Arthritis Care & Research最新文献

{"title":"Association of Pain During Exercise With Exercise-Induced Hypoalgesia in People With Knee Osteoarthritis","authors":"Soyoung Lee,&nbsp;Tuhina Neogi,&nbsp;Benjamin M. Senderling,&nbsp;S. Reza Jafarzadeh,&nbsp;Mary Gheller,&nbsp;Pirinka G. Tuttle,&nbsp;Charmaine Demanuele,&nbsp;Lars Viktrup,&nbsp;Paul Wacnik,&nbsp;Deepak Kumar","doi":"10.1002/acr.25524","DOIUrl":"10.1002/acr.25524","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>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>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>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>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>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>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>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>\u0000 \u0000 <div>\u0000 <figure>\u0000 <div><picture>\u0000 <source></source></picture><p></p>\u0000 </div>\u0000 </figure>\u0000 </div>\u0000 </section>\u0000 </div>","PeriodicalId":8406,"journal":{"name":"Arthritis Care & Research","volume":"77 7","pages":"900-905"},"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}

{"title":"Ageism in Rheumatologic Care: Ensuring Equity and Quality for Older Adults.","authors":"Jiha Lee, Devyani Misra, Una E Makris","doi":"10.1002/acr.25521","DOIUrl":"10.1002/acr.25521","url":null,"abstract":"","PeriodicalId":8406,"journal":{"name":"Arthritis Care & Research","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143596192","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":"American College of Rheumatology Guidance Statements for Addressing Mental Health Concerns in Youth With Pediatric Rheumatologic Diseases.","authors":"Natoshia R Cunningham, Ashley N Danguecan, Samantha L Ely, Yaa Amponsah, Alaina Davis, Suzanne Edison, Julia Harris, Jordan T Jones, Alana Goldstein-Leever, Alison Manning, Anne McHugh, Crystal Mui, Ekemini Ogbu, Nikki Reitz, Martha Rodriguez, Natalie Rosenwasser, Alyse Tankanow, Erin Treemarcki, Katherine Winner, Tamar B Rubinstein, Andrea M Knight","doi":"10.1002/acr.25519","DOIUrl":"10.1002/acr.25519","url":null,"abstract":"<p><strong>Objective: </strong>Pediatric rheumatologic diseases (PRDs) are characterized by high rates of anxiety and depression known to impact health-related outcomes. We present guidance statements to assess and manage mental health concerns for youth with PRDs in pediatric rheumatology practice.</p><p><strong>Methods: </strong>Development of the guidance statements was initiated in 2019 and concluded in November 2023. It included (1) the formation of a task force (including pediatric rheumatologists, pediatric behavioral health providers, patients, and parents) led by two licensed pediatric psychologists and two board-certified pediatric rheumatologists, (2) iterative drafting of statements and rating of evidence based on the Oxford Centre for Evidence-Based Medicine levels of evidence, (3) an open comment period followed by revision of statements, (4) a Delphi panel process to attain consensus on the statements, and (5) review by the American College of Rheumatology (ACR) Committee on Quality of Care and refinement of statements to an identified list of those with the strongest empiric evidence for endorsement by the ACR.</p><p><strong>Results: </strong>The task force drafted 34 statements for addressing mental health concerns in pediatric rheumatology, including identification, management, and clinic environment/education considerations. After two rounds of Delphi panel voting by a random sample of 76 members of the Childhood Arthritis and Rheumatology Research Alliance, 31 statements attained at least 80% consensus. Eleven of those statements had high empirical support and endorsement and were thus selected as the final guidance statements, including recommendations for depression and anxiety screening in youth aged 12 years and older, management of identified symptoms, and education of patients about mental health.</p><p><strong>Conclusion: </strong>It is a goal that these recommendations be used to empower pediatric rheumatology teams to consider how they may better address mental health concerns in their setting and help improve both mental health- and health-related outcomes for youth with rheumatologic diseases.</p>","PeriodicalId":8406,"journal":{"name":"Arthritis Care & Research","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143571843","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":"Global Trends in Risk Factors for Low Back Pain: An Analysis of the Global Burden of Disease Study Data From 1990 to 2021","authors":"Katharine E. Roberts,&nbsp;Manuela L. Ferreira,&nbsp;Paula R. Beckenkamp,&nbsp;Sneha Nicholson,&nbsp;Lyn March,&nbsp;Paulo H. Ferreira","doi":"10.1002/acr.25520","DOIUrl":"10.1002/acr.25520","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>The increasing burden associated with low back pain (LBP) is a critical issue. This is a novel analysis of trends in risk factors for LBP aiming to identify risk factors that require further attention or consideration in global policies to reduce the burden of LBP.