Arthritis Care & Research最新文献

{"title":"Reply.","authors":"Jaspreet Kaur, Abhishek Abhishek, Georgina Nakafero, Christian Mallen, Michael Doherty, Weiya Zhang","doi":"10.1002/acr.25535","DOIUrl":"10.1002/acr.25535","url":null,"abstract":"","PeriodicalId":8406,"journal":{"name":"Arthritis Care & Research","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143750882","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":"2024 American College of Rheumatology (ACR) Guideline for the Screening, Treatment, and Management of Lupus Nephritis.","authors":"Lisa R Sammaritano, Anca Askanase, Bonnie L Bermas, Maria Dall'Era, Alí Duarte-García, Linda T Hiraki, Brad H Rovin, Mary Beth F Son, Anthony Alvarado, Cynthia Aranow, April Barnado, Anna Broder, Hermine I Brunner, Vaidehi Chowdhary, Gabriel Contreras, Christele Felix, Elizabeth D Ferucci, Keisha L Gibson, Aimee O Hersh, Peter M Izmirly, Kenneth Kalunian, Diane Kamen, Brandi Rollins, Benjamin J Smith, Asha Thomas, Homa Timlin, Daniel J Wallace, Michael Ward, Muayad Azzam, Christie M Bartels, Joanne S Cunha, Kimberly DeQuattro, Andrea Fava, Gabriel Figueroa-Parra, Shivani Garg, Jessica Greco, Maria C Cuéllar-Gutiérrez, Priyanka Iyer, Andrew S Johannemann, April Jorge, Shanthini Kasturi, Hassan Kawtharany, Jana Khawandi, Kyriakos A Kirou, Alexandra Legge, Kelly V Liang, Megan M Lockwood, Alain Sanchez-Rodriguez, Marat Turgunbaev, Jessica N Williams, Amy S Turner, Reem A Mustafa","doi":"10.1002/acr.25528","DOIUrl":"10.1002/acr.25528","url":null,"abstract":"<p><strong>Objective: </strong>The objective is to provide evidence-based and expert guidance for the screening, treatment, and management of lupus nephritis.</p><p><strong>Methods: </strong>The Core Team developed clinical questions for screening, treatment, and management of lupus nephritis using the PICO format (population, intervention, comparator, and outcome). Systematic literature reviews were completed for each PICO question, and the Grading of Recommendations Assessment, Development and Evaluation (GRADE) methodology was used to assess the quality of evidence and to formulate recommendations. The Voting Panel achieved a consensus ≥70% on the direction (for or against) and strength (strong or conditional) of each recommendation.</p><p><strong>Results: </strong>We present 28 graded recommendations (7 strong, 21 conditional) and 13 ungraded, consensus-based good practice statements for the screening and management of lupus nephritis. Our recommendations focus on the unifying principle that lupus nephritis therapy is continuous and ongoing, rather than consisting of discrete induction/initial and maintenance/subsequent therapies. Therapy should include pulse glucocorticoids followed by oral glucocorticoid taper and two additional immunosuppressive agents for 3-5 years for those achieving complete renal response.</p><p><strong>Conclusion: </strong>This guideline provides direction for clinicians regarding screening and treatment decisions for management of lupus nephritis. These recommendations should not be used to limit or deny access to therapies, as treatment decisions may vary due to the unique clinical situation and personal preferences of each individual patient.</p>","PeriodicalId":8406,"journal":{"name":"Arthritis Care & Research","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143699367","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.","authors":"Alicia Calderone, Dylan Hansen, Laura Taylor, Mandana Nikpour","doi":"10.1002/acr.25530","DOIUrl":"10.1002/acr.25530","url":null,"abstract":"","PeriodicalId":8406,"journal":{"name":"Arthritis Care & Research","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143690962","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":"Diverse Treatment Goals in Psoriatic Arthritis: Insights From Participants in the PARC Cohort.","authors":"Astia Allenzara, Kathleen Bush, M Elaine Husni, Soumya M Reddy, Jose U Scher, Ethan Craig, Joelle Koplin, Jessica A Walsh, Alexis Ogdie","doi":"10.1002/acr.25527","DOIUrl":"10.1002/acr.25527","url":null,"abstract":"<p><strong>Objective: </strong>The aim of this study was to examine patient-reported treatment goals among individuals with psoriatic arthritis.</p><p><strong>Methods: </strong>Participants in the Psoriatic Arthritis Research Consortium completed standardized assessments, including patient-reported outcome (PROs) instruments, between 2017 and 2020. Additionally, participants were asked two open-ended questions at enrollment or therapy initiation to identify patients' top improvement priority and their treatment impact goals, respectively: \"If you could improve one thing about your disease, what would it be?