Clinical and experimental rheumatology最新文献

{"title":"Turkish Society for Rheumatology recommendations for topical and systemic treatments in Sjögren's disease.","authors":"Veli Yazısız, Berkan Armağan, Nevsun İnanç, Cemal Bes, Atalay Doğru, Gökhan Sargin, Müçteba Enes Yayla, Mustafa Ekici, Gonca Mumcu, Gonca Karabulut, Emel Gönüllü, Hakan Emmungil, Nilay Erdik, Canan Albayrak Yaşar, Duygu Kerim, Elif Akyazı Şener, Ayşegül Avcu, Esin Alpöz, Hülya Çankaya, Melis Palamar, Semra Akkaya Turhan, Yasemin Kabasakal","doi":"10.55563/clinexprheumatol/li5fmv","DOIUrl":"https://doi.org/10.55563/clinexprheumatol/li5fmv","url":null,"abstract":"<p><strong>Objectives: </strong>The aim of this work was to develop standardised recommendations for the treatment of Sjögren's disease (SjD) based on existing evidence and expert opinion.</p><p><strong>Methods: </strong>The task force (TF) consisted of Turkish specialists in rheumatology, ophthalmology and dentistry with an interest in SjD. The group used the Population, Intervention, Comparison and Outcome (PICO) format to frame its clinical questions. A systematic literature review on the therapeutic management of SjD was subsequently conducted in accordance with PRISMA guidelines. Levels of evidence (LoE) were assigned according to the 2011 Oxford Centre for Evidence-Based Medicine (CEBM) standards.</p><p><strong>Results: </strong>The recommendations are categorised under the following headings: general recommendations, management of ocular and oral dryness, and management of systemic organ involvements. Management of sicca symptoms benefits from a wealth of high-level evidence, highlighting topical therapies as the gold standard. Conversely, the treatment of systemic involvement relies heavily on case series and clinical experience. Here, glucocorticoids, hydroxychloroquine, and immunosuppressive agents remain cornerstone therapies. Overall, biologic therapies have demonstrated limited efficacy in SjD; however, they may be beneficial in selected patient subgroups and can be considered in cases of refractory systemic involvement.</p><p><strong>Conclusions: </strong>The recommendations on SjD treatment, derived from a systematic literature review and clinical experience, will guide clinicians in the management of patients, based on a set of overarching principles.</p>","PeriodicalId":10274,"journal":{"name":"Clinical and experimental rheumatology","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149104846","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The impact of colchicine treatment on long-term complications of familial Mediterranean fever since its introduction in 1972: an evaluation of artificial intelligence performance.","authors":"Eli Ben-Chetrit, Phillip D Levin, Eldad Ben-Chetrit","doi":"10.55563/clinexprheumatol/f2828p","DOIUrl":"https://doi.org/10.55563/clinexprheumatol/f2828p","url":null,"abstract":"<p><strong>Objectives: </strong>Familial Mediterranean fever (FMF) is a hereditary autoinflammatory disease characterised by recurrent febrile serositis and complicated in severe cases by AA amyloidosis, renal failure, infertility and adverse pregnancy outcomes. Since its introduction in 1972, colchicine has dramatically improved the prognosis of FMF.</p><p><strong>Methods: </strong>In this study, we try to explore the ability of three artificial intelligence (AI)-based medical information platforms: Open Evidence, ChatGPT-4, and ChatGPT-5.2, to summarise the impact of colchicine treatment on FMF-related complications. Each platform was presented with two identical clinically focused questions addressing AA amyloidosis complications, fertility, and pregnancy outcomes. Only the initial responses were analysed. Outputs were compared descriptively according to response length, structure, clinical content, contextualisation, citation characteristics, and overall presentation. References were manually verified, and textual similarity was assessed using TF-IDF cosine similarity analysis.</p><p><strong>Results: </strong>All three systems correctly conveyed the major clinical benefits of colchicine in FMF. However, substantial differences were observed in depth, contextualisation and citation quality. Open Evidence generated concise and focused responses with directly accessible references but limited contextual discussion. ChatGPT-4 produced more detailed and historically contextualised summaries, whereas ChatGPT-5.2 generated the most comprehensive responses, including discussion beyond the scope of the questions. Most references corresponded to real publications, although occasional bibliographic inaccuracies were identified, particularly among ChatGPT-generated citations. Cosine similarity analysis demonstrated overlap in core medical concepts despite marked differences in phrasing and organisation..