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

{"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":"10.1097/RHU.0000000000002263","url":null,"abstract":"","PeriodicalId":520664,"journal":{"name":"Journal of clinical rheumatology : practical reports on rheumatic & musculoskeletal diseases","volume":" ","pages":"e135-e136"},"PeriodicalIF":1.8,"publicationDate":"2025-09-01","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":"The Structure of Motivations Behind Physicians' Treatment Choices for Patients With Rheumatic Diseases: A Bioethical Analysis of a Cross-sectional Study.","authors":"Irazú Contreras-Yáñez, Guillermo Guaracha-Basáñez, Diana Marcela Padilla-Ortiz, Virginia Pascual-Ramos","doi":"10.1097/RHU.0000000000002268","DOIUrl":"https://doi.org/10.1097/RHU.0000000000002268","url":null,"abstract":"<p><strong>Background/objective: </strong>The framework for the study centered on the treatment decisions made by physicians during their medical encounters with patients with rheumatic diseases. Our primary objective was to analyze, from a bioethical perspective, the underlying latent factors that influence these treatment decisions, focusing on the physician motivations behind them.</p><p><strong>Methods: </strong>This cross-sectional study was carried out at an outpatient clinic where 14 certified rheumatologists and 10 trainees worked (February 2023-February 2024). Standardized data from 703 patient-physician encounters regarding the physician's treatment choice, their motivations, and patients' disease activity level were obtained. Exploratory factorial analysis defined how motivations integrate latent factors and structure treatment choices in various health care scenarios, defined by the physician choice and degree and the patient level of disease activity.</p><p><strong>Results: </strong>The patients were primarily middle-aged women with long-standing rheumatic diseases. Certified rheumatologists and trainees were primarily females. The factorial analysis revealed a 4-factor structure in the majority of the health care scenarios; these latent factors accounted for 54.6% to 65.4% of total variance. The first factor (\"Medications shortage and uncertainty\") explained the largest percentage of total variance of the treatment choice; this factor violates justice principle. The second factor (\"Patient-centered\") was associated with motivations related to the patient's sociodemographics, clinical aspects, and preferences, which is related to autonomy principle. The third factor (\"Accessibility and affordability\") impacts justice principle. The fourth factor (\"Evidence-based medicine and experience\") was related to beneficence and nonmaleficence principles.</p><p><strong>Conclusions: </strong>Making treatment decisions is influenced by factors that shape the ethical lattice physicians based their decisions upon.</p>","PeriodicalId":520664,"journal":{"name":"Journal of clinical rheumatology : practical reports on rheumatic & musculoskeletal diseases","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144986332","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 1-Year Response in Rheumatic Mexican Patients Using JAK Inhibitors: Data From BIOBADAMEX.","authors":"Vijaya Rivera-Terán, Iris Jazmín Colunga-Pedraza, David Vega-Morales, Javier Merayo-Chalico, Angel Alejandro Castillo-Ortiz, Luis Francisco Valdés-Corona, Fedra Irazoque-Palazuelos, Julio César Casasola-Vargas, Daniel Xibillé-Friedmann, Sandra Carrillo-Vázquez, Guillermo Guaracha-Basañez, Estefanía Torres-Valdez Md, Yatzil Reyna-Juarez, Beatriz Alcalá-Carmona, Jiram Torres-Ruiz, César Pacheco-Tena","doi":"10.1097/RHU.0000000000002269","DOIUrl":"https://doi.org/10.1097/RHU.0000000000002269","url":null,"abstract":"<p><strong>Objective: </strong>We aim to evaluate the clinical features, first-year treatment response, and frequency of adverse events in Mexican patients receiving Janus kinase inhibitor (JAK-i) using data from the Mexican Adverse Events Registry (BIOBADAMEX).</p><p><strong>Methods: </strong>We included all BIOBADAMEX patients from 2022 to 2024 and described the sociodemographic, clinical, treatment characteristics and adverse events of the approved JAK-i in Mexico: tofacitinib, baricitinib, and upadacitinib. We assessed the JAK-i efficacy comparing baseline and the 1-year response mean disease activity scores.