A. Tollisen, A. Selvaag, A. Aasland, T. Ingebrigtsen, J. Sagen, A. Lerdal, B. Flatø
Objective To explore quality of life (QOL) using the individualized Patient Generated Index (PGI) in young adults who were diagnosed with juvenile idiopathic arthritis (JIA) in childhood, and to examine associations between PGI ratings and standardized health-related outcome measures. Methods Patients (N = 79, mean age 25.1 [SD 4.2] yrs, 72% female) completed the PGI and the standardized measures: Health Assessment Questionnaire–Disability Index, 12-item Short Form Health Survey (SF-12; physical and mental health-related QOL [HRQOL]), Brief Pain Inventory (pain severity and interference), 5-item Hopkins Symptom Checklist, and visual analog scale for fatigue. Information on morning stiffness, medications, and demographics was also collected. Patients were compared to 79 matched controls. Results The most frequently nominated areas of importance for patients’ personally generated QOL (assessed by PGI) were physical activity (n = 38, 48%), work/school (n = 31, 39%), fatigue (n = 29, 37%) and self-image (n = 26, 33%). Nomination of physical activity was associated with older age, morning stiffness, and more pain interference. Nomination of fatigue was associated with current use of disease-modifying antirheumatic drugs, whereas nomination of self-image was associated with polyarticular course JIA and pain interference. Nomination of work/school was not associated with other factors. Higher PGI scores (indicating better QOL) correlated positively with all SF-12 subscales except role emotional, and negatively with disability, pain severity, pain interference, and morning stiffness. Compared to controls, patients had more pain, poorer physical HRQOL, and less participation in full-time work or school. Conclusion Physical activity, work/school, fatigue, and self-image were frequently nominated areas affecting QOL in young adults with JIA. The PGI included aspects of QOL not covered in standardized measures.
{"title":"Personally Generated Quality of Life Outcomes in Adults With Juvenile Idiopathic Arthritis","authors":"A. Tollisen, A. Selvaag, A. Aasland, T. Ingebrigtsen, J. Sagen, A. Lerdal, B. Flatø","doi":"10.3899/jrheum.211245","DOIUrl":"https://doi.org/10.3899/jrheum.211245","url":null,"abstract":"Objective To explore quality of life (QOL) using the individualized Patient Generated Index (PGI) in young adults who were diagnosed with juvenile idiopathic arthritis (JIA) in childhood, and to examine associations between PGI ratings and standardized health-related outcome measures. Methods Patients (N = 79, mean age 25.1 [SD 4.2] yrs, 72% female) completed the PGI and the standardized measures: Health Assessment Questionnaire–Disability Index, 12-item Short Form Health Survey (SF-12; physical and mental health-related QOL [HRQOL]), Brief Pain Inventory (pain severity and interference), 5-item Hopkins Symptom Checklist, and visual analog scale for fatigue. Information on morning stiffness, medications, and demographics was also collected. Patients were compared to 79 matched controls. Results The most frequently nominated areas of importance for patients’ personally generated QOL (assessed by PGI) were physical activity (n = 38, 48%), work/school (n = 31, 39%), fatigue (n = 29, 37%) and self-image (n = 26, 33%). Nomination of physical activity was associated with older age, morning stiffness, and more pain interference. Nomination of fatigue was associated with current use of disease-modifying antirheumatic drugs, whereas nomination of self-image was associated with polyarticular course JIA and pain interference. Nomination of work/school was not associated with other factors. Higher PGI scores (indicating better QOL) correlated positively with all SF-12 subscales except role emotional, and negatively with disability, pain severity, pain interference, and morning stiffness. Compared to controls, patients had more pain, poorer physical HRQOL, and less participation in full-time work or school. Conclusion Physical activity, work/school, fatigue, and self-image were frequently nominated areas affecting QOL in young adults with JIA. The PGI included aspects of QOL not covered in standardized measures.","PeriodicalId":35278,"journal":{"name":"The Journal of rheumatology. Supplement","volume":"69 1","pages":"1138 - 1145"},"PeriodicalIF":0.0,"publicationDate":"2022-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80283477","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Delays in diagnosis remain a major gap in the care of patients with axial spondyloarthritis (axSpA). Despite efforts to improve awareness among family physicians and nonrheumatologist specialists, the average duration from onset of symptoms to diagnosis of axSpA is approximately 8 years,1 which is one of the longest in rheumatology. Such delays in diagnosis are associated with late initiation of therapy and worse disease outcomes.
