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Ocular inflammatory manifestations in patients with rheumatoid arthritis 类风湿关节炎患者的眼部炎症表现
IF 1.2 Q4 RHEUMATOLOGY Pub Date : 2025-05-01 DOI: 10.1016/j.reuma.2025.501891
Raul E. Ruiz-Lozano , Luis Arnaldo Prida-Espaillat , Reinaldo A. Moll-Auais , Eugenia M. Ramos-Dávila , Manuel E. Quiroga-Garza , Aaron Zhao , Ali Khodor , Amr Almobayed , David Vega-Morales , Alejandro Rodriguez-Garcia

Purpose

This review emphasizes the significance of clinical findings, pathogenic mechanisms, diagnosis, management, and complications related to the ocular manifestations of rheumatoid arthritis, underscoring the need for interdisciplinary collaboration between rheumatologists and ophthalmologists.

Methods

A comprehensive literature search was conducted using PubMed, Embase, Web of Science, and Google Scholar for all English-language articles published from inception to July 2024. The following search string was utilized: (“rheumatoid arthritis”) AND (“dry eye disease” OR “dry eye” OR “episcleritis” OR “scleritis” OR “peripheral ulcerative keratitis” OR “central corneal ulcer*” OR “paracentral corneal ulcer*” OR “ocular manifestations” OR “ocular involvement”). Letters to the editor, editorials, short communications, case reports, case series, review articles, and original articles were reviewed, along with relevant references from those publications.

Results

The most common ocular manifestations in patients with rheumatoid arthritis include keratoconjunctivitis sicca (dry eye disease), episcleritis, scleritis, peripheral ulcerative keratitis, and central and paracentral corneal ulceration. Ocular involvement can be the initial presentation of the disease and may correlate with disease activity. If left untreated, ocular inflammation in rheumatoid arthritis can lead to permanent vision loss.

Conclusions

The diverse ocular inflammatory manifestations in RA patients may indicate either the disease's initial presentation or the status of extra-articular activity. A multidisciplinary approach that includes rheumatologists and ophthalmologists is essential to prevent sight-threatening complications.
目的综述类风湿关节炎眼部表现的临床表现、发病机制、诊断、治疗和并发症的重要性,强调风湿病学家和眼科医生之间跨学科合作的必要性。方法利用PubMed、Embase、Web of Science、b谷歌Scholar等数据库对自成立以来至2024年7月发表的所有英文论文进行综合文献检索。使用以下搜索字符串:(“类风湿性关节炎”)和(“干眼病”或“干眼”或“外巩膜炎”或“巩膜炎”或“周围性溃疡性角膜炎”或“中央性角膜溃疡*”或“中央旁性角膜溃疡*”或“眼部表现”或“眼部受累”)。审查了给编辑的信、社论、简短通讯、病例报告、病例系列、评论文章和原始文章,以及这些出版物的相关参考文献。结果类风湿性关节炎患者最常见的眼部表现为干眼病、表皮炎、巩膜炎、周围性溃疡性角膜炎、中央和中央旁性角膜溃疡。眼部受累可能是疾病的最初表现,并可能与疾病活动有关。如果不及时治疗,类风湿性关节炎引起的眼部炎症会导致永久性视力丧失。结论RA患者不同的眼部炎症表现可能表明疾病的初始表现或关节外活动的状态。包括风湿病学家和眼科医生在内的多学科方法对于预防威胁视力的并发症至关重要。
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引用次数: 0
Some aspects of body thermoregulation, environmental temperature and vascular hypothesis in systemic sclerosis patients 系统性硬化症患者体温调节、环境温度及血管假说的若干方面
IF 1.2 Q4 RHEUMATOLOGY Pub Date : 2025-05-01 DOI: 10.1016/j.reuma.2025.501894
Francisco Javier Olmedo Garzón
In line with vascular hypothesis of systemic sclerosis (SSc), it is proposed that visceral Raynaud's phenomenon (RP)/endothelial dysfunction causes severe oxygen supply/consumption imbalance in internal organs, leading to visceral ischemic failure in early SSc, especially with cold environmental temperature (Te) and severe RP. There would also be a decrease in body thermogenesis and a decrease in heat loss caused by chronic visceral ischemia and by systemic vasculopathy, respectively. At any given time, these disorders could produce low core temperature (Tc). Hence, SSc is proposed as a candidate cause of secondary hypothermia. It is suggested that SSc could be an adaptive response in cold Te to systemic endothelial damage with secondary chronic visceral ischemia/slow metabolism. This pathophysiological mechanism is proposed in early visceral failure, prognosis, SSc phenotype according to ethnicity, and other manifestations. The impact of Te and Tc on SSc warrants further investigations.
根据系统性硬化血管假说(vascular hypothesis of systemic sclerosis, SSc),提出内脏雷诺现象(内脏Raynaud's phenomenon, RP)/内皮功能障碍导致内脏供氧/消耗严重失衡,导致SSc早期内脏缺血性衰竭,尤其是环境温度较低(Te)和严重的RP。慢性内脏缺血和全身性血管病变也会导致机体产热减少和热损失减少。在任何给定时间,这些紊乱都可能产生较低的堆芯温度(Tc)。因此,SSc被认为是继发性体温过低的一个候选原因。提示SSc可能是低温Te对继发性慢性内脏缺血/代谢缓慢的全身内皮损伤的适应性反应。这种病理生理机制在早期内脏衰竭、预后、SSc种族表型和其他表现中被提出。Te和Tc对SSc的影响值得进一步研究。
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引用次数: 0
Pósteres: P319-P510 海报:P319-P510
IF 1.2 Q4 RHEUMATOLOGY Pub Date : 2025-05-01 DOI: 10.1016/S1699-258X(25)00148-2
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引用次数: 0
One-year retention rate of ixekizumab in patients with psoriatic arthritis and axial spondyloarthritis: Real-world data from the BIOBADASER registry ixekizumab在银屑病关节炎和轴性脊柱炎患者中的1年保留率:来自BIOBADASER注册的真实世界数据
IF 1.2 Q4 RHEUMATOLOGY Pub Date : 2025-05-01 DOI: 10.1016/j.reuma.2025.501872
Clementina López-Medina , Lucía Otero-Varela , Fernando Sánchez-Alonso , Vega Jovaní , Lorena Expósito-Pérez , Sheila Melchor-Díaz , Yanira Pérez-Vera , Paula Pretel-Ruiz , Javier Manero , Antonio Mera-Varela , Lourdes Mateo , Dolores Ruiz-Montesino , José Andrés Lorenzo-Martín , Teresa Pedraz-Penalva , Isabel Castrejón

