Scandinavian Journal of Rheumatology最新文献

Objective: To evaluate whether rapid and sustained suppression of inflammation, using the NEO-RACo treatment, including prednisolone 7.5 mg/day for 2 years, in patients with early active rheumatoid arthritis (RA) can prevent the reduction of bone mineral density (BMD) in a 10 year follow-up.

Method: In the NEO-RACo study, 99 patients, aged 18-60 years, with early RA and without earlier use of disease-modifying anti-rheumatic drugs (DMARDs), were treated with a triple combination of conventional synthetic DMARDs and 7.5 mg prednisolone daily for 2 years and double blindly randomized to receive either placebo or infliximab infusions for the first 6 months. After 2 years, the therapies could be modified, always aiming for strict remission. All patients also received 1000 mg calcium and 800 IU vitamin D₃ daily. BMD was measured by dual-energy X-ray absorptiometry at baseline, 2 years, 5 years, and 10 years. BMD Z-score ≤ -2.0 was considered to be below the expected value.

Results: At baseline, two patients (2%) had a Z-score ≤ -2.0, including one patient with osteoporosis. At the time of the last BMD measurement, five patients (5%) had a Z-score ≤ -2.0, and no new-onset osteoporosis cases occurred. No significant differences emerged between the randomization groups.

Conclusions: Both randomization groups were treated early and aggressively, and the decrease in BMD was low throughout the 10 year follow-up. The use of infliximab during the first 6 months provided no extra benefit regarding bone loss.Trial Registration: http://www.clintrials.gov (NCT00908089).

Objective: To evaluate the causal effect of genetically predicted serum urate (SU) levels on the risk of overall and major site-specific cancers in individuals of European ancestry, using Mendelian randomization (MR) analysis.

Method: Data from two population-based cohorts from southern Sweden, the Malmö Diet and Cancer Study (MDCS) and Malmö Preventive Project (MPP), and summary-statistics data from the Global Urate Genetic Consortium (GUGC) and UK Biobank cohort were used. A set of 26 SU-related variants was used as instrumental variables to perform a range of one- (using MDCS-MPP) and two-sample (using GUGC and UK Biobank) MR analyses. Causal relationships were assessed between genetically determined SU and 13 site-specific cancers (bladder, breast, color ectal, gastric, hepatic, lung, pancreatic, prostate, renal, skin, lymphatic, haematopoietic, and gynaecological cancers, and brain tumour) and 'any cancer'. We also performed epidemiological association analyses on individual-level data to determine SU-cancer relationships.

Results: There was some suggestive evidence of an association between higher levels of genetically predicted SU and lower risk of brain (p = 0.04; one-sample MR) and colorectal (p = 0.02; two-sample MR) cancers, although these findings were not consistent across both MR approaches. No significant associations were observed between SU levels and the risk of other cancers (all p > 0.05).

Conclusion: Our MR study found no consistent evidence of a causal effect of genetically predicted SU on overall or Q3 common site-specific cancers in European individuals.

Rheumatoid arthritis (RA) is an essential cause of secondary sarcopenia, and patients with RA face a higher risk of developing sarcopenia. In the literature, there is a lack of reviews on animal models of RA-related sarcopenia. This review examines sarcopenia-related changes and mechanisms in induced and immune-mediated arthritis animal models and highlights potential preclinical therapies. The mechanisms for developing sarcopenia in these animal models involved inflammation, protein degradation pathways, protein synthesis, muscle regeneration and differentiation, oxidative stress, energy metabolism, and amino acid metabolism. Some anti-rheumatic drugs, supplements and nutrients, antioxidants, and physical therapy and training have been shown to improve muscle atrophy, maintain muscle mass, and prevent grip strength loss in different RA-related sarcopenia animal models. Overall, this review aims to deepen the mechanistic understanding of RA-related sarcopenia and provide a basis for developing innovative therapies.

Objective: Pain hypersensitivity and hypersensitivity to other sensory modalities (visual, auditory, olfactory, and tactile) are considered defining features in nociplastic pain states. A self-report measure of sensory sensitivity may help to characterize sensory profiles across pain populations. This study aimed to evaluate the psychometric properties of a newly developed Danish nine-item Sensory Sensitivity Profile (SSP) questionnaire in patients with fibromyalgia.

Method: Baseline assessments from a randomized controlled trial population of 200 individuals with a confirmed diagnosis of fibromyalgia who had completed the SSP were used in this study. Rasch analysis was applied to the dataset, allowing for a detailed analysis of the rating scale properties and further aspects of validity, including fit of individual scale items to a unidimensional model indicating assessment of a single construct, and assessment of the instrument's ability to provide precise and reliable measures of sensory sensitivity.

Results: The Rasch analyses revealed that the 0-3 ordinal rating scale of the SSP had sound psychometric properties, and supported the idea that the nine SSP items contributed towards measurement of a single construct. The study population exhibited expected and valid response patterns, with sensitivity to sound and pain being the most endorsed items. The SSP demonstrated adequate precision and reliability of item difficulty estimates and person sensory sensitivity measures when applied in our study population.