</p><p><strong>Results: </strong>A total of 222 patients were included, 39.6% received tofacitinib, 47.3% baricitinib, and 13.1% upadacitinib. The most common diagnosis was rheumatoid arthritis (77%). Sixty-eight percent of patients had comorbidities, 6% had prior history of malignancy, and 57% previously used a biologic. Mean age at JAK-i initiation was 49.6 (±13.9) years with an overall latency period of 9.4 years. DAS28 (Disease Activity Score in 28 joints) reduced from 4.7 (±1.2) at baseline to 2.99 (±1.2) in the first year (p = 0.001), and Bath Ankylosing Spondylitis Disease Activity Index from 4.8 (±3.9) to 2 (±1.5). JAK-i withdrawal was 29%; nonmedical reasons were the main motive. Sixty-five adverse events were reported; all were nonsevere with only 1 case of herpes zoster and no reports of malignancy or thrombosis. Differences in clinical and treatment characteristics between JAK-i were found.</p><p><strong>Conclusions: </strong>Our study showed older age for JAK-i initiation, a lower overall latency period, and lower use of prior biologic disease-modifying antirheumatic drug when compared with existing data in the literature. The main motive for JAK-i withdrawal was nonmedical reasons. Adverse events were nonsevere; interestingly, there was only 1 case of herpes zoster and no reports of malignancy or thrombosis.</p>","PeriodicalId":520664,"journal":{"name":"Journal of clinical rheumatology : practical reports on rheumatic & musculoskeletal diseases","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144860067","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":"Mortality Prediction in Antineutrophil Cytoplasmic Antibody-Associated Vasculitis With Kidney Involvement: Validation of the DANGER Score.","authors":"Emiliano Rivero-Otamendi, Valeria Navarro-Sánchez, Adriana Hernández-Andrade, María Fernanda Zavala-Miranda, Andrea Hinojosa-Azaola, Daniela Edith Sánchez-Mejía, Juan Manuel Mejía-Vilet","doi":"10.1097/RHU.0000000000002275","DOIUrl":"https://doi.org/10.1097/RHU.0000000000002275","url":null,"abstract":"<p><strong>Background/objective: </strong>The DANGER (Death in ANCA Glomerulonephritis-Estimating the Risk) score was developed to assess mortality risk in patients with antineutrophil cytoplasmic antibody-associated vasculitis (AAV). This study aimed to validate score in a cohort of Latin American patients.</p><p><strong>Methods: </strong>This cohort study included patients with AAV evaluated between 2000 and 2022. The DANGER score was calculated, and its performance evaluated using the c-statistic and time-dependent area under the receiver operating characteristic curve. Multivariable Cox regression analysis was performed to identify variables that could enhance the score's predictive accuracy.</p><p><strong>Results: </strong>We included 154 patients, 104 (68%) female, with a median age of 52 years (interquartile range [IQR], 38-61 years) and creatinine of 2.5 mg/dL (IQR, 1.7-2.5 mg/dL). Over a median follow-up of 74 months (IQR, 32-126 months), 24 patients died, with mortality rates of 6.5%, 8.6%, and 11.9% at 1, 2, and 5 years, respectively. The leading cause of death was infection. Mortality rates at 1 and 3 years in the low-, intermediate-, and high-risk categories were 1.0% and 3.1%, 14.0% and 16.8%, and 40.0% and 70.0%, respectively. The overall c-statistic for the DANGER model was 0.81 (95% confidence interval [CI], 0.73-0.90), with areas under the receiver operating characteristic curve of 0.81 (95% CI, 0.70-0.91), 0.78 (95% CI, 0.67-0.89), and 0.80 (95% CI, 0.70-0.90) at 1, 3, and 5 years, respectively. A revised model incorporating age, creatinine, C-reactive protein, and pulmonary involvement had a c-statistic of 0.86 (95% CI, 0.79-0.94).</p><p><strong>Conclusions: </strong>The DANGER score has good predictive accuracy for mortality in AAV patients with kidney involvement. In younger patients, the score may be modified to include variables such as C-reactive protein and severe pulmonary involvement to enhance its performance.</p>","PeriodicalId":520664,"journal":{"name":"Journal of clinical rheumatology : practical reports on rheumatic & musculoskeletal diseases","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144860069","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":"Pediatric-Onset Polyarteritis Nodosa and Deficiency of Adenosine Deaminase 2: Clinical Overlap and Divergence.","authors":"Sıla Atamyıldız Uçar, Eray Tunce, Şeyma Türkmen, Metin Eser, Betül Sözeri","doi":"10.1097/RHU.0000000000002270","DOIUrl":"https://doi.org/10.1097/RHU.0000000000002270","url":null,"abstract":"<p><strong>Background: </strong>To compare the clinical features and disease severity of classic polyarteritis nodosa (PAN) with its monogenic form, deficiency of adenosine deaminase 2 (DADA2), in pediatric patients, in order to distinguish overlapping vasculitic phenotypes.</p><p><strong>Methods: </strong>This cross-sectional study included 36 pediatric patients with PAN-like vasculitis, comprising 22 with classic PAN (14 systemic, 8 cutaneous) and 14 with DADA2, followed up at our tertiary referral pediatric rheumatology department between August 2016 and February 2025. Demographic features, clinical manifestations, treatment choices, and outcomes were compared between the groups.