Pub Date : 2024-01-04DOI: 10.1186/s42358-023-00346-8
Ana Carolina Matias Dinelly Pinto, Rodolfo de Melo Nunes, Waleska Vidal de Freitas Carvalho, Virgínia Claudia Carneiro Girão, Francisco Airton Castro Rocha
Objective: Despite some knowledge gaps in scientific evidence, MgCl2 is largely used for pain relief in musculoskeletal diseases. Mg salts were shown to provide analgesia postoperatively in orthopedic surgery and low Mg levels were linked to arthritis development and severity. We determined the anti-inflammatory activity of MgCl2 in an acute arthritis model.
Methods: Mice received 0.1 mg/25µL Zymosan (Zy) or saline into the knees. Joint pain was evaluated using von Frey test; cell influx, and interleukin (IL)-1 level were assessed in joint lavage at 6 h. Synovia were excised for histopathology and analysis of immunoexpression of nuclear factor kappa B (NFκB) and tumor necrosis factor (TNF)-α. Groups (n = 6/group) received either 90 mg/kg MgCl2/100 µL or saline per os (systemic) or 500 µg/25 µL MgCl2 or saline intra-articularly (i.a.) 30 min prior to Zy.
Results: MgCl2 given either systemically or locally significantly reduced cell influx (p = 0.0012 and p = 0.0269, respectively), pain (p = 0.0005 and p = 0.0038, respectively), and intra-articular IL-1 level (p = 0.0391), as compared to saline. Systemic MgCl2 significantly decreased NFκB (p < 0.05) immmunoexpression, as compared to saline.
Conclusion: MgCl2 given systemically or locally displayed anti-inflammatory activity in a severe acute arthritis model reducing cell influx, pain, and cytokine release. MgCl2 operates at least partially via inhibiting NFκB activation. This is the first in vivo demonstration that MgCl2 decreases cytokine release in arthritis, prompting reduction of inflammation and pain relief.
{"title":"Systemic and local antiinflammatory effect of magnesium chloride in experimental arthritis.","authors":"Ana Carolina Matias Dinelly Pinto, Rodolfo de Melo Nunes, Waleska Vidal de Freitas Carvalho, Virgínia Claudia Carneiro Girão, Francisco Airton Castro Rocha","doi":"10.1186/s42358-023-00346-8","DOIUrl":"10.1186/s42358-023-00346-8","url":null,"abstract":"<p><strong>Objective: </strong>Despite some knowledge gaps in scientific evidence, MgCl<sub>2</sub> is largely used for pain relief in musculoskeletal diseases. Mg salts were shown to provide analgesia postoperatively in orthopedic surgery and low Mg levels were linked to arthritis development and severity. We determined the anti-inflammatory activity of MgCl<sub>2</sub> in an acute arthritis model.</p><p><strong>Methods: </strong>Mice received 0.1 mg/25µL Zymosan (Zy) or saline into the knees. Joint pain was evaluated using von Frey test; cell influx, and interleukin (IL)-1 level were assessed in joint lavage at 6 h. Synovia were excised for histopathology and analysis of immunoexpression of nuclear factor kappa B (NFκB) and tumor necrosis factor (TNF)-α. Groups (n = 6/group) received either 90 mg/kg MgCl<sub>2</sub>/100 µL or saline per os (systemic) or 500 µg/25 µL MgCl<sub>2</sub> or saline intra-articularly (i.a.) 30 min prior to Zy.</p><p><strong>Results: </strong>MgCl<sub>2</sub> given either systemically or locally significantly reduced cell influx (p = 0.0012 and p = 0.0269, respectively), pain (p = 0.0005 and p = 0.0038, respectively), and intra-articular IL-1 level (p = 0.0391), as compared to saline. Systemic MgCl<sub>2</sub> significantly decreased NFκB (p < 0.05) immmunoexpression, as compared to saline.</p><p><strong>Conclusion: </strong>MgCl<sub>2</sub> given systemically or locally displayed anti-inflammatory activity in a severe acute arthritis model reducing cell influx, pain, and cytokine release. MgCl<sub>2</sub> operates at least partially via inhibiting NFκB activation. This is the first in vivo demonstration that MgCl<sub>2</sub> decreases cytokine release in arthritis, prompting reduction of inflammation and pain relief.</p>","PeriodicalId":48634,"journal":{"name":"Advances in Rheumatology","volume":"64 1","pages":"6"},"PeriodicalIF":2.0,"publicationDate":"2024-01-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139099036","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-01-02DOI: 10.1186/s42358-023-00338-8
Larissa Vargas Cruz, Júlia Boechat Farani, Júlia Rabello Costa, João Victor de Andrade Águas, Bruna Ruschel, Franciele de Almeida Menegat, Andrese Aline Gasparin, Claiton Viegas Brenol, Charles Lubianca Kohem, Adrieli Bessa, Francisco Forestiero, Felipe Thies, Penélope Esther Palominos
Patients with psoriatic arthritis (PsA) experience reduced physical function and impaired quality of life. Better patient-reported functional outcomes are found when lower disease activity is achieved. To evaluate the variation of physical function by HAQ-DI over time in PsA patients treated with standard therapy in a real-life setting: to verify predictors of achieving a minimum clinically important difference (MCID) in function by HAQ-DI (ΔHAQ-DI ≤ − 0.35) and to measure the impact of achieving REM/LDA on long-term function by HAQ-DI. This is a longitudinal analysis of a real-life retrospective cohort. Data from PsA patients with at least 4 years of follow-up in the PsA clinic from 2011 to 2019 were extracted from electronic medical records. The variations of physical function by HAQ-DI and disease activity by DAPSA over time were calculated. A multivariate hierarchical regression model was applied to verify predictors of MCID in HAQ-DI. A comparison of HAQ-DI variation between patients with DAPSA REM, LDA, moderate and high disease activity was made using the generalized estimating equation model (GEE), adjusted by Bonferroni test. The Spearman correlation method was applied to verify the correlation of ΔDAPSA and ΔHAQ-DI over time. Statistical analysis was performed in SPSS program version 21.0. Seventy-three patients were included in the analysis. Physical function measured by HAQ-DI was determined by PsA disease activity measured by DAPSA (p < 0.000). A moderate and statistically significant correlation between ΔDAPSA and ΔHAQ-DI was observed (rs = 0.60; p < 0.001). Only patients in DAPSA REM demonstrated a constant decline in HAQ-DI scores during the follow-up. White ethnicity and older age at baseline were predictors for not achieving MCID in HAQ-DI [RR 0.33 (0.16–0.6795% CI p = 0.002) and RR 0.96 (0.93–0.9895% CI p < 0.000), respectively, while higher scores of HAQ-DI at baseline were predictors of achieving MCID [RR 1.71 (1.12–2.6095%CI p = 0.013)]. In PsA, patients who maintained DAPSA REM/LDA over time had better long-term functional outcomes. Higher HAQ-DI scores at baseline, non-white ethnicity and younger age were predictors for achieving a clinical meaningful improvement of HAQ-DI.
