Pub Date : 2024-09-07DOI: 10.1016/j.semarthrit.2024.152544
I.A. Szilagyi , N.L. Nguyen , C.G. Boer , D. Schiphof , F. Ahmadizar , M. Kavousi , S.M.A. Bierma-Zeinstra , J.B.J. van Meurs
Objective
Although a relationship between osteoarthritis and components of metabolic syndrome (MetS) has been suggested, most of the results have been cross-sectional. We, therefore, aimed to investigate the sex-specific longitudinal association of (components of) MetS with progression of radiographic osteoarthritis and chronic pain in the knee joints in a large prospective cohort.
Method
In the large population-based Rotterdam study of up to 6,138 individuals, median follow-up time 5.7 (IQR 5.5) years, we examined the relation between MetS and its components (abdominal obesity, high triglycerides, low high-density lipoprotein, elevated blood pressure, and type 2 diabetes) with the progression of osteoarthritis using generalized estimating equations, generalized linear models and competing risk analysis. Analyses were stratified for sex. Covariates adjusted for: age, smoking, alcohol use, education, sub-cohort, baseline K/L grade, months between radiographs and BMI.
Results
The presence of MetS (37.6 % in men, 39 % in women) and elevated blood pressure was associated with an increased risk of knee osteoarthritis progression in both men and women. MetS was associated with an increased risk of incident chronic knee pain (CKP) in men. In addition, abdominal obesity and high triglycerides showed higher riskfor incidence of CKP in men,but not in women. The associations were attenuated and no longer significant after BMI-adjustment, except for the association of MetS and high triglycerides with incidence of CKP in men that stayed significant (OR 1.04, 95 %CI 1.00–1.07 for MetS and OR 1.04, 95 %CI 1.01–1.07 for high triglycerides).
Conclusion
Metabolic syndrome and individual metabolic components, such as abdominal obesity and elevated blood pressure, were associated with radiographic progression of knee OA in both men and women, but not independent of BMI. Metabolic syndrome and high triglycerides were associated with incidence of CKP only in men.
目的虽然骨关节炎与代谢综合征（MetS）之间存在关系，但大多数结果都是横断面的。因此，我们的目的是在一个大型前瞻性队列中调查 MetS（成分）与膝关节放射学骨关节炎和慢性疼痛进展之间的性别特异性纵向关系。我们使用广义估计方程、广义线性模型和竞争风险分析，研究了 MetS 及其组成部分（腹部肥胖、高甘油三酯、低高密度脂蛋白、血压升高和 2 型糖尿病）与骨关节炎进展之间的关系。分析按性别分层。结果在男性和女性中，MetS（男性为 37.6%，女性为 39%）和血压升高与膝关节骨性关节炎进展风险增加有关。在男性中，MetS 与慢性膝关节疼痛（CKP）的发病风险增加有关。此外，腹部肥胖和高甘油三酯在男性中显示出更高的慢性膝关节痛发病风险，但在女性中却没有。除了 MetS 和高甘油三酯与男性 CKP 发病率的关系仍然显著（MetS 的 OR 值为 1.04，95 %CI 为 1.00-1.07；高甘油三酯的 OR 值为 1.04，95 %CI 为 1.01-1.07）外，其他关系在进行体重指数调整后均有所减弱且不再显著。结论代谢综合征和个别代谢成分，如腹部肥胖和血压升高，与男性和女性膝关节 OA 的影像学进展有关，但与体重指数无关。代谢综合征和高甘油三酯仅与男性的 CKP 发生率有关。
{"title":"Metabolic syndrome, radiographic osteoarthritis progression and chronic pain of the knee among men and women from the general population: The Rotterdam study","authors":"I.A. Szilagyi , N.L. Nguyen , C.G. Boer , D. Schiphof , F. Ahmadizar , M. Kavousi , S.M.A. Bierma-Zeinstra , J.B.J. van Meurs","doi":"10.1016/j.semarthrit.2024.152544","DOIUrl":"10.1016/j.semarthrit.2024.152544","url":null,"abstract":"<div><h3>Objective</h3><p>Although a relationship between osteoarthritis and components of metabolic syndrome (MetS) has been suggested, most of the results have been cross-sectional. We, therefore, aimed to investigate the sex-specific longitudinal association of (components of) MetS with progression of radiographic osteoarthritis and chronic pain in the knee joints in a large prospective cohort.</p></div><div><h3>Method</h3><p>In the large population-based Rotterdam study of up to 6,138 individuals, median follow-up time 5.7 (IQR 5.5) years, we examined the relation between MetS and its components (abdominal obesity, high triglycerides, low high-density lipoprotein, elevated blood pressure, and type 2 diabetes) with the progression of osteoarthritis using generalized estimating equations, generalized linear models and competing risk analysis. Analyses were stratified for sex. Covariates adjusted for: age, smoking, alcohol use, education, sub-cohort, baseline K/L grade, months between radiographs and BMI.