Rheumatology International最新文献

The aim of this study is to identify factors associated with kinesiophobia in patients with systemic sclerosis (SSc). A total of 72 adult patients diagnosed with SSc were included in this cross-sectional study. Clinical parameters reflecting disease severity, organ involvement, and inflammatory status were recorded. Kinesiophobia level was assessed using the Tampa Scale for Kinesiophobia (TSK). The Berg Balance Scale (BBS), Y Balance Test (YBT), Timed Up and Go Test (TUG), and 10-Meter Walk Test (10MWT) were used to evaluate balance and functional capacity. Factors associated with kinesiophobia was analyzed using multiple linear regression analysis. Kinesiophobia (TSK ≥ 37) was identified in 26 patients (36.1%). Disease related parameters, including disease duration, disease activity, comorbidity burden, skin and other organ involvement (lung, gastrointestinal) were higher in patients with kinesiophobia (p < 0.05, for all). Patients with kinesiophobia had significantly lower BBS score, slower walking speed, longer TUG duration, and were unable to perform the YBT, compared to those without kinesiophobia (all p < 0.001). In the multivariable regression analysis, (β = - 1.26, CI - 1.59 to - 0.94, p < 0.001) and TUG (β = 1.24, CI 0.04-2.43, p = 0.043) showed to be associated with kinesiophobia severity independently. The multivariable model accounted for 65% of the variance in kinesiophobia (adjusted R² = 0.65). In patients with SSc, static imbalance and decreased mobilization capacity are closely associated with kinesiophobia. Monitoring these parameters should be prioritized for the management of kinesiophobia in patients with SSc.

Fibromyalgia is a widespread chronic pain condition affecting quality of life. Emotional distress and loneliness are factors commonly related to pain and suffering. However, no study has analyzed how all these variables interplay in individuals living with fibromyalgia. The study objective was to empirically test the relationships among loneliness, anxiety, depression, pain, and suffering in this population. Descriptive, observational, cross-sectional study. Structural equation modeling (SEM) was used to assess the relationships between loneliness, anxiety, and depression to the experience of pain and suffering in 317 fibromyalgia patients who attended a specialized pain management facility. Loneliness was positively associated with anxiety, pain, depression, and suffering. Moreover, in our sample, anxiety, depression, suffering, and pain demonstrated significant covariation. We also found that depression is positively related to pain and suffering. Our study demonstrates that loneliness in fibromyalgia is closely linked to anxiety, depression, pain, and suffering. Regular, comprehensive interventions that incorporate social support strategies may help reduce this burden.

IgG4-related disease (IgG4-RD) is a rare immune-mediated, fibroinflammatory disease with heterogenous presentations and no standardized treatment recommendations. This study investigates long-term efficacy and safety of current therapeutic strategies with a focus on rituximab. A retrospective analysis was conducted on 24 patients diagnosed with IgG4-RD at a German tertiary center (2010-2020) using the 2020 revised comprehensive diagnostic criteria. Patients were recruited from Rheumatology and Nephrology. Data included organ involvement, laboratory results, histology, treatments, relapses, therapy-related damage, and comorbidities. The cohort included 12 males and 12 females, median age at diagnosis 53 (95%CI 37.0; 61.0) years. Males had more affected organs (2.4 vs. 1.6; p = 0.036) and higher IgG4 levels (>5× upper limit: 33.3% vs. 16.7%; p = 0.036). Immunosuppressive therapy was initiated in 87.5% of patients, with glucocorticoids (GC) universally included. Rituximab was administered to 71.4%, mainly as a 4 x 375 mg/m² regimen (77.3%), with a median follow-up post first rituximab of 51.0 months (95%CI 27.0; 63.0). Adverse events were not more frequent with rituximab compared to other regimens. At last visit, 47.6% were off immunosuppressives and 38.1% remained on GC. Active organ involvement declined, though 16.7% showed organ damage progression. Relapses were frequent (81.0%), but less common upon rituximab initiation (26.7%). This representative IgG4-RD cohort demonstrates that long-term treatment with rituximab as maintenance therapy is generally effective and safe regardless of therapeutic regimen. Despite this glucocorticoid use remains high, highlighting the need for guidelines to standardize the use of glucocorticoids and DMARDs like rituximab in both induction and maintenance therapy.