Clinical and experimental rheumatology最新文献

{"title":"Rheumatoid arthritis: emerging insights into molecular mechanisms and targeted immunotherapy.","authors":"Weiming Yang, Juanjuan Chen, Xiaozhong Wang","doi":"10.55563/clinexprheumatol/dgbqaa","DOIUrl":"https://doi.org/10.55563/clinexprheumatol/dgbqaa","url":null,"abstract":"<p><p>Rheumatoid arthritis (RA) is a chronic, systemic, autoimmune inflammatory disease that characterised by persistent synovial joints inflammation, which ultimately results in progressive joint destruction and significant disability. Ineffective drug treatment for severe arthritis can lead to significant physical disability and a marked decline in quality of life. Recent research has significantly advanced our understanding of the underlying molecular mechanisms of RA, which leads to the emergence of novel immunotherapeutic strategies that provide patients with a broader range of treatment options. This review aims to synthesise the current knowledge of the molecular mechanisms of RA, related signalling pathways, and the latest immunotherapy approaches, including biologic agents, targeted small molecules, and novel therapies.Furthermore, we will discuss the efficacy and safety profiles of these therapies, analyse pressing issues in contemporary research, and explore future directions in the field.</p>","PeriodicalId":10274,"journal":{"name":"Clinical and experimental rheumatology","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144945127","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":"Interaction of HLA-DRB1 shared epitope and smoking on the development of anti-citrullinated protein antibody positive rheumatoid arthritis in Greek patients.","authors":"Evangelia N Mole, Aikaterini E Tarassi, Alexandra G Tsirogianni, Theophilos E Athanasiades, Vasiliki E Kitsiou, Diamanto I Kouniaki, Sousana V Gazi, Panayiotis G Vlachoyiannopoulos","doi":"10.55563/clinexprheumatol/vcfdjy","DOIUrl":"10.55563/clinexprheumatol/vcfdjy","url":null,"abstract":"<p><strong>Objectives: </strong>Rheumatoid arthritis (RA) is a complex, multifactorial autoimmune disease, whose aetiopathogenesis involves genetic and environmental factors. The aim of this case-control study is to confirm the impact of interaction of genetic and environmental factors in the pathogenesis of RA in Greek smoker and non-smoker patients.</p><p><strong>Methods: </strong>We assessed the effects of shared epitope (SE) alleles and smoking on the presence of ACPA autoimmunity in three hundred Greek patients with longstanding RA (150 smokers and 150 non-smokers). Three hundred and forty-six Greek blood donors volunteers and hospital personnel served as controls.</p><p><strong>Results: </strong>An increased frequency of HLA-DRB1 *01:01, *10:01, *04:04 and *04:05 alleles, as well as the protective role of *04:03 allele in Greek patients were confirmed during comparison with controls. The presence of any SE influenced the development of RA (OR: 4.37[3.13-6.11], p<0.001). A strong effect for ACPA production was observed in individuals carrying any SE allele (OR: 4.3[2.57-7.22], p<0.001). Single SE carriers in combination with smoking had an increased risk of developing ACPA-positive RA (OR: 6.53[1.47-28.91], p=0.013), which further increased in smokers with a double gene copy (OR: 15.27[1.39-167.52], p=0.026). The strongest interaction, with regard to ACPA-positive RA, was observed in individuals that possessed the HLA-DRB1 *01:01 (OR: 12.55[1.32-119.35], p=0.028) SE allele, whereas the combination of SE genes and smoking did not influence the risk of ACPA-negative RA (OR: 2.01[0.76-5.26], p=0.15).</p><p><strong>Conclusions: </strong>We identified that smoking and the presence of SE alleles increased the risk of developing ACPA-positive RA, indicating a strong genetic-environmental correlation that probably triggers the pathogenesis of RA in Greek patients.</p>","PeriodicalId":10274,"journal":{"name":"Clinical and experimental rheumatology","volume":" ","pages":"1541-1547"},"PeriodicalIF":3.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144752488","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":"Avacopan-induced liver injury: an uncommon but emerging concern?","authors":"Jia Sern, Keesha Ravintharan, Fahd Adeeb","doi":"10.55563/clinexprheumatol/o74k69","DOIUrl":"10.55563/clinexprheumatol/o74k69","url":null,"abstract":"","PeriodicalId":10274,"journal":{"name":"Clinical and experimental rheumatology","volume":" ","pages":"1692-1693"},"PeriodicalIF":3.