The Journal of Rheumatology最新文献

{"title":"Clinically Inactive Disease and Remission in Patients with Juvenile Idiopathic Arthritis Receiving Tofacitinib: Post-Hoc Analysis of a Phase III Trial.","authors":"Alessandro Consolaro,Nicolino Ruperto,Daniel J Lovell,Olga Synoverska,Carlos Abud-Mendoza,Alberto Spindler,Yulia Vyzhga,Ekaterina Alexeeva,Jeffrey Chaitow,Peter Chiraseveenuprapund,Irina Lazariciu,Lori Stockert,Mary Jane Cadatal,Annette Diehl,Hermine I Brunner,","doi":"10.3899/jrheum.2024-0536","DOIUrl":"https://doi.org/10.3899/jrheum.2024-0536","url":null,"abstract":"OBJECTIVETo evaluate rates of clinically inactive disease and remission in patients with juvenile idiopathic arthritis (JIA) receiving tofacitinib, using the 2021 Juvenile Arthritis Disease Activity Score (JADAS) thresholds and American College of Rheumatology (ACR) criteria.METHODSThis post hoc analysis included patients with active JIA (polyarticular course JIA, psoriatic arthritis, or enthesitis-related arthritis) enrolled in a phase III, randomized, withdrawal study of tofacitinib. In part 1 (weeks 0-18) patients received open-label tofacitinib. In part 2 (weeks 18-44) patients who achieved ACR improvement ≥30% were randomized to tofacitinib or placebo for 26 weeks/until JIA flare. Disease activity was assessed using the JADAS in 10 joints (JADAS10), based on C-reactive protein, with interpretation as per 2021 polyarthritis thresholds. JADAS10 remission was defined as ≥24 continuous weeks of JADAS10 clinically inactive disease (JADAS10-CID). ACR clinically inactive disease (ACR-CID) and ACR clinical remission were also assessed.RESULTSOf 225 patients with JIA in part 1, 173 (76.9%) were randomized in part 2 to continue tofacitinib or switch to placebo. Rates of JADAS10-CID and ACR-CID increased throughout part 1 to 30.5% and 15.8% (week 18), respectively. In part 2, these were sustained with tofacitinib (week 44: JADAS10-CID: 35.2%; ACR-CID: 25.0%) and decreased when patients switched to placebo (week 44: JADAS10-CID: 25.9%; ACR-CID: 15.3%). A small proportion of patients achieved JADAS10 remission at week 44 (tofacitinib: 14.8%; placebo: 7.1%).CONCLUSIONIn patients with JIA receiving tofacitinib, JADAS10-CID and ACR-CID rates improved rapidly and were sustained over time; a small proportion of patients achieved JADAS10 remission. Inactive disease is a feasible treatment target in patients receiving tofacitinib.","PeriodicalId":501812,"journal":{"name":"The Journal of Rheumatology","volume":"7 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143903052","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 of Type of Joint Involvement With Distinct Clinical Features and Outcomes in Patients With Acute Parvovirus B19-Related Arthritis.","authors":"Bernardo D'Onofrio,Elisa Gremese,Carlo Selmi","doi":"10.3899/jrheum.2024-1025","DOIUrl":"https://doi.org/10.3899/jrheum.2024-1025","url":null,"abstract":"","PeriodicalId":501812,"journal":{"name":"The Journal of Rheumatology","volume":"43 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143903049","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":"Arthritis Mutilans in Psoriatic Arthritis: The Consequences of Delayed Treatment.","authors":"Deepti Agarwal,Kavita Krishna","doi":"10.3899/jrheum.2025-0012","DOIUrl":"https://doi.org/10.3899/jrheum.2025-0012","url":null,"abstract":"","PeriodicalId":501812,"journal":{"name":"The Journal of Rheumatology","volume":"3 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143841023","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":"Revisiting Magnetic Resonance Imaging Structural Lesions in the Sacroiliac Joints.","authors":"Denis Poddubnyy","doi":"10.3899/jrheum.2025-0274","DOIUrl":"https://doi.org/10.3899/jrheum.2025-0274","url":null,"abstract":"","PeriodicalId":501812,"journal":{"name":"The Journal of Rheumatology","volume":"67 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143841195","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":"Acrocyanosis After Immunotherapy: Vasculitis or Vasculopathy? New Iatrogenic Disease Case Series From CanRIO.","authors":"Yuliya Lytvyn,Megan E Himmel,Carrie Ye,Shahin Jamal,Alexandra P Saltman,","doi":"10.3899/jrheum.2024-0486","DOIUrl":"https://doi.org/10.3899/jrheum.2024-0486","url":null,"abstract":"","PeriodicalId":501812,"journal":{"name":"The Journal of Rheumatology","volume":"60 