Pub Date : 2025-01-15DOI: 10.3899/jrheum.2024-1033
Olga Rusinovich Lovgach,Zulema Plaza,Mónica Fernández Castro,José Rosas,Victor Martínez-Taboada,Alejandro Olivé,Raul Menor Almagro,Belen Serrano Benavente,Judit Font-Urgelles,Angel Garcia-Aparicio,Sara Manrique-Arija,Jesús Alberto Garcia-Vadillo,Ruth Lopez-Gonzalez,Javier Narvaez García,Ma Beatriz Rodriguez-Lozano,Carlos Galisteo,Juan Jorge Gonzalez-Martin,Paloma Vela-Casasempere,Cristina Bohorquez,Celia Erausquin,Ma Beatriz Paredes-Romero,Leyre Riancho-Zarrabeitia,Sheila Melchor Diaz,Jose Maria Pego-Reigosa,Sergio Heredia,Clara Moriano,Ma Angeles Blazquez Cañamero,Paula Estrada,Enrique Judez,Joaquín Belzunegui Otano,Consuelo Ramos Giráldez,Marta Domínguez Álvaro,Fernando Sánchez Alonso,José Luis Andréu Sánchez
OBJECTIVETo quantify the mortality risk in a large, well-characterized cohort of Sjögren's disease (SjD) patients and to identify independent predictors of mortality in this population.METHODSWe included 314 patients diagnosed with SjD according to the 2002 American-European Consensus Group criteria from a prospective, multicenter SjögrenSER-PROS cohort. Detailed data on systemic manifestations, serological markers, disease activity, and mortality was collected after 9 years of follow up. The primary outcome was overall mortality, secondary analyses aimed to identify independent predictors of mortality using Cox proportional hazards models. Standardized mortality ratios were calculated by comparing the observed deaths in the SjD cohort to the expected deaths in an age- and sex-matched general population.RESULTSThe study identified a 70% increased mortality risk in the SjD cohort compared to the general population, with a standard mortality ratio (SMR) of 1.7. Infections (35.71%), malignancies (23.8%), and cardiovascular disease (7.14%) were the most common causes of death. Multivariate analysis revealed that older age (HR 1.11 per year, 95% CI 1.05-1.17), C4 hypocomplementemia (HR 3.75, 95% CI 1.52-9.24), elevated erythrocyte sedimentation rate (HR 1.01, 95% CI 1.00-1.03), history of heart failure (HR 4.24, 95% CI 1.89-9.51), and pulmonary involvement (HR 3.31, 95% CI 1.48-7.41) were independent predictors of mortality.CONCLUSIONThis study shows a significantly increased mortality risk in SjD, with infections, malignancies, and cardiovascular disease as leading causes of death. Independent predictors of mortality include advanced age, C4 hypocomplementemia, elevated ESR, heart failure, and pulmonary involvement, underscoring the need for proactive, individualized management.
