Arthritis Care & Research最新文献

{"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}

{"title":"Accuracy of diagnostic codes and algorithms used to identify rheumatoid arthritis and juvenile idiopathic arthritis in administrative claims and electronic health records: systematic review and meta-analysis.","authors":"Constanza Saka-Herrán, Jessica Bennett, Yara Alkabti, Muhammad Fatir, Barbara Clyne, Caroline McCarthy, Gráinne Tynan, Nikki Dunne, Michelle Flood, Eoghan McCarthy, Frank Moriarty","doi":"10.1002/acr.25662","DOIUrl":"https://doi.org/10.1002/acr.25662","url":null,"abstract":"<p><strong>Objective: </strong>This systematic review aimed to assess the diagnostic accuracy of algorithms used to identify rheumatoid arthritis (RA) and juvenile idiopathic arthritis (JIA) in electronic health records (EHRs).</p><p><strong>Methods: </strong>We searched MEDLINE, Embase, and CENTRAL databases and included studies that validated case definitions against a reference standard such as rheumatologist-confirmed diagnosis or ACR/EULAR classification criteria. Title/abstract screening, full-text review, data extraction and quality assessment were all completed in duplicate. Results were synthesised narratively and using a bivariate random-effects meta-analysis of sensitivity and specificity.</p><p><strong>Results: </strong>A total of 35 studies were included. Algorithms varied widely in complexity, ranging from single ICD codes to combinations including disease-modifying antirheumatic drugs (DMARDs), hospitalisation records, and specialist diagnosis. Algorithms combining ICD codes with DMARD prescriptions (pooled sensitivity= 0.79 95% CI 0.61-0.90, specificity= 0.96 95% CI 0.72-1.00, PPV= 0.78 95% CI 0.63-0.88) or requiring an ICD code assigned by a rheumatologist (pooled sensitivity= 0.91 95% CI 0.70-0.98, specificity= 0.94 95% CI 0.49-1.00, PPV= 0.70 95% CI 0.64-0.75) showed the highest accuracy, with balanced sensitivity, specificity, and positive predictive value (PPV). Less restrictive algorithms demonstrated high sensitivity but lower PPV. Substantial heterogeneity was observed across studies, likely due to differences in algorithm structure, data sources, and validation methods. Despite this variability, we used conceptually coherent categories to allow for meaningful synthesis, prioritising clinical interpretability.</p><p><strong>Conclusions: </strong>These findings support the use of more specific algorithms when diagnostic certainty is essential and highlight the need for further validation of high-performing algorithms across diverse healthcare systems.</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":"145298288","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":"Clinical conditions associated with a high antinuclear antibody titer in individuals without autoimmune disease.","authors":"Matthew Chung, John P Shelley, Gul Karakoc, John Still, Xiaodi Ruan, Jonathan Mosley, C Michael Stein, Vivian K Kawai","doi":"10.1002/acr.25682","DOIUrl":"https://doi.org/10.1002/acr.25682","url":null,"abstract":"<p><strong>Objective: </strong>Antinuclear antibodies (ANAs) are present at high titers in 2% of the general population but their clinical significance in individuals without an autoimmune (AI) disease is not known. We tested the hypothesis that the presence of a high ANA titer in non- AI conditions is associated with disease.</p><p><strong>Methods: </strong>We conducted a retrospective case-control study in the Vanderbilt University Medical Center's de-identified electronic medical record system. Individuals without AI disease who had an ANA test were classified into 3 groups: high titer (HT, ANA≥1:640), low titer (LT, ANA≤1:80), and negative ANA (NG). The prevalence of diagnoses recorded within 90 days of the ANA test were compared among groups in a phenome-wide association study (PheWAS) adjusting for age at ANA testing, sex, median body mass index (BMI), and reported race. A P-value <5x10^-5 was considered significant.</p><p><strong>Results: </strong>A total of 28,781 individuals qualified for the study: 3.1% in the HT, 12.3% in the LT, and 84.6% in the NG groups. BMI was similar between groups (P-value=0.345), but individuals in the HT group were older (P=3.9x10^-73). A high ANA titer increased risk of 46 and 67 clinical diagnoses when comparing the HT group with the LT and the NG groups, respectively. The most significant associations in both comparisons included liver disorders/complications and risk factors for liver disease.