</p></div><div><h3>Results</h3><p>The presence of MetS (37.6 % in men, 39 % in women) and elevated blood pressure was associated with an increased risk of knee osteoarthritis progression in both men and women. MetS was associated with an increased risk of incident chronic knee pain (CKP) in men. In addition, abdominal obesity and high triglycerides showed higher riskfor incidence of CKP in men,but not in women. The associations were attenuated and no longer significant after BMI-adjustment, except for the association of MetS and high triglycerides with incidence of CKP in men that stayed significant (OR 1.04, 95 %CI 1.00–1.07 for MetS and OR 1.04, 95 %CI 1.01–1.07 for high triglycerides).</p></div><div><h3>Conclusion</h3><p>Metabolic syndrome and individual metabolic components, such as abdominal obesity and elevated blood pressure, were associated with radiographic progression of knee OA in both men and women, but not independent of BMI. Metabolic syndrome and high triglycerides were associated with incidence of CKP only in men.</p></div>","PeriodicalId":21715,"journal":{"name":"Seminars in arthritis and rheumatism","volume":null,"pages":null},"PeriodicalIF":4.6,"publicationDate":"2024-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0049017224001847/pdfft?md5=10f24876f313d8f92aa8763cf3049e7e&pid=1-s2.0-S0049017224001847-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142241278","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-01DOI: 10.1016/j.semarthrit.2024.152545
Patricia Vega-Fernandez , Kelly Rogers , Pinar Ozge Avar-Aydin , Megan Quinlan-Waters , Jennifer Huggins , Hermine I Brunner , Daniel J. Lovell , Mekibib Altaye , Amy Cassedy , Arthur B Meyers , Tracy V Ting
Objective
To validate the ankle-specific Pediatric Arthritis Ultrasound Scoring System (PAUSS-ankle) in children with juvenile idiopathic arthritis (JIA).
Methods
Patients with a diagnosis of JIA prospectively underwent a standard clinical assessment and musculoskeletal ultrasound (MSUS) of one or both ankles. B-mode and Power-Doppler mode MSUS images were acquired and scored according to the PAUSS-ankle protocol. A subset of patients received a contrast-enhanced MRI (ceMRI) of the affected ankle. ceMRI scoring for synovitis was performed according to the Rheumatoid Arthritis MRI System (RAMRIS). Test characteristics of the PAUSS-ankle scores were evaluated with ceMRI as reference. Associations between the findings on physical examination, PAUSS-ankle, and RAMRIS were investigated.
Results
Thirty-two patients with JIA contributed 63 MSUS and 15 ceMRIs of the ankles. The PAUSS-ankle total B-mode score had a moderate correlation with physical examination findings (correlation (r)=0.43, p < 0.001). The PAUSS-ankle B-mode score ≥1 exhibited a sensitivity of 79 % and specificity of 100 %, demonstrating excellent diagnostic accuracy with an area under the curve (AUC)= 0.89 (confidence intervals, CI, 0.78–1.00) while clinical assessment had a sensitivity of 57 % and AUC= 0.71 (CI: 0.58–0.85). The PAUSS-ankle B-mode score had significant strong correlations (r = 0.68–0.90, p < 0.005) with the RAMRIS for the assessment of disease severity for each joint area and the ankle joint as a whole.
Conclusion
Our findings demonstrate excellent diagnostic accuracy of the PAUSS-ankle in detecting the presence and severity of ankle synovitis when compared to ceMRI. The PAUSS-ankle holds significant promise as an accurate measurement that may complement current clinical standards.
目的 在幼年特发性关节炎（JIA）患儿中验证踝关节特异性儿科关节炎超声评分系统（PAUSS-ankle）。方法 对确诊为 JIA 的患者进行前瞻性的标准临床评估，并对一侧或双侧踝关节进行肌肉骨骼超声检查（MSUS）。根据 PAUSS-踝关节方案采集 B 型和动力多普勒模式 MSUS 图像并进行评分。一部分患者接受了受累踝关节的对比增强核磁共振成像（ceMRI）检查。ceMRI根据类风湿性关节炎核磁共振成像系统（RAMRIS）对滑膜炎进行评分。以ceMRI为参考，评估了PAUSS-踝关节评分的测试特征。结果32名JIA患者接受了63次MSUS检查和15次ceMRI检查。PAUSS-踝关节B型总分与体格检查结果呈中度相关（相关性（r）=0.43，p <0.001）。PAUSS-足踝 B 型评分≥1 分的灵敏度为 79%，特异性为 100%，显示出极佳的诊断准确性，曲线下面积 (AUC)= 0.89（置信区间，CI，0.78-1.00），而临床评估的灵敏度为 57%，AUC= 0.71（CI：0.58-0.85）。在评估每个关节区域和整个踝关节的疾病严重程度时，PAUSS-踝关节 B 型评分与 RAMRIS 有显著的强相关性（r = 0.68-0.90，p < 0.005）。PAUSS-踝关节作为一种精确的测量方法，有望补充当前的临床标准。