目的：量化大量特征明确的Sjögren病（SjD）患者的死亡风险，并确定该人群中死亡率的独立预测因素。方法：我们从一个前瞻性、多中心SjögrenSER-PROS队列中纳入了314例根据2002年美欧共识组标准诊断为SjD的患者。经过9年的随访，收集了系统表现、血清学标志物、疾病活动性和死亡率的详细数据。主要结局是总死亡率，次要分析旨在使用Cox比例风险模型确定死亡率的独立预测因子。通过比较SjD队列中观察到的死亡率与年龄和性别匹配的一般人群中的预期死亡率来计算标准化死亡率。结果研究发现，与一般人群相比，SjD队列的死亡风险增加了70%，标准死亡率（SMR）为1.7。感染（35.71%）、恶性肿瘤（23.8%）和心血管疾病（7.14%）是最常见的死亡原因。多因素分析显示，年龄较大（HR 1.11 /年，95% CI 1.05-1.17）、C4低补体血症（HR 3.75, 95% CI 1.52-9.24）、红细胞沉降率升高（HR 1.01, 95% CI 1.00-1.03）、心力衰竭史（HR 4.24, 95% CI 1.89-9.51）和肺部受累（HR 3.31, 95% CI 1.48-7.41）是死亡率的独立预测因素。结论：该研究显示SjD的死亡风险显著增加，感染、恶性肿瘤和心血管疾病是主要死亡原因。死亡率的独立预测因素包括高龄、C4低补体血症、ESR升高、心力衰竭和肺部受累，强调需要积极、个性化的管理。
{"title":"Mortality in patients with Sjögren Disease: A Prospective Cohort Study Identifying Key Predictors.","authors":"Olga Rusinovich Lovgach,Zulema Plaza,Mónica Fernández Castro,José Rosas,Victor Martínez-Taboada,Alejandro Olivé,Raul Menor Almagro,Belen Serrano Benavente,Judit Font-Urgelles,Angel Garcia-Aparicio,Sara Manrique-Arija,Jesús Alberto Garcia-Vadillo,Ruth Lopez-Gonzalez,Javier Narvaez García,Ma Beatriz Rodriguez-Lozano,Carlos Galisteo,Juan Jorge Gonzalez-Martin,Paloma Vela-Casasempere,Cristina Bohorquez,Celia Erausquin,Ma Beatriz Paredes-Romero,Leyre Riancho-Zarrabeitia,Sheila Melchor Diaz,Jose Maria Pego-Reigosa,Sergio Heredia,Clara Moriano,Ma Angeles Blazquez Cañamero,Paula Estrada,Enrique Judez,Joaquín Belzunegui Otano,Consuelo Ramos Giráldez,Marta Domínguez Álvaro,Fernando Sánchez Alonso,José Luis Andréu Sánchez","doi":"10.3899/jrheum.2024-1033","DOIUrl":"https://doi.org/10.3899/jrheum.2024-1033","url":null,"abstract":"OBJECTIVETo quantify the mortality risk in a large, well-characterized cohort of Sjögren's disease (SjD) patients and to identify independent predictors of mortality in this population.METHODSWe included 314 patients diagnosed with SjD according to the 2002 American-European Consensus Group criteria from a prospective, multicenter SjögrenSER-PROS cohort. Detailed data on systemic manifestations, serological markers, disease activity, and mortality was collected after 9 years of follow up. The primary outcome was overall mortality, secondary analyses aimed to identify independent predictors of mortality using Cox proportional hazards models. Standardized mortality ratios were calculated by comparing the observed deaths in the SjD cohort to the expected deaths in an age- and sex-matched general population.RESULTSThe study identified a 70% increased mortality risk in the SjD cohort compared to the general population, with a standard mortality ratio (SMR) of 1.7. Infections (35.71%), malignancies (23.8%), and cardiovascular disease (7.14%) were the most common causes of death. Multivariate analysis revealed that older age (HR 1.11 per year, 95% CI 1.05-1.17), C4 hypocomplementemia (HR 3.75, 95% CI 1.52-9.24), elevated erythrocyte sedimentation rate (HR 1.01, 95% CI 1.00-1.03), history of heart failure (HR 4.24, 95% CI 1.89-9.51), and pulmonary involvement (HR 3.31, 95% CI 1.48-7.41) were independent predictors of mortality.CONCLUSIONThis study shows a significantly increased mortality risk in SjD, with infections, malignancies, and cardiovascular disease as leading causes of death. Independent predictors of mortality include advanced age, C4 hypocomplementemia, elevated ESR, heart failure, and pulmonary involvement, underscoring the need for proactive, individualized management.","PeriodicalId":501812,"journal":{"name":"The Journal of Rheumatology","volume":"142 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142988859","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-15DOI: 10.3899/jrheum.2024-0545
Francesco Caso,Roberto Giacomelli,Marcella Nunziato,Federica Di Maggio,Raffaele Scarpa,Piero Ruscitti,Francesco Salvatore
