检索结果-南通市图书馆

Continuation,reduction,or withdrawal of tofacitinib in patients with rheumatoid arthritis achieving sustained disease control:a multicenter,open-label,randomized controlled trial

引用

Chinese Medical Journal 2023年第3期136卷 331-340页

作者： Mengyan Wang Yu Xue Fang Du Lili Ma Liang-jing Lu Lindi Jiang Yi-Li Tao Chengde Yang Hui Shi Honglei Liu Xiaobing Cheng Junna Ye Yutong Su Dongbao Zhao Sheng-Ming Dai Jialin Teng Qiongyi Hu department of rheumatology and immunology Ruijin HospitalShanghai Jiao Tong University School of MedicineShanghai 200025China department of rheumatology and immunology Huashan Hospital Affiliated to Fudan UniversityShanghai 200040China department of rheumatology Renji HospitalShanghai Jiaotong University School of MedicineShanghai 200127China department of rheumatology Zhongshan HospitalFudan UniversityShanghai 200032China department of rheumatology and immunology Shanghai Sixth People’s HospitalShanghai Jiao Tong University School of MedicineShanghai 200233China department of rheumatology and immunology Changhai HospitalNaval Medical UniversityShanghai 200433China

Background:Rheumatoid arthritis(RA),a chronic systemic autoimmune disease,is characterized by synovitis and progressive damage to the bone and cartilage of the joints,leading to disability and reduced quality of life.This study was a randomized clinical trial comparing the outcomes between withdrawal and dose reduction of tofacitinib in patients with RA who achieved sustained disease control.Methods:The study was designed as a multicenter,open-label,randomized controlled trial.Eligible patients who were taking tofacitinib(5 mg twice daily)and had achieved sustained RA remission or low disease activity(disease activity score in 28 joints[DAS28]≤3.2)for at least 3 months were enrolled at six centers in Shanghai,China.Patients were randomly assigned(1:1:1)to one of three treatment groups:continuation of tofacitinib(5 mg twice daily);reduction in tofacitinib dose(5 mg daily);and withdrawal of tofacitinib.Efficacy and safety were assessed up to 6 months.Results:Overall,122 eligible patients were enrolled,with 41 in the continuation group,42 in the dose-reduction group,and 39 in the withdrawal group.After 6 months,the percentage of patients with a DAS28-erythrocyte sedimentation rate(ESR)of<3.2 was significantly lower in the withdrawal group than that in the reduction and continuation groups(20.5%,64.3%,and 95.1%,respectively;P<0.0001 for both comparisons).The average flare-free time was 5.8 months for the continuation group,4.7 months for the dose reduction group,and 2.4 months for the withdrawal group.Conclusion:Withdrawal of tofacitinib in patients with RA with stable disease control resulted in a rapid and significant loss of efficacy,while standard or reduced doses of tofacitinib maintained a favorable state.Trial Registration:***,ChiCTR2000039799.

关键词： Tofacitinib Rheumatoid arthritis Withdrawal Dose reduction

来源：

维普期刊数据库

同方期刊数据库评论

在线全文

学校读者我要写书评

暂无评论

Amyloidosis with recurrent oral and peptic ulcers mimicking Behcet's syndrome:A case report

引用

rheumatology & Autoimmunity 2022年第1期2卷 40-44页

作者： Jiajing Peng Tian Liu department of rheumatology and immunology Peking University People's HospitalBeijingChina department of rheumatology and immunology Beijing Tongren HospitalBeijingChina

