Pub Date : 2023-12-29DOI: 10.1016/j.jbspin.2023.105683
Reinder Raadsen , Bas Dijkshoorn , Laurette van Boheemen , Edwin ten Boekel , Arno W.R. van Kuijk , Michael T. Nurmohamed
Objectives
The aim of the current study was to explore the changes in lipid and NT-proBNP levels in rheumatoid arthritis (RA) patients through different phases of the disease: from the pre-clinical stage and RA onset up to the treatment phase with biological disease-modifying anti-rheumatic drugs (bDMARDS).
Methods
Thirty-eight consecutive patients, initially with arthralgia and rheumatoid factor and/or anti-citrullinated protein antibodies without arthritis, who later developed RA and eventually started treatment with bDMARDs, were included. Lipid spectrum and N-terminal pro-brain natriuretic peptide (NT-proBNP) levels were measured longitudinally from several months before diagnosis through treatment with bDMARDs.
Results
From baseline, C-reactive protein (CPR) initially increased sharply, decreasing with the start of biological treatment. Low-density lipoprotein-cholesterol (LDL-c) remained stable, high-density lipoprotein-cholesterol (HDL-c) increased, apolipoprotein A1 (ApoA1 and lipoprotein (a) (Lp(a)), and total cholesterol (TC)/HDL-c ratio and apolipoprotein B (ApoB) decreased during follow-up. NT-proBNP closely followed progression of CRP. TC, LDL-c, TC/HDL-c ratio, ApoA and ApoB inverse correlated with CRP, while Lp(a) positively correlated. HDL-c and triglycerides showed no correlation.
Conclusion
Changes in the lipid profile and NT-proBNP in RA patients seem to be related to inflammation, with changes reflecting an increase in CVD risk occurring along with rises in CRP levels. These changes seem to already be present at diagnosis, indicating the need for timely control of inflammation.
{"title":"Lipid profile and NT-proBNP changes from pre-clinical to established rheumatoid arthritis: A 12 years follow-up explorative study","authors":"Reinder Raadsen , Bas Dijkshoorn , Laurette van Boheemen , Edwin ten Boekel , Arno W.R. van Kuijk , Michael T. Nurmohamed","doi":"10.1016/j.jbspin.2023.105683","DOIUrl":"10.1016/j.jbspin.2023.105683","url":null,"abstract":"<div><h3>Objectives</h3><p>The aim of the current study was to explore the changes in lipid and NT-proBNP levels in rheumatoid arthritis (RA) patients through different phases of the disease: from the pre-clinical stage and RA onset up to the treatment phase with biological disease-modifying anti-rheumatic drugs (bDMARDS).</p></div><div><h3>Methods</h3><p>Thirty-eight consecutive patients, initially with arthralgia and rheumatoid factor and/or anti-citrullinated protein antibodies without arthritis, who later developed RA and eventually started treatment with bDMARDs, were included. Lipid spectrum and N-terminal pro-brain natriuretic peptide (NT-proBNP) levels were measured longitudinally from several months before diagnosis through treatment with bDMARDs.</p></div><div><h3>Results</h3><p>From baseline, C-reactive protein (CPR) initially increased sharply, decreasing with the start of biological treatment. Low-density lipoprotein-cholesterol (LDL-c) remained stable, high-density lipoprotein-cholesterol (HDL-c) increased, apolipoprotein A1 (ApoA1 and lipoprotein (a) (Lp(a)), and total cholesterol (TC)/HDL-c ratio and apolipoprotein B (ApoB) decreased during follow-up. NT-proBNP closely followed progression of CRP. TC, LDL-c, TC/HDL-c ratio, ApoA and ApoB inverse correlated with CRP, while Lp(a) positively correlated. HDL-c and triglycerides showed no correlation.</p></div><div><h3>Conclusion</h3><p>Changes in the lipid profile and NT-proBNP in RA patients seem to be related to inflammation, with changes reflecting an increase in CVD risk occurring along with rises in CRP levels. These changes seem to already be present at diagnosis, indicating the need for timely control of inflammation.</p></div>","PeriodicalId":54902,"journal":{"name":"Joint Bone Spine","volume":null,"pages":null},"PeriodicalIF":4.2,"publicationDate":"2023-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1297319X23001628/pdfft?md5=d713e06862741ae60129bcb025f30a84&pid=1-s2.0-S1297319X23001628-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139065597","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-12-29DOI: 10.1016/j.jbspin.2023.105686
Audrey Benyamine , Antoine Poulet , Pauline Belenotti , Hugo Nihous , Nicoleta Ene , Pierre André Jarrot , Laure Swiader , Julien Mancini , Nathalie Beaufils , Arnaud Essaydi , Jean Gabert , Pierre Jean Weiller , Gilles Kaplanski
Objectives
Non-Hodgkin's lymphoma (NHL) risk assessment is crucial in Sjögren's syndrome (SS). We studied the prevalence of clonal immunoglobulin gene rearrangements in minor salivary glands (MSG) and their correlations with lymphoma occurrence and with previously established NHL predictors.
