Journal of Rheumatology最新文献

{"title":"Unacceptable Work State in Rheumatoid Arthritis: Establishment of Thresholds for Presenteeism and Clinical Measurement Instruments.","authors":"Dafne Capelusnik, Sofia Ramiro, Elena Nikiphorou, Walter P Maksymowych, Marina Nighat Magrey, Helena Marzo-Ortega, Annelies Boonen","doi":"10.3899/jrheum.2024-0833","DOIUrl":"10.3899/jrheum.2024-0833","url":null,"abstract":"<p><strong>Objective: </strong>We aimed to identify threshold values of presenteeism measurement instruments that reflect unacceptable work state in employed patients with rheumatoid arthritis (RA) and whether those thresholds can predict future adverse work outcomes (AWOs). Additionally, we assessed the performance of presenteeism thresholds previously established in axial spondyloarthritis (axSpA) among patients with RA for the same instruments.</p><p><strong>Methods: </strong>Data from the multinational Patient-Reported Outcomes in Employment Study in Rheumatoid Arthritis (RA-PROSE) study were used. Thresholds to determine when patients consider themselves in an \"unacceptable work state\" were calculated at baseline for 4 instruments assessing presenteeism and for the patient global assessment of RA-related pain. Different approaches derived from the receiver-operating characteristic methodology were used. Accuracy of thresholds to predict AWO throughout 12 months was assessed and previously developed presenteeism thresholds for axSpA were also tested.</p><p><strong>Results: </strong>A total of 104 employed patients were included: 15% of the patients considered themselves in an unacceptable work state, of which 7 (7%) had at least 1 AWO over 12 months. Thresholds of all instruments specifically developed in RA showed good performance vs the external criterion (area under the curve [AUC] > 0.75), except for the Quantity and Quality (QQ) method (AUC 0.62). The available axSpA thresholds were more accurate by reducing overestimation. The final optimal thresholds were Work Productivity and Activity Impairment Questionnaire (WPAI)-presenteeism ≥ 40, QQ method < 97, Workplace Activity Limitations Scale ≥ 0.75, 25-item Work Limitations Questionnaire with modified physical demands scale ≥ 29, and pain intensity ≥ 4. For AWO over 12 months, pain and WPAI performed best in predicting AWO.</p><p><strong>Conclusion: </strong>The final thresholds to assess unacceptable presenteeism for axSpA were also chosen as most accurate for use in RA. In addition, accurate thresholds of pain reflecting unacceptable work state are available.</p>","PeriodicalId":50064,"journal":{"name":"Journal of Rheumatology","volume":" ","pages":"436-443"},"PeriodicalIF":3.6,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143076131","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":"Isolated Urticarial Rash in the Clinical Spectrum of HA20.","authors":"Maria Vincenza Mastrolia, Lucy Duan, Alexandra Pennal, Ronald M Laxer, Dilan Dissanayake","doi":"10.3899/jrheum.2024-1134","DOIUrl":"10.3899/jrheum.2024-1134","url":null,"abstract":"","PeriodicalId":50064,"journal":{"name":"Journal of Rheumatology","volume":" ","pages":"520-522"},"PeriodicalIF":3.6,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143426206","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":"Effect of Bimekizumab on Patient-Reported Outcomes and Work Productivity in Patients With Psoriatic Arthritis: 1-Year Results From 2 Phase III Studies.","authors":"Dafna D Gladman, Philip J Mease, Laure Gossec, M Elaine Husni, Alice B Gottlieb, Barbara Ink, Rajan Bajracharya, Jason Coarse, Nikos Lyris, Jérémy Lambert, William Tillett","doi":"10.3899/jrheum.2024-0923","DOIUrl":"10.3899/jrheum.2024-0923","url":null,"abstract":"<p><strong>Objective: </strong>To assess the longer-term effect of bimekizumab up to 1 year on patient-reported symptoms, health-related quality of life (HRQOL), and work productivity in patients with active PsA who were biologic disease-modifying antirheumatic drug (bDMARD)-naïve or had inadequate response/intolerance to tumor necrosis factor inhibitors (TNFi-IR).</p><p><strong>Methods: </strong>BE OPTIMAL (ClinicalTrials.gov: NCT03895203; bDMARD-naïve patients) and BE COMPLETE (NCT03896581; TNFi-IR patients) are phase III studies of subcutaneous bimekizumab 160 mg every 4 weeks. Both studies were double-blind and placebo-controlled to 16 weeks. Patients who completed week 52 of BE OPTIMAL or week 16 of BE COMPLETE were eligible for the open-label extension, BE VITAL (NCT04009499), during which all patients received bimekizumab. Patient-reported pain, fatigue, physical function, HRQOL, and work productivity are reported to week 52 or 40 (52/40) using individual study data for bimekizumab and placebo treatment arms.