Seminars in arthritis and rheumatism最新文献_第4页

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

The efficacy of metformin for pain, function, and quality of life in knee osteoarthritis: A systematic review and meta-analysis 二甲双胍对膝关节骨关节炎患者疼痛、功能和生活质量的疗效：一项系统回顾和荟萃分析

IF 4.4 2区医学 Q1 RHEUMATOLOGY

Seminars in arthritis and rheumatism

Pub Date : 2025-12-31 DOI: 10.1016/j.semarthrit.2025.152908

Chi-Lan Kao , Shih-Ming Chen , Chih-Cheng Hsieh , Tzu-Rong Peng , Pei-Yun Tsai , Chia-Yu Lin , Ming-Chia Lee

Background

Knee osteoarthritis (KOA) is a leading cause of disability worldwide; however current therapies offer only symptomatic relief. Metformin, a widely used antidiabetic agent, has been demonstrated to have anti-inflammatory and chondroprotective effects in preclinical models, suggesting its KOA modifying properties.

Methods

We conducted a systematic review and meta-analysis of randomized controlled trials evaluating the effects of metformin in patients with KOA. A comprehensive search of PubMed, Embase, and Cochrane Library was performed up to May 2025. Two reviewers independently screened studies and extracted data. Statistical analyses were conducted using a random-effects model to account for between-study heterogeneity. Subgroup analyses based on formulation, treatment duration, and nonsteroidal anti-inflammatory drugs (NSAIDs) co-administration were also performed.

Results

Five studies (n = 337) were included. Metformin significantly reduced pain scores (standardized mean difference [SMD] = −1.295; 95 % confidence interval [CI]: −2.063 to −0.526) and stiffness (SMD = −0.746; 95 % CI: −1.385 to −0.107), improved physical function (SMD = −2.042; 95 % CI: −3.372 to −0.712), and health-related quality of life (SMD = −1.505; 95 % CI: −2.896 to −0.115). Effects were consistent regardless of oral or topical metformin use, treatment duration, and NSAID use, although the benefits were greater when metformin was combined with NSAIDs.

Conclusion

While metformin demonstrated consistent benefits in pain and functional outcomes, these findings should be interpreted as symptomatic and adjunctive effects rather than definitive disease modification. Future trials incorporating structural endpoints are needed to confirm disease-modifying potential.

膝骨关节炎（KOA）是世界范围内致残的主要原因；然而，目前的治疗只能缓解症状。二甲双胍是一种广泛使用的降糖药，在临床前模型中已被证明具有抗炎和软骨保护作用，表明其具有改变KOA的特性。方法对评价二甲双胍对KOA患者疗效的随机对照试验进行系统回顾和荟萃分析。对PubMed， Embase和Cochrane Library进行了全面的检索，直至2025年5月。两位审稿人独立筛选研究并提取数据。采用随机效应模型进行统计分析，以解释研究间的异质性。基于处方、治疗时间和非甾体抗炎药（NSAIDs）联合使用的亚组分析也进行了。结果纳入5项研究（n = 337）。二甲双胍显著降低了疼痛评分（标准化平均差[SMD] = - 1.295； 95%可信区间[CI]: - 2.063至- 0.526）和僵硬（SMD = - 0.746; 95% CI: - 1.385至- 0.107），改善了身体功能（SMD = - 2.042; 95% CI: - 3.372至- 0.712），以及与健康相关的生活质量（SMD = - 1.505; 95% CI: - 2.896至- 0.115）。无论口服或外用二甲双胍、治疗持续时间和使用非甾体抗炎药，效果都是一致的，尽管二甲双胍与非甾体抗炎药联合使用的效果更大。结论：虽然二甲双胍在疼痛和功能结局方面表现出一致的益处，但这些发现应被解释为症状和辅助作用，而不是确定的疾病改变。未来的试验需要结合结构终点来确认疾病改善的潜力。

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引用次数: 0

Erratum to “Magnetic resonance imaging for adult idiopathic inflammatory myopathies: a scoping review of protocols, grading systems and applications”[Seminars in Arthritis and Rheumatism Volume 75, (2025) 152865] 对“成人特发性炎性肌病的磁共振成像：协议，分级系统和应用的范围审查”的勘误[关节炎和风湿病研讨会，第75卷，（2025）152865]

