Journal of Rheumatic Diseases最新文献

{"title":"Validity of a claim-based algorithm for classifying disease activity levels using Systemic Lupus Erythematosus Disease Activity Index 2000 in Korean patients with systemic lupus erythematosus.","authors":"Yoon-Kyoung Sung, Ha-Rim Park, Eunwoo Nam, Hyoungyoung Kim, Sun-Young Jung, Eun Jin Jang, Soo-Kyung Cho","doi":"10.4078/jrd.2025.0053","DOIUrl":"10.4078/jrd.2025.0053","url":null,"abstract":"<p><strong>Objective: </strong>To validate algorithms for classifying disease activity in patients with systemic lupus erythematosus (SLE) using Korean claims data.</p><p><strong>Methods: </strong>We used data from a prospective cohort of SLE patients enrolled at a single academic center between October 2014 and August 2020. Disease activity was assessed at each visit using the Systemic Lupus Erythematosus Disease Activity Index 2000 (SLEDAI-2K), with the annual average score serving as the gold standard. Three claims-based algorithms incorporating diagnostic codes for comorbidities and medication use were evaluated (1) a previously established model including SLE-related comorbidities, immunosuppressants, and oral glucocorticoids, (2) a modified version incorporating intravenous glucocorticoids, and (3) a version with adjusted glucocorticoid dosage criteria (5 mg) to better identify mild to moderate disease. The performance of each algorithm in classifying mild disease activity-defined as SLEDAI-2K <3-was assessed by calculating sensitivity, specificity, positive predictive value (PPV), negative predictive value, and the area under the curve.</p><p><strong>Results: </strong>A total of 151 patients were included. The mean age was 34.5±8.7 years, and 94.7% were female. The mean initial SLEDAI-2K score was 3.6±2.6. The PPV for identifying mild disease activity ranged from 75.9% to 77.2%, with Algorithm 3 demonstrating the highest PPV. However, incorporating intravenous glucocorticoids or adjusting dosage thresholds did not result in further improvement.</p><p><strong>Conclusion: </strong>A claims-based algorithm using diagnostic and medication codes demonstrated a PPV of 77.2% for classifying mild disease activity in SLE. This approach may offer a practical method for disease activity assessment in Korean claims-based research.</p>","PeriodicalId":56161,"journal":{"name":"Journal of Rheumatic Diseases","volume":"32 4","pages":"264-270"},"PeriodicalIF":3.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12455033/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145139653","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":"Rituximab in Sjögren's disease: reconciling evidence from randomized and observational studies.","authors":"Young Ho Lee","doi":"10.4078/jrd.2025.0110","DOIUrl":"10.4078/jrd.2025.0110","url":null,"abstract":"","PeriodicalId":56161,"journal":{"name":"Journal of Rheumatic Diseases","volume":"32 4","pages":"229-231"},"PeriodicalIF":3.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12455029/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145139506","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":"Association between sarcopenia and physical activity in individuals with spondyloarthritis.","authors":"Bruna Oliveira Corrêa do Amaral, Christianne de Faria Coelho-Ravagnani, Ana Beatriz Silva de Vasconcelos, Silvio Assis de Oliveira-Junior, Paula Felippe Martinez","doi":"10.4078/jrd.2025.0018","DOIUrl":"10.4078/jrd.2025.0018","url":null,"abstract":"<p><strong>Objective: </strong>To assess the association between sarcopenia and physical activity in individuals with spondyloarthritis (SpA).</p><p><strong>Methods: </strong>Physical functional performance of individuals with SpA (SpA group [SG] n=29, 10 males, mean age=50.6±10.2 years) and a control group (CG, n=29), matched by age and sex, was assessed by handgrip strength; Five Times Sit-to-Stand (FTSTS) test; Timed Up and Go (TUG) test; and Chester Step test. International Society for the Assessment of Spondylarthritis Health Index (ASAS-HI) Questionnaire was applied to SG. Physical activity level was assessed by the International Physical Activity Questionnaire and daily steps count (pedometer). Diagnosis of sarcopenia followed the criteria by the European Working Group on Sarcopenia in Elderly People 2.</p><p><strong>Results: </strong>SG had lower functional physical performance and level of physical activity compared with CG. Presarcopenia was detected only in SG (41.4% of individuals). In SG, TUG test showed significant correlation with sedentary behavior (p=0.008), FTSTS test with vigorous physical activity (p=0.009), and ASAS-HI (p=0.039); handgrip strength had a positive correlation with time since diagnosis (p=0.003) and a negative correlation with the number of SpA clinical features (p=0.046). In SG, time spent performing vigorous physical activity showed an independent association with presarcopenia.