Christian Dejaco, Sofia Ramiro, Milena Bond, Philipp Bosch, Cristina Ponte, Sarah Louise Mackie, Thorsten A Bley, Daniel Blockmans, Sara Brolin, Ertugrul Cagri Bolek, Rebecca Cassie, Maria C Cid, Juan Molina-Collada, Bhaskar Dasgupta, Berit Dalsgaard Nielsen, Eugenio De Miguel, Haner Direskeneli, Christina Duftner, Alojzija Hočevar, Anna Molto, Valentin Sebastian Schäfer, Luca Seitz, Riemer H J A Slart, Wolfgang A Schmidt
Objectives: To update the EULAR recommendations for the use of imaging modalities in primary large vessel vasculitis (LVV).
Methods: A systematic literature review update was performed to retrieve new evidence on ultrasound, MRI, CT and [18F]-fluorodeoxyglucose positron emission tomography (FDG-PET) for diagnosis, monitoring and outcome prediction in LVV. The task force consisted of 24 physicians, health professionals and patients from 14 countries. The recommendations were updated based on evidence and expert opinion, iterating until voting indicated consensus. The level of agreement was determined by anonymous votes.
Results: Three overarching principles and eight recommendations were agreed. Compared to the 2018 version, ultrasound is now recommended as first-line imaging test in all patients with suspected giant cell arteritis, and axillary arteries should be included in the standard examination. As an alternative to ultrasound, cranial and extracranial arteries can be examined by FDG-PET or MRI. For Takayasu arteritis, MRI is the preferred imaging modality; FDG-PET, CT or ultrasound are alternatives. Although imaging is not routinely recommended for follow-up, ultrasound, FDG-PET or MRI may be used for assessing vessel abnormalities in LVV patients with suspected relapse, particularly when laboratory markers of inflammation are unreliable. MR-angiography, CT-angiography or ultrasound may be used for long-term monitoring of structural damage, particularly at sites of preceding vascular inflammation.
Conclusions: The 2023 EULAR recommendations provide up-to-date guidance for the role of imaging in the diagnosis and assessment of patients with LVV.
{"title":"EULAR recommendations for the use of imaging in large vessel vasculitis in clinical practice: 2023 update.","authors":"Christian Dejaco, Sofia Ramiro, Milena Bond, Philipp Bosch, Cristina Ponte, Sarah Louise Mackie, Thorsten A Bley, Daniel Blockmans, Sara Brolin, Ertugrul Cagri Bolek, Rebecca Cassie, Maria C Cid, Juan Molina-Collada, Bhaskar Dasgupta, Berit Dalsgaard Nielsen, Eugenio De Miguel, Haner Direskeneli, Christina Duftner, Alojzija Hočevar, Anna Molto, Valentin Sebastian Schäfer, Luca Seitz, Riemer H J A Slart, Wolfgang A Schmidt","doi":"10.1136/ard-2023-224543","DOIUrl":"10.1136/ard-2023-224543","url":null,"abstract":"<p><strong>Objectives: </strong>To update the EULAR recommendations for the use of imaging modalities in primary large vessel vasculitis (LVV).</p><p><strong>Methods: </strong>A systematic literature review update was performed to retrieve new evidence on ultrasound, MRI, CT and [<sup>18</sup>F]-fluorodeoxyglucose positron emission tomography (FDG-PET) for diagnosis, monitoring and outcome prediction in LVV. The task force consisted of 24 physicians, health professionals and patients from 14 countries. The recommendations were updated based on evidence and expert opinion, iterating until voting indicated consensus. The level of agreement was determined by anonymous votes.</p><p><strong>Results: </strong>Three overarching principles and eight recommendations were agreed. Compared to the 2018 version, ultrasound is now recommended as first-line imaging test in all patients with suspected giant cell arteritis, and axillary arteries should be included in the standard examination. As an alternative to ultrasound, cranial and extracranial arteries can be examined by FDG-PET or MRI. For Takayasu arteritis, MRI is the preferred imaging modality; FDG-PET, CT or ultrasound are alternatives. Although imaging is not routinely recommended for follow-up, ultrasound, FDG-PET or MRI may be used for assessing vessel abnormalities in LVV patients with suspected relapse, particularly when laboratory markers of inflammation are unreliable. MR-angiography, CT-angiography or ultrasound may be used for long-term monitoring of structural damage, particularly at sites of preceding vascular inflammation.</p><p><strong>Conclusions: </strong>The 2023 EULAR recommendations provide up-to-date guidance for the role of imaging in the diagnosis and assessment of patients with LVV.</p>","PeriodicalId":8087,"journal":{"name":"Annals of the Rheumatic Diseases","volume":null,"pages":null},"PeriodicalIF":27.4,"publicationDate":"2024-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9954374","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Objectives: To systemically analyse the heterogeneity in the clinical manifestations and prognoses of patients with antisynthetase syndrome (ASS) and evaluate the transcriptional signatures related to different clinical phenotypes.
