Reumatologia clinica最新文献

{"title":"Lupus nephritis in Mexican patients: Response to intensive therapy","authors":"Georgina Aguilera Barragán-Pickens ,&nbsp;David Herrera van-Oostdam ,&nbsp;Fedra Irazoque-Palazuelos ,&nbsp;Miguel Saavedra-Salinas ,&nbsp;Sergio Cerpa-Cruz ,&nbsp;Claudia Mendoza-Pinto ,&nbsp;Luis Valdez ,&nbsp;Enrique Cuevas Orta ,&nbsp;Eva Santillán-Guerrero ,&nbsp;Carlos Abud-Mendoza ,&nbsp;LUNPOS GROUP","doi":"10.1016/j.reumae.2025.501896","DOIUrl":"10.1016/j.reumae.2025.501896","url":null,"abstract":"<div><h3>Introduction</h3><div>lupus nephritis represents a challenge in treatment. In spite of intensive therapy, is common a sustained renal incomplete response.</div></div><div><h3>Objective</h3><div>To describe different responses to adequate/intensive treatment to lupus nephritis.</div></div><div><h3>Methods</h3><div>Observational retrospective study, including Mexican<!--> <!-->&gt;<!--> <!-->18 years old patients with lupus nephritis who visited tertiary rheumatology centers in several urban cities in Mexico. SLE was diagnosed according to 1997 ACR. The exclusion criteria were follow-up<!--> <!-->&lt;<!--> <!-->6 months and reduced GFR due to other comorbidities such as diabetes or other primary renal disease.</div></div><div><h3>Results</h3><div>We included 193 patients with a mean age of 34 years, 80% were women. Biopsy was available in 166 patients (86%): class IV in 42%, class III in 23%, the mean of activity and chronicity index were 6.4 and 2.6 respectively; class V represented 10.2%. The least frequent class was Class II (9%), and mixed classes (III or IV<!--> <!-->+<!--> <!-->V) accounted for 11%.</div><div>Cyclophosphamide (CYC) was used in 146 patients (76.6%), mycophenolate (MMF) in 144 and tacrolimus (TCR) in 28. In most cases, were used combination therapy.</div><div>Only 38 patients had a follow-up of less than 1 year; 16 (42%) had CR, 13 (34%) had NR, and 9 (23%) PR. 55% of patients with PR received a multitarget protocol, 75% of CR received the NIH protocol, and 61.5% of NR the NIH protocol.</div><div>Of patients followed up for more than a year (155), 35% had persistently inactive response, 24.5% were relapsing–remitting, 20% were chronically active, and 20% showed a mixed pattern.</div></div><div><h3>Conclusions</h3><div>Prevalence of persistent or intermittent activity patterns was high (64.5%). Most Mexican rheumatologists switched to more intensive treatment, adding a second or third drug.</div></div>","PeriodicalId":94193,"journal":{"name":"Reumatologia clinica","volume":"21 5","pages":"Article 501896"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144563653","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ocular inflammatory manifestations in patients with rheumatoid arthritis","authors":"Raul E. Ruiz-Lozano ,&nbsp;Luis Arnaldo Prida-Espaillat ,&nbsp;Reinaldo A. Moll-Auais ,&nbsp;Eugenia M. Ramos-Dávila ,&nbsp;Manuel E. Quiroga-Garza ,&nbsp;Aaron Zhao ,&nbsp;Ali Khodor ,&nbsp;Amr Almobayed ,&nbsp;David Vega-Morales ,&nbsp;Alejandro Rodriguez-Garcia","doi":"10.1016/j.reumae.2025.501891","DOIUrl":"10.1016/j.reumae.2025.501891","url":null,"abstract":"<div><h3>Purpose</h3><div>This review emphasizes the significance of clinical findings, pathogenic mechanisms, diagnosis, management, and complications related to the ocular manifestations of rheumatoid arthritis, underscoring the need for interdisciplinary collaboration between rheumatologists and ophthalmologists.</div></div><div><h3>Methods</h3><div>A comprehensive literature search was conducted using PubMed, Embase, Web of Science, and Google Scholar for all English-language articles published from inception to July 2024. The following search string was utilized: (“rheumatoid arthritis”) AND (“dry eye disease” OR “dry eye” OR “episcleritis” OR “scleritis” OR “peripheral ulcerative keratitis” OR “central corneal ulcer*” OR “paracentral corneal ulcer*” OR “ocular manifestations” OR “ocular involvement”). Letters to the editor, editorials, short communications, case reports, case series, review articles, and original articles were reviewed, along with relevant references from those publications.