Demographic, clinical, treatment, outcome, and comorbidities of patients with relapsing polychondritis: Experience from Brazilian tertiary center, and literature review

Demographic, clinical, treatment, outcome, and comorbidities of patients with relapsing polychondritis: Experience from Brazilian tertiary center, and literature review | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Demographic, clinical, treatment, outcome, and comorbidities of patients with relapsing polychondritis: Experience from Brazilian tertiary center, and literature review Patricia Pilar Lury Ortale Ueda, Luiz Antonio Leandrini Komati, and 1 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-5248270/v1 This work is licensed under a CC BY 4.0 License Status: Under Review Version 1 posted 9 You are reading this latest preprint version Abstract Background Due to the rarity of relapsing polychondritis (RP), we described the demographic, clinical, treatment, outcomes, and comorbidities of patients with RP from our tertiary service. Additionally, a literature review was conducted. Methods A total of 47 Brazilian patients with RP between 2000 and 2024 were analyzed. All patient data were collected from pre-parametrized and pre-standardized electronic medical records. A literature review using PubMed with “relapsing polychondritis” as the search term included 25 articles after applying the strict exclusion criteria. Results A total of 47 patients were evaluated. The median age was 40 (34–51) years, with a female-to-male ratio of 1.4:1, and 89.4% were of white ethnicity. The median time from symptom onset to diagnosis was 39 months and the median follow-up duration was 7 years. Ear cartilage biopsy was performed in 12.8% of cases. The clinical manifestations included auricular chondritis, arthralgia, and ocular involvement. Approximately half of the patients had hypertension and dyslipidemia, one-third had diabetes mellitus, and one-fifth had hypothyroidism. Tracheostomy and cochlear implantation were required in 12.8% and 6.4% of the patients, respectively. Disease outcomes showed that 46.8% of patients were in remission, 29.8% had active disease, and 25.5% were controlled with immunosuppressive therapy. Mortality occurred in 4.3% of the cases. In the literature review, 25 studies were analyzed, most of which originated in Asia. Studies have reported the classical manifestations of RP, such as auricular chondritis, arthritis, and ocular involvement. The median age of the patients with RP was similar across studies, averaging 46.4 years, with a predominance of female patients. A comparison with the literature showed consistency in clinical manifestations, particularly auricular chondritis and septum nasal chondritis, although few studies have explored comorbidities, disease evolution, and outcomes. Conclusions The reviewed articles described classical clinical manifestations, but few articles reported data on other manifestations and comorbidities that can occur in RP. Our study provided new insights by mapping symptom evaluations, thereby enhancing the understanding of disease evolution. Understanding and characterizing RP will allow for better assistance in its diagnosis and follow-up. Systemic autoimmune disease relapsing polychondritis revision Figures Figure 1 INTRODUCTION Relapsing polychondritis (RP) is a rare systemic autoimmune disease characterized by the inflammation of cartilaginous and/or proteoglycan-rich tissues. 1,2 In addition to classic ear involvement, the disease can affect other organs and systems, 1–3 such as the eyes, heart, joints, blood vessels, and the upper and lower airways. 4 The annual incidence of RP is 0.71 cases/million, affecting both sexes. Mortality is twice as high as that in the general population. 5 Regarding the evolution of RP, recurrent inflammation leads to tissue destruction 6 and results in neurological, ocular, dermatological, and other manifestations. 7 Clinical manifestations include inflammation of certain tissues or organs, such as chondritis (auricular, nasal, costal, joints, etc.), episcleritis, scleritis, uveitis, corneal ulcers, and retinal vasculitis. 8 Until now, there are few epidemiological studies with significant samples of RP patients. 1,4,11–13,22−42 Furthermore, these studies were limited to patients from the Northern Hemisphere, especially Asia, 11–13,23,25,27,33,37,39,42 Europe, 1,4,35,38 and North America. 26,34,36,40,43 However, only one study has been conducted in the Southern Hemisphere, particularly in South America, with a small sample size. 22 Therefore, we aimed to describe the demographic and clinical features, evolution, and comorbidities of a representative sample of patients with RP undergoing follow-up at a Brazilian tertiary center. Second, a literature review was conducted. PATIENTS AND METHODS This retrospective cohort study included patients with RP who underwent regular outpatient follow-up at a tertiary rheumatology service from 2000 to 2024. Patients with RP were included according to the classification criteria of McAdam et al. 10 The following pre-parameterized and pre-standardized information was extracted from the patients’ medical records: a) Demographic and anthropometric data: Current age, sex, and ethnicity; b) Clinical: Age at disease onset and duration; c) Drug therapy: Use of remote and current medications (glucocorticosteroids, immunosuppressants, immunomodulators, and immunobiologicals); d) Clinical evolution and current status of the disease (remission, activity, or control with immunosuppressive therapy); e) Comorbidities: Systemic arterial hypertension (or use of antihypertensive medication), dyslipidemia, diabetes mellitus, hypothyroidism, chronic obstructive lung disease, heart failure, myocardial infarction, stroke, and neoplasm; f) Habits: Smoking (if present or absent). Literature review . This search was based on the PubMed database, using “relapsing polychondritis” as the descriptor in the title or abstract. The analysis of the articles was independently performed by two authors. Duplicate studies were initially excluded, followed by case reports with fewer than 50 cases, literature review articles, conference summaries and annals, comments and errata of articles and book chapters, articles in the English language, and articles not available. Statistical analysis. The results were presented as median (interquartile range) or mean ± standard deviation for continuous variables, and as numbers (%) for categorical variables. RESULTS Patients with RP in the present study A total of 47 patients with RP were evaluated, with a median age at disease onset of 40 (34-51) years. The female-to-male ratio was 1.4:1, and white ethnicity was observed in 42 (89.4%) patients. The median duration between diagnosis and symptom onset was 39 (38-50) months, and the median follow-up duration was 7 (2-10) years. Ear cartilage biopsy was performed in six (12.8%) cases. The initial and cumulative clinical manifestations of the 47 patients with RP are shown in Table 1, and the previous (cumulative) and current treatments are shown in Table 2. The cumulative clinical manifestations of the 47 patients with RP are described in Table 3 together with those described in the literature. Regarding surgery, six (12.8%) and three (6.4%) patients in the present study underwent tracheostomy and cochlear implantation, respectively (Table 4). Systemic arterial hypertension and dyslipidemia were present in approximately half of our patients, whereas diabetes mellitus and hypothyroidism were present in one-third and one-fifth of our patients, respectively (Table 4). Chronic obstructive lung disease and myelodysplasia syndrome were present in two (4.3%) patients and heart failure in one (2.1%) patient. None of the patients had a myocardial infarction, stroke, or neoplasm. Ten (21.3%) patients were smokers. RP mortality in our sample occurred in two (4.3%) cases. Regarding the disease status of our patients at the last consultation, 22 (46.8%) patients presented with disease in remission, 14 (29.8%) patients had disease activity, and 12 (25.5%) patients had disease controlled with immunosuppressive therapy. Literature review A total of 25 articles published between 1997 and 2024 were selected for the present study (Figure 1, Tables 3 and 4). These studies are geographically diverse, but most are from Asia, mainly from China, 11-13,24,27,30,31,41 followed by Japan. 23,25,28,29,33,39,42 Other studies were conducted in the USA, 26,34,36,40,43 Deutschland, 38 France, 35 and Great Britain. 1 In terms of sex distribution, nine studies primarily featured female participants, 1,25,28,34,37,40,43 three had an equal representation of male and female participants, 11,13,48 and two specified the sex distribution. 12,26 The remaining studies included a higher number of male participants. 23,24,27,29-31,33,38,39,41,42 This distribution highlights the predominance of studies from Asia, indicating the lack of a comprehensive global scope. The average age of the participants across the studies, based on the data provided by 14 articles, 1,13, 23,24,27,28,31,33,34,36-38,40,41 was 46.4 years. The reviewed articles reported clinical manifestations reported in the reviewed articles varied, with specific manifestations noted at both initial onset and follow-up stages. Auricular chondritis has been observed in many studies, 1,3,10-12,20,22-25,27,30,33,38 but few have been divided into initial 27 or follow-up 23,24 onset. Arthralgia was mostly shown in the general 11,12,13,35 and only one showed initial onset. 13 Arthritis was present in the general form, 1,24,25,27,31,35,37,43 but only two had an initial onset 24,27 and one had a follow-up onset. 24 Septum nasal chondritis has been reported in several studies; 11,25,26,28-30,33,34,36-40,42,43 however, there is no information on its evolution. Hearing loss was reported in 11 studies: 1,12,13,23,24,27,34-37,43 three at the initial onset, 13,24,27 and one at the onset of follow-up. 24 Ocular involvement was present in 15 studies. 11,12,23,24,26-30,35-38,40,48 Uveitis and episcleritis were only mentioned once. 35 Laryngeal involvement was mentioned in four studies. 11,27,31,35 Tracheobronchial involvement was found in five studies. 11,27,28,35,36 Laryngotracheitis was present in four articles. 1,24,30,37 Costochondritis was found in nine articles, 24,27,30,33,35,37,38,41,43 those being only two classified in initial onset 27 and follow-up onset. 24 Subglottic stenosis was found in three articles. 1,26,36 Neurological disorders were present in many articles, specifically in 13 studies, 11-13,23,27-30,34,37-39,42 of which two mentioned initial onset 23,27 and only one mentioned follow-up onset. 23 Cardiac disorders were present in only two studies, 23,27 each of which described it as an initial onset 27 or follow-up onset. 23 Renal disorder was mentioned in eight articles, 11,12,23,24,29,37,38,42 but only one collected data on the follow-up onset. 23 Tracheal involvement, vestibular disorders, and bronchitis were not observed in any of the studies. Auricular chondritis at initial onset was observed in 55.6% of patients, 27 74% 23,24 developed as a follow-up symptom, and 67.3% presented with this symptom. 1,11,23-25,27,28,30,31,33-38,40 A median of 48.1% of patients presented septum nasal chondritis. 11,25,26,28-30,33,34,36-40,42,43 Ocular involvement affected 39.8% of patients. 11,12,23,24,26-30,35-38,40,48 Costochondritis occurred in 32.4%, 24,27,30,33,35,37,38,41,43 2.4% initially 27 and 15% eventually developed this symptom. 24 Neurological disorders were generally present in 12.8%, 11-13,28-30,34,37-39,42 initially 3.5%, 23,27 and 9.6% of patients 23 at follow-up. Renal disorders generally occurred in 4.9% of cases; 11,12,24,29,37,38,42 none of the studies brought data from the initial onset, but follow-up was 9.2%. 23 Arthralgia occurred in 45% 11-13,35 of patients, 7.1% had initial onset, 13 and none were described as follow-up. Arthritis occurred in 37.7%, 1,24,25,27,31,35,37,43 5.6% initial, 24,27 and 56% follow-up. 24 Nasal bridges account for 33.9% of the cases. 1,23 Hearing loss was generally 41.7%, 1,12,23,24,27,34-37,43 5.8% at the initial follow-up, 13,24,27 and 25% at the follow-up. 24 Uveitis generally occurs in 13% of patients, 35 whereas episcleritis occurs in only 36% of patients. 35 Laryngeal involvement was observed in 33.3%. 11,27,31,35 Tracheobronchial involvement affected 59.6% of patients. 11,27,28,35,36 Laryngotracheitis occurs in 68% of the cases, 1,24,30,37 whereas subglottic stenosis occurred in 11.4%. 