Joint Bone Spine最新文献

{"title":"French recommendations for assessing and managing the risk of cancer before the initiation of targeted therapies for chronic rheumatic inflammatory diseases.","authors":"Jérôme Avouac, Olivier Fogel, Maxime Beydon, Grégoire Martin de Frémont, Gary Birsen, Xavier Carcopino, Claire Immediato Daien, Sandra Desouches, Charlotte Domblides, Cécile Gaujoux-Viala, Jacques-Eric Gottenberg, Jean-Guillaume Letarouilly, Gaetane Nocturne, Clément Prati, Jean Hugues Salmon, Jérémie Sellam, Marie-Elise Truchetet, Marie Wislez, Irène Pico-Philippe, Danielle Vacher, Raphaèle Seror, Anna Molto","doi":"10.1016/j.jbspin.2025.105944","DOIUrl":"https://doi.org/10.1016/j.jbspin.2025.105944","url":null,"abstract":"<p><strong>Objective: </strong>Chronic inflammatory rheumatic diseases (CIRDs) are associated with a higher risk of cancer due to persistent inflammation, immune dysregulation, and immunomodulatory therapies. The growing use of targeted therapies necessitates systematic cancer risk assessment prior to treatment initiation.</p><p><strong>Objective: </strong>To develop practical recommendations for cancer risk assessment and management before initiating targeted therapies in patients with CIRDs, while balancing therapeutic benefits with oncologic safety.</p><p><strong>Methods: </strong>Conducted under the French Society of Rheumatology, this initiative followed standardized procedures. A multidisciplinary task force was established, including rheumatologists, oncologists, pulmonologists, gynecologists, and patient representatives. Two systematic literature reviews (2005-2024) were performed to assess cancer risk in CIRD patients under conventional and targeted DMARDs. Recommendations were formulated based on evidence synthesis and expert consensus, with multiple voting rounds to establish levels of agreement.</p><p><strong>Results: </strong>The task force proposed three overarching principles and eight evidence-based recommendations. It advocated the application of general population cancer screening programs, adapted to the specific needs of immunocompromised patients with CIRDs. These adaptations may involve earlier and/or more frequent screening. Recommendations also support systematic risk assessment before initiating therapies, reinforced preventive strategies like HPV vaccination and smoking cessation, and at least one dermatologic evaluation during follow-up. Decisions regarding higher-risk therapies, such as JAK inhibitors and abatacept, should involve multidisciplinary discussions.</p><p><strong>Conclusion: </strong>These recommendations provide a practical, individualized framework for cancer risk assessment in CIRD patients. By integrating adapted screening, prevention, and shared decision-making, they aim to optimize patient safety while preserving disease control.</p>","PeriodicalId":54902,"journal":{"name":"Joint Bone Spine","volume":" ","pages":"105944"},"PeriodicalIF":3.8,"publicationDate":"2025-07-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144638741","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Remission and Objective Signs of Inflammation in Axial Spondyloarthritis - Mapping the Symptom-Inflammation Landscape in Axial Spondyloarthritis.","authors":"Mikhail Protopopov, Fabian Proft","doi":"10.1016/j.jbspin.2025.105946","DOIUrl":"https://doi.org/10.1016/j.jbspin.2025.105946","url":null,"abstract":"","PeriodicalId":54902,"journal":{"name":"Joint Bone Spine","volume":" ","pages":"105946"},"PeriodicalIF":3.8,"publicationDate":"2025-07-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144638742","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy of intra-articular platelet-rich plasma compared with placebo in knee osteoarthritis: a systematic review and meta-analysis.","authors":"Maxime Auroux, Thaïs Debionne, Sabine Mainbourg, Roland Chapurlat","doi":"10.1016/j.jbspin.2025.105947","DOIUrl":"https://doi.org/10.1016/j.jbspin.2025.105947","url":null,"abstract":"<p><strong>Objectives: </strong>Our primary aim was to evaluate the efficacy on pain and function of intra articular platelet-rich plasma (PRP) injection in knee osteoarthritis (KOA) compared with intra articular saline solution injection.