Journal of Rheumatology

OBJECTIVE: Abnormal functional connectivity (FC) and structure in the brain are found in patients with fibromyalgia (FM). This study investigated FC and structural alterations of the visual cortical system, the emerging contributor to pain processing, in patients with FM. METHODS: Thirty pain-free participants and 26 patients with FM were enrolled. Clinical characteristics were evaluated using standardized scales. Structural and resting-state functional magnetic resonance imaging were conducted...

With the growth in demand for pediatric rheumatology services alongside a rapidly growing Canadian population,1 monitoring the delivery of pediatric rheumatology services is important to inform human resource planning. We used a population-based approach to describe the annual supply of, and clinical services provided by, pediatric rheumatologists in Ontario, Canada, between 2010 and 2019.

OBJECTIVE: To evaluate the impact of a patient-centered rheumatoid arthritis (RA) treat to target (T2T) disease management approach on patient outcomes and patient satisfaction with care. METHODS: In this longitudinal, observational pilot study, rheumatologists implemented a modified T2T approach that integrated PROMIS measures for depression, fatigue, pain interference, physical function, and social function into RA care. Study participants selected one PROMIS domain to target treatment and completed quarterly follow-up assessments...

SARS-CoV-2 has certainly been at the forefront of medical discussion and research for the past 3 years. While many are adjusting back to "normal," thanks to the rapid advancements in prevention and treatment, high-risk groups, such as adults with systemic autoimmune rheumatic diseases (SARDs), still require careful monitoring and care.

OBJECTIVE: Some patients with rheumatoid arthritis (RA) who persist in remission may decide to stop their therapy. We evaluated baseline characteristics associated with remaining in remission or low disease activity (LDA) following medication withdrawal. METHODS: SEAM-RA was a phase 3, multicenter, randomized withdrawal, double-blind, controlled study in patients with RA on methotrexate + etanercept. If remission (Simplified Disease Activity Index [SDAI] ≤3...

OBJECTIVE: Calcium pyrophosphate deposition (CPPD) disease prevalence is similar to gout and osteoarthritis (OA), yet CPPD outcomes research greatly lags behind these other forms of arthritis. We compared validated patient-reported outcome measures in patients with CPPD versus gout and OA. METHODS: Patients with CPPD were recruited from Brigham and Women's Hospital, 2018-2022. Presence of CPPD manifestations (acute calcium pyrophosphate [CPP] crystal arthritis, chronic CPP inflammatory arthritis, and/or OA with CPPD) was confirmed by medical record review...

Premature atherosclerosis has been observed during the course of different systemic inflammatory diseases, such as rheumatoid arthritis (RA), systemic lupus erythematosus, and antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV).1-3 As a result, cardiovascular (CV) events, including myocardial infarction, stroke, heart failure, coronary artery disease, and death, occur 1.65 to 3 times more commonly in patients with AAV as compared to the general population, and the risk appears to be highest in the first year following diagnosis...

Amiri et al1 provide extensive burden of disease estimates for gout in the Middle East and North Africa (MENA) region sourced from the Global Burden of Disease (GBD) 2019 study. We would like to draw attention to the considerable uncertainty with these estimates and advise readers to interpret the estimates cautiously.

OBJECTIVE: Axial spondyloarthritis (axSpA) is associated with decreased function and mobility of patients due to inflammation and radiographic damage. The Epionics SPINE device (ES), an electronic device that objectively measures spinal mobility, including range of motion (RoM) and speed (RoK) of movement, has been clinically validated in axSpA. We investigated the performance of the ES relative to radiographic damage in the axial skeleton of patients with axSpA. METHODS: A total of 103 patients with axSpA (31 non- [nr-] and 72 radiographic [r]- axSpA) were consecutively examined...

Syphilis is a sexually transmitted disease caused by the spirochete Treponema pallidum and can affect any organ in the body including the eye or central nervous system.1 Ocular involvement of neurosyphilis most frequently involves panuveitis but can also include retinal vasculitis, interstitial keratitis, or optic neuropathy.2,3 .

