Journal of Rheumatology最新文献

{"title":"Role of CD19 Chimeric Antigen Receptor T Cell Therapy in Idiopathic Inflammatory Myopathies.","authors":"Anushka Aggarwal, Maha Almackenzie, Rohit Aggarwal","doi":"10.3899/jrheum.2024-1115","DOIUrl":"https://doi.org/10.3899/jrheum.2024-1115","url":null,"abstract":"<p><p>Idiopathic inflammatory myopathies (IIMs) comprise a spectrum of autoinflammatory disease characterized primarily by muscle inflammation, with secondary involvement of diverse organs including joints, skin, lungs, heart, and the gastrointestinal system. Managing these conditions poses considerable challenges, often inflicting profound distress on the afflicted individuals. Encouragingly, the deployment of chimeric antigen receptor (CAR) T cell therapy has demonstrated promising efficacy across various autoimmune diseases, extending hope for ameliorating the burden of IIM. This review provides an overview of the role of B cells in IIM pathogenesis, currently available B cell-depleting therapies, reasons for their lack of efficacy, and the application of CD19 CAR T cell therapy in the management of IIM, encompassing indications, efficacy, and tolerability profiles in these patient populations. Through this comprehensive review, we propose clinical trial design, target population, response criteria, and long-term follow-up measures for future clinical trials focusing on CD19 CAR T cell therapy in IIM. This overview aims to streamline research efforts and enhance the efficacy of therapeutic interventions in challenging cases.</p>","PeriodicalId":50064,"journal":{"name":"Journal of Rheumatology","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143634790","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":"Trust in Health Information Sources Among Patients with Systemic Lupus Erythematosus in the Social Networking Era: The TRUMP²-SLE Study.","authors":"Takanori Ichikawa, Dai Kishida, Yasuhiro Shimojima, Nobuyuki Yajima, Nao Oguro, Ryusuke Yoshimi, Natsuki Sakurai, Chiharu Hidekawa, Ken-Ei Sada, Yoshia Miyawaki, Keigo Hayashi, Kenta Shidahara, Yuichi Ishikawa, Yoshiki Sekijima, Noriaki Kurita","doi":"10.3899/jrheum.2024-1088","DOIUrl":"https://doi.org/10.3899/jrheum.2024-1088","url":null,"abstract":"<p><strong>Objective: </strong>The growing use of social networking services (SNSs) has impacted how patients with systemic lupus erythematosus (SLE) access health information, potentially influencing their interaction with healthcare providers. This study aimed to examine patients' preferences, actual use, and trust in various health information sources, along with the factors influencing the trust among patients with SLE.</p><p><strong>Methods: </strong>A multicenter cross-sectional survey was conducted from June 2020 to August 2021, involving 510 Japanese adults with SLE. Participants reported their preferred and actual sources of health information, including SNSs, and their level of trust in these sources. Modified Poisson regression was used to analyze factors influencing trust, including internet usage and health literacy (HL) (functional, communicative, and critical).</p><p><strong>Results: </strong>Most respondents (98.2%) expressed trust in doctors, while trust in websites/blogs (52.0%) and SNSs (26.8%) was lower. Despite this, the internet was the most frequent initial source of health information (45.3%), encompassing medical institution websites, patient blogs, X (formerly Twitter), and Instagram. Longer internet usage periods were associated with a greater trust in websites/blogs and SNSs. Higher functional HL was correlated with an increased trust in doctors but decreased trust in websites/blogs and SNSs. Higher communicative HL was linked to a greater trust in doctors, websites, and blogs.</p><p><strong>Conclusion: </strong>Although many patients with SLE initially seek health information online, they prefer consulting rheumatologists. Internet usage duration and multidimensional HL influence trust in online sources. Healthcare providers should consider these factors when disseminating health information and engaging with patients.</p>","PeriodicalId":50064,"journal":{"name":"Journal of Rheumatology","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143634794","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":"ANA Multiplex Utilization Across a Large Federal Hospital System; An Investigation of Ordering Practices and Rheumatologic Outcomes.","authors":"Hamish Patel, David DeMasters, Jeanne Tofferi","doi":"10.3899/jrheum.2024-0641","DOIUrl":"https://doi.org/10.3899/jrheum.2024-0641","url":null,"abstract":"<p><strong>Objective: </strong>To understand the ordering patterns of the antinuclear antibody (ANA) multiplex testing in a single, large Department of Defense (DoD) tertiary healthcare system.