Arthritis Care & Research最新文献

{"title":"Risk of hepatotoxicity in patients with gout treated with febuxostat or benzbromarone: a propensity score-matched cohort study.","authors":"Wenyan Sun, Lingling Cui, Robert Terkeltaub, Ying Chen, Xinde Li, Xiaoyu Cheng, Tian Liu, Nicola Dalbeth, Changgui Li","doi":"10.1002/acr.25547","DOIUrl":"https://doi.org/10.1002/acr.25547","url":null,"abstract":"<p><strong>Objective: </strong>The objective of this study was to evaluate and compare the risk of hepatotoxicity associated with the use of febuxostat and benzbromarone in patients with gout.</p><p><strong>Methods: </strong>New users of febuxostat or benzbromarone with monitoring of liver function at least three times in a year after initiation of the study drugs were identified from an electronic medical record database. Propensity score matching (PSM) was performed between the two groups 1:1 to match for age, sex, and pre-treatment alanine aminotransferase (ALT) and aspartate aminotransferase (AST). Kaplan-Meier analysis was used to estimate the probability of hepatotoxicity (defined as ALT or AST >3x upper limit of normal). Hazard ratios (HR) and 95% confidence intervals (CI) were calculated using Cox regression. Subgroup analysis was performed based on age, body mass index, and comorbidities.</p><p><strong>Results: </strong>2,338 patients with gout were eligible. A total of 37% experienced Common Terminology Criteria for Adverse Events (CTCAE) v5 grade 1-3 AST/ALT abnormality. After PSM, 488 febuxostat users were matched with 488 receiving benzbromarone with a mean follow-up of 1.20 years. The incidence of hepatotoxicity was 39.6 and 16.8 per 1,000 person-years for febuxostat users and benzbromarone users, respectively. Febuxostat use was associated with a significantly greater risk of hepatotoxicity than benzbromarone (adjusted HR 2.75, 95% CI 1.28-5.91), especially in patients with elevated transaminases at baseline. Findings did not differ according to pre-specified subgroups.</p><p><strong>Conclusion: </strong>Febuxostat use is associated with a significantly greater risk of mild to moderate perturbation of liver function compared to benzbromarone in patients with gout.</p>","PeriodicalId":8406,"journal":{"name":"Arthritis Care & Research","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143802410","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":"Perceived Stress and Prediction of Worse Patient-Reported Outcomes in a Rheumatoid Arthritis Cohort.","authors":"Sarah L Patterson, Joonsuk Park, Wendy Hartogensis, Patricia Katz","doi":"10.1002/acr.25543","DOIUrl":"https://doi.org/10.1002/acr.25543","url":null,"abstract":"<p><strong>Objective: </strong>Studies have suggested a potential link between traumatic experiences, psychological stress, and autoimmunity, but the impact of stress on disease activity and symptom severity in rheumatoid arthritis (RA) remains unclear. We examined whether perceived stress independently associates with worse RA disease outcomes at subsequent visits over 18 months of follow-up.</p><p><strong>Methods: </strong>Participants were enrolled in a longitudinal RA cohort with study assessments every six months. We measured stress via the 4-item Perceived Stress Scale (PSS) and the following disease outcomes: patient-reported disease activity (Rheumatoid Arthritis Disease Activity Index), pain (PROMIS Pain Interference), fatigue (PROMIS Fatigue), and physical function (PROMIS Physical Function). Time-lagged linear mixed effects models evaluated longitudinal associations of stress with all four outcomes at the subsequent timepoint while controlling for potential confounders.</p><p><strong>Results: </strong>The sample (n=133) was 88% female, 45% White, 35% Hispanic, 9% African American, and 6% Asian American; the mean age was 58 (±13) years. In adjusted time-lagged longitudinal analyses, stress independently associated with greater self-reported disease activity (β=0.11, 95% CI=0.03, 0.19), more pain (β=0.61, 95% CI=0.29, 0.94), more fatigue (β=0.71, 95% CI=0.32, 1.11), and lower physical function (β=-0.33, 95% CI=-0.59, -0.06). The effect size represented clinically significant differences for pain, fatigue, and physical function, but not disease activity.</p><p><strong>Conclusion: </strong>Among a longitudinal RA cohort, those with greater perceived stress had worse pain, greater fatigue, and lower physical function at follow-up. Findings underscore the need to integrate stress resilience interventions and programs that augment psychosocial support in healthcare systems that serve people living with RA.