Current Rheumatology Reviews

Osteoarthritis (OA) is the most common joint disease and a leading cause for impaired function and disability with significant treatment costs and socio-economic burden. Despite recent achievements in the knowledge on disease pathogenesis, the treatment is still a challenge and contrary to the inflammatory joint diseases, no disease-modifying drugs are currently available for OA. Different response in different localizations of the disease further complicates the therapeutic choice. The standard pharmacological treatment includes agents for control of pain and inflammation (non-steroidal anti-inflammatory drugs, analgesics including opioids, intraarticular corticosteroids) and the group of the symptomatic slow acting drugs for OA such as glucosamine sulfate, chondroitin sulfate, diacerein, unsaponifiables extract of soybean and avocado administered orally and intrarticular hyaluronic acid. In addition, a number of studies investigate the efficacy of classic disease-modifying drugs used in inflammatory arthritides and antiresoptive agents as potential future therapies that could prevent structural progression of the disease. In a number of small studies, therapeutic efficacy of hydroxychloroquine (HCT) in OA has been suggested, but the results are contradictory. The first results from a multicenter, randomized, double-blind, placebo-controlled trial focused on symptomatic hand OA were recently reported (British HERO study). It has been concluded that HCQ was not superior than placebo as analgesic treatment or for reduction of the radiographic progression in hand OA. Placebo-controlled trial evaluating the efficacy of HCT in inflammatory and erosive hand OA is under way (OA TREAT study). Another field of recent research is the efficacy of TNF-alpha blockers based on the knowledge of their high efficacy in the inflammatory joint diseases and the significant role of TNF-alpha in the pathogenesis of OA. However, current evidence from the available studies does not support the use of TNF-alpha blockers in OA. The benefit of TNF-alpha blockers in specific sub-groups of patients with higher level of inflammation, objective criteria for the expected responders as well as cost-effectiveness of such treatment is a matter of further research and discussion. New biologic agents that target the nerve growth factor-β are other currently investigated drugs as a potential symptomatic therapeutic option in OA. Significant research has been also focused on revealing potential symptomatic or eventually disease-modifying efficacy of drugs that target bone metabolism due to contemporary notion for the crucial role of the subchondral bone in OA pathology and the positive association between the increased subchondral bone turnover and the progressive cartilage loss. A significant delay of joint width narrowing vs. placebo has been observed in patients with symptomatic knee OA after treatment with strontium renelate. The intraarticular administration of platelet-rich plasma is evaluated as potential future therapy and has been tried in knee and hip OA with beneficial effect. Based on the current knowledge about the OA pathogenesis and the undergoing studies, new therapies for OA are awaited both as a safe symptomatic treatment - alternative to the conventional treatment options and as a disease-modifying therapy that would revolutionize the contemporary approach to OA.

Walter Hermann

Sevdalina Lambova

Ulf Müller- Ladner

Current Treatment Options for Osteoarthritis

骨关节炎的当前治疗方案

Introduction: Investigating CD68+ positive cells in the synovial tissue is crucial for understanding the pathogenesis of psoriatic arthritis (PsA) and developing targeted treatment strategies. The role of CD68+ positive cells in the synovial tissue of patients with PsA for joint destruction has not been fully studied. Objective: The objective of the study was to examine the presence of CD68+ cells in the synovial tissue of patients with PsA, particularly those with high inflammatory activity. Methods: Synovial tissue samples were collected during knee joint replacement surgeries from patients with PsA (16 patients) and gonarthrosis (25 patients). Immunohistochemical methods were employed to detect CD68+ cell expression in the tissue samples. The results were analyzed by histologists, and the staining intensity and percentage of positively stained cells were evaluated. The data were then divided into three groups for statistical analysis: negative, weakly positive, and strongly positive histological samples. Routine indices for disease activity, VAS, DAPSA, PASDAI, and mCPDAI were used to assess PsA activity in all patients and to assess correlations with CD68+ positive cells in the synovial tissue. Statistical analysis was performed using SPSS version 26.0 (SPSS Inc., Chicago, IL, USA). Results: The expression of CD68+ positive cells was significantly higher in patients with PsA compared to those with activated gonarthrosis (p &lt; 0.001). The indices for disease activity, VAS, DAPSA, PASDAI, mCPDAI, and mCPDAI showed a significant positive relationship with the expression of CD68 + cells on synovial tissue in patients with PsA (p &lt; 0.01) Conclusion: The findings of the study confirm the increased numbers of CD68+ cells in PsA vs. gonathrosis synovium. This suggests the need to explore therapeutic approaches aimed at suppressing or blocking CD68+ cells to potentially mitigate joint damage.

