Arthritis Care & Research最新文献

{"title":"Comparing Community-Level Social Determinants of Health With Patient Race in Total Hip Arthroplasty Outcomes.","authors":"Bella Mehta, Yi Yiyuan, Diyu Pearce-Fisher, Kaylee Ho, Susan M Goodman, Michael L Parks, Fei Wang, Mark A Fontana, Said Ibrahim, Peter Cram, Rich Caruana","doi":"10.1002/acr.25511","DOIUrl":"10.1002/acr.25511","url":null,"abstract":"<p><strong>Objective: </strong>Social determinants of health (SDOH), including race, have a key role in total hip arthroplasty (THA) disparities. We compared the collective influence of community-level SDOH to the influence of individual factors such as race, on THA outcomes.</p><p><strong>Methods: </strong>This retrospective cohort study of the Pennsylvania Health Care Cost Containment Council Database (2012-2018) included 105,336 patients undergoing unilateral primary elective THA. We extracted \"community\" factors from the US census by geocoding patient zip codes, including walkability index, household income, foreign-born individuals, English proficiency, computer and internet access, unpaid family workers, those lacking health insurances, and education. We trained an explainable boosting machine, a modern form of generalized additive models, to predict 90-day readmission, 90-day mortality, one-year revision, and length of stay (LOS). Mean absolute scores were aggregated to measure variable importance (ie, variables that contributed most to the prediction).</p><p><strong>Results: </strong>The rates of readmission, revision, and mortality were 8%, 1.5%, and 0.3%, respectively, with a median LOS of two days. Predictive performance measured by area under the receiver operating characteristic curve was 0.76 for mortality, 0.66 for readmission, and 0.57 for one-year revision. For LOS, the root mean squared error was 0.41 (R² = 0.2). The top three predictors of mortality were community, discharge location, and age; for readmission, they were discharge location, age, and comorbidities; for revision, they were community, discharge location, and comorbidities; and for LOS, they were discharge location, community, and comorbidities.</p><p><strong>Conclusion: </strong>Community-level SDOH were significantly more important than individual race in contributing to the prediction of THA outcomes, especially for 90-day mortality.</p>","PeriodicalId":8406,"journal":{"name":"Arthritis Care & Research","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143481962","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":"Long-Term Outcomes of Children Born to Anti-Ro Antibody-Positive Mothers With and Without Rheumatic Disease.","authors":"Talia Diaz, Ashely Danguecan, Daniela Dominguez, Andrea Knight, Carl A Laskin, Deborah M Levy, Edgar Jaeggi, Melissa Misztal, Piushkumar Mandhane, Theo Moraes, Lawrence Ng, Franklin Silverio, Earl D Silverman, Elinor Simons, Stuart E Turvey, Padmaja Subbarao, Linda T Hiraki","doi":"10.1002/acr.25510","DOIUrl":"10.1002/acr.25510","url":null,"abstract":"<p><strong>Objective: </strong>The objective of this study was to estimate the prevalence of allergy, and/or neurodevelopmental and autoimmune diagnoses in children born to anti-Ro antibody-positive mothers.</p><p><strong>Methods: </strong>We conducted a cohort study of children born to anti-Ro antibody-positive mothers observed in the neonatal lupus erythematosus (NLE) clinic at The Hospital for Sick Children. Participants one year of age or older were invited to complete a health status questionnaire. Prevalence of allergic, neurodevelopmental, and autoimmune disease diagnoses was compared between the NLE cohort and the non-NLE population-based CHILD Cohort Study cohort. Descriptive statistics were used for demographics, NLE manifestations, and outcomes. Fisher's exact test compared the prevalence of diagnoses between subgroups. We tested the association between allergies and neurodevelopmental conditions and NLE with logistic regression models. A P-value < 0.006 was considered significant.</p><p><strong>Results: </strong>We included 321 participants born to anti-Ro antibody-positive mothers. The median age at survey completion was six years, 51% of participants were female, and 50% (n = 162) had NLE. We found no significant difference in any disease prevalence between children with and without NLE manifestations (P = 0.57) or between children born to mothers with and without a rheumatic disease (P = 0.11). Disease prevalence was similar between the NLE and CHILD cohorts (allergic disease 30% vs 22% [P= 0.25], neurodevelopmental conditions 5% vs 2% [P = 0.45], autoimmune disease 4% vs 2% [P = 0.68]).