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대한류마티스학회> Journal of Rheumatic Diseases(구 대한류마티스학회지)

Journal of Rheumatic Diseases(구 대한류마티스학회지) update

  • : 대한류마티스학회
  • : 의약학분야  >  내과학
  • : KCI등재
  • :
  • : 연속간행물
  • : 계간
  • : 2093-940X
  • : 2233-4718
  • : 대한류마티스학회지(~2010) → journal of rheumatic diseases(2011~)

수록정보
수록범위 : 1권1호(1994)~29권2호(2022) |수록논문 수 : 1,420
Journal of Rheumatic Diseases(구 대한류마티스학회지)
29권2호(2022년 04월) 수록논문
최근 권호 논문
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KCI등재

1Rituximab can Decrease Proteinuria in Refractory Lupus Nephritis

저자 : Chang-hee Suh

발행기관 : 대한류마티스학회 간행물 : Journal of Rheumatic Diseases(구 대한류마티스학회지) 29권 2호 발행 연도 : 2022 페이지 : pp. 59-60 (2 pages)

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2Recent Advances in Basic and Clinical Aspects of Rheumatoid Arthritis-associated Interstitial Lung Diseases

저자 : Hanna Lee , Sang-il Lee , Hyun-ok Kim

발행기관 : 대한류마티스학회 간행물 : Journal of Rheumatic Diseases(구 대한류마티스학회지) 29권 2호 발행 연도 : 2022 페이지 : pp. 61-70 (10 pages)

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Rheumatoid arthritis (RA) is a common autoimmune disease that mainly affects the joints and systemic organs, such as the skin, eyes, heart, gastrointestinal tract, and lungs. In particular, among various pulmonary involvements, interstitial lung disease (ILD) is closely related to the selection of anti-rheumatic drugs and the long-term prognosis of patients with RA. Although the exact pathogenesis of RA-ILD is not well defined, several mechanistic pathways, similar to those of idiopathic pulmonary fibrosis, have been elucidated recently. Conversely, RA-related autoantibodies, including anti-cyclic citrullinated peptide antibody, are detectable in circulation and in the lungs, even in the absence of articular symptoms. RA-ILD can also predate years before the occurrence of joint symptoms. This evidence supports the fact that local dysregulated mucosal immunity in the lung causes systemic autoimmunity, resulting in clinically evident polyarthritis of RA. Because the early diagnosis of RA-ILD is important, imaging tests, such as computed tomography and pulmonary function tests, are being used for early diagnosis, but there is no clear guideline for the early diagnosis of RA-ILD and selection of optimal disease-modifying anti-rheumatic drugs for the treatment of patients with RA with ILD. In addition, the efficacy of nintedanib, a new anti-fibrotic agent, for RA-ILD treatment, has been investigated recently. This review collectively discusses the basic and clinical aspects, such as pathogenesis, animal models, diagnosis, and treatment, of RA-ILD.

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3Korean College of Rheumatology: Forty Years of Excellence

저자 : Jung-yoon Choe , Tae-hwan Kim

발행기관 : 대한류마티스학회 간행물 : Journal of Rheumatic Diseases(구 대한류마티스학회지) 29권 2호 발행 연도 : 2022 페이지 : pp. 71-74 (4 pages)

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4The Korean College of Rheumatology: 40 Years of Public Health Influence

저자 : Jisoo Lee , Yoon-kyoung Sung , Myeung-su Lee , Han Joo Baek

발행기관 : 대한류마티스학회 간행물 : Journal of Rheumatic Diseases(구 대한류마티스학회지) 29권 2호 발행 연도 : 2022 페이지 : pp. 75-78 (4 pages)

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5Assessment on Treatments With Conventional Synthetic Disease-modifying Drugs Before Initiating Biologics in Patients With Rheumatoid Arthritis in Korea: A Populationbased Study

저자 : Min Jung Kim , Eun Hye Park , Anna Shin , You-jung Ha , Yun Jong Lee , Eun Bong Lee , Han Joo Baek , Eun Ha Kang

발행기관 : 대한류마티스학회 간행물 : Journal of Rheumatic Diseases(구 대한류마티스학회지) 29권 2호 발행 연도 : 2022 페이지 : pp. 79-88 (10 pages)

