":"Classic Magnetic Resonance Imaging Features Unmask Progressive Multifocal Leukoencephalopathy in Rituximab-Treated Neuropsychiatric Systemic Lupus Erythematosus.","authors":"Cheng-Hsun Lin, Yu-Pang Lin","doi":"10.3899/jrheum.2025-0410","DOIUrl":"https://doi.org/10.3899/jrheum.2025-0410","url":null,"abstract":"","PeriodicalId":50064,"journal":{"name":"Journal of Rheumatology","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144976805","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":"How Representative Are Data From Clinical Trials in Axial Spondyloarthritis for Women?","authors":"Irene E van der Horst-Bruinsma, Sander I van Leuven","doi":"10.3899/jrheum.2025-0871","DOIUrl":"https://doi.org/10.3899/jrheum.2025-0871","url":null,"abstract":"","PeriodicalId":50064,"journal":{"name":"Journal of Rheumatology","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144976910","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":"Health-related Quality of Life in DMARD-treated adults with Juvenile Idiopathic Arthritis Compared to Rheumatoid Arthritis and the General Population.","authors":"Imane Bardan, Till Uhlig, Joe Sexton, Tore Kristian Kvien, Gunnstein Bakland, Pawel Mielnik, Yi Hu, Øyvind Molberg, Anna-Birgitte Aga, Eirik Klami Kristianslund","doi":"10.3899/jrheum.2025-0384","DOIUrl":"https://doi.org/10.3899/jrheum.2025-0384","url":null,"abstract":"<p><strong>Objective: </strong>To explore health-related quality of life (HRQoL) measured by Short Form 36 (SF-36), SF-36 physical component score (PCS), SF-36 mental component score (MCS) and Short Form 6D (SF-6D) in adults with juvenile idiopathic arthritis (JIA) compared to rheumatoid arthritis (RA) and the general population.</p><p><strong>Methods: </strong>We used six-month follow-up data from the Norwegian disease-modifying antirheumatic drug study (NOR-DMARD), including adult JIA and RA patients starting or switching disease-modifying anti-rheumatic drug (DMARD) treatment. Age- and gender adjusted regression analyses were used to compare outcomes between JIA, RA and the general Norwegian population.</p><p><strong>Results: </strong>Register data was available for 232 JIA- and 2764 RA patients at six months follow-up. JIA patients had poorer physical, but similar mental health as RA (adjusted difference (95% CI): PCS -3.58 (-6.09 to -1.08); MCS 2.02 (-0.51 to 4.54)). Compared to the general population, PCS scores were lower in both JIA and RA (adjusted differences; JIA-general population: -15.70 (-18.21 to -13.19), RA-general population: -12.12 (-12.76 to -11.47), but MCS was similar across groups. Average SF-6D utility levels were comparable in JIA and RA, but lower than the general population. Similar proportions of JIA and RA experienced improvements exceeding minimal clinical important difference (MCID) in SF-36 scale scores, PCS, MCS and SF-6D after six months.</p><p><strong>Conclusion: </strong>Compared to RA and the general population, JIA had lower physical HRQoL six months after DMARD initiation. Mental health composite scores were similar between JIA, RA and the general population. Both disease groups showed similar levels of improvement with treatment.</p>","PeriodicalId":50064,"journal":{"name":"Journal of Rheumatology","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144976945","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 F L 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":"10.3899/jrheum.2024-1034","url":null,"abstract":"<p><strong>Objective: </strong>To develop a quality standard, termed a Clinical Care Standard (CCS), for the diagnosis and management of rheumatoid arthritis (RA).</p><p><strong>Methods: </strong>A Working Group with consumer representation cocreated 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 (HCPs) and consumers was conducted to establish consensus. For each quality statement, respondents were asked to indicate, on a scale of 1-9, (1) if it is a priority area for improvement in RA care, and (2) their agreement with the content of the statement. For (1) and (2), 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; and 7 to 9 indicated it was high priority and agreement. Criteria for inclusion were a mean score ≥ 7 for priority and a mean score ≥ 7 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 HCPs. The predefined criteria for inclusion were met by 12/13 quality statements.</p><p><strong>Conclusion: </strong>The Australian Rheumatology Association has developed the first CCS for RA in Australia. This standard will serve as an important lever for HCPs and services, consumer organizations, and policy makers to improve the quality of care for adults with RA.</p>","PeriodicalId":50064,"journal":{"name":"Journal of Rheumatology","volume":" ","pages":"883-892"},"PeriodicalIF":3.4,"publicationDate":"2025-09-01","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":"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":"10.3899/jrheum.2024-1321","url":null,"abstract":"<p><strong>Objective: </strong>The long-term effectiveness of denosumab, an antireceptor activator of nuclear factor-κB ligand monoclonal antibody, for increasing bone mineral density (BMD) and reducing fracture risk in postmenopausal women with osteoporosis (OP) has been demonstrated; however, the long-term effectiveness and safety in patients with rheumatic diseases (RDs) remain unclear. Therefore, the present study investigated the long-term effectiveness and safety of denosumab for OP in patients with RDs.