International Journal of Rheumatic Diseases最新文献

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Clinical effectiveness of baricitinib and abatacept in patients with rheumatoid arthritis 类风湿性关节炎患者使用巴利替尼和阿巴他赛普的临床疗效。

IF 2.4 4区医学 Q2 RHEUMATOLOGY

International Journal of Rheumatic Diseases

Pub Date : 2024-11-10 DOI: 10.1111/1756-185X.15414

Shuji Asai, Nobunori Takahashi, Kenya Terabe, Yutaka Yoshioka, Toshihisa Kojima, Tomonori Kobayakawa, Yasumori Sobue, Tatsuo Watanabe, Yuji Hirano, Yasuhide Kanayama, Takefumi Kato, Masahiro Hanabayashi, Mochihito Suzuki, Shiro Imagama

Aim

The objective of this study was to compare the clinical effectiveness of baricitinib and abatacept in patients with rheumatoid arthritis (RA).

Methods

This study included 274 patients treated with abatacept and 241 treated with baricitinib who were followed for >52 weeks. Potential treatment selection bias was addressed by using inverse probability of treatment weighting. The paired t-test was used to assess differences in Clinical Disease Activity Index (CDAI) score relative to baseline. A generalized estimating equation was used to compare the two treatment groups.

Results

The estimated mean CDAI score was 18.2 at baseline and significantly decreased to 12.6 at 4 weeks, 8.9 at 12 weeks, 7.4 at 24 weeks, and 6.1 at 52 weeks in the abatacept group. The estimated mean CDAI score was 18.6 at baseline and significantly decreased to 9.5 at 4 weeks, 6.5 at 12 weeks, 5.7 at 24 weeks, and 5.5 at 52 weeks in the baricitinib group. The baricitinib group had significantly lower CDAI scores at 4, 12, and 24 weeks compared to the abatacept group. Subgroup analyses revealed that this difference was evident among patients with high disease activity and without concomitant use of methotrexate but was less pronounced among those with remission to moderate disease activity status with methotrexate use.

Conclusion

Both baricitinib and abatacept were effective in reducing disease activity in patients with RA. Baricitinib demonstrated potential advantages over abatacept in terms of early disease control, particularly in patients with high disease activity and without methotrexate use.

目的：本研究旨在比较类风湿关节炎（RA）患者服用巴利昔尼和阿巴他赛普的临床疗效：这项研究纳入了274名接受阿巴他赛治疗的患者和241名接受巴利替尼治疗的患者，这些患者的随访时间均超过52周。通过使用反概率治疗加权法解决了潜在的治疗选择偏倚问题。采用配对t检验评估临床疾病活动指数（CDAI）评分相对于基线的差异。使用广义估计方程比较两个治疗组：阿巴他赛普治疗组的估计平均CDAI评分基线为18.2分，4周时显著降至12.6分，12周时降至8.9分，24周时降至7.4分，52周时降至6.1分。巴利昔尼组的CDAI估计平均得分在基线时为18.6分，4周时显著降至9.5分，12周时降至6.5分，24周时降至5.7分，52周时降至5.5分。与阿帕替尼组相比，巴利昔尼组在4周、12周和24周时的CDAI评分明显降低。亚组分析显示，这种差异在疾病活动度高且未同时使用甲氨蝶呤的患者中很明显，但在疾病活动度缓解至中度且使用甲氨蝶呤的患者中不太明显：结论：巴利替尼和阿巴他赛普都能有效降低RA患者的疾病活动度。在早期疾病控制方面，巴利昔尼比阿巴西普更具潜在优势，尤其是在疾病活动度高且未使用甲氨蝶呤的患者中。

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引用次数: 0

Rheumatic manifestations and sequela of acute parvovirus B19 infection in hospitalized adult population 住院成人急性副病毒 B19 感染的风湿表现和后遗症。

IF 2.4 4区医学 Q2 RHEUMATOLOGY

International Journal of Rheumatic Diseases

Pub Date : 2024-11-08 DOI: 10.1111/1756-185X.15409

Fadi Hassan, Wasim Khoury, Rula Daood, Amir Saab, Mohammad E. Naffaa, Helana Jeries

Background

Parvovirus B19 infection has been associated with various clinical entities including musculoskeletal manifestations and the development of different autoimmune diseases. The aim of our study is to examine the musculoskeletal manifestations associated with acute parvovirus B19 infection and the possible development of chronic autoimmune rheumatic diseases.