Stanislava Popova-Belova

Mariela Geneva-Popova

Velichka Popova

Krasimir Kraev

Expression of CD68+ Cells in Synovial Tissue from Patients with PsA and its Association with Disease Activity Indices: A Clinical Pilot Study

银屑病关节炎患者滑膜组织中CD68+细胞的表达及其与疾病活动指数的相关性：一项临床初步研究

Systemic Lupus Erythematosus (SLE) (C1) is a disease with multi-organ involvement that can have a variety of cutaneous manifestations in 76% of cases during the disease. Less than 1% of these patients are diagnosed with confirmed bullous systemic lupus erythematosus (C1). Given the wide differential diagnosis of a bullous lesion, it is imperative to reach a conclusive diagnosis as it can have a direct impact on the course of management of the disease. Here, we present a case of SLE with a de novo presentation of bullous lesions. Throughout the length of the report, we will go through the protracted clinical course of the patient, followed by a clinically relevant discussion of the condition.

Saima Majid Mattoo

Sarah Mohammed Iftikhar

Rajesh Gupta Gopal

Imadeldin Ahmed Hamad

Shubhada Mandar Bichu

De novo Presentation of Systemic Lupus as Bullous Erythematosus: A Case Report

系统性红斑狼疮新发表现为大疱性红斑：一例报告

Introduction: Unlike restrictive pulmonary function and apical fibrobullous disease, diffuse interstitial lung disease is scarce in patients with ankylosing spondylitis (AS). We present a systematic review of the association between AS and SS. We also report a new case of SS revealed by interstitial lung disease in AS patients treated with tumor necrosis factor (TNF) inhibitors. Materials and methods: The systematic review was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guideline using the MEDLINE and SCOPUS databases and included case reports and case series describing the association between AS and SS. Results: There were sixty-three patients, including our case: 16 males and 47 females. The mean age was 49.2 years. The mean SpA duration was 14.1 years. The mean delay between SpA and SS was 12.8 years (0-27). SS was diagnosed after SpA in 62% of cases (n=39). It preceded SpA in 36.5% (n=23) and was concomitant with SpA in 1 case. All patients had sicca symptoms. MSGB showed focal sialadenitis grade III or grade IV in the Chisholm classification in 20 patients. Anti- nuclear antibody was positive in 75.8% of cases. Among them, anti-SSA and anti-SSB were positive in 44.4% and 35.3% of cases. Except for our patient, no patient had interstitial lung disease. SS extra glandular manifestations were reported in 12 cases. Conclusion: The occurrence of Sjögren’s syndrome is uncommon in patients with ankylosing spondylitis. This association has been reported in the literature, suggesting a pathogenetic link between these two diseases. This association should be considered in ankylosing spondylitis patients with diffuse interstitial lung disease. Knowing this association is necessary for therapeutic adjustment. Our study has some limitations. Publication bias was the major bias in our study. Indeed, we only included case reports and case series describing the association between SpA and SS. We did not search for unpublished work. Moreover, the follow-up was not specified in most included articles.

