The Journal of Rheumatology最新文献

Unmet Needs in Spondyloarthritis: Pathogenesis, Clinical Trial Design, and Nonpharmacologic Therapy. 脊柱关节炎未满足的需求：发病机制、临床试验设计和非药物疗法。

The Journal of Rheumatology Pub Date : 2024-10-24 DOI: 10.3899/jrheum.2024-0939

Laura C Coates,Georg Schett,Chenchen Wang,Pamela F Weiss

{"title":"Unmet Needs in Spondyloarthritis: Pathogenesis, Clinical Trial Design, and Nonpharmacologic Therapy.","authors":"Laura C Coates,Georg Schett,Chenchen Wang,Pamela F Weiss","doi":"10.3899/jrheum.2024-0939","DOIUrl":"https://doi.org/10.3899/jrheum.2024-0939","url":null,"abstract":"A program focused on pathogenesis, clinical trial design, and nonpharmacologic mind-body therapy for of spondyloarthritis (SpA) was presented at the Spondylitis Association of America Unmet Needs Conference IV. SpA pathogenesis is incompletely understood but involves a complex set of drivers, including genetics, biomechanical stress, and microbial factors. Affected tissues may include axial and peripheral joints, entheses, skin, uvea, and intestines. The specific role of key cytokines like interleukin (IL)-23, IL-17, and tumor necrosis factor in the phases of this inflammatory process remains unclear. New insights into pathogenesis will continue to generate targets for novel therapeutics. How to optimally evaluate those therapeutics in clinical trials, and for the various manifestations of SpA, remains less clear. Future trials need better generalizability, robust subgroup analyses to assess differential responses for distinct disease manifestations, a focus on comparative efficacy, and outcomes relevant to the clinician and the patient. Additionally, study designs need to leverage available technology to facilitate subject participation in trials. In view of the interplay between biologic, physical, and psychological aspects of disease, there is increasing attention to nonpharmacologic agents, with the aim of maximizing long-term health-related quality of life through the control of symptoms and inflammation. Recent studies provide encouraging evidence that mind-body interventions such as tai chi, qigong, yoga, and meditation have benefits for patients with SpA, particularly those with pain. The advances in our understanding of pathogenesis, novel therapeutics, and nonpharmacologic interventions have revolutionized the management of SpA, but numerous questions around optimal management remain.","PeriodicalId":501812,"journal":{"name":"The Journal of Rheumatology","volume":"236 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142490537","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}

引用次数: 0

Unmet Needs in Spondyloarthritis: Understanding and Managing Chronic Pain. 脊柱关节炎未满足的需求：了解和管理慢性疼痛。

The Journal of Rheumatology Pub Date : 2024-10-24 DOI: 10.3899/jrheum.2024-0936

Yvonne C Lee,Anne-Marie Malfait,Alexis R Ogdie

引用次数: 0

Unmet Needs in Spondyloarthritis: Imaging in Axial Spondyloarthritis. 脊柱关节炎未满足的需求：轴性脊柱关节炎的成像。

