The Journal of Rheumatology最新文献

{"title":"Pulmonary Arterial Hypertension Incidence in Scleroderma Patients Treated with Bosentan for Digital Ulcers: Evidence from the Italian SPRING Registry.","authors":"Fabio Cacciapaglia,Rossella De Angelis,Clodoveo Ferri,Gianluigi Bajocchi,Silvia Bellando-Randone,Cosimo Bruni,Martina Orlandi,Marco Fornaro,Edoardo Cipolletta,Giovanni Zanframundo,Roberta Foti,Giovanna Cuomo,Alarico Ariani,Edoardo Rosato,Gemma Lepri,Francesco Girelli,Elisabetta Zanatta,Silvia Laura Bosello,Ilaria Cavazzana,Francesca Ingegnoli,Maria De Santis,Giuseppe Murdaca,Giuseppina Abignano,Pettiti Giorgio,Alessandra Della Rossa,Maurizio Caminiti,Annamaria Iuliano,Giovanni Ciano,Lorenzo Beretta,Gianluca Bagnato,Ennio Lubrano,Ilenia De Andres,Alessandro Giollo,Marta Saracco,Cecilia Agnes,Corrado Campochiaro,Federica Lumetti,Amelia Spinella,Luca Magnani,Giacomo De Luca,Veronica Codullo,Elisa Visalli,Carlo Iandoli,Antonietta Gigante,Greta Pellegrino,Franco Cozzi,Maria Grazia Lazzaroni,Elena Generali,Gianna Mennillo,Simone Barsotti,Giuseppa Pagano-Mariano,Federica Furini,Licia Vultaggio,Simone Parisi,Clara Lisa Peroni,Gerolamo Bianchi,Enrico Fusaro,Gian Domenico Sebastiani,Marcello Govoni,Salvatore D'Angelo,Erika Pigatto,Franco Franceschini,Serena Guiducci,Lorenzo Dagna,Andrea Doria,Dilia Giuggioli,Valeria Riccieri,Carlo Salvarani,Marco Matucci-Cerinic,Florenzo Iannone,","doi":"10.3899/jrheum.2024-0750","DOIUrl":"https://doi.org/10.3899/jrheum.2024-0750","url":null,"abstract":"OBJECTIVEBosentan (BOS) is approved for treating pulmonary arterial hypertension (PAH) and preventing digital ulcers (DU) in systemic sclerosis (SSc). Our study aimed to evaluate whether BOS prescribed for DU could reduce the incidence of PAH in a large SSc cohort from the SPRING registry.METHODSPatients with SSc from the SPRING registry, meeting ACR/EULAR 2013 classification criteria with data on PAH onset, DU status, BOS exposure, and at least a one-year follow-up between 2015 and 2020, and no known PAH at baseline were included. PAH was diagnosed with right heart catheterization during the follow-up, and its incidence rate (IR) was calculated. Kaplan-Meier curves were determined, and multivariate regression identified PAH risk factors.RESULTSAmong 727 eligible patients with SSc, followed for a median of 2.0 years, 54 (7.4%) developed PAH [IR 3.71 per 100 patients/years]. Patients with DU who were never exposed to BOS had a higher incidence of PAH [IR 4.90 per 100 patients/years] compared to those exposed to BOS, whose rates matched those without DU and who were never exposed to BOS. Risk factors independently associated with PAH development included DU (HR 1.85), age (HR 1.05), modified Rodnan Skin Score (mRSS) >4 (HR 2.07), ILD (HR 2.29), and acetylsalicylic acid treatment (HR 1.78).CONCLUSIONIn our cohort, DU were confirmed as a leading risk factor for PAH development, and BOS use for DU prevention may reduce this risk. Only patients with DU who were not on BOS had an increased PAH incidence.","PeriodicalId":501812,"journal":{"name":"The Journal of Rheumatology","volume":"55 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142988852","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":"Uncommon Clinical and Radiological Presentation of Monosodium Urate Crystal Deposition in Parotid Glands.","authors":"Kei Yiu Douglas Hui,Huiliang Koh,Andrew Makmur,Ju Ee Seet","doi":"10.3899/jrheum.2024-0611","DOIUrl":"https://doi.org/10.3899/jrheum.2024-0611","url":null,"abstract":"","PeriodicalId":501812,"journal":{"name":"The Journal of Rheumatology","volume":"7 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142988804","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 characteristics and influencing factors of hyperkyphosis in a Chinese Cohort with axial spondyloarthritis: