Journal of Rheumatology最新文献

{"title":"Cancer Incidence and Outcome for Patients With Rheumatoid Arthritis: A Long-term Population Study in Western Australia.","authors":"Johannes Nossent, Helen I Keen, David B Preen, Charles A Inderjeeth","doi":"10.3899/jrheum.2024-0724","DOIUrl":"10.3899/jrheum.2024-0724","url":null,"abstract":"<p><strong>Objective: </strong>Our aim was to compare the incidence of malignancy and its effect on mortality between hospitalized patients with rheumatoid arthritis (RA) and controls.</p><p><strong>Methods: </strong>We conducted a population-level observational study of patients with RA (International Classification of Diseases, 9th revision, Clinical Modification [ICD-9-CM] code 714 and International Statistical Classification of Diseases and Related Health Problems, 10th revision, Australian Modification [ICD-10-AM] codes M05-M06) in the Hospital Morbidity Data Collection (HMDC) in Western Australia (WA) between 1985 and 2015, as well as nonexposed hospitalized controls matched on sex, age, and year of index admission. HMDC data were linked to the WA Cancer Registry and the WA Death Registry data, and cancer incidence rates (CIRs) per 1000 person-years, incidence rate ratios (IRR) with 95% CIs, and Kaplan Meier survival were estimated.</p><p><strong>Results: </strong>Among 14,041 patients with RA (67.56% female, median age 65.1 years) and 33,785 controls (65.16% female, median age 65.3 years), preexisting cancer in patients with RA was less prevalent than in controls (7.6% vs 14.2%; <i>P</i> < 0.01). In participants without prior cancer, the overall post index CIR was lower in those with RA (CIR 19.68 vs 24.77; IRR 0.79, 95% CI 0.76-0.83) and stable over 3 study decades. CIR was higher in patients with RA for lung (CIR 1.17, 95% CI 1.04-1.34) and hematological cancer (CIR 1.21, 95% CI 1.03-1.43) but lower for most other cancer types. Overall median survival was lower for patients with RA than controls (3.3 vs 5.3 years; <i>P</i> < 0.001) with increased mortality rates observed for most cancer subtypes.</p><p><strong>Conclusion: </strong>Overall CIR in patients with RA was consistently lower over time than in matched controls. CIR was only increased for lung and hematological cancer. Despite the overall lower CIR, post cancer mortality was higher for patients with RA in most cancer subtypes.</p>","PeriodicalId":50064,"journal":{"name":"Journal of Rheumatology","volume":" ","pages":"219-225"},"PeriodicalIF":3.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142840026","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":""},"PeriodicalIF":3.6,"publicationDate":"2025-03-01","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":"Zebra Bodies in Kidney Biopsy: Drug-Induced Phospholipidosis in a Patient With Systemic Lupus Erythematosus.","authors":"Tania Aguila, Riya Madan, Matthew B Palmer, Chris T Derk","doi":"10.3899/jrheum.2024-1312","DOIUrl":"10.3899/jrheum.2024-1312","url":null,"abstract":"","PeriodicalId":50064,"journal":{"name":"Journal of Rheumatology","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143558552","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":"Tight Control and Radiological Progression: The Radiographic Outcomes of the TICOPA Study.","authors":"Lija James, Philip S Helliwell, Elizabeth M A Hensor, Philip G Conaghan, Paul Emery, Laura C Coates","doi":"10.3899/jrheum.2024-1035","DOIUrl":"10.3899/jrheum.2024-1035","url":null,"abstract":"<p><strong>Objective: </strong>The Tight Control of Psoriatic Arthritis (TICOPA) study was the first to undertake the treat-to-target approach in psoriatic arthritis (PsA). Our aim was to further investigate the radiographic changes in the TICOPA study.</p><p><strong>Methods: </strong>The TICOPA trial recruited patients with early treatment-naïve PsA. Plain radiographs of the hands and feet were taken at weeks 0 and 48. Clinical outcomes were recorded by a blinded assessor every 12 weeks. In post hoc analysis, bootstrapped quantile regression, adjusting for baseline values and minimization factors, was used to compare radiographic scores (modified Sharp/van der Heijde [mSvdH]), defined according to treatment arm or disease activity states.