</p>","PeriodicalId":8406,"journal":{"name":"Arthritis Care & Research","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143778737","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":"Barriers and Facilitators for Implementing Resilience Coaching for Youth with Chronic Musculoskeletal Pain: Pediatric Rheumatologists' Perspectives.","authors":"Sabrina Gmuca, Anyun Chatterjee, Mackenzie McGill, Nellie Butler, Katherine S Kellom, Jami F Young, Tonya M Palermo, Pamela F Weiss, Abby R Rosenberg, Peter F Cronholm","doi":"10.1002/acr.25531","DOIUrl":"https://doi.org/10.1002/acr.25531","url":null,"abstract":"<p><strong>Objective: </strong>Promoting Resilience in Stress Management (PRISM) is a resilience coaching program designed for adolescents with chronic illness. We aimed to examine the perceived feasibility, acceptability, and appropriateness of PRISM among pediatric rheumatologists managing adolescents with chronic musculoskeletal pain as well as obtain recommendations for improvement to inform future implementation efforts.</p><p><strong>Methods: </strong>We performed semi-structured interviews with pediatric rheumatologists across several US institutions. Interviews were audio-recorded and transcribed verbatim. Hybrid inductive-deductive coding was employed to capture emergent themes, guided by the Consolidated Framework for Implementation Research (CFIR) 2.0, and develop the codebook. We performed double coding for 20% (n=2) of the transcripts to develop the codebook and ensure inter-rater reliability.</p><p><strong>Results: </strong>Ten pediatric rheumatologists were interviewed and feedback on PRISM was uniformly positive in terms of perceived clinical value and favorability for local implementation. Perceived facilitators included PRISM's brevity, remote delivery, and the potential for a peer group session. Finding the funding and having enough staff for such a program as well as the concerns around competing demands and building PRISM into adolescents' busy schedules were the primary perceived barriers for implementation.</p><p><strong>Conclusion: </strong>Pediatric rheumatologists report that PRISM would be valuable and of interest to their patients with chronic musculoskeletal pain and the resilience coaching program could be further augmented by the addition of a peer support component. Implementation strategies are needed to support program costs and staffing to effectively deliver and sustain the program.</p>","PeriodicalId":8406,"journal":{"name":"Arthritis Care & Research","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143778770","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":"Lower or higher levels 25-hydroxyvitamin D levels are associated with adverse pregnancy outcomes: comment on the article by Madanchi et al.","authors":"Gang Wang, Zhichun Liu","doi":"10.1002/acr.25545","DOIUrl":"https://doi.org/10.1002/acr.25545","url":null,"abstract":"","PeriodicalId":8406,"journal":{"name":"Arthritis Care & Research","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143778773","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 lupus international collaborating clinics frailty index (SLICC-FI) predicts worsening health-related quality of life, data from the almenara lupus cohort.","authors":"Anubhav Singh, Rocío V Gamboa-Cárdenas, Victor Pimentel-Quiroz, Zoila Rodriguez-Bellido, Cesar Pastor-Asurza, Risto Perich-Campos, Graciela S Alarcón, Manuel Francisco Ugarte-Gil","doi":"10.1002/acr.25544","DOIUrl":"https://doi.org/10.1002/acr.25544","url":null,"abstract":"<p><strong>Objectives: </strong>Systemic Lupus International Collaborating Clinics-Frailty Index (SLICC-FI) as a predictor of quality of life (QoL) in systemic lupus erythematosus (SLE) patients has not been evaluated longitudinally. We estimated the association of SLICC-FI scores with future QoL in our prevalent Latin American Mestizo cohort.</p><p><strong>Methods: </strong>Patients from a single-center SLE cohort were included. Health-related (HR) QoL was ascertained with the LupusQoL and frailty with the SLICC-FI. Generalized estimating equations were performed, using each domain of the LupusQoL as an outcome in the subsequent visit, and the SLICC-FI (as a continuous variable) in the previous visit. Alternative analyses were also carried out including the SLICC-FI as a categorical variable. In both approaches, the multivariable models were adjusted for possible confounders (age at diagnosis, sex, socioeconomic status, ethnicity, SLEDAI-2K, SLICC/ACR damage index (SDI), disease duration at baseline, prednisone daily dose, antimalarial and immunosuppressive drug use, and the same domain of the LupusQoL in the previous visit).