{"title":"Validation of the ankle-specific pediatric arthritis ultrasound scoring system in children with juvenile idiopathic arthritis","authors":"Patricia Vega-Fernandez , Kelly Rogers , Pinar Ozge Avar-Aydin , Megan Quinlan-Waters , Jennifer Huggins , Hermine I Brunner , Daniel J. Lovell , Mekibib Altaye , Amy Cassedy , Arthur B Meyers , Tracy V Ting","doi":"10.1016/j.semarthrit.2024.152545","DOIUrl":"10.1016/j.semarthrit.2024.152545","url":null,"abstract":"<div><h3>Objective</h3><p>To validate the ankle-specific Pediatric Arthritis Ultrasound Scoring System (PAUSS-ankle) in children with juvenile idiopathic arthritis (JIA).</p></div><div><h3>Methods</h3><p>Patients with a diagnosis of JIA prospectively underwent a standard clinical assessment and musculoskeletal ultrasound (MSUS) of one or both ankles. B-mode and Power-Doppler mode MSUS images were acquired and scored according to the PAUSS-ankle protocol. A subset of patients received a contrast-enhanced MRI (ceMRI) of the affected ankle. ceMRI scoring for synovitis was performed according to the Rheumatoid Arthritis MRI System (RAMRIS). Test characteristics of the PAUSS-ankle scores were evaluated with ceMRI as reference. Associations between the findings on physical examination, PAUSS-ankle, and RAMRIS were investigated.</p></div><div><h3>Results</h3><p>Thirty-two patients with JIA contributed 63 MSUS and 15 ceMRIs of the ankles. The PAUSS-ankle total B-mode score had a moderate correlation with physical examination findings (correlation (r)=0.43, <em>p</em> < 0.001). The PAUSS-ankle B-mode score ≥1 exhibited a sensitivity of 79 % and specificity of 100 %, demonstrating excellent diagnostic accuracy with an area under the curve (AUC)= 0.89 (confidence intervals, CI, 0.78–1.00) while clinical assessment had a sensitivity of 57 % and AUC= 0.71 (CI: 0.58–0.85). The PAUSS-ankle B-mode score had significant strong correlations (<em>r</em> = 0.68–0.90, <em>p</em> < 0.005) with the RAMRIS for the assessment of disease severity for each joint area and the ankle joint as a whole.</p></div><div><h3>Conclusion</h3><p>Our findings demonstrate excellent diagnostic accuracy of the PAUSS-ankle in detecting the presence and severity of ankle synovitis when compared to ceMRI. The PAUSS-ankle holds significant promise as an accurate measurement that may complement current clinical standards.</p></div>","PeriodicalId":21715,"journal":{"name":"Seminars in arthritis and rheumatism","volume":null,"pages":null},"PeriodicalIF":4.6,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0049017224001859/pdfft?md5=a57497983a79d83a1fbbe21fd7684714&pid=1-s2.0-S0049017224001859-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142162609","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-30DOI: 10.1016/j.semarthrit.2024.152542
U Kiltz , A Molto , C Lopez-Medina , M Dougados , D van der Heijde , A Boonen , F Van den Bosch , J Braun
Objective
To test trial and longitudinal known group discrimination of thresholds of meaning for improvement and health states of the ASAS Health Index (ASAS HI) in patients with active axSpA treated in a randomized study.
Methods
Data from baseline and week 48 from the tight-controlled, treat-to-target trial TICOSPA study were used. The performance of different thresholds to assess change or health states of the ASAS HI were evaluated between arms and against changes in patients’ relevant outcomes and various external responder criteria. Analyses were performed by comparing the mean values t-tests or proportion of responders of continuous and dichotomous external criteria respectively. Trial discrimination of the ASAS HI thresholds were assessed by odds ratios and Phi coefficient in a large number of potential ASAS HI thresholds. Differences in health states in relevant external outcomes between ASAS HI responders and non-responders was assessed by comparing the best performing improvement and state thresholds by using t-tests and chi-square, as appropriate. Missing data on outcomes was handled by non-responder imputation (NRI).
Results
All 160 patients had available ASAS HI data. Trial discrimination was larger for absolute ASAS HI change of ≥2.0, ≥2.5, and ≥3.0 points followed by ASAS HI 20 % improvement. Odds ratio ranged between 1.27 and 1.75 for absolute and between 1.0 and 1.64 for relative improvement outcomes. Longitudinal discrimination of ASAS HI improvement ≥30 % or ≥ 3.0 points had a larger reduction in patient global and disease activity and reached more often remission compared to patients with no significant improvement in global functioning. Patients who achieved ASAS HI ≤ 5.0 compared with patients who did not achieve such states were more likely to have ASAS partial remission, ASDAS inactive disease or ASDAS low activity at week 48.
Conclusions
The data-driven thresholds of the ASAS HI identified in a longitudinal observational setting perform well in the context of a randomized trial.