Introduction:Amyloidosis and Behcet's syndrome(BS)are systemic diseases that affect multiple systems.Similar mucocutaneous damage occurs in amyloidosis and BS,thus causing a delayed or incorrect diagnosis.The prognosis of patients with amyloidosis is poor.Therefore,exclusion of other diagnoses is important before confirming the presence of BS.Case Report:We report a case of a 43-year-old woman who initially presented with peptic ulcers,recurrent oral ulcers,and suspicious genital ulcers resembling BS.She was treated with systemic steroids at the local hospital for approximately 2 years.However,her symptoms were not relieved,and the gradual presence of macroglossia,hoarseness,periorbital purpura,proteinuria,and cardiac involvement strongly suggested amyloidosis.She was diagnosed with immunoglobulin light chain amyloidosis(lambda type)after extensive examinations,including an elevated monoclonal protein concentration,Congo red staining,and immunohistochemical staining of abdominal fat.She was then treated with a chemotherapy regimen(melphalan and dexamethasone).Conclusion:Recurrent oral ulcers can be the first manifestation of amyloidosis.The diagnosis of BS requires the exclusion of other diseases,and amyloidosis should be considered as a differential diagnosis.

关键词： amyloidosis Behcet's syndrome ulcer

来源：

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Update on classification,diagnosis,and management of immunoglobulin G4-related disease

引用

Chinese Medical Journal 2022年第4期135卷 381-392页

作者： Yu Chen Shaozhe Cai Lingli Dong Hisanori Umehara department of rheumatology and immunology Tongji HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhanHubeiChina department of rheumatology and immunology Nagahama City HospitalOinuichoNagahamaShiga 526-0043Japan

Immunoglobulin G4-related disease(IgG4-RD)is a newly recognized chronic fibro-inflammatory autoimmune disease,and its recognition has been constantly increasing worldwide over the last few years.A correct and timely recognition,as well as appropriate intervention,is crucial for the treatment of IgG4-RD.For certain subtypes of IgG4-RD,organ-specific criteria are formulated to make the diagnosis more accurate.New biomarkers have emerged in the recent years to aid the disease diagnosis,its prognosis prediction,as well as therapy response monitoring.Although recurrence is very common in IgG4-RD,glucocorticoid is still the first-line treatment for the majority of patients.The factors that affect the likelihood of disease relapse are multifaceted.The selection strategy of various steroid-sparing agents is still being explored.Besides,when patients have special sites involvement leading to severe clinical conditions,surgical operation or interventional therapy should also be considered.An update on classification,diagnosis,and management of IgG4-RD is provided in the current study to fully elucidate the recommended clinical practice of this mysterious disease.

关键词： IgG4-related disease Review Update Management

来源：

维普期刊数据库

同方期刊数据库评论

在线全文

学校读者我要写书评

暂无评论

Risk of infections of biological and targeted drugs in patients with spondyloarthritis: meta-analysis of randomized clinical trials

引用

Chinese Medical Journal 2022年第8期135卷 911-919页

作者： Lidong Hu Siliang Man Xiaojian Ji Yiwen Wang Xingkang Liu Jiaxin Zhang Chuan Song Jian Zhu Feng Huang department of rheumatology and immunology The Rrst Medical CenterChinese PLA General HospitalBeijing 100853China department of rheumatology Beijing Jishuitan HospitalBeijing 100035Chini

Background: Concerns exist regarding the risk of infections in patients with spondyloarthritis (SpA) treated with biologics. We assessed the risk of infections of biological and targeted drugs in patients with SpA by performing a meta-analysis based on randomized controlled trials (RCTs).Methods: A systematic literature search was conducted in PubMed, Embase, Web of Science, the Cochrane Library, and China Biology Medicine Disc for RCTs evaluating the risk of infections of biological therapy in patients with SpA from inception through August 9, 2021. We calculated a pooled Peto odds ratio (OR) for infections in biologics-treated patientsvs. placebo patients. The risk of bias on the included RCTs was assessed by using the Cochrane Risk of Bias Tool.Results: In total, 62 studies were included in this meta-analysis. Overall, the risk of infection (Peto OR: 1.16, 95% confidence interval [CI]: 1.07-1.26,P < 0.001), serious infection (Peto OR: 1.65, 95% CI: 1.26-2.17,P < 0.001), upper respiratory tract infection (URTI) (Peto OR: 1.17, 95% CI: 1.04-1.32,P = 0.008), nasopharyngitis (Peto OR: 1.25, 95% CI: 1.10-1.42,P < 0.001), andCandida infection (Peto OR: 2.64, 95% CI: 1.48-4.71,P = 0.001) were increased in SpA patients treated with biologics compared with placebo. Sensitivity analysis based on biologics classes was conducted, and results demonstrated that compared with placebo, there was a higher risk of infection for tumor necrosis factor (TNF)-α inhibitors (Peto OR: 1.38, 95% CI: 1.13-1.68,P = 0.001) and interleukin (IL)-17 inhibitors (Peto OR: 1.55, 95% CI: 1.08-2.22,P = 0.018) in axial SpA, and for Janus kinase inhibitors in peripheral SpA (Peto OR: 1.39, 95% CI: 1.14-1.69,P = 0.001);higher risk of serious infection for IL-17 inhibitors in peripheral SpA (Peto OR: 3.46, 95% CI: 1.26-9.55,P = 0.016) and axial SpA (Peto OR: 2.01, 95% CI: 1.38-2.91,P < 0.001);higher risk of URTI for TNF-α inhibitors in axial SpA (Peto OR: 1.37, 95% CI: 1.05-1.78,P= 0.019), and for apremilast in peripheral SpA (Peto OR: 1.60, 95% CI:

关键词： Spondyloarthritis Biological therapy Infection Herpes zoster Meta-analysis

来源：

维普期刊数据库

同方期刊数据库评论

在线全文

学校读者我要写书评

暂无评论

Increased human neutrophil lipocalin and its clinical relevance in adult-onset Still’s disease

引用

Chinese Medical Journal 2023年第23期136卷 2867-2873页

作者： Ji Li Yingni Li Ru Li Xiangbo Ma Lianjie Shi Shengguang Li Qian Guo Yuan Jia Zhanguo Li department of rheumatology and immunology Peking University People’s HospitalBeijing Key Laboratory for Rheumatism Mechanism and Immune Diagnosis(BZ0135)Beijing 100044China department of rheumatology and immunology Peking University International HospitalBeijing 102206China department of rheumatology and immunology Handan Central HospitalHandanHebei 056001China Peking-Tsinghua Center for Life Sciences Beijing 100044China

Background:Human neutrophil lipocalin(HNL)has been used extensively to differentiate acute bacterial infection from febrile diseases as a biomarker to reflect the activation of the neutrophil.The serum HNL levels in the adult-onset Still’s disease(AOSD)patients with and without infection,as well as the healthy controls(HCs),were analyzed statistically in this study to evaluate the value of HNL for the diagnosis of AOSD.Methods:A total of 129 AOSD patients were enrolled,from whom blood samples were drawn and the AOSD diagnosis was confirmed through the review of the medical records,where the systemic score,demographic characteristics,clinical manifestations,and laboratory parameters were also collected for the patients;in addition,a total of 40 HCs were recruited among the blood donors from the healthcare center with the relevant information collected.The HNL test was done for the blood samples with the enzyme-linked immunosorbent assay and the analyses were done for the correlations of HNL with clinical manifestations and diagnostic effectiveness.Results:The serum HNL increased significantly in the patients with only AOSD as compared with that in the HCs(139.76±8.99 ng/mL vs.55.92±6.12 ng/mL;P<0.001).The serum HNL level was correlated with the white blood cell(WBC)count(r=0.335,P<0.001),neutrophil count(r=0.334,P<0.001),erythrocyte sedimentation rate(r=0.241,P=0.022),C-reactive protein(r=0.442,P<0.0001),and systemic score(r=0.343,P<0.0001)in the AOSD patients significantly.Patients with fever,leukocytosis≥15,000/mm^(3),and myalgia in the HNL-positive group were observed relatively more than those in the HNL-negative group(P=0.009,P=0.023,and P=0.007,respectively).HNL was a more sensitive indicator than ferritin and C-reactive protein(CRP)to differentiate the AOSD patients with bacterial infection from AOSD-only patients,and the Youden index was 0.6 for HNL and 0.29 for CRP.Conclusion:Serum HNL can be used as a biomarker for the diagnosis of the AOSD,and HNL is also observed to be associated with the disease activ

关键词： Adult-onset Still’s disease Human neutrophil lipocalin Diagnosis Biomarker Disease activity

