Arthritis Research & Therapy最新文献

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The role of Anti-PAD4, Anti-CarP, and Anti-RA33 antibodies combined with RF and ACPA in predicting abatacept response in rheumatoid arthritis 抗- pad4、抗- carp和抗- ra33抗体联合RF和ACPA预测类风湿性关节炎阿巴接受反应的作用
IF 4.9 2区 医学
Arthritis Research & Therapy Pub Date : 2025-01-15 DOI: 10.1186/s13075-024-03470-y
Alberto Floris, Maria Maddalena Angioni, Mattia Fadda, Micaela Rita Naitza, Mattia Congia, Elisabetta Chessa, Matteo Piga, Alberto Cauli
{"title":"The role of Anti-PAD4, Anti-CarP, and Anti-RA33 antibodies combined with RF and ACPA in predicting abatacept response in rheumatoid arthritis","authors":"Alberto Floris, Maria Maddalena Angioni, Mattia Fadda, Micaela Rita Naitza, Mattia Congia, Elisabetta Chessa, Matteo Piga, Alberto Cauli","doi":"10.1186/s13075-024-03470-y","DOIUrl":"https://doi.org/10.1186/s13075-024-03470-y","url":null,"abstract":"To explore the role of newly emerging autoantibodies (AAbs) - peptidyl-arginine deiminase 4 (aPAD4), carbamylated proteins (aCarP), and anti-RA33 (aRA33) - alongside the traditionally assessed rheumatoid factor (RF) and anti-citrullinated protein antibodies (ACPA), in predicting the response to abatacept (ABT) and its retention rate in rheumatoid arthritis (RA) patients. Data from 121 consecutive ABT-treated RA patients were recorded. The RF and ACPA status were retrospectively assessed by reviewing the patients’ clinical records. Positivity for aPAD4, aCarP and aRA33 were determined by Enzyme-Linked Immunosorbent Assay (ELISA). The achievement of a moderate or good EULAR response at 6 months and the 3-years retention were analyzed as treatment outcomes. Multiple logistic regression models and Cox regression hazard analysis models were built to identify the association between such outcomes and the different AAbs, after adjustment for different confounders. The AAbs were assessed both individually and in different combinations to identify the most robust predictive model. In the studied cohort, RF, ACPA, aPAD4, aCarP and aRA33-Ab tested positive in 74.4%, 69.4%, 43.8%, 23.9%, 14.9% patients, respectively. A moderate or good EULAR response at 6 months was achieved by 64.5% of subjects and the cumulative 3-years retention rate was 56.6%. A higher EULAR response rate was recorded in patient with positivity for RF (67% in subjects tested positive vs. 58% in negative), ACPA (68% vs. 57%), aPAD4 (68% vs. 62%), and aCarP (72% vs. 62%), although statistical significance was not reached likely due to sample size limitations. Similarly, ACPA, aPAD4, aCarP were associated with higher 3-year retention rates, though not statistically significant individually. The combined analysis revealed that positivity for ACPA and/or aPAD4 predicted a significantly higher EULAR response rate at 6 months compared with double negativity (adjusted OR 2.7, p 0.026). Furthermore, positivity for at least one of ACPA, aPAD4, or aCarP predicted a significantly higher 3-year ABT retention rate compared to triple negativity (62.1% single or double positive vs. 33.5% triple negative, adjusted HR 0.48, p 0.022). This study highlights the potential benefits of using a combined assessment of ACPA aPAD4 and aCarP in predicting effectiveness of ABT in RA.","PeriodicalId":8419,"journal":{"name":"Arthritis Research & Therapy","volume":"24 1","pages":""},"PeriodicalIF":4.9,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142981501","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}
引用次数: 0
Distribution of spinal damage in patients with axial spondyloarthritis as assessed by MRI: a prospective and blinded study MRI评估轴性脊柱炎患者脊柱损伤分布:一项前瞻性盲法研究
IF 4.9 2区 医学
Arthritis Research & Therapy Pub Date : 2025-01-14 DOI: 10.1186/s13075-024-03465-9
Andreas Haidmayer, Gabriel Adelsmayr, Christopher Spreizer, Eva Valentina Klocker, Franz Quehenberger, Michael Fuchsjaeger, Jens Thiel, Josef Hermann