1,26,36 Cardiac disorders occurred in 7.1% of the cases, 23 initially 6.3%, 27 and 7.1% at follow-up. 23 Bronchitis was not observed in any data (initial, general, and follow-up); the same was observed for vestibular disorders, septum nasal chondritis, ocular involvement, nasal bridge, uveitis, episcleritis, laryngeal involvement, tracheobronchial involvement, laryngotracheitis, or subglottic stenosis. DISCUSSION Among the 25 selected articles reviewed in this study, the clinical manifestations addressed were predominantly the classical symptoms of RP that were cumulatively presented. However, there has been limited discussion on other symptomatology and comorbidities that may accompany RP. Nonetheless, for full comprehension of RP progression, its clinical presentation must be thoroughly detailed, as in the present study. In this context, our current demographic study offers novel insights by providing a detailed temporal visualization of symptoms and treatment progression among patients with RP. This approach enriches our understanding of clinical evolution and treatment of this disease. In this study, several significant strengths were identified. First, it involved a substantial sample size drawn from a continent with a limited number of clinical studies, thereby filling a critical gap in literature. Moreover, this study distinguishes itself from the existing literature by addressing a wide range of general aspects including clinical presentation, treatment, outcomes, comorbidities, and complications, thus contributing to a more holistic view of the disease under investigation. In the literature review, data collection was conducted without applying the exclusion criteria based on the year of publication, which allowed the inclusion of studies spanning a wide temporal range. This approach provides a broader perspective by capturing the evolution of knowledge and practices over time. By including both older and more recent studies, this review offers a comparison of the scientific progress across different years. Additionally, it allowed the identification of research gaps, underexplored symptoms, and so on. As for most of the initial symptoms, the current study had almost twice the number of cases compared with the selected articles. This significant difference highlights the robustness of our initial data collection and the thoroughness with which we identify and document the early symptoms. As for most of the initial symptoms, the current study had almost twice the number of cases compared to the selected articles. This significant difference highlights the robustness of our initial data collection and the thoroughness with which we identified and documented early clinical manifestations. However, regarding follow-up symptoms, our study included nearly half of the number of patients with general symptoms reported in the selected articles. This discrepancy could be attributed to several factors, including differences in the study design, population characteristics, and criteria used for symptom tracking. Additionally, we were unable to identify a consistent pattern in the general symptom category, unlike in other symptom categories where clear trends were observed. This lack of a pattern could suggest a higher variability in how general symptoms manifest and progress over time, or it might indicate that these symptoms are influenced by a broader range of external factors. The sample composition in this study was predominantly white and female. In contrast, only nine of the 25 studies reviewed had the majority of female participants. Regarding ethnicity, none of the studies were from South America and most of them were from Asia. This lack of representation from Latin America highlights the significance of our study as it adds valuable insight into the understanding of the disease in the South American population. The absence of data from other demographic groups in the reviewed studies limited the generalizability of their findings, underscoring the importance of more diverse research in this field. Regarding the demographic characteristics and onset of RP, the female-to-male ratio was 1.4:1, which was lower than the average ratio of 1.9:1 reported in the selected articles. Additionally, the age at diagnosis in our sample was 40 years, whereas the average age in the selected articles was 46.5 years. The analysis of cardiovascular risk in patients with RP revealed significant differences between the selected patients and those in other studies in which comorbidities were inadequately addressed, hampering data analysis. However, systemic arterial hypertension was significantly more prevalent in our study (48.9%) than in the selected studies (9.6%). Dyslipidemia was also elevated in our sample (46.9%). The prevalence of DM was more than double in our patients (31.9%) compared with that in the data collected (13.4%). Regarding heart failure, our data showed a low prevalence (2.1%), whereas the prevalence of myocardial infarction and stroke was zero in our sample compared to 3.5 and 2.1 in other studies, respectively. Finally, the prevalence of smoking was lower in our patients (21.3%) than that in other studies (40.7%). These findings highlight the need for a personalized approach to manage cardiovascular diseases and their risk factors in patients with RP. RP is characterized by episodic and unpredictable recurrence. Despite its recurrent nature, almost half of the patients achieved a controlled disease status at their last follow-up, with specific data showing 46.8% in remission, 29.8% with active disease, and 25.5% with controlled disease. This highlights the complexity of RP’s clinical trajectory of RP. The ability to attain disease control in a significant proportion of patients demonstrates advances in therapeutic approaches and potential for long-term management. Furthermore, there was a potential selection bias inherent in the study design, as the participants were drawn from a tertiary service population, likely representing individuals with more severe symptoms or delayed diagnosis. This could overestimate symptom severity and misrepresent typical progression. Additionally, relying on a tertiary population may overlook early symptoms and stages, limiting the applicability of this study to a broader population. CONCLUSIONS The reviewed articles described only classical manifestations of the disease but poorly described other clinical manifestations and comorbidities that can occur in RP. A demographic study in Brazil provided new insights by visualizing symptoms and treatment progression, and enhancing the understanding of the disease’s clinical evolution, outcomes, and comorbidities. Abbreviations MP Methylprednisolone RP Relapsing polychondritis Declarations ETHICAL APPROVAL AND CONSENT TO PARTICIPATE The study was approved by the local ethics committee (CAAE 80531424.8.0000.0068). COMPETING INTERESTS All authors declare that they have no conflicts of interest. CONSENT FOR PUBLICATION Not applicable. AVAILABILITY OF DATA AND MATERIALS Not applicable. FUNDING Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq): #301500/2022-3 AUTHORS’ CONTRIBUTIONS All authors contributed equally to the writing and reviewing of the manuscript . References Sangle SR, Hughes CD, Barry L, Qureshi S, Cheah CK, Poh YJ, et al. Relapsing polychondritis - A single centre study in the United Kingdom. Autoimmun Rev. 2023;22:103352. Nakamaru Y, Takagi D, Maeda M, Furuta Y, Fukuda S, Maguchi S. Treatment of relapsing polychondritis. Nihon Jibiinkoka Gakkai Kaiho. 2003;106:185-191. Yoshida T, Yoshifuji H, Shirakashi M, Nakakura A, Murakami K, Kitagori K, et al. 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Ferrada MA, Sikora KA, Luo Y, Wells KV, Patel B, Groarke EM, et al. Somatic Mutations in UBA1 Define a Distinct Subset of Relapsing Polychondritis Patients With VEXAS. Arthritis Rheumatol. 2021;73:1886-1895. Tables Table 1. Initial and follow-up/cumulative clinical manifestations of 47 patients with relapsing polychondritis Clinical manifestations Initial Follow-up/ Cumulative Auricular chondritis 47 (100) 47 (100) Arthralgia 15 (31.9) 25 (53.2) Arthritis 13 (27.7) 16 (34.0) Septum nasal chondrites 11 (23.4) 17 (36.2) Nasal bridge 0 5 (10.6) Hearing loss 10 (21.3) 13 (27.7) Uveitis 9 (19.1) 14 (29.8) Episcleritis 7 (14.9) 8 (17.0) Laryngeal disorder 5 (10.6) 5 (10.6) Tracheal disorder 2 (4.3) 10 (21.3) Bronchitis 3 (6.4) 6 (12.8) Costochondritis 7 (14.9) 10 (21.3) Subglottic stenosis 3 (6.4) 7 (14.9) Vestibular disorder 2 (4.3) 8 (17.0) Neurological disorder 2 (4.3) 5 (10.6) Cardiac disorder 0 1 (2.1) Renal disorder 0 1 (2.1) Results expressed as frequency (%). Table 2. Previous (cumulative) and current treatment of patients with 47 relapsing polychondritis Treatment Previous (cumulative) Current Glucocorticoid Pulse therapy with MP 11 (23.4) 0 Using 39 (83.0) 17 (36.2) Dose (mg/day) - 15 (15-30) Intravenous immunoglobulin 4 (8.5) 0 Cyclophosphamide 14 (29.8) 0 Methotrexate 39 (83.0) 11 (23.4) Azathioprine 21 (44.7) 8 (17.0) Mycophenolate mofetil 10 (21.3) 1 (2.1) Antimalarial 7 (14.9) 1 (2.1) Leflunomide 6 (12.8) 1 (2.1) Dapsone 3 (6.4) 0 Cyclosporine 4 (4.5) 1 (2.1) Thalidomide 2 (4.3) 1 (2.1) Immunobiological 12 (25.5) 7 (14.9) Data are expressed as median (interquartile 25 th – 75 th ) or frequency (%). MP: methylprednisolone. Table 3. General features of study with relapsing polychondritis Authors Ref Year Study Cases (n) Age at RP diagnosis (years) F:M ratio Auricular chondritis (%) Arthralgia (%) Arthritis (%) Septum nasal chondritis (%) Nasal bridge (%) Hearing loss (%) Ocular involvement (%) Uveitis (%) Episcleritis (%) Laryngeal involvement (%) Tracheobronchial (%) Laryngotracheitis (%) Costochondritis (%) Subglottic stenosis (%) Vestibular involvement (%) Neurological involvement (%) Cardiac involvement (%) Renal involvement (%) Current study 2024 Brazil 47 40 1.4:1 87.2 53.2 34 36.2 10.6 27.7 46.8 29.8 17 10.6 34.0 31.9 21.3 14.9 10.6 10.6 2.1 2.1 Zeuner et al. 20 1997 Deutschland 62 46.6 0.7:1 93.5 - - 56.5 - - 49 - - - - - 2.3 - - 9.7 - 7.9 Ernst et al. 8 2009 USA 145 - - - - - 35.2 - - 32.5 - - - - - - 5.5 - - - - Shimizu et al. 2 2015 Japan 239 52.7 0.9:1 78.2 - - - 39.3 61.7 46.1 - - - - - - - - 9.6 7.1 9.2 Shimizu et al. 15 2015 Japan 239 52.7 0.9:1 78 - - 15.3 - - - - - - - - 19.4 - - - - - Lin et al. 4 2016 China 158 45.3 0.7:1 68 - 56 - - 25 44 - - - - 69 15 - - - - 3 Horváth et al. 5 2016 Hungary 233 - 1:1 - - - - - - 57.3 - - - - - - - - - - - Dion et al. 17 2016 France 142 - 1.7:1 89 66.2 33.1 - - 27 56 13 36 43 22 - 40 - - - - - Ferrada et al. 18 2018 USA 304 43,2 6.4:1 86 - - 63 - 34 53 - - - 74 - - 15 - - - - Shimizu et al. 24 2018 Japan 239 - 0.9:1 - - - 39 - - - - - - - - - - - 9.6 - 6.7 Zhang et al. 19 2019 China 87 45.9 1.7:1 57.5 - 14.9 16.1 - 9.2 50 - - - - 42.5 47 - - 1.1 - 6.5 Shimizu et al. 21 2020 Japan 229 - 0.9:1 - - - 40 - - - - - - - - - - - 12 - - Chen et al. 3 2021 China 295 41 1:1 - 40 - - - - - - - - - - - - - 12 - - Zhang et al. 9 2021 China 126 47.1 0.9:1 59.6 - 12.7 - - 9.5 47 - - 13.5 38.1 - 2.4 - - - - - Cao et al.12 2021 China 181 - 0.8: 1 83.2 - - 61.9 - - 34.8 - - - - 77.3 58 - - 3.2 - - Ferrada et al. 16 2021 USA 73 43 5.6:1 14 - - 39 - 26 - - - - - - - - - 12 - - Ferrada et al. 26 2021 USA 85 - 5.5:1 - - 91 84 - 29 - - - - - - 85 - - - - - Nakajima et al. 10 2022 - 117 43.2 2.3:1 78.6 - - 47.9 - - 19.8 - - - 59.9 - - - - 4.8 - - Shimizu et al. 11 2022 Japan 190 - 0.9:1 - - - 26.3 - - 43.2 - - - - - - - - 45 - 7.9 Wang et al. 13 2022 China 72 55.2 0.7:1 62.4 - 8.3 - - - - - - 11.1 - - - - - - - - Sangle et al. 6 2023 Great Britain 68 48 2.1:1 58.8 - 20 - 15 20.6 - - - - - 73.5 - 5.9 - - - - Handa et al. 7 2023 Japan 77 - 1.2:1 22.1 - 60.3 64.7 - - - - - - - - - - - - - - Luo et al. 22 2023 USA 66 38 3.3:1 64 - - 76 - - 24 - - - - - - - - - - - Yi et al. 23 2023 China 52 48 0.6:1 - - - - - - - - - - - - 42 - - - - - Yin et al. 25 2023 China 187 - 1:1 - 48.4 - 56.3 - - 58.4 - - 47.9 79.2 - - - - 14.2 - 2.5 Yin et al. 27 2023 China 146 - - 21.9 41.8 - - - 16.8 18.9 - - - - - - - - 4.9 - 1.2 Table 4. Surgery, comorbidities, habits, and outcome of patients with relapsing polychondritis Authors (Ref) Tracheostomy (%) Cochlear implant (%) Arterial hypertension (%) Dyslipidaemia (%) Diabetes mellitus (%) Hypothyroidism (%) Myelodisyplasta syndrome (%) Chronic obstructive lung disease (%) Heart failure (%) Myocardial infartion (%) Stroke (%) Smokers (%) Neoplasia (%) Mortality (%) Current study 12.8 6.4 48.9 46.8 31.9 19.1 4.3 4.3 2.1 0 0 21.3 0 4.3 Zeuner et al. 20 - - - - - - - - - - - - - Ernst et al. 8 2 - - - - - - - - - - - - - Shimizu et al. 2 17.6 - - - - - - - - 6.5 - - - - Shimizu et al. 15 - - - - - - 2.1 - - 1.2 2.1 - - - Lin et al. 4 - - - - - - - - - 0.6 - - - 6 Horváth et al. 5 - - - - 16 - - - - - - - 27 - Dion et al. 17 - - - - - - - - - - - - - 11 Ferrada et al. 18 - - - - - - - - - - - - - - Shimizu et al. 24 - - - - - - 2.1 - - - - - - - Zhang et al. 19 - - - - - - 1.1 - - - - - - Shimizu et al. 21 - - - - - - - - - - - - - - Chen et al. 3 14.9 - - - - - - - - - - - 2 8.8 Zhang et al. 9 - - - - - - 0.8 - - - - - - 14.3 Cao et al.12 - - 13.2 - 15.5 - - - - - - 42.5 - - Ferrada et al. 16 1 - - - - - - - - - - - - - Ferrada et al. 26 - - - - - - - - - - - - - 4 Nakajima et al. 10 - - - - - - - - - - - - - - Shimizu et al. 11 2.6 - - - - - - - - - - - - 1.6 Wang et al. 13 - - - - - - - - - 5.6 - 40.3 - 6.9 Sangle et al. 6 - - - - 19 - - - - - - - - 18 Handa et al. 7 32.4 - - - - - - - - - - - - 22 Luo et al. 22 - - - - - - - - - - - - - - Yi et al. 23 - - - - - - - - - - - - - - Yin et al. 25 - - 8.4 - 3.7 - - - - - - 39.3 - - Yin et al. 27 9 - 7.3 - 13 - - - - - - - - - Additional Declarations No competing interests reported. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-5248270","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":366952206,"identity":"cf3acec4-c2b0-408c-ade8-1a81e9113589","order_by":0,"name":"Patricia Pilar Lury Ortale Ueda","email":"","orcid":"","institution":"Universidade de São Paulo","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Patricia","middleName":"Pilar Lury Ortale","lastName":"Ueda","suffix":""},{"id":366952207,"identity":"9c184444-5ac4-485b-96e7-5c46b7edebe4","order_by":1,"name":"Luiz Antonio Leandrini Komati","email":"","orcid":"","institution":"Universidade de São Paulo","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Luiz","middleName":"Antonio Leandrini","lastName":"Komati","suffix":""},{"id":366952208,"identity":"d7706577-e81b-4bef-8072-f85255f41af9","order_by":2,"name":"Samuel Katsuyuki Shinjo","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA3ElEQVRIiWNgGAWjYNCCAgYGA2YgZqgA8XiI0WIA03KGJC0gmrGNCC3y7afTJD4YMNibs/MeKPg477C9OQPvsQ94zT+Tu01yhgFD4s5mvgTDmdsOJ+5s4Euegd9JudukeQwYEgwO8xgY8247nGBwgMcYv8P6326T/gN0GETLnMP2BLUw3ADaArSLcQNYS8Nhxg2EtBjceLvZssdAIhGkxXDGsXSQp5IJOCx3440fFTb2BufPmBl8qLEGBl3vYfwOgwAJEMEGjhtQnBINmB+AtZCgYxSMglEwCkYGAADdIUJJd1tn8wAAAABJRU5ErkJggg==","orcid":"","institution":"Universidade de São Paulo","correspondingAuthor":true,"submittingAuthor":false,"prefix":"","firstName":"Samuel","middleName":"Katsuyuki","lastName":"Shinjo","suffix":""}],"badges":[],"createdAt":"2024-10-11 20:23:09","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-5248270/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-5248270/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":67285862,"identity":"c2151a7b-1034-49e3-b83e-70c28a84e4f8","added_by":"auto","created_at":"2024-10-23 09:27:14","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":74834,"visible":true,"origin":"","legend":"\u003cp\u003eFlowchart of the present study\u003c/p\u003e","description":"","filename":"Figure1.png","url":"https://assets-eu.researchsquare.com/files/rs-5248270/v1/88c8bf8ca79095593684941b.png"},{"id":67286408,"identity":"8b99979f-b7af-4521-9543-dbc2ef2834e2","added_by":"auto","created_at":"2024-10-23 09:35:14","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":930926,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-5248270/v1/41f338a7-598b-4006-9300-6f65bafb8725.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Demographic, clinical, treatment, outcome, and comorbidities of patients with relapsing polychondritis: Experience from Brazilian tertiary center, and literature review","fulltext":[{"header":"INTRODUCTION","content":"\u003cp\u003eRelapsing polychondritis (RP) is a rare systemic autoimmune disease characterized by the inflammation of cartilaginous and/or proteoglycan-rich tissues.\u003csup\u003e1,2\u003c/sup\u003e In addition to classic ear involvement, the disease can affect other organs and systems,\u003csup\u003e1\u0026ndash;3\u003c/sup\u003e such as the eyes, heart, joints, blood vessels, and the upper and lower airways.\u003csup\u003e4\u003c/sup\u003e\u003c/p\u003e \u003cp\u003eThe annual incidence of RP is 0.71 cases/million, affecting both sexes. Mortality is twice as high as that in the general population.\u003csup\u003e5\u003c/sup\u003e\u003c/p\u003e \u003cp\u003eRegarding the evolution of RP, recurrent inflammation leads to tissue destruction\u003csup\u003e6\u003c/sup\u003e and results in neurological, ocular, dermatological, and other manifestations.\u003csup\u003e7\u003c/sup\u003e Clinical manifestations include inflammation of certain tissues or organs, such as chondritis (auricular, nasal, costal, joints, etc.), episcleritis, scleritis, uveitis, corneal ulcers, and retinal vasculitis.\u003csup\u003e8\u003c/sup\u003e\u003c/p\u003e \u003cp\u003eUntil now, there are few epidemiological studies with significant samples of RP patients.\u003csup\u003e1,4,11\u0026ndash;13,22\u0026minus;42\u003c/sup\u003e Furthermore, these studies were limited to patients from the Northern Hemisphere, especially Asia,\u003csup\u003e11\u0026ndash;13,23,25,27,33,37,39,42\u003c/sup\u003e Europe,\u003csup\u003e1,4,35,38\u003c/sup\u003e and North America.\u003csup\u003e26,34,36,40,43\u003c/sup\u003e However, only one study has been conducted in the Southern Hemisphere, particularly in South America, with a small sample size.\u003csup\u003e22\u003c/sup\u003e\u003c/p\u003e \u003cp\u003eTherefore, we aimed to describe the demographic and clinical features, evolution, and comorbidities of a representative sample of patients with RP undergoing follow-up at a Brazilian tertiary center. Second, a literature review was conducted.\u003c/p\u003e"},{"header":"PATIENTS AND METHODS","content":"\u003cp\u003eThis retrospective cohort study included patients with RP who underwent regular outpatient follow-up at a tertiary rheumatology service from 2000 to 2024.\u003c/p\u003e\n\u003cp\u003ePatients with RP were included according to the classification criteria of McAdam et al.\u003csup\u003e10\u003c/sup\u003e\u003c/p\u003e\n\u003cp\u003eThe following pre-parameterized and pre-standardized information was extracted from the patients\u0026rsquo; medical records:\u003c/p\u003e\n\u003cp\u003ea) \u0026nbsp;\u0026nbsp;Demographic and anthropometric data: Current age, sex, and ethnicity;\u003c/p\u003e\n\u003cp\u003eb)\u0026nbsp; \u0026nbsp;Clinical: Age at disease onset and duration;\u003c/p\u003e\n\u003cp\u003ec)\u0026nbsp; \u0026nbsp;Drug therapy: Use of remote and current medications (glucocorticosteroids, immunosuppressants, immunomodulators, and immunobiologicals);\u003c/p\u003e\n\u003cp\u003ed)\u0026nbsp; \u0026nbsp;Clinical evolution and current status of the disease (remission, activity, or control with immunosuppressive therapy);\u003c/p\u003e\n\u003cp\u003ee) \u0026nbsp; Comorbidities: Systemic arterial hypertension (or use of antihypertensive medication), dyslipidemia, diabetes mellitus, hypothyroidism, chronic obstructive lung disease, heart failure, myocardial infarction, stroke, and neoplasm;\u003c/p\u003e\n\u003cp\u003ef) \u0026nbsp; Habits: Smoking (if present or absent).\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eLiterature review\u003c/strong\u003e. This search was based on the PubMed database, using \u0026ldquo;relapsing polychondritis\u0026rdquo; as the descriptor in the title or abstract. The analysis of the articles was independently performed by two authors. Duplicate studies were initially excluded, followed by case reports with fewer than 50 cases, literature review articles, conference summaries and annals, comments and errata of articles and book chapters, articles in the English language, and articles not available.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eStatistical analysis.\u003c/strong\u003e The results were presented as median (interquartile range) or mean \u0026plusmn; standard deviation for continuous variables, and as numbers (%) for categorical variables.\u003c/p\u003e"},{"header":"RESULTS","content":"\u003ch2\u003ePatients with RP in the present study\u003c/h2\u003e\n\u003cp\u003eA total of 47 patients with RP were evaluated, with a median age at disease onset of 40 (34-51) years. The female-to-male ratio was 1.4:1, and\u0026nbsp;white ethnicity was observed in 42 (89.4%) patients. The median duration between diagnosis and symptom onset was 39 (38-50) months, and the median follow-up duration was 7 (2-10) years. Ear cartilage biopsy was performed in six (12.8%) cases.\u003c/p\u003e\n\u003cp\u003eThe initial and cumulative clinical manifestations of the 47 patients with RP are shown in Table 1, and the previous (cumulative) and current treatments are shown in Table 2.\u003c/p\u003e\n\u003cp\u003eThe cumulative clinical manifestations of the 47 patients with RP are described in Table 3 together with those described in the literature.\u003c/p\u003e\n\u003cp\u003eRegarding surgery, six (12.8%) and three (6.4%) patients in the present study underwent tracheostomy and cochlear implantation, respectively (Table 4).\u003c/p\u003e\n\u003cp\u003eSystemic arterial hypertension and dyslipidemia were present in approximately half of our patients, whereas diabetes mellitus and hypothyroidism were present in one-third and one-fifth of our patients, respectively (Table 4). Chronic obstructive lung disease and myelodysplasia syndrome were present in two (4.3%) patients and heart failure in one (2.1%) patient. None of the patients had a myocardial infarction, stroke, or neoplasm. Ten (21.3%) patients were smokers. RP mortality in our sample occurred in two (4.3%) cases.\u003c/p\u003e\n\u003cp\u003eRegarding the disease status of our patients at the last consultation, 22 (46.8%) patients presented with disease in remission, 14 (29.8%) patients had disease activity, and 12 (25.5%) patients had disease controlled with immunosuppressive therapy.\u0026nbsp;\u003c/p\u003e\n\u003ch2\u003eLiterature review\u003c/h2\u003e\n\u003cp\u003eA total of 25 articles published between 1997 and 2024 were selected for the present study (Figure 1, Tables 3 and 4). These studies are geographically diverse, but most are from Asia, mainly from China,\u003csup\u003e11-13,24,27,30,31,41\u003c/sup\u003e followed by Japan.\u003csup\u003e23,25,28,29,33,39,42\u003c/sup\u003e Other studies were conducted in the USA,\u003csup\u003e26,34,36,40,43\u003c/sup\u003e Deutschland,\u003csup\u003e38\u003c/sup\u003e France,\u003csup\u003e35\u003c/sup\u003e and Great Britain.\u003csup\u003e1\u003c/sup\u003e In terms of sex distribution, nine studies primarily featured female participants,\u003csup\u003e1,25,28,34,37,40,43\u003c/sup\u003e three had an equal representation of male and female participants,\u003csup\u003e11,13,48\u003c/sup\u003e and two specified the sex distribution.\u003csup\u003e12,26\u003c/sup\u003e The remaining studies included a higher number of male participants.\u003csup\u003e23,24,27,29-31,33,38,39,41,42\u003c/sup\u003e This distribution highlights the predominance of studies from Asia, indicating the lack of a comprehensive global scope. The average age of the participants across the studies, based on the data provided by 14 articles,\u003csup\u003e1,13, 23,24,27,28,31,33,34,36-38,40,41\u003c/sup\u003e was 46.4 years.\u003c/p\u003e\n\u003cp\u003eThe reviewed articles reported clinical manifestations reported in the reviewed articles varied, with specific manifestations noted at both initial onset and follow-up stages.\u003c/p\u003e\n\u003cp\u003eAuricular chondritis has been observed in many studies,\u003csup\u003e1,3,10-12,20,22-25,27,30,33,38\u003c/sup\u003e but few have been divided into initial\u003csup\u003e27\u003c/sup\u003e or follow-up\u003csup\u003e23,24\u003c/sup\u003e onset. Arthralgia was mostly shown in the general\u003csup\u003e11,12,13,35\u003c/sup\u003e and only one showed initial onset.\u003csup\u003e13\u003c/sup\u003e Arthritis was present in the general form,\u003csup\u003e1,24,25,27,31,35,37,43\u003c/sup\u003e but only two had an initial onset\u003csup\u003e24,27\u003c/sup\u003e and one had a follow-up onset.\u003csup\u003e24\u003c/sup\u003e Septum nasal chondritis has been reported in several studies;\u003csup\u003e11,25,26,28-30,33,34,36-40,42,43\u003c/sup\u003e however, there is no information on its evolution. Hearing loss was reported in 11 studies:\u003csup\u003e1,12,13,23,24,27,34-37,43\u003c/sup\u003e three at the initial onset,\u003csup\u003e13,24,27\u003c/sup\u003e and one at the onset of follow-up.\u003csup\u003e24\u003c/sup\u003e Ocular involvement was present in 15 studies.\u003csup\u003e11,12,23,24,26-30,35-38,40,48\u003c/sup\u003e Uveitis and episcleritis were only mentioned once.\u003csup\u003e35\u003c/sup\u003e Laryngeal involvement was mentioned in four studies.\u003csup\u003e11,27,31,35\u003c/sup\u003e Tracheobronchial involvement was found in five studies.\u003csup\u003e11,27,28,35,36\u003c/sup\u003e Laryngotracheitis was present in four articles.\u003csup\u003e1,24,30,37\u003c/sup\u003e Costochondritis was found in nine articles,\u003csup\u003e24,27,30,33,35,37,38,41,43\u003c/sup\u003e those being only two classified in initial onset\u003csup\u003e27\u003c/sup\u003e and follow-up onset.\u003csup\u003e24\u003c/sup\u003e Subglottic stenosis was found in three articles.\u003csup\u003e1,26,36\u003c/sup\u003e Neurological disorders were present in many articles, specifically in 13 studies,\u003csup\u003e11-13,23,27-30,34,37-39,42\u003c/sup\u003e of which two mentioned initial onset\u003csup\u003e23,27\u003c/sup\u003e and only one mentioned follow-up onset.\u003csup\u003e23\u003c/sup\u003e Cardiac disorders were present in only two studies,\u003csup\u003e23,27\u003c/sup\u003e each of which described it as an initial onset\u003csup\u003e27\u003c/sup\u003e or follow-up onset.\u003csup\u003e23\u003c/sup\u003e Renal disorder was mentioned in eight articles,\u003csup\u003e11,12,23,24,29,37,38,42\u003c/sup\u003e but only one collected data on the follow-up onset.\u003csup\u003e23\u003c/sup\u003e Tracheal involvement, vestibular disorders, and bronchitis were not observed in any of the studies.\u003c/p\u003e\n\u003cp\u003eAuricular chondritis at initial onset was observed in 55.6% of patients,\u003csup\u003e27\u003c/sup\u003e 74%\u003csup\u003e23,24\u003c/sup\u003e developed as a follow-up symptom, and 67.3% presented with this symptom.\u003csup\u003e1,11,23-25,27,28,30,31,33-38,40\u003c/sup\u003e A median of 48.1% of patients presented septum nasal chondritis.\u003csup\u003e11,25,26,28-30,33,34,36-40,42,43\u003c/sup\u003e Ocular involvement affected 39.8% of patients.\u003csup\u003e11,12,23,24,26-30,35-38,40,48\u003c/sup\u003e Costochondritis occurred in 32.4%,\u003csup\u003e24,27,30,33,35,37,38,41,43\u003c/sup\u003e 2.4% initially\u003csup\u003e27\u003c/sup\u003e and 15% eventually developed this symptom.\u003csup\u003e24\u003c/sup\u003e Neurological disorders were generally present in 12.8%,\u003csup\u003e11-13,28-30,34,37-39,42\u003c/sup\u003e initially 3.5%,\u003csup\u003e23,27\u003c/sup\u003e and 9.6% of patients\u003csup\u003e23\u003c/sup\u003e at follow-up. Renal disorders generally occurred in 4.9% of cases;\u003csup\u003e11,12,24,29,37,38,42\u003c/sup\u003e none of the studies brought data from the initial onset, but follow-up was 9.2%.\u003csup\u003e23\u003c/sup\u003e Arthralgia occurred in 45%\u003csup\u003e11-13,35\u003c/sup\u003e of patients, 7.1% had initial onset,\u003csup\u003e13\u003c/sup\u003e and none were described as follow-up. Arthritis occurred in 37.7%,\u003csup\u003e1,24,25,27,31,35,37,43\u003c/sup\u003e 5.6% initial,\u003csup\u003e24,27\u003c/sup\u003e and 56% follow-up.