</p><p><strong>Results: </strong>Bimekizumab-randomized patients demonstrated sustained mean improvements from baseline in patient-reported outcomes to week 52/40, including pain (visual analog scale [0-100 mm]: bDMARD-naïve -30.5; TNFi-IR -31.8), fatigue (Functional Assessment of Chronic Illness Therapy-Fatigue scale [0-52]: bDMARD-naïve 5.3; TNFi-IR 6.0), physical function (Health Assessment Questionnaire-Disability Index [0-3]: bDMARD-naïve -0.34; TNFi-IR -0.39), and HRQOL (36-item Short Form Health Survey, physical component summary: bDMARD-naïve 8.1; TNFi-IR 8.4); placebo patients who switched to bimekizumab at week 16 demonstrated comparable levels of improvement from week 16 to week 52/40. Improvements in overall work impairment were sustained among bimekizumab-randomized patients to week 52. Similar trends were observed for absenteeism, presenteeism, and activity impairment.</p><p><strong>Conclusion: </strong>Bimekizumab treatment resulted in sustained improvements in patient-reported symptoms, HRQOL, and work productivity up to 1 year in bDMARD-naïve and TNFi-IR patients with active PsA.</p>","PeriodicalId":50064,"journal":{"name":"Journal of Rheumatology","volume":" ","pages":"466-478"},"PeriodicalIF":3.6,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143076086","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":"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":"10.3899/jrheum.2024-0976","url":null,"abstract":"<p><strong>Objective: </strong>Some concerns remain about the safety of nintedanib in patients with rheumatoid arthritis-related interstitial lung disease (RA-ILD), such as in the presence of comorbidities or in combination with biologic, targeted synthetic, and/or conventional synthetic disease-modifying antirheumatic drugs (DMARDs). In this multicenter study, we retrospectively evaluated the safety of nintedanib in a real-world population of patients with RA-ILD from the Italian Group for the Study of Early Arthritis (GISEA) registry and the possible role of comorbidities and DMARDs on drug safety and withdrawal. Our secondary aim was to investigate the causes of nintedanib discontinuation.</p><p><strong>Methods: </strong>Sixty-five patients treated with nintedanib in accordance with 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>The 12-month retention rate of nintedanib was 76.7% and the drug was effective in about 80% of patients with ≥ 6 months of follow-up. Adverse events (AEs) were recorded in 36 subjects (55.3%), and these were 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 the continuation of the treatment in 22, whereas 15 (23.1%) withdrew from the drug. All reductions and discontinuations were owing to treatment-related AEs. Comorbidities were significantly associated with side effects in multivariate analysis, whereas AEs due to nintedanib were the main cause of discontinuation.</p><p><strong>Conclusion: </strong>Combination therapy with DMARDs did not reduce the safety and effectiveness of nintedanib, and AEs were the main cause of drug withdrawal or dose reduction, mainly owing to comorbidities.</p>","PeriodicalId":50064,"journal":{"name":"Journal of Rheumatology","volume":" ","pages":"420-425"},"PeriodicalIF":3.6,"publicationDate":"2025-05-01","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":"Risk of Heart Failure in Patients With Immune-Mediated Inflammatory Diseases: A Population-Based Study.","authors":"Sahil Koppikar, Bindee Kuriya, Jacob A Udell, Bing Yu, Anna Chu, Douglas S Lee, Jessica Widdifield, Lihi Eder","doi":"10.3899/jrheum.2024-0866","DOIUrl":"10.3899/jrheum.2024-0866","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the risk of heart failure (HF) in patients with immune-mediated inflammatory diseases (IMIDs) compared to the general population with and without diabetes mellitus (DM).</p><p><strong>Methods: </strong>A population-based cohort study was conducted in patients with rheumatoid arthritis (RA), radiographic axial spondyloarthritis (r-axSpA), psoriatic arthritis, and psoriasis (PsO) in Ontario from 2011 until 2019. The study outcome was first hospitalization for HF. Incidence rates of HF were calculated for each cohort. Hazard ratios (HRs) for HF were calculated using Cox proportional hazard models. The etiology of HF was descriptively classified into mutually exclusive groups based on comorbidities during HF hospitalization.