{"title":"Distribution of spinal damage in patients with axial spondyloarthritis as assessed by MRI: a prospective and blinded study","authors":"Andreas Haidmayer, Gabriel Adelsmayr, Christopher Spreizer, Eva Valentina Klocker, Franz Quehenberger, Michael Fuchsjaeger, Jens Thiel, Josef Hermann","doi":"10.1186/s13075-024-03465-9","DOIUrl":"https://doi.org/10.1186/s13075-024-03465-9","url":null,"abstract":"Axial spondyloarthritis (SpA) leads to structural bone lesions in every part of the vertebral column. These lesions are only partially visualized on conventional radiographs, omitting posterior parts of the vertebral column and the thoracic spine, that may nevertheless contribute to impaired spinal mobility and function in patients with axial SpA. In this prospective and blinded investigation, we assessed the distribution of structural spinal lesions using magnetic resonance imaging (MRI) of the whole spine in 55 patients with axial SpA classified according to the Assessment in Spondyloarthritis International Society (ASAS) criteria. After assessment of spinal mobility and function two blinded radiologists independently evaluated MRIs of 23 vertebral units in every patient. Non-parametric statistical methods, Spearman‘s correlation and linear regression models were used to analyze structural lesion distribution and the relationship with clinical spinal mobility and function parameters. In 55 patients with axial SpA (13 females, average disease duration 14.9 years) 657 ventral and 139 dorsal vertebral body structural bone lesions and, notably, 534 facet joint lesions could be visualized. The median number of lesions per patient was higher in the thoracic (8.5, range 1.0–41.0) than in the lumbar (7.5, range 0.0-27.5) and the cervical spine (3.5, range 0.0-24.5). A negative correlation was noted between the number of osteoproliferative structural bone lesions and impairment of spinal mobility and function in univariate, but not in multivariate analyses. MRI of the whole spine revealed a high prevalence of lesions in dorsal parts of the vertebral column and in the thoracic spine in patients with axial SpA that may not be adequately visualized on conventional radiographs. These findings could further contribute to a better understanding of reduced mobility of the spine typically associated with axial SpA and assist diagnostics.","PeriodicalId":8419,"journal":{"name":"Arthritis Research & Therapy","volume":"16 1","pages":""},"PeriodicalIF":4.9,"publicationDate":"2025-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142974804","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}
引用次数: 0
Eltrombopag for the treatment of refractory connective tissue disease-related thrombocytopenia: a pilot study of 52 cases Eltrombopag用于治疗难治性结缔组织病相关血小板减少症:52例的初步研究
IF 4.9 2区 医学
Arthritis Research & Therapy Pub Date : 2025-01-10 DOI: 10.1186/s13075-024-03472-w
Siying Deng, Bei Wang, Ziwei Hu, Shaozhe Cai, Lingli Dong
{"title":"Eltrombopag for the treatment of refractory connective tissue disease-related thrombocytopenia: a pilot study of 52 cases","authors":"Siying Deng, Bei Wang, Ziwei Hu, Shaozhe Cai, Lingli Dong","doi":"10.1186/s13075-024-03472-w","DOIUrl":"https://doi.org/10.1186/s13075-024-03472-w","url":null,"abstract":"The objective of this study was to investigate the therapeutic effectiveness and safety profile of Eltrombopag, a thrombopoietin receptor agonist, as prolonged therapy in refractory CTD-ITP patients. We conducted a pilot observational study of Eltrombopag in CTD-ITP patients who were unresponsive to or intolerant of conventional medications. Eltrombopag was administered orally at 25–75 mg/qd and adjusted on the basis of tolerance and efficacy until a minimum dosage of 25 mg/qd was reached. Clinical and laboratory data were collected and analysed monthly. The therapeutic response, relapse, and adverse events during the follow-up were also reviewed and evaluated. Fifty-two patients were enrolled and followed monthly for a median of 6 months. Thirty-six (90%) patients achieved durable overall remission. The remission rates were 67.5% at month 1, 87.5% at month 2, 97.5% at month 3, and 95% at month 6. The platelet count of the patients improved significantly, with the median reaching 50 × 109/L within 2 weeks (p = 0.003). Disease activity indices were reduced in SLE and pSS patients (p = 0.016), allowing glucocorticoid tapering (p = 0.004). One patient had no response, four relapsed, and fifteen (28.8%) experienced clinically relevant adverse events. In the analyses, protopathy, comorbidity, and prior treatment were associated with efficacy. For refractory CTD-ITP patients, Eltrombopag demonstrated significant clinical improvement, safety, and a steroid-sparing effect with prolonged use. Patient characteristics at baseline may affect treatment efficacy. First-line treatment with immunosuppressant therapy has a poor effect on ITP secondary to connective tissue disease and brings unignorable side effects on patients. Few studies have sufficiently elucidated the effects of Eltrombopag, a thrombopoietin