The Journal of Rheumatology Pub Date : 2024-10-24 DOI: 10.3899/jrheum.2024-0937

Lianne S Gensler,Lennart Jans,Sharmila Majumdar,Denis Poddubnyy

{"title":"Unmet Needs in Spondyloarthritis: Imaging in Axial Spondyloarthritis.","authors":"Lianne S Gensler,Lennart Jans,Sharmila Majumdar,Denis Poddubnyy","doi":"10.3899/jrheum.2024-0937","DOIUrl":"https://doi.org/10.3899/jrheum.2024-0937","url":null,"abstract":"Imaging biomarkers in axial spondyloarthritis (axSpA) are currently the most specific biomarkers for the diagnosis of this condition. Despite advances in imaging, from plain radiographs-which detect only damage-to magnetic resonance imaging (MRI)-which identifies disease activity and structural change-there are still many challenges that remain. Imaging in sacroiliitis is characterized by active and structural changes. Current classification criteria stress the importance of bone marrow edema (BME); however, BME can occur in various diseases, mechanical conditions, and healthy individuals. Thus, the identification of structural lesions such as erosion, subchondral fat, backfill, and ankylosis is important to distinguish from mimics on differential diagnosis. Various imaging modalities are available to examine structural lesions, but computed tomography (CT) is considered the current reference standard. Nonetheless, recent advances in MRI allow for direct bone imaging and the reconstruction of CT-like images that can provide similar information. Therefore, the ability of MRI to detect and measure structural lesions is strengthened. Here, we present an overview of the spectrum of current and cutting-edge techniques for SpA imaging in clinical practice; namely, we discuss the advantages, disadvantages, and usefulness of imaging in SpA through radiography, low-dose and dual-energy CT, and MRI. Cutting-edge MRI sequences including volumetric interpolated breath-hold examination, ultrashort echo time, zero echo time, and deep learning-based synthetic CT that creates CT-like images without ionizing radiation, are discussed. Imaging techniques allow for quantification of inflammatory and structural lesions, which is important in the assessment of treatment response and disease progression. Radiographic damage is poorly sensitive to change. Artificial intelligence has already revolutionized radiology practice, including protocolization, image quality, and image interpretation.","PeriodicalId":501812,"journal":{"name":"The Journal of Rheumatology","volume":"35 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142490538","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}

引用次数: 0

Enhancing Equity in Clinical Research: A Multifaceted Proposal for Spondyloarthritis. 加强临床研究的公平性：脊柱关节炎的多方面建议。

The Journal of Rheumatology Pub Date : 2024-10-24 DOI: 10.3899/jrheum.2024-0938

Maureen Dubreuil,Elizabeth D Ferucci,Hani El-Gabalawy,Sarfaraz Hasni,Edith M Williams

{"title":"Enhancing Equity in Clinical Research: A Multifaceted Proposal for Spondyloarthritis.","authors":"Maureen Dubreuil,Elizabeth D Ferucci,Hani El-Gabalawy,Sarfaraz Hasni,Edith M Williams","doi":"10.3899/jrheum.2024-0938","DOIUrl":"https://doi.org/10.3899/jrheum.2024-0938","url":null,"abstract":"Clinical research advances medical knowledge and improves healthcare outcomes. However, disparities in research participation hinder progress. The Unmet Research Needs in Spondyloarthritis Conference IV highlighted critical insights and strategies to enhance equity in clinical research. Talks focused on engaging underrepresented communities and addressing disparities in rheumatic diseases, particularly spondyloarthritis (SpA), to ensure research results are generalizable and inclusive. Disparities in SpA management, such as greater back pain severity among Black and Hispanic Americans and sex-based differences in pain management, emphasize the need for equitable research. Dr. Elizabeth Ferucci discussed the racial disparities in rheumatologic care, highlighting the importance of early access to rheumatologists and culturally informed primary care to improve outcomes. Dr. Hani El-Gabalawy's talk on engaging Indigenous communities stressed the importance of community consent and reciprocal benefits. Dr. Sarfaraz Hasni's presentation on mitigating disparities in research participation underscored the need for inclusive practices and strategies to promote diverse representation. Finally, Dr. Edith Williams emphasized institutional approaches to fostering equity, including diverse recruitment practices and institutional review board alignment with diversity priorities. Strategies to enhance equity in clinical research include community engagement, addressing logistical barriers to participation, and ensuring diverse research teams. These approaches can dismantle barriers for underrepresented communities, making research more accessible and reflective of the broader population. The SpA research community must commit to creating structures that foster inclusivity, ensuring medical advancements benefit all populations, especially historically underrepresented groups. The principles and strategies proposed serve as a roadmap for achieving equity in SpA research.","PeriodicalId":501812,"journal":{"name":"The Journal of Rheumatology","volume":"25 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142490503","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}

引用次数: 0

Prologue: Spondyloarthritis Unmet Research Needs Conference IV. 序言：脊柱关节炎未满足的研究需求会议 IV.

