Seminars in arthritis and rheumatism最新文献

英文中文

Alleviation of depression rather than pain predicts disease improvement in fibromyalgia patients with prominent psychological symptoms–a prospective observational study 缓解抑郁而不是疼痛预示着纤维肌痛患者有明显心理症状的疾病改善——一项前瞻性观察研究

IF 4.4 2区医学 Q1 RHEUMATOLOGY

Seminars in arthritis and rheumatism

Pub Date : 2026-01-11 DOI: 10.1016/j.semarthrit.2026.152920

Kuo-Wei Lee , Yi-On Fong , Yen-Ju Lin , Fu-Wen Liang , Meng-Ni Wu , Chiou-Lian Lai , Chih-Hsien Hung

Background

How depression and anxiety symptoms affect fibromyalgia (FM) phenotypes and initial treatment outcomes remains unclear. This study prospectively investigated the impact of psychological symptoms on disease manifestations and therapeutic responses in individuals with newly diagnosed FM.

Methods

FM patients and healthy controls were prospectively recruited and assessed with questionnaires measuring emotional symptoms and disease conditions. The effects of anxiety and depression symptoms on FM manifestations and therapeutic responses (using pregabalin with/without imipramine; no placebo control) were investigated using cluster, correlation, regression, and mediation analyses through a 4-week follow-up.

Results

One hundred twelve newly diagnosed FM cases were included. Based on their psychological symptoms, patients were classified into two subgroups exhibiting different phenotypes; patients with prominent anxiety and depression symptoms (FM-AD) had more intense pain, worse disease severity, and poorer therapeutic responses than those without (FM-nAD; all p < 0.001). Correlation analyses showed that, along with pain, both depression and anxiety symptoms crucially modulated disease severity (all p < 0.001). Although pain relief conduced clinical improvement overall, linear mixed-effect regression analysis denoted that depression remission (p = 0.039), but not pain reduction (p = 0.062), determined clinical improvement for FM-AD cases. Notably, depression remission exerted a direct impact (p = 0.003) on disease improvement in FM-AD cases, independent of pain reduction (indirect effect: p = 0.101).

Conclusion

Psychological symptoms, as much as pain, vitally determined disease severity in FM. For FM-AD individuals, alleviation of depression, rather than pain relief alone, pivotally predicted disease improvement. Early detecting and addressing depression in FM management could help with discriminating phenotypes, thereby improving FM care strategy.

背景：抑郁和焦虑症状如何影响纤维肌痛（FM）的表型和初始治疗结果尚不清楚。本研究前瞻性地探讨了心理症状对新诊断的FM患者的疾病表现和治疗反应的影响。方法前瞻性招募fm患者和健康对照者，采用情绪症状和疾病状况问卷进行评估。焦虑和抑郁症状对FM表现和治疗反应的影响（使用普瑞巴林加/不加丙咪嗪，无安慰剂对照）通过4周的随访，采用聚类、相关、回归和中介分析进行研究。结果共纳入112例新诊断的FM病例。根据患者的心理症状，将患者分为两个亚组，表现出不同的表型；有明显焦虑和抑郁症状（FM-AD）的患者比没有FM-AD的患者有更强烈的疼痛、更严重的疾病严重程度和更差的治疗反应（FM-nAD；均p <； 0.001）。相关分析显示，与疼痛一起，抑郁和焦虑症状对疾病严重程度起着至关重要的调节作用（均p <； 0.001）。虽然疼痛缓解总体上促进了临床改善，但线性混合效应回归分析表明，抑郁缓解（p = 0.039）而非疼痛减轻（p = 0.062）决定了FM-AD病例的临床改善。值得注意的是，抑郁缓解对FM-AD病例的疾病改善有直接影响（p = 0.003），独立于疼痛减轻（间接影响：p = 0.101）。结论FM患者的心理症状与疼痛一样，是决定病情严重程度的重要因素。对于FM-AD个体，抑郁的缓解，而不是疼痛的缓解，是预测疾病改善的关键。在FM管理中早期发现和处理抑郁症有助于区分表型，从而改善FM护理策略。

