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Associated factors to health-related quality of life in anti-neutrophil cytoplasmic antibodies-associated vasculitis patients: Data from the Almenara Vasculitis Cohort 抗中性粒细胞细胞质抗体相关血管炎患者健康相关生活质量的相关因素:来自Almenara血管炎队列的数据
Pub Date : 2025-08-01 DOI: 10.1016/j.reumae.2025.501942
Allison Milagros Figueroa-Sánchez , Leonor Stefani León-Yaurimucha , Manuel F. Ugarte-Gil , Victor R. Pimentel-Quiroz

Objective

To determine the factors associated with health-related quality of life (HRQoL) in adult patients with ANCA-associated vasculitis (AAV).

Methodology

An observational, analytical, retrospective study was conducted using a convenience sampling technique. Data were obtained from the Almenara Vasculitis Cohort during the period from December 2022 to December 2023. Sociodemographic and disease-related features were obtained using a data collection form. Disease activity, damage accrual, and HRQoL were assessed using the BVASv3, VDI, and SF-36 questionnaires, respectively. Cross-sectional univariable and multivariable linear regression models were performed. Multivariate models were generated using a backward selection procedure with an alpha to stay in the model of 0.05.

Results

Fifty-five patients were evaluated; 41 (74.6%) of them were female. Their mean age and disease duration were 58.7 (13.5) and 5.8 (5.2) years, respectively. In the multivariate analysis, low socioeconomic status, older age, and higher erythrocyte sedimentation rate (ESR) were associated with worse HRQoL. Conversely, male sex, have a diagnosis of eosinophilic granulomatosis with polyangiitis (EGPA), have an employment, and the use of immunosuppressive (IS) drugs other than cyclophosphamide or rituximab were associated with better HRQoL.

Conclusions

In our study, male sex, have an employment, the EGPA subtype, and treatment with IS other than rituximab and cyclophosphamide were associated with better HRQoL. Meanwhile, older age, low socioeconomic status, and high ESR levels were associated with worse HRQoL.
目的:探讨成人anca相关性血管炎(AAV)患者健康相关生活质量(HRQoL)的相关因素。方法:采用方便抽样技术进行观察性、分析性、回顾性研究。数据来自2022年12月至2023年12月期间的Almenara血管炎队列。使用数据收集表获得社会人口学和疾病相关特征。分别使用BVASv3、VDI和SF-36问卷评估疾病活动性、损害累积和HRQoL。采用截面单变量和多变量线性回归模型。使用反向选择程序生成多变量模型,alpha保持在0.05的模型中。结果:共评估55例患者;其中女性41例(74.6%)。平均年龄58.7(13.5)岁,病程5.8(5.2)岁。在多变量分析中,低社会经济地位、年龄较大和较高的红细胞沉降率(ESR)与较差的HRQoL相关。相反,男性,诊断为嗜酸性肉芽肿病合并多血管炎(EGPA),有工作,使用除环磷酰胺或利妥昔单抗外的免疫抑制(IS)药物与较好的HRQoL相关。结论:在我们的研究中,男性、有工作、EGPA亚型以及使用非利妥昔单抗和环磷酰胺的IS治疗与较好的HRQoL相关。同时,年龄较大、社会经济地位低、ESR水平高与HRQoL较差相关。
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引用次数: 0
Anti-MDA5 antibody dermatomyositis: PET findings of early interstitial lung disease 抗mda5抗体皮肌炎:早期间质性肺病的PET表现
Pub Date : 2025-08-01 DOI: 10.1016/j.reumae.2025.501919
Wan-Hao Tsai , Chiehyu Shen
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引用次数: 0
Does human microbiota interact with immunosuppressive treatment of systemic autoimmune rheumatological diseases? A systematic review 人体微生物群是否与系统性自身免疫性风湿病的免疫抑制治疗相互作用?系统回顾。
Pub Date : 2025-08-01 DOI: 10.1016/j.reumae.2025.501938
Noemí Franco-Domingo , Patricia Saiz-López , Loreto Carmona-Ortells

Objective

To collect and analyse studies evaluating the interaction between the human microbiota (HM) and immunosuppressive (IS) treatments for systemic autoimmune rheumatological diseases (ARDs), and their impact on the disease.

Methods

A systematic review was performed based on an electronic search strategy in Medline, Embase, and Cochrane Library (inception-02/2024). We included papers studying the interaction of HM and IS treatments in adult patients with ARDs in which parameters of diversity and taxonomic composition were measured. We excluded spondyloarthritis for which more extensive knowledge is available. Studies of any language were allowed, prioritising clinical trials but also including observational longitudinal prospective and retrospective, and case-control studies.