</p><p><strong>Conclusions: </strong>A high ANA titer in the absence of an AI disease was associated with increased risk of liver disorders and related risk factors and complications.</p>","PeriodicalId":8406,"journal":{"name":"Arthritis Care & Research","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145290822","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 \"Febuxostat use is associated with a significantly greater risk of mild to moderate perturbation of liver function compared to benzbromarone in patients with gout: comment on the article by Sun et al\".","authors":"Wenyan Sun, Lingling Cui, Changgui Li","doi":"10.1002/acr.25664","DOIUrl":"https://doi.org/10.1002/acr.25664","url":null,"abstract":"","PeriodicalId":8406,"journal":{"name":"Arthritis Care & Research","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145285436","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 Effect of Early Tumor Necrosis Factor Inhibitor Initiation on Chronic Opioid Use in Individuals with Axial Spondylarthritis.","authors":"Eva Petrow, Jose A Meade-Aguilar, Christine Peloquin, S Reza Jafarzadeh, Tuhina Neogi, Maureen Dubreuil, Jean Liew","doi":"10.1002/acr.25659","DOIUrl":"https://doi.org/10.1002/acr.25659","url":null,"abstract":"<p><strong>Objective: </strong>Opioid use remains common despite effective therapies for axial spondyloarthritis (axSpA). We assessed whether early tumor necrosis factor inhibitor (TNFi) use is associated with reduced risk of chronic opioid use.</p><p><strong>Methods: </strong>Using the Merative^TM MarketScan® Commercial Database containing health insurance billing claims data, we conducted a time-stratified, propensity score (PS)-matched cohort study of adults 18-65 years with axSpA. Early TNFi exposure was defined using pharmacy and medical claims as any incident TNFi use within 6 months of axSpA diagnosis. We used propensity scores to match early TNFi users 1:1 to those not starting TNFi within 6 months, in 1-year cohort accrual blocks. We compared risk of chronic opioid use (≥90 days' prescription) among early TNFi users versus comparators using Cox proportional hazard models, overall and stratified by prior opioid use (within 12 months).</p><p><strong>Results: </strong>We included 8,508 individuals with axSpA after PS-matching (4,254 early TNFi initiators and 4,254 comparators) with mean age 42 years and 50% were female. Chronic opioid use occurred in 20.9% (22.3% early TNFi initiators and 19.6% comparators). Early TNFi initiators had 17% higher risk of chronic opioid use versus matched comparators (95% CI 1.06-1.28), with higher risk of chronic opioid use for early TNFi initiators in the opioid-naïve but not opioid-experienced stratum (HR 1.96, 95% CI 1.41-2.74 vs HR 1.06, 95% CI 0.96-1.17).</p><p><strong>Conclusion: </strong>Early TNFi initiation was not associated with reduced risk of chronic opioid use versus later or no TNFi initiation. Confounding by indication in administrative claims data limit result interpretation.</p>","PeriodicalId":8406,"journal":{"name":"Arthritis Care & Research","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145285496","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":"Risk of Hepatotoxicity in Patients With Gout Treated With Febuxostat or Benzbromarone: comment on article by Sun W et al.","authors":"Sree Hari Reddy Gadekallu","doi":"10.1002/acr.25663","DOIUrl":"https://doi.org/10.1002/acr.25663","url":null,"abstract":"","PeriodicalId":8406,"journal":{"name":"Arthritis Care & Research","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145285426","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":"Gut-lung axis and SSc-ILD: Toward validated multimodal predictive models.","authors":"Gianluca Pagnoni, Aurora Vicenzi, Francesca Coppi","doi":"10.1002/acr.25666","DOIUrl":"https://doi.org/10.1002/acr.25666","url":null,"abstract":"","PeriodicalId":8406,"journal":{"name":"Arthritis Care & Research","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145285516","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":"Response for: International Investigation of the Gut-Lung Axis in Systemic Sclerosis-Interstitial Lung Disease.","authors":"Kristofer Andréasson, Jennifer S Labus, Arissa Young, Swapna Joshi, Grace Hyun Kim, Jonathan Goldin, Jonathan P Jacobs, Elizabeth R Volkmann","doi":"10.1002/acr.25667","DOIUrl":"https://doi.org/10.1002/acr.25667","url":null,"abstract":"","PeriodicalId":8406,"journal":{"name":"Arthritis Care & Research","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145285476","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}