</p><p><strong>Methods: </strong>Records of patients with an ANA multiplex assay ordered over a one-year period were evaluated in a large DoD hospital system. Duplicate tests and patients with a previously established Autoimmune Rheumatic Disease (ARD) prior to the year of study were excluded. The remaining 2,499 patients' charts were reviewed for clinical presentation, ordering specialty, ordering rationale, and whether subsequent rheumatology evaluations resulted in a new ARD diagnosis.</p><p><strong>Results: </strong>The ANA multiplex assay was ordered most often by primary care and medicine subspecialties for over 100 reasons. In the ANA multiplex assay negative group n = 37/2,228,1.66% individuals were diagnosed with a new ARD. In the ANA multiplex assay positive group n = 37/271, 13.7% individuals were diagnosed with a new ARD. Sjögren disease, systemic lupus erythematosus, and undifferentiated connective tissue disease were the most common newly diagnosed ARDs in the ANA multiplex assay positive group. Rheumatoid arthritis and seronegative spondyloarthritis were the most common new ARD diagnoses in the ANA multiplex assay negative group. In this study, 97% of the ordered ANA assays did not lead to an ARD diagnosis.</p><p><strong>Conclusion: </strong>This study demonstrates frequent utilization of the ANA multiplex assay in the evaluation of non-specific signs and symptoms with a low rate of ANA associated ARDs suggesting a need for implementation of strategies to improve understanding of appropriate clinical contexts that warrant ANA testing.</p>","PeriodicalId":50064,"journal":{"name":"Journal of Rheumatology","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143634695","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. Solomon et al reply.","authors":"Tia Solomon, Anne Powell, John Findeisen","doi":"10.3899/jrheum.2025-0166","DOIUrl":"https://doi.org/10.3899/jrheum.2025-0166","url":null,"abstract":"","PeriodicalId":50064,"journal":{"name":"Journal of Rheumatology","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-03-15","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":"Indicators of Functional Disability by Receipt of Disability Benefits among Individuals with SLE.","authors":"Laura C Plantinga, Eric T Roberts, Courtney Hoge, Brad D Pearce, C Barrett Bowling","doi":"10.3899/jrheum.2024-0961","DOIUrl":"https://doi.org/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=442; mean age, 46.2; 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 NIH Toolbox Fluid Cognition score <77.5 (1.5 SD below the mean)]; activity limitations [physical functioning T-scores <35 (1.5 SD below the mean); at least some difficulty performing at least one 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 post-estimation 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. 50.0%, <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 (43.2% vs. 22.0%, <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":""},"PeriodicalIF":3.6,"publicationDate":"2025-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","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":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Frameshift Mutation of <i>NLRP12</i> in a Patient With Chronic Recurrent Multifocal Osteomyelitis.","authors":"Koki Nakamura, Hiroyuki Nakamura, Masatoshi Kanda, Hiroki Takahashi","doi":"10.3899/jrheum.2024-0874","DOIUrl":"https://doi.org/10.3899/jrheum.2024-0874","url":null,"abstract":"","PeriodicalId":50064,"journal":{"name":"Journal of Rheumatology","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143634595","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":"Interferon Response Gene Score in Juvenile Dermatomyositis Correlates Strongly with Disease Activity.","authors":"Jayne MacMahon, Mohammed Massumi, Trang T Duong, Rose H Garrett, Audrey Bell-Peter, Kristi Whitney, Jo-Anne Marcuz, Y Ingrid Goh, Rae S M Yeung, Brian M Feldman","doi":"10.3899/jrheum.2024-0806","DOIUrl":"https://doi.org/10.3899/jrheum.2024-0806","url":null,"abstract":"<p><strong>Objective: </strong>Type 1 interferons (IFNs) have been identified as potentially important measures of disease activity in Juvenile Dermatomyositis (JDM). An Interferon Response Gene-score (IRG-score) has been defined using NanoString technology and appears to correlate with disease activity in cross-sectional samples of JDM patients. This study aimed to determine if there is evidence of a correlation between disease activity and IRG-score, in patients with JDM, both early in disease course and longitudinally.