Results

Of 2570 papers identified, 20 were included (15 from rheumatoid arthritis, 3 from systemic lupus erythematosus, 1 from primary Sjögren's syndrome and 1 from systemic sclerosis), overall, with a moderate risk of bias. The paucity of studies and niche specificity limited the study to the gut microbiota. A trend towards decreased diversity and compositional changes in gut microbiota and partial restitution in patients responding to IS treatment was identified. The heterogeneity observed in the design and outcome measures of the studies precluded a metaanalysis; however, the results point to a possible relationship between HM alterations and response to IS treatments in ARDs.

Conclusions

Available studies suggest a potential association between the HM and the response to IS therapies in ARDs. However, the overall moderate quality of evidence and substantial methodological heterogeneity limit the strength of combined conclusions. Standardization of microbiota-related studies is needed to enable data integration and support more robust inferences.
目的:收集和分析评估人体微生物群(HM)与免疫抑制(IS)治疗系统性自身免疫性风湿病(ARDs)相互作用及其对疾病影响的研究。方法:基于Medline、Embase和Cochrane图书馆(inception-02/2024)的电子检索策略进行系统评价。我们纳入了研究成人ARDs患者HM和IS治疗相互作用的论文,其中测量了多样性和分类组成参数。我们排除了脊椎关节炎,因为我们对它有更广泛的了解。允许任何语言的研究,优先考虑临床试验,但也包括观察性纵向前瞻性和回顾性研究,以及病例对照研究。结果:在纳入的2570篇论文中,20篇被纳入(15篇来自类风湿性关节炎,3篇来自系统性红斑狼疮,1篇来自原发性Sjögren综合征,1篇来自系统性硬化症),总体上具有中等偏倚风险。研究的缺乏和生态位的特异性限制了对肠道微生物群的研究。确定了对IS治疗有反应的患者肠道微生物群多样性减少和组成变化以及部分恢复的趋势。在研究的设计和结果测量中观察到的异质性排除了荟萃分析;然而,研究结果指出,在ARDs患者中,HM改变和对IS治疗的反应之间可能存在关系。结论:现有研究表明,在ARDs患者中,HM和对IS治疗的反应之间存在潜在的关联。然而,证据的总体质量适中和方法的异质性限制了综合结论的强度。需要对微生物群相关研究进行标准化,以实现数据整合并支持更可靠的推断。
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引用次数: 0
Achlorophyllic algae and chronic bursitis: An exceptional association 绿藻和慢性滑囊炎:一种特殊的关联。
Pub Date : 2025-08-01 DOI: 10.1016/j.reumae.2025.501920
Pablo González del Pozo, Paula Álvarez Peñalba, Stefanie Burger, Norma Alejandra Callejas Pineda, Rubén Queiro Silva, Sara Alonso Castro
We describe a case about a 79-year-old woman with rheumatoid arthritis with chronic left olecranon bursitis refractory to conventional therapy. Following appropriate diagnostic workup, Prototheca spp alga was identified as the causative agent. The exceptional nature of the case is emphasized.
我们描述一个病例约79岁的妇女类风湿关节炎慢性左鹰嘴滑囊炎难治性常规治疗。经过适当的诊断检查,原鞘藻类被确定为病原体。强调了该案件的特殊性质。
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引用次数: 0
Cognitive dysfunction in systemic lupus erythematosus: Insights from a two-year longitudinal study in a Brazilian cohort 系统性红斑狼疮的认知功能障碍:来自巴西一项为期两年的纵向研究的见解
Pub Date : 2025-08-01 DOI: 10.1016/j.reumae.2025.501941
Eduarda Scoto Dias , José Henrique Tercziany Vanzin , Eduardo Augusto Borba , Mahara Freitas dos Santos , Thiago Alberto F.G. dos Santos , Thelma Skare , Renato Nisihara

Objectives

The objective of this study was to examine cognitive dysfunction in a Brazilian sample of SLE patients for two years.

Methods

A sample of 50 individuals with SLE was assessed at baseline for epidemiological and treatment data, disease activity by SLEDAI 2K (SLE disease activity 2000), cumulative damage by SLICC/ACR DI (Systemic Lupus International Collaborating Clinics/American College of Rheumatology Damage Index), depression by CES-D (Center for Epidemiological Studies-Depression) and cognitive function through MoCA (Montreal Cognitive Assessment). The same assessment was repeated after two years.

Results

The prevalence of cognitive impairment at baseline was 68%. The baseline cognitive assessment showed impairment in visuospatial/executive function (p = 0.002), naming (p = 0.04), attention (p < 0.0001) and delayed recall (p < 0.0001). The median MoCA results did not change in two years (p = 0.45), but 6 individuals (12%) that had normal cognitive function at baseline developed mild cognitive impairment and two (4%) that had mild cognitive impairment, improved. When considering the MoCA domains the only significant difference was improvement in abstraction (p = 0.001). No correlations between MoCA delta (difference between second and first value) and delta SLEDAI, delta SLICC and delta CES-D were found (all with p > 0.05). Also, no associations were found with used treatment or autoantibodies profile.