Methods: A total of 701 patients with ASS were retrospectively enrolled. The clinical presentation and prognosis were assessed in association with four anti-aminoacyl transfer RNA synthetase (ARS) antibodies: anti-Jo1, anti-PL7, anti-PL12 and anti-EJ. Unsupervised machine learning was performed for patient clustering independent of anti-ARS antibodies. Transcriptome sequencing was conducted in clustered ASS patients and healthy controls.
Results: Patients with four different anti-ARS antibody subtypes demonstrated no significant differences in the incidence of rapidly progressive interstitial lung disease (RP-ILD) or prognoses. Unsupervised machine learning, independent of anti-ARS specificity, identified three endotypes with distinct clinical features and outcomes. Endotype 1 (RP-ILD cluster, 23.7%) was characterised by a high incidence of RP-ILD and a high mortality rate. Endotype 2 (dermatomyositis (DM)-like cluster, 14.5%) corresponded to patients with DM-like skin and muscle symptoms with an intermediate prognosis. Endotype 3 (arthritis cluster, 61.8%) was characterised by arthritis and mechanic's hands, with a good prognosis. Transcriptome sequencing revealed that the different endotypes had distinct gene signatures and biological processes.
Conclusions: Anti-ARS antibodies were not significant in stratifying ASS patients into subgroups with greater homogeneity in RP-ILD and prognoses. Novel ASS endotypes were identified independent of anti-ARS specificity and differed in clinical outcomes and transcriptional signatures, providing new insights into the pathogenesis of ASS.
目的系统分析抗合成酶综合征(ASS)患者临床表现和预后的异质性,并评估与不同临床表型相关的转录特征:方法:共回顾性登记了 701 例 ASS 患者。临床表现和预后评估与四种抗氨基酸转移RNA合成酶(ARS)抗体有关:抗Jo1、抗PL7、抗PL12和抗EJ。对患者的聚类进行了无监督机器学习,与抗ARS抗体无关。对聚类的ASS患者和健康对照组进行了转录组测序:结果:四种不同抗ARS抗体亚型的患者在快速进展性间质性肺病(RP-ILD)的发病率或预后方面没有明显差异。无监督机器学习(与抗ARS特异性无关)确定了三种具有不同临床特征和预后的内型。内型1(RP-ILD群,23.7%)的特点是RP-ILD发病率高、死亡率高。内型2(皮肌炎(DM)样群,14.5%)患者有DM样皮肤和肌肉症状,预后中等。内型3(关节炎群,61.8%)的特征是关节炎和机械手,预后良好。转录组测序显示,不同的内型具有不同的基因特征和生物过程:结论:抗 ASS 抗体在将 ASS 患者分为 RP-ILD 和预后同质性更高的亚组方面作用不大。新发现的ASS内型不受抗ARS特异性的影响,在临床结果和转录特征方面各不相同,这为了解ASS的发病机制提供了新的视角。
{"title":"Novel endotypes of antisynthetase syndrome identified independent of anti-aminoacyl transfer RNA synthetase antibody specificity that improve prognostic stratification.","authors":"Shiyu Wu, Xinyue Xiao, Yingfang Zhang, Xinxin Zhang, Guochun Wang, Qinglin Peng","doi":"10.1136/ard-2023-225284","DOIUrl":"10.1136/ard-2023-225284","url":null,"abstract":"<p><strong>Objectives: </strong>To systemically analyse the heterogeneity in the clinical manifestations and prognoses of patients with antisynthetase syndrome (ASS) and evaluate the transcriptional signatures related to different clinical phenotypes.</p><p><strong>Methods: </strong>A total of 701 patients with ASS were retrospectively enrolled. The clinical presentation and prognosis were assessed in association with four anti-aminoacyl transfer RNA synthetase (ARS) antibodies: anti-Jo1, anti-PL7, anti-PL12 and anti-EJ. Unsupervised machine learning was performed for patient clustering independent of anti-ARS antibodies. Transcriptome sequencing was conducted in clustered ASS patients and healthy controls.