Journal of Rheumatology最新文献

{"title":"Mining for Gems: Early Detection of Calcinosis in Juvenile Dermatomyositis Using Low-Dose Computed Tomography.","authors":"Yulia Vyzhga, Andrea S Doria, Brian M Feldman, Shirley M Tse","doi":"10.3899/jrheum.2024-0594","DOIUrl":"10.3899/jrheum.2024-0594","url":null,"abstract":"","PeriodicalId":50064,"journal":{"name":"Journal of Rheumatology","volume":" ","pages":"396"},"PeriodicalIF":3.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142299772","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":"Cardiometabolic Effects of Apremilast in Patients With Psoriatic Arthritis: A Prospective Cohort Study.","authors":"Romy Hansildaar, Eva H van Geel, Fatih Çoban, Bas Dijkshoorn, Maaike Heslinga, Reinhard Bos, Mies A Korteweg, Arno W R van Kuijk, Michael T Nurmohamed","doi":"10.3899/jrheum.2024-0791","DOIUrl":"10.3899/jrheum.2024-0791","url":null,"abstract":"<p><strong>Objective: </strong>Psoriatic arthritis (PsA) is associated with metabolic and cardiovascular (CV) disease. Studies have suggested that treatment with apremilast is associated with weight loss and other cardiometabolic benefits. This study aimed to examine the effects of apremilast on body weight, body composition, and CV risk factors in patients with PsA.</p><p><strong>Methods: </strong>This longitudinal, nonrandomized, multicenter trial included adults with active PsA initiating apremilast (30 mg twice daily after a step-up regimen). Patients were followed for 12 months, and measurements were done at baseline and repeated at weeks 26 and 52. Body composition, the primary outcome, was assessed using dual-energy x-ray absorptiometry. Secondary outcomes included disease activity (Disease Activity Score in 28 joints [DAS28] based on C-reactive protein [CRP]), blood pressure (BP), lipids, intima-media thickness, and glucose. Statistical analysis involved mixed models adjusted for relevant covariates.</p><p><strong>Results: </strong>Forty-four patients were included, with a mean age of 56 (SD 11) years and a median BMI (kg/m²) of 28 (IQR 24-33). A total of 17 patients completed the study, whereas 27 discontinued due to ineffectiveness or side effects. After 1 year of apremilast, significant reductions were observed in multiple body mass measures, including total fat (-7.4 kg; <i>P</i> = 0.005) and android fat (-1.1 kg; <i>P</i> = 0.002). Lean mass remained stable. BP showed minor reduction, whereas lipids, intima-media thickness, and glucose levels did not change. Disease activity improved, with a significant decrease in DAS28-CRP (-0.6; <i>P</i> = 0.01). Android fat correlated most strongly with disease activity reduction (<i>r</i> 0.31; <i>P</i> = 0.004).</p><p><strong>Conclusion: </strong>This study demonstrates that apremilast reduces fat mass in patients with PsA and suggests beneficial CV and metabolic effects, potentially reducing the risk of CV events.</p>","PeriodicalId":50064,"journal":{"name":"Journal of Rheumatology","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143425797","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":"Infected Tumoral Calcinosis Associated With Rheumatoid Arthritis.","authors":"Eri Sugawara, Keita Ninagawa, Kazuaki Katsumata","doi":"10.3899/jrheum.2024-0761","DOIUrl":"10.3899/jrheum.2024-0761","url":null,"abstract":"","PeriodicalId":50064,"journal":{"name":"Journal of Rheumatology","volume":" ","pages":"397"},"PeriodicalIF":3.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142564967","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":"Association Between Rheumatoid Arthritis and Ambulatory Blood Pressure.","authors":"Gang Wang, Zhichun Liu","doi":"10.3899/jrheum.2024-1292","DOIUrl":"10.3899/jrheum.2024-1292","url":null,"abstract":"","PeriodicalId":50064,"journal":{"name":"Journal of Rheumatology","volume":" ","pages":"403-404"},"PeriodicalIF":3.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143558518","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":"Urine Protein Tests in Systemic Lupus Erythematosus: What Do They Mean?","authors":"Mona Aflaki, Joanne M Bargman","doi":"10.3899/jrheum.2024-0910","DOIUrl":"10.3899/jrheum.2024-0910","url":null,"abstract":"<p><p>The development of lupus nephritis (LN) in patients with systemic lupus erythematosus is associated with increased morbidity and mortality. Proteinuria is a key indicator of kidney involvement; detecting and monitoring proteinuria is therefore crucial as it acts as a surrogate marker for disease activity and has significant prognostic value. This review explores the general mechanisms of proteinuria and highlights the limitations of current measurement techniques. In the absence of specific urinary markers for LN disease activity, evaluating proteinuria involves considering its trajectory, amplitude of change, and the overall clinical status of the patient. Differentiating between acute disease vs proteinuria that may stem from scarring and glomerular basement membrane remodeling can be challenging. Additionally, in the absence of other signs of active disease, the time to recovery and resolution of proteinuria may be prolonged.