\u003csup\u003e24\u003c/sup\u003e Nasal bridges account for 33.9% of the cases.\u003csup\u003e1,23\u003c/sup\u003e Hearing loss was generally 41.7%,\u003csup\u003e1,12,23,24,27,34-37,43\u003c/sup\u003e 5.8% at the initial follow-up,\u003csup\u003e13,24,27\u003c/sup\u003e and 25% at the follow-up.\u003csup\u003e24\u003c/sup\u003e Uveitis generally occurs in 13% of patients,\u003csup\u003e35\u003c/sup\u003e whereas episcleritis occurs in only 36% of patients.\u003csup\u003e35\u003c/sup\u003e Laryngeal involvement was observed in 33.3%.\u003csup\u003e11,27,31,35\u003c/sup\u003e Tracheobronchial involvement affected 59.6% of patients.\u003csup\u003e11,27,28,35,36\u003c/sup\u003e Laryngotracheitis occurs in 68% of the cases,\u003csup\u003e1,24,30,37\u003c/sup\u003e whereas subglottic stenosis occurred in 11.4%.\u003csup\u003e1,26,36\u003c/sup\u003e Cardiac disorders occurred in 7.1% of the cases,\u003csup\u003e23\u003c/sup\u003e initially 6.3%,\u003csup\u003e27\u003c/sup\u003e and 7.1% at follow-up.\u003csup\u003e23\u003c/sup\u003e Bronchitis was not observed in any data (initial, general, and follow-up); the same was observed for vestibular disorders, septum nasal chondritis, ocular involvement, nasal bridge, uveitis, episcleritis, laryngeal involvement, tracheobronchial involvement, laryngotracheitis, or subglottic stenosis.\u003c/p\u003e"},{"header":"DISCUSSION","content":"\u003cp\u003eAmong the 25 selected articles reviewed in this study, the clinical manifestations addressed were predominantly the classical symptoms of RP that were cumulatively presented. However, there has been limited discussion on other symptomatology and comorbidities that may accompany RP. Nonetheless, for full comprehension of RP progression, its clinical presentation must be thoroughly detailed, as in the present study. In this context, our current demographic study offers novel insights by providing a detailed temporal visualization of symptoms and treatment progression among patients with RP. This approach enriches our understanding of clinical evolution and treatment of this disease.\u003c/p\u003e \u003cp\u003eIn this study, several significant strengths were identified. First, it involved a substantial sample size drawn from a continent with a limited number of clinical studies, thereby filling a critical gap in literature. Moreover, this study distinguishes itself from the existing literature by addressing a wide range of general aspects including clinical presentation, treatment, outcomes, comorbidities, and complications, thus contributing to a more holistic view of the disease under investigation.\u003c/p\u003e \u003cp\u003eIn the literature review, data collection was conducted without applying the exclusion criteria based on the year of publication, which allowed the inclusion of studies spanning a wide temporal range. This approach provides a broader perspective by capturing the evolution of knowledge and practices over time. By including both older and more recent studies, this review offers a comparison of the scientific progress across different years. Additionally, it allowed the identification of research gaps, underexplored symptoms, and so on. As for most of the initial symptoms, the current study had almost twice the number of cases compared with the selected articles. This significant difference highlights the robustness of our initial data collection and the thoroughness with which we identify and document the early symptoms.\u003c/p\u003e \u003cp\u003eAs for most of the initial symptoms, the current study had almost twice the number of cases compared to the selected articles. This significant difference highlights the robustness of our initial data collection and the thoroughness with which we identified and documented early clinical manifestations. However, regarding follow-up symptoms, our study included nearly half of the number of patients with general symptoms reported in the selected articles. This discrepancy could be attributed to several factors, including differences in the study design, population characteristics, and criteria used for symptom tracking. Additionally, we were unable to identify a consistent pattern in the general symptom category, unlike in other symptom categories where clear trends were observed. This lack of a pattern could suggest a higher variability in how general symptoms manifest and progress over time, or it might indicate that these symptoms are influenced by a broader range of external factors.\u003c/p\u003e \u003cp\u003eThe sample composition in this study was predominantly white and female. In contrast, only nine of the 25 studies reviewed had the majority of female participants. Regarding ethnicity, none of the studies were from South America and most of them were from Asia. This lack of representation from Latin America highlights the significance of our study as it adds valuable insight into the understanding of the disease in the South American population. The absence of data from other demographic groups in the reviewed studies limited the generalizability of their findings, underscoring the importance of more diverse research in this field.\u003c/p\u003e \u003cp\u003eRegarding the demographic characteristics and onset of RP, the female-to-male ratio was 1.4:1, which was lower than the average ratio of 1.9:1 reported in the selected articles. Additionally, the age at diagnosis in our sample was 40 years, whereas the average age in the selected articles was 46.5 years.\u003c/p\u003e \u003cp\u003eThe analysis of cardiovascular risk in patients with RP revealed significant differences between the selected patients and those in other studies in which comorbidities were inadequately addressed, hampering data analysis. However, systemic arterial hypertension was significantly more prevalent in our study (48.9%) than in the selected studies (9.6%). Dyslipidemia was also elevated in our sample (46.9%). The prevalence of DM was more than double in our patients (31.9%) compared with that in the data collected (13.4%). Regarding heart failure, our data showed a low prevalence (2.1%), whereas the prevalence of myocardial infarction and stroke was zero in our sample compared to 3.5 and 2.1 in other studies, respectively. Finally, the prevalence of smoking was lower in our patients (21.3%) than that in other studies (40.7%). These findings highlight the need for a personalized approach to manage cardiovascular diseases and their risk factors in patients with RP.\u003c/p\u003e \u003cp\u003eRP is characterized by episodic and unpredictable recurrence. Despite its recurrent nature, almost half of the patients achieved a controlled disease status at their last follow-up, with specific data showing 46.8% in remission, 29.8% with active disease, and 25.5% with controlled disease. This highlights the complexity of RP\u0026rsquo;s clinical trajectory of RP. The ability to attain disease control in a significant proportion of patients demonstrates advances in therapeutic approaches and potential for long-term management.\u003c/p\u003e \u003cp\u003eFurthermore, there was a potential selection bias inherent in the study design, as the participants were drawn from a tertiary service population, likely representing individuals with more severe symptoms or delayed diagnosis. This could overestimate symptom severity and misrepresent typical progression. Additionally, relying on a tertiary population may overlook early symptoms and stages, limiting the applicability of this study to a broader population.\u003c/p\u003e"},{"header":"CONCLUSIONS","content":"\u003cp\u003eThe reviewed articles described only classical manifestations of the disease but poorly described other clinical manifestations and comorbidities that can occur in RP. A demographic study in Brazil provided new insights by visualizing symptoms and treatment progression, and enhancing the understanding of the disease\u0026rsquo;s clinical evolution, outcomes, and comorbidities.\u003c/p\u003e"},{"header":"Abbreviations","content":"\u003cp\u003eMP Methylprednisolone\u003c/p\u003e\n\u003cp\u003eRP Relapsing polychondritis\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eETHICAL APPROVAL AND CONSENT TO PARTICIPATE\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe study was approved by the local ethics committee (CAAE 80531424.8.0000.0068).\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCOMPETING INTERESTS\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAll authors declare that they have no conflicts of interest.\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCONSENT FOR PUBLICATION\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable.\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAVAILABILITY OF DATA AND MATERIALS\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable.\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFUNDING\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eConselho Nacional de Desenvolvimento Cient\u0026iacute;fico e Tecnol\u0026oacute;gico (CNPq): #301500/2022-3\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAUTHORS\u0026rsquo; CONTRIBUTIONS\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAll authors contributed equally to the writing and reviewing of the manuscript\u003cstrong\u003e.\u003c/strong\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n \u003cli\u003eSangle SR, Hughes CD, Barry L, Qureshi S, Cheah CK, Poh YJ, et al. Relapsing polychondritis - A single centre study in the United Kingdom. Autoimmun Rev. 2023;22:103352.\u003c/li\u003e\n \u003cli\u003eNakamaru Y, Takagi D, Maeda M, Furuta Y, Fukuda S, Maguchi S. Treatment of relapsing polychondritis. Nihon Jibiinkoka Gakkai Kaiho. 2003;106:185-191.\u003c/li\u003e\n \u003cli\u003eYoshida T, Yoshifuji H, Shirakashi M, Nakakura A, Murakami K, Kitagori K, et al. Risk factors for the recurrence of relapsing polychondritis. Arthritis Res Ther. 2022;24:127.\u003c/li\u003e\n \u003cli\u003eHorvath A, Pall N, Molnar K, Kovats T, Surjan G, Vicsek T, et al. A nationwide study of the epidemiology of relapsing polychondritis. Clin Epidemiol.\u0026nbsp;2016;8:211-230.\u003c/li\u003e\n \u003cli\u003eHazra N, Dregan A, Charlton J, Gulliford MC, D\u0026rsquo;Cruz DP. Incidence and mortality of relapsing polychondritis in the UK: a population-based cohort study.\u0026nbsp;Rheumatology. 2015;54:2181-2187.\u003c/li\u003e\n \u003cli\u003eKemta Lekpa F, Chevalier X. Refractory relapsing polychondritis: challenges and solutions.\u0026nbsp;Open Access Rheumatol. 2018;10:1-11.\u003c/li\u003e\n \u003cli\u003eBorgia F, Giuffrida R, Guarneri F, Cannav\u0026ograve; S. Relapsing polychondritis.\u0026nbsp;An updated review. Biomedicines. 2018;6:84.\u003c/li\u003e\n \u003cli\u003eLiu Y, Li X, Cheng L, Zhan H, Huang Y, Li H, et al. Progress and challenges in the use of blood biomarkers in relapsing polychondritis. Clin Exp Immunol. 2023;212:199-211.\u003c/li\u003e\n \u003cli\u003eMaciążek-Chyra B, Szmyrka M, Skoczyńska M, Sokolik R, Lasocka J, Wiland P. Relapsing polychondritis - analysis of symptoms and criteria.\u0026nbsp;Rheumatology. 2019;57:8-18.\u003c/li\u003e\n \u003cli\u003eMcAdam LP, O\u0026rsquo;Hanlan MA, Bluestone R, Pearson CM. Relapsing polychondritis: prospective study of 23 patients and a review of the literature. Medicine. 1976;55:193-215.\u003c/li\u003e\n \u003cli\u003eYin R, Zhao M, Xu D, Wang Q, Li M, Zhang W, et al. 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Mod Rheumatol Case Rep. 2022;7:197-201.\u003c/li\u003e\n \u003cli\u003eDucci RDP, Germiniani FMB, Czecko LEA, Paiva ES, Teive HAG.\u0026nbsp;Relapsing polychondritis and lymphocytic meningitis with varied neurological symptoms. Rev Bras Reumatol. 2017;57:623-625.\u003c/li\u003e\n \u003cli\u003eMart\u0026iacute;nez-Balzano CD, Sosa A, O\u0026rsquo;Reilly S, Gong Y, Irwin R. A 66-year-old man with a past history of relapsing polychondritis presented with right upper lobe consolidation, nodular airway lesions, and a corticosteroid-responsive chronic cough.\u0026nbsp;Chest. 2015;148:e142-e147.\u003c/li\u003e\n \u003cli\u003ePassos CO, Onofre GR, Rita C.L Martins, Graff DL, Pagani EA, Sodr\u0026eacute; CT, et al.\u0026nbsp;Composition of urinary glycosaminoglycans in a patient with relapsing polychondritis. Clin Biochem. 2002;35:377-381.\u003c/li\u003e\n \u003cli\u003eHaslag-Minoff J, Regunath H. Relapsing polychondritis.\u0026nbsp;N Engl J Med. 2018;378:1715.\u003c/li\u003e\n \u003cli\u003eFonseca AR, Sheila, Marta, Aymor\u0026eacute; IL, Domingues RC, Sztajnbok FR.\u0026nbsp;Relapsing polychondritis in childhood: three case reports, comparison with adulthood disease and literature review. Rheumatol Int. 2012;33:1873-1878.\u003c/li\u003e\n \u003cli\u003eHuang Y, Mei J, Li Q, Cai C. Clinical analysis of 11 patients with relapsing polychondritis. In Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi.\u0026nbsp;J Clin Otorhinolaryngol, Head, and Neck Surg. 2009;23:625-627.\u003c/li\u003e\n \u003cli\u003ePallo PAO, Levy-Neto M, Pereira RMR, Shinjo SK.\u0026nbsp;Relapsing polychondritis: prevalence of cardiovascular diseases and its risk factors, and general disease features according to gender.\u0026nbsp;Rev Bras Reumatol. 2017;57:338-345.\u003c/li\u003e\n \u003cli\u003eShimizu J, Oka H, Yamano Y, Yudoh K, Suzuki N. Cardiac involvement in relapsing polychondritis in Japan.\u0026nbsp;Rheumatology (Oxford). 2016;55:583-584.\u003c/li\u003e\n \u003cli\u003eLin DF, Yang WQ, Zhang PP, Lv Q, Jin O, Gu JR.