</p><p><strong>Results: </strong>Patients with four different anti-ARS antibody subtypes demonstrated no significant differences in the incidence of rapidly progressive interstitial lung disease (RP-ILD) or prognoses. Unsupervised machine learning, independent of anti-ARS specificity, identified three endotypes with distinct clinical features and outcomes. Endotype 1 (RP-ILD cluster, 23.7%) was characterised by a high incidence of RP-ILD and a high mortality rate. Endotype 2 (dermatomyositis (DM)-like cluster, 14.5%) corresponded to patients with DM-like skin and muscle symptoms with an intermediate prognosis. Endotype 3 (arthritis cluster, 61.8%) was characterised by arthritis and mechanic's hands, with a good prognosis. Transcriptome sequencing revealed that the different endotypes had distinct gene signatures and biological processes.</p><p><strong>Conclusions: </strong>Anti-ARS antibodies were not significant in stratifying ASS patients into subgroups with greater homogeneity in RP-ILD and prognoses. Novel ASS endotypes were identified independent of anti-ARS specificity and differed in clinical outcomes and transcriptional signatures, providing new insights into the pathogenesis of ASS.</p>","PeriodicalId":8087,"journal":{"name":"Annals of the Rheumatic Diseases","volume":null,"pages":null},"PeriodicalIF":20.3,"publicationDate":"2024-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139939397","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Peter Mandl, Maria Antonietta D'Agostino, Victoria Navarro-Compán, Irina Geßl, Garifallia Sakellariou, Abhishek Abhishek, Fabio Becce, Nicola Dalbeth, Hang-Korng Ea, Emilio Filippucci, Hilde Berner Hammer, Annamaria Iagnocco, Annette de Thurah, Esperanza Naredo, Sebastien Ottaviani, Tristan Pascart, Fernando Pérez-Ruiz, Irene A Pitsillidou, Fabian Proft, Juergen Rech, Wolfgang A Schmidt, Luca Maria Sconfienza, Lene Terslev, Brigitte Wildner, Pascal Zufferey, Georgios Filippou
Objective: To formulate evidence-based recommendations and overarching principles on the use of imaging in the clinical management of crystal-induced arthropathies (CiAs).
Methods: An international task force of 25 rheumatologists, radiologists, methodologists, healthcare professionals and patient research partners from 11 countries was formed according to the EULAR standard operating procedures. Fourteen key questions on the role of imaging in the most common forms of CiA were generated. The CiA assessed included gout, calcium pyrophosphate deposition disease and basic calcium phosphate deposition disease. Imaging modalities included conventional radiography, ultrasound, CT and MRI. Experts applied research evidence obtained from four systematic literature reviews using MEDLINE, EMBASE and CENTRAL. Task force members provided level of agreement (LoA) anonymously by using a Numerical Rating Scale from 0 to 10.
