Journal of Rheumatology最新文献

The nonprofit organization International Dermatology Outcome Measures (IDEOM) is committed to improving the implementation of patient-centered outcome measures in dermatologic disease. At a conference adjacent to the Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA) 2023 annual meeting, the IDEOM Psoriatic Disease Workgroup presented updates on recent efforts in outcome measure advancement. Dr. Alice Gottlieb presented the preliminary findings of a study within the Mount Sinai Health System that aims to determine how well the IDEOM musculoskeletal (MSK) symptom framework, which uses the Psoriasis Epidemiology Screening Tool (PEST) and the Psoriatic Arthritis Impact of Disease (PsAID) instruments, functions in clinical settings. Drs. Joseph Merola and Lourdes Perez-Chada updated attendees on the IDEOM MSK-Q, a 9-item patient-reported questionnaire designed to measure the intensity and impact of MSK symptoms on the quality of life in patients with psoriasis (PsO) with or without psoriatic arthritis (PsA). Dr. Vibeke Strand summarized the Outcome Measures in Rheumatology (OMERACT) 2023 conference sessions. Dr. April Armstrong discussed the preliminary findings of a multicentered study designed to validate the 7-item Dermatology Treatment Satisfaction Instrument (DermSat-7) among patients with PsO. She also introduced the Psoriasis and Psoriatic Arthritis Treatment Satisfaction Instrument, a tool that seeks to capture the level of patient satisfaction with current therapy for PsO and PsA. This report summarizes the developments discussed at the IDEOM PsO and PsA research workgroups during the GRAPPA 2023 annual meeting.

Proper assessment of patients with psoriatic arthritis (PsA) requires assessment of all disease domains, including axial disease. Magnetic resonance imaging (MRI) is the method of choice for evaluating axial involvement in PsA. When assessing patients with PsA for spinal involvement, it is important to assess both vertebral body lesions and posterolateral lesions, such as inflammation in facet joints and costovertebral joints, and enthesitis at spinous and transverse processes. The Canada-Denmark (CanDen) assessment system for spine MRIs is the preferred method for detailed evaluation of inflammation and structural damage at various anatomical locations in the spine, and it is reproducible and sensitive to change. The Assessment of Spondyloarthritis international Society (ASAS) has recently published MRI definitions of inflammatory and structural lesions in the spine, incorporating the CanDen definitions of spinal lesions on MRI. Applying the ASAS definitions and the CanDen assessment system in clinical practice and trials is recommended. Ongoing research/studies, not least the Axial Involvement in Psoriatic Arthritis (AXIS) study, may provide a data-driven definition of axial involvement in PsA. Ongoing research is expected to further improve and validate assessment tools for axial PsA and to provide a much-needed data-driven consensus-based definition of axial involvement in PsA.

Objective: To evaluate the progression of coronary artery calcification (CAC) and associated risk factors in a systemic lupus erythematosus (SLE) cohort.

Methods: We reassessed the presence of CAC in patients with SLE who were screened 9 years before, using multidetector computed tomography. Clinical variables (cumulated disease activity and damage accrual), antiphospholipid syndrome and SLE serology, and cardiovascular (CV) risk factors (hypertension, BMI [kg/m²], modified Framingham risk score, lipid profile, menopausal status) were assessed longitudinally.

Results: We included 104 patients from the parent study. Most of them were women (94.2%), with a mean age of 41.0 (SD 8.3) years and mean disease duration of 14.8 (SD 2.9) years. We documented CAC in 17 patients (16.3%). Seven cases were from the parent study and 10 were incident cases. The cumulative incidence of CAC was 9% and the incidence density was 1 per 100 person-years. CAC occurred more frequently in the age groups 30-39 years and 40-44 years. All patients with previous CAC had worsening of their calcium indexes, and none developed clinical CV events. When comparing prevalent CAC cases (n = 17) vs patients without calcification (n = 87), both groups were similar in traditional CV risk factors, disease duration, Systemic Lupus Erythematosus Disease Activity Index 2000 (SLEDAI-2K) area under the curve (AUC), and Systemic Lupus International Collaborating Clinics (SLICC) score, but were more likely to be postmenopausal and have higher apolipoprotein B (apoB) levels. Patients with previous CAC had higher apoB levels, SLEDAI-2K AUC scores, and anticardiolipin IgG antibodies than incident cases.