{"title":"Patients with longstanding pPatients with longstanding psoriatic arthritis can achieve DAPSA remission or low disease activity and it correlates to better functional outcomes: results from a Latin-American real-life cohort","authors":"Larissa Vargas Cruz, Júlia Boechat Farani, Júlia Rabello Costa, João Victor de Andrade Águas, Bruna Ruschel, Franciele de Almeida Menegat, Andrese Aline Gasparin, Claiton Viegas Brenol, Charles Lubianca Kohem, Adrieli Bessa, Francisco Forestiero, Felipe Thies, Penélope Esther Palominos","doi":"10.1186/s42358-023-00338-8","DOIUrl":"https://doi.org/10.1186/s42358-023-00338-8","url":null,"abstract":"Patients with psoriatic arthritis (PsA) experience reduced physical function and impaired quality of life. Better patient-reported functional outcomes are found when lower disease activity is achieved. To evaluate the variation of physical function by HAQ-DI over time in PsA patients treated with standard therapy in a real-life setting: to verify predictors of achieving a minimum clinically important difference (MCID) in function by HAQ-DI (ΔHAQ-DI ≤ − 0.35) and to measure the impact of achieving REM/LDA on long-term function by HAQ-DI. This is a longitudinal analysis of a real-life retrospective cohort. Data from PsA patients with at least 4 years of follow-up in the PsA clinic from 2011 to 2019 were extracted from electronic medical records. The variations of physical function by HAQ-DI and disease activity by DAPSA over time were calculated. A multivariate hierarchical regression model was applied to verify predictors of MCID in HAQ-DI. A comparison of HAQ-DI variation between patients with DAPSA REM, LDA, moderate and high disease activity was made using the generalized estimating equation model (GEE), adjusted by Bonferroni test. The Spearman correlation method was applied to verify the correlation of ΔDAPSA and ΔHAQ-DI over time. Statistical analysis was performed in SPSS program version 21.0. Seventy-three patients were included in the analysis. Physical function measured by HAQ-DI was determined by PsA disease activity measured by DAPSA (p < 0.000). A moderate and statistically significant correlation between ΔDAPSA and ΔHAQ-DI was observed (rs = 0.60; p < 0.001). Only patients in DAPSA REM demonstrated a constant decline in HAQ-DI scores during the follow-up. White ethnicity and older age at baseline were predictors for not achieving MCID in HAQ-DI [RR 0.33 (0.16–0.6795% CI p = 0.002) and RR 0.96 (0.93–0.9895% CI p < 0.000), respectively, while higher scores of HAQ-DI at baseline were predictors of achieving MCID [RR 1.71 (1.12–2.6095%CI p = 0.013)]. In PsA, patients who maintained DAPSA REM/LDA over time had better long-term functional outcomes. Higher HAQ-DI scores at baseline, non-white ethnicity and younger age were predictors for achieving a clinical meaningful improvement of HAQ-DI.","PeriodicalId":48634,"journal":{"name":"Advances in Rheumatology","volume":"40 1","pages":""},"PeriodicalIF":2.3,"publicationDate":"2024-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139078260","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-01-02DOI: 10.1186/s42358-023-00341-z
Lindomar Mineiro, Tamires Terezinha Gallo da Silva, Silvia Regina Valderramas, Sergio Candido Kowalski, Eduardo dos Santos Paiva, Anna Raquel Silveira Gomes
Knowledge of patients about Rheumatoid Arthritis (RA) is a necessary aspect to better approach self-management support in a patient-centered manner. The research instrument known as the Rheumatoid Arthritis Knowledge Assessment Scale (RAKAS), consisting of 13 items, is simple, reliable and reproducible, and can be applied in both clinical practice and research protocols. This study aimed to translate and culturally adapt the RAKAS vocabulary into Brazilian Portuguese and to evaluate its concurrent validity. The RAKAS was translated into Brazilian Portuguese and administered to 52 elderly women with RA recruited between May 2021 and May 2022. Concurrent validity was assessed using the Spearman’s correlation coefficient between RAKAS and Patient Knowledge Questionnaire (PKQ). The participants considered RAKAS-13/BRAZIL easy to understand and did not report any doubts in answering the final version. Concurrent validity of the RAKAS–13/BRAZIL was low compared to the PKQ (ρ = 0.283, p = 0.038). Conclusion: The Brazilian Portuguese version of the RAKAS (RAKAS–13/BRASIL) proved to be a questionnaire that was easy and quick to administer to assess patient knowledge about Rheumatoid Arthritis, despite its low correlation with the PKQ in the present study.
