International Journal of Rheumatic Diseases最新文献

Objective: This study aimed to evaluate the diagnostic utility of combining musculoskeletal ultrasound (MSUS) with serum levels of hypoxia-inducible factor-1α (HIF-1α) and cyclooxygenase-2 (COX-2) for acute gouty arthritis (AGA).

Methods: The study included 112 patients hospitalized for gouty arthritis between February 2021 and February 2022. Of these, 60 patients presented with AGA, while 62 had non-acute gouty arthritis (NAGA). Semi-quantitative musculoskeletal ultrasound (MSUS) scores and serum levels of hypoxia-inducible factor-1α (HIF-1α) and cyclooxygenase-2 (COX-2) were compared between the two groups. A Disease Activity Score-28 (DAS28) was used to further classify the AGA group into low-activity and high-activity subgroups.

Results: MSUS scores, DAS28, and serum levels of HIF-1α and COX-2 were significantly elevated in the AGA group compared to the NAGA group (p < 0.05). Furthermore, within the AGA group, the high-activity subgroup exhibited higher MSUS semi-quantitative scores, DAS28 scores, and serum levels of HIF-1α and COX-2 compared to the low-activity subgroup (p < 0.05). Pearson correlation analysis revealed a positive correlation between the MSUS semi-quantitative score and serum levels of HIF-1α, COX-2, as well as the DAS28 score in patients diagnosed with AGA (p < 0.05). The combined application of MSUS semi-quantitative scoring and serological markers provided significantly enhanced diagnostic accuracy for AGA and better assessment of disease activity compared to any individual marker.

Conclusions: MSUS and serum HIF-1α and COX-2 represent valuable tools for assessing the acute phase and disease activity of AGA. The combined diagnostic approach demonstrates superior effectiveness and holds potential for broader clinical application.

Objectives: This meta-analysis aimed to explore the impact of biologics on the development of cardiovascular events (CEs) in patients with ankylosing spondylitis (AS).

Methods: We collected literature related to the effects of biologics on CEs in AS patients through computerized searches of Embase, Web of Science, PubMed, and the Cochrane Library, as well as manual searches. The literature retrieval spanned from the inception of these databases up to March 28, 2025. Literature selection and data extraction were performed in accordance with predefined eligibility criteria. The Newcastle-Ottawa Scale and the Cochrane Risk of Bias tool for randomized trials were utilized to evaluate the quality of eligible articles. Data analysis was performed using STATA 15.0.

Results: This meta-analysis incorporated 23 eligible articles encompassing 92 623 subjects. The results illustrated that the biologics group had a lower overall CE risk than the non-biologics group (RR = 0.61, 95% CI, 0.44-0.84, p = 0.003). Specifically, the biologics group demonstrated a reduced risk of myocardial infarction (RR = 0.42, 95% CI, 0.27-0.65, p < 0.001) and ischemic heart disease (RR = 0.09, 95% CI, 0.04-0.17, p < 0.001). However, there were no significant differences in the risk of heart failure between the two groups (p > 0.05). There was no statistically significant variation in the occurrence of CEs between the two groups with the use of etanercept, ixekizumab, or golimumab (p > 0.05).

Conclusion and relevance: Overall, biologic use may mitigate the risk of CEs, particularly impacting IHD and MI. Given the limitations inherent in the current body of research, additional large randomized controlled trials examining other CE subtypes and specific drug effects are needed.

Trial registration: Not applicable.

Aim: This post hoc analysis of all-case post-marketing surveillance in Japanese patients with rheumatoid arthritis assessed risk factors for major adverse cardiovascular events (MACE), malignancies, and serious infections (SI).

Methods: Data of patients who received tofacitinib (≥ 1 dose) were stratified by each combination of age (< 50 years and ≥ 50 years) and the number of cardiovascular (CV) risk factors (0 or ≥ 1). Incidence rates (IRs) of each adverse event (AE)-MACE, malignancies, and SI, stratified by age, CV risk factors, and patient background factors were calculated.

Results: Overall, 7021 patients were stratified by each combination of age (< 50 and ≥ 50 years) and the number of CV risk factors (0 or ≥ 1). The IRs for malignancies and SI were higher in patients aged ≥ 50 vs. < 50 years. The IRs for all AEs were higher in patients with ≥ 1 CV risk factors than 0 CV risk factors. Older age was strongly correlated with all AEs. MACE and SI were more likely to be affected by any CV risk factors, while the other AE was influenced by some of them.

Conclusions: Older age was a risk factor for all AEs (MACE, malignancies, and SI). MACE risk was also increased in patients with ≥ 1 CV risk factors versus those without. SI risk might also be increased in patients with ≥ 1 CV risk factors.