IF 4.4 2区医学 Q1 RHEUMATOLOGY

Seminars in arthritis and rheumatism

Pub Date : 2025-12-31 DOI: 10.1016/j.semarthrit.2025.152899

Jessica A. Day , Daniel Brito de Araújo , Mickael Essouma , Edoardo Conticini , Lisa G. Rider , Daren Gibson , Adriana Maluf Elias , Claudia Saad Magalhães , Simone Appenzeller , Adam Schiffenbauer , Anneke J van der Koi , Siamak Moghadam-Kia , Vitor Tavares Paula , Julio Brandão Guimarães , Edoardo Marrani , Andrea Schwarz Doria , Samuel Katsuyuki Shinjo

引用次数: 0

Risk and temporal trends of heart failure subtype risk in Rheumatoid Arthritis 类风湿关节炎心衰亚型风险的风险和时间趋势

IF 4.4 2区医学 Q1 RHEUMATOLOGY

Seminars in arthritis and rheumatism

Pub Date : 2025-12-30 DOI: 10.1016/j.semarthrit.2025.152905

Tate M. Johnson , Bryant R. England

引用次数: 0

Determining the best discriminatory physical functioning outcome measurement instrument for psoriatic arthritis trials: A meta-epidemiological study 确定银屑病关节炎试验中最佳歧视性身体功能结果测量工具：一项荟萃流行病学研究。

IF 4.4 2区医学 Q1 RHEUMATOLOGY

Seminars in arthritis and rheumatism

Pub Date : 2025-12-29 DOI: 10.1016/j.semarthrit.2025.152907

Ying-Ying Leung , Tobias Haugegaard , Tommy Kok Annfeldt , Richard Holland , Vibeke Strand , Philip Mease , Peter Tugwell , George A. Wells , Beverley J. Shea , Ashish J. Mathew , Niti Goel , Christine Lindsay , Alexis Ogdie , Ana-Maria Orbai , Laura C. Coates , Dafna D. Gladman , William Tillett , Jeffrey Chau , Robin Christensen

Objectives

To empirically compare the discriminant capacities of three outcome measurement instruments for assessment of physical functioning for psoriatic arthritis (PsA): HAQ-DI, SF36-PF and SF36-PCS.

Methods

We applied a network meta-analysis technique in a sample of randomized trials (RCTs) for PsA. For randomized comparison, we calculated net effect size estimates for each outcome measurement instrument using standardized mean differences (SMDs); positive values indicated a beneficial effect of the intervention compared to the control groups. We analyzed the differences between outcome measurement instruments at the trial level by applying a multiple-treatment meta-analysis to compare the SMDs within and across randomized comparisons for each outcome measurement instrument.

Results

From 42 articles (31 RCTs), 57, 18, and 18 randomized comparisons enabled a direct comparison between HAQ-DI and SF36-PCS (difference in SMDs: 0.057, 95 % confidence interval, CI: 0.003 to 0.110), SF36-PF and SF36-PCS (difference in SMDs: 0.101, 95 % CI: 0.018 to 0.184); and HAQ-DI and SF36-PF (difference in SMDs:0.059, 95 % CI:0.142 to 0.024), respectively. The network meta-analysis technique confirmed that both HAQ-DI and SF36-PF were more responsive to change than SF36-PCS, with differences between SMDs of 0.057 (95 % CI: 0.003 to 0.110) and 0.109 (95 % CI: 0.032 to 0.185), respectively. No difference in discriminatory capacity between HAQ-DI and SF36-PF was noted.

Conclusions

HAQ-DI and SF-36-PF were equally responsive to change and superior to SF36-PCS in PsA RCTs. We illustrated a new method for quantitative comparison of the performance of different outcome measurement instruments for a particular domain.