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引用次数: 0

Risk of ILD and safety outcomes across DMARD classes in rheumatoid arthritis and RA-ILD 类风湿性关节炎和RA-ILD的DMARD分级间ILD风险和安全性结局

IF 4.4 2区医学 Q1 RHEUMATOLOGY

Seminars in arthritis and rheumatism

Pub Date : 2026-01-11 DOI: 10.1016/j.semarthrit.2026.152921

Kyung-Ann Lee , Bora Lee , Hyun-Sook Kim

Objectives

To evaluate the risk of interstitial lung disease (ILD) and safety outcomes of disease-modifying antirheumatic drug (DMARD) classes in rheumatoid arthritis (RA), focusing on patients with RA-associated ILD (RA-ILD).

Methods

We conducted a nationwide cohort study using Korean National Health Insurance Service data (2011–2020). Adults with newly diagnosed RA prescribed at least one csDMARD were included and followed until 2022. Four treatment groups were evaluated: TNFi, non-TNFi biologics (abatacept, rituximab, tocilizumab), JAKi, and csDMARDs. RA-ILD was defined as ≥2 ILD claims plus chest computed tomography confirmation. Outcomes included ILD incidence, hospitalisation, infection, MACE, and all-cause mortality. Time-varying Cox models with inverse probability of treatment weighting were applied for first-event analyses.

Results

We analysed 26,120 patients with RA (209,852 treatment episodes), including 641 RA-ILD patients (1688 episodes). Adjusted ILD incidence was similar across DMARD classes. In RA and RA-ILD, non-TNFi biologics were associated with higher risks of hospitalisation (RA aHR 1.30, 95% CI 1.21–1.40; RA-ILD 1.35, 1.02–1.80), infection (RA 1.16, 1.05–1.28; RA-ILD 1.51, 1.06–2.15), and mortality (RA 4.09, 3.04–5.50; RA-ILD 4.31, 2.21–8.41) compared with csDMARDs. ILD-related admissions were similar, but pneumonia-related hospitalisations and recurrences were higher with non-TNFi biologics. TNFi and JAKi showed no significant associations with hospitalisation or infection. MACE risk did not differ across groups.

Conclusions

DMARD class was not associated with ILD incidence or ILD-related hospitalisation. Non-TNFi biologics were consistently linked to increased pneumonia-related hospitalisation, recurrence, and mortality, highlighting the need for close infection monitoring in patients receiving these agents.

目的评估类风湿关节炎（RA）患者间质性肺疾病（ILD）的风险和改善疾病的抗风湿药物（DMARD）类别的安全性结果，重点关注RA相关ILD （RA-ILD）患者。方法：我们使用韩国国民健康保险服务数据（2011-2020）进行了一项全国性队列研究。新诊断的RA患者至少服用一种csDMARD，随访至2022年。评估四个治疗组：TNFi、非TNFi生物制剂（阿巴接受、利妥昔单抗、托珠单抗）、JAKi和csDMARDs。RA-ILD定义为≥2例ILD声明加上胸部计算机断层扫描证实。结果包括ILD发生率、住院率、感染、MACE和全因死亡率。采用逆概率处理加权的时变Cox模型进行首次事件分析。结果我们分析了26,120例RA患者（209,852次治疗），其中641例RA- ild患者（1688次）。调整后的ILD发病率在不同的DMARD类别中相似。在RA和RA- ild中，与csDMARDs相比，非tnfi生物制剂与更高的住院风险（RA aHR 1.30, 95% CI 1.21-1.40; RA- ild 1.35, 1.02-1.80）、感染（RA 1.16, 1.05-1.28; RA- ild 1.51, 1.06-2.15）和死亡率（RA 4.09, 3.04-5.50; RA- ild 4.31, 2.21-8.41）相关。与ild相关的入院率相似，但与肺炎相关的住院率和非tnfi生物制剂的复发率更高。TNFi和JAKi与住院或感染无显著相关性。MACE风险在各组间没有差异。结论sdmard分级与ILD发病率或ILD相关住院无关。非tnfi生物制剂一直与肺炎相关住院、复发和死亡率增加有关，强调了对接受这些药物的患者进行密切感染监测的必要性。