</p><p><strong>Conclusion: </strong>Presarcopenia is more frequent in individuals with SpA than in control individuals and is associated with low practice of vigorous-intensity physical activity.</p>","PeriodicalId":56161,"journal":{"name":"Journal of Rheumatic Diseases","volume":"32 4","pages":"271-282"},"PeriodicalIF":3.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12455030/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145139561","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":"The correlation between retinal microvascular changes by optical coherence tomography angiography and nailfold capillaroscopic findings in patients with systemic sclerosis.","authors":"Sahar Abd-Elrahman Elsayed, Amr Mounir, Engy Mohamed Mostafa, Dalia Salah Saif, Ola Mounir","doi":"10.4078/jrd.2024.0124","DOIUrl":"10.4078/jrd.2024.0124","url":null,"abstract":"<p><strong>Objective: </strong>We aimed to detect the correlation between retinal microvascular changes by optical coherence tomography angiography (OCTA) and nailfold capillaroscopic findings in patients with systemic sclerosis (SSc).</p><p><strong>Methods: </strong>Forty SSc patients and thirty healthy controls were included. A complete history was taken, general and rheumatological examination and laboratory investigations were performed. In addition, all the participants were examined using nail fold capillaroscopy (NFC) and OCTA.</p><p><strong>Results: </strong>Our patients have decreased nailfold capillary density, central macular thickness, superficial full vessel density (VD), superior, inferior, and medial superficial peri-foveal VD, superior, inferior, and temporal superficial parafoveal VD, and temporal para-foveal full VD compared to the controls. The modified Rodnan skin score was negatively correlated with the nail fold capillary density, central macular thickness, superficial full VD, superior, temporal, and medial superficial perifoveal VD, superior superficial parafoveal VD, and temporal perifoveal full VD. The nailfold capillary density was positively correlated with the central macular thickness, the superficial full VD, the superior, temporal, and medial superficial perifoveal VD, the superior superficial parafoveal VD, and temporal perifoveal full VD.</p><p><strong>Conclusion: </strong>The nailfold capillary density measured by NFC positively correlates with the retinal VD measured by OCTA, suggesting that NFC could be a valuable marker for retinal vessel involvement in SSc patients. In addition, our results highlight the importance of combining OCTA with NFC for diagnosing and monitoring microvascular changes in SSc patients.</p>","PeriodicalId":56161,"journal":{"name":"Journal of Rheumatic Diseases","volume":"32 3","pages":"198-210"},"PeriodicalIF":2.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12202278/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144531313","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":"Efficacy of early rituximab treatment in primary Sjögren's syndrome: a systematic review and meta-analysis.","authors":"Mohammad Shahdadian, Mohammad Ali Saghiri, Eugenio Capitle","doi":"10.4078/jrd.2024.0149","DOIUrl":"10.4078/jrd.2024.0149","url":null,"abstract":"<p><strong>Objective: </strong>This systematic review and meta-analysis aimed to assess Rituximab (RTX)'s efficacy and safety in primary Sjögren's syndrome (pSS), particularly how treatment timing influences outcomes.</p><p><strong>Methods: </strong>The study included randomized controlled trials (RCTs) and quasi-experimental studies evaluating RTX in pSS patients, focusing on disease activity (European League Against Rheumatism Sjögren's Syndrome Disease Activity Index [ESSDAI] score) and adverse events (AEs). Searches were conducted in MEDLINE, Embase, SCOPUS, and Cochrane Library databases up to July 2024. Risk of bias was assessed using Cochrane Risk of Bias 2.0 (RoB 2) and Joanna Briggs Institute (JBI) checklists. Meta-analysis was performed in Stata 17 with a random-effects model, reporting mean differences in ESSDAI and I² for heterogeneity.</p><p><strong>Results: </strong>From 555 articles, 15 studies were included (4 RCTs and 11 quasi-experimental studies). RCT meta-analysis showed a mean difference of 0.09 (95% confidence interval [CI] -0.43, 0.61), indicating no significant RTX efficacy. In contrast, the pooled quasi-experimental analysis revealed a mean difference of -4.36 (95% CI -5.83, -2.89), suggesting a significant reduction in disease activity. Meta-regression indicated no significant correlation between RTX efficacy and mean disease duration. Subgroup analysis of disease duration (under vs. over 60 months) showed no significant difference. Safety assessment indicated no significant differences in AEs between RTX and placebo in RCTs. In quasi-experimental studies, infusion reactions and infections were the most common AEs, with serious infections being the most severe.