{"title":"Translation, transcultural adaptation into Brazilian Portuguese and concurrent validity of the rheumatoid arthritis assessment scale (RAKAS–13/Brazil)","authors":"Lindomar Mineiro, Tamires Terezinha Gallo da Silva, Silvia Regina Valderramas, Sergio Candido Kowalski, Eduardo dos Santos Paiva, Anna Raquel Silveira Gomes","doi":"10.1186/s42358-023-00341-z","DOIUrl":"https://doi.org/10.1186/s42358-023-00341-z","url":null,"abstract":"Knowledge of patients about Rheumatoid Arthritis (RA) is a necessary aspect to better approach self-management support in a patient-centered manner. The research instrument known as the Rheumatoid Arthritis Knowledge Assessment Scale (RAKAS), consisting of 13 items, is simple, reliable and reproducible, and can be applied in both clinical practice and research protocols. This study aimed to translate and culturally adapt the RAKAS vocabulary into Brazilian Portuguese and to evaluate its concurrent validity. The RAKAS was translated into Brazilian Portuguese and administered to 52 elderly women with RA recruited between May 2021 and May 2022. Concurrent validity was assessed using the Spearman’s correlation coefficient between RAKAS and Patient Knowledge Questionnaire (PKQ). The participants considered RAKAS-13/BRAZIL easy to understand and did not report any doubts in answering the final version. Concurrent validity of the RAKAS–13/BRAZIL was low compared to the PKQ (ρ = 0.283, p = 0.038). Conclusion: The Brazilian Portuguese version of the RAKAS (RAKAS–13/BRASIL) proved to be a questionnaire that was easy and quick to administer to assess patient knowledge about Rheumatoid Arthritis, despite its low correlation with the PKQ in the present study.","PeriodicalId":48634,"journal":{"name":"Advances in Rheumatology","volume":"19 1","pages":""},"PeriodicalIF":2.3,"publicationDate":"2024-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139078160","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-01-02DOI: 10.1186/s42358-023-00345-9
Pouya Hadighi, Seyedeh Tahereh Faezi, Seyed Mohammad Javad Mortazavi, Mohsen Rokni, Leila Aghaghazvini, Amir Kasaeian, Mohammad Nejadhosseinian, Hoda Haerian, Hamid Reza Fateh
Osteonecrosis is a major cause of morbidity for patients with systemic lupus erythematosus (SLE). Although core decompression is an approved and trusted technique to prevent further joint deterioration, this surgical method seems to be less beneficial for SLE patients. We aimed to evaluate the outcomes of core decompression in SLE patients with primary stages of femoral head osteonecrosis. In this study, 23 patients (39 affected hip joints) with osteonecrosis of the femoral head with stage II of the disease, based on the Ficat-Arlet classification system, underwent core decompression. Also, patients demographic characteristics, clinical data, medication history, comorbidities, immunological findings, hip plain radiographs, history of total hip arthroplasty after core decompression, and patients satisfaction with joint function according to the Oxford hip score questionnaire were obtained. In the study, 53.8% of affected joints showed signs of radiographic deterioration in follow-up imaging. Sixty-one and a half percent (61.5%) of patients had unsatisfactory joint performance. A third (33.3%) of affected hip joints underwent total hip arthroplasty up to 5 years from core decompression. SLE patients with a history of receiving bisphosphonate were 83.2% less dissatisfied with their joint function than patients without a history of bisphosphonate use (P < 0.02). Of the 23 studied cases, the mean cumulative dose of prednisolone before and after core decompression surgery was 46.41 mg and 14.74 mg respectively. Besides, one case (2.6%) that had a high anti-phospholipid antibodies level during follow-up did not have any radiographic deterioration, and 9 cases (23.1%) had some degrees of radiographic deterioration. The patients group that used bis-phosphonate, had a higher level of satisfaction with joint function after core decompression. Patients with high-level anti-phospholipid antibodies are related to a poor prognosis after core decompression.
{"title":"Evaluation of core decompression outcome in systemic lupus erythematosus with hip osteonecrosis: a retrospective cohort study","authors":"Pouya Hadighi, Seyedeh Tahereh Faezi, Seyed Mohammad Javad Mortazavi, Mohsen Rokni, Leila Aghaghazvini, Amir Kasaeian, Mohammad Nejadhosseinian, Hoda Haerian, Hamid Reza Fateh","doi":"10.1186/s42358-023-00345-9","DOIUrl":"https://doi.org/10.1186/s42358-023-00345-9","url":null,"abstract":"Osteonecrosis is a major cause of morbidity for patients with systemic lupus erythematosus (SLE). Although core decompression is an approved and trusted technique to prevent further joint deterioration, this surgical method seems to be less beneficial for SLE patients. We aimed to evaluate the outcomes of core decompression in SLE patients with primary stages of femoral head osteonecrosis. In this study, 23 patients (39 affected hip joints) with osteonecrosis of the femoral head with stage II of the disease, based on the Ficat-Arlet classification system, underwent core decompression. Also, patients demographic characteristics, clinical data, medication history, comorbidities, immunological findings, hip plain radiographs, history of total hip arthroplasty after core decompression, and patients satisfaction with joint function according to the Oxford hip score questionnaire were obtained. In the study, 53.8% of affected joints showed signs of radiographic deterioration in follow-up imaging. Sixty-one and a half percent (61.5%) of patients had unsatisfactory joint performance. A third (33.3%) of affected hip joints underwent total hip arthroplasty up to 5 years from core decompression. SLE patients with a history of receiving bisphosphonate were 83.2% less dissatisfied with their joint function than patients without a history of bisphosphonate use (P < 0.02). Of the 23 studied cases, the mean cumulative dose of prednisolone before and after core decompression surgery was 46.41 mg and 14.74 mg respectively. Besides, one case (2.6%) that had a high anti-phospholipid antibodies level during follow-up did not have any radiographic deterioration, and 9 cases (23.1%) had some degrees of radiographic deterioration. The patients group that used bis-phosphonate, had a higher level of satisfaction with joint function after core decompression. Patients with high-level anti-phospholipid antibodies are related to a poor prognosis after core decompression.","PeriodicalId":48634,"journal":{"name":"Advances in Rheumatology","volume":"21 1","pages":""},"PeriodicalIF":2.3,"publicationDate":"2024-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139078219","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-01-02DOI: 10.1186/s42358-023-00344-w
Thaís Evelyn Karnopp, Vinicius da Silva Freitas, Andressa Leite Di Domenico, Gustavo Flores Chapacais, Natália Garcia dos Santos, Eduarda Correa Freitas, Andrese Aline Gasparin, Odirlei André Monticielo
Systemic lupus erythematosus (SLE) is an autoimmune disease that can affect several organs and systems. The central and/or peripheral nervous system can suffer from complications known as neuropsychiatric lupus (NPSLE). Studies have associated the manifestations of SLE or NPSLE with vitamin D deficiency. It has been shown that hypovitaminosis D can lead to cognition deficits and cerebral hypoperfusion in patients with NPSLE. In this review article, we will address the main features related to vitamin D supplementation or serum vitamin D levels with neuropsychiatric manifestations, either in patients or in animal models of NPSLE.