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引用次数: 0

Correspondence to 'Nailfold capillaroscopy as a predictor of major cardiovascular events and mortality in systemic sclerosis' 对应于“甲襞毛细血管镜检查作为系统性硬化症主要心血管事件和死亡率的预测指标”

IF 4.4 2区医学 Q1 RHEUMATOLOGY

Seminars in arthritis and rheumatism

Pub Date : 2026-01-10 DOI: 10.1016/j.semarthrit.2026.152915

Yanxia Chen , Jinlin Liu

引用次数: 0

Correspondence to ‘Development of a prediction model for progression of rheumatoid arthritis-associated interstitial lung disease using serologic and clinical factors’ 对应于“利用血清学和临床因素开发类风湿关节炎相关间质性肺病进展的预测模型”。

IF 4.4 2区医学 Q1 RHEUMATOLOGY

Seminars in arthritis and rheumatism

Pub Date : 2026-01-07 DOI: 10.1016/j.semarthrit.2026.152914

Yanxia Chen , Jinlin Liu

引用次数: 0

Exploring the association between adiposity, pain intensity, and effusion-synovitis in people with knee osteoarthritis: A cross-sectional study 探讨膝关节骨关节炎患者肥胖、疼痛强度和积液性滑膜炎之间的关系：一项横断面研究

IF 4.4 2区医学 Q1 RHEUMATOLOGY

Seminars in arthritis and rheumatism

Pub Date : 2026-01-04 DOI: 10.1016/j.semarthrit.2026.152913

YV Raghava Neelapala , C Thomas Appleton , Luciana Macedo , Steve Hanna , Dylan Kobsar , Trevor B Birmingham , Lisa C. Carlesso

Objectives

To examine (i) the association of adiposity with pain intensity and/or effusion-synovitis in people with knee osteoarthritis (OA), adjusting for body mass index (BMI), and (ii) whether indicators of systemic immune inflammation (i.e., the systemic immune-inflammation index (SII) and the systemic immune response index (SIRI)) moderate the above associations.

Methods

Individuals with knee OA were sampled from the Western Ontario Registry for Early Osteoarthritis Knee Study. Total body and visceral fat percentages were measured using bioimpedance analysis, and effusion-synovitis was graded using knee ultrasonography. Multiple regression models with interaction terms were used to examine the association between fat percentages and pain intensity (linear)/effusion-synovitis (logistic), and the interaction effect of fat and SII/SIRI on pain intensity/effusion-synovitis. The analyses were adjusted for confounders (age, sex, BMI, radiographic severity of the opposite knee, and anxio-depressive symptoms).

Results

Data from 225 participants (mean age: 61.1 (10.9), 68% female, mean BMI: 31.7 (7.7)) were analyzed. The associations for adjusted fat and pain intensity models were as follows: total body fat: β): - 0.03 (-0.54 to 0.46) and visceral fat: β (: -0.25 (-1.03 to 0.51)., The odds ratios for adjusted fat and effusion-synovitis models were total body fat: OR): 0.98 (0.92 to 1.05) and visceral fat: OR (): 1.01 (0.91 to 1.11)). Neither the main nor the interaction effects were significant.

Conclusion

Our preliminary results do not support an association of adiposity and its interaction with generalized inflammation with pain/effusion-synovitis adjusted for BMI. Further studies are needed.