</p><p><strong>Methods: </strong>All patients attending JDM clinic in SickKids were approached to enrol in the Childhood Arthritis and Rheumatic Diseases (CARD) biobank. We identified patients with a diagnosis of JDM, enrolled between January 2015 and June 2022. NanoString IRG-score was calculated from extracted RNA. The Modified Disease Activity Score (mDAS) was calculated based on clinical data collected prospectively through SickKids JDM registry. Spearman's correlation was calculated using all enrolment visit samples, and linear mixed model regression was used for subjects with multiple samples.</p><p><strong>Results: </strong>43 subjects with 87 bio-samples were identified, including 18 treatment-naïve subjects. Spearman's correlation at the enrolment visit was strong (r_s = 0.78) with similar results seen in the treatment-naïve cohort (r_s = 0.63). This relationship persisted over time, with linear mixed modelling of the treatment-naïve cohort showing beta-coefficient for the IRG-Score of 0.004 with p-value <0.001.</p><p><strong>Conclusion: </strong>This study shows evidence of a significant correlation between IRG-score and disease activity, which is maintained over time. This highlights the potential for IRG-score to be an important biomarker in JDM.</p>","PeriodicalId":50064,"journal":{"name":"Journal of Rheumatology","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143634787","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":"Pediatric Rheumatology Care in the Canadian Context: A Qualitative Analysis of Care Providers.","authors":"Molly J Dushnicky, Eden S Har-Gil, Jennifer J Y Lee, Deborah M Levy","doi":"10.3899/jrheum.2024-0965","DOIUrl":"10.3899/jrheum.2024-0965","url":null,"abstract":"<p><strong>Objective: </strong>Previous work highlighted a national deficit in pediatric rheumatologists and allied health professionals (AHPs), with a geographic maldistribution in Canada. The aim of this current study was to further evaluate the clinical care structures and processes in place within Canadian pediatric rheumatology centers that promote or impede care delivery from the perspective of pediatric rheumatology healthcare providers.</p><p><strong>Methods: </strong>Data were collected through semistructured interviews with pediatric rheumatologists and Advanced Clinician Practitioners in Arthritis Care (ACPACs) across Canada. Analysis was performed by 2 investigators following the 4 stages of qualitative content analysis: decontextualization, recontextualization, categorization, and compilation. Data were analyzed through latent analysis due to the informal nature of interviews, and themes were identified iteratively.</p><p><strong>Results: </strong>Twelve individuals (9 pediatric rheumatologists, 3 AHPs) agreed to participate in the study. Interviewees practiced across Canada with a range of career experience. The following themes emerged: (1) geographic barriers negatively affect access to care; (2) ACPAC practitioners and community pediatric rheumatologists improve access to care; and (3) there is inconsistent access to physiotherapists, social workers, and occupational therapists who are knowledgeable about pediatric rheumatology care and disease.</p><p><strong>Conclusion: </strong>Although there was variation in pediatric rheumatology practice across Canada, there were common themes of supports and barriers to clinical care. The description of these themes can (1) help guide pediatric rheumatology practice by highlighting thriving practice patterns, and (2) concomitantly emphasize the deficits in resources and functioning, both of which can advise future advocacy work.</p>","PeriodicalId":50064,"journal":{"name":"Journal of Rheumatology","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143076117","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":"Predictors of Secukinumab Treatment Response and Continuation in Axial Spondyloarthritis: Results From the EuroSpA Research Collaboration Network.","authors":"Marion Pons, Stylianos Georgiadis, Merete Lund Hetland, Zohra Faizy Ahmadzay, Simon Rasmussen, Sara N Christiansen, Daniela Di Giuseppe, Johan K Wallman, Karel Pavelka, Jakub Závada, Catalin Codreanu, Bente Glintborg, Anne G Loft, Helena Santos, Maria H Lourenço, Michael J Nissen, Adrian Ciurea, Laura Kuusalo, Vappu Rantalaiho, Brigitte Michelsen, Pawel Mielnik, Katja P Pirkmajer, Ziga Rotar, Bjorn Gudbjornsson, Olafur Palsson, Irene van der Horst-Bruinsma, Marleen van de Sande, Isabel Castrejón, Gary J Macfarlane, Karin Laas, Mikkel Østergaard, Lykke M Ørnbjerg","doi":"10.3899/jrheum.2024-0920","DOIUrl":"10.3899/jrheum.2024-0920","url":null,"abstract":"<p><strong>Objective: </strong>In patients with axial spondyloarthritis (axSpA) initiating secukinumab (SEC), we aimed to identify baseline (treatment start) predictors of achieving low disease activity (LDA) after 6 months, as measured by the Axial Spondyloarthritis Disease Activity Score using C-reactive protein (ASDAS-CRP) and Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), as well as treatment continuation after 12 months.