系统性红斑狼疮（SLE）是一种可影响多个器官和系统的自身免疫性疾病。中枢和/或外周神经系统会出现并发症，即神经精神性狼疮（NPSLE）。研究表明，系统性红斑狼疮或非系统性红斑狼疮的表现与维生素 D 缺乏有关。研究表明，维生素D不足可导致非系统性红斑狼疮患者出现认知障碍和脑灌注不足。在这篇综述文章中，我们将讨论在非系统性红斑狼疮患者或动物模型中，维生素D补充或血清维生素D水平与神经精神表现相关的主要特征。
{"title":"What is known about the effects of vitamin D in neuropsychiatric lupus?","authors":"Thaís Evelyn Karnopp, Vinicius da Silva Freitas, Andressa Leite Di Domenico, Gustavo Flores Chapacais, Natália Garcia dos Santos, Eduarda Correa Freitas, Andrese Aline Gasparin, Odirlei André Monticielo","doi":"10.1186/s42358-023-00344-w","DOIUrl":"https://doi.org/10.1186/s42358-023-00344-w","url":null,"abstract":"Systemic lupus erythematosus (SLE) is an autoimmune disease that can affect several organs and systems. The central and/or peripheral nervous system can suffer from complications known as neuropsychiatric lupus (NPSLE). Studies have associated the manifestations of SLE or NPSLE with vitamin D deficiency. It has been shown that hypovitaminosis D can lead to cognition deficits and cerebral hypoperfusion in patients with NPSLE. In this review article, we will address the main features related to vitamin D supplementation or serum vitamin D levels with neuropsychiatric manifestations, either in patients or in animal models of NPSLE. ","PeriodicalId":48634,"journal":{"name":"Advances in Rheumatology","volume":"17 1","pages":""},"PeriodicalIF":2.3,"publicationDate":"2024-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139078275","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-01-02DOI: 10.1186/s42358-023-00343-x
Anna Korogodina, Navneet Kaur, Xianhong Xie, Adhya Mehta, Krystal L. Cleven, Bibi Ayesha, Anand Kumthekar
Interstitial lung disease (ILD) remains one of the most important causes of morbidity and mortality in patients with Connective Tissue Diseases (CTD). This study evaluated the impact of hospitalization on mortality in an ethnically and racially diverse cohort of CTD-ILD patients. We conducted a medical records review study at Montefiore Medical Center, Bronx, NY. We included 96 patients and collected data on demographic characteristics, reasons for hospitalization, length of stay, immunosuppressant therapy use, and mortality. We stratified our patients into two cohorts: hospitalized and non-hospitalized. The hospitalized cohort was further subdivided into cardiopulmonary and non-cardiopulmonary admissions. Two-sample tests or Wilcoxon’s rank sum tests for continuous variables and Chi-square or Fisher’s exact tests for categorical variables were used for analyses as deemed appropriate. We identified 213 patients with CTD-ILD. Out of them, 96 patients met the study’s inclusion criteria. The majority of patients were females (79%), and self-identified as Hispanic (54%) and Black (40%). The most common CTDs were rheumatoid arthritis (RA) (29%), inflammatory myositis (22%), and systemic sclerosis (15%). The majority (76%) of patients required at least one hospitalization. In the non-hospitalized group, no deaths were observed, however we noted significant increase of mortality risk in hospitalized group (p = 0.02). We also observed that prolonged hospital stay (> 7 days) as well as older age and male sex were associated with increased mortality. Prolonged (> 7 days) hospital stay and hospitalization for cardiopulmonary causes, as well as older age and male sex were associated with an increased mortality risk in our cohort of CTD-ILD patients.
{"title":"The impact of hospitalization on mortality in patients with connective tissue disease-associated interstitial lung disease: a medical records review study","authors":"Anna Korogodina, Navneet Kaur, Xianhong Xie, Adhya Mehta, Krystal L. Cleven, Bibi Ayesha, Anand Kumthekar","doi":"10.1186/s42358-023-00343-x","DOIUrl":"https://doi.org/10.1186/s42358-023-00343-x","url":null,"abstract":"Interstitial lung disease (ILD) remains one of the most important causes of morbidity and mortality in patients with Connective Tissue Diseases (CTD). This study evaluated the impact of hospitalization on mortality in an ethnically and racially diverse cohort of CTD-ILD patients. We conducted a medical records review study at Montefiore Medical Center, Bronx, NY. We included 96 patients and collected data on demographic characteristics, reasons for hospitalization, length of stay, immunosuppressant therapy use, and mortality. We stratified our patients into two cohorts: hospitalized and non-hospitalized. The hospitalized cohort was further subdivided into cardiopulmonary and non-cardiopulmonary admissions. Two-sample tests or Wilcoxon’s rank sum tests for continuous variables and Chi-square or Fisher’s exact tests for categorical variables were used for analyses as deemed appropriate. We identified 213 patients with CTD-ILD. Out of them, 96 patients met the study’s inclusion criteria. The majority of patients were females (79%), and self-identified as Hispanic (54%) and Black (40%). The most common CTDs were rheumatoid arthritis (RA) (29%), inflammatory myositis (22%), and systemic sclerosis (15%). The majority (76%) of patients required at least one hospitalization. In the non-hospitalized group, no deaths were observed, however we noted significant increase of mortality risk in hospitalized group (p = 0.02). We also observed that prolonged hospital stay (> 7 days) as well as older age and male sex were associated with increased mortality. Prolonged (> 7 days) hospital stay and hospitalization for cardiopulmonary causes, as well as older age and male sex were associated with an increased mortality risk in our cohort of CTD-ILD patients.","PeriodicalId":48634,"journal":{"name":"Advances in Rheumatology","volume":"15 1","pages":""},"PeriodicalIF":2.3,"publicationDate":"2024-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139078214","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-12-13DOI: 10.1186/s42358-023-00342-y
Diego Roger Silva, Sandra Mara Meireles, Christine Brumini, Jamil Natour
This study aims to evaluate the effect of functional versus resistance exercise training on the functional capacity and quality of life of psoriatic arthritis patients. Forty-one psoriatic arthritis patients (18 to 65 years old) were randomized into two groups: functional training group and resistance exercise group. The functional training group underwent functional exercises with elastic band and the functional training group underwent machine resistance exercise twice a week for 12 weeks. Outcome measures were: The Bath Ankylosing Spondylitis Functional Index (BASFI) and Health Assessment Questionnaire for the Spondyloarthropathies (HAQ-S) for functional capacity and functional status, one-repetition maximum test for muscle strength, the Short Form 36 health survey questionnaire (SF-36) for quality of life, and the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) and the Disease Activity Score 28 (DAS-28) for disease activity. Analyzes were performed by a blinded evaluator at baseline (T0), six (T6) and twelve (T12) weeks after the beginning of the exercise. At baseline, the groups were homogeneous in the clinical and demographic characteristics. There was a statistical intra-group improvement for both groups in the BASFI, BASDAI, HAQ-s, and DAS-28. In the quality-of-life assessment, both groups showed statistical intra-group improvements for all domains except the “emotional aspect” domain in the resistance exercise group. In the muscle strength, there was a statistical improvement for all exercises in both groups, except for the “alternate biceps (bilateral)” exercise. Functional training and resistance exercise are similarly effective in improving functional capacity, functional status, disease activity, general quality of life, and muscle strength in patients with psoriatic arthritis. Trial registration: ClinicalTrials.gov: NCT04304326. Registered 11 March 2020, https://clinicaltrials.gov/ct2/show/NCT04304326?term=NCT04304326&draw=2&rank=1 .