{"title":"The Reshaping of Modifiable Risk Factors as a Strategy to Prevent the Development of Rheumatoid Arthritis.","authors":"Francesco Caso,Roberto Giacomelli,Marcella Nunziato,Federica Di Maggio,Raffaele Scarpa,Piero Ruscitti,Francesco Salvatore","doi":"10.3899/jrheum.2024-0545","DOIUrl":"https://doi.org/10.3899/jrheum.2024-0545","url":null,"abstract":"","PeriodicalId":501812,"journal":{"name":"The Journal of Rheumatology","volume":"30 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142988853","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-15DOI: 10.3899/jrheum.2024-0443
Kyung Min Ko,Su-Jin Moon
OBJECTIVEThis study aimed to assess infection occurrence of infection and risk factors among ankylosing spondylitis (AS) patients treated with biologics in a real-world setting.METHODSThis prospective observational cohort study included AS patients from the Korean College of Rheumatology BIOlogics (KOBIO) registry who initiated or switched to biologic agent between December 2012 and July 2023. The primary outcome was the first occurrence of any infection, ranging from mild to severe, classified by organ system. The infection rate per 1,000 person-years (PY), with a 95% confidence interval were calculated using the Poisson distribution method. Cox proportional hazard regression models, adjusted for confounders, estimated hazard ratios for infection risk, considering only the first infection event.RESULTSThis analysis included 2,129 patients with a total of 7,107.67 PY of follow-up. The predominant infections observed were of the upper and lower respiratory tract (25.89/1000 PY), followed by herpes zoster (HZ) (6.13/1000 PY). Multivariate Cox regression analysis revealed significant risk factors for infection, including age, ischemic heart disease, complicated diabetes, chronic kidney disease (CKD), and peripheral arthritis. In contrast, male sex was identified as a protective factor against the development of infections.CONCLUSIONThe infection rate was 39 events/1,000 PY with respiratory tract infections being most common, followed by HZ. Significant risk factors included age, female sex, ischemic heart disease, complicated diabetes, CKD and peripheral arthritis for the occurrence of infection in patients with AS treated with biologics.
{"title":"Incidence and risk of infections in patients with ankylosing spondylitis receiving biologic therapies: A prospective observational study using the KOBIO registry.","authors":"Kyung Min Ko,Su-Jin Moon","doi":"10.3899/jrheum.2024-0443","DOIUrl":"https://doi.org/10.3899/jrheum.2024-0443","url":null,"abstract":"OBJECTIVEThis study aimed to assess infection occurrence of infection and risk factors among ankylosing spondylitis (AS) patients treated with biologics in a real-world setting.METHODSThis prospective observational cohort study included AS patients from the Korean College of Rheumatology BIOlogics (KOBIO) registry who initiated or switched to biologic agent between December 2012 and July 2023. The primary outcome was the first occurrence of any infection, ranging from mild to severe, classified by organ system. The infection rate per 1,000 person-years (PY), with a 95% confidence interval were calculated using the Poisson distribution method. Cox proportional hazard regression models, adjusted for confounders, estimated hazard ratios for infection risk, considering only the first infection event.RESULTSThis analysis included 2,129 patients with a total of 7,107.67 PY of follow-up. The predominant infections observed were of the upper and lower respiratory tract (25.89/1000 PY), followed by herpes zoster (HZ) (6.13/1000 PY). Multivariate Cox regression analysis revealed significant risk factors for infection, including age, ischemic heart disease, complicated diabetes, chronic kidney disease (CKD), and peripheral arthritis. In contrast, male