This study aimed to identify indicators for the early diagnosis and management of pulmonary arterial hypertension (PAH) in patients with connective tissue disease (CTD).
Method
This retrospective study included patients with CTD who met the criteria for right heart catheterization (RHC) according to contemporary guidelines for pulmonary hypertension (PH) with an intermediate to high echocardiographic probability of PH at a medical center in Taiwan. The data collected was analyzed.
Results
This study enrolled 92 patients, comprising 21 with systemic sclerosis (SSc) and 71 without SSc (non-SSc). PH and PAH were diagnosed in 67 (72.8%) and 55 (59.8%) patients, respectively, and 41 (44.6%) patients required PAH-specific medications. A high echocardiographic probability of PH significantly predicted both PH and PAH in all patients (adjusted odds ratio [OR] 7.30, 95% confidence interval [CI] 2.34–22.76 and OR 6.02, 95% CI 1.65–21.93), as well as in the non-SSc subgroup (adjusted OR 20.51 [4.41–95.45] and 15.95 [2.62–96.92]). N-terminal pro-B-type natriuretic peptide (NT-proBNP) ≥ 300 pg/mL predicted PH in the overall cohort and non-SSc subgroup (adjusted OR 3.55 [1.15–10.96] and 5.22 [1.15–23.66]). Pericardial effusion was associated with PH and PAH in the overall cohort (adjusted OR 11.99 [1.35–106.62] and 11.13 [1.23–101.07]) but not in the non-SSc subgroup. None of the aforementioned parameters significantly associated with the need for PAH-specific medications.
Conclusions
A high echocardiographic probability of PH and NT-proBNP ≥ 300 pg/mL predict PH in CTD patients. Pericardial effusion may further aid in PH/PAH detection, though not in the non-SSc subgroup. RHC remains essential to confirm treatment eligibility.
{"title":"Early Detection of Pulmonary Arterial Hypertension in Connective Tissue Disease: A Single-Center Retrospective Study","authors":"Shu-Ping Han, Yi-Hsing Chen, Wen-Nan Huang, Yi-Ming Chen, Tsu-Yi Hsieh, Wei-Ting Hung, Ching-Tsai Lin, Chih-Wei Tseng, Kuo-Tung Tang, Yu-Wan Liao, Tsai-hung Yen, Hsin-Hua Chen, Yen-Po Lin, Chi-Yao Huang, Chih-Hung Lai, Wei-Wen Lin, Kae-Woei Liang, Chiann-Yi Hsu, Pin-Kuei Fu, Yu-Wei Chen","doi":"10.1111/1756-185x.70503","DOIUrl":"10.1111/1756-185x.70503","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>This study aimed to identify indicators for the early diagnosis and management of pulmonary arterial hypertension (PAH) in patients with connective tissue disease (CTD).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>This retrospective study included patients with CTD who met the criteria for right heart catheterization (RHC) according to contemporary guidelines for pulmonary hypertension (PH) with an intermediate to high echocardiographic probability of PH at a medical center in Taiwan. The data collected was analyzed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>This study enrolled 92 patients, comprising 21 with systemic sclerosis (SSc) and 71 without SSc (non-SSc). PH and PAH were diagnosed in 67 (72.8%) and 55 (59.8%) patients, respectively, and 41 (44.6%) patients required PAH-specific medications. A high echocardiographic probability of PH significantly predicted both PH and PAH in all patients (adjusted odds ratio [OR] 7.30, 95% confidence interval [CI] 2.34–22.76 and OR 6.02, 95% CI 1.65–21.93), as well as in the non-SSc subgroup (adjusted OR 20.51 [4.41–95.45] and 15.95 [2.62–96.92]). N-terminal pro-B-type natriuretic peptide (NT-proBNP) ≥ 300 pg/mL predicted PH in the overall cohort and non-SSc subgroup (adjusted OR 3.55 [1.15–10.96] and 5.22 [1.15–23.66]). Pericardial effusion was associated with PH and PAH in the overall cohort (adjusted OR 11.99 [1.35–106.62] and 11.13 [1.23–101.07]) but not in the non-SSc subgroup. None of the aforementioned parameters significantly associated with the need for PAH-specific medications.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>A high echocardiographic probability of PH and NT-proBNP ≥ 300 pg/mL predict PH in CTD patients. Pericardial effusion may further aid in PH/PAH detection, though not in the non-SSc subgroup. RHC remains essential to confirm treatment eligibility.</p>\u0000 </section>\u0000 </div>","PeriodicalId":14330,"journal":{"name":"International Journal of Rheumatic Diseases","volume":"28 12","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145793594","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
This study aims to elucidate the diagnostic process of giant cell arteritis (GCA) by subtype in Japan.