{"title":"Effectiveness of functional training versus resistance exercise in patients with psoriatic arthritis: randomized controlled trial","authors":"Diego Roger Silva, Sandra Mara Meireles, Christine Brumini, Jamil Natour","doi":"10.1186/s42358-023-00342-y","DOIUrl":"https://doi.org/10.1186/s42358-023-00342-y","url":null,"abstract":"This study aims to evaluate the effect of functional versus resistance exercise training on the functional capacity and quality of life of psoriatic arthritis patients. Forty-one psoriatic arthritis patients (18 to 65 years old) were randomized into two groups: functional training group and resistance exercise group. The functional training group underwent functional exercises with elastic band and the functional training group underwent machine resistance exercise twice a week for 12 weeks. Outcome measures were: The Bath Ankylosing Spondylitis Functional Index (BASFI) and Health Assessment Questionnaire for the Spondyloarthropathies (HAQ-S) for functional capacity and functional status, one-repetition maximum test for muscle strength, the Short Form 36 health survey questionnaire (SF-36) for quality of life, and the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) and the Disease Activity Score 28 (DAS-28) for disease activity. Analyzes were performed by a blinded evaluator at baseline (T0), six (T6) and twelve (T12) weeks after the beginning of the exercise. At baseline, the groups were homogeneous in the clinical and demographic characteristics. There was a statistical intra-group improvement for both groups in the BASFI, BASDAI, HAQ-s, and DAS-28. In the quality-of-life assessment, both groups showed statistical intra-group improvements for all domains except the “emotional aspect” domain in the resistance exercise group. In the muscle strength, there was a statistical improvement for all exercises in both groups, except for the “alternate biceps (bilateral)” exercise. Functional training and resistance exercise are similarly effective in improving functional capacity, functional status, disease activity, general quality of life, and muscle strength in patients with psoriatic arthritis. Trial registration: ClinicalTrials.gov: NCT04304326. Registered 11 March 2020, https://clinicaltrials.gov/ct2/show/NCT04304326?term=NCT04304326&draw=2&rank=1 .","PeriodicalId":48634,"journal":{"name":"Advances in Rheumatology","volume":"69 1","pages":""},"PeriodicalIF":2.3,"publicationDate":"2023-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138578898","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Many people with non-specific chronic low back pain (NSCLBP) do not recover with current conventional management. Systematic reviews show multidimensional treatment improves pain better than usual active interventions. It is unclear whether multidimensional physiotherapy improves pain better than usual physiotherapy. This study determines the effectiveness of this treatment to reduce pain and disability and improve quality of life, pain cognitions, and electroencephalographic pattern in individuals with NSCLBP.
Methods: 70 eligible participants aged 18 to 50 years with NSCLBP were randomized into either the experimental group (multidimensional physiotherapy) or the active control group (usual physiotherapy). Pain intensity was measured as the primary outcome. Disability, quality of life, pain Catastrophizing, kinesiophobia, fear Avoidance Beliefs, active lumbar range of motion, and brain function were measured as secondary outcomes. The outcomes were measured at pre-treatment, post-treatment, 10, and 22 weeks. Data were analyzed using intention-to-treat approaches.
Results: There were 17 men and 18 women in the experimental group (mean [SD] age, 34.57 [6.98] years) and 18 men and 17 women in the active control group (mean [SD] age, 35.94 [7.51] years). Multidimensional physiotherapy was not more effective than usual physiotherapy at reducing pain intensity at the end of treatment. At the 10 weeks and 22 weeks follow-up, there were statistically significant differences between multidimensional physiotherapy and usual physiotherapy (mean difference at 10 weeks, -1.54; 95% CI, -2.59 to -0.49 and mean difference at 22 weeks, -2.20; 95% CI, - 3.25 to - 1.15). The standardized mean difference and their 95% confidence intervals (Cohen's d) revealed a large effect of pain at 22 weeks: (Cohen's d, -0.89; 95% CI (-1.38 to-0.39)). There were no statistically significant differences in secondary outcomes.
Conclusions: In this randomized controlled trial, multidimensional physiotherapy resulted in statistically and clinically significant improvements in pain compared to usual physiotherapy in individuals with NSCLBP at 10 and 22 weeks.
