{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,27]],"date-time":"2026-01-27T19:39:47Z","timestamp":1769542787579,"version":"3.49.0"},"reference-count":19,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2026,1,22]],"date-time":"2026-01-22T00:00:00Z","timestamp":1769040000000},"content-version":"vor","delay-in-days":21,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Int J of Rheum Dis"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>Bucillamine is a conventional synthetic disease\u2010modifying antirheumatic drug that can be used as a methotrexate alternative. However, which patients with rheumatoid arthritis can benefit from bucillamine treatment has not been established.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Patients who had taken bucillamine and discontinued it in 2021 due to a nationwide supply shortage were included in this study. We followed up these patients regarding arthritis exacerbation after bucillamine discontinuation until March 2025. Baseline clinical patient characteristics were compared between the exacerbation and non\u2010exacerbation groups.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Thirteen of the 18 patients experienced arthritis exacerbation, whereas five remained exacerbation\u2010free for up to 48\u2009months. The baseline rheumatoid factor levels were significantly higher in the exacerbation group (49\u2009U\/mL) than in the non\u2010exacerbation group (6\u2009U\/mL). Receiver operating characteristic and Kaplan\u2013Meier analyses showed that baseline RF levels \u2265\u200928\u2009U\/mL predicted arthritis exacerbation after bucillamine discontinuation (sensitivity 76.2% and specificity 80.0%).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Following bucillamine discontinuation, arthritis exacerbations occurred more frequently in patients with rheumatoid factor levels of 28\u2009U\/mL or higher, alongside an increase in these levels. Rheumatoid factor levels may serve as a useful biomarker for identifying patients who would benefit from continued bucillamine therapy.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/1756-185x.70551","type":"journal-article","created":{"date-parts":[[2026,1,23]],"date-time":"2026-01-23T06:57:36Z","timestamp":1769151456000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Rheumatoid Factor Levels Are Associated With Arthritis Exacerbation After Bucillamine Discontinuation"],"prefix":"10.1111","volume":"29","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9600-9549","authenticated-orcid":false,"given":"Yusuke","family":"Ogata","sequence":"first","affiliation":[{"name":"Takikawa Municipal Hospital  Takikawa Hokkaido Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Masumi","family":"Bamba","sequence":"additional","affiliation":[{"name":"Takikawa Municipal Hospital  Takikawa Hokkaido Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Koichi","family":"Bamba","sequence":"additional","affiliation":[{"name":"Takikawa Municipal Hospital  Takikawa Hokkaido Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ryo","family":"Hisada","sequence":"additional","affiliation":[{"name":"Department of Rheumatology, Endocrinology, and Nephrology, Faculty of Medicine and Graduate School of Medicine Hokkaido University  Sapporo Hokkaido Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hiroyuki","family":"Nakamura","sequence":"additional","affiliation":[{"name":"Department of Rheumatology, Endocrinology, and Nephrology, Faculty of Medicine and Graduate School of Medicine Hokkaido University  Sapporo Hokkaido Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2026,1,22]]},"reference":[{"key":"e_1_2_13_2_1","doi-asserted-by":"publisher","DOI":"10.1136\/ard\u20102022\u2010223356"},{"key":"e_1_2_13_3_1","doi-asserted-by":"publisher","DOI":"10.1093\/mr\/roac017"},{"key":"e_1_2_13_4_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10165\u2010009\u20100209\u20106"},{"key":"e_1_2_13_5_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10165\u2010006\u20100527\u2010x"},{"key":"e_1_2_13_6_1","doi-asserted-by":"publisher","DOI":"10.1007\/pl00006849"},{"issue":"3","key":"e_1_2_13_7_1","first-page":"260","article-title":"Treatment Continuation Rate in Relation to Efficacy and Toxicity in Long\u2010Term Therapy With Low\u2010Dose Methotrexate, Sulfasalazine, and Bucillamine in 1,358 Japanese Patients With Rheumatoid Arthritis","volume":"24","author":"Nagashima M.","year":"2006","journal-title":"Clinical and Experimental 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