Patients and Methods

Retrospective cohort study that included adult hospitalized patients diagnosed with an acute parvovirus B19 infection between 1 January 2021 and 1 February 2024. Subjects were followed-up for 6–12 months after hospitalization aiming to identify patients who developed chronic autoimmune rheumatic diseases.

Results

The study included 23 patients diagnosed with acute parvovirus B19 infection. Patients were predominantly females (16, 69.6%) with mean age at diagnosis of 39.3 ± 13.11 years. Most patients were Jewish (15, 65.2%). The two most common acute symptoms were fever (82.6%) and myalgia (56.5%). Polyarthritis was present only in three patients (13%) and all of them had wrists involvement. Anti-nuclear antibodies and rheumatoid factor were the most common autoantibodies present with equal prevalence each (13%). Five patients were treated with prednisone during the acute phase (21%), two (8.7%) of them needed drug escalation and were subsequently treated with hydroxychloroquine and methotrexate. One patient developed systemic lupus erythematosus during the first 6 months of follow-up.

Conclusion

Musculoskeletal manifestations developing during acute parvovirus B19 are usually self-limited with only a small minority of patients developing chronic autoimmune diseases. It is crucial to differentiate self-limited manifestations related to acute parvovirus B19 from idiopathic autoimmune diseases aiming to avoid unnecessary immunosuppressive therapy.

背景：副病毒 B19 感染与多种临床症状有关，包括肌肉骨骼表现和不同自身免疫性疾病的发展。我们的研究旨在探讨与急性 parvovirus B19 感染相关的肌肉骨骼表现以及慢性自身免疫性风湿病的可能发展：回顾性队列研究，包括2021年1月1日至2024年2月1日期间被诊断为急性副病毒B19感染的成人住院患者。研究对象在住院后接受了6-12个月的随访，旨在确定哪些患者患上了慢性自身免疫性风湿病：研究共纳入 23 名确诊为急性 parvovirus B19 感染的患者。患者以女性为主（16 人，69.6%），确诊时的平均年龄为 39.3 ± 13.11 岁。大多数患者为犹太人（15 人，占 65.2%）。最常见的两种急性症状是发热（82.6%）和肌痛（56.5%）。仅有三名患者（13%）出现多关节炎，且所有患者的腕部均受累。抗核抗体和类风湿因子是最常见的自身抗体，两者的发病率相同（13%）。五名患者在急性期接受了泼尼松治疗（21%），其中两名患者（8.7%）需要药物升级，随后接受了羟氯喹和甲氨蝶呤治疗。一名患者在最初 6 个月的随访期间患上了系统性红斑狼疮：结论：急性副病毒 B19 引起的肌肉骨骼表现通常是自限性的，只有少数患者会发展为慢性自身免疫性疾病。将急性副病毒 B19 引起的自限性表现与特发性自身免疫性疾病区分开来至关重要，以避免不必要的免疫抑制治疗。

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引用次数: 0

Case Report of Unusual Manifestation of Mevalonate Kinase Deficiency Syndrome Mimicking Juvenile Idiopathic Arthritis With Systemic Onset. 甲羟戊酸激酶缺乏综合征异常表现的病例报告，模仿全身发病的幼年特发性关节炎。

IF 2.4 4区医学 Q2 RHEUMATOLOGY

International Journal of Rheumatic Diseases

Pub Date : 2024-11-01 DOI: 10.1111/1756-185X.15416

Ludmila V Bregel, Alla E Matunova, Qing Zhou, Mikhail M Kostik

引用次数: 0

JAK Inhibitors and Cardiovascular Disease in Psoriatic Arthritis: Friends or Foe? 银屑病关节炎中的 JAK 抑制剂与心血管疾病：是敌是友？

IF 2.4 4区医学 Q2 RHEUMATOLOGY

International Journal of Rheumatic Diseases

Pub Date : 2024-11-01 DOI: 10.1111/1756-185X.15419

Jenny Lin-Hong Shi, Wei-Yuan Chuang, Lai-Shan Tam

引用次数: 0

Defining Objective BASDAI Cut-Offs for Disease Activity States and Improvement Scores in Axial Spondyloarthritis: A Multicentric Collaboration. 定义轴性脊柱关节炎疾病活动状态和改善评分的客观 BASDAI 临界值：多中心协作。

IF 2.4 4区医学 Q2 RHEUMATOLOGY

International Journal of Rheumatic Diseases

Pub Date : 2024-11-01 DOI: 10.1111/1756-185X.15418

Rudra Prosad Goswami, Moumita Chatterjee, Shyamashis Das

Objective: To estimate objective cut-off values for Bath ankylosing Spondylitis Disease Activity Index (BASDAI) corresponding to Ankylosing Spondylitis Disease Activity Score with CRP (ASDAS) cut-off values (1.3, 2.1, and 3.5), and for interval changes (ΔBASDAI) corresponding to ΔASDAS (1.1 and 2).