</p><p><strong>Conclusion: </strong>RTX did not show significant improvement in RCTs. However, RTX significantly reduced pSS activity at week 24 or month 6 following treatment, based on quasi-experimental studies. We found no significant correlation between RTX efficacy and disease duration.</p>","PeriodicalId":56161,"journal":{"name":"Journal of Rheumatic Diseases","volume":"32 3","pages":"211-224"},"PeriodicalIF":2.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12202284/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144531310","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":"Understanding and addressing anti-drug antibody formation in tumor necrosis factor-α inhibitor therapy for ankylosing spondylitis.","authors":"Tae-Jong Kim","doi":"10.4078/jrd.2025.0067","DOIUrl":"10.4078/jrd.2025.0067","url":null,"abstract":"","PeriodicalId":56161,"journal":{"name":"Journal of Rheumatic Diseases","volume":"32 3","pages":"151-153"},"PeriodicalIF":2.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12202282/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144531314","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":"Frequency of lumbosacral transitional vertebra and its relationship with disease related parameters of patients with axial spondyloarthritis.","authors":"Serkan Sevindik, Kemal Erol, Funda Levendoğlu, Ilknur Albayrak Gezer","doi":"10.4078/jrd.2025.0013","DOIUrl":"10.4078/jrd.2025.0013","url":null,"abstract":"<p><strong>Objective: </strong>The aim of this study was to evaluate the prevelance of lumbosacral transitional vertebrae (LSTV) in patients with axial spondyloarthritis (ax-SpA), and to explore the relationship of the presence of LSTV with the burden of disease.</p><p><strong>Methods: </strong>A total of 177 patients classified with ax-SpA according to ASAS (Assessment of Spondyloarthritis International Society) criteria who were admitted to Selçuk University Medical Faculty rheumatology outpatient clinic were included, consecutively. Demographic, clinical, and laboratory data were recorded. LSTV was evaluated on AnteroPosterior (AP) pelvic radiographs and AP lumbar radiographs according to the Castellvi classification.</p><p><strong>Results: </strong>Of 177 patients with axSpA, 99 (55.9%) were radiographic axSpA (r-axSpA). LSTV was detected in 51 (28.8%) patients with ax-SpA (with the frequency of 32.3% in r-axSpA and 24.4% in non-r-axSpA [nr-axSpA] [p>0.05]). Most frequent LSTV subtype was type 1 (32 of 51 [62.7%]). Thirty-two (62.7%) of 51 patients with LSTV were r-axSpA, and 19 (37.3%) patients with LSTV were nr-axSpA (p=0.245). The demographic characteristics of the group with and without LSTV were similar. There was no significant difference in terms of VAS, BASDAI, BASFI, ASDAS-CRP, BASMI, HAQ, EQ-5D-3L scores and no difference in disease activity in terms of presence of LSTV in patients with ax-SpA.</p><p><strong>Conclusion: </strong>The prevalence of LSTV in patients with ax-SpA was 28.8%, consistent with some population based studies in the literature. There was no difference between patients with and without LSTV in terms of burden of disease in patients with ax-SpA.</p>","PeriodicalId":56161,"journal":{"name":"Journal of Rheumatic Diseases","volume":"32 3","pages":"190-197"},"PeriodicalIF":2.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12202283/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144531311","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":"Chimeric Antigen Receptor T-cell therapy in systemic autoimmune rheumatic diseases: current insights and future prospects.","authors":"Bong-Woo Lee, Eui-Jong Kwon, Ji Hyeon Ju","doi":"10.4078/jrd.2024.0122","DOIUrl":"10.4078/jrd.2024.0122","url":null,"abstract":"<p><p>Chimeric Antigen Receptor (CAR) T-cell therapy, revolutionary in treating hematological malignancies, is emerging as a promising approach for systemic autoimmune rheumatic diseases (SARDs). This review examines the potential of CAR T-cell therapy in treating conditions such as systemic lupus erythematosus (SLE), systemic sclerosis (SSc), and idiopathic inflammatory myopathies (IIMs). The evolution of CAR T cells technology, from first to fifth generation, has enhanced its efficacy and persistence. Early clinical studies in SARDs have shown encouraging results, with some patients achieving drug-free remission. CD19-targeted CAR T cells have demonstrated significant B-cell depletion and clinical improvement in patients with SLE, SSc, and IIMs. Despite promising outcomes, challenges remain, including cytokine release syndrome and the need for careful patient selection. Future directions include exploring dual-targeting CARs, chimeric autoantibody receptors (CAARs), and alternative cell sources like γδ T cells, regulatory T cells, natural killer cells. The integration of CAR-based cell therapy into treatment paradigms of patients with SARDs requires further research to optimize efficacy, mitigate side effects, and identify suitable target biomarkers. While hurdles exist CAR-based cell therapy holds the potential to revolutionize management of patients with SARDs, offering hope for long-term, drug-free remission in these complex autoimmune conditions.