Arthritis Care & Research最新文献

{"title":"Testing A Personalized Approach to Chronic Low Back Pain: A Randomized Controlled Trial in Older Veterans.","authors":"Debra K Weiner, Angela Gentili, Meika A Fang, Edward Garay, Laura Lawson, Lenore Joseph, Cathy C Lee, Michelle I Rossi, Beverly Thorn, Subashan Perera","doi":"10.1002/acr.25671","DOIUrl":"https://doi.org/10.1002/acr.25671","url":null,"abstract":"<p><strong>Objective: </strong>We aimed to test the efficacy of personalized treatment of older Veterans with chronic low back pain (CLBP) delivered by Aging Back Clinics (ABC) as compared with usual care (UC).</p><p><strong>Methods: </strong>Two hundred ninety-nine Veterans age 65-89 with CLBP from 3 VA medical centers underwent baseline testing, randomization to ABC or UC and 12 months follow-up. ABC care was guided by trained physicians and published algorithms targeting key conditions contributing to CLBP (e.g., hip osteoarthritis, depression, fibromyalgia). UC was guided by the participant's primary care provider. The primary outcome was 6-month change in the Oswestry Disability Index (ODI). Among multiple secondary outcomes were pain intensity, quality of life (PROMIS-Global Health), self-reported physical function (PROMIS-29), falls, life space, and health care utilization collected at 3, 6, 9, and 12 months. Analyses were conducted according to intention-to-treat.</p><p><strong>Results: </strong>There were no significant group differences in ODI change. Greater improvement with ABC in the PROMIS-29 physical function scale was observed at 12 months (1.7 vs -0.4 points), PROMIS Global physical health at 6 (1.3 vs -1.2) and 12 months (0.7 vs -1.5), PROMIS Global mental health at 6 months (0.2 vs -2.3), present and prior week average/worst pain over 12 months (all p<0.05). There were marginally significantly fewer falls over 12 months (p=0.0527).</p><p><strong>Conclusions: </strong>We did not find confirmatory evidence that personalized care (ABC) was superior with respect to ODI. We did find preliminary evidence that ABC was superior in other respects including improved self-reported physical health, less pain and fewer falls.</p>","PeriodicalId":8406,"journal":{"name":"Arthritis Care & Research","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145343094","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Digital behavioral therapy improves outcome in patients with axial spondyloarthritis and persistent pain: a randomized controlled trial.","authors":"David Kiefer, Yade Sonkaya, Dietmar Krause, Markus Voglau, Bernhard Mintrop, Imke Redeker, Xenofon Baraliakos, Uta Kiltz","doi":"10.1002/acr.25679","DOIUrl":"https://doi.org/10.1002/acr.25679","url":null,"abstract":"<p><strong>Objectives: </strong>Axial spondyloarthritis (axSpA) is often associated with persistent pain despite effective anti-inflammatory treatment. Digital health applications (DHA) provide innovative approaches to address multidimensional aspects of persistent pain through psychological and behavioral strategies. The aim of this study was to assess the impact of a DHA utilizing the acceptance and commitment therapy (ACT) on disease outcomes, including the West-Haven-Yale-Multidimensional-Pain-Inventory (MPI), in axSpA patients experiencing persistent pain despite stable pharmacological therapy.</p><p><strong>Methods: </strong>This unblinded, multicentric, randomized controlled trial compared an intervention group (IG) receiving the ACT-app with a standard of care (SOC) group. The ACT-app provided behavioral therapy. The primary outcome was MPI pain-related-life-interference; secondary outcomes included pain severity, affective distress and other patient reported outcomes after 12 weeks. Linear models estimating the effect of the ACT-app on the change of MPI pain-related life interference and affective distress were calculated.</p><p><strong>Results: </strong>136 patients were randomized to IG (n=73) with ACT-app and SOC (n=63) without ACT-app. Among IG, 44 actively used ACT-app. All lessons in the ACT-app were completed by 19 (43%) IG patients. Baseline characteristics, including MPI-scores, were comparable between groups. IG showed a reduction in pain-related-life-interference as well as in other outcomes. The improvements in pain-related-life-interference (-0.36, 95%CI: -0.73 to 0.01) and affective distress related to the disease (-0.4, 95%CI: -0.84 to 0.03) were greater compared to SOC.</p><p><strong>Conclusion: </strong>The ACT-app demonstrated a meaningful reduction in pain-related-life-interference, supporting that DHAs might become a complementary tool in managing pain for axSpA patients. Studies about improvement of adherence to DHAs are warranted.