The Journal of Rheumatology最新文献

{"title":"Quantifying Cutaneous Dermatomyositis: A Novel 3D Image-based Approach.","authors":"Nantakarn Pongtarakulpanit,Anuradha Bishnoi,Tanya Chandra,Sedin Dzanko,Eugenia Gkiaouraki,Shiri Keret,Raisa Lomanto Silva,Shreya Sriram,Didem Saygin,Vladimir M Liarski,Dana P Ascherman,Chester V Oddis,Siamak Moghadam-Kia,Rohit Aggarwal","doi":"10.3899/jrheum.2025-0537","DOIUrl":"https://doi.org/10.3899/jrheum.2025-0537","url":null,"abstract":"OBJECTIVEVisual examination of skin lesions has considerable subjectivity and inter-rater variability. This study assessed the feasibility of a 3D image-based assessment of cutaneous disease activity in dermatomyositis (DM).METHODSDM patients were evaluated in a prospective study at 2 time points for skin rash assessment using the Cutaneous Dermatomyositis Disease Area and Severity Index (CDASI) and 3D images. A \"3D image disease activity score (3DAS)\" was calculated based on the percentage of the rashes relative to the total body surface area, multiplied by the degree of rash redness. The construct validity and responsiveness of 3DAS were evaluated using the Spearman correlation coefficient (rsp) against standard CDASI and patient-reported outcome measures (PROMs). A generalized linear regression model assessed the relationship between the 3D image-derived rash area and redness with the CDASI score.RESULTS27 DM patients (81.5% female, 96.3% White; median age 50.0 years) were enrolled. The median (IQR) CDASI score at baseline was 6.0 (0.0 - 17.0). For the construct validity, 3DAS correlated strongly with the CDASI (rsp = 0.83, p < 0.001) and PROMs. The generalized linear regression analysis identified the rash area and redness from 3D images as significant predictors of the CDASI score. Regarding responsiveness, absolute changes from baseline in the 3DAS correlated strongly with the CDASI score (rsp = 0.61, p = 0.004).CONCLUSIONOur results demonstrate favorable validity and responsiveness of the 3D images for evaluating rash in DM patients. The 3D image-derived rash area and redness are significant predictors of CDASI scores.","PeriodicalId":501812,"journal":{"name":"The Journal of Rheumatology","volume":"34 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145203766","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":"Racial and Ethnic Disparities in Disease-Modifying Antirheumatic Drug Use Among Adults With Rheumatoid Arthritis in the United States.","authors":"Ashkan F Ara,Matthew Chenoweth,Srikanth Kadiyala,Utibe R Essien,Christopher Scannell","doi":"10.3899/jrheum.2025-0290","DOIUrl":"https://doi.org/10.3899/jrheum.2025-0290","url":null,"abstract":"","PeriodicalId":501812,"journal":{"name":"The Journal of Rheumatology","volume":"99 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145203772","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":"Confidence in the Use of Immunomodulatory Medications During Pregnancy: How Can Patient and Clinician Experience Be Improved?","authors":"Laura Andreoli,Mette Julsgaard,Karen Schreiber","doi":"10.3899/jrheum.2025-0941","DOIUrl":"https://doi.org/10.3899/jrheum.2025-0941","url":null,"abstract":"","PeriodicalId":501812,"journal":{"name":"The Journal of Rheumatology","volume":"125 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145203718","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 Debate: Be it Resolved That Clinical Enthesitis Indices Do Not Reflect True Enthesitis and Hence Should Be Discontinued.","authors":"Betul Macit,Sibel Zehra Aydin,Atul Deodhar","doi":"10.3899/jrheum.2025-0910","DOIUrl":"https://doi.org/10.3899/jrheum.2025-0910","url":null,"abstract":"Enthesitis is increasingly recognized as a key manifestation of psoriatic disease (PsD). However, how best to assess enthesitis remains a point of discussion due to limitations of the existing assessment tools, including their inability to differentiate between inflammatory and noninflammatory enthesitis as well as a high placebo response in clinical trials. At the Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA) 2024 annual meeting, a debate was held to address whether traditional clinical enthesitis indices should be discontinued for PsD. Dr. Sibel Aydin advocated for their discontinuation, emphasizing that clinical indices often capture \"enthesalgia\" (pain at the entheseal sites overlapping with pain disorders like fibromyalgia) rather than true inflammatory enthesitis. These clinical indices may lack specificity for