Journal of clinical rheumatology : practical reports on rheumatic & musculoskeletal diseases最新文献

{"title":"Clinical Characteristics of Antinuclear Antibody-Negative Systemic Lupus Erythematosus: A Systematic Review.","authors":"Fernando Antonio Glasner da Rocha Araujo, Isabella Vargas de Souza Lima, Mittermayer Barreto Santiago","doi":"10.1097/RHU.0000000000002258","DOIUrl":"10.1097/RHU.0000000000002258","url":null,"abstract":"<p><strong>Abstract: </strong>Although antinuclear antibody (ANA) positivity on HEp-2 cells is a mandatory criterion for the classification of systemic lupus erythematosus (SLE), patients with ANA-negative SLE may still present with severe clinical manifestations. However, this subgroup of patients has been rarely studied, and the most relevant publications are limited to isolated case reports. This systematic review aimed to identify the clinical features and other potential markers (autoantibodies) that may aid in the identification of ANA-negative SLE. The review followed the PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analyses) guidelines. The PICOS criteria were as follows: population (patients diagnosed with SLE), intervention (ANA panel testing), comparison (ANA-positive vs. ANA-negative patients), outcome (clinical manifestations and other autoantibodies), and study design (prospective and retrospective primary studies, including case series and case reports). One hundred eighty-eight publications were initially identified. After screening, 21 studies (152 patients) were included in the final analysis. Cutaneous was the most common clinical manifestation observed in patients with ANA-negative SLE, followed by photosensitivity and joint complaints. The most commonly detected autoantibodies were anti-SSA/Ro and anti-dsDNA. To our knowledge, this is the first comprehensive systematic review of the clinical and laboratory characteristics of patients with ANA-negative SLE.</p>","PeriodicalId":520664,"journal":{"name":"Journal of clinical rheumatology : practical reports on rheumatic & musculoskeletal diseases","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144602794","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":"Global Guidelines for Psoriatic Arthritis Management: A Comparative Analysis.","authors":"Shikha Singla, Parjanya Bhatt, Enrique Roberto Soriano","doi":"10.1097/RHU.0000000000002254","DOIUrl":"10.1097/RHU.0000000000002254","url":null,"abstract":"<p><strong>Background: </strong>Psoriatic arthritis (PsA) is a complex immune-mediated heterogeneous inflammatory disease. Treatment decisions are challenging given the multisystem involvement. To further guide management strategies, we conducted a comparative analysis of the latest global guidelines highlighting the contrast in their approach to treat different PsA domains.</p><p><strong>Methods: </strong>Major global guidelines for PsA management were reviewed, including American College of Rheumatology 2018 update, European Alliance of Associations for Rheumatology 2023 update, British Society of Rheumatology 2022, Group for Research and Assessment of Psoriasis and Psoriatic Arthritis 2021, and Pan American League of Associations for Rheumatology 2024.</p><p><strong>Results: </strong>The guidelines unanimously recommend a treat-to-target strategy with a focus on active PsA. Divergence existed in treatment sequencing regarding the use of biologic and targeted disease-modifying antirheumatic drugs (DMARDs). Variations were also noted in the management of enthesitis and dactylitis. Addressing comorbidities and associated conditions is regarded to be a cornerstone for optimizing disease control and preventing flares.</p><p><strong>Conclusion: </strong>This review highlights the different management strategies among the global guidelines. Furthermore, we pointed at promising new therapeutic targets that are likely to be incorporated into future recommendations.