</p>","PeriodicalId":8406,"journal":{"name":"Arthritis Care & Research","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145343139","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Patient-Reported Outcomes Measurement Information System scale v1.2 Global Health (PROMIS-GH) is useful to assess mental and physical health in individuals with chronic musculoskeletal pain, rheumatoid arthritis, hip/knee osteoarthritis, or people undergoing physiotherapy: Results of factor and item response theory analyses.","authors":"Emanuele M Giusti, Leonardo Pellicciari, Martine H P Crins, Paul Dekker, Martin van der Esch, Marike van der Leeden, Willem F Lems, Joost Dekker, Maarten Boers, Dirkjan van Schaardenburg, Johan Joly, Patrick Verschueren, Kristien Van der Elst, Rene Westhovens, Caroline B Terwee, Leo D Roorda","doi":"10.1002/acr.25674","DOIUrl":"https://doi.org/10.1002/acr.25674","url":null,"abstract":"<p><strong>Objective: </strong>This study aims to assess whether the 10-item Patient-Reported Outcomes Measurement Information System Scale v1.2-Global Health (PROMIS-GH) is useful to assess Global Mental Health (GMH) and Global Physical Health (GPH) in individuals with musculoskeletal disorders.</p><p><strong>Methods: </strong>PROMIS-GH was administered to 4295 individuals (mean±SD age 56±14y, 70% female, chronic musculoskeletal pain [n=1142], rheumatoid arthritis [n=1987], hip/knee osteoarthritis [n=418], undergoing physiotherapy [n=947]). We investigated the legitimacy of calculating a GMH and a GPH subscale score (Confirmatory Factor Analyses) and of converting raw ordinal subscale scores to interval scores (checking IRT-assumptions [unidimensionality, local independence, monotonicity] and Graded Response Model fit), the ability of the subscales to discriminate different levels of health (items' discrimination parameters α), to cover relevant range of GMH and GPH (range of difficulty parameters β), their precision (item- and subscale-level information), and to compare demographical and clinical subgroups (Differential Item Functioning [DIF]).</p><p><strong>Results: </strong>It is legitimate to calculate a GMH and a GPH subscale score (CFI=0.98/0.97, TLI=0.97/0.95, RMSEA=0.15/0.19, SRMR=0.05/0.07), and to convert raw scores to interval scores (IRT-assumptions met and model fit). Discrimination (items' α≥2), coverage (lowest β≤-2) and precision (reliability≥0.70 for large portions of the health domain) were adequate for all items, except item Global10, underscoring that they can distinguish individuals with different levels of GMH and GPH with precision. The subscales can be used to compare demographical and clinical subgroups (no DIF).</p><p><strong>Conclusion: </strong>The PROMIS-GH can be used to measure GMH and GPH in individuals with musculoskeletal disorders. Replacement or improvement of item Global10 could be considered.</p>","PeriodicalId":8406,"journal":{"name":"Arthritis Care & Research","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145328277","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Climate Change, Environmental Risk Factors and Gout.","authors":"Mary L Guan, Tamiko R Katsumoto, Michael Toprover, Nidaa Rasheed, Shuchi Anand, Michael H Pillinger, Michael H Weisman, Suzanne R Tamang","doi":"10.1002/acr.25673","DOIUrl":"https://doi.org/10.1002/acr.25673","url":null,"abstract":"","PeriodicalId":8406,"journal":{"name":"Arthritis Care & Research","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145328145","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Systemic sclerosis associated myopathy in a large single-center cohort: Autoantibody profiles, histological features, and independent risk of mortality.","authors":"Julie J Paik, Caoilfhionn M Connolly, Fredrick Wigley, Laura K Hummers","doi":"10.1002/acr.25672","DOIUrl":"https://doi.org/10.1002/acr.25672","url":null,"abstract":"<p><strong>Objective: </strong>Skeletal myopathy is common in systemic sclerosis (SSc) but its associated clinical manifestations and long term outcomes are poorly characterized. The purpose of this study is to characterize patients with skeletal myopathy and define its impact on survival.</p><p><strong>Methods: </strong>This retrospective cohort study included patients in the Johns Hopkins Scleroderma Center Research Registry with and without skeletal myopathy. Clinical data including autoantibody profiles and muscle histopathology were compared between those with and without myopathy. Survival analyses including Cox proportional hazards and regression analyses were performed.