目的：实证比较HAQ-DI、SF36-PF和SF36-PCS三种结果测量工具评估银屑病关节炎（PsA）身体功能的判别能力。方法：我们在PsA随机试验（rct）样本中应用网络荟萃分析技术。对于随机比较，我们使用标准化平均差异（SMDs）计算每个结果测量工具的净效应大小估计值；与对照组相比，正值表明干预的有益效果。我们在试验水平上分析了结果测量工具之间的差异，采用多治疗荟萃分析来比较每种结果测量工具的随机比较内部和之间的smd。结果：在42篇文章（31项随机对照试验）中，57、18和18项随机比较可以直接比较HAQ-DI和SF36-PCS （SMDs差异0.057,95%可信区间CI: 0.003至0.110）、SF36-PF和SF36-PCS (SMDs差异0.101,95%可信区间CI: 0.018至0.184)；HAQ-DI和SF36-PF （smd差异为0.059,95% CI为0.142 ~ 0.024）。网络荟萃分析技术证实，HAQ-DI和SF36-PF对变化的反应比SF36-PCS更敏感，smd之间的差异分别为0.057 （95% CI: 0.003至0.110）和0.109 （95% CI: 0.032至0.185）。HAQ-DI和SF36-PF之间的区分能力没有差异。结论：在PsA随机对照试验中，HAQ-DI和SF-36-PF对变化的反应相同，且优于SF36-PCS。我们说明了一种新的方法来定量比较不同的结果测量仪器的性能为特定领域。

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引用次数: 0

Almost half of the patients with axial spondyloarthritis reporting an acceptable symptom state have high disease activity; data from two standard-of-care cohorts 几乎一半报告可接受症状状态的轴型脊柱炎患者有高疾病活动性；数据来自两个标准治疗队列

IF 4.4 2区医学 Q1 RHEUMATOLOGY

Seminars in arthritis and rheumatism

Pub Date : 2025-12-29 DOI: 10.1016/j.semarthrit.2025.152903

Marlies Carbo , Anne Kampman , Davy Paap , Freke Wink , Casper Webers , Harald Vonkeman , Astrid van Tubergen , Suzanne Arends , Anneke Spoorenberg

Objectives

To assess the proportion of axial spondylarthritis (axSpA) patients reporting PASS, explore variables associated with PASS and determine the relation with axSpA Disease Activity Score (ASDAS) to predict PASS in two Dutch standard-of-care cohorts.

Methods

Patients from the GLAS cohort were included in this cross-sectional analysis. External validation was performed in the SpA-Net cohort. Univariable and multivariable logistic regression were performed to identify determinants of PASS. The predictive accuracy and threshold of the ASDAS for predicting PASS were determined using AUC and highest Youden’s index.

Results

Of 673 included GLAS patients, 63 % were male, mean age was 48 (±14) years, and mean ASDAS 2.3 (±0.9). In total, 77 % perceived their symptom state as acceptable. Of these patients, 44 % had an ASDAS ≥2.1. In multivariable regression, lower ASDAS, absence of tender entheses and older age were independently associated with reported PASS (R² = 0.39). The ASDAS showed good accuracy in predicting PASS, with AUC of 0.84 (95 % CI 0.80–0.85) and optimal cut-off value of 2.6 (sensitivity 78 %, specificity 77 %). Similar results were found in the 159 patients from SpA-Net.

Conclusion

In daily clinical practice, 3 out of 4 axSpA patients report an acceptable symptom state, although almost half of them have high disease activity. In line, the ASDAS threshold for predicting PASS is 2.6. Our results show that the PASS question provides additional information to disease activity, which can contribute to better shared decision making.

目的评估报告PASS的轴型脊柱炎（axSpA）患者的比例，探索与PASS相关的变量，并确定与axSpA疾病活动评分（ASDAS）的关系，以预测两个荷兰标准治疗队列中的PASS。方法来自GLAS队列的患者纳入横断面分析。在SpA-Net队列中进行外部验证。采用单变量和多变量逻辑回归来确定PASS的决定因素。采用AUC和最高约登指数确定ASDAS预测PASS的预测精度和阈值。结果673例GLAS患者中，63%为男性，平均年龄48（±14）岁，平均ASDAS 2.3（±0.9）岁。总的来说，77%的人认为他们的症状状态是可以接受的。在这些患者中，44%的患者ASDAS≥2.1。在多变量回归中，较低的ASDAS、没有压痛性鼻窦和年龄较大与报告的PASS独立相关（R²= 0.39）。ASDAS预测PASS具有良好的准确性，AUC为0.84 (95% CI 0.80-0.85)，最佳临界值为2.6（敏感性78%，特异性77%）。在SpA-Net的159名患者中也发现了类似的结果。结论在日常临床实践中，4例axSpA患者中有3例症状状态可接受，但近一半患者有较高的疾病活动性。因此，预测PASS的ASDAS阈值是2.6。我们的研究结果表明，PASS问题为疾病活动提供了额外的信息，这有助于更好地共同决策。

