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Prediagnostic Amino Acid Metabolites and Risk of Gout, Accounting for Serum Urate: Prospective Cohort Study and Mendelian Randomization. 诊断前氨基酸代谢物与痛风风险(考虑血清尿酸盐):前瞻性队列研究与孟德尔随机化。
IF 3.7 2区 医学 Q1 RHEUMATOLOGY Pub Date : 2024-08-21 DOI: 10.1002/acr.25420
Natalie McCormick, Amit D Joshi, Chio Yokose, Bing Yu, Adrienne Tin, Robert Terkeltaub, Tony R Merriman, Oana Zeleznik, A Heather Eliassen, Gary C Curhan, Hang-Korng Ea, Matthew Nayor, Laura M Raffield, Hyon K Choi

Objective: Our objective was to prospectively investigate prediagnostic population-based metabolome for risk of hospitalized gout (ie, most accurate, severe, and costly cases), accounting for serum urate.

Methods: We conducted prediagnostic metabolome-wide analyses among 249,677 UK Biobank participants with nuclear magnetic resonance metabolomic profiling (N = 168 metabolites, including eight amino acids) from baseline blood samples (2006-2010) without a history of gout. We calculated multivariable hazard ratios (HRs) for hospitalized incident gout, before and after adjusting for serum urate levels; we included patients with nonhospitalized incident gout in a sensitivity analysis. Potential causal effects were evaluated with two-sample Mendelian randomization.

Results: Correcting for multiple testing, 107 metabolites were associated with incidence of hospitalized gout (n = 2,735) before urate adjustment, including glycine and glutamine (glutamine HR 0.64, 95% confidence interval [CI] 0.54-0.75, P = 8.3 × 10-8; glycine HR 0.69, 95% CI 0.61-0.78, P = 3.3 × 10-9 between extreme quintiles), and glycoprotein acetyls (HR 2.48, 95% CI 2.15-2.87, P = 1.96 × 10-34). Associations remained significant and directionally consistent following urate adjustment (HR 0.83, 95% CI 0.70-0.98; HR 0.86, 95% CI 0.76-0.98; HR 1.41, 95% CI 1.21-1.63 between extreme quintiles), respectively; corresponding HRs per SD were 0.91 (95% CI 0.86-0.97), 0.94 (95% CI 0.91-0.98), and 1.10 (95% CI 1.06-1.14). Findings persisted when including patients with nonhospitalized incident gout. Mendelian randomization corroborated their potential causal role on hyperuricemia or gout risk; with change in urate levels of -0.05 mg/dL (95% CI -0.08 to -0.01) and -0.12 mg/dL (95% CI -0.22 to -0.03) per SD of glycine and glutamine, respectively, and odds ratios of 0.94 (95% CI 0.88-1.00) and 0.81 (95% CI 0.67-0.97) for gout.

Conclusion: These prospective findings with causal implications could lead to biomarker-based risk prediction and potential supplementation-based interventions with glycine or glutamine.

研究目的我们的目标是在考虑血清尿酸盐的情况下,前瞻性地研究基于人群的诊断前代谢组,以了解住院痛风(即最准确、最严重、花费最高的病例)的风险:我们对 249,677 名英国生物库参与者的基线血液样本(2006-2010 年)进行了 NMR 代谢组分析(N=168 种代谢物,包括 8 种氨基酸),并对无痛风病史的参与者进行了诊断前全代谢组分析。在调整血清尿酸水平之前和之后,我们计算了住院痛风发病的多变量危险比(HRs);在一项敏感性分析中,我们纳入了非住院痛风发病病例。我们采用双样本孟德尔随机法评估了潜在的因果效应:结果:校正多重检验后,107 种代谢物与尿酸调整前的住院痛风发病率(N=2735)相关,包括甘氨酸和谷氨酰胺(成反比;HR=0.64[95%CI:0.54,0.75],P=8.3x10-8和HR=0.69[0.61,0.78],P=3.3x10-9),以及糖蛋白乙酰(GlycA;HR=2.48[2.15,2.87],P=1.96x10-34)。尿酸调整后,相关性仍很明显且方向一致(HR=0.83 [0.70,0.98],0.86 [0.76,0.98],极端五分位数之间为 1.41 [1.21,1.63]);每 SD 的相应 HR 分别为 0.91 (0.86,0.97),0.94 (0.91,0.98) 和 1.10 (1.06,1.14)。如果将非住院的痛风病例也包括在内,结果依然如此。孟德尔随机分析证实了它们对高尿酸血症或痛风风险的潜在因果作用;甘氨酸和谷氨酰胺每增加 SD,尿酸水平的变化分别为-0.05 mg/dL (-0.08, -0.01)和-0.12 mg/dL (-0.22, -0.03),而痛风的 OR 分别为 0.94 (0.88, 1.00)和 0.81 (0.67, 0.97):这些具有因果影响的前瞻性研究结果可用于基于生物标志物的风险预测和潜在的甘氨酸或谷氨酰胺补充剂干预。
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引用次数: 0
Neighborhood Characteristics & Walking Behavior Among Adults with Arthritis: An NHIS Study. 邻里特征与患有关节炎的成年人的步行行为:一项国家健康调查研究
IF 3.7 2区 医学 Q1 RHEUMATOLOGY Pub Date : 2024-08-19 DOI: 10.1002/acr.25418
Ciri Pocha, Timothy Chrusciel, Joanne Salas, Seth Eisen, Leigh Callahan, Marcia G Ory, Jeffrey F Scherrer, Sarah Gebauer

Objective: This study investigated the association of perceived neighborhood qualities with likelihood of transit walking, leisure walking, neighborhood walking, and meeting physical activity (PA) recommendations among US adults with arthritis.