</p><p><strong>Results: </strong>Paired baseline and week 48 radiographs were available for 169/206 (82%) at week 48 (84 tight control [TC] arm, 85 standard care [StdC] arm). There was no difference in change in total mSvdH score seen with TC compared to StdC (median [IQR] 0.0 [-2.0 to 0.5] vs 0.0 [-2.0 to 0.0]; difference 0.0 [95% CI 0.0-0.0]). Median total mSvdH score change was lower in those achieving minimal disease activity, Disease Activity in Psoriatic Arthritis remission, and very low disease activity. The number of people with radiographic progression (an increase in total erosion score of ≥ 2 at week 48) was numerically lower in the TC group (5/84 [5.9%] vs 12/85 [14.1%]). Patients with radiographical progression presented with polyarticular disease and high C-reactive protein, and had poorer clinical outcomes at weeks 12 and 24.</p><p><strong>Conclusion: </strong>These data confirm the benefit of achieving low disease activity states on subsequent radiographic outcomes but did not show a significant impact related to a TC management approach.</p>","PeriodicalId":50064,"journal":{"name":"Journal of Rheumatology","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143076093","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":"Tight Control and Radiological Progression: The Radiographic Outcomes of the TICOPA Study.","authors":"Lija James, Philip S Helliwell, Elizabeth M A Hensor, Philip G Conaghan, Paul Emery, Laura C Coates","doi":"10.3899/jrheum.2024-1035.C1","DOIUrl":"10.3899/jrheum.2024-1035.C1","url":null,"abstract":"<p><p>J Rheumatol 2025; doi: 10.3899/jrheum.2024-1035In the Abstract, Results, regarding the definition of radiographic progression, the text should be \"an increase in total erosion score of ≥ 2 at week 48.\" Similarly, in the Results section on page 3, paragraph 1, the text should be \"On evaluation of radiographic progression (defined as an increase in total erosion score of ≥ 2) at week 48, 17/169 patients (10.1%) were found to have radiographic progression, representing 14.1% (12/85) of the StdC arm vs 6% (5/84) of the TC arm.\" The authors would like to clarify that radiographic progression is defined as an increase in the total erosion score of ≥ 2. We apologize for any lack of clarity. This clarification does not affect the conclusions of the study.This correction applies only to the February 15 2025 First Release. The correct text appears in the print and online issues.</p>","PeriodicalId":50064,"journal":{"name":"Journal of Rheumatology","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143558385","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":"Inequities in Fee-For-Service Remuneration affecting Rheumatologists and Patient-Centred Care across Canada: An Environmental Scan.","authors":"Timothy S H Kwok, Shirley Lake, Claire E H Barber, Steven Katz, Carol A Hitchon, Konstantin Jilkine, David Collins, Christopher Lyddell, Ardyth Milne, Michael A Stein, Jean-Philip Deslauriers, Juris Lazovskis, Stephen Morais, Shaina Goudie, Lauren K King, Jessica Widdifield","doi":"10.3899/jrheum.2024-1170","DOIUrl":"10.3899/jrheum.2024-1170","url":null,"abstract":"<p><strong>Objective: </strong>Access to rheumatology services in Canada is becoming increasingly challenging due to the rising burden of rheumatic and musculoskeletal diseases (RMDs) in a rapidly growing population, and a workforce supply deficit that is projected to worsen in coming years. Specialist physician remuneration has been demonstrated to influence physician practices, thereby affecting access to health services and quality of care. Hence, we sought to compare fee-for-service remuneration structures across the provinces in Canada.</p><p><strong>Methods: </strong>We performed an environmental scan to compare publicly-funded billing codes and reimbursement fees for common rheumatology services across provinces in Canada as of July 2024. We further assessed whether reimbursement structures support person-centredness (access to care dimension).