The Journal of Rheumatology Pub Date : 2024-10-24 DOI: 10.3899/jrheum.2024-0933

Robert A Colbert,Ellen Carroll,Maureen Dubreuil,Lianne S Gensler,Nigil Haroon,Richard Howard,Alexis R Ogdie,Cassie Shafer,Pamela F Weiss,Kristine A Kuhn

引用次数: 0

Are There Disease Endotypes in Axial Spondyloarthritis and How Would We Define Them? 轴性脊柱关节炎是否存在疾病内型，我们该如何定义它们？

The Journal of Rheumatology Pub Date : 2024-10-24 DOI: 10.3899/jrheum.2024-0935

Kevin D Deane,Laura T Donlin,Christopher T Ritchlin,Kristine A Kuhn

引用次数: 0

The Rheumatologist as the Agent of Change: Utility of Guidelines in the Management of Gout. 风湿病医生是变革的推动者：痛风管理指南的实用性。

The Journal of Rheumatology Pub Date : 2024-10-15 DOI: 10.3899/jrheum.2024-0957

Puja P Khanna

引用次数: 0

Epidemiological characteristics of patients with juvenile dermatomyositis in China: a multicenter study. 中国幼年皮肌炎患者的流行病学特征：一项多中心研究。

The Journal of Rheumatology Pub Date : 2024-10-15 DOI: 10.3899/jrheum.2024-0003

Xuanyi Liu,Junmei Zhang,Hui Xu,Weiying Kuang,Jianghong Deng,Xiaohua Tan,Chao Li,Shipeng Li,Yuan Xue,Guoshuang Feng,Caifeng Li,

{"title":"Epidemiological characteristics of patients with juvenile dermatomyositis in China: a multicenter study.","authors":"Xuanyi Liu,Junmei Zhang,Hui Xu,Weiying Kuang,Jianghong Deng,Xiaohua Tan,Chao Li,Shipeng Li,Yuan Xue,Guoshuang Feng,Caifeng Li,","doi":"10.3899/jrheum.2024-0003","DOIUrl":"https://doi.org/10.3899/jrheum.2024-0003","url":null,"abstract":"OBJECTIVEJuvenile dermatomyositis (JDM) is a rare but chronic autoimmune disease with systemic nonsuppurative inflammation. Many studies have focused on the clinical characteristics and therapy of JDM. A few studies have reported the epidemiological characteristics and social burden of JDM patients abroad, but there has been no study in China.METHODSThis study was based on the FUTang Updating medical REcords Database. Data was extracted from the registry information of inpatient medical records. The epidemiological characteristics and economic burden of Chinese JDM patients were analyzed.RESULTSA total of 1164 JDM patients from 24 hospitals were enrolled from Jan 2016 to Dec 2021. The ratio of boys to girls was 1:1.23, and half were between 6 and 12 years old. Over half(n=629) were admitted to the hospital at least twice for intensive treatment. 20% of JDM patients suffered from lung involvement and 2.2% suffered from subcutaneous calcification. The median days of hospitalization were 10 (range 6 to 14), in addition, the median United States dollar (USD) of expense was 2370.5(1373.7,3541.9). Lung involvement was the major factor causing high inpatient burden, length of stay, and expense. Nearly, 17% of JDM patients were admitted to the hospital as emergencies, suggesting sever disease activity stage needing urgent treatment. No deaths occurred in our study.CONCLUSIONOur study documents the epidemiological characteristics and social burden of JDM patients in China, contributing to the enhanced comprehension and effective management of JDM in the country.","PeriodicalId":501812,"journal":{"name":"The Journal of Rheumatology","volume":"22 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142443770","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}

引用次数: 0

Rising? trends in Anxiety and Depression among Individuals with Rheumatoid Arthritis: A Population-Based Study. 类风湿关节炎患者焦虑和抑郁的上升趋势：基于人群的研究。

The Journal of Rheumatology Pub Date : 2024-10-15 DOI: 10.3899/jrheum.2024-0165

Rachel E Giblon,Sara J Achenbach,Elena Myasoedova,John M Davis,Vanessa Kronzer,William V Bobo,Cynthia S Crowson