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143841021","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":"Frailty and Associated Outcomes in Patients with Vasculitis.","authors":"Sebastian E Sattui,John Stadler,Renee L Borchin,Cristina Burroughs,Laura Gandolfo,David Cuthbertson,Christine Yeung,Kalen Larson,Peter A Merkel,Robert Spiera,","doi":"10.3899/jrheum.2024-1079","DOIUrl":"https://doi.org/10.3899/jrheum.2024-1079","url":null,"abstract":"OBJECTIVETo describe the frequency and outcomes associated with self-reported frailty in patients with vasculitis.METHODSVascStrong is a longitudinal study utilizing the Vasculitis Patient-Powered Research Network, an internet-based cohort of patients with vasculitis. Data collected included patient global assessment (PGA) and several domains of the Patient-Reported Outcomes Measurement Information Systems (PROMIS). Frailty was measured at baseline and 1-year follow-up using the FRAIL scale, a 5 domain self-reported measure. Patients were classified as non-frail, pre-frail, and frail based on 0, 1-2, or ≥3 criteria, respectively. At follow-up, patients reported the occurrence over the prior year of hospitalizations, infections, fractures, and disease flares. A multivariable logistic regression was performed to identify factors associated with frailty.RESULTSThe baseline survey included 328 patients. Patients had a mean age of 59.5 years, were predominantly female (71.6%) and non-Hispanic white. Prevalence of pre-frailty and frailty was 42.1% and 21.6%, respectively. The majority of patients with each form of vasculitis were classified as frail or pre-frail. Pre-frail and frail patients reported worse PROMIS scores at baseline and follow-up. Frailty was independently associated with female sex, higher PGA scores, being overweight, and obesity, but not with age. At 1-year, 272/328 (82.9%) patients answered the follow-up survey. Transitions in frailty status were observed in 99 (36.4%) patients. Hospitalizations and flares were more frequent in frail patients.CONCLUSIONSelf-reported frailty or pre-frailty is common in the majority of patients with multiple forms of vasculitis, indicating there is a substantial subset of patients at risk for worse outcomes.","PeriodicalId":501812,"journal":{"name":"The Journal of Rheumatology","volume":"29 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143841194","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":"Survival After Lung Transplantation in Patients With Rheumatoid Arthritis-Associated Lung Disease.","authors":"Amir A Razmjou,Angela Pham,Elizabeth R Volkmann,Veena K Ranganath","doi":"10.3899/jrheum.2025-0025","DOIUrl":"https://doi.org/10.3899/jrheum.2025-0025","url":null,"abstract":"","PeriodicalId":501812,"journal":{"name":"The Journal of Rheumatology","volume":"8 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143841191","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":"Effective treatment of Jak1/3 inhibitor in Blau syndrome from a multi-center retrospective study in central China.","authors":"Yangyang Hu,Pengcheng Li,Jinhua Liu,Zhipeng Zeng,Xiong Zhang,Wen Yin,Hai Xu,Jing Cai,Yikai Yu","doi":"10.3899/jrheum.2024-0822","DOIUrl":"https://doi.org/10.3899/jrheum.2024-0822","url":null,"abstract":"OBJECTIVETo investigate the effectiveness of the JAK 1/3 inhibitor tofacitinib in treating Blau syndrome and explore the association between various clinical and genetic features and therapeutic responses within the cohort.METHODSA five-year, multi-center, retrospective, observational study was conducted across seven centers, focusing on genetic profiles and the clinical manifestations of cohort. Genetic analysis, including whole exome sequencing and NOD-2 and STAT3 rs2293152 phenotypic comparisons, was performed to assess therapeutic responses.RESULTSBaseline data for the cohort, with a median disease duration of 9.3 years. All patients exhibited arthritis, with 2 cases being oligoarticular and 22 polyarticular. The median joint count involved was 6, primarily affecting wrists, proximal interphalangeal joints, ankles, and knees. Radiographic analysis revealed symmetrical non-erosive arthropathy in 92.3% of patients. Notably, two-thirds of the cohort displayed previously unrecognized dysplastic bone changes. Ocular involvement was observed in all patients. Notably, no association was found between different NOD-2 sequences and therapy response. Conversely, patients harboring the STAT3 rs2293152 GG polymorphism