sex was identified as a protective factor against the development of infections.CONCLUSIONThe infection rate was 39 events/1,000 PY with respiratory tract infections being most common, followed by HZ. Significant risk factors included age, female sex, ischemic heart disease, complicated diabetes, CKD and peripheral arthritis for the occurrence of infection in patients with AS treated with biologics.","PeriodicalId":501812,"journal":{"name":"The Journal of Rheumatology","volume":"7 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142988858","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-15DOI: 10.3899/jrheum.2024-1273
Nadia Sweet,Heather Huang,Christie M Bartels
{"title":"Mind Matters in Rheumatoid Arthritis: The Rising Burden of Anxiety and Depression.","authors":"Nadia Sweet,Heather Huang,Christie M Bartels","doi":"10.3899/jrheum.2024-1273","DOIUrl":"https://doi.org/10.3899/jrheum.2024-1273","url":null,"abstract":"","PeriodicalId":501812,"journal":{"name":"The Journal of Rheumatology","volume":"11 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142988860","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-15DOI: 10.3899/jrheum.2024-1113
Victor Mocanu,Claire E H Barber,Patrick McLane,Kelsey Chomistek,Eileen Davidson,Meghan J Elliott,Clare Hildebrandt,Steven Katz,Katie Lin,Shanon McQuitty,Nazret Russon,Brian R Holroyd,Eddy Lang,Cheryl Barnabe
OBJECTIVEGreater accessibility to ambulatory services may mitigate emergency department (ED) presentations for lower acuity issues. This study examined ED utilization patterns for individuals with psoriatic arthritis (PsA) and ankylosing spondylitis (AS) in a universal access healthcare setting.METHODSLinked population-based administrative datasets in Alberta, Canada (fiscal years 2008-2017) were assessed for yearly ED visit frequency, timing, triage acuity, most responsible diagnoses, and disposition for persons with PsA and AS.RESULTSA total of 4,984 individuals with PsA and 14,690 with AS had 53,174 and 124,037 unique ED encounters, respectively. On average, 47.6% of persons with PsA and 35.7% with AS accessed the ED annually. Low acuity encounters (triaged as less urgent or non-urgent) were common, comprising 44.2% and 50.3% of visits for PsA and AS cohorts, respectively. Infection and injury were the most common responsible diagnoses. Presentations for arthritis flares were infrequent (1.2% and 2.0% for PsA and AS cohorts, respectively) with no significant differences by sex or urbanicity. Rural patients had nearly twice the mean number of visits per year, had a higher frequency of less acute presentations, and were admitted less often in both disease cohorts. Sex differences included differential timing of presentation to EDs, and females with PsA had a lower frequency of admission relative to males.CONCLUSIONED use for less and non-urgent health concerns was frequent for persons with PsA and AS, particularly in rural settings. These data can inform tailored health service delivery including access solutions for persons residing in rural areas.
目的提高非住院医疗服务的可及性可减少急诊科（ED）就诊率。本研究调查了在全民医疗保健环境中银屑病关节炎（PsA）和强直性脊柱炎（AS）患者的急诊室使用模式。方法评估了加拿大艾伯塔省基于人口的行政数据集（2008-2017 财年）中 PsA 和 AS 患者的年度急诊室就诊频率、时间、分诊敏锐度、最主要的诊断和处置情况。结果共有 4,984 名 PsA 患者和 14,690 名 AS 患者分别在急诊室就诊 53,174 次和 124,037 次。平均每年有 47.6% 的 PsA 患者和 35.7% 的 AS 患者到急诊室就诊。低急诊率（分流为不太紧急或非紧急）很常见，分别占 PsA 和 AS 组群就诊人数的 44.2% 和 50.3%。感染和损伤是最常见的诊断原因。关节炎复发的就诊率不高（PsA 和 AS 组别分别为 1.2% 和 2.0%），性别或城市化程度差异不明显。农村患者每年就诊的平均次数几乎是城市患者的两倍，出现急性发作的频率较高，在两个疾病群中入院治疗的频率较低。结论 PsA 和强直性脊柱炎患者，尤其是在农村地区，经常因较轻和非紧急的健康问题就诊。这些数据可为提供有针对性的医疗服务提供依据，包括为居住在农村地区的患者提供就医解决方案。