{"title":"Spondyloarthritis Among Patients With Uveitis: Can We Improve Referral Pathways?","authors":"L. Eder","doi":"10.3899/jrheum.220263","DOIUrl":"https://doi.org/10.3899/jrheum.220263","url":null,"abstract":"Delays in diagnosis remain a major gap in the care of patients with axial spondyloarthritis (axSpA). Despite efforts to improve awareness among family physicians and nonrheumatologist specialists, the average duration from onset of symptoms to diagnosis of axSpA is approximately 8 years,1 which is one of the longest in rheumatology. Such delays in diagnosis are associated with late initiation of therapy and worse disease outcomes.","PeriodicalId":35278,"journal":{"name":"The Journal of rheumatology. Supplement","volume":"70 1","pages":"659 - 660"},"PeriodicalIF":0.0,"publicationDate":"2022-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84018299","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
J. Kędra, P. Claudepierre, R. Flipo, M. Garrido-Cumbrera, F. Alliot-Launois, E. Desfleurs, L. Grange, L. Gossec
The effect of axial spondyloarthritis (axSpA) on patients' quality of life (QOL) has been well assessed in terms of body structures and functions, but literature is scarce in terms of social interactions and activities, work, and fears related to social interactions or activities.1.
{"title":"Impact of Axial Spondyloarthritis on Quality of Life: Results From the European Map of Axial Spondyloarthritis (EMAS) Study in France","authors":"J. Kędra, P. Claudepierre, R. Flipo, M. Garrido-Cumbrera, F. Alliot-Launois, E. Desfleurs, L. Grange, L. Gossec","doi":"10.3899/jrheum.210864","DOIUrl":"https://doi.org/10.3899/jrheum.210864","url":null,"abstract":"The effect of axial spondyloarthritis (axSpA) on patients' quality of life (QOL) has been well assessed in terms of body structures and functions, but literature is scarce in terms of social interactions and activities, work, and fears related to social interactions or activities.1.","PeriodicalId":35278,"journal":{"name":"The Journal of rheumatology. Supplement","volume":"43 1","pages":"1176 - 1178"},"PeriodicalIF":0.0,"publicationDate":"2022-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84884285","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Realizing in the fall of 2021 that I had started medical school exactly 50 years ago, on September 7, 1971, I thought that it would be interesting for the 2022 Dunlop-Dottridge Lecture to briefly review what we knew about vasculitis prior to 1971 and then reflect on what we have learned since.
{"title":"Vasculitis: What Have We Learned in the Last 50 Years?","authors":"S. Carette","doi":"10.3899/jrheum.220207","DOIUrl":"https://doi.org/10.3899/jrheum.220207","url":null,"abstract":"Realizing in the fall of 2021 that I had started medical school exactly 50 years ago, on September 7, 1971, I thought that it would be interesting for the 2022 Dunlop-Dottridge Lecture to briefly review what we knew about vasculitis prior to 1971 and then reflect on what we have learned since.","PeriodicalId":35278,"journal":{"name":"The Journal of rheumatology. Supplement","volume":"24 1","pages":"848 - 852"},"PeriodicalIF":0.0,"publicationDate":"2022-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82587023","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Calcinosis (hydroxyapatite and calcium phosphate crystal deposition) within the extracellular matrix of the dermis and subcutaneous tissue is a frequent manifestation of adult and pediatric systemic autoimmune rheumatic diseases, specifically systemic sclerosis, dermatomyositis, mixed connective tissue disease, and systemic lupus erythematosus. In this article, we review classification of calcinosis, highlight mechanisms that may contribute to the pathogenesis of calcinosis, and summarize the evidence evaluating nonpharmacologic and pharmacologic interventions for the treatment of calcinosis.