Methods
Molecular B-cell expansion was studied in fresh-frozen MSG of 207 patients with either suspected SS or with suspected lymphoma during SS, using a standardised multiplex PCR assay combined with heteroduplex analysis by microcapillary electrophoresis. The assignation of clonal cases was based on EuroClonality consortium guidelines.
Results
Among 207 studied patients, 31 (15%) had MSG monoclonal B-cell infiltration. Monoclonality was significantly more frequent in patients with SS (28/123, 22.8%) compared with patients without SS (3/84, 3.6%, P < 0.001). Monoclonal B-cell infiltration in MSG of SS patients correlated significantly with ongoing salivary gland NHL, salivary gland swelling, CD4+ T-cell lymphopenia, rheumatoid factor (RF) activity, low complement levels and type 2 mixed cryoglobulinemia. The accumulation of biological risk factors was associated with a higher rate of MSG B-cell monoclonality given that patients with only positive RF had no probability of MSG B-cell monoclonality, RF-positive patients with 1 or 2 other risk factors had a 25.0% and 85.7% probability of MSG B-cell monoclonality, respectively.
Conclusion
The detection of MSG monoclonal B-cell expansion by this easy-to-perform molecular assay is useful, both at the time of diagnosis and during the course of SS. Monoclonal B-cell expansion is associated with a subset of SS patients presenting either ongoing lymphoma or other established lymphoma predictive factors.
目的:非霍奇金淋巴瘤(NHL)风险评估对于斯约格伦综合征(SS)至关重要。我们研究了小唾液腺(MSG)中克隆免疫球蛋白基因重排的发生率及其与淋巴瘤发生的相关性,以及与先前确定的 NHL 预测因素的相关性:方法:采用标准化多重 PCR 检测法和微毛细管电泳异质双链分析法,对 207 例疑似 SS 患者或 SS 期间疑似淋巴瘤患者的新鲜冷冻 MSG 进行了分子 B 细胞扩增研究。克隆病例的分配以欧洲克隆性联盟指南为基础:在研究的207名患者中,31人(15%)有MSG单克隆B细胞浸润。与非 SS 患者(3/84,3.6%,P <0.001)相比,SS 患者(28/123,22.8%)的单克隆率明显更高。SS 患者 MSG 中的单克隆 B 细胞浸润与正在发生的唾液腺 NHL、唾液腺肿胀、CD4+ T 细胞淋巴细胞减少症、类风湿因子(RF)活性、低补体水平和 2 型混合型低温球蛋白血症密切相关。生物风险因素的累积与较高的MSG B细胞单克隆率有关,因为只有RF阳性的患者没有MSG B细胞单克隆的可能性,RF阳性并伴有1或2个其他风险因素的患者分别有25.0%和85.7%的MSG B细胞单克隆的可能性:结论:通过这种操作简便的分子检测方法检测MSG单克隆B细胞扩增在诊断时和SS病程中都很有用。单克隆 B 细胞扩增与 SS 患者中出现持续淋巴瘤或其他已确定的淋巴瘤预测因素的人群有关。
{"title":"Molecular B-cell clonality assay in minor salivary glands as a useful tool for the lymphoma risk assessment in Sjögren's syndrome","authors":"Audrey Benyamine , Antoine Poulet , Pauline Belenotti , Hugo Nihous , Nicoleta Ene , Pierre André Jarrot , Laure Swiader , Julien Mancini , Nathalie Beaufils , Arnaud Essaydi , Jean Gabert , Pierre Jean Weiller , Gilles Kaplanski","doi":"10.1016/j.jbspin.2023.105686","DOIUrl":"10.1016/j.jbspin.2023.105686","url":null,"abstract":"<div><h3>Objectives</h3><p>Non-Hodgkin's lymphoma (NHL) risk assessment is crucial in Sjögren's syndrome (SS). We studied the prevalence of clonal immunoglobulin gene rearrangements in minor salivary glands (MSG) and their correlations with lymphoma occurrence and with previously established NHL predictors.</p></div><div><h3>Methods</h3><p>Molecular B-cell expansion was studied in fresh-frozen MSG of 207 patients with either suspected SS or with suspected lymphoma during SS, using a standardised multiplex PCR assay combined with heteroduplex analysis by microcapillary electrophoresis. The assignation of clonal cases was based on EuroClonality consortium guidelines.</p></div><div><h3>Results</h3><p>Among 207 studied patients, 31 (15%) had MSG monoclonal B-cell infiltration. Monoclonality was significantly more frequent in patients with SS (28/123, 22.8%) compared with patients without SS (3/84, 3.6%, <em>P</em> <!--><<!--> <!