The Journal of Rheumatology最新文献

{"title":"Results of a Nationwide Multicenter Study in Childhood Sjögren Disease.","authors":"Gülşah Kılbaş,Semra Ayduran,Seher Şener,Taner Coşkuner,Kadir Ulu,Hakan Kısaoğlu,Esma Aslan,Elif Kılıç Könte,Ceyda Arslanaoğlu,Tuncay Aydın,Yağmur Şadırvan Oğuzkaya,Figen Çakmak,Deniz Gezgin Yıldırım,Melike Mehveş Kaplan,Saadet Nilay Tiğrak,Serkan Türkuçar,Hafize Emine Sönmez,Miray Kışla Ekinci,Kübra Öztürk,Ferhat Demir,Esra Bağlan,Burcu Bozkaya,Sema Nur Taşkın,Selcan Demir,Erdal Sağ,Ezgi Deniz Batu,Sezgin Şahin,Sevcan A Bakkaloğlu Ezgü,Sara Sebnem Kılıc,Ayşenur Paç Kısaarslan,Banu Çelikel Acar,Mukaddes Kalyoncu,Nuray Aktay Ayaz,Betül Sözeri,Erbil Ünsal,Özgür Kasapçopur,Seza Özen,Selçuk Yüksel","doi":"10.3899/jrheum.2024-1048","DOIUrl":"https://doi.org/10.3899/jrheum.2024-1048","url":null,"abstract":"OBJECTIVEThis nation-wide, multicenter study was conducted to assess the demographic, clinical features, treatment regimens, and prognosis of primary Sjögren disease (SjD) in childhood.METHODSThis retrospective study included a total of 81 patients under 18 years of age from 21 pediatric rheumatology centers. Among these, 51 patients fulfilled the diagnosis of childhood SjD strictly according to the 2016 ACR/EULAR classification criteria. The remaining 30 patients, who did not fully meet these criteria but exhibited clinical and laboratory findings suggestive of SjD, were categorized as 'at-risk for childhood SjD' to highlight diagnostic challenges and spectrum of early presentations, based on comprehensive clinical evaluation by experienced pediatric rheumatologists.RESULTSThe cohort consisted of 81 patients (85.2% female, 14.8% male) with a median age at symptom onset of 11.4 years and a median follow-up of 24 months. Common clinical manifestations included dry mouth, dry eyes, arthralgia, fatigue, and parotitis. Fifty-one of the 81 patients met the 2016 ACR/EULAR classification criteria, while the remaining 30 were classified as an at-risk group. The most common clinical findings in 30 patients 'at-risk group' were xerostomia (90%), arthralgia (56.7%), fatigue (50%), and dry eyes (43.3%). Dry mouth, and peripheral nervous system involvements were found to be higher in patients categorized as at-risk (p = 0.03, p = 0.02, respectively).CONCLUSIONThe current classification criteria for childhood SjD appear to be inadequate, highlighting the need for pediatric-specific criteria that more accurately reflect the distinct clinical patterns observed in children.","PeriodicalId":501812,"journal":{"name":"The Journal of Rheumatology","volume":"8 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144640098","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":"Antimicrobial use and serious infections among psoriatic arthritis patients after initiating tumor necrosis factor inhibitors: a nationwide matched cohort study.","authors":"Telma Thrastardottir,Aron Hjalti Bjornsson,Alexis Ogdie,Arna Hauksdottir,Sigurdur Yngvi Kristinsson,Bjorn Gudbjornsson,Thorvardur Jon Love, ","doi":"10.3899/jrheum.2025-0029","DOIUrl":"https://doi.org/10.3899/jrheum.2025-0029","url":null,"abstract":"OBJECTIVETo analyse antimicrobial use and serious infections (SI) among psoriatic arthritis (PsA) patients before and after initiating TNF inhibitor (TNFi) treatment.METHODSIn this nationwide matched cohort study, we extracted data on PsA patients initiating TNFi from 2005 to 2018 from the ICEBIO registry and matched them by age, sex, and calendar time to five randomly selected comparators from the general population. All filled prescriptions for antimicrobials, glucocorticoids, and methotrexate two years before and after initiating TNFi treatment were extracted from the Icelandic Prescription Medicines Register. All infection-related hospitalisations, a proxy for SI, were extracted from the Icelandic Hospital Discharge Register.RESULTSThe study included 399 PsA patients and 1,986 matched comparators. Patients received more antimicrobial prescriptions before TNFi treatment, with a mean number of prescriptions (NP) per year of 1.26 vs. 