Journal of Rheumatology最新文献

{"title":"Prevalence, Predictors, and Prognosis of Serious Infections in Takayasu Arteritis: A Cohort Study.","authors":"Durga Prasanna Misra, Upendra Rathore, Swapnil Jagtap, Prabhaker Mishra, Darpan R Thakare, Kritika Singh, Tooba Qamar, Deeksha Singh, Juhi Dixit, Manas Ranjan Behera, Neeraj Jain, Manish Ora, Dharmendra Singh Bhadauria, Sanjay Gambhir, Vikas Agarwal, Sudeep Kumar","doi":"10.3899/jrheum.2023-1254","DOIUrl":"10.3899/jrheum.2023-1254","url":null,"abstract":"<p><strong>Objective: </strong>To describe the incidence, risk factors, and outcomes associated with serious infections in patients with Takayasu arteritis (TA).</p><p><strong>Methods: </strong>Serious infections, defined as infections resulting in hospitalization or death or unusual infections like tuberculosis, were identified from a cohort of patients with TA. Corticosteroid and disease-modifying antirheumatic drug (DMARD) use at the time of serious infection was noted. Demographic characteristics, clinical presentation, angiography, and disease activity at presentation, and the use of DMARDs during follow-up were compared between patients with TA with or without serious infections. Mortality in patients with TA who developed serious infections was compared to those who did not using hazard ratios (HR; with 95% CI).</p><p><strong>Results: </strong>Of 238 patients with TA, 38 (16%) had developed serious infections (50 episodes, multiple episodes in 8; 3 episodes resulted in death). Among the 38 initial episodes, 11/38 occurred in those not on corticosteroids and 14/38 in those not on DMARDs. Pneumonia (n = 19) was the most common infection, followed by tuberculosis (n = 12). Patients with TA who developed serious infections vs those who did not had higher disease activity at presentation (active disease 97.4% vs 69.5%, mean Indian Takayasu Arteritis Activity Score 2010 12.7 (SD 7.3) vs 10.2 (SD 7.0), mean Disease Extent Index in Takayasu Arteritis 11.2 (SD 6.1) vs 8.8 (SD 6.1) and were more frequently initiated on corticosteroids or DMARDs. HRs calculated using exponential parametric regression survival-time model revealed increased mortality rate in patients with TA who developed serious infections (HR 5.52, 95% CI 1.75-17.39).</p><p><strong>Conclusion: </strong>Serious infections, which occurred in the absence of immunosuppressive treatment in approximately one-fifth of patients with TA, were associated with increased mortality in patients with TA.</p>","PeriodicalId":50064,"journal":{"name":"Journal of Rheumatology","volume":" ","pages":"1187-1192"},"PeriodicalIF":3.6,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140337398","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":"Children With Type I Interferonopathy: Commonalities and Diversities in a Large Patient Cohort.","authors":"Fatih Haslak, Huseyin Kilic, Sezgin Sahin, Busra Hotaman, Nur Memnune Cebi, Mehmet Yildiz, Amra Adrovic, Aybuke Gunalp, Elif Kilic Konte, Esma Aslan, Umit Gul, Nergis Akay, Yilmaz Zindar, Fitnat Ulug, Serhat Guler, Ayca Kiykim, Sezin Aydemir, Kenan Barut, Sema Saltik, Haluk C Cokugras, Ozgur Kasapcopur","doi":"10.3899/jrheum.2024-0294","DOIUrl":"10.3899/jrheum.2024-0294","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to provide a comprehensive overview of the clinical features, laboratory and screening results, treatment options, and outcomes of patients with type I interferonopathy. Our secondary goal was to identify the predictors of long-term morbidity or mortality.</p><p><strong>Methods: </strong>We included children with genetically confirmed type I interferonopathies, with a follow-up duration of > 1 year. Data were obtained retrospectively from medical records.</p><p><strong>Results: </strong>Of the 40 eligible patients for the study, 52.5% were female, with a median age of disease onset of 1.5 years (range 0.1-13.2 yrs). They were diagnosed at an average age of 6.8 (SD 4.6) years. Aicardi-Goutières syndrome was the most common diagnosis (n = 15, 37.5%). The central nervous system was the most frequently affected system (n = 27, 67.5%). Janus kinase inhibitors were administered to 17 (42.5%) patients. Twenty-five patients (62.5%) developed at least 1 permanent morbidity or died during follow-up; thus, they were included in the poor outcome group. Although younger age at disease onset, intracranial calcification (ICC), and lack of chilblains and elevated acute-phase reactants were significant in univariate logistic regression analysis, only ICC on magnetic resonance imaging at admission (adjusted odds ratio 19.69, 95% CI 1.08-359.05, <i>P</i> = 0.04) was found to be a significant predictor of poor outcomes in multivariate logistic regression analysis.</p><p><strong>Conclusion: </strong>For the first time, we evaluated the predictors of poor outcomes in patients with type I interferonopathy with a broad spectrum of subtypes. Further, our study's unique patient characteristics can provide valuable insights into these extremely rare conditions.