</p><p><strong>Results: </strong>DADA2 patients had significantly earlier symptom onset (median 4 vs. 11 years, p = 0.002) and higher rates of parental consanguinity (p < 0.001) compared with systemic PAN (sPAN) patients. The most common clinical features in sPAN were constitutional symptoms (100%), followed by cutaneous (78.6%), musculoskeletal (57.1%), and renal involvement (57.1%). Growth retardation (14.3% vs. 57.1%, p = 0.018) and livedo racemosa (7.1% vs. 50%, p = 0.012) were more common in DADA2, whereas fatigue (92.9% vs. 35.7%, p = 0.002), renal involvement (57.1% vs. 0%, p < 0.011), diastolic hypertension (78.6% vs. 7.1%, p < 0.001), and purpura (35.7% vs. 0%, p = 0.014) predominated in PAN. Neurological manifestations were observed in 4 PAN patients (2 peripheral, 2 central) and 1 DADA2 patient with ischemic stroke. Biologic therapy was required in 4 PAN patients, whereas 11 of 14 DADA2 patients were treated with anti-tumor necrosis factor agents.</p><p><strong>Conclusion: </strong>Anti-TNF therapy remains the mainstay of treatment in DADA2 and is effective in preventing disease progression. In contrast, classic sPAN may require escalation to biologic agents in refractory cases or when neurologic or end-organ involvement is present.</p>","PeriodicalId":520664,"journal":{"name":"Journal of clinical rheumatology : practical reports on rheumatic & musculoskeletal diseases","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144860070","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":"Distinctive Variables From Sociodemographic, Physical Function, Social, and Psychoaffective Spheres Are Significantly Linked to the Perception of Mistreatment of Patients With Rheumatic Diseases.","authors":"Irazú Contreras-Yáñez, Guillermo Arturo Guaracha-Basañez, Egla Samantha Sánchez-Peralta, Margarita Isabel Alarcón-Jarquín, Loraine Ledón-Llanes, America Sánchez-Hernández, Diana Elsa Flores-Alvarado, Virginia Pascual-Ramos","doi":"10.1097/RHU.0000000000002266","DOIUrl":"https://doi.org/10.1097/RHU.0000000000002266","url":null,"abstract":"<p><strong>Background: </strong>Mistreatment adversely affects outcomes from patients with rheumatic diseases (RMDs). We previously observed that half of Mexican outpatients with RMDs perceived mistreatment. The study examines the factors associated with mistreatment.</p><p><strong>Methods: </strong>This cross-sectional study was conducted at 2 academic urban centers for RMDs located in Mexico (June 28, 2023, to January 10, 2025). Consecutive outpatients completed the Mistreatment Scale adapted for RMDs, and additional patients reported outcome measures. Sociodemographic, disease-related variables, comorbid conditions, and treatment-related data were recorded using standardized formats. Mistreatment was defined when an individual's scale score was ≥1. If attributed to a specific RMD, it was classified as mistreatment related to RMD; this applied when a participant showed all patterns of mistreatment with a score of at least 1, linked to the underlying RMD. Participants showing 2 or more distinct patterns fall under the multiple mistreatment category. Multivariate regression analysis was used.</p><p><strong>Results: </strong>We included 746 outpatients with RMDs. Most frequent diagnoses were rheumatoid arthritis (n = 251 [34%]) and systemic lupus erythematosus (n = 240 [32%]). In the 728 patients where the mistreatment construct could be assessed, 358 (49.2%) experienced mistreatment. Among them, 109 patients (30.4%) scored mistreatment related to RMD subcategory and n = 167 (46.6%) multiple mistreatment. We found that mistreatment and its categories were linked to distinctive variables across various human spheres, including sociodemographics, physical functioning, social relationships, and psychoaffective spheres.</p><p><strong>Conclusions: </strong>Nearly 50% of the patients with RMD had the perception of mistreatment. This was linked to multiple variables including sociodemographics, physical functioning, social relationships, and mental health.</p>","PeriodicalId":520664,"journal":{"name":"Journal of clinical rheumatology : practical reports on rheumatic & musculoskeletal diseases","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144839899","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":"Assessing Rheumatoid Arthritis Disease Activity Measures in Ethnic Minority Patients in the United States: Real-World Data From the Ethnic Minority Rheumatoid Arthritis Consortium Registry.","authors":"Mercedes Quiñones, Sharon Dowell, Rodolfo Perez Alamino, Christopher J Swearingen, Edward Treadwell, Ignacio Garcia-Valladares, Theresa Lawrence-Ford, Cynthia Lawrence-Elliott, Akgun Ince, Yvonne Sherrer, Angelia Mosley-Williams, Yusuf Yazici, Gail S Kerr","doi":"10.1097/RHU.0000000000002256","DOIUrl":"https://doi.org/10.1097/RHU.0000000000002256","url":null,"abstract":"<p><strong>Objective: </strong>To identify differences in disease activity parameters that influence assessment, management, and outcomes of ethnic minority (EM) rheumatoid arthritis (RA) patients.