</div></div><div><h3>Results</h3><div>The most common ocular manifestations in patients with rheumatoid arthritis include keratoconjunctivitis sicca (dry eye disease), episcleritis, scleritis, peripheral ulcerative keratitis, and central and paracentral corneal ulceration. Ocular involvement can be the initial presentation of the disease and may correlate with disease activity. If left untreated, ocular inflammation in rheumatoid arthritis can lead to permanent vision loss.</div></div><div><h3>Conclusions</h3><div>The diverse ocular inflammatory manifestations in RA patients may indicate either the disease's initial presentation or the status of extra-articular activity. A multidisciplinary approach that includes rheumatologists and ophthalmologists is essential to prevent sight-threatening complications.</div></div>","PeriodicalId":94193,"journal":{"name":"Reumatologia clinica","volume":"21 5","pages":"Article 501891"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144563654","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"RS3PE post-COVID: New evidence of autoimmune diseases following SARS-CoV-2 infection","authors":"Begoña Miquel Veyrat,&nbsp;José Chordá Ribelles,&nbsp;Mar Gómez Martí","doi":"10.1016/j.reumae.2025.501898","DOIUrl":"10.1016/j.reumae.2025.501898","url":null,"abstract":"","PeriodicalId":94193,"journal":{"name":"Reumatologia clinica","volume":"21 5","pages":"Article 501898"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144532172","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Some aspects of body thermoregulation, environmental temperature and vascular hypothesis in systemic sclerosis patients","authors":"Francisco Javier Olmedo Garzón","doi":"10.1016/j.reumae.2025.501894","DOIUrl":"10.1016/j.reumae.2025.501894","url":null,"abstract":"<div><div>In line with vascular hypothesis of systemic sclerosis (SSc), it is proposed that visceral Raynaud's phenomenon (RP)/endothelial dysfunction causes severe oxygen supply/consumption imbalance in internal organs, leading to visceral ischemic failure in early SSc, especially with cold environmental temperature (Te) and severe RP. There would also be a decrease in body thermogenesis and a decrease in heat loss caused by chronic visceral ischemia and by systemic vasculopathy, respectively. At any given time, these disorders could produce low core temperature (Tc). Hence, SSc is proposed as a candidate cause of secondary hypothermia. It is suggested that SSc could be an adaptive response in cold Te to systemic endothelial damage with secondary chronic visceral ischemia/slow metabolism. This pathophysiological mechanism is proposed in early visceral failure, prognosis, SSc phenotype according to ethnicity, and other manifestations. The impact of Te and Tc on SSc warrants further investigations.</div></div>","PeriodicalId":94193,"journal":{"name":"Reumatologia clinica","volume":"21 5","pages":"Article 501894"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144563655","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"One-year retention rate of ixekizumab in patients with psoriatic arthritis and axial spondyloarthritis: Real-world data from the BIOBADASER registry","authors":"Clementina López-Medina ,&nbsp;Lucía Otero-Varela ,&nbsp;Fernando Sánchez-Alonso ,&nbsp;Vega Jovaní ,&nbsp;Lorena Expósito-Pérez ,&nbsp;Sheila Melchor-Díaz ,&nbsp;Yanira Pérez-Vera ,&nbsp;Paula Pretel-Ruiz ,&nbsp;Javier Manero ,&nbsp;Antonio Mera-Varela ,&nbsp;Lourdes Mateo ,&nbsp;Dolores Ruiz-Montesino ,&nbsp;José Andrés Lorenzo-Martín ,&nbsp;Teresa Pedraz-Penalva ,&nbsp;Isabel Castrejón","doi":"10.1016/j.reumae.2025.501872","DOIUrl":"10.1016/j.reumae.2025.501872","url":null,"abstract":"<div><h3>Introduction</h3><div>Ixekizumab (IXE) is a selective interleukin 17A (IL-17A) monoclonal antibody approved for the treatment of psoriatic arthritis (PsA) and axial spondyloarthritis (axSpA). Limited real-world data are available on its retention rate and effectiveness. The objective of this study was to assess the one-year retention rate of IXE in a real-world cohort of patients with axSpA and PsA and to identify potential predictive factors for drug retention.