The Journal of Rheumatology最新文献

{"title":"Assessment of giant cell arteritis-associated visual outcomes at a tertiary hospital in Ontario, Canada.","authors":"Mats L Junek,Rahul Chanchlani,Amadeo R Rodriguez,Nader Khalidi,Amber O Molnar","doi":"10.3899/jrheum.2025-0459","DOIUrl":"https://doi.org/10.3899/jrheum.2025-0459","url":null,"abstract":"OBJECTIVEThere are limited data concerning outcomes in those with giant cell arteritis-associated vision changes (GCA, GCAVCs). We estimated the association of intravenous, compared to oral, glucocorticoids with outcomes in GCAVCs.METHODSWe conducted a retrospective cohort study at a tertiary healthcare facility in Ontario, Canada. Individuals aged 50 years or older with an international classification of disease version 10 (ICD-10) diagnostic code for GCA associated with a healthcare visit between November 2017 to December 2023 were identified for inclusion. Diagnoses of GCA were verified as the final diagnosis of the treating clinician and were required to be supported by histologic, radiographic, and/or biochemical evidence of inflammatory vasculopathy. GCAVCs were identified by clinical assessments. Treatment exposures were defined as whether the individual was first exposed to intravenous or oral glucocorticoids. The primary outcome was reported visual improvement after treatment. We used logistic regression to estimate treatment effects adjusting for demographic and disease factors.RESULTSIn 289 individuals with GCA, 77 (26.6%) had GCAVCs. 70.1% of GCAVCs led to permanent vision loss and visual recovery was seen in 16.0% of participants. We found no difference in outcomes for those first treated with intravenous versus oral glucocorticoids (adjusted odds ratios 0.43-1.72, 95% confidence interval range 0.02-123.68).CONCLUSIONGCAVCs are common and frequently associated with permanent vision loss. While the precision of our results was limited by sample size, we did not find evidence that IV before oral glucocorticoids was associated with visual improvement in GCAVCs.","PeriodicalId":501812,"journal":{"name":"The Journal of Rheumatology","volume":"35 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144959943","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Discovery and Clinical Validation of C1M and C4M as Soluble Biomarkers for Diagnosis, Prognosis, and Symptom Prediction in Psoriatic Disease and Other Inflammatory Arthropathies.","authors":"Maria-Angeliki Gkini,Wilson Liao,Kurt de Vlam,Vinod Chandran,Signe Holm Nielsen","doi":"10.3899/jrheum.2025-0671","DOIUrl":"https://doi.org/10.3899/jrheum.2025-0671","url":null,"abstract":"Psoriatic disease (PsD) is a complex, heterogeneous disease with unmet medical needs in terms of its diagnosis, management, and prognosis. The identification of biomarkers could improve the implementation of precision medicine in PsD, but to date, none of these biomarkers have been clinically validated. Biomarkers can support clinical trials in several ways, including (1) diagnostics, (2) drug pharmacodynamics, (3) prognostics for patient selection and monitoring of drug efficacy, and (4) predictive models for clinical outcomes. Biomarkers can sometimes be used for both diagnosis and prognosis. Benefits of biomarkers use may include shorter duration of clinical trials, faster access to new treatments, and a personalized approach to disease management. Several potential biomarkers have recently demonstrated promise for use in PsD, including C1M, a serum biomarker reflecting collagen type I collagen degradation, and C4M, a type IV collagen metabolite, but clinical validation has not yet been completed. Here, and as presented at the Group for Research and Assessment of Psoriasis and Psoriatic Arthritis 2024 annual meeting, we summarize the status of biomarker discovery for PsD and their overlap with other musculoskeletal diseases such as rheumatoid arthritis and axial spondyloarthritis.","PeriodicalId":501812,"journal":{"name":"The Journal of Rheumatology","volume":"18 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144960078","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Individual and Socio-ecological Resilience in Childhood-Onset Systemic Lupus Erythematosus: Associations with Patient Characteristics and Psychosocial Patient-Reported Outcomes.","authors":"Isabella Zaffino,Louise Boulard,Joanna Law,Ashley Danguecan,Asha Jeyanathan,Lawrence Ng,Sandra Williams-Reid,Kiah Reid,Angela Cortes,Eugene Cortes,Deborah M Levy,Linda T Hiraki,Andrea M Knight","doi":"10.3899/jrheum.2025-0375","DOIUrl":"https://doi.org/10.3899/jrheum.2025-0375","url":null,"abstract":"OBJECTIVEThis study investigates individual and socio-ecological resilience and their relationship with sociodemographic and disease characteristics, and psychosocial patient-reported outcomes in childhood-onset systemic lupus erythematosus (cSLE).METHODSWe conducted a cross-sectional study of patients with cSLE ages 11-22 years at a Canadian tertiary center from October 2021-July 2024. The Connor-Davidson Resilience Scale (CD-RISC 10) assessed individual resilience. The Child and Youth Resilience Measure-Revised (CYRM-R) assessed socio-ecological resilience. Linear regression models examined associations between resilience with socio-demographic (e.g., health literacy, adverse childhood experiences (ACEs)) and disease factors (e.g., age of onset, duration, disease activity). Pearson correlations determined relationships between resilience and patient-reported depressive and anxiety symptoms, executive functioning, pain interference and fatigue.RESULTSOf 49 participants, mean scores for individual psychological resilience were CD-RISC 10 of 26.0 (SD=7.1) and socio-ecological resilience were CYRM-R of 73.4 (SD=9.1). Higher resilience on CD-RISC 10 (b=0.99, 95%CI [0.45 to 1.55], p<0.01) and CYRM-R (b=0.84, 95%CI [0.13 to 1.55], p=0.02) was associated with better health literacy on the communication subscale. Lower CYRM-R scores were associated with higher number of ACEs (b=-1.02, 95% CI [-1.88 to -0.17], p=0.02). For patient-reported outcomes, lower scores for both individual and socio-ecological resilience correlated with worse depressive symptoms (r=-0.44, p=0.003 for CD-RISC 10; r=-0.55, p=0.001 for CYRM-R) and executive functioning (r=-0.49, p=0.002 for CD-RISC 10; r=-0.56, p=0.002 for CYRM-R).CONCLUSIONGreater resilience was associated with fewer ACEs, and better health-related communication, patient-reported mental health and executive functioning. Findings highlight the importance of fostering resilience to improve outcomes in youth with cSLE.","PeriodicalId":501812,"journal":{"name":"The Journal of Rheumatology","volume":"43 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144959941","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"GRAPPA Patient Research Partner Network Composition and Engagement: A Survey to Determine Strategic Areas for Growth.","authors":"Christine A Lindsay,Suzanne M Grieb,Arnon Katz","doi":"10.3899/jrheum.2025-0536","DOIUrl":"https://doi.org/10.3899/jrheum.2025-0536","url":null,"abstract":"The Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA) Patient Research Partner (PRP) Network conducted a survey to identify its key strengths and gaps, with the goal of enhancing its global reach and representation. The survey revealed strong gender parity and high long-term project participation among PRP members. However, it also indicated a need for greater ethnic and geographical diversity among the members. To address this, the PRP Network will expand its membership and specifically recruit partners from underrepresented regions such as Africa, Asia, Australia/New Zealand, South America, and Eastern Europe. Additionally, the network aims to expand its age range to include a more representative selection of research partners, thereby advancing GRAPPA's overarching objectives. The results of the survey were presented at the GRAPPA 2024 annual meeting.","PeriodicalId":501812,"journal":{"name":"The Journal of Rheumatology","volume":"65 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144959948","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Incidence and Predictors of Secondary Failure to Biologic Therapy in Patients with Psoriatic Arthritis.","authors":"Fadi Kharouf,Ali AlHadri,Shangyi Gao,Daniel Pereira,Richard J Cook,Vinod Chandran,Dafna D Gladman","doi":"10.3899/jrheum.2025-0518","DOIUrl":"https://doi.org/10.3899/jrheum.2025-0518","url":null,"abstract":"OBJECTIVESecondary failure to biologic DMARDs (bDMARDs) is challenging and contributes to the complexity of managing psoriatic arthritis (PsA). We aimed to define the frequency and incidence of this phenomenon in PsA and identify the risk factors for its occurrence.METHODSWe retrieved data on PsA patients from our single-centre, specialized-care, prospective observational cohort who initiated and remained on bDMARDs for ≥1 year after clinic enrollment between 2000 and 2023. We defined response to therapy at the one-year visit (baseline) as achievement of ≥40% reduction in the swollen joint count (SJC) and either ≥50% reduction in PASI or PASI ≤2. We defined secondary failure as the inability to maintain response criteria or as the clinician's judgment of loss of effectiveness. To examine factors associated with secondary failure, we fitted Cox regression models.RESULTSOf 482 patients included in the study, 264 (54.8%) were responders at one year. Of these, 94 (35.6%) developed secondary failure at a median of 1.6 [IQR: 0.7, 3.8] years from response. In the multivariable model, higher SJC (HR 1.39, 95% CI 1.05-1.84) and PASI (HR 1.14, 95% CI 1.01-1.29) at baseline were associated with secondary failure. TNFi vs. other bDMARD use (HR 