{"title":"Potentially Avoidable Emergency Department Utilization by Persons with Psoriatic Arthritis and Ankylosing Spondylitis: A Population-Based Cohort Study.","authors":"Victor Mocanu,Claire E H Barber,Patrick McLane,Kelsey Chomistek,Eileen Davidson,Meghan J Elliott,Clare Hildebrandt,Steven Katz,Katie Lin,Shanon McQuitty,Nazret Russon,Brian R Holroyd,Eddy Lang,Cheryl Barnabe","doi":"10.3899/jrheum.2024-1113","DOIUrl":"https://doi.org/10.3899/jrheum.2024-1113","url":null,"abstract":"OBJECTIVEGreater accessibility to ambulatory services may mitigate emergency department (ED) presentations for lower acuity issues. This study examined ED utilization patterns for individuals with psoriatic arthritis (PsA) and ankylosing spondylitis (AS) in a universal access healthcare setting.METHODSLinked population-based administrative datasets in Alberta, Canada (fiscal years 2008-2017) were assessed for yearly ED visit frequency, timing, triage acuity, most responsible diagnoses, and disposition for persons with PsA and AS.RESULTSA total of 4,984 individuals with PsA and 14,690 with AS had 53,174 and 124,037 unique ED encounters, respectively. On average, 47.6% of persons with PsA and 35.7% with AS accessed the ED annually. Low acuity encounters (triaged as less urgent or non-urgent) were common, comprising 44.2% and 50.3% of visits for PsA and AS cohorts, respectively. Infection and injury were the most common responsible diagnoses. Presentations for arthritis flares were infrequent (1.2% and 2.0% for PsA and AS cohorts, respectively) with no significant differences by sex or urbanicity. Rural patients had nearly twice the mean number of visits per year, had a higher frequency of less acute presentations, and were admitted less often in both disease cohorts. Sex differences included differential timing of presentation to EDs, and females with PsA had a lower frequency of admission relative to males.CONCLUSIONED use for less and non-urgent health concerns was frequent for persons with PsA and AS, particularly in rural settings. These data can inform tailored health service delivery including access solutions for persons residing in rural areas.","PeriodicalId":501812,"journal":{"name":"The Journal of Rheumatology","volume":"17 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142988806","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
OBJECTIVEThis study examines the impact of dose step-down in patients with rheumatoid arthritis (RA) who achieved sustained disease control with baricitinib 4-mg once-daily up to 96-weeks.METHODSPatients who completed a baricitinib phase 3 study could enter a long-term extension (LTE). In the LTE, patients who received baricitinib 4-mg for ≥15 months and maintained clinical disease activity index (CDAI) low disease activity (LDA) or remission (REM) were blindly randomized to continue 4-mg or taper to 2-mg. If needed, 2-mg treated patients could be rescued to 4-mg, and 4-mg treated patients could be rescued by adding or increasing conventional synthetic disease-modifying antirheumatic drugs. Efficacy and safety were assessed through 96-weeks. Non-responder imputation, considering rescued or discontinued patients as non-responders, was used for CDAI response analyses.RESULTSAt 96-weeks, most patients maintained LDA in both 2-mg and 4-mg arms, with a lower maintenance rate in 2-mg than 4-mg (NRI 59.9% and 70.2%, respectively). Patients maintained REM in 2-mg and 4-mg arms, 30.8% and 36.6% respectively. Rescue rates were 14.7% for baricitinib 4-mg and 22.5% for 2-mg. Of 112 patients who lost LDA in the 2-mg arm and rescued to 4-mg, 76.2% and 75.6% achieved LDA again at 12- and 24-weeks post-rescue.CONCLUSIONIn a randomized, blinded, phase 3 LTE study, maintenance of RA control following induction of sustained LDA/REM with baricitinib 4-mg was greater with continued 4-mg than after taper to 2-mg. Nonetheless, 76% of patients tapered to 2-mg could maintain LDA/REM or recapture with return to 4-mg if needed.