</p><p><strong>Methods: </strong>RA patients enrolled in the Ethnic Minority Rheumatoid Arthritis Consortium registry between 2010 and 2018 were studied. Comparisons among self-identified racial and ethnic subsets and associations with RA disease activity measures and thresholds for randomized controlled trial (RCT) inclusion criteria were estimated using univariable analytical methods.</p><p><strong>Results: </strong>An observational cohort of 1315 RA patients of mean disease duration of 10.3 years was studied and comprised 380 (28.9%) Black, 178 (13.5%) Hispanic, and 126 (9.6%) Asian individuals. Compared with White participants, Black participants had lower socioeconomic status and, along with Hispanic participants, reported less years of education and tobacco use but greater disease activity and comorbidity. All 3 ethnic subsets had more prevalent seropositive RA with Black and Hispanic participants having less use of RA therapies compared with Asian participants who had the highest disease-modifying antirheumatic drug use. Composite disease activity measures that included a laboratory parameter found greater numbers to be in remission compared with patient-reported measures alone in the entire cohort. However, Black participants were less frequently in remission across all measures (approximately 2-fold for Disease Activity Score-28 joints with C-reactive protein vs. Disease Activity Score-28 joints with erythrocyte sedimentation rate) and more frequently met the RCT inclusion criteria.</p><p><strong>Conclusion: </strong>In a real-world EM RA cohort, subjective disease activity measures were discordant with objective parameters. Further, in Black participants, achieving remission criteria was dependent on laboratory assay chosen but frequently met active disease threshold eligibility for RCTs. Standardization of RA disease measures in EM patients is needed to achieve parity with current thresholds of optimum RA care.</p>","PeriodicalId":520664,"journal":{"name":"Journal of clinical rheumatology : practical reports on rheumatic & musculoskeletal diseases","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144839898","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":"Rurality and Delayed Diagnosis of Giant Cell Arteritis-A Single-Center Experience.","authors":"Ruoning Ni, Aleksander Lenert, Bharat Kumar","doi":"10.1097/RHU.0000000000002267","DOIUrl":"10.1097/RHU.0000000000002267","url":null,"abstract":"<p><strong>Objective: </strong>The study objectives were to compare the characteristics of patients with giant cell arteritis (GCA) from nonrural and rural areas and to identify factors associated with delayed GCA diagnosis.</p><p><strong>Methods: </strong>In this historical cross-sectional analysis, adults meeting the 2022 European Alliance of Associations for Rheumatology/American College of Rheumatology GCA classification criteria and followed at the University of Iowa rheumatology clinics from 2/1/2000 to 2/7/2024 were included. Geographic categories were defined using the 2010 Rural-Urban Commuting Area (RUCA) codes. Characteristics of nonrural (RUCA 1-3) and rural (RUCA 4-10) GCA patient groups were compared. Bivariable analyses were performed between each predictor and time to GCA diagnosis with simple linear regression. Multivariable linear regression models were fitted to identify the best predictors of time to GCA diagnosis.</p><p><strong>Results: </strong>In total, 317 subjects with GCA were included in this study (mean age, 72 years; 74.8% women). Nonrural (n = 172) and rural (n = 145) subjects had similar disease manifestations, including abrupt headache, vision loss, and jaw claudication. The mean time to GCA diagnosis was significantly longer in rural compared with nonrural GCA subjects (130 ± 185 vs. 45 ± 45 days, p < 0.0001). A significantly higher rate of hospitalizations was observed among rural subjects (24.1% vs. 12.2%, p = 0.0075). Bivariable analyses identified 4 variables associated with time to GCA diagnosis. In multivariable linear regression analyses, RUCA code (β = 13.99, 95% confidence interval, 9.23 to 18.75), age, and headache provided the best fit (adjusted R2 = 0.1196, Akaike corrected information criterion = 3082, p < 0.001).</p><p><strong>Conclusion: </strong>Rurality was identified as the strongest predictor of delayed diagnosis in GCA. Rural patients also experienced delays in undergoing temporal artery biopsy and a higher proportion of hospitalizations.