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引用次数: 0

Characteristics and long-term outcomes of patients with rheumatoid arthritis and concurrent calcium pyrophosphate deposition disease 类风湿关节炎并发焦磷酸钙沉积病患者的特点和长期预后

IF 4.4 2区医学 Q1 RHEUMATOLOGY

Seminars in arthritis and rheumatism

Pub Date : 2025-12-29 DOI: 10.1016/j.semarthrit.2025.152902

Natalie Schanzer , Bryant R. England , Katherine D. Wysham , Thomas R. Riley IV , Brian Sauer , Grant W. Cannon , Ted R. Mikuls , Joshua F. Baker

Purpose

To compare the characteristics, treatment patterns, and long-term outcomes of patients with concurrent calcium pyrophosphate deposition disease (CPPD) and rheumatoid arthritis (RA) to patients with RA without CPPD.

Methods

We studied patients with RA from the Veteran’s Affairs RA (VARA) registry and identified patients with CPPD using administrative codes. We compared characteristics of patients with concurrent CPPD and RA to those with RA alone at enrollment. We used parsimonious multivariable logistic regression to study the probability of achieving a low disease activity as well as receiving prednisone and new biologic or targeted synthetic disease modifying antirheumatic drugs (b/tsDMARDs) over follow-up, adjusting for pre-hypothesized confounders and stratifying by autoantibody status.

Results

Among 2771 U.S. veterans with RA, we identified 64 (2.3 %) patients with CPPD at enrollment. Patients with CPPD were older [68.5 (9.0) v. 64.2 (11.0), p < 0.001], had higher rates of comorbidities, including osteoarthritis (93.8 % v. 80.1 %, p = 0.007), spine disease, and diabetes, and were less likely to have ACPA (63.5 % v. 77.8 %, p = 0.01). While those with CPPD were numerically less likely to achieve low disease activity over time, this was not statistically significant. Among seronegative patients, CPPD patients exhibited more prednisone use (OR 2.44 [95 % CI 1.15–5.22]) and more frequent initiation of b/tsDMARDs (OR 2.79 [95 % CI 1.46–5.32]) as well as higher rates of joint replacement and death during follow-up.

Conclusions

Seronegative RA patients with CPPD changed therapies more frequently, used more prednisone, and had worse long-term outcomes. These findings suggest some seronegative RA may represent CPPD and require alternative diagnostic and treatment approaches.

目的比较焦磷酸钙沉积病（CPPD）合并类风湿关节炎（RA）患者与无CPPD合并类风湿关节炎（RA）患者的特点、治疗模式和长期预后。方法研究退伍军人事务RA （VARA）登记的RA患者，并使用行政代码识别CPPD患者。在入组时，我们比较了伴有CPPD和RA的患者与仅伴有RA的患者的特征。我们使用简约的多变量逻辑回归来研究在随访期间实现低疾病活动性以及接受强的松和新的生物或靶向合成疾病修饰抗风湿药物（b/tsDMARDs）的概率，调整预先假设的混杂因素并根据自身抗体状态分层。结果在2771名患有RA的美国退伍军人中，我们在入组时确定了64名（2.3%）CPPD患者。CPPD患者年龄较大[68.5 (9.0)vs . 64.2 (11.0), p < 0.001]，合并症发生率较高，包括骨关节炎（93.8% vs . 80.1%, p = 0.007）、脊柱疾病和糖尿病，ACPA发生率较低（63.5% vs . 77.8%, p = 0.01）。虽然CPPD患者在数字上不太可能随着时间的推移达到低疾病活动性，但这在统计学上并不显著。在血清阴性患者中，CPPD患者在随访期间表现出更多的强的松使用（OR 2.44 [95% CI 1.15-5.22]）和更频繁的b/ tsdmard启动（OR 2.79 [95% CI 1.46-5.32]）以及更高的关节置换率和死亡率。结论血清阴性RA合并CPPD患者更频繁地改变治疗方法，使用更多的强的松，长期预后更差。这些发现提示一些血清阴性的RA可能代表CPPD，需要其他的诊断和治疗方法。