</p>","PeriodicalId":520664,"journal":{"name":"Journal of clinical rheumatology : practical reports on rheumatic & musculoskeletal diseases","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144602795","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":"Pulmonary Artery Involvement and Parenchymal Lung Changes in Behçet Disease: A Comparative Cohort Thoracic Computed Tomography Imaging Study.","authors":"Cemal Bes, Rabia Deniz, Sezgi Karabulut Gök, Ceren Tansu Yavuz, Oya Altun, Ferdanur Deniz, Arda Okumuş, Duygu Sevinç Özgür, Gamze Akkuzu, Bilgin Karaalioğlu, Fatih Yıldırım, Serap Baş","doi":"10.1097/RHU.0000000000002264","DOIUrl":"https://doi.org/10.1097/RHU.0000000000002264","url":null,"abstract":"<p><strong>Background/objective: </strong>Pulmonary involvement of Behçet disease (BD) typically manifests as vascular involvement in the form of pulmonary artery thrombosis and/or aneurysm, although various parenchymal lung findings may also be observed. We aimed to analyze the indications for imaging and thoracic computed tomography (TCT) findings in BD patients.</p><p><strong>Methods: </strong>In this medical records review, single-center, comparative cohort study, 196 BD patients who underwent TCT for any reason between July 2020 and July 2024 were included. The patients' demographic data, disease-related clinical features, indications for TCT, and TCT findings were recorded.</p><p><strong>Results: </strong>The mean age of the patients was 40.0 ± 12.0 years, with a female-to-male ratio of 56/140 and disease duration of 8.9 ± 9.1 years. The most common indications for TCT imaging were suspected pulmonary vascular involvement (PVI) (139/196), unexplained acute phase elevation (46/196), and infection (36/196). PVI was present in 23 patients. Patients with PVI also exhibited additional parenchymal findings. Ground-glass opacities and atelectasis were significantly more common in patients with PVI compared with those without.</p><p><strong>Conclusion: </strong>TCT imaging is essential for identifying both vascular and parenchymal pulmonary complications in BD, especially in patients with atypical symptoms or elevated inflammatory markers.</p>","PeriodicalId":520664,"journal":{"name":"Journal of clinical rheumatology : practical reports on rheumatic & musculoskeletal diseases","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144602796","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":"Predictors of Persistent Disease Activity and Damage in Systemic Sclerosis: Associations With Mortality in a Single-Center Cohort Study.","authors":"Beatrice Moccaldi, Marco Binda, Salvatore Prete, Andrea Martini, Anna Cuberli, Maria Favaro, Andrea Doria, Elisabetta Zanatta","doi":"10.1097/RHU.0000000000002253","DOIUrl":"https://doi.org/10.1097/RHU.0000000000002253","url":null,"abstract":"<p><strong>Background/objective: </strong>The assessment of \"disease activity\" and \"damage\" has recently been standardized in systemic sclerosis (SSc), with the creation of composite indices. We aimed to identify predictors of persistent disease activity and moderate-severe damage in a monocentric SSc cohort and to evaluate the impact of persistent disease activity and moderate-severe damage on mortality.</p><p><strong>Methods: </strong>Adult SSc patients with a disease duration ≤7 years were enrolled in this cohort study. Disease activity was evaluated by EUSTAR-AI (European Scleroderma Trials and Research Group Activity Index), severity by Medsger Severity Scale and damage by SCTC-DI (Scleroderma Clinical Trials Consortium Damage Index). \"Persistent disease activity\" was defined as EUSTAR-AI ≥2,5 in ≥50% of follow-up visits and moderate-severe damage as SCTC-DI ≥6. Statistical analysis was performed using Jamovi computer software.</p><p><strong>Results: </strong>One hundred one SSc patients (85% females and 33% diffuse cutaneous SSc, with a median disease duration of 2 years; interquartile range, 1-5 years) were enrolled and followed up for a median time of 27 months (interquartile range, 14-48 months). Erythrocyte sedimentation rate (p = 0.004), Medsger Severity Scale (p = 0.044), and SCTC-DI at baseline (p = 0.022) were independent predictors of persistent disease activity. Severe organ involvement-interstitial lung disease, cardiac involvement, and pulmonary arterial hypertension-and diffuse cutaneous SSc were associated with moderate-severe damage at the end of follow-up. Persistent disease activity and moderate-severe damage were associated with poor survival (p = 0.0152 and p < 0.001, respectively).