Conclusion: From the perspective of the Rasch measurement model, this first version of the SSP demonstrated adequate psychometric properties for characterizing and quantifying sensitivity to specific sensory modalities in patients with fibromyalgia.

Objective: To investigate the reliability of lacrimal gland ultrasound (LGUS) in patients with clinically suspected Sjögren's disease (SjD).

Method: Of 41 consecutive patients with clinically suspected SjD, 28 were diagnosed with SjD and 13 were classified as non-SjD. Forty patients were scored for bilateral lacrimal gland (LG) B-mode evaluation; LGs were 'not visible' in one case. Of these 40, 31 patients also underwent colour Doppler ultrasound (CDUS) evaluation. Images and videos were scored for both LGs using the Hocevar, Outcome Measures in Rheumatology (OMERACT) B-mode, and OMERACT CDUS scoring systems, and scored independently by four blinded observers in two sessions.

Results: For the Hocevar scoring system, intraobserver reliability was fair to moderate, with intraclass correlation coefficients (ICCs) ranging from 0.34 to 0.50. Interobserver reliability was fair, with ICCs of 0.31 and 0.25 between sessions 1 and 2. Individual Hocevar items showed poor to fair interobserver reliability. For the OMERACT B-mode scoring system, intraobserver reliability was fair to moderate, with ICCs ranging from 0.27 to 0.54. Interobserver reliability was poor to fair, with ICCs of 0.23 and 0.16 in sessions 1 and 2. Finally, for OMERACT CDUS, intraobserver reliability was good, with ICCs ranging from 0.61 to 0.80, and interobserver reliability also good, with ICCs of 0.63 and 0.69 in sessions 1 and 2.

Conclusion: This study, performing LGUS in patients with clinically suspected SjD, shows that the reliability of B-mode ultrasound may be a concern. The reliability of OMERACT CDUS is superior to Hocevar and OMERACT B-mode scoring of the LGs.

Objectives: To systematically review and meta-analyse the risk factors proposed by the American College of Rheumatology and American College of Chest Physicians as screening tools for rheumatoid arthritis-associated interstitial lung disease (RA-ILD), focusing exclusively on studies using high-resolution computed tomography (HRCT) in prospectively collected data from unselected RA patients.

Method: A comprehensive search was conducted to identify studies evaluating RA-ILD risk factors. Selection criteria included studies using HRCT in prospective, unselected RA cohorts. Data synthesis was performed to compute the prevalence of RA-ILD and evaluate the performance of dichotomous and continuous risk factors.

Results: In the analysis of nine studies involving 1380 RA patients, RA-ILD was identified in 18.9% via HRCT, with prevalence rates ranging from 6.7% to 42.7%. No studies were found that examined the risk factors collectively. Male sex and history of smoking were, respectively, 12.6% and 12.2% higher in RA-ILD patients compared to those without ILD. Average age at RA disease onset was 7.0 years higher in RA-ILD patients than in the non-ILD group. Disease Activity Scores in 28 joints (DAS28) were similar between the two groups. However, limited data were available for high-titre seropositivity and body mass index.

Conclusions: The proposed risk factors for RA-ILD screening lack robust evidence, and existing data indicate insufficient individual predictive power. Physicians are advised to continue screening for RA-ILD using comprehensive clinical judgement rather than relying solely on these risk factors. Further research is necessary to develop robust screening tools to improve early detection of RA-ILD.

Objectives: This study aims to translate and cross-culturally adapt the European Alliance of Associations for Rheumatology (EULAR) Systemic Sclerosis Impact of Disease (ScleroID) questionnaire to Danish; and to assess its reliability in patients with systemic sclerosis (SSc).

Method: The translation and cross-cultural adaptation of the ScleroID questionnaire were conducted according to COnsensus-based Standard for the selection of health Measurement INstruments (COSMIN) guidelines. The test-retest reliability was assessed in 50 Danish patients with SSc.

Results: All steps for the translation process were followed and approved by the developers of ScleroID. The translation process resulted in changes to the wording of 'aspects' to 'symptoms', 'phenomenon' to 'syndrome', and 'social life' to 'social relations and leisure activities' to create a more meaningful translation in a Danish context. For the Danish version of the ScleroID, the intraclass correlation coefficient (ICC) was 0.90 [95% confidence interval (CI) 0.83; 0.94]. The ICC for each of the 10 individual health domains in ScleroID ranged from 0.52 (95% CI 0.29; 0.70) (digital ulcers) to 0.87 (0.78; 0.92) (lower gastrointestinal symptoms and fatigue).

Conclusion: The overall ICC for the Danish version of the ScleroID was excellent, which indicates that it can be implemented as a reliable patient-reported outcome measure in patients with SSc in Denmark.