Methods
This was a secondary analysis of a multicenter retrospective study of patients with GCA treated with tocilizumab. Patients were included in the cohort if a clinical diagnosis of GCA was made by a board-certified rheumatologist. Cranial GCA (C-GCA) was defined as a positive temporal artery biopsy (TAB), temporal artery ultrasound (TAU), or the presence of cranial manifestations. Large vessel GCA (LV-GCA) was defined by a positive computed tomography (CT), positron emission tomography (PET)-CT, or limb claudication attributable to GCA. We evaluated the diagnostic performance of each examination and assessed concordance between TAU and TAB. The diagnostic process was illustrated using flowcharts.
Results
We identified 61 GCA patients, with a median age of 74 years; 40 were female. Among C-GCA patients, the positivity rates were 52.6% (20/38) for TAU, 70% (7/10) for magnetic resonance imaging (MRI), and 81.8% (36/44) for TAB. The positivity rates in LV-GCA were 81.5% (22/27) for CT and 100% (16/16) for PET-CT. Concordance between TAU and TAB varied considerably across institutions. The diagnostic workflow showed that patients with C-GCA typically underwent multiple diagnostic examinations, and most (83.3%) TAU-negative patients with C-GCA had either a positive head MRI or TAB.
Conclusion
This multicenter Japanese study demonstrated the low sensitivity of TAU for cranial GCA, with performance varying across institutions. Combining head MRI and TAB with TAU may improve the diagnosis of GCA in Japanese clinical practice.
{"title":"Performance of Diagnostic Examinations for Giant Cell Arteritis and Subtypes: A Multicenter Japanese Study","authors":"Nobuhiro Oda, Sho Fukui, Fumika N. Nagase, Takanori Ito, Hajime Inokuchi, Toshihiro Yamaguchi, Mitsuru Watanabe, Masei Suda, Naoho Takizawa, Yoichiro Haji, Yasuhiro Suyama, Atsushi Nomura, Eishi Uechi, Ryo Rokutanda, Hiromichi Tamaki","doi":"10.1111/1756-185x.70517","DOIUrl":"10.1111/1756-185x.70517","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>This study aims to elucidate the diagnostic process of giant cell arteritis (GCA) by subtype in Japan.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This was a secondary analysis of a multicenter retrospective study of patients with GCA treated with tocilizumab. Patients were included in the cohort if a clinical diagnosis of GCA was made by a board-certified rheumatologist. Cranial GCA (C-GCA) was defined as a positive temporal artery biopsy (TAB), temporal artery ultrasound (TAU), or the presence of cranial manifestations. Large vessel GCA (LV-GCA) was defined by a positive computed tomography (CT), positron emission tomography (PET)-CT, or limb claudication attributable to GCA. We evaluated the diagnostic performance of each examination and assessed concordance between TAU and TAB. The diagnostic process was illustrated using flowcharts.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>We identified 61 GCA patients, with a median age of 74 years; 40 were female. Among C-GCA patients, the positivity rates were 52.6% (20/38) for TAU, 70% (7/10) for magnetic resonance imaging (MRI), and 81.8% (36/44) for TAB. The positivity rates in LV-GCA were 81.5% (22/27) for CT and 100% (16/16) for PET-CT. Concordance between TAU and TAB varied considerably across institutions. The diagnostic workflow showed that patients with C-GCA typically underwent multiple diagnostic examinations, and most (83.3%) TAU-negative patients with C-GCA had either a positive head MRI or TAB.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This multicenter Japanese study demonstrated the low sensitivity of TAU for cranial GCA, with performance varying across institutions. Combining head MRI and TAB with TAU may improve the diagnosis of GCA in Japanese clinical practice.</p>\u0000 </section>\u0000 </div>","PeriodicalId":14330,"journal":{"name":"International Journal of Rheumatic Diseases","volume":"28 12","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145793566","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Humidifier disinfectants (HDs) containing polyhexamethylene guanidine/oligo(2-(2-ethoxy)ethoxyethyl)guanidinium chloride (PHMG/PGH) have a strong association with interstitial lung disease (ILD). Whether PHMG/PGH increases seropositive rheumatoid arthritis (RA) or interacts with RA to raise ILD risk is unknown.
