Joint Bone Spine最新文献

英文中文

Tapering or stopping tocilizumab in PMR: Toward optimized treatment withdrawal 在PMR中逐渐减少或停止托珠单抗：朝着优化的治疗停药。

IF 4.3 3区医学 Q1 RHEUMATOLOGY

Joint Bone Spine

Pub Date : 2025-12-18 DOI: 10.1016/j.jbspin.2025.106016

Baptiste Chevet , Valérie Devauchelle-Pensec

引用次数: 0

High disease activity is associated with incident osteoporotic fractures among veterans with rheumatoid arthritis 高疾病活动度与类风湿关节炎退伍军人骨质疏松性骨折发生率相关

IF 4.3 3区医学 Q1 RHEUMATOLOGY

Joint Bone Spine

Pub Date : 2025-12-17 DOI: 10.1016/j.jbspin.2025.106020

Katherine D. Wysham , Hannah F. Brubeck , Aaron Baraff , Punyasha Roul , Marianna Olave , John S. Richards , Paul Monach , Dolores M. Shoback , Patricia P. Katz , Brian C. Sauer , Beth Wallace , Jose M. Garcia , Grant W. Cannon , Ted R. Mikuls , Bryant R. England , Joshua F. Baker

Objectives

Rheumatoid arthritis (RA) increases osteoporosis and fracture risk. The relationship between disease activity and fracture is not well characterized. We aimed to study whether RA disease activity and its components were associated with incident osteoporotic fracture.

Methods

Data were from the multicenter Veterans Affairs RA (VARA) registry. Fractures were identified by ICD9/10 codes and validated by chart review. Multivariable Cox regression was used to quantify associations of time-varying and cumulative RA disease activity, using DAS28-ESR, with incident osteoporotic fracture. To directly compare hazard ratios (HRs), DAS28-ESR components were scaled, centered and evaluated in multivariable models. Sensitivity analyses, including evaluating DAS28-ESR categories, were also performed.

Results

Among 2912 veterans, 248 (9%) experienced incident osteoporotic fracture. Those who fractured were more likely to be female (19 versus 11%), White (83 vs. 75%) and had higher baseline disease activity (DAS28-ESR 4.0 ± 1.5 vs. 3.8 ± 1.6). The time-varying model demonstrated an 18% increased risk of incident osteoporotic fracture per unit increase of DAS28-ESR (aHR 1.18 [95% CI 1.09–1.28], P < 0.001). The cumulative model revealed a 3% increased risk per DAS28-ESR unit-year (aHR 1.03 [95% CI 1.01–1.05], P < 0.001). Patient global assessment of disease activity had the highest point estimates of the disease activity components in both time-varying and cumulative models. Compared to remission, moderate and high disease activity carried a 2-fold risk of incident osteoporotic fracture (aHR 2.24 and 2.01 respectively, both P < 0.01).

Conclusion

Time-varying and cumulative RA disease activity are associated with incident osteoporotic fracture. These data support achieving low disease activity or remission to reduce the risk of incident osteoporotic fracture.

目的：类风湿关节炎（RA）增加骨质疏松和骨折的风险。疾病活动度与骨折之间的关系尚未明确。我们的目的是研究RA疾病活动性及其成分是否与骨质疏松性骨折的发生有关。方法：数据来自多中心退伍军人事务RA （VARA）登记。骨折采用ICD9/10编码识别，并通过图表评审进行验证。采用多变量Cox回归，使用DAS28-ESR量化时变和累积类风湿性关节炎疾病活动性与骨质疏松性骨折的关联。为了直接比较风险比（hr），在多变量模型中对DAS28-ESR成分进行了缩放、居中和评估。敏感性分析，包括评估DAS28-ESR分类，也进行了。结果：2912名退伍军人中，248名（9%）发生骨质疏松性骨折。骨折患者多为女性（19%对11%）、白人（83%对75%），基线疾病活动性较高（DAS28-ESR 4.0±1.5对3.8±1.6）。时变模型显示，DAS28-ESR每增加一个单位，骨质疏松性骨折的发生风险增加18% （aHR 1.18 [95%CI 1.09-1.28]）。结论：时变和累积性RA疾病活度与骨质疏松性骨折的发生有关。这些数据支持实现低疾病活动度或缓解以降低发生骨质疏松性骨折的风险。