</p><p><strong>Methods: </strong>From 11 European registries, patients with axSpA who initiated SEC treatment in routine care, with available data on 6-month ASDAS-CRP and BASDAI assessments were included. Logistic regression analyses on multiply imputed baseline data were performed; potential baseline predictors included demographic, diagnosis, lifestyle, clinical, and patient-reported variables.</p><p><strong>Results: </strong>In a pooled cohort of 1174 patients with axSpA, 5 of 19 potential assessed variables were mutually predictive for achieving LDA by ASDAS-CRP and BASDAI: higher physician global assessment score, noncurrent smoking, lack of prior exposure to biologic/targeted synthetic disease-modifying antirheumatic drugs, and lower Health Assessment Questionnaire scores and BASDAI scores. Moreover, radiographic axSpA and CRP ≤ 10 mg/L were associated with achieving ASDAS-CRP LDA, and HLA-B27 positivity and history of psoriasis with achieving BASDAI LDA, whereas earlier time of secukinumab initiation (2015-2017) was associated with treatment continuation.</p><p><strong>Conclusion: </strong>In this European real-world study of patients with axSpA initiating SEC, predictors of achieving LDA by ASDAS-CRP and BASDAI at 6 months and remaining on treatment at 12 months included both clinical, patient-reported, and lifestyle factors, underscoring the complex mechanisms of real-world drug effectiveness.</p>","PeriodicalId":50064,"journal":{"name":"Journal of Rheumatology","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143076121","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":"Sex Differences in Rheumatoid Arthritis: New Insights From Clinical and Patient-Reported Outcome Perspectives.","authors":"Gonul Hazal Koc, Agnes E M Looijen, Irene E van der Horst-Bruinsma, Pascal H P de Jong","doi":"10.3899/jrheum.2024-1258","DOIUrl":"10.3899/jrheum.2024-1258","url":null,"abstract":"<p><strong>Objective: </strong>The disease course and burden of rheumatoid arthritis (RA) may differ between female and male individuals, but existing data on these differences are limited and often contradictory. Therefore, we investigated whether clinical outcomes and patient-reported outcomes (PROs) differ between female and male patients with RA over time.</p><p><strong>Methods: </strong>All female (n = 286) and male (n = 139) patients with RA according to 1987 and/or 2010 criteria from Treatment in the Rotterdam Early Arthritis Cohort (tREACH), a stratified single-blinded trial with a treat-to-target (T2T) approach and fixed medication protocol, were included. Clinical outcomes include disease activity, medication usage, sustained disease-modifying antirheumatic drug (DMARD)-free remission (SDFR), and radiographic progression. In addition, the following PROs were investigated: general health, pain, functional ability, health-related quality of life, fatigue, productivity loss, and a possible depression or anxiety disorder. For comparisons over time, a mixed model or Cox proportional hazard model was used. The mixed models were adjusted for age, initial treatment, and disease activity (Disease Activity Score in 44 joints [DAS44]).</p><p><strong>Results: </strong>Female patients had a higher DAS44 over time compared to male patients (β 0.36, 95% CI 0.25-0.47, <i>P</i> < 0.001), which also resulted in more treatment adjustments including use of biologic DMARDs (bDMARDs; 36% vs 24%, <i>P</i> < 0.001). Although not significant, first bDMARD survival seemed shorter in female patients (hazard ratio [HR] 1.4, 95% CI 0.8-2.6, <i>P</i> = 0.24). However, no differences were found in SDFR and radiographic progression. With regard to PROs, only functional ability differed significantly between sexes after adjusting for confounders, including disease activity (Health Assessment Questionnaire-Disability Index, β 0.10, 95% CI 0.04-0.17, <i>P</i> < 0.001).</p><p><strong>Conclusion: </strong>Clinical outcomes and PROs are intertwined, and both improve with a T2T management approach. Nevertheless, female patients with RA have higher disease activity, a greater need for bDMARDs-although these have lower efficacy-and more functional impairment over time, underscoring the need for sex-specific management recommendations. (Trial registration number: ISRCTN26791028).</p>","PeriodicalId":50064,"journal":{"name":"Journal of Rheumatology","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143558055","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}