Clinical Rheumatology, Journal Year: 2024, Volume and Issue: unknown
Published: Dec. 30, 2024
Language: Английский
Immunological Medicine, Journal Year: 2025, Volume and Issue: unknown, P. 1 - 10
Published: Jan. 31, 2025
Recent evidence indicates an increased risk of chronic kidney disease (CKD) in patients with rheumatoid arthritis (RA), prevalence rates ranging from 20.8% to 24.5%. Risk factors for CKD among RA include advancing age, diabetes, cardiovascular disease, hypertension and activity. Medications such as glucocorticoids nonsteroidal anti-inflammatory drugs (NSAIDs) may also accelerate progression. Inflammatory cytokines, notably interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α) IL-1, play significant roles the pathogenesis both CKD, promoting systemic inflammation renal impairment. Elevated levels various cytokines have been detected plasma urine patients, they raise morbidity mortality rates, even during early stages. Effective management activity modifications treatment reduce burden are essential lowering improving patient outcomes. Biological disease-modifying antirheumatic (DMARDs), particularly those targeting IL-6 TNF-α, show potential mitigating progression patients. However, individualized careful function monitoring critical, impact management. Future research should focus on therapeutic strategies that address optimize care.
Language: Английский
Citations
2
Scandinavian Journal of Rheumatology, Journal Year: 2025, Volume and Issue: unknown, P. 1 - 4
Published: Feb. 5, 2025
Language: Английский
Citations
0
BMJ Open, Journal Year: 2025, Volume and Issue: 15(2), P. e089956 - e089956
Published: Feb. 1, 2025
Depression frequently occurs among individuals suffering from chronic kidney disease (CKD), diminishing life quality considerably while accelerating the course. This study aims to create a predictive model identify patients with CKD at high risk for depression. Analysis of cross-sectional data. US National Health and Nutrition Examination Survey (2007-2014). A total 2303 (weighted=17 422 083) complete data were included in analysis. We used least absolute shrinkage selection operator regression variable constructed weighted logistic through stepwise backward elimination based on minimisation Akaike information criterion, visualised nomogram. Internal validation was conducted using 1000 bootstrap resamples. Model discrimination assessed receiver operating characteristic curves, calibration evaluated Hosmer-Lemeshow test net benefits clinical impact analysed decision curve analysis comparative chart curves. The final 10 predictors: age, gender, poverty income ratio, body mass index, smoking, sleep time, disorder, chest pain, diabetes arthritis. achieved an area under 0.776 (95% CI 0.745 0.806) good fit (Hosmer-Lemeshow p=0.805). Interventions within 0.1-0.6 probability range showed significant benefits. have crafted discriminative power that could potentially help clinicians depression, thereby facilitating early intervention improving prognosis these patients.
Language: Английский
Citations
0
Autoimmunity Reviews, Journal Year: 2025, Volume and Issue: 24(6), P. 103792 - 103792
Published: March 6, 2025
Language: Английский
Citations
0
Frontiers in Immunology, Journal Year: 2025, Volume and Issue: 16
Published: April 17, 2025
Objective This study aims to identify potential independent risk factors for rheumatoid arthritis (RA)- related mortality and develop a nomogram model predict individualized risk. Methods included 310 RA patients from the National Health Nutrition Examination Survey (NHANES) during 1999 - 2018. We applied LASSO, univariate, multivariate logistic regression analyses determine in training cohort construct model. Calibration plots evaluated nomogram’s accuracy. Finally, we established clinical utility through DCA performed internal validation within cohort. Results Of patients, 140 experienced deaths, corresponding rate of 45.16%. Within cohort, age, heart failure, systemic inflammatory response index (SIRI) emerged as predictors mortality. A model, constructed multivariable analysis, demonstrated an AUC 0. 852 (95% CI: 799 904) 904 846 963) The calibration curve revealed strong agreement between predicted actual probabilities. In both cohorts, highlighted significant net benefits predicting Conclusions demonstrates SIRI’s ability with good discrimination utility. gives clinicians simple tool quickly high promoting early intervention, personalized treatment, better prognosis.