</p><p><strong>Methods: </strong>A search for randomized controlled studies (RCTs) using intra articular platelet-rich plasma injection compared with intra articular saline solution injection up to November 2022 (PROSPERO registration number: CRD42022311893) was undertaken in publication databases. Studies that reported pain and function evaluation with visual analogue scale (VAS) and/or WOMAC, size sample, study date and location were included. A meta-analysis was conducted to estimate the efficacy on pain and function of intra articular platelet-rich plasma injection.</p><p><strong>Results: </strong>We identified 11 RCTs including 1616 patients (849 on PRP, 767 on placebo) conducted in 7 countries, with 56% of patients being women. The mean age was 56.9 years. VAS analysis at 3 and 6 months after intervention was in favor of PRP use (respective Mean difference (MD) -1.1 (95%CI -1.8; -0.4) and -2.0 (95%CI -2.8; -1.2)) but with high heterogeneity, whereas no efficacy was shown at 12 months. The variation of total WOMAC at 3 months after intervention was in favor of PRP use (MD -12.9 (95%CI -20.5; -5.3)), but no efficacy was shown at 6 and 12 months.</p><p><strong>Conclusion: </strong>We have found a weak efficacy of PRP in knee osteoarthritis, up to 6 months after intervention, so the clinical relevance of PRP use is debatable.</p>","PeriodicalId":54902,"journal":{"name":"Joint Bone Spine","volume":" ","pages":"105947"},"PeriodicalIF":3.8,"publicationDate":"2025-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144627790","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk of non-bacterial opportunistic infections associated with janus kinase inhibitors versus tumor necrosis factor inhibitors among rheumatoid arthritis patients: a cohort study.","authors":"Anna Shin, Rim Choi Se, Jung Yun Pyo, You-Jung Ha, Yun Jong Lee, Eun Bong Lee, Eun Ha Kang","doi":"10.1016/j.jbspin.2025.105945","DOIUrl":"https://doi.org/10.1016/j.jbspin.2025.105945","url":null,"abstract":"<p><strong>Objective: </strong>To compare the risk of serious opportunistic infections between janus kinase inhibitors (JAKis) versus tumor necrosis factor inhibitors (TNFis) among rheumatoid arthritis (RA) patients.</p><p><strong>Methods: </strong>Using 2009-2020 Korea National Health Insurance Service database, we conducted a cohort study on RA patients initiating a JAKi or TNFi. The primary outcome was a composite of hospitalized viral, fungal, and tuberculous infections. Secondary outcomes were individual components of the primary outcome. Propensity-score fine-stratification (PSS) and weighting were applied to control confounding. Hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated using Cox proportional hazard models. Subgroup analyses by age, cumulative corticosteroid dose, and comorbidity score were done.</p><p><strong>Results: </strong>During a mean follow-up of 479 days, PSS-weighted 4,252 JAKi initiators and 6,653 TNFi initiators generated 173 cases of serious opportunistic infections, of which incidence rate was 1.66 and 0.87 per 100 person-years in JAKi and TNFi users, respectively, with the PSS-weighted HR (95% CI) of 1.94 (1.44-2.64). The PSS-weighted HR (95% CI) for secondary outcomes was 2.89 (1.98-4.20) for viral, 2.07 (0.59-7.26) for fungal, 0.55 (0.27-1.15) for tuberculosis. Results were consistent across subgroups.</p><p><strong>Conclusions: </strong>This population-based cohort study on RA patients found that the overall risk of serious opportunistic infections was higher with JAKi than TNFi. However, individual types of infections showed different patterns in that the risk of viral infections (and fungal infections only numerically) was higher among JAKi initiators, while that of tuberculosis tended to be lower in TNFi initiators.