Joint Bone Spine最新文献

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Evolution of FIB-4 score in SpA and PsA patients taking anti-TNF or anti-IL17 服用抗肿瘤坏死因子或抗 IL17 的 SpA 和 PsA 患者的 FIB-4 评分变化。

IF 3.8 3区医学 Q1 RHEUMATOLOGY

Joint Bone Spine

Pub Date : 2024-07-29 DOI: 10.1016/j.jbspin.2024.105763

引用次数: 0

Saddle nose deformity in eosinophilic granulomatosis with polyangiitis 嗜酸性粒细胞肉芽肿伴多血管炎的鞍鼻畸形。

IF 3.8 3区医学 Q1 RHEUMATOLOGY

Joint Bone Spine

Pub Date : 2024-07-29 DOI: 10.1016/j.jbspin.2024.105765

引用次数: 0

Osteochondrosis of the primary ossification center (Kohler's Disease) of the patella 髌骨初级骨化中心骨软骨病（科勒氏病）。

IF 3.8 3区医学 Q1 RHEUMATOLOGY

Joint Bone Spine

Pub Date : 2024-07-29 DOI: 10.1016/j.jbspin.2024.105766

引用次数: 0

Interest in various treatments for osteoarthritis among the French population: A Google Trends analysis 法国人对骨关节炎各种治疗方法的兴趣：谷歌趋势分析。

IF 3.8 3区医学 Q1 RHEUMATOLOGY

Joint Bone Spine

Pub Date : 2024-07-17 DOI: 10.1016/j.jbspin.2024.105762

引用次数: 0

Cluster analysis of clinical manifestations assigns systemic lupus erythematosus-phenotype subgroups: A multicentre study on 440 patients 对临床表现进行聚类分析，划分出系统性红斑狼疮表型亚组：一项对 440 名患者进行的多中心研究。

IF 3.8 3区医学 Q1 RHEUMATOLOGY

Joint Bone Spine

Pub Date : 2024-07-06 DOI: 10.1016/j.jbspin.2024.105760

Objective

Systemic lupus erythematous (SLE) is a heterogenous disease characterised by a large panel of autoantibodies and a wide spectrum of clinical signs and symptoms that engender different outcomes. We aimed to identify distinct, homogeneous SLE patients’ phenotypes.

Methods

This retrospective study enrolled SLE patients meeting the Systemic Lupus International Collaborating Clinics (SLICC) classification criteria, enrolled in the French multicentre “APS (antiphospholipid syndrome) and SLE” Registry. Based on 29 variables selected to cover a broad range of clinical and laboratory (excluding autoantibodies) SLE manifestations, unsupervised multiple correspondence analysis followed by hierarchical ascendent-clustering analysis assigned different phenotypes.

Results

We included 440 patients, mostly women (94.3%). Median age at SLE diagnosis was 24 (IQR 19–32) years. Cluster analysis yielded three distinct subgroups based on cumulative clinical manifestations, not autoantibody pattern. Cluster 1 (n = 91) comprised mostly Caucasian patients, with APS-associated clinical and biological manifestations, e.g., livedo, seizure, thrombocytopaenia and haemolytic anaemia. Cluster 2 (n = 221), the largest, included patients with mild clinical manifestations, mainly articular, more frequently associated with Sjögren's syndrome and with less frequent autoantibody-positivity. Cluster 3 (n = 128) consisted of patients with the largest panel of SLE-specific clinical manifestations (cutaneous, articular, proliferative nephritis, pleural, cardiac and haematological), the most frequent autoantibody-positivity, low complement levels, and more often of Asian and sub-Saharan African origin.

Conclusion

This unsupervised clustering method distinguished three distinct SLE patient subgroups, highlighting SLE heterogeneity.