{"title":"Management of Calcinosis Cutis in Rheumatic Diseases","authors":"Hadiya Elahmar, B. Feldman, S. Johnson","doi":"10.3899/jrheum.211393","DOIUrl":"https://doi.org/10.3899/jrheum.211393","url":null,"abstract":"Calcinosis (hydroxyapatite and calcium phosphate crystal deposition) within the extracellular matrix of the dermis and subcutaneous tissue is a frequent manifestation of adult and pediatric systemic autoimmune rheumatic diseases, specifically systemic sclerosis, dermatomyositis, mixed connective tissue disease, and systemic lupus erythematosus. In this article, we review classification of calcinosis, highlight mechanisms that may contribute to the pathogenesis of calcinosis, and summarize the evidence evaluating nonpharmacologic and pharmacologic interventions for the treatment of calcinosis.","PeriodicalId":35278,"journal":{"name":"The Journal of rheumatology. Supplement","volume":"19 1","pages":"980 - 989"},"PeriodicalIF":0.0,"publicationDate":"2022-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75073049","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
We thank Dr Schou for her insightful comments.1 The interpretation of data from an observational study such as this is complex, and the conclusions are by necessity less robust than in a randomized controlled trial.
{"title":"Dr. Griffiths et al reply","authors":"J. Leadbetter, H. Griffiths","doi":"10.3899/jrheum.220120","DOIUrl":"https://doi.org/10.3899/jrheum.220120","url":null,"abstract":"We thank Dr Schou for her insightful comments.1 The interpretation of data from an observational study such as this is complex, and the conclusions are by necessity less robust than in a randomized controlled trial.","PeriodicalId":35278,"journal":{"name":"The Journal of rheumatology. Supplement","volume":"29 1","pages":"1075 - 1075"},"PeriodicalIF":0.0,"publicationDate":"2022-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89469464","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
S. Matsuda, T. Kotani, H. Kuwabara, Takayasu Suzuka, Takao Kiboshi, Y. Wada, T. Ishida, Youhei Fujiki, Hideyuki Shiba, K. Hata, T. Shoda, Y. Hirose, T. Takeuchi
Objective To address the pathomechanism of microscopic polyangiitis (MPA) complicated by interstitial lung disease (ILD) using serum biomarker profile and pulmonary histopathology. Methods Serum biomarkers from patients with MPA-ILD (n = 32), MPA without ILD (n = 17), and healthy controls (n = 10) were examined. Based on the biomarker profiles, principal component analysis (PCA) and cluster analysis were performed to classify patients with MPA-ILD into subgroups. Clinical characteristics and prognosis were assessed for each subgroup. Two lung biopsies were examined following H&E staining and immunostaining. Results T cell and macrophage polarization was skewed toward the T helper (Th) 2 cells and M2 macrophages in the MPA-ILD group relative to that in MPA without ILD group. The PCA allowed classification of the 19 biomarker profiles into 3 groups: (1) B cell– and neutrophil-related cytokines, vascular angiogenesis-related factors, extracellular matrix-producing factors; (2) Th1-driven cytokines, M1 macrophage-driven cytokines, and Th2-driven cytokines; and (3) M2 macrophage-induced and driven cytokines. The cluster analysis stratified the patients with MPA-ILD into clinically fibrotic-dominant (CFD) and clinically inflammatory-dominant (CID) groups. Notably, severe infections were significantly higher in the CFD group than in the CID group. Immunohistochemical staining demonstrated intense CXC motif chemokine ligand 13 staining in B cells and Th2 cells in the interstitium of the lungs of patients with MPA-ILD. Conclusion. The activation of M2 macrophages, Th2 cells, and B cells plays a key role in the pathomechanism of MPA-ILD. Classification of MPA-ILD based on serum biomarker profile would be useful in predicting the disease activity and the complications of severe infection in MPA-ILD.