detecting inflammation, which can lead to inaccurate assessments. Further, studies show high reports of placebo response when using clinical indices, suggesting their limitations in discriminating active disease from noninflammatory pain mechanisms. Aydin advocated for prioritizing emerging imaging tools over traditional clinical indices. Dr. Atul Deodhar argued against discontinuation of traditional clinical enthesitis indices, highlighting that despite limitations, these indices have been used successfully in multiple randomized controlled trials, leading to approval of numerous treatment options for psoriatic arthritis. Although promising, alternative imaging modalities like ultrasound to evaluate inflammation come with their own challenges, including operator dependency, variability in interpretation, and lack of regulatory approval as a standardized outcome measure. This report presents both perspectives, analyzing the evidence and implications for the future of enthesitis assessment in clinical practice.","PeriodicalId":501812,"journal":{"name":"The Journal of Rheumatology","volume":"17 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145203867","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":"Renal AA Amyloidosis Associated With Systemic Lupus Erythematosus Treated With Anakinra.","authors":"Jesús López-Martínez,Joan Esplugues Clos,Andrea Fernández-Valmaña,Carlos Feijoo-Massó","doi":"10.3899/jrheum.2025-0431","DOIUrl":"https://doi.org/10.3899/jrheum.2025-0431","url":null,"abstract":"","PeriodicalId":501812,"journal":{"name":"The Journal of Rheumatology","volume":"114 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145203719","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":"Trends in Patient Accrual Rates, Screening Failures, and Related Reasons in Antineutrophil Cytoplasmic Antibody-Associated Vasculitis Randomized Controlled Trials.","authors":"Michele Iudici,Barbara Russo,Xavier Puéchal","doi":"10.3899/jrheum.2025-0691","DOIUrl":"https://doi.org/10.3899/jrheum.2025-0691","url":null,"abstract":"","PeriodicalId":501812,"journal":{"name":"The Journal of Rheumatology","volume":"38 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145203720","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":"Evaluating Implementation Context to Prepare for Scaling-Up the Integration of Interdisciplinary Healthcare Providers in Rheumatology Practices: A Rheumatology Workforce Survey.","authors":"Jessica Widdifield,Celia Laur,Timothy S H Kwok,Laura Oliva,C Thomas Appleton,Vandana Ahluwalia,J Carter Thorne,Nicolas S Bodmer,Molly J Gomes,Jenna C Wong,Jennifer Ji Young Lee,Claire E H Barber,Laura Passalent,Lauren K King","doi":"10.3899/jrheum.2025-0683","DOIUrl":"https://doi.org/10.3899/jrheum.2025-0683","url":null,"abstract":"OBJECTIVEInterdisciplinary healthcare providers (IHPs) can support effective delivery of optimal rheumatology care. To inform widespread implementation efforts, we assessed rheumatology workforce characteristics and determinants of integrating of IHPs within rheumatology practices in Ontario, Canada.METHODSA convergent mixed methods design included an environmental scan to identify clinically active rheumatologists and a workforce survey guided by the Consolidated Framework for Implementation Research 2.0. Quantitative data were analyzed descriptively and stratified by subgroups. Qualitative responses were analyzed using conventional content analysis. Integration of findings enabled a comprehensive understanding of implementation determinants.RESULTSOf the 293 Ontario rheumatologists identified by the environmental scan (as of 2025), 26 were nearing retirement, leaving approximately 267 eligible for the survey. 197 rheumatologists participated in the survey, yielding a response rate of 74%, and coverage of >90% of practice sites. Pediatric rheumatologists and those in hospital-based settings had more structural and collaborative supports than community-based rheumatologists. Overall, 177 (91%) indicated they were interested in adding IHPs, with 126 (65%) preferring an Extended Role/Scope Provider. While inadequate funding was the key deterrent to adoption, motivational readiness was high: 92% perceived an IHP team-based model as an improvement, 85% saw it as a good fit, and 83% considered it a priority to better meet patient needs. Many noted a lack of supportive climate, including lack of support, processes, and resources to enable this practice change.CONCLUSIONRheumatologists