-->0.001). Monoclonal B-cell infiltration in MSG of SS patients correlated significantly with ongoing salivary gland NHL, salivary gland swelling, CD4<sup>+</sup> T-cell lymphopenia, rheumatoid factor (RF) activity, low complement levels and type 2 mixed cryoglobulinemia. The accumulation of biological risk factors was associated with a higher rate of MSG B-cell monoclonality given that patients with only positive RF had no probability of MSG B-cell monoclonality, RF-positive patients with 1 or 2 other risk factors had a 25.0% and 85.7% probability of MSG B-cell monoclonality, respectively.</p></div><div><h3>Conclusion</h3><p>The detection of MSG monoclonal B-cell expansion by this easy-to-perform molecular assay is useful, both at the time of diagnosis and during the course of SS. Monoclonal B-cell expansion is associated with a subset of SS patients presenting either ongoing lymphoma or other established lymphoma predictive factors.</p></div>","PeriodicalId":54902,"journal":{"name":"Joint Bone Spine","volume":null,"pages":null},"PeriodicalIF":4.2,"publicationDate":"2023-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139065649","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-12-29DOI: 10.1016/j.jbspin.2023.105682
Haopeng Ni, Songhan Tang, Ying Zhang
Fibrodysplasia ossificans progressiva (FOP) is an exceedingly rare human genetic disorder characterized by the progressive and incapacitating formation of ectopic bone outside the skeleton. We report a case of FOP patient with mutations within the ACVR1 gene (c.982G > A; p.G328R). 18F-FDG positron emission tomography/computed tomography (PET/CT) was carried out for disease assessment. Previous studies have shown increased FDG uptake in regions of heterotopic ossification (HO) in FOP. However, in our study, the PET/CT features demonstrate that active ossificans exhibit increased 18F-FDG uptake, whereas end-stage ossifications do not. Collectively, 18F-FDG PET/CT emerges as a prospective approach to evaluate medication efficacy in the early stages, directing early intervention and pharmacological management of FOP before ossifications formation.
{"title":"A fibrodysplasia ossificans progressiva patient with a rare missense mutation in ACVR1 detected on 18F-FDG PET/CT","authors":"Haopeng Ni, Songhan Tang, Ying Zhang","doi":"10.1016/j.jbspin.2023.105682","DOIUrl":"10.1016/j.jbspin.2023.105682","url":null,"abstract":"<div><p>Fibrodysplasia ossificans progressiva (FOP) is an exceedingly rare human genetic disorder characterized by the progressive and incapacitating formation of ectopic bone outside the skeleton. We report a case of FOP patient with mutations within the <em>ACVR1</em> gene (c.982G<!--> <!-->><!--> <!-->A; p.G328R). <sup>18</sup>F-FDG positron emission tomography/computed tomography (PET/CT) was carried out for disease assessment. Previous studies have shown increased FDG uptake in regions of heterotopic ossification (HO) in FOP. However, in our study, the PET/CT features demonstrate that active ossificans exhibit increased <sup>18</sup>F-FDG uptake, whereas end-stage ossifications do not. Collectively, <sup>18</sup>F-FDG PET/CT emerges as a prospective approach to evaluate medication efficacy in the early stages, directing early intervention and pharmacological management of FOP before ossifications formation.</p></div>","PeriodicalId":54902,"journal":{"name":"Joint Bone Spine","volume":null,"pages":null},"PeriodicalIF":4.2,"publicationDate":"2023-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139071912","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-12-22DOI: 10.1016/j.jbspin.2023.105679
Jinlong Zhao , Bangxin Sha , Lingfeng Zeng , Yaoxing Dou , Hetao Huang , Guihong Liang , Jianke Pan , Kunhao Hong , Guanghui Zhou , Weiyi Yang , Jun Liu
Objective
The purpose of this study was to explore the relationship between serum uric acid (SUA) concentrations and all-cause mortality in individuals with osteoarthritis (OA).
