Reumatologia clinica最新文献_第2页

Principal component and cluster analysis of functional parameters in rheumatic patients: Identifying the most efficient assessment tool 风湿病患者功能参数的主成分和聚类分析：确定最有效的评估工具

Reumatologia clinica

Pub Date : 2026-01-01 DOI: 10.1016/j.reumae.2026.502023

David Vega-Morales , Jorge Medina-Castillo , Pablo Herrera-Sandate , Ana K. Vazquez-Bañuelos , Rodrigo J. Castillo-de la Garza , Luis A. Chavez-Alvarez , Lourdes Gil-Flores , Julio A. Lagarda-Ramos

Background

Rheumatic diseases significantly impact hand function, leading to disability and reduced quality of life. Various tools assess upper limb function, including the DASH questionnaire, grip strength measurement, and range of motion (ROM) evaluation. However, the most efficient parameters for assessing functional impairment remain unclear.

Objective

To determine the most relevant anthropometric and functional measurements for evaluating hand function impairment in patients with rheumatic diseases, using principal component analysis (PCA) and cluster analysis.

Methods

We conducted a cross-sectional study in 36 patients with inflammatory arthritis, primarily rheumatoid arthritis (RA). Hand function was assessed using the DASH questionnaire, grip and pinch strength tests (Jamar dynamometer and Mathiowetz protocol), and ROM measurements. PCA was applied to identify the most relevant functional variables, and K-means clustering was used to classify patients into functional subgroups.

Results

Grip and pinch strength were the dominant factors, explaining 33.5% of total variance, while ROM contributed less to functional impairment assessment. Cluster analysis identified four functional subgroups, differentiating patients based on grip strength and disability levels (DASH score). Patients with higher grip strength exhibited lower disability, while those with severe disability had significantly weaker grip strength, reinforcing its importance as a functional marker.

Conclusion

Grip strength is a key indicator of upper limb function impairment in RA and other rheumatic diseases. Given its strong association with disability and its dominance in variance explanation, grip strength measurement alone may serve as a time-efficient and reliable assessment tool, especially in resource-limited settings. Further research should validate grip strength as a primary clinical indicator and optimize assessment protocols for rheumatic patients.

背景：风湿性疾病严重影响手部功能，导致残疾和生活质量下降。各种工具评估上肢功能，包括DASH问卷，握力测量和活动范围（ROM）评估。然而，评估功能损害的最有效参数仍不清楚。目的应用主成分分析（PCA）和聚类分析，确定评估风湿病患者手功能损害最相关的人体测量和功能测量指标。方法我们对36例炎性关节炎患者进行了横断面研究，主要是类风湿关节炎（RA）。通过DASH问卷、握力和捏紧强度测试（Jamar测力计和matiowetz方案）和ROM测量来评估手功能。应用PCA识别最相关的功能变量，并使用K-means聚类将患者划分为功能亚组。结果握力和捏紧力是主要影响因素，占总方差的33.5%，而ROM对功能损害的影响较小。聚类分析确定了四个功能亚组，根据握力和残疾水平（DASH评分）对患者进行区分。握力越强的患者残疾程度越低，而严重残疾的患者握力明显越弱，这加强了握力作为功能指标的重要性。结论撕裂强度是类风湿类疾病上肢功能损害的重要指标。考虑到握力测量与残疾的密切联系及其在方差解释中的主导地位，握力测量单独可以作为一种有效且可靠的评估工具，特别是在资源有限的情况下。进一步的研究应验证握力作为主要临床指标，并优化风湿病患者的评估方案。

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引用次数: 0

RESER/NVAN: Spanish Registry of patients with ANCA- associated vasculitis: objectives and methodology RESER/NVAN：西班牙ANCA相关血管炎患者登记：目的和方法。

Reumatologia clinica

Pub Date : 2025-12-01 DOI: 10.1016/j.reumae.2025.501990

Susana Romero-Yuste , Manuel Macía , Marta Domínguez-Álvaro , Antonio Fernández-Nebro , Miquel Blasco , Javier Narváez , Gema Fernández , Íñigo Rúa-Figueroa , Desirée Luis-Rodríguez , Beatriz Ventosa , on behalf of the VRESER/NVAN project collaboration group