{"title":"Characteristics and long-term outcomes of patients with rheumatoid arthritis and concurrent calcium pyrophosphate deposition disease","authors":"Natalie Schanzer , Bryant R. England , Katherine D. Wysham , Thomas R. Riley IV , Brian Sauer , Grant W. Cannon , Ted R. Mikuls , Joshua F. Baker","doi":"10.1016/j.semarthrit.2025.152902","DOIUrl":"10.1016/j.semarthrit.2025.152902","url":null,"abstract":"<div><h3>Purpose</h3><div>To compare the characteristics, treatment patterns, and long-term outcomes of patients with concurrent calcium pyrophosphate deposition disease (CPPD) and rheumatoid arthritis (RA) to patients with RA without CPPD.</div></div><div><h3>Methods</h3><div>We studied patients with RA from the Veteran’s Affairs RA (VARA) registry and identified patients with CPPD using administrative codes. We compared characteristics of patients with concurrent CPPD and RA to those with RA alone at enrollment. We used parsimonious multivariable logistic regression to study the probability of achieving a low disease activity as well as receiving prednisone and new biologic or targeted synthetic disease modifying antirheumatic drugs (b/tsDMARDs) over follow-up, adjusting for pre-hypothesized confounders and stratifying by autoantibody status.</div></div><div><h3>Results</h3><div>Among 2771 U.S. veterans with RA, we identified 64 (2.3 %) patients with CPPD at enrollment. Patients with CPPD were older [68.5 (9.0) v. 64.2 (11.0), <em>p</em> < 0.001], had higher rates of comorbidities, including osteoarthritis (93.8 % v. 80.1 %, <em>p</em> = 0.007), spine disease, and diabetes, and were less likely to have ACPA (63.5 % v. 77.8 %, <em>p</em> = 0.01). While those with CPPD were numerically less likely to achieve low disease activity over time, this was not statistically significant. Among seronegative patients, CPPD patients exhibited more prednisone use (OR 2.44 [95 % CI 1.15–5.22]) and more frequent initiation of b/tsDMARDs (OR 2.79 [95 % CI 1.46–5.32]) as well as higher rates of joint replacement and death during follow-up.</div></div><div><h3>Conclusions</h3><div>Seronegative RA patients with CPPD changed therapies more frequently, used more prednisone, and had worse long-term outcomes. These findings suggest some seronegative RA may represent CPPD and require alternative diagnostic and treatment approaches.</div></div>","PeriodicalId":21715,"journal":{"name":"Seminars in arthritis and rheumatism","volume":"77 ","pages":"Article 152902"},"PeriodicalIF":4.4,"publicationDate":"2025-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145886336","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}

引用次数: 0

Obesity and its associations with clinical manifestations and disease burden of patients with spondyloarthritis: An ancillary study from the ASAS-PerSpA project. 肥胖及其与脊椎关节炎患者临床表现和疾病负担的关系：ASAS-PerSpA项目的辅助研究

IF 4.4 2区医学 Q1 RHEUMATOLOGY

Seminars in arthritis and rheumatism

Pub Date : 2025-12-28 DOI: 10.1016/j.semarthrit.2025.152904

Mehmet Tuncay Duruöz, Sevtap Acer Kasman, Halise Hande Gezer, Clementina López-Medina, Maxime Dougados

Objective: This study aims to explore the relationship of obesity with clinical manifestations and disease burden including biologic/targeted DMARD (btDMARD), SpA-related surgery, work productivity loss, and patient-reported health status.