{"title":"Baricitinib dose reduction in patients with rheumatoid arthritis achieving sustained disease control: Final results from the RA-BEYOND study.","authors":"Christopher J Edwards,Gerhard Krönke,Jérôme Avouac,Zhanguo Li,Fabrizio Conti,Alejandro Balsa,Daojun Mo,Ewa Haladyj,Peter Fischer,Masaru Tanaka,Yasushi Takita,Kohei Hagimori,Tsutomu Takeuchi","doi":"10.3899/jrheum.2024-0906","DOIUrl":"https://doi.org/10.3899/jrheum.2024-0906","url":null,"abstract":"OBJECTIVEThis study examines the impact of dose step-down in patients with rheumatoid arthritis (RA) who achieved sustained disease control with baricitinib 4-mg once-daily up to 96-weeks.METHODSPatients who completed a baricitinib phase 3 study could enter a long-term extension (LTE). In the LTE, patients who received baricitinib 4-mg for ≥15 months and maintained clinical disease activity index (CDAI) low disease activity (LDA) or remission (REM) were blindly randomized to continue 4-mg or taper to 2-mg. If needed, 2-mg treated patients could be rescued to 4-mg, and 4-mg treated patients could be rescued by adding or increasing conventional synthetic disease-modifying antirheumatic drugs. Efficacy and safety were assessed through 96-weeks. Non-responder imputation, considering rescued or discontinued patients as non-responders, was used for CDAI response analyses.RESULTSAt 96-weeks, most patients maintained LDA in both 2-mg and 4-mg arms, with a lower maintenance rate in 2-mg than 4-mg (NRI 59.9% and 70.2%, respectively). Patients maintained REM in 2-mg and 4-mg arms, 30.8% and 36.6% respectively. Rescue rates were 14.7% for baricitinib 4-mg and 22.5% for 2-mg. Of 112 patients who lost LDA in the 2-mg arm and rescued to 4-mg, 76.2% and 75.6% achieved LDA again at 12- and 24-weeks post-rescue.CONCLUSIONIn a randomized, blinded, phase 3 LTE study, maintenance of RA control following induction of sustained LDA/REM with baricitinib 4-mg was greater with continued 4-mg than after taper to 2-mg. Nonetheless, 76% of patients tapered to 2-mg could maintain LDA/REM or recapture with return to 4-mg if needed.","PeriodicalId":501812,"journal":{"name":"The Journal of Rheumatology","volume":"14 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142988807","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
OBJECTIVEBosentan (BOS) is approved for treating pulmonary arterial hypertension (PAH) and preventing digital ulcers (DU) in systemic sclerosis (SSc). Our study aimed to evaluate whether BOS prescribed for DU could reduce the incidence of PAH in a large SSc cohort from the SPRING registry.METHODSPatients with SSc from the SPRING registry, meeting ACR/EULAR 2013 classification criteria with data on PAH onset, DU status, BOS exposure, and at least a one-year follow-up between 2015 and 2020, and no known PAH at baseline were included. PAH was diagnosed with right heart catheterization during the follow-up, and its incidence rate (IR) was calculated. Kaplan-Meier curves were determined, and multivariate regression identified PAH risk factors.RESULTSAmong 727 eligible patients with SSc, followed for a median of 2.0 years, 54 (7.4%) developed PAH [IR 3.71 per 100 patients/years]. Patients with DU who were never exposed to BOS had a higher incidence of PAH [IR 4.90 per 100 patients/years] compared to those exposed to BOS, whose rates matched those without DU and who were never exposed to BOS. Risk factors independently associated with PAH development included DU (HR 1.85), age (HR 1.05), modified Rodnan Skin Score (mRSS) >4 (HR 2.07), ILD (HR 2.29), and acetylsalicylic acid treatment (HR 1.78).CONCLUSIONIn our cohort, DU were confirmed as a leading risk factor for PAH development, and BOS use for DU prevention may reduce this risk. Only patients with DU who were not on BOS had an increased PAH incidence.