目的研究(i)肥胖与膝关节骨性关节炎（OA）患者疼痛强度和/或积液性滑膜炎的相关性，调整体重指数（BMI），以及（ii）系统性免疫炎症指标（即系统性免疫炎症指数（SII）和系统性免疫反应指数（SIRI））是否调节上述相关性。方法从安大略省西部早期骨关节炎膝关节研究登记处抽取患有膝关节炎的个体。使用生物阻抗分析测量全身和内脏脂肪百分比，并使用膝关节超声检查对积液-滑膜炎进行分级。采用带交互项的多元回归模型检验脂肪百分比与疼痛强度（线性）/积液-滑膜炎（logistic）之间的关系，以及脂肪和SII/SIRI对疼痛强度/积液-滑膜炎的交互作用。根据混杂因素（年龄、性别、BMI、对侧膝关节的放射学严重程度和焦虑抑郁症状）对分析进行了调整。结果225名参与者(平均年龄：61.1（10.9)，68%为女性，平均BMI: 31.7(7.7)）的数据被分析。调整后的脂肪和疼痛强度模型的相关性如下：全身脂肪：β): - 0.03(-0.54 ~ 0.46)，内脏脂肪：β(: -0.25（-1.03 ~ 0.51）。调整脂肪和积液-滑膜炎模型的比值比为：全身脂肪：OR: 0.98(0.92 ~ 1.05)，内脏脂肪：OR(): 1.01（0.91 ~ 1.11）。主效应和交互效应均不显著。结论：我们的初步结果不支持肥胖及其与全身炎症（疼痛/积液-滑膜炎）的相互作用的关联。需要进一步的研究。

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引用次数: 0

Response to Chen and Liu regarding correspondence to “Development of a prediction model for progression of rheumatoid arthritis–associated interstitial lung disease using serologic and clinical factors: The prospective KORAIL cohort” 对Chen和Liu关于“基于血清学和临床因素的类风湿关节炎相关间质性肺病进展预测模型的建立：前瞻性KORAIL队列”的回应。

IF 4.4 2区医学 Q1 RHEUMATOLOGY

Seminars in arthritis and rheumatism

Pub Date : 2026-01-03 DOI: 10.1016/j.semarthrit.2026.152912

Sung Hae Chang , Misti L. Paudel , Eun Young Lee , Jeffrey A. Sparks

引用次数: 0

COVID-19 vaccination and systemic autoimmune rheumatic diseases: No evidence of disproportionately increased reporting in VAERS COVID-19疫苗接种和系统性自身免疫性风湿病：无证据表明VAERS报告比例增加。

IF 4.4 2区医学 Q1 RHEUMATOLOGY

Seminars in arthritis and rheumatism

Pub Date : 2026-01-02 DOI: 10.1016/j.semarthrit.2025.152911

Jacopo Ciaffi , Ginevra Torrigiani , Piero Ruscitti , Antonella Zambon , Francesco Ursini

Objectives

To investigate whether systemic autoimmune rheumatic diseases (SARDs) were disproportionately reported as adverse events following COVID-19 vaccination compared with other vaccines, using data from the Vaccine Adverse Event Reporting System (VAERS).

Methods

We conducted a retrospective disproportionality analysis of VAERS reports collected between December 2020 and December 2024. Reports were identified using a structured query based on MedDRA terms for specific SARDs, including polymyalgia rheumatica, giant cell arteritis, systemic lupus erythematosus, systemic sclerosis, Sjögren’s syndrome, myositis, and other vasculitides. For each disease, the proportional reporting ratio (PRR), reporting odds ratio (ROR), and Bayesian information component (IC) were calculated, comparing COVID-19 vaccines (BNT162b2, mRNA-1273, Ad26.COV2.S) with all other vaccines in VAERS. Analyses were further stratified by sex to explore consistency.