Methods: An ancillary analysis of the Assessment of Spondyloarthritis International Society PerSpA (PERipheral involvement in SpA) cross-sectional study from 24 participating countries. The PerSpA study included the data of clinical characteristics, btDMARD use and history (number of btDMARD kinds ever-prescribed, number of discontinuation, and the reasons for discontinuation), SpA-related surgery, work productivity and activity impairment, and patient-reported health status (ASAS Health Index, Bath Ankylosing Spondylitis Functional Index, and global wellbeing). Patients were divided into three groups according to the current BMI (BMI_c) and comparisons between the obese patients, overweights, and normal weights were performed for the above-mentioned parameters. The study population was also divided into different three groups according to their 20-year-old BMI (BMI_20y) and they were compared in itself.

Results: Among the 4449 patients, 34.6% were overweight, 21% obese, and 44.4% normal-weight. Obese/overweight patients had a higher btDMARD burden, btDMARD inefficacy, work impairment, and worse patient-reported health (p < 0.05 for all). The differences were preserved in comparisons adjusted for age, gender, and smoking. When the patients were compared according to their BMI_20y, similar differences were also found.

Conclusions: Obesity invites a biological therapy burden, work productivity loss, and worse patient-reported health status in patients with SpA.

目的：本研究旨在探讨肥胖与临床表现和疾病负担的关系，包括生物/靶向性DMARD （btDMARD）、spa相关手术、工作效率下降和患者报告的健康状况。方法：对来自24个参与国的国际脊柱关节炎协会（PerSpA）评估的横向研究进行辅助分析。PerSpA研究包括临床特征、btDMARD使用和病史（已开处方的btDMARD种类数量、停药次数和停药原因）、spa相关手术、工作效率和活动障碍以及患者报告的健康状况（ASAS健康指数、浴缸强强性脊柱炎功能指数和整体健康指数）的数据。根据当前BMI （BMIc）将患者分为三组，并对上述参数进行肥胖患者、超重患者和正常体重患者的比较。研究人群也根据他们20岁时的身体质量指数（BMI20y）分为不同的三组，并进行单独比较。结果：4449例患者中，超重34.6%，肥胖21%，体重正常44.4%。肥胖/超重患者有更高的btDMARD负担、btDMARD无效、工作障碍和更差的患者报告健康状况（p < 0.05）。在调整了年龄、性别和吸烟的比较中，差异得以保留。当根据患者的BMI20y进行比较时，也发现了类似的差异。结论：肥胖会增加SpA患者的生物治疗负担、工作效率下降以及患者报告的健康状况恶化。

{"title":"Obesity and its associations with clinical manifestations and disease burden of patients with spondyloarthritis: An ancillary study from the ASAS-PerSpA project.","authors":"Mehmet Tuncay Duruöz, Sevtap Acer Kasman, Halise Hande Gezer, Clementina López-Medina, Maxime Dougados","doi":"10.1016/j.semarthrit.2025.152904","DOIUrl":"https://doi.org/10.1016/j.semarthrit.2025.152904","url":null,"abstract":"<p><strong>Objective: </strong>This study aims to explore the relationship of obesity with clinical manifestations and disease burden including biologic/targeted DMARD (btDMARD), SpA-related surgery, work productivity loss, and patient-reported health status.</p><p><strong>Methods: </strong>An ancillary analysis of the Assessment of Spondyloarthritis International Society PerSpA (PERipheral involvement in SpA) cross-sectional study from 24 participating countries. The PerSpA study included the data of clinical characteristics, btDMARD use and history (number of btDMARD kinds ever-prescribed, number of discontinuation, and the reasons for discontinuation), SpA-related surgery, work productivity and activity impairment, and patient-reported health status (ASAS Health Index, Bath Ankylosing Spondylitis Functional Index, and global wellbeing). Patients were divided into three groups according to the current BMI (BMI<sub>c</sub>) and comparisons between the obese patients, overweights, and normal weights were performed for the above-mentioned parameters. The study population was also divided into different three groups according to their 20-year-old BMI (BMI<sub>20y</sub>) and they were compared in itself.</p><p><strong>Results: </strong>Among the 4449 patients, 34.6% were overweight, 21% obese, and 44.4% normal-weight. Obese/overweight patients had a higher btDMARD burden, btDMARD inefficacy, work impairment, and worse patient-reported health (p < 0.05 for all). The differences were preserved in comparisons adjusted for age, gender, and smoking. When the patients were compared according to their BMI<sub>20y</sub>, similar differences were also found.</p><p><strong>Conclusions: </strong>Obesity invites a biological therapy burden, work productivity loss, and worse patient-reported health status in patients with SpA.</p>","PeriodicalId":21715,"journal":{"name":"Seminars in arthritis and rheumatism","volume":" ","pages":"152904"},"PeriodicalIF":4.4,"publicationDate":"2025-12-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145946283","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}

