Pub Date : 2025-11-15DOI: 10.3899/jrheum.2025-0801
Dana Y L Lee,Johannes S Kern,Anne Powell
{"title":"Looking Beyond the Back: A Case of Unrecognized Hidradenitis Suppurativa in Radiographic Axial Spondyloarthritis.","authors":"Dana Y L Lee,Johannes S Kern,Anne Powell","doi":"10.3899/jrheum.2025-0801","DOIUrl":"https://doi.org/10.3899/jrheum.2025-0801","url":null,"abstract":"","PeriodicalId":501812,"journal":{"name":"The Journal of Rheumatology","volume":"143 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145525158","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 : 2025-11-15DOI: 10.3899/jrheum.2025-0777
Mathias Eerens,Kasper Hermans
{"title":"Tarsal-Carpal Coalition Syndrome: A Rare Cause of Peripheral Joint Pain.","authors":"Mathias Eerens,Kasper Hermans","doi":"10.3899/jrheum.2025-0777","DOIUrl":"https://doi.org/10.3899/jrheum.2025-0777","url":null,"abstract":"","PeriodicalId":501812,"journal":{"name":"The Journal of Rheumatology","volume":"125 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145525219","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 : 2025-11-15DOI: 10.3899/jrheum.2025-0635
Owen Taylor-Williams,Johannes Nossent,Charles A Inderjeeth
OBJECTIVERheumatoid Arthritis (RA) is a potentially devastating autoimmune disease associated with multiple comorbidities, including osteoporosis (OP) and cardiovascular disease, which exert significant morbidity and mortality burdens. Despite the recognised connection between RA and fracture risk, few studies have evaluated post-fracture survival in RA, and no studies have evaluated RA's impact on post-fracture survival between 1990-2010 when there was a rapid growth in disease-modifying antirheumatic drugs (DMARD) availability in combination with a paradigm shift in the understanding of RA.METHODSWe performed a case-control matched retrospective cohort study of 1304 RA patients, using routinely collected administrative health data from public and private hospitals in Western Australia to assess survival after a first fracture.RESULTSWe found RA associated with a significant survival disadvantage after fracture (HR for death 1.28, 95% CI 1.18-1.39). In contrast to expectations, post fracture survival did not improve from 1990-1999 to 2000-2010 in RA patients or controls (HR RA 0.95; 95% CI 0.75-1.20 and HR controls 0.856; 95% CI 0.71-1.04). Further, we found that RA is a risk factor for increased odds of fracture-related re-presentations (OR 1.27, 95% CI 1.08-1.49).CONCLUSIONUsing data from hospitals in Western Australia, this study demonstrates that people with RA have worse survival after fracture, and, in contrast to expectation, this survival has not improved despite significant therapeutic advances over the past 40 years. Consequently, this study emphasises the need to better understand and treat fractures in RA to improve the lives of RA patients.
目的类风湿性关节炎（RA）是一种潜在的破坏性自身免疫性疾病，与多种合并症相关，包括骨质疏松症（OP）和心血管疾病，这些疾病具有显著的发病率和死亡率负担。尽管公认RA与骨折风险之间存在联系，但很少有研究评估RA的骨折后生存，并且没有研究评估1990-2010年期间RA对骨折后生存的影响，当时疾病改善抗风湿药物（DMARD）的可用性快速增长，同时对RA的理解也发生了范式转变。方法我们对1304例RA患者进行了病例对照匹配的回顾性队列研究，使用西澳大利亚公立和私立医院常规收集的行政卫生数据来评估首次骨折后的生存率。结果我们发现RA与骨折后显著的生存劣势相关（死亡风险比1.28,95% CI 1.18-1.39）。与预期相反，从1990-1999年到2000-2010年，RA患者或对照组的骨折后生存率没有提高（HR RA 0.95; 95% CI 0.75-1.20； HR对照组0.856;95% CI 0.71-1.04）。此外，我们发现RA是骨折相关复发几率增加的危险因素（OR 1.27, 95% CI 1.08-1.49）。结论：本研究使用来自西澳大利亚医院的数据表明，RA患者骨折后的生存率较差，与预期相反，尽管过去40年来治疗取得了重大进展，但生存率并没有提高。因此，本研究强调需要更好地了解和治疗RA患者的骨折，以改善RA患者的生活。