a multicentre retrospective study.","authors":"Yuening Chen,Zhaoyang Geng,Yu Wang,Hongxiao Liu","doi":"10.3899/jrheum.2024-0731","DOIUrl":"https://doi.org/10.3899/jrheum.2024-0731","url":null,"abstract":"OBJECTIVEThis study aimed to investigate the clinical characteristics and influencing factors of axial spondyloarthritis (axSpA) hyperkyphosis in a Chinese cohort.METHODSA cross-sectional study was conducted on 607 patients with axSpA attending 12 hospitals across 11 centers from March 2022 to March 2024.Univariate and multivariate logistic regression analyses were used to explore the relevant influencing factors of hyperkyphosis. A nomogram model for impact factor visualisation and spearman correlation analysis was used to analyze the relationship between the influencing factors.RESULTSMultivariable logistic regression revealed that male sex,disease duration,patient global assessment (PGA),erythrocyte sedimentation rate (ESR),the modified stoke spondylitis score（mSASSS）,pharmacological treatment, and ankylosing spondylitis disease activity score-c-reactive protein (ASDAS-CRP) significantly influenced hyperkyphosis(all P < 0.05).Based on the results of the multivariate regression analysis, we constructed a nomogram model for clinical evaluation with an AUC of 0.98 and an accuracy of 0.95.Spearman correlation analysis showed a positive correlation between the spondyloarthritis international society health index (ASAS-HI) and mSASSS (R=0.16, P<0.001), while pharmacological treatment was negatively correlated with disease activity and mSASSS (R=-0.24, -0.18, P<0.001).CONCLUSIONControlling disease activity in the clinic is crucial. Active pharmacological treatment should be employed to delay radiological progression, enhance patients' ASAS-HI, psychological status, and physical functioning. Additionally, strict smoking cessation and weight control are recommended to reduce disability.","PeriodicalId":501812,"journal":{"name":"The Journal of Rheumatology","volume":"27 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142988854","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":"Serum Biomarkers of Pulmonary Damage and Risk for Progression of Rheumatoid Arthritis-Associated Interstitial Lung Disease.","authors":"Sung Hae Chang,Yong-Beom Park,Gregory C McDermott,Misti L Paudel,Keigo Hayashi,You-Jung Ha,Jeong Seok Lee,Min Uk Kim,Chan Ho Park,Ji-Won Kim,Jang Woo Ha,Sang Wan Chung,Sung Won Lee,Eun Ha Kang,Yeon Ah Lee,Jung-Yoon Choe,Eun Young Lee,Jeffrey A Sparks","doi":"10.3899/jrheum.2024-0713","DOIUrl":"https://doi.org/10.3899/jrheum.2024-0713","url":null,"abstract":"OBJECTIVETo investigate baseline and change of pulmonary damage biomarkers (serum Krebs von den Lungen 6 [KL-6], human surfactant protein D [hSP-D], and matrix metalloproteinase 7 [MMP-7]) with rheumatoid arthritis-associated interstitial lung disease (RA-ILD) progression.METHODSIn the Korean Rheumatoid Arthritis Interstitial Lung Disease (KORAIL) cohort, a prospective cohort, we enrolled patients with RA and ILD confirmed by chest computed tomography imaging and followed annually. ILD progression was defined as worsening in physiological and radiological domains of the 2022 American Thoracic Society, European Respiratory Society, Japanese Respiratory Society, and Latin American Thoracic Society guideline for progressive pulmonary fibrosis (PPF). Associations between biomarkers and RA-ILD progression were analyzed using multivariable Cox regression, adjusting for potential confounders.RESULTSWe analyzed 136 patients with RA-ILD (mean age 66.5 yrs, 30% male, 60.3% with usual interstitial pneumonia pattern). During a median 3.0 years of follow-up, 47 patients (34.6%) experienced progression. Higher baseline KL-6 and hSP-D levels were associated with higher risk of ILD progression (multivariable