Objective

To describe the objectives, design and methods of the Spanish Multicentre Registry of Patients with ANCA-associated Vasculitis (RESER/NVAN), as well as its strengths and limitations. RESER/NVAN is a project promoted by the Spanish Society of Rheumatology, in collaboration with the Spanish Society of Nephrology, whose main objective is to estimate the incidence of ANCA-associated vasculitis in Spain.

Methods

Retrospective longitudinal observational study of ANCA-associated vasculitis patients ≥18 years of age diagnosed between 1 January 2015 and 31 March 2021. All patients in the reference area of each centre were included, with the reference area being the area that includes the population attended by the centre. Thirty-two centres distributed throughout the Spanish geography participated, and the administrative and/or clinical databases of each centre and those of the services that could be involved in the diagnosis and/or treatment of these patients were reviewed. Sociodemographic and anthropometric variables, lifestyle habits, comorbidities and variables characterising vasculitis were collected.

Conclusions

RESER/NVAN represents one of the largest cohorts of patients with ANCA-associated vasculitis in Spain. Despite its retrospective nature, the study provides comprehensive and reliable information on ANCA-associated vasculitis and is an excellent source of data for future analyses to increase knowledge of this disease.

目的：描述西班牙anca相关性血管炎患者多中心登记（RESER/NVAN）的目的、设计和方法，以及其优势和局限性。RESER/NVAN是由西班牙风湿病学会与西班牙肾病学会合作推动的一个项目，其主要目标是估计西班牙anca相关血管炎的发病率。方法：对2015年1月1日至2021年3月31日诊断的年龄≥18岁的anca相关性血管炎患者进行回顾性纵向观察研究。每个中心参考区域的所有患者都被包括在内，参考区域是包括该中心服务的人口的区域。分布在西班牙各地的32个中心参与了调查，对每个中心的行政和/或临床数据库以及可能参与诊断和/或治疗这些病人的服务部门的数据库进行了审查。收集社会人口学和人体测量变量、生活习惯、合并症和表征血管炎的变量。结论：RESER/NVAN是西班牙最大的anca相关血管炎患者队列之一。尽管是回顾性研究，但该研究为anca相关血管炎提供了全面可靠的信息，是未来分析以增加对该疾病认识的极好数据来源。

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引用次数: 0

Treatment of rheumatoid arthritis in patients with chronic kidney disease: A real-world experience 慢性肾脏疾病患者类风湿关节炎的治疗：真实世界的经验。

Reumatologia clinica

Pub Date : 2025-12-01 DOI: 10.1016/j.reumae.2025.501995

Wilmer Gerardo Rojas-Zuleta, Yesith Guillermo Toloza-Pérez, Carolina Becerra Arias, Jorge Donado Gómez, Jeixa Jennifer Canizales Rodríguez, Oscar Jair Felipe Díaz

Introduction/Objectives

Rheumatoid arthritis is associated with an increased risk of chronic kidney disease, which complicates the safe use of disease-modifying antirheumatic drugs (DMARDs), particularly in patients with severe renal impairment. Our aim was to describe treatment patterns and clinical outcomes in this population.

Methods

Descriptive study of a cohort of RA patients with an estimated glomerular filtration rate (eGFR) <30 ml/min/1.73 m², managed in a comprehensive care program between 2022 to 2024. Clinical, therapeutic, and safety data were collected.

Results

A total of 38 patients were identified, most of whom were elderly women with a high burden of comorbidities. Leflunomide was the most frequently used conventional synthetic DMARD. Biologic therapy was used in 42% of cases, with rituximab being the most commonly prescribed agent. Most patients achieved remission or low disease activity, with no serious adverse events reported.

Conclusions

These findings provide real-world evidence on the effectiveness and safety of DMARDs in a population often excluded from clinical trials, underscoring the need for prospective studies to inform long-term therapeutic decisions.