{"title":"Pulmonary Arterial Hypertension Incidence in Scleroderma Patients Treated with Bosentan for Digital Ulcers: Evidence from the Italian SPRING Registry.","authors":"Fabio Cacciapaglia,Rossella De Angelis,Clodoveo Ferri,Gianluigi Bajocchi,Silvia Bellando-Randone,Cosimo Bruni,Martina Orlandi,Marco Fornaro,Edoardo Cipolletta,Giovanni Zanframundo,Roberta Foti,Giovanna Cuomo,Alarico Ariani,Edoardo Rosato,Gemma Lepri,Francesco Girelli,Elisabetta Zanatta,Silvia Laura Bosello,Ilaria Cavazzana,Francesca Ingegnoli,Maria De Santis,Giuseppe Murdaca,Giuseppina Abignano,Pettiti Giorgio,Alessandra Della Rossa,Maurizio Caminiti,Annamaria Iuliano,Giovanni Ciano,Lorenzo Beretta,Gianluca Bagnato,Ennio Lubrano,Ilenia De Andres,Alessandro Giollo,Marta Saracco,Cecilia Agnes,Corrado Campochiaro,Federica Lumetti,Amelia Spinella,Luca Magnani,Giacomo De Luca,Veronica Codullo,Elisa Visalli,Carlo Iandoli,Antonietta Gigante,Greta Pellegrino,Franco Cozzi,Maria Grazia Lazzaroni,Elena Generali,Gianna Mennillo,Simone Barsotti,Giuseppa Pagano-Mariano,Federica Furini,Licia Vultaggio,Simone Parisi,Clara Lisa Peroni,Gerolamo Bianchi,Enrico Fusaro,Gian Domenico Sebastiani,Marcello Govoni,Salvatore D'Angelo,Erika Pigatto,Franco Franceschini,Serena Guiducci,Lorenzo Dagna,Andrea Doria,Dilia Giuggioli,Valeria Riccieri,Carlo Salvarani,Marco Matucci-Cerinic,Florenzo Iannone,","doi":"10.3899/jrheum.2024-0750","DOIUrl":"https://doi.org/10.3899/jrheum.2024-0750","url":null,"abstract":"OBJECTIVEBosentan (BOS) is approved for treating pulmonary arterial hypertension (PAH) and preventing digital ulcers (DU) in systemic sclerosis (SSc). Our study aimed to evaluate whether BOS prescribed for DU could reduce the incidence of PAH in a large SSc cohort from the SPRING registry.METHODSPatients with SSc from the SPRING registry, meeting ACR/EULAR 2013 classification criteria with data on PAH onset, DU status, BOS exposure, and at least a one-year follow-up between 2015 and 2020, and no known PAH at baseline were included. PAH was diagnosed with right heart catheterization during the follow-up, and its incidence rate (IR) was calculated. Kaplan-Meier curves were determined, and multivariate regression identified PAH risk factors.RESULTSAmong 727 eligible patients with SSc, followed for a median of 2.0 years, 54 (7.4%) developed PAH [IR 3.71 per 100 patients/years]. Patients with DU who were never exposed to BOS had a higher incidence of PAH [IR 4.90 per 100 patients/years] compared to those exposed to BOS, whose rates matched those without DU and who were never exposed to BOS. Risk factors independently associated with PAH development included DU (HR 1.85), age (HR 1.05), modified Rodnan Skin Score (mRSS) >4 (HR 2.07), ILD (HR 2.29), and acetylsalicylic acid treatment (HR 1.78).CONCLUSIONIn our cohort, DU were confirmed as a leading risk factor for PAH development, and BOS use for DU prevention may reduce this risk. Only patients with DU who were not on BOS had an increased PAH incidence.","PeriodicalId":501812,"journal":{"name":"The Journal of Rheumatology","volume":"55 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142988852","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-15DOI: 10.3899/jrheum.2024-0611
Kei Yiu Douglas Hui,Huiliang Koh,Andrew Makmur,Ju Ee Seet
{"title":"Uncommon Clinical and Radiological Presentation of Monosodium Urate Crystal Deposition in Parotid Glands.","authors":"Kei Yiu Douglas Hui,Huiliang Koh,Andrew Makmur,Ju Ee Seet","doi":"10.3899/jrheum.2024-0611","DOIUrl":"https://doi.org/10.3899/jrheum.2024-0611","url":null,"abstract":"","PeriodicalId":501812,"journal":{"name":"The Journal of Rheumatology","volume":"7 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142988804","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-15DOI: 10.3899/jrheum.2024-0731
Yuening Chen,Zhaoyang Geng,Yu Wang,Hongxiao Liu
