Rheumatology

There is emerging evidence that knee alignment is associated with progression of osteoarthritis (OA). The aim of this study was to examine the relationship between baseline knee angle and the rate of cartilage loss in subjects with knee OA.One hundred and seventeen subjects with knee OA had standing radiographs and MRI on their symptomatic knee at baseline and at the 1.9+/-0.2 yr follow-up. Knee cartilage volume was measured at baseline and follow-up. Knee angle was defined as the angle subtended by a line drawn through the mid-shaft of the femur with respect to one drawn through the mid-shaft of the tibia.At baseline, in the medial compartment, as the angle decreased (i.e. was less varus) the tibial and femoral cartilage volume increased. In the lateral compartment, as the angle became more valgus, there was a reduction in tibial and femoral cartilage volume. In the longitudinal study, for every 1 degrees increase in baseline varus angulation there was an average annual loss of medial femoral cartilage of 17.7 micro l [95% confidence interval (CI) 6.5-28.8]. Although not statistically significant, there was a trend for a similar relationship between loss of medial tibial cartilage volume and baseline knee angle. In the lateral compartment, there was an average loss of tibial cartilage volume of 8.0 micro l (95% CI 0.0-16.0) for every 1 degrees increase in valgus angle.Baseline knee angle is associated with the rate of cartilage loss in the knee. Further work will be needed to determine whether therapies aimed at modifying the knee angle will reduce the progression of knee OA.

F. Cicuttini

A. Wluka

J. Hankin

Y. Wang

Longitudinal study of the relationship between knee angle and tibiofemoral cartilage volume in subjects with knee osteoarthritis

To investigate the association between neutrophil activation and cardiovascular risk in gout patients. We hypothesize that neutrophil activation mediates inflammation and therefore takes part in atherogenesis in gout patients.Patient data were collected from 75 consecutive gout patients participating in the Reade gout cohort Amsterdam. Levels of neutrophil extracellular traps (NETs) and neutrophil activation (calprotectin and peroxidase activity) were analysed by ELISA and fluorimetry in plasma and compared with healthy controls. Markers of neutrophil activation were related to clinical markers of cardiovascular risk, including BMI, smoking, blood pressure, lipid profile and 10 year risk of cardiovascular mortality (EU-SCORE).Increased levels of NETs were found in gout patients, although increased levels were not associated with cardiovascular risk. However, markers of neutrophil activation, including peroxidase activity correlated with waist:hip ratio (β = 0.33, P < 0.001), cholesterol ratio (β = 0.46, P < 0.005) and triglycerides (β = 0.60, P < 0.001) as well as the 10 year risk of cardiovascular mortality (β = 0.44, P = 0.001). Calprotectin levels were elevated in hypertension (P = 0.005) and diabetes (P = 0.02). Finally, gout patients with high levels of both peroxidase and calprotectin ('neutrophil activation signature') had a markedly elevated cardiovascular risk score (P = 0.001), with 68% of the patients having high cardiovascular risk (odds ratio 2.9, P = 0.03).We demonstrated elevated levels of neutrophil activation markers, MPO and calprotectin in gout patients as compared with healthy controls. Of note, neutrophil activation markers were associated with several risk factors for cardiovascular disease, including hyperlipidaemia, hypertension and diabetes. Finally, the presence of a neutrophil activation signature was strongly associated with an increased 10 year risk of cardiovascular mortality. Further studies are needed to determine whether gout-specific factors and/or cardiovascular risk factors contribute to the elevated neutrophil activation observed in these patients.

Daisy Vedder

Martijn Gerritsen

Michael T Nurmohamed

Ronald F van Vollenhoven

Christian Lood

A neutrophil signature is strongly associated with increased cardiovascular risk in gout