0.39, 95% CI 0.18-0.88), initiation as first-line bDMARD (HR 0.48, 95% CI 0.25-0.91), and treatment initiation during more recent calendar years (HR 0.34, 95% CI 0.12-0.98) were associated with less secondary failure.CONCLUSIONSecondary failure to bDMARDs is common in PsA and may be influenced by both disease- and therapy-related factors.","PeriodicalId":501812,"journal":{"name":"The Journal of Rheumatology","volume":"32 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144959940","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Challenges of ASAS criteria in Real-World Colombia SpA patients. A cross-sectional study.","authors":"Igor Rueda,Gustavo José Rodriguez,Ana María Santos,Juan Camilo Santacruz Devia,Sofía Arias-Correal,Keisy Orduz Uribe,Elias Quintero-Munoz,Cristian Mesa Pedraza,Juan Camilo Rueda,Juan Manuel Bello,Giovanny Ballesteros,Enrique Calvo,John Londono","doi":"10.3899/jrheum.2025-0073","DOIUrl":"https://doi.org/10.3899/jrheum.2025-0073","url":null,"abstract":"OBJECTIVEThe Assessment of SpondyloArthritis international Society (ASAS) criteria classify spondyloarthritis (SpA) based on clinical presentation. Although widely applied, their performance in Colombia's population remains unclear. The study aimed to characterize a Colombian SpA cohort, identify factors associated with peripheral SpA (pSpA), compare SpA subtypes, assess the performance of ASAS criteria, and compare them with modified New York (mNY) and European Spondyloarthropathy Study Group (ESSG) criteria.METHODSThis cross-sectional study included patients with newly diagnosed SpA by at least one expert rheumatologist. Participants completed a structured survey, physical examination, imaging, and laboratory tests. Researchers classified patients using ASAS, ESSG, and mNY criteria and compared clinical characteristics across groups. Finally, the performance of the ASAS criteria relative to the rheumatologist's diagnosis, mNY, and ESSG.RESULTSThe study analyzed 461 SpA patients, of whom 58.1% had pSpA. Patients with axial SpA (axSpA) and pSpA differed significantly in age at onset, initial symptoms, buttock pain, Schober test, sacroiliitis, and HLA alleles. The ASAS criteria demonstrated a sensitivity of 90.8% compared to rheumatologist diagnosis. Notably, 33% of patients classified as ankylosing spondylitis by mNY or ESSG were misclassified as pSpA under ASAS due to unmet entry criteria for axSpA.CONCLUSIONThis large Colombian SpA cohort, predominantly pSpA, revealed distinct clinical and imaging features between axSpA and pSpA. The ASAS criteria showed high sensitivity but failed to classify a subset of patients with radiographic sacroiliitis as axSpA, highlighting limitations in their entry criteria for axSpA.","PeriodicalId":501812,"journal":{"name":"The Journal of Rheumatology","volume":"61 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144959945","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Health-related Quality of Life in DMARD-treated adults with Juvenile Idiopathic Arthritis Compared to Rheumatoid Arthritis and the General Population.","authors":"Imane Bardan,Till Uhlig,Joe Sexton,Tore Kristian Kvien,Gunnstein Bakland,Pawel Mielnik,Yi Hu,Øyvind Molberg,Anna-Birgitte Aga,Eirik Klami Kristianslund","doi":"10.3899/jrheum.2025-0384","DOIUrl":"https://doi.org/10.3899/jrheum.2025-0384","url":null,"abstract":"OBJECTIVETo explore health-related quality of life (HRQoL) measured by Short Form 36 (SF-36), SF-36 physical component score (PCS), SF-36 mental component score (MCS) and Short Form 6D (SF-6D) in adults with juvenile idiopathic arthritis (JIA) compared to rheumatoid arthritis (RA) and the general population.METHODSWe used six-month follow-up data from the Norwegian disease-modifying antirheumatic drug study (NOR-DMARD), including adult JIA and RA patients starting or switching disease-modifying anti-rheumatic drug (DMARD) treatment. Age- and gender adjusted regression analyses were used to compare outcomes between JIA, RA and the general Norwegian population.RESULTSRegister data was available for 232 JIA- and 2764 RA patients at six months follow-up. JIA patients had poorer physical, but similar mental health as RA (adjusted difference (95% CI): PCS -3.58 (-6.09 to -1.08); MCS 2.02 (-0.51 to 4.54)). Compared to the general population, PCS scores were lower in both JIA and RA (adjusted differences; JIA-general population: -15.70 (-18.21 to -13.19), RA-general population: -12.12 (-12.76 to -11.47), but MCS was similar across groups. Average SF-6D utility levels were comparable in JIA and RA, but lower than the general population. Similar proportions of JIA and RA experienced improvements exceeding minimal clinical important difference (MCID) in SF-36 scale scores, PCS, MCS and SF-6D after six months.CONCLUSIONCompared to RA and the general population, JIA had lower physical HRQoL six