Results: Five overarching principles and 10 recommendations were developed encompassing the role of imaging in various aspects of patient management: making a diagnosis of CiA, monitoring inflammation and damage, predicting outcome, response to treatment, guided interventions and patient education. Overall, the LoA for the recommendations was high (8.46-9.92).
Conclusions: These are the first recommendations that encompass the major forms of CiA and guide the use of common imaging modalities in this disease group in clinical practice.
{"title":"2023 EULAR recommendations on imaging in diagnosis and management of crystal-induced arthropathies in clinical practice.","authors":"Peter Mandl, Maria Antonietta D'Agostino, Victoria Navarro-Compán, Irina Geßl, Garifallia Sakellariou, Abhishek Abhishek, Fabio Becce, Nicola Dalbeth, Hang-Korng Ea, Emilio Filippucci, Hilde Berner Hammer, Annamaria Iagnocco, Annette de Thurah, Esperanza Naredo, Sebastien Ottaviani, Tristan Pascart, Fernando Pérez-Ruiz, Irene A Pitsillidou, Fabian Proft, Juergen Rech, Wolfgang A Schmidt, Luca Maria Sconfienza, Lene Terslev, Brigitte Wildner, Pascal Zufferey, Georgios Filippou","doi":"10.1136/ard-2023-224771","DOIUrl":"10.1136/ard-2023-224771","url":null,"abstract":"<p><strong>Objective: </strong>To formulate evidence-based recommendations and overarching principles on the use of imaging in the clinical management of crystal-induced arthropathies (CiAs).</p><p><strong>Methods: </strong>An international task force of 25 rheumatologists, radiologists, methodologists, healthcare professionals and patient research partners from 11 countries was formed according to the EULAR standard operating procedures. Fourteen key questions on the role of imaging in the most common forms of CiA were generated. The CiA assessed included gout, calcium pyrophosphate deposition disease and basic calcium phosphate deposition disease. Imaging modalities included conventional radiography, ultrasound, CT and MRI. Experts applied research evidence obtained from four systematic literature reviews using MEDLINE, EMBASE and CENTRAL. Task force members provided level of agreement (LoA) anonymously by using a Numerical Rating Scale from 0 to 10.</p><p><strong>Results: </strong>Five overarching principles and 10 recommendations were developed encompassing the role of imaging in various aspects of patient management: making a diagnosis of CiA, monitoring inflammation and damage, predicting outcome, response to treatment, guided interventions and patient education. Overall, the LoA for the recommendations was high (8.46-9.92).</p><p><strong>Conclusions: </strong>These are the first recommendations that encompass the major forms of CiA and guide the use of common imaging modalities in this disease group in clinical practice.</p>","PeriodicalId":8087,"journal":{"name":"Annals of the Rheumatic Diseases","volume":null,"pages":null},"PeriodicalIF":20.3,"publicationDate":"2024-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11103298/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139721375","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Philip S Hench and the discovery of cortisone.","authors":"Eric L Matteson, Gene Hunder","doi":"10.1136/ard-2024-225823","DOIUrl":"10.1136/ard-2024-225823","url":null,"abstract":"","PeriodicalId":8087,"journal":{"name":"Annals of the Rheumatic Diseases","volume":null,"pages":null},"PeriodicalIF":27.4,"publicationDate":"2024-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140890917","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ioannis Parodis, Charlotte Girard-Guyonvarc'h, Laurent Arnaud, Oliver Distler, Andrea Domján, Cornelia H M Van den Ende, Kim Fligelstone, Agnes Kocher, Maddalena Larosa, Martin Lau, Alexandros Mitropoulos, Mwidimi Ndosi, Janet L Poole, Anthony Redmond, Valentin Ritschl, Helene Alexanderson, Yvonne Sjöberg, Gunilla von Perner, Till Uhlig, Cecilia Varju, Johanna E Vriezekolk, Elisabet Welin, René Westhovens, Tanja A Stamm, Carina Boström
Objective: To develop evidence-based recommendations for the non-pharmacological management of systemic lupus erythematosus (SLE) and systemic sclerosis (SSc).