0.60 (p<0.001). The mean NP increased to 1.64 (p<0.001) in the 12 months following TNFi initiation but returned to baseline thereafter. No statistically significant increase in SI was found. Adjusted for covariates, PsA patients had HR of 1.43 (95% CI 1.18-1.72, p<0.001) for receiving a prescription for antimicrobials following TNFi treatment initiation compared to themselves before TNFi treatment. The risk was increased in the first year after treatment initiation but not in the second year, suggesting a transient effect.CONCLUSIONFollowing TNFi initiation, antimicrobial use rose temporarily, with no significant increase in SI. These results support the safety of TNFi in PsA management and the risk of SI should not weigh heavily in treatment decisions.","PeriodicalId":501812,"journal":{"name":"The Journal of Rheumatology","volume":"92 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144640100","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":"Personalizing Management of Systemic Sclerosis-Associated Interstitial Lung Disease: Are Autoantibodies the Key for Risk Stratification?","authors":"Cosimo Bruni,Muriel Elhai,Oliver Distler","doi":"10.3899/jrheum.2025-0692","DOIUrl":"https://doi.org/10.3899/jrheum.2025-0692","url":null,"abstract":"","PeriodicalId":501812,"journal":{"name":"The Journal of Rheumatology","volume":"22 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144640101","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":"Necrotizing and non-Necrotizing Granulomatous Reactions in Cancer Patients Treated with Immune Checkpoint Inhibitors: a Systematic Literature Review.","authors":"Elizabeth Y Wang,Genna Braverman,Nilasha Ghosh,Deanna P Jannat-Khah,Karmela K Chan,Jean-Marie Michot,Bridget Jivanelli,Anne R Bass","doi":"10.3899/jrheum.2025-0108","DOIUrl":"https://doi.org/10.3899/jrheum.2025-0108","url":null,"abstract":"OBJECTIVEImmune checkpoint inhibitors (ICI) have improved cancer outcomes but often cause immune-related adverse events (irAE), including granulomatous reactions (GR). We analyzed GR in patients receiving anti-CTLA4, anti-PD1/PDL1 and combination anti-CTLA4/PD1 therapies.METHODSWe performed a literature review of GR in patients receiving ICI. Data were extracted from 166 articles, including demographics, GR organ distribution and pathological findings.RESULTSIn 261 patients, the mean age of GR onset was 59.3 ± 13.0 years. The most common cancer types were melanoma (57%) and lung cancer (21%). Lymph nodes (35%) and skin (24%) were the predominantly affected organs, however GR also involved the liver, kidney, and bone. Granulomas were non-necrotizing in 64% of cases and necrotizing in 15% of cases. Forty-five percent of patients were treated with systemic steroids, and eleven percent required a steroid-sparing agent. Median follow-up time was 10.1 [4, 22] months. Most GR (64%) had resolved by last follow-up. Compared to those treated with combination ICI, patients treated with anti-PD1/PDL-1 monotherapy were older and had a longer time to onset of the GR. They were less likely to be treated with steroids for GR. In melanoma patients, necrotizing GR were more common in combination ICI. GR in the lungs and nodes were more likely to be non-necrotizing, and GR in the liver were more commonly necrotizing.CONCLUSIONGR in cancer patients treated with ICI can occur in many organ systems and were most commonly non-necrotizing. Patients treated with combination ICI had more severe reactions. Most granulomatous reactions resolved with steroid treatment or ICI discontinuation.","PeriodicalId":501812,"journal":{"name":"The Journal of Rheumatology","volume":"96 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144640099","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":"Herpes Zoster Vaccine and Rheumatoid Arthritis.","authors":"Shih-Wei Lai","doi":"10.3899/jrheum.2025-0272","DOIUrl":"https://doi.org/10.3899/jrheum.2025-0272","url":null,"abstract":"","PeriodicalId":501812,"journal":{"name":"The Journal of Rheumatology","volume":"25 