Conclusions

Cognitive dysfunction in SLE is dynamic and may require periodic re-assessments. Changes in cognition were not associated with disease activity, depression or cumulative damage in this sample.
本研究的目的是研究巴西SLE患者两年的认知功能障碍。方法50例SLE患者在基线时进行流行病学和治疗资料评估,疾病活动性通过SLEDAI 2K (SLE疾病活动性2000)评估,累积损害通过SLICC/ACR DI(系统性狼疮国际合作诊所/美国风湿病学会损伤指数)评估,抑郁通过CES-D(抑郁症流行病学研究中心)评估,认知功能通过MoCA(蒙特利尔认知评估)评估。两年后又进行了同样的评估。结果基线时认知障碍患病率为68%。基线认知评估显示视觉空间/执行功能受损(p = 0.002),命名(p = 0.04),注意力(p < 0.0001)和延迟回忆(p < 0.0001)。MoCA的中位数结果在两年内没有变化(p = 0.45),但6名(12%)基线认知功能正常的患者出现轻度认知障碍,2名(4%)轻度认知障碍患者出现改善。当考虑MoCA域时,唯一显著的差异是抽象的改善(p = 0.001)。MoCA δ(二值与一值之差)与δ SLEDAI、δ SLICC、δ CES-D无相关性(p > 0.05)。此外,未发现与使用的治疗方法或自身抗体谱相关。结论SLE患者的认知功能障碍是动态的,可能需要定期重新评估。在这个样本中,认知的改变与疾病活动、抑郁或累积损伤无关。
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引用次数: 0
Effectiveness of a checklist for the control of the disease activity in patients with axial spondyloarthritis 检查表对控制轴性脊柱炎患者疾病活动的有效性
Pub Date : 2025-08-01 DOI: 10.1016/j.reumae.2025.501918
Raquel Almodóvar , Elia Pérez-Fernández , Marta Valero , Virginia Villaverde , Laura González , Beatriz Joven Ibáñez , Eva Tomero Muriel , Alejandro Prada Ojeda , M.a Teresa Navio , Laura Cebrián Méndez , Leticia Lojo , Ramón Mazzucchelli , Pedro Zarco Montejo

Objectives

To assess the effectiveness of a checklist for disease activity and comorbidity control in patients with axial spondyloarthritis (axSpA).

Method

A quasi-experimental retrospective multicentre pre-post intervention study was carried out in Spain between 2016 and 2022. Improvement in disease activity and comorbidity status was determined before and after the implementation of a checklist control in patients diagnosed with axSpA. Disease activity was determined by means of Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) and C-reactive protein (CRP) levels. Comorbidity status was determined by analysing several risk factors (blood pressure, body weight, blood test, etc.). An analysis of variance with mixed models between pre and post collected values was performed. The change in therapeutic level and disease status (low activity, remission) was determined by means of the Mc-Nemar asymmetry test.

Results

A total of 108 patients with axSpA were included in the study. After checklist implementation, a statistically significant reduction in BASDAI of 0.44 (95%CI: 0.06–0.82, p = 0.023) and a significant reduction of 3.82 mg/L (p = 0.001) in CRP was observed. Besides, an increase in uricemia of 0.24 mg/dl was found (95%CI: 1.49–6.14, p = 0.001), while no other statistically significant change in comorbidities was observed.

