The Journal of Rheumatology最新文献

{"title":"Does Prior Authorization for Tocilizumab Lead to Unacceptable Treatment Delays in Giant Cell Arteritis?","authors":"Zhuan Jiang,Lillian Barra","doi":"10.3899/jrheum.2025-0423","DOIUrl":"https://doi.org/10.3899/jrheum.2025-0423","url":null,"abstract":"","PeriodicalId":501812,"journal":{"name":"The Journal of Rheumatology","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144065638","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":"Access, Effectiveness, Safety And Survival Of Secukinumab In Patients With Axial Spondyloarthritis And Axial Psoriatic Arthritis: Real-Life Study In Argentina.","authors":"María Victoria Martire,Josefina Marin,Hernán Maldonado Ficco,Mariana Benegas,Pamela Giorgis,Diego Vila,Carolina Ayelen Isnardi,María Julieta Gamba,Javier Federico Flores Trejo,Rodolfo Perez-Alamino,Antonio Jorge Chemez,Leandro Ferreyra Garrott,Micaela A Cosatti,Emilio Andrés Buschiazzo,María de Los Angeles Correa,Rodrigo Aguila Maldonado,Brian Manases Roldan,Camila Lizarraga,Maria Agustina Alfaro,Julieta Morbiducci,Lia Valentina Ingolotti,Gisela Pendón,Romina Estefanía Nieto,María Sofía Velloso,Alejandro Martinez Muñoz,Nicolás Lloves Schenone,Natalia V Zamora,Etel Saturansky,Ana Carolina Costi,Maria Jezabel Haye Salinas,Carla Antonela Airoldi,Amelia Granel","doi":"10.3899/jrheum.2024-1185","DOIUrl":"https://doi.org/10.3899/jrheum.2024-1185","url":null,"abstract":"OBJECTIVETo describe the access, effectiveness, survival and adverse events (AE) of secukinumab (SEC) in patients with axial spondyloarthritis (axSpA) and axial psoriatic arthritis (axPsA).METHODSA multicentre, observational, retrospective cohort study. Patients ≥18 years with axSpA) and patients with PsA with axial involvement who had received at least one dose of SEC were included. The number of days elapsed between the request for the drug and the first application was calculated. Effectiveness was defined as BASDAI < 4 at six months. Drug survival was analysed using Kaplan-Meier curves and Cox regression analysis.RESULTSOne hundred seventeen patients were included, 72 (61.5%) with axPsA and 45 (38.5%) with axSpA. Those having public health insurance presented a longer delay in receiving SEC 90 days (IQR 60-150) vs those with social security (p=0.01) and those with private health coverage (p=0.009). Effectiveness of SEC after 6 months was achieved in 72 (61.5%) patients, 44 (61.5%) patients with axial PsA and 28 (62.2%) patients with axSpA, (p=0.91). The median SEC survival was 48 months (95% CI 32-63). The only factor associated with reduced survival was SEC being given in the third or higher line of treatment (HR 3.43, 95%CI 1.11-11.10, p=0.04). The incidence of AE was 7.9 events per 100 patients/year (CI 95% 5-12).CONCLUSIONThe delay in receiving SEC was longer in patients with public health insurance. Patients using SEC as third-line or higher therapy had 3.4 times less survival. AE were mild and no AE of interest were observed.","PeriodicalId":501812,"journal":{"name":"The Journal of Rheumatology","volume":"15 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144065690","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":"Analysis of gut homing receptors in circulating MAIT cells and their presence in synovial tissue from patients with axial spondyloarthritis.","authors":"Éric Toussirot,André Ramon,Caroline Laheurte,Eléonore Gravelin,Charline Vauchy,Franck Monnien,Marc Puyraveau,Maxime Samson,Philippe Saas","doi":"10.3899/jrheum.2024-1294","DOIUrl":"https://doi.org/10.3899/jrheum.2024-1294","url":null,"abstract":"OBJECTIVEmucosal-associated invariant T cells (MAIT) have been involved in the pathophysiology of axial spondyloarthritis (axSpA). We aimed to further investigate the phenotype of circulating MAIT cells in patients with axSpA by assessing the expression of an activation marker and gut homing receptors as well as the impact of TNF-α blockade. The presence of MAIT cells in synovial biopsies from axSpA patients was also studied.METHODSblood samples were obtained from 26 axSpA patients (11 radiographic, 15 nonradiographic) and 27 healthy controls (HC). Frequency of Vα7.2+CD161+ MAIT cells was determined in axSpA and HC. Expression of CD69, CCR9 and CD49d on MAIT cells was analyzed by flow cytometry. The presence of MAIT cells was examined in synovial biopsy samples from three axSpA patients and compared to synovial biopsies from 3 rheumatoid arthritis (RA) patients and 4 osteoarthritis (OA) patients by confocal