Journal of Rheumatology最新文献

{"title":"East Meets West: A Canadian Rheumatology Resident's Experience in Hong Kong.","authors":"Alan L Zhou, Shirley C W Chan","doi":"10.3899/jrheum.2025-0093","DOIUrl":"10.3899/jrheum.2025-0093","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":"143558546","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":"Characteristics of Overlap Syndrome in a Large Cohort of Brazilian Patients With Systemic Sclerosis: A Retrospective Analysis.","authors":"Cipriano R Gama, Andre S Franco, Adriana B Bortoluzzo, Renata Miossi, Ana Cristina Medeiros-Ribeiro, Ana Paula Luppino Assad, Percival D Sampaio-Barros","doi":"10.3899/jrheum.2024-0505","DOIUrl":"10.3899/jrheum.2024-0505","url":null,"abstract":"<p><strong>Objective: </strong>Systemic sclerosis (SSc) often presents alongside other connective tissue disorders, termed \"overlap syndrome (OS).\" This study aimed to characterize patients with SSc with OS compared to those without OS in a tertiary university hospital in Brazil.</p><p><strong>Methods: </strong>A retrospective analysis of demographic, clinical, and laboratory data from 787 SSc patients was performed using electronic medical records. Patients were classified based on the 2013 American College of Rheumatology/European Alliance of Associations for Rheumatology criteria for SSc and additional criteria for systemic lupus erythematosus (SLE), idiopathic inflammatory myopathy (IIM), Sjögren disease (SjD), and rheumatoid arthritis (RA). Statistical analysis, including univariate and multivariate methods, identified factors associated with OS.</p><p><strong>Results: </strong>Ninety-one patients (11.6%) had OS, mainly with SLE (29.7%), SjD (26.4%), RA (24.2%), or IIM (19.8%). Patients with OS were younger, with an earlier age at onset (<i>P</i> = 0.004) and at diagnosis (<i>P</i> = 0.003). They presented a higher prevalence of limited SSc (<i>P</i> _trend = 0.06), musculoskeletal symptoms (<i>P</i> < 0.001), neoplasia (<i>P</i> = 0.03), and sicca symptoms (<i>P</i> < 0.001); and were associated with a lower frequency of pulmonary hypertension (<i>P</i> = 0.048) and comorbidities such as diabetes mellitus (<i>P</i> = 0.02) and dyslipidemia (<i>P</i> = 0.02). A higher prevalence of anti-Ro (<i>P</i> = 0.007) and a lower prevalence of anti-Scl70 (<i>P</i> = 0.003) were also observed. Patients with OS were more frequently prescribed glucocorticoids (GCs; <i>P</i> < 0.001), methotrexate (<i>P</i> = 0.01), and leflunomide (<i>P</i> = 0.001). Multivariate analysis identified limited SSc (odds ratio [OR] 3.1), neoplasia (OR 3.4), and use of GCs (OR 8.2) and leflunomide (OR 5.5) with OS. No worse prognosis was observed.</p><p><strong>Conclusion: </strong>Overall, Brazilian patients with SSc with OS have distinct clinical characteristics but do not have a worse prognosis compared to those without OS.</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":"143426485","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":"Epidemiology of Isolated Cutaneous Lupus Erythematosus in the Multiethnic Population of Reunion Island: A Retrospective Multicenter Study.","authors":"Mathurin Maillet, Babacar S Tounkara, Damien Vagner, Kelly Bagny, Sébastien Duquenne, Céline Lartigau-Roussin, Anne Kolbe, Yves Lauret, Andry Randrianjohany, Serge Laureau, Nicole Denat, Aude Alquier, Nathalie Sultan-Bichat, Antoine Bertolotti, Loïc Raffray","doi":"10.3899/jrheum.2024-0661","DOIUrl":"10.3899/jrheum.2024-0661","url":null,"abstract":"<p><strong>Objective: </strong>Few data are available about the epidemiology of cutaneous lupus erythematosus (CLE) in the Southern hemisphere and in multiethnic populations. We describe the prevalence, incidence, and clinical characteristics of isolated CLE in the multiethnic population of Reunion Island, France, including patients with dark skin.</p><p><strong>Methods: </strong>The study was performed in all public hospitals and private dermatology practices in Reunion Island. Cases were identified through informatics databases. Cases were defined as isolated CLE, meaning they did not fulfill the criteria for systemic lupus erythematosus (SLE). Incident cases were collected from 2008 to 2021. Prevalence was calculated on January 1, 2022. A capture-recapture analysis was performed to estimate both prevalence and incidence.</p><p><strong>Results: </strong>A total of 268 cases of CLE were identified and 218 were incident cases. The standardized prevalence of CLE was 43 out of 100,000 persons and the average annual standardized incidence was 3.1 per 100,000 person-years (PY). With a capture-recapture analysis, prevalence and annual incidence were estimated to be 99 out of 100,000 persons (95% CI 77.10-136.45) and 5.7 per 100,000 PY (95% CI 4.40-7.95), respectively. The mean age at diagnosis was 41.7 years and the ratio of female to male individuals was 4:1. Patients with dark skin had a higher rate of discoid CLE and were more likely to receive immunosuppressants. Generalized discoid CLE, panniculitis, and overlapping subtypes of CLE appeared as predictive markers of progression toward SLE.</p><p><strong>Conclusion: </strong>The prevalence and incidence of CLE in the multiethnic population of Reunion Island seem higher than in light-skinned populations. We highlight new risk factors of evolution toward SLE that should be known by practitioners to adjust follow-up.</p>","PeriodicalId":50064,"journal":{"name":"Journal of Rheumatology","volume":" ","pages":"251-256"},"PeriodicalIF":3.