目的：系统性红斑狼疮（SLE）是一种异质性疾病，其特点是自身抗体种类繁多，临床症状和体征范围广泛，导致不同的结果。我们旨在确定系统性红斑狼疮患者独特的同质性表型：这项回顾性研究招募了符合系统性红斑狼疮国际合作诊所（SLICC）分类标准的系统性红斑狼疮患者，这些患者都是法国多中心 "APS（抗磷脂综合征）和系统性红斑狼疮‿登记处 "的登记患者。根据所选的涵盖广泛的系统性红斑狼疮临床和实验室（不包括自身抗体）表现的 29 个变量，进行无监督多重对应分析，然后进行分层升序聚类分析，得出不同的表型：我们共纳入了 440 名患者，其中大部分为女性（94.3%）。确诊系统性红斑狼疮时的中位年龄为 24 岁（IQR 19-32 岁）。聚类分析根据累积的临床表现（而非自身抗体模式）得出了三个不同的亚组。群组1（人数=91）主要由白种人组成，具有与APS相关的临床和生物学表现，如活组织病、癫痫发作、血小板减少症和溶血性贫血。第 2 组（人数=221）是最大的一组，包括临床表现轻微的患者，主要是关节型患者，更常见的是与斯约格伦综合征相关的患者，自身抗体阳性率较低。第3组（n=128）的患者有最多的系统性红斑狼疮特异性临床表现（皮肤、关节、增生性肾炎、胸膜、心脏和血液），最常见的自身抗体阳性，补体水平低，且多为亚洲和撒哈拉以南非洲血统：结论：这种无监督聚类方法可区分三个不同的系统性红斑狼疮患者亚群，突出了系统性红斑狼疮的异质性。

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引用次数: 0

Risk of flare in patients with SLE in remission after hydroxychloroquine or chloroquine withdrawal 停用羟氯喹或氯喹后病情缓解的系统性红斑狼疮患者复发的风险。

IF 3.8 3区医学 Q1 RHEUMATOLOGY

Joint Bone Spine

Pub Date : 2024-07-02 DOI: 10.1016/j.jbspin.2024.105756

Objective

Previous studies have provided evidence that the discontinuation of hydroxychloroquine (HCQ), and chloroquine (CQ), in patients with systemic lupus erythematosus (SLE) is associated with an increased risk of disease flares, with limited information on the level of disease activity at the time of HCQ/CQ discontinuation. Here we aimed to describe the risk of SLE flare after withdrawal of HCQ or CQ in patients with SLE in remission.

Methods

Case-control study (1:2) comparing the evolution of patients with SLE after HCQ/CQ withdrawal for antimalarial retinopathy (cases) with patients with SLE matched for sex, antimalarial treatment duration and age at SLE diagnosis, whose antimalarial treatment was continued throughout the entire follow-up period (controls). To be included in the study, patients had to be in remission for at least one year according to the DORIS classification. The primary endpoint was the proportion of patient experiencing a flare according to the SELENA-SLEDAI Flare Index after a 36-month follow-up.

Results

We studied 48 cases and 96 controls. The proportion of patients experiencing a flare was significantly higher in the HCQ/CQ withdrawal group as compared to the maintenance group (15 [31.3%] patients versus 12 [12.5%]; OR 3.1 [95%CI 1.2–8.2], P = 0.01). Withdrawal of HCQ/CQ was inferior with respect to occurrence of severe SLE flare (12 [25.0%] vs 11 [11.5%]; OR 2.5 [95%CI 0.9–6.9], P = 0.053) and time to first flare (HR 6.3 [2.0–19.9], P < 0.005). Elevated serum levels of anti-dsDNA antibodies were identified as a risk factor for SLE flare following HCQ/CQ discontinuation (HR 5.4 [1.5–18.7], P < 0.01).

Conclusion

Withdrawal of HCQ or CQ in patients with SLE in remission is associated with a 3-fold increased risk of relapse.

目的：以往的研究已提供证据表明，系统性红斑狼疮（SLE）患者停用羟氯喹（HCQ）和氯喹（CQ）与疾病复发风险增加有关，但有关停用HCQ/CQ时疾病活动水平的信息却很有限。在此，我们旨在描述缓解期系统性红斑狼疮患者停用 HCQ 或 CQ 后系统性红斑狼疮复发的风险：病例对照研究（1:2）：比较因抗疟视网膜病变而停用 HCQ/CQ 后的系统性红斑狼疮患者（病例）与在性别、抗疟治疗持续时间和系统性红斑狼疮诊断时年龄方面匹配的系统性红斑狼疮患者（对照组）的演变情况，后者在整个随访期间继续接受抗疟治疗。根据 DORIS 的分类，患者必须缓解至少一年才能被纳入研究。研究的主要终点是根据SELENA-SLEDAI复发指数对随访36个月后出现复发的患者比例进行评估：我们对 48 例病例和 96 例对照进行了研究。与维持组相比，停用HCQ/CQ组出现复发的患者比例明显更高（15（31.3%）对12（12.5%）；OR 3.1 (95%CI 1.2-8.2), p=0.01）。在严重系统性红斑狼疮复发（12（25.0%）对 11（11.5%）；OR 2.5（95%CI 0.9-6.9），P=0.053）和首次复发时间（HR 6.3 [2.0-19.9]，P=0.053）方面，停用 HCQ/CQ 的效果较差：缓解期系统性红斑狼疮患者停用HCQ或CQ会导致复发风险增加3倍。