Methods
We constructed a registry-linked retrospective cohort by linking HD-claimant from the Korean Environmental Industry & Technology Institute (KEITI) to the National Health Insurance Service. Individuals who were aged ≥ 20 years as of January 1, 2003, were followed until death or December 31, 2021. PHMG/PGH exposure was modeled time-varyingly (pre vs. post). Seropositive RA (ICD-10 M05) was identified through claims screening with medical record review; ILD was defined by J84 claims. RA incidence was estimated using Poisson regression. For ILD, we applied time-dependent Cox models for PHMG/PGH exposure and post-RA status, adjusting for demographics, smoking, residence, and other HD components. Additive interaction was quantified by the relative excess risk due to interaction (RERI), attributable proportion (AP), and synergy index (S).
Results
Total 3452 adults (mean follow-up 15.9 ± 5.6 person-years) were analyzed; 1.7% developed seropositive RA and 21.6% ILD. RA incidence was 0.830 before exposure and 1.105 after (per 1000 person-years; p = 0.61). ILD hazards were elevated for PHMG/PGH exposure (HR 3.62, 95% CI 3.11–4.20) and for seropositive RA (HR 3.80, 2.70–5.34). Co-occurrence was observed more-than-additive risk: RERI 1.467 (95% CI 0.814–2.120), AP 0.143 (0.079–0.206), S 1.188 (1.049–1.326).
Conclusions
PHMG/PGH exposure was not associated with increased incidence of seropositive RA. PHMG/PGH and seropositive RA each independently raised ILD risk, with more-than-additive association when combined. Given the retrospective, internally compared design, mechanistic work is warranted.
背景：含有聚六亚甲基胍/低聚（2-（2-乙氧基）乙氧乙基）氯胍（PHMG/PGH）的加湿器消毒剂（hd）与间质性肺疾病（ILD）有很强的相关性。PHMG/PGH是否会增加血清阳性类风湿性关节炎（RA）或与RA相互作用以增加ILD风险尚不清楚。方法：我们通过将韩国环境产业与技术研究所（KEITI）的hd索赔人与国民健康保险服务联系起来，构建了一个与登记相关的回顾性队列。对截至2003年1月1日年龄≥20岁的个体进行随访，直至死亡或2021年12月31日。PHMG/PGH暴露随时间变化建模（前后）。血清学阳性RA （ICD-10 M05）通过医疗记录审查的索赔筛选确定；ILD由J84索赔定义。使用泊松回归估计RA发病率。对于ILD，我们应用时间依赖的Cox模型来分析PHMG/PGH暴露和ra后状态，并根据人口统计学、吸烟、居住和其他HD因素进行调整。通过相互作用的相对过量风险（rei）、可归因比例（AP）和协同作用指数(S)对加性相互作用进行量化。结果：共分析3452名成人（平均随访15.9±5.6人年）；血清RA阳性率为1.7%，ILD阳性率为21.6%。暴露前RA发病率为0.830，暴露后为1.105（每1000人年；p = 0.61）。暴露于PHMG/PGH的ILD风险升高（HR 3.62, 95% CI 3.11-4.20），血清RA阳性的ILD风险升高（HR 3.80, 2.70-5.34）。共发生风险大于加性风险：rri为1.467 (95% CI 0.814-2.120)， AP为0.143 (0.079-0.206)，S为1.188（1.049-1.326）。结论：PHMG/PGH暴露与血清阳性RA发病率增加无关。PHMG/PGH和血清阳性RA各自单独增加ILD的风险，当联合使用时，相关性大于相加性。鉴于回顾性的，内部比较的设计，机械的工作是必要的。
