Reumatologia Clinica最新文献

{"title":"Usefulness of ultrasound in the assessment of the efficacy of apremilast in psoriatic arthritis: Articular, enthesitic and nail index","authors":"Juan José de Agustin ,&nbsp;Gustavo Adolfo Añez ,&nbsp;Delia Reina ,&nbsp;Sergi Heredia ,&nbsp;Julio Ramirez ,&nbsp;Andrea Mireya Cuervo ,&nbsp;Jesus Rodriguez ,&nbsp;Carmen Moragues ,&nbsp;Patricia Moya ,&nbsp;Ana Maria Laiz Alonso ,&nbsp;Mireia Moreno ,&nbsp;Marta Arevalo ,&nbsp;Manel Pujol ,&nbsp;Georgina Salvador ,&nbsp;Noemi Busquets ,&nbsp;Andres Ponce ,&nbsp;Maria Pascual Pastor","doi":"10.1016/j.reuma.2025.501921","DOIUrl":"10.1016/j.reuma.2025.501921","url":null,"abstract":"<div><h3>Background</h3><div>Psoriatic arthritis (PsA) affects joints and entheses. The objective is to use ultrasound (US) to see inflammatory changes in joints and entheses in patients with active PsA starting Apremilast. Primary objective: 20% reduction in the US index (UIC) at 12 months.</div></div><div><h3>Methodology</h3><div>Multicenter, prospective, open-label study. Patients with PsA (≥2 swollen joints) and ≥2 US synovitis in joints and ≥1 US enthesitis at screening were recruited. Follow-up was 52 weeks (baseline and 1, 6, 9, 12 months). US (joint, tendon, and entheses), clinical (SJC, TJC, LEI, PGA, PtGA), and biological (ESR and CRP) parameters were recorded.</div></div><div><h3>Results</h3><div>48 patients were evaluated, 46 were included in the follow-up and 26 completed the 52-week study. The primary endpoint was achieved, with reductions of up to 40%. All clinical and ultrasound variables decreased significantly after 12 months. 75 adverse events (AEs) were recorded in 33 patients, and only one serious event (SAE). Reasons for withdrawal included AEs (6 patients), lack of efficacy (8 patients), and other reasons (loss to follow-up, withdrawal of consent) for 6 patients.</div></div><div><h3>Conclusions</h3><div>Changes in different domains of PsA in patients treated with Apremilast can be best identified by ultrasound. Ultrasound is an excellent tool to study joints, tendons, and entheses in PsA. Apremilast is a safe, well-tolerated, and effective treatment for several patterns of PsA (joints, entheses) as demonstrated by ultrasound. Ultrasound can also identify nail diseases in patients with PsA.</div></div>","PeriodicalId":47115,"journal":{"name":"Reumatologia Clinica","volume":"21 7","pages":"Article 501921"},"PeriodicalIF":1.3,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144831511","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}

{"title":"¿Interacciona la microbiota humana con el tratamiento inmunosupresor de las enfermedades reumatológicas autoinmunes sistémicas? Revisión sistemática","authors":"Noemí Franco-Domingo ,&nbsp;Patricia Saiz-López ,&nbsp;Loreto Carmona-Ortells","doi":"10.1016/j.reuma.2025.501938","DOIUrl":"10.1016/j.reuma.2025.501938","url":null,"abstract":"<div><h3>Objective</h3><div>To collect and analyse studies evaluating the interaction between the human microbiota (HM) and immunosuppressive (IS) treatments for systemic autoimmune rheumatological diseases (ARDs), and their impact on the disease.</div></div><div><h3>Methods</h3><div>A systematic review was performed based on an electronic search strategy in Medline, Embase, and Cochrane Library (inception-02/2024). We included papers studying the interaction of HM and IS treatments in adult patients with ARDs in which parameters of diversity and taxonomic composition were measured. We excluded spondyloarthritis for which more extensive knowledge is available. Studies of any language were allowed, prioritising clinical trials but also including observational longitudinal prospective and retrospective, and case-control studies.</div></div><div><h3>Results</h3><div>Of 2570 papers identified, 20 were included (15 from rheumatoid arthritis, 3 from systemic lupus erythematosus, 1 from primary Sjögren's syndrome and 1 from systemic sclerosis), overall, with a moderate risk of bias. The paucity of studies and niche specificity limited the study to the gut microbiota. A trend towards decreased diversity and compositional changes in gut microbiota and partial restitution in patients responding to IS treatment was identified. The heterogeneity observed in the design and outcome measures of the studies precluded a metaanalysis; however, the results point to a possible relationship between HM alterations and response to IS treatments in ARDs.</div></div><div><h3>Conclusions</h3><div>Available studies suggest a potential association between the HM and the response to IS therapies in ARDs. However, the overall moderate quality of evidence and substantial methodological heterogeneity limit the strength of combined conclusions. Standardization of microbiota-related studies is needed to enable data integration and support more robust inferences.</div></div>","PeriodicalId":47115,"journal":{"name":"Reumatologia Clinica","volume":"21 7","pages":"Article 501938"},"PeriodicalIF":1.3,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144831512","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}

