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The inclusion of Indigenous voices in health research 将土著人的声音纳入健康研究。
IF 15 1区 医学 Q1 RHEUMATOLOGY Pub Date : 2025-02-01 DOI: 10.1016/S2665-9913(24)00335-7
Katherine A Collins
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引用次数: 0
Coronary polyarteritis nodosa in a young adult 青年人冠状动脉结节性多动脉炎1例。
IF 15 1区 医学 Q1 RHEUMATOLOGY Pub Date : 2025-02-01 DOI: 10.1016/S2665-9913(24)00397-7
Michele Marchini
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引用次数: 0
Older age and frailty in ANCA-associated vasculitis: the thin line between undertreating and overtreating
IF 15 1区 医学 Q1 RHEUMATOLOGY Pub Date : 2025-02-01 DOI: 10.1016/S2665-9913(24)00399-0
Sara Thietart , Xavier Puéchal
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引用次数: 0
Research in Brief
IF 15 1区 医学 Q1 RHEUMATOLOGY Pub Date : 2025-02-01 DOI: 10.1016/S2665-9913(25)00003-7
Jennifer Thorley
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引用次数: 0
Advancing personalised precision treatment for Still's disease based on molecular characteristics and disease progression 根据分子特征和疾病进展,推进斯蒂尔病的个性化精准治疗。
IF 15 1区 医学 Q1 RHEUMATOLOGY Pub Date : 2025-02-01 DOI: 10.1016/S2665-9913(24)00225-X
Yujie Shen MM , Jinchao Jia MD , Jialin Teng MD , Prof Chengde Yang MD , Qiongyi Hu MD
Still's disease, a systemic autoinflammatory disorder with a classic multigenetic background, is characterised by polyarthritis, high-spiking fever, salmon-like evanescent skin rash, and hyperferritinaemia. Although the exact cause of Still's disease remains unclear, it is believed to be influenced by genetic factors, infections, and immune dysregulation. Current studies indicate that neutrophils and macrophages play crucial roles in the pathogenesis of Still's disease, along with involvement of natural killer cells, T cells, and B cells. Advances in biologic agents have expanded treatment strategies beyond conventional approaches, with cytokine-targeted agents showing promise in the management of Still's disease. Some cytokine-targeting biologic agents can be developed based on clinical manifestations, complications, immune cells, and molecular networks. Emphasis of immunophenotyping for precise clinical subtyping and targeted molecular therapies based on these findings is crucial for optimising treatment outcomes. In this Review, we discuss the latest advancements in the understanding of Still's disease pathogenesis and corresponding therapeutic approaches.
斯蒂尔病是一种具有典型多基因遗传背景的系统性自身炎症性疾病,其特征是多关节炎、高热、鲑鱼状皮疹和高铁蛋白血症。尽管 Still's 病的确切病因仍不清楚,但据信它受到遗传因素、感染和免疫失调的影响。目前的研究表明,中性粒细胞和巨噬细胞在 Still's 病的发病机制中起着关键作用,自然杀伤细胞、T 细胞和 B 细胞也参与其中。生物制剂的进步使治疗策略超越了传统方法,细胞因子靶向制剂在治疗斯蒂尔病方面大有可为。一些细胞因子靶向生物制剂可根据临床表现、并发症、免疫细胞和分子网络进行开发。强调通过免疫分型进行精确的临床亚型分析,并根据这些发现进行有针对性的分子治疗,对于优化治疗效果至关重要。在本综述中,我们将讨论在了解斯蒂尔病发病机制和相应治疗方法方面取得的最新进展。
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引用次数: 0
Effect of apremilast on hand and whole-body MRI assessments of inflammation in patients with psoriatic arthritis (MOSAIC): a phase 4, multicentre, single-arm, open-label study 阿普司特对银屑病关节炎患者手部和全身核磁共振炎症评估的影响(MOSAIC):一项第 4 期、多中心、单臂、开放标签研究。
IF 15 1区 医学 Q1 RHEUMATOLOGY Pub Date : 2025-02-01 DOI: 10.1016/S2665-9913(24)00232-7