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Objective: To assess pre-biologic treatments with conventional synthetic disease-modifying drugs (csDMARDs) prior to biologics initiation among patients with rheumatoid arthritis (RA).
Methods: Using Korea National Health Insurance database, we examined pre-biologic treatments of RA patients on the following four items: whether 1) initial methotrexate (MTX) therapy was given, 2) MTX dose was escalated up to ≥15 mg/week within 1-year post-diagnosis, 3) prednisone-equivalent glucocorticoid was used at a dose of ≤7.5 mg/day, and 4) glucocorticoid was discontinued within 6 months of treatment. Multivariable logistic regressions identified predictors of items 2) and 4) fulfillment.
Results: Among 6,986 biologics initiators with RA, 54.9% used MTX as the 1st csDMARD. Within 1-year post-diagnosis, 85.2% used MTX with half of them achieving a dose of ≥15 mg/week. The majority (75.2%) of patients used glucocorticoids initially and 64.5% were still on glucocorticoids at 6 months, mostly at a dose of ≤7.5 mg/day. csDMARD combination was observed in 85.7%. Item 2) fulfillment was associated with males, younger age, glucocorticoid, combination therapy, cyclo-oxygenase-2 inhibitors, and viral hepatitis. Item 4) fulfillment was associated with males, MTX dose of ≥15 mg/week, combination therapy, viral hepatitis, and hospitalizations.
Conclusion: RA patients in Korea were predominantly treated with MTX-based csDMARD combination plus glucocorticoids before initiating biologics, without sufficient MTX dose escalation or glucocorticoid discontinuation. Items 2) and 4) fulfillments were associated with patient age and gender, concomitant treatments, and comorbidities.

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Objective: This study aims to evaluate the change in serum metalloproteinase-3 (MMP-3) following the management of active rheumatoid arthritis (RA) and define the relationships between MMP-3 and disease activity indices.
Methods: Data from a previously reported a 24-week, randomized controlled trial to investigate efficacy of tocilizumab in active RA refractory to methotrexate were analyzed. The serum level of MMP-3 were measured at week 0, 12, 20, and 24. The changes in MMP-3, and the relationship between MMP-3 and clinical parameters was assessed based on treatment group, methotrexate with or without tocilizumab.
Results: A total of 95 patients were included in this study. The serum MMP-3 significantly decreased and showed similar pattern with other disease activity indices during treatment period in both treatment groups (p<0.001). The MMP-3 was positively correlated with ESR, CRP, DAS28, SDAI, and CDAI for 302 visits throughout 24 weeks (p<0.001). In another correlation analysis to evaluate the treatment effect at 24 week time point, methotrexate group showed significant correlation between serum markers: MMP-3 (r=0.321, p=0.043); ESR (r=0.450, p=0.002); and CRP (r=0.536, p< 0.001), with DAS28, but tocilizumab group didn't show meaningful correlation between serum markers and DAS28 (p >0.05).
Conclusion: Serum MMP-3 showed positive correlation with disease activity indices in active RA patients. Furthermore, serum MMP-3 significantly decreased from baseline to week 20. As there is no single serum marker that can represent the disease activity particularly in tocilizumab treatment, MMP-3 might be a useful adjunct indicator to evaluate the treatment response in active RA patients.

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7Time-integrated Cumulative Parameters Predictive of Radiographic Progression of Rheumatoid Arthritis: Real-world Data From a Prospective Single-center Cohort

저자 : Youngjae Park , Mei-ling Li , Ji-won Kim , Jung Hee Koh , Yune-jung Park , Wan-uk Kim

발행기관 : 대한류마티스학회 간행물 : Journal of Rheumatic Diseases(구 대한류마티스학회지) 29권 2호 발행 연도 : 2022 페이지 : pp. 98-107 (10 pages)

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Objective: With many chronic inflammatory diseases, outcomes are determined by assessing both disease activity at presentation and cumulative activity over time. Here, we investigated whether cumulative activity better reflects the radiographic progression (RP) of rheumatoid arthritis (RA) than measurement of activity at a single time point.
Methods: From a prospective cohort of RA patients, most of whom were treated with anti-rheumatic drugs, we selected 117 subjects for whom laboratory, clinical, and radiographic parameters potentially influencing RP were monitored serially for more than 1 year. X-ray images of both hands and both feet were scored using the van der Heijde modified total Sharp score (mTSS). In addition to cross-sectional values at baseline, longitudinal and cumulative values for each parameter were calculated in a timeintegrated and averaged manner.
Results: Among the values measured at baseline, mTSS, but not the baseline erythrocyte sedimentation rate (ESR) or C-reactive protein level, was associated with RP. By contrast, multivariate analyses identified cumulative values such as the cumulative ESR, cumulative tender joint count, cumulative swollen joint count (SJC), and cumulative Disease Activity Score 28-ESR as major determinants of RP. In particular, the cumulative SJC showed the best predictive performance for RP.
Conclusion: This study highlights the importance of cumulative indices for predicting progression of RA. Specifically, dynamic and cumulative values of RA activity-related factors, particularly the cumulative SJC, may be the major determinants of RP in the current practice.