{"title":"Comment on “Prevalence of hidradenitis suppurativa in patients with axial spondyloarthritis”","authors":"Sarah Aijaz ,&nbsp;Raveen Muzaffer ,&nbsp;Muhammad Zarrar ,&nbsp;Zauha Fawad Memon","doi":"10.1016/j.reuma.2025.501914","DOIUrl":"10.1016/j.reuma.2025.501914","url":null,"abstract":"","PeriodicalId":47115,"journal":{"name":"Reumatologia Clinica","volume":"21 6","pages":"Article 501914"},"PeriodicalIF":1.2,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144663127","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}

{"title":"Guía de práctica clínica para el tratamiento de la espondiloartritis axial y la artritis psoriásica. ESPOGUÍA 2024","authors":"Juan D. Cañete ,&nbsp;Petra Díaz del Campo Fontecha ,&nbsp;en nombre del Grupo Elaborador de la ESPOGUÍA","doi":"10.1016/j.reuma.2025.501892","DOIUrl":"10.1016/j.reuma.2025.501892","url":null,"abstract":"<div><div>The important advances in the area of therapeutic interventions and the time elapsed have justified the complete update of the Clinical practice guideline on the treatment of axial spondyloarthritis and psoriatic arthritis (ESPOGUIA2017). Methodologically, the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system has been incorporated, which allows the quality or certainty of the evidence to be assessed for each outcome of interest, previously prioritized by the drafting group and which structures the process of formulating recommendations explicitly. Thus, an updated clinical practice guideline has been developed to serve as a reference in the management of spondyloarthritis, to contribute to reduce unjustified variability, and to reinforce the importance of bringing clinical practice closer to the best available scientific evidence.</div></div>","PeriodicalId":47115,"journal":{"name":"Reumatologia Clinica","volume":"21 6","pages":"Article 501892"},"PeriodicalIF":1.2,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144663121","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}

{"title":"Residence at high altitude as a risk factor for high probability of pulmonary hypertension in patients with systemic sclerosis: A case–control study","authors":"Luis Javier Cajas ,&nbsp;Julia Recalde Reyes ,&nbsp;Javier Alejandro Correa ,&nbsp;Wilder Carvajal ,&nbsp;Carolina Torres ,&nbsp;José S. Cortés","doi":"10.1016/j.reuma.2025.501899","DOIUrl":"10.1016/j.reuma.2025.501899","url":null,"abstract":"<div><h3>Introduction</h3><div>This study investigated the association between high-altitude residence (&gt;2500<!--> <!-->m above sea level) and the presence of high probability of pulmonary hypertension (PH) in patients with systemic sclerosis (SSc).</div></div><div><h3>Methods</h3><div>A retrospective case–control study was conducted with 368 patients diagnosed with SSc at the rheumatology outpatient clinic of a university hospital in Bogotá, Colombia. Patients were divided into two groups based on the presence of high probability of PH. Clinical, demographic, and high-altitude residence data were collected and analyzed. A multiple logistic regression model was used to control confounding variables.</div></div><div><h3>Results</h3><div>Patients residing at high altitudes had a significantly greater risk of presenting high probability of PH than those living at lower altitudes did (odds ratio: 2.0). Other significant factors included the diffuse cutaneous subtype of SSc and the presence of interstitial lung disease.</div></div><div><h3>Discussion</h3><div>High-altitude residence is a potential risk factor for presenting high probability of PH in SSc patients, warranting closer monitoring and tailored management in these populations. Further studies are warranted to confirm these findings.</div></div>","PeriodicalId":47115,"journal":{"name":"Reumatologia Clinica","volume":"21 6","pages":"Article 501899"},"PeriodicalIF":1.2,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144663122","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}