</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 sixty-five patients with RDs were enrolled (median age 66.5 years, 92.1% female, 68.5% receiving GC therapy). Lumbar spine BMD significantly increased over 7 years (<i>P</i> < 0.001), whereas femoral neck, trochanter, and total hip BMD significantly increased for up to 3 years (<i>P</i> < 0.001). Lumbar spine BMD significantly increased regardless of 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 RDs.</p>","PeriodicalId":50064,"journal":{"name":"Journal of Rheumatology","volume":" ","pages":"927-933"},"PeriodicalIF":3.4,"publicationDate":"2025-09-01","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":"Identifying resolution of clinically suspect arthralgia: a step towards understanding spontaneous reversal of an at-risk stage of rheumatoid arthritis.","authors":"Sarah J H Khidir, Elise van Mulligen, Annette H M van der Helm-van Mil","doi":"10.3899/jrheum.2025-0052","DOIUrl":"https://doi.org/10.3899/jrheum.2025-0052","url":null,"abstract":"<p><strong>Objective: </strong>Symptoms in the at-risk stage of clinically suspect arthralgia (CSA) can progress to Rheumatoid Arthritis (RA) or disappear spontaneously. The area of reversal of an at-risk stage is yet unexplored. Therefore, we aimed to determine its definition by evaluating patient-reported and rheumatologist-reported measures, and examine characteristics at baseline and over time of at-risk individuals with reversal.</p><p><strong>Methods: </strong>845 consecutively included CSA-patients were followed for 2 years. Reversal was assessed as patient-reported resolution of pain (pain-score≤20 on numerical rating scale (NRS 0-100) and as resolution of CSA, as defined by the rheumatologist (clinical outcomes recorded in medical records were obtained). Clinical and functional characteristics and MRIdetected subclinical joint-inflammation were studied over time.</p><p><strong>Results: </strong>Among patients eligible for reversal, pain-resolution was achieved in 244/505 patients(48%) and rheumatologist-defined CSA-resolution in 357/505(71%). Patients with CSA-resolution but persistent pain, had pain from other causes than CSA/imminent-RA. Patients with pain-resolution without CSA-resolution, had remaining inflammatory symptoms (e.g. morning stiffness). Reversal of the at-risk stage was therefore best defined as rheumatologist-confirmed resolution of CSA. Patients achieving CSA-resolution had similar levels of subclinical joint-inflammation at presentation, but less pain, fatigue and morning stiffness than those without CSA-resolution. Over time, patients with CSA-resolution improved spontaneously in subclinical joint-inflammation (IRR=0.87/year, 95%CI=0.80-0.95,p=0.001) and functional disabilities (β=-0.07/year, 95%CI=-0.09 to -0.05,p<0.001).</p><p><strong>Conclusion: </strong>Clinically, reversal of at-risk stage is better defined by rheumatologist-confirmed resolution of CSA, rather than a single patient-reported measure as pain. CSA-resolution associated with improved subclinical joint-inflammation and functional disabilities. This identification is a step towards investigating mechanisms underlying reversal of RA-risk.</p>","PeriodicalId":50064,"journal":{"name":"Journal of Rheumatology","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144976848","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":"East Meets West: A Canadian Rheumatology Resident's Experience in Hong Kong.","authors":"Alan L Zhou, Shirley C W Chan","doi":"10.3899/jrheum.2025-0093","DOIUrl":"10.3899/jrheum.2025-0093","url":null,"abstract":"","PeriodicalId":50064,"journal":{"name":"Journal of Rheumatology","volume":" ","pages":"945-947"},"PeriodicalIF":3.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143558546","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":"Discovery and Clinical Validation of C1M and C4M as Soluble Biomarkers for Diagnosis, Prognosis, and Symptom Prediction in Psoriatic Disease and Other Inflammatory Arthropathies.","authors":"Maria-Angeliki Gkini, Wilson Liao, Kurt de Vlam, Vinod Chandran, Signe Holm Nielsen","doi":"10.3899/jrheum.2025-0671","DOIUrl":"https://doi.org/10.3899/jrheum.2025-0671","url":null,"abstract":"<p><p>Psoriatic disease (PsD) is a complex, heterogeneous disease with unmet medical needs in terms of its diagnosis, management, and prognosis. The identification of biomarkers could improve the implementation of precision medicine in PsD, but to date, none of these biomarkers have been clinically validated. Biomarkers can support clinical trials in several ways, including (1) diagnostics, (2) drug pharmacodynamics, (3) prognostics for patient selection and monitoring of drug