{"title":"Effect of multidimensional physiotherapy on non-specific chronic low back pain: a randomized controlled trial.","authors":"Sanaz Bemani, Javad Sarrafzadeh, Shohreh Noorizadeh Dehkordi, Saeed Talebian, Reza Salehi, Jamileh Zarei","doi":"10.1186/s42358-023-00329-9","DOIUrl":"10.1186/s42358-023-00329-9","url":null,"abstract":"<p><strong>Background: </strong>Many people with non-specific chronic low back pain (NSCLBP) do not recover with current conventional management. Systematic reviews show multidimensional treatment improves pain better than usual active interventions. It is unclear whether multidimensional physiotherapy improves pain better than usual physiotherapy. This study determines the effectiveness of this treatment to reduce pain and disability and improve quality of life, pain cognitions, and electroencephalographic pattern in individuals with NSCLBP.</p><p><strong>Methods: </strong>70 eligible participants aged 18 to 50 years with NSCLBP were randomized into either the experimental group (multidimensional physiotherapy) or the active control group (usual physiotherapy). Pain intensity was measured as the primary outcome. Disability, quality of life, pain Catastrophizing, kinesiophobia, fear Avoidance Beliefs, active lumbar range of motion, and brain function were measured as secondary outcomes. The outcomes were measured at pre-treatment, post-treatment, 10, and 22 weeks. Data were analyzed using intention-to-treat approaches.</p><p><strong>Results: </strong>There were 17 men and 18 women in the experimental group (mean [SD] age, 34.57 [6.98] years) and 18 men and 17 women in the active control group (mean [SD] age, 35.94 [7.51] years). Multidimensional physiotherapy was not more effective than usual physiotherapy at reducing pain intensity at the end of treatment. At the 10 weeks and 22 weeks follow-up, there were statistically significant differences between multidimensional physiotherapy and usual physiotherapy (mean difference at 10 weeks, -1.54; 95% CI, -2.59 to -0.49 and mean difference at 22 weeks, -2.20; 95% CI, - 3.25 to - 1.15). The standardized mean difference and their 95% confidence intervals (Cohen's d) revealed a large effect of pain at 22 weeks: (Cohen's d, -0.89; 95% CI (-1.38 to-0.39)). There were no statistically significant differences in secondary outcomes.</p><p><strong>Conclusions: </strong>In this randomized controlled trial, multidimensional physiotherapy resulted in statistically and clinically significant improvements in pain compared to usual physiotherapy in individuals with NSCLBP at 10 and 22 weeks.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov NCT04270422; IRCT IRCT20140810018754N11.</p>","PeriodicalId":48634,"journal":{"name":"Advances in Rheumatology","volume":"63 1","pages":"57"},"PeriodicalIF":2.3,"publicationDate":"2023-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138483188","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-11-29DOI: 10.1186/s42358-023-00340-0
G D Mota, C L Marques, S L Ribeiro, C Albuquerque, G Castro, D Fernandino, F Omura, A Ranzolin, G Resende, N Silva, M Souza, S Studart, R Xavier, M Yazbek, Marcelo M Pinheiro
<p><strong>Background: </strong>Some studies have suggested the HLA-B27 gene may protect against some infections, as well as it could play a benefit role on the viral clearance, including hepatitis C and HIV. However, there is lack of SARS-CoV-2 pandemic data in spondyloarthritis (SpA) patients.</p><p><strong>Aim: </strong>To evaluate the impact of HLA-B27 gene positivity on the susceptibility and severity of COVID-19 and disease activity in axial SpA patients.</p><p><strong>Methods: </strong>The ReumaCoV-Brasil is a multicenter, observational, prospective cohort designed to monitor immune-mediated rheumatic diseases patients during SARS-CoV-2 pandemic in Brazil. Axial SpA patients, according to the ASAS classification criteria (2009), and only those with known HLA-B27 status, were included in this ReumaCov-Brasil's subanalysis. After pairing them to sex and age, they were divided in two groups: with (cases) and without (control group) COVID-19 diagnosis. Other immunodeficiency diseases, past organ or bone marrow transplantation, neoplasms and current chemotherapy were excluded. Demographic data, managing of COVID-19 (diagnosis, treatment, and outcomes, including hospitalization, mechanical ventilation, and death), comorbidities, clinical details (disease activity and concomitant medication) were collected using the Research Electronic Data Capture (REDCap) database. Data are presented as descriptive analysis and multiple regression models, using SPSS program, version 20. P level was set as 5%.</p><p><strong>Results: </strong>From May 24th, 2020 to Jan 24th, 2021, a total of 153 axial SpA patients were included, of whom 85 (55.5%) with COVID-19 and 68 (44.4%) without COVID-19. Most of them were men (N = 92; 60.1%) with mean age of 44.0 ± 11.1 years and long-term disease (11.7 ± 9.9 years). Regarding the HLA-B27 status, 112 (73.2%) patients tested positive. There were no significant statistical differences concerning social distancing, smoking, BMI (body mass index), waist circumference and comorbidities. Regarding biological DMARDs, 110 (71.8%) were on TNF inhibitors and 14 (9.15%) on IL-17 antagonists. Comparing those patients with and without COVID-19, the HLA-B27 positivity was not different between groups (n = 64, 75.3% vs. n = 48, 48%, respectively; p = 0.514). In addition, disease activity was similar before and after the infection. Interestingly, no new episodes of arthritis, enthesitis or extra-musculoskeletal manifestations were reported after the COVID-19. The mean time from the first symptoms to hospitalization was 7.1 ± 3.4 days, and although the number of hospitalization days was numerically higher in the B27 positive group, no statistically significant difference was observed (5.7 ± 4.11 for B27 negative patients and 13.5 ± 14.8 for B27 positive patients; p = 0.594). Only one HLA-B27 negative patient died. No significant difference was found regarding concomitant medications, including conventional or biologic DMARDs between the gro
背景:一些研究表明，HLA-B27基因可以预防某些感染，以及它可能在病毒清除方面发挥有益作用，包括丙型肝炎和艾滋病毒。然而，在脊椎关节炎(SpA)患者中缺乏SARS-CoV-2大流行数据。目的:探讨HLA-B27基因阳性对轴向SpA患者COVID-19易感性、严重程度及疾病活动性的影响。方法:ReumaCoV-Brasil是一项多中心、观察性、前瞻性队列研究，旨在监测巴西SARS-CoV-2大流行期间免疫介导的风湿病患者。根据ASAS的分类标准(2009)，只有那些已知HLA-B27状态的轴向SpA患者被纳入ReumaCov-Brasil的亚分析。在将他们与性别和年龄配对后，将他们分为两组:确诊(病例)和未确诊(对照组)。排除其他免疫缺陷疾病、既往器官或骨髓移植、肿瘤和当前化疗。使用研究电子数据采集(REDCap)数据库收集人口统计数据、COVID-19的管理(诊断、治疗和结果，包括住院、机械通气和死亡)、合并症、临床细节(疾病活动和伴随用药)。数据采用描述性分析和多元回归模型，使用SPSS软件，版本20。P水平设为5%。结果:2020年5月24日至2021年1月24日，共纳入轴向SpA患者153例，其中合并病例85例(55.5%)，未合并病例68例(44.4%)。其中大多数为男性(N = 92;60.1%)，平均年龄44.0±11.1岁，长期患病(11.7±9.9岁)。HLA-B27阳性112例(73.2%)。在社交距离、吸烟、身体质量指数(BMI)、腰围和合并症方面没有显著的统计学差异。在生物dmard方面，110例(71.8%)为TNF抑制剂，14例(9.15%)为IL-17拮抗剂。与非COVID-19患者相比，组间HLA-B27阳性差异无统计学意义(n = 64、75.3% vs. n = 48、48%;p = 0.514)。此外，感染前后的疾病活动性相似。有趣的是，在COVID-19之后，没有报告新的关节炎、腱鞘炎或肌肉骨骼外表现。从首次出现症状到住院的平均时间为7.1±3.4天，B27阳性组的住院天数虽然在数值上高于B27阴性组(5.7±4.11天)和B27阳性组(13.5±14.8天)，但差异无统计学意义(p < 0.05);p = 0.594)。仅有1例HLA-B27阴性患者死亡。在合用药物方面，包括常规或生物dmard，两组间没有发现显著差异。结论:轴向SpA患者的HLA-B27阳性与COVID-19发病率无显著差异，提示对SARS-CoV-2感染缺乏保护作用。此外，感染前后的疾病活动性相似。试验注册:本研究经巴西人类研究伦理委员会(CONEP)批准，CAAE 30186820.2.1001.8807，并在巴西临床试验登记处注册- REBEC, RBR-33YTQC。所有患者入组前均阅读并签署知情同意书。