简介/目的：类风湿性关节炎与慢性肾脏疾病的风险增加相关，这使得疾病缓解抗风湿药（DMARDs）的安全使用复杂化，特别是在严重肾功能损害患者中。我们的目的是描述这一人群的治疗模式和临床结果。方法：描述性研究一组估计肾小球滤过率（eGFR） 2的RA患者，在2022年至2024年的综合护理计划中进行管理。收集临床、治疗和安全性数据。结果：共确定了38例患者，其中大多数为老年妇女，合并症负担高。来氟米特是最常用的常规合成DMARD。42%的病例使用生物治疗，其中利妥昔单抗是最常用的处方药物。大多数患者达到缓解或低疾病活动度，无严重不良事件报道。结论：这些发现为dmard在经常被排除在临床试验之外的人群中的有效性和安全性提供了真实的证据，强调了前瞻性研究为长期治疗决策提供信息的必要性。

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引用次数: 0

Nailfold capillaroscopy in inflammatory bowel disease: A shared approach in gastroenterology and rheumatology 甲襞毛细血管镜检查在炎症性肠病中的应用：胃肠病学和风湿病学的共同方法

Reumatologia clinica

Pub Date : 2025-12-01 DOI: 10.1016/j.reumae.2025.501998

Maha S.I. Abdelrahman , Doaa Abdeltawab , Rasha Hamed Shehata

Introduction and objectives

Inflammatory bowel disease (IBD) has systemic consequences that extend beyond the gastrointestinal tract. While nailfold capillaroscopy (NFC) is widely utilized in many rheumatological disorders, its significance in evaluating microvascular changes in IBD remains unknown. This study aimed to standardize NFC use in IBD patients and relate NFC results to clinical and laboratory criteria.

Methods

This observational case–control study included histology- and colonoscopy-diagnosed IBD patients. We performed NFC on eight fingers of each subject using a Dino-Lite digital microscope, adhering to European Alliance of Associations for Rheumatology guidelines. Capillary characteristics, including density, morphology, and dimensions, as well as microhemorrhages, were assessed at 200×.

Results

The study included 50 IBD patients and 30 healthy controls. IBD patients had significantly lower capillary density (7.52 ± 0.68 capillaries/mm) than controls (8.18 ± 0.63 capillaries/mm, p < 0.001), with 26% of IBD patients exhibiting densities below seven capillaries/mm. In IBD patients, microhemorrhages were more prevalent than in controls (p = 0.032). Raynaud's phenomenon was more commonly detected in patients with low mean capillary density (p = 0.04).

Conclusion

IBD patients had reduced mean capillary density and increased microhemorrhages. These changes suggested that NFC could be a non-invasive way provides unique insights into IBD microvascular health.

.

简介和目的炎症性肠病（IBD）具有超越胃肠道的全身性后果。虽然甲襞毛细血管镜（NFC）被广泛应用于许多风湿病，但其在评估IBD微血管变化方面的意义尚不清楚。本研究旨在规范IBD患者NFC的使用，并将NFC结果与临床和实验室标准联系起来。方法本观察性病例对照研究纳入了经组织学和结肠镜诊断的IBD患者。根据欧洲风湿病协会联盟的指导方针，我们使用Dino-Lite数码显微镜对每位受试者的八个手指进行了近距离接触检查。在200x下评估毛细血管特征，包括密度、形态和尺寸，以及微出血。结果本研究包括50例IBD患者和30例健康对照。IBD患者的毛细血管密度（7.52±0.68支/mm）明显低于对照组（8.18±0.63支/mm， p < 0.001）， 26%的IBD患者的毛细血管密度低于7支/mm。在IBD患者中，微出血比对照组更普遍（p = 0.032）。雷诺现象多见于平均毛细血管密度较低的患者（p = 0.04）。结论ibd患者平均毛细血管密度降低，微出血增加。这些变化表明，NFC可能是一种非侵入性的方法，为IBD微血管健康提供了独特的见解。