Language: Английский
Citations
0
Rheumatology and Therapy, Journal Year: 2025, Volume and Issue: unknown
Published: April 21, 2025
This work aims to illustrate the evolution and ongoing challenges of rheumatoid arthritis (RA) management with targeted therapy over 20 years, using a cohort study from world's oldest society. Data were obtained FIRST registry, multicenter patients RA treated biologic/targeted synthetic disease-modifying antirheumatic drugs (b/tsDMARDs). Patients followed for 60 months assessed drug efficacy, retention, reasons discontinuation. Analysis 5130 treatments 16,616 person-years revealed shifts in strategies demographics. Despite an aging population (51.9-64.3 years) increasing comorbidities (lung disease: 11.1-36.2%, malignancy: 2.2-13.1%), b/tsDMARD use expanded include lower disease activity. With better control, discontinuations due adverse events decreased, particularly infections fell 2.1 0.7 per 100 person-years. Remission rates improved time naïve group but remained largely unchanged prior b/tsDMARDs group. Retention varied by bDMARD class, TNF inhibitors (TNFi) showing decrease IL-6 receptor (IL-6Ri) CTLA4-Ig increase retention. TNFi had high remission low whereas IL-6Ri higher Changes functional improvement modest overall, aged 75 years older, gains limited. The highlights evolving landscape society, noting efficacy safety. However, unmet needs persist, not fully achieving treat-to-target goals those limited improvement.
Language: Английский
Citations
0
Journal of Clinical Medicine, Journal Year: 2024, Volume and Issue: 13(24), P. 7594 - 7594
Published: Dec. 13, 2024
Despite remarkable advances in the management of RA, there are still unmet needs that rheumatologists need to address. In this review, we focused on difficult-to-treat RA (D2T RA) and late-onset (LORA), summarized their characteristics management. The prevalence D2T is reported be 6–28% many factors have been identified as risk for including female sex, long disease duration, seropositivity rheumatoid factor anti-cyclic citrullinated peptide antibody high titer, baseline activity, comorbidities. broadly divided into inflammatory non-inflammatory conditions, clinical features differ according background. A proportion can managed with treatment modification, mainly interleukin-6 receptor inhibitors or Janus kinase inhibitors, but some patients a poor prognosis; thus, implementation precision medicine by stratifying status needed. aging society, epidemiology changing LORA increasing worldwide. has distinct compared young-onset such acute onset, low seropositivity, inflammation. pathogenesis remains elucidated, proinflammatory cytokines, interleukin-6, significantly elevated. several concerns other than itself, geriatric syndrome multimorbidity. treat-to-target strategy effective LORA, evidence lacking; it important accumulate related basic data establish optimal LORA.
Language: Английский
Citations
1
Frontiers in Immunology, Journal Year: 2024, Volume and Issue: 15
Published: Sept. 19, 2024
Background Rheumatoid arthritis (RA) patients suffering from chronic renal insufficiency tend to exhibit subtle manifestations at the beginning. Urine albumin creatinine ratio (ACR) is a sensitive indicator for early assessment of function. However, it unclear whether serves as an independent risk factor influencing prognosis RA patients. Methods National Health and Nutrition Examination Survey (NHANES) data 2009-2018 were included. Kaplan-Meier (K-M) curves plotted compare cumulative survival probability with different urinary excretion. The association ACR mortality among was investigated Cox regression model, restricted cubic spline (RCS) stratified analyses. prognostic efficacy estimated glomerular filtration rate (eGFR) evaluated by receiver operating characteristic (ROC) curves. Results model adjusted covariates showed 53% (HR 1.53, 95% CI 1.06-2.21) increase in all-cause statistically non-significant cardiovascular disease (CVD) microalbuminuria (30mg/g ≤ACR<300mg/g). ACR≥300mg/g associated 2.62, 1.55-4.45) CVD 5.67, 1.96-16.39). RCS demonstrated nonlinear correlation between microalbuminuria. Subgroup analysis that higher characterized following features: female, other ethnicity, eGFR≥60 ml/min/1.73 m2, hypertension or hyperlipidemia. Compared eGFR, provided better than eGFR values area under curve (AUC) (AUC=0.683, 0.613-0.754) (AUC=0.681, 0.541-0.820). Conclusion affecting increased albuminuria. There upward trend those macroalbuminuria when increased.
Language: Английский
Citations
0
Clinical Rheumatology, Journal Year: 2024, Volume and Issue: unknown
Published: Dec. 30, 2024
Language: Английский
Citations
0