目的测试随机研究中接受治疗的活动性轴索硬化症患者的ASAS健康指数（ASAS Health Index，ASAS HI）改善意义阈值和健康状态的试验和纵向已知组别判别：方法： 采用严格对照、目标治疗试验 TICOSPA 研究的基线和第 48 周数据。根据患者相关结果的变化和各种外部应答者标准，评估了各组间评估 ASAS HI 变化或健康状态的不同阈值的性能。分析方法是分别比较连续和二分外部标准的平均值 t 检验或应答者比例。在大量潜在的 ASAS HI 临界值中，通过几率比和 Phi 系数评估 ASAS HI 临界值的试验区分度。ASAS HI应答者和未应答者在相关外部结果中的健康状态差异通过比较表现最佳的改善和状态阈值进行评估，根据情况使用t检验和秩和检验。结果缺失数据由非应答者估算（NRI）处理：所有 160 名患者都有 ASAS HI 数据。ASAS HI绝对值变化≥2.0、≥2.5和≥3.0分，然后ASAS HI改善20%，试验区分度较大。绝对改善结果的比值比介于 1.27 和 1.75 之间，相对改善结果的比值比介于 1.0 和 1.64 之间。与整体功能无明显改善的患者相比，ASAS HI改善≥30%或≥3.0分的纵向分辨患者的整体功能和疾病活动度下降幅度更大，更常达到缓解。与未达到这种状态的患者相比，达到ASAS HI≤5.0的患者在第48周时更有可能出现ASAS部分缓解、ASDAS非活动性疾病或ASDAS低活动性：在纵向观察中确定的 ASAS HI 数据驱动阈值在随机试验中表现良好。
{"title":"Performance of cut-offs of the ASAS Health Index to discriminate between treatment groups in patients with axial spondyloarthritis in the TICOSPA trial","authors":"U Kiltz , A Molto , C Lopez-Medina , M Dougados , D van der Heijde , A Boonen , F Van den Bosch , J Braun","doi":"10.1016/j.semarthrit.2024.152542","DOIUrl":"10.1016/j.semarthrit.2024.152542","url":null,"abstract":"<div><h3>Objective</h3><p>To test trial and longitudinal known group discrimination of thresholds of meaning for improvement and health states of the ASAS Health Index (ASAS HI) in patients with active axSpA treated in a randomized study.</p></div><div><h3>Methods</h3><p>Data from baseline and week 48 from the tight-controlled, treat-to-target trial TICOSPA study were used. The performance of different thresholds to assess change or health states of the ASAS HI were evaluated between arms and against changes in patients’ relevant outcomes and various external responder criteria. Analyses were performed by comparing the mean values <em>t</em>-tests or proportion of responders of continuous and dichotomous external criteria respectively. Trial discrimination of the ASAS HI thresholds were assessed by odds ratios and Phi coefficient in a large number of potential ASAS HI thresholds. Differences in health states in relevant external outcomes between ASAS HI responders and non-responders was assessed by comparing the best performing improvement and state thresholds by using <em>t</em>-tests and chi-square, as appropriate. Missing data on outcomes was handled by non-responder imputation (NRI).</p></div><div><h3>Results</h3><p>All 160 patients had available ASAS HI data. Trial discrimination was larger for absolute ASAS HI change of ≥2.0, ≥2.5, and ≥3.0 points followed by ASAS HI 20 % improvement. Odds ratio ranged between 1.27 and 1.75 for absolute and between 1.0 and 1.64 for relative improvement outcomes. Longitudinal discrimination of ASAS HI improvement ≥30 % or ≥ 3.0 points had a larger reduction in patient global and disease activity and reached more often remission compared to patients with no significant improvement in global functioning. Patients who achieved ASAS HI ≤ 5.0 compared with patients who did not achieve such states were more likely to have ASAS partial remission, ASDAS inactive disease or ASDAS low activity at week 48.</p></div><div><h3>Conclusions</h3><p>The data-driven thresholds of the ASAS HI identified in a longitudinal observational setting perform well in the context of a randomized trial.</p></div>","PeriodicalId":21715,"journal":{"name":"Seminars in arthritis and rheumatism","volume":null,"pages":null},"PeriodicalIF":4.6,"publicationDate":"2024-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0049017224001823/pdfft?md5=3716c9528cf039be7e5ecf1b7ad73640&pid=1-s2.0-S0049017224001823-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142126625","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-23DOI: 10.1016/j.semarthrit.2024.152540
Jie Gao, Yu Wang
{"title":"Letter to the editor to 'Soluble CXCL16 is a prognostic biomarker associated with rapidly progressive interstitial lung disease complicated with dermatomyositis'","authors":"Jie Gao, Yu Wang","doi":"10.1016/j.semarthrit.2024.152540","DOIUrl":"10.1016/j.semarthrit.2024.152540","url":null,"abstract":"","PeriodicalId":21715,"journal":{"name":"Seminars in arthritis and rheumatism","volume":null,"pages":null},"PeriodicalIF":4.6,"publicationDate":"2024-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142098146","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-23DOI: 10.1016/j.semarthrit.2024.152539
Jinchi Tang , Michiel M.A. van Buuren , Fleur Boel , Noortje S. Riedstra , Myrthe A. van den Berg , Jos Runhaar , Sita Bierma-Zeinstra , Rintje Agricola
Objectives
To determine the association between baseline cam morphology and self-reported hip pain assessed at annual visits over a 10-year follow-up period stratified by biological sex. The secondary aim was to study the association between the magnitude of cam morphology and the severity of pain in symptomatic hips.
