{"id":"https://openalex.org/W7220388265","doi":"https://doi.org/10.1093/mrcr/rxag098","title":"Successful use of a Janus-kinase (JAK) inhibitor in chronic chikungunya arthritis refractory to conventional synthetic DMARDs: A case report","display_name":"Successful use of a Janus-kinase (JAK) inhibitor in chronic chikungunya arthritis refractory to conventional synthetic DMARDs: A case report","publication_year":2026,"publication_date":"2026-01-01","ids":{"openalex":"https://openalex.org/W7220388265","doi":"https://doi.org/10.1093/mrcr/rxag098","pmid":"https://pubmed.ncbi.nlm.nih.gov/42831672"},"language":"en","primary_location":{"id":"doi:10.1093/mrcr/rxag098","doi":"https://doi.org/10.1093/mrcr/rxag098","is_oa":false,"landing_page_url":"https://doi.org/10.1093/mrcr/rxag098","pdf_url":null,"source":{"id":"https://openalex.org/S4210214405","display_name":"Modern Rheumatology Case Reports","issn_l":"2472-5625","issn":["2472-5625"],"is_oa":false,"is_in_doaj":false,"is_core":true,"listed_in":["cwts-core","medline","poland-20","russia-white-list-4"],"host_organization":"https://openalex.org/P4310311648","host_organization_name":"Oxford University Press","host_organization_lineage":["https://openalex.org/P4310311648","https://openalex.org/P4310311647"],"host_organization_lineage_names":["Oxford University Press","University of Oxford"],"type":"journal"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Modern Rheumatology Case Reports","raw_type":"journal-article"},"volume":null,"type":"article","is_traditional":true,"indexed_in":["crossref","pubmed"],"open_access":{"is_oa":false,"oa_status":"closed","oa_url":null,"any_repository_has_fulltext":false},"authorships":[{"author_position":"first","author":{"id":"https://openalex.org/A5035057752","display_name":"Jobson Lopes de Oliveira","orcid":"https://orcid.org/0000-0001-8912-1121","observed_orcids":["https://orcid.org/0000-0001-8912-1121"]},"institutions":[{"id":"https://openalex.org/I4210122181","display_name":"Unichristus","ror":"https://ror.org/02kt6vs55","country_code":"BR","type":"education","lineage":["https://openalex.org/I4210122181"]}],"countries":["BR"],"is_corresponding":false,"raw_author_name":"Jobson Lopes de Oliveira","raw_affiliation_strings":["Departamento de Cl\u00ednica M\u00e9dica, Faculdade de Medicina, Universidade Christus (Unichristus) , Fortaleza, Cear\u00e1 ,"],"raw_orcid":"https://orcid.org/0000-0001-8912-1121","affiliations":[{"raw_affiliation_string":"Departamento de Cl\u00ednica M\u00e9dica, Faculdade de Medicina, Universidade Christus (Unichristus) , Fortaleza, Cear\u00e1 ,","institution_ids":["https://openalex.org/I4210122181"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5034824565","display_name":"J. Kennedy Amaral","orcid":"https://orcid.org/0000-0002-0528-8600","observed_orcids":["https://orcid.org/0000-0002-0528-8600"]},"institutions":[{"id":"https://openalex.org/I4210090750","display_name":"Universidade Federal do Cariri","ror":"https://ror.org/00a4xxf76","country_code":"BR","type":"education","lineage":["https://openalex.org/I4210090750"]}],"countries":["BR"],"is_corresponding":false,"raw_author_name":"Jos\u00e9 Kennedy Amaral","raw_affiliation_strings":["Programa de P\u00f3s-Gradua\u00e7\u00e3o em Ci\u00eancias da Sa\u00fade, Faculdade de Medicina, Universidade Federal do Cariri , Barbalha, Cear\u00e1 ,"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Programa de P\u00f3s-Gradua\u00e7\u00e3o em Ci\u00eancias da Sa\u00fade, Faculdade de Medicina, Universidade Federal do Cariri , Barbalha, Cear\u00e1 ,","institution_ids":["https://openalex.org/I4210090750"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5003009697","display_name":"Igor