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144533523","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":"Residual Disease Activity and Burden of Disease in Canadian Patients with Axial Spondyloarthritis: Results from a Multi-registry Analysis (UNISON-Axial SpA).","authors":"Denis Choquette,Dafna D Gladman,Robert D Inman,Proton Rahman,Marie-Claude Laliberté,Pierre-André Fournier,Tanya Girard,Stephanie Wichuk,Louis Coupal,Vinod Chandran,Sherry Rohekar,Tristan Boyd,Michel Zummer,Nicolas Richard,Carter Thorne,Dianne Mosher,Olga Ziouzina,Alexander Tsoukas,Michael Starr,Jonathan Chan,Sibel Zehra Aydin,Walter P Maksymowych","doi":"10.3899/jrheum.2024-1303","DOIUrl":"https://doi.org/10.3899/jrheum.2024-1303","url":null,"abstract":"OBJECTIVEThere is a key knowledge gap in quantifying residual disease activity in Canadian patients with axial spondyloarthritis (axSpA). The objective of this study was to evaluate and describe residual disease activity and burden of disease in Canadian patients with axSpA.METHODSThis was an observational, retrospective analysis of data extracted from the Rhumadata™ (Québec), SPondyloArthritis Research Consortium of Canada (SPARCC, East/Atlantic and West regions, and Ontario), and FOllow-up Research Cohort of Ankylosing SpondyliTis (FORCAST, Alberta) registries. The primary endpoint was proportion of patients who failed to achieve sustained low disease activity (LDA) at 12 months; LDA was defined as a Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) score <3 and sustained LDA defined as achieving LDA at both 6 and 12 months after the most recent change in treatment. Analyses included outcomes by treatment class (nonsteroidal anti-inflammatory drugs [NSAIDs], tumor necrosis factor inhibitor, or interleukin-17 inhibitor).RESULTSA total of 980 patients (Rhumadata™, N=488; SPARCC, N=239; FORCAST, N=253) were included. Nearly half of patients with axSpA from Rhumadata™/Québec (49.5%) and FORCAST/Alberta (55.3%) and 65.8% of those from SPARCC/Ontario failed to achieve LDA (BASDAI <3) at 6 months after treatment initiation. At 12 months, failure to achieve sustained LDA rose to 62.0% in Rhumadata™/Québec, 65.1% in FORCAST/Alberta, and 81.0% in SPARCC/Ontario. Pain persisted in nearly half of all patients.CONCLUSIONThis analysis demonstrated that most Canadians with axSpA failed to achieve sustained LDA after 12 months of initiating their latest therapy and confirms a high unmet need for additional treatments.","PeriodicalId":501812,"journal":{"name":"The Journal of Rheumatology","volume":"11 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144533519","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":"Endothelial Cell and Neutrophil Activation in Untreated Intercritical Patients With Gout.","authors":"Michael Toprover,Binita Shah,Kamelia Drenkova,Ana Leonard,Michael H Pillinger,Michael Garshick","doi":"10.3899/jrheum.2025-0255","DOIUrl":"https://doi.org/10.3899/jrheum.2025-0255","url":null,"abstract":"","PeriodicalId":501812,"journal":{"name":"The Journal of Rheumatology","volume":"154 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144533613","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":"Prevalence, Risk Factors, and Outcomes of Chronic Kidney Disease in Systemic Lupus Erythematosus Patients with and without Lupus Nephritis.","authors":"Keren Cohen-Hagai,Mor Saban,Sydney Benchetrit,Dorin Bar-Ziv,Naomi Nacasch,Moshe Shashar,Yael Pri-Paz Basson,Ori Wand,Ayelet Grupper,Shaye Kivity,Oshrat E Tayer-Shifman","doi":"10.3899/jrheum.2024-1087","DOIUrl":"https://doi.org/10.3899/jrheum.2024-1087","url":null,"abstract":"OBJECTIVEChronic kidney disease (CKD) has significant clinical and therapeutic implications. This study assesses CKD prevalence, risk factors, and long-term outcomes in systemic lupus erythematosus (SLE) with and without lupus nephritis (LN).METHODSThis single-center, retrospective medical records review study (2014-2023) included adult SLE patients. CKD was defined as estimated glomerular filtration rate (eGFR) <60 ml/min/1.73m2 or albuminuria ≥30 mg/24h in at least two consecutive tests, spaced ≥ 3 months apart. Statistical