</p>","PeriodicalId":50064,"journal":{"name":"Journal of Rheumatology","volume":" ","pages":"308-315"},"PeriodicalIF":3.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143076134","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":"Clinical Expression of Radiographic Axial Spondyloarthritis and Its Association With HLA-B27 in European and Ibero-American Populations.","authors":"María Ángeles Puche-Larrubia, Lourdes Ladehesa-Pineda, Pilar Font-Ugalde, Rubén Burgos-Vargas, Percival Sampaio-Barros, José Maldonado-Cocco, Anabela Barcelos, Jordi Gratacós, Xavier Juanola, Alejandro Escudero-Contreras, Janitzia Vázquez-Mellado, Iván Arias de la Rosa, Eduardo Collantes-Estévez, Clementina López-Medina","doi":"10.3899/jrheum.2024-1085.C1","DOIUrl":"10.3899/jrheum.2024-1085.C1","url":null,"abstract":"","PeriodicalId":50064,"journal":{"name":"Journal of Rheumatology","volume":" ","pages":"404"},"PeriodicalIF":3.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143558519","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":"Knowledge, Awareness, and Attitudes Regarding Axial Spondylarthritis Among Nonrheumatology Physicians in the United States.","authors":"William Odell, Swetha Alexander, Narinder Maheshwari, Abhijeet Danve","doi":"10.3899/jrheum.2024-0552","DOIUrl":"10.3899/jrheum.2024-0552","url":null,"abstract":"<p><strong>Objective: </strong>We surveyed physicians in the United States to assess knowledge, awareness, and attitudes toward axial spondyloarthritis (axSpA). The objective was to identify barriers for referral and opportunities for intervention to reduce diagnostic delay of axSpA.</p><p><strong>Methods: </strong>An online questionnaire was distributed nationwide to nonrheumatology physicians (NRPs) serving patients with chronic back pain (CBP), namely in family/internal medicine, spine surgery/orthopedics, pain management, physical medicine/rehabilitation, and to rheumatologists as the comparator group.</p><p><strong>Results: </strong>Seven hundred fifty physicians completed the survey (response rate 24%). The majority of NRPs were familiar with inflammatory back pain (IBP); 87% could identify > 4 of 8 IBP items, but only 41% routinely assess for IBP in practice. NRPs screen patients for axSpA risk factors ≤ 50% of the time. NRPs order C-reactive protein and HLA-B27 tests significantly less often, and antinuclear antibodies and rheumatoid factor tests significantly more often than rheumatologists in patients with CBP. Only 50% of NRPs correctly answered sacroiliac/pelvic radiograph as the correct initial imaging test, and 37% correctly selected magnetic resonance imaging of the pelvis as the next imaging test. Unfamiliarity with the terms axSpA and nonradiographic axSpA was reported by 11% and 35% of NRPs, respectively, and NRPs less often consider axSpA as a possible diagnosis in patients with CBP. Formal referral guidelines for patients with suspected axSpA were felt to be important by NRPs and rheumatologists alike.</p><p><strong>Conclusion: </strong>There is a substantial lack of knowledge and awareness about nomenclature, laboratory testing, and proper imaging of axSpA among NRPs. Unnecessary laboratory tests are commonly ordered by NRPs and rheumatologists. Formal referral guidelines and improved education may help reduce diagnostic delay of axSpA.</p>","PeriodicalId":50064,"journal":{"name":"Journal of Rheumatology","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143558549","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":"344-351"},"PeriodicalIF":3.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11961325/pdf/","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":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Progressive Pulmonary Fibrosis in Rheumatoid Arthritis-Associated Interstitial Lung Disease.","authors":"Jorge Rojas-Serrano","doi":"10.3899/jrheum.2024-1333","DOIUrl":"10.3899/jrheum.2024-1333","url":null,"abstract":"","PeriodicalId":50064,"journal":{"name":"Journal of Rheumatology","volume":" ","pages":"299-301"},"PeriodicalIF":3.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143076125","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. Stein and Ormseth reply.","authors":"C Michael Stein, Michelle J Ormseth","doi":"10.3899/jrheum.2025-0054","DOIUrl":"10.3899/jrheum.2025-0054","url":null,"abstract":"","PeriodicalId":50064,"journal":{"name":"Journal of Rheumatology","volume":" ","pages":"404"},"PeriodicalIF":3.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143558524","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}