Methods
The nationwide prospective Cohort Hip and Cohort Knee (CHECK) study includes 1,002 participants aged 45-65 years. Logistic regression with generalized estimating equations were used to determine the strength of the associations between (1) baseline cam morphology (both alpha angle ≥60° and as a continuous measure) and the presence of hip pain at 10 annual follow-up visits and (2) the alpha angle (continuous) and the severity of pain as classified by Numerical Rating Scale at 5-,8-, 9-, and 10-years. The results are expressed as odds ratios (OR), adjusted for age, biological sex (only in the sex-combined group), body mass index, and follow-up Kellgren and Lawrence grade.
Results
In total, 1,658 hips were included at baseline (1,335 female hips (79.2%)). The prevalence of cam morphology was 11.1% among all hips (29.1% in males; 6.4% in females). No association was found between cam morphology at baseline and the presence of hip pain at any follow-up in the female or sex-combined group. In males, only at 5-year follow-up, significant adjusted ORs were observed for the presence of cam morphology (1.77 (95%CI: 1.01-3.09)) and the alpha angle (1.02 (95%CI:1.00-1.04)). No evidence of associations was found between the alpha angle and the severity of hip pain in any of three groups.
Conclusion
Within this study, no consistent associations were found between cam morphology and hip pain at multiple follow-ups. There might be a weak relationship between cam morphology and hip pain in males, while no such relation was found in females. We did not identify an association between the alpha angle and severity of hip pain.
{"title":"The association between cam morphology and hip pain in males and females within 10 years: A national prospective cohort study (CHECK)","authors":"Jinchi Tang , Michiel M.A. van Buuren , Fleur Boel , Noortje S. Riedstra , Myrthe A. van den Berg , Jos Runhaar , Sita Bierma-Zeinstra , Rintje Agricola","doi":"10.1016/j.semarthrit.2024.152539","DOIUrl":"10.1016/j.semarthrit.2024.152539","url":null,"abstract":"<div><h3>Objectives</h3><p>To determine the association between baseline cam morphology and self-reported hip pain assessed at annual visits over a 10-year follow-up period stratified by biological sex. The secondary aim was to study the association between the magnitude of cam morphology and the severity of pain in symptomatic hips.</p></div><div><h3>Methods</h3><p>The nationwide prospective Cohort Hip and Cohort Knee (CHECK) study includes 1,002 participants aged 45-65 years. Logistic regression with generalized estimating equations were used to determine the strength of the associations between (1) baseline cam morphology (both alpha angle ≥60° and as a continuous measure) and the presence of hip pain at 10 annual follow-up visits and (2) the alpha angle (continuous) and the severity of pain as classified by Numerical Rating Scale at 5-,8-, 9-, and 10-years. The results are expressed as odds ratios (OR), adjusted for age, biological sex (only in the sex-combined group), body mass index, and follow-up Kellgren and Lawrence grade.</p></div><div><h3>Results</h3><p>In total, 1,658 hips were included at baseline (1,335 female hips (79.2%)). The prevalence of cam morphology was 11.1% among all hips (29.1% in males; 6.4% in females). No association was found between cam morphology at baseline and the presence of hip pain at any follow-up in the female or sex-combined group. In males, only at 5-year follow-up, significant adjusted ORs were observed for the presence of cam morphology (1.77 (95%CI: 1.01-3.09)) and the alpha angle (1.02 (95%CI:1.00-1.04)). No evidence of associations was found between the alpha angle and the severity of hip pain in any of three groups.</p></div><div><h3>Conclusion</h3><p>Within this study, no consistent associations were found between cam morphology and hip pain at multiple follow-ups. There might be a weak relationship between cam morphology and hip pain in males, while no such relation was found in females. We did not identify an association between the alpha angle and severity of hip pain.</p></div>","PeriodicalId":21715,"journal":{"name":"Seminars in arthritis and rheumatism","volume":null,"pages":null},"PeriodicalIF":4.6,"publicationDate":"2024-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0049017224001793/pdfft?md5=4ad240d7ff5c40cd48945eb94da5a83c&pid=1-s2.0-S0049017224001793-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142146217","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-22DOI: 10.1016/j.semarthrit.2024.152541
Changhong Li , Hua Zhang , Jinxia Zhao
{"title":"Response to the letter entitled \" Letter to the editor to Soluble CXCL16 is a prognostic biomarker associated with rapidly progressive interstitial lung disease complicated with dermatomyositis\" by Gao et al.","authors":"Changhong Li , Hua Zhang , Jinxia Zhao","doi":"10.1016/j.semarthrit.2024.152541","DOIUrl":"10.1016/j.semarthrit.2024.152541","url":null,"abstract":"","PeriodicalId":21715,"journal":{"name":"Seminars in arthritis and rheumatism","volume":null,"pages":null},"PeriodicalIF":4.6,"publicationDate":"2024-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142087012","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-22DOI: 10.1016/j.semarthrit.2024.152543
Rainer Ebid
{"title":"Macrophages–Autoimmunity–Treatment option","authors":"Rainer Ebid","doi":"10.1016/j.semarthrit.2024.152543","DOIUrl":"10.1016/j.semarthrit.2024.152543","url":null,"abstract":"","PeriodicalId":21715,"journal":{"name":"Seminars in arthritis and rheumatism","volume":null,"pages":null},"PeriodicalIF":4.6,"publicationDate":"2024-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142087013","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-22DOI: 10.1016/j.semarthrit.2024.152535
Andriko Palmowski , Eric T Roberts , Jing Li , Emma Kersey , Rachael Stovall , Frank Buttgereit , Jinoos Yazdany , Gabriela Schmajuk
Objective
To assess relationships between the timing of glucocorticoid (GC) initiation, entrance into rheumatology care, and the duration of GC use in older adults with early rheumatoid arthritis (eRA) in the U.S.