Methods
All participant data were retrieved from the National Health and Nutrition Examination Survey database. A total of 4671 participants (age range: 20 to 85 years old), including 2988 females and 1683 males, were included in this study. The determination of death outcome was based on the National Death Index (up to December 31, 2019). We explored the nonlinear relationship between SUA concentrations and all-cause mortality in OA patients by establishing a Cox proportional risk model and a two-segment Cox proportional risk model and ran an interaction test to identify the high-risk population for all-cause mortality.
Results
During 30,645 person-years of follow-up, the number of all-cause deaths for females and males was 736 and 516, respectively. After multivariate adjustment, we found a nonlinear relationship between SUA concentrations and all-cause mortality in both females and males with OA. In addition, we found a J-shaped relationship between SUA concentrations and all-cause mortality. The SUA concentration thresholds for all-cause mortality of females and males were stable at 5.6 mg/dl and 6.2 mg/dl, respectively. Compared with SUA concentrations below the inflection point, the all-cause mortality risk at higher SUA concentrations in females and males with OA increased by 20% (hazard ratio [HR]: 1.2, 95% confidence interval [CI]: 1.1 to 1.2) and 25% (HR: 1.2, 95% CI: 1.12 to 1.39), respectively.
Conclusions
There is a nonlinear relationship between SUA concentrations and all-cause mortality in the American OA population (J-shaped association). The all-cause mortality thresholds for SUA concentrations in females and males are 5.6 mg/dl and 6.2 mg/dl, respectively.
方法所有参与者的数据均来自美国国家健康与营养调查数据库。本研究共纳入 4671 名参与者(年龄范围:20 至 85 岁),包括 2988 名女性和 1683 名男性。死亡结果的确定基于国家死亡指数(截至 2019 年 12 月 31 日)。我们通过建立 Cox 比例风险模型和两段式 Cox 比例风险模型探讨了 SUA 浓度与 OA 患者全因死亡率之间的非线性关系,并通过交互检验确定了全因死亡率的高危人群。经过多变量调整后,我们发现在患有 OA 的女性和男性中,SUA 浓度与全因死亡率之间存在非线性关系。此外,我们还发现 SUA 浓度与全因死亡率之间存在 J 型关系。女性和男性全因死亡率的 SUA 浓度临界值分别稳定在 5.6 毫克/分升和 6.2 毫克/分升。与低于拐点的SUA浓度相比,女性和男性OA患者在SUA浓度较高时的全因死亡风险分别增加了20%(危险比[HR]:1.2,95%置信区间[CI]:1.1至1.2)和25%(HR:1.2,95%置信区间[CI]:1.12至1.39)。女性和男性 SUA 浓度的全因死亡率阈值分别为 5.6 mg/dl 和 6.2 mg/dl。
{"title":"J-shaped association of serum uric acid concentrations with all-cause mortality in individuals with osteoarthritis: A prospective cohort study","authors":"Jinlong Zhao , Bangxin Sha , Lingfeng Zeng , Yaoxing Dou , Hetao Huang , Guihong Liang , Jianke Pan , Kunhao Hong , Guanghui Zhou , Weiyi Yang , Jun Liu","doi":"10.1016/j.jbspin.2023.105679","DOIUrl":"10.1016/j.jbspin.2023.105679","url":null,"abstract":"<div><h3>Objective</h3><p>The purpose of this study was to explore the relationship between serum uric acid (SUA) concentrations and all-cause mortality in individuals with osteoarthritis (OA).</p></div><div><h3>Methods</h3><p>All participant data were retrieved from the National Health and Nutrition Examination Survey database. A total of 4671 participants (age range: 20 to 85 years old), including 2988 females and 1683 males, were included in this study. The determination of death outcome was based on the National Death Index (up to December 31, 2019). We explored the nonlinear relationship between SUA concentrations and all-cause mortality in OA patients by establishing a Cox proportional risk model and a two-segment Cox proportional risk model and ran an interaction test to identify the high-risk population for all-cause mortality.</p></div><div><h3>Results</h3><p>During 30,645 person-years of follow-up, the number of all-cause deaths for females and males was 736 and 516, respectively. After multivariate adjustment, we found a nonlinear relationship between SUA concentrations and all-cause mortality in both females and males with OA. In addition, we found a J-shaped relationship between SUA concentrations and all-cause mortality. The SUA concentration thresholds for all-cause mortality of females and males were stable at 5.6<!--> <!-->mg/dl and 6.2<!--> <!-->mg/dl, respectively. Compared with SUA concentrations below the inflection point, the all-cause mortality risk at higher SUA concentrations in females and males with OA increased by 20% (hazard ratio [HR]: 1.2, 95% confidence interval [CI]: 1.1 to 1.2) and 25% (HR: 1.2, 95% CI: 1.12 to 1.39), respectively.</p></div><div><h3>Conclusions</h3><p>There is a nonlinear relationship between SUA concentrations and all-cause mortality in the American OA population (J-shaped association). The all-cause mortality thresholds for SUA concentrations in females and males are 5.6<!--> <!-->mg/dl and 6.2<!--> <!-->mg/dl, respectively.</p></div>","PeriodicalId":54902,"journal":{"name":"Joint Bone Spine","volume":null,"pages":null},"PeriodicalIF":4.2,"publicationDate":"2023-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1297319X23001586/pdfft?md5=f5bd39fa79cb04adaa112795843fa9b4&pid=1-s2.0-S1297319X23001586-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139017919","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Objective: The purpose of this study was to explore the relationship between serum uric acid (SUA) concentrations and all-cause mortality in individuals with osteoarthritis (OA).