\" and \"What would an effective treatment change for you?\" We categorized each response into a theme. The themes were matched to constructs measured by PRO items (ie, pain, fatigue, skin, etc). We describe themes and scores from matched PRO items.</p><p><strong>Results: </strong>Assessments were completed by 193 participants. Decreasing pain (56%) and improving skin (12%) were the most common improvement priorities. Impact goals were more diverse and included decreasing pain (24%), general improvement in life (18%), and the ability to be more active (15%), participate in recreational activities (9%), function at work (11%), and exercise (5%). Of note, responses were often matched to more than one PRO item or instrument. The scores for PRO items that matched the patient's improvement priority or the impact goal were higher than scores for the remainder of the population (ie, fatigue item scores were higher among individuals identifying fatigue as their improvement priority).</p><p><strong>Conclusion: </strong>The heterogeneity of treatment goals underscores the importance of eliciting patient treatment goals to guide personalized management. Specific items within PROs may be helpful in identifying and following patient-specific treatment goals.</p>","PeriodicalId":8406,"journal":{"name":"Arthritis Care & Research","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143690964","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 environmental temperature and higher relative humidity had significant associations with worsened Raynaud phenomenon in systemic sclerosis: comment on the article by Taylor et al.","authors":"Gang Wang, Zhichun Liu","doi":"10.1002/acr.25529","DOIUrl":"10.1002/acr.25529","url":null,"abstract":"","PeriodicalId":8406,"journal":{"name":"Arthritis Care & Research","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143673483","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":"Placebo Effect Sizes in Clinical Trials of Knee Osteoarthritis Using Intra-Articular Injections of Biologic Agents.","authors":"Johanna M Borst, Severin Ruoss, Ian Palmer, Trevor Smith, Kenneth Kalunian, Samuel R Ward","doi":"10.1002/acr.25526","DOIUrl":"10.1002/acr.25526","url":null,"abstract":"<p><strong>Objective: </strong>Patients with knee osteoarthritis rely on symptomatic treatments, in which up to 75% of the pain reduction can be attributed to the placebo effect. This effect may vary based on treatment type (eg, biologics vs nonbiologic injection) and route of administration (eg, intra-articular vs topical vs oral). The placebo effect is an integral part of treatment effect size calculation; thus, network analyses comparing efficacies of different treatments may be inaccurate. The objective of this study was to test the hypothesis that placebo effects differ between treatment types and route of delivery.</p><p><strong>Methods: </strong>A systematic literature search was conducted in August 2019. Randomized trials comparing pain outcomes of oral, topical, or intra-articular placebo interventions to active treatments were included. The outcome measure of interest was change in pain scores from baseline. Data were stratified by length of follow-up and treatment subcategory.</p><p><strong>Results: </strong>A total of 129 articles were included with 9,218 patients receiving placebo treatments. Reduction in pain from baseline occurred in 93% of the subcategory data points. Biologic intra-articular placebo injections had the greatest pain reduction at one month (mean ± SD visual analog scale -32.2 ± 24.6; mean ± SD Western Ontario and McMaster Universities Arthritis Index -16.3 ± 3.81). At one month and two months, placebo intra-articular injections had a greater pain reduction than oral placeboes (P ≤ 0.01).</p><p><strong>Conclusion: </strong>The robust placebo effect is influenced by the active treatment category and changes over time. The variation in placebo response despite analogous placebo methodologies implies using network meta-analyses to compare treatments from different active treatment categories by evaluating the change from placebo is inaccurate.</p>","PeriodicalId":8406,"journal":{"name":"Arthritis Care & Research","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143656165","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 of Pain During Exercise With Exercise-Induced Hypoalgesia in People With Knee Osteoarthritis.","authors":"Soyoung Lee, Tuhina Neogi, Benjamin M Senderling, S Reza Jafarzadeh, Mary Gheller, Pirinka G Tuttle, Charmaine Demanuele, Lars Viktrup, Paul Wacnik, Deepak Kumar","doi":"10.1002/acr.25524","DOIUrl":"10.1002/acr.25524","url":null,"abstract":"<p><strong>Objective: </strong>A paradoxical relationship between pain during exercise and the hypoalgesic effect of exercise has not been studied well in the knee osteoarthritis (OA) population. We sought to investigate the relation of pain evoked during exercise to exercise-induced hypoalgesia (EIH) and to determine if the efficiency of conditioned pain modulation (CPM), a proxy of the descending pain inhibitory system, mediates this relationship in people with knee OA.