{"title":"HLA-B27 did not protect against COVID-19 in patients with axial spondyloarthritis - data from the ReumaCov-Brasil Registry.","authors":"G D Mota, C L Marques, S L Ribeiro, C Albuquerque, G Castro, D Fernandino, F Omura, A Ranzolin, G Resende, N Silva, M Souza, S Studart, R Xavier, M Yazbek, Marcelo M Pinheiro","doi":"10.1186/s42358-023-00340-0","DOIUrl":"10.1186/s42358-023-00340-0","url":null,"abstract":"<p><strong>Background: </strong>Some studies have suggested the HLA-B27 gene may protect against some infections, as well as it could play a benefit role on the viral clearance, including hepatitis C and HIV. However, there is lack of SARS-CoV-2 pandemic data in spondyloarthritis (SpA) patients.</p><p><strong>Aim: </strong>To evaluate the impact of HLA-B27 gene positivity on the susceptibility and severity of COVID-19 and disease activity in axial SpA patients.</p><p><strong>Methods: </strong>The ReumaCoV-Brasil is a multicenter, observational, prospective cohort designed to monitor immune-mediated rheumatic diseases patients during SARS-CoV-2 pandemic in Brazil. Axial SpA patients, according to the ASAS classification criteria (2009), and only those with known HLA-B27 status, were included in this ReumaCov-Brasil's subanalysis. After pairing them to sex and age, they were divided in two groups: with (cases) and without (control group) COVID-19 diagnosis. Other immunodeficiency diseases, past organ or bone marrow transplantation, neoplasms and current chemotherapy were excluded. Demographic data, managing of COVID-19 (diagnosis, treatment, and outcomes, including hospitalization, mechanical ventilation, and death), comorbidities, clinical details (disease activity and concomitant medication) were collected using the Research Electronic Data Capture (REDCap) database. Data are presented as descriptive analysis and multiple regression models, using SPSS program, version 20. P level was set as 5%.</p><p><strong>Results: </strong>From May 24th, 2020 to Jan 24th, 2021, a total of 153 axial SpA patients were included, of whom 85 (55.5%) with COVID-19 and 68 (44.4%) without COVID-19. Most of them were men (N = 92; 60.1%) with mean age of 44.0 ± 11.1 years and long-term disease (11.7 ± 9.9 years). Regarding the HLA-B27 status, 112 (73.2%) patients tested positive. There were no significant statistical differences concerning social distancing, smoking, BMI (body mass index), waist circumference and comorbidities. Regarding biological DMARDs, 110 (71.8%) were on TNF inhibitors and 14 (9.15%) on IL-17 antagonists. Comparing those patients with and without COVID-19, the HLA-B27 positivity was not different between groups (n = 64, 75.3% vs. n = 48, 48%, respectively; p = 0.514). In addition, disease activity was similar before and after the infection. Interestingly, no new episodes of arthritis, enthesitis or extra-musculoskeletal manifestations were reported after the COVID-19. The mean time from the first symptoms to hospitalization was 7.1 ± 3.4 days, and although the number of hospitalization days was numerically higher in the B27 positive group, no statistically significant difference was observed (5.7 ± 4.11 for B27 negative patients and 13.5 ± 14.8 for B27 positive patients; p = 0.594). Only one HLA-B27 negative patient died. No significant difference was found regarding concomitant medications, including conventional or biologic DMARDs between the gro","PeriodicalId":48634,"journal":{"name":"Advances in Rheumatology","volume":"63 1","pages":"56"},"PeriodicalIF":2.3,"publicationDate":"2023-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138463775","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-11-28DOI: 10.1186/s42358-023-00339-7
Nadia Emi Aikawa, Eduardo Ferreira Borba, Verena Andrade Balbi, Adriana Maluf Elias Sallum, Izabel Mantovani Buscatti, Lucia Maria Arruda Campos, Kátia Tomie Kozu, Cristiana Couto Garcia, Artur Silva Vidal Capão, Adriana Coracini Tonacio de Proença, Elaine Pires Leon, Alberto José da Silva Duarte, Marta Heloisa Lopes, Clovis Artur Silva, Eloisa Bonfá
Introduction: Seasonal influenza A (H3N2) virus is an important cause of morbidity and mortality in the last 50 years in population that is greater than the impact of H1N1. Data assessing immunogenicity and safety of this virus component in juvenile systemic lupus erythematosus (JSLE) is lacking in the literature.
Objective: To evaluate short-term immunogenicity and safety of influenza A/Singapore (H3N2) vaccine in JSLE.
Methods: 24 consecutive JSLE patients and 29 healthy controls (HC) were vaccinated with influenza A/Singapore/INFIMH-16-0019/2016(H3N2)-like virus. Influenza A (H3N2) seroprotection (SP), seroconversion (SC), geometric mean titers (GMT), factor increase in GMT (FI-GMT) titers were assessed before and 4 weeks post-vaccination. Disease activity, therapies and adverse events (AE) were also evaluated.
Results: JSLE patients and controls were comparable in current age [14.5 (10.1-18.3) vs. 14 (9-18.4) years, p = 0.448] and female sex [21 (87.5%) vs. 19 (65.5%), p = 0.108]. Before vaccination, JSLE and HC had comparable SP rates [22 (91.7%) vs. 25 (86.2%), p = 0.678] and GMT titers [102.3 (95% CI 75.0-139.4) vs. 109.6 (95% CI 68.2-176.2), p = 0.231]. At D30, JSLE and HC had similar immune response, since no differences were observed in SP [24 (100%) vs. 28 (96.6%), p = 1.000)], SC [4 (16.7%) vs. 9 (31.0%), p = 0.338), GMT [162.3 (132.9-198.3) vs. 208.1 (150.5-287.8), p = 0.143] and factor increase in GMT [1.6 (1.2-2.1) vs. 1.9 (1.4-2.5), p = 0.574]. SLEDAI-2K scores [2 (0-17) vs. 2 (0-17), p = 0.765] and therapies remained stable throughout the study. Further analysis of possible factors influencing vaccine immune response among JSLE patients demonstrated similar GMT between patients with SLEDAI < 4 compared to SLEDAI ≥ 4 (p = 0.713), as well as between patients with and without current use of prednisone (p = 0.420), azathioprine (p = 1.0), mycophenolate mofetil (p = 0.185), and methotrexate (p = 0.095). No serious AE were reported in both groups and most of them were asymptomatic (58.3% vs. 44.8%, p = 0.958). Local and systemic AE were alike in both groups (p > 0.05).