microscopy.RESULTSpatients with axSpA were characterized by a higher frequency of CD3+ and CD8+ MAIT cells expressing CD69, CCR9 and CD49d, especially in the radiographic subgroup. MAIT cells were detected in a synovial biopsy sample from one patient with axSpA. After TNF-α blockade, a decrease in the frequency of MAIT cells and TNF-α/IL-17A - producing-MAIT cells was observed.CONCLUSIONMAIT cells were activated and expressed gut homing receptors, indicating their potential involvement in the gut-joint axis of axSpA. MAIT cell frequency and function were reduced by TNF-α blockade. MAIT cells could be found in synovial tissue in axSpA.","PeriodicalId":501812,"journal":{"name":"The Journal of Rheumatology","volume":"128 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144065753","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":"Cone beam computed tomography for assessment of erosions in early rheumatoid arthritis - a pilot study.","authors":"Inger Gjertsson,Ylva Aurell,Anna Rudin,Anna-Karin Hultgård Ekwall,Eva Klingberg,Kristina Forslind","doi":"10.3899/jrheum.2024-1276","DOIUrl":"https://doi.org/10.3899/jrheum.2024-1276","url":null,"abstract":"OBJECTIVECone beam computed tomography (CBCT) can accurately assess erosive disease in the hands, wrists and feet in established rheumatoid arthritis (RA). The aim of this study was to compare CBCT with conventional radiography (CR) for the assessment of erosions in patients with early RA.METHODSCBCT and CR of the hands, wrists and feet of 17 patients with treatment naive early RA were assessed at diagnosis and at 6- and 12-months follow-up. Erosions on CBCT scans were scored by the same observer using the modified Rheumatoid Arthritis Magnetic Resonance Imaging Score (mod.RAMRIS), which evaluates the same joints as the Sharp van der Heijde Score (SHS). Radiographs were scored for erosions using the SHS by the same observer.RESULTSAt baseline there was a significant difference in the erosion score between CBCT and CR, shown with a percentage of maximum score. The number of erosions and the number of eroded joints were significantly higher with CBCT compared with CR at 6 and 12 months. The number of detected repair of erosions was higher with CBCT than with CR at both 6 and 12 months.CONCLUSIONCBCT was more sensitive than CR to detect erosions and repair in patients with early RA. CBCT has the potential to become a sensitive tool for monitoring destructive disease in patients with RA.","PeriodicalId":501812,"journal":{"name":"The Journal of Rheumatology","volume":"32 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144065637","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":"Implementation and evaluation of a virtual rheumatology training program in East Africa.","authors":"Carol A Hitchon,Rosie Scuccimarri,Ines Colmegna,Florence Masaisa,Girish M Mody,Michele Meltzer,","doi":"10.3899/jrheum.2024-1122","DOIUrl":"https://doi.org/10.3899/jrheum.2024-1122","url":null,"abstract":"OBJECTIVEAccess to rheumatology education and care is limited in many African countries, leading to suboptimal clinical care and poor outcomes for patients. Virtual education is a feasible means to deliver curricula remotely. A virtual rheumatology course for medical residents in sub-Saharan Africa was developed. We describe the course and its evaluation.METHODSAn annual 16-week virtual rheumatology program was delivered to internal medicine residents in Rwanda between 2021 and 2024. Lectures on core rheumatology topics were provided, in English, by an international faculty with representatives from Africa to ensure regionally relevant content. In 2023, the virtual course was supplemented by a weeklong in-person visit. Participants completed questionnaires to evaluate their experiences with the course, their confidence in evaluating rheumatologic conditions, and any recommendations for course improvement. Instructors evaluated their experiences with the course. Summary statistics and representative quotations are provided.RESULTSPost-course evaluations were available from 55 residents and seven instructors. All residents who completed the questionnaires reported the lectures were useful. Many [32/54 (59%)] requested additional time for case discussions and in-person teaching. Post-course, residents rated their confidence in assessing and managing rheumatologic cases as good [median 7/10 (range 4-10)]. Conflicting clinical duties prevented most residents [42/55 (76%)] from attending all lectures. Instructors reported some