</p><p><strong>Conclusion: </strong>In a large multiethnic cohort of infants born to anti-Ro antibody-positive mothers, there was no significant difference in the prevalence of allergic, neurodevelopmental, or autoimmune diseases between children with and without NLE or between those born to anti-Ro antibody-positive mothers and a population-based non-NLE cohort.</p>","PeriodicalId":8406,"journal":{"name":"Arthritis Care & Research","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143466799","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":"Patient Perceptions of Medication Therapy for Prevention of Posttraumatic Osteoarthritis Following Anterior Cruciate Ligament Injury: A Qualitative Content Analysis.","authors":"Lily M Waddell, Donald P Mitchener, Kelly C Frier, Morgan H Jones, Elena Losina, Nick Bansback, Liana Fraenkel, Jason S Kim, Jeffrey N Katz, Faith Selzer, Adam Easterbrook","doi":"10.1002/acr.25508","DOIUrl":"10.1002/acr.25508","url":null,"abstract":"<p><strong>Objective: </strong>Posttraumatic osteoarthritis (PTOA) accounts for nearly 12% of osteoarthritis incidences and often occurs after anterior cruciate ligament (ACL) tear. Ensuring the uptake of preventive treatments for PTOA requires that investigators and clinicians understand factors influencing patients to seek preventive therapies. This qualitative, descriptive study aimed to assess individuals' willingness to adopt a medication therapy for PTOA prevention following ACL injury.</p><p><strong>Methods: </strong>We enrolled participants who had an ACL tear within two years of enrollment. Study individuals participated in a semistructured interview or focus group. We reviewed audio transcriptions for accuracy, and then organized the data inductively, beginning with open coding of audio transcriptions using NVivo 12. Finally, using a qualitative content analysis approach, we identified, revised, and constructed themes and subthemes.</p><p><strong>Results: </strong>Twenty-five individuals (mean age 25 years, 60% women) participated. Participants were an average of 10 months after injury (mean 310 days, 95% confidence interval [CI] 249-371) and reported a mean Knee Injury and Osteoarthritis Outcome Score pain score of 80.3 (95% CI 74.5-86.2). We identified three main themes related to general treatment for PTOA (eg, unwanted side effects), medication treatment for PTOA (eg, concern about pill size and dose frequency), and clinical trial attributes (eg, time commitment).</p><p><strong>Conclusion: </strong>Although participants expressed great interest in trying medication therapy for PTOA prevention, there was variability in which components of treatment mattered to them. Our results stress the importance of using qualitative approaches such as this one to inform the design of trials and treatments that real-world patients will pursue with enthusiasm.</p>","PeriodicalId":8406,"journal":{"name":"Arthritis Care & Research","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143397918","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":"Prevalence and Clinical Characteristics of Vasculitis in the Alaska Native and American Indian Peoples of Alaska.","authors":"Ben A Henderson, Vivek R Mehta, Peter Holck, Tammy L Choromanski, Amy Wilson, Flora Lee, Elizabeth D Ferucci","doi":"10.1002/acr.25506","DOIUrl":"10.1002/acr.25506","url":null,"abstract":"<p><strong>Objective: </strong>Our objective was to determine the prevalence and clinical characteristics of vasculitis in Alaska Native and American Indian (AN/AI) peoples of Alaska.</p><p><strong>Methods: </strong>We queried the electronic health records of participating tribal health organizations within the Alaska Tribal Health System (ATHS) to identify adults with diagnostic codes related to vasculitis. Medical record abstraction was performed for all adults with potential vasculitis to confirm fulfillment of inclusion criteria, subtype, and clinical characteristics. The denominator for prevalence was the 2019 ATHS user population ≥ 18 (except giant cell arteritis [GCA], defined for persons ≥ 50).</p><p><strong>Results: </strong>The age-adjusted prevalence per 1,000,000 AN/AI adults was 752 (95% confidence interval [CI] 581-959) for all vasculitis, with systemic vasculitis being the most common at 518 (95% CI 379-695). The most prevalent types of systemic vasculitis were antineutrophil cytoplasmic antibody-associated vasculitis (AAV) at 340 per million adults (95% CI 230-488) and GCA at 28 per 100,000 ≥ 50 (95% CI 12-56). The most prevalent subtype of AAV was granulomatosis with polyangiitis (GPA) at 244 per million adults (95% CI 148-380). AAV was diagnosed at a mean age of 54.2 years (SD 17), often with high markers of inflammation and renal involvement. GCA was diagnosed at a mean age of 69.6 years (SD 9.2).