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引用次数: 0

Diagnostic challenge: Bethlem myopathy mimicking inflammatory myopathy 诊断挑战：模仿炎性肌病的伯利恒肌病

Reumatologia clinica

Pub Date : 2025-12-01 DOI: 10.1016/j.reumae.2025.501997

Olga Rusinovich-Lovgach , Luz Morán , Oscar Toldos-Gonzalez , Marta Vaquero Martínez , Borja Cabal-Paz , José Luis Andréu Sánchez

We describe a young man with persistent hyperCKemia and MRI findings initially suggestive of inflammatory myopathy, in whom genetic testing confirmed Bethlem myopathy. This case illustrates how collagen VI-related myopathies can mimic idiopathic inflammatory myopathies (IIM), underlining the need for integrated clinical, imaging, biopsy, and genetic data to ensure diagnostic accuracy and avoid unnecessary immunosuppression.

我们描述了一个年轻人与持续高血血症和MRI结果最初提示炎性肌病，其中基因检测证实伯利恒肌病。本病例说明了vi型胶原蛋白相关肌病如何与特发性炎性肌病（IIM）相似，强调了综合临床、影像学、活检和遗传数据以确保诊断准确性和避免不必要的免疫抑制的必要性。

引用次数: 0

Prevalence and impact of chronic joint diseases on the sexual sphere compared to a healthy population: A multicenter cross-sectional study 与健康人群相比，慢性关节疾病对性领域的患病率和影响：一项多中心横断面研究

Reumatologia clinica

Pub Date : 2025-12-01 DOI: 10.1016/j.reumae.2025.501993

Carlos Valera-Ribera , Juan José Alegre-Sancho , Àngels Martínez-Ferrer , Montserrat Robustillo-Villarino

Objectives

To describe the prevalence of sexual dysfunction (SD) in patients with rheumatoid arthritis (RA), psoriatic arthritis (PsA) and a control group, and identify associated factors.

Methods

Adults of any sexual orientation with PsA (CASPAR criteria) or RA (EULAR/ACR 2010 criteria) were consecutively included in this cross-sectional observational study. The Changes in Sexual Functioning Questionnaire (CSFQ-14) was self-administered to evaluate variations in sexual function due to disease or medication. We also evaluated the potential association of sociodemographic and clinical data with SD. Results were compared with a control group of healthy individuals.

Results

Overall 188 individuals were included, 72 with PsA and 27 with RA. In total, 30.43%, 48.15% and 5.88% of the PsA, RA and control groups, respectively, had scores within the SD range. The overall patient population had a mean CSFQ-14 score 8.2 points lower than the control group. All domains of the CSFQ-14 questionnaire were negatively affected by PsA or RA (p < 0.001). The risk of SD is associated with age, sex, perceived health, employment situation, and economic status. The estimated odds ratio of having SD was 8.7 times higher in patients diagnosed with PsA and 10 times higher in patients diagnosed with RA.

Conclusions

Patients with RA or PsA have a poorer sexual life in all sexual sphere domains, compared to a healthy population. Our study confirms the value of the CSFQ-14 questionnaire for assessing sexual health and as a tool for the integral management of patients with chronic joint diseases.

目的了解类风湿性关节炎（RA）、银屑病关节炎（PsA）患者及对照组的性功能障碍（SD）患病率，并确定相关因素。方法本横断面观察性研究连续纳入了任何性取向的成人PsA （CASPAR标准）或RA （EULAR/ACR 2010标准）。性功能变化问卷（CSFQ-14）是自我管理的，以评估由于疾病或药物引起的性功能变化。我们还评估了社会人口学和临床数据与SD的潜在关联。结果与对照组健康个体进行比较。结果共纳入188例患者，其中PsA 72例，RA 27例。PsA组、RA组和对照组评分在SD范围内的分别为30.43%、48.15%和5.88%。总体患者人群的CSFQ-14平均得分比对照组低8.2分。PsA或RA对CSFQ-14问卷的所有领域均有负面影响（p < 0.001）。SD的风险与年龄、性别、感知健康、就业状况和经济状况有关。诊断为PsA的患者SD的比值比为8.7倍，诊断为RA的患者SD的比值比为10倍。结论与健康人群相比，RA或PsA患者在所有性领域的性生活都较差。我们的研究证实了CSFQ-14问卷在评估性健康和作为慢性关节疾病患者综合管理工具方面的价值。