Albuquerque Nogueira","orcid":"https://orcid.org/0000-0002-3810-672X","observed_orcids":["https://orcid.org/0000-0002-3810-672X"]},"institutions":[{"id":"https://openalex.org/I17974374","display_name":"Universidade de S\u00e3o Paulo","ror":"https://ror.org/036rp1748","country_code":"BR","type":"education","lineage":["https://openalex.org/I17974374"]},{"id":"https://openalex.org/I4210156537","display_name":"Clinics Hospital of Ribeir\u00e3o Preto","ror":"https://ror.org/04n6fhj26","country_code":"BR","type":"healthcare","lineage":["https://openalex.org/I17974374","https://openalex.org/I4210156537"]}],"countries":["BR"],"is_corresponding":false,"raw_author_name":"Igor Albuquerque Nogueira","raw_affiliation_strings":["Departamento de Cl\u00ednica M\u00e9dica, Hospital das Cl\u00ednicas da Faculdade de Medicina de Ribeir\u00e3o Preto, Universidade de S\u00e3o Paulo , Ribeir\u00e3o Preto, S\u00e3o Paulo ,"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Departamento de Cl\u00ednica M\u00e9dica, Hospital das Cl\u00ednicas da Faculdade de Medicina de Ribeir\u00e3o Preto, Universidade de S\u00e3o Paulo , Ribeir\u00e3o Preto, S\u00e3o Paulo ,","institution_ids":["https://openalex.org/I17974374","https://openalex.org/I4210156537"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5021315011","display_name":"Lu\u00eds Arthur Brasil Gadelha Farias","orcid":"https://orcid.org/0000-0002-8978-9903","observed_orcids":["https://orcid.org/0000-0002-8978-9903"]},"institutions":[{"id":"https://openalex.org/I17974374","display_name":"Universidade de S\u00e3o Paulo","ror":"https://ror.org/036rp1748","country_code":"BR","type":"education","lineage":["https://openalex.org/I17974374"]},{"id":"https://openalex.org/I4210122181","display_name":"Unichristus","ror":"https://ror.org/02kt6vs55","country_code":"BR","type":"education","lineage":["https://openalex.org/I4210122181"]},{"id":"https://openalex.org/I4210145268","display_name":"Hospital das Cl\u00ednicas da Faculdade de Medicina da Universidade de S\u00e3o Paulo","ror":"https://ror.org/03se9eg94","country_code":"BR","type":"healthcare","lineage":["https://openalex.org/I4210145268"]}],"countries":["BR"],"is_corresponding":false,"raw_author_name":"Luis Arthur Brasil Gadelha Farias","raw_affiliation_strings":["Departamento de Cl\u00ednica M\u00e9dica, Faculdade de Medicina, Universidade Christus (Unichristus) , Fortaleza, Cear\u00e1 ,","Departamento de Doen\u00e7as Infecciosas do Hospital das Cl\u00ednicas, Laborat\u00f3rio de Investiga\u00e7\u00e3o M\u00e9dica, Universidade de S\u00e3o Paulo , S\u00e3o Paulo, SP ,","Departamento de Infectologia, Hospital S\u00e3o Jos\u00e9 de Doen\u00e7as Infecciosas , Fortaleza, CE ,"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Departamento de Cl\u00ednica M\u00e9dica, Faculdade de Medicina, Universidade Christus (Unichristus) , Fortaleza, Cear\u00e1 ,","institution_ids":["https://openalex.org/I4210122181"]},{"raw_affiliation_string":"Departamento de Doen\u00e7as Infecciosas do Hospital das Cl\u00ednicas, Laborat\u00f3rio de Investiga\u00e7\u00e3o M\u00e9dica, Universidade de S\u00e3o Paulo , S\u00e3o Paulo, SP ,","institution_ids":["https://openalex.org/I17974374","https://openalex.org/I4210145268"]},{"raw_affiliation_string":"Departamento de Infectologia, Hospital S\u00e3o Jos\u00e9 de Doen\u00e7as Infecciosas , Fortaleza, CE ,","institution_ids":[]}]},{"author_position":"last","author":{"id":"https://openalex.org/A5000921802","display_name":"Robert Taylor