The Journal of Rheumatology最新文献

{"title":"Skin Eruption and Nerve Impairment: Eosinophil Activation Link.","authors":"Kazuro Kamada,Yuichiro Fujieda,Mika Watanabe,Tatsuya Atsumi","doi":"10.3899/jrheum.2024-0989","DOIUrl":"https://doi.org/10.3899/jrheum.2024-0989","url":null,"abstract":"","PeriodicalId":501812,"journal":{"name":"The Journal of Rheumatology","volume":"83 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142988750","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 expression of radiographic axial spondyloarthritis and its association with HLA-B27 in European and Ibero-American populations.","authors":"María Ángeles Puche-Larrubia,Lourdes Ladehesa-Pineda,Pilar Font-Ugalde,Rubén Burgos-Vargas,Percival Sampaio-Barros,José Maldonado-Cocco,Anabela Barcelos,Jordi Gratacós,Xavier Juanola,Alejandro Escudero-Contreras,Janitzia Vázquez-Mellado,Iván Arias de la Rosa,Eduardo Collantes-Estévez,Clementina López-Medina","doi":"10.3899/jrheum.2024-1085","DOIUrl":"https://doi.org/10.3899/jrheum.2024-1085","url":null,"abstract":"OBJECTIVETo compare the clinical and sociodemographic characteristics of Ibero-American patients with radiographic axial spondyloarthritis (r-axSpA) to those of European patients, with a particular focus on the influence of HLA-B27.METHODSThis was an observational, cross-sectional, and multicentre study of patients who fulfilled the European Spondyloarthropathy Study Group (ESSG) criteria for SpA from the REGISPONSER and RESPONDIA registries. Univariate and multivariate analyses between European and Ibero-American populations stratified by HLA-B27 status were conducted. Race stratification (White, Black American, and Indian American) was also performed to evaluate clinical differences according to HLA-B27.RESULTSA total of 2592 patients with a clinical diagnosis of r-axSpA were included in the analysis: 1083 (41.8%) Ibero-American patients and 1509 (58.2%) European patients. Among the HLA-B27-positive patients, Ibero-American status was independently associated with conventional synthetic disease-modifying antirheumatic drugs (csDMARD) intake (OR: 4.21), arthritis (OR: 2.36), enthesitis (OR: 6.01), dactylitis (OR: 6.10), severe structural damage (BASRI) (OR: 1.12) and poor functionality (BASFI) (OR: 1.40). Multivariate analysis of HLAB27-negative patients revealed that Ibero-American status was independently associated with enthesitis (OR: 11.67), csDMARDs (OR: 15.51) and total BASRI (OR: 1.34). Clinical manifestations also varied across racial groups, with differences noted in the prevalence of peripheral joint manifestations such as more arthritis and enthesitis in American Indian patients than in White and Black American patients.CONCLUSIONIbero-American r-axSpA patients in our study exhibit more peripheral manifestations, more structural damage, and worse functionality than European patients, regardless of the presence of HLA-B27.","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":"142988798","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":"Epidemiology of Antisynthetase Syndrome and Risk of Malignancy in a Population-based Cohort (1998-2019).","authors":"Caitrin M Coffey,Cassondra A Hulshizer,Cynthia S Crowson,Jay H Ryu,Floranne C Ernste","doi":"10.3899/jrheum.2024-0945","DOIUrl":"https://doi.org/10.3899/jrheum.2024-0945","url":null,"abstract":"OBJECTIVEPopulation-based epidemiology studies about antisynthetase syndrome (ASSD) are lacking. Our aims were to determine the incidence and prevalence of ASSD and assess malignancy risk among patients following ASSD diagnosis.METHODSA retrospective, population-based cohort of adults with incident ASSD residing in Olmsted County, Minnesota, in 1998-2019 was assembled. Fulfillment of ASSD Solomon et al. classification criteria and clinical data were collected by manual chart review. Patients were followed until death, migration from the area, or December 31, 2019. Malignancy was defined by physician diagnosis in the medical record. Incidence rate was age- and sex-adjusted to the 2010 U.S. white population. Point prevalence rate was obtained on Jan 1, 2015.RESULTS13 patients with ASSD were identified (7 [54%] female, 13 [100%] Caucasian, median age 44.9 years [IQR: 41.9-58.3]). The age- and sex-adjusted incidence of ASSD was 0.56 (95% CI: 0.25-0.87) per 100,000 population. Incidence was highest in the 50-59 age group. Age- and sex-adjusted prevalence was 9.2 per 100,000 (95% CI: 3.4-15.0). 2 of 13 (15%) were diagnosed with malignancy within the follow-up interval; none within 3 years of ASSD diagnosis. At median 11.9 (IQR: 7.0-13.4) years of follow-up, 12/13 (92%) of patients were alive.CONCLUSIONAntisynthetase syndrome is rare, with incidence of 0.56 per 100,000 population and prevalence of 9 per 100,000. In this cohort, incidence was similar between males and females, and highest in persons ages 50-59 years. None of the patients developed malignancy within 3 years of ASSD diagnosis.","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":"142988802","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":"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}