{"title":"Rheumatoid arthritis is associated with higher post-fracture mortality and fracture-related care.","authors":"Owen Taylor-Williams,Johannes Nossent,Charles A Inderjeeth","doi":"10.3899/jrheum.2025-0635","DOIUrl":"https://doi.org/10.3899/jrheum.2025-0635","url":null,"abstract":"OBJECTIVERheumatoid Arthritis (RA) is a potentially devastating autoimmune disease associated with multiple comorbidities, including osteoporosis (OP) and cardiovascular disease, which exert significant morbidity and mortality burdens. Despite the recognised connection between RA and fracture risk, few studies have evaluated post-fracture survival in RA, and no studies have evaluated RA's impact on post-fracture survival between 1990-2010 when there was a rapid growth in disease-modifying antirheumatic drugs (DMARD) availability in combination with a paradigm shift in the understanding of RA.METHODSWe performed a case-control matched retrospective cohort study of 1304 RA patients, using routinely collected administrative health data from public and private hospitals in Western Australia to assess survival after a first fracture.RESULTSWe found RA associated with a significant survival disadvantage after fracture (HR for death 1.28, 95% CI 1.18-1.39). In contrast to expectations, post fracture survival did not improve from 1990-1999 to 2000-2010 in RA patients or controls (HR RA 0.95; 95% CI 0.75-1.20 and HR controls 0.856; 95% CI 0.71-1.04). Further, we found that RA is a risk factor for increased odds of fracture-related re-presentations (OR 1.27, 95% CI 1.08-1.49).CONCLUSIONUsing data from hospitals in Western Australia, this study demonstrates that people with RA have worse survival after fracture, and, in contrast to expectation, this survival has not improved despite significant therapeutic advances over the past 40 years. Consequently, this study emphasises the need to better understand and treat fractures in RA to improve the lives of RA patients.","PeriodicalId":501812,"journal":{"name":"The Journal of Rheumatology","volume":"40 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145525150","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 : 2025-11-15DOI: 10.3899/jrheum.2025-0322
Rosa I Rodríguez Viera,Julia Malitska,Susan Sultani,Nazia Chaudhuri,Guillermo Lopez-Campos,Koray N Potel,Steven O'Reilly,Bettina C Schock
OBJECTIVEA common complication in systemic sclerosis (SSc) is the development of SSc-associated interstitial lung disease (SSc-ILD), which has poor prognosis and high mortality rates. The pulmonary microenvironment may include mediators involved in disease pathogenesis that could be targets for new therapies to reduce SSc-to-SSc-ILD transition. Here, we aimed to identify soluble mediators in bronchoalveolar lavage fluid (BALF) that would differentiate SSc-ILD from SSc only patients through a systematic review.METHODSUsing a pre-registered study protocol, two databases (Web of Science, PubMed) were screened for publications between 2000-2024 in adult patients (keywords "Systemic sclerosis AND biomarker AND (lung lavage OR bronchoalveolar lavage)"). Mediators were meta-analysed (RevMan) and functionally enriched pathways identified (STRING-DB/G:Profiler).RESULTSScreening identified 20 (out of 82) publications for inclusion into the systematic review; with qualitative synthesis (n=12) and meta-analyses (n=5). 30 different mediators were identified, 17 were available for SSc versus SSc-ILD comparison. Mediators showed a strong interconnectedness and were clustered into 3 groups: those released from tertiary granules (predominately extracellular matrix remodelling function), with chemokine receptor binding or antioxidant function.CONCLUSIONDue to the limited number of studies, we were unable to perform a meta-analysis on mediators between SSc and SSc-ILD, highlighting the need for further studies. However, our review strongly highlights the involvement of the pulmonary epithelium in SSc-ILD, contributing to positive feedback between injured epithelial cells and fibroblast activation/fibrosis. Further research into the role of the epithelium is needed to identify novel mechanisms leading to SSc-ILD that could serve as novel pharmacological targets.
