Arthritis Care & Research最新文献

{"title":"Development of a personalized visualization and analysis tool to improve clinical care in complex multisystem diseases with application to scleroderma.","authors":"Ji Soo Kim, John Scott, Lauren Fisher, Lauren N Smith, Willie Stewart, Adrianne Woods, Rob Smithwright, Diane Koher, Parastoo Aslanbeik, Aalok B Shah, Brad Tibbils, Samantha I Pitts, Ayse P Gurses, Yushi Yang, Ana-Maria Orbai, Antony Rosen, Laura K Hummers, Scott L Zeger, Ami A Shah","doi":"10.1002/acr.25613","DOIUrl":"https://doi.org/10.1002/acr.25613","url":null,"abstract":"<p><strong>Background: </strong>In complex diseases, it is challenging to assess a patient's disease state, trajectory, treatment exposures, and risk of multiple outcomes simultaneously, efficiently and at the point of care.</p><p><strong>Methods: </strong>We developed an interactive patient-level data visualization and analysis tool (VAT) that automates illustration of a scleroderma patient's trajectory across multiple organs and illustrates this relative to a reference population, including patient subgroups who share risk factors with the index patient, to improve estimation of disease state. We conducted VAT usability testing with patients and clinicians. We then embedded results from internally cross-validated, Bayesian multivariate mixed models that calculate an individual's risk of critical events, utilizing baseline risk factors, patient-level information in past trajectories in multiple dimensions, and known outcomes from the entire population and relevant subgroups.</p><p><strong>Results: </strong>The web-based application aggregates complex, longitudinal data to illustrate patient-, subgroup- and population-level health trajectories across multiple organ systems. Patients (N=7) exposed to the VAT reported increased knowledge about their disease and confidence in medical decision-making. Rheumatologists (N=4) were able to access 8.6-times more data in 81.5% of the time using 2/3 fewer clicks using the VAT compared to the EMR. Statistical modeling was successfully embedded in the VAT, enabling real-time estimation of a patient's risks of multiple complications.</p><p><strong>Conclusions: </strong>Systematic analysis and visualization of individual- and population-level data in a complex disease has potential to improve medical decision-making and warrants further study. Individualized risk estimation disseminated at the point of care may enable targeted screening and early intervention in high-risk patients.</p>","PeriodicalId":8406,"journal":{"name":"Arthritis Care & Research","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144625223","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":"Beyond the bloodstream-rethinking colchicine monitoring through a clinical lens: comment on the article by Stamp et al.","authors":"Yadi Li, Zheng Wei, Jianlong Zhou","doi":"10.1002/acr.25605","DOIUrl":"10.1002/acr.25605","url":null,"abstract":"","PeriodicalId":8406,"journal":{"name":"Arthritis Care & Research","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144625222","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":"​Did a Non-Medical Biosimilar Switching Policy Cause an Increase in Non-Biologic/Biosimilar Health Care Resource Utilization or Cost in Patients With Inflammatory Arthritis?","authors":"HaoHung Dang, Sandra Blitz, Nick Bansback, Michael Law, Mark Harrison","doi":"10.1002/acr.25610","DOIUrl":"https://doi.org/10.1002/acr.25610","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to evaluate the impact of a series of policies that mandated switching patients with inflammatory arthritis (IA) from an originator biologic to a biosimilar in British Columbia, Canada, on health care resource use and cost.</p><p><strong>Methods: </strong>The health data of patients with IA were obtained from five linked administrative databases held by Population Data BC from January 2013 to December 2022. Our analysis focused on trends in monthly average use and costs of four care resources: physician services, hospital services, emergency department visits, and concomitant drug use. Using interrupted time series analysis, we evaluated the impact of switching policies targeting (1) infliximab or etanercept and (2) adalimumab on total health care costs, excluding biologic and biosimilar costs.