</p>","PeriodicalId":50064,"journal":{"name":"Journal of Rheumatology","volume":" ","pages":"1208-1217"},"PeriodicalIF":3.6,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141876542","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":"Lincoln Sign in Synovitis, Acne, Pustulosis, Hyperostosis, and Osteomyelitis Syndrome.","authors":"Yusuke Yamamoto, Hirofumi Shoda, Tetsuji Sawada","doi":"10.3899/jrheum.2024-0441","DOIUrl":"10.3899/jrheum.2024-0441","url":null,"abstract":"","PeriodicalId":50064,"journal":{"name":"Journal of Rheumatology","volume":" ","pages":"1259"},"PeriodicalIF":3.6,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141876548","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":"Evaluating and Refining Strategies for Rheumatoid Arthritis Prevention in First Nations Communities.","authors":"Sijia Liu, Ruwei Hu","doi":"10.3899/jrheum.2024-0726","DOIUrl":"10.3899/jrheum.2024-0726","url":null,"abstract":"","PeriodicalId":50064,"journal":{"name":"Journal of Rheumatology","volume":" ","pages":"1266-1267"},"PeriodicalIF":3.6,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142299770","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":"Wearable in Systemic Sclerosis: A Pilot Study of the Apollo Wearable Demonstrates Improvement in Fatigue, Raynaud Phenomenon and Quality-of-Life in Patients with Systemic Sclerosis.","authors":"Krista Hammaker, Haomin Hu, Maureen Laffoon, Leigh A Freno, Robert Lafyatis, Yongseok Park, Robyn T Domsic","doi":"10.3899/jrheum.2024-0551","DOIUrl":"https://doi.org/10.3899/jrheum.2024-0551","url":null,"abstract":"<p><strong>Objective: </strong>In systemic sclerosis (SSc) patients, fatigue is the highest ranked symptom affecting quality of life (QoL), followed by Raynaud phenomenon (RP). We report results from a pilot study (NCT04854850) of the Apollo wearable device in SSc patients.</p><p><strong>Methods: </strong>Twenty-five adult participants with SSc, moderate fatigue and RP were enrolled. Participants completed a 4-week intervention, during which they wore the Apollo device daily for a minimum of 15 minutes. The primary outcome was change on the PROMIS-Fatigue 13a (PROMIS-Fatigue) scale at 4 weeks. (ClinicalTrials.gov Identifier: NCT04854850) RESULTS: After 4 weeks of using the Apollo wearable, participants reported less fatigue on the PROMIS-Fatigue (p <0.001) scale. The average daily number of RP attacks declined (p < 0.01), as did the Raynaud condition score (p<0.001) after 4 weeks of use. Average device usage (2.87 hours per day) far exceeded the requested time, and no adverse events occurred. The PROMIS-29 sub scores assessment demonstrated quality of life (QoL) improvement in physical function (p <0.01), sleep disturbance (p = 0.001), and ability to participate in social roles and activities (p < 0.001). Significant improvements were also noted for depression (p < 0.01) and disability (p < 0.05) measures.</p><p><strong>Conclusion: </strong>Use of the Apollo wearable for four weeks was associated with improvement in fatigue and RP symptom in SSc patients, with improved QoL measures and lower depression scores. Future studies should further test the efficacy of the Apollo wearable in these domains and SSc patient QoL.</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":"142774199","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":"Candidate Biomarkers for Response to Treatment in Psoriatic Disease.","authors":"Rachel Offenheim, Omar F Cruz-Correa, Darshini Ganatra, Dafna D Gladman","doi":"10.3899/jrheum.2024-0396","DOIUrl":"10.3899/jrheum.2024-0396","url":null,"abstract":"<p><strong>Objective: </strong>To determine whether biologic therapy alters serum C-X-C motif chemokine ligand 10 (CXCL10), matrix metalloproteinase 3 (MMP3), S100 calcium-binding protein A8 (S100A8), acid phosphatase 5 (ACP5), and C-C motif chemokine ligand 2 (CCL2) levels in patients with psoriatic arthritis (PsA) and cutaneous psoriasis without arthritis (PsC), and whether baseline levels of these proteins predict response to treatment for PsA.</p><p><strong>Methods: </strong>We included (1) patients with PsA taking tumor necrosis factor inhibitors (TNFi), interleukin 17 inhibitors (IL-17i), methotrexate (MTX), and those who were untreated with bDMARDs or csDMARDs; (2) patients with PsC taking bDMARDs; and (3) matched patients with PsC who were not treated with bDMARDs or csDMARDs. Serum samples at baseline and at the 3- to 6-month follow-up visit were retrieved from the biobank. Protein levels were quantified using a Luminex multiplex assay. We compared follow-up vs baseline protein levels within groups and change in levels between groups. For the predictive potential of the biomarkers, we developed logistic regression classification models. Response to treatment was defined as (1) achieving low disease activity or remission (according to the Disease Activity Index for Psoriatic Arthritis); (2) ≥ 75% reduction in Psoriasis Area and Severity Index; and (3) ≥ 50% reduction in actively inflamed joint count.