Introduction

Ixekizumab (IXE) is a selective interleukin 17A (IL-17A) monoclonal antibody approved for the treatment of psoriatic arthritis (PsA) and axial spondyloarthritis (axSpA). Limited real-world data are available on its retention rate and effectiveness. The objective of this study was to assess the one-year retention rate of IXE in a real-world cohort of patients with axSpA and PsA and to identify potential predictive factors for drug retention.

Method

Prospective and observational study derived from BIOBADASER 3.0, a multicenter registry of advanced therapies including patients who have ever received IXE for PsA or axSpA. The one-year retention rate of the treatment in both diseases was evaluated using Kaplan–Meier curves and multivariable Cox regressions.

Results

A total of 335 patients ever exposed to IXE were included (PsA = 250; axSpA = 85). IXE was used as first-line treatment only in 5.3% of patients, and after TNFi in 94.7% of patients. In axSpA and PsA, drug survival at 12 months was 69.5% (95% CI 64.0–74.3), slightly higher in PsA (71.3% (95% CI 65.0–75.6)) versus axSpA (63.8% (95% CI 51.5–73.7)). The multivariable Cox regression models showed that female sex and longer disease duration were factors associated with IXE withdrawal in the whole population, while concomitant use of methotrexate reduced the risk of discontinuation.