{"title":"Association of M2 Macrophages, Th2, and B Cells With Pathomechanism in Microscopic Polyangiitis Complicated by Interstitial Lung Disease","authors":"S. Matsuda, T. Kotani, H. Kuwabara, Takayasu Suzuka, Takao Kiboshi, Y. Wada, T. Ishida, Youhei Fujiki, Hideyuki Shiba, K. Hata, T. Shoda, Y. Hirose, T. Takeuchi","doi":"10.3899/jrheum.220123","DOIUrl":"https://doi.org/10.3899/jrheum.220123","url":null,"abstract":"Objective To address the pathomechanism of microscopic polyangiitis (MPA) complicated by interstitial lung disease (ILD) using serum biomarker profile and pulmonary histopathology. Methods Serum biomarkers from patients with MPA-ILD (n = 32), MPA without ILD (n = 17), and healthy controls (n = 10) were examined. Based on the biomarker profiles, principal component analysis (PCA) and cluster analysis were performed to classify patients with MPA-ILD into subgroups. Clinical characteristics and prognosis were assessed for each subgroup. Two lung biopsies were examined following H&E staining and immunostaining. Results T cell and macrophage polarization was skewed toward the T helper (Th) 2 cells and M2 macrophages in the MPA-ILD group relative to that in MPA without ILD group. The PCA allowed classification of the 19 biomarker profiles into 3 groups: (1) B cell– and neutrophil-related cytokines, vascular angiogenesis-related factors, extracellular matrix-producing factors; (2) Th1-driven cytokines, M1 macrophage-driven cytokines, and Th2-driven cytokines; and (3) M2 macrophage-induced and driven cytokines. The cluster analysis stratified the patients with MPA-ILD into clinically fibrotic-dominant (CFD) and clinically inflammatory-dominant (CID) groups. Notably, severe infections were significantly higher in the CFD group than in the CID group. Immunohistochemical staining demonstrated intense CXC motif chemokine ligand 13 staining in B cells and Th2 cells in the interstitium of the lungs of patients with MPA-ILD. Conclusion. The activation of M2 macrophages, Th2 cells, and B cells plays a key role in the pathomechanism of MPA-ILD. Classification of MPA-ILD based on serum biomarker profile would be useful in predicting the disease activity and the complications of severe infection in MPA-ILD.","PeriodicalId":35278,"journal":{"name":"The Journal of rheumatology. Supplement","volume":"51 1","pages":"913 - 921"},"PeriodicalIF":0.0,"publicationDate":"2022-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90691548","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Y. Lo, Tang Jun Tiffany Li, Ting-Chun Lin, You-Yin Chen, Jiunn-Horng Kang
Objective In patients with fibromyalgia (FM), the brain shows altered structure and functional connectivity, but the mechanisms underlying these changes remain unclear. This study investigated the associated changes in brain microstructures and neuroinflammation of patients with FM. Methods We recruited 14 patients with FM and 14 healthy controls (HCs). Visual analog scale (VAS), Beck Anxiety Inventory (BAI), and Beck Depression Inventory-II (BDI-II) were used for assessing their pain, anxiety, and depression levels, respectively. Diffusion kurtosis imaging (DKI) was used to visualize microstructural alterations associated with neuroinflammation in specific brain regions. The biomarkers for neuron damage, including serum tau and amyloid β protein fragment 1-42 (Aβ1-42) levels, were assessed. Spearman correlation of DKI parameters with VAS, BAI, and BDI-II scores as well as tau and Aβ1-42 levels were assessed. Results The patients with FM had significantly higher levels of Aβ1-42 levels than HCs. Compared with HCs, the patients with FM showed significantly lower DKI parameters in the bilateral dorsolateral prefrontal cortex and orbitofrontal cortex. Patients with FM showed a significant correlation between the axial kurtosis values of the amygdala and VAS scores (left: ρ = −0.60, P = 0.02; right: ρ = −7.04, P = 0.005). Conclusion To the best of our knowledge, this is the first study to use DKI to examine the brains of patients with FM. We noted significant DKI changes associated with neuroinflammation at specific areas in patients with FM. Our results provide valuable information on brain neuroinflammation and pathophysiological changes in patients with FM.