Prof Mikkel Østergaard MD , Mikael Boesen MD , Walter P Maksymowych FRCP , Robert G Lambert FRCPC , Michael R Bubb MD , Olga Kubassova PhD , Guillermo Valenzuela MD , Jyotsna Reddy MD , Stephen Colgan PhD , Yuri Klyachkin PhD , Cynthia Deignan PhD , Zhenwei Zhou PhD , Hamid Amouzadeh PhD , Philip J Mease MD
<div><h3>Background</h3><div>The Psoriatic Arthritis Magnetic Resonance Imaging Scoring System (PsAMRIS) and MRI Whole-Body Scoring System for Inflammation in Peripheral Joints and Entheses in Inflammatory Arthritis (MRI-WIPE) have not been used together to assess treatment of psoriatic arthritis in a clinical trial. We aimed to assess the effect of apremilast treatment on inflammation, with outcomes measured by PsAMRIS and MRI-WIPE.</div></div><div><h3>Methods</h3><div>MOSAIC was a phase 4, multicentre, single-arm, open-label study conducted at 29 sites across ten countries (Belgium, Canada, Denmark, Germany, Italy, Russia, Spain, Switzerland, the UK, and the USA). Adults aged 18 years or older with a documented diagnosis of psoriatic arthritis for a duration of 3 months to 5 years self-enrolled and were included if they met the classification criteria for active psoriatic arthritis at screening. Patients were required to have at least three swollen and three tender joints with hand involvement and at least one active enthesitis site according to the Spondyloarthritis Research Consortium of Canada enthesitis index or the Leeds enthesitis index. Patients were excluded if they had previous treatment with a biological disease-modifying antirheumatic drug or previous treatment with more than two conventional synthetic disease-modifying antirheumatic drugs. After a 5-day titration period, patients received apremilast 30 mg orally twice per day. Concomitant stable methotrexate up to 25 mg per week was permitted. The primary endpoint was change from baseline to week 24 in a composite inflammation score of bone marrow oedema, synovitis, and tenosynovitis in the hand as assessed by PsAMRIS. The full analysis set and safety population included all enrolled patients who received at least one dose of apremilast. This completed study is registered with <span><span>ClinicalTrials.gov</span><svg><path></path></svg></span> (<span><span>NCT03783026</span><svg><path></path></svg></span>).</div></div><div><h3>Findings</h3><div>Between Feb 6, 2019, and May 11, 2022, 123 patients were enrolled in the MOSAIC study. Of these 123 patients, 122 (99%) were treated with apremilast and included in the full analysis set and safety population. 67 (55%) of 122 patients were female, 55 (45%) were male, and 116 (95%) were White. 80 (66%) of 122 patients completed 48 weeks of treatment. The least squares mean change from baseline to week 24 in the composite inflammation score of bone marrow oedema, synovitis, and tenosynovitis as assessed by PsAMRIS was −2·32 (95% CI −4·73 to 0·09). 95 (78%) of 122 patients had at least one treatment-emergent adverse event. Six (5%) patients had a severe treatment-emergent adverse event and six (5%) patients had a serious treatment-emergent adverse event. No serious treatment-emergent adverse events were considered to be related to apremilast.</div></div><div><h3>Interpretation</h3><div>Apremilast improved inflammation in joints and entheses on