</p><p><strong>Results: </strong>Reimbursement for a new consultation in Canada ranges widely, from $153.51 to 239.57 per encounter. This is also apparent in follow-up visit payments ranging from $65.55 to 131.52. There is disparity in billing rates available to reflect medically complex patients. Virtual care is also inconsistently funded across Canada. Multidisciplinary/interdisciplinary team-based care models are sparsely funded, with only British Columbia and Quebec having a dedicated billing code to fund nursing co-managed care. We identified large provincial variations in reimbursement fees for procedures (including injections/arthrocentesis and point-of-care ultrasonography) across provinces.</p><p><strong>Conclusion: </strong>These findings raise health policy issues for funding equitable rheumatology services across Canada prompting action to reduce pay disparities, remove restrictions/stipulations that impair person-centred care, and further optimize standardization of health services across Canada.</p>","PeriodicalId":50064,"journal":{"name":"Journal of Rheumatology","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143558548","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. Weber and Liao reply.","authors":"Brittany N Weber, Katherine P Liao","doi":"10.3899/jrheum.2024-1186","DOIUrl":"10.3899/jrheum.2024-1186","url":null,"abstract":"","PeriodicalId":50064,"journal":{"name":"Journal of Rheumatology","volume":" ","pages":"296"},"PeriodicalIF":3.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142840039","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":"Concurrent IgG4-Related Disease and Giant Cell Arteritis: A Rare Case Study.","authors":"Katrina R Gener, Ekaterina Simakova, Marina Handal","doi":"10.3899/jrheum.2024-0861","DOIUrl":"10.3899/jrheum.2024-0861","url":null,"abstract":"","PeriodicalId":50064,"journal":{"name":"Journal of Rheumatology","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143558521","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 Care Utilization and Cost of Herpes Zoster Infection in Patients with Rheumatoid Arthritis, a Retrospective Cohort Study.","authors":"Mohammad Movahedi, Angela Cesta, Xiuying Li, Mark Tatangelo, Claire Bombardier","doi":"10.3899/jrheum.2024-0911","DOIUrl":"10.3899/jrheum.2024-0911","url":null,"abstract":"<p><strong>Objective: </strong>Rheumatoid arthritis (RA) patients have an increased risk of developing herpes zoster (HZ) compared to the general population. We aimed to measure health care utilization (HCU) and related costs of HZ from the public payer's perspective among RA patients.</p><p><strong>Methods: </strong>Adult RA patients diagnosed with HZ between 2008 and 2020 were matched (sex, age, and HZ date) to: 1) RA patients without HZ, 2) non-RA population with HZ, and 3) non-RA population without HZ. Unadjusted gamma distribution models and generalized estimating equations (GEEs) were used to compare HCU costs and number of clinical events (CEs), including hospital admissions, emergency department and physician visits, in RA with HZ to each matched cohort.</p><p><strong>Results: </strong>We identified 15,573 RA patients diagnosed with HZ and a similar number for each of the three matched cohorts. Mean total cost ranged from 13,507 CAD at year 1 to 17,120 CAD at year 10 for the RA with HZ cohort compared to 12,651 to 14,534 CAD in the RA without HZ cohort. Physician billing and inpatient hospital costs were the largest drivers for all cohorts. Compared to RA patients with HZ, each matched cohort experienced a significantly lower mean number of total CEs, with the highest difference in total CEs one year following a HZ infection.</p><p><strong>Conclusion: </strong>HCU and related costs were higher in RA patients with HZ compared to RA patients without HZ and non-RA populations with and without HZ. Treatment strategies that minimize the risk of HZ and updating patients' vaccinations should be considered.</p>","PeriodicalId":50064,"journal":{"name":"Journal of Rheumatology","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143558547","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":"Necrotizing Sarcoid Granulomatosis in a Patient With Systemic Sclerosis.","authors":"Bernardo D'Onofrio, Egesta Lopci, Maria De Santis, Carlo Selmi","doi":"10.3899/jrheum.2024-0573","DOIUrl":"10.3899/jrheum.2024-0573","url":null,"abstract":"","PeriodicalId":50064,"journal":{"name":"Journal of Rheumatology","volume":" ","pages":"292"},"PeriodicalIF":3.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142114266","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}