Methods: A task force comprising 7 rheumatologists, 15 other healthcare professionals and 3 patients was established. Following a systematic literature review performed to inform the recommendations, statements were formulated, discussed during online meetings and graded based on risk of bias assessment, level of evidence (LoE) and strength of recommendation (SoR; scale A-D, A comprising consistent LoE 1 studies, D comprising LoE 4 or inconsistent studies), following the European Alliance of Associations for Rheumatology standard operating procedure. Level of agreement (LoA; scale 0-10, 0 denoting complete disagreement, 10 denoting complete agreement) was determined for each statement through online voting.
Results: Four overarching principles and 12 recommendations were developed. These concerned common and disease-specific aspects of non-pharmacological management. SoR ranged from A to D. The mean LoA with the overarching principles and recommendations ranged from 8.4 to 9.7. Briefly, non-pharmacological management of SLE and SSc should be tailored, person-centred and participatory. It is not intended to preclude but rather complement pharmacotherapy. Patients should be offered education and support for physical exercise, smoking cessation and avoidance of cold exposure. Photoprotection and psychosocial interventions are important for SLE patients, while mouth and hand exercises are important in SSc.
Conclusions: The recommendations will guide healthcare professionals and patients towards a holistic and personalised management of SLE and SSc. Research and educational agendas were developed to address needs towards a higher evidence level, enhancement of clinician-patient communication and improved outcomes.
{"title":"EULAR recommendations for the non-pharmacological management of systemic lupus erythematosus and systemic sclerosis.","authors":"Ioannis Parodis, Charlotte Girard-Guyonvarc'h, Laurent Arnaud, Oliver Distler, Andrea Domján, Cornelia H M Van den Ende, Kim Fligelstone, Agnes Kocher, Maddalena Larosa, Martin Lau, Alexandros Mitropoulos, Mwidimi Ndosi, Janet L Poole, Anthony Redmond, Valentin Ritschl, Helene Alexanderson, Yvonne Sjöberg, Gunilla von Perner, Till Uhlig, Cecilia Varju, Johanna E Vriezekolk, Elisabet Welin, René Westhovens, Tanja A Stamm, Carina Boström","doi":"10.1136/ard-2023-224416","DOIUrl":"10.1136/ard-2023-224416","url":null,"abstract":"<p><strong>Objective: </strong>To develop evidence-based recommendations for the non-pharmacological management of systemic lupus erythematosus (SLE) and systemic sclerosis (SSc).</p><p><strong>Methods: </strong>A task force comprising 7 rheumatologists, 15 other healthcare professionals and 3 patients was established. Following a systematic literature review performed to inform the recommendations, statements were formulated, discussed during online meetings and graded based on risk of bias assessment, level of evidence (LoE) and strength of recommendation (SoR; scale A-D, A comprising consistent LoE 1 studies, D comprising LoE 4 or inconsistent studies), following the European Alliance of Associations for Rheumatology standard operating procedure. Level of agreement (LoA; scale 0-10, 0 denoting complete disagreement, 10 denoting complete agreement) was determined for each statement through online voting.</p><p><strong>Results: </strong>Four overarching principles and 12 recommendations were developed. These concerned common and disease-specific aspects of non-pharmacological management. SoR ranged from A to D. The mean LoA with the overarching principles and recommendations ranged from 8.4 to 9.7. Briefly, non-pharmacological management of SLE and SSc should be tailored, person-centred and participatory. It is not intended to preclude but rather complement pharmacotherapy. Patients should be offered education and support for physical exercise, smoking cessation and avoidance of cold exposure. Photoprotection and psychosocial interventions are important for SLE patients, while mouth and hand exercises are important in SSc.