Methods
Data from the Rheumatology Informatics System for Effectiveness (RISE) registry and Medicare (2016–2018) were linked. Patients with ≥2 RA ICD codes in RISE were included; the first being the index date which signaled entrance into rheumatology care. GC initiation (between 3 months before to 6 months after the index date) and continuous GC use up to 12 months after the index date were captured using Medicare claims. Cox proportional hazards models with adjustment for confounders assessed differences in the duration of GC use for patients initiating GCs before versus after the index date. Average daily GC doses were estimated.
Results
1,733 patients (67 % female; mean age 76 ± 6 years) were included. 41 % initiated GCs, on average 16 ± 58 days before entering rheumatologic care. The mean duration of GC use was 157 days (95 %-CI 143 to 170). GC initiation before rheumatologic care was associated with longer GC use, even after adjustment for confounders (hazard ratio 0.61; 95 %-CI [0.51 to 0.74]). For patients using GCs for ≥3 months, average daily GC doses were <5 mg/d prednisone equivalent.
Conclusion
GCs are regularly used in eRA and most often initiated before patients enter rheumatology care. Long-term, low-dose GC use is common and associated with initiation before rheumatology care. Earlier referral to rheumatology might reduce GC exposure among U.S. patients with eRA.
{"title":"Initiation of glucocorticoids before entering rheumatology care associates with long-term glucocorticoid use in older adults with early rheumatoid arthritis: A joint analysis of Medicare and the Rheumatology Informatics System for Effectiveness (RISE) data","authors":"Andriko Palmowski , Eric T Roberts , Jing Li , Emma Kersey , Rachael Stovall , Frank Buttgereit , Jinoos Yazdany , Gabriela Schmajuk","doi":"10.1016/j.semarthrit.2024.152535","DOIUrl":"10.1016/j.semarthrit.2024.152535","url":null,"abstract":"<div><h3>Objective</h3><p>To assess relationships between the timing of glucocorticoid (GC) initiation, entrance into rheumatology care, and the duration of GC use in older adults with early rheumatoid arthritis (eRA) in the U.S.</p></div><div><h3>Methods</h3><p>Data from the Rheumatology Informatics System for Effectiveness (RISE) registry and Medicare (2016–2018) were linked. Patients with ≥2 RA ICD codes in RISE were included; the first being the index date which signaled entrance into rheumatology care. GC initiation (between 3 months before to 6 months after the index date) and continuous GC use up to 12 months after the index date were captured using Medicare claims. Cox proportional hazards models with adjustment for confounders assessed differences in the duration of GC use for patients initiating GCs before versus after the index date. Average daily GC doses were estimated.</p></div><div><h3>Results</h3><p>1,733 patients (67 % female; mean age 76 ± 6 years) were included. 41 % initiated GCs, on average 16 ± 58 days before entering rheumatologic care. The mean duration of GC use was 157 days (95 %-CI 143 to 170). GC initiation before rheumatologic care was associated with longer GC use, even after adjustment for confounders (hazard ratio 0.61; 95 %-CI [0.51 to 0.74]). For patients using GCs for ≥3 months, average daily GC doses were <5 mg/d prednisone equivalent.</p></div><div><h3>Conclusion</h3><p>GCs are regularly used in eRA and most often initiated before patients enter rheumatology care. Long-term, low-dose GC use is common and associated with initiation before rheumatology care. Earlier referral to rheumatology might reduce GC exposure among U.S. patients with eRA.</p></div>","PeriodicalId":21715,"journal":{"name":"Seminars in arthritis and rheumatism","volume":null,"pages":null},"PeriodicalIF":4.6,"publicationDate":"2024-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0049017224001756/pdfft?md5=560a31dbb2a8bef8ee537339ed3cc063&pid=1-s2.0-S0049017224001756-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142049328","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-16DOI: 10.1016/j.semarthrit.2024.152538
Kendal A. Marriott , Michelle Hall , Jacquelyn M. Maciukiewicz , Rachel D. Almaw , Emily G. Wiebenga , Natasha K. Ivanochko , Daniel Rinaldi , Emma V. Tung , Kim L. Bennell , Monica R. Maly
Background
In knee and hip osteoarthritis (OA), the mechanism for resistance exercise improving clinical outcomes and the dose-response between strength and clinical outcomes are unknown; in part due to inconsistent trial designs across studies.
