Role of Interleukin 6 Inhibitors in the Management of Rheumatoid Arthritis
Rheumatoid arthritis (RA) is a multisystem disease that affects the joints and various organs, resulting in compromised quality of life and increased mortality. A wide spectrum of treatment options is available for RA. Conventional synthetic disease-modifying antirheumatic drugs (csDMARDs) are the first-line of treatment for RA, whereas tumor necrosis factor α inhibitors are commonly used as a second-line biological disease-modifying antirheumatic drug following inadequate response to csDMARDs. However, remission remains difficult to achieve. No single agent is effective for all patients. It is important to consider patie...
Source: JCR: Journal of Clinical Rheumatology - December 1, 2021 Category: Rheumatology Tags: Reviews Source Type: research

Can We Expect Any Effect of Rituximab on Fatigue in Primary Sjögren Syndrome?: A Systematic Review and Critical Appraisal
Conclusions The use of rituximab for the treatment of pSS-related fatigue cannot be supported by the currently available evidence. (Source: JCR: Journal of Clinical Rheumatology)
Source: JCR: Journal of Clinical Rheumatology - December 1, 2021 Category: Rheumatology Tags: Reviews Source Type: research

Paraneoplastic Arthritides: Insights to Pathogenesis, Diagnostic Approach, and Treatment
Paraneoplastic arthritides are a group of inflammatory rheumatic syndromes induced by an occult and manifest malignancy, characterized by a wide range of musculoskeletal signs and symptoms that masquerade other rheumatic diseases such as rheumatoid arthritis. Although the pathogenesis of paraneoplastic arthritides is unknown, immune-mediated mechanisms can induce a paraneoplastic syndrome, with a dominant feature the polyarthritis. Common entities of paraneoplastic arthritides include paraneoplastic polyarthritis, hypertrophic osteoarthropathy, remitting seronegative symmetrical synovitis with pitting edema, palmar fasciit...
Source: JCR: Journal of Clinical Rheumatology - December 1, 2021 Category: Rheumatology Tags: Reviews Source Type: research

Elevated Serum IgG4 Was Found in Eosinophilic Granulomatosis With Polyangiitis
Objective The aim was to determine the levels and clinical impact of immunoglobulin G4 (IgG4) and other IgG subclasses in a Chinese population with eosinophilic granulomatosis with polyangiitis (EGPA). Methods We enrolled 49 patients who had EGPA, 27 who had granulomatosis with polyangiitis (GPA), 31 who had microscopic polyangiitis (MPA), and 30 healthy controls (HCs). Serum IgG subclasses were measured using commercial immunonephelometric assays and compared among different groups. Results Fifteen EGPA patients (30.61%) had elevated IgG4 levels, based on a cutoff value of 135 mg/dL. In addition, 2 GPA p...
Source: JCR: Journal of Clinical Rheumatology - December 1, 2021 Category: Rheumatology Tags: Reviews Source Type: research

Intensive Multicomponent Fibromyalgia Treatment: A Translational Study to Evaluate Effectiveness in Routine Care Delivery
Objective The current study was designed to evaluate the translation of clinical trial outcomes and clinical guidelines for the treatment of fibromyalgia (FM) into an intensive multicomponent clinical program embedded in routine care delivery. The study aimed to assess the adaptation of these recommended strategies into routine clinical care while evaluating their effectiveness and durability in improving functional status and level of distress in a large clinical sample of FM patients. Methods Four hundred eighty-nine patients with FM completed a 2-day program that incorporated best practice recommendations for...
Source: JCR: Journal of Clinical Rheumatology - December 1, 2021 Category: Rheumatology Tags: Original Articles Source Type: research

Determinants of Diagnostic Delay in Complex Regional Pain Syndrome Type 1: An Observational Study of 180 Consecutive New Cases
Conclusions Foot localization, prior physiotherapy prescribed for symptoms later diagnosed as CRPS, and a disease without overt clinical manifestations were independent predictive factors for a delayed diagnosis. Clinicians should pay attention to these issues to ensure a timely diagnosis and possibly avoid progression toward a chronic disease. (Source: JCR: Journal of Clinical Rheumatology)
Source: JCR: Journal of Clinical Rheumatology - December 1, 2021 Category: Rheumatology Tags: Original Articles Source Type: research

Incidence Rates of Interstitial Lung Disease Events in Tofacitinib-Treated Rheumatoid Arthritis Patients: Post Hoc Analysis From 21 Clinical Trials
Conclusions Across P1/2/3/4/long-term extension studies, incidence rates for ILD events were 0.18 following tofacitinib treatment, and ILD events were associated with known risk factors for ILD in RA. (Source: JCR: Journal of Clinical Rheumatology)
Source: JCR: Journal of Clinical Rheumatology - December 1, 2021 Category: Rheumatology Tags: Original Articles Source Type: research