Methods: All participant data were retrieved from the National Health and Nutrition Examination Survey database. A total of 4671 participants (age range: 20 to 85 years old), including 2988 females and 1683 males, were included in this study. The determination of death outcome was based on the National Death Index (up to December 31, 2019). We explored the nonlinear relationship between SUA concentrations and all-cause mortality in OA patients by establishing a Cox proportional risk model and a two-segment Cox proportional risk model and ran an interaction test to identify the high-risk population for all-cause mortality.
Results: During 30,645 person-years of follow-up, the number of all-cause deaths for females and males was 736 and 516, respectively. After multivariate adjustment, we found a nonlinear relationship between SUA concentrations and all-cause mortality in both females and males with OA. In addition, we found a J-shaped relationship between SUA concentrations and all-cause mortality. The SUA concentration thresholds for all-cause mortality of females and males were stable at 5.6 mg/dl and 6.2 mg/dl, respectively. Compared with SUA concentrations below the inflection point, the all-cause mortality risk at higher SUA concentrations in females and males with OA increased by 20% (hazard ratio [HR]: 1.2, 95% confidence interval [CI]: 1.1 to 1.2) and 25% (HR: 1.2, 95% CI: 1.12 to 1.39), respectively.
Conclusions: There is a nonlinear relationship between SUA concentrations and all-cause mortality in the American OA population (J-shaped association). The all-cause mortality thresholds for SUA concentrations in females and males are 5.6 mg/dl and 6.2 mg/dl, respectively.
研究目的本研究旨在探讨骨关节炎(OA)患者血清尿酸(SUA)浓度与全因死亡率之间的关系:所有参与者的数据均来自美国国家健康与营养调查数据库。本研究共纳入 4671 名参与者(年龄范围:20 至 85 岁),包括 2988 名女性和 1683 名男性。死亡结果的确定基于国家死亡指数(截至 2019 年 12 月 31 日)。我们通过建立 Cox 比例风险模型和两段式 Cox 比例风险模型,探讨了 SUA 浓度与 OA 患者全因死亡率之间的非线性关系,并进行了交互检验,以确定全因死亡率的高危人群:在30645人年的随访中,女性和男性全因死亡人数分别为736人和516人。经过多变量调整后,我们发现在患有 OA 的女性和男性中,SUA 浓度与全因死亡率之间存在非线性关系。此外,我们还发现 SUA 浓度与全因死亡率之间存在 J 型关系。女性和男性全因死亡率的 SUA 浓度临界值分别稳定在 5.6 毫克/分升和 6.2 毫克/分升。与低于拐点的SUA浓度相比,女性和男性OA患者在SUA浓度较高时的全因死亡风险分别增加了20%(危险比[HR]:1.2,95%置信区间[CI]:1.1至1.2)和25%(危险比:1.2,95%置信区间[CI]:1.12至1.39):结论:在美国 OA 人口中,SUA 浓度与全因死亡率之间存在非线性关系(J 型关系)。女性和男性 SUA 浓度的全因死亡率阈值分别为 5.6 mg/dl 和 6.2 mg/dl。
{"title":"J-shaped association of serum uric acid concentrations with all-cause mortality in individuals with osteoarthritis: A prospective cohort study","authors":"Jinlong Zhao, Bangxin Sha, Lingfeng Zeng, Yaoxing Dou, Hetao Huang, Guihong Liang, Jianke Pan, Kunhao Hong, Guanghui Zhou, Weiyi Yang, Jun Liu","doi":"10.1016/j.jbspin.2023.105679","DOIUrl":"https://doi.org/10.1016/j.jbspin.2023.105679","url":null,"abstract":"<p>Objective: The purpose of this study was to explore the relationship between serum uric acid (SUA) concentrations and all-cause mortality in individuals with osteoarthritis (OA).