</p><p><strong>Conclusions: </strong>The recommendations will guide healthcare professionals and patients towards a holistic and personalised management of SLE and SSc. Research and educational agendas were developed to address needs towards a higher evidence level, enhancement of clinician-patient communication and improved outcomes.</p>","PeriodicalId":8087,"journal":{"name":"Annals of the Rheumatic Diseases","volume":null,"pages":null},"PeriodicalIF":27.4,"publicationDate":"2024-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10147532","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Maria José Soler, Conxita Jacobs Cachá, Hans-Joachim Anders
{"title":"Correspondence on: 'SGLT2 inhibitors alleviated podocyte damage in lupus nephritis by decreasing inflammation and enhancing autophagy' by Zhao <i>et al</i>.","authors":"Maria José Soler, Conxita Jacobs Cachá, Hans-Joachim Anders","doi":"10.1136/ard-2023-225248","DOIUrl":"10.1136/ard-2023-225248","url":null,"abstract":"","PeriodicalId":8087,"journal":{"name":"Annals of the Rheumatic Diseases","volume":null,"pages":null},"PeriodicalIF":20.3,"publicationDate":"2024-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139085623","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Denise Beckmann, Annika Krause, Uwe Hansen, Hans P Kiener, Thomas Karonitsch, Stephan Blüml, Joachim Kremerskothen, Hermann Pavenstädt, Thomas Pap, Adelheid Korb-Pap
{"title":"Focal adhesion protein Lasp1 links the Arp2/3 complex to adherens junctions and promotes motility of arthritic fibroblast-like synoviocytes.","authors":"Denise Beckmann, Annika Krause, Uwe Hansen, Hans P Kiener, Thomas Karonitsch, Stephan Blüml, Joachim Kremerskothen, Hermann Pavenstädt, Thomas Pap, Adelheid Korb-Pap","doi":"10.1136/ard-2023-225241","DOIUrl":"10.1136/ard-2023-225241","url":null,"abstract":"","PeriodicalId":8087,"journal":{"name":"Annals of the Rheumatic Diseases","volume":null,"pages":null},"PeriodicalIF":20.3,"publicationDate":"2024-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139904863","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Greetings from the editor 2024/2.","authors":"Josef S Smolen","doi":"10.1136/ard-2024-226019","DOIUrl":"https://doi.org/10.1136/ard-2024-226019","url":null,"abstract":"","PeriodicalId":8087,"journal":{"name":"Annals of the Rheumatic Diseases","volume":null,"pages":null},"PeriodicalIF":27.4,"publicationDate":"2024-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140943915","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Kamyar Moradi, Robert M Kwee, Bahram Mohajer, Ali Guermazi, Frank W Roemer, Hamza Ahmed Ibad, Ida K Haugen, Francis Berenbaum, Shadpour Demehri
Objectives: There is no evidence linking specific osteoarthritis (OA) types, such as erosive hand OA (EHOA), with distant generalised changes in muscle composition (sarcopenia), which can potentially be modified. This study pioneers the exploration of the association between EHOA and sarcopenia, both of which are predominantly observed in the older adults.
Methods: Using the Osteoarthritis Initiative cohort, we selected hand OA (modified Kellgren and Lawrence (grade ≥2 in ≥1 hand joint) participants with radiographic central erosions in ≥1 joints (EHOA group) and propensity score-matched hand OA participants with no erosion (non-EHOA group). MRI biomarkers of thigh muscles were measured at baseline, year 2 and year 4 using a validated deep-learning algorithm. To adjust for 'local' effects of coexisting knee OA (KOA), participants were further stratified according to presence of radiographic KOA. The outcomes were the differences between EHOA and non-EHOA groups in the 4-year rate of change for both intramuscular adipose tissue (intra-MAT) deposition and contractile (non-fat) area of thigh muscles.