{"title":"Prevalence and impact of chronic joint diseases on the sexual sphere compared to a healthy population: A multicenter cross-sectional study","authors":"Carlos Valera-Ribera , Juan José Alegre-Sancho , Àngels Martínez-Ferrer , Montserrat Robustillo-Villarino","doi":"10.1016/j.reumae.2025.501993","DOIUrl":"10.1016/j.reumae.2025.501993","url":null,"abstract":"<div><h3>Objectives</h3><div>To describe the prevalence of sexual dysfunction (SD) in patients with rheumatoid arthritis (RA), psoriatic arthritis (PsA) and a control group, and identify associated factors.</div></div><div><h3>Methods</h3><div>Adults of any sexual orientation with PsA (CASPAR criteria) or RA (EULAR/ACR 2010 criteria) were consecutively included in this cross-sectional observational study. The Changes in Sexual Functioning Questionnaire (CSFQ-14) was self-administered to evaluate variations in sexual function due to disease or medication. We also evaluated the potential association of sociodemographic and clinical data with SD. Results were compared with a control group of healthy individuals.</div></div><div><h3>Results</h3><div>Overall 188 individuals were included, 72 with PsA and 27 with RA. In total, 30.43%, 48.15% and 5.88% of the PsA, RA and control groups, respectively, had scores within the SD range. The overall patient population had a mean CSFQ-14 score 8.2 points lower than the control group. All domains of the CSFQ-14 questionnaire were negatively affected by PsA or RA (<em>p</em>  <!-->0.001). The risk of SD is associated with age, sex, perceived health, employment situation, and economic status. The estimated odds ratio of having SD was 8.7 times higher in patients diagnosed with PsA and 10 times higher in patients diagnosed with RA.</div></div><div><h3>Conclusions</h3><div>Patients with RA or PsA have a poorer sexual life in all sexual sphere domains, compared to a healthy population. Our study confirms the value of the CSFQ-14 questionnaire for assessing sexual health and as a tool for the integral management of patients with chronic joint diseases.</div></div>","PeriodicalId":94193,"journal":{"name":"Reumatologia clinica","volume":"21 10","pages":"Article 501993"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145712466","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Diffuse idiopathic skeletal hyperostosis in patients with prediabetes 糖尿病前期患者弥漫性特发性骨骼增生

Reumatologia clinica

Pub Date : 2025-12-01 DOI: 10.1016/j.reumae.2025.502017

Ayfer Altıntas , Emre Ali Acar , Sadettin Uslu , Ihsan Sebnem Orgüc , Zeliha Hekimsoy , Timur Pirildar

Objective

To investigate the frequency of diffuse idiopathic skeletal hyperostosis (DISH) in patients with prediabetes.

Material and methods

A total of 166 prediabetic patients were prospectively evaluated, of whom 67 with symptoms suggestive of DISH underwent thoracic and lumbar radiography. DISH was diagnosed according to Resnick and Niwayama criteria. Demographic, clinical and laboratory data were analyzed.

Results

DISH was diagnosed in 9 patients (13.4% of symptomatic; 5.4% overall). Patients with DISH were older and more frequently hypertensive compared to those without DISH (p = 0.004 and p = 0.047, respectively). Other parameters such as body mass index, fasting glucose, and smoking showed higher trends in the DISH group but did not reach statistical significance.

Conclusion

This is the first study to examine DISH in a prediabetic population. Our findings suggest a possible association between DISH and prediabetic status, although further studies are needed to confirm this relationship.