Schoen","orcid":"https://orcid.org/0000-0003-1844-8316","observed_orcids":["https://orcid.org/0000-0003-1844-8316"]},"institutions":[{"id":"https://openalex.org/I32971472","display_name":"Yale University","ror":"https://ror.org/03v76x132","country_code":"US","type":"education","lineage":["https://openalex.org/I32971472"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"Robert T Schoen","raw_affiliation_strings":["Section of Rheumatology, Allergy, and Immunology, Yale University School of Medicine , New Haven, CT ,"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Section of Rheumatology, Allergy, and Immunology, Yale University School of Medicine , New Haven, CT ,","institution_ids":["https://openalex.org/I32971472"]}]}],"institutions":[],"countries_distinct_count":2,"institutions_distinct_count":6,"corresponding_author_ids":[],"corresponding_institution_ids":[],"apc_list":{"value":1071,"currency":"USD","value_usd":1071},"apc_paid":null,"fwci":4.5989,"has_fulltext":false,"cited_by_count":1,"citation_normalized_percentile":{"value":0.87809019,"is_in_top_1_percent":false,"is_in_top_10_percent":false},"cited_by_percentile_year":{"min":91,"max":95},"biblio":{"volume":"10","issue":"2","first_page":null,"last_page":null},"is_retracted":false,"is_paratext":false,"is_xpac":false,"primary_topic":{"id":"https://openalex.org/T10166","display_name":"Mosquito-borne diseases and control","score":0.5770999789237976,"subfield":{"id":"https://openalex.org/subfields/2739","display_name":"Public Health, Environmental and Occupational Health"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},"topics":[{"id":"https://openalex.org/T10166","display_name":"Mosquito-borne diseases and control","score":0.5770999789237976,"subfield":{"id":"https://openalex.org/subfields/2739","display_name":"Public Health, Environmental and Occupational Health"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T10200","display_name":"Rheumatoid Arthritis Research and Therapies","score":0.1256999969482422,"subfield":{"id":"https://openalex.org/subfields/2745","display_name":"Rheumatology"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T11616","display_name":"Autoimmune and Inflammatory Disorders Research","score":0.12049999833106995,"subfield":{"id":"https://openalex.org/subfields/2720","display_name":"Hematology"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}}],"keywords":[{"id":"https://openalex.org/keywords/baricitinib","display_name":"baricitinib","score":0.8429999947547913},{"id":"https://openalex.org/keywords/jak-inhibitors","display_name":"JAK inhibitors","score":0.8730000257492065},{"id":"https://openalex.org/keywords/refractory-arthritis","display_name":"refractory arthritis","score":0.7369999885559082},{"id":"https://openalex.org/keywords/disease-modifying-antirheumatic-drugs","display_name":"disease-modifying antirheumatic drugs","score":0.8460000157356262},{"id":"https://openalex.org/keywords/leflunomide","display_name":"leflunomide","score":0.8769999742507935},{"id":"https://openalex.org/keywords/hydroxychloroquine","display_name":"hydroxychloroquine","score":0.7720000147819519},{"id":"https://openalex.org/keywords/prednisone","display_name":"prednisone","score":0.6209999918937683}],"concepts":[{"id":"https://openalex.org/C71924100","wikidata":"https://www.wikidata.org/wiki/Q11190","display_name":"Medicine","level":0,"score":0.9247999787330627},{"id":"https://openalex.org/C2777575956","wikidata":"https://www.wikidata.org/wiki/Q187255","display_name":"Rheumatoid