Maroua Slouma

Takwa Mehmli

Emna Hannech

Rim Dhahri

Islam Mejri

Meriem Affes

Imen Gharsallah

Sjögren’s Syndrome and Ankylosing Spondylitis Association: A Case-Based Review

干燥综合征与强直性脊柱炎关联：基于病例的综述

Upadacitinib, a Janus kinase (JAK) inhibitor used in rheumatoid arthritis treatment, has prompted safety concerns due to potential cardiovascular adverse events. However, current evidence does not provide a definitive conclusion.

Fatemeh Omidi

Parisa Delkash

Mohammad Javad Nasiri

Mehdi Mirsaeidi

Upadacitinib and Cardiovascular Adverse Events in Rheumatoid Arthritis: A Systematic Review and Meta-Analysis

乌帕他替尼与类风湿性关节炎中心血管不良事件：系统综述与荟萃分析

Background: Ankylosing Spondylitis is a chronic inflammatory rheumatic disease with both articular and extra-articular features. While cardiovascular involvement in Ankylosing spondylitis is rare, it can be life-threatening. This condition is typically associated with the HLAB27 antigen and often presents in the advanced stages of the disease. This case is particularly uncommon as cardiovascular involvement was identified at the time of diagnosis in a patient who tested negative for HLA-B27. Case Presentation: Here, we present an uncommon case of a 37-year-old male with 3 years of evolving Ankylosing Spondylitis negative for HLA-B27, who was incidentally found to have a giant aortic aneurysm during cardiovascular screening at the time of his rheumatic disease diagnosis. The patient underwent surgical intervention using the Tyron-David procedure. Subsequent post-operative follow-ups revealed satisfactory outcomes without complications, Conclusion: Even in the absence of clinical signs, and even in the early stages of Ankylosing spondylitis, it is necessary to screen for this condition, at least with transthoracic ultrasound. Early screening ensures prompt treatment, which will save the patient’s life.

Boudoukhane Manel

Oueslati Ichrak

Bettaieb Hiba

Bourguiba Rim

Helali Wiem

Doggui Mohamed Hedi

Belakhel Syrine

Unmasking the Hidden Peril: A Case Report of Ankylosing Spondylitis Revealing a Giant Aortic Aneurysm

揭开隐匿危险的面纱：一例强直性脊柱炎揭示巨大主动脉瘤的病例报告

短名	CRR
Journal Impact	1.13
国际分区	RHEUMATOLOGY(Q4)

ISSN	1573-3971, 1875-6360
h-index	29

涉及主题	医学生物内科学病理免疫学外科遗传学疾病心理学化学精神科类风湿性关节炎生物化学放射科关节炎内分泌学
出版信息	出版商: Bentham Science Publishers B.V.，出版周期: ，期刊类型: journal，开源期刊: 否
基本数据	创刊年份: 2006，原创研究文献占比: 62.50%，自引率:8.30%， Gold OA占比: 1.67%

Current Rheumatology Reviews

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Current Treatment Options for Osteoarthritis

Expression of CD68+ Cells in Synovial Tissue from Patients with PsA and its Association with Disease Activity Indices: A Clinical Pilot Study

De novo Presentation of Systemic Lupus as Bullous Erythematosus: A Case Report

Sjögren’s Syndrome and Ankylosing Spondylitis Association: A Case-Based Review

Upadacitinib and Cardiovascular Adverse Events in Rheumatoid Arthritis: A Systematic Review and Meta-Analysis

De novo Presentation of Systemic Lupus as Bullous Erythematosus: A Case Report

Expression of CD68+ Cells in Synovial Tissue from Patients with PsA and its Association with Disease Activity Indices: A Clinical Pilot Study

Upadacitinib and Cardiovascular Adverse Events in Rheumatoid Arthritis: A Systematic Review and Meta-Analysis

Sjögren’s Syndrome and Ankylosing Spondylitis Association: A Case-Based Review

Unmasking the Hidden Peril: A Case Report of Ankylosing Spondylitis Revealing a Giant Aortic Aneurysm