Purpose
To determine whether the effects of resistance exercise interventions on pain and function differ based on comparator group; and whether there is an association between improvements in lower extremity strength with improvements in pain and function in knee and hip OA.
Methods
We searched 6 databases (inception to January 28 2023,) for randomized controlled trials (RCTs) comparing land-based, resistance exercise-only interventions with no intervention or any other intervention. There were four subgroups for comparator intervention: NONE (none/placebo/sham/usual care), EXE (other exercise interventions alone), NONEXE (non-exercise interventions alone), COMBO (combined exercise + non-exercise interventions). The between-group effect (ES) was calculated for immediate post-intervention pain and function (activities of daily living (ADL) and sports/recreation (SPORT)). Meta-regression analyses were completed to evaluate the association between improvements in lower extremity strength (independent variable) and improvements in pain, ADL and SPORT (dependent variables), irrespective of comparator intervention.
Results
For knee OA (257 studies), there were large benefits for pain [ES (95 % CI) = -0.92 (-1.15, -0.69)], ADL [-0.79 (-1.01, -0.56)] and SPORT [-0.79 (-1.02, -0.56)] favouring resistance exercise interventions compared to NONE. For knee pain, there was also a moderate benefit favouring COMBO interventions compared to resistance exercise interventions [0.44 (0.23, 0.65)]. For hip OA (15 studies), there were moderate benefits for pain [-0.51 (-0.68, -0.33)], ADL [-0.57 (-0.78, -0.36)] and SPORT [-0.52 (-0.70, -0.35)] favouring exercise interventions compared to NONE. For hip pain, there was also a moderate benefit favouring NONEXE interventions compared to resistance exercise interventions [0.57 (0.17, 0.97)]. For knee OA, greater strength gains were associated with larger improvements in pain [β (95 % CI) = -0.24 (-0.38, -0.09)], ADL [-0.43 (-0.73, -0.12)] and SPORT [-0.37 (-0.73, -0.00)].
Conclusion
In knee and hip OA, the effects of resistance exercise on pain and function improvements depend on the comparator intervention. For knee OA, a dose-response relationship was observed between lower extremity strength gains with pain and function improvements.
{"title":"The control group matters: Pain, physical function and strength improvements relative to the comparator intervention in knee and hip osteoarthritis","authors":"Kendal A. Marriott , Michelle Hall , Jacquelyn M. Maciukiewicz , Rachel D. Almaw , Emily G. Wiebenga , Natasha K. Ivanochko , Daniel Rinaldi , Emma V. Tung , Kim L. Bennell , Monica R. Maly","doi":"10.1016/j.semarthrit.2024.152538","DOIUrl":"10.1016/j.semarthrit.2024.152538","url":null,"abstract":"<div><h3>Background</h3><p>In knee and hip osteoarthritis (OA), the mechanism for resistance exercise improving clinical outcomes and the dose-response between strength and clinical outcomes are unknown; in part due to inconsistent trial designs across studies.</p></div><div><h3>Purpose</h3><p>To determine whether the effects of resistance exercise interventions on pain and function differ based on comparator group; and whether there is an association between improvements in lower extremity strength with improvements in pain and function in knee and hip OA.</p></div><div><h3>Methods</h3><p>We searched 6 databases (inception to January 28 2023,) for randomized controlled trials (RCTs) comparing land-based, resistance exercise-only interventions with no intervention or any other intervention. There were four subgroups for comparator intervention: NONE (none/placebo/sham/usual care), EXE (other exercise interventions alone), NONEXE (non-exercise interventions alone), COMBO (combined exercise + non-exercise interventions). The between-group effect (ES) was calculated for immediate post-intervention pain and function (activities of daily living (ADL) and sports/recreation (SPORT)). Meta-regression analyses were completed to evaluate the association between improvements in lower extremity strength (independent variable) and improvements in pain, ADL and SPORT (dependent variables), irrespective of comparator intervention.</p></div><div><h3>Results</h3><p>For knee OA (257 studies), there were large benefits for pain [ES (95 % CI) = -0.92 (-1.15, -0.69)], ADL [-0.79 (-1.01, -0.56)] and SPORT [-0.79 (-1.02, -0.56)] favouring resistance exercise interventions compared to NONE. For knee pain, there was also a moderate benefit favouring COMBO interventions compared to resistance exercise interventions [0.44 (0.23, 0.65)]. For hip OA (15 studies), there were moderate benefits for pain [-0.51 (-0.68, -0.33)], ADL [-0.57 (-0.78, -0.36)] and SPORT [-0.52 (-0.70, -0.35)] favouring exercise interventions compared to NONE. For hip pain, there was also a moderate benefit favouring NONEXE interventions compared to resistance exercise interventions [0.57 (0.17, 0.97)]. For knee OA, greater strength gains were associated with larger improvements in pain [β (95 % CI) = -0.24 (-0.38, -0.09)], ADL [-0.43 (-0.73, -0.12)] and SPORT [-0.37 (-0.73, -0.00)].</p></div><div><h3>Conclusion</h3><p>In knee and hip OA, the effects of resistance exercise on pain and function improvements depend on the comparator intervention. For knee OA, a dose-response relationship was observed between lower extremity strength gains with pain and function improvements.</p></div>","PeriodicalId":21715,"journal":{"name":"Seminars in arthritis and rheumatism","volume":null,"pages":null},"PeriodicalIF":4.6,"publicationDate":"2024-08-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0049017224001781/pdfft?md5=b213f890a73d859c14d35883761f06a9&pid=1-s2.0-S0049017224001781-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142098144","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-15DOI: 10.1016/j.semarthrit.2024.152533
Rachel Murdoch , Lene Terslev , Julia Martin , Borislav Mihov , Gregory D Gamble , Søren Torp-Pedersen , Anne M Horne , Nicola Dalbeth
Objectives
Use of handheld portable ultrasound is increasing and would improve access for people with rheumatic disease when conventional, cart-based ultrasound is unavailable. This study compared handheld and cart-based ultrasound for the assessment of gout lesions in people with gout.