</p><p><strong>Results: </strong>We included 3,150 patients in the study. Hospital and physician services accounted for the majority of the total care cost for patients with IA. We found no evidence of any increases in physician services, hospital services, emergency department visits, or concomitant drug use after either nonmedical switch policy. We also found no significant change in level and trend in total health care costs for both policies: infliximab or etanercept (level -$40, 95% confidence interval [CI] -$99 to $19; trend $5.42, 95% CI -$0.62 to $11.46) and adalimumab (level -$34, 95% CI -$139 to $70; trend -$8.97, -$17.94 to $0.00).</p><p><strong>Conclusion: </strong>Nonmedical biosimilar switching policies did not lead to increases in other health care service use and costs.</p>","PeriodicalId":8406,"journal":{"name":"Arthritis Care & Research","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145353626","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":"A Scoping Review on AI-Supported Interventions for Non-Pharmacological Management of Chronic Rheumatic Diseases.","authors":"Nirali Shah, Alexis Castellanos, Yen T Chen, John D Piette, Amy Bucher, Susan L Murphy","doi":"10.1002/acr.25612","DOIUrl":"10.1002/acr.25612","url":null,"abstract":"<p><p>This review summarizes AI-supported non-pharmacological interventions for adults with chronic rheumatic diseases, detailing their components, purpose, and current evidence base. We searched Embase, PubMed, Cochrane, and Scopus databases for studies describing AI-supported interventions for adults with chronic rheumatic diseases. Eligible interventions targeted clinical outcomes (pain, function, disability, fatigue), psychological measures (depression, anxiety), or behavioral outcomes (physical activity, nutrition). All publication types (journal articles, conference abstracts, protocols) published in English language until January 19, 2025, were considered, and interventions of any duration, frequency, country of origin, or setting (inpatient, outpatient, community, and home setting) were included. Two reviewers independently screened studies and one extracted data on study characteristics, intervention components, AI methodologies, and outcomes. Fifteen AI-supported interventions were identified, primarily targeting osteoarthritis (OA) (73%) and focusing on education and exercise advice (67%). The most common AI tool was rule-based expert systems (40%), followed by natural language processing systems (33%) and machine learning algorithms (27%). The interventions ranged from 3 weeks to 12 months, while sample sizes ranged from 7 to 427 participants reflecting huge variability across studies. Most interventions demonstrated high usability, engagement, and adherence. Improvements in exercise compliance, physical activity, and symptoms such as pain and physical function were reported, though effects varied across studies and were sometimes not sustained long-term. AI-supported interventions show promise in promoting education, exercise, and behavioral guidance for adults with chronic rheumatic diseases. There is evidence for high usability and engagement but the clinical impact on long-term symptom management is uncertain.</p>","PeriodicalId":8406,"journal":{"name":"Arthritis Care & Research","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144625221","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":"Trends in Dermato-polymyositis Mortality, 1999-2022: A Nationwide Population-based Study, United States.","authors":"Elizabeth Matz, Ram R Singh","doi":"10.1002/acr.25609","DOIUrl":"https://doi.org/10.1002/acr.25609","url":null,"abstract":"<p><strong>Objective: </strong>We evaluated trends in dermato-polymyositis (DPM) mortality relative to all-cause mortality in the United States, 1999-2022.</p><p><strong>Methods: </strong>We used the Center for Disease Control and Prevention's databases (Multiple Causes of Death for 1999-2020 and Provisional Mortality Statistics for 2021 and 2022) to obtain death counts for DPM and non-DPM (all causes other than DPM). We calculated age-standardized mortality rates (ASMR) for both groups and computed the ratio of DPM-ASMR to non-DPM-ASMR for each of the 24 years. We performed joinpoint regression analysis to estimate annual percent change (APC) in DPM and non-DPM ASMRs and in the DPM-ASMR:non-DPM-ASMR ratios, overall and by sex, age, and race/ethnicity.</p><p><strong>Results: </strong>There were 12,882 DPM and 63,549,485 non-DPM deaths during 1999-2022. Mortality decreased at a higher APC (-3.8% [95% CI, -4.3%, -3.4%]) for DPM than non-DPM (-1.2% [95% CI, -1.5%, -0.9%]) until the start of the COVID-19 pandemic, when it increased for both at similar APCs. Consequently, the ratios of DPM-ASMRs to non-DPM-ASMRs decreased over these 24 years in all subgroups. The DPM-ASMR to non-DPM-ASMR ratios were higher in females than males, and in younger individuals (≤64 years) than those ≥65 years. The odds of premature death were higher for DPM than non-DPM. Non-Hispanic Black, Hispanic, and non-Hispanic others had higher DPM-ASMR to non-DPM-ASMR ratios than White individuals.