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}
Yufeng Pan, Zhiyuan Qiu, Junjun Wang, Di Jin, Jingjing Ma
<p>Primary immune thrombocytopenia (ITP) is an acquired autoimmune disease (AID) marked by isolated thrombocytopenia. Its main clinical manifestation is an increased risk of skin and mucosal bleeding associated with platelet levels. The pathogenic mechanism is primarily attributed to immune abnormalities mediated by antiplatelet antibodies and disturbances in lymphocyte subsets. The antinuclear antibody (ANA) is a key serological marker for the diagnosis and evaluation of AID. There is a trend toward higher rates of ANA positivity in ITP patients. Humoral, cellular immunity, and epigenetic regulation constitute the unique immunophenotypic characteristics of ANA-positive ITP. In these patients, serum complement C3 levels are significantly reduced, and antiplatelet antibodies co-deposited with complement C1q to form immune complexes, leading to platelet damage through complement-dependent cytotoxicity mediated by autoantibodies [<span>1</span>]. The proportion of granular megakaryocytes is significantly higher in the ANA-positive group compared to the negative group. Overexpression of genes related to the TGF-β/Smad pathway and hypermethylation in the promoter region of the TET2 gene promote fibrosis of the bone marrow microenvironment, resulting in impaired platelet production [<span>2</span>]. ANA-positive ITP exhibits a more complex immunological profile than typical ITP, with a higher risk of progression to AID, more pronounced immune dysregulation, more severe clinical manifestations, and a poorer prognosis. This observation led us to investigate whether ANA-positive ITP constitutes a distinct clinical entity and warrants classification within the spectrum of rheumatic disorders.</p><p>Current studies indicate that 17.5% to 33.3% of ITP patients are already ANA-positive. Women of childbearing age (20–40 years) constitute a high-risk group for developing ANA-positive ITP in adults [<span>3</span>]. This characteristic is closely associated with immune microenvironment dysregulation, sex hormone levels (estrogen and progesterone), and genetic polymorphisms. The latest study involving 360 patients with primary ITP showed that the incidence of AID (81.2% vs. 52.5%) and the risk of progression (a 16.8-fold increase) we significantly higher in the ANA-positive group than in the ANA-negative group. ANA positivity, anti-SSB antibodies, and high C3 levels were identified as independent predictors of disease progression in the ANA-positive group [<span>4</span>]. Furthermore, the 10-year CTD conversion risk exceeds 40% in individuals with both high-titer ANA and low complement levels. The treatment effect and prognosis of ANA-positive ITP patients were negatively correlated with titer values, and the risk of thrombotic events and bleeding was significantly higher than in the negative group.</p><p>The 2019 International ITP Working Group guidelines suggest that ANA may be considered as an early warning indicator of ITP translational risk, but ANA is stil
{"title":"ANA-Positive Primary Immune Thrombocytopenia: An Independent Clinical Entity—Potential Connective Tissue Diseases?","authors":"Yufeng Pan, Zhiyuan Qiu, Junjun Wang, Di Jin, Jingjing Ma","doi":"10.1111/1756-185x.70512","DOIUrl":"https://doi.org/10.1111/1756-185x.70512","url":null,"abstract":"<p>Primary immune thrombocytopenia (ITP) is an acquired autoimmune disease (AID) marked by isolated thrombocytopenia. Its main clinical manifestation is an increased risk of skin and mucosal bleeding associated with platelet levels. The pathogenic mechanism is primarily attributed to immune abnormalities mediated by antiplatelet antibodies and disturbances in lymphocyte subsets. The antinuclear antibody (ANA) is a key serological marker for the diagnosis and evaluation of AID. There is a trend toward higher rates of ANA positivity in ITP patients. Humoral, cellular immunity, and epigenetic regulation constitute the unique immunophenotypic characteristics of ANA-positive ITP. In these patients, serum complement C3 levels are significantly reduced, and antiplatelet antibodies co-deposited with complement C1q to form immune complexes, leading to platelet damage through complement-dependent cytotoxicity mediated by autoantibodies [<span>1</span>]. The proportion of granular megakaryocytes is significantly higher in the ANA-positive group compared to the negative group. Overexpression of genes related to the TGF-β/Smad pathway and hypermethylation in the promoter region of the TET2 gene promote fibrosis of the bone marrow microenvironment, resulting in impaired platelet production [<span>2</span>]. ANA-positive ITP exhibits a more complex immunological profile than typical ITP, with a higher risk of progression to AID, more pronounced immune dysregulation, more severe clinical manifestations, and a poorer prognosis. This observation led us to investigate whether ANA-positive ITP constitutes a distinct clinical entity and warrants classification within the spectrum of rheumatic disorders.</p><p>Current studies indicate that 17.5% to 33.3% of ITP patients are already ANA-positive. Women of childbearing age (20–40 years) constitute a high-risk group for developing ANA-positive ITP in adults [<span>3</span>]. This characteristic is closely associated with immune microenvironment dysregulation, sex hormone levels (estrogen and progesterone), and genetic polymorphisms. The latest study involving 360 patients with primary ITP showed that the incidence of AID (81.2% vs. 52.5%) and the risk of progression (a 16.8-fold increase) we significantly higher in the ANA-positive group than in the ANA-negative group. ANA positivity, anti-SSB antibodies, and high C3 levels were identified as independent predictors of disease progression in the ANA-positive group [<span>4</span>]. Furthermore, the 10-year CTD conversion risk exceeds 40% in individuals with both high-titer ANA and low complement levels. The treatment effect and prognosis of ANA-positive ITP patients were negatively correlated with titer values, and the risk of thrombotic events and bleeding was significantly higher than in the negative group.</p><p>The 2019 International ITP Working Group guidelines suggest that ANA may be considered as an early warning indicator of ITP translational risk, but ANA is stil","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":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1756-185x.70512","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145739723","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
This study investigated the distribution of disease severity in patients with systemic lupus erythematosus (SLE), explored its impact on health-care resource utilization and costs, and evaluated SLE severity transitions over time.