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引用次数: 0

Temporomandibular joint tophus 颞下颌关节。

IF 4.3 3区医学 Q1 RHEUMATOLOGY

Joint Bone Spine

Pub Date : 2025-12-16 DOI: 10.1016/j.jbspin.2025.106019

Shio-Yi Liao , Ching-Lan Wu , Chien-Chih Lai

引用次数: 0

Dual JAK and IL-23 blockade: A mechanistically supported strategy in refractory psoriatic arthritis. A case report. 双重JAK和IL-23阻断：难治性银屑病关节炎的机制支持策略。

IF 4.3 3区医学 Q1 RHEUMATOLOGY

Joint Bone Spine

Pub Date : 2025-12-16 DOI: 10.1016/j.jbspin.2025.106017

Paul Gervaise , Simon Glatigny , Maxime Breban , Félicie Costantino

引用次数: 0

Potential targets of air pollutants inducing ankylosing spondylitis: Evidence from eQTL Mendelian randomization and colocalization 空气污染物诱导强直性脊柱炎的潜在目标：来自eQTL孟德尔随机化和共定位的证据。

IF 4.3 3区医学 Q1 RHEUMATOLOGY

Joint Bone Spine

Pub Date : 2025-12-16 DOI: 10.1016/j.jbspin.2025.106018

Tiantaixi Tu , Nuoyan Zhou , Ye Yang , Tongtong Zheng , Qingfeng Xie , Xinwang Ying

引用次数: 0

Successful dual targeted therapy with upadacitinib and risankizumab in psoriatic arthritis, uveitis and alopecia areata upadacitinib和risankizumab成功双重靶向治疗银屑病关节炎，葡萄膜炎和斑秃。

IF 4.3 3区医学 Q1 RHEUMATOLOGY

Joint Bone Spine

Pub Date : 2025-12-02 DOI: 10.1016/j.jbspin.2025.106015

Núria Adell , Jaime Notario , Javier Narváez , Laura Berbel-Arcobé

引用次数: 0

Platelet-rich plasma and knee osteoarthritis: A critical overview of the multiple biases and methodological complexity 富血小板血浆和膝关节骨关节炎：多重偏倚和方法复杂性的关键概述。

IF 4.3 3区医学 Q1 RHEUMATOLOGY

Joint Bone Spine

Pub Date : 2025-11-25 DOI: 10.1016/j.jbspin.2025.106014

Hervé Bard , Paul Ornetti , Éric Noël , Florent Eymard

Intra-articular injections of platelet-rich plasma (PRP) are increasingly utilized in the management of knee osteoarthritis (KOA) and various other medical specialties. However, the efficacy of PRP remains a contentious issue; some experts consider it to be a placebo, while others advocate for its therapeutic value. Evidence from controlled clinical trials and meta-analyses has often yielded contradictory results, frequently failing to demonstrate a clear clinical benefit despite favorable outcomes observed in real-world settings. Several factors may contribute to these inconsistencies, with the lack of standardization in PRP preparation and the heterogeneity of KOA phenotypes being the most significant. Phenotyping is more effectively accomplished in specialized clinical environments, which may elucidate the improved outcomes associated with better patient selection. After delineating the specific characteristics of PRP injections and the primary sources of variability, we emphasize the necessity for comprehensive characterization of the injected product and accurate phenotyping of KOA. Additionally, we examine the methodological biases that impede the interpretation of clinical results and propose a treat-to-target approach as a more suitable evaluation strategy. These methodological challenges should not undermine the potential of regenerative medicine, which offers considerable promise. Compared to conventional therapies, regenerative medicine is generally more compatible with human physiology, better tolerated, and potentially less expensive. However, the advancement of this field necessitates strict scientific rigor and objectivity. This involves a meticulous recognition of biases and methodological limitations, as well as a deeper understanding of the underlying mechanisms of action, to refine and optimize therapeutic protocols.