Conclusions

In this real-world study, IXE showed an acceptable retention rate in patients with PsA and axSpA after one year of follow-up. Female sex and longer disease duration were associated with risk of withdrawal.
ixekizumab (ixxe)是一种选择性白细胞介素17A (IL-17A)单克隆抗体,被批准用于治疗银屑病关节炎(PsA)和轴性脊柱炎(axSpA)。关于其留存率和有效性的真实数据有限。本研究的目的是评估现实世界axSpA和PsA患者中IXE的1年保留率,并确定药物保留率的潜在预测因素。方法:前瞻性和观察性研究来源于BIOBADASER 3.0,这是一个多中心的先进治疗注册,包括曾因PsA或axSpA接受IXE治疗的患者。采用Kaplan-Meier曲线和多变量Cox回归评估两种疾病治疗的1年保留率。结果共纳入335例暴露于IXE的患者(PsA = 250;axSpA = 85)。仅5.3%的患者使用IXE作为一线治疗,而在TNFi后使用IXE的患者比例为94.7%。在axSpA和PsA中,12个月的药物生存率为69.5% (95% CI 64.0-74.3), PsA (71.3% (95% CI 65.0-75.6)略高于axSpA (63.8% (95% CI 51.5-73.7))。多变量Cox回归模型显示,在整个人群中,女性和较长的病程是IXE停药的相关因素,而同时使用甲氨蝶呤降低了停药的风险。在这项现实世界的研究中,IXE在PsA和axSpA患者中随访1年后显示出可接受的保留率。女性和较长的疾病持续时间与停药风险相关。
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引用次数: 0
Lupus nephritis in Mexican patients: Response to intensive therapy 墨西哥狼疮性肾炎患者:对强化治疗的反应
IF 1.2 Q4 RHEUMATOLOGY Pub Date : 2025-05-01 DOI: 10.1016/j.reuma.2025.501896
Georgina Aguilera Barragán-Pickens , David Herrera van-Oostdam , Fedra Irazoque-Palazuelos , Miguel Saavedra-Salinas , Sergio Cerpa-Cruz , Claudia Mendoza-Pinto , Luis Valdez , Enrique Cuevas Orta , Eva Santillán-Guerrero , Carlos Abud-Mendoza , LUNPOS GROUP

Introduction

lupus nephritis represents a challenge in treatment. In spite of intensive therapy, is common a sustained renal incomplete response.

Objective

To describe different responses to adequate/intensive treatment to lupus nephritis.

Methods

Observational retrospective study, including Mexican > 18 years old patients with lupus nephritis who visited tertiary rheumatology centers in several urban cities in Mexico. SLE was diagnosed according to 1997 ACR. The exclusion criteria were follow-up < 6 months and reduced GFR due to other comorbidities such as diabetes or other primary renal disease.

Results

We included 193 patients with a mean age of 34 years, 80% were women. Biopsy was available in 166 patients (86%): class IV in 42%, class III in 23%, the mean of activity and chronicity index were 6.4 and 2.6 respectively; class V represented 10.2%. The least frequent class was Class II (9%), and mixed classes (III or IV + V) accounted for 11%.
Cyclophosphamide (CYC) was used in 146 patients (76.6%), mycophenolate (MMF) in 144 and tacrolimus (TCR) in 28. In most cases, were used combination therapy.
Only 38 patients had a follow-up of less than 1 year; 16 (42%) had CR, 13 (34%) had NR, and 9 (23%) PR. 55% of patients with PR received a multitarget protocol, 75% of CR received the NIH protocol, and 61.5% of NR the NIH protocol.
Of patients followed up for more than a year (155), 35% had persistently inactive response, 24.5% were relapsing–remitting, 20% were chronically active, and 20% showed a mixed pattern.