Methods: This cross-sectional study utilized 2020 National Health Interview Survey data. Included participants were adults reporting clinician-diagnosed arthritis and who reported the ability to walk. Exposures of interest were perceived neighborhood attributes. Outcomes were transit walking, leisure walking, neighborhood walking, and meeting PA recommendations. Standardized mean difference percent (SMD%) was used to assess relationships between exposures and outcomes with SMD% >10% resulting in inclusion in final adjusted multivariate logistic regression models for odds of outcomes. All analyses were weighted to account for complex survey methodology.

Results: The analytic sample included 7,322 adults with arthritis. Fully adjusted logistic regression models showed presence of roads to walk on was associated with meeting PA recommendations (OR=1.26[95%CI=1.07-1.49]). Three attributes were positively associated with transit walking, while safety from crime was negatively associated (OR=2.33[95%CI=1.75-3.10], OR=1.49[95%CI=1.17-1.91], OR=1.67[95%CI=1.34-2.08]), OR=0.70[95%CI=0.53-0.92]). Roads to walk and places to walk and relax were associated with leisure and neighborhood walking (OR=1.46[95%CI=1.21-1.76], OR=1.56[95%CI=1.34-1.82], OR=1.58[95%CI=1.29-1.93], OR=1.63[95%CI=1.40-1.90], respectively).

Conclusion: This study identified several neighborhood characteristics associated with higher likelihood of walking behaviors among adults with arthritis. Factors associated with walking behavior varied by type of walking. The shared correlates between leisure and neighborhood walking imply they occur in the same setting. Patients with arthritis may benefit from exercise recommendations that are informed by the presence or absence of facilitating infrastructure in their neighborhoods.

目的:本研究调查了患有关节炎的美国成年人感知到的邻里品质与公交步行、休闲步行、邻里步行以及满足体育锻炼建议的可能性之间的关系:本研究调查了患有关节炎的美国成年人感知到的邻里品质与公交步行、休闲步行、邻里步行以及满足身体活动(PA)建议的可能性之间的关系:这项横断面研究利用了 2020 年全国健康访谈调查数据。研究对象为经临床医生确诊患有关节炎且有步行能力的成年人。关注的暴露因素是感知到的邻里属性。研究结果包括公交步行、休闲步行、邻里步行和满足 PA 建议。标准化平均差异百分率(SMD%)用于评估暴露与结果之间的关系,SMD%>10%的暴露将被纳入最终调整的多变量逻辑回归模型,以计算结果的几率。所有分析均已加权,以考虑复杂的调查方法:分析样本包括 7322 名成人关节炎患者。完全调整后的逻辑回归模型显示,是否有可供步行的道路与是否符合体育锻炼建议有关(OR=1.26[95%CI=1.07-1.49])。三个属性与过境步行呈正相关,而与犯罪安全呈负相关(OR=2.33[95%CI=1.75-3.10]、OR=1.49[95%CI=1.17-1.91]、OR=1.67[95%CI=1.34-2.08]),OR=0.70[95%CI=0.53-0.92])。步行道路和步行休闲场所与休闲和邻里步行相关(OR=1.46[95%CI=1.21-1.76],OR=1.56[95%CI=1.34-1.82],OR=1.58[95%CI=1.29-1.93],OR=1.63[95%CI=1.40-1.90]):本研究发现了一些与患有关节炎的成年人更有可能采取步行行为相关的邻里特征。与步行行为相关的因素因步行类型而异。休闲步行和邻里步行之间的共同相关性意味着它们发生在相同的环境中。根据社区内是否存在便利的基础设施,为关节炎患者提供锻炼建议,可能会使他们受益。
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引用次数: 0
Long-Term Mortality Following SARS-CoV-2 Infection in Rural Versus Urban Dwellers With Autoimmune or Inflammatory Rheumatic Disease: A Retrospective Cohort Analysis From the National COVID Cohort Collaborative. 患有自身免疫性或炎症性风湿病 (AIRD) 的农村居民与城市居民感染 SARS-CoV-2 后的长期死亡率:全国 COVID 队列协作组织 (N3C) 的回顾性队列分析。
IF 3.7 2区 医学 Q1 RHEUMATOLOGY Pub Date : 2024-08-19 DOI: 10.1002/acr.25421
A Jerrod Anzalone, Lesley E Jackson, Namrata Singh, Maria I Danila, Elizabeth Reisher, Rena C Patel, Jasvinder A Singh

Objective: Autoimmune or inflammatory rheumatic diseases (AIRDs) increase the risk for poor COVID-19 outcomes. Although rurality is associated with higher post-COVID-19 mortality in the general population, whether rurality elevates this risk among people with AIRD is unknown. We assessed associations between rurality and post-COVID-19 all-cause mortality, up to two years post infection, among people with AIRD using a large nationally sampled US cohort.

Methods: This retrospective study used the National COVID Cohort Collaborative, a medical records repository containing COVID-19 patient data. We included adults with two or more AIRD diagnostic codes and a COVID-19 diagnosis documented between April 2020 and March 2023. Rural residency was categorized using patient residential zip codes. We adjusted for AIRD medications and glucocorticoid prescription, age, sex, race and ethnicity, tobacco or substance use, comorbid burden, and SARS-CoV-2 variant-dominant periods. Multivariable Cox proportional hazards with inverse probability treatment weighting assessed associations between rurality and two-year all-cause mortality.

Results: Among the 86,467 SARS-CoV-2-infected persons with AIRD, we observed a higher risk for two-year post-COVID-19 mortality in rural versus urban dwellers. Rural-residing persons with AIRD had higher two-year all-cause mortality risk (adjusted hazard ratio 1.24, 95% confidence interval 1.19-1.29). Glucocorticoid, immunosuppressive, and rituximab prescriptions were associated with a higher risk for two-year post-COVID-19 mortality, whereas risk with nonbiologic or biologic disease-modifying antirheumatic drugs was lower.