关节内注射富血小板血浆（PRP）越来越多地用于膝关节骨关节炎（KOA）和其他各种医学专业的治疗。然而，PRP的有效性仍然是一个有争议的问题；一些专家认为它是一种安慰剂，而另一些人则主张它的治疗价值。来自对照临床试验和荟萃分析的证据经常产生相互矛盾的结果，尽管在现实环境中观察到良好的结果，但经常无法证明明确的临床益处。有几个因素可能导致这些不一致，其中PRP制备缺乏标准化和KOA表型的异质性是最显著的。表型分析在专门的临床环境中更有效地完成，这可能阐明与更好的患者选择相关的改善结果。在描述了PRP注射的具体特征和变异的主要来源之后，我们强调了对注射产物进行全面表征和准确分型KOA的必要性。此外，我们研究了妨碍临床结果解释的方法学偏差，并提出了一种更合适的评估策略——从治疗到目标的方法。这些方法上的挑战不应该破坏再生医学的潜力，它提供了相当大的希望。与传统疗法相比，再生医学通常更符合人体生理，耐受性更好，而且可能更便宜。然而，这一领域的发展需要严格的科学严谨性和客观性。这包括对偏见和方法局限性的细致认识，以及对潜在作用机制的更深入理解，以完善和优化治疗方案。

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引用次数: 0

Prevalence of neuropathic-like pain phenotype in people with hand osteoarthritis: A systematic literature review and meta-analysis 手骨关节炎患者神经性疼痛表型的患病率：系统文献综述和荟萃分析。

IF 4.3 3区医学 Q1 RHEUMATOLOGY

Joint Bone Spine

Pub Date : 2025-11-24 DOI: 10.1016/j.jbspin.2025.106012

Sylvain Mathieu , Camille Fauchon , Alice Courties , Jérémie Sellam

Objective

To determine the prevalence of neuropathic-like pain (NP) in people with hand osteoarthritis (HOA), and to compare the demographic and clinical characteristics of HOA patients who experience NP with those who do not.

Methods

A systematic literature review was conducted, using the PubMed, Embase, Web of Science and the Cochrane Library databases up to 12 February 2025. NP prevalence was calculated using meta-proportion analysis. The inverse of variance method was used to express differences in characteristics between HOA patients with or without NP as standardized mean differences.

Results

Eight studies comprising a total of 1084 patients were included, of whom 409 had HOA with NP, corresponding to a prevalence of 42.2% (95% CI: 31.8–53.0). HOA patients with NP were younger and experienced significantly greater pain intensity (58.5 ± 18.5 versus 48.8 ± 19.3 mm; P < 0.001), as well as having a higher FIHOA score, though this did not reach statistical significance (12.9 ± 6.9 versus 11.9 ± 7.2; P = 0.19). No differences were found in sex, BMI, CRP levels or the proportion of erosive disease between patients with and without NP.

Conclusion

In order to better determine the pain phenotype, it is crucial to search for a neuropathic component in HOA patients in routine care. These patients often experience neuropathic pain, which may indicate a more painful and disabling condition involving specific neurophysiological abnormalities. This could influence the approach to personalised pain management.