receptor agonist, in refractory ITP secondary to CTD. Here, we report a series of refractory ITP-CTD patients treated with Eltrombopag. A 90% durable overall remission rate was observed at week 24, and remission rates promptly increased from 67.5% at month 1 to 89.5% at month 2. Eltrombopag had a rapid onset of action and permitted a steroid-sparing effect as the response was sustained. A 28.8% adverse event rate was observed. The baseline characteristics of patients may influence drug efficacy. This study may provide important supporting information for developing a treatment strategy for refractory CTD-ITP patients based on Eltrombopag.","PeriodicalId":8419,"journal":{"name":"Arthritis Research & Therapy","volume":"204 1","pages":""},"PeriodicalIF":4.9,"publicationDate":"2025-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142940151","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}
引用次数: 0
Inhibition of macrophage polarization and pyroptosis in collagen-induced arthritis through MSC-exo and ginsenoside Rh2 MSC-exo和人参皂苷Rh2对胶原诱导关节炎巨噬细胞极化和焦亡的抑制作用
IF 4.9 2区 医学
Arthritis Research & Therapy Pub Date : 2025-01-09 DOI: 10.1186/s13075-025-03473-3
Zhongsheng Zhou, Shuhui Wu, Yang Li, Pu Shao, Jinlan Jiang
{"title":"Inhibition of macrophage polarization and pyroptosis in collagen-induced arthritis through MSC-exo and ginsenoside Rh2","authors":"Zhongsheng Zhou, Shuhui Wu, Yang Li, Pu Shao, Jinlan Jiang","doi":"10.1186/s13075-025-03473-3","DOIUrl":"https://doi.org/10.1186/s13075-025-03473-3","url":null,"abstract":"Rheumatoid arthritis (RA) is a chronic autoimmune disease characterized by joint inflammation, tissue damage, and fibrosis, significantly affecting the quality of life. While there are currently some effective treatments available, they often come with side effects. There is an urgent need to find new treatments that can further improve therapeutic outcomes and reduce side effects. Our study investigates the role of Mesenchymal Stem Cell exosomes (MSC-exo) combined with Ginsenoside Rh2 (Rh2) in the treatment of RA. We specifically focus on how this combined strategy influences macrophage polarization and pyroptosis. This research utilized a collagen-induced rat arthritis model. The study findings reveal that the combination of MSC-exo combined with Rh2 can inhibit the polarization of M1 macrophages, increase the proportion of M2-like macrophages, and suppress M1-like macrophage pyroptosis via the NLRP3/Caspase11/GSDMD-N pathway. In the rat arthritis model, the combination of MSC-exo and Rh2 showed synergistic therapeutic effects. This research contributes to a deeper understanding of RA’s pathogenesis and presents new potential targeted therapeutic interventions. The combined application of MSC-exo and Rh2 offers promising insights for future innovative strategies in RA treatment, paving the way for more effective management of this autoimmune disease.","PeriodicalId":8419,"journal":{"name":"Arthritis Research & Therapy","volume":"101 1","pages":""},"PeriodicalIF":4.9,"publicationDate":"2025-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142936811","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}
引用次数: 0
Disease activity in patients with idiopathic inflammatory myopathy according to time since diagnosis and positivity to antisynthetase autoantibodies: data from the Myo-Spain registry 根据诊断时间和抗合成酶自身抗体阳性的特发性炎性肌病患者的疾病活动性:来自Myo-Spain登记的数据
IF 4.9 2区 医学
Arthritis Research & Therapy Pub Date : 2025-01-08 DOI: 10.1186/s13075-024-03471-x
Tatiana Cobo-Ibáñez, Ivan Castellví, Ana Pros, Marta Domínguez-Álvaro, Laura Nuño-Nuño, Julia Martínez-Barrio, Vega Jovaní, Fredeswinda Romero-Bueno, Esther Ruiz-Lucea, Eva Tomero, Ernesto Trallero-Araguás, Javier Narváez, Jordi Camins-Fàbregas, Alberto Ruiz-Román, Jesús Loarce-Martos, Susana Holgado-Pérez, V Miguel Flores-Rodríguez, Francisca Sivera, Carolina Merino-Argumanez, Antonio Juan-Mas, Irene Altabás-González, María Martín-López, Joaquín María Belzunegui-Otano, Carmen Carrasco-Cubero, Mercedes Freire-González, Iñigo Rúa-Figueroa, Nuria Lozano-Rivas, Julio David Suarez-Cuba, Olga Martínez, Rafaela Ortega-Castro, Patricia Alcocer, Alejandro Gómez-Gómez, Olga Sánchez-Pernaute, José Luis Tandaipan, Irene Carrión-Barberà, Chamaida Plasencia-Rodríguez, Oihane Ibarguengoitia-Barrena, Paola Vidal-Montal, Vera Ortiz-Santamaria, Noemi Garrido-Puñal, Anne Riveros, Esmeralda Delgado-Frías, Juan Miguel López-Gómez, Carmen Barbadillo, José María Pego-Reigosa, Beatriz E. Joven-Ibáñ..