Conclusion: Rural residence in people with AIRD was independently associated with higher two-year post-COVID-19 mortality in a large US cohort after adjusting for background risk factors. Policymakers and health care providers should consider these findings when designing interventions to improve outcomes in people with AIRD following SARS-CoV-2 infection, especially among high-risk rural residents.

目的:自身免疫性或炎症性风湿病(AIRD)会增加 COVID-19 后不良预后的风险。在一般人群中,乡村地区与 COVID-19 后较高的死亡率有关,但乡村地区是否会增加 AIRD 患者的这一风险尚不清楚。我们通过一项大型的美国全国性抽样队列研究,评估了乡村地区与 AIRD 患者感染 COVID-19 后长达 2 年的全因死亡率之间的关系:方法:这项回顾性研究利用了国家 COVID 队列协作组织(National COVID Cohort Collaborative),这是一个包含 COVID-19 患者数据的医疗记录库。我们纳入了在 2020 年 4 月至 2023 年 3 月期间记录有≥2 个 AIRD 诊断代码和 COVID-19 诊断的成年人。农村居住地根据患者居住地邮政编码进行分类。我们对 AIRD 药物和糖皮质激素使用情况、年龄、性别、种族和民族、烟草/药物使用情况、合并症负担和 SARS-CoV-2 变体主导期进行了调整。采用逆概率治疗加权的多变量 Cox 比例危险度评估了乡村地区与 2 年全因死亡率之间的关系:在 86,467 名 SARS-CoV-2 感染者中,我们发现农村居民与城市居民相比,在 COVID-19 后 2 年的死亡风险更高。居住在农村的 AIRD 患者 2 年全因死亡风险更高(aHR 1.24,95% CI 1.19-1.29)。使用糖皮质激素、免疫抑制剂和利妥昔单抗与COVID-19后2年死亡风险较高有关,而使用非生物或生物DMARDs的风险较低:结论:在一个大型美国队列中,AIRD患者居住在农村与COVID-19后2年较高的死亡率有独立的相关性。政策制定者和医疗服务提供者在设计干预措施以改善SARS-CoV-2感染后AIRD患者的预后时应考虑这些发现,尤其是在风险较高的农村居民中。
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引用次数: 0
Family history of arthritis, osteoporosis, and carpal tunnel syndrome and risk of these conditions among U.S. adults. 关节炎、骨质疏松症和腕管综合征家族史与美国成年人患这些疾病的风险。
IF 3.7 2区 医学 Q1 RHEUMATOLOGY Pub Date : 2024-08-19 DOI: 10.1002/acr.25416
Danielle Rasooly, Ramal Moonesinghe, Elizabeth Fallon, Kamil E Barbour, Muin J Khoury

Objective: The aim was to estimate odds ratios of associations between family history of arthritis, osteoporosis, and carpal tunnel syndrome and prevalence in a real-world population, uncovering family histories of related conditions that may increase risk due to shared heritability, condition pathophysiology, or social/environmental factors.

Methods: Using data from 156,307 participants in the All of Us (AoU) Research Program, we examined associations between self-reported first-degree family history of 5 common types of arthritis (fibromyalgia, gout, osteoarthritis (OA), rheumatoid arthritis (RA), and systemic lupus erythematosus (SLE)), osteoporosis, and carpal tunnel syndrome and prevalence. We evaluate associations across 7 conditions and performed stratified analyses by race and ethnicity, sex, socioeconomic differences, body mass index, and type of affected relative.

Results: Over 38% of AoU participants reported a family history of any arthritis, osteoporosis, or carpal tunnel syndrome. Adults with a family history of any arthritis, osteoporosis, and carpal tunnel syndrome exhibited 3.68 to 7.59 (4.90, on average) odds of having the same condition, and 0.70 to 2.10 (1.24, on average) odds of having a different condition. The strongest associations observed were between family history of OA and prevalence of OA (OR 7.59, 95%CI 7.32-7.88), and family history of SLE and prevalence of SLE (OR 6.34, 95%CI 5.17-7.74). We additionally uncover race and ethnicity and sex disparities in family history associations.

Conclusion: Family history of several related conditions was associated with increased risk for arthritis, osteoporosis, and carpal tunnel syndrome, underscoring the importance of family history of related conditions for primary prevention.