引用次数: 0

Management of antineutrophil cytoplasmic antibody vasculitis-associated orbital inflammatory disease: A systematic literature review 抗中性粒细胞细胞质抗体血管炎相关眼窝炎的治疗：系统的文献综述

IF 4.4 2区医学 Q1 RHEUMATOLOGY

Seminars in arthritis and rheumatism

Pub Date : 2025-12-23 DOI: 10.1016/j.semarthrit.2025.152900

Emma Neary , Katie Healey , Marie Clements-Baker , Jean-Paul Makhzoum , Arielle Mendel

Objective

Ocular manifestations frequently occur in ANCA-associated vasculitides (AAV). Orbital inflammatory disease (OID) is a subset with limited management guidelines. This systematic review evaluated interventions for AAV-OID.

Methods

We searched Embase, MEDLINE, Web of Science, ClinicalTrials.gov, and Cochrane Central without language or date restrictions for clinical trials, case-control studies, observational studies, and case series (≥5 patients) of adults treated for AAV-OID. Included studies reported therapy type and clinical response after ≥1 month. The primary outcome was clinical response, defined as any improvement in signs or symptoms, up to and including remission. Secondary outcomes included remission, relapse, sustained remission (>6 months), and serious adverse events. Two reviewers independently screened records and appraised studies using the Newcastle-Ottawa Scale (NOS). A qualitative synthesis and meta-analysis of proportions were performed using a random effects model.

Results

Of 1001 studies screened, 18 met inclusion criteria (277 patients; 14 retrospective cohorts, 4 case series). Most (17/18) had NOS scores ≥5. Thirteen studies included rituximab (RTX), 10 cyclophosphamide, 7 RTX + another immunosuppressant (IS), 11 conventional IS, and 7 surgical therapies. Most studies involved refractory/relapsing cases. In 4 RTX monotherapy series, 95% (95 %CI 89–100%, p < 0.001) had a clinical response and 84% (95%CI 72–95%, p < 0.001) achieved remission at 6 months.

Conclusion

Our results suggest high remission rates of OID with RTX but highlight the need for high-quality prospective studies examining treatments for AAV-OID.

目的anca相关性血管增生（AAV）常出现眼部表现。眼窝炎症性疾病（OID）是治疗指南有限的一类疾病。本系统综述评估了AAV-OID的干预措施。方法：我们检索Embase、MEDLINE、Web of Science、ClinicalTrials.gov和Cochrane Central，没有语言和日期限制，检索成人AAV-OID治疗的临床试验、病例对照研究、观察性研究和病例系列（≥5例患者）。纳入的研究报告了≥1个月后的治疗类型和临床反应。主要结局是临床反应，定义为体征或症状的任何改善，直至并包括缓解。次要结局包括缓解、复发、持续缓解（6个月）和严重不良事件。两名评论者使用纽卡斯尔-渥太华量表（NOS）独立筛选记录和评价研究。采用随机效应模型对比例进行定性综合和荟萃分析。结果在1001项研究中，18项符合纳入标准（277例患者，14个回顾性队列，4个病例系列）。多数（17/18）患者NOS评分≥5分。13项研究包括利妥昔单抗（RTX）、10项环磷酰胺、7项RTX +另一种免疫抑制剂（IS）、11项常规IS和7项手术治疗。大多数研究涉及难治性/复发病例。在4个RTX单药治疗系列中，95% （95%CI 89-100%, p < 0.001）有临床反应，84% （95%CI 72-95%, p < 0.001）在6个月时达到缓解。结论：我们的研究结果表明，RTX治疗的OID有很高的缓解率，但也强调了对AAV-OID治疗方法进行高质量前瞻性研究的必要性。