目的：确定手骨关节炎（HOA）患者神经性样痛（NP）的患病率，并比较有神经性样痛和无神经性样痛的HOA患者的人口学和临床特征。方法：使用PubMed， Embase， Web of Science和Cochrane Library数据库进行系统的文献综述，截至2025年2月12日。NP患病率采用元比例分析计算。方差倒数法将有NP或无NP的HOA患者之间的特征差异表示为标准化平均差异。结果：8项研究共纳入1,084例患者，其中409例为HOA合并NP，患病率为42.2% （95% CI:31.8-53.0）。伴有NP的HOA患者更年轻，疼痛强度明显高于NP患者（58.5±18.5 mm vs 48.8±19.3 mm）。结论：为了更好地确定疼痛表型，在常规护理中寻找HOA患者的神经病变成分至关重要。这些患者经常经历神经性疼痛，这可能表明一种更痛苦和致残的状况，涉及特定的神经生理异常。这可能会影响个性化疼痛管理的方法。

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引用次数: 0

Occupational consequences of osteoarthritis. A scoping review 骨关节炎的职业后果。范围审查。

IF 4.3 3区医学 Q1 RHEUMATOLOGY

Joint Bone Spine

Pub Date : 2025-11-24 DOI: 10.1016/j.jbspin.2025.106013

Anne-Christine Rat , Oriane Bazin , Isabelle Thaon

Objective

The objective of this scoping review was to identify the factors that are associated with the negative consequences of OA (hip, knee and hand OA) on employment.

Methods

The review included publications in English and French from 2000–2023. The selected articles were required to include an outcome criterion representing a negative effect of OA on employment, such as work loss, sick leave, disability pension (DP), loss of productivity, health at work, and work-life balance.

Results

The outcome criteria were grouped into 7 categories, including work participation, disability pensions (DPs), work loss or early retirement, absenteeism, productivity loss, changes in work, and expected work limitations. Factors associated with the negative consequences of OA can be categorized into characteristics of OA (symptoms, management), personal characteristics (sociodemographic and individual characteristics such as comorbidities, physical activity, representation of the disease, feelings of responsibility in its management), job characteristics (physical demands, night work, working hours, possibilities of adapting to work, and support from colleagues), environments (difficulties associated with transportation, demands of multiple roles in life, lack of information about adaptation possibilities), and adaptation strategies (e.g. changing the way in which tasks are performed, using technical aids, thinking about how to perform each movement, planning activities, receiving help, using cognitive techniques).

Conclusion

Based on the results of this review, we present a framework describing the impact of factors associated with work-related difficulties in patients with OA. These factors will make it possible to develop interventions aimed at helping individuals with OA in maintaining employment.

目的：本综述的目的是确定与OA（髋关节、膝关节和手部OA）对就业的负面影响相关的因素。方法：纳入2000-2023年的英文和法文出版物。所选条目必须包括一项反映OA对就业的负面影响的结果标准，如工作损失、病假、残疾养恤金、生产力损失、工作健康和工作与生活平衡。结果：结果标准分为7个类别，包括工作参与、残疾养老金、失业或提前退休、缺勤、生产力损失、工作变化和预期工作限制。与OA负面后果相关的因素可分为OA特征（症状、管理）、个人特征（社会人口学和个人特征，如合并症、身体活动、疾病的表现、管理中的责任感）、工作特征（身体需求、夜班、工作时间、适应工作的可能性和同事的支持）、环境（与交通有关的困难，生活中多重角色的需求，缺乏关于适应可能性的信息）和适应策略（例如改变执行任务的方式，使用技术辅助，思考如何执行每个动作，计划活动，接受帮助，使用认知技术）。结论：基于本综述的结果，我们提出了一个描述OA患者工作困难相关因素影响的框架。这些因素将使制定干预措施成为可能，旨在帮助OA患者维持就业。

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引用次数: 0

Answer to Jing, et al 回答Jing等人。

IF 4.3 3区医学 Q1 RHEUMATOLOGY

Joint Bone Spine

Pub Date : 2025-11-13 DOI: 10.1016/j.jbspin.2025.106003

Yinglun Zhang , Zhibin Jin , Jing Yao , Dandan Wang , Yunxian Yu , Weijing Zhang

引用次数: 0

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Joint Bone Spine

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