</p><p><strong>Conclusions: </strong>AI-based medical information systems may provide rapid, clinically useful summaries of FMF and colchicine-associated outcomes. Nevertheless, human verification and expert interpretation remain essential because inaccuracies, hallucinations and citation inconsistencies persist. These tools should currently be regarded as complementary resources rather than replacements for conventional reviews or expert clinical judgment.</p>","PeriodicalId":10274,"journal":{"name":"Clinical and experimental rheumatology","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149104905","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical features, treatment and long-term outcomes of Schnitzler syndrome: a report from China.","authors":"Shaoying Wang, Chunlei Li, Di Wu, Min Shen","doi":"10.55563/clinexprheumatol/ne4ohh","DOIUrl":"https://doi.org/10.55563/clinexprheumatol/ne4ohh","url":null,"abstract":"","PeriodicalId":10274,"journal":{"name":"Clinical and experimental rheumatology","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149104532","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Airway computed tomography features and surgical outcomes in ANCA-associated vasculitis and relapsing polychondritis: a retrospective comparative study.","authors":"Yinghua Zhao, Xiao Bai, Zhengang Wang","doi":"10.55563/clinexprheumatol/b7h5aj","DOIUrl":"https://doi.org/10.55563/clinexprheumatol/b7h5aj","url":null,"abstract":"<p><strong>Objectives: </strong>Both antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) and relapsing polychondritis (RP) are rare diseases. Distinguishing between the two becomes particularly challenging when airway involvement is the predominant clinical manifestation. We informed to compare airway imaging features and surgical outcomes between AAV and RP.</p><p><strong>Methods: </strong>We retrospectively analysed 56 patients (29 AAV patients and 27 RP patients) with airway involvement who underwent neck and chest thin-section computed tomography (CT). We compared the two groups in terms of clinical manifestations, imaging findings, and surgical outcomes.</p><p><strong>Results: </strong>RP patients were younger at onset. In AAV patients, involvement predominantly occurred in the distal bronchi (86%), with parenchymal lung disease being the most frequent manifestation (83%). RP patients more frequently been involved of the subglottic region (89%) and cervical trachea (74%) and tended to have more extensive airway involvement. RP patients more often exhibited airway wall thickening, luminal stenosis, and wall calcification. In addition, among those requiring tracheostomy, successful decannulation after medical treatment was achieved in 86% (6/7) of AAV patients but only 30% (3/10) of RP patients.</p><p><strong>Conclusions: </strong>AAV preferentially involves the distal bronchi, whereas RP predominantly affects the central airways and is frequently associated with persistent structural airway damage. Taken together, this study characterises the clinical and CT imaging features of airway involvement in AAV and RP and may provide preliminary reference for the clinical differentiation and individualised management of airway disease in these two conditions.</p>","PeriodicalId":10274,"journal":{"name":"Clinical and experimental rheumatology","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149104515","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"PD-1 on CD8+T cells are low in Behçet's disease and is not normalised with type-I interferon.","authors":"Seyda Bilgin, Taylan Kaplan, Rabia Deniz, Arman Cakar, Hacer Durmus, Yeşim Parman, Cemal Bes, Fatma Alibaz, Ahmet Gül, Haner Direskeneli, Güher Saruhan-Direskeneli","doi":"10.55563/clinexprheumatol/u8iusx","DOIUrl":"https://doi.org/10.55563/clinexprheumatol/u8iusx","url":null,"abstract":"<p><strong>Objectives: </strong>Programmed cell death-1 (PD-1) protein on CD8+T cells may affect disease development as a regulatory molecule through various mechanisms. On the other hand, type-I interferons (IFN-I) are used in autoimmune and autoinflammatory diseases to induce regulatory mechanisms. This study aims to investigate PD-1 molecules on CD8+T cells in Behçet's disease (BD) and their response to IFN-I.</p><p><strong>Methods: </strong>BD (n=37) patients were compared with age- and sex-matched healthy (n=24) and diseased controls (n=29). Peripheral mononuclear cells (PBMCs) were stained for PD-1, CD45RA and CCR7 molecules on CD3+CD8+T cells. Cells from patients and controls were further activated in vitro by anti-CD3 and interferon (IFN-α/2α1b) and the induction of PD-1, TIM-3 and TIGIT on CD8+T cells was analysed.