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8Differential Diagnosis of Inflammatory Arthropathy Accompanying Active Tuberculosis Infection

저자 : Youjin Jung , Byoong Yong Choi

발행기관 : 대한류마티스학회 간행물 : Journal of Rheumatic Diseases(구 대한류마티스학회지) 29권 2호 발행 연도 : 2022 페이지 : pp. 108-115 (8 pages)

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Objective: The study aimed to ascertain the clinical manifestations of inflammatory arthritis accompanying tuberculosis (TB) for the differential diagnosis.
Methods: We retrospectively reviewed patients with active TB who presented with inflammatory arthropathy at Seoul Medical Center. Among 2,872 patients with active TB infection, 47 had inflammatory arthropathy: 14 had crystal-induced arthropathy; 12, TB arthritis; 12, Poncet's disease (PD); 8, Rheumatoid arthritis (RA); and 1, septic arthritis. The clinical characteristics and laboratory and radiographic findings of each group were analyzed.
Results: In TB arthritis, weight-bearing joints were more commonly affected than the elbow and wrist joints. When compared to TB arthritis, PD demonstrated a significantly higher proportion of polyarthritis and involved both large and small-to-mediumsized joints. The duration of arthritis symptoms after anti-TB treatment was significantly shorter in patients with PD (56 days vs. 90 days, p=0.028). When compared to PD, RA flares during active TB infection involved only small-to-medium-sized joints rather than a mixed distribution (62.5% vs. 16.7%, p=0.035). Patients with PD more commonly had fever at onset and showed a good response to nonsteroidal anti-inflammatory drugs alone or were in remission within 3 months after anti-TB treatment. The presence of rheumatoid factor or anti-cyclic citrullinated peptide and radiographic progression after 12 months was frequently observed in patients with RA flares.
Conclusion: The differential diagnosis of inflammatory arthritis accompanying active tuberculosis infection is challenging. Comprehensive history taking and physical examination, synovial fluid analysis, and a high level of clinical suspicion are essential to avoid delayed diagnosis and to reduce the significant morbidity involved.

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9Idiopathic Inflammatory Arthritis in the Auditory Canal in a Patient With Hearing Impairment: A Case Report and Literature Review

저자 : So Hye Nam , Gi Hwan Kim , Hong Ju Park , Yong-gil Kim

발행기관 : 대한류마티스학회 간행물 : Journal of Rheumatic Diseases(구 대한류마티스학회지) 29권 2호 발행 연도 : 2022 페이지 : pp. 116-122 (7 pages)

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Inflammatory arthritis can affect the auditory system during the disease course. Although most cases show asymptomatic hearing impairment, it can result in hearing loss. Here we describe the case of a 70-year-old female with hearing impairment associated with idiopathic inflammatory arthritis in her auditory system. She had suffered from hearing difficulties for decades; however, the causes of her hearing impairment had not been evaluated. Pure tone audiometry showed severe sensorineural hearing loss requiring a cochlear implant. The workup for the cochlear implant revealed erosive changes in the incudomalleolar and incudostapedial joints with soft tissue swelling on temporal bone computed tomography. Bone pathology revealed plasmacytic infiltration and granulomatous inflammation. Laboratory examinations showed elevated levels of inflammatory markers; otherwise, she had negative results for all autoantibodies. In patients with idiopathic hearing loss, inflammatory arthritis of the middle ear without peripheral arthritis can provide a clue regarding the cause of the hearing loss.

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10A Case of Macrophage Activation Syndrome During the Treatment of Adult-onset Still's Disease With Tocilizumab

저자 : Ju Ho Lee , You-jung Ha , Eun Ha Kang , Sung Hae Chang , Yun Jong Lee

발행기관 : 대한류마티스학회 간행물 : Journal of Rheumatic Diseases(구 대한류마티스학회지) 29권 2호 발행 연도 : 2022 페이지 : pp. 123-128 (6 pages)

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Macrophage activation syndrome (MAS) is a fatal complication of adult-onset Still's disease (AOSD). Although anti-cytokine agents have been recommended for refractory AOSD or complicated with MAS, MAS cases have been rarely reported during anticytokine treatment. Herein, we describe the first AOSD case complicated with MAS during the treatment with tocilizumab in Korea. Two years after tocilizumab maintenance therapy, high fever and hypertransaminasemia recurred. MAS was diagnosed based on hyperferritinemia, elevated soluble IL-2 receptor levels, and the presence of hemophagocytic histiocytes in the bone marrow. However, she had normal white blood cell counts and acute phase reactant levels. High-dose glucocorticoid and anakinra therapies were not effective, but her disease improved with etoposide. This case shows that tocilizumab may not prevent MAS development and can modify clinical features making it challenging to diagnose. Cytotoxic therapy such as etoposide may be required in MAS cases that develop during anti-cytokine therapy.

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