Results

Among approximately 680,000 valid adverse event reports, encompassing both COVID-19 and non–COVID-19 vaccines, no significant disproportionality signal was identified for any SARD. Polymyalgia rheumatica, giant cell arteritis, systemic lupus erythematosus, systemic sclerosis, Sjögren’s syndrome, and myositis showed no evidence of disproportionate reporting following COVID-19 vaccination. The category “other vasculitides” displayed a lower reporting frequency following COVID-19 vaccination compared with other vaccines. Stratified analyses yielded consistent findings across sex subgroups.

Conclusion

In a large national pharmacovigilance dataset, COVID-19 vaccines were not associated with a disproportionate increase in reports of any SARD. These results support the favorable safety profile of COVID-19 vaccines with respect to autoimmune rheumatic events, while highlighting the value of ongoing post-marketing surveillance for rare immune-mediated reactions.

目的：利用疫苗不良事件报告系统（VAERS）的数据，调查与其他疫苗相比，系统性自身免疫性风湿病（SARDs）作为COVID-19疫苗接种后不良事件的报告是否不成比例。方法：对2020年12月至2024年12月收集的VAERS报告进行回顾性歧化分析。使用基于MedDRA术语的结构化查询来识别特定SARDs的报告，包括风湿性多肌痛、巨细胞动脉炎、系统性红斑狼疮、系统性硬化症、Sjögren综合征、肌炎和其他血管疾病。对每种疾病计算比例报告比（PRR）、报告优势比（ROR）和贝叶斯信息分量（IC），比较COVID-19疫苗（BNT162b2、mRNA-1273、Ad26.COV2）。S)与所有其他VAERS疫苗。进一步按性别分层分析以探讨一致性。结果：在约68万份有效不良事件报告中，包括COVID-19和非COVID-19疫苗，未发现任何SARD的显著歧化信号。风湿病多肌痛、巨细胞动脉炎、系统性红斑狼疮、系统性硬化症、Sjögren综合征和肌炎在COVID-19疫苗接种后没有不成比例的报告证据。与其他疫苗相比，COVID-19疫苗接种后“其他血管”类别的报告频率较低。分层分析得出了跨性别亚组的一致结果。结论：在一个大型的国家药物警戒数据集中，COVID-19疫苗与任何SARD报告的不成比例的增加无关。这些结果支持了COVID-19疫苗在自身免疫性风湿病事件方面的良好安全性，同时强调了对罕见免疫介导反应进行持续上市后监测的价值。

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Biologic switching challenges in psoriatic arthritis: A pediatric reflection, letter to "biologic switching in psoriatic arthritis: Insights from real-world data and key risk factors" 银屑病关节炎的生物转换挑战：儿科反思，致“银屑病关节炎的生物转换：来自现实世界数据和关键危险因素的见解”的信

IF 4.4 2区医学 Q1 RHEUMATOLOGY

Seminars in arthritis and rheumatism

Pub Date : 2026-01-01 DOI: 10.1016/j.semarthrit.2025.152910

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Response to letter to the editor regarding "Nailfold Capillaroscopy as a predictor of cardiovascular events and mortality in systemic sclerosis" 关于“甲襞毛细血管镜检查作为系统性硬化症心血管事件和死亡率的预测指标”致编辑的信的回复

IF 4.4 2区医学 Q1 RHEUMATOLOGY

Seminars in arthritis and rheumatism

Pub Date : 2026-01-01 DOI: 10.1016/j.semarthrit.2025.152909

Carlos Valera-Ribera, Juan José Alegre-Sancho, Joaquín Lacasa-Molina, Montserrat Robustillo-Villarino, Javier Narváez

引用次数: 0

Comment on "Risk and temporal trends of heart failure subtypes in rheumatoid arthritis" 对“类风湿关节炎心衰亚型的风险和时间趋势”的评论

IF 4.4 2区医学 Q1 RHEUMATOLOGY

Seminars in arthritis and rheumatism

Pub Date : 2026-01-01 DOI: 10.1016/j.semarthrit.2025.152906

Lin Zhang , Lidan Yang

引用次数: 0

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