ACR open rheumatology最新文献

{"title":"Clinical Images: High-resolution vessel wall magnetic resonance imaging detecting central nervous system vasculitis.","authors":"Wan-Hao Tsai, Ko-Jen Li","doi":"10.1002/acr2.70068","DOIUrl":"10.1002/acr2.70068","url":null,"abstract":"","PeriodicalId":93845,"journal":{"name":"ACR open rheumatology","volume":"7 6","pages":"e70068"},"PeriodicalIF":2.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12125274/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144192586","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Trends in Systemic Lupus Erythematous Mortality in the United States, 1999-2022.","authors":"Sagar Patel, Joseph Bettag, Nikita Baral, Abubakar Tauseef, Ali Bin Abdul Jabbar","doi":"10.1002/acr2.70057","DOIUrl":"10.1002/acr2.70057","url":null,"abstract":"<p><strong>Objective: </strong>Systemic lupus erythematosus (SLE) is a chronic autoimmune disease with variable mortality rates among different demographic groups. Despite treatment advancements, disparities in SLE outcomes continue to exist.</p><p><strong>Methods: </strong>This study used the Centers for Disease Control and Prevention Wide-ranging Online Data for Epidemiologic Research database data from 1999 to 2022 to examine SLE-related mortality trends. Age-adjusted mortality rates (AAMRs) were calculated, and Joinpoint regression was employed to evaluate annual percentage changes (APCs) over time for mortality stratified by gender, race, census regions, age groups, and states.</p><p><strong>Results: </strong>A total of 52,430 SLE-related deaths occurred over the study period. The AAMR decreased from 1 per 100,000 in 1999 to 0.78 per 100,000 in 2022. The AAMR of SLE-related deaths decreased by 21% from 1 in 1999 to 0.79 in 2019 (average APC -1.23, 95% confidence interval -1.48 to -0.96). It increased by 21.52% from 0.79 in 2019 to 0.96 in 2021. From 1999 to 2019, men decreased by 33.33% compared to 21.02% in women, whereas women saw a more considerable increase from 2019 to 2021. Non-Hispanic Asians or Pacific Islander patients saw the most decrease (-43.37%), followed by Hispanic patients (-40.60%), non-Hispanic African American patients (-25.83%), and non-Hispanic White patients (-21.43%). Hispanic patients saw the most significant increase from 2019 to 2021, whereas non-Hispanic African American patients had the highest AAMR among all racial and ethnic subgroups from 1999 to 2022. The South had the highest AAMR throughout the study period among census regions.</p><p><strong>Conclusion: </strong>Persistent disparities have been observed in SLE-related mortality rates from 1999 to 2022, with female sex, non-Hispanic African American race, and southern region being disproportionately impacted by worse mortality outcomes.</p>","PeriodicalId":93845,"journal":{"name":"ACR open rheumatology","volume":"7 6","pages":"e70057"},"PeriodicalIF":2.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12174472/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144318925","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Observational studies on glucocorticoid harm should always consider confounding by indication: comment on the article Katz et al.","authors":"Maarten Boers","doi":"10.1002/acr2.70023","DOIUrl":"10.1002/acr2.70023","url":null,"abstract":"","PeriodicalId":93845,"journal":{"name":"ACR open rheumatology","volume":"7 6","pages":"e70023"},"PeriodicalIF":2.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12176451/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144328050","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reply.","authors":"Jiha Lee, Una E Makris","doi":"10.1002/acr2.70084","DOIUrl":"10.1002/acr2.70084","url":null,"abstract":"","PeriodicalId":93845,"journal":{"name":"ACR open rheumatology","volume":"7 6","pages":"e70084"},"PeriodicalIF":2.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12183103/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144369703","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence of Frailty and Associated Factors in a US-Wide Cohort of Rheumatic Diseases.","authors":"Katherine D Wysham, Catherine L A Chang, Namrata Singh, James S Andrews, Kristin Wipfler, Sarah B Lieber, Sebastian E Sattui, Rachael Stovall, Joshua F Baker, Patricia P Katz, Kaleb Michaud","doi":"10.1002/acr2.70046","DOIUrl":"10.1002/acr2.70046","url":null,"abstract":"<p><strong>Objective: </strong>We quantified the prevalence of self-reported frailty and identified associated factors in a US-wide cohort of people with rheumatic and musculoskeletal diseases (RMDs).</p><p><strong>Methods: </strong>Frailty was measured using the FRAIL scale, a patient-reported frailty instrument, in FORWARD, The US-based National Databank for Rheumatic Diseases. Frailty prevalence was determined overall and by individual RMD, which included rheumatoid arthritis, connective tissue diseases (CTDs), osteoarthritis (OA), fibromyalgia, spondyloarthritis (SpA), and vasculitis. Multivariable logistic regression models evaluated the cross-sectional associations between RMDs and frailty, as well as factors associated with frailty within each RMD.