</p><p><strong>Methods: </strong>We used baseline data from two clinical trials for people with symptomatic knee OA (n = 68). The maximum pain rating (0-10) during a series of knee exercises was defined as the outcome. EIH was assessed as an increase (ie, improvement) in the pressure pain threshold (PPT) after a bout of exercises. Efficient CPM was defined as an increase (ie, improvement) in PPT after a painful conditioning stimulus (forearm ischemia). We performed a causal mediation analysis to examine the association between pain during exercise and EIH as well as the mediating role of CPM efficiency on the relation of pain during exercise with EIH.</p><p><strong>Results: </strong>People with knee OA who had at least a one-unit increase in pain with exercise were 43% more likely (odds ratio [OR] 1.43, 95% confidence interval [CI] 1.05-1.94) to experience subsequent EIH than those without pain increase. The efficiency of CPM did not mediate the relationship between pain during exercise and EIH (OR 1.00, 95% CI 0.96-1.04).</p><p><strong>Conclusion: </strong>Our finding suggests that some amount of discomfort or pain during exercise may have beneficial analgesic effects; however, this is not likely via activation of the descending pain inhibitory system.</p>","PeriodicalId":8406,"journal":{"name":"Arthritis Care & Research","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143646939","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":"Racial, Ethnic, Sex, and Geographical Diversity in Myositis Clinical Trials.","authors":"Raisa Lomanto Silva, Manuel Carpio Tumba, Sneha Gupta, Diana Louden, Latika Gupta, Pedro M Machado, Julie J Paik, Lesley Ann Saketkoo, Sebastian E Sattui, Didem Saygin","doi":"10.1002/acr.25525","DOIUrl":"10.1002/acr.25525","url":null,"abstract":"<p><strong>Objective: </strong>The number of randomized clinical trials (RCTs) with patients with idiopathic inflammatory myopathies (IIMs) has grown exponentially over the last decade. Race, ethnicity, and sex reporting and representation of participants as well as the geographic distribution of enrolling sites in IIM RCTs are unknown. This information can provide critical insights into the current state of enrollment practices and generalizability in IIM RCTs.</p><p><strong>Methods: </strong>A systematic literature review assessed IIM RCTs published between 2010 to 2023. Sex and gender reporting was analyzed per Sex and Gender Equity in Research guidelines. Appropriate reporting of race and ethnicity was defined as reporting them for all trial participants. Countries were categorized based on the Human Development Index. US enrollment sites were grouped using the National Center for Health Statistics Urban-Rural Classification Scheme and medically underserved areas (MUAs).</p><p><strong>Results: </strong>Of the 19 RCTs included, race was appropriately reported in 58%. Black, Asian, and Hispanic or Latino participants represented 3%, 7%, and 2% of the enrollees, respectively. Ethnicity was only reported in 26% of RCTs, and 16% conflated race and ethnicity. Temporal trends showed encouraging results for race and ethnicity representation. Most trials (90%) had greater than 45% women participants. Geographic regions of sites included North America, Europe, Asia, and Australasia, with no sites in South America or Africa. The majority of US sites were located in large metropolitan areas, whereas none were in nonmetropolitan areas, and only 31% in MUAs.</p><p><strong>Conclusion: </strong>Racial, ethnic, and geographic representation in IIM RCTs remains a critical issue. Inadequate reporting of race and ethnicity and limited sociodemographic and geographic representation of participants raise concerns about the generalizability of findings of IIM RCTs.</p>","PeriodicalId":8406,"journal":{"name":"Arthritis Care & Research","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143656166","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":"Juvenile Idiopathic Arthritis, Earnings, and Work Loss: A Nationwide Matched Cohort Study.","authors":"Heather Miller, Martin Neovius, Erik Sundberg, Johan Askling, Gustaf Bruze","doi":"10.1002/acr.25522","DOIUrl":"10.1002/acr.25522","url":null,"abstract":"<p><strong>Objective: </strong>This study compares trajectories of earnings and work loss in individuals with juvenile idiopathic arthritis (JIA) versus matched comparators from the general population.