Methods
The lower limbs of 21 participants with gout were independently scanned at six sites (1st and 2nd metatarsophalangeal joints, knee, patellar ligament, Achilles tendon, and peroneal tendons) using cart-based (LOGIQ P9) and handheld (Vscan Air™) ultrasound by two rheumatologists. One rheumatologist was randomized to scan the right or left leg first with the cart-based or handheld ultrasound. The other rheumatologist scanned the legs in the opposite order with the imaging devices reversed. Images were saved and blinded images scored for double contour, tophus, erosion and aggregates using OMERACT definitions by two rheumatologists experienced in gout ultrasound.
Results
On handheld ultrasound, 90% of participants had at least one site with double contour, tophus and erosions, and 100% had at least one site with aggregates. There were similar findings using cart-based ultrasound. However, site-level inter-device analysis showed only fair-good agreement: kappa (percentage agreement) for double contour 0.22 (67%), tophus 0.46 (77%), erosion 0.63 (83%) and aggregates 0.37 (75%). There were more aggregates detected by cart-based ultrasound in joints and more tophi detected by handheld ultrasound in ligaments and tendons.
Conclusions
Handheld ultrasound can detect gout lesions in people with established gout. However, concordance between cart-based and handheld ultrasound in detection of some gout lesions is low, particularly double contour and aggregates.
{"title":"Comparison of a handheld ultrasound device with cart-based ultrasound for the assessment of gout lesions in people with established gout","authors":"Rachel Murdoch , Lene Terslev , Julia Martin , Borislav Mihov , Gregory D Gamble , Søren Torp-Pedersen , Anne M Horne , Nicola Dalbeth","doi":"10.1016/j.semarthrit.2024.152533","DOIUrl":"10.1016/j.semarthrit.2024.152533","url":null,"abstract":"<div><h3>Objectives</h3><p>Use of handheld portable ultrasound is increasing and would improve access for people with rheumatic disease when conventional, cart-based ultrasound is unavailable. This study compared handheld and cart-based ultrasound for the assessment of gout lesions in people with gout.</p></div><div><h3>Methods</h3><p>The lower limbs of 21 participants with gout were independently scanned at six sites (1st and 2nd metatarsophalangeal joints, knee, patellar ligament, Achilles tendon, and peroneal tendons) using cart-based (LOGIQ P9) and handheld (Vscan Air™) ultrasound by two rheumatologists. One rheumatologist was randomized to scan the right or left leg first with the cart-based or handheld ultrasound. The other rheumatologist scanned the legs in the opposite order with the imaging devices reversed. Images were saved and blinded images scored for double contour, tophus, erosion and aggregates using OMERACT definitions by two rheumatologists experienced in gout ultrasound.</p></div><div><h3>Results</h3><p>On handheld ultrasound, 90% of participants had at least one site with double contour, tophus and erosions, and 100% had at least one site with aggregates. There were similar findings using cart-based ultrasound. However, site-level inter-device analysis showed only fair-good agreement: kappa (percentage agreement) for double contour 0.22 (67%), tophus 0.46 (77%), erosion 0.63 (83%) and aggregates 0.37 (75%). There were more aggregates detected by cart-based ultrasound in joints and more tophi detected by handheld ultrasound in ligaments and tendons.</p></div><div><h3>Conclusions</h3><p>Handheld ultrasound can detect gout lesions in people with established gout. However, concordance between cart-based and handheld ultrasound in detection of some gout lesions is low, particularly double contour and aggregates.</p></div>","PeriodicalId":21715,"journal":{"name":"Seminars in arthritis and rheumatism","volume":null,"pages":null},"PeriodicalIF":4.6,"publicationDate":"2024-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0049017224001732/pdfft?md5=4eb28523b0dd53a5cbcc22b8cd439b41&pid=1-s2.0-S0049017224001732-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142021343","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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