arthritis","level":2,"score":0.7682999968528748},{"id":"https://openalex.org/C2781273456","wikidata":"https://www.wikidata.org/wiki/Q243257","display_name":"Chikungunya","level":3,"score":0.7432000041007996},{"id":"https://openalex.org/C2775905006","wikidata":"https://www.wikidata.org/wiki/Q248550","display_name":"Leflunomide","level":3,"score":0.728600025177002},{"id":"https://openalex.org/C2777077863","wikidata":"https://www.wikidata.org/wiki/Q170990","display_name":"Arthritis","level":2,"score":0.6211000084877014},{"id":"https://openalex.org/C126322002","wikidata":"https://www.wikidata.org/wiki/Q11180","display_name":"Internal medicine","level":1,"score":0.5584999918937683},{"id":"https://openalex.org/C142424586","wikidata":"https://www.wikidata.org/wiki/Q7307572","display_name":"Refractory (planetary science)","level":2,"score":0.5209000110626221},{"id":"https://openalex.org/C2778570526","wikidata":"https://www.wikidata.org/wiki/Q653197","display_name":"Rash","level":2,"score":0.5088000297546387},{"id":"https://openalex.org/C2781001862","wikidata":"https://www.wikidata.org/wiki/Q501561","display_name":"Pericarditis","level":2,"score":0.490200012922287},{"id":"https://openalex.org/C203014093","wikidata":"https://www.wikidata.org/wiki/Q101929","display_name":"Immunology","level":1,"score":0.4223000109195709},{"id":"https://openalex.org/C2778143017","wikidata":"https://www.wikidata.org/wiki/Q111208","display_name":"Erythrocyte sedimentation rate","level":2,"score":0.38589999079704285},{"id":"https://openalex.org/C2781059491","wikidata":"https://www.wikidata.org/wiki/Q422232","display_name":"Methotrexate","level":2,"score":0.3675999939441681},{"id":"https://openalex.org/C90924648","wikidata":"https://www.wikidata.org/wiki/Q120569","display_name":"Gastroenterology","level":1,"score":0.3416999876499176},{"id":"https://openalex.org/C2776821229","wikidata":"https://www.wikidata.org/wiki/Q16965166","display_name":"Inflammatory arthritis","level":3,"score":0.32829999923706055},{"id":"https://openalex.org/C2522874641","wikidata":"https://www.wikidata.org/wiki/Q808","display_name":"Virus","level":2,"score":0.31839999556541443},{"id":"https://openalex.org/C2778720950","wikidata":"https://www.wikidata.org/wiki/Q424972","display_name":"Prednisone","level":2,"score":0.30970001220703125},{"id":"https://openalex.org/C2777425658","wikidata":"https://www.wikidata.org/wiki/Q422438","display_name":"Chloroquine","level":3,"score":0.2955000102519989},{"id":"https://openalex.org/C2776233030","wikidata":"https://www.wikidata.org/wiki/Q17149812","display_name":"Janus kinase inhibitor","level":4,"score":0.290800005197525},{"id":"https://openalex.org/C2908564923","wikidata":"https://www.wikidata.org/wiki/Q810254","display_name":"Antirheumatic drugs","level":4,"score":0.2892000079154968},{"id":"https://openalex.org/C2909063479","wikidata":"https://www.wikidata.org/wiki/Q810254","display_name":"Antirheumatic Agents","level":3,"score":0.288100004196167},{"id":"https://openalex.org/C198451711","wikidata":"https://www.wikidata.org/wiki/Q327657","display_name":"Rheumatology","level":2,"score":0.26829999685287476},{"id":"https://openalex.org/C3020491458","wikidata":"https://www.wikidata.org/wiki/Q131742","display_name":"Chronic hepatitis","level":3,"score":0.2676999866962433},{"id":"https://openalex.org/C141071460","wikidata":"https://www.wikidata.org/wiki/Q40821","display_name":"Surgery","level":1,"score":0.2581999897956848},{"id":"https://openalex.org/C2777014857","wikidata":"https://www.wikidata.org/wiki/Q1383410","display_name":"Exacerbation","level":2,"score":0.2574000060558319}],"mesh":[{"descriptor_ui":"D000075242","descriptor_name":"Janus Kinase Inhibitors","qualifier_ui":"Q000627","qualifier_name":"therapeutic