</div></div><div><h3>Method</h3><div>Prospective and observational study derived from BIOBADASER 3.0, a multicenter registry of advanced therapies including patients who have ever received IXE for PsA or axSpA. The one-year retention rate of the treatment in both diseases was evaluated using Kaplan–Meier curves and multivariable Cox regressions.</div></div><div><h3>Results</h3><div>A total of 335 patients ever exposed to IXE were included (PsA<!--> <!-->=<!--> <!-->250; axSpA<!--> <!-->=<!--> <!-->85). IXE was used as first-line treatment only in 5.3% of patients, and after TNFi in 94.7% of patients. In axSpA and PsA, drug survival at 12 months was 69.5% (95% CI 64.0–74.3), slightly higher in PsA (71.3% (95% CI 65.0–75.6)) versus axSpA (63.8% (95% CI 51.5–73.7)). The multivariable Cox regression models showed that female sex and longer disease duration were factors associated with IXE withdrawal in the whole population, while concomitant use of methotrexate reduced the risk of discontinuation.</div></div><div><h3>Conclusions</h3><div>In this real-world study, IXE showed an acceptable retention rate in patients with PsA and axSpA after one year of follow-up. Female sex and longer disease duration were associated with risk of withdrawal.</div></div>","PeriodicalId":94193,"journal":{"name":"Reumatologia clinica","volume":"21 5","pages":"Article 501872"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144563657","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hypophosphatemic osteomalacia secondary to mesenchymal tumor","authors":"Aurora González Murcia ,&nbsp;Isabel Valencia Ramírez ,&nbsp;Teresa Catalina Plaza Aguado ,&nbsp;José Antonio González Ferrández","doi":"10.1016/j.reumae.2025.501897","DOIUrl":"10.1016/j.reumae.2025.501897","url":null,"abstract":"<div><div>We present the case of a 42-year-old male patient who was admitted for the study of axial and pelvic girdle pain, being diagnosed with hypophosphatemic osteomalacia secondary to a mesenchymal tumour after ruling out other causes of osteomalacia.</div></div>","PeriodicalId":94193,"journal":{"name":"Reumatologia clinica","volume":"21 5","pages":"Article 501897"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144532171","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Do psychosocial factors predict disease severity in fibromyalgia syndrome?","authors":"Hasan Huseyin Gokpinar ,&nbsp;Cihan Caner Aksoy ,&nbsp;Muhammed Fatih Ozdemir ,&nbsp;İsmail Saraçoğlu","doi":"10.1016/j.reumae.2025.501893","DOIUrl":"10.1016/j.reumae.2025.501893","url":null,"abstract":"<div><h3>Objective</h3><div>The aim of this study was to examine anxiety, depression, pain centralization, and pain catastrophization in patients with fibromyalgia syndrome (FMS) and evaluate whether these factors are predictors of disease severity in FMS.</div></div><div><h3>Patient and methods</h3><div>Depression was assessed with the Beck Depression Inventory (BDI), anxiety with the Beck Anxiety Inventory (BAI), pain centralization with the Centrality of Pain Scale (COPS), pain catastrophization with the Pain Catastrophizing Scale (PCS), and FMS severity with the Fibromyalgia Impact Questionnaire (FIQ). Two separate hierarchical linear regression analyses were performed to determine whether there was a significant association between disease severity and the assessed psychosocial factors.