{"title":"Seropositive Rheumatoid Arthritis and Polyhexamethylene Guanidine/Oligo(2-(2-Ethoxy)ethoxyethyl)guanidinium Chloride Exposure Are Associated With a Synergistic Effect on the Risk of Developing Interstitial Lung Disease: Registry Based Cohort-Study","authors":"Hyowon Choi, Seungjun Ryu, Yeon-Soon Ahn","doi":"10.1111/1756-185x.70510","DOIUrl":"10.1111/1756-185x.70510","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Humidifier disinfectants (HDs) containing polyhexamethylene guanidine/oligo(2-(2-ethoxy)ethoxyethyl)guanidinium chloride (PHMG/PGH) have a strong association with interstitial lung disease (ILD). Whether PHMG/PGH increases seropositive rheumatoid arthritis (RA) or interacts with RA to raise ILD risk is unknown.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We constructed a registry-linked retrospective cohort by linking HD-claimant from the Korean Environmental Industry & Technology Institute (KEITI) to the National Health Insurance Service. Individuals who were aged ≥ 20 years as of January 1, 2003, were followed until death or December 31, 2021. PHMG/PGH exposure was modeled time-varyingly (pre vs. post). Seropositive RA (ICD-10 M05) was identified through claims screening with medical record review; ILD was defined by J84 claims. RA incidence was estimated using Poisson regression. For ILD, we applied time-dependent Cox models for PHMG/PGH exposure and post-RA status, adjusting for demographics, smoking, residence, and other HD components. Additive interaction was quantified by the relative excess risk due to interaction (RERI), attributable proportion (AP), and synergy index (<i>S</i>).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Total 3452 adults (mean follow-up 15.9 ± 5.6 person-years) were analyzed; 1.7% developed seropositive RA and 21.6% ILD. RA incidence was 0.830 before exposure and 1.105 after (per 1000 person-years; <i>p</i> = 0.61). ILD hazards were elevated for PHMG/PGH exposure (HR 3.62, 95% CI 3.11–4.20) and for seropositive RA (HR 3.80, 2.70–5.34). Co-occurrence was observed more-than-additive risk: RERI 1.467 (95% CI 0.814–2.120), AP 0.143 (0.079–0.206), <i>S</i> 1.188 (1.049–1.326).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>PHMG/PGH exposure was not associated with increased incidence of seropositive RA. PHMG/PGH and seropositive RA each independently raised ILD risk, with more-than-additive association when combined. Given the retrospective, internally compared design, mechanistic work is warranted.</p>\u0000 </section>\u0000 </div>","PeriodicalId":14330,"journal":{"name":"International Journal of Rheumatic Diseases","volume":"28 12","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145793526","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Mie Fusama, Hideko Nakahara, Yuko Kaneko, Sarah E. Bennett, Mwidimi Ndosi, Tsutomu Takeuchi
Aim
EULAR recommendations for the role of nurses in managing chronic inflammatory arthritis were updated in 2018. This study aimed to: (i) assess the level of agreement and implementation of these recommendations among nurses and rheumatologists, and (ii) identify barriers to the implementation of these recommendations in clinical practice in Japan.