</p><p><strong>Conclusion: </strong>DPM mortality decreased at a higher rate than all-cause mortality until the pandemic, when it proportionately increased for both DPM and all causes. Females, younger, Black, Hispanic, and non-Hispanic other individuals had higher DPM mortality relative to all-cause mortality. Findings highlight the need for improved screening, earlier intervention, and targeted efforts to address racial/ethnic disparities in DPM outcomes.</p>","PeriodicalId":8406,"journal":{"name":"Arthritis Care & Research","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144625227","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":"Robert M Fairchild, Lorinda Chung","doi":"10.1002/acr.25607","DOIUrl":"10.1002/acr.25607","url":null,"abstract":"","PeriodicalId":8406,"journal":{"name":"Arthritis Care & Research","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144625226","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":"Late-Onset Scleroderma Renal Crisis Does Occur - A Multi-Center Study.","authors":"Swati Mehta, Sumbal Wajid, Isam Albaba, Virginia Steen, Robyn T Domsic-Degazio, Alexa Luta, Paul J Feustel, Loay Salman, Lee Shapiro","doi":"10.1002/acr.25608","DOIUrl":"https://doi.org/10.1002/acr.25608","url":null,"abstract":"<p><strong>Objective: </strong>Scleroderma renal crisis (SRC) is historically described to occur within first 5 years of SSc diagnosis. However, it has been observed to occur beyond 5 years. In this analysis, we aim to describe the prevalence, clinical features and outcomes of late onset SRC and compare them to early onset SRC.</p><p><strong>Methods: </strong>This retrospective observational study included patients diagnosed with SRC between 1995 to 2018 at three university-affiliated hospitals. Late onset SRC was defined as SRC occurring 5 years after SSc diagnosis. After obtaining IRB approval, data including demographics, SRC onset, clinical characteristics, laboratory data, and outcomes were extracted. Continuous data were expressed as mean/median, and categorical as frequencies/percentages. Differences were analyzed via Pearson's chi-square.</p><p><strong>Results: </strong>A total of 223 SRC patients were identified, with 169 (75.8%) classified as early onset and 54 (24.2%) as late onset. Late onset group had a mean SRC onset at 12.2 years after SSc diagnosis. Male predominance was observed in late compared to early group (59% vs 9%). Steroid exposure was more common in late vs early group (56% vs 29%). There was no evidence of difference in autoantibodies profile and outcomes between early and late onset groups.</p><p><strong>Conclusions: </strong>Late onset SRC was seen in up to 25% of SRC patients, with a mean of 12 years after SSc diagnosis. Our findings reveal comparable clinical characteristics and outcomes between early and late onset SRC, underlying the importance of recognizing SRC regardless of disease duration to optimize outcomes.</p>","PeriodicalId":8406,"journal":{"name":"Arthritis Care & Research","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144625224","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":"A Twist in the Diagnosis: Chronic Arthropathy Without Inflammation.","authors":"María Á Puche-Larrubia, Inmaculada C Aranda-Valera, Alejandro Escudero-Contreras, Rosa Roldán-Molina","doi":"10.1002/acr.25597","DOIUrl":"10.1002/acr.25597","url":null,"abstract":"","PeriodicalId":8406,"journal":{"name":"Arthritis Care & Research","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144574747","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":"Development of the 2023 ACR/EULAR Antiphospholipid Syndrome Classification Criteria, Phase III-C Report: Assessment of Patient Scenarios (Derivation Cohort) and Refinement of Definitions.","authors":"Medha Barbhaiya, Stephane Zuily, Deanna Jannat-Khah, Mary-Carmen Amigo, Danieli Andrade, Tadej Avcin, Maria L Bertolaccini, D Ware Branch, Nathalie Costedoat-Chalumeau, Guilherme Ramires de Jesús, Katrien M J Devreese, David Garcia, Jose A Gomez Puerta, Francis Guillemin, Steven R Levine, Roger A Levy, Michael D Lockshin, Thomas L Ortel, Michelle Petri, Giovanni Sanna, Savino Sciascia, Surya V Seshan, Maria Tektonidou, Denis Wahl, Rohan Willis, Cecile Yelnik, Alison Hendry, Ray Naden, Karen H Costenbader, Doruk Erkan","doi":"10.1002/acr.25599","DOIUrl":"https://doi.org/10.1002/acr.25599","url":null,"abstract":"<p><strong>Objective: </strong>The 2023 ACR/EULAR Antiphospholipid Syndrome (APS) Classification criteria aim to identify patients with high likelihood of APS for research. Phases I/II of our four-phase methodological approach resulted in 27 candidate criteria organized in clinical and laboratory domains. Here, we summarize Phase III efforts to reduce and refine criteria using patient scenarios.