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142774195","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":"Tocilizumab (TCZ) for Giant Cell Arteritis: Clinical Outcomes Following Relapses and TCZ Discontinuation Due to Adverse Events.","authors":"Fumika N Nagase, Sho Fukui, Naoho Takizawa, Toshihiro Yamaguchi, Nobuhiro Oda, Hajime Inokuchi, Takanori Ito, Mitsuru Watanabe, Masei Suda, Yoichiro Haji, Yasuhiro Suyama, Ryo Rokutanda, Masahiro Minoda, Atsushi Nomura, Eishi Uechi, Hiromichi Tamaki","doi":"10.3899/jrheum.2024-0612","DOIUrl":"10.3899/jrheum.2024-0612","url":null,"abstract":"<p><strong>Objective: </strong>Tocilizumab (TCZ) is effective for giant cell arteritis (GCA). However, little is known regarding treatment modification and clinical outcomes after unfavorable events such as GCA relapses or TCZ discontinuation due to adverse events (AEs).</p><p><strong>Methods: </strong>This multicenter retrospective study included patients with GCA who initiated TCZ from 2008 to 2021 at 5 Japanese hospitals. GCA relapses and TCZ-related AEs were monitored for 2 years after TCZ initiation. In patients with GCA relapses, subsequent clinical courses, including relapse symptoms and treatment modification, were followed for 90 days after the relapses. Similarly, patients who discontinued TCZ because of AEs were additionally followed until 1 year after the TCZ discontinuation to evaluate AEs, relapses, and treatment changes.</p><p><strong>Results: </strong>Of 62 eligible patients, 10 patients (16%) relapsed after initiating TCZ therapy. Most relapses (8 of 10) occurred after extending TCZ intervals or discontinuing TCZ. Combinations of adjusting TCZ intervals, adjusting glucocorticoid (GC) dose, and/or adding or increasing methotrexate (MTX) therapy could manage the relapses without serious complications. In the entire cohort, AEs occurred in 28 patients (45%), and 8 patients (13%) discontinued TCZ because of AEs. After AE-related TCZ discontinuation, 6 patients attempted to taper GCs without other immunosuppressive therapy (IST), and 4 subsequently relapsed. In contrast, 2 patients who used other IST or biologic therapy could decrease GCs without relapses.</p><p><strong>Conclusion: </strong>Although GCA relapses can occur after initiating TCZ therapy, most relapses can be safely managed by adjusting TCZ, GC, and/or MTX doses. Adding IST or biologic treatments may potentially be related to preventing relapses when patients discontinue TCZ because of AEs.</p>","PeriodicalId":50064,"journal":{"name":"Journal of Rheumatology","volume":" ","pages":"270-279"},"PeriodicalIF":3.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142640142","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":"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":"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":"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}

{"title":"A Dromedary Tale: A Tragi-Comedary on Science, Where Reliance Over Defiance Must Prevail.","authors":"Naomi Schlesinger, Elliot D Rosenstein, Richard S Panush","doi":"10.3899/jrheum.2025-0086","DOIUrl":"https://doi.org/10.3899/jrheum.2025-0086","url":null,"abstract":"","PeriodicalId":50064,"journal":{"name":"Journal of Rheumatology","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143425785","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":"The Lived Experiences of Older Adults With Systemic Lupus Erythematosus: Patient Perspectives.","authors":"Sarah B Lieber, Sarah R Young, Yvonne Shea, Sarah P Gottesman, Robyn Lipschultz, Dongmei Sun, M Carrington Reid, Lisa A Mandl, Iris Navarro-Millán","doi":"10.3899/jrheum.2024-0478","DOIUrl":"10.3899/jrheum.2024-0478","url":null,"abstract":"<p><strong>Objective: </strong>Little is known about perceptions of aging among individuals with systemic lupus erythematosus (SLE). Gaining this knowledge could help to identify targets for future behavioral interventions aimed at successful aging with SLE. This qualitative study sought to elicit the lived experiences and essence of aging from older adults with SLE.</p><p><strong>Methods: </strong>We conducted semistructured interviews with adults aged ≥ 65 years with SLE seen at a single tertiary center. Qualitative data were analyzed thematically using a phenomenological approach. We collected data on sociodemographic characteristics and disease features prior to each qualitative interview.</p><p><strong>Results: </strong>Among 30 participants with a mean age of 71.3 years and mean SLE duration of 26.3 years (range 5-62 yrs), 4 overarching themes emerged to describe the essence of aging with SLE: SLE and comorbid conditions, cumulative effect of SLE symptoms, SLE disease trajectory, and self-perceptions of aging. Older adults with SLE shared variable aging experiences, including perspectives on multimorbidity and disease trajectory, as well as self-perceptions of aging.</p><p><strong>Conclusion: </strong>We identified both positive and negative self-perceptions of aging, often informed by participants' lived experiences of cumulative effects of SLE symptoms and SLE disease trajectory, and underscoring the diversity of their experiences. Understanding self-perceptions of aging in this population could inform the development of evidence-based strategies to empower older adults with SLE to harness their positivity and resilience, and thus improve health-related outcomes, including health-related quality of life.</p>","PeriodicalId":50064,"journal":{"name":"Journal of Rheumatology","volume":" ","pages":"145-150"},"PeriodicalIF":3.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11803822/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142564977","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}