</p><p><strong>Methods: </strong>Patients with JIA (n = 4,737) were identified in the Swedish National Patient Register (2001-2017) and individually matched to up to five general population comparators on birth year, sex, and residence county (n = 23,645). Earnings and work loss data were retrieved from nationwide registers from age 18 years. Differences between patients with JIA and general population comparators were estimated using linear regression adjusted for sex, age, age at identification, and calendar year as well as parental education, work loss, and earnings.</p><p><strong>Results: </strong>During a median of 11 years' follow-up, patients with JIA had 5.5% lower earnings than matched comparators (mean annual difference -€736; 95% confidence interval [CI] -€1,026 to €445). The difference in earnings was larger before than after age 26 years. Beyond age 26 years, the difference in earnings was less than 4%. Patients with JIA had more work loss than matched comparators throughout follow-up (mean difference 11; 95% CI 8-13 days/year). This difference was consistent throughout follow-up, but significant effect modification with calendar period of entry (<2005 vs ≥2005) was found, with later entry associated with lower work loss.</p><p><strong>Conclusion: </strong>Patients with JIA had lower mean annual earnings and higher work loss than matched general population comparators, but earnings differences diminished in magnitude with age and work loss diminished with calendar period of identification. In JIA, a minority of patients accounted for the majority of the negative impact on economic outcomes, which persists into adulthood.</p>","PeriodicalId":8406,"journal":{"name":"Arthritis Care & Research","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143646943","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":"Multicenter Study of Associations Between Area-Level Child Opportunity, Initial Disease Severity, and Outcomes Among Children with Lupus.","authors":"Joyce C Chang, Jessica P Liu, Emily A Smitherman, Pooja N Patel, Gabrielle Alonzi, Livie Timmerman, Gabrielle A Morgan, Francesca T deFaria, Laura M Berbert, Edie A Weller, Karen H Costenbader, Mary Beth F Son","doi":"10.1002/acr.25523","DOIUrl":"10.1002/acr.25523","url":null,"abstract":"<p><strong>Objective: </strong>Child opportunity encompasses neighborhood resources and conditions that influence healthy childhood development. We determined whether area-level opportunity is associated with disease severity or disease control in a geographically and socioeconomically diverse multicenter cohort of patients with childhood-onset systemic lupus erythematosus (cSLE).</p><p><strong>Methods: </strong>We linked medical records of patients with cSLE at three tertiary centers (2016-2022) to the Child Opportunity Index (COI) 2.0 (29 indicators across education, health and environment, socioeconomics). Primary outcomes included severe initial disease presentation (composite of Systemic Lupus Erythematosus Disease Activity Index [SLEDAI-2K] ≥10, intensive care, or dialysis) and acute care (inpatient/emergency) visits. Associations between nationally ranked COI levels and outcomes were estimated using mixed effects models clustered by site and adjusted for age, sex, race and ethnicity, language, and insurance status.</p><p><strong>Results: </strong>Among 538 patients with cSLE, living in areas with low versus very high COI was associated with 1.93 times higher adjusted odds of severe disease presentation (95% confidence interval [CI] 1.05-3.57) and 2.03 higher adjusted incidence of acute care visits within the first year (95% CI 1.29-3.18). At the most recent follow-up, living in low versus very high COI areas was associated with higher disease activity (adjusted β 1.69 [95% CI 0.54-2.84]) and lower odds of concurrent achievement of SLEDAI-2K ≤ 4 and ≤7.5 mg/day of prednisone, adjusted for initial disease severity and disease duration (adjusted odds ratio 0.44 [95% CI 0.22-0.88]).</p><p><strong>Conclusion: </strong>Structural inequities in area-level child opportunity may contribute to disparities in both cSLE severity and disease control. Tailoring interventions for communities with low levels of child opportunity may improve access to pediatric subspecialty care and cSLE outcomes.</p>","PeriodicalId":8406,"journal":{"name":"Arthritis Care & Research","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143646935","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}