来源：

维普期刊数据库

同方期刊数据库评论

在线全文

学校读者我要写书评

暂无评论

Pathogenesis of anti-melanoma differentiation-associated gene-5(MDA5)dermatomyositis

引用

Chinese Medical Journal 2022年第18期135卷 2188-2190页

作者： Chenghua Weng Zhichun Liu department of rheumatology and immunology The Second Affiliated Hospital of Soochow UniversitySuzhouJiangsu 215000China

Dermatomyositis(DM)is an idiopathic inflammatory myopathy,with typical cutaneous manifestations and muscle lesions,usually involving multiple organs.Patients with antimelanoma differentiation-associated gene-5(MDA5)DM usually present with clinical amyopathic DM(CADM),which is characterized by a series of unique skin and systemic manifestations,including skin ulcer and interstitial lung disease(ILD).Among them,ILD is the most common complication of anti-MDA5 DM,and in some cases,it can develop into rapidly progressive ILD(RP-ILD).^([1,2])

关键词： MDA5 organs lesions

来源：

维普期刊数据库

同方期刊数据库评论

在线全文

学校读者我要写书评

暂无评论

Anti-cyclic citrullinated peptide antibody predicts the development of rheumatoid arthritis in patients with undifferentiated arthritis

引用

Chinese Medical Journal 2019年第24期132卷 2899-2904页

作者： Chun Li Yan Zhang Hui Song Jie Gao Dong-Bao Zhao Qi Zhu Dong-Yi He Li Wang Xiang-Pei Li Xu-Dong Liu Wei-Guo Xiao Xin-Yu Wu Hua-Xiang Wu Wei Tu Shao-Xian Hu Xin Wang Zhi-Jun Li Zhi-Min Lu Zhan-Yun Da Bo Liang Xiao-Min Liu Jin-Wei Zhao Ling Li Feng Han Wu-Fang Qi Wei Wei Xu Ma Zhen-Bin Li Gui-Min Zheng Feng-Xiao Zhang Yi Li You-Lian Wang Guang-Hui Ling Jin-Wei Chen Xiao-Qiang Hou Jing Zhang Qing-Ping Chen Chang-Lian Liu Yan Zhang Jia-Shun Zeng Qing-Hua Zou Yong-Fei Fang Yin Su Zhan-Guo Li department of rheumatology and immunology Peking University People's HospitalBeijing 100044China department of rheumatology and immunology Beijing Jishuitan HospitalBeijing 100035China department of rheumatology and immunology Changhai HospitalShanghai 200433China department of rheumatology Shanghai Guanghua Hospital of Integrated Traditional Chinese and Western MedicineShanghai 200052China department of rheumatology and immunology Anhui Provincial HospitalHefeiAnhui 230001China department of rheumatology and immunology The First Hospital of China Medical UniversityShenyangLiaoning 110001China department of rheumatology The Second Affiliated Hospital of Zhejiang University School of MedicineHangzhouZhejiang 310009China department of rheumatology and immunology Tongji HospitalWuhanHubei 430030China department of rheumatology The First Affiliated Hospital of Bengbu Medical CollegeBengbuAnhui 233004China department of rheumatology and immunology Affiliated Hospital of Nantong UniversityNantongJiangsu 226001China department of rheumatology and immunology The Hospital of Shunyi District BeijingBeijing 101300China department of Infection and immunology Tianjin Union Medical CenterTianjin 300121China department of rheumatology and immunology Tianjin First Central HospitalTianjin 300192China department of rheumatology and immunology Tianjin Medical University General HospitalTianjin 300052China department of rheumatology and immunology Peace HospitalShijiazhuangHebei 050000China department of rheumatology and immunology Hebei General HospitalShijiazhuangHebei 050051China department of rheumatology Jiangxi Provincial People's HospitalNanchangJiangxi 330006China Division of rheumatology and immunology The Second Xiangya Hospital of Central South UniversityChangshaHunan 410011China department of rheumatology and immunology The First College of Clinical Medical Science of China Three Gorges University&Yichang Central People's HospitalYichangHubei 443003China department of Rheu