{"title":"The role of the pulmonary microenvironment in driving Systemic Sclerosis (SSc) to Systemic Sclerosis-Interstitial Lung Disease (SSc-ILD) transition.","authors":"Rosa I Rodríguez Viera,Julia Malitska,Susan Sultani,Nazia Chaudhuri,Guillermo Lopez-Campos,Koray N Potel,Steven O'Reilly,Bettina C Schock","doi":"10.3899/jrheum.2025-0322","DOIUrl":"https://doi.org/10.3899/jrheum.2025-0322","url":null,"abstract":"OBJECTIVEA common complication in systemic sclerosis (SSc) is the development of SSc-associated interstitial lung disease (SSc-ILD), which has poor prognosis and high mortality rates. The pulmonary microenvironment may include mediators involved in disease pathogenesis that could be targets for new therapies to reduce SSc-to-SSc-ILD transition. Here, we aimed to identify soluble mediators in bronchoalveolar lavage fluid (BALF) that would differentiate SSc-ILD from SSc only patients through a systematic review.METHODSUsing a pre-registered study protocol, two databases (Web of Science, PubMed) were screened for publications between 2000-2024 in adult patients (keywords \"Systemic sclerosis AND biomarker AND (lung lavage OR bronchoalveolar lavage)\"). Mediators were meta-analysed (RevMan) and functionally enriched pathways identified (STRING-DB/G:Profiler).RESULTSScreening identified 20 (out of 82) publications for inclusion into the systematic review; with qualitative synthesis (n=12) and meta-analyses (n=5). 30 different mediators were identified, 17 were available for SSc versus SSc-ILD comparison. Mediators showed a strong interconnectedness and were clustered into 3 groups: those released from tertiary granules (predominately extracellular matrix remodelling function), with chemokine receptor binding or antioxidant function.CONCLUSIONDue to the limited number of studies, we were unable to perform a meta-analysis on mediators between SSc and SSc-ILD, highlighting the need for further studies. However, our review strongly highlights the involvement of the pulmonary epithelium in SSc-ILD, contributing to positive feedback between injured epithelial cells and fibroblast activation/fibrosis. Further research into the role of the epithelium is needed to identify novel mechanisms leading to SSc-ILD that could serve as novel pharmacological targets.","PeriodicalId":501812,"journal":{"name":"The Journal of Rheumatology","volume":"13 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145525153","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 : 2025-11-15DOI: 10.3899/jrheum.2025-0845
Rodrigo Garcia-Salinas,Xenofon Baraliakos,Fernando Sommerfleck,Enrique R Soriano,Andre L Ribeiro,Verónica Avellanal,Javier Badilla,Antonio Cachafeiro,Nelly Colman,Boris Garro,Sebastián Ibañez Vodnizza,John Londoño,Daniel Palleiro,Cesar Pacheco-Tena,Carlos Rios,Jossiel Then,Manuel F Ugarte-Gil,Carlo Vinicio Caballero,Paula A Beltran,Ruby Patricia Arias-Tache,Juan Alberto Benavides Cuadros,Pedro Santos-Moreno
OBJECTIVEAxial spondyloarthritis (axSpA) is a chronic inflammatory condition primarily affecting the sacroiliac joints and spine, often complicated by extra-musculoskeletal manifestations such as uveitis, psoriasis, and inflammatory bowel disease. Delayed diagnosis due to nonspecific symptoms, coupled with regional disparities in healthcare infrastructure in Latin America, exacerbates disease burden, emphasizing the need for specialized care. This project aimed to develop a regional consensus for establishing Centers of Excellence (CoEs) in axSpA management.METHODSA Delphi methodology was employed, involving 16 rheumatology experts from 12 Latin American countries. A structured process included systematic literature review, questionnaire validation, and consensus-building during a virtual and in-person meeting. Criteria were categorized into initial premises, structure, processes, and outcomes, guided by the Donabedian quality evaluation framework.RESULTSThe consensus established three CoE classifications-Standard, Optimal, and Model-defined by resource availability and care standards. Human resources criteria highlighted multidisciplinary teams, including rheumatologists, physiatrists, and dermatologists, with agreement rates ranging from 70.6% to 100%. Structural requirements, such as electronic health systems for traceability and continuous training, achieved consensus levels between 81.3% and 100%. Process-related criteria emphasized comprehensive care models, T2T strategy implementation, and validated clinimetric tools (e.g., ASDAS, BASDAI), with approval ratings of 70.6% to 100%.CONCLUSIONThis consensus establishes a scalable framework for CoEsin axSpAin Latin America, balancing high-quality care standards with regional healthcare limitations.