</p><p>Methods: All participant data were retrieved from the National Health and Nutrition Examination Survey database. A total of 4671 participants (age range: 20 to 85 years old), including 2988 females and 1683 males, were included in this study. The determination of death outcome was based on the National Death Index (up to December 31, 2019). We explored the nonlinear relationship between SUA concentrations and all-cause mortality in OA patients by establishing a Cox proportional risk model and a two-segment Cox proportional risk model and ran an interaction test to identify the high-risk population for all-cause mortality.</p><p>Results: During 30,645 person-years of follow-up, the number of all-cause deaths for females and males was 736 and 516, respectively. After multivariate adjustment, we found a nonlinear relationship between SUA concentrations and all-cause mortality in both females and males with OA. In addition, we found a J-shaped relationship between SUA concentrations and all-cause mortality. The SUA concentration thresholds for all-cause mortality of females and males were stable at 5.6 mg/dl and 6.2 mg/dl, respectively. Compared with SUA concentrations below the inflection point, the all-cause mortality risk at higher SUA concentrations in females and males with OA increased by 20% (hazard ratio [HR]: 1.2, 95% confidence interval [CI]: 1.1 to 1.2) and 25% (HR: 1.2, 95% CI: 1.12 to 1.39), respectively.</p><p>Conclusions: There is a nonlinear relationship between SUA concentrations and all-cause mortality in the American OA population (J-shaped association). The all-cause mortality thresholds for SUA concentrations in females and males are 5.6 mg/dl and 6.2 mg/dl, respectively.</p>","PeriodicalId":54902,"journal":{"name":"Joint Bone Spine","volume":null,"pages":null},"PeriodicalIF":4.2,"publicationDate":"2023-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139020426","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
We aimed to describe the following in patients with polymyalgia rheumatica (PMR): (1) real-world glucocorticoid (GC) therapy, (2) improvement in inflammatory parameters associated with disease activity (C-reactive protein [CRP] level and erythrocyte sedimentation rate [ESR]), and (3) incidence of GC-related adverse events (AEs).
Methods
A cohort study was conducted using a Japanese electronic medical records database. We included newly diagnosed PMR patients aged ≥ 50 years with baseline CRP levels ≥ 10 mg/L and/or ESR > 30 mm/h and an initial GC dose of ≥ 5 mg/day. The outcomes were GC dose, inflammatory parameters, and GC-related AEs.
Results
A total of 373 PMR patients (mean age, 77.3 years) were analyzed. The median initial GC dose was 15.0 mg/day, which gradually decreased to 3.5 mg/day by week 52. The median cumulative GC dose at week 52 was 2455.0 mg. The median CRP level on day 0 was 64.3 mg/L, which decreased during weeks 4–52 (1.4–3.2 mg/L). At week 52, 39.0% of patients had a CRP level > 3.0 mg/L. The cumulative incidence of GC-related AEs at week 52 was 49.0% for osteoporosis, 30.2% for diabetes, 14.9% for hypertension, 12.2% for peptic ulcer, 11.3% for dyslipidemia, 2.9% for glaucoma, and 4.3% for serious infection. The incidence of osteoporosis and diabetes increased with the GC dose.
Conclusion
The incidence of GC-related AEs was associated with the GC dose in PMR patients. Further research is required to identify treatment strategies that can effectively control PMR disease activity while minimizing GC use.