</p><p><strong>Conclusion: </strong>The prevalence of AAV (especially GPA) in AN/AI peoples is high. GCA prevalence is lower than White populations, but higher than many other populations. AN/AI peoples with AAV and GCA may present at younger ages with more severe disease than other populations.</p>","PeriodicalId":8406,"journal":{"name":"Arthritis Care & Research","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143397920","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":"Temporal Trends and Demographic Insights Into Mortality From Systemic Lupus Erythematosus, 1999-2020.","authors":"Ansaam Daoud, Loai Dweik, Omer Pamuk","doi":"10.1002/acr.25509","DOIUrl":"10.1002/acr.25509","url":null,"abstract":"<p><strong>Objective: </strong>Previous studies showed a decline in systemic lupus erythematosus (SLE) mortality rates from 1968 to 2013, yet mortality rates remained high relative to non-SLE mortality rates, with notable disparities. We aimed to delineate demographic characteristics associated with SLE deaths and map out the national and geographic trends of the last two decades.</p><p><strong>Methods: </strong>We analyzed SLE deaths data from 1999 to 2020 using the Centers for Disease Control and Prevention's Wide-Ranging Online Data for Epidemiologic Research Multiple Cause of Death database. Age-adjusted mortality rates (AAMRs) were computed based on sex, race and ethnicity, and state. Trends over the study period were evaluated using a simple linear regression model.</p><p><strong>Results: </strong>From 1999 to 2020, we identified 27,213 deaths with SLE as the underlying cause in the United States. Female participants experienced a higher AAMR (6.21 per million, 95% confidence interval [95% CI] 6.13-6.29) than male participants (1.20 per million, 95% CI 1.16-1.24). African American participants had the highest AAMR (10.7 per million, 95% CI 10.48-10.92), particularly among female participants (17.68 per million, 95% CI 17.29-18.06). Linear regression analysis found a significant decline in the SLE AAMR from 1999 to 2020 (R² = 0.902), with decreases noticed across all demographic groups. The SLE AAMR to the non-SLE AAMR ratio showed a sustained decline from 2005 to 2020 (R² = 0.8552). Analysis of the geographic distribution of SLE AAMR in the United States reveals a pronounced concentration in Southern states.</p><p><strong>Conclusion: </strong>Since 1999, SLE-related mortality rates have consistently declined across various demographic groups, though rates remain disproportionately high in African American participants, particularly among African American female participants and in Southern states.</p>","PeriodicalId":8406,"journal":{"name":"Arthritis Care & Research","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143397922","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":"Lupus Flares: More Common in Dialysis Patients Than in Post-Kidney Transplant Recipients: A Systematic Review and Meta-Analysis.","authors":"Ansaam Daoud, Loai Dweik, Niraj Desai, Sarfaraz A Hasni, Omer N Pamuk","doi":"10.1002/acr.25507","DOIUrl":"10.1002/acr.25507","url":null,"abstract":"<p><strong>Objective: </strong>In this study, we performed a systematic literature review and meta-analysis to assess the frequency of systemic lupus erythematosus (SLE) flares in patients with end-stage renal disease (ESRD) and patients undergoing renal replacement therapy (RRT), hemodialysis (HD), peritoneal dialysis (PD), and kidney transplant (KT).</p><p><strong>Methods: </strong>Literature from 1973 to 2023 was searched for studies on the frequency of lupus flares after RRT. Data were extracted for ESRD and each RRT modality. Forest plots and random effect models were used to evaluate the odds ratios (95% confidence interval [CI]) of SLE flares after ESRD or RRT, and study heterogeneity was assessed using I² statistics.</p><p><strong>Results: </strong>A total of 57 studies fulfilled the study entry criteria. A total of 29 studies evaluated extrarenal SLE flares after HD/PD, and five studies evaluated extrarenal SLE flares after KT. The frequency of extrarenal SLE flares was compared between HD and PD in seven studies and between HD/PD and KT in four studies. The recurrence of lupus nephritis (LN) was analyzed in 29 studies. Overall, 35.9% of patients with ESRD had at least one extrarenal flare after RRT. The frequency of extrarenal SLE flare was similar in PD and HD (oods ratio [OR] 1.05, 95% CI 0.57-1.94). Extrarenal flare risk was significantly higher in the PD/HD group compared with that of the KT group (OR 4.36, 95% CI 1.66-11.47; P = 0.0028). The recurrence of LN after KT was 3.39%.