Method
Nurses and doctors in rheumatology care in Japan were asked to complete a survey on (1) levels of agreement and implementation of each recommendation (0–10: 0 “not at all” and 10 “yes, entirely”), as well as (2) reasons for disagreeing and/or barriers to implementation. Quantitative and qualitative data were first analyzed separately then paired side by side for comparison and identification of similar categories within and across the eight recommendations.
Results
There were 309 complete responses (215 nurses and 94 doctors). Both nurses and doctors showed high levels of acceptability with a median of 10 for all recommendations. Implementation levels were significantly lower, indicating the discrepancy between acceptance and implementation in both groups. Ten categories were extracted from a total of 1300 comments, illustrating perceived barriers. The most common categories were lack of time, knowledge, and resistance to role expansion in the nursing division.
Conclusion
This study highlights the gap between acceptance of the recommendations in Japan and their implementation in practice. Despite strong agreement, challenges like time constraints, knowledge gaps, and systemic barriers hinder implementation. Overcoming these requires interprofessional collaboration and nurturing a supportive environment for rheumatology nursing role development.
{"title":"Acceptability and Barriers to Implementation of the EULAR Recommendations for the Role of the Nurse in the Management of Chronic Inflammatory Arthritis: A Mixed-Methods Study With Nurses and Rheumatologists in Japan","authors":"Mie Fusama, Hideko Nakahara, Yuko Kaneko, Sarah E. Bennett, Mwidimi Ndosi, Tsutomu Takeuchi","doi":"10.1111/1756-185x.70511","DOIUrl":"10.1111/1756-185x.70511","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>EULAR recommendations for the role of nurses in managing chronic inflammatory arthritis were updated in 2018. This study aimed to: (i) assess the level of agreement and implementation of these recommendations among nurses and rheumatologists, and (ii) identify barriers to the implementation of these recommendations in clinical practice in Japan.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>Nurses and doctors in rheumatology care in Japan were asked to complete a survey on (1) levels of agreement and implementation of each recommendation (0–10: 0 “not at all” and 10 “yes, entirely”), as well as (2) reasons for disagreeing and/or barriers to implementation. Quantitative and qualitative data were first analyzed separately then paired side by side for comparison and identification of similar categories within and across the eight recommendations.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>There were 309 complete responses (215 nurses and 94 doctors). Both nurses and doctors showed high levels of acceptability with a median of 10 for all recommendations. Implementation levels were significantly lower, indicating the discrepancy between acceptance and implementation in both groups. Ten categories were extracted from a total of 1300 comments, illustrating perceived barriers. The most common categories were lack of time, knowledge, and resistance to role expansion in the nursing division.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This study highlights the gap between acceptance of the recommendations in Japan and their implementation in practice. Despite strong agreement, challenges like time constraints, knowledge gaps, and systemic barriers hinder implementation. Overcoming these requires interprofessional collaboration and nurturing a supportive environment for rheumatology nursing role development.</p>\u0000 </section>\u0000 </div>","PeriodicalId":14330,"journal":{"name":"International Journal of Rheumatic Diseases","volume":"28 12","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145774380","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Hasan Kocaayan, Elif Durak Ediboglu, Tuba Demirci Yıldırım, Bahar Ozdemir Ulusoy, Tahir Saygin Ogut, Busra Firlatan, Duygu Sevinc Ozgur, Senar San, Melih Kiziltepe, Riza Can Kardas, Duygu Sahin, Cansu Akleylek, Zeynep Dundar Ok, Nazife Sule Bilge, Emine Uslu, Esra Erpek, Askin Ates, Arif Babayigit, Pinar Akyuz Dagli, Ertugrul Cagri Bolek, Gizem Ayan, Berkan Armagan, Hamit Kucuk, Veli Cobankara, Levent Kilic, Ayse Cefle, Mehmet Engin Tezcan, Funda Erbasan, Cemal Bes, Ender Terzioglu, Fatos Onen, Ahmet Omma, Omer Karadag, Servet Akar, Turkish Vasculitis Study Group (TRVaS)
Objective
This study aims to assess the incidence and factors linked to venous thromboembolic events (VTE) in a large national cohort of antineutrophil cytoplasmic autoantibody (ANCA)-associated vasculitis (AAV) from the Turkish Vasculitis Study Group (TR-VaS).