{"title":"Unmet Needs in Spondyloarthritis: Understanding and Managing Chronic Pain.","authors":"Yvonne C Lee,Anne-Marie Malfait,Alexis R Ogdie","doi":"10.3899/jrheum.2024-0936","DOIUrl":"https://doi.org/10.3899/jrheum.2024-0936","url":null,"abstract":"Among patients with axial spondyloarthritis (axSpA), persistent pain remains a critical unmet need. In this review, we discuss the prevalence of chronic pain and fibromyalgia in patients with axSpA and examine the existing knowledge on the pathophysiology of chronic pain in SpA, osteoarthritis, and rheumatoid arthritis. Finally, we discuss the specific unmet needs that must be addressed to improve long-term outcomes in axSpA, specifically those that will improve chronic pain in this patient population.","PeriodicalId":501812,"journal":{"name":"The Journal of Rheumatology","volume":"34 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142490535","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":"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}

{"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}

{"title":"Prologue: Spondyloarthritis Unmet Research Needs Conference IV.","authors":"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","doi":"10.3899/jrheum.2024-0933","DOIUrl":"https://doi.org/10.3899/jrheum.2024-0933","url":null,"abstract":"The Spondylitis Association of America (SAA) and the National Institute of Arthritis, Musculoskeletal and Skin Diseases (NIAMS) convened a conference on the campus of the National Institutes of Health (NIH) on September 28 and 29, 2023, to identify unmet needs in spondyloarthritis (SpA) research. The conference featured presentations by experts in areas of disease endotypes, pain, innovative imaging in SpA, health disparities in rheumatic diseases, and therapeutics. Members of the conference planning committee moderated the sessions and led the development of manuscripts summarizing recommendations to address unmet research needs. Early career investigators were invited to submit abstracts, which were presented at a networking session during the conference. Here, we highlight each of the sessions comprising the conference in the form of manuscripts published together as a conference summary.","PeriodicalId":501812,"journal":{"name":"The Journal of Rheumatology","volume":"14 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142490502","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":"Are There Disease Endotypes in Axial Spondyloarthritis and How Would We Define Them?","authors":"Kevin D Deane,Laura T Donlin,Christopher T Ritchlin,Kristine A Kuhn","doi":"10.3899/jrheum.2024-0935","DOIUrl":"https://doi.org/10.3899/jrheum.2024-0935","url":null,"abstract":"Is axial spondyloarthritis (axSpA) one disease or does it comprise multiple types? If the latter, how do we define those types-through clinical or imaging features, HLA-B27 status, or by other immunologic features? Data comparing disease outcomes for individuals with nonradiographic vs radiographic axSpA, or for male vs female patients, demonstrate distinctions. So then, how should we define endotypes? Endotypes are known as the subtype of a health condition defined by a functional or pathophysiologic function. Here, we review the endotypes used for defining rheumatoid arthritis, asthma, and psoriatic arthritis. Taking the lessons learned from these diseases, we discuss how they can be applied to defining endotypes in axSpA. A key unmet need for axSpA is access to affected tissues for interrogation of their pathologic mechanisms, from which tissue-specific endotypes can be defined. These tissue-based features should be combined with clinical data and imaging to inform classification criteria in the future.","PeriodicalId":501812,"journal":{"name":"The Journal of Rheumatology","volume":"30 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142490534","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 Rheumatologist as the Agent of Change: Utility of Guidelines in the Management of Gout.","authors":"Puja P Khanna","doi":"10.3899/jrheum.2024-0957","DOIUrl":"https://doi.org/10.3899/jrheum.2024-0957","url":null,"abstract":"The development and implementation of guidelines are intended to improve the quality of care by translating current evidence into clinical practice. However, the publication and dissemination of guidelines do not intuitively result in their use. Evidence indicates that structured implementation can improve guideline adherence.1.","PeriodicalId":501812,"journal":{"name":"The Journal of Rheumatology","volume":"101 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142443683","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}