</div></div><div><h3>Results</h3><div>The study was completed with a total of 48 FMS patients (mean age 49.54<!--> <!-->±<!--> <!-->8.28 years). FIQ score was moderately correlated with COPS score (<em>r</em>_Spearman <!-->=<!--> <!-->0.670, <em>p</em> <!-->&lt;<!--> <!-->0.001) and PCS score (<em>r</em>_Spearman <!-->=<!--> <!-->0.663, <em>p</em> <!-->&lt;<!--> <!-->0.001). In the logistic regression model, COPS and PCS scores were significant predictors of FIQ score. The predictive variables explained 43.7% of the variation in FIQ score.</div></div><div><h3>Conclusion</h3><div>This study showed that pain centralization and catastrophization can be considered indicators of disease severity in FMS. The results suggest that routine assessment of pain centralization and pain catastrophizing behaviors in individuals with FMS is needed and that cognitive behavioral therapy approaches may be beneficial in reducing disease severity.</div></div>","PeriodicalId":94193,"journal":{"name":"Reumatologia clinica","volume":"21 5","pages":"Article 501893"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144563656","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Study of the impact of the inclusion of global pain and functional capacity assessment in the definition of remission and its maintenance for rheumatoid arthritis. Aims and methodology","authors":"Alejandro Balsa ,&nbsp;Daniel Seoane-Mato ,&nbsp;Marta Domínguez-Álvaro ,&nbsp;Mercedes Alperi ,&nbsp;Virginia Ruiz-Esquide ,&nbsp;Javier Bachiller-Corral ,&nbsp;Federico Díaz-González ,&nbsp;on behalf of the Remission-RA Study group","doi":"10.1016/j.reumae.2025.501895","DOIUrl":"10.1016/j.reumae.2025.501895","url":null,"abstract":"<div><h3>Background and objective</h3><div>The SUMAR project established a definition for remission that includes the patient's perspective (global assessment of pain and HAQ) in the definition of remission in rheumatoid arthritis (RA). This new definition needs to be assessed on clinical practice. The main objective of the RA-Remission study is to estimate the proportion of patients in sustained remission according to SUMAR definition through 2-year follow-up, among patients in SUMAR remission at baseline. This manuscript describes the objectives and methodology of the study.</div></div><div><h3>Materials and methods</h3><div>This is a longitudinal, prospective, observational and multicentre study, involving 10 centres. Patients with RA who have achieved clinical remission in accordance to their attending rheumatologist clinical judgement within the last 6 months will be included. Follow-up visits will take place at 3, 6, 12, 12, 18 and 24 months. Ultrasound assessment of the power Doppler (PD) signal for 30 joints and 6 tendon regions will be performed at each participating centre by an expert blinded to all other study findings. Definitions of remission according to SUMAR, PD and activity indices will be used. Sustained remission will be considered for each of the definitions when the patient in remission at the baseline visit maintains it during all follow-up visits. To estimate the proportion of patients maintaining remission at two years with an accuracy of at least 6%, 180 patients will need to be recruited.</div></div><div><h3>Discussion and conclusions</h3><div>The main strength of the design is the use of ultrasound assessment as the gold standard for assessing inflammatory activity.