{"title":"Establishing Centers of Excellence for Axial Spondyloarthritis in Latin America: Consensus Recommendations from the REAL-PANLAR Group.","authors":"Rodrigo Garcia-Salinas,Xenofon Baraliakos,Fernando Sommerfleck,Enrique R Soriano,Andre L Ribeiro,Verónica Avellanal,Javier Badilla,Antonio Cachafeiro,Nelly Colman,Boris Garro,Sebastián Ibañez Vodnizza,John Londoño,Daniel Palleiro,Cesar Pacheco-Tena,Carlos Rios,Jossiel Then,Manuel F Ugarte-Gil,Carlo Vinicio Caballero,Paula A Beltran,Ruby Patricia Arias-Tache,Juan Alberto Benavides Cuadros,Pedro Santos-Moreno","doi":"10.3899/jrheum.2025-0845","DOIUrl":"https://doi.org/10.3899/jrheum.2025-0845","url":null,"abstract":"OBJECTIVEAxial spondyloarthritis (axSpA) is a chronic inflammatory condition primarily affecting the sacroiliac joints and spine, often complicated by extra-musculoskeletal manifestations such as uveitis, psoriasis, and inflammatory bowel disease. Delayed diagnosis due to nonspecific symptoms, coupled with regional disparities in healthcare infrastructure in Latin America, exacerbates disease burden, emphasizing the need for specialized care. This project aimed to develop a regional consensus for establishing Centers of Excellence (CoEs) in axSpA management.METHODSA Delphi methodology was employed, involving 16 rheumatology experts from 12 Latin American countries. A structured process included systematic literature review, questionnaire validation, and consensus-building during a virtual and in-person meeting. Criteria were categorized into initial premises, structure, processes, and outcomes, guided by the Donabedian quality evaluation framework.RESULTSThe consensus established three CoE classifications-Standard, Optimal, and Model-defined by resource availability and care standards. Human resources criteria highlighted multidisciplinary teams, including rheumatologists, physiatrists, and dermatologists, with agreement rates ranging from 70.6% to 100%. Structural requirements, such as electronic health systems for traceability and continuous training, achieved consensus levels between 81.3% and 100%. Process-related criteria emphasized comprehensive care models, T2T strategy implementation, and validated clinimetric tools (e.g., ASDAS, BASDAI), with approval ratings of 70.6% to 100%.CONCLUSIONThis consensus establishes a scalable framework for CoEsin axSpAin Latin America, balancing high-quality care standards with regional healthcare limitations.","PeriodicalId":501812,"journal":{"name":"The Journal of Rheumatology","volume":"2 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145525177","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}
OBJECTIVESLE is an autoimmune disease linked to higher cardiovascular risks, such as ACS. Limited real-world data exists on ACS outcomes in SLE patients. This study examines trends in ACS hospitalizations among SLE patients (2006-2019) and compares outcomes and healthcare utilization between ACS patients with and without SLE.METHODSUtilizing data from the US National Inpatient Sample from 2006 to 2019, ACS hospitalizations were classified by the presence or absence of SLE using ICD-9 and ICD-10 codes. Hospitalization rates, mortality, length of stay, and charges were compared between the two groups. Chi-square and t-tests assessed associations with SLE for categorical and continuous variables, respectively, with p < 0.05 as the significance threshold.RESULTSOf 17,318,554 ACS hospitalizations, 70,882 involved SLE patients, who were more often under 50, female, African American, and had higher rates of antiphospholipid syndrome, chronic and ESRD, and prior thromboembolism. From 2006 to 2019, ACS hospitalization rates fell by 40% in SLE patients-mainly from 2015 to 2019-and by 50% in non-SLE patients. In-hospital mortality was similar (7.0% vs. 6.9%, P=0.52), though SLE patients experienced longer hospital stays (6.2 vs. 5.5 days, P<0.001) and higher charges ($79,909 vs. $74,294, P<0.001).CONCLUSIONSLE patients with ACS require higher healthcare utilization, with longer hospital stays and higher charges. Although ACS hospitalization rates declined for both groups, the decrease was greater in non-SLE patients. These findings underscore the need for continuous targeted cardiovascular risk management strategies in SLE patients to reduce morbidity and healthcare burden.