目的探讨糖尿病前期弥漫性特发性骨骼肥厚症（DISH）的发生率。材料与方法对166例糖尿病前期患者进行前瞻性评估，其中67例有DISH症状的患者行胸腰椎x线片检查。根据Resnick和Niwayama标准诊断DISH。对人口学、临床和实验室数据进行分析。结果9例患者确诊为dish，占症状患者的13.4%，总患者的5.4%。与无DISH的患者相比，有DISH的患者年龄更大，高血压发生率更高（p = 0.004和p = 0.047）。其他参数如体重指数、空腹血糖和吸烟在DISH组显示出更高的趋势，但没有达到统计学意义。结论：本研究首次在糖尿病前期人群中检测DISH。我们的研究结果表明DISH与糖尿病前期状态之间可能存在关联，尽管需要进一步的研究来证实这种关系。

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引用次数: 0

Incidence of pulmonary hypertension in patients with Takayasu's arteritis: A transthoracic echocardiographic evaluation 高松动脉炎患者肺动脉高压的发生率：经胸超声心动图评价

Reumatologia clinica

Pub Date : 2025-12-01 DOI: 10.1016/j.reumae.2025.501994

Ata Koohi , Farid Rashidi , Davood Attaran , Zahra Mirfeizi , Mohammad Hasan Jokar , Alireza Khabbazi , Mehrzad Hajalilou , Ehsan Ramezanian Nik , Hoorac Poorzand , Soroush Attaran , Atiyeh Ghassemi

Aim

In this study, we aim to evaluate the incidence of pulmonary hypertension (PH) using transthoracic echocardiography (TTE) in Takayasu arteritis (TA) patients.

Methods

Thirty-four outpatient Takayasu arteritis patients underwent transthoracic echocardiography (TTE) following the ESC-ERS guidelines. A tricuspid regurgitation velocity (TRV) greater than 3.4 m/s indicated a high probability of pulmonary hypertension (PH). The patients were categorized based on their New York Heart Association (NYHA) functional class (FC) and symptomatic status. All patients underwent a six-minute walk test (6MWT) and pulmonary function tests (PFT).

Results

A total of 30 patients with a mean age of 40 ± 9.3 years were enrolled in the study. Among these patients, four (13.3%) were met the criteria for high probability of PH (TRV: 4 ± 0.92), with a mean systolic pulmonary artery pressure (SPAP) of 76.7 ± 37. There were no significant differences in terms of age, disease duration, and erythrocyte sedimentation rate (ESR) between the PH and non-PH groups. However, there was a significant difference in tricuspid annular plane systolic excursion TAPSE/SPAP ratio between NYHA functional class (FC) Group 1 and Group 2 (1.2 ± 0.16 vs 0.83 ± 0.24, p = 0.018). Additionally, TAPSE showed a correlation with forced expiratory volume in the first second/forced vital capacity (FEV₁/FVC) (r = 0.446, p = 0.043).

Conclusions

Pulmonary hypertension is a not uncommon complication in Takayasu arteritis (13.3% vs 11.3% in the literature). Considering the symptoms and functional capacity, lowering the threshold for initiating transthoracic echocardiography (TTE) evaluation may be beneficial for early risk stratification of pulmonary hypertension in patients with Takayasu arteritis.

目的在本研究中，我们旨在利用经胸超声心动图（TTE）评估高松动脉炎（TA）患者肺动脉高压（PH）的发生率。方法34例门诊高须动脉炎患者按照ESC-ERS指南行经胸超声心动图检查。三尖瓣反流速度（TRV）大于3.4 m/s提示肺动脉高压（PH）的可能性较大。根据纽约心脏协会（NYHA）功能等级（FC）和症状状态对患者进行分类。所有患者都进行了6分钟步行测试（6MWT）和肺功能测试（PFT）。结果共纳入30例患者，平均年龄40±9.3岁。其中4例（13.3%）符合PH高概率标准（TRV: 4±0.92），平均肺动脉收缩压（SPAP）为76.7±37。PH组和非PH组在年龄、病程和红细胞沉降率（ESR）方面没有显著差异。然而，NYHA功能分级（FC） 1组与2组三尖瓣环面收缩漂移TAPSE/SPAP比值差异有统计学意义（1.2±0.16 vs 0.83±0.24,p = 0.018）。此外，TAPSE与第一秒用力呼气量/用力肺活量（FEV1/FVC）相关（r = 0.446, p = 0.043）。结论肺动脉高压是高须动脉炎的常见并发症（文献中分别为13.3%和11.3%）。考虑到症状和功能能力，降低启动经胸超声心动图（TTE）评估的阈值可能有利于高松动脉炎患者肺动脉高压的早期风险分层。