背景:银屑病关节炎磁共振成像评分系统(PsAMRIS银屑病关节炎磁共振成像评分系统(PsAMRIS)和炎症性关节炎外周关节和内膜炎症核磁共振成像全身评分系统(MRI-WIPE)尚未在临床试验中同时用于评估银屑病关节炎的治疗。我们旨在通过PsAMRIS和MRI-WIPE测量结果,评估阿普司特治疗对炎症的影响:MOSAIC是一项4期、多中心、单臂、开放标签研究,在10个国家(比利时、加拿大、丹麦、德国、意大利、俄罗斯、西班牙、瑞士、英国和美国)的29个地点进行。年龄在18岁或18岁以上、被确诊患有银屑病关节炎3个月至5年的成人自行报名参加,如果他们在筛查时符合活动性银屑病关节炎的分类标准,则被纳入研究范围。根据加拿大脊柱关节炎研究联合会(Spondyloarthritis Research Consortium of Canada)的关节炎指数或利兹关节炎指数,患者必须至少有三个关节肿胀和三个关节触痛,且手部受累,并至少有一个活动性关节炎部位。如果患者曾接受过生物改善病情抗风湿药物治疗,或曾接受过两种以上传统合成改善病情抗风湿药物治疗,则排除在外。经过 5 天的滴定期后,患者开始口服阿普司特 30 毫克,每天两次。允许同时服用稳定的甲氨蝶呤,每周不超过25毫克。主要终点是PsAMRIS评估的手部骨髓水肿、滑膜炎和腱鞘炎综合炎症评分从基线到第24周的变化。完整的分析集和安全性人群包括所有接受了至少一次阿普司特治疗的入组患者。这项已完成的研究已在ClinicalTrials.gov(NCT03783026)上注册:2019年2月6日至2022年5月11日期间,MOSAIC研究共招募了123名患者。在这123名患者中,有122人(99%)接受了阿普司特治疗,并纳入了完整的分析集和安全人群。122名患者中有67名(55%)为女性,55名(45%)为男性,116名(95%)为白人。122名患者中有80名(66%)完成了48周的治疗。PsAMRIS评估的骨髓水肿、滑膜炎和腱鞘炎综合炎症评分从基线到第24周的最小二乘法平均变化为-2-32(95% CI -4-73至0-09)。122 名患者中有 95 人(78%)至少出现过一次治疗突发不良事件。6名患者(5%)发生了严重的治疗突发不良事件,6名患者(5%)发生了严重的治疗突发不良事件。没有严重治疗突发不良事件被认为与阿普司特有关:阿普瑞米司特改善了手部和全身核磁共振成像评估中关节和内膜的炎症。我们的研究结果鼓励将核磁共振成像(包括全身核磁共振成像)作为银屑病关节炎患者试验的客观结果测量指标:安进公司。
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引用次数: 0
Faecal microbiota transplantation in patients with systemic sclerosis and lower gastrointestinal tract symptoms in Norway (ReSScue): a phase 2, randomised, double-blind, placebo-controlled trial.
IF 15 1区 医学 Q1 RHEUMATOLOGY Pub Date : 2025-01-31 DOI: 10.1016/S2665-9913(24)00334-5
Håvard Fretheim, Imon Barua, Gunnstein Bakland, Alvilde Dhainaut, Anne-Kristine Halse, Maylen N Carstens, Henriette Didriksen, Øyvind Midtvedt, Knut E A Lundin, Lars Aabakken, Vikas K Sarna, Hasse K Zaré, Dinesh Khanna, Oliver Distler, Tore Midtvedt, Espen S Bækkevold, Inge C Olsen, Diana Domanska, Maiju E Pesonen, Øyvind Molberg, Anna-Maria Hoffmann-Vold

Background: Gastrointestinal tract involvement is highly prevalent in systemic sclerosis, with few treatment options. We assessed the efficacy and safety of faecal microbiota transplantation using standardised anaerobic cultivated human intestinal microbiome (ACHIM) as a novel treatment option for patients with systemic sclerosis and symptomatic lower gastrointestinal tract involvement.

Methods: In this phase 2, randomised, double-blind, placebo-controlled trial done at four university hospitals in Norway, we enrolled adults aged 18-85 years with systemic sclerosis and moderate-to-severe lower gastrointestinal tract symptoms (bloating or diarrhoea). Participants were randomly assigned 1:1 to intestinal infusions of placebo or ACHIM at weeks 0 and 2, stratified by worst symptom (bloating or diarrhoea). The primary endpoint was change in worst lower gastrointestinal tract symptom (bloating or diarrhoea) from week 0 to week 12, measured using the University of California Los Angeles Scleroderma Clinical Trial Consortium Gastrointestinal Tract 2.0 scoring system in the intention-to-treat population. Safety was assessed at weeks 0, 2, 4, 6, and 12 in all participants who received at least one infusion. A person with lived experience of systemic sclerosis was involved in the study planning and conduct. This trial was registered at ClinicalTrials.gov, NCT04300426.