{"title":"Rising? trends in Anxiety and Depression among Individuals with Rheumatoid Arthritis: A Population-Based Study.","authors":"Rachel E Giblon,Sara J Achenbach,Elena Myasoedova,John M Davis,Vanessa Kronzer,William V Bobo,Cynthia S Crowson","doi":"10.3899/jrheum.2024-0165","DOIUrl":"https://doi.org/10.3899/jrheum.2024-0165","url":null,"abstract":"OBJECTIVETo investigate trends in depression and anxiety over three decades among individuals with rheumatoid arthritis (RA).METHODSPatients with incident RA (age >18 years, meeting 1987 ACR criteria in 1985-2014) were identified using the Rochester Epidemiology Project. Individuals with RA were matched 1:1 with non-RA comparators on age, sex, and calendar year of RA incidence. Patients were followed until death, migration or 12/31/2020. Depression and anxiety were defined using established ICD9/10 code sets. Cox models were used to compare trends in the occurrence of depression and anxiety diagnoses and cooccurring anxiety and depression by decade and RA status, adjusted for potential confounders.RESULTSThe study included 1,012 individuals with RA and 1,012 matched controls (mean age 55.9 years; 68.38% female). Hazard ratios (HR) demonstrated a temporal increase in anxiety and co-occurring anxiety and depression from 2005-2014 compared to 1985-1994 for individuals both with and without RA. Persons with RA exhibited a rising occurrence of anxiety (HR: 1.27; 95% confidence interval (CI): 0.86-1.88). and concomitant anxiety and depression (HR: 1.49; 95% CI: 0.96-2.33) compared to controls. Trends were most pronounced in seropositive RA patients (HR for anxiety: 4.01; 95% CI: 2.21-7.30).CONCLUSIONAnxiety and concomitant anxiety and depression diagnoses are elevated in individuals with RA. The increasing occurrence of anxiety and co-occurring anxiety and depression suggests rising awareness and diagnosis of these disorders. Adding to stable but high rates of depression diagnoses, individuals with RA now have evidence of a widening gap in mental health diagnoses that clinicians should address.","PeriodicalId":501812,"journal":{"name":"The Journal of Rheumatology","volume":"56 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142443771","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}

引用次数: 0

The Journal of Rheumatology Pub Date : 2024-10-15 DOI: 10.3899/jrheum.2024-0608

Maria Rydholm,Sofia Hagel,Lennart T H Jacobsson,Carl Turesson

{"title":"Disability Related to the Upper Extremities in Early Rheumatoid Arthritis - Long-term Course and Disease Parameter Impact: a cohort study.","authors":"Maria Rydholm,Sofia Hagel,Lennart T H Jacobsson,Carl Turesson","doi":"10.3899/jrheum.2024-0608","DOIUrl":"https://doi.org/10.3899/jrheum.2024-0608","url":null,"abstract":"OBJECTIVETo investigate the course of disability related to the upper extremities (UE) in early rheumatoid arthritis (RA), and to assess correlations between such disability and clinical parameters, including grip force.METHODSIn an inception cohort of patients with early RA (diagnosed 1995-2005, N=222, follow-up 10 years), disability of the UE was assessed using a subscore of the Health assessment questionnaire disability index (HAQ-DI), and average grip force of the dominant hand was measured. Changes between consecutive follow-up visits in the HAQ-DI-UE subscore, and correlations at each visit with key clinical parameters, were assessed. The relation between joint involvement and HAQ-DI-UE was examined using multivariate linear regression analysis.RESULTSThe HAQ-DI-UE decreased significantly from inclusion to the 6-month follow-up (mean change -0.26; 95% CI -0.18 to -0.34), and increased significantly after 2 years. There were fairly strong correlations for HAQ-DI-UE with grip force (r:-0.50 to -0.62), patient's global assessment (r: 0.58 to 0.64) and patient's assessment of pain (r:0.54 to 0.60) at all time points through 5 years, but only moderate to weak correlations with swollen joints, CRP and ESR. At inclusion wrist synovitis and tender proximal interphalangeal (PIP) joints had both an independent impact on HAQ-DI-UE, whereas tenderness of the shoulder and the wrist had a greater importance at 6 months.CONCLUSIONDisability related to the upper extremities decreased significantly during the first 6 months, and increased again after 2 years. The correlations with clinical parameters underline the major impact of pain and impaired hand function in early RA.","PeriodicalId":501812,"journal":{"name":"The Journal of Rheumatology","volume":"41 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142443773","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}

引用次数: 0