Conclusions

The implementation of a checklist in daily clinical practice leads to a significant improvement in the control of disease activity in patients with axSpA.
目的评估轴性脊柱炎(axSpA)患者疾病活动性和合并症控制检查表的有效性。方法2016 - 2022年在西班牙开展准实验回顾性多中心干预前后研究。在诊断为axSpA的患者实施检查表对照前后,确定疾病活动性和合并症状态的改善。采用巴斯强直性脊柱炎疾病活动性指数(BASDAI)和c反应蛋白(CRP)水平测定疾病活动性。通过分析几个危险因素(血压、体重、血液检查等)确定合并症状况。使用混合模型对采集前后的数据进行方差分析。通过Mc-Nemar不对称检验确定治疗水平和疾病状态(低活动,缓解)的变化。结果共纳入108例axSpA患者。实施检查表后,BASDAI显著降低0.44 (95%CI: 0.06-0.82, p = 0.023), CRP显著降低3.82 mg/L (p = 0.001)。此外,尿毒症增加0.24 mg/dl (95%CI: 1.49 ~ 6.14, p = 0.001),而其他合并症无统计学意义的变化。结论在日常临床实践中实施检查表可显著改善axSpA患者疾病活动的控制。
{"title":"Effectiveness of a checklist for the control of the disease activity in patients with axial spondyloarthritis","authors":"Raquel Almodóvar ,&nbsp;Elia Pérez-Fernández ,&nbsp;Marta Valero ,&nbsp;Virginia Villaverde ,&nbsp;Laura González ,&nbsp;Beatriz Joven Ibáñez ,&nbsp;Eva Tomero Muriel ,&nbsp;Alejandro Prada Ojeda ,&nbsp;M.a Teresa Navio ,&nbsp;Laura Cebrián Méndez ,&nbsp;Leticia Lojo ,&nbsp;Ramón Mazzucchelli ,&nbsp;Pedro Zarco Montejo","doi":"10.1016/j.reumae.2025.501918","DOIUrl":"10.1016/j.reumae.2025.501918","url":null,"abstract":"<div><h3>Objectives</h3><div>To assess the effectiveness of a checklist for disease activity and comorbidity control in patients with axial spondyloarthritis (axSpA).</div></div><div><h3>Method</h3><div>A quasi-experimental retrospective multicentre pre-post intervention study was carried out in Spain between 2016 and 2022. Improvement in disease activity and comorbidity status was determined before and after the implementation of a checklist control in patients diagnosed with axSpA. Disease activity was determined by means of Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) and C-reactive protein (CRP) levels. Comorbidity status was determined by analysing several risk factors (blood pressure, body weight, blood test, etc.). An analysis of variance with mixed models between pre and post collected values was performed. The change in therapeutic level and disease status (low activity, remission) was determined by means of the Mc-Nemar asymmetry test.</div></div><div><h3>Results</h3><div>A total of 108 patients with axSpA were included in the study. After checklist implementation, a statistically significant reduction in BASDAI of 0.44 (95%CI: 0.06–0.82, <em>p</em> <!-->=<!--> <!-->0.023) and a significant reduction of 3.82<!--> <!-->mg/L (<em>p</em> <!-->=<!--> <!-->0.001) in CRP was observed. Besides, an increase in uricemia of 0.24<!--> <!-->mg/dl was found (95%CI: 1.49–6.14, <em>p</em> <!-->=<!--> <!-->0.001), while no other statistically significant change in comorbidities was observed.</div></div><div><h3>Conclusions</h3><div>The implementation of a checklist in daily clinical practice leads to a significant improvement in the control of disease activity in patients with axSpA.</div></div>","PeriodicalId":94193,"journal":{"name":"Reumatologia clinica","volume":"21 7","pages":"Article 501918"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145005436","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
Transcultural adaptation and validation of the Transition Readiness Assessment Questionnaire (TRAQ) into Mexican Spanish 墨西哥西班牙语的跨文化适应和过渡准备评估问卷(TRAQ)的验证
Pub Date : 2025-08-01 DOI: 10.1016/j.reumae.2025.501917
Sara G. Rosiles-De la Garza , Ingris Pelaez-Ballestas , Fernando García-Rodríguez , Ana V. Villarreal-Treviño , Elisa L. Dávila-Sotelo , Leonor G. Hinojosa-Amaya , Jesús E. Treviño-Alvarado , Óscar González-Llano , Laura Villarreal-Matínez , Yajaira V. Jiménez-Antolínez , Julia E. Colunga-Pedraza , Nadina E. Rubio-Pérez

Purpose

The aim of the present study was to translate and perform a transcultural adaptation and validation of the TRAQ into Mexican Spanish.

Methodology

Transversal and observational study. First, the TRAQ was translated and transculturally adapted into Mexican Spanish. Then, the adapted TRAQ was administered to patients of any gender between 12 and 21 years of age and a chronic disease diagnosis. Correlation matrices for the questionnaire were obtained and their reliability was measured through homogeneity and internal consistency.

Results

The TRAQ was successfully translated and transculturally adapted into Mexican Spanish. After this, a pilot test of the questionnaire was performed with 40 patients. Lastly, the final validation phase was undertaken with 141 patients, with a median age of 13.9 years. The internal consistency analysis revealed a Cronbach's alpha global evaluation of 0.76, while the results organized through domains varied from 0.47 to 0.60.