\u0026nbsp;Clinical and prognostic characteristics of 158 cases of relapsing polychondritis in China and review of the literature. Rheumatol Int. 2016;36:1003-1009.\u003c/li\u003e\n \u003cli\u003eHanda H, Ooka S, Shimizu J, Suzuki N, Masamichi Mineshita.\u0026nbsp;Evaluation of airway involvement and treatment in patients with relapsing polychondritis.\u0026nbsp;Sci Rep. 2023;13:8307.\u003c/li\u003e\n \u003cli\u003eErnst A, Rafeq S, Boiselle P, Sung A, Reddy C, Michaud G, et al.\u0026nbsp;Relapsing polychondritis and airway involvement. Chest. 2009;135:1024-1030.\u003c/li\u003e\n \u003cli\u003eZhang L, Yun S, Wu T, He Y, Guo J, Han L, et al. Clinical patterns and the evolution of relapsing polychondritis based on organ involvement: a Chinese retrospective cohort study. Orphanet J Rare Dis. 2021;16:225.\u003c/li\u003e\n \u003cli\u003eTerao C. Co-occurrence of relapsing polychondritis and autoimmune thyroid diseases.\u0026nbsp;Orphanet J Rare Dis. 2022;17:101.\u003c/li\u003e\n \u003cli\u003eShimizu J, Yamano Y, Kimito Kawahata, Suzuki N. Nationwide cross-sectional survey of patients with relapsing polychondritis in 2019 demonstrates red.uction of airway involvement compared with that in 2009. Sci Rep. 2022;12:465\u003c/li\u003e\n \u003cli\u003eCao X, Zhu L, Li H, Jiang L, Xu D, Zhao J, et al.\u0026nbsp;Comparison of relapsing polychondritis patients with and without central nervous system involvement: A retrospective study of 181 patients. Int J Immunopathol Pharmacol. 2021;35:20587384211000547.\u003c/li\u003e\n \u003cli\u003eWang D, Guan L, Dong X, Zhu X, Tong Z. Comparison of relapsing polychondritis patients with and without respiratory involvement based on chest computed tomography: a retrospective cohort study.\u0026nbsp;BMC Pulm Med. 2022;22:222.\u003c/li\u003e\n \u003cli\u003eTsuruoka H, Handa H, Yamashiro T, Nishine H, Inoue T, Mineshita M. Correlation between computed tomographic analysis and pulmonary function measurements in patients with relapsing polychondritis.\u0026nbsp;Respiration. 2021;100:109-115.\u003c/li\u003e\n \u003cli\u003eShimizu J, Oka H, Yamano Y, Kazuo Yudoh, Suzuki N. Cutaneous manifestations of patients with relapsing polychondritis: an association with extracutaneous complications.\u0026nbsp;Clin Rheumatol. 2016;35:781-783.\u003c/li\u003e\n \u003cli\u003eFerrada M, Rimland CA, Quinn K, Sikora K, Kim J, Allen C, et al. Defining clinical Subgroups in relapsing polychondritis: A prospective observational cohort Study. Arthritis Rheumatol. 2020;72:1396-1402.\u003c/li\u003e\n \u003cli\u003eDion J, Costedoat-Chalumeau N, S\u0026egrave;ne D, Cohen-Bittan J, Leroux G, Dion C, et al. Relapsing polychondritis can be characterized by three different clinical phenotypes: Analysis of a recent series of 142 patients. Arthritis Rheumatol. 2016;68:2992-3001.\u003c/li\u003e\n \u003cli\u003eFerrada MA, Grayson PC, Banerjee S, Sikora KA, Colbert RA, Ninet Sinaii, et al. Patient perception of disease‐related symptoms and complications in relapsing polychondritis. Arthritis Care Res. 2018;70:1124-1131.\u003c/li\u003e\n \u003cli\u003eZhang L, Wu TG, He YJ, Guo JY, Han LS, Lu JM, et al. Diagnosing relapsing polychondritis remains a common challenge: experience from a Chinese retrospective cohort. Clin Rheumatol. 2020;39:2179-2184.\u003c/li\u003e\n \u003cli\u003eZeuner M, Straub RH, Rauh G, Albert ED, J. Sch\u0026ouml;lmerich, Lang B. Relapsing polychondritis: clinical and immunogenetic analysis of 62 patients.\u0026nbsp;J Rheumatol. 1997;24:96-101.\u003c/li\u003e\n \u003cli\u003eShimizu J, Yamano Y, Kimito Kawahata, Suzuki N. Elucidation of predictors of disease progression in patients with relapsing polychondritis at the onset: potential impact on patient monitoring.\u0026nbsp;BMC Rheumatol. 2020;4:41.\u003c/li\u003e\n \u003cli\u003eLuo Y, Ferrada MA, Sikora KA, Rankin C, Alessi HD, Kastner DL, et al. Ultra-rare genetic variation in relapsing polychondritis: A whole-exome sequencing study. Ann Rheum Dis. 2024;83:253-260.\u003c/li\u003e\n \u003cli\u003eYi J, Huang J, Hou P, Lin Z, Lin J, Lin SY, et al. Imaging features and clinical value of 18F-FDG PET/CT for predicting airway involvement in patients with relapsing polychondritis. Arthritis Res Ther. 2023;25:198.\u003c/li\u003e\n \u003cli\u003eShimizu J, Yamano Y, Kawahata K, Suzuki N. Relapsing polychondritis patients were divided into three subgroups: patients with respiratory involvement (R subgroup), patients with auricular involvement (A subgroup), and overlapping patients with both involvements (O subgroup), and each group had distinctive clinical characteristics.\u0026nbsp;Medicine. 2018;97:e12837.\u003c/li\u003e\n \u003cli\u003eFerrada MA, Sikora KA, Luo Y, Wells KV, Patel B, Groarke EM, et al. Somatic Mutations in UBA1 Define a Distinct Subset of Relapsing Polychondritis Patients With VEXAS. Arthritis Rheumatol. 2021;73:1886-1895.\u003c/li\u003e\n\u003c/ol\u003e"},{"header":"Tables","content":"\u003cp\u003eTable 1. Initial and follow-up/cumulative clinical manifestations of 47 patients with relapsing polychondritis\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"597\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 50%;\"\u003e\n \u003cp\u003eClinical manifestations\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 24.9117%;\"\u003e\n \u003cp\u003eInitial\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 25.0883%;\"\u003e\n \u003cp\u003eFollow-up/\u003c/p\u003e\n \u003cp\u003eCumulative\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 50%;\"\u003e\n \u003cp\u003eAuricular chondritis\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 24.9117%;\"\u003e\n \u003cp\u003e47 (100)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 25.0883%;\"\u003e\n \u003cp\u003e47 (100)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 50%;\"\u003e\n \u003cp\u003eArthralgia\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 24.9117%;\"\u003e\n \u003cp\u003e15 (31.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 25.0883%;\"\u003e\n \u003cp\u003e25 (53.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 50%;\"\u003e\n \u003cp\u003eArthritis\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 24.9117%;\"\u003e\n \u003cp\u003e13 (27.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 25.0883%;\"\u003e\n \u003cp\u003e16 (34.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 50%;\"\u003e\n \u003cp\u003eSeptum nasal chondrites\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 24.9117%;\"\u003e\n \u003cp\u003e11 (23.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 25.0883%;\"\u003e\n \u003cp\u003e17 (36.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 50%;\"\u003e\n \u003cp\u003eNasal bridge\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 24.9117%;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 25.0883%;\"\u003e\n \u003cp\u003e5 (10.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 50%;\"\u003e\n \u003cp\u003eHearing loss\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 24.9117%;\"\u003e\n \u003cp\u003e10 (21.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 25.0883%;\"\u003e\n \u003cp\u003e13 (27.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 50%;\"\u003e\n \u003cp\u003eUveitis\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 24.9117%;\"\u003e\n \u003cp\u003e9 (19.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 25.0883%;\"\u003e\n \u003cp\u003e14 (29.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 50%;\"\u003e\n \u003cp\u003eEpiscleritis\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 24.9117%;\"\u003e\n \u003cp\u003e7 (14.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 25.0883%;\"\u003e\n \u003cp\u003e8 (17.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 50%;\"\u003e\n \u003cp\u003eLaryngeal disorder\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 24.9117%;\"\u003e\n \u003cp\u003e5 (10.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 25.0883%;\"\u003e\n \u003cp\u003e5 (10.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 50%;\"\u003e\n \u003cp\u003eTracheal disorder\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 24.9117%;\"\u003e\n \u003cp\u003e2 (4.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 25.0883%;\"\u003e\n \u003cp\u003e10 (21.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 50%;\"\u003e\n \u003cp\u003eBronchitis\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 24.9117%;\"\u003e\n \u003cp\u003e3 (6.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 25.0883%;\"\u003e\n \u003cp\u003e6 (12.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 50%;\"\u003e\n \u003cp\u003eCostochondritis\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 24.9117%;\"\u003e\n \u003cp\u003e7 (14.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 25.0883%;\"\u003e\n \u003cp\u003e10 (21.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 50%;\"\u003e\n \u003cp\u003eSubglottic stenosis\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 24.9117%;\"\u003e\n \u003cp\u003e3 (6.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 25.0883%;\"\u003e\n \u003cp\u003e7 (14.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 50%;\"\u003e\n \u003cp\u003eVestibular disorder\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 24.9117%;\"\u003e\n \u003cp\u003e2 (4.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 25.0883%;\"\u003e\n \u003cp\u003e8 (17.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 50%;\"\u003e\n \u003cp\u003eNeurological disorder\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 24.9117%;\"\u003e\n \u003cp\u003e2 (4.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 25.0883%;\"\u003e\n \u003cp\u003e5 (10.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 50%;\"\u003e\n \u003cp\u003eCardiac disorder\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 24.9117%;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 25.0883%;\"\u003e\n \u003cp\u003e1 (2.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 50%;\"\u003e\n \u003cp\u003eRenal disorder\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 24.9117%;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 25.0883%;\"\u003e\n \u003cp\u003e1 (2.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eResults expressed as frequency (%).\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eTable 2. Previous (cumulative) and current treatment of patients with 47 relapsing polychondritis\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"601\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 44.5614%;\"\u003e\n \u003cp\u003eTreatment\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 30%;\"\u003e\n \u003cp\u003ePrevious (cumulative)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 25.4386%;\"\u003e\n \u003cp\u003eCurrent\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 44.5614%;\"\u003e\n \u003cp\u003eGlucocorticoid\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 30%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 25.4386%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 44.5614%;\"\u003e\n \u003cp\u003ePulse therapy with MP\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 30%;\"\u003e\n \u003cp\u003e11 (23.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 25.4386%;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 44.5614%;\"\u003e\n \u003cp\u003eUsing\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 30%;\"\u003e\n \u003cp\u003e39 (83.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 25.4386%;\"\u003e\n \u003cp\u003e17 (36.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 44.5614%;\"\u003e\n \u003cp\u003eDose (mg/day)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 30%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 25.4386%;\"\u003e\n \u003cp\u003e15 (15-30)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 44.5614%;\"\u003e\n \u003cp\u003eIntravenous immunoglobulin\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 30%;\"\u003e\n \u003cp\u003e4 (8.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 25.4386%;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 44.5614%;\"\u003e\n \u003cp\u003eCyclophosphamide\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 30%;\"\u003e\n \u003cp\u003e14 (29.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 25.4386%;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 44.5614%;\"\u003e\n \u003cp\u003eMethotrexate\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 30%;\"\u003e\n \u003cp\u003e39 (83.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 25.4386%;\"\u003e\n \u003cp\u003e11 (23.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 44.5614%;\"\u003e\n \u003cp\u003eAzathioprine\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 30%;\"\u003e\n \u003cp\u003e21 (44.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 25.4386%;\"\u003e\n \u003cp\u003e8 (17.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 44.5614%;\"\u003e\n \u003cp\u003eMycophenolate mofetil\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 30%;\"\u003e\n \u003cp\u003e10 (21.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 25.4386%;\"\u003e\n \u003cp\u003e1 (2.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 44.5614%;\"\u003e\n \u003cp\u003eAntimalarial\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 30%;\"\u003e\n \u003cp\u003e7 (14.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 25.4386%;\"\u003e\n \u003cp\u003e1 (2.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 44.5614%;\"\u003e\n \u003cp\u003eLeflunomide\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 30%;\"\u003e\n \u003cp\u003e6 (12.