中性粒细胞特征与痛风患者心血管风险增加密切相关

Abstract Objectives To evaluate the efficacy of pharmacological interventions for treating early-stage, pain predominant, adhesive capsulitis, also known as frozen shoulder. Methods We performed a systematic review in accordance with Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines. Searches were conducted on MEDLINE, EMBASE and Cochrane Central Register of Controlled Trials on 24 February 2022. Outcomes were shoulder pain, shoulder function and range of movement. Synthesis involved both qualitative analysis for all studies and pairwise meta-analyses followed by a network meta-analysis for randomized controlled trials (RCTs). Results A total of 3252 articles were found, of which 31 met inclusion criteria, and 22 of these were RCTs. IA injection of CS (8 RCTs, 340 participants) and IA injection of platelet-rich plasma (PRP) (3 RCTs, 177 participants) showed benefit at 12 weeks compared with physical therapy in terms of shoulder pain and function, while oral NSAIDs (2 RCTs, 44 participants) and IA injection of hyaluronate (2 RCTs, 42 participants) did not show a benefit. Only IA PRP showed benefit over physical therapy for shoulder range of movement. Conclusion These results shows that IA CS and IA PRP injections are beneficial for early-stage frozen shoulder. These findings should be appraised with care considering the risk of bias, heterogeneity and inconsistency of the included studies. We believe that research focused on early interventions for frozen shoulder could improve patient outcomes and lead to cost-savings derived from avoiding long-term disability. Further well-designed studies comparing with standardized physical therapy or placebo are required to improve evidence to guide management.

Juan Enrique Berner

Marios Nicolaides

Stephen Ali

Georgios Pafitanis

Jane Preece

Sally Hopewell

Jagdeep Nanchahal

Pharmacological interventions for early-stage frozen shoulder: a systematic review and network meta-analysis

早期冻结肩的药物干预：系统评价与网状meta分析

Evidence from over 10 years of clinical experience demonstrates that biosimilar medicines approved in the European Union can be used for all their registered indications as safely as their originators and with no negative impact on therapeutic efficacy. The debate on the use of biosimilars in rheumatology focuses specifically on the safety of switching between biosimilars and reference products. Studies conducted to date, including randomised double-blind and open-label extension trials, have not demonstrated any significant differences in therapeutic efficacy or safety between patients switched from one medicine to another and those who were continued on a single medicine. According to the latest recommendations for the use of biosimilars in rheumatic diseases, developed by an international task force in 2017, there is no clinical evidence that a single switch from an originator to a biosimilar medicine is associated with any significant risk for patient safety or reduction in therapeutic efficacy.

Piotr Wiland

Bogdan Batko

Marek Brzosko

Eugeniusz Kucharz

Włodzimierz Samborski

Jerzy Świerkot

Ewa Więsik-Szewczyk

Julia Feldman

Reumatologia/Rheumatology

Biosimilar switching – current state of knowledge

生物类似药转换——当前知识现状

Objectives . To determine whether risedronate (RIS) slows down trabecular bone loss in the medial compartment of the proximal tibia, a characteristic of patients with progressive knee osteoarthritis (OA).

J. C. Buckland-Wright

E. A. Messent

C. O. Bingham

R. J. Ward

C. Tonkin

A 2 yr longitudinal radiographic study examining the effect of a bisphosphonate (risedronate) upon subchondral bone loss in osteoarthritic knee patients

Maria Maślińska

The 25th Congress of the Polish Society for Rheumatology

第25届波兰风湿病学会大会

Piotr W. Boros

The role of pulmonary function tests in the management of patients with connective tissue diseases and lung involvement

肺功能检查在结缔组织病合并肺部受累患者管理中的作用

Abstract Objectives Although Behçet's disease (BD) typically manifests in the second or third decade of life, initial symptoms may appear at a younger age. It may also take a longer time for the full disease phenotype to develop after the first symptom onset in pediatric patients. In this study we aimed to assess the clinical course of pediatric-onset BD in adulthood period. Methods The files of 112 patients diagnosed with BD before the age of 18, selected from five tertiary clinics, were retrospectively examined. Patients with a follow-up of less than six months were excluded. Results The study comprised 93 patients with pediatric-onset BD, of whom 64.5% (n = 60) were male. The median age of diagnosis was 15 years (13–17). Major organ involvement was present in 49 (52.5%) patients. The most commonly affected organ was the eye (29%). Sixty-eight (73.1%) patients had follow-up data in adulthood. Fourty patients had only mucocutaneous manifestations in the pediatric period. During follow-up in adulthood, 15 (53.3% were male) had new major organ involvement with a mean of 10.1 (SD: 7.9) years after diagnosis. Twenty-eight patients (41.1%) experienced major organ involvement during the pediatric period. In adulthood follow-up, 12 (42.8%) developed new major organ involvement and/or relapse of the same organ. Eighteen (26.5%) of 68 pediatric-onset BD patients had new major organ involvement, and 9 (13.2%) had a relapse during adulthood follow-up. Conclusion Our results showed that nearly one-third of pediatric BD patients have a new major organ involvement or a relapse in adulthood. Regular follow-up of pediatric BD patients in adulthood is essential to prevent long-term damage in this disease subset.