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The Global Burden of Disease study metadata were used to describe the trends in three modifiable categories of risk factors that contribute to the burden associated with LBP. The trends in occupational/ergonomic, behavioral (smoking), and metabolic (high body mass index [BMI]) risk factors for LBP between 1990 and 2021 have been described with attention to global areas, high sociodemographic index (SDI) areas, and low SDI areas.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The number of years lived with disability (YLDs) caused by LBP increased globally, in high and low SDI areas between 1990 and 2021. The impact of smoking and occupational/ergonomic risk factors have decreased; however, the impact of high BMI has increased markedly in the same time frame, with a particularly concerning impact in high SDI areas and on women.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The burden of LBP is increasing globally, with a significant proportion of the YLDs caused by LBP attributed to three modifiable lifestyle factors: occupation/ergonomics, smoking, and high BMI. Of significant concern is the rapidly increasing impact of high BMI on YLDs caused by LBP, with the greatest impact seen among women in low and high SDI areas. The role of additional risk factors (eg, physical inactivity) still needs to be determined in the context of the global burden of LBP.</p>\u0000 \u0000 <div>\u0000 <figure>\u0000 <div><picture>\u0000 <source></source></picture><p></p>\u0000 </div>\u0000 </figure>\u0000 </div>\u0000 </section>\u0000 </div>","PeriodicalId":8406,"journal":{"name":"Arthritis Care & Research","volume":"77 7","pages":"837-847"},"PeriodicalIF":3.7,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/acr.25520","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143571808","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":"Rheumatology Medical Education Year in Review, 2023 to 2024.","authors":"Ann Cameron Barr, David Leverenz","doi":"10.1002/acr.25517","DOIUrl":"10.1002/acr.25517","url":null,"abstract":"","PeriodicalId":8406,"journal":{"name":"Arthritis Care & Research","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143565922","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":"Better Patient Care and Team Satisfaction Call for \"Both-And\" Approach.","authors":"Jennifer Brandt, S Sam Lim, Christie M Bartels","doi":"10.1002/acr.25516","DOIUrl":"10.1002/acr.25516","url":null,"abstract":"","PeriodicalId":8406,"journal":{"name":"Arthritis Care & Research","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143536563","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":"Effectiveness of a Telephone-Delivered Walk With Ease Program on Arthritis-Related Symptoms, Function, and Activity: A Randomized Trial","authors":"Christine A. Pellegrini,&nbsp;Sara Wilcox,&nbsp;Yesil Kim,&nbsp;Scott Jamieson,&nbsp;Katherine DeVivo,&nbsp;Daniel Heidtke","doi":"10.1002/acr.25515","DOIUrl":"10.1002/acr.25515","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Walk With Ease (WWE) is a six-week arthritis-appropriate evidence-based physical activity program traditionally offered in a face-to-face format. Because many populations encounter participation barriers to in-person programs, WWE was modified for telephone delivery (WWE-T). The short- and long-term effects of this program on physical activity and arthritis-related outcomes were examined.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Participants (n = 267) with arthritis were randomized to WWE-T or a wait list control. WWE-T participants received two telephone calls per week (one group and one individual call) for six weeks. Group calls focused on arthritis education and social support. Individual calls focused on problem-solving and goal setting. Physical function tests, patient-reported outcomes, and physical activity were assessed at baseline, 6 weeks, 6 months, and 12 months.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Participants were 92% female and 60% Black and had a mean ± SD age of 64.1 ± 9.4 years and a body mass index of 34.2 ± 7.7. Retention ranged from 93.6% at 6 weeks to 83.8% at 12 months. Participants attended a mean ± SD of 9.8 ± 2.6 calls. At six weeks, WWE-T participants had greater improvements in physical function (<i>P</i> = 0.03), fatigue (<i>P</i> = 0.03), self-efficacy (<i>P</i> ≤ 0.0001), and activity impairment due to health (<i>P</i> = 0.01) as compared to the control group. By 12 months, WWE-T participants had better physical function (<i>P</i> = 0.02), higher arthritis self-efficacy (<i>P</i> ≤ 0.0001), lower depression symptoms (<i>P</i> = 0.02), and lower impairment of daily activities (<i>P</i> = 0.02) than at baseline.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>A WWE-T program led to improvements in physical function, self-efficacy, and impairment related to daily activities in adults with arthritis. Although changes were not seen in all outcomes, this remotely delivered program may be an effective alternative for adults with arthritis who face barriers to in-person programs.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8406,"journal":{"name":"Arthritis Care & Research","volume":"77 7","pages":"928-938"},"PeriodicalIF":3.7,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/acr.25515","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143536566","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}