Systemic Sclerosis Is Associated With Increased Inpatient Mortality in Patients Admitted for Atrial Fibrillation: Analysis of the National Inpatient Sample
Conclusions Patients admitted primarily for AFib with a secondary diagnosis of SSc have more than 3 times the odds of inpatient death compared with those without coexisting SSc. Hospital LOS, total hospital charges, likelihood of undergoing ablation, and electrical cardioversion were similar in both groups. (Source: JCR: Journal of Clinical Rheumatology)
Source: JCR: Journal of Clinical Rheumatology - December 1, 2021 Category: Rheumatology Tags: Original Articles Source Type: research

Urinary Cellular Profile as a Biomarker for Lupus Nephritis
Conclusions Urinary CD8+, CD4+, and CD14+ cells are highly sensitive and specific markers for detecting proliferative LN. A low CD4:CD8 ratio provides a further clue. Urinary CD14 cell counts may be a potential biomarker to differentiate between the different classes of proliferative LN. (Source: JCR: Journal of Clinical Rheumatology)
Source: JCR: Journal of Clinical Rheumatology - December 1, 2021 Category: Rheumatology Tags: Original Articles Source Type: research

The Effects of Hyperbaric Oxygen on Rheumatoid Arthritis: A Pilot Study
Conclusions Hyperbaric oxygen therapy is effective for joint pain in patients with RA based on data from multiple, validated clinical measures. Further research with more subjects and the use of a control group is necessary. (Source: JCR: Journal of Clinical Rheumatology)
Source: JCR: Journal of Clinical Rheumatology - December 1, 2021 Category: Rheumatology Tags: Original Articles Source Type: research

Pneumococcal Vaccination Among Lupus Patients: Who Are the Recipients?
Conclusions The volume of lupus patients that rheumatologists see is strongly associated with the likelihood that their SLE patients will have PPSV23 recommended and delivered, suggesting a volume outcome relationship. (Source: JCR: Journal of Clinical Rheumatology)
Source: JCR: Journal of Clinical Rheumatology - December 1, 2021 Category: Rheumatology Tags: Original Articles Source Type: research

Pain and Fatigue in Patients With Ankylosing Spondylitis Treated With Tumor Necrosis Factor Inhibitors: Multinational Real-World Findings
Background/Objective Patients with ankylosing spondylitis (AS) experience symptoms and comorbidities that impact their health-related quality of life (HRQoL) and ability to work. This real-world, global survey was conducted among AS patients receiving tumor necrosis factor inhibitors (TNFis) to evaluate both the frequency and severity of persistent symptoms, and the impact of pain and fatigue on HRQoL, employment status, and work activity. Methods Patients with AS and their treating physicians from 13 countries across 5 continents completed questionnaires capturing demographics, patient symptoms, current disease...
Source: JCR: Journal of Clinical Rheumatology - December 1, 2021 Category: Rheumatology Tags: Original Articles Source Type: research

Sleep Disturbance Trajectories in Osteoarthritis
Conclusions Four trajectories of restless sleep over 8 years were identified using data collected from over 4000 older adults aged 45 to 79 years with or at higher risk for knee OA. The presence of depressive symptoms, less physical activity, knee pain, poor mental health, cardiovascular disease, or pulmonary disease was each associated with unfavorable trajectories. (Source: JCR: Journal of Clinical Rheumatology)
Source: JCR: Journal of Clinical Rheumatology - December 1, 2021 Category: Rheumatology Tags: Original Articles Source Type: research

Going Further: Comprehensive Disease Control of Rheumatoid Arthritis, Targeting Cytokines and Chemokines
This study aimed to elucidate the cytokines and chemokines inhibited by different treatments (conventional synthetic DMARD [csDMARD], biological and targeted synthetic DMARD) in rheumatoid arthritis (RA). Methods Fifty-nine RA patients with low disease activity or remission included in a cross-sectional study were classified by treatment in groups: abatacept, certolizumab, rituximab (RTX), tocilizumab, tofacitinib (TOF), baricitinib (BAR), and csDMARD. Cytokine and chemokine serum levels were measured by LEGENDplex Human Inflammation panel. Quantitative variables were compared using Student t or Mann-Whitney U test ...
Source: JCR: Journal of Clinical Rheumatology - December 1, 2021 Category: Rheumatology Tags: Original Articles Source Type: research

Temperament and Character Profiles of Ankylosing Spondylitis Patients Compared With Major Depression Patients and Healthy Controls
Background/Objective Depressive disorder is common in patients with ankylosing spondylitis (AS), who exhibit specific brain imaging abnormalities resembling those in major depression (MD). We compared temperament and character profiles between patients with AS and MD. Methods The study involved 36 patients with AS, 40 with MD, and 36 healthy controls (HCs). The participants were age-, sex-, and education-matched. Depression, anxiety, temperament, and character were evaluated using the Temperament and Character Inventory and physician-rated Hamilton Depression and Anxiety Scales. Disease severity was assessed usi...
Source: JCR: Journal of Clinical Rheumatology - December 1, 2021 Category: Rheumatology Tags: Original Articles Source Type: research