目的目的是估算现实世界人群中关节炎、骨质疏松症和腕管综合征家族史与患病率之间的几率比,揭示可能因共同遗传性、病理生理学或社会/环境因素而增加风险的相关疾病家族史:利用 "我们所有人(AoU)研究计划 "中 156,307 名参与者的数据,我们研究了自我报告的 5 种常见关节炎(纤维肌痛、痛风、骨关节炎 (OA)、类风湿性关节炎 (RA) 和系统性红斑狼疮 (SLE))、骨质疏松症和腕管综合征的一级家族史与患病率之间的关联。我们评估了 7 种疾病之间的关联,并根据种族和民族、性别、社会经济差异、体重指数和受影响亲属的类型进行了分层分析:结果:超过 38% 的奥大参与者报告有关节炎、骨质疏松症或腕管综合征家族史。有关节炎、骨质疏松症和腕管综合征家族史的成年人患相同疾病的几率为 3.68 至 7.59(平均 4.90),患不同疾病的几率为 0.70 至 2.10(平均 1.24)。所观察到的最强关联是:OA 家族史与 OA 患病率之间的关联(OR 7.59,95%CI 7.32-7.88),以及系统性红斑狼疮家族史与系统性红斑狼疮患病率之间的关联(OR 6.34,95%CI 5.17-7.74)。此外,我们还发现了家族史相关性中的种族、民族和性别差异:结论:几种相关疾病的家族史与关节炎、骨质疏松症和腕管综合征风险的增加有关,强调了相关疾病家族史对一级预防的重要性。
{"title":"Family history of arthritis, osteoporosis, and carpal tunnel syndrome and risk of these conditions among U.S. adults.","authors":"Danielle Rasooly, Ramal Moonesinghe, Elizabeth Fallon, Kamil E Barbour, Muin J Khoury","doi":"10.1002/acr.25416","DOIUrl":"https://doi.org/10.1002/acr.25416","url":null,"abstract":"<p><strong>Objective: </strong>The aim was to estimate odds ratios of associations between family history of arthritis, osteoporosis, and carpal tunnel syndrome and prevalence in a real-world population, uncovering family histories of related conditions that may increase risk due to shared heritability, condition pathophysiology, or social/environmental factors.</p><p><strong>Methods: </strong>Using data from 156,307 participants in the All of Us (AoU) Research Program, we examined associations between self-reported first-degree family history of 5 common types of arthritis (fibromyalgia, gout, osteoarthritis (OA), rheumatoid arthritis (RA), and systemic lupus erythematosus (SLE)), osteoporosis, and carpal tunnel syndrome and prevalence. We evaluate associations across 7 conditions and performed stratified analyses by race and ethnicity, sex, socioeconomic differences, body mass index, and type of affected relative.</p><p><strong>Results: </strong>Over 38% of AoU participants reported a family history of any arthritis, osteoporosis, or carpal tunnel syndrome. Adults with a family history of any arthritis, osteoporosis, and carpal tunnel syndrome exhibited 3.68 to 7.59 (4.90, on average) odds of having the same condition, and 0.70 to 2.10 (1.24, on average) odds of having a different condition. The strongest associations observed were between family history of OA and prevalence of OA (OR 7.59, 95%CI 7.32-7.88), and family history of SLE and prevalence of SLE (OR 6.34, 95%CI 5.17-7.74). We additionally uncover race and ethnicity and sex disparities in family history associations.</p><p><strong>Conclusion: </strong>Family history of several related conditions was associated with increased risk for arthritis, osteoporosis, and carpal tunnel syndrome, underscoring the importance of family history of related conditions for primary prevention.</p>","PeriodicalId":8406,"journal":{"name":"Arthritis Care & Research","volume":null,"pages":null},"PeriodicalIF":3.7,"publicationDate":"2024-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141999380","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Development of the 2023 ACR/EULAR Antiphospholipid Syndrome Classification Criteria, Phase III-D Report: Multicriteria Decision Analysis. 制定 2023 年 ACR/EULAR 抗磷脂综合征分类标准,III-D 阶段报告:多标准决策分析。
IF 3.7 2区 医学 Q1 RHEUMATOLOGY Pub Date : 2024-08-12 DOI: 10.1002/acr.25415
Medha Barbhaiya, Stephane Zuily, Mary-Carmen Amigo, Danieli Andrade, Tadej Avcin, Maria Laura Bertolaccini, D Ware Branch, Nathalie Costedoat-Chalumeau, Mark Crowther, Guilherme Ramires de Jesus, Katrien M J Devreese, Camille Frances, David Garcia, Jose A Gómez-Puerta, Francis Guillemin, Steven R Levine, Roger A Levy, Michael D Lockshin, Thomas L Ortel, Michelle Petri, Giovanni Sanna, Savino Sciascia, Surya V Seshan, Maria G Tektonidou, Denis Wahl, Rohan Willis, Cecile Yelnik, Alison Hendry, Ray Naden, Karen Costenbader, Doruk Erkan

Objective: The 2023 American College of Rheumatology/EULAR antiphospholipid syndrome (APS) classification criteria development, which aimed to identify patients with high likelihood of APS for research, employed a four-phase methodology. Phase I and II resulted in 27 proposed candidate criteria, which are organized into laboratory and clinical domains. Here, we summarize the last stage of phase III efforts, employing a consensus-based multicriteria decision analysis (MCDA) to weigh candidate criteria and identify an APS classification threshold score.

Methods: We evaluated 192 unique, international real-world patients referred for "suspected APS" with a wide range of APS manifestations. Using proposed candidate criteria, subcommittee members rank ordered 20 representative patients from highly unlikely to highly likely to have APS. During an in-person meeting, the subcommittee refined definitions and participated in an MCDA exercise to identify relative weights of candidate criteria. Using consensus decisions and pairwise criteria comparisons, 1000Minds software assigned criteria weights, and we rank ordered 192 patients by their additive scores. A consensus-based threshold score for APS classification was set.

Results: Premeeting evaluation of 20 representative patients demonstrated variability in APS assessment. MCDA resolved 81 pairwise decisions; relative weights identified domain item hierarchy. After assessing 192 patients by weights and additive scores, the Steering Committee reached consensus that APS classification should require separate clinical and laboratory scores, rather than a single-aggregate score, to ensure high specificity.

Conclusion: Using MCDA, candidate criteria preliminary weights were determined. Unlike other disease classification systems using a single-aggregate threshold score, separate clinical and laboratory domain thresholds were incorporated into the new APS classification criteria.