Tugce Bozkurt

Mehmet Yıldız

Rabia Deniz

Ayten Yazıcı

Murat Karabacak

Hakan Karataş

Seda Kutluğ-Ağaçkıran

Aybüke Günalp

Elif Kılıç Könte

Sezgin Şahin

Oya Köker

Kenan Barut

Cemal Bes

Ayşe Cefle

Tulin Ergun

Haner Direskeneli

Özgür Kasapçopur

Fatma Alibaz-Oner

Clinical course of pediatric-onset Behçet's Disease in young adulthood

年轻成年期儿童期起病的贝赫切特病的临床过程

Hyung Woo Kim

Tae Ik Chang

Seung Hyeok Han

Rheumatology (Oxford)

Comment on: Association between colchicine use and adverse cardiovascular events in patients with gout: a nationwide nested case-control study: Reply

评论：秋水仙碱使用与痛风患者心血管不良事件的关联：一项全国性嵌套病例对照研究的回复

Introduction This study compared treatment with biologic agents and Janus kinase inhibitors (JAKi) in combination with methotrexate (MTX) for rheumatoid arthritis (RA) in a real-world setting at a large center in Poland. There is a persistent shortage of such studies, and illustrating the switching of medications in search of a suitable way of treatment for a given patient is a crucial step towards future personalized therapy. Aim of the study This study is an extension of the initial work published in 2022 in &lt;i&gt;Reumatologia&lt;/i&gt;, with the addition of an analysis of patients treated with upadacitinib. The study compared the effectiveness and side effects after treatment of biological disease modifying antirheumatic drugs (bDMARDs) and targeted synthetic DMARDs (tsDMARDs) in combination with MTX. Materials and methods A total of 130 patients with active severe RA (Disease Activity Score for 28 joints based on the erythrocyte sedimentation rate [DAS28-ESR] value &gt; 5.1) were treated at the Rheumatologic Outpatients Department of the Central Clinical Hospital of the Ministry of the Interior and Administration, Warsaw, Poland between January 2010 and September 2021. All patients were treated with MTX 25 mg per week. They were divided into two groups: group I (80 patients) treated with biologic agents, and group II (50 patients) treated with JAKi. Assessment of DAS28-ESR and Simplified Disease Activity Index (SDAI) and analy­sis of Boolean criteria for remission were performed. Remission or low disease activity, switching between drugs and adverse events were assessed and compared between studied groups. Results Patients treated with tsDMARDs had previously used a higher number of conventional synthetic DMARDs (csDMARDs) and bDMARDs compared to those treated with bDMARDs. However, they achieved lower SDAI and assessment of disease activity using Visual Analogue Scale (VAS) values, and a higher proportion of patients achieved Boolean criteria for remission after treatment. Conclusions The results of treatment with JAKi were successful, but the potential side effects indicate that this treatment may not be equally suitable for all RA patients.

Małgorzata Wisłowska

Comparison of treatment of severe rheumatoid arthritis patients with biological agents and JAK-STAT inhibitors. An extension study

生物制剂与JAK-STAT抑制剂治疗重度类风湿关节炎患者的比较：一项扩展研究

Abbreviation	Reumatologia
Journal Impact	1.44
Quartiles(Global)	RHEUMATOLOGY(Q3)

ISSN	0034-6233, 1462-0324, 1462-0332, 2084-9834
h-index	198
Top Journals	Yes

Publication Information	Publisher: Oxford University Press，Publishing cycle: ，Journal Type: journal，Open Access Journals: Yes
Basic data	Year of publication: 1998，Proportion of original research papers: 0.00%，Self Citation Rate:7.10%， Gold OA Rate: 98.82%
Average review cycle	网友分享经验：10 Weeks

Rheumatology

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