</p><p><strong>Results: </strong>Among 4,345 individuals, 1,422 were frail (33%). Participants were on average 67.1 ± 11.6 years of age, 82% were female, and 89% self-identified as White. Difficulty with ambulation was the most common frailty feature. With OA as referent, those with CTD had a higher odds of frailty (odds ratio [OR] 1.44, 95% confidence interval [CI] 1.01-2.04), and those with SpA had a lower odds (OR 0.45, 95% CI 0.31-0.67). Age, female sex, pain, disease severity, disease duration, and elevated body mass index categories were all associated with frailty. In the RMD-stratified analyses, disease severity remained associated with frailty in all RMDs except vasculitis.</p><p><strong>Conclusion: </strong>Frailty was present in 1 in 3 participants with RMDs, a higher prevalence than estimates from the general population, and primarily manifests as difficulty with mobility. Disease severity was consistently associated with an increased odds of frailty across RMDs. Future interventions to improve physical activity and prevent disease damage may improve frailty status in people with RMDs.</p>","PeriodicalId":93845,"journal":{"name":"ACR open rheumatology","volume":"7 6","pages":"e70046"},"PeriodicalIF":2.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12133383/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144217787","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Discriminating Disease Flare From Infection in Febrile Patients With Systemic Lupus Erythematosus in a Safety-Net Hospital System: A Multicenter Study.","authors":"Abhimanyu Amarnani, Flora Liu, Melissa Lee Wilson, Nathan Lim, William Stohl, Leanna Wise","doi":"10.1002/acr2.70051","DOIUrl":"10.1002/acr2.70051","url":null,"abstract":"<p><strong>Objective: </strong>The objective of this study was to assess clinical laboratory parameters that distinguish between disease flare and infection in febrile patients with systemic lupus erythematosus (SLE) at safety-net hospitals in Los Angeles.</p><p><strong>Methods: </strong>We reviewed electronic medical records of patients admitted from August 1, 2016, through July 31, 2019, categorizing them as disease flare, bacterial infection (culture positive), culture-negative infection, and both flare and infection. Laboratory parameters collected within 48 hours of admission (complete blood cell count with differential, liver function panel, erythrocyte sedimentation rate [ESR], C-reactive protein [CRP], C3, C4, lactate, procalcitonin, and ferritin) were analyzed.</p><p><strong>Results: </strong>Several laboratory parameters significantly distinguished febrile patients with disease flare from those with infection. An optimized multivariable logistic regression model revealed that an elevated ESR:CRP ratio (>1.17), low white blood cell (WBC) count (<6.25 × 10⁹/L), low absolute neutrophil count (<5.55 × 10⁹/L), and low CRP (<113 mg/L), C3 (<44.5 mg/dL), and C4 (<13.5 mg/dL) levels helped discriminate disease flare from culture-positive infection. These laboratory parameters yielded areas under the receiving operating characteristic curve of 0.87 (95% confidence interval [CI] 0.76-0.97) for flare versus culture-positive infection and 0.94 (95% CI 0.88-1.00) for flare versus culture-negative infection. These optimized models, using multiple laboratory parameters, significantly outperformed the ESR:CRP ratio alone (P < 0.02) in discriminating flare from infection.</p><p><strong>Conclusion: </strong>The ESR:CRP ratio plus C3 and C4 levels, WBC count, neutrophil count, and monocyte count discriminate flare from either culture-positive or culture-negative infection in febrile patients with SLE. Our findings warrant prospective validation.</p>","PeriodicalId":93845,"journal":{"name":"ACR open rheumatology","volume":"7 6","pages":"e70051"},"PeriodicalIF":2.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12159916/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144276990","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of Delay of Treatment With Disease-Modifying Antirheumatic Drugs in Psoriatic Arthritis: The CorEvitas Psoriatic Arthritis/Spondyloarthritis Registry.","authors":"Philip J Mease, Miroslawa Nowak, Jiyoon Choi, Thomas Lehman, Antoine Sreih, Kaylee Ho, Nicole Middaugh, Alexis Ogdie","doi":"10.1002/acr2.70019","DOIUrl":"10.1002/acr2.70019","url":null,"abstract":"<p><strong>Objective: </strong>Our objective was to describe characteristics and compare clinical and patient-reported outcomes (PROs) for disease-modifying antirheumatic drug (DMARD)-naive patients with psoriatic arthritis (PsA) who initiate DMARD therapy early versus late.