Seminars in arthritis and rheumatism最新文献

英文中文

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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引用次数: 0

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

Sıla Atamyıldız Uçar, Eray Tunce, Betül Sözeri

引用次数: 0

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

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。

{"title":"Almost half of the patients with axial spondyloarthritis reporting an acceptable symptom state have high disease activity; data from two standard-of-care cohorts","authors":"Marlies Carbo , Anne Kampman , Davy Paap , Freke Wink , Casper Webers , Harald Vonkeman , Astrid van Tubergen , Suzanne Arends , Anneke Spoorenberg","doi":"10.1016/j.semarthrit.2025.152903","DOIUrl":"10.1016/j.semarthrit.2025.152903","url":null,"abstract":"<div><h3>Objectives</h3><div>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.</div></div><div><h3>Methods</h3><div>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.</div></div><div><h3>Results</h3><div>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.</div></div><div><h3>Conclusion</h3><div>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.</div></div>","PeriodicalId":21715,"journal":{"name":"Seminars in arthritis and rheumatism","volume":"77 ","pages":"Article 152903"},"PeriodicalIF":4.4,"publicationDate":"2025-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145886337","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

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}

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