OBJECTIVEThis study aimed to investigate the clinical characteristics and influencing factors of axial spondyloarthritis (axSpA) hyperkyphosis in a Chinese cohort.METHODSA cross-sectional study was conducted on 607 patients with axSpA attending 12 hospitals across 11 centers from March 2022 to March 2024.Univariate and multivariate logistic regression analyses were used to explore the relevant influencing factors of hyperkyphosis. A nomogram model for impact factor visualisation and spearman correlation analysis was used to analyze the relationship between the influencing factors.RESULTSMultivariable logistic regression revealed that male sex,disease duration,patient global assessment (PGA),erythrocyte sedimentation rate (ESR),the modified stoke spondylitis score（mSASSS）,pharmacological treatment, and ankylosing spondylitis disease activity score-c-reactive protein (ASDAS-CRP) significantly influenced hyperkyphosis(all P < 0.05).Based on the results of the multivariate regression analysis, we constructed a nomogram model for clinical evaluation with an AUC of 0.98 and an accuracy of 0.95.Spearman correlation analysis showed a positive correlation between the spondyloarthritis international society health index (ASAS-HI) and mSASSS (R=0.16, P<0.001), while pharmacological treatment was negatively correlated with disease activity and mSASSS (R=-0.24, -0.18, P<0.001).CONCLUSIONControlling disease activity in the clinic is crucial. Active pharmacological treatment should be employed to delay radiological progression, enhance patients' ASAS-HI, psychological status, and physical functioning. Additionally, strict smoking cessation and weight control are recommended to reduce disability.
{"title":"Clinical characteristics and influencing factors of hyperkyphosis in a Chinese Cohort with axial spondyloarthritis: a multicentre retrospective study.","authors":"Yuening Chen,Zhaoyang Geng,Yu Wang,Hongxiao Liu","doi":"10.3899/jrheum.2024-0731","DOIUrl":"https://doi.org/10.3899/jrheum.2024-0731","url":null,"abstract":"OBJECTIVEThis study aimed to investigate the clinical characteristics and influencing factors of axial spondyloarthritis (axSpA) hyperkyphosis in a Chinese cohort.METHODSA cross-sectional study was conducted on 607 patients with axSpA attending 12 hospitals across 11 centers from March 2022 to March 2024.Univariate and multivariate logistic regression analyses were used to explore the relevant influencing factors of hyperkyphosis. A nomogram model for impact factor visualisation and spearman correlation analysis was used to analyze the relationship between the influencing factors.RESULTSMultivariable logistic regression revealed that male sex,disease duration,patient global assessment (PGA),erythrocyte sedimentation rate (ESR),the modified stoke spondylitis score（mSASSS）,pharmacological treatment, and ankylosing spondylitis disease activity score-c-reactive protein (ASDAS-CRP) significantly influenced hyperkyphosis(all P < 0.05).Based on the results of the multivariate regression analysis, we constructed a nomogram model for clinical evaluation with an AUC of 0.98 and an accuracy of 0.95.Spearman correlation analysis showed a positive correlation between the spondyloarthritis international society health index (ASAS-HI) and mSASSS (R=0.16, P<0.001), while pharmacological treatment was negatively correlated with disease activity and mSASSS (R=-0.24, -0.18, P<0.001).CONCLUSIONControlling disease activity in the clinic is crucial. Active pharmacological treatment should be employed to delay radiological progression, enhance patients' ASAS-HI, psychological status, and physical functioning. Additionally, strict smoking cessation and weight control are recommended to reduce disability.","PeriodicalId":501812,"journal":{"name":"The Journal of Rheumatology","volume":"27 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142988854","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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