</p><p><strong>Methods: </strong>Using standardized definitions for candidate criteria, the Steering Committee collected antiphospholipid antibody (aPL)-positive cases referred for \"suspected APS\". Treating physicians assessed APS case likelihood using a Likert Scale. Poisson regression calculated risk ratios (RR) and 95% confidence intervals to quantify the direction and size of the association of candidate criteria with \"highly likely\" versus \"equivocal or unlikely\" APS, which guided Steering Committee candidate criteria refinement and organization.</p><p><strong>Results: </strong>We collected 314 suspected APS cases (137 [44%] highly likely, 177 [56%] equivocal/unlikely APS). Provoking venous thromboembolism (VTE) or arterial thromboses (AT) risk factors reduced the size of the association with highly likely APS (RR 4.31 [95%CI 2.11-8.78] to RR 1.56 [95%CI 0.89-2.75] for VTE, and RR 3.48 [95%CI 1.91-6.32] to RR 1.64 [95%CI 0.77-3.51] for AT). Persistent lupus anticoagulant, anticardiolipin IgG antibody >40U, and anti-β₂-glycoprotein-I IgG antibody >40U were positively associated with highly likely APS (all p<0.05). Eventually, items within eight additive and independent clinical and laboratory domains were refined.</p><p><strong>Conclusion: </strong>Referred suspected APS cases provided insight into associations of individual candidate criteria with APS likelihood. Risk ratio analyses helped refine items and organize the draft classification system into eight additive and independent clinical and laboratory domains.</p>","PeriodicalId":8406,"journal":{"name":"Arthritis Care & Research","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144574748","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 lignan intake, whole grain foods, and the risk of gout: results from two prospective cohort studies.","authors":"Sharan K Rai, Yang Hu, Ming Ding, Frank B Hu, Molin Wang, Jorge E Chavarro, Natalie McCormick, Hyon K Choi, Qi Sun","doi":"10.1002/acr.25596","DOIUrl":"https://doi.org/10.1002/acr.25596","url":null,"abstract":"<p><strong>Objective: </strong>Multiple plant-based dietary patterns are inversely associated with gout, although the individual constituents driving this association remain unclear. Dietary lignans, a major group of phytoestrogens abundant in plant foods, are metabolized by the gut microflora and may modulate gout risk. We examined the associations between dietary lignan intake, certain whole grain foods rich in lignans, and incident gout.</p><p><strong>Methods: </strong>We analyzed data from 122,680 individuals in the Health Professionals Follow-up Study and Nurses' Health Study. We administered a food frequency questionnaire every 2-4 years. We used Cox models to evaluate associations between dietary lignans, whole grain foods, and confirmed gout.</p><p><strong>Results: </strong>Higher intakes of matairesinol (hazard ratio [HR] and 95% confidence interval [CI] comparing extreme quintiles: 0.78 [0.69, 0.90]; P trend=0.002) and secoisolariciresinol (0.78 [0.68, 0.89]; P trend=0.002) were both associated with lower gout risk, while pinoresinol and lariciresinol were not associated with gout. We found inverse associations of whole grain cold breakfast cereals (HR for those consuming ≥1 serving/day 0.62 [0.53, 0.73]), cooked oatmeal/oat bran (HR for those consuming ≥2 servings/week 0.78 [0.70, 0.86]), and bran added to food (HR for those consuming ≥2 servings/week 0.84 [0.74, 0.95]), but not dark breads or other cooked breakfast cereals, with gout.</p><p><strong>Conclusion: </strong>Higher intakes of matairesinol and secoisolariciresinol, as well as whole grain cold breakfast cereals, oatmeal, and added bran, were each significantly associated with lower gout risk. These findings support adherence to healthful plant-based diets for gout and suggest a potential role of the gut microbiome in gout pathogenesis.</p>","PeriodicalId":8406,"journal":{"name":"Arthritis Care & Research","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144574749","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}