</p><p><strong>Results: </strong>672 (17%) of 3,919 patients in the cohort had a skeletal myopathy. When compared to those without a myopathy, those with myopathy were more commonly of the diffuse subtype (60.4% vs 32.6%, p <0.0001), African-American (30.4% vs 13.9%, p<0.0001), and with shorter disease duration at first visit (4.52 + 6.2 years vs 6.5 + 8.0 years, p<0.00001). Anti-PM-Scl, U3RNP, and anti-Ku were associated with the presence of myopathy, while anti-centromere was protective against myopathy. Myopathy was associated with an increased risk of mortality in univariate Cox regression analyses (HR 1.59 [1.40-1.81],p<0.0001). In multivariate Cox proportional regression analyses, myopathy had an independent risk of death even after controlling for other confounders (HR 1.60 [1.32-1.93], p<0.0001).</p><p><strong>Conclusion: </strong>Skeletal myopathy in SSc is associated with distinct clinical and autoantibody profiles, as well as independently increased risk of mortality. These findings highlight the importance of early detection and further investigation into how myopathy predicts patient outcomes, with the goal of improving targeted therapies and survival in this high-risk population.</p>","PeriodicalId":8406,"journal":{"name":"Arthritis Care & Research","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145328196","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Knee Crepitus After ACLR: Not Predictive, But Still Pragmatic.","authors":"Shuai Chen","doi":"10.1002/acr.25678","DOIUrl":"https://doi.org/10.1002/acr.25678","url":null,"abstract":"","PeriodicalId":8406,"journal":{"name":"Arthritis Care & Research","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145328224","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between Discordance of Disease Activity Indices and Quantitative Sensory Testing Measures of Nociplastic Pain in Patients with Rheumatoid Arthritis.","authors":"Clarice P Lin, Burcu Aydemir, Jing Song, Lutfiyya N Muhammad, Tuhina Neogi, Wendy Marder, Clifton O Bingham, Marcy B Bolster, Daniel J Clauw, Dorothy D Dunlop, Yvonne C Lee","doi":"10.1002/acr.25668","DOIUrl":"https://doi.org/10.1002/acr.25668","url":null,"abstract":"<p><strong>Objective: </strong>This study investigates the association between discordance in commonly collected clinical indicators of rheumatoid arthritis (RA) disease activity and abnormalities in quantitative sensory testing (QST) observed in individuals with nociplastic pain. The goal is to identify low-burden methods of assessing nociplastic pain in rheumatology practice.</p><p><strong>Methods: </strong>Data from 225 patients with active RA were included for cross-sectional analyses. Measures of discordance in disease activity were: 1) tender swollen joint count difference (TSJD), 2) proportion of subjective components over total DAS28 (DAS28-P), and 3) patient global assessment minus evaluator global assessment (PtGA - EGA). QST measures were pressure pain thresholds (PPT) at the trapezius, temporal summation (TS), and conditioned pain modulation (CPM). We evaluated associations between measures of discordance and QST using unadjusted and multivariable linear regression models.</p><p><strong>Results: </strong>The mean TSJD was 5.4 (± 8.2), and the mean DAS28-P was 49.7% (± 13.3%). The mean patient global assessment minus evaluator global assessment was 0.7 (± 2.2). Higher TSJD was associated with lower trapezius PPT (β = -0.05, [-0.08, -0.02]) and higher TS (β = 0.29, [0.05, 0.53]). Higher DAS28-P was associated with lower trapezius PPT (β = -0.05 [-0.07, -0.04]) and higher TS (β = 0.21, [0.06, 0.35]). PtGA - EGA was not associated with any QST measures.</p><p><strong>Conclusion: </strong>Two of our proposed measures of discordance (higher TSJD, DAS28-P) were modestly associated with worse QST measures of nociplastic pain (lower trapezius PPT, higher TS), suggesting that discordance between patient-reported and physician-assessed measures of disease activity may reflect an element of nociplastic pain.</p>","PeriodicalId":8406,"journal":{"name":"Arthritis Care & Research","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145298360","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Financial Distress and its Determinants in Rheumatoid Arthritis.","authors":"Amber Brown Keebler, Yunju Im, Sofia Pedro, Ted R Mikuls, Edward S Peters, Kaleb Michaud","doi":"10.1002/acr.25670","DOIUrl":"https://doi.org/10.1002/acr.25670","url":null,"abstract":"<p><strong>Objective: </strong>To quantify the degree of financial distress and identify its determinants in adults with rheumatoid arthritis (RA) given the frequent chronic use of expensive disease modifying therapies.