Method
This retrospective analysis included patients with granulomatosis with polyangiitis, microscopic polyangiitis, renal-limited vasculitis, and eosinophilic granulomatosis with polyangiitis. VTE that occurred within 3 months before the diagnosis of AAV or during the follow-up period was classified as AAV-associated VTE (AAV-VTE). Demographic, clinical, and disease-related features, along with the presence of well-known VTE risk factors, were compared between AAV patients with and without VTE. Multivariate analyses were performed to identify independent risk factors linked to the development of AAV-VTE.
Results
A total of 559 patients were included, and VTE was detected in 43 (7.7%). In univariate analysis, baseline body mass index (BMI) (HR: 1.13, 95% CI: 1.02–1.25, p = 0.01), erythrocyte sedimentation rate (HR: 1.01, 95% CI: 1.00–1.02, p = 0.04), BVAS score (HR: 1.05, 95% CI: 1.01–1.09, p = 0.01), renal involvement (HR: 2.01, CI: 0.96–4.20, p = 0.06), the presence of immobilization (HR: 11.4, 95% CI: 5.64–23.37, p < 0.001), and trauma (HR: 28.84, 95% CI: 3.5–215.7, p < 0.001) were identified as risk factors for VTE-AAV. In multivariate analysis, baseline BMI (HR: 1.14, CI: 1.02–1.26, p = 0.002) was the only independent risk factor for the development of VTE.
Conclusion
Our findings suggest that physicians caring for AAV patients should be cautious about the risk of VTE in patients with an elevated BMI and active disease, along with other recognized risk factors for VTE.
目的：本研究旨在评估来自土耳其血管炎研究组（TR-VaS）的抗中性粒细胞胞浆自身抗体（ANCA）相关血管炎（AAV）的大型国家队列中静脉血栓栓塞事件（VTE）的发生率和相关因素。方法：回顾性分析肉芽肿病合并多血管炎、镜下多血管炎、肾限制性血管炎和嗜酸性肉芽肿病合并多血管炎患者。在AAV诊断前3个月内或随访期间发生的VTE被归类为AAV相关性VTE （AAV-VTE）。比较伴有和不伴有静脉血栓栓塞的AAV患者的人口学、临床和疾病相关特征以及已知的静脉血栓栓塞危险因素的存在。进行多变量分析以确定与AAV-VTE发展相关的独立危险因素。结果：共纳入559例患者，检出静脉血栓栓塞43例（7.7%）。在单因素分析中，基线体重指数（BMI） （HR: 1.13, 95% CI: 1.02-1.25, p = 0.01），红细胞沉降率（HR: 1.01, 95% CI: 1.00-1.02, p = 0.04）， BVAS评分（HR: 1.05, 95% CI: 1.01-1.09, p = 0.01），肾脏受累（HR: 2.01, CI: 0.96-4.20, p = 0.06），存在固定（HR: 11.4, 95% CI: 5.64-23.37, p）。我们的研究结果表明，照顾AAV患者的医生应该谨慎对待BMI升高和活动性疾病患者的静脉血栓栓塞风险，以及其他已知的静脉血栓栓塞危险因素。
{"title":"Venous Thromboembolism May Be Increased in the Early Phases of ANCA-Associated Vasculitis and Could Be Associated With a High Body Mass Index: TR-VaS Experience","authors":"Hasan Kocaayan, Elif Durak Ediboglu, Tuba Demirci Yıldırım, Bahar Ozdemir Ulusoy, Tahir Saygin Ogut, Busra Firlatan, Duygu Sevinc Ozgur, Senar San, Melih Kiziltepe, Riza Can Kardas, Duygu Sahin, Cansu Akleylek, Zeynep Dundar Ok, Nazife Sule Bilge, Emine Uslu, Esra Erpek, Askin Ates, Arif Babayigit, Pinar Akyuz Dagli, Ertugrul Cagri Bolek, Gizem Ayan, Berkan Armagan, Hamit Kucuk, Veli Cobankara, Levent Kilic, Ayse Cefle, Mehmet Engin Tezcan, Funda Erbasan, Cemal Bes, Ender Terzioglu, Fatos Onen, Ahmet Omma, Omer Karadag, Servet Akar, Turkish Vasculitis Study Group (TRVaS)","doi":"10.1111/1756-185x.70506","DOIUrl":"10.1111/1756-185x.70506","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>This study aims to assess the incidence and factors linked to venous thromboembolic events (VTE) in a large national cohort of antineutrophil cytoplasmic autoantibody (ANCA)-associated vasculitis (AAV) from the Turkish Vasculitis Study Group (TR-VaS).