{"title":"Disease activity in patients with idiopathic inflammatory myopathy according to time since diagnosis and positivity to antisynthetase autoantibodies: data from the Myo-Spain registry","authors":"Tatiana Cobo-Ibáñez, Ivan Castellví, Ana Pros, Marta Domínguez-Álvaro, Laura Nuño-Nuño, Julia Martínez-Barrio, Vega Jovaní, Fredeswinda Romero-Bueno, Esther Ruiz-Lucea, Eva Tomero, Ernesto Trallero-Araguás, Javier Narváez, Jordi Camins-Fàbregas, Alberto Ruiz-Román, Jesús Loarce-Martos, Susana Holgado-Pérez, V Miguel Flores-Rodríguez, Francisca Sivera, Carolina Merino-Argumanez, Antonio Juan-Mas, Irene Altabás-González, María Martín-López, Joaquín María Belzunegui-Otano, Carmen Carrasco-Cubero, Mercedes Freire-González, Iñigo Rúa-Figueroa, Nuria Lozano-Rivas, Julio David Suarez-Cuba, Olga Martínez, Rafaela Ortega-Castro, Patricia Alcocer, Alejandro Gómez-Gómez, Olga Sánchez-Pernaute, José Luis Tandaipan, Irene Carrión-Barberà, Chamaida Plasencia-Rodríguez, Oihane Ibarguengoitia-Barrena, Paola Vidal-Montal, Vera Ortiz-Santamaria, Noemi Garrido-Puñal, Anne Riveros, Esmeralda Delgado-Frías, Juan Miguel López-Gómez, Carmen Barbadillo, José María Pego-Reigosa, Beatriz E. Joven-Ibáñ..","doi":"10.1186/s13075-024-03471-x","DOIUrl":"https://doi.org/10.1186/s13075-024-03471-x","url":null,"abstract":"To evaluate the main outcomes of disease activity and their association with other measures of activity, damage, and quality of life in patients with idiopathic inflammatory myopathy (IIM) according to time since diagnosis and positivity to antisynthetase autoantibodies (ASAs). Cross-sectional multicenter study within the Spanish Myo-Spain registry. Cases were classified as incident (≤ 12 months since diagnosis) and prevalent. The main outcomes of disease activity were the Myositis Disease Activity Assessment visual analogue scale (MYOACT), the Manual Muscle Test 8 (MMT-8), physician global activity (PhGA), and extramuscular activity. Other measures of activity, damage, and quality of life included patient global disease activity, MYOACT muscular, creatine phosphokinase, Health Assessment Questionnaire, physician and patient global damage, global damage of the Myositis Damage Index, and the 12-item Short-Form Health Survey (SF-12). We analyzed associations using a multivariate generalized linear model and a simple linear regression model. A total of 554 patients with different diagnostic subgroups of IIM were included (136 incident and 418 prevalent cases), with 215 ASA-positive patients (58 incident and 157 prevalent cases). All measures of disease activity were higher in the incident cases (p < 0.05), except for MYOACT muscular and creatine phosphokinase, for which no differences were recorded in ASA-positive patients. No differences were found between incident and prevalent cases for measures of damage. Values for the physical component of the SF-12 were higher in the prevalent cases (p < 0.05). The multivariate model was initially significant overall for the main activity outcomes. Positivity to ASAs was positively and negatively associated with the MYOACT index and MMT-8, respectively (p < 0.05), although no association was recorded with PhGA and extramuscular activity. Prevalent cases were negatively associated with the main outcomes of activity, except with MMT-8, for which the association was positive (p < 0.05). The main activity outcomes validated in polymyositis and dermatomyositis could also be used in other subtypes of IIM, such as antisynthetase syndrome. Recent diagnosis is associated with greater disease activity, as assessed based on these activity outcomes. PhGA and extramuscular activity are not modified by ASA positivity, thus supporting their preferred use for assessing treatment response in IIM with ASAs.","PeriodicalId":8419,"journal":{"name":"Arthritis Research & Therapy","volume":"11 3 1","pages":""},"PeriodicalIF":4.9,"publicationDate":"2025-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142935871","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}