hazard ratios [HRs] 1.37 [95% CI 1.03-1.82] and 1.51 [95% CI 1.09-2.08], respectively), whereas only the highest quartile of MMP-7 showed an increased risk (multivariable HR 2.60 [95% CI 1.07-6.33]). Increasing levels of serum KL-6 at 1 year showed the strongest association with progression (ΔKL-6: multivariable HR 2.00 [95% CI 1.29-3.11]), additionally adjusting for baseline biomarker levels.CONCLUSIONIn this first prospective study to apply PPF criteria to RA-ILD, 34.6% progressed over 3 years. Higher baseline KL-6 and hSP-D were associated with progression. In follow-up, greater change in KL-6 was associated with progression. Serial measurement of pulmonary damage biomarkers may predict RA-ILD progression and may be helpful in monitoring patients and treatment decisions.","PeriodicalId":501812,"journal":{"name":"The Journal of Rheumatology","volume":"50 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142988800","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":"Association between abatacept exposure levels and infection occurrence in patients with rheumatoid arthritis: post hoc analysis of the AVERT-2 study.","authors":"Paul Emery,Roy Fleischmann,Robert Wong,Karissa Lozenski,Yoshiya Tanaka,Vivian P Bykerk,Clifton O Bingham,Thomas W J Huizinga,Gustavo Citera,Vidya Perera,Bindu Murthy,Kelly Fellows Maxwell,Julie Passarell,William D Hedrich,Daphne Williams","doi":"10.3899/jrheum.2024-0498","DOIUrl":"https://doi.org/10.3899/jrheum.2024-0498","url":null,"abstract":"OBJECTIVETo determine if higher serum exposure during subcutaneous (SC) abatacept treatment was associated with an increased infection risk in adult patients with early rheumatoid arthritis (RA).METHODSData from AVERT-2 (Assessing Very Early Rheumatoid arthritis Treatment-2, NCT02504268), a randomized, placebo-controlled study in anticitrullinated protein antibody- positive patients with early RA, were analyzed. A post hoc population pharmacokinetic (PPK) analysis was performed. Association between steady-state abatacept concentration exposures (steady-state time-averaged serum concentration, steady-state trough serum concentration, steady-state maximum serum concentration) and first infection was evaluated using Kaplan-Meier plots of probability versus time on treatment and Cox proportional-hazards models.RESULTSPK of SC abatacept was defined as a linear 2-compartment model with first-order absorption and elimination; higher body weight was the only covariate with a clinically relevant effect in the final PPK model. Infections occurred in 330/693 (47.6%; 11/693 [1.6%] serious infections) patients treated with abatacept+methotrexate (MTX) and 134/301 (44.5%; 4/301 [1.3%] serious infections), with abatacept placebo+MTX. Exposure-response analysis demonstrated no exposure relationship for an increased risk of first infection with concomitant use of MTX and glucocorticoids during the induction period, baseline glucocorticoid use, or higher than median body weight at baseline (> 70 kg).CONCLUSIONThis exposure-response analysis of AVERT-2 showed no increase in the risk of first infection, regardless of abatacept exposure level in patients with RA treated with SC abatacept. Similarly, no effect on the risk of first infection was found for concomitant MTX and glucocorticoid use in patients with RA treated with SC abatacept+MTX.","PeriodicalId":501812,"journal":{"name":"The Journal of Rheumatology","volume":"54 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142988856","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":"Association between patient perception of disease status and different components of the Minimal Disease Activity (MDA) criteria in psoriatic arthritis.","authors":"Sarah M Yazji,Philip S Helliwell,Andra Balanescu,Emmanuelle Dernis,Uta Kiltz,Umut Kalyoncu,Ying Ying