demonstrated favorable responses treatment, regardless of whether JAK1/3 inhibitors or TNF-α inhibitors were used.CONCLUSIONTofacitinib could be an effective therapeutic option for BS patients who demonstrate resistance to TNF-α inhibitors or corticosteroids. Specifically, the STAT3 rs2293152 GG polymorphism was associated with improved response to treatment, suggesting a genotype-influenced therapeutic efficacy.","PeriodicalId":501812,"journal":{"name":"The Journal of Rheumatology","volume":"3 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143841193","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":"Patients' perspectives and experiences with medication for gout: A thematic synthesis of qualitative studies.","authors":"Olav Tvedten,Sacha Bossina,Muguet Koobasi,Allison Jaure,Brian Liang,Clarice Tang,Kathleen Tymms,Gabor Major,Ayano Kelly","doi":"10.3899/jrheum.2024-1021","DOIUrl":"https://doi.org/10.3899/jrheum.2024-1021","url":null,"abstract":"OBJECTIVETo describe patients' perspectives and experiences of medications for gout to inform patient-centred practice.METHODSSystematic review (MEDLINE, Embase, PsychInfo, CINAHL) and thematic analysis of studies using qualitative methodology to May 2023.RESULTSFive dominant themes were identified in 45 studies involving 1203 patients:- denying illness, negotiating uncertainty, juggling competing priorities, avoiding suffering and lifestyle restrictions, and developing strategies and empowerment.CONCLUSIONPatients with gout wanted to avoid suffering and lifestyle restrictions but were concerned with stigmatisation and had uncertainty about medications. Comprehensive information about the disease and reframing the role of the different medications is needed to overcome the barriers to adherence to available and effective treatment. Our results highlight the fundamental importance of maintaining a patient-centred focus and include some avenues of how clinicians may redefine their approach to gout management.","PeriodicalId":501812,"journal":{"name":"The Journal of Rheumatology","volume":"29 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143841190","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":"Canadian Rheumatology Association Guidance for Developing & Endorsing Quality Measures to Support Learning Health Systems.","authors":"Racheal Githumbi,Claire E H Barber,Susan J Bartlett,Karine Toupin-April,Marinka Twilt,Diane Lacaille,Cheryl Barnabe,Kiran Dhiman,Alison M Hoens,Adrian Grebowicz,Tara McMillan,Jessica Widdifield","doi":"10.3899/jrheum.2024-1065","DOIUrl":"https://doi.org/10.3899/jrheum.2024-1065","url":null,"abstract":"OBJECTIVETo review methods for developing and endorsing Quality Measures (QMs) to inform a national quality measurement framework for rheumatology care in Canada.METHODSWe conducted a rapid environmental scan of measure development organizations from Canada, the United Kingdom, the United States and Australia. Major phases in the development of QMs were abstracted. The results were reviewed and synthesized with members of the Canadian Rheumatology Association's Digital Measurement Subcommittee through iterative review across 3 virtual meetings. The guidance was approved at the committee and the CRA board level.RESULTSFive key steps in the measure development cycle are proposed including: conceptualization and prioritization, measure specification development, testing and validation, implementation and reporting, continuous evaluation and maintenance. Foundational to all phases is the engagement of individuals from diverse backgrounds with lived experience of disease, healthcare providers, quality measurement scientists, and partner organizations. Measures should be aligned with domains of quality (effectiveness, efficiency, equity, patient-centeredness, safety and timeliness of care delivery) and be developed transparently. Endorsement of future QMs should, at minimum, prioritize validity, feasibility and acceptability or use/usability.CONCLUSIONThis paper establishes a comprehensive and relevant framework for the development and/or endorsement of QMs in Canadian rheumatology care. This framework will permit streamlining of future quality improvement efforts at the national level.","PeriodicalId":501812,"journal":{"name":"The Journal of Rheumatology","volume":"4 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143841203","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}