{"title":"Melanoniquia inducida por mepacrina","authors":"Begoña de Escalante Yangüela ,&nbsp;Miguel García Gil ,&nbsp;Juan Vallejo Grijalba ,&nbsp;Cilia Peralta Ginés","doi":"10.1016/j.reuma.2025.501911","DOIUrl":"10.1016/j.reuma.2025.501911","url":null,"abstract":"","PeriodicalId":47115,"journal":{"name":"Reumatologia Clinica","volume":"21 6","pages":"Article 501911"},"PeriodicalIF":1.2,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144663157","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}

{"title":"Paradoxical reaction after switching between adalimumab biosimilars in a patient with psoriatic arthritis","authors":"Mariano F. Palatnik ,&nbsp;Emilce S. Fonseca ,&nbsp;María Lorena Brance","doi":"10.1016/j.reuma.2025.501913","DOIUrl":"10.1016/j.reuma.2025.501913","url":null,"abstract":"","PeriodicalId":47115,"journal":{"name":"Reumatologia Clinica","volume":"21 6","pages":"Article 501913"},"PeriodicalIF":1.2,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144663126","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}

{"title":"Factores asociados a eventos cardiovasculares mayores en una cohorte de pacientes con artritis reumatoide","authors":"Pedro Arbey Quevedo Mayorga ,&nbsp;Jhon Sebastián Giraldo ,&nbsp;Jhon Jairo Tipasoca Pineda ,&nbsp;Cristhian Camilo Guzmán Gualteros ,&nbsp;Julián Esteban Romero ,&nbsp;Isabel Cristina Gonzalez ,&nbsp;Maria Camila Hernandez ,&nbsp;Viviana Carolina Pachón ,&nbsp;Daniel Sarmiento","doi":"10.1016/j.reuma.2025.501915","DOIUrl":"10.1016/j.reuma.2025.501915","url":null,"abstract":"<div><h3>Introduction</h3><div>Rheumatoid arthritis (RA) is a systemic autoimmune disease with articular and extra-articular manifestations. Mortality in RA is influenced by an increased risk of cardiovascular events by up to 48% (RR: 1.48; 95% CI: 1.3-1.62), with a higher standardized mortality rate (SMR) due to cardiovascular causes compared to the general population. Our main objective was to examine the effect of clinical and serological variables on the risk of major cardiovascular events (MCE) in a cohort of RA patients.</div></div><div><h3>Materials and methods</h3><div>This was a retrospective cohort study. Patients more tha 18 years old and active follow-up in the RA care models of Hospital Universitario Clínica San Rafael and Clínica Nogales were included. Patients with prior major cardiovascular events or polyautoimmunity syndromes before the RA diagnosis were excluded. Survival analysis was performed to evaluate the probability of remaining free of MCEs, along with Cox proportional hazards analysis and structural equation modeling using a PATH analysis to assess direct and indirect effects.</div></div><div><h3>Results</h3><div>A total of 406 patients were included, 342 (84%) of whom were women, with a mean age of 44.8<!--> <!-->±<!--> <!-->13.1 years and a disease duration of 13<!--> <!-->±<!--> <!-->13.4 months. The average DAS28 activity score was 2.5<!--> <!-->±<!--> <!-->1.78, with 48.7% having active disease (DAS28<!--> <!-->&gt;<!--> <!-->2.6). Nineteen patients experienced MCEs, resulting in a cumulative incidence (CI) of 4.68% (4.4% myocardial infarction and 1.4% stroke). The most frequent risk factors were hypertension (23.7%) and smoking (24.8%). Bivariate analysis showed that heart failure (RR: 1.58; 95% CI: 1.12-2.23; <em>P</em>=.01), and hypertension (RR: 2.36; 95% CI: 1.22-4.60; <em>P</em>&lt;.01) were significantly associated with MCEs. The probability of MCE-free survival at six months post-diagnosis was 50%. In the Cox model, only hypertension and age at diagnosis were significantly associated with MCE outcomes. In the PATH analysis, dyslipidemia was significantly associated with myocardial infarction without a mediating effect from corticosteroids (coef: 1.83; <em>P</em>&lt;.001).</div></div><div><h3>Conclusion</h3><div>Traditional risk factors increase the risk of MCEs in RA patients. Additionally, dyslipidemia acts as an independent risk factor without mediation by other variables, making it a therapeutic target for preventing these outcomes.</div></div>","PeriodicalId":47115,"journal":{"name":"Reumatologia Clinica","volume":"21 6","pages":"Article 501915"},"PeriodicalIF":1.2,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144663123","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}