Conclusions

Prevalence of persistent or intermittent activity patterns was high (64.5%). Most Mexican rheumatologists switched to more intensive treatment, adding a second or third drug.
狼疮性肾炎是治疗中的一个挑战。尽管强化治疗,常见的是持续的肾不完全反应。目的探讨充分/强化治疗对狼疮性肾炎的不同疗效。方法采用观察性回顾性研究,包括墨西哥>;18岁狼疮肾炎患者访问三级风湿病中心在几个城市在墨西哥。根据1997年ACR诊断SLE。排除标准为随访;由于其他合并症,如糖尿病或其他原发性肾脏疾病,GFR降低。结果纳入193例患者,平均年龄34岁,80%为女性。166例(86%)患者进行了活检:IV级占42%,III级占23%,平均活动性和慢性指数分别为6.4和2.6;V类占10.2%。最不常见的是II类(9%),混合类(III或IV + V)占11%。环磷酰胺(CYC) 146例(76.6%),霉酚酸酯(MMF) 144例,他克莫司(TCR) 28例。在大多数情况下,我们使用联合治疗。只有38例患者随访时间少于1年;16例(42%)有CR, 13例(34%)有NR, 9例(23%)有PR。55%的PR患者接受了多靶点方案,75%的CR患者接受了NIH方案,61.5%的NR患者接受了NIH方案。在随访超过一年的患者中(155例),35%的患者持续无反应,24.5%的患者复发缓解,20%的患者长期活跃,20%的患者表现为混合模式。结论持续性或间歇性活动模式的患病率较高(64.5%)。大多数墨西哥风湿病学家转而采用更强化的治疗方法,增加了第二种或第三种药物。
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引用次数: 0
Comment on: “Safety of biologic and synthetic targeted therapies in patients with immune-mediated diseases: Data from the BIOBADAGUAY registry” 评论:“生物和合成靶向治疗在免疫介导性疾病患者中的安全性:来自BIOBADAGUAY注册的数据”
IF 1.2 Q4 RHEUMATOLOGY Pub Date : 2025-04-01 DOI: 10.1016/j.reuma.2025.501871
Sarah Aijaz , Raveen Muzaffer
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引用次数: 0
Novel imaging findings of masticatory muscle edema in dermatomyositis associated with ovarian cancer: A case report 卵巢癌皮肌炎伴咀嚼肌水肿的新影像学表现:1例报告
IF 1.2 Q4 RHEUMATOLOGY Pub Date : 2025-04-01 DOI: 10.1016/j.reuma.2025.501857
Leonardo F. Freitas , Márcio Luís Duarte , Kevin J. Abrams
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引用次数: 0
Raoul Dufy: color y resiliencia en la lucha contra la artritis reumatoide Raoul Dufy:抗击类风湿关节炎的色彩与韧性
IF 1.2 Q4 RHEUMATOLOGY Pub Date : 2025-04-01 DOI: 10.1016/j.reuma.2025.501847
Fernando Canillas, Marta Canillas
Raoul Dufy was born in 1877 in the city of Le Havre, France. He showed an early interest in painting and attended the École des Beaux Arts in Paris, where he was influenced by Impressionism and later by Fauvism and Cubism. He achieved a style of his own, marked by colour. His paintings depicted modern life, often with bright colours and energetic scenes of urban and social life. In 1935, he developed severe rheumatoid arthritis, which affected his hands and joints. Despite this, he continued to create art until his death. He underwent numerous medical treatments of the time. In 1950, he was invited to the United States to participate in initial ACTH and cortisone therapies and achieved a significant improvement. He returned to France, but died in 1953 at the age of 76 from an intestinal haemorrhage. His artistic legacy and his strength to face this disease are an inspiration for the future.
拉乌尔·杜菲1877年出生于法国勒阿弗尔。他表现出对绘画的早期兴趣,并参加了École des Beaux Arts在巴黎,在那里他受到印象派,后来野兽派和立体派的影响。他形成了自己的风格,以色彩为标志。他的画描绘了现代生活,经常用明亮的色彩和充满活力的城市和社会生活场景。1935年,他患上了严重的类风湿性关节炎,影响了他的手和关节。尽管如此,他仍然继续创作艺术,直到他去世。他当时接受了多次治疗。1950年应邀到美国参加ACTH和可的松的初始治疗,并取得了显著的改善。他回到法国,但在1953年死于肠道出血,享年76岁。他的艺术遗产和他面对这种疾病的力量是对未来的鼓舞。
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引用次数: 0
Evaluation of kinesiophobia and physical activity levels in patients with fibromyalgia syndrome and chronic neck pain 纤维肌痛综合征和慢性颈痛患者运动恐惧症和体力活动水平的评估
IF 1.2 Q4 RHEUMATOLOGY Pub Date : 2025-04-01 DOI: 10.1016/j.reuma.2025.501849
Melek Aykut Selçuk , Gülseren Demir Karakılıç , Esra Mert , Burcu Duyur Çakıt

Introduction

We aimed to evaluate pain, kinesiophobia, physical activity, depression, disease severity and fatigue in patients with Fibromyalgia syndrome (FMS) and chronic neck pain (CNP) and healthy controls.

Material and methods

Fifty-two patients with FMS (group 1), 52 patients with CNP (group 2) and 52 healthy controls (group 3) were included in the study. Visual Analog Scale (VAS) was used to evaluate pain intensity and fatigue, Tampa Scale of Kinesiophobia (TSK) for kinesiophobia, Beck Depression Inventory (BDI) for depression, International Physical Activity Questionnaire (IPAQ) Short Form for physical activity level, Revised Fibromyalgia Impact Questionnaire (rFIQ) for functional status in FMS, and Neck Pain Disability Index (NPDI) for neck pain-related disability in patients with CNP.