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引用次数: 0

Hip involvement and its impact on treatment decision in patients with axial spondyloarthritis; treasure experience 轴性脊柱关节炎患者的髋关节受累及其对治疗决策的影响；宝藏经验。

IF 3.8 3区医学 Q1 RHEUMATOLOGY

Joint Bone Spine

Pub Date : 2024-07-02 DOI: 10.1016/j.jbspin.2024.105755

引用次数: 0

From imaging findings to fracture liaison services: Is the referral pathway for vertebral fragility fractures effective? 从成像结果到骨折联络服务：椎体脆性骨折的转诊途径是否有效？

IF 3.8 3区医学 Q1 RHEUMATOLOGY

Joint Bone Spine

Pub Date : 2024-06-26 DOI: 10.1016/j.jbspin.2024.105753

引用次数: 0

Double vertebrae Kummell's Disease 双椎骨库姆梅尔病。

IF 3.8 3区医学 Q1 RHEUMATOLOGY

Joint Bone Spine

Pub Date : 2024-06-26 DOI: 10.1016/j.jbspin.2024.105752

引用次数: 0

Progression of multiple vertebral fractures after denosumab discontinuation under treatment with romosozumab. A case-report 罗莫单抗治疗下停用地诺单抗后多发性椎体骨折恶化。病例报告。

IF 3.8 3区医学 Q1 RHEUMATOLOGY

Joint Bone Spine

Pub Date : 2024-06-26 DOI: 10.1016/j.jbspin.2024.105754

Michail Krikelis , Susana Gazi , Georgios Trovas , Konstantinos Makris , Efstathios Chronopoulos , Symeon Tournis

Introduction

Denosumab (Dmab) is widely used for the treatment of post-menopausal osteoporosis. Its discontinuation is sometimes accompanied by multiple vertebral fractures. Romosozumab (Rmab) has not been tested for its ability to prevent the rebound phenomenon.

Case presentation

We present the case of a 68-year-old female patient with post-menopausal osteoporosis under treatment with Rmab who presented with multiple vertebral fractures after denosumab discontinuation. The addition of Rmab did not prevent new-onset rebound-associated vertebral fractures. The patient discontinued Rmab and Dmab was re-initiated. After six months, no new vertebral fractures occurred, bone mineral density increased and bone turnover markers remained suppressed.

Discussion

Our clinical case illustrates the ineffectiveness of Rmab to prevent the multiple vertebral fracture cascade attributable to discontinuation of Dmab. We believe that treatment with Rmab might not be enough to prevent this phenomenon. Treatment with Dmab or possibly combination treatment with Dmab and Rmab could be another treatment option.

简介地诺单抗（Dmab）被广泛用于治疗绝经后骨质疏松症。停药后有时会出现多发性脊椎骨折。目前尚未检测过罗莫单抗（Rmab）防止反弹现象的能力：我们提供了一例 68 岁女性绝经后骨质疏松症患者的病例，该患者正在接受雷马单抗治疗，在停用地诺单抗后出现多发性椎体骨折。加用 Rmab 并不能防止新发的反弹相关性脊椎骨折。患者停用了雷马单抗，并重新启用了地诺单抗。六个月后，没有发生新的椎体骨折，骨质密度增加，骨转换标志物仍然受到抑制：我们的临床病例说明，Rmab 能有效预防因停用 Dmab 而导致的多发性椎体骨折。我们认为，使用 Rmab 治疗可能不足以预防这一现象。使用 Dmab 治疗或 Dmab 和 Rmab 联合治疗可能是另一种治疗选择。

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