use","is_major_topic":true},{"descriptor_ui":"D001170","descriptor_name":"Arthritis, Infectious","qualifier_ui":"Q000188","qualifier_name":"drug therapy","is_major_topic":true},{"descriptor_ui":"D001384","descriptor_name":"Azetidines","qualifier_ui":"Q000627","qualifier_name":"therapeutic use","is_major_topic":true},{"descriptor_ui":"D005260","descriptor_name":"Female","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D006801","descriptor_name":"Humans","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D007555","descriptor_name":"Isoxazoles","qualifier_ui":"Q000627","qualifier_name":"therapeutic use","is_major_topic":false},{"descriptor_ui":"D008875","descriptor_name":"Middle Aged","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D011687","descriptor_name":"Purines","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D011720","descriptor_name":"Pyrazoles","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D013449","descriptor_name":"Sulfonamides","qualifier_ui":"Q000627","qualifier_name":"therapeutic use","is_major_topic":true},{"descriptor_ui":"D016896","descriptor_name":"Treatment Outcome","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D018501","descriptor_name":"Antirheumatic Agents","qualifier_ui":"Q000627","qualifier_name":"therapeutic use","is_major_topic":true},{"descriptor_ui":"D065632","descriptor_name":"Chikungunya Fever","qualifier_ui":"Q000150","qualifier_name":"complications","is_major_topic":true},{"descriptor_ui":"D065632","descriptor_name":"Chikungunya Fever","qualifier_ui":"Q000188","qualifier_name":"drug therapy","is_major_topic":true}],"locations_count":2,"locations":[{"id":"doi:10.1093/mrcr/rxag098","doi":"https://doi.org/10.1093/mrcr/rxag098","is_oa":false,"landing_page_url":"https://doi.org/10.1093/mrcr/rxag098","pdf_url":null,"source":{"id":"https://openalex.org/S4210214405","display_name":"Modern Rheumatology Case Reports","issn_l":"2472-5625","issn":["2472-5625"],"is_oa":false,"is_in_doaj":false,"is_core":true,"listed_in":["cwts-core","medline","poland-20","russia-white-list-4"],"host_organization":"https://openalex.org/P4310311648","host_organization_name":"Oxford University Press","host_organization_lineage":["https://openalex.org/P4310311648","https://openalex.org/P4310311647"],"host_organization_lineage_names":["Oxford University Press","University of Oxford"],"type":"journal"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Modern Rheumatology Case Reports","raw_type":"journal-article"},{"id":"pmid:42831672","doi":null,"is_oa":false,"landing_page_url":"https://pubmed.ncbi.nlm.nih.gov/42831672","pdf_url":null,"source":{"id":"https://openalex.org/S4306525036","display_name":"PubMed","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":"https://openalex.org/I1299303238","host_organization_name":"National Institutes of Health","host_organization_lineage":["https://openalex.org/I1299303238"],"host_organization_lineage_names":[],"type":"repository"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Modern rheumatology case reports","raw_type":"Case Reports"}],"best_oa_location":null,"sustainable_development_goals":[{"score":0.9940000176429749,"id":"https://metadata.un.org/sdg/3","display_name":"Good health and well-being"}],"study_designs":[{"id":"https://openalex.org/study-designs/case-report","display_name":"Case