{"title":"Time trends in acute coronary syndrome hospitalizations and outcomes in patients with Systemic Lupus Erythematosus: A US inpatient cohort analysis.","authors":"Konstantinos Parperis,George Bertsias,Marios Lampi,Maria Constantinou,Bikash Bhattarai","doi":"10.3899/jrheum.2025-0627","DOIUrl":"https://doi.org/10.3899/jrheum.2025-0627","url":null,"abstract":"OBJECTIVESLE is an autoimmune disease linked to higher cardiovascular risks, such as ACS. Limited real-world data exists on ACS outcomes in SLE patients. This study examines trends in ACS hospitalizations among SLE patients (2006-2019) and compares outcomes and healthcare utilization between ACS patients with and without SLE.METHODSUtilizing data from the US National Inpatient Sample from 2006 to 2019, ACS hospitalizations were classified by the presence or absence of SLE using ICD-9 and ICD-10 codes. Hospitalization rates, mortality, length of stay, and charges were compared between the two groups. Chi-square and t-tests assessed associations with SLE for categorical and continuous variables, respectively, with p < 0.05 as the significance threshold.RESULTSOf 17,318,554 ACS hospitalizations, 70,882 involved SLE patients, who were more often under 50, female, African American, and had higher rates of antiphospholipid syndrome, chronic and ESRD, and prior thromboembolism. From 2006 to 2019, ACS hospitalization rates fell by 40% in SLE patients-mainly from 2015 to 2019-and by 50% in non-SLE patients. In-hospital mortality was similar (7.0% vs. 6.9%, P=0.52), though SLE patients experienced longer hospital stays (6.2 vs. 5.5 days, P<0.001) and higher charges ($79,909 vs. $74,294, P<0.001).CONCLUSIONSLE patients with ACS require higher healthcare utilization, with longer hospital stays and higher charges. Although ACS hospitalization rates declined for both groups, the decrease was greater in non-SLE patients. These findings underscore the need for continuous targeted cardiovascular risk management strategies in SLE patients to reduce morbidity and healthcare burden.","PeriodicalId":501812,"journal":{"name":"The Journal of Rheumatology","volume":"3 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145525178","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 : 2025-11-15DOI: 10.3899/jrheum.2025-0532
Ali Y Ayla,Elana J Bernstein,Meng Zhang,John M VanBuren,Flavia V Castelino,Lorinda Chung,Luke Evnin,Tracy M Frech,Jessica K Gordon,Faye N Hant,Laura K Hummers,Dinesh Khanna,Kimberly S Lakin,Dorota Lebiedz-Odrobina,Yiming Luo,Ashima Makol,Maureen Mayes,Zsuzsanna H McMahan,Jerry A Molitor,Duncan F Moore,Carrie Richardson,Nora Sandorfi,Ami A Shah,Ankoor Shah,Victoria K Shanmugam,Brian Skaug,Virginia D Steen,Elizabeth R Volkmann,Carleigh Zahn,Wenjin J Zheng,Shervin Assassi
OBJECTIVEDysregulated collagen turnover is implicated in systemic sclerosis (SSc) pathogenesis. We evaluated collagen turnover biomarkers in relation to the severity of fibrotic manifestations, key cytokines, and progression in SSc.METHODSBaseline and 6-month serum samples of early SSc patients in the CONQUER cohort were analyzed for type III (PRO-C3 and C3M) and type VI (PRO-C6 and C6M) collagen turnover biomarkers, as well as C-reactive protein (CRP), interleukin-6 (IL-6), and interferon (IFN)-inducible proteins. The modified Rodnan skin score (mRSS) and forced vital capacity percent predicted (FVC%) served as surrogate markers of disease severity.RESULTS222 patients were included. PRO-C3 (p<0.001) and PRO-C6 (p<0.001) concentrations were higher in patients with diffuse disease, while C6M (p=0.041) was higher in those with ILD. Baseline PRO-C3 (p<0.001) and PRO-C6 (p<0.001) positively correlated with mRSS, whereas C3M (p=0.029) and C6M (p=0.011) negatively correlated with FVC%, although the magnitude of the observed correlations was in the weak range (Rs<0.4). Collagen biomarker concentrations positively correlated with CRP, IL-6, and IFN-inducible proteins at baseline. While changes in CRP correlated positively with changes in collagen degradation protein levels (C3M and C6M), they did not correlate with changes in collagen formation protein levels (PRO-C3 and PRO-C6). In contrast, changes in IFN score showed the highest correlation with changes in PRO-C6.CONCLUSIONPRO-C3 and PRO-C6 correlated with skin disease severity, while C3M and C6M correlated with lung disease severity. Collagen turnover biomarkers correlated with CRP, IL-6, and IFN-inducible proteins, providing support for the link between inflammation and fibrosis in SSc.