</p><p><strong>Results: </strong>PD-1 on CD8+T cells with potentially regulatory functions were significantly lower in BD patients, regardless of disease activity, than in controls. CD3 stimulation of PBMCs induced PD-1 expression in all groups, whereas the addition of interferon to stimulated CD8+T cells produced differential responses: the increase of PD-1 on CD8+T cells in controls was not observed in BD patients. The responsive increase of similar co-inhibitory molecules, TIM-3 and TIGIT, in controls was not seen in BD patients either.</p><p><strong>Conclusions: </strong>The decreased PD-1 expression on CD8+T cells, along with the decreased PD-1, TIM-3 and TIGIT responses of CD8+T cells upon IFN-I stimulation, demonstrated an altered immune response in BD.</p>","PeriodicalId":10274,"journal":{"name":"Clinical and experimental rheumatology","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149104878","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Monitoring disease activity in eosinophilic granulomatosis with polyangiitis: a scoping review.","authors":"Michelangelo Tesi, Ilaria Fibbi, Carlotta Rella, Alessandra Bettiol, Rosaria Talarico, Giacomo Emmi, Augusto Vaglio","doi":"10.55563/clinexprheumatol/kysrv8","DOIUrl":"https://doi.org/10.55563/clinexprheumatol/kysrv8","url":null,"abstract":"<p><strong>Objectives: </strong>Eosinophilic granulomatosis with polyangiitis (EGPA) is a rare vasculitis characterised by eosinophilic inflammation, asthma, and often anti-neutrophil cytoplasmic antibody (ANCA) positivity. Monitoring disease activity is challenging because conventional tools, mainly the Birmingham Vasculitis Activity Score (BVAS), account for manifestations not relevant to EGPA while insufficiently capturing respiratory and eosinophilic features.This scoping review aims to systematically evaluate current methods, biomarkers, imaging studies or other procedures to monitor disease activity or treatment response in EGPA.</p><p><strong>Methods: </strong>Eligible studies were those published between January 2005 and March 2025, including at least five EGPA patients (≥10% of the cohort), and focusing on disease activity or treatment response. Non-human studies, case reports, reviews, and investigations focused on diagnosis were excluded.</p><p><strong>Results: </strong>Of 874 records screened, 58 studies met inclusion criteria. Clinical studies frequently adopted MIRRA trial definitions of remission (BVAS=0, prednisone ≤4 mg/day), but criteria varied across studies, with the most adopted secondary endpoints being oral glucocorticoid sparing, changes in eosinophil count and in pulmonary function. Biomarker investigations explored conventional lab parameters as well as emerging molecular candidates, but none achieved consistent reliability in distinguishing active from inactive disease. Imaging and procedures such as pulmonary function tests, high-resolution CT, FeNO, echocardiography, and cardiac MRI showed promise but lacked validation.</p><p><strong>Conclusions: </strong>No robust tool currently exists for EGPA monitoring, even though interesting biomarkers and imaging techniques warrant further validation. Future research should prioritise harmonising definitions of remission and relapse, distinguishing systemic from organ-specific activity, and integrate clinical, biomarker, and imaging approaches to develop EGPAspecific monitoring strategies.</p>","PeriodicalId":10274,"journal":{"name":"Clinical and experimental rheumatology","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148987943","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Serum CXCL13 is not elevated in ocular Behçet's disease: a brief report.","authors":"Iffet Merve Uçar Baytaroğlu, Ata Baytaroğlu, Şerife Nur Çiftci, Meryem Ü Kurban, Soycan Tüner, Gülay Alp","doi":"10.55563/clinexprheumatol/32aleo","DOIUrl":"https://doi.org/10.55563/clinexprheumatol/32aleo","url":null,"abstract":"","PeriodicalId":10274,"journal":{"name":"Clinical and experimental rheumatology","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148988205","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical manifestations, treatment and prognosis analysis of childhood ANCA-associated vasculitis.","authors":"Xiao-Pei Yang, Wei Li, Tian-Ge Wu, Xue-Ju Xu, Tian-Fang Li","doi":"10.55563/clinexprheumatol/1aja3e","DOIUrl":"https://doi.org/10.55563/clinexprheumatol/1aja3e","url":null,"abstract":"<p><strong>Objectives: </strong>To analyse the clinical manifestations and treatment of childhood-onset antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) and to identify risk factors for progression to end-stage renal disease (ESRD).</p><p><strong>Methods: </strong>We retrospectively enrolled patients aged <18 years diagnosed with AAV at the First Affiliated Hospital of Zhengzhou University. Comparative analyses were performed between microscopic polyangiitis (MPA) and granulomatosis with polyangiitis (GPA) groups regarding clinical manifestations, laboratory findings, disease activity, treatment regimens, and progression to ESRD. Statistical methods included the t-test, chi-square test, Cox regression analysis, and Kaplan-Meier curves.