Conclusions

The translated and transculturally adapted TRAQ revealed a good internal consistency, similar to other transcultural adoptions previously described in the medical literature. This process will allow us to ensure cultural and linguistic relevance for Mexican patients, particularly given the unique socio-cultural context of the Mexican population.
目的:本研究的目的是将TRAQ翻译成墨西哥西班牙语,并对其进行跨文化改编和验证。方法:横向观察性研究。首先,TRAQ被翻译并跨文化改编成墨西哥西班牙语。然后,对年龄在12至21岁之间的任何性别和慢性疾病诊断的患者进行适应性TRAQ。获得问卷的相关矩阵,并通过同质性和内部一致性测量问卷的信度。结果TRAQ被成功翻译成墨西哥西班牙语,并进行了跨文化改编。在此之后,对40名患者进行了问卷的初步测试。最后,141例患者进行了最后的验证阶段,中位年龄为13.9岁。内部一致性分析显示,Cronbach's alpha整体评价为0.76,而通过域组织的结果从0.47到0.60不等。结论TRAQ的翻译和跨文化改编显示出良好的内部一致性,类似于先前在医学文献中描述的其他跨文化采用。这一过程将使我们能够确保墨西哥患者的文化和语言相关性,特别是考虑到墨西哥人口独特的社会文化背景。
{"title":"Transcultural adaptation and validation of the Transition Readiness Assessment Questionnaire (TRAQ) into Mexican Spanish","authors":"Sara G. Rosiles-De la Garza ,&nbsp;Ingris Pelaez-Ballestas ,&nbsp;Fernando García-Rodríguez ,&nbsp;Ana V. Villarreal-Treviño ,&nbsp;Elisa L. Dávila-Sotelo ,&nbsp;Leonor G. Hinojosa-Amaya ,&nbsp;Jesús E. Treviño-Alvarado ,&nbsp;Óscar González-Llano ,&nbsp;Laura Villarreal-Matínez ,&nbsp;Yajaira V. Jiménez-Antolínez ,&nbsp;Julia E. Colunga-Pedraza ,&nbsp;Nadina E. Rubio-Pérez","doi":"10.1016/j.reumae.2025.501917","DOIUrl":"10.1016/j.reumae.2025.501917","url":null,"abstract":"<div><h3>Purpose</h3><div>The aim of the present study was to translate and perform a transcultural adaptation and validation of the TRAQ into Mexican Spanish.</div></div><div><h3>Methodology</h3><div>Transversal and observational study. First, the TRAQ was translated and transculturally adapted into Mexican Spanish. Then, the adapted TRAQ was administered to patients of any gender between 12 and 21 years of age and a chronic disease diagnosis. Correlation matrices for the questionnaire were obtained and their reliability was measured through homogeneity and internal consistency.</div></div><div><h3>Results</h3><div>The TRAQ was successfully translated and transculturally adapted into Mexican Spanish. After this, a pilot test of the questionnaire was performed with 40 patients. Lastly, the final validation phase was undertaken with 141 patients, with a median age of 13.9 years. The internal consistency analysis revealed a Cronbach's alpha global evaluation of 0.76, while the results organized through domains varied from 0.47 to 0.60.</div></div><div><h3>Conclusions</h3><div>The translated and transculturally adapted TRAQ revealed a good internal consistency, similar to other transcultural adoptions previously described in the medical literature. This process will allow us to ensure cultural and linguistic relevance for Mexican patients, particularly given the unique socio-cultural context of the Mexican population.</div></div>","PeriodicalId":94193,"journal":{"name":"Reumatologia clinica","volume":"21 7","pages":"Article 501917"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145005307","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
Usefulness of ultrasound in the assessment of the efficacy of apremilast in psoriatic arthritis: Articular, enthesitic and nail index 超声评价阿普米司特治疗银屑病关节炎的疗效:关节、全身和指甲指数
Pub Date : 2025-08-01 DOI: 10.1016/j.reumae.2025.501921
Juan José de Agustin , Gustavo Adolfo Añez , Delia Reina , Sergi Heredia , Julio Ramirez , Andrea Mireya Cuervo , Jesus Rodriguez , Carmen Moragues , Patricia Moya , Ana Maria Laiz Alonso , Mireia Moreno , Marta Arevalo , Manel Pujol , Georgina Salvador , Noemi Busquets , Andres Ponce , Maria Pascual Pastor

Background

Psoriatic arthritis (PsA) affects joints and entheses. The objective is to use ultrasound (US) to see inflammatory changes in joints and entheses in patients with active PsA starting Apremilast. Primary objective: 20% reduction in the US index (UIC) at 12 months.

Methodology

Multicenter, prospective, open-label study. Patients with PsA (≥2 swollen joints) and ≥2 US synovitis in joints and ≥1 US enthesitis at screening were recruited. Follow-up was 52 weeks (baseline and 1, 6, 9, 12 months). US (joint, tendon, and entheses), clinical (SJC, TJC, LEI, PGA, PtGA), and biological (ESR and CRP) parameters were recorded.

Results

48 patients were evaluated, 46 were included in the follow-up and 26 completed the 52-week study. The primary endpoint was achieved, with reductions of up to 40%. All clinical and ultrasound variables decreased significantly after 12 months. 75 adverse events (AEs) were recorded in 33 patients, and only one serious event (SAE). Reasons for withdrawal included AEs (6 patients), lack of efficacy (8 patients), and other reasons (loss to follow-up, withdrawal of consent) for 6 patients.