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143986714","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":"Retention rate and predictors of discontinuation for secukinumab treatment: real-life data in a cohort of patients with spondyloarthritis.","authors":"Elisa Bellis, Mariele Gatto, Gloria Crepaldi, Valeria Data, Claudia Lomater, Elena M Marucco, Silvia Perrone, Marta Saracco, Annamaria Iagnocco","doi":"10.55563/clinexprheumatol/cruuvo","DOIUrl":"10.55563/clinexprheumatol/cruuvo","url":null,"abstract":"<p><strong>Objectives: </strong>This study evaluated the real-world retention rate and predictors of discontinuation for secukinumab therapy in patients with spondyloarthritis (SpA).</p><p><strong>Methods: </strong>This observational, retrospective cohort study included SpA patients treated with secukinumab at a referral centre. Baseline demographic and clinical data were recorded, covering comorbidities, prior biologic/targeted synthetic therapies, and disease duration. Secukinumab retention rates were analysed at 12 months and at the end of the study (last observation or discontinuation). Drug retention rate (DRR) was assessed using time-to-discontinuation, with log-rank testing for comparisons. Cox proportional hazards regression models identified baseline predictors of discontinuation.</p><p><strong>Results: </strong>A total of 178 patients (64.6% female) were included. The overall DRR for secukinumab was 64%, with the highest retention rate of 78% at 1 year. Discontinuation reasons included secondary inefficacy (57.8%), primary inefficacy (25%), and adverse events (17.2%), with infections being the most common adverse event. Higher body mass index (BMI) (HR 1.07, 95% CI: 1.02-1.12, p=0.010) and previous treatments (HR 1.34, 95% CI: 1.03-1.73, p=0.030) predicted long-term discontinuation. For 12-month discontinuation, peripheral phenotype (HR 4.28, 95% CI: 1.26-14.48, p=0.019) and prior biologic/targeted synthetic therapies (HR 1.76, 95% CI: 1.24-2.51, p=0.002) were predictors, while axial involvement was protective (HR 0.37, 95% CI: 0.17-0.83, p=0.016).</p><p><strong>Conclusions: </strong>Secukinumab demonstrates sustained effectiveness in SpA patients, with a significant proportion maintaining therapy over time. Retention is influenced by BMI, prior treatments, and disease phenotype, suggesting that outcomes may be optimised through tailored patient selection and early intervention.</p>","PeriodicalId":10274,"journal":{"name":"Clinical and experimental rheumatology","volume":" ","pages":"1561-1567"},"PeriodicalIF":3.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144636283","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 performance of histological criteria for IgG4-related disease in clinical practice.","authors":"Alojzija Hočevar, Aleš Grošelj, Gregor Hawlina, Matic Koželj, Andrej Škoberne, Jože Pižem, Vesna Jurčić","doi":"10.55563/clinexprheumatol/peqyb4","DOIUrl":"10.55563/clinexprheumatol/peqyb4","url":null,"abstract":"","PeriodicalId":10274,"journal":{"name":"Clinical and experimental rheumatology","volume":" ","pages":"1696-1697"},"PeriodicalIF":3.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144224542","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":"Ultrasound-detected lumps in synovial fluid, a sonographic finding associated with non-inflammatory joint effusion.","authors":"Julio Ramírez, Collin Dexter Adao-Abe, Anastasia Mocritcaia, Adriá Garcia-Gargallo, Joshua Peñafiel-Sam, Claudia Arango, Juan Camilo Sarmiento-Monroy, Helena Flórez, José Alfredo Gómez-Puerta, Lucía Alascio, Ana Belén Azuaga-Piñango","doi":"10.55563/clinexprheumatol/mxbra0","DOIUrl":"10.55563/clinexprheumatol/mxbra0","url":null,"abstract":"<p><strong>Objectives: </strong>Joint aspiration plays a crucial role in diagnosis and relieves symptoms but may be unnecessary in some cases. Identifying substitute indicators for synovial white blood cell (WBC) counts could provide alternatives. This study aimed to evaluate US-detected lumps (small hyperechoic structures detached from the synovium) in synovial fluid (SF) as potential diagnostic markers for non-inflammatory joint effusion.</p><p><strong>Methods: </strong>We carried out a cross-sectional study. Consecutive patients with synovial effusion were selected. US, joint aspiration and analysis of the WBC count of the effusion were performed. Patients with crystal deposits were excluded. Lumps were defined as US small hyperechoic spots within the SF. Sensitivity, specificity, and ROC analysis determined the utility of lumps in distinguishing non-inflammatory from inflammatory effusions.</p><p><strong>Results: </strong>A total of 108 patients with symptomatic synovial effusion underwent US imaging and joint aspiration (88.8% were knees). Before the joint aspiration, the clinician attributed the joint effusion to degenerative joint disease in 59 patients (54.6%) and inflammatory conditions in 49 patients (45.4%) based on previous imaging tests. Following the joint aspiration, non-inflammatory effusion (<2,000 cells/mm³) was observed in 54 patients (50%). US lumps were present in 40 patients (37%), predominantly with non-inflammatory SF (85%). SF with lumps had a lower mean WBC count (1,043 vs. 8,644 cells/mm³, p=0.0001). US lumps demonstrated diagnostic value for non-inflammatory effusion, with an AUC of 0.835, sensitivity of 65.3%, and specificity of 89.3%.