</p><p><strong>Results: </strong>A total of 29 patients were included, of whom 22 were female and 23 had MPA. The median age at diagnosis was 13.9 years (IQR 12.3-16.5 years), and the median diagnostic interval was 1 month (IQR 0.6-1.5 months). The most common clinical manifestations were renal, respiratory, and musculoskeletal involvement, and the presentations were similar between MPA and GPA. Fifteen patients progressed to ESRD, 12 of whom had ESRD at initial diagnosis. Glucocorticoids served as the mainstay of treatment. At 12 months post-treatment, 12 patients achieved remission, 3 achieved renal remission, 8 remained on dialysis, and 6 underwent renal transplantation. Long-term survival was achieved in most patients, with one death. Multivariate Cox regression analysis identified elevated serum creatinine as an independent risk factor for progression to ESRD.</p><p><strong>Conclusions: </strong>In this cohort, childhood-onset AAV occurred predominantly in females, with MPA as the major subtype and the kidneys being the most frequently involved organ. Glucocorticoids formed the mainstay of treatment. Approximately half of the children achieved remission following treatment. Patients with elevated serum creatinine levels are at higher risk of progressing to ESRD. Most children achieved long-term survival.</p>","PeriodicalId":10274,"journal":{"name":"Clinical and experimental rheumatology","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148988307","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sex and menopausal status differences in coronary calcification and extra-coronary computed tomography findings in inflammatory arthritis.","authors":"Mohammed A Mohammed, Elsie Nguyen, Sohan Shahab, Wei Wu, Shadi Akhtari, Paula Harvey, Lihi Eder, Bindee Kuriya","doi":"10.55563/clinexprheumatol/1jusyn","DOIUrl":"https://doi.org/10.55563/clinexprheumatol/1jusyn","url":null,"abstract":"<p><strong>Objectives: </strong>Patients with inflammatory arthritis (IA) have increased cardiovascular risk. Coronary artery calcium (CAC) scoring by computed tomography (CT) detects early coronary disease. While sex and menopause influence CVD risk, their impact on CT findings in IA is unclear. In this study we aimed to describe the extent and distribution of CT-detected cardiovascular abnormalities in IA, including coronary calcification, and potential differences due to sex and menopause.</p><p><strong>Methods: </strong>This was a cross-sectional analysis of IA patients aged >40 years without prior CVD. The primary outcome was CAC score by the Agatston method (0, 1-99, ≥100); secondary outcomes included calcified plaque distribution and other CT-detected abnormalities such as aortic enlargement. Multivariable logistic regression assessed associations with post-menopausal status.</p><p><strong>Results: </strong>Among 597 IA patients, 31% were male (mean age 57.3), 14% pre-menopausal female (46.3 years), and 55% post-menopausal female (61.9 years). Spondyloarthropathy was more common in males (70%); RA was more common in females (70%). CAC ≥100 occurred in 28% of males, 20% of post-, and 1.4% of pre-menopausal females (p<0.0001). Post-menopausal females had more aortic calcification (44%), aortic enlargement (23%, all p≤0.001), while males had more left main, circumflex and right coronary calcification (p≤0.001). Post-menopausal females had lower odds of elevated CAC vs. males (OR 0.29, 95% CI 0.17-0.49). Independent predictors of CAC ≥100 included older age, higher CRP, and smoking. Post-menopausal associations with aortic changes were not significant after adjustment.</p><p><strong>Conclusions: </strong>Sex and menopausal status are associated with coronary and extra-coronary CT abnormalities in IA patients. These observations underscore the need to acknowledge and better understand sex-related differences in CVD risk expression, as traditional and disease-related risk factors may not confer equivalent risk in females and males.</p>","PeriodicalId":10274,"journal":{"name":"Clinical and experimental rheumatology","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148988226","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Elderly-onset Behçet's disease presenting with uveitis in a 77-year-old woman.","authors":"Kiymet Kasapoglu, Abdullah Ağin, Banu Cicek Yalcin Dulundu, Feyza Onder","doi":"10.55563/clinexprheumatol/hz70vb","DOIUrl":"https://doi.org/10.55563/clinexprheumatol/hz70vb","url":null,"abstract":"","PeriodicalId":10274,"journal":{"name":"Clinical and experimental rheumatology","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148988299","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}