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引用次数: 0

Hand function impairment in Systemic Sclerosis: determinants through investigations of clinical, radiographic and ultrasonographic features 系统性硬化症的手功能损害：通过临床、x线和超声特征调查的决定因素

IF 4.4 2区医学 Q1 RHEUMATOLOGY

Seminars in arthritis and rheumatism

Pub Date : 2025-12-22 DOI: 10.1016/j.semarthrit.2025.152901

Giulia Franchi , Elena Marazzi , Alain Lescoat , Sophie Hecquet , Sandrine Carvès , Guillaume Coiffier , Marine Tas , Veronica Codullo , Carlomaurizio Montecucco , Jérôme Avouac , Yannick Allanore

Objectives

to investigate the impact of cutaneous, vascular, and musculoskeletal (MSK) involvements on hand function-related patient-reported outcomes (PROs) by assessing clinical, radiographic, and ultrasonographic (US) features in a real-world cohort of Systemic Sclerosis (SSc) patients.

Methods

patients were enrolled in a multicentre cross-sectional study. PROs included Cochin Hand Function Scale (CHFS). Medical history and clinical examination, hands and wrists’ ultrasonography and radiography were collected. Analogue data were obtained from an external validation cohort. Separate and pooled cohorts’ analyses were conducted.

Results

140 consecutive patients were enrolled from 3 centres. In both univariate and multivariate analyses, CHFS scores showed a significant correlation with modified Rodnan Skin Score (mRSS) (p < 0.001) and with US-detected tenosynovitis (p < 0.01). A trend was observed for the presence of US-detected tenosynovitis with a sclerosing pattern and for the presence of calcinosis, with statistically significant correlations in univariate analysis (p = 0.01 and 0.02, respectively) but not in multivariate analysis (p = 0.06 and 0.055, respectively).

Conclusion

our findings support the multifactorial origin of hand function impairment in SSc patients, with mostly contributions from cutaneous and MSK involvement. Skin fibrosis and US-detected tenosynovitis were the most significant variables explaining hand disability as measured by CHFS. Ultrasonography may represent a valuable complementary tool, assessing MSK disease severity and activity.

What was already known

cutaneous, vascular and musculoskeletal involvement contribute to hand function impairment in SSc patients

What was learned from this study

● Skin fibrosis and US-detected tenosynovitis are the most relevant features. ● Ultrasonography may provide complementary information in the routine care of SSc patients.

目的通过评估系统性硬化症（SSc）患者的临床、x线和超声（US）特征，研究皮肤、血管和肌肉骨骼（MSK）受累对患者报告的手功能相关结果（PROs）的影响。方法采用多中心横断面研究。PROs包括Cochin手功能量表（CHFS）。收集病史、临床检查、手、手腕超声及x线片。从外部验证队列中获得类似数据。进行了单独和合并队列分析。结果从3个中心连续入组140例患者。在单变量和多变量分析中，CHFS评分显示与改良罗德曼皮肤评分（mRSS）（p < 0.001）和us检测的腱鞘炎（p < 0.01）有显著相关性。在us检测到的伴有硬化的腱鞘炎和钙质沉着的存在中观察到一种趋势，在单变量分析中具有统计学意义的相关性（p = 0.01和0.02），但在多变量分析中没有统计学意义（p = 0.06和0.055）。结论：我们的研究结果支持SSc患者手功能损害的多因素起源，主要来自皮肤和MSK受累。通过CHFS测量，皮肤纤维化和us检测到的腱鞘炎是解释手部残疾的最重要变量。超声检查可能是评估MSK疾病严重程度和活动性的一种有价值的补充工具。已知的皮肤、血管和肌肉骨骼受损伤是SSc患者手部功能损害的原因。从本研究中了解到：皮肤纤维化和us检测到的腱鞘炎是最相关的特征。●超声检查可为SSc患者的常规护理提供补充信息。

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引用次数: 0