Conclusion: CAC in patients with SLE progressed over time but was not associated with adverse CV events during the first 9 years of follow-up. ApoB levels and postmenopausal status might be associated with this progression.

Objective: The main aim of the study was to evaluate the performance of 2 proposed criteria for difficult-to-treat (D2T) psoriatic arthritis (PsA) in a group of patients and to evaluate the agreement between the 2 sets of criteria.

Methods: We performed a cross-sectional analysis of 2 longitudinal cohorts of patients with PsA fulfilling the Classification Criteria for Psoriatic Arthritis (CASPAR), with at least 1 year of follow-up. A detailed medical history was collected and a physical examination was performed for all recruited patients. The proposed criteria for patients with D2T PsA were applied in our group. To test the performance of the 2 sets of criteria, we used an external validator (absence of patient acceptable symptom state + physician global assessment ≥ 6 cm). Finally, the agreement between the 2 sets of criteria was assessed.

Results: We evaluated 378 patients with PsA (219 male/159 female), with a mean age (range) of 58 (19-75) years. Seventy-five (19.8%) patients fulfilled the D2T criteria proposed by Perrotta et al and 58 (15.3%) the D2T criteria proposed by Kumthekar et al. Both criteria showed comparable performance, with low sensitivity (Perrotta: 37.8%, Kumthekar: 29.7%) but good specificity (Perrotta: 82.1%, Kumthekar: 86.2%). Finally, the agreement between the 2 sets of criteria is substantial (Fleiss [Formula: see text] 0.72), suggesting that both criteria identify nearly the same group of patients.

Conclusion: Our study compared 2 published sets of criteria showing comparable performance and substantial agreement. This study may pave the way for further research in this field.

Nine patient research partners (PRPs) attended the Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA) 2023 annual meeting in person in Dublin, Ireland. The importance of close relations between researchers, clinicians, and PRPs was highlighted at the PRP premeeting, with discussion regarding PRP engagement within GRAPPA with the GRAPPA leadership team. A presentation was given by PRPs at the plenary session, and there was continued active engagement of PRPs in breakout sessions, workshops, and plenary sessions compared to previous annual meetings. The GRAPPA PRP Network is committed to supporting the GRAPPA mission and contributing the unique perspectives of dedicated, knowledgeable individuals with the lived experience of psoriatic disease. This report provides a summary of the GRAPPA PRP Network meetings at the GRAPPA 2023 annual meeting and the continued commitment of the GRAPPA PRP Network to enhance PRP involvement within GRAPPA activities.

Objective: Rheumatoid arthritis (RA) has been associated with an elevated dementia risk. This study aimed to examine how different diagnostic dementia definitions perform in patients with RA compared to individuals without RA.

Methods: The study population included 2050 individuals (1025 with RA) from a retrospective, population-based cohort in southern Minnesota and compared the performance of 3 code-based dementia diagnostic algorithms with medical record review diagnosis of dementia. For the overall comparison, each patient's complete medical history was used, with no time frames. Sensitivity analyses were performed using 1-, 2-, and 5-year windows around the date that dementia was identified in the medical record (reference standard).

Results: Algorithms performed very similarly in persons with and without RA. The algorithms generally had high specificity, negative predictive values, and accuracy, regardless of the time window studied (> 88%). Sensitivity and positive predictive values varied depending on the algorithm and the time window. Sensitivity values ranged 56.5-95.9%, and positive predictive values ranged 55.2-83.1%. Performance measures declined with more restrictive time windows.

Conclusion: Routinely collected electronic health record (EHR) data were used to define code-based dementia diagnostic algorithms with good performance (vs diagnosis by medical record review). These results can inform future studies that use retrospective databases, especially in the same or a similar EHR infrastructure, to identify dementia in individuals with RA.

Contemporary translational and clinical research advances in psoriatic disease (PsD) were highlighted at the Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA) 2023 annual meeting basic science workshop. This year's workshop focused on key topics, including the significance of the annual GRAPPA meetings as a platform for collaboration and knowledge exchange. Discussions centered around expanding our understanding of tumor necrosis factor inhibitor (TNFi) treatment in PsD and enhancing early detection strategies for PsD comorbidities, specifically for the timely intervention and management of cardiovascular (CV) comorbidities. Insights on the role of the C-C chemokine receptor type 6 (CCR6) in PsD and psoriatic arthritis were provided, suggesting that blockade of CCR6 can reduce psoriasis-like dermatitis and joint inflammation in mouse models.