</p><p><strong>Results: </strong>A total of 243,061 patients with IMID, 748,517 with DM, and 8,278,934 non-IMID, non-DM controls were analyzed. The crude incidence rate for HF in IMID was 2.70 per 1000 person-years, with the highest rate in RA and lowest in r-axSpA. The risk of being hospitalized for HF was higher in IMID compared with non-IMID comparators (HR 1.34, 95% CI 1.30-1.38). This risk was highest among patients with RA (HR 1.61, 95% CI 1.54-1.68) and lowest in PsO (HR 1.09, 95% CI 1.03-1.15). In comparison, the risk of HF hospitalization in patients with DM was higher (HR 2.19, 95% CI 2.16-2.21). The most common antecedent comorbidity associated with HF in all patients with IMID was ischemic heart disease. In patients with IMID without DM, atrial fibrillation had a similar effect as ischemic heart disease.</p><p><strong>Conclusion: </strong>The risk of HF hospitalization is increased in patients with IMID compared to the general population.</p>","PeriodicalId":50064,"journal":{"name":"Journal of Rheumatology","volume":" ","pages":"489-497"},"PeriodicalIF":3.6,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143558041","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":"Historical Perspective on Antinuclear Antibody Testing.","authors":"Gyorgy Abel, M Qasim Ansari, Melissa R Snyder, Anne E Tebo, Mark H Wener, Stanley J Naides","doi":"10.3899/jrheum.2023-1121","DOIUrl":"10.3899/jrheum.2023-1121","url":null,"abstract":"<p><p>Serum factors binding to cell nuclei were first described in the 1940s, and the antibodies responsible for the binding to self (autoantibodies) were discovered in the late 1950s. Routine standardized testing using a cell line (HEp-2) started in the 1980s and continues to evolve. In addition to the classic immunofluorescence assay (IFA), various immunochemical techniques have been developed for the measurement of antinuclear antibodies (ANAs). The complexity of ANA IFA pattern reading and the varying sensitivities, specificities, and overall clinical performance of the alternative methods have often generated controversies and sometimes even confusion among healthcare providers and laboratorians. A better understanding of the historical roots of ANA testing can aid in understanding these controversies and assist with selecting the best-performing methods. In this review, we present historic and contemporary ANA testing methods, highlighting the pros and cons of each. We also provide an overview of the current practice of ANA testing based on several recent large laboratory surveys. For optimal patient care, it is critical that clinicians and laboratorians using ANA testing understand the performance and limitations of the methods used by their institutions, as well as the meaning of the test results. Recently published surveys and standardization efforts initiated by several stakeholder scientific organizations will likely lead to new ANA diagnostic guidelines, to be followed by an improvement in testing practices, management, and outcomes for patients with autoimmune disorders.</p>","PeriodicalId":50064,"journal":{"name":"Journal of Rheumatology","volume":" ","pages":"412-419"},"PeriodicalIF":3.6,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143076096","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":"Indicators of Functional Disability by Receipt of Disability Benefits Among Individuals With Systemic Lupus Erythematosus.","authors":"Laura C Plantinga, Eric T Roberts, Courtney Hoge, Brad D Pearce, C Barrett Bowling","doi":"10.3899/jrheum.2024-0961","DOIUrl":"10.3899/jrheum.2024-0961","url":null,"abstract":"<p><strong>Objective: </strong>We estimated the prevalence of potential functional disability among those with systemic lupus erythematosus (SLE), by receipt of disability benefits.</p><p><strong>Methods: </strong>Participants (N = 443, mean age 46.2 years, 91.7% women, 82.6% Black) were recruited from a population-based SLE cohort. Indicators of potential disability included functioning impairments (Short Physical Performance Battery score ≤ 10; age-corrected National Institutes of Health Toolbox Cognition Battery composite score for fluid cognition < 77.5 [1.5 SD below the mean]); activity limitations (physical functioning <i>T</i>-scores < 35 [1.5 SD below the mean]); at least some difficulty performing ≥ 1 of the instrumental activities of daily living (IADLs) or basic activities of daily living (BADLs); and participation restrictions (any vs no reported effect of health on ability to work; restricted community mobility). We performed multivariable logistic regression models predicting potential disability indicators by self-reported receipt of disability benefits and then obtained adjusted prevalence estimates using postestimation margins.