{"title":"Type III and type VI collagen neoepitopes are associated with disease severity in systemic sclerosis.","authors":"Ali Y Ayla,Elana J Bernstein,Meng Zhang,John M VanBuren,Flavia V Castelino,Lorinda Chung,Luke Evnin,Tracy M Frech,Jessica K Gordon,Faye N Hant,Laura K Hummers,Dinesh Khanna,Kimberly S Lakin,Dorota Lebiedz-Odrobina,Yiming Luo,Ashima Makol,Maureen Mayes,Zsuzsanna H McMahan,Jerry A Molitor,Duncan F Moore,Carrie Richardson,Nora Sandorfi,Ami A Shah,Ankoor Shah,Victoria K Shanmugam,Brian Skaug,Virginia D Steen,Elizabeth R Volkmann,Carleigh Zahn,Wenjin J Zheng,Shervin Assassi","doi":"10.3899/jrheum.2025-0532","DOIUrl":"https://doi.org/10.3899/jrheum.2025-0532","url":null,"abstract":"OBJECTIVEDysregulated collagen turnover is implicated in systemic sclerosis (SSc) pathogenesis. We evaluated collagen turnover biomarkers in relation to the severity of fibrotic manifestations, key cytokines, and progression in SSc.METHODSBaseline and 6-month serum samples of early SSc patients in the CONQUER cohort were analyzed for type III (PRO-C3 and C3M) and type VI (PRO-C6 and C6M) collagen turnover biomarkers, as well as C-reactive protein (CRP), interleukin-6 (IL-6), and interferon (IFN)-inducible proteins. The modified Rodnan skin score (mRSS) and forced vital capacity percent predicted (FVC%) served as surrogate markers of disease severity.RESULTS222 patients were included. PRO-C3 (p<0.001) and PRO-C6 (p<0.001) concentrations were higher in patients with diffuse disease, while C6M (p=0.041) was higher in those with ILD. Baseline PRO-C3 (p<0.001) and PRO-C6 (p<0.001) positively correlated with mRSS, whereas C3M (p=0.029) and C6M (p=0.011) negatively correlated with FVC%, although the magnitude of the observed correlations was in the weak range (Rs<0.4). Collagen biomarker concentrations positively correlated with CRP, IL-6, and IFN-inducible proteins at baseline. While changes in CRP correlated positively with changes in collagen degradation protein levels (C3M and C6M), they did not correlate with changes in collagen formation protein levels (PRO-C3 and PRO-C6). In contrast, changes in IFN score showed the highest correlation with changes in PRO-C6.CONCLUSIONPRO-C3 and PRO-C6 correlated with skin disease severity, while C3M and C6M correlated with lung disease severity. Collagen turnover biomarkers correlated with CRP, IL-6, and IFN-inducible proteins, providing support for the link between inflammation and fibrosis in SSc.","PeriodicalId":501812,"journal":{"name":"The Journal of Rheumatology","volume":"176 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145525181","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 : 2025-11-15DOI: 10.3899/jrheum.2025-0313
Julia G Harris,Jade H Singleton,Tracy V Ting,Edward J Oberle,Jon M Burnham,Melissa L Mannion,Catherine A Bingham,Jennifer E Weiss,Ronald M Laxer,Michael Shishov,Beth S Gottlieb,Mileka Gilbert,Nancy Pan,Michelle Batthish,Danielle C Fair,Linda Ray,Melissa M Hazen,Esi M Morgan,Sheetal S Vora,
OBJECTIVEJuvenile idiopathic arthritis (JIA) is complicated by morbidity, with suboptimal rates of prolonged remission, decreased health-related quality of life, and functional limitations. The Pediatric Rheumatology Care and Outcomes Improvement Network (PR-COIN), a North American learning health network, has a centralized registry of patients with JIA to track quality measures. We assessed for health disparities in our collaborative JIA population by evaluating our performance on disease activity outcomes, overall well-being, and pain by race and ethnicity, age, sex, and JIA subtype.METHODSA cross-sectional analysis of patients in the PR-COIN registry was conducted to estimate the association between race and ethnicity groups and outcomes including physician global assessment of disease activity (PGA), patient/parent global assessment of overall well-being (PtGA), active joint count, 