引用次数: 0
Mortality in patients with giant cell arteritis in Spain: results from the ARTESER registry 西班牙巨细胞动脉炎患者的死亡率:来自ARTESER登记的结果
IF 4.9 2区 医学
Arthritis Research & Therapy Pub Date : 2025-01-07 DOI: 10.1186/s13075-024-03468-6
Juan Molina-Collada, Marta Domínguez-Álvaro, Rafael B. Melero-González, Eugenio de Miguel, Maite Silva-Díaz, Jesús Alejandro Valero Jaimes, Ismael González, Julio Sánchez Martín, Javier Narváez, Joan Calvet, Ivette Casafont-Solé, Jose A Román Ivorra, Selene Labrada Arrabal, Margarida Vasques Rocha, Carlota L Iñiguez, María Sagrario Bustabad Reyes, Cristina Campos Fernández, María Alcalde Villar, Antonio Juan Mas, Ricardo Blanco
{"title":"Mortality in patients with giant cell arteritis in Spain: results from the ARTESER registry","authors":"Juan Molina-Collada, Marta Domínguez-Álvaro, Rafael B. Melero-González, Eugenio de Miguel, Maite Silva-Díaz, Jesús Alejandro Valero Jaimes, Ismael González, Julio Sánchez Martín, Javier Narváez, Joan Calvet, Ivette Casafont-Solé, Jose A Román Ivorra, Selene Labrada Arrabal, Margarida Vasques Rocha, Carlota L Iñiguez, María Sagrario Bustabad Reyes, Cristina Campos Fernández, María Alcalde Villar, Antonio Juan Mas, Ricardo Blanco","doi":"10.1186/s13075-024-03468-6","DOIUrl":"https://doi.org/10.1186/s13075-024-03468-6","url":null,"abstract":"To compare mortality rates between GCA patients and the general population in Spain, and to identify associated factors influencing mortality. ARTESER, a multicenter registry by the Spanish Society of Rheumatology, includes GCA patients from June 2013 to March 2019. Demographic, clinical, imaging, histological and mortality data were collected retrospectively. Only patients with at least one year of follow-up were included for analysis. The mortality rates were expressed as the number of deaths per 1000 person-years, with 95% confidence interval (CI) by sex and age group. Kaplan-Meier method was performed for survival analysis. The factors influencing mortality were analyzed using Cox regression model. A total of 1200 patients with GCA were analyzed, with a mean (SD) follow-up of 2.18 (1.53) years. The overall five-year cumulative mortality rate (95%CI) was 37.86 (31.75-43.96) per 1000 patients/year. The cumulative mortality rate was significantly higher in males than females (59.04vs29.06; p<0.001). The age- and sex-adjusted cumulative mortality rate was similar to the Spanish general population (19.75vs20.72;p=0.559). In the multivariate analysis, older age (HR 1.11, 95%CI 1.073-1.142) and male sex (HR 1.775, 95%CI 1.214-2.594) were associated with increased mortality. Headache (HR 0.55, 95%CI 0.362-0.843) and high hemoglobin levels (HR 0.85, 95%CI 0.744-0.970) were protective factors against death. The overall five-year age- and sex-adjusted cumulative mortality rate in GCA is similar compared to the general population. Older age and male sex appear to be associated with an increased risk of mortality, whereas headache and high hemoglobin levels might serve as protective factors against death.","PeriodicalId":8419,"journal":{"name":"Arthritis Research & Therapy","volume":"15 1","pages":""},"PeriodicalIF":4.9,"publicationDate":"2025-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142934963","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}
引用次数: 0
Gastrointestinal lesions of eosinophilic granulomatosis with polyangiitis: a prediction model and clinical patterns 嗜酸性粒细胞肉芽肿伴多血管炎的胃肠道病变:预测模型和临床模式
IF 4.9 2区 医学
Arthritis Research & Therapy Pub Date : 2025-01-04 DOI: 10.1186/s13075-024-03467-7
Suying Liu, Yunjiao Yang, Linna Han, Chengmei He, Mengtao Li, Xinping Tian, Juan Meng, Li Wang, Fengchun Zhang