challenges, especially insufficient interaction during virtual lectures.CONCLUSIONA virtual rheumatology course is a feasible means to deliver rheumatology education to medical trainees but does not replace the need for in-person education. The program is adaptable to other regions with limited rheumatology resources.","PeriodicalId":501812,"journal":{"name":"The Journal of Rheumatology","volume":"129 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144065689","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 Road to a New Horizon in Psoriatic Arthritis.","authors":"Dafna D Gladman","doi":"10.3899/jrheum.2025-0330","DOIUrl":"https://doi.org/10.3899/jrheum.2025-0330","url":null,"abstract":"Although arthritis among patients with psoriasis was described in the 19th century, the question of whether there was a specific form of arthritis associated with psoriasis was not raised until the middle of the 20th century. It was only after the seminal work of Moll and Wright that psoriatic arthritis (PsA) was recognized as a distinct entity. There was little interest in studying the disease until the second half of the 20th century. Initially, it was thought to be a mild disease, but subsequent studies over the past 50 years demonstrated that it was a severe disease, occurring much more frequently than first described and leading to progressive joint damage, disability, reduced quality of life and function, and an increased mortality risk. Comorbidities were found to be more common in this patient population, possibly contributing to the poor outcomes. Advances of new therapies and better assessment tools have led to improvement in the outcomes of patients with PsA. However, there are still unmet needs that will require addressing in the next few years to improve the lives of patients with this disease.","PeriodicalId":501812,"journal":{"name":"The Journal of Rheumatology","volume":"30 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144065695","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":"Pyoderma Gangrenosum-Associated Autoinflammatory Syndrome With Skin Abscesses: Successful Treatment With Anti-Interleukin 1 Therapy.","authors":"Gilberto Pires da Rosa,Bárbara Vieira Granja,Filomena Azevedo,Sofia Magina","doi":"10.3899/jrheum.2025-0036","DOIUrl":"https://doi.org/10.3899/jrheum.2025-0036","url":null,"abstract":"","PeriodicalId":501812,"journal":{"name":"The Journal of Rheumatology","volume":"17 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144065836","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":"Effects of Juvenile Idiopathic Inflammatory Myopathies on Growth, Development, and Maturation: A Systematic Review and Meta-Analysis.","authors":"Jessica C Guo,Olivia D Garisto,Jessie Cunningham,Y Ingrid Goh,Jill Hamilton,Brian M Feldman","doi":"10.3899/jrheum.2024-0088","DOIUrl":"https://doi.org/10.3899/jrheum.2024-0088","url":null,"abstract":"OBJECTIVEThe purpose of this review is to assess the effects of JIIM on growth and pubertal development.METHODSA systematic review was conducted by searching EMBASE, MEDLINE, PubMed®, PsycINFO, Cochrane, and Web of Science to identify studies published in English from inception to December 2024. Data were extracted regarding puberty- and development-related outcomes. Meta-analyses were conducted for outcomes measured consistently across studies, using the R package metafor (Version 3.4-0).RESULTSOf 5,838 identified unique records, 24 were included. Inter-rater reliability for abstract and full-text screening was Κ=0.93 and Κ=1.0, respectively. Eighteen articles discussed growth (14/18 demonstrated decreased height or growth failure). Meta-analysis of 7 studies noted the overall prevalence of growth failure is 17.9%, 95% C.I. [10.7-25.0]. Five articles reported delays of secondary sex characteristics or puberty. Five articles discussed age of menarche onset; 4 reported delays and one did not.CONCLUSIONJIIM can cause several deleterious effects on development including growth failure. The impact of hormonal changes or delayed puberty has been less well studied. Endocrine abnormalities should be actively screened for and treated. Additional research is needed to assess long-term impacts.","PeriodicalId":501812,"journal":{"name":"The Journal of Rheumatology","volume":"28 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144065634","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 and predictors of achieving sustained remission in psoriatic arthritis. A Swedish nationwide registry