{"title":"Microstructural Evidence of Neuroinflammation for Psychological Symptoms and Pain in Patients With Fibromyalgia","authors":"Y. Lo, Tang Jun Tiffany Li, Ting-Chun Lin, You-Yin Chen, Jiunn-Horng Kang","doi":"10.3899/jrheum.211170","DOIUrl":"https://doi.org/10.3899/jrheum.211170","url":null,"abstract":"Objective In patients with fibromyalgia (FM), the brain shows altered structure and functional connectivity, but the mechanisms underlying these changes remain unclear. This study investigated the associated changes in brain microstructures and neuroinflammation of patients with FM. Methods We recruited 14 patients with FM and 14 healthy controls (HCs). Visual analog scale (VAS), Beck Anxiety Inventory (BAI), and Beck Depression Inventory-II (BDI-II) were used for assessing their pain, anxiety, and depression levels, respectively. Diffusion kurtosis imaging (DKI) was used to visualize microstructural alterations associated with neuroinflammation in specific brain regions. The biomarkers for neuron damage, including serum tau and amyloid β protein fragment 1-42 (Aβ1-42) levels, were assessed. Spearman correlation of DKI parameters with VAS, BAI, and BDI-II scores as well as tau and Aβ1-42 levels were assessed. Results The patients with FM had significantly higher levels of Aβ1-42 levels than HCs. Compared with HCs, the patients with FM showed significantly lower DKI parameters in the bilateral dorsolateral prefrontal cortex and orbitofrontal cortex. Patients with FM showed a significant correlation between the axial kurtosis values of the amygdala and VAS scores (left: ρ = −0.60, P = 0.02; right: ρ = −7.04, P = 0.005). Conclusion To the best of our knowledge, this is the first study to use DKI to examine the brains of patients with FM. We noted significant DKI changes associated with neuroinflammation at specific areas in patients with FM. Our results provide valuable information on brain neuroinflammation and pathophysiological changes in patients with FM.","PeriodicalId":35278,"journal":{"name":"The Journal of rheumatology. Supplement","volume":"7 1","pages":"942 - 947"},"PeriodicalIF":0.0,"publicationDate":"2022-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84974069","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
G. Cagnotto, L. Jacobsson, E. Rydell, A. Eberhard, M. Compagno, C. Turesson
Objective The aim of the present study was to investigate whether the relationship between sex and clinical outcomes in early rheumatoid arthritis (RA) varies by autoantibody status. Methods Two inception cohorts of consecutive patients with early RA (ie, symptom duration ≤ 12 months) in the southern region of Sweden were investigated. Patients were stratified by anticitrullinated peptide antibody (ACPA) status. The primary outcome was remission (Disease Activity Score in 28 joints [DAS28] < 2.6) at 12 months. Secondary outcomes were remission at 6 months and European Alliance of Associations for Rheumatology good response at 6 and 12 months compared to baseline. In logistic regression models, which were adjusted for age, DAS28 values, and Health Assessment Questionnaire values at baseline, the relationship between sex and clinical outcomes, stratified by ACPA status, was investigated. Results In total, 426 patients with early RA were included: 160 patients were ACPA negative and 266 patients were ACPA positive. At 12 months, 27.1% (38/140) of females and 24.1% (13/54) of males with ACPA-positive RA achieved DAS28 remission. In ACPA-negative RA, 16.0% (13/81) of females and 48.6% (18/37) of males achieved DAS28 remission at 12 months. Males had higher odds of reaching remission at 12 months in the ACPA-negative patient group (pooled adjusted odds ratio [OR] 4.79, 95% CI 1.97-11.6), but not in the ACPA-positive group (pooled adjusted OR 1.06, 95% CI 0.49-2.30). Conclusion Male sex was associated with better clinical outcomes in ACPA-negative early RA, but not in ACPA-positive early RA. The poor outcomes in females with early seronegative RA suggest that this represents a difficult-to-treat patient group.