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 25.4386%;\"\u003e\n \u003cp\u003e1 (2.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 44.5614%;\"\u003e\n \u003cp\u003eDapsone\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 30%;\"\u003e\n \u003cp\u003e3 (6.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 25.4386%;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 44.5614%;\"\u003e\n \u003cp\u003eCyclosporine\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 30%;\"\u003e\n \u003cp\u003e4 (4.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 25.4386%;\"\u003e\n \u003cp\u003e1 (2.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 44.5614%;\"\u003e\n \u003cp\u003eThalidomide\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 30%;\"\u003e\n \u003cp\u003e2 (4.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 25.4386%;\"\u003e\n \u003cp\u003e1 (2.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 44.5614%;\"\u003e\n \u003cp\u003eImmunobiological\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 30%;\"\u003e\n \u003cp\u003e12 (25.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 25.4386%;\"\u003e\n \u003cp\u003e7 (14.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eData are expressed as median (interquartile 25\u003csup\u003eth\u003c/sup\u003e \u0026ndash; 75\u003csup\u003eth\u003c/sup\u003e) or frequency (%).\u003c/p\u003e\n\u003cp\u003eMP: methylprednisolone.\u003c/p\u003e\n\u003cp\u003eTable 3. General features of study with relapsing polychondritis\u0026nbsp;\u003c/p\u003e\n\u003cdiv align=\"\"\u003e\n \u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\" width=\"965\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 9.84456%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAuthors\u003csup\u003eRef\u003c/sup\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6.83938%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eYear\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8.80829%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eStudy\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.93782%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eCases\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e(n)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11.7098%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAge at RP diagnosis (years)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.93782%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eF:M ratio\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.93782%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAuricular chondritis (%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eArthralgia (%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eArthritis (%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eSeptum nasal chondritis (%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eNasal bridge (%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eHearing loss (%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eOcular involvement (%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eUveitis (%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 2.48705%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eEpiscleritis (%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eLaryngeal involvement (%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eTracheobronchial (%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eLaryngotracheitis (%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eCostochondritis (%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eSubglottic stenosis (%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eVestibular involvement (%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eNeurological involvement (%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 2.48705%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eCardiac involvement (%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 2.48705%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eRenal involvement (%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 9.84456%;\"\u003e\n \u003cp\u003eCurrent study\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6.83938%;\"\u003e\n \u003cp\u003e2024\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8.80829%;\"\u003e\n \u003cp\u003eBrazil\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.93782%;\"\u003e\n \u003cp\u003e47\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11.7098%;\"\u003e\n \u003cp\u003e40\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.93782%;\"\u003e\n \u003cp\u003e1.4:1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.93782%;\"\u003e\n \u003cp\u003e87.2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e53.2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e34\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e36.2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e10.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e27.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e46.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e29.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 2.48705%;\"\u003e\n \u003cp\u003e17\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e10.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e34.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e31.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e21.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e14.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e10.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e10.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 2.48705%;\"\u003e\n \u003cp\u003e2.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 2.48705%;\"\u003e\n \u003cp\u003e2.1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 9.84456%;\"\u003e\n \u003cp\u003eZeuner et al.\u003csup\u003e20\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6.83938%;\"\u003e\n \u003cp\u003e1997\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8.80829%;\"\u003e\n \u003cp\u003eDeutschland\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.93782%;\"\u003e\n \u003cp\u003e62\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11.7098%;\"\u003e\n \u003cp\u003e46.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.93782%;\"\u003e\n \u003cp\u003e0.7:1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.93782%;\"\u003e\n \u003cp\u003e93.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e56.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e49\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 2.48705%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e2.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e9.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 2.48705%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 2.48705%;\"\u003e\n \u003cp\u003e7.9\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 9.84456%;\"\u003e\n \u003cp\u003eErnst et al.\u003csup\u003e8\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6.83938%;\"\u003e\n \u003cp\u003e2009\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8.80829%;\"\u003e\n \u003cp\u003eUSA\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.93782%;\"\u003e\n \u003cp\u003e145\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11.7098%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.93782%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.93782%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e35.2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e32.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 2.48705%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e5.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 2.48705%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 2.48705%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 9.84456%;\"\u003e\n \u003cp\u003eShimizu et al.\u003csup\u003e2\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6.83938%;\"\u003e\n \u003cp\u003e2015\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8.80829%;\"\u003e\n \u003cp\u003eJapan\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.93782%;\"\u003e\n \u003cp\u003e239\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11.7098%;\"\u003e\n \u003cp\u003e52.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.93782%;\"\u003e\n \u003cp\u003e0.9:1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.93782%;\"\u003e\n \u003cp\u003e78.2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e39.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e61.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e46.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 2.48705%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e9.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 2.48705%;\"\u003e\n \u003cp\u003e7.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 2.48705%;\"\u003e\n \u003cp\u003e9.2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 9.84456%;\"\u003e\n \u003cp\u003eShimizu et al.\u003csup\u003e15\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6.83938%;\"\u003e\n \u003cp\u003e2015\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8.80829%;\"\u003e\n \u003cp\u003eJapan\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.93782%;\"\u003e\n \u003cp\u003e239\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11.7098%;\"\u003e\n \u003cp\u003e52.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.93782%;\"\u003e\n \u003cp\u003e0.9:1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.93782%;\"\u003e\n \u003cp\u003e78\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e15.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 2.48705%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e19.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 2.48705%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 2.48705%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 9.84456%;\"\u003e\n \u003cp\u003eLin et al.\u003csup\u003e4\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6.83938%;\"\u003e\n \u003cp\u003e2016\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8.80829%;\"\u003e\n \u003cp\u003eChina\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.93782%;\"\u003e\n \u003cp\u003e158\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11.7098%;\"\u003e\n \u003cp\u003e45.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.93782%;\"\u003e\n \u003cp\u003e0.7:1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.93782%;\"\u003e\n \u003cp\u003e68\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e56\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e25\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e44\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 2.48705%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e69\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e15\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 2.48705%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 2.48705%;\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 9.84456%;\"\u003e\n \u003cp\u003eHorv\u0026aacute;th et al.\u003csup\u003e5\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6.83938%;\"\u003e\n \u003cp\u003e2016\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8.80829%;\"\u003e\n \u003cp\u003eHungary\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.93782%;\"\u003e\n \u003cp\u003e233\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11.7098%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.93782%;\"\u003e\n \u003cp\u003e1:1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.93782%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e57.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 2.48705%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 2.48705%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 2.48705%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 9.84456%;\"\u003e\n \u003cp\u003eDion et al.\u003csup\u003e17\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6.83938%;\"\u003e\n \u003cp\u003e2016\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8.80829%;\"\u003e\n \u003cp\u003eFrance\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.93782%;\"\u003e\n \u003cp\u003e142\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11.7098%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.93782%;\"\u003e\n \u003cp\u003e1.7:1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.93782%;\"\u003e\n \u003cp\u003e89\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e66.2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e33.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e27\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e56\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e13\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 2.48705%;\"\u003e\n \u003cp\u003e36\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e43\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e22\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e40\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 2.48705%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 2.48705%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 9.84456%;\"\u003e\n \u003cp\u003eFerrada et al.