Methods
SLE patients between 2015 and 2017 in Taiwan's National Health Insurance Research Database were retrospectively analyzed, and classified into the mild, moderate, or severe SLE groups. Annual health-care resource utilization, associated costs, lupus flare events, and severity transitions were analyzed.
Results
A total of 20 181 patients with SLE were included, 29.3% of whom had mild, 60.7% had moderate, and 9.9% had severe SLE. Severity was correlated with health-care utilization and related costs, as well as the frequency and severity of flares. Patients with severe and moderate SLE incurred 2.18 and 1.42 times greater annual medical costs than those with mild SLE, respectively. Over the 2-year follow-up, the severe group experienced 13.23 flares, including 1.2 severe flares, significantly higher than those experienced by the moderate (9.38 flares, 0.34 severe flares) and mild (3.61 flares, 0.04 severe flares) SLE groups. Despite consistent severity distribution over 2 years, severity transitions occurred. Approximately 60% of severe patients improved within 1 year, 13% becoming mild. Conversely, fewer mild (2.8%–3.4%) and moderate (4.5%–5.4%) patients progressed to severe status annually.
Conclusion
This study offers insights into the distribution and transition patterns of SLE severity, and the correlation with health-care utilization, costs, and flare severity/frequency within a nationwide cohort. These findings highlight the importance of targeted interventions for controlling disease severity in SLE management.
{"title":"Systemic Lupus Erythematosus Severity Transitions and Related Impact on Health-Care Utilization and Costs","authors":"Yu-Sheng Chang, Jui-Hung Kao, Wen-Nan Huang","doi":"10.1111/1756-185x.70500","DOIUrl":"https://doi.org/10.1111/1756-185x.70500","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>This study investigated the distribution of disease severity in patients with systemic lupus erythematosus (SLE), explored its impact on health-care resource utilization and costs, and evaluated SLE severity transitions over time.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>SLE patients between 2015 and 2017 in Taiwan's National Health Insurance Research Database were retrospectively analyzed, and classified into the mild, moderate, or severe SLE groups. Annual health-care resource utilization, associated costs, lupus flare events, and severity transitions were analyzed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 20 181 patients with SLE were included, 29.3% of whom had mild, 60.7% had moderate, and 9.9% had severe SLE. Severity was correlated with health-care utilization and related costs, as well as the frequency and severity of flares. Patients with severe and moderate SLE incurred 2.18 and 1.42 times greater annual medical costs than those with mild SLE, respectively. Over the 2-year follow-up, the severe group experienced 13.23 flares, including 1.2 severe flares, significantly higher than those experienced by the moderate (9.38 flares, 0.34 severe flares) and mild (3.61 flares, 0.04 severe flares) SLE groups. Despite consistent severity distribution over 2 years, severity transitions occurred. Approximately 60% of severe patients improved within 1 year, 13% becoming mild. Conversely, fewer mild (2.8%–3.4%) and moderate (4.5%–5.4%) patients progressed to severe status annually.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This study offers insights into the distribution and transition patterns of SLE severity, and the correlation with health-care utilization, costs, and flare severity/frequency within a nationwide cohort. These findings highlight the importance of targeted interventions for controlling disease severity in SLE management.</p>\u0000 </section>\u0000 </div>","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":"145739726","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}
Ming-Ju Wu, Heng-Ju Hsu, Su-Boon Yong, Chin-Yuan Yii, Chia-Jung Li
{"title":"Dupilumab Treatment Is Associated With Clinical Improvement and a Shift Toward a Health-Associated Nasal Passage Microbiota in Diffuse Type 2 Chronic Rhinosinusitis","authors":"Ming-Ju Wu, Heng-Ju Hsu, Su-Boon Yong, Chin-Yuan Yii, Chia-Jung Li","doi":"10.1111/1756-185x.70468","DOIUrl":"10.1111/1756-185x.70468","url":null,"abstract":"","PeriodicalId":14330,"journal":{"name":"International Journal of Rheumatic Diseases","volume":"28 12","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145714199","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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