Report"}],"awards":[],"funders":[],"has_content":{"grobid_xml":false,"pdf":false},"content_urls":null,"referenced_works_count":23,"referenced_works":["https://openalex.org/W1679916628","https://openalex.org/W2136631930","https://openalex.org/W2396806161","https://openalex.org/W2545389116","https://openalex.org/W2584476310","https://openalex.org/W2748091531","https://openalex.org/W2767394258","https://openalex.org/W2977432369","https://openalex.org/W3007336436","https://openalex.org/W3033280955","https://openalex.org/W3136549884","https://openalex.org/W3204047493","https://openalex.org/W3206870195","https://openalex.org/W4210529991","https://openalex.org/W4221093585","https://openalex.org/W4308769923","https://openalex.org/W4308967283","https://openalex.org/W4312082612","https://openalex.org/W4385629247","https://openalex.org/W4390583766","https://openalex.org/W4392192472","https://openalex.org/W4407388227","https://openalex.org/W4412107348"],"related_works":["https://openalex.org/W7125596970","https://openalex.org/W4385629247","https://openalex.org/W2110964442","https://openalex.org/W2793117904","https://openalex.org/W3022924456","https://openalex.org/W4390583766","https://openalex.org/W2791214937","https://openalex.org/W2786513782","https://openalex.org/W2793343441","https://openalex.org/W2793912179"],"abstract_inverted_index":{"Chronic":[0],"chikungunya":[1,51,57,196],"arthritis":[2,13,58,197],"is":[3],"a":[4,44,60,128,135,188],"debilitating":[5],"post-viral":[6],"inflammatory":[7],"condition":[8],"that":[9,182],"clinically":[10],"mimics":[11],"rheumatoid":[12,61],"and":[14,72,86,139,149,171],"often":[15],"requires":[16],"long-term":[17],"treatment":[18],"with":[19,48,59,80,99,127,175,194],"disease-modifying":[20,30],"antirheumatic":[21,31],"drugs.":[22],"Treatment":[23],"options":[24],"are":[25,33],"limited":[26],"when":[27],"conventional":[28,200],"synthetic":[29],"drugs":[32],"not":[34],"tolerated":[35],"or":[36],"lose":[37],"efficacy.":[38],"We":[39],"report":[40],"the":[41,91,152,165],"case":[42,180],"of":[43,130],"50-year-old":[45],"Brazilian":[46],"woman":[47],"serologically":[49],"confirmed":[50],"virus":[52],"infection":[53],"who":[54],"developed":[55],"chronic":[56,195],"arthritis-like":[62],"phenotype.":[63],"Following":[64],"an":[65],"acute":[66],"febrile":[67],"illness":[68],"accompanied":[69],"by":[70,84],"rash":[71],"negative":[73],"dengue":[74],"serology,":[75],"she":[76],"was":[77,102,107,110,142],"initially":[78],"managed":[79],"symptomatic":[81],"analgesics,":[82],"followed":[83],"prednisone":[85],"hydroxychloroquine.":[87],"Despite":[88],"this":[89],"treatment,":[90],"disease":[92,153],"activity":[93,154],"score":[94,129,155],"in":[95,146],"28":[96],"joints":[97],"calculated":[98],"C-reactive":[100,162],"protein":[101,163],"elevated":[103],"at":[104],"6.78.":[105],"Methotrexate":[106],"introduced":[108],"but":[109],"discontinued":[111],"after":[112,124],"3":[113],"weeks":[114],"due":[115],"to":[116,157,199],"drug-induced":[117],"pneumonitis.":[118],"She":[119],"later":[120],"failed":[121],"leflunomide":[122],"therapy":[123],"12":[125],"months,":[126],"4.33.":[131],"Baricitinib":[132],"(4":[133],"mg/day),":[134],"Janus":[136,183],"kinase":[137,184],"1":[138,160],"2":[140],"inhibitor,":[141],"then":[143],"initiated,":[144],"resulting":[145],"marked":[147],"clinical":[148],"laboratory":[150],"improvement:":[151],"decreased":[156],"1.90":[158],"over":[159],"year,":[161],"normalised,":[164],"erythrocyte":[166],"sedimentation":[167],"rate":[168],"declined":[169],"progressively,":[170],"morning":[172],"stiffness":[173],"resolved,":[174],"no":[176],"infectious":[177],"complications.":[178],"This":[179],"suggests":[181],"inhibition":[185],"may":[186],"be":[187],"therapeutic":[189],"option":[190],"for":[191],"selected":[192],"patients":[193],"refractory":[198],"treatment.":[201]},"counts_by_year":[{"year":2026,"cited_by_count":1}],"updated_date":"2026-11-10T11:39:43.021295","created_date":"2026-10-06T00:00:00"}