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引用次数: 0

A novel Autologous Cytokine-Rich Serum (SARC) to treat knee osteoarthritis patients’ refractory to a previous glucocorticoid intra-articular injection. A pilot study 一种新型的自体细胞因子丰富血清（SARC）治疗膝关节骨性关节炎患者对既往糖皮质激素关节内注射的难治性。一项初步研究

Reumatologia clinica

Pub Date : 2025-12-01 DOI: 10.1016/j.reumae.2025.502016

Cristóbal Orellana , Silvia Garcia Cirera , Albert Rodrigo Parés , Laia Uriel Brotons , Àlex Arqué Corredor , Cristina Aymerich , Rafael Gómez , Anna Carreras , Antoni Berenguer-Llergo , Joan Calvet

Background

At present, there is a lack of treatments specifically designed to target knee osteoarthritis (KOA). Various intra-articular products have widespread and become commonplace in clinical practice, despite a scarcity of evidence supporting this procedure. Among these, SARC stands out as a novel Autologous Cytokine-Rich Serum derived from the patient's own platelets and white blood cells. This pilot study aims to assess the effectiveness of SARC treatment by measuring improvements in pain and physical disability in patients with symptomatic KOA.

Methods

We recruited 40 symptomatic KOA patients with Kellgren–Lawrence stage 2 or 3, who had been refractory to glucocorticoid intra-articular treatment in the past year. They were assigned to two regimens (single vs. three-dose administrations), and were evaluated for their change in pain and physical function using the KOOS questionnaires at various time points over one year.

Results

At one year after treatment, 36% and 33% of patients achieved a 20% improvement in pain and functional disability, respectively. Patients treated with three intra-articular SARC injections showed a slightly higher improvement (40%) than the single-dose group (26–32%), although differences were not statistically significant. In average, both reversed KOOS scores showed significant improvements compared to baseline, especially for the three-dose group (14 and 16 points, respectively; p-values <0.0001). No adverse events were reported during the study.

Conclusion

A notable proportion of patients with KOA refractory to a previous glucocorticoid injection responded positively to intra-articular SARC treatment. Further studies are required to validate these findings and identify biomarkers of treatment response.

目前，缺乏专门针对膝关节骨关节炎（KOA）的治疗方法。尽管缺乏证据支持这种手术，但各种关节内产品在临床实践中已经广泛应用并变得司空见惯。其中，SARC作为一种新型的从患者自身血小板和白细胞中提取的富含细胞因子的自体血清脱颖而出。本初步研究旨在通过测量症状性KOA患者疼痛和身体残疾的改善来评估SARC治疗的有效性。方法我们招募40例有症状的Kellgren-Lawrence期2或3期患者，这些患者在过去一年中对糖皮质激素关节内治疗难治性。他们被分配到两种方案（单剂量和三剂量给药），并在一年内的不同时间点使用oos问卷评估他们的疼痛和身体功能的变化。结果治疗一年后，36%和33%的患者疼痛和功能障碍分别改善了20%。接受三次关节内SARC注射的患者的改善程度（40%）略高于单剂量组（26-32%），但差异无统计学意义。平均而言，与基线相比，两种逆转的KOOS评分均有显着改善，特别是三剂量组（分别为14和16分；p值<；0.0001）。研究期间无不良事件报告。结论既往糖皮质激素注射难治性KOA患者中有显著比例对关节内SARC治疗有积极反应。需要进一步的研究来验证这些发现并确定治疗反应的生物标志物。