Conclusions

Changes in different domains of PsA in patients treated with Apremilast can be best identified by ultrasound. Ultrasound is an excellent tool to study joints, tendons, and entheses in PsA. Apremilast is a safe, well-tolerated, and effective treatment for several patterns of PsA (joints, entheses) as demonstrated by ultrasound. Ultrasound can also identify nail diseases in patients with PsA.
背景银屑病关节炎(PsA)影响关节和关节。目的是使用超声(US)来观察开始使用阿普拉米司特的活性PsA患者关节和关节的炎症变化。主要目标:12个月内美国指数(UIC)降低20%。方法:多中心、前瞻性、开放标签研究。筛查时伴有PsA(≥2个关节肿胀)、≥2个关节US滑膜炎和≥1个US腱鞘炎的患者。随访52周(基线及1、6、9、12个月)。记录US(关节、肌腱和关节)、临床(SJC、TJC、LEI、PGA、PtGA)和生物学(ESR和CRP)参数。结果48例患者接受评估,46例纳入随访,26例完成了52周的研究。主要终点达到了,减少了40%。12个月后,所有临床和超声指标均显著下降。33例患者记录了75例不良事件(ae),仅1例严重事件(SAE)。停药原因包括ae(6例)、缺乏疗效(8例)和其他原因(失去随访、撤回同意)6例。结论阿普米司特治疗后PsA不同区域的变化可通过超声诊断。超声是一种很好的工具来研究关节,肌腱和关节在PsA。阿普拉米司特是一种安全,耐受性良好,有效的治疗多种类型的PsA(关节,关节)的超声证实。超声也可以识别PsA患者的指甲疾病。
{"title":"Usefulness of ultrasound in the assessment of the efficacy of apremilast in psoriatic arthritis: Articular, enthesitic and nail index","authors":"Juan José de Agustin ,&nbsp;Gustavo Adolfo Añez ,&nbsp;Delia Reina ,&nbsp;Sergi Heredia ,&nbsp;Julio Ramirez ,&nbsp;Andrea Mireya Cuervo ,&nbsp;Jesus Rodriguez ,&nbsp;Carmen Moragues ,&nbsp;Patricia Moya ,&nbsp;Ana Maria Laiz Alonso ,&nbsp;Mireia Moreno ,&nbsp;Marta Arevalo ,&nbsp;Manel Pujol ,&nbsp;Georgina Salvador ,&nbsp;Noemi Busquets ,&nbsp;Andres Ponce ,&nbsp;Maria Pascual Pastor","doi":"10.1016/j.reumae.2025.501921","DOIUrl":"10.1016/j.reumae.2025.501921","url":null,"abstract":"<div><h3>Background</h3><div>Psoriatic arthritis (PsA) affects joints and entheses. The objective is to use ultrasound (US) to see inflammatory changes in joints and entheses in patients with active PsA starting Apremilast. Primary objective: 20% reduction in the US index (UIC) at 12 months.</div></div><div><h3>Methodology</h3><div>Multicenter, prospective, open-label study. Patients with PsA (≥2 swollen joints) and ≥2 US synovitis in joints and ≥1 US enthesitis at screening were recruited. Follow-up was 52 weeks (baseline and 1, 6, 9, 12 months). US (joint, tendon, and entheses), clinical (SJC, TJC, LEI, PGA, PtGA), and biological (ESR and CRP) parameters were recorded.</div></div><div><h3>Results</h3><div>48 patients were evaluated, 46 were included in the follow-up and 26 completed the 52-week study. The primary endpoint was achieved, with reductions of up to 40%. All clinical and ultrasound variables decreased significantly after 12 months. 75 adverse events (AEs) were recorded in 33 patients, and only one serious event (SAE). Reasons for withdrawal included AEs (6 patients), lack of efficacy (8 patients), and other reasons (loss to follow-up, withdrawal of consent) for 6 patients.</div></div><div><h3>Conclusions</h3><div>Changes in different domains of PsA in patients treated with Apremilast can be best identified by ultrasound. Ultrasound is an excellent tool to study joints, tendons, and entheses in PsA. Apremilast is a safe, well-tolerated, and effective treatment for several patterns of PsA (joints, entheses) as demonstrated by ultrasound. Ultrasound can also identify nail diseases in patients with PsA.</div></div>","PeriodicalId":94193,"journal":{"name":"Reumatologia clinica","volume":"21 7","pages":"Article 501921"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145005301","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
Autoimmune inner ear disease and localized scleroderma in childhood: A case report 儿童自身免疫性内耳病和局限性硬皮病1例报告。
Pub Date : 2025-06-01 DOI: 10.1016/j.reumae.2025.501912
Pilar del Rosario Guarnizo Zuccardi , Jacqueline de los Ángeles Piñeros Haiek , Natalia Rodríguez Bonilla , Sara Patricia Romero Orjuela , Sara Juliana Guerrero León
Autoimmune inner ear disease is frequently characterized by progressive bilateral hearing loss, which is not necessarily symmetrical. Vertigo, aural fullness, and tinnitus may also accompany it. There are 2 ways that the inner ear might be impacted: either as a primary disorder when the immune response directly attacks inner ear cells or as a secondary symptom of a systemic autoimmune disease.
We describe the case of an 11-year-old boy with morphea, who was diagnosed with autoimmune inner ear disease after he developed hearing loss. This relationship in children has not yet been documented in any prior reports. To improve diagnosis, management, and treatment and avoid long-term consequences, further research is required.
自身免疫性内耳疾病通常以进行性双侧听力损失为特征,这种损失不一定是对称的。眩晕、听觉充盈和耳鸣也可能伴随。内耳可能受到影响的方式有两种:当免疫反应直接攻击内耳细胞时,作为原发性疾病或作为系统性自身免疫性疾病的继发症状。我们描述的情况下,一个11岁的男孩与睡眠,谁被诊断为自身免疫性内耳疾病后,他发展听力损失。这种关系在儿童中尚未在任何先前的报告中得到证实。为了改善诊断、管理和治疗并避免长期后果,需要进一步的研究。
{"title":"Autoimmune inner ear disease and localized scleroderma in childhood: A case report","authors":"Pilar del Rosario Guarnizo Zuccardi ,&nbsp;Jacqueline de los Ángeles Piñeros Haiek ,&nbsp;Natalia Rodríguez Bonilla ,&nbsp;Sara Patricia Romero Orjuela ,&nbsp;Sara Juliana Guerrero León","doi":"10.1016/j.reumae.2025.501912","DOIUrl":"10.1016/j.reumae.2025.501912","url":null,"abstract":"<div><div>Autoimmune inner ear disease is frequently characterized by progressive bilateral hearing loss, which is not necessarily symmetrical. Vertigo, aural fullness, and tinnitus may also accompany it. There are 2 ways that the inner ear might be impacted: either as a primary disorder when the immune response directly attacks inner ear cells or as a secondary symptom of a systemic autoimmune disease.</div><div>We describe the case of an 11-year-old boy with morphea, who was diagnosed with autoimmune inner ear disease after he developed hearing loss. This relationship in children has not yet been documented in any prior reports. To improve diagnosis, management, and treatment and avoid long-term consequences, further research is required.</div></div>","PeriodicalId":94193,"journal":{"name":"Reumatologia clinica","volume":"21 6","pages":"Article 501912"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144791068","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
Major cardiovascular events associated factors in a cohort of patients with rheumatoid arthritis 类风湿关节炎患者队列中的主要心血管事件相关因素
Pub Date : 2025-06-01 DOI: 10.1016/j.reumae.2025.501915
Pedro Arbey Quevedo Mayorga , Jhon Sebastián Giraldo , Jhon Jairo Tipasoca Pineda , Cristhian Camilo Guzmán Gualteros , Julián Esteban Romero , Isabel Cristina Gonzalez , Maria Camila Hernandez , Viviana Carolina Pachón , Daniel Sarmiento