{"title":"Enfermedad autoinmune del oído interno y esclerodermia localizada en la infancia: a propósito de un caso","authors":"Pilar del Rosario Guarnizo Zuccardi ,&nbsp;Jacqueline de los Ángeles Piñeros Haiek ,&nbsp;Natalia Rodríguez Bonilla ,&nbsp;Sara Patricia Romero Orjuela ,&nbsp;Sara Juliana Guerrero León","doi":"10.1016/j.reuma.2025.501912","DOIUrl":"10.1016/j.reuma.2025.501912","url":null,"abstract":"<div><div>Autoimmune inner ear disease is frequently characterized by progressive bilateral hearing loss, which is not necessarily symmetrical. Vertigo, aural fullness, and tinnitus may also accompany it. There are 2 ways that the inner ear might be impacted: either as a primary disorder when the immune response directly attacks inner ear cells or as a secondary symptom of a systemic autoimmune disease.</div><div>We describe the case of an 11-year-old boy with morphea, who was diagnosed with autoimmune inner ear disease after he developed hearing loss. This relationship in children has not yet been documented in any prior reports. To improve diagnosis, management, and treatment and avoid long-term consequences, further research is required.</div></div>","PeriodicalId":47115,"journal":{"name":"Reumatologia Clinica","volume":"21 6","pages":"Article 501912"},"PeriodicalIF":1.2,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144663125","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}

{"title":"Encuesta para evaluar la exposición a los factores ambientales en los pacientes con artritis reumatoide","authors":"Alexandra Zúñiga ,&nbsp;Alba Luz León Álvarez ,&nbsp;Luisa Carbal-Reyes ,&nbsp;Daniel Rodríguez ,&nbsp;Juan-Camilo Díaz ,&nbsp;Gloria Vásquez ,&nbsp;Diana Castaño","doi":"10.1016/j.reuma.2025.501916","DOIUrl":"10.1016/j.reuma.2025.501916","url":null,"abstract":"<div><h3>Introduction and aims</h3><div>This study develops and validates an instrument to investigate and identify environmental factors associated with rheumatoid arthritis (RA), in order to improve the understanding of potential triggers.</div></div><div><h3>Methods</h3><div>Using an exhaustive review of the literature and the involvement of a panel of rheumatology experts, a survey was designed based mainly on environmental exposures that covered various dimensions. The distribution of the evaluated categories was assessed to determine their sufficiency, coherence, relevance, and clarity by Kruskal-Wallis test, Kendall's W for concordance, and finally, it was subjected to content validation by experts and underwent pilot testing.</div></div><div><h3>Results</h3><div>The survey consisted of 89 items total divided in 7 dimensions (sociodemographic aspects, consumables —cigarette—, other consumables, occupational or pollutants, previous diagnoses, other factors, and questions for potential cases). The assessment conducted by the experts showed a high concordance among them with values between 0.76 and 0.96. The pilot test demonstrated that the survey can be satisfactorily applied to Spanish-speaking people with different levels of education.</div></div><div><h3>Discussion and conclusions</h3><div>The created and validated instrument offers a solid tool adapted to the Latin American culture to investigate environmental factors associated with RA. Its development contributes to filling a gap in the scientific literature and highlights the importance of considering these factors in the understanding and intervention of the disease, both in patients with RA and individuals at potential risk of developing this disease.</div></div>","PeriodicalId":47115,"journal":{"name":"Reumatologia Clinica","volume":"21 6","pages":"Article 501916"},"PeriodicalIF":1.2,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144663124","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}