</p><p><strong>Results: </strong>In PsA, TNFi reduced serum levels of all 5 proteins, IL-17i increased ACP5 and CCL2, and MTX reduced MMP3. Changes in MMP3 and S100A8 levels were significantly different between untreated PsA and matched biologic-treated PsA (<i>P</i> < 0.05). There were no significant differences between treated or untreated patients with PsC. Baseline levels of CXCL10, MMP3, S100A8, and ACP5 had good predictive value (area under the curve > 0.80) for response to biologics in patients with PsA.</p><p><strong>Conclusion: </strong>Treatment with biologics and MTX affect serum CXCL10, MMP3, S100A8, ACP5, and CCL2 levels in patients with PsA. MMP3, S100A8, ACP5, and CXCL10 have potential use as serum biomarkers to predict response to treatment for PsA.</p>","PeriodicalId":50064,"journal":{"name":"Journal of Rheumatology","volume":" ","pages":"1176-1186"},"PeriodicalIF":3.6,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142114260","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":"Gut Microbiomics of Sustained Knee Pain in Patients With Knee Osteoarthritis.","authors":"Jingyi Huang, Ming Liu, Andrew Furey, Proton Rahman, Guangju Zhai","doi":"10.3899/jrheum.2024-0361","DOIUrl":"10.3899/jrheum.2024-0361","url":null,"abstract":"<p><strong>Objective: </strong>To examine whether gut microbes were associated with postsurgery-sustained knee pain in patients with knee osteoarthritis (OA) by a gut microbiomics approach.</p><p><strong>Methods: </strong>Patients receiving total knee replacement (TKR) because of primary knee OA were recruited. Sustained knee pain status at ≥ 1 year after TKR was defined by the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). Fasting plasma and fecal samples were collected. Metabolomic profiling was performed on fasting plasma. 16S rRNA sequencing was performed on fecal samples to determine microbial composition.</p><p><strong>Results: </strong>Twenty patients with TKR because of primary knee OA were included in the study, with 10 experiencing sustained postsurgery pain and 10 without such pain. Age, sex, and BMI (kg/m²) were matched. Linear discriminant analysis of microbiome data identified 13 bacterial taxa that were highly abundant in the pain group and 5 that were highly abundant in the nonpain group (<i>P</i> < 0.05 for all). Plasma metabolomic profiling measured 622 metabolites. The correlation analysis indicated the 18 taxa were significantly correlated with 231 metabolites (<i>P</i> < 0.05 for all). Sparse partial least squares discriminant analysis showed that 30/231 metabolites explained 29% of total variance and can be used to clearly separate patients with sustained knee pain from patients in the nonpain group. Pathway enrichment analysis showed that these significant metabolites were enriched in the arachidonic acid metabolic pathway, bile acid biosynthesis, and linoleic acid metabolism.</p><p><strong>Conclusion: </strong>Gut microbes may play a significant role in sustained knee pain in patients with knee OA after TKR, potentially through their activation of inflammatory pathways, lipid metabolism, and central sensitization.</p>","PeriodicalId":50064,"journal":{"name":"Journal of Rheumatology","volume":" ","pages":"1218-1225"},"PeriodicalIF":3.6,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142114263","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. Although the effects of sex or gender on time to diagnosis have 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, and/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 and/or 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 an accelerated failure time parametric survival model.</p><p><strong>Results: </strong>We included 404 patients (mean age 49 years; 38.6% 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 similarly increased by 21% (95% CI 0.92-1.57). Considering that there is 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":"2024-12-01","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}

{"title":"Acute Severe Inflammatory Lumbar Spinal Pain Induced by Calcium Pyrophosphate Crystals: Computed Tomography Is Everything.","authors":"Abuelmagd Abdalla, Colm Byrne, Eoin Kavanagh, Geraldine M McCarthy","doi":"10.3899/jrheum.2024-0555","DOIUrl":"10.3899/jrheum.2024-0555","url":null,"abstract":"","PeriodicalId":50064,"journal":{"name":"Journal of Rheumatology","volume":" ","pages":"1260-1261"},"PeriodicalIF":3.6,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141989385","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. El-Gabalawy and O'Neil reply.","authors":"Hani El-Gabalawy, Liam O'Neil","doi":"10.3899/jrheum.2024-0856","DOIUrl":"10.3899/jrheum.2024-0856","url":null,"abstract":"","PeriodicalId":50064,"journal":{"name":"Journal of Rheumatology","volume":" ","pages":"1267-1268"},"PeriodicalIF":3.6,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142299767","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}