Background:Clinical outcomes of undifferentiated arthritis(UA)are diverse,and only 40%of patients with UA develop rheumatoid arthritis(RA)after 3 years.Discovering predictive markers at disease onset for further intervention is critical.Therefore,our objective was to analyze the clinical outcomes of UA and ascertain the predictors for RA development.Methods:We performed a prospective,multi-center study from January 2013 to October 2016 among Chinese patients diagnosed with UA in 22 tertiary-care hospitals.Clinical and serological parameters were obtained at recruitment.Follow-up was undertaken in all patients every 12 weeks for 2 years.Predictive factors of disease progression were identified using multivariate Cox proportional hazards regression.Results:A total of 234 patients were recruited in this study,and 17(7.3%)patients failed to follow up during the study.Among the 217 patients who completed the study,83(38.2%)patients went into remission.UA patients who developed RA had a higher rheumatoid factor(RF)-positivity(42.9%vs.16.8%,χ^2=8.228,P=0.008),anti-cyclic citrullinated peptide(CCP)antibodypositivity(66.7%vs.10.7%,χ^2=43.897,P<0.001),and double-positivity rate of RF and anti-CCP antibody(38.1%vs.4.1%,χ^2=32.131,P<0.001)than those who did not.Anti-CCP antibody but not RF was an independent predictor for RA development(hazard ratio 18.017,95%confidence interval:5.803–55.938;P<0.001).Conclusion:As an independent predictor of RA,anti-CCP antibody should be tested at disease onset in all patients with UA.

关键词： Anti-cyclic citrullinated peptide antibody Arthritis,Rheumatoid Rheumatoid factor Undifferentiated arthritis

来源：

维普期刊数据库

同方期刊数据库评论

在线全文

学校读者我要写书评

暂无评论

Botulinum toxin in the treatment of Raynaud phenomenon in patients with systemic sclerosis:a systemic review

引用

Chinese Medical Journal 2022年第9期135卷 1133-1134页

作者： Ruyi Cai Zixi Yi Ting Li Rong Mu department of rheumatology and immunology Peking University Third HospitalBeijing 100191China

To the Editor: Raynaud phenomenon (RP) is a transient, vasospastic phenomenon that is prominent in systemic sclerosis (SSc). Most patients with SSc develop RP and can result in recurrent digital ulcers (DU) and critical ischemic events. General management of RP, including lifestyle changes, pharmacological and surgical intervention, can hardly lead to optimal remission of RP symptoms and ischemic complications quickly.

关键词： patients sclerosis treatment

来源：

维普期刊数据库

同方期刊数据库评论

在线全文

学校读者我要写书评

暂无评论

High-dose thalidomide increases the risk of peripheral neuropathy in the treatment of ankylosing spondylitis

引用

Neural Regeneration Research 2015年第5期10卷 814-818页

作者： Hong-xia Xue Wen-yi Fu Hua-dong Cui Li-li Yang Ning Zhang Li-juan Zhao department of rheumatology and immunology Shengjing Hospital of China Medical University department of rheumatology and immunology the First Affiliated Hospital of China Medical University

Thalidomide is an effective drug for the treatment of ankylosing spondylitis but might induce peripheral neuropathy. This major adverse reaction has attracted much concern. The current study aimed to observe the incidence of thalidomide-induced peripheral neuropathy among an- kylosing spondylitis patients for 1 year after treatment. In this study, 207 ankylosing spondylitis cases received thalidomide treatment, while 116 ankylosing spondylitis cases received other treat- ments. Results showed that the incidence of thalidomide-induced peripheral neuropathy in the thalidomide group was higher than that in the non-thalidomide group. There was no significant difference in the incidence of neuropathy between the 〈 6 months medication and 〉 6 months medication groups. There were no differences in the mean age, gender, or daily dose between the two groups. The incidence of peripheral neuropathy among patients receiving 25, 50, 75, or 100 mg thalidomide per day was 4.6%, 8.5%, 17.1%, 21.7%, respectively. The incidence was significantly different between the groups receiving 25 mg and 100 mg thalidomide. In conclu- sion, thalidomide can induce peripheral neuropathy within 1 year after treatment of ankylosing spondylitis; however, age and gender have no obvious impact on the incidence of peripheral neuropathy. The incidence of peripheral neuropathy is associated with increasing daily doses of thalidomide.