</div></div>","PeriodicalId":94193,"journal":{"name":"Reumatologia clinica","volume":"21 5","pages":"Article 501895"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144532173","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of serum IgG4 levels as a screening tool for IgG4-related disease: Data from a retrospective study","authors":"Pablo Martínez Calabuig ,&nbsp;Jorge Juan Fragío Gil ,&nbsp;Roxana González Mazarío ,&nbsp;Laura Salvador Maicas ,&nbsp;Mireia Lucía Sanmartín Martínez ,&nbsp;Antonio Sierra Rivera ,&nbsp;Laura Abenza Barberá ,&nbsp;María Cristina Sabater Abad ,&nbsp;Francesc Puchades Gimeno ,&nbsp;Inmaculada Castelló Miralles ,&nbsp;Amalia Rueda Cid ,&nbsp;Cristina Campos Fernández ,&nbsp;on behalf of the HGUV IgG4-Related Disease Working Group","doi":"10.1016/j.reumae.2025.501852","DOIUrl":"10.1016/j.reumae.2025.501852","url":null,"abstract":"<div><h3>Background and objective</h3><div>IgG4-related disease (IgG4-RD) is a systemic, immune-mediated, fibro-inflammatory condition with an uncertain etiology and pathophysiology that can affect multiple organs, presenting common clinical, radiological, and serological features. Although the disease is associated with IgG4, serum levels are not elevated in all patients and have also been described in other diseases. The aim of this study is to evaluate the clinical utility of elevated serum IgG4 as a screening marker in the suspicion of IgG4-related disease.</div></div><div><h3>Materials and methods</h3><div>A retrospective single-center study was conducted, analysing serological IgG4 test requests from electronic medical records of patients ordered by various hospital departments from January 2010 to June 2023. Only those with elevated IgG4 levels were included in the analysis. Additionally, demographic data and final diagnoses, including those with IgG4-RD, were collected.</div></div><div><h3>Results</h3><div>A total of 2288 test requests were reviewed, of which 247 showed elevated IgG4 levels (181 after excluding duplicates). Among the patients with elevated IgG4, only 11 met the criteria for IgG4-RD based on the 2011 Umehara-Okazaki classification and its 2020 update. However, only 6 patients (3.31%) met the more recent 2019 ACR/EULAR classification criteria for IgG4-RD. In the remaining patients with elevated IgG4, the most common diagnoses were respiratory diseases, such as COPD and asthma, followed by systemic autoimmune diseases, primarily SLE, RA, and EGPA. Elevated IgG4 levels were also observed in malignant neoplasms, predominantly lung and hematologic cancers.</div></div><div><h3>Conclusions</h3><div>Our study highlights that elevated IgG4 levels are not exclusive to IgG4-RD and can also be observed in various respiratory diseases (e.g., COPD), autoimmune diseases (e.g., SLE and RA), and neoplasms (e.g., lung cancer).</div></div>","PeriodicalId":94193,"journal":{"name":"Reumatologia clinica","volume":"21 4","pages":"Article 501852"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144096600","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Raoul Dufy: Color and resilience in the fight against rheumatoid arthritis","authors":"Fernando Canillas,&nbsp;Marta Canillas","doi":"10.1016/j.reumae.2025.501847","DOIUrl":"10.1016/j.reumae.2025.501847","url":null,"abstract":"<div><div>Raoul Dufy was born in 1877 in the city of Le Havre, France. He showed an early interest in painting and attended the École des Beaux Arts in Paris, where he was influenced by Impressionism and later by Fauvism and Cubism. He achieved a style of his own, marked by colour. His paintings depicted modern life, often with bright colours and energetic scenes of urban and social life. In 1935, he developed severe rheumatoid arthritis, which affected his hands and joints. Despite this, he continued to create art until his death. He underwent numerous medical treatments of the time. In 1950, he was invited to the United States to participate in initial ACTH and cortisone therapies and achieved a significant improvement. He returned to France, but died in 1953 at the age of 76 from an intestinal haemorrhage. His artistic legacy and his strength to face this disease are an inspiration for the future.</div></div>","PeriodicalId":94193,"journal":{"name":"Reumatologia clinica","volume":"21 4","pages":"Article 501847"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144228105","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}