{"title":"Gastrointestinal lesions of eosinophilic granulomatosis with polyangiitis: a prediction model and clinical patterns","authors":"Suying Liu, Yunjiao Yang, Linna Han, Chengmei He, Mengtao Li, Xinping Tian, Juan Meng, Li Wang, Fengchun Zhang","doi":"10.1186/s13075-024-03467-7","DOIUrl":"https://doi.org/10.1186/s13075-024-03467-7","url":null,"abstract":"Severe gastrointestinal lesions are associated with a poor prognosis in eosinophilic granulomatosis with polyangiitis (EGPA). The goal of this study was to develop an effective predictive model for gastrointestinal lesions and to examine clinical patterns, associated factors, treatment, and outcomes of gastrointestinal lesions in EGPA. We retrospectively enrolled 165 EGPA patients. The independent associated factors were analyzed using multivariate logistic regression. A nomogram was conducted to quantify the predictive factors. The correlation between different organ lesions was calculated to explore the clinical patterns. A total of 52 patients had gastrointestinal lesions, and 22 developed severe disorders. Common manifestations included abdominal pain (78%), diarrhea (40.4%), and nausea and/or vomiting (32.7%). Severe gastrointestinal lesions included hemorrhage (26.9%), ulcers (17.3%), obstruction (9.6%), and pancreatitis (5.8%). Eosinophilic tissue infiltration, weight loss, and myalgia were independently associated with gastrointestinal involvement. Patients with severe gastrointestinal lesions had a shorter duration from initial symptoms to EGPA diagnosis, less frequent asthma, and ear-nose-throat involvement, and were more likely to receive methylprednisolone pulse. Weight loss, central nervous system involvement, myalgia, and eosinophilic tissue infiltration were retained in the nomogram. An eosinophil ratio of over 19.2% identified gastrointestinal lesions. Significantly more patients with gastrointestinal involvement had a Five Factor Score ≥ 2. Five well-defined clinical models were identified, including the brain-gut pattern. Severe gastrointestinal lesions are common in EGPA and early detection is critical. Eosinophils are an important factor associated with gastrointestinal involvement of EGPA. We developed a model to predict the risk of gastrointestinal lesions. The brain-gut pattern might deserve further investigation in EGPA.","PeriodicalId":8419,"journal":{"name":"Arthritis Research & Therapy","volume":"385 1","pages":""},"PeriodicalIF":4.9,"publicationDate":"2025-01-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142925008","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}
引用次数: 0
Obesity and fibromyalgia are associated with Difficult-to-Treat Rheumatoid Arthritis (D2T-RA) independent of age and gender 肥胖和纤维肌痛与难治性类风湿关节炎(D2T-RA)相关,与年龄和性别无关
IF 4.9 2区 医学
Arthritis Research & Therapy Pub Date : 2025-01-03 DOI: 10.1186/s13075-024-03432-4
Nicoletta Luciano, Elisa Barone, Enrico Brunetta, Alessio D’Isanto, Maria De Santis, Angela Ceribelli, Marta Caprioli, Giacomo M. Guidelli, Daniela Renna, Carlo Selmi
{"title":"Obesity and fibromyalgia are associated with Difficult-to-Treat Rheumatoid Arthritis (D2T-RA) independent of age and gender","authors":"Nicoletta Luciano, Elisa Barone, Enrico Brunetta, Alessio D’Isanto, Maria De Santis, Angela Ceribelli, Marta Caprioli, Giacomo M. Guidelli, Daniela Renna, Carlo Selmi","doi":"10.1186/s13075-024-03432-4","DOIUrl":"https://doi.org/10.1186/s13075-024-03432-4","url":null,"abstract":"There is still a significant proportion of patients with rheumatoid arthritis (RA) in whom multiple therapeutic lines are ineffective. These cases are defined by the EULAR criteria as Difficult-to-Treat RA (D2T-RA) for which there is limited knowledge of predisposing factors. To identify the clinical features associated with D2T-RA in real-life practice. We retrospectively collected demographic, clinical, and serological data on 458 patients consecutively seen for RA between January 2019 and January 2023. We compared patients fulfilling