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>This retrospective analysis included patients with granulomatosis with polyangiitis, microscopic polyangiitis, renal-limited vasculitis, and eosinophilic granulomatosis with polyangiitis. VTE that occurred within 3 months before the diagnosis of AAV or during the follow-up period was classified as AAV-associated VTE (AAV-VTE). Demographic, clinical, and disease-related features, along with the presence of well-known VTE risk factors, were compared between AAV patients with and without VTE. Multivariate analyses were performed to identify independent risk factors linked to the development of AAV-VTE.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 559 patients were included, and VTE was detected in 43 (7.7%). In univariate analysis, baseline body mass index (BMI) (HR: 1.13, 95% CI: 1.02–1.25, <i>p</i> = 0.01), erythrocyte sedimentation rate (HR: 1.01, 95% CI: 1.00–1.02, <i>p</i> = 0.04), BVAS score (HR: 1.05, 95% CI: 1.01–1.09, <i>p</i> = 0.01), renal involvement (HR: 2.01, CI: 0.96–4.20, <i>p</i> = 0.06), the presence of immobilization (HR: 11.4, 95% CI: 5.64–23.37, <i>p</i> < 0.001), and trauma (HR: 28.84, 95% CI: 3.5–215.7, <i>p</i> < 0.001) were identified as risk factors for VTE-AAV. In multivariate analysis, baseline BMI (HR: 1.14, CI: 1.02–1.26, <i>p</i> = 0.002) was the only independent risk factor for the development of VTE.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Our findings suggest that physicians caring for AAV patients should be cautious about the risk of VTE in patients with an elevated BMI and active disease, along with other recognized risk factors for VTE.</p>\u0000 </section>\u0000 </div>","PeriodicalId":14330,"journal":{"name":"International Journal of Rheumatic Diseases","volume":"28 12","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145774419","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Diffuse Skin Tightening and Swelling of the Extremities in a Woman","authors":"Lan Zhang, Yang Yang","doi":"10.1111/1756-185x.70518","DOIUrl":"10.1111/1756-185x.70518","url":null,"abstract":"","PeriodicalId":14330,"journal":{"name":"International Journal of Rheumatic Diseases","volume":"28 12","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145774394","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Shuo Cheng, Suo Zhang, Jiaming Huang, Xue Guo, Meiying Wang
{"title":"Treatment of Lupus Retinopathy With the Combination of Telitacicept and Methylprednisolone: A Case Report","authors":"Shuo Cheng, Suo Zhang, Jiaming Huang, Xue Guo, Meiying Wang","doi":"10.1111/1756-185x.70509","DOIUrl":"https://doi.org/10.1111/1756-185x.70509","url":null,"abstract":"","PeriodicalId":14330,"journal":{"name":"International Journal of Rheumatic Diseases","volume":"28 12","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145739722","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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