Introduction

Rheumatoid arthritis (RA) is a systemic autoimmune disease with articular and extra-articular manifestations. Mortality in RA is influenced by an increased risk of cardiovascular events by up to 48% (RR: 1.48, 95% CI 1.36–1.62), with a higher standardized mortality rate (SMR) due to cardiovascular causes compared to the general population. Our main objective was to examine the effect of clinical and serological variables on the risk of major cardiovascular events (MCE) in a cohort of RA patients.

Materials and methods

This was a retrospective cohort study. Patients more tha 18 years old and active follow-up in the RA care models of Hospital Universitario Clínica San Rafael and Clínica Nogales were included. Patients with prior major cardiovascular events or polyautoimmunity syndromes before the RA diagnosis were excluded. Survival analysis was performed to evaluate the probability of remaining free of MCEs, along with Cox proportional hazards analysis and structural equation modeling using a PATH analysis to assess direct and indirect effects.

Results

A total of 406 patients were included, 342 (84%) of whom were women, with a mean age of 44.8 ± 13.1 years and a disease duration of 13 ± 13.4 months. The average DAS28 activity score was 2.5 ± 1.78, with 48.7% having active disease (DAS28 > 2.6). Nineteen patients experienced MCEs, resulting in a cumulative incidence (CI) of 4.68% (4.4% myocardial infarction and 1.4% stroke). The most frequent risk factors were hypertension (23.7%) and smoking (24.8%). Bivariate analysis showed that heart failure (RR = 1.58, 95% CI 1.12–2.23, p = 0.01), and hypertension (RR = 2.36, 95% CI 1.22–4.60, p < 0.01) were significantly associated with MCEs. The probability of MCE-free survival at six months post-diagnosis was 50%. In the Cox model, only hypertension and age at diagnosis were significantly associated with MCE outcomes. In the PATH analysis, dyslipidemia was significantly associated with myocardial infarction without a mediating effect from corticosteroids (coef = 1.83, p < 0.001).