</p>","PeriodicalId":54902,"journal":{"name":"Joint Bone Spine","volume":" ","pages":"105945"},"PeriodicalIF":3.8,"publicationDate":"2025-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144627791","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Practical management of rheumatic immune-related adverse events occurring with immune checkpoint inhibitors: a narrative review.","authors":"Alice Tison, Thomas Escoda, Marie Kostine, Divi Cornec, Laurent Chiche","doi":"10.1016/j.jbspin.2025.105938","DOIUrl":"https://doi.org/10.1016/j.jbspin.2025.105938","url":null,"abstract":"<p><p>Immune checkpoint inhibitors (ICIs) have dramatically changed the management of cancer and their indications are expanding, leading to an increase in immune-related adverse events (irAEs). Recently, attention has focused on previously underestimated rheumatic irAEs, including inflammatory arthritis (IA), polymyalgia rheumatica-like phenotypes and Sicca syndrome, but also fasciitis, and rare but severe immune mediated myositis, with a possible association with myasthenia-like symptoms or myocarditis. Rheumatic irAEs may have a prolonged course and affect a patient's quality of life. Patients with IA or systemic autoimmune disease prior to ICI initiation are also at risk of flares. Current management of rheumatic toxicities relies on the opinion of experts, mostly based on the management of the classical rheumatic conditions they mimic. Due to the lack of high-quality data in the literature, few recommendations are available, with remaining concerns regarding the impact of immunosuppressive drugs on cancer response. The aim of this article is to provide practical guidelines to help rheumatologists and oncologists in their daily practice to deal with ICI related inflammatory rheumatic conditions, from the introduction of an ICI in the case of preexisting autoimmune disease, to the occurrence of rheumatic toxicity, as well as discussions concerning ICI rechallenge after a severe rheumatic irAE.</p>","PeriodicalId":54902,"journal":{"name":"Joint Bone Spine","volume":" ","pages":"105938"},"PeriodicalIF":3.8,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144562002","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Residual disease in axial spondyloarthritis. Facts and issues.","authors":"Daniel Wendling, Philippe Goupille, Frank Verhoeven, Clément Prati","doi":"10.1016/j.jbspin.2025.105943","DOIUrl":"10.1016/j.jbspin.2025.105943","url":null,"abstract":"<p><p>Residual disease in axial spondyloarthritis (axSpA) is defined by the persistence of signs, symptoms, or disease burden despite active treatment. Magnetic resonance imaging (MRI) inflammation may still be present in up to one-third of patients in clinical remission. Moreover, residual symptoms are frequently reported in patients with low disease activity (LDA), with 20-40% of patients experiencing pain or fatigue scores greater than 4 out of 10 on a visual analogue scale. Nociplastic pain (central sensitization) and neuropathic pain components are commonly associated with residual symptoms, as is female gender. Other contributing factors may include psycho-behavioral disorders, low physical activity, sarcopenia, sleep disturbances, and comorbidities. This residual disease is a key feature of difficult-to-manage (D2M) axSpA. A comprehensive assessment of the patient's context and a thorough evaluation of pain mechanisms are essential first steps in the management of these patients. Non-pharmacological strategies should be prioritized and reinforced in this setting, while certain targeted disease-modifying anti-rheumatic drugs (DMARDs) may have a specific effect on pain independently of their anti-inflammatory properties. There is a pressing need for new biomarkers that more specifically reflect the inflammatory process in spondyloarthritis, as therapeutic response is currently assessed primarily through patient-reported outcomes (PROs). Although no consensus definition exists to date, the recognition of residual disease and its associated factors is crucial in axSpA - particularly in a condition where objective signs of inflammation may be absent - to prevent overtreatment.