efficacy, and (4) predictive models for clinical outcomes. Biomarkers can sometimes be used for both diagnosis and prognosis. Benefits of biomarkers use may include shorter duration of clinical trials, faster access to new treatments, and a personalized approach to disease management. Several potential biomarkers have recently demonstrated promise for use in PsD, including C1M, a serum biomarker reflecting collagen type I collagen degradation, and C4M, a type IV collagen metabolite, but clinical validation has not yet been completed. Here, and as presented at the Group for Research and Assessment of Psoriasis and Psoriatic Arthritis 2024 annual meeting, we summarize the status of biomarker discovery for PsD and their overlap with other musculoskeletal diseases such as rheumatoid arthritis and axial spondyloarthritis.</p>","PeriodicalId":50064,"journal":{"name":"Journal of Rheumatology","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144976882","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":"Incidence and Predictors of Secondary Failure to Biologic Therapy in Patients with Psoriatic Arthritis.","authors":"Fadi Kharouf, Ali AlHadri, Shangyi Gao, Daniel Pereira, Richard J Cook, Vinod Chandran, Dafna D Gladman","doi":"10.3899/jrheum.2025-0518","DOIUrl":"https://doi.org/10.3899/jrheum.2025-0518","url":null,"abstract":"<p><strong>Objective: </strong>Secondary failure to biologic DMARDs (bDMARDs) is challenging and contributes to the complexity of managing psoriatic arthritis (PsA). We aimed to define the frequency and incidence of this phenomenon in PsA and identify the risk factors for its occurrence.</p><p><strong>Methods: </strong>We retrieved data on PsA patients from our single-centre, specialized-care, prospective observational cohort who initiated and remained on bDMARDs for ≥1 year after clinic enrollment between 2000 and 2023. We defined response to therapy at the one-year visit (baseline) as achievement of ≥40% reduction in the swollen joint count (SJC) and either ≥50% reduction in PASI or PASI ≤2. We defined secondary failure as the inability to maintain response criteria or as the clinician's judgment of loss of effectiveness. To examine factors associated with secondary failure, we fitted Cox regression models.</p><p><strong>Results: </strong>Of 482 patients included in the study, 264 (54.8%) were responders at one year. Of these, 94 (35.6%) developed secondary failure at a median of 1.6 [IQR: 0.7, 3.8] years from response. In the multivariable model, higher SJC (HR 1.39, 95% CI 1.05-1.84) and PASI (HR 1.14, 95% CI 1.01-1.29) at baseline were associated with secondary failure. TNFi vs. other bDMARD use (HR 0.39, 95% CI 0.18-0.88), initiation as first-line bDMARD (HR 0.48, 95% CI 0.25-0.91), and treatment initiation during more recent calendar years (HR 0.34, 95% CI 0.12-0.98) were associated with less secondary failure.</p><p><strong>Conclusion: </strong>Secondary failure to bDMARDs is common in PsA and may be influenced by both disease- and therapy-related factors.</p>","PeriodicalId":50064,"journal":{"name":"Journal of Rheumatology","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144976885","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":"Managing Musculoskeletal Symptoms in Patients With Psoriasis: Who Should Be in the Driver's Seat?","authors":"Karen Briner, Pamela Diaz, Fabian Proft, Laura J Savage","doi":"10.3899/jrheum.2025-0237","DOIUrl":"https://doi.org/10.3899/jrheum.2025-0237","url":null,"abstract":"<p><p>The Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA) 2024 annual meeting included a lively debate regarding the optimal management of musculoskeletal (MSK) symptoms in patients with psoriasis (PsO) at risk of or with early psoriatic arthritis (PsA). Drs. Fabian Proft and Laura Savage presented comprehensive, evidence-based retrospective arguments from the perspectives of rheumatology and dermatology. Proft advocated for rheumatologists to lead PsA management by highlighting the specialized training that allows rheumatologists to identify inflammatory diseases and use advanced imaging techniques to differentiate PsA from mechanical MSK conditions. In contrast, Savage emphasized the pivotal role of dermatologists, who often serve as the first healthcare providers (HCPs) to encounter emergent PsA in their patients with PsO. Dermatologists are increasingly aware of the importance of early detection and timely intervention, as well as of the new data that support the concept of \"treating to intercept\" in patients at risk of transition from PsO to PsA. Both experts highlighted systemic barriers hindering collaborative care and underscored the necessity of patient-centered approaches that effectively address skin and joint manifestations. This article summarizes the insightful debate, reinforcing the importance of a multidisciplinary approach to optimize patient outcomes with PsA.</p>","PeriodicalId":50064,"journal":{"name":"Journal of Rheumatology","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144977038","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}