</p><p><strong>Conclusion: </strong>Extrarenal lupus flares can still occur in more than one-third of patients with ESRD receiving RRT. Dialysis patients have a higher flare risk than those after KT, with comparable flare risk among patients receiving HD and PD.</p>","PeriodicalId":8406,"journal":{"name":"Arthritis Care & Research","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143397916","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":"Effects of Pharmacologic and Nonpharmacologic Interventions for the Management of Sleep Problems in People With Fibromyalgia: Systematic Review and Network Meta-Analysis of Randomized Controlled Trials.","authors":"Jemma Hudson, Mari Imamura, Clare Robertson, Daniel Whibley, Lorna Aucott, Katie Gillies, Paul Manson, Debra Dulake, Abhishek Abhishek, Nicole K Y Tang, Gary J Macfarlane, Miriam Brazzelli","doi":"10.1002/acr.25505","DOIUrl":"10.1002/acr.25505","url":null,"abstract":"<p><strong>Objective: </strong>Fibromyalgia is a chronic condition characterized by widespread musculoskeletal pain and fatigue. Almost everyone with fibromyalgia has sleep problems. We aimed to evaluate the effectiveness and safety of current interventions for the management of fibromyalgia-related sleep problems.</p><p><strong>Methods: </strong>Major electronic databases were searched in November 2021. We focused on randomized controlled trials assessing pharmacologic and/or nonpharmacologic interventions in adults and children and identified 168 studies for inclusion. We assessed the methodologic quality of included studies using the Cochrane Risk-of-Bias tool. Our primary outcome of interest was sleep quality assessed using validated patient-reported outcome measures.</p><p><strong>Results: </strong>Results from primary studies were analyzed using network meta-analyses (NMA). The NMA for sleep quality included 65 studies evaluating 35 treatment categories (8,247 participants). Most studies were at high overall risk of bias. Compared with placebo or sham treatments, there was some evidence that exercise (specifically land-based aerobic exercise training in combination with flexibility training [standardized mean difference (SMD) -4.69, 95% credible interval (Crl) -8.14 to -1.28] and aquatic-based aerobic exercise training [SMD -2.63, 95% Crl -4.74 to -0.58]) may improve sleep. There was also a suggestion that land-based strengthening exercise, psychological and behavioral therapy with a focus on sleep, electrotherapy, weight loss, dental splints, antipsychotics, and tricyclics may have a modest effect on sleep.</p><p><strong>Conclusion: </strong>There is a low level of certainty surrounding the effectiveness of interventions for the management of sleep problems in people with fibromyalgia, but some forms of exercise training appear more likely to provide an improvement in sleep quality.</p>","PeriodicalId":8406,"journal":{"name":"Arthritis Care & Research","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143389694","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":"Correction to Benefits of Early Versus Late Initiation of Intravenous Immunoglobulin in the Treatment of Patients With Anti–3-Hydroxy-3-Methylglutaryl-Coenzyme A Reductase Immune-Mediated Necrotizing Myopathy","authors":"","doi":"10.1002/acr.25496","DOIUrl":"10.1002/acr.25496","url":null,"abstract":"<p>Sharf K, Do T, Ghetie D, Choi D, Chahin N. Benefits of Early Versus Late Initiation of Intravenous Immunoglobulin in the Treatment of Patients With Anti-3-Hydroxy-3-Methylglutaryl-Coenzyme A Reductase Immune-Mediated Necrotizing Myopathy. Arthritis Care Res (Hoboken). 2024 Nov;76(11):1584-1592. doi: 10.1002/acr.25406.</p><p>In Table 2, all values for serum CK should be reported in units per liter (U/L), not L/L as mistakenly published. See below for the corrected Table 2.