</p><p><strong>Methods: </strong>Patients with PsA from the CorEvitas PsA/Spondyloarthritis Registry were classified by reported time between diagnosis and DMARD initiation. Early and late initiators were patients whose first DMARD treatment occurred ≤1 year or >1 year, respectively, following PsA diagnosis. Change in disease activity and PRO measures from initiation to the six-month follow-up was calculated for each group; mean change for each continuous outcome and proportion achieving binary outcomes were reported for early and late initiators. Associations of early versus late DMARD initiation with disease activity and PROs at six months were calculated using adjusted linear and Poisson regressions.</p><p><strong>Results: </strong>The mean patient age was 53 years, more than half of patients were female, and 90% of patients were White. Mean time from diagnosis to DMARD initiation was 0.2 years in early initiators (n = 229, 79%) and 8.6 years in late initiators (n = 62, 21%). In adjusted analyses, achievement of minimal disease activity (adjusted risk ratio 2.01, 95% confidence interval [CI] 1.03-4.40) and mean change in Clinical Disease Activity Index (β -3.4, 95% CI -6.2 to -0.49) were statistically different between early and late initiators.</p><p><strong>Conclusion: </strong>Among patients from the PsA registry, those who had both early and late initiation of DMARD therapy experienced improvements throughout all disease activity and PROs across six months of treatment. Minimal disease activity, a key treatment target, was more likely observed in early initiators, highlighting the value of early identification and treatment. Delay of Treatment With Disease-Modifying Antirheumatic Drugs in Psoriatic Arthritis: The CorEvitas Psoriatic Arthritis/Spondyloarthritis Registry.</p>","PeriodicalId":93845,"journal":{"name":"ACR open rheumatology","volume":"7 6","pages":"e70019"},"PeriodicalIF":2.8,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12183766/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144478196","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"How and Who? Examining Real-World Evidence of Engagement and Use of an Electronic Patient-Reported Outcome Smartphone Application in Routine Clinical Care for Patients With Inflammatory Arthritides.","authors":"Iuliia Biliavska, Erik Lenguerrand, Jonathan H Tobias, Philip D H Hamann","doi":"10.1002/acr2.70049","DOIUrl":"10.1002/acr2.70049","url":null,"abstract":"<p><strong>Objective: </strong>We evaluate the use of an app to remotely collect electronic patient-reported outcomes (ePROs) in patients attending routine rheumatology clinics with inflammatory arthritis (IA) over a four year period.</p><p><strong>Methods: </strong>This is a secondary analysis of real-world data obtained from patients with IA who attended routine appointments between 2018 and 2022. Patients used an app to track their disease course by using Routine Assessment of Patient Index Data 3 (RAPID3), Health Assessment Questionnaire - Disability Index, or self-assessing tender and swollen joint counts. Elapsed days of the app use, number, and time between ePROs reports were analyzed using Poisson and Tobit regression models. Results were stratified by gender, age, diagnosis, baseline disease severity, and disability.</p><p><strong>Results: </strong>At least one ePRO report was provided by 673 patients. Mean age was 53.7 ± 13.9 years; 458 (68%) were female. RAPID3 was reported by 613 (91%) patients, 531 (79%) provided more than one RAPID3, and 82 (12%) provided one RAPID3; there was no difference between groups stratified by gender, age, IA type, and baseline arthritis severity. Median engagement was 14.8 months (interquartile range 12.8-17). The proportion of enrolled patients completing a RAPID3 every month reduced from 91% at baseline to 38% at 6 months, and 24% at month 12. Older patients (60-69 years old) were more likely to be long-term users than those aged less than 50 years old (P < 0.006). Patients aged over 60 provided more reports than younger users (P < 0.0001). Gender, baseline arthritis activity, and disability level were not associated with the length or frequency of app use.</p><p><strong>Conclusion: </strong>This analysis offers insights into engagement and long-term sustainability of remote ePRO collection in a real-world rheumatology setting.</p>","PeriodicalId":93845,"journal":{"name":"ACR open rheumatology","volume":"7 5","pages":"e70049"},"PeriodicalIF":2.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12053926/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144054986","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Key Features of Effective Yoga Interventions in Addition to Standard Medical Treatment for Rheumatoid Arthritis: A Systematic Review and Meta-Analysis.","authors":"Isha Biswas, Jaspreet Kaur, Fiona Pearce, Sarah Lewis, Kaushik Chattopadhyay","doi":"10.1002/acr2.70054","DOIUrl":"10.1002/acr2.70054","url":null,"abstract":"<p><strong>Objective: </strong>This systematic review aimed to synthesize the content, structure, and delivery characteristics of effective yoga interventions in addition to standard medical treatment for rheumatoid arthritis (RA).