目的探讨性别与早期类风湿关节炎(RA)临床结局之间的关系是否因自身抗体状态而异。方法对瑞典南部地区两个连续的早期RA患者(即症状持续时间≤12个月)进行初始队列调查。根据抗瓜氨酸肽抗体(ACPA)水平对患者进行分层。主要终点是12个月时的缓解(28个关节的疾病活动评分[DAS28] < 2.6)。次要结果是6个月时缓解，欧洲风湿病协会联盟在6和12个月时与基线相比有良好的反应。在逻辑回归模型中，调整了年龄、DAS28值和基线健康评估问卷值，研究了性别与临床结果之间的关系，并按ACPA状态分层。结果共纳入426例早期RA患者，其中ACPA阴性160例，ACPA阳性266例。12个月时，27.1%(38/140)的女性和24.1%(13/54)的男性acpa阳性RA患者达到DAS28缓解。在acpa阴性RA中，16.0%(13/81)的女性和48.6%(18/37)的男性在12个月时达到DAS28缓解。在acpa阴性患者组中，男性在12个月时达到缓解的几率更高(综合校正比值比[OR] 4.79, 95% CI 1.97-11.6)，但在acpa阳性患者组中没有(综合校正比值比[OR] 1.06, 95% CI 0.49-2.30)。结论男性与acpa阴性早期RA的临床预后相关，而与acpa阳性早期RA的临床预后无关。早期血清阴性RA的女性患者预后不佳，表明这是一个难以治疗的患者群体。
{"title":"Male Sex Predicts a Favorable Outcome in Early ACPA-Negative Rheumatoid Arthritis: Data From an Observational Study","authors":"G. Cagnotto, L. Jacobsson, E. Rydell, A. Eberhard, M. Compagno, C. Turesson","doi":"10.3899/jrheum.211199","DOIUrl":"https://doi.org/10.3899/jrheum.211199","url":null,"abstract":"Objective The aim of the present study was to investigate whether the relationship between sex and clinical outcomes in early rheumatoid arthritis (RA) varies by autoantibody status. Methods Two inception cohorts of consecutive patients with early RA (ie, symptom duration ≤ 12 months) in the southern region of Sweden were investigated. Patients were stratified by anticitrullinated peptide antibody (ACPA) status. The primary outcome was remission (Disease Activity Score in 28 joints [DAS28] < 2.6) at 12 months. Secondary outcomes were remission at 6 months and European Alliance of Associations for Rheumatology good response at 6 and 12 months compared to baseline. In logistic regression models, which were adjusted for age, DAS28 values, and Health Assessment Questionnaire values at baseline, the relationship between sex and clinical outcomes, stratified by ACPA status, was investigated. Results In total, 426 patients with early RA were included: 160 patients were ACPA negative and 266 patients were ACPA positive. At 12 months, 27.1% (38/140) of females and 24.1% (13/54) of males with ACPA-positive RA achieved DAS28 remission. In ACPA-negative RA, 16.0% (13/81) of females and 48.6% (18/37) of males achieved DAS28 remission at 12 months. Males had higher odds of reaching remission at 12 months in the ACPA-negative patient group (pooled adjusted odds ratio [OR] 4.79, 95% CI 1.97-11.6), but not in the ACPA-positive group (pooled adjusted OR 1.06, 95% CI 0.49-2.30). Conclusion Male sex was associated with better clinical outcomes in ACPA-negative early RA, but not in ACPA-positive early RA. The poor outcomes in females with early seronegative RA suggest that this represents a difficult-to-treat patient group.","PeriodicalId":35278,"journal":{"name":"The Journal of rheumatology. Supplement","volume":"41 ","pages":"990 - 997"},"PeriodicalIF":0.0,"publicationDate":"2022-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72495682","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
A. Armstrong, Rasika M Reddy, O. FitzGerald, K. Callis Duffin, P. Helliwell, P. Mease, A. Kavanaugh, J. Merola, William Tillet, M. D. de Wit
The Group for Research and Assessment of Psoriasis and Psoriatic Arthritis hosted a Meet the Experts session at its 2021 virtual meeting. Dermatology and rheumatology experts held 5 sessions that broadly centered on psoriasis and psoriatic arthritis.
{"title":"2021 GRAPPA Meet the Experts Session: A Summary of Presentations.","authors":"A. Armstrong, Rasika M Reddy, O. FitzGerald, K. Callis Duffin, P. Helliwell, P. Mease, A. Kavanaugh, J. Merola, William Tillet, M. D. de Wit","doi":"10.3899/jrheum.211326","DOIUrl":"https://doi.org/10.3899/jrheum.211326","url":null,"abstract":"The Group for Research and Assessment of Psoriasis and Psoriatic Arthritis hosted a Meet the Experts session at its 2021 virtual meeting. Dermatology and rheumatology experts held 5 sessions that broadly centered on psoriasis and psoriatic arthritis.","PeriodicalId":35278,"journal":{"name":"The Journal of rheumatology. Supplement","volume":"237 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86977262","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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