</p><p>Thank you for correcting this,</p><p>Kyle Sharf, DO</p><p>Nizar Chahin, MD</p>","PeriodicalId":8406,"journal":{"name":"Arthritis Care & Research","volume":"77 3","pages":"419"},"PeriodicalIF":3.7,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/acr.25496","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143078471","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Geographic Clustering of Systemic Sclerosis in Areas of Environmental Pollution.","authors":"Noelle N Kosarek, Megan E Romano, Erika L Moen, Robert W Simms, Ashleigh Erickson, Dinesh Khanna, Patricia A Pioli, Michael L Whitfield","doi":"10.1002/acr.25504","DOIUrl":"10.1002/acr.25504","url":null,"abstract":"<p><strong>Objective: </strong>Systemic sclerosis (SSc) is a rare autoimmune disease characterized by fibrosis of the skin and other organs. SSc is thought to arise in genetically predisposed individuals with occupational triggers, although further environmental etiologies still need to be identified. Limited research exists detailing which environmental factors lead to the downstream inflammatory and fibrotic symptoms experienced by patients with SSc across the United States. This study describes a retrospective cohort of 179,188 individuals with an SSc or SSc-related diagnosis code enrolled in the Medicare beneficiary program between the years 2014 and 2018.</p><p><strong>Methods: </strong>The incidence of SSc and SSc-related diagnosis codes in all US zip codes with beneficiary counts greater than 11 was calculated. We conducted global and local Moran's Index (Moran's I) as well as a hot spot analysis with the Getis Ord Gi statistic to determine whether SSc and SSc-related diagnosis codes exhibited clustered or dispersed patterns across the United States. We identified clusters of SSc and SSc-related diagnosis code with high incidences in or around Superfund sites, which are federally identified areas of environmental contamination.</p><p><strong>Results: </strong>SSc exhibited clustered patterns in two analyzed cohorts based on global Moran's I statistics of 0.588 and 0.521. Results of local Moran's I indicated clusters of disease in Mississippi, New York, Wisconsin, and Michigan, among others. Some zip codes with high disease incidences were home to at least one Superfund site.</p><p><strong>Conclusion: </strong>SSc exhibits nonrandom, clustered distributions in a US Medicare beneficiary cohort composed of 179,188 individuals from 2014 to 2018.</p>","PeriodicalId":8406,"journal":{"name":"Arthritis Care & Research","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143078473","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":"Pregnancy Outcomes of Targeted Synthetic Disease-Modifying Antirheumatic Drugs Among Patients With Autoimmune Diseases: A Scoping Review.","authors":"Vienna Cheng, Neda Amiri, Vicki Cheng, Ursula Ellis, Jacquelyn J Cragg, Mark Harrison, Laurie Proulx, Mary A De Vera","doi":"10.1002/acr.25502","DOIUrl":"10.1002/acr.25502","url":null,"abstract":"<p><strong>Objective: </strong>Targeted synthetic disease-modifying antirheumatic drugs (tsDMARDs) have expanded the management of autoimmune diseases, including rheumatic diseases. As the use of these drugs grows, it is important to understand their effects on pregnancy. We conducted a scoping review to synthesize the current evidence on the impacts of tsDMARDs on pregnancy outcomes.</p><p><strong>Methods: </strong>We searched the Embase, MEDLINE, and CENTRAL databases in November 2023. We included studies that examined tsDMARD exposure for chronic autoimmune disease(s), particularly in mothers during pregnancy, fathers before conception, and/or fetuses/neonates in utero. We extracted data on sample size, study design, tsDMARD exposure (dose and duration), and reproductive health outcomes.</p><p><strong>Results: </strong>Of 6,712 studies screened, eight were included, namely nine case reports, one case series, four cross-sectional studies, and one cohort study among patients with ulcerative colitis, rheumatoid arthritis, and psoriasis. Sample sizes ranged from 1 to 116 pregnancies or offspring, with six studies on tofacitinib, one on baricitinib, one on upadacitinib, and no studies on apremilast. Overall, 19 fetal/neonatal outcomes, six fetal/neonatal-maternal outcomes, and three maternal outcomes were extracted. The most frequently reported fetal/neonatal outcomes were congenital anomaly (n = 4), preterm birth (n = 4), and the fetal/neonatal-maternal outcome of spontaneous abortion (n = 4). Only one study reported on the maternal outcome of delivery via Cesarean section.</p><p><strong>Conclusion: </strong>Our scoping review of evidence to date on the perinatal use of tsDMARDs reveal small sample sizes and a limited number of studies, all largely descriptive in nature. Findings highlight evidence gaps that preclude providers and patients from making informed decisions when considering the perinatal use of tsDMARDs.</p>","PeriodicalId":8406,"journal":{"name":"Arthritis Care & Research","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143078481","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}