OBJECTIVE: Radiography is still used worldwide for detection of sacroiliitis in juvenile spondyloarthritis (SpA), despite low sensitivity and reliability. We aimed to define unequivocal evidence of sacroiliitis on pelvic radiography in skeletally immature youth for use in classification criteria when MRI is unavailable. METHODS: Subjects were a retrospective cohort of juvenile spondyloarthritis (SpA) patients with a radiograph and MRI as part of a diagnostic evaluation for axial disease...

The assessment of disease impact for rheumatological conditions is a challenging topic of relevant interest in the last years. Severity is closely related to disease impact, and related to several aspects of clinical conditions, including, among others, disease activity, physical function, and damage.

Juvenile systemic sclerosis (jSSc) is a rare but potentially life-threatening disease, with a prevalence of 3 to 4 in 1,000,000 children. Similar to that in adults,1 interstitial lung disease (ILD) is the major cause of morbidity in children with systemic sclerosis (SSc) and occurs at similar prevalences.2 .

OBJECTIVE: Systemic sclerosis (SSc) is burdened by Raynaud's phenomenon (RP) and digital ulcers (DUs) and sometimes standard vasoactive therapies are ineffective or contraindicated. Selexipag is an oral selective IP prostacyclin receptor agonist approved for the treatment of SSc-related pulmonary arterial hypertension. We aimed to evaluate clinical and instrumental efficacy of selexipag in SSc digital vasculopathy. METHODS: SSc patients with severe digital vasculopathy refractory or with contraindication to all other vasoactive therapies were administered selexipag, evaluating at baseline and after 3 months clinical outcomes regarding RP and DUs and digital perfusion assessed by laser speckle contrast analysis (LASCA)...

Disease activity in rheumatoid arthritis (RA) is often described in terms of inflammation, although noninflammatory mechanisms are also integral to the disease. Pain is the most important symptom for many people with RA,1 and is therefore a key component of clinically relevant measures of RA disease activity.

OBJECTIVE: Lupus nephritis (LN), a common manifestation of systemic lupus erythematosus, is associated with a higher risk of kidney failure and death. The renal pathology of LN helps elucidate the severity of inflammation and the extent of irreversible damage. We aimed to identify histologic variables that correlate with risks of kidney failure and mortality. METHODS: Between 2006 and 2019, a total of 526 patients with LN were enrolled. Renal pathology was classified according to the International Society of Nephrology/Renal Pathology Society classification...

Arthritis induced by immune checkpoint inhibitors (ICPi) has been reported to occur in 1% to 7% of ICPi-treated patients with cancer.1-4 Treatment generally starts with glucocorticoids (GCs) before disease-modifying antirheumatic drugs (DMARDs) are considered.5 .

OBJECTIVE: To determine the clinical phenotype and outcomes of patients with idiopathic inflammatory myopathies (IIMs) and myocarditis. METHODS: Using the Johns Hopkins Myositis Center Research Registry, we identified 31 adult patients with IIM-out of a total of 3082 with confirmed or suspected muscle disease-with an encounter code of myocarditis from 2004 to 2021. Of these, 14 adult patients with IIM were adjudicated to have clinical myocarditis. Information about demographics, autoantibodies, and clinical outcomes was retrospectively collected and analyzed...

We read with great interest the article published by Chung et al, which emphasizes the low frequency of guideline-congruent cervical cancer screening (CCS) among women with systemic lupus erythematosus (SLE).1 An adequate CCS was correlated with the use of immunosuppressants and the presence of a gynecologist, whereas Hispanic ethnicity was negatively correlated.

With improved disease control, an increasing number of women with rheumatic diseases (RDs) are considering pregnancies. Though there are many international guidelines available for managing pregnancies in RD, the execution of a plan for such care is generally limited by several factors, leaving gaps between evidence and practice.1-4 .