背景:2023 年 ACR/EULAR 抗磷脂综合征(APS)分类标准的制定,旨在为研究工作确定极有可能患有 APS 的患者,采用了四阶段方法。第一和第二阶段提出了 27 项候选标准,分为实验室和临床两个领域。在此,我们总结了第三阶段最后一个阶段的工作,即采用基于共识的多标准决策分析(MCDA)来权衡候选标准并确定 APS 分类阈值得分:我们评估了 192 例因 "疑似 APS "而转诊的国际真实病例,这些病例具有多种 APS 表现。小组委员会成员采用提议的候选标准,将 20 个具有代表性的病例从极不可能 APS 到极有可能 APS 排序。在一次面对面的会议上,分会对定义进行了完善,并参与了MCDA演练,以确定候选标准的相对权重。1000Minds™ 软件采用共识决策和成对标准比较的方法分配标准权重,我们按照 192 个病例的相加分数进行了排序。结果:对 20 个代表性病例的会前评估表明,APS 评估存在差异。MCDA 解决了 81 个配对决定;相对权重确定了领域项目层次。在对 192 个病例进行权重和加分评估后,指导委员会达成共识,认为 APS 分类应要求分别进行临床和实验室评分,而不是单一的综合评分,以确保高特异性:结论:利用 MCDA,确定了候选标准的初步权重。与其他使用单一总阈值得分的疾病分类系统不同,新的 APS 分类标准中纳入了单独的临床和实验室领域阈值。
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引用次数: 0
Biomarker Changes in Response to Tofacitinib Treatment in Patients with Polyarticular Course Juvenile Idiopathic Arthritis. 多关节病程幼年特发性关节炎患者接受托法替尼治疗后的生物标志物变化
IF 3.7 2区 医学 Q1 RHEUMATOLOGY Pub Date : 2024-08-12 DOI: 10.1002/acr.25417
Ekemini A Ogbu, Hermine I Brunner, Esraa Eloseily, Yonatan Butbul Aviel, Kabita Nanda, Heinrike Schmeling, Heather Tory, Yosef Uziel, Diego Oscar Viola, Dawn M Wahezi, Stacey E Tarvin, Alyssa Sproles, Chen Chen, Nicolino Ruperto, Bin Huang, Alexei Grom, Sherry Thornton

Objective: Examine levels of candidate blood-based biomarkers (CBB) in juvenile idiopathic arthritis (JIA) treated with tofacitinib.

Methods: JIA patients who participated in clinical trial NCT02592434 received tofacitinib from baseline to week 18. Serial serum samples were assayed for CBB (S100A8/9, S100A12, IL-18, SAA, resistin, VEGF, Angiopoietin-1, Angiopoietin-2, MMP8, MMP2, TIMP1, Leptin, CXCL9, sIL2R, ICAM-1, sTNFr, IL-6, IL-23, MCP1, CCL18, and CCL20). Association of CBB with JIA response to treatment from baseline to week 18 were assessed.

Results: This study included 166 patients with polyarticular-course JIA. Paired serum samples from 143 patients were available at both baseline and week 18. There were 35% (50/143) of patients with a JIA-American College of Rheumatology 90 (JIA-ACR90) level improvement while 90/121/137 (63%/85%/96%) achieved JIA-ACR70/50/30 improvement at wk18. Despite small numerical differences by JIA category, there were no baseline CBB values that independently predicted a decrease in JADAS-27 or JIA-ACR90 response by week 18. Decrease in resistin level (baseline to week 18) was significantly associated with wk18 improvement in JADAS-27 and JIA-ACR90 response, after adjusting for age, sex, JIA disease duration and baseline resistin [(r2 0.79, SE, 0.070, p<0.01 and OR(95%CI) = 1.134(1.018, 1.264)]. HLA-B27 positivity was significantly associated with not achieving a JIA-ACR90 response at week 18 (p=0.0097).

Conclusion: Among the CBB included, only resistin was significantly associated with treatment response, and no CBB was identified that forecasts JIA improvement after initiation of tofacitinib. The association of HLA-B27 positivity with lower response to tofacitinib in JIA is intriguing and merits further study.

目的:研究接受托法替尼治疗的幼年特发性关节炎(JIA)患者的候选血液生物标志物(CBB)水平:研究接受托法替尼治疗的幼年特发性关节炎(JIA)患者的候选血液生物标志物(CBB)水平:参加 NCT02592434 临床试验的幼年特发性关节炎患者从基线到第 18 周均接受了托法替尼治疗。对连续血清样本进行CBB(S100A8/9、S100A12、IL-18、SAA、抵抗素、血管内皮生长因子、血管生成素-1、血管生成素-2、MMP8、MMP2、TIMP1、瘦素、CXCL9、sIL2R、ICAM-1、sTNFr、IL-6、IL-23、MCP1、CCL18和CCL20)检测。评估了从基线到第18周CBB与JIA治疗反应的关系:本研究共纳入了166名多关节型JIA患者。143名患者的配对血清样本在基线和第18周均可获得。有 35% 的患者(50/143)在第 18 周达到了美国风湿病学会 JIA-ACR90 (JIA-ACR90) 的改善水平,而 90/121/137 的患者(63%/85%/96%)在第 18 周达到了 JIA-ACR70/50/30 的改善水平。尽管不同的 JIA 类别在数值上存在微小差异,但没有任何 CBB 基线值能够独立预测第 18 周时 JADAS-27 或 JIA-ACR90 反应的下降。在对年龄、性别、JIA 病程和基线抵抗素进行调整后,抵抗素水平的下降(从基线到第 18 周)与第 18 周 JADAS-27 和 JIA-ACR90 反应的改善显著相关[(r2 0.79, SE, 0.070, p结论:在纳入的CBB中,只有抗阻素与治疗反应显著相关,没有发现CBB能预测开始使用托法替尼后JIA的改善情况。HLA-B27阳性与JIA患者对托法替尼反应较低有关,这一点很有意思,值得进一步研究。
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引用次数: 0
Baseline Dual-Energy Computed Tomography Urate Volume Predicts Fulfillment of Gout Remission After Two Years of Urate-Lowering Therapy. 基线双能计算机断层扫描尿酸盐容量可预测降尿酸治疗两年后痛风缓解的实现情况。
IF 3.7 2区 医学 Q1 RHEUMATOLOGY Pub Date : 2024-08-12 DOI: 10.1002/acr.25414
Adwoa Dansoa Tabi-Amponsah, Sarah Stewart, Greg Gamble, Anthony J Doyle, Karen Billington, Chang-Nam Son, Kieran Latto, Lisa K Stamp, William J Taylor, Anne Horne, Nicola Dalbeth

Objective: This study aimed to identify variables that predict gout remission in people with erosive gout receiving urate-lowering therapy.