{"title":"Glucocorticoid treatment and clinical outcomes in patients with polymyalgia rheumatica: A cohort study using routinely collected health data","authors":"Yoshiya Tanaka , Shinichi Tanaka , Toshiki Fukasawa , Shoichiro Inokuchi , Hidetoshi Uenaka , Takeshi Kimura , Toshiya Takahashi , Naoto Kato","doi":"10.1016/j.jbspin.2023.105680","DOIUrl":"10.1016/j.jbspin.2023.105680","url":null,"abstract":"<div><h3>Objective</h3><p>We aimed to describe the following in patients with polymyalgia rheumatica (PMR): (1) real-world glucocorticoid (GC) therapy, (2) improvement in inflammatory parameters associated with disease activity (C-reactive protein [CRP] level and erythrocyte sedimentation rate [ESR]), and (3) incidence of GC-related adverse events (AEs).</p></div><div><h3>Methods</h3><p>A cohort study was conducted using a Japanese electronic medical records database. We included newly diagnosed PMR patients aged<!--> <!-->≥<!--> <!-->50<!--> <!-->years with baseline CRP levels<!--> <!-->≥<!--> <!-->10<!--> <!-->mg/L and/or ESR<!--> <!-->><!--> <!-->30<!--> <!-->mm/h and an initial GC dose of<!--> <!-->≥<!--> <!-->5<!--> <!-->mg/day. The outcomes were GC dose, inflammatory parameters, and GC-related AEs.</p></div><div><h3>Results</h3><p>A total of 373 PMR patients (mean age, 77.3 years) were analyzed. The median initial GC dose was 15.0<!--> <!-->mg/day, which gradually decreased to 3.5<!--> <!-->mg/day by week 52. The median cumulative GC dose at week 52 was 2455.0<!--> <!-->mg. The median CRP level on day 0 was 64.3<!--> <!-->mg/L, which decreased during weeks 4–52 (1.4–3.2<!--> <!-->mg/L). At week 52, 39.0% of patients had a CRP level<!--> <!-->><!--> <!-->3.0<!--> <!-->mg/L. The cumulative incidence of GC-related AEs at week 52 was 49.0% for osteoporosis, 30.2% for diabetes, 14.9% for hypertension, 12.2% for peptic ulcer, 11.3% for dyslipidemia, 2.9% for glaucoma, and 4.3% for serious infection. The incidence of osteoporosis and diabetes increased with the GC dose.</p></div><div><h3>Conclusion</h3><p>The incidence of GC-related AEs was associated with the GC dose in PMR patients. Further research is required to identify treatment strategies that can effectively control PMR disease activity while minimizing GC use.</p></div>","PeriodicalId":54902,"journal":{"name":"Joint Bone Spine","volume":null,"pages":null},"PeriodicalIF":4.2,"publicationDate":"2023-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1297319X23001598/pdfft?md5=a8e69bc31ac4c2c1389618a81c760ec5&pid=1-s2.0-S1297319X23001598-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139020378","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-12-21DOI: 10.1016/j.jbspin.2023.105677
Johanna Sigaux , Luca Semerano , Marie-Christophe Boissier
{"title":"Integrating social and economic status in rheumatoid arthritis exposure studies","authors":"Johanna Sigaux , Luca Semerano , Marie-Christophe Boissier","doi":"10.1016/j.jbspin.2023.105677","DOIUrl":"10.1016/j.jbspin.2023.105677","url":null,"abstract":"","PeriodicalId":54902,"journal":{"name":"Joint Bone Spine","volume":null,"pages":null},"PeriodicalIF":4.2,"publicationDate":"2023-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138886565","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Cardiac conduction disorders in ankylosing spondylitis: A systematic literature review and meta-analyses of controlled studies","authors":"Mickaël Dalecky , Tiphaine Dujardin , Arnaud Pflimlin , Athan Baillet , Xavier Romand","doi":"10.1016/j.jbspin.2023.105676","DOIUrl":"10.1016/j.jbspin.2023.105676","url":null,"abstract":"","PeriodicalId":54902,"journal":{"name":"Joint Bone Spine","volume":null,"pages":null},"PeriodicalIF":4.2,"publicationDate":"2023-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138683827","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The involvement of facet joints (FJ) in patients with inflammatory rheumatic disorders remains underexplored. This review aims to look at FJ disease from a rheumatologist's perspective, with the emphasis given to the clinical presentations and patterns of FJ engagement in axial spondyloarthritis (axSpA), psoriatic arthritis (PsA), rheumatoid arthritis (RA), and crystal-related arthropathies, and discussion of challenges in studying FJ in rheumatic disease.
Methods
A systematic PubMed search using the pertinent keywords was performed, relevant articles extracted, and the acquired data critically assessed, interpreted, and organized according to the authors’ experience and judgment.