months after DMARD initiation. Mental health composite scores were similar between JIA, RA and the general population. Both disease groups showed similar levels of improvement with treatment.","PeriodicalId":501812,"journal":{"name":"The Journal of Rheumatology","volume":"11 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144959944","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Identifying resolution of clinically suspect arthralgia: a step towards understanding spontaneous reversal of an at-risk stage of rheumatoid arthritis.","authors":"Sarah J H Khidir,Elise van Mulligen,Annette H M van der Helm-van Mil","doi":"10.3899/jrheum.2025-0052","DOIUrl":"https://doi.org/10.3899/jrheum.2025-0052","url":null,"abstract":"OBJECTIVESymptoms in the at-risk stage of clinically suspect arthralgia (CSA) can progress to Rheumatoid Arthritis (RA) or disappear spontaneously. The area of reversal of an at-risk stage is yet unexplored. Therefore, we aimed to determine its definition by evaluating patient-reported and rheumatologist-reported measures, and examine characteristics at baseline and over time of at-risk individuals with reversal.METHODS845 consecutively included CSA-patients were followed for 2 years. Reversal was assessed as patient-reported resolution of pain (pain-score≤20 on numerical rating scale (NRS 0-100) and as resolution of CSA, as defined by the rheumatologist (clinical outcomes recorded in medical records were obtained). Clinical and functional characteristics and MRIdetected subclinical joint-inflammation were studied over time.RESULTSAmong patients eligible for reversal, pain-resolution was achieved in 244/505 patients(48%) and rheumatologist-defined CSA-resolution in 357/505(71%). Patients with CSA-resolution but persistent pain, had pain from other causes than CSA/imminent-RA. Patients with pain-resolution without CSA-resolution, had remaining inflammatory symptoms (e.g. morning stiffness). Reversal of the at-risk stage was therefore best defined as rheumatologist-confirmed resolution of CSA. Patients achieving CSA-resolution had similar levels of subclinical joint-inflammation at presentation, but less pain, fatigue and morning stiffness than those without CSA-resolution. Over time, patients with CSA-resolution improved spontaneously in subclinical joint-inflammation (IRR=0.87/year, 95%CI=0.80-0.95,p=0.001) and functional disabilities (β=-0.07/year, 95%CI=-0.09 to -0.05,p<0.001).CONCLUSIONClinically, reversal of at-risk stage is better defined by rheumatologist-confirmed resolution of CSA, rather than a single patient-reported measure as pain. CSA-resolution associated with improved subclinical joint-inflammation and functional disabilities. This identification is a step towards investigating mechanisms underlying reversal of RA-risk.","PeriodicalId":501812,"journal":{"name":"The Journal of Rheumatology","volume":"46 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144960294","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sabbatical in a Pediatric Rheumatology Unit in India.","authors":"Yosef Uziel","doi":"10.3899/jrheum.2025-0230","DOIUrl":"https://doi.org/10.3899/jrheum.2025-0230","url":null,"abstract":"","PeriodicalId":501812,"journal":{"name":"The Journal of Rheumatology","volume":"76 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144959947","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Usual Suspects: Established and Emerging Predictor Variables for Remission in Rheumatoid Arthritis.","authors":"Elle Sauve,Cheryl Barnabe","doi":"10.3899/jrheum.2025-0476","DOIUrl":"https://doi.org/10.3899/jrheum.2025-0476","url":null,"abstract":"There are several potential factors that predict the outcome of remission in rheumatoid arthritis (RA). These reflect various domains including personal characteristics, health status, disease characteristics and treatment exposures. While some predictors are consistently identified across a variety of settings, others have limited or conflicting data, and new potential predictors are emerging. In this review, we summarize the available evidence to highlight predictors that should be incorporated into all rheumatology prognostic research, namely age, sex, smoking status, body mass index, function, disease duration, rheumatoid factor status, disease activity at treatment start, inflammatory markers, and treatment strategy. We identify opportunities for improving the measurement and characterization of these factors for improved precision in determining prognosis. We propose new predictors that could expand our understanding of factors influencing the attainment of remission, but that require further investigation.","PeriodicalId":501812,"journal":{"name":"The Journal of Rheumatology","volume":"294 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144857735","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}