</p><p><strong>Results: </strong>Those who reported receiving disability benefits (45.6%) vs not (54.4%) were more likely to have impairments in functioning (physical performance [71.3% vs 50%, <i>P</i> < 0.001]; fluid cognition [35.4% vs 19.2%, <i>P</i> = 0.01]), limitations in activities (self-reported physical limitations [26.7% vs 7.5%, <i>P</i> < 0.001]; IADLs [73.1% vs 42.9%, <i>P</i> < 0.001]; BADLs [60.6% vs 30.8%, <i>P</i> < 0.001]), and restrictions in participation (work [77.8% vs 60.6%, <i>P</i> = 0.09]; community mobility [43.1% vs 22%, <i>P</i> < 0.001]). These associations were not changed with adjustment for personal and SLE factors.</p><p><strong>Conclusion: </strong>Receipt of disability benefits may be an incomplete marker of functioning. A substantial proportion of those not receiving benefits have impairments, limitations, and restrictions that should be addressed.</p>","PeriodicalId":50064,"journal":{"name":"Journal of Rheumatology","volume":" ","pages":"479-488"},"PeriodicalIF":3.6,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12045728/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143634785","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dr. Solomon et al reply.","authors":"Tia Solomon, Anne Powell, John Findeisen","doi":"10.3899/jrheum.2025-0166","DOIUrl":"10.3899/jrheum.2025-0166","url":null,"abstract":"","PeriodicalId":50064,"journal":{"name":"Journal of Rheumatology","volume":" ","pages":"526"},"PeriodicalIF":3.6,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143634770","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":"Rural-Dwelling Patients With Rheumatoid Arthritis and Risk of Myocardial Infarction Hospitalization: An Observational Study Using the National Inpatient Sample.","authors":"Jasvinder A Singh, Sumanth R Chandrupatla","doi":"10.3899/jrheum.2024-1036","DOIUrl":"10.3899/jrheum.2024-1036","url":null,"abstract":"<p><strong>Objective: </strong>To assess whether there is a rural-urban and income-related disparity in the incidence and outcomes of hospitalization for myocardial infarction (MI) in patients with rheumatoid arthritis (RA).</p><p><strong>Methods: </strong>We used the 2016-2019 US National Inpatient Sample (NIS) data and selected all patients with RA. Rural vs urban residential status was identified using NIS classifications. We categorized median household income based on patient ZIP code by quartile. We assessed the multivariable-adjusted odds ratios (aORs) to examine the association of rural residence with MI hospitalization.</p><p><strong>Results: </strong>The crude rate of MI hospitalization per 100,000 area-specific hospitalizations in people with RA was significantly higher for rural vs urban residents, 2441 vs 1878 (<i>P</i> < 0.001). In multivariable-adjusted models, compared to urban residents, rural-residing residents with RA were almost twice as likely to be hospitalized with MI (aOR 1.70; <i>P</i> < 0.001). Rural residence was not significantly associated with higher hospital charges or MI hospitalization costs (<i>P</i> > 0.05). Compared to the lowest quartile, the 2 highest income quartiles were significantly associated with lower odds of MI hospitalization in patients with RA; aORs were 0.87 (<i>P</i> < 0.001) and 0.92 (<i>P</i> = 0.01). Female sex, African American race, elective admission, Medicare payer, government hospital ownership, rural hospital location, and small hospital bed size were significantly associated with lower odds of MI hospitalization.</p><p><strong>Conclusion: </strong>Our study findings of rural-urban and socioeconomic status disparities for MI hospitalizations in patients with RA provide policymakers with data and information for action. Policy decisions based on these data can potentially reduce these disparities and improve outcomes for rural residents.</p>","PeriodicalId":50064,"journal":{"name":"Journal of Rheumatology","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143765471","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":"Mucosa-Associated Lymphoid Tissue Lymphoma as a Rare Mimicker of Relapsing Polychondritis.","authors":"Norihisa Tada, Nao Oguro, Nobuyuki Yajima","doi":"10.3899/jrheum.2024-0837","DOIUrl":"10.3899/jrheum.2024-0837","url":null,"abstract":"","PeriodicalId":50064,"journal":{"name":"Journal of Rheumatology","volume":" ","pages":"513-514"},"PeriodicalIF":3.6,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142564969","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}