study.","authors":"Olafur Palsson,Jon T Einarsson,Johan K Wallman,Thorvardur J Love,Bjorn Gudbjornsson,Meliha C Kapetanovic","doi":"10.3899/jrheum.2024-1250","DOIUrl":"https://doi.org/10.3899/jrheum.2024-1250","url":null,"abstract":"OBJECTIVETo estimate the prevalence and predictors of sustained remission (SR) in psoriatic arthritis (PsA) patients receiving biologic or targeted synthetic disease-modifying antirheumatic drugs (b/tsDMARDs) in Sweden.METHODSAll PsA patients initiating b/tsDMARDs and who were registered in the national Swedish Rheumatology Quality register (SRQ) April 1999-December 2019 were included. Data on disease/treatment characteristics at first b/tsDMARD (baseline) and all subsequent visits were extracted from SRQ. Remission was defined as DAS28CRP≤2.6, DAPSA28≤4 or the evaluator's global assessment of disease activity (EGA) on a scale 0-4 (remission=0), and SR when these criteria persisted during at least two consecutive visits for ≥6 months. Baseline predictors of SR were explored using logistic regression analysis.RESULTSData on 4.669 PsA patients with 48.773 visits were available. 81% patients achieved DAS28CRP remission ever, and 54% achieved SR at least once. The corresponding percentages for DAPSA28 were 46% and 24%, and for EGA were 69% and 38%, ever reaching remission and SR, respectively. Male sex was positive predictor of reaching SR when measured by DAPSA28 and EGA but not by DAS28CRP. Fewer swollen joints at baseline predicted SR according to all three remission criteria.CONCLUSIONA considerable proportion of PsA patients receiving various b/tsDMARDs never achieved remission, and approximately half never achieved SR in this Swedish nationwide registry study. Fewer swollen joints at first b/tsDMARD start increases the likelihood of SR, regardless of remission criteria used. There was still sex difference when measured with DAPSA28 and EGA, with men being more likely to reach SR.","PeriodicalId":501812,"journal":{"name":"The Journal of Rheumatology","volume":"53 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144065691","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 Impact of Early Attainment of Minimal Disease Activity on Radiographic Outcomes: A Real-World Longitudinal Cohort Study in Psoriatic Arthritis.","authors":"Gonul Hazal Koc,Marc R Kok,Selinde V J Snoeck Henkemans,Jolanda J Luime,Ilja Tchetverikov,Jos H van der Kaap,Paul Baudoin,Petra Kok,Yvonne P M Goekoop-Ruiterman,Petra A J M Vos,Maikel van Oosterhout,Lindy A Korswagen,Radboud J E M Dolhain,Marijn Vis","doi":"10.3899/jrheum.2024-1162","DOIUrl":"https://doi.org/10.3899/jrheum.2024-1162","url":null,"abstract":"OBJECTIVETo evaluate the effect of achieving Minimal Disease Activity (MDA) within the first year on radiologic damage at follow-up 3 years in patients with newly diagnosed Psoriatic Arthritis (PsA).METHODSData were used from the Dutch southwest Early PsA cohort, a real-world cohort of newly diagnosed PsA patients, focusing for this manuscript on those with oligoarthritis or polyarthritis. Patients were stratified into three groups: [1] Sustained-MDA- achieving MDA at least at both 9 and 12 months post-diagnosis; [2] Non-sustained-MDA- achieving MDA in the first year but not sustaining it at 9 and 12 months; [3] No-MDA- not achieving MDA in the first year. Radiographic assessment was utilized by the PsA-modified Total Sharp/van de Heijde Score. Group comparisons at follow-up 3 years for radiographic changes were conducted using a Linear Mixed Model.RESULTS284 patients were categorized into three groups: 96 patients (34%) in the sustained- MDA group, 83 (29%) in the non-sustained-MDA group, and 105 (37%) in the no-MDA group. According to baseline characteristics, in the no-MDA group, a notably higher rate of females (70%) and an elevated tender joint count (median (IQR): 7(4-12)) were observed. Patients who did not achieve MDA in the first year experienced remarkably higher radiographic changes during follow-up than the sustained-MDA group (β = 0.05 (95% CI 0.02 to 0.08), p < 0.01).CONCLUSIONRadiographic changes during the 3-year follow-up were markedly higher in those unable to achieve MDA within the first year of follow-up, emphasizing the long-term structural benefits of reaching stringent disease activity targets early in the disease course.","PeriodicalId":501812,"journal":{"name":"The Journal of Rheumatology","volume":"25 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144065693","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}