analyses included chi-squared tests, t-tests, multivariable regression, and Cox proportional hazards models.RESULTS175 SLE patients were included with a mean follow-up of 18.3±14.7 years; 12 required kidney replacement therapy. CKD was diagnosed in 54.6% (89/163) of patients, including 15.7% with reduced eGFR only, 52.8% with albuminuria only, and 31.5% with both. LN was associated with a higher hazard ratio (HR=5.4) for CKD. Nevertheless, 46.1% of CKD patients had no history of LN. CKD was associated with increased cardiovascular morbidity, hospitalization rates for SLE exacerbations and infections. Cox analyses identified LN as the strongest predictor of CKD; other predictors were age and lower eGFR at diagnosis. CKD was an important predictor of mortality among patients with lupus, both in univariate and multivariable analyses (19.1% vs. 1.4%, p<0.001).CONCLUSIONCKD is highly prevalent in SLE, including in patients without prior LN. CKD is associated with increased morbidity and mortality. This study emphasizes the clinical relevance of CKD diagnosis and management in SLE patients.","PeriodicalId":501812,"journal":{"name":"The Journal of Rheumatology","volume":"47 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144533517","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":"Comparative Analysis of Damage Accrual in Lupus Nephritis Stratified by Biological Sex.","authors":"Fadi Kharouf,Pankti Mehta,Ali Alhadri,Qixuan Li,Laura P Whittall Garcia,Dafna D Gladman,Zahi Touma","doi":"10.3899/jrheum.2025-0302","DOIUrl":"https://doi.org/10.3899/jrheum.2025-0302","url":null,"abstract":"OBJECTIVESeveral studies in systemic lupus erythematosus (SLE) have suggested that male individuals may experience a higher risk of damage compared to female individuals. However, this has not been adequately explored in cohorts focused specifically on lupus nephritis (LN). We aimed to investigate sex-based differences in the accrual of both extrarenal and renal damage in a cohort of patients with LN.METHODSThis retrospective study included patients with SLE from an observational cohort who developed LN at or after clinic entry. Outcomes of extrarenal and renal damage were assessed using the Systemic Lupus International Collaborating Clinics/American College of Rheumatology Damage Index (SDI) and kidney function measures. Statistical analyses included Fine-Gray subdistribution hazard models and Kaplan-Meier survival analysis.RESULTSThe cohort included 460 patients, with a predominance of female individuals (83.5%) and a median age of 33 years. Over a median follow-up of 8.6 years, 45.3% of patients accrued extrarenal damage, defined as an increase in nonrenal SDI by ≥ 1, whereas 32.2% experienced renal damage, defined as a composite of either a sustained ≥ 30% decline in estimated glomerular filtration rate or progression to end-stage kidney disease. No significant differences in the accrual of damage were observed between male and female individuals, and the time to outcomes was not statistically different between both sexes. Multivariable analysis revealed that male sex was not associated with higher damage accrual, either extrarenal (hazard ratio [HR] 1.13, 95% CI 0.76-1.70) or renal (HR 1.26, 95% CI 0.67-2.36).CONCLUSIONExtrarenal and renal damage accrual are frequent in patients with LN and do not appear to be higher in male individuals.","PeriodicalId":501812,"journal":{"name":"The Journal of Rheumatology","volume":"648 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144533518","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":"Quantification of Hand Blood Flow by 82Rubidium Positron Emission Tomography.","authors":"Attila Feher,Ilayda Gunes,Ibolya Csecs,Dana C Peters,Albert J Sinusas,Edward J Miller,Monique Hinchcliff","doi":"10.3899/jrheum.2025-0415","DOIUrl":"https://doi.org/10.3899/jrheum.2025-0415","url":null,"abstract":"","PeriodicalId":501812,"journal":{"name":"The Journal of Rheumatology","volume":"3 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144533521","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}