</p>","PeriodicalId":54902,"journal":{"name":"Joint Bone Spine","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144562004","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nasal septal perforation in adult Still's disease","authors":"Esra Erpek ,&nbsp;Eren Erdem ,&nbsp;Ediboğlu Elif ,&nbsp;Solmaz Dilek ,&nbsp;Akar Servet","doi":"10.1016/j.jbspin.2025.105942","DOIUrl":"10.1016/j.jbspin.2025.105942","url":null,"abstract":"<div><h3>Background</h3><div>Adult-onset Still's disease (AOSD) is a rare systemic inflammatory disorder characterized by fever, rash, arthritis, and pharyngitis. Ear, nose, and throat (ENT) complications beyond pharyngitis are uncommon.</div></div><div><h3>Case presentation</h3><div>A 31-year-old female presented with fever, sore throat, maculopapular rash, and arthritis. Laboratory findings revealed elevated inflammatory markers, hyperferritinemia, and leukocytosis. After extensive exclusion of infectious and autoimmune causes, AOSD was diagnosed, and treatment with corticosteroids and methotrexate was initiated. Clinical symptoms improved within a week. However, one month later, the patient developed nasal bleeding and crusting. ENT examination revealed anterior nasal septal perforation. Known causes of septal perforation, including infection, trauma, intranasal drug use, and vasoconstrictor sprays, were excluded.</div></div><div><h3>Conclusion</h3><div>This case highlights nasal septal perforation as a rare and possibly underrecognized complication of AOSD. Clinicians should consider ENT evaluation during both active disease and follow-up periods.</div></div>","PeriodicalId":54902,"journal":{"name":"Joint Bone Spine","volume":"92 5","pages":"Article 105942"},"PeriodicalIF":3.8,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144562001","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pulmonary alveolar proteinosis in Sjögren's syndrome","authors":"Shio-Yi Liao ,&nbsp;Hsien-Tzung Liao","doi":"10.1016/j.jbspin.2025.105937","DOIUrl":"10.1016/j.jbspin.2025.105937","url":null,"abstract":"","PeriodicalId":54902,"journal":{"name":"Joint Bone Spine","volume":"92 5","pages":"Article 105937"},"PeriodicalIF":3.8,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144562003","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-term outcomes after a functional restoration program for non-specific chronic low back pain: A 10-year longitudinal study","authors":"Louis Jacob ,&nbsp;Camille Heslot ,&nbsp;Mélanie Ribau ,&nbsp;Charlotte Logiou ,&nbsp;Jean-François Vergnol ,&nbsp;Odile Morchoisne ,&nbsp;David Petrover ,&nbsp;Augustin Latourte ,&nbsp;Pascal Richette ,&nbsp;Johann Beaudreuil","doi":"10.1016/j.jbspin.2025.105941","DOIUrl":"10.1016/j.jbspin.2025.105941","url":null,"abstract":"<div><h3>Background</h3><div>There is a scarcity of data on the long-term evolution of patients after functional restoration for non-specific chronic low back pain (NSCLBP). Therefore, this longitudinal study investigated overall improvement and other sociodemographic and clinical parameters in patients with NSCLBP within 10 years of participating in a functional restoration program.</div></div><div><h3>Methods</h3><div>Functional restoration was undergone in a French university hospital between 2009 and 2011. Patients were evaluated at the inclusion, the end of the program, three months, 12 months, and 10 years. The primary outcome of the study was the overall improvement in the 10 years following functional restoration. There were multiple secondary outcomes (e.g., the Quebec Back Pain Disability Scale [QBPDS] and return to work). Changes over time were assessed using generalized estimating equations.