</p><p><strong>Results: </strong>Four-hundred and twenty-eight patients and 2645 visits were included in this study and they were followed for 4.71 (3.52) years. At baseline, the mean (SD) of disease duration (years), the SDI and the SLICC-FI were 7.2 (6.6), 1.0 (1.3) and 0.17 (0.05), respectively. In the main analyses, after adjusting for possible confounders, higher SLICC-FI scores predicted a worse LupusQoL in the domains of pain, planning, emotional health and fatigue. In the alternative analyses, after adjustment, frail and least fit categories were predictive of worse LupusQoL in the domain of fatigue, and frailty predicted worse body image, compared to least fit.</p><p><strong>Conclusion: </strong>Higher SLICC-FI scores predicted worse HRQoL as measured by the LupusQoL in patients from the Almenara lupus cohort. Our findings reinforce the prognostic value of this tool in SLE.</p>","PeriodicalId":8406,"journal":{"name":"Arthritis Care & Research","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143778748","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":"Reply to Lower or higher levels 25-hydroxyvitamin D levels are associated with adverse pregnancy outcomes: comment on the article by Madanchi et al.","authors":"Michelle Petri, Andrea Fava, Daniel W Goldman, Nima Madanchi, Laurence S Magder","doi":"10.1002/acr.25546","DOIUrl":"https://doi.org/10.1002/acr.25546","url":null,"abstract":"","PeriodicalId":8406,"journal":{"name":"Arthritis Care & Research","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143778742","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":"Analysis of the longitudinal behavior of serum levels of Soluble Flt-1 and Placental Growth Factor in pregnant women with Systemic Lupus Erythematosus.","authors":"Nilson R de Jesús, Guilherme R de Jesús, Marcela I Lacerda, Flávia C Dos Santos, Jeane de S Nogueira, Luiz Cristóvão Porto, Evandro S F Coutinho, Evandro M Klumb","doi":"10.1002/acr.25536","DOIUrl":"https://doi.org/10.1002/acr.25536","url":null,"abstract":"<p><strong>Objective: </strong>This study analyzed longitudinal trajectories of soluble fms-like tyrosine kinase-1 (sFlt-1) and placental growth factor (PlGF) and sFlt-1/PlGF ratio in a cohort of pregnant patients with systemic lupus erythematosus (SLE).</p><p><strong>Methods: </strong>Blood samples were collected (14-18, 24-26, 30-32, 34-36 and 38-40 weeks), stored at -80°C and evaluated for serum levels of sFlt-1, PlGF and sFlt1/PlGF ratios. Patients were classified as inactive SLE (SLEPDAI < 4), active disease (SLEPDAI > 4), or preeclampsia (PE). Medians and interquartile ranges (IQR) were calculated for each group, and linear models with random effects were used.</p><p><strong>Results: </strong>A total of 527 samples were obtained from 163 patients and all cases were subsequently classified as inactive disease [109 (66.9%)], active disease [33 (20.2%)], and inactive disease with PE [21 (12.9%)]. In exploratory analysis, patients with PE had higher mean serum levels of sFlt-1 and sFlt-1/PlGF ratios and lower PlGF levels than patients with inactive and active SLE (p=0.01 to p<0.001). Using linear models with random effects, there was no significant differences in mean serum levels of these angiogenic markers comparing inactive and active disease. Patients with PE showed a marked increase in sFlt-1 from the 24th week, constantly low PlGF levels from the 14th week and progressive increase of sFlt-1/ PlGF ratio during pregnancy. All these differences were statistically significant compared to the groups without PE.</p><p><strong>Conclusion: </strong>Pregnant SLE patients who developed PE had higher sFlt-1 levels and sFlt-1/PlGF ratios, and lower PlGF levels, and these last two changes were detected at the beginning of second trimester, before clinical manifestation. SLE activity did not interfere with longitudinal behavior of these angiogenic markers.</p>","PeriodicalId":8406,"journal":{"name":"Arthritis Care & Research","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143771243","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":"Higher levels of high-sensitivity CRP are associated with future development of Psoriatic Arthritis in Psoriasis: A prospective cohort study.","authors":"Lihi Eder, Xianwei Li, Vinod Chandran, Cheryl F Rosen, Richard J Cook, Dafna D Gladman","doi":"10.1002/acr.25539","DOIUrl":"https://doi.org/10.1002/acr.25539","url":null,"abstract":"<p><strong>Objective: </strong>We aimed to assess whether high sensitivity c-reactive protein (hsCRP) could predict the development of psoriatic arthritis (PsA) in patients with psoriasis.