the D2T-RA criteria with the remaining RA cohort using univariate comparisons and logistic regression to determine the impact of clinical features, comorbidities on outcome variable, adjusted for confounders. Seventy-one/458 (16%) patients fulfilled the 2021 EULAR criteria for D2T-RA with no significant differences for age (median 62 years interquartile range -IQR- 58- 65 vs. 62 IQR 60 – 63 in non-D2T), gender prevalence (23% in both groups) and positivity rates for rheumatoid factors (62% vs. 62% in non-D2T) and Anti-Citrullinated Protein Antibodies (ACPA) (69% vs. 61% in non-D2T). Conversely, D2T-RA cases had significant longer disease duration (median 15 years IQR 13–17 vs. 10 years IQR 9–11 in non-D2T; p < 0.0001). D2T-RA also had more erosions at baseline (24% vs. 11% in non-D2T; p < 0.0001) and higher disease activity index (CDAI) at the last follow up visit (15.7 ± 10.5 vs. 7.5 ± 8.8 in non-D2T; p < 0.0001). D2T-RA cases suffered with higher frequency of obesity (33% vs. 19% in non-D2T, p = 0.021) and fibromyalgia (25% vs. 10% in non-D2T, p < 0.0001). The multivariate analysis confirmed the correlations of D2T-RA with disease duration (Odds ratio -OR- 1.06, 95% confidence interval -CI—1.03–1.09; p < 0.0001), baseline erosions (OR 2.73, 95% CI 1.28–5.82; p = 0.009), obesity (OR 2.22, 95% CI 1.10–4.50; p = 0.026) and fibromyalgia (OR 3.91, 95% CI 1.76–8.70; p = 0.001), independent of age and gender. High disease activity, baseline erosions and disease duration are significantly associated with the D2T phenotype of RA while we confirm the importance of obesity and fibromyalgia.","PeriodicalId":8419,"journal":{"name":"Arthritis Research & Therapy","volume":"36 1","pages":""},"PeriodicalIF":4.9,"publicationDate":"2025-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142917139","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}
引用次数: 0
Predicting autoimmune thyroiditis in primary Sjogren’s syndrome patients using a random forest classifier: a retrospective study 使用随机森林分类器预测原发性干燥综合征患者自身免疫性甲状腺炎:一项回顾性研究
IF 4.9 2区 医学
Arthritis Research & Therapy Pub Date : 2025-01-02 DOI: 10.1186/s13075-024-03469-5
Jia-yun Wu, Jing-yu Zhang, Wen-qi Xia, Yue-ning Kang, Ru-yi Liao, Yu-ling Chen, Xiao-min Li, Ya Wen, Fan-xuan Meng, Li-ling Xu, Sheng-hui Wen, Hui-fen Liu, Yuan-qing Li, Jie-ruo Gu, Qing Lv, Yong Ren
{"title":"Predicting autoimmune thyroiditis in primary Sjogren’s syndrome patients using a random forest classifier: a retrospective study","authors":"Jia-yun Wu, Jing-yu Zhang, Wen-qi Xia, Yue-ning Kang, Ru-yi Liao, Yu-ling Chen, Xiao-min Li, Ya Wen, Fan-xuan Meng, Li-ling Xu, Sheng-hui Wen, Hui-fen Liu, Yuan-qing Li, Jie-ruo Gu, Qing Lv, Yong Ren","doi":"10.1186/s13075-024-03469-5","DOIUrl":"https://doi.org/10.1186/s13075-024-03469-5","url":null,"abstract":"Primary Sjogren’s syndrome (pSS) and autoimmune thyroiditis (AIT) share overlapping genetic and immunological profiles. This retrospective study evaluates the efficacy of machine learning algorithms, with a focus on the Random Forest Classifier, to predict the presence of thyroid-specific autoantibodies (TPOAb and TgAb) in pSS patients. A total of 96 patients with pSS were included in the retrospective study. All participants underwent a complete clinical and laboratory evaluation. All participants underwent thyroid function tests, including TPOAb and TgAb, and were accordingly divided into positive and negative thyroid autoantibody groups. Four machine learning algorithms were then used to analyze the risk factors affecting patients with pSS with positive and negative for thyroid autoantibodies. The results indicated that the Random Forest Classifier algorithm (AUC = 0.755) outperformed the other three machine learning algorithms. The random forest classifier indicated Age, IgG, C4 and dry mouth were the main factors influencing the prediction of positive thyroid autoantibodies in