report high motivation for practice change to integrate IHPs. System-level and practice-level implementation strategies are needed to support workforce transformation.","PeriodicalId":501812,"journal":{"name":"The Journal of Rheumatology","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145203880","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":"Clinical Features and Outcome Measures Across Still's Disease (sJIA and AOSD) Cohorts Worldwide: A Systematic Literature Review.","authors":"Erin Balay-Dustrude,Mariana Correia Marques,Simone Appenzeller,Claudia Bracaglia,Fatma Dedeoglu,Esraa Eloseily,Penelope Martinez Jimenez,Michael J Ombrello,Karen Onel,Marinka Twilt,Xurong Zhao,Francesca Minoia,Susan Shenoi, ","doi":"10.3899/jrheum.2025-0822","DOIUrl":"https://doi.org/10.3899/jrheum.2025-0822","url":null,"abstract":"OBJECTIVEMultinational research is essential to improve recognition and management of systemic juvenile idiopathic arthritis (sJIA). Current cohorts vary in the clinical parameters and outcome measures collected. sJIA and Adult-Onset Still's Disease (AOSD) are widely considered to comprise a single disease spectrum, however, classification criteria and clinical tools used differ between groups. This systematic literature review aimed to identify clinical features and outcome measures collected across sJIA and AOSD cohorts worldwide to guide development of a minimal dataset for Still's Disease.METHODSA literature search was conducted from 2000-2024 using OVID MEDLINE, Embase, and Wiley Cochrane Library (Trials). Included articles were in English and described sJIA or AOSD cohorts of ≥20 patients, reporting patient characteristics, clinical and laboratory features, and outcome measures.RESULTS240 articles were included (95 sJIA, 134 AOSD, 11 mixed), from 37 countries, describing 23,136 patients. ILAR classification was used in 77.8% of sJIA studies, while 98.5% of AOSD studies used Yamaguchi criteria. There was no clear consensus on the definition of macrophage activation syndrome. Race and ethnicity were only reported in 11.7% of articles. Cohorts evaluated aligned on the most commonly collected laboratory items for both AOSD and sJIA, with some agreement among clinical features, while disease outcome measures used to evaluate and follow disease trajectory were variable.CONCLUSIONData reporting across sJIA and AOSD cohorts for clinical and outcome measures is widely heterogeneous. Consensus on identification of a standardized minimal dataset for Still's Disease cohorts is needed to foster future collaboration and improve patient outcomes.","PeriodicalId":501812,"journal":{"name":"The Journal of Rheumatology","volume":"101 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145203767","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":"Anifrolumab in Systemic Lupus Erythematosus With Severe Hematological Manifestations: A Spanish Multicenter Study.","authors":"Adrián Mayo-Juanatey,Santos Castañeda,Vanesa Calvo-Río,Marta Garijo-Bufort,Miriam Retuerto-Guerrero,Marina Salido Olivares,Juan José Alegre-Sancho","doi":"10.3899/jrheum.2025-0658","DOIUrl":"https://doi.org/10.3899/jrheum.2025-0658","url":null,"abstract":"","PeriodicalId":501812,"journal":{"name":"The Journal of Rheumatology","volume":"27 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145203862","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 2024 Annual Meeting: An Update on Major Project Milestones.","authors":"Keith Colaco,Lihi Eder,Suzanne M Grieb,Ying Ying Leung,Ennio Lubrano,Philip J Mease,Lourdes M Perez-Chada,Denis Poddubnyy,Enrique R Soriano,Vinod Chandran","doi":"10.3899/jrheum.2025-0839","DOIUrl":"https://doi.org/10.3899/jrheum.2025-0839","url":null,"abstract":"At the Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA) 2024 annual meeting, members were updated on several ongoing activities during the key project update session. These activities included the Biomarker Project, the Axial Psoriatic Arthritis Molecular and Clinical Characterization study, the Diagnostic Ultrasound Enthesitis Tool (DUET) study, the Sex- and Gender-Based Analysis of the Effectiveness of Advanced Therapies in Psoriatic Arthritis (SAGE-PsA) study, the Early Recognition of PsA (COMPOSITION) study, and the GRAPPA treatment recommendations.","PeriodicalId":501812,"journal":{"name":"The Journal of Rheumatology","volume":"99 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145203716","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}