Leung,Ana-Maria Orbai,Josef S Smolen,Maarten de Wit,Laure Gossec,Laura C Coates","doi":"10.3899/jrheum.2024-1149","DOIUrl":"https://doi.org/10.3899/jrheum.2024-1149","url":null,"abstract":"OBJECTIVEThe aim of this analysis was to evaluate the relationship between the criteria met of the Minimal Disease Activity (MDA) score for psoriatic arthritis (PsA) and patient-perceived disease status.METHODSWe analysed data from the ReFlaP study (NCT03119805), a cross-sectional international study of adult patients with PsA. Patients self-reported if they felt their PsA was in remission (REM), low disease activity (LDA) or neither. The relationship between patient-reported status and MDA domains met was analysed using point biserial correlation, chi-square test (Χ2), odds ratio, and specificity.RESULTS88.4% of study patients who met MDA reported good disease status (REM/LDA). Pain was the most commonly missed domain for these patients. A moderate to strong correlation was found between meeting more MDA domains and patient-reported good status irrespective of domain missed. On individual domain testing, MDA state and patient-reported REM/LDA were significantly associated irrespective of domain missed with the exception of enthesitis. Specificity of the MDA score irrespective of domain missed was above 90%. The odds of MDA patients reporting poor disease status was significant only for when pain < 1 was the unmet domain. This significance was not supported by sensitivity analysis.CONCLUSIONThis study suggests strong agreement between MDA status and patient-reported good status irrespective of domain missed. Pain < 1 or 2 on a 0-10 numerical rating scale was the hardest domain to meet. The high specificity regardless of the unmet domain suggests patients who feel their disease is active are minimally misclassified by the score.","PeriodicalId":501812,"journal":{"name":"The Journal of Rheumatology","volume":"13 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142988801","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":"Inpatient management of gout: we are still failing.","authors":"Kate Alfeld,Murray L Barclay,Richard McNeill,Chris Frampton,Matt Doogue,Lisa K Stamp","doi":"10.3899/jrheum.2024-1075","DOIUrl":"https://doi.org/10.3899/jrheum.2024-1075","url":null,"abstract":"OBJECTIVEDespite effective treatment, gout is poorly managed. The aim of this study was to determine rates of serum urate (SU) testing and allopurinol dose adjustment in patients on allopurinol admitted to Christchurch based hospitals.METHODSThe hospital electronic prescribing and administration (ePA) system was used to identify patients on allopurinol during hospital admissions from March 2016-March 2023. Demographics, SU, renal function and changes to allopurinol therapy were recorded for each admission. Results were stratified by target SU and renal function.RESULTSOf 18,081 admissions taking allopurinol, SU was measured in 2,950 (16.32%). The mean SU was 0.37 (SD 0.12) mmol/L, with 1,270 (43.05%) above target SU (0.36 mmol/L). Admissions with chronic kidney disease (CKD) stage 3-5 were more likely to have SU above target than CKD1-2 (78.7% vs 21.3% (p<0.001). Of those with SU above target allopurinol was ceased in 148 (11.7%), dose reduced in 44 (3.5%), increased in 92 (7.2%), and unchanged in 986 (77.6%) during the admission. Those above target SU with CKD stage 3-5 were more likely to stop/decrease allopurinol dose compared to those with CKD stage 1-2 (16.4% vs 10.4%; p=0.01).CONCLUSIONMore than 80% of hospital admissions did not have SU measured despite the patient receiving allopurinol. Most admissions, acknowledging limitations, had suboptimal management of the allopurinol dose in the context of their SU. These results reflect a missed opportunity to review and optimise gout