</p><p><strong>Conclusion: </strong>Persistent disease activity and moderate-severe damage are associated with increased mortality in SSc. Early identification of at-risk patients may help improve outcomes.</p>","PeriodicalId":520664,"journal":{"name":"Journal of clinical rheumatology : practical reports on rheumatic & musculoskeletal diseases","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144593777","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 MTRR 66 A/G and MTR 2756 A/G Polymorphisms and Response to Methotrexate in Rheumatoid Arthritis. A Meta-analysis.","authors":"Young Ho Lee, Gwan Gyu Song","doi":"10.1097/RHU.0000000000002257","DOIUrl":"https://doi.org/10.1097/RHU.0000000000002257","url":null,"abstract":"<p><strong>Abstract: </strong>This study aimed to investigate the association between methotrexate (MTX) response in rheumatoid arthritis and the polymorphisms methionine synthase reductase (MTRR) 66 A/G and methionine synthase (MTR) 2756 A/G. Relevant studies were identified through searches in MEDLINE, EMBASE, Web of Science, and Cochrane databases. A meta-analysis was conducted to evaluate the relationship between MTX response and the MTRR 66 A/G and MTR 2756 A/G polymorphisms. Eight studies that examined MTRR 66 A/G (with 688 responders and 541 nonresponders) and MTR 2756 A/G (518 responders and 261 nonresponders) were included. The meta-analysis found no significant association between MTX responsiveness and the MTRR 66 GG + GA genotype (odds ratio [OR] = 1.289, 95% confidence interval [CI] = 0.991-1.676, p = 0.059). However, stratified analysis revealed a significant association in studies with larger sample sizes (n ≥ 150) (OR = 1.343, 95% CI = 1.015-1.776, p = 0.039), but not in smaller studies (n < 150) (OR = 0.952, 95% CI = 0.444-2.039, p = 0.899). No association was found with treatment response based on follow-up duration. The MTR 2756 GG + GA genotype also showed no significant association with MTX responsiveness (OR = 1.053, 95% CI = 0.765-1.450, p = 0.751). Subgroup analyses by ethnicity, sample size, and follow-up period revealed no additional associations with treatment response. The limited number of studies (n = 4) for the MTR 2756 A/G polymorphism was included in the meta-analysis for the MTR 2756 A/G polymorphism, which has the potential for reduced statistical power as a consequence. This meta-analysis suggests that the MTRR 66 A/G GG + GA genotype is associated with a better response to MTX treatment in rheumatoid arthritis, whereas the MTR 2756 A/G polymorphism does not significantly impact treatment response. However, the significant association between MTRR 66 A/G and MTX response was observed only in the subgroup of larger studies, which indicates that the overall strength of evidence might be weak.</p>","PeriodicalId":520664,"journal":{"name":"Journal of clinical rheumatology : practical reports on rheumatic & musculoskeletal diseases","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144586175","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":"Letter to the Editor: Age-Related Differences Between Juvenile and Adult Autoimmune Inflammatory Myopathies.","authors":"Maheen Sheraz, Arooj Bibi, Birjesh Sathian, Javed Iqbal","doi":"10.1097/RHU.0000000000002262","DOIUrl":"https://doi.org/10.1097/RHU.0000000000002262","url":null,"abstract":"","PeriodicalId":520664,"journal":{"name":"Journal of clinical rheumatology : practical reports on rheumatic & musculoskeletal diseases","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144586176","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":"Letter to the Editor: Childhood Familial Mediterranean Fever in the USA: Spectrum of Clinical Phenotypes and MEFV Genotypes in a Cohort From Southeast Michigan.","authors":"Ibrahim Nagmeldin Hassan","doi":"10.1097/RHU.0000000000002259","DOIUrl":"https://doi.org/10.1097/RHU.0000000000002259","url":null,"abstract":"","PeriodicalId":520664,"journal":{"name":"Journal