10-joint clinical Juvenile Arthritis Disease Activity Score (cJADAS10), arthritis-related pain intensity score, and morning stiffness duration.RESULTSData from 9601 patients were analyzed. Current age was positively and significantly associated with higher scores of pain intensity, PGA, PtGA, and cJADAS10. Non-Hispanic Black patients had statistically higher cJADAS10 scores compared to non-Hispanic White patients, in addition to statistically higher pain intensity scores, and PGA and PtGA scores. Female patients had statistically higher scores compared to male patients for all outcome variables assessed.CONCLUSIONWe found disparities in outcomes of patients with JIA related to race and ethnicity, sex, and age. This information is imperative to drive further improvement efforts and understand possible causes of these differences to close disparity gaps and improve outcomes for all patients with JIA.
{"title":"Evaluation of Health Disparities in Outcomes of Patients With Juvenile Idiopathic Arthritis.","authors":"Julia G Harris,Jade H Singleton,Tracy V Ting,Edward J Oberle,Jon M Burnham,Melissa L Mannion,Catherine A Bingham,Jennifer E Weiss,Ronald M Laxer,Michael Shishov,Beth S Gottlieb,Mileka Gilbert,Nancy Pan,Michelle Batthish,Danielle C Fair,Linda Ray,Melissa M Hazen,Esi M Morgan,Sheetal S Vora, ","doi":"10.3899/jrheum.2025-0313","DOIUrl":"https://doi.org/10.3899/jrheum.2025-0313","url":null,"abstract":"OBJECTIVEJuvenile idiopathic arthritis (JIA) is complicated by morbidity, with suboptimal rates of prolonged remission, decreased health-related quality of life, and functional limitations. The Pediatric Rheumatology Care and Outcomes Improvement Network (PR-COIN), a North American learning health network, has a centralized registry of patients with JIA to track quality measures. We assessed for health disparities in our collaborative JIA population by evaluating our performance on disease activity outcomes, overall well-being, and pain by race and ethnicity, age, sex, and JIA subtype.METHODSA cross-sectional analysis of patients in the PR-COIN registry was conducted to estimate the association between race and ethnicity groups and outcomes including physician global assessment of disease activity (PGA), patient/parent global assessment of overall well-being (PtGA), active joint count, 10-joint clinical Juvenile Arthritis Disease Activity Score (cJADAS10), arthritis-related pain intensity score, and morning stiffness duration.RESULTSData from 9601 patients were analyzed. Current age was positively and significantly associated with higher scores of pain intensity, PGA, PtGA, and cJADAS10. Non-Hispanic Black patients had statistically higher cJADAS10 scores compared to non-Hispanic White patients, in addition to statistically higher pain intensity scores, and PGA and PtGA scores. Female patients had statistically higher scores compared to male patients for all outcome variables assessed.CONCLUSIONWe found disparities in outcomes of patients with JIA related to race and ethnicity, sex, and age. This information is imperative to drive further improvement efforts and understand possible causes of these differences to close disparity gaps and improve outcomes for all patients with JIA.","PeriodicalId":501812,"journal":{"name":"The Journal of Rheumatology","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145525149","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 : 2025-11-15DOI: 10.3899/jrheum.2025-0504
Shannon K O'Connor,Prasad Devarajan,Jinqi Liu,Michael A Maldonado,Alyssa Sproles,James Rose,Sherry Thornton,Chen Chen,Bin Huang,Hermine I Brunner