Conclusion

Traditional risk factors increase the risk of MCEs in RA patients. Additionally, dyslipidemia acts as an independent risk factor without mediation by other variables, making it a therapeutic target for preventing these outcomes.
类风湿关节炎(RA)是一种具有关节和关节外表现的全身自身免疫性疾病。类风湿性关节炎的死亡率受心血管事件风险增加的影响高达48% (RR: 1.48, 95% CI 1.36-1.62),与普通人群相比,心血管原因导致的标准化死亡率(SMR)更高。我们的主要目的是研究临床和血清学变量对RA患者主要心血管事件(MCE)风险的影响。材料和方法:这是一项回顾性队列研究。患者年龄大于18岁,并积极随访医院的RA护理模式Clínica圣拉斐尔和Clínica诺加利斯。排除RA诊断前有重大心血管事件或多自身免疫综合征的患者。通过生存分析来评估mce存活的概率,同时采用Cox比例风险分析和结构方程建模,采用PATH分析来评估直接和间接影响。结果:共纳入406例患者,其中女性342例(84%),平均年龄44.8±13.1岁,病程13±13.4个月。平均DAS28活性评分为2.5±1.78,其中48.7%为活动性疾病(DAS28>2.6)。19例患者发生mce,累积发生率(CI)为4.68%(4.4%的心肌梗死和1.4%的卒中)。最常见的危险因素是高血压(23.7%)和吸烟(24.8%)。双因素分析显示,心衰(RR=1.58, 95% CI 1.12-2.23, p=0.01)和高血压(RR=2.36, 95% CI 1.22-4.60, p)是RA患者发生mce的主要危险因素。此外,血脂异常是一个独立的危险因素,不受其他变量的调节,使其成为预防这些结果的治疗靶点。
{"title":"Major cardiovascular events associated factors in a cohort of patients with rheumatoid arthritis","authors":"Pedro Arbey Quevedo Mayorga ,&nbsp;Jhon Sebastián Giraldo ,&nbsp;Jhon Jairo Tipasoca Pineda ,&nbsp;Cristhian Camilo Guzmán Gualteros ,&nbsp;Julián Esteban Romero ,&nbsp;Isabel Cristina Gonzalez ,&nbsp;Maria Camila Hernandez ,&nbsp;Viviana Carolina Pachón ,&nbsp;Daniel Sarmiento","doi":"10.1016/j.reumae.2025.501915","DOIUrl":"10.1016/j.reumae.2025.501915","url":null,"abstract":"<div><h3>Introduction</h3><div>Rheumatoid arthritis (RA) is a systemic autoimmune disease with articular and extra-articular manifestations. Mortality in RA is influenced by an increased risk of cardiovascular events by up to 48% (RR: 1.48, 95% CI 1.36–1.62), with a higher standardized mortality rate (SMR) due to cardiovascular causes compared to the general population. Our main objective was to examine the effect of clinical and serological variables on the risk of major cardiovascular events (MCE) in a cohort of RA patients.</div></div><div><h3>Materials and methods</h3><div>This was a retrospective cohort study. Patients more tha 18 years old and active follow-up in the RA care models of Hospital Universitario Clínica San Rafael and Clínica Nogales were included. Patients with prior major cardiovascular events or polyautoimmunity syndromes before the RA diagnosis were excluded. Survival analysis was performed to evaluate the probability of remaining free of MCEs, along with Cox proportional hazards analysis and structural equation modeling using a PATH analysis to assess direct and indirect effects.</div></div><div><h3>Results</h3><div>A total of 406 patients were included, 342 (84%) of whom were women, with a mean age of 44.8<!--> <!-->±<!--> <!-->13.1 years and a disease duration of 13<!--> <!-->±<!--> <!-->13.4 months. The average DAS28 activity score was 2.5<!--> <!-->±<!--> <!-->1.78, with 48.7% having active disease (DAS28<!--> <!-->&gt;<!--> <!-->2.6). Nineteen patients experienced MCEs, resulting in a cumulative incidence (CI) of 4.68% (4.4% myocardial infarction and 1.4% stroke). The most frequent risk factors were hypertension (23.7%) and smoking (24.8%). Bivariate analysis showed that heart failure (RR<!--> <!-->=<!--> <!-->1.58, 95% CI 1.12–2.23, p<!--> <!-->=<!--> <!-->0.01), and hypertension (RR<!--> <!-->=<!--> <!-->2.36, 95% CI 1.22–4.60, p<!--> <!-->&lt;<!--> <!-->0.01) were significantly associated with MCEs. The probability of MCE-free survival at six months post-diagnosis was 50%. In the Cox model, only hypertension and age at diagnosis were significantly associated with MCE outcomes. In the PATH analysis, dyslipidemia was significantly associated with myocardial infarction without a mediating effect from corticosteroids (coef<!--> <!-->=<!--> <!-->1.83, p<!--> <!-->&lt;<!--> <!-->0.001).</div></div><div><h3>Conclusion</h3><div>Traditional risk factors increase the risk of MCEs in RA patients. Additionally, dyslipidemia acts as an independent risk factor without mediation by other variables, making it a therapeutic target for preventing these outcomes.</div></div>","PeriodicalId":94193,"journal":{"name":"Reumatologia clinica","volume":"21 6","pages":"Article 501915"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144796584","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}
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Reumatologia clinica
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