of clinical rheumatology : practical reports on rheumatic & musculoskeletal diseases","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144556518","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":"Reply to Letter to the Editor: Childhood Familial Mediterranean Fever in the USA: Spectrum of Clinical Phenotypes and MEFV Genotypes in a Cohort From Southeast Michigan.","authors":"Basil M Fathalla","doi":"10.1097/RHU.0000000000002260","DOIUrl":"https://doi.org/10.1097/RHU.0000000000002260","url":null,"abstract":"","PeriodicalId":520664,"journal":{"name":"Journal of clinical rheumatology : practical reports on rheumatic & musculoskeletal diseases","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144556519","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":"Response to the Letter to the Editor: Age-Related Differences Between Juvenile and Adult Autoimmune Inflammatory Myopathies.","authors":"Melike Mehveş Kaplan, Zahide Ekici Tekin, Elif Çelikel, Vildan Güngörer, Cüneyt Karagöl, Nimet Öner, Merve Cansu Polat, Didem Öztürk, Emine Özçelik, Mehveş Işıklar Ekici, Pınar Akyüz Dağlı, Şükran Erten, Banu Çelikel Acar","doi":"10.1097/RHU.0000000000002263","DOIUrl":"https://doi.org/10.1097/RHU.0000000000002263","url":null,"abstract":"","PeriodicalId":520664,"journal":{"name":"Journal of clinical rheumatology : practical reports on rheumatic & musculoskeletal diseases","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144556520","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":"Adverse Effects Related to SARS-CoV-2 Vaccination in Patients With Rheumatic Diseases and Psoriasis From Argentina.","authors":"Carolina A Isnardi, Cecilia Pisoni, Micaela Cosatti, Karen Roberts, Belén M Virasoro, Jennifer Kreimer, Cristina Echeverría, María E D'Angelo, Dora Pereira, Ingrid Petkovic, Yohana Soledad Tissera, María Á Correa, Gustavo Rodríguez Gil, Rosana Quintana, Karina Cogo, Carla Alonso, Nora Kogan, Ana L Toledo, M Agustina Alfaro, Romina Nieto, Lucila García, Alejandra Rollano Perasso, María E Debernardi, Zaida Troyano, Ingrid Strusberg, Guillermo J Pons-Estel, Emilce E Schneeberger","doi":"10.1097/RHU.0000000000002251","DOIUrl":"https://doi.org/10.1097/RHU.0000000000002251","url":null,"abstract":"<p><strong>Background/objective: </strong>Patients with systemic rheumatic diseases were initially excluded from coronavirus disease 2019 (COVID-19) vaccine trials. Real-world data on vaccine safety in this population remain limited, particularly for non-mRNA vaccines. The aim of this study was to evaluate the safety of COVID-19 vaccines in patients with rheumatic diseases and/or psoriasis.</p><p><strong>Methods: </strong>A longitudinal observational study including vaccinated patients ≥18 years old with rheumatic diseases and/or psoriasis vaccinated against COVID-19 was conducted. Adverse events (AEs) and disease flares were documented. Multivariable logistic regression analysis identified factors associated with AEs.</p><p><strong>Results: </strong>Among 2160 patients with rheumatic diseases and/or psoriasis vaccinated against COVID-19 (3988 doses), 29.6% reported at least 1 AE, mostly mild/moderate flu-like symptoms and local hypersensitivity. AE incidence was highest for mRNA-1273 (316.7/1000 doses) and lowest for BBIBP-CorV (95.4/1000). Heterologous regimens and ChAdOx1 nCoV-19 as first dose were associated with increased AE risk, whereas BBIBP-CorV showed the opposite effect. Disease flares occurred in 2.5% of patients, predominantly arthritis and arthralgia, without association with any specific vaccines.</p><p><strong>Conclusion: </strong>COVID-19 vaccines were generally well tolerated, with AE rates comparable to the general population. Heterologous regimens and vector-based and mRNA vaccines had higher AE incidence. These findings provide valuable safety data on vaccines used in Argentina and the region.</p>","PeriodicalId":520664,"journal":{"name":"Journal of clinical rheumatology : practical reports on rheumatic & musculoskeletal diseases","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144478483","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}