\u003csup\u003e18\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6.83938%;\"\u003e\n \u003cp\u003e2018\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8.80829%;\"\u003e\n \u003cp\u003eUSA\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.93782%;\"\u003e\n \u003cp\u003e304\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11.7098%;\"\u003e\n \u003cp\u003e43,2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.93782%;\"\u003e\n \u003cp\u003e6.4:1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.93782%;\"\u003e\n \u003cp\u003e86\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e63\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e34\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e53\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 2.48705%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e74\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e15\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 2.48705%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 2.48705%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 9.84456%;\"\u003e\n \u003cp\u003eShimizu et al.\u003csup\u003e24\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6.83938%;\"\u003e\n \u003cp\u003e2018\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8.80829%;\"\u003e\n \u003cp\u003eJapan\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.93782%;\"\u003e\n \u003cp\u003e239\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11.7098%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.93782%;\"\u003e\n \u003cp\u003e0.9:1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.93782%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e39\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 2.48705%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e9.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 2.48705%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 2.48705%;\"\u003e\n \u003cp\u003e6.7\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 9.84456%;\"\u003e\n \u003cp\u003eZhang et al.\u003csup\u003e19\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6.83938%;\"\u003e\n \u003cp\u003e2019\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8.80829%;\"\u003e\n \u003cp\u003eChina\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.93782%;\"\u003e\n \u003cp\u003e87\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11.7098%;\"\u003e\n \u003cp\u003e45.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.93782%;\"\u003e\n \u003cp\u003e1.7:1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.93782%;\"\u003e\n \u003cp\u003e57.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e14.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e16.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e9.2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e50\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 2.48705%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e42.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e47\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e1.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 2.48705%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 2.48705%;\"\u003e\n \u003cp\u003e6.5\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 9.84456%;\"\u003e\n \u003cp\u003eShimizu et al.\u003csup\u003e21\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6.83938%;\"\u003e\n \u003cp\u003e2020\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8.80829%;\"\u003e\n \u003cp\u003eJapan\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.93782%;\"\u003e\n \u003cp\u003e229\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11.7098%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.93782%;\"\u003e\n \u003cp\u003e0.9:1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.93782%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e40\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 2.48705%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e12\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 2.48705%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 2.48705%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 9.84456%;\"\u003e\n \u003cp\u003eChen et al.\u003csup\u003e3\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6.83938%;\"\u003e\n \u003cp\u003e2021\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8.80829%;\"\u003e\n \u003cp\u003eChina\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.93782%;\"\u003e\n \u003cp\u003e295\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11.7098%;\"\u003e\n \u003cp\u003e41\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.93782%;\"\u003e\n \u003cp\u003e1:1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.93782%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e40\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 2.48705%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e12\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 2.48705%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 2.48705%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 9.84456%;\"\u003e\n \u003cp\u003eZhang et al.\u003csup\u003e9\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6.83938%;\"\u003e\n \u003cp\u003e2021\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8.80829%;\"\u003e\n \u003cp\u003eChina\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.93782%;\"\u003e\n \u003cp\u003e126\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11.7098%;\"\u003e\n \u003cp\u003e47.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.93782%;\"\u003e\n \u003cp\u003e0.9:1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.93782%;\"\u003e\n \u003cp\u003e59.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e12.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e9.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e47\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 2.48705%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e13.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e38.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e2.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 2.48705%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 2.48705%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 9.84456%;\"\u003e\n \u003cp\u003eCao et al.12\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6.83938%;\"\u003e\n \u003cp\u003e2021\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8.80829%;\"\u003e\n \u003cp\u003eChina\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.93782%;\"\u003e\n \u003cp\u003e181\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11.7098%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.93782%;\"\u003e\n \u003cp\u003e0.8: 1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.93782%;\"\u003e\n \u003cp\u003e83.2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e61.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e34.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 2.48705%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e77.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e58\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e3.2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 2.48705%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 2.48705%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 9.84456%;\"\u003e\n \u003cp\u003eFerrada et al.\u003csup\u003e16\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6.83938%;\"\u003e\n \u003cp\u003e2021\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8.80829%;\"\u003e\n \u003cp\u003eUSA\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.93782%;\"\u003e\n \u003cp\u003e73\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11.7098%;\"\u003e\n \u003cp\u003e43\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.93782%;\"\u003e\n \u003cp\u003e5.6:1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.93782%;\"\u003e\n \u003cp\u003e14\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e39\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e26\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 2.48705%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e12\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 2.48705%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 2.48705%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 9.84456%;\"\u003e\n \u003cp\u003eFerrada et al.\u003csup\u003e26\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6.83938%;\"\u003e\n \u003cp\u003e2021\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8.80829%;\"\u003e\n \u003cp\u003eUSA\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.93782%;\"\u003e\n \u003cp\u003e85\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11.7098%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.93782%;\"\u003e\n \u003cp\u003e5.5:1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.93782%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e91\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e84\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e29\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 2.48705%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e85\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 2.48705%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 2.48705%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 9.84456%;\"\u003e\n \u003cp\u003eNakajima et al.\u003csup\u003e10\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6.83938%;\"\u003e\n \u003cp\u003e2022\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8.80829%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.93782%;\"\u003e\n \u003cp\u003e117\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11.7098%;\"\u003e\n \u003cp\u003e43.2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.93782%;\"\u003e\n \u003cp\u003e2.3:1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.93782%;\"\u003e\n \u003cp\u003e78.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e47.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e19.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 2.48705%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e59.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e4.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 2.48705%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 2.48705%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 9.84456%;\"\u003e\n \u003cp\u003eShimizu et al.\u003csup\u003e11\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6.83938%;\"\u003e\n \u003cp\u003e2022\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8.80829%;\"\u003e\n \u003cp\u003eJapan\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.93782%;\"\u003e\n \u003cp\u003e190\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11.7098%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.93782%;\"\u003e\n \u003cp\u003e0.9:1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.93782%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e26.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e43.2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 2.48705%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e45\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 2.48705%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 2.48705%;\"\u003e\n \u003cp\u003e7.9\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 9.84456%;\"\u003e\n \u003cp\u003eWang et al.\u003csup\u003e13\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6.83938%;\"\u003e\n \u003cp\u003e2022\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8.80829%;\"\u003e\n \u003cp\u003eChina\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.93782%;\"\u003e\n \u003cp\u003e72\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11.7098%;\"\u003e\n \u003cp\u003e55.2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.93782%;\"\u003e\n \u003cp\u003e0.7:1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.93782%;\"\u003e\n \u003cp\u003e62.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e8.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 2.48705%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e11.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 2.48705%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 2.48705%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 9.84456%;\"\u003e\n \u003cp\u003eSangle et al.\u003csup\u003e6\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6.83938%;\"\u003e\n \u003cp\u003e2023\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8.80829%;\"\u003e\n \u003cp\u003eGreat Britain\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.93782%;\"\u003e\n \u003cp\u003e68\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11.7098%;\"\u003e\n \u003cp\u003e48\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.93782%;\"\u003e\n \u003cp\u003e2.1:1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.93782%;\"\u003e\n \u003cp\u003e58.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e20\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e15\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e20.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 2.48705%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e73.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e5.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 2.48705%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 2.48705%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 9.84456%;\"\u003e\n \u003cp\u003eHanda et al.\u003csup\u003e7\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6.83938%;\"\u003e\n \u003cp\u003e2023\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8.80829%;\"\u003e\n \u003cp\u003eJapan\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.93782%;\"\u003e\n \u003cp\u003e77\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11.7098%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.93782%;\"\u003e\n \u003cp\u003e1.2:1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.93782%;\"\u003e\n \u003cp\u003e22.