</p>","PeriodicalId":56161,"journal":{"name":"Journal of Rheumatic Diseases","volume":"32 3","pages":"154-165"},"PeriodicalIF":2.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12202281/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144531308","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":"Change of autoantibody levels in established rheumatoid arthritis patients treated by biological disease-modifying anti-rheumatic drugs -the AIRTIGHT study.","authors":"Shohei Anno, Kentaro Inui, Masahiro Tada, Yuko Sugioka, Tadashi Okano, Kenji Mamoto, Tatsuya Koike","doi":"10.4078/jrd.2024.0130","DOIUrl":"10.4078/jrd.2024.0130","url":null,"abstract":"<p><strong>Objective: </strong>Previous studies reported that abatacept (ABT) decreased autoantibodies in early rheumatoid arthritis (RA) patients. We investigated the impact of ABT, and other biological disease-modifying anti-rheumatic drugs (bDMARDs) on autoantibody levels in established RA patients.</p><p><strong>Methods: </strong>This prospective observational study included 50 RA patients treated with ABT and 115 RA patients treated with non-ABT bDMARDs. Serum levels of anticitrullinated peptide antibodies (ACPA), immunoglobulin (Ig) M-rheumatoid factor (IgM-RF), IgG-RF, and anti-agalactosyl IgG antibody (anti-Gal (0) IgG) were measured at baseline and after 48 weeks of treatment.</p><p><strong>Results: </strong>After propensity score matching, 25 patients with ABT and 25 patients with non-ABT were finally analyzed. Disease activity score in 28 joints using C-reactive protein significantly decreased in both ABT group (4.5 to 3.3, p<0.01) and non-ABT group (4.4 to 2.5, p<0.01) after 48 weeks treatment. In ABT group, median titers at baseline and 48 weeks were 62.7 and 57.8 U/mL for ACPA (p=0.22), 35.0 and 39.0 IU/mL for IgM-RF (p=0.21), 0.5 and 0.5 IU/mL for IgG-RF (p=0.19), and 50.4 and 53.5 AU/mL for anti-Gal (0) IgG (p=0.22), respectively. Changes of all autoantibody titer were not significant in ABT group. Non-ABT group showed significant decreases in ACPA (baseline 143.0 to 57.8 U/mL at week 48, p=0.03), IgM-RF (50.0 to 37.0 IU/mL, p<0.01), and anti-Gal (0) IgG (93.2 to 61.8 AU/mL, p<0.01) except IgG-RF (0.6 to 0.5 IU/mL, p=0.22).</p><p><strong>Conclusion: </strong>Autoantibody-lowering effect of ABT was not strong in established RA patients in our study.</p>","PeriodicalId":56161,"journal":{"name":"Journal of Rheumatic Diseases","volume":"32 3","pages":"182-189"},"PeriodicalIF":2.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12202280/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144531307","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":"Current state and future directions of basic research in rheumatoid arthritis.","authors":"Byeongzu Ghang, Jin Kyun Park, Ji Hyeon Ju, Seungwoo Han","doi":"10.4078/jrd.2024.0151","DOIUrl":"10.4078/jrd.2024.0151","url":null,"abstract":"<p><p>Rheumatoid arthritis (RA) is a chronic autoimmune disease characterized by synovial inflammation and joint destruction. Despite advances in biologic therapies targeting inflammatory mediators such as tumor necrosis factor (TNF)-α, interleukin (IL)-6, Janus kinase (JAK), and B cells, many patients do not respond adequately, emphasizing the need for deeper insights into RA pathogenesis. Research highlights the intricate interplay of genetic and epigenetic factors driving immune dysregulation. The breakdown of immune tolerance, often initiated in mucosal sites such as the gut, lung, and oral cavity, promotes the citrullination of antigens, leading to anti-citrullinated protein antibody production and subsequent immune activation. Single-cell and multi-omics approaches have shed light on underexplored immune cell types, such as T peripheral helper cells, CD4+/CD8+ cytotoxic T cells, and autoreactive B cells, broadening the understanding beyond traditionally studied Th17, Th1 cells, macrophages, and fibroblast-like synoviocytes. Future basic research in RA should prioritize elucidating the mechanisms behind peripheral tolerance breakdown, the pathogenesis of seronegative RA, and the molecular pathways driving refractory and recurrent disease. Moreover, leveraging multi-omics approaches to dissect disease heterogeneity will be pivotal for advancing personalized treatment strategies and improving long-term outcomes in RA patients.</p>","PeriodicalId":56161,"journal":{"name":"Journal of Rheumatic Diseases","volume":"32 3","pages":"166-181"},"PeriodicalIF":2.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12202279/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144531309","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}