Findings: Between Sept 24, 2020, and Jan 14, 2022, 67 participants were enrolled and randomly allocated to placebo (n=34) or ACHIM (n=33). Mean age was 58·91 years (SD 11·59). 62 (93%) of 67 participants were women, five (7%) were men, and 50 (75%) were anti-centromere antibody positive. Change in worst lower gastrointestinal tract symptom from week 0 to week 12 did not differ between participants who received ACHIM (-0·13, 95% CI -0·37 to 0·11) and participants who received placebo (-0·33, -0·57 to -0·09; average marginal effect 0·20, 95% CI -0·12 to 0·52; p=0·22). Adverse events, mostly mild and short-lived gastrointestinal tract symptoms, were reported by 16 (48%) of 33 participants in the ACHIM group and 19 (56%) of 34 in the placebo group. During gastroscopy, one participant had a duodenal perforation.

Interpretation: Faecal microbiota transplantation with ACHIM was well tolerated in participants with systemic sclerosis but did not result in an improvement in lower gastrointestinal tract symptoms.

Funding: KLINBEFORSK.

Translation: For the Norwegian translation of the abstract see Supplementary Materials section.

{"title":"Faecal microbiota transplantation in patients with systemic sclerosis and lower gastrointestinal tract symptoms in Norway (ReSScue): a phase 2, randomised, double-blind, placebo-controlled trial.","authors":"Håvard Fretheim, Imon Barua, Gunnstein Bakland, Alvilde Dhainaut, Anne-Kristine Halse, Maylen N Carstens, Henriette Didriksen, Øyvind Midtvedt, Knut E A Lundin, Lars Aabakken, Vikas K Sarna, Hasse K Zaré, Dinesh Khanna, Oliver Distler, Tore Midtvedt, Espen S Bækkevold, Inge C Olsen, Diana Domanska, Maiju E Pesonen, Øyvind Molberg, Anna-Maria Hoffmann-Vold","doi":"10.1016/S2665-9913(24)00334-5","DOIUrl":"https://doi.org/10.1016/S2665-9913(24)00334-5","url":null,"abstract":"<p><strong>Background: </strong>Gastrointestinal tract involvement is highly prevalent in systemic sclerosis, with few treatment options. We assessed the efficacy and safety of faecal microbiota transplantation using standardised anaerobic cultivated human intestinal microbiome (ACHIM) as a novel treatment option for patients with systemic sclerosis and symptomatic lower gastrointestinal tract involvement.</p><p><strong>Methods: </strong>In this phase 2, randomised, double-blind, placebo-controlled trial done at four university hospitals in Norway, we enrolled adults aged 18-85 years with systemic sclerosis and moderate-to-severe lower gastrointestinal tract symptoms (bloating or diarrhoea). Participants were randomly assigned 1:1 to intestinal infusions of placebo or ACHIM at weeks 0 and 2, stratified by worst symptom (bloating or diarrhoea). The primary endpoint was change in worst lower gastrointestinal tract symptom (bloating or diarrhoea) from week 0 to week 12, measured using the University of California Los Angeles Scleroderma Clinical Trial Consortium Gastrointestinal Tract 2.0 scoring system in the intention-to-treat population. Safety was assessed at weeks 0, 2, 4, 6, and 12 in all participants who received at least one infusion. A person with lived experience of systemic sclerosis was involved in the study planning and conduct. This trial was registered at ClinicalTrials.gov, NCT04300426.</p><p><strong>Findings: </strong>Between Sept 24, 2020, and Jan 14, 2022, 67 participants were enrolled and randomly allocated to placebo (n=34) or ACHIM (n=33). Mean age was 58·91 years (SD 11·59). 62 (93%) of 67 participants were women, five (7%) were men, and 50 (75%) were anti-centromere antibody positive. Change in worst lower gastrointestinal tract symptom from week 0 to week 12 did not differ between participants who received ACHIM (-0·13, 95% CI -0·37 to 0·11) and participants who received placebo (-0·33, -0·57 to -0·09; average marginal effect 0·20, 95% CI -0·12 to 0·52; p=0·22). Adverse events, mostly mild and short-lived gastrointestinal tract symptoms, were reported by 16 (48%) of 33 participants in the ACHIM group and 19 (56%) of 34 in the placebo group. During gastroscopy, one participant had a duodenal perforation.</p><p><strong>Interpretation: </strong>Faecal microbiota transplantation with ACHIM was well tolerated in participants with systemic sclerosis but did not result in an improvement in lower gastrointestinal tract symptoms.</p><p><strong>Funding: </strong>KLINBEFORSK.</p><p><strong>Translation: </strong>For the Norwegian translation of the abstract see Supplementary Materials section.</p>","PeriodicalId":48540,"journal":{"name":"Lancet Rheumatology","volume":" ","pages":""},"PeriodicalIF":15.0,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143123765","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"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
Is faecal microbiota transplantation ready for prime time in systemic sclerosis?