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引用次数: 0

Patients’ and rheumatologists’ perceptions about shared decision-making implementation: A Latin-American survey 患者和风湿病学家对共同决策实施的看法：一项拉丁美洲调查

Reumatologia clinica

Pub Date : 2025-12-01 DOI: 10.1016/j.reumae.2025.501974

Adriana Lucía Vanegas-García , Mauricio Restrepo-Escobar , Álvaro Arbeláez-Cortés , Gina Sicilia Ochoa Galeano , Luis Lira Weldt , Guillermo Andrés Quiceno , Virginia Pascual-Ramos

Background

Shared decision-making (SDM) has been linked to improved patient- and physician-reported outcomes. To achieve these benefits, both parties need to agree on implementing SDM. The objective of the study was to compare the perception of SDM process implementation in daily practice between patients with rheumatic diseases (RMDs) and rheumatologists.

Methods

This cross-sectional study was conducted in April 2024 in Latin America (LATAM). Adult patients diagnosed with RMDs and rheumatologists were invited to participate in a web-based survey based on the Spanish patient version of the 9-item SDM questionnaire (SDM-Q-9) and the physician version (SDM-Q-Doc). Both versions were validated tools for evaluating patients’ and physicians’ perceived levels of SDM. Descriptive statistics and comparative tests (e.g., chi-square or Mann–Whitney U test) were used to analyze the data. Statistical significance was set at p < 0.05, and analyses were conducted using STATA 17 software.

Results

We received surveys from 369 patients, primarily systemic lupus erythematosus (51.8%) and rheumatoid arthritis (19.5%), across 17 countries. The largest number of responses was from Mexico (42%) and Colombia (11.9%). The survey was completed by 144 rheumatologists from 10 countries, primarily from Colombia (52.8%) and Chile (23.6%). Physicians most frequently strongly agree/agree that they engaged in the different steps of the SDM process, compared to patients, and this difference was less evident for the step “sharing with the patient the different options for treating the condition.” Also, a higher percentage of rheumatologists (96.5%) reported engaging in SDM during clinical practice compared to patients (62.3%), p = 0.001.

Conclusions

In LATAM, rheumatologists more frequently referred to implementing the SDM process during clinical care than patients with RMDs. Further research is needed to improve patient-centered care.

共享决策（SDM）与改善患者和医生报告的结果有关。为了实现这些好处，双方需要就实施SDM达成一致。该研究的目的是比较风湿病患者（rmd）和风湿病学家在日常实践中对SDM过程实施的看法。方法本横断面研究于2024年4月在拉丁美洲（LATAM）进行。被诊断为rmd的成年患者和风湿病学家被邀请参加一项基于西班牙语患者版本的9项SDM问卷（SDM- q -9）和医生版本（SDM- q - doc）的网络调查。这两个版本都是评估患者和医生感知的SDM水平的有效工具。采用描述性统计和比较检验（如卡方检验或Mann-Whitney U检验）对数据进行分析。p <； 0.05为差异有统计学意义，采用stata17软件进行分析。我们收到了来自17个国家的369名患者的调查，主要是系统性红斑狼疮（51.8%）和类风湿关节炎（19.5%）。回答最多的是墨西哥（42%）和哥伦比亚（11.9%）。该调查由来自10个国家的144名风湿病学家完成，主要来自哥伦比亚（52.8%）和智利（23.6%）。与患者相比，医生通常强烈同意他们参与SDM过程的不同步骤，而在“与患者分享治疗疾病的不同选择”这一步骤中，这种差异不太明显。此外，与患者（62.3%）相比，风湿病学家（96.5%）在临床实践中参与SDM的比例更高，p = 0.001。结论在拉丁美洲，风湿病学家比rmd患者更频繁地在临床护理中实施SDM过程。需要进一步的研究来改善以患者为中心的护理。

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