Results

The mean age was similar in all three groups (42.96) and the ratio of female was higher in all three groups (94.2%, 90%, 88.6%). High level kinesiophobia was present in 86.6% of patients in group 1, 63.3% of patients in group 2 and 23.4% of participants in group 3 and statistically, kinesiophobia was more common in groups 1 than in groups 2 and 3 and in group 2 than in group 3. The rate of depression was 80%, 50% and 16% in groups 1, 2 and 3, respectively. In group 1, 70% of patients had low, 23.3% had moderate, and 6.6% had high physical activity levels. In group 2, 46.6% of patients had low, 36.6% had moderate, and 16.6% had high physical activity levels; in group 3, 23.3% had low, 53.4% had moderate, and 23.3% had high physical activity levels. There was a statistically significant difference in physical activity levels among the three groups and between group 1 and group 3 (p < 0.05), but no statistically significant difference was revealed in the remaining paired comparisons (p > 0.05). TSK score was positively and weakly correlated with VAS-pain (p:0.032, r:0.392) and rFIQ scores (p:0.025, r:0.408) in group 1, positively and strongly correlated with BDI scores (p:0.002, r:0.547) in group 1, and negatively and weakly correlated with physical activity levels (p:0.039, r: −0.378) in group 2.

Conclusions

The patients with group 1 and group 2 had higher levels of kinesiophobia, pain intensity, fatigue and a lower physical activity level than group 3.
本研究旨在评估纤维肌痛综合征(FMS)和慢性颈部疼痛(CNP)患者和健康对照者的疼痛、运动恐惧症、体力活动、抑郁、疾病严重程度和疲劳。材料与方法将52例FMS患者(1组)、52例CNP患者(2组)和52例健康对照(3组)纳入研究。采用视觉模拟量表(VAS)评估疼痛强度和疲劳程度,采用坦帕运动恐惧量表(TSK)评估运动恐惧程度,采用贝克抑郁量表(BDI)评估抑郁程度,采用国际体育活动问卷(IPAQ)简表评估体育活动水平,采用修正纤维肌痛影响问卷(rFIQ)评估FMS患者的功能状态,采用颈痛残疾指数(NPDI)评估CNP患者的颈痛相关残疾。结果三组患者平均年龄相近(42.96岁),女性比例较高(94.2%,90%,88.6%)。1组患者中有86.6%、2组患者中有63.3%、3组患者中有23.4%存在高水平的运动恐惧症,且1组患者的运动恐惧症发生率高于2组和3组,2组患者的运动恐惧症发生率高于3组。1、2、3组抑郁率分别为80%、50%、16%。在第1组中,70%的患者体力活动水平低,23.3%为中度,6.6%为高。在第2组中,46.6%的患者体力活动水平低,36.6%的患者体力活动水平中等,16.6%的患者体力活动水平高;在第3组中,23.3%的人体力活动水平低,53.4%的人体力活动水平中等,23.3%的人体力活动水平高。三组之间、1组与3组之间的身体活动量差异有统计学意义(p <;0.05),其余配对比较差异无统计学意义(p >;0.05)。1组TSK评分与VAS-pain (p:0.032, r:0.392)、rFIQ评分(p:0.025, r:0.408)呈显著正、弱相关,与BDI评分呈显著正、强相关(p:0.002, r:0.547),与体力活动水平呈显著负、弱相关(p:0.039, r:−0.378)。结论1组和2组患者运动恐惧症、疼痛强度、疲劳程度均高于3组,体力活动水平低于3组。
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引用次数: 0
Sarcoidosis inducida por capecitabina en una paciente oncológica: presentación clínica con artritis 癌症患者中卡培他滨引起的结节病:关节炎的临床表现
IF 1.2 Q4 RHEUMATOLOGY Pub Date : 2025-04-01 DOI: 10.1016/j.reuma.2025.501870
Yedra Usón-Rodríguez , Fátima Mocha-Campillo , Maialen Guerrero-Gómez , Juan Lao-Romera , Marina Soledad Moreno-García
Sarcoidosis is a multisystemic granulomatous disease of uncertain etiology. Several drugs have been linked to the development of sarcoidosis or systemic granulomatous reactions indistinguishable from this disease. We present the clinical case of a patient diagnosed with breast cancer and undergoing treatment with capecitabine who, after developing systemic and musculoskeletal symptoms, was ultimately diagnosed with capecitabine-induced sarcoidosis.
结节病是一种病因不明的多系统肉芽肿性疾病。有几种药物与结节病或系统性肉芽肿反应的发展有关,与这种疾病难以区分。我们提出了一个临床病例,患者诊断为乳腺癌,并接受卡培他滨治疗后,出现全身和肌肉骨骼症状,最终被诊断为卡培他滨诱导的结节病。
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引用次数: 0
期刊
Reumatologia Clinica
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