</p><p><strong>Methods: </strong>We analyzed data from a prospective cohort of patients with psoriasis without PsA at enrollment. Participants were assessed annually by a rheumatologist for signs and symptoms of PsA. Information on patient demographics, psoriasis features, medications and musculoskeletal symptoms was collected. hsCRP levels were measured in serum samples collected at baseline using standard commercial assays. The association between hsCRP levels and risk of development of PsA was assessed using multivariable Cox proportional hazards model adjusted for age, sex, psoriasis severity and duration, nail lesions, body mass index (BMI), fatigue, and medication use.</p><p><strong>Results: </strong>A total of 589 patients with psoriasis followed from 2006 to 2019 were analyzed. 57 patients developed PsA during the follow up period. Mean level of hsCRP was 3.1±5.5 mg/L (hsCRP levels in incident PsA cases: 5.4±13.1). Significantly higher levels of hs-CRP at baseline were found in patients with arthralgia, obesity and in females. Higher hs-CRP levels were associated with future development of PsA in multivariable analysis (hazard ratio (HR) 1.04, 95% confidence interval (CI) 1.01, 1.07, p=0.007). Similar effect size was seen in males and females. No significant interaction was found between hsCRP and sex or BMI.</p><p><strong>Conclusion: </strong>Higher levels of systemic inflammation, as measured by hsCRP, are associated with future development of PsA.</p>","PeriodicalId":8406,"journal":{"name":"Arthritis Care & Research","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143771355","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":"Metabolic Consequences of Rheumatoid Arthritis.","authors":"Stevie Barry, Emily Sheng, Joshua F Baker","doi":"10.1002/acr.25537","DOIUrl":"https://doi.org/10.1002/acr.25537","url":null,"abstract":"<p><p>Patients with rheumatoid arthritis (RA) may have metabolic disruption for multiple reasons that can contribute to adverse long-term outcomes. RA patients appear to have a higher risk of sarcopenia, type 1 and type 2 diabetes, metabolic syndrome and hypertension. Systemic inflammation in RA can cause a 'lipid paradox' with reduced low-density lipoprotein being associated with higher rates of cardiovascular disease. In this review, we discuss changes to body composition, insulin resistance, lipids and blood pressure that often occur in patients with RA. We examine the current understanding of the mechanisms underlying disruptions in metabolic pathways in RA, their clinical effects, and how treatment affects these changes.</p>","PeriodicalId":8406,"journal":{"name":"Arthritis Care & Research","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143771357","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":"Avoidable Hospitalizations in Persons with Rheumatoid Arthritis: A Population-Based Study Using Administrative Data.","authors":"Dani G Contreras, Claire E H Barber, J Antonio Aviña-Zubieta, Hude Quan, Seungwon Lee, James A King, Cheryl Barnabe","doi":"10.1002/acr.25541","DOIUrl":"https://doi.org/10.1002/acr.25541","url":null,"abstract":"<p><strong>Objective: </strong>We estimated incidence rates of avoidable hospitalizations by persons with rheumatoid arthritis (RA) relative to the general population.</p><p><strong>Methods: </strong>We identified individuals meeting a validated case definition for RA based on ICD-9-CM and ICD-10-CA codes in years 2002-2023. Four general population controls were matched to each RA case by age and sex. We identified hospitalizations for ambulatory care sensitive conditions (ACSCs) including grand mal seizures, chronic lower respiratory diseases, asthma, diabetes, heart failure and pulmonary edema, hypertension, and angina from 2007-2023 by established diagnostic codes. Incidence rate ratios 3 and 5 years from date of diagnosis were calculated using a multivariable regression model adjusting for age, sex, and location of residence. A Cox proportional hazards model was used to identify predictors of avoidable hospitalizations among RA patients.</p><p><strong>Results: </strong>Cases (n=83,811) had 1.12 times the risk of hospitalization for heart failure and pulmonary edema compared to those without RA (n=190,304) (IRR 1.12, 95% 1.01, 1.25). Significant predictors of ACSC hospitalizations for RA cases were increasing age, prolonged exposure to corticosteroids, and having comorbid conditions, especially if the comorbid condition is an ACSC (HR 10.1, 95% CI 7.8, 13.0).</p><p><strong>Conclusion: </strong>Persons with RA are at a higher risk of potentially avoidable hospitalizations 3 and 5 years after diagnosis compared to those without RA. Improved ambulatory care access and quality, inclusive of primary care and contributing role of subspecialty care, is proposed to prevent unnecessary hospitalizations and reduce burden on the acute care system.</p>","PeriodicalId":8406,"journal":{"name":"Arthritis Care & Research","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143771351","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}