management.","PeriodicalId":501812,"journal":{"name":"The Journal of Rheumatology","volume":"30 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142988855","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":"Psychometric Evaluation of the Scleroderma Skin Questionnaire: A Novel Patient Reported Outcome for Skin Disease in Patients with Systemic Sclerosis.","authors":"Jeong Min Yu,John M VanBuren,Angela Child,Jessica S Alvey,Lisa A Mandl,Laura C Pinheiro,Shervin Assassi,Elana J Bernstein,Flavia V Castelino,Lorinda Chung,Luke Evnin,Tracy M Frech,Faye N Hant,Laura K Hummers,Dinesh Khanna,Kimberly S Lakin,Dorota Lebiedz-Odrobina,Yiming Luo,Ashima Makol,Jerry A Molitor,Duncan F Moore,Carrie Richardson,Nora Sandorfi,Ami A Shah,Ankoor Shah,Victoria K Shanmugam,Brian Skaug,Virginia D Steen,Elizabeth R Volkmann,Jessica K Gordon","doi":"10.3899/jrheum.2024-0736","DOIUrl":"https://doi.org/10.3899/jrheum.2024-0736","url":null,"abstract":"OBJECTIVETo evaluate the psychometric properties of the Scleroderma Skin Questionnaire (SSQ), a novel patient-reported outcome (PRO) to assess systemic sclerosis (SSc) related skin symptoms.METHODSThe SSQ was administered to 799 adults (mean age 52.7; 82% female) enrolled in the SSc Collaborative National Quality and Efficacy Registry (CONQUER). Internal consistency was determined using Cronbach's α and McDonald's ω total (ωt). The correlation of the SSQ was assessed with the modified Rodnan Skin Score (mRSS), Physician Global Assessment (PGA), Scleroderma Health Assessment Questionnaire (SHAQ), Patient-Reported Outcomes Measurement Information System-29 (PROMIS-29), and Patient Global Assessment to assess criterion, convergent, and divergent validity. Correlations were also assessed between patients' self-reported recall of skin changes over the past six months (\"SSQ 6-Month\") and six-month change in mRSS.RESULTSCronbach's α was 0.90 and ωt was 0.92, indicating high internal consistency. The SSQ was moderately correlated with mRSS (r=0.56), with stronger correlations in diffuse (r=0.54) versus limited subtypes (r=0.24; all p<0.05). The SSQ was also moderately-to-strongly correlated with PROMIS-29 physical (r=-0.50) and pain interference subscales (r=0.61), strongly with SHAQ's HAQ score (r=0.63) and severity subscale (r=0.62), and moderately with PGA's scleroderma activity score (r=0.48; all p<0.05). SSQ 6-Month correlated weakly with the six-month change in mRSS (r=0.26; p<0.05).CONCLUSIONSSQ demonstrated high reliability and moderate correlation with mRSS and legacy PROs. This study provides initial support for SSQ but not SSQ 6-Month to assess skin symptoms in patients with SSc.","PeriodicalId":501812,"journal":{"name":"The Journal of Rheumatology","volume":"99 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142988803","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":"Effect of Characteristic Inflammatory and Structural Pelvic Magnetic Resonance Imaging Lesions on Expert Assessment of Axial Juvenile Spondyloarthritis.","authors":"Adam Mayer,Timothy G Brandon,Amita Aggarwal,Ruben Burgos-Vargas,Robert A Colbert,Gerd Horneff,Rik Joos,Ronald M Laxer,Kirsten Minden,Angelo Ravelli,Nicolino Ruperto,Judith A Smith,Matthew L Stoll,Shirley M Tse,Filip Van den Bosch,Walter P Maksymowych,Robert G Lambert,David M Biko,Nancy A Chauvin,Michael L Francavilla,Jacob L Jaremko,Nele Herregods,Ozgur Kasapcopur,Mehmet Yildiz,Hemalatha Srinivasalu,Jennifer A Faerber,Ray Naden,Alison M Hendry,Pamela F Weiss","doi":"10.3899/jrheum.2024-0696","DOIUrl":"https://doi.org/10.3899/jrheum.2024-0696","url":null,"abstract":"OBJECTIVETo evaluate the influence of pelvic magnetic resonance imaging (MRI) findings on axial disease assessment in juvenile spondyloarthritis (JSpA).METHODSThis was a cross-sectional study of patients with JSpA with suspected axial