Methods: In this multicentric study, adult patients with active axial spondyloarthritis (axSpA) treated with either tofacitinib 5 mg twice daily or adalimumab 40 mg subcutaneously fortnightly were recruited. Available paired data on BASDAI and ASDAS and paired interval change of these parameters (taken at least 3-months apart) were analyzed. Cut-off values for BASDAI were determined from a multinomial logistic regression and that for ΔBASDAI were determined with ordinal logistic regression with predicted probabilities. Diagnostics were assessed with correct classification rate (CRR), polychoric correlations (PCC), Goodman and Kruskal Gamma (GKG), and Matthew's correlation coefficient (MCC).

Results: Total 962 observations of paired data and 670 interval change data were available from 266 patient (mean age 35 years, mean disease duration 7 years, mean BASDAI 2.7, and mean ASDAS 2.1). Following ASDAS classes were observed: inactive disease 131 (13.6%), moderate disease activity 322 (33.5%), high disease activity 420 (43.65%), and very high disease activity 89 (9.25%). The three cut-offs generated for BASDAI were 0.8, 2.5, and 6 for BASDAI and those for ΔBASDAI were 2 and 4. The CRR for BASDAI cut-offs was 65.59 and that for ΔBASDAI was 54.9. For the BASDAI cut-offs, both PCC and GKG showed high values (> 0.85) and the MCC was 0.471.

Conclusion: In patients with axSpA, without any clinical or serological confounders, BASDAI values 0.8, 2.5, and 6 corresponded to ASDAS-CRP values 1.3, 2.1, and 3.5, respectively, and ΔBASDAI values of 2 and 4 correspond to ΔASDAS cut-offs of 1.1 and 2.

目的估算巴斯强直性脊柱炎疾病活动指数（BASDAI）与强直性脊柱炎疾病活动评分（ASDAS）临界值（1.3、2.1和3.5）相对应的客观临界值，以及与ΔASDAS（1.1和2）相对应的间期变化（ΔBASDAI）：在这项多中心研究中，招募了接受托法替尼（tofacitinib）5 毫克、每天两次或阿达木单抗（adalimumab）40 毫克、每两周一次皮下注射治疗的活动性轴性脊柱关节炎（axSpA）成年患者。对 BASDAI 和 ASDAS 的现有配对数据以及这些参数的配对间隔变化（至少间隔 3 个月）进行了分析。BASDAI 的临界值通过多叉逻辑回归确定，ΔBASDAI 的临界值通过预测概率的序数逻辑回归确定。诊断结果通过正确分类率（CRR）、多变量相关系数（PCC）、Goodman 和 Kruskal Gamma（GKG）以及马修相关系数（MCC）进行评估：从 266 名患者（平均年龄 35 岁，平均病程 7 年，平均 BASDAI 2.7，平均 ASDAS 2.1）共获得 962 个配对数据观测值和 670 个区间变化数据。ASDAS 分级如下：非活动性疾病 131 例（13.6%）、中度疾病活动 322 例（33.5%）、高度疾病活动 420 例（43.65%）和极高度疾病活动 89 例（9.25%）。BASDAI 的三个临界值分别为 0.8、2.5 和 6，ΔBASDAI 的临界值分别为 2 和 4。BASDAI 临界值的 CRR 为 65.59，ΔBASDAI 临界值的 CRR 为 54.9。就 BASDAI 临界值而言，PCC 和 GKG 均显示高值（> 0.85），MCC 为 0.471：结论：在没有任何临床或血清学混杂因素的axSpA患者中，BASDAI值0.8、2.5和6分别对应于ASDAS-CRP值1.3、2.1和3.5，ΔBASDAI值2和4对应于ΔASDAS临界值1.1和2。

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引用次数: 0

Relationship between proton pump inhibitor and acute gout attacks in patients with acute upper gastrointestinal bleeding combined with gout. 急性上消化道出血合并痛风患者服用质子泵抑制剂与痛风急性发作之间的关系。

IF 2.4 4区医学 Q2 RHEUMATOLOGY

International Journal of Rheumatic Diseases

Pub Date : 2024-11-01 DOI: 10.1111/1756-185X.15403

Qiaoli Xu

引用次数: 0

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