Methods: We analyzed data from a two-year, double-masked randomized-controlled trial of people with erosive gout, randomized to a serum urate target of <0.20 mmol/L or <0.30 mmol/L using oral urate-lowering therapies. All participants had dual-energy computed tomography (DECT) scans of the feet and ankles at baseline. The proportion of participants achieving gout remission according to the 2016 preliminary gout remission criteria and simplified gout remission criteria (without the patient reported outcomes) was analyzed. Logistic regression models were used to evaluate predictors of gout remission in year 2.

Results: The preliminary gout remission criteria were fulfilled in 11 of 97 participants (11%) at year 1 and 21 of 92 participants (23%) at year 2. The simplified criteria were fulfilled in 26 of 97 participants (27%) in year 1 and 40 of 92 participants (44%) in year 2. In multivariable regression models, baseline DECT monosodium urate crystal volume was the only significant independent predictor of gout remission at year 2, using either criteria. Each 1-cm3 increase in the baseline DECT monosodium urate crystal volume decreased the odds of fulfilling the 2016 preliminary gout remission criteria (odds ratio [OR] 0.65, 95% confidence interval [CI] 0.46-0.93; P = 0.02) and the simplified gout remission criteria (OR 0.57, 95% CI 0.41-0.78; P < 0.001).

Conclusion: In people with erosive gout on urate-lowering therapy, higher baseline DECT monosodium urate crystal volume is associated with lower odds of gout remission after two years of treatment, defined by either the preliminary gout remission criteria or simplified gout remission criteria.

研究目的本研究旨在确定可预测接受降尿酸治疗的侵蚀性痛风患者痛风缓解的变量:我们分析了一项为期两年的侵蚀性痛风患者双盲随机对照试验的数据:第一年有 11/97 人(11%)符合痛风缓解初步标准,第二年有 21/92 人(23%)符合标准。第一年有 26/97 人(27%)符合简化标准,第二年有 40/92 人(44%)符合简化标准。在多变量回归模型中,无论采用哪种标准,基线 DECT 尿酸单钠晶体体积都是第二年痛风缓解的唯一重要独立预测因素。基线DECT单钠尿酸盐晶体体积每增加1立方厘米,符合2016年初步痛风缓解标准(0.65 [95% CI 0.46-0.93],p=0.02)和简化痛风缓解标准(0.57 [95% CI 0.41-0.78],p结论:在接受降尿酸治疗的侵蚀性痛风患者中,根据初步痛风缓解标准或简化痛风缓解标准,基线DECT单钠尿酸盐晶体体积越大,治疗两年后痛风缓解的几率越低。
{"title":"Baseline Dual-Energy Computed Tomography Urate Volume Predicts Fulfillment of Gout Remission After Two Years of Urate-Lowering Therapy.","authors":"Adwoa Dansoa Tabi-Amponsah, Sarah Stewart, Greg Gamble, Anthony J Doyle, Karen Billington, Chang-Nam Son, Kieran Latto, Lisa K Stamp, William J Taylor, Anne Horne, Nicola Dalbeth","doi":"10.1002/acr.25414","DOIUrl":"10.1002/acr.25414","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to identify variables that predict gout remission in people with erosive gout receiving urate-lowering therapy.</p><p><strong>Methods: </strong>We analyzed data from a two-year, double-masked randomized-controlled trial of people with erosive gout, randomized to a serum urate target of <0.20 mmol/L or <0.30 mmol/L using oral urate-lowering therapies. All participants had dual-energy computed tomography (DECT) scans of the feet and ankles at baseline. The proportion of participants achieving gout remission according to the 2016 preliminary gout remission criteria and simplified gout remission criteria (without the patient reported outcomes) was analyzed. Logistic regression models were used to evaluate predictors of gout remission in year 2.</p><p><strong>Results: </strong>The preliminary gout remission criteria were fulfilled in 11 of 97 participants (11%) at year 1 and 21 of 92 participants (23%) at year 2. The simplified criteria were fulfilled in 26 of 97 participants (27%) in year 1 and 40 of 92 participants (44%) in year 2. In multivariable regression models, baseline DECT monosodium urate crystal volume was the only significant independent predictor of gout remission at year 2, using either criteria. Each 1-cm<sup>3</sup> increase in the baseline DECT monosodium urate crystal volume decreased the odds of fulfilling the 2016 preliminary gout remission criteria (odds ratio [OR] 0.65, 95% confidence interval [CI] 0.46-0.93; P = 0.02) and the simplified gout remission criteria (OR 0.57, 95% CI 0.41-0.78; P < 0.001).</p><p><strong>Conclusion: </strong>In people with erosive gout on urate-lowering therapy, higher baseline DECT monosodium urate crystal volume is associated with lower odds of gout remission after two years of treatment, defined by either the preliminary gout remission criteria or simplified gout remission criteria.</p>","PeriodicalId":8406,"journal":{"name":"Arthritis Care & Research","volume":null,"pages":null},"PeriodicalIF":3.7,"publicationDate":"2024-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141970529","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Evaluating the associations between dysautonomia, gastrointestinal transit, and clinical phenotype in patients with systemic sclerosis 评估系统性硬化症患者自律神经失调、胃肠道转运和临床表型之间的关系
IF 4.7 2区 医学 Q1 RHEUMATOLOGY Pub Date : 2024-08-11 DOI: 10.1002/acr.25411
Maria Paula Alvarez-Hernandez, Brittany Adler, Jamie Perin, Michael Hughes, Zsuzsanna H. McMahan
Our objective was to identify systemic sclerosis (SSc) patients with a high burden of autonomic symptoms and to determine whether they have a distinct clinical phenotype, gastrointestinal (GI) transit or extraintestinal features.
我们的目的是找出自主神经症状较重的系统性硬化症(SSc)患者,并确定他们是否有独特的临床表型、胃肠道(GI)转运或肠外特征。
{"title":"Evaluating the associations between dysautonomia, gastrointestinal transit, and clinical phenotype in patients with systemic sclerosis","authors":"Maria Paula Alvarez-Hernandez, Brittany Adler, Jamie Perin, Michael Hughes, Zsuzsanna H. McMahan","doi":"10.1002/acr.25411","DOIUrl":"https://doi.org/10.1002/acr.25411","url":null,"abstract":"Our objective was to identify systemic sclerosis (SSc) patients with a high burden of autonomic symptoms and to determine whether they have a distinct clinical phenotype, gastrointestinal (GI) transit or extraintestinal features.","PeriodicalId":8406,"journal":{"name":"Arthritis Care & Research","volume":null,"pages":null},"PeriodicalIF":4.7,"publicationDate":"2024-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141942058","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Association of muscle quantity and quality with knee extension strength in knee osteoarthritis: the Nagahama study. 膝关节骨性关节炎患者肌肉数量和质量与膝关节伸展力量的关系:Nagahama 研究。
IF 3.7 2区 医学 Q1 RHEUMATOLOGY Pub Date : 2024-08-09 DOI: 10.1002/acr.25412
Shogo Okada, Masashi Taniguchi, Tome Ikezoe, Tadao Tsuboyama, Hiromu Ito, Shuichi Matsuda, Fumihiko Matsuda, Noriaki Ichihashi