disease. Three experts reviewed each case and rated their confidence (-3 to +3) in the presence of axial disease, first with clinical data and second with clinical and MRI data. Agreement was defined as ≥ 2/3 clinical experts with a rating of ≤ -1 or ≥ 1, and high confidence agreement as ≤ -2 or ≥ 2. The association of clinical features and both global assessments was tested with modified Poisson regression models.RESULTSTwo hundred seventy-two of 303 cases (89.8%) achieved agreement with clinical data alone. Adding imaging data affected agreement in 38.9% (118/303) and directionality of agreement in 23.4% (71/303). Agreement was facilitated in 26/31 cases and lost in 21/272 cases. Of those 71 cases that changed directionality, 33 changed from axial disease being absent to present and 38 from present to absent. The final model had an area under the receiver-operating characteristic (AUROC) curve of 0.93 and 3 factors were independently associated with expert agreement (HLA-B27: relative risk [RR] 1.41, 95% CI 1.14-1.74; pain improvement with activity: RR 1.27, 95% CI 1.05-1.54; and bone marrow edema on MRI: RR 4.08, 95% CI 2.91-5.73).CONCLUSIONThe addition of imaging data affected directionality and improved high confidence agreement of expert assessment of axial disease. These results underscore the integral role of MRI in the determination of axial disease in JSpA.","PeriodicalId":501812,"journal":{"name":"The Journal of Rheumatology","volume":"37 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142988805","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":"Disease activity indices used in axial spondyloarthritis perform similarly in real-life clinical settings.","authors":"Sara Alonso,Ignacio Braña,Marta Loredo,Estefanía Pardo,Stefanie Burger,Rubén Queiro","doi":"10.3899/jrheum.2024-0916","DOIUrl":"https://doi.org/10.3899/jrheum.2024-0916","url":null,"abstract":"OBJECTIVEMonitoring of axial spondyloarthritis (axSpA) activity using validated indices (BASDAI/ASDAS) is widely recommended but rarely followed in practice. The reasons, although varied, may be found in the scarcity of studies comparing the performance of these indices in daily practice. Here we compare the performance of activity indices in clinical practice.METHODSObservational cross-sectional study involving 330 patients. The BASDAI, ASDAS, BASFI and ASAS HI indices were included. Their correlations, degree of concordance, and discriminating capacity for different levels of activity and impact were compared using the appropriate statistics.RESULTSA total of 127 (38.5%) women and 203 (61.5%) men were included, mean age 47.6 (SD 12.9) years, median disease duration 8 [IQR 4-16] years. At inclusion, 209 (63.3%) patients were receiving biological therapies, mostly anti-TNF. All measurement indices were highly correlated (Pearson's r ≥ 0.73). Concordance between instruments was substantial both with regard to the different activity thresholds and the different disease impact categories (k ≥ 0.61). BASDAI cutoffs of 3.95 (AUC 0.90) and 5.85 (AUC 0.90) accurately identified the ASDAS high and very high activity categories, respectively. An ASDAS ≥ 2.1 (AUC 0.87) and a BASDAI ≥ 3 (AUC 0.92) accurately discriminated the ASAS-HI high impact category. Regardless of systemic therapy use, there was substantial agreement between BASDAI remission (≤2) and ASDAS inactive disease (<1.3).CONCLUSIONThe metrological performance of standard activity indices in axSpA was similar. The BASDAI values that identify the ASDAS categories are novel. We suggest using these indices interchangeably in clinical routine.","PeriodicalId":501812,"journal":{"name":"The Journal of Rheumatology","volume":"44 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142988857","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}