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e60.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e64.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 2.48705%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 2.48705%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 2.48705%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 9.84456%;\"\u003e\n \u003cp\u003eLuo et al.\u003csup\u003e22\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6.83938%;\"\u003e\n \u003cp\u003e2023\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8.80829%;\"\u003e\n \u003cp\u003eUSA\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.93782%;\"\u003e\n \u003cp\u003e66\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11.7098%;\"\u003e\n \u003cp\u003e38\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.93782%;\"\u003e\n \u003cp\u003e3.3:1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.93782%;\"\u003e\n \u003cp\u003e64\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e76\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e24\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 2.48705%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 2.48705%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 2.48705%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 9.84456%;\"\u003e\n \u003cp\u003eYi et al.\u003csup\u003e23\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6.83938%;\"\u003e\n \u003cp\u003e2023\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8.80829%;\"\u003e\n \u003cp\u003eChina\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.93782%;\"\u003e\n \u003cp\u003e52\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11.7098%;\"\u003e\n \u003cp\u003e48\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.93782%;\"\u003e\n \u003cp\u003e0.6:1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.93782%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 2.48705%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e42\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 2.48705%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 2.48705%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 9.84456%;\"\u003e\n \u003cp\u003eYin et al.\u003csup\u003e25\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6.83938%;\"\u003e\n \u003cp\u003e2023\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8.80829%;\"\u003e\n \u003cp\u003eChina\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.93782%;\"\u003e\n \u003cp\u003e187\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11.7098%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.93782%;\"\u003e\n \u003cp\u003e1:1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.93782%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e48.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e56.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e58.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 2.48705%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e47.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e79.2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e14.2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 2.48705%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 2.48705%;\"\u003e\n \u003cp\u003e2.5\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 9.84456%;\"\u003e\n \u003cp\u003eYin et al.\u003csup\u003e27\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6.83938%;\"\u003e\n \u003cp\u003e2023\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8.80829%;\"\u003e\n \u003cp\u003eChina\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.93782%;\"\u003e\n \u003cp\u003e146\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11.7098%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.93782%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.93782%;\"\u003e\n \u003cp\u003e21.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e41.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e16.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e18.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 2.48705%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 3.10881%;\"\u003e\n \u003cp\u003e4.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 2.48705%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 2.48705%;\"\u003e\n \u003cp\u003e1.2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003c/table\u003e\n\u003c/div\u003e\n\u003cp\u003e\u0026nbsp;\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eTable 4. Surgery, comorbidities, habits, and outcome of patients with relapsing polychondritis\u0026nbsp;\u003c/p\u003e\n\u003cdiv align=\"center\"\u003e\n \u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\" width=\"587\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003e\u003cstrong\u003eAuthors (Ref)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u003cstrong\u003eTracheostomy (%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u003cstrong\u003eCochlear implant (%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u003cstrong\u003eArterial hypertension (%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u003cstrong\u003eDyslipidaemia (%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u003cstrong\u003eDiabetes mellitus (%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u003cstrong\u003eHypothyroidism (%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u003cstrong\u003eMyelodisyplasta \u0026nbsp;syndrome (%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u003cstrong\u003eChronic obstructive lung disease (%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u003cstrong\u003eHeart failure (%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u003cstrong\u003eMyocardial infartion (%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u003cstrong\u003eStroke (%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u003cstrong\u003eSmokers (%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u003cstrong\u003eNeoplasia (%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u003cstrong\u003eMortality (%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eCurrent study\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e12.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e6.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e48.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e46.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e31.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e19.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e4.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e4.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e2.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e21.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e4.3\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eZeuner et al.\u003csup\u003e20\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eErnst et al.\u003csup\u003e8\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eShimizu et al.\u003csup\u003e2\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e17.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e6.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eShimizu et al.\u003csup\u003e15\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e2.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e1.2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e2.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eLin et al.\u003csup\u003e4\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n 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\u003ctd\u003e\n \u003cp\u003e32.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e22\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eLuo et 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\u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003c/table\u003e\n\u003c/div\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":true,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"advances-in-rheumatology","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"adrh","sideBox":"Learn more about [Advances in Rheumatology](https://advancesinrheumatology.biomedcentral.com/)","snPcode":"42358","submissionUrl":"https://submission.springernature.com/new-submission/42358/3","title":"Advances in Rheumatology","twitterHandle":"","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"stoa","reportingPortfolio":"BMC/SO AJ","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"Systemic autoimmune disease, relapsing polychondritis, revision","lastPublishedDoi":"10.21203/rs.3.rs-5248270/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-5248270/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cb\u003eBackground\u003c/b\u003e\u003c/p\u003e \u003cp\u003eDue to the rarity of relapsing polychondritis (RP), we described the demographic, clinical, treatment, outcomes, and comorbidities of patients with RP from our tertiary service. Additionally, a literature review was conducted.\u003c/p\u003e\u003cp\u003e\u003cb\u003eMethods\u003c/b\u003e\u003c/p\u003e \u003cp\u003eA total of 47 Brazilian patients with RP between 2000 and 2024 were analyzed. All patient data were collected from pre-parametrized and pre-standardized electronic medical records. A literature review using PubMed with \u0026ldquo;relapsing polychondritis\u0026rdquo; as the search term included 25 articles after applying the strict exclusion criteria.\u003c/p\u003e\u003cp\u003e\u003cb\u003eResults\u003c/b\u003e\u003c/p\u003e \u003cp\u003eA total of 47 patients were evaluated. The median age was 40 (34\u0026ndash;51) years, with a female-to-male ratio of 1.4:1, and 89.4% were of white ethnicity. The median time from symptom onset to diagnosis was 39 months and the median follow-up duration was 7 years. Ear cartilage biopsy was performed in 12.8% of cases. The clinical manifestations included auricular chondritis, arthralgia, and ocular involvement. Approximately half of the patients had hypertension and dyslipidemia, one-third had diabetes mellitus, and one-fifth had hypothyroidism. Tracheostomy and cochlear implantation were required in 12.8% and 6.4% of the patients, respectively. Disease outcomes showed that 46.8% of patients were in remission, 29.8% had active disease, and 25.5% were controlled with immunosuppressive therapy. Mortality occurred in 4.3% of the cases. In the literature review, 25 studies were analyzed, most of which originated in Asia. Studies have reported the classical manifestations of RP, such as auricular chondritis, arthritis, and ocular involvement. The median age of the patients with RP was similar across studies, averaging 46.4 years, with a predominance of female patients. A comparison with the literature showed consistency in clinical manifestations, particularly auricular chondritis and septum nasal chondritis, although few studies have explored comorbidities, disease evolution, and outcomes.\u003c/p\u003e\u003cp\u003e\u003cb\u003eConclusions\u003c/b\u003e\u003c/p\u003e \u003cp\u003eThe reviewed articles described classical clinical manifestations, but few articles reported data on other manifestations and comorbidities that can occur in RP. Our study provided new insights by mapping symptom evaluations, thereby enhancing the understanding of disease evolution. Understanding and characterizing RP will allow for better assistance in its diagnosis and follow-up.\u003c/p\u003e","manuscriptTitle":"Demographic, clinical, treatment, outcome, and comorbidities of patients with relapsing polychondritis: Experience from Brazilian tertiary center, and literature review","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2024-10-23 09:27:09","doi":"10.21203/rs.3.rs-5248270/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Revision requested","date":"2024-12-12T14:09:55+00:00","index":"","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2024-12-03T14:04:12+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2024-11-10T12:16:13+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"337404120994126814296704823018491450748","date":"2024-11-06T14:40:19+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"148956007304327012445425502713151134725","date":"2024-11-02T15:11:01+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2024-10-21T15:25:35+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2024-10-16T11:14:38+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2024-10-16T11:13:02+00:00","index":"","fulltext":""},{"type":"submitted","content":"Advances in Rheumatology","date":"2024-10-11T20:11:59+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"advances-in-rheumatology","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"adrh","sideBox":"Learn more about [Advances in Rheumatology](https://advancesinrheumatology.biomedcentral.com/)","snPcode":"42358","submissionUrl":"https://submission.springernature.com/new-submission/42358/3","title":"Advances in Rheumatology","twitterHandle":"","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"stoa","reportingPortfolio":"BMC/SO AJ","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"f1dbd594-48b7-4ee5-b613-77911d4ae3a0","owner":[],"postedDate":"October 23rd, 2024","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"under-review","subjectAreas":[],"tags":[],"updatedAt":"2025-05-05T21:38:11+00:00","versionOfRecord":[],"versionCreatedAt":"2024-10-23 09:27:09","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-5248270","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-5248270","identity":"rs-5248270","version":["v1"]},"buildId":"rHA-KDH7Qsr4HCuvH75dn","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}