</div></div><div><h3>Results</h3><div>The study included 51 patients (mean [SD] age 45.6 [8.3] years; 54.9% women; 66.7% employees or workers; and 66.7% full or part-time work disability). The percentage of overall improvement was 76.5% at 10 years (versus 92.0% at the end of the program; <em>P</em>-value &lt; 0.050). The QBPDS score improved from a mean score of 43.2 at inclusion to 32.2 at 10 years (<em>P</em>-value<!--> <!-->&lt;<!--> <!-->0.001). Finally, return to work occurred in more than half of patients with work disability at three months (62.5%) and 10 years (60.0%), and this return was stable over time (<em>P</em>-value not significant).</div></div><div><h3>Conclusions</h3><div>Patients with NSCLBP had favorable outcomes up to 10 years after functional restoration. Further data are needed to corroborate the present findings.</div></div>","PeriodicalId":54902,"journal":{"name":"Joint Bone Spine","volume":"92 5","pages":"Article 105941"},"PeriodicalIF":3.8,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144531194","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Quantitative HRCT as a surrogate outcome measure for nintedanib treatment in systemic sclerosis-interstitial lung disease and idiopathic pulmonary fibrosis","authors":"Marco Di Battista ,&nbsp;Chiara Romei ,&nbsp;Laura Tavanti ,&nbsp;Vincenzo Uggenti ,&nbsp;Sara Mitolo ,&nbsp;Edoardo Airò ,&nbsp;Francesco Pistelli ,&nbsp;Davide Chimera ,&nbsp;Laura Carrozzi ,&nbsp;Emanuele Neri ,&nbsp;Annalisa De Liperi ,&nbsp;Alessandra Della Rossa ,&nbsp;Marta Mosca","doi":"10.1016/j.jbspin.2025.105934","DOIUrl":"10.1016/j.jbspin.2025.105934","url":null,"abstract":"<div><h3>Objective</h3><div>We assessed the effect of nintedanib (NIN) in terms of quantitative HRCT changes in both idiopathic pulmonary fibrosis (IPF) and systemic sclerosis-associated progressive interstitial lung disease (SSc-ILD), evaluating the relationships between imaging variations and clinical-functional outcomes.</div></div><div><h3>Methods</h3><div>We prospectively enrolled SSc-ILD and IPF patients treated with NIN and retrospectively selected the same number of subjects from a historical untreated cohort comparable for disease, age, gender and follow-up period. HRCT scans were processed with CALIPER software, obtaining the percentage of normal parenchyma, ILD and vascular-related structures (VRS).</div></div><div><h3>Results</h3><div>Quantitative HRCT changes of 36 NIN treated patients (12 SSc-ILD and 24 IPF) were compared with 36 untreated subjects with pulmonary fibrosis. After a mean follow-up period of 22 months, NIN therapy was associated with a percentage stabilization of normal parenchyma (from 81.3<!--> <!-->±<!--> <!-->11.8% to 78.6<!--> <!-->±<!--> <!-->15.6%; <em>P</em> <!-->=<!--> <!-->not significant) and ILD (from 14.5<!--> <!-->±<!--> <!-->10.4% to 16.7<!--> <!-->±<!--> <!-->14.2%; <em>P</em> <!-->=<!--> <!-->not significant) both in SSc-ILD and IPF, avoiding the loss of normal parenchyma (from 87.4<!--> <!-->±<!--> <!-->7.3% to 78.8<!--> <!-->±<!--> <!-->16.7%; <em>P</em> <!-->&lt;<!--> <!-->0.001) and ILD worsening (from 9.0<!--> <!-->±<!--> <!-->5.9% to 16.5<!--> <!-->±<!--> <!-->14.8%; <em>P</em> <!-->&lt;<!--> <!-->0.001) observed in the untreated cohort. VRS was significantly increased regardless of antifibrotic therapy (<em>P</em> <!-->&lt;<!--> <!-->0.001). NIN treated patients who experienced a clinically meaningful worsening at pulmonary function tests or at the reported dyspnoea, presented a significant loss of normal parenchyma in parallel with a greater increase in ILD (<em>P</em> <!-->&lt;<!--> <!-->0.05 for all).</div></div><div><h3>Conclusion</h3><div>NIN appears effective in reducing the radiological decline of pulmonary fibrosis. Quantitative HRCT is proposed as a surrogate outcome measure for clinical practice and future trials.</div></div>","PeriodicalId":54902,"journal":{"name":"Joint Bone Spine","volume":"92 6","pages":"Article 105934"},"PeriodicalIF":3.8,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144509507","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}