Results: After adjusting for potential confounders, 844 thighs were included (211 EHOA:633 non-EHOA; 67.1±7.5 years, female/male:2.9). Multilevel mixed-effect regression models showed that EHOA is associated a different 4-year rate of change in intra-MAT deposition (estimate, 95% CI: 71.5 mm2/4 years, 27.9 to 115.1) and contractile area (estimate, 95% CI: -1.8%/4 years, -2.6 to -1.0) of the Quadriceps. Stratified analyses showed that EHOA presence is associated with adverse changes in thigh muscle quality only in participants without KOA.
Conclusions: EHOA is associated with longitudinal worsening of thigh muscle composition only in participants without concomitant KOA. Further research is needed to understand the systemic factors linking EHOA and sarcopenia, which unlike EHOA is modifiable through specific interventions.
{"title":"Erosive hand osteoarthritis and sarcopenia: data from Osteoarthritis Initiative cohort.","authors":"Kamyar Moradi, Robert M Kwee, Bahram Mohajer, Ali Guermazi, Frank W Roemer, Hamza Ahmed Ibad, Ida K Haugen, Francis Berenbaum, Shadpour Demehri","doi":"10.1136/ard-2023-224997","DOIUrl":"10.1136/ard-2023-224997","url":null,"abstract":"<p><strong>Objectives: </strong>There is no evidence linking specific osteoarthritis (OA) types, such as erosive hand OA (EHOA), with distant generalised changes in muscle composition (sarcopenia), which can potentially be modified. This study pioneers the exploration of the association between EHOA and sarcopenia, both of which are predominantly observed in the older adults.</p><p><strong>Methods: </strong>Using the Osteoarthritis Initiative cohort, we selected hand OA (modified Kellgren and Lawrence (grade ≥2 in ≥1 hand joint) participants with radiographic central erosions in ≥1 joints (EHOA group) and propensity score-matched hand OA participants with no erosion (non-EHOA group). MRI biomarkers of thigh muscles were measured at baseline, year 2 and year 4 using a validated deep-learning algorithm. To adjust for 'local' effects of coexisting knee OA (KOA), participants were further stratified according to presence of radiographic KOA. The outcomes were the differences between EHOA and non-EHOA groups in the 4-year rate of change for both intramuscular adipose tissue (intra-MAT) deposition and contractile (non-fat) area of thigh muscles.</p><p><strong>Results: </strong>After adjusting for potential confounders, 844 thighs were included (211 EHOA:633 non-EHOA; 67.1±7.5 years, female/male:2.9). Multilevel mixed-effect regression models showed that EHOA is associated a different 4-year rate of change in intra-MAT deposition (estimate, 95% CI: 71.5 mm<sup>2</sup>/4 years, 27.9 to 115.1) and contractile area (estimate, 95% CI: -1.8%/4 years, -2.6 to -1.0) of the Quadriceps. Stratified analyses showed that EHOA presence is associated with adverse changes in thigh muscle quality only in participants without KOA.</p><p><strong>Conclusions: </strong>EHOA is associated with longitudinal worsening of thigh muscle composition only in participants without concomitant KOA. Further research is needed to understand the systemic factors linking EHOA and sarcopenia, which unlike EHOA is modifiable through specific interventions.</p>","PeriodicalId":8087,"journal":{"name":"Annals of the Rheumatic Diseases","volume":null,"pages":null},"PeriodicalIF":20.3,"publicationDate":"2024-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139501854","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Tuva Moseng, Theodora P M Vliet Vlieland, Simone Battista, David Beckwée, Vladimira Boyadzhieva, Philip G Conaghan, Daniela Costa, Michael Doherty, Andrew G Finney, Tsvetoslav Georgiev, Milena Gobbo, Norelee Kennedy, Ingvild Kjeken, Féline P B Kroon, L Stefan Lohmander, Hans Lund, Christian D Mallen, Karel Pavelka, Irene A Pitsillidou, Margaret P Rayman, Anne Therese Tveter, Johanna E Vriezekolk, Dieter Wiek, Gustavo Zanoli, Nina Østerås
Introduction: Hip and knee osteoarthritis (OA) are increasingly common with a significant impact on individuals and society. Non-pharmacological treatments are considered essential to reduce pain and improve function and quality of life. EULAR recommendations for the non-pharmacological core management of hip and knee OA were published in 2013. Given the large number of subsequent studies, an update is needed.