OBJECTIVETo evaluate the ability of the Renal Activity Index for Lupus (RAIL) score, a urine biomarker-derived score, to capture and predict the course of active LN in adult patients.METHODSAvailable serial urine samples collected up to week 52 from a subset of adults with active biopsy-proven proliferative LN participating in the double-blind randomized ALLURE trial of abatacept (NCT01714817) were used to calculate RAIL-scores from creatinine-adjusted urine biomarkers (NGAL, KIM-1, MCP-1, adiponectin, hemopexin, ceruloplasmin). Discriminative performance of RAIL-scores alone over time were compared with urine protein-to-creatinine-ratio (UPCR), kidney function (eGFR), and mixed model analysis of RAIL-score adjusted for baseline UPCR, eGFR, age, weight, sex, and race (RAIL-adjBL), with comparisons by renal response states including complete renal response (CRR), partial renal response but not CRR (PRR-only), and non-response (NR).RESULTSThe analysis included 240 patients who contributed 599 samples. At weeks 12/24/52 there were 44/22/15 patients with PRR-only, 27/33/18 with CRR, and 127/61/15 with NR. RAIL-scores, eGFR, and UPCR improved over time, irrespective of abatacept use but were significantly lower with CRR compared to NR. The eGFR alone had poor accuracy [area under the receiver operating characteristic curve (AUC) <0.51] to discriminate renal response. Only after correction of baseline UPCR and eGFR, the RAIL-score had excellent accuracy to reflect CRR from other renal response states at the current (AUC=0.83-0.84) and next visit (AUC=0.84-0.85) and performed better than UPCR; without correction UPCR and RAIL-score had similarly good accuracy.CONCLUSIONRAIL-scores identify active LN and longitudinally predict the course of adult LN.
{"title":"The Renal Activity Index for Lupus: Validation for Prediction of Kidney Inflammation in Adult Patients with Lupus Nephritis.","authors":"Shannon K O'Connor,Prasad Devarajan,Jinqi Liu,Michael A Maldonado,Alyssa Sproles,James Rose,Sherry Thornton,Chen Chen,Bin Huang,Hermine I Brunner","doi":"10.3899/jrheum.2025-0504","DOIUrl":"https://doi.org/10.3899/jrheum.2025-0504","url":null,"abstract":"OBJECTIVETo evaluate the ability of the Renal Activity Index for Lupus (RAIL) score, a urine biomarker-derived score, to capture and predict the course of active LN in adult patients.METHODSAvailable serial urine samples collected up to week 52 from a subset of adults with active biopsy-proven proliferative LN participating in the double-blind randomized ALLURE trial of abatacept (NCT01714817) were used to calculate RAIL-scores from creatinine-adjusted urine biomarkers (NGAL, KIM-1, MCP-1, adiponectin, hemopexin, ceruloplasmin). Discriminative performance of RAIL-scores alone over time were compared with urine protein-to-creatinine-ratio (UPCR), kidney function (eGFR), and mixed model analysis of RAIL-score adjusted for baseline UPCR, eGFR, age, weight, sex, and race (RAIL-adjBL), with comparisons by renal response states including complete renal response (CRR), partial renal response but not CRR (PRR-only), and non-response (NR).RESULTSThe analysis included 240 patients who contributed 599 samples. At weeks 12/24/52 there were 44/22/15 patients with PRR-only, 27/33/18 with CRR, and 127/61/15 with NR. RAIL-scores, eGFR, and UPCR improved over time, irrespective of abatacept use but were significantly lower with CRR compared to NR. The eGFR alone had poor accuracy [area under the receiver operating characteristic curve (AUC) <0.51] to discriminate renal response. Only after correction of baseline UPCR and eGFR, the RAIL-score had excellent accuracy to reflect CRR from other renal response states at the current (AUC=0.83-0.84) and next visit (AUC=0.84-0.85) and performed better than UPCR; without correction UPCR and RAIL-score had similarly good accuracy.CONCLUSIONRAIL-scores identify active LN and longitudinally predict the course of adult LN.","PeriodicalId":501812,"journal":{"name":"The Journal of Rheumatology","volume":"149 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145525218","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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