</p><p><strong>Methods: </strong>The Joanna Briggs Institute guidelines were followed. Seventeen databases were searched for randomized controlled trials (RCTs) assessing yoga's effectiveness in treating RA outcomes (disease activity score, pain, and function). Meta-analyses and narrative synthesis were conducted.</p><p><strong>Results: </strong>Nine articles representing five RCTs were included and had low methodological quality scores. Yoga interventions, in addition to standard medical treatment, improved disease activity scores (standardized mean difference [SMD] -0.46, 95% confidence interval [CI] -0.73 to -0.18) and function (SMD -0.42, 95% CI -0.78 to -0.07) but did not effectively reduce pain (SMD -1.06, 95% CI -2.62 to 0.50) compared to standard medical treatment alone. All five RCTs found yoga's beneficial effects on one or more outcomes. All yoga interventions included center-based (supervised, group) sessions, and two included additional home-based (unsupervised, individual) sessions. All interventions incorporated 20 yogic poses (6 standing, 5 supine, 5 prone, and 4 seated), 7 breathing practices, and 4 meditation and relaxation practices. Two interventions offered RA-specific yogic pose modifications. Center-based sessions were delivered at least once weekly for 8 weeks' median duration and around 68 minutes per session. Home-based yoga was recommended thrice weekly for a 10-week mean duration and 40 minutes per session.</p><p><strong>Conclusion: </strong>Yoga might be useful in addition to standard medical treatment for RA. Given previous studies' methodological limitations, a high-quality RCT should be conducted based on our synthesized key features of effective yoga interventions.</p>","PeriodicalId":93845,"journal":{"name":"ACR open rheumatology","volume":"7 5","pages":"e70054"},"PeriodicalIF":2.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12064992/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144058650","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy of Immersive Virtual Reality Combined With Multisensor Biofeedback on Chronic Pain in Fibromyalgia: A Pilot Randomized Controlled Trial.","authors":"Luca Chittaro, Simone Longhino, Marta Serafini, Sofia Cacioppo, Luca Quartuccio","doi":"10.1002/acr2.70048","DOIUrl":"10.1002/acr2.70048","url":null,"abstract":"<p><strong>Objective: </strong>Fibromyalgia (FM) is a syndrome marked by chronic pain, fatigue, and mood disorders. Nonpharmacologic strategies are recommended to avoid overuse of opioids or nonsteroidal anti-inflammatory drugs, but current approaches often provide limited relief. This study aimed to preliminarily assess the efficacy and feasibility of a new combined intervention of immersive virtual reality with multisensor biofeedback (IVR-BF) in FM management.</p><p><strong>Methods: </strong>In this single-center, pilot, open-label, randomized controlled trial, adult patients with FM were randomly assigned 1:1 to either the treatment (TR) group, receiving IVR-BF immediately, or a waitlist control (WL) group, receiving IVR-BF after the TR group completed treatment. The primary outcome was reduction in visual analog scale (VAS) pain scores in the TR group, after five IVR-BF sessions, compared to the WL group, after the waiting period. Secondary outcomes included improvements in FM impact (FM Impact Questionnaire [FIQ] score) and qualitative aspect of pain (Short-form McGill Pain Questionnaire [SF-MPQ] score). A longitudinal analysis was conducted across all patients to examine the trends in VAS pain, SF-MPQ, and FIQ score during the trial.</p><p><strong>Results: </strong>Fifty patients were screened, and 20 female patients (10 TR and 10 WL) completed the trial and were analyzed. Those in the TR group showed significantly lower VAS pain scores compared to those in the WL group (P = 0.011), along with significant improvement in the FIQ score (P = 0.018). The longitudinal analysis revealed progressive improvements in VAS pain, SF-MPQ, and FIQ score, supported by physiologic improvements (heart rate variability, respiratory rate, skin conductance). No significant safety concerns were reported. Patients expressed a high level of satisfaction with the IVR experience.</p><p><strong>Conclusion: </strong>IVR-BF is a feasible treatment that shows potential in reducing pain and improving quality of life in patients with FM, supporting the need for larger trials to further evaluate its efficacy.</p>","PeriodicalId":93845,"journal":{"name":"ACR open rheumatology","volume":"7 5","pages":"e70048"},"PeriodicalIF":2.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12080186/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144082618","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}