</p>","PeriodicalId":520664,"journal":{"name":"Journal of clinical rheumatology : practical reports on rheumatic & musculoskeletal diseases","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12329242/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144796667","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of Factors Associated With Uveitis Onset Timing in Oligoarticular Juvenile Idiopathic Arthritis.","authors":"Sıla Atamyıldız Uçar, Eray Tunce, Alev Koçkar, Esra Kardeş, Betül Sözeri","doi":"10.1097/RHU.0000000000002248","DOIUrl":"10.1097/RHU.0000000000002248","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the timing of uveitis onset in patients with oligoarticular juvenile idiopathic arthritis (oJIA) and to identify clinical characteristics associated with its development.</p><p><strong>Methods: </strong>This medical records review study included 611 oJIA patients followed for at least 6 months between August 2016 and February 2024. Patients were classified as with uveitis (n = 96, 15.7%) or without uveitis (n = 515, 84.3%). Uveitis cases were further stratified by timing: group 1 (n = 65, 10.6%) developed uveitis after arthritis onset, whereas group 2 (n = 31, 5.1%) were diagnosed with uveitis at their first ophthalmologic evaluation. Demographics, clinical features, and treatment characteristics were compared across groups.</p><p><strong>Results: </strong>Uveitis occurred in 15.7% of oJIA patients. Patients with uveitis had a significantly younger age at arthritis onset with a median of 4.3 years (interquartile range [IQR], 1.9-9.3 years), compared with those without uveitis (8.5 years; IQR, 5-11.5 years) ( p < 0.001), and had a higher antinuclear antibody positivity rate (70.8% vs. 45.6%, p < 0.001). Methotrexate was the predominant initial treatment for oJIA, and the median duration of usage was 13 months (IQR, 6.8-26 months) until the onset of uveitis. Among the 81 patients who received etanercept as their initial biologic, 14 (17.3%) developed uveitis during the follow-up period. A total of 25 patients (26%) had ocular complications, with a significantly higher proportion observed in those with uveitis at their initial examination (n = 14, 45.1%) compared with those who develop uveitis after arthritis onset (n = 11, 16.9%) ( p = 0.003).</p><p><strong>Conclusion: </strong>Our study highlights younger age at oJIA diagnosis and antinuclear antibody positivity as significant risk factors for uveitis development. Uveitis in oJIA may occur before, concurrently with or after arthritis onset. Early recognition, routine screening, and timely therapeutic escalations are essential to improve outcomes in patients with oJIA-associated uveitis.</p>","PeriodicalId":520664,"journal":{"name":"Journal of clinical rheumatology : practical reports on rheumatic & musculoskeletal diseases","volume":" ","pages":"e58-e65"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144201316","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":"Dermatologic Adverse Effects of Chloroquine: A Review.","authors":"Alison Grise, Anna Wanzenberg, Jon de Vries, Naveed Sami","doi":"10.1097/RHU.0000000000002261","DOIUrl":"https://doi.org/10.1097/RHU.0000000000002261","url":null,"abstract":"<p><strong>Abstract: </strong>Chloroquine has been linked to numerous adverse effects impacting several organ systems in the body. The dermatologic adverse effects of chloroquine have not been extensively analyzed in the current literature. A recent publication reviewed these effects of hydroxychloroquine, a medication with a similar composition and use as chloroquine. We conducted a narrative review of the English literature on this topic to better understand the dermatologic toxicity of chloroquine. Many of the dermatologic adverse effects associated with chloroquine use identified in this review were well tolerated or resolved after discontinuation of treatment. The most commonly reported adverse dermatologic effect of chloroquine was pruritus, with at least 464 distinct cases across 29 studies. All dermatologic reactions to chloroquine occurred within 3 months of drug initiation. Due to the varying reporting styles and methodology of studies, this analysis demonstrates the need for future studies to better elucidate the risks for dermatologic adverse effects of chloroquine regarding underlying conditions and treatment regimens. Future research should aim to identify all possible dermatologic adverse effects so that clinicians may confidently determine the risk to their patients.</p>","PeriodicalId":520664,"journal":{"name":"Journal of clinical rheumatology : practical reports on rheumatic & musculoskeletal diseases","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144736563","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}