Objective: We aimed to examine whether lower-limb muscle quantity and quality assessed by bioelectrical impedance analysis (BIA) were associated with knee extension strength and if the association differed with knee osteoarthritis (OA) severity.

Methods: We included 1,525 participants (63.6% women; mean age, 68.0±5.3 years) from the Nagahama Prospective Cohort. Knee extension strength was measured during maximum voluntary isometric contraction. Lower limb muscle mass and extracellular-to-intracellular water (ECW/ICW) ratio were used as indicators of muscle quantity and quality, respectively, and assessed via a BIA device. We executed multiple linear regression analyses to investigate the association of muscle quantity and quality with knee extension strength. Additionally, participants were classified into three groups with respect to OA severity and symptoms: control, early, and advanced OA groups; subgroup analyses were also executed.

Results: The muscle mass (p<0.001) and ECW/ICW ratio (p=0.009) were significantly associated with knee extension strength. In the subgroup analysis, the muscle mass was significantly associated with knee extension strength (p<0.001), but there was no association between ECW/ICW ratio and knee extension strength (p=0.731) in the control group. In the early and advanced OA groups, the muscle mass (both p<0.001) and ECW/ICW ratio (early OA: p=0.034, advanced OA: p=0.015) were significantly associated with knee extension strength.

Conclusions: Lower limb muscle quality was associated with knee extension strength, and the association was stronger in patients with knee OA. These findings suggest that both muscle quantity as well as quality should be assessed to better understand muscle function in patients with knee OA.

目的:我们旨在研究通过生物电阻抗分析(BIA)评估的下肢肌肉数量和质量是否与膝关节伸展力量有关,以及这种关联是否与膝关节骨性关节炎(OA)的严重程度有关:我们纳入了来自长滨前瞻性队列的1525名参与者(63.6%为女性;平均年龄为68.0±5.3岁)。测量最大自主等长收缩时的伸膝力量。下肢肌肉质量和细胞外水/细胞内水(ECW/ICW)比率分别作为肌肉数量和质量的指标,并通过 BIA 设备进行评估。我们采用多元线性回归分析来研究肌肉数量和质量与膝关节伸展力量的关系。此外,我们还根据 OA 严重程度和症状将参与者分为三组:对照组、早期 OA 组和晚期 OA 组;并进行了分组分析:结果:肌肉质量(p结论:下肢肌肉质量与膝关节伸展力量相关,膝关节OA患者的相关性更强。这些研究结果表明,为了更好地了解膝关节OA患者的肌肉功能,应同时评估肌肉的数量和质量。
{"title":"Association of muscle quantity and quality with knee extension strength in knee osteoarthritis: the Nagahama study.","authors":"Shogo Okada, Masashi Taniguchi, Tome Ikezoe, Tadao Tsuboyama, Hiromu Ito, Shuichi Matsuda, Fumihiko Matsuda, Noriaki Ichihashi","doi":"10.1002/acr.25412","DOIUrl":"https://doi.org/10.1002/acr.25412","url":null,"abstract":"<p><strong>Objective: </strong>We aimed to examine whether lower-limb muscle quantity and quality assessed by bioelectrical impedance analysis (BIA) were associated with knee extension strength and if the association differed with knee osteoarthritis (OA) severity.</p><p><strong>Methods: </strong>We included 1,525 participants (63.6% women; mean age, 68.0±5.3 years) from the Nagahama Prospective Cohort. Knee extension strength was measured during maximum voluntary isometric contraction. Lower limb muscle mass and extracellular-to-intracellular water (ECW/ICW) ratio were used as indicators of muscle quantity and quality, respectively, and assessed via a BIA device. We executed multiple linear regression analyses to investigate the association of muscle quantity and quality with knee extension strength. Additionally, participants were classified into three groups with respect to OA severity and symptoms: control, early, and advanced OA groups; subgroup analyses were also executed.</p><p><strong>Results: </strong>The muscle mass (p<0.001) and ECW/ICW ratio (p=0.009) were significantly associated with knee extension strength. In the subgroup analysis, the muscle mass was significantly associated with knee extension strength (p<0.001), but there was no association between ECW/ICW ratio and knee extension strength (p=0.731) in the control group. In the early and advanced OA groups, the muscle mass (both p<0.001) and ECW/ICW ratio (early OA: p=0.034, advanced OA: p=0.015) were significantly associated with knee extension strength.</p><p><strong>Conclusions: </strong>Lower limb muscle quality was associated with knee extension strength, and the association was stronger in patients with knee OA. These findings suggest that both muscle quantity as well as quality should be assessed to better understand muscle function in patients with knee OA.</p>","PeriodicalId":8406,"journal":{"name":"Arthritis Care & Research","volume":null,"pages":null},"PeriodicalIF":3.7,"publicationDate":"2024-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141905727","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Functional Patient-Reported Outcome Measures After Hip or Knee Arthroplasty: A Systematic Review and Content Analysis Using the International Classification of Functioning, Disability, and Health. 髋关节或膝关节置换术后患者报告的功能性结果测量:使用国际功能、残疾和健康分类(ICF)进行系统回顾和内容分析。
IF 3.7 2区 医学 Q1 RHEUMATOLOGY Pub Date : 2024-08-09 DOI: 10.1002/acr.25413
Motahareh Karimijashni, Forough Abtahi, Shokoofih Abbasalipour, Parisa Ranjbar, Armaghan Dabbagh, Marie Westby, Tim Ramsay, Paul E Beaulé, Stéphane Poitras