Methods: The Standardised Operating Procedures for EULAR recommendations were followed. A multidisciplinary Task Force with 25 members representing 14 European countries was established. The Task Force agreed on an updated search strategy of 11 research questions. The systematic literature review encompassed dates from 1 January 2012 to 27 May 2022. Retrieved evidence was discussed, updated recommendations were formulated, and research and educational agendas were developed.
Results: The revised recommendations include two overarching principles and eight evidence-based recommendations including (1) an individualised, multicomponent management plan; (2) information, education and self-management; (3) exercise with adequate tailoring of dosage and progression; (4) mode of exercise delivery; (5) maintenance of healthy weight and weight loss; (6) footwear, walking aids and assistive devices; (7) work-related advice and (8) behaviour change techniques to improve lifestyle. The mean level of agreement on the recommendations ranged between 9.2 and 9.8 (0-10 scale, 10=total agreement). The research agenda highlighted areas related to these interventions including adherence, uptake and impact on work.
Conclusions: The 2023 updated recommendations were formulated based on research evidence and expert opinion to guide the optimal management of hip and knee OA.
{"title":"EULAR recommendations for the non-pharmacological core management of hip and knee osteoarthritis: 2023 update.","authors":"Tuva Moseng, Theodora P M Vliet Vlieland, Simone Battista, David Beckwée, Vladimira Boyadzhieva, Philip G Conaghan, Daniela Costa, Michael Doherty, Andrew G Finney, Tsvetoslav Georgiev, Milena Gobbo, Norelee Kennedy, Ingvild Kjeken, Féline P B Kroon, L Stefan Lohmander, Hans Lund, Christian D Mallen, Karel Pavelka, Irene A Pitsillidou, Margaret P Rayman, Anne Therese Tveter, Johanna E Vriezekolk, Dieter Wiek, Gustavo Zanoli, Nina Østerås","doi":"10.1136/ard-2023-225041","DOIUrl":"10.1136/ard-2023-225041","url":null,"abstract":"<p><strong>Introduction: </strong>Hip and knee osteoarthritis (OA) are increasingly common with a significant impact on individuals and society. Non-pharmacological treatments are considered essential to reduce pain and improve function and quality of life. EULAR recommendations for the non-pharmacological core management of hip and knee OA were published in 2013. Given the large number of subsequent studies, an update is needed.</p><p><strong>Methods: </strong>The Standardised Operating Procedures for EULAR recommendations were followed. A multidisciplinary Task Force with 25 members representing 14 European countries was established. The Task Force agreed on an updated search strategy of 11 research questions. The systematic literature review encompassed dates from 1 January 2012 to 27 May 2022. Retrieved evidence was discussed, updated recommendations were formulated, and research and educational agendas were developed.</p><p><strong>Results: </strong>The revised recommendations include two overarching principles and eight evidence-based recommendations including (1) an individualised, multicomponent management plan; (2) information, education and self-management; (3) exercise with adequate tailoring of dosage and progression; (4) mode of exercise delivery; (5) maintenance of healthy weight and weight loss; (6) footwear, walking aids and assistive devices; (7) work-related advice and (8) behaviour change techniques to improve lifestyle. The mean level of agreement on the recommendations ranged between 9.2 and 9.8 (0-10 scale, 10=total agreement). The research agenda highlighted areas related to these interventions including adherence, uptake and impact on work.</p><p><strong>Conclusions: </strong>The 2023 updated recommendations were formulated based on research evidence and expert opinion to guide the optimal management of hip and knee OA.</p>","PeriodicalId":8087,"journal":{"name":"Annals of the Rheumatic Diseases","volume":null,"pages":null},"PeriodicalIF":20.3,"publicationDate":"2024-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11103326/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139428329","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}