Conclusion: This is the first study that identified adequate immune protection against H3N2-influenza strain with additional vaccine-induced increment of immune response and an adequate safety profile in JSLE. ( www.
Clinicaltrials: gov , NCT03540823).
简介:季节性甲型流感(H3N2)病毒是过去50年人口发病率和死亡率的重要原因，其影响大于H1N1。文献中缺乏评估该病毒成分在幼年系统性红斑狼疮(JSLE)中的免疫原性和安全性的数据。目的:评价甲型流感/新加坡(H3N2)疫苗治疗JSLE的短期免疫原性和安全性。方法:连续24例JSLE患者和29例健康对照(HC)接种甲型流感/新加坡/INFIMH-16-0019/2016(H3N2)样病毒。在接种前和接种后4周评估甲型流感(H3N2)血清保护(SP)、血清转化(SC)、几何平均滴度(GMT)、GMT因子升高(FI-GMT)滴度。疾病活动性、治疗和不良事件(AE)也进行了评估。结果:JSLE患者和对照组在当前年龄[14.5(10.1-18.3)比14(9-18.4)岁，p = 0.448]和女性[21(87.5%)比19 (65.5%)，p = 0.108]具有可比性。接种疫苗前，JSLE和HC的SP率[22(91.7%)比25 (86.2%)，p = 0.678]和GMT滴度[102.3 (95% CI 75.0-139.4)比109.6 (95% CI 68.2-176.2)， p = 0.231]相当。在D30时，JSLE和HC具有相似的免疫应答，因为SP[24(100%)对28 (96.6%)，p = 1.000)]， SC[4(16.7%)对9 (31.0%)，p = 0.338)， GMT[162.3(132.9-198.3)对208.1 (150.5-287.8)，p = 0.143]和GMT因子增加[1.6(1.2-2.1)对1.9 (1.4-2.5)，p = 0.574]没有差异。SLEDAI-2K评分[2 (0-17)vs. 2 (0-17)， p = 0.765]和治疗在整个研究过程中保持稳定。进一步分析影响JSLE患者疫苗免疫应答的可能因素表明，SLEDAI患者之间的GMT相似(0.05)。结论:这是第一个在JSLE中发现对h3n2流感毒株有足够的免疫保护，额外的疫苗诱导的免疫反应增加和足够的安全性的研究。(www.Clinicaltrials: gov, NCT03540823)。
{"title":"Safety and immunogenicity of influenza A(H3N2) component vaccine in juvenile systemic lupus erythematosus.","authors":"Nadia Emi Aikawa, Eduardo Ferreira Borba, Verena Andrade Balbi, Adriana Maluf Elias Sallum, Izabel Mantovani Buscatti, Lucia Maria Arruda Campos, Kátia Tomie Kozu, Cristiana Couto Garcia, Artur Silva Vidal Capão, Adriana Coracini Tonacio de Proença, Elaine Pires Leon, Alberto José da Silva Duarte, Marta Heloisa Lopes, Clovis Artur Silva, Eloisa Bonfá","doi":"10.1186/s42358-023-00339-7","DOIUrl":"10.1186/s42358-023-00339-7","url":null,"abstract":"<p><strong>Introduction: </strong>Seasonal influenza A (H3N2) virus is an important cause of morbidity and mortality in the last 50 years in population that is greater than the impact of H1N1. Data assessing immunogenicity and safety of this virus component in juvenile systemic lupus erythematosus (JSLE) is lacking in the literature.</p><p><strong>Objective: </strong>To evaluate short-term immunogenicity and safety of influenza A/Singapore (H3N2) vaccine in JSLE.</p><p><strong>Methods: </strong>24 consecutive JSLE patients and 29 healthy controls (HC) were vaccinated with influenza A/Singapore/INFIMH-16-0019/2016(H3N2)-like virus. Influenza A (H3N2) seroprotection (SP), seroconversion (SC), geometric mean titers (GMT), factor increase in GMT (FI-GMT) titers were assessed before and 4 weeks post-vaccination. Disease activity, therapies and adverse events (AE) were also evaluated.</p><p><strong>Results: </strong>JSLE patients and controls were comparable in current age [14.5 (10.1-18.3) vs. 14 (9-18.4) years, p = 0.448] and female sex [21 (87.5%) vs. 19 (65.5%), p = 0.108]. Before vaccination, JSLE and HC had comparable SP rates [22 (91.7%) vs. 25 (86.2%), p = 0.678] and GMT titers [102.3 (95% CI 75.0-139.4) vs. 109.6 (95% CI 68.2-176.2), p = 0.231]. At D30, JSLE and HC had similar immune response, since no differences were observed in SP [24 (100%) vs. 28 (96.6%), p = 1.000)], SC [4 (16.7%) vs. 9 (31.0%), p = 0.338), GMT [162.3 (132.9-198.3) vs. 208.1 (150.5-287.8), p = 0.143] and factor increase in GMT [1.6 (1.2-2.1) vs. 1.9 (1.4-2.5), p = 0.574]. SLEDAI-2K scores [2 (0-17) vs. 2 (0-17), p = 0.765] and therapies remained stable throughout the study. Further analysis of possible factors influencing vaccine immune response among JSLE patients demonstrated similar GMT between patients with SLEDAI < 4 compared to SLEDAI ≥ 4 (p = 0.713), as well as between patients with and without current use of prednisone (p = 0.420), azathioprine (p = 1.0), mycophenolate mofetil (p = 0.185), and methotrexate (p = 0.095). No serious AE were reported in both groups and most of them were asymptomatic (58.3% vs. 44.8%, p = 0.958). Local and systemic AE were alike in both groups (p > 0.05).</p><p><strong>Conclusion: </strong>This is the first study that identified adequate immune protection against H3N2-influenza strain with additional vaccine-induced increment of immune response and an adequate safety profile in JSLE. ( www.</p><p><strong>Clinicaltrials: </strong>gov , NCT03540823).</p>","PeriodicalId":48634,"journal":{"name":"Advances in Rheumatology","volume":"63 1","pages":"55"},"PeriodicalIF":2.3,"publicationDate":"2023-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138452859","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"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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