MATERIALS AND METHODS: This is a case-control study that included 105 RA patients classified into active and inactive groups according to disease activity score (DAS28) with 50 healthy matched controls. Clinical and laboratory assessments were done including enzyme-linked immunosorbent assay (ELISA) measurement of CCN1 with a bilateral assessment of CIMT using high resolutionultrasonography. Comparison of CCN1 between RA patients and controls, a correlation between CCN1, DAS28, swollen joint count (SJC), tender joint count (TJC), and CIMT were analyzed.
RESULTS: There was significant elevation of CCN1 in RA patients compared to controls (235.62±62.5 vs. 73.11±18.2, respectively). The cut off value of CCN1 was 99.25 pg/ml, with an area under the curve (AUC) =0.995, p<0.001, 98 % sensitivity and 95% specificity. CCN1 was inversely correlated with DAS28 and its components in both active and inactive RA patients (r=- 0.92, r=- 0.94, p<0.001). CCN1 was inversely correlated with SJC (r= -0.64, r= - 0.67, p<0.001), TJC (r=- 0.56, r= - 0.63, p<0.001), and with Larsen xray score (r=- 0.68, r= - 0.78, p<0.001) in both active and inactive RA patients, respectively. The CCN1 levels in active RA patients were significantly lower than that in patients with low disease activity. A significant positive correlation between CCN1 levels and CIMT in RA patient groups (r=0.88, r=0.47, p<0.001, respectively) was found.
CONCLUSION: Serum CCN1 could be a helpful biomarker in the diagnosis of RA, associated with RA remission. Disruption of serum CCN1 is engaged in the pathogenesis of atherosclerosis in RA patients which could be a clue for a future treatment strategy of atherosclerosis in RA by controlling CCN1 disruption. Regular follow-up of RA patients is recommended for early detection of subclinical atherosclerosis. New research ideas for controlling CCN1 disruption as new aspects of atherosclerosis treatment in RA patients are needed.
METHODS: With representation from Europe (43%; n = 133), North America (17%; n = 53), South America (16%; n = 49), Asia (13%; n = 40), Australasia (5%; n = 16), the Middle East (4%; n = 12), and Africa (2%; n = 6), the combined experience of treating bone sarcomas among attendees totalled approximately 30,000 cases annually, equivalent to 66 years of experience in the UK alone. The meeting's process began with the formation of a local organizing committee, regional leads, and a scientific committee comprising representatives from 150 specialist units across 47 countries. Supported by major orthopaedic oncology organizations, the meeting used a modified Delphi process to develop consensus statements through online questionnaires, thematic groupings, narrative reviews, and anonymous pre-meeting polling.
RESULTS: Strong (> 80%) consensus was achieved on 19 out of 21 statements, reflecting agreement among delegates. Key areas of consensus included the role of radiology in diagnosis and surveillance, the management of locally recurrent disease, and the treatment of dedifferentiated chondrosarcoma. Notably, there was agreement that routine chemotherapy has no role in chondrosarcoma treatment, and radiological surveillance is safe for intraosseous chondrosarcomas. Despite the overall consensus, areas of controversy remain, particularly regarding the treatment of atypical cartilage tumours and surgical margins. These unresolved issues underscore the need for further research and collaboration within the orthopaedic oncology community.
CONCLUSION: BOOM represents the largest global consensus meeting in orthopaedic oncology, providing valuable guidance for clinicians managing chondrosarcoma worldwide. The consensus statements offer a reference for clinical practice, highlight key research priorities, and aim to improve patient outcomes on a global scale.