关键词： nerve regeneration peripheral nerve injury thalidomide ankylosing spondflitis adversereactions peripheral neuropathy prospective study treatment dose treatment time age sex neuralregeneration

来源：

维普期刊数据库

同方期刊数据库评论

在线全文

学校读者我要写书评

暂无评论

Possible effects of chemokine-like factor-like MARVEL transmembrane domain-containing family on antiphospholipid syndrome

引用

Chinese Medical Journal 2021年第14期134卷 1661-1668页

作者： Ying-Ying Ge Hong-Ji Duan Xiao-Li Deng department of rheumatology and immunology Peking University Third HospitalBeijing 100191China

Antiphospholipid syndrome(APS)is a systemic autoimmune disease defined by thrombotic or obstetrical events and persistent antiphospholipid antibodies(aPLs).Chemokine-like factor-like MARVEL transmembrane domain-containing family(CMTM)is widely expressed in the immune system and may closely related to APS.This review aimed to systematically summarize the possible effects of CMTM on APS.Publications were collected from PubMed and Web of Science databases up to August 2020.CKLF,CKLFSF,CMTM,antiphospholipid syndrome,immune cells,and immune molecules were used as search criteria.Immune cells,including neutrophil,dendritic cells(DCs),T-cells,B-cells,and inflammatory cytokines,play an important role in the development of APS.Chemokine-like factor 1(CKLF1)has a chemotactic effect on many cells and can affect the expression of inflammatory cytokines and adhesion molecules through the nuclear factor-kB(NF-kB)pathway or mitogen-activated protein kinase(MARK)pathway.CKLF1 can participate in the maturation of DCs,T lymphocyte activation,and the activation of neutrophils through the MAPK pathway.CMTM1 may act on Annexin A2 by regulating Ca^(2+) signaling.CMTM2 and CMTM6 are up-regulated in neutrophils of APS patients.Some CMTM family members influence the activation and accumulation of platelets.CMTM3 and CMTM7 are binding partners of B-cell linker protein(BLNK),thereby linking B cell receptor(BCR)and activating BLNK-mediated signal transduction in B cells.Moreover,CMTM3 and CMTM7 can act on DCs and B-1a cell development,respectively.CMTM may have potential effects on the development of APS by acting on immune cells and immune molecules.Thus,CMTM may act as a novel prognostic factor or immunomodulatory treatment option of APS.

关键词： Antiphospholipid syndrome CMTM Pathogenesis

来源：

维普期刊数据库

同方期刊数据库评论

在线全文

学校读者我要写书评

暂无评论

欢迎您,

建议与咨询留下您的常用邮箱和电话号码，以便我们向您反馈解决方案和替代方法

时间限定

文献类型

馆藏选择

核心期刊

语言

文献类型

帮助

文字说明：

检索规则说明：

检索范例：

分类表

所选分类

限定检索结果

文献类型

馆藏范围

日期分布

学科分类号

主题

机构

作者

语言

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

请选择保存的检索档案：

请选择收藏分类：

通借通还

欢迎您,

建议与咨询 留下您的常用邮箱和电话号码，以便我们向您反馈解决方案和替代方法

时间限定

文献类型

馆藏选择

核心期刊

语言

文献类型

帮助

文字说明：

检索规则说明：

检索范例：

分类表

所选分类

限定检索结果

文献类型

馆藏范围

日期分布

学科分类号

主题

机构

作者

语言

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

请选择保存的检索档案： 新增检索档案 确定 取消

请选择收藏分类： 新增自定义分类 确定 取消

通借通还

建议与咨询留下您的常用邮箱和电话号码，以便我们向您反馈解决方案和替代方法

请选择保存的检索档案：

请选择收藏分类：