</p><p><strong>Methods: </strong>We identified adults enrolled in the FORWARD databank with either RA or non-inflammatory musculoskeletal disease (NIMSKD) completing the Functional Assessment of Chronic Illness Therapy - Comprehensive Score for Financial Toxicity (FACIT-COST) questionnaire. In this cross-sectional study, FACIT-COST was analyzed as a continuous (higher score indicates less financial distress) and binary variable (presence of financial distress with threshold <26). Least Absolute Shrinkage and Selection Operator (LASSO) was applied to linear and logistic regression to select covariates for inclusion in multivariable models.</p><p><strong>Results: </strong>Participants with RA (n=2277) had lower FACIT-COST scores indicating greater financial distress than those with NIMSKD (n=1340) (meanof 30.2±9.4 vs. 34.0±8.4; unadjusted-p<0.001). Assessed as a binary outcome, financial distress was more frequent in RA than NIMSKD (29% vs. 15%; unadjusted p<0.001). Differences in financial distress by diagnosis persisted following multivariable adjustment. Among those with RA, determinants identified in multivariable models included depression (aOR 1.12; 95% CI 1.09-1.16) and disease severity.</p><p><strong>Conclusion: </strong>Financial distress is prevalent in adults with RA and appears to be greatest in those with comorbidities, specifically depression, identifying a potential area for intervention. Notably, expensive biologic or targeted synthetic disease-modifying anti-rheumatic drugs were not associated with FACIT-COST scores.</p>","PeriodicalId":8406,"journal":{"name":"Arthritis Care & Research","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145298315","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The impact of social factors on VAS pain in spondyloarthritis patients: a Propensity Score Matching analysis.","authors":"Luis Ángel Calvo Pascual, David Castro Corredor, Eduardo Collantes-Estévez, Clementina López-Medina","doi":"10.1002/acr.25675","DOIUrl":"https://doi.org/10.1002/acr.25675","url":null,"abstract":"","PeriodicalId":8406,"journal":{"name":"Arthritis Care & Research","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145298393","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessment of skin in patients with systemic sclerosis using high-frequency ultrasound and shear wave elastography: A comparative study with histology, molecular and clinical parameters.","authors":"Ruhani Desai, Filemon Tan, Minghua Wu, Jeffery L Browning, Samuel Theodore, Meng Zhang, Brian Skaug, Harshdeep Singh Chawla, Manmohan Singh, Salavat Aglyamov, Kirill V Larin, Maureen Mayes, Shervin Assassi","doi":"10.1002/acr.25658","DOIUrl":"https://doi.org/10.1002/acr.25658","url":null,"abstract":"<p><strong>Objective: </strong>Ultrasound (US) has been proposed as a potential tool for assessing skin fibrosis in systemic sclerosis (SSc). However, a large-scale comparison of US-based assessment with histological markers of skin fibrosis has not been reported. We evaluated the US-based skin assessments for their face validity (differentiation between involved SSc and healthy control [HC] skin), construct validity (comparison to modified Rodnan Skin score [mRSS]), and criterion validity (comparison to histological and gene expression fibrosis markers).</p><p><strong>Method: </strong>Twenty HCs and 52 SSc patients underwent clinical and US assessment followed by a forearm skin biopsy. Predefined areas were assessed on the finger, hand, and forearm bilaterally. mRSS, US, histological and molecular (RT-qPCR) evaluations were performed by blinded, independent assessors. Dermal thickness, echogenicity, and elastography were assessed using a high-frequency GE LOGIQ P9 ultrasound machine.</p><p><strong>Result: </strong>Except in the hand area, the US variables could not differentiate between HC and clinically affected SSc skin (face validity). There was only a weak to moderate correlation between US-based measurements and mRSS in the hand and finger areas (construct validity). US-based thickness showed moderate correlation with histological thickness (Rs=0.43, 0.002), but no statistically significant correlations with other histological or gene expression markers of fibrosis in SSc patients (criterion validity).</p><p><strong>Conclusion: </strong>High-frequency US assessment of SSc skin does not show consistent and strong face, construct, or criterion validity. The role of this assessment tool remains limited, underscoring the need for further development of a quantitative and accurate tool for assessing SSc skin fibrosis.</p>","PeriodicalId":8406,"journal":{"name":"Arthritis Care & Research","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145298327","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}