IF 15 1区 医学 Q1 RHEUMATOLOGY Pub Date : 2025-01-31 DOI: 10.1016/S2665-9913(24)00376-X
Shu Wen Tay, Andrea Hsiu Ling Low
{"title":"Is faecal microbiota transplantation ready for prime time in systemic sclerosis?","authors":"Shu Wen Tay, Andrea Hsiu Ling Low","doi":"10.1016/S2665-9913(24)00376-X","DOIUrl":"https://doi.org/10.1016/S2665-9913(24)00376-X","url":null,"abstract":"","PeriodicalId":48540,"journal":{"name":"Lancet Rheumatology","volume":" ","pages":""},"PeriodicalIF":15.0,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143123780","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"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
Safety of CAR T-cell therapy for cancer in pre-existing autoimmune or inflammatory disease: a retrospective comparative cohort study.
IF 15 1区 医学 Q1 RHEUMATOLOGY Pub Date : 2025-01-28 DOI: 10.1016/S2665-9913(24)00402-8
Kathleen M M Vanni, Kaitlin R McCarter, Xiaosong Wang, Caitlyn Duffy, Jamie P Dela Cruz, Holly Wobma, Sarah Nikiforow, Elena M Massarotti, Karen H Costenbader, Jessica S Little, Ellen M Gravallese, Gregory C McDermott, Caron A Jacobson, Jeffrey A Sparks
{"title":"Safety of CAR T-cell therapy for cancer in pre-existing autoimmune or inflammatory disease: a retrospective comparative cohort study.","authors":"Kathleen M M Vanni, Kaitlin R McCarter, Xiaosong Wang, Caitlyn Duffy, Jamie P Dela Cruz, Holly Wobma, Sarah Nikiforow, Elena M Massarotti, Karen H Costenbader, Jessica S Little, Ellen M Gravallese, Gregory C McDermott, Caron A Jacobson, Jeffrey A Sparks","doi":"10.1016/S2665-9913(24)00402-8","DOIUrl":"https://doi.org/10.1016/S2665-9913(24)00402-8","url":null,"abstract":"","PeriodicalId":48540,"journal":{"name":"Lancet Rheumatology","volume":" ","pages":""},"PeriodicalIF":15.0,"publicationDate":"2025-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143075971","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"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
Performance of large language models in rheumatology board-like questions: accuracy, quality, and safety.
IF 15 1区 医学 Q1 RHEUMATOLOGY Pub Date : 2025-01-22 DOI: 10.1016/S2665-9913(24)00400-4
Jaime Flores-Gouyonnet, María C Cuéllar-Gutiérrez, Gabriel Figueroa-Parra, Bradly Kimbrough, Elena K Joerns, Erika Navarro-Mendoza, Cynthia S Crowson, Ryan J Lennon, Mario Bautista-Vargas, Mariana González-Treviño, Alain Sanchez-Rodriguez, Alí Duarte-García
{"title":"Performance of large language models in rheumatology board-like questions: accuracy, quality, and safety.","authors":"Jaime Flores-Gouyonnet, María C Cuéllar-Gutiérrez, Gabriel Figueroa-Parra, Bradly Kimbrough, Elena K Joerns, Erika Navarro-Mendoza, Cynthia S Crowson, Ryan J Lennon, Mario Bautista-Vargas, Mariana González-Treviño, Alain Sanchez-Rodriguez, Alí Duarte-García","doi":"10.1016/S2665-9913(24)00400-4","DOIUrl":"https://doi.org/10.1016/S2665-9913(24)00400-4","url":null,"abstract":"","PeriodicalId":48540,"journal":{"name":"Lancet Rheumatology","volume":" ","pages":""},"PeriodicalIF":15.0,"publicationDate":"2025-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143042418","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"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
期刊
Lancet Rheumatology
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