pSS patients. It is feasible to predict AIT in pSS using machine learning algorithms. Analyzing clinical and laboratory data from 96 pSS patients, the Random Forest model demonstrated superior performance (AUC = 0.755), identifying age, IgG levels, complement component 4 (C4), and absence of dry mouth as primary predictors. This approach offers a promising tool for early identification and management of AIT in pSS patients. This retrospective study was approved and monitored by the Ethics Committee of The Third Affiliated Hospital of Sun Yat-sen University (No.II2023-254-02).","PeriodicalId":8419,"journal":{"name":"Arthritis Research & Therapy","volume":"36 1","pages":""},"PeriodicalIF":4.9,"publicationDate":"2025-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142911487","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}
引用次数: 0
Comparative analysis of arterial involvement in predominant cranial and isolated extracranial phenotypes of giant cell arteritis using 18F-FDG PET-CT 18F-FDG PET-CT对巨细胞动脉炎主要颅型和孤立颅外型动脉受累的比较分析
IF 4.9 2区 医学
Arthritis Research & Therapy Pub Date : 2024-12-28 DOI: 10.1186/s13075-024-03464-w
Javier Narvaez, Paola Vidal-Montal, Iván Sánchez-Rodríguez, Aida Sabaté-Llobera, Montserrat Cortés-Romera, Judith Palacios-Olid, Pol Maymó-Paituvi, Joan Miquel Nolla
{"title":"Comparative analysis of arterial involvement in predominant cranial and isolated extracranial phenotypes of giant cell arteritis using 18F-FDG PET-CT","authors":"Javier Narvaez, Paola Vidal-Montal, Iván Sánchez-Rodríguez, Aida Sabaté-Llobera, Montserrat Cortés-Romera, Judith Palacios-Olid, Pol Maymó-Paituvi, Joan Miquel Nolla","doi":"10.1186/s13075-024-03464-w","DOIUrl":"https://doi.org/10.1186/s13075-024-03464-w","url":null,"abstract":"To investigate differences in arterial involvement patterns on 18F-FDG PET-CT between predominant cranial and isolated extracranial phenotypes of giant cell arteritis (GCA). A retrospective review of 18F-FDG PET-CT findings was conducted on 140 patients with confirmed GCA. The patients were divided into two groups: the cranial group, which presented craniofacial ischemic symptoms either at diagnosis or during follow-up, and the isolated extracranial group which never exhibited such manifestations. Of the 140 patients (90 women), 99 (71%) were considered to have a predominantly cranial phenotype, while 41 (29%) had isolated extracranial GCA. Patients with the extracranial phenotype were younger (p = 0.001), had lower TAB positivity (25%), and experienced longer diagnostic delays (p = 0.004). Polymyalgia rheumatica was more common in the extracranial group (p = 0.029), which also showed fewer constitutional symptoms, milder increases in acute phase reactants, and more frequent limb claudication and aortic complications, although these differences were not statistically significant. When comparing arterial involvement on 18F-FDG PET-CT, we observed statistically significant differences. The extracranial phenotype showed greater involvement across all segments of the thoracic aorta (p = 0.001), as well as in the abdominal aorta (p = 0.005), subclavian (p = 0.021), iliac (p = 0.004), and femoral arteries (p = 0.025). In contrast, the cranial phenotype exhibited a higher frequency of vertebral artery involvement (p < 0.001). Significant differences in arterial involvement patterns on 18F-FDG PET-CT were observed between phenotypes. These findings may explain atypical symptoms such as inflammatory lower back pain or limb claudication and the increased risk of aortic complications in extracranial GCA.","PeriodicalId":8419,"journal":{"name":"Arthritis Research & Therapy","volume":"31 1","pages":""},"PeriodicalIF":4.9,"publicationDate":"2024-12-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142887605","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}
引用次数: 0
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