Results
FJ involvement is common in patients with radiographic axSpA, occurs throughout the spine, but is more frequently seen in the thoracic segment. The existing data suggests that the FJ are primarily affected by the disease process, while altered spine biomechanics due to the presence of syndesmophytes at the same vertebral level contributes to the FJ fusion. Predominant involvement of FJ of the cervical spinal segment has been suggested in PsA; however, prevalence and clinical significance of FJ involvement in PsA is still markedly underexplored. RA-related FJ disease of the cervical spine in patients with poorly controlled RA is not uncommon and can be related to significant morbidity, while the burden of FJ involvement in the thoracic and lumbar spinal segments in RA is also underexplored. FJ disease is possible in the course of crystal-related arthropathies, but the high level of suspicion is a prerequisite for the timely diagnosis.
Conclusions
The involvement of FJ in the course of inflammatory rheumatic disease is not uncommon. Prospective studies are needed to understand the epidemiology and significance of FJ disease in inflammatory rheumatic conditions.
背景:炎症性风湿病患者的面关节(FJ)受累情况仍未得到充分探讨。这篇综述旨在从风湿病学家的视角审视面关节疾病,重点关注轴性脊柱关节炎(axSpA)、银屑病关节炎(PsA)、类风湿性关节炎(RA)和晶体相关关节病中面关节受累的临床表现和模式,并讨论研究风湿病中面关节所面临的挑战:使用相关关键词在PubMed上进行系统搜索,提取相关文章,并根据作者的经验和判断对所获得的数据进行严格评估、解释和整理:FJ受累在影像学表现为axSpA的患者中很常见,发生在整个脊柱,但在胸椎段更为多见。现有数据表明,FJ 主要受疾病过程的影响,而由于同一椎体水平存在联合骨赘而导致的脊柱生物力学改变则是 FJ 融合的原因之一。有研究表明,PsA 患者的颈椎节段 FJ 主要受累;然而,对 PsA 中 FJ 受累的患病率和临床意义的研究仍明显不足。在 RA 控制不佳的患者中,与 RA 相关的颈椎 FJ 疾病并不少见,而且可能与严重的发病率有关,而对 RA 中胸椎和腰椎节段 FJ 受累的负担也未充分探讨。晶体相关性关节病的病程中可能存在 FJ 病变,但高度怀疑是及时诊断的前提:结论:FJ受累于炎症性风湿病并不少见。需要进行前瞻性研究,以了解 FJ 病在炎症性风湿病中的流行病学和重要性。
{"title":"Facet joint involvement in the inflammatory rheumatic disease","authors":"Arsen Shpigelman , Aniela Shouval , Ilai Koder , Shiri Keret , Gleb Slobodin","doi":"10.1016/j.jbspin.2023.105674","DOIUrl":"10.1016/j.jbspin.2023.105674","url":null,"abstract":"<div><h3>Background</h3><p>The involvement of facet joints (FJ) in patients with inflammatory rheumatic disorders remains underexplored. This review aims to look at FJ disease from a rheumatologist's perspective, with the emphasis given to the clinical presentations and patterns of FJ engagement in axial spondyloarthritis (axSpA), psoriatic arthritis (PsA), rheumatoid arthritis (RA), and crystal-related arthropathies, and discussion of challenges in studying FJ in rheumatic disease.</p></div><div><h3>Methods</h3><p>A systematic PubMed search using the pertinent keywords was performed, relevant articles extracted, and the acquired data critically assessed, interpreted, and organized according to the authors’ experience and judgment.</p></div><div><h3>Results</h3><p>FJ involvement is common in patients with radiographic axSpA, occurs throughout the spine, but is more frequently seen in the thoracic segment. The existing data suggests that the FJ are primarily affected by the disease process, while altered spine biomechanics due to the presence of syndesmophytes at the same vertebral level contributes to the FJ fusion. Predominant involvement of FJ of the cervical spinal segment has been suggested in PsA; however, prevalence and clinical significance of FJ involvement in PsA is still markedly underexplored. RA-related FJ disease of the cervical spine in patients with poorly controlled RA is not uncommon and can be related to significant morbidity, while the burden of FJ involvement in the thoracic and lumbar spinal segments in RA is also underexplored. FJ disease is possible in the course of crystal-related arthropathies, but the high level of suspicion is a prerequisite for the timely diagnosis.</p></div><div><h3>Conclusions</h3><p>The involvement of FJ in the course of inflammatory rheumatic disease is not uncommon. Prospective studies are needed to understand the epidemiology and significance of FJ disease in inflammatory rheumatic conditions.</p></div>","PeriodicalId":54902,"journal":{"name":"Joint Bone Spine","volume":null,"pages":null},"PeriodicalIF":4.2,"publicationDate":"2023-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138684497","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}