Objective: This systematic review aimed to identify the existing patient-reported outcome measures (PROMs) used in hip or knee arthroplasty for adults with osteoarthritis and assess their content validity using the modified International Classification of Functioning, Disability, and Health (ICF) core set for osteoarthritis (OA).

Methods: Four databases were systematically searched to identify disease or joint-specific PROMs evaluating function after hip or knee arthroplasty. Two reviewers independently evaluated the content of PROMs based on established ICF linking rules.

Results: From 449 studies included in this review, 50 PROMs were identified. The mobility chapter of activities and participation was the most common component, followed by the sensory function and pain chapter of body function and structure. The most frequent ICF activity and participation categories were d451 going up and down stairs, d4701 using private motorized transportation, d4104 standing, and d4154 maintaining a standing position. However, 11 ICF categories of the modified OA core set were not captured in any PROMs. This ICF-based content analysis of PROMs revealed that included activity and participation categories vary widely, with little overlap among PROMs. The Knee Injury and Osteoarthritis Outcome Score and the Hip Disability and Osteoarthritis Outcome Score had the most coverage for activity and participation (36.7%).

Conclusion: Even though our search identified 50 specific PROMs, there remain gaps in content related to activity and participation coverage. By providing a content analysis of the PROMs used after hip or knee arthroplasty, this study may help clinicians select PROMs based on covered categories and relevant clinical objectives.

目的:本系统性综述旨在确定现有用于成人骨关节炎患者髋关节或膝关节置换术的患者报告结果测量指标(PROMs),并使用修改后的骨关节炎(OA)国际功能、残疾和健康分类(ICF)核心集评估其内容有效性:方法:系统检索了四个数据库,以确定评估髋关节或膝关节置换术后功能的疾病或关节特异性 PROM。两名审稿人根据既定的 ICF 链接规则独立评估了 PROM 的内容:本次综述共纳入了 449 项研究,其中确定了 50 个 PROM。最常见的内容是活动和参与的移动性章节,其次是身体功能和结构的感觉功能和疼痛章节。最常见的 ICF 活动和参与类别是 d451:上下楼梯、d4701:使用私人机动交通工具、d4104:站立和 d4154:保持站立姿势。然而,任何 PROM 均未包含经修订的 OA 核心集中的 11 个 ICF 类别。这种基于 ICF 的 PROM 内容分析显示,所包含的活动和参与类别差异很大,PROM 之间几乎没有重叠。膝关节损伤和骨关节炎结果评分以及髋关节残疾和骨关节炎结果评分在活动和参与方面的覆盖率最高(36.7%):尽管我们的搜索发现了 50 个特定的 PROMs,但与活动和参与度相关的内容仍然存在空白。通过对髋关节或膝关节置换术后使用的 PROMs 进行内容分析,本研究可帮助临床医生根据覆盖类别和相关临床目标选择 PROMs。
{"title":"Functional Patient-Reported Outcome Measures After Hip or Knee Arthroplasty: A Systematic Review and Content Analysis Using the International Classification of Functioning, Disability, and Health.","authors":"Motahareh Karimijashni, Forough Abtahi, Shokoofih Abbasalipour, Parisa Ranjbar, Armaghan Dabbagh, Marie Westby, Tim Ramsay, Paul E Beaulé, Stéphane Poitras","doi":"10.1002/acr.25413","DOIUrl":"10.1002/acr.25413","url":null,"abstract":"<p><strong>Objective: </strong>This systematic review aimed to identify the existing patient-reported outcome measures (PROMs) used in hip or knee arthroplasty for adults with osteoarthritis and assess their content validity using the modified International Classification of Functioning, Disability, and Health (ICF) core set for osteoarthritis (OA).</p><p><strong>Methods: </strong>Four databases were systematically searched to identify disease or joint-specific PROMs evaluating function after hip or knee arthroplasty. Two reviewers independently evaluated the content of PROMs based on established ICF linking rules.</p><p><strong>Results: </strong>From 449 studies included in this review, 50 PROMs were identified. The mobility chapter of activities and participation was the most common component, followed by the sensory function and pain chapter of body function and structure. The most frequent ICF activity and participation categories were d451 going up and down stairs, d4701 using private motorized transportation, d4104 standing, and d4154 maintaining a standing position. However, 11 ICF categories of the modified OA core set were not captured in any PROMs. This ICF-based content analysis of PROMs revealed that included activity and participation categories vary widely, with little overlap among PROMs. The Knee Injury and Osteoarthritis Outcome Score and the Hip Disability and Osteoarthritis Outcome Score had the most coverage for activity and participation (36.7%).</p><p><strong>Conclusion: </strong>Even though our search identified 50 specific PROMs, there remain gaps in content related to activity and participation coverage. By providing a content analysis of the PROMs used after hip or knee arthroplasty, this study may help clinicians select PROMs based on covered categories and relevant clinical objectives.</p>","PeriodicalId":8406,"journal":{"name":"Arthritis Care & Research","volume":null,"pages":null},"PeriodicalIF":3.7,"publicationDate":"2024-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141905728","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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Arthritis Care & Research
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