</p><p><strong>Conclusions: </strong>US lumps in SF are strongly associated with non-inflammatory joint effusion. Their detection indicates low WBC counts, potentially reducing the need for joint aspiration, especially in patients with mild symptoms or hard-to-access joints.</p>","PeriodicalId":10274,"journal":{"name":"Clinical and experimental rheumatology","volume":" ","pages":"1577-1581"},"PeriodicalIF":3.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144636290","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":"Isolated neurosarcoidosis presenting as granulomatous hypophysitis complicated by arginine vasopressin deficiency.","authors":"Victor Ghazi, Bshara Sleem, Georges El Hasbani, Carole Kesrouani, Ali S M Jawad, Imad Uthman","doi":"10.55563/clinexprheumatol/xi4pdx","DOIUrl":"10.55563/clinexprheumatol/xi4pdx","url":null,"abstract":"","PeriodicalId":10274,"journal":{"name":"Clinical and experimental rheumatology","volume":" ","pages":"1698"},"PeriodicalIF":3.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144076352","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":"Bibliometric insights into transforming the management of rheumatoid arthritis: three decades of progress against opportunistic infections.","authors":"Wenzhong Hu, Yun Xu","doi":"10.55563/clinexprheumatol/7q3n0m","DOIUrl":"10.55563/clinexprheumatol/7q3n0m","url":null,"abstract":"<p><strong>Objectives: </strong>The aim of this study was to investigate the research trends, patterns of opportunistic infections in rheumatoid arthritis (RA) and their impact on patient management strategies, especially in the context of the widespread use of DMARDs.</p><p><strong>Methods: </strong>Research papers on RA and opportunistic infections were analysed by performing a literature search in the Web of Science Core Collection (WoSCC) database, covering the period from January 1, 1994 to December 31, 2023. Bibliometric analyses were performed using VOS viewer and Cite Space software, including country and institution analyses, journal and co-citation journal analyses, author and co-citation author analyses, and key word co-occurrence and clustering analyses.</p><p><strong>Results: </strong>Two hundred and ninety-three research papers were analysed, and it was found that research publications on RA-associated opportunistic infections have shown a general upward trend over the past three decades, with a significant increase especially between 2007 and 2021. Japan, the United States, and China have the highest research output in this area, with institutions such as Yang Ming University and Taichung Veterans General Hospital being more active. Key word analysis revealed 'infection', 'risk', 'treatment', and 'infliximab' as research hotspots. Cluster analysis showed that tuberculosis, latent tuberculosis infection and hepatitis B virus were the focus of attention.</p><p><strong>Conclusions: </strong>Research on opportunistic infections in RA has shown a clear trend of growth and extensive international collaboration, reflecting a deep understanding of the risk of opportunistic infections in RA patients treated with DMARDs. Future studies should strengthen the identification of high-risk patient groups, the use of biomarkers, the balance of safety and efficacy in treatment regimens, and patient education to promote the optimisation of RA management strategies.</p>","PeriodicalId":10274,"journal":{"name":"Clinical and experimental rheumatology","volume":" ","pages":"1611-1621"},"PeriodicalIF":3.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144752471","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 connective tissue growth factor is aberrantly expressed in idiopathic inflammatory myopathy.","authors":"Leiyi Yang, Hongjiang Liu, Qibing Xie, Geng Yin","doi":"10.55563/clinexprheumatol/2n2sag","DOIUrl":"10.55563/clinexprheumatol/2n2sag","url":null,"abstract":"","PeriodicalId":10274,"journal":{"name":"Clinical and experimental rheumatology","volume":" ","pages":"1694-1695"},"PeriodicalIF":3.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144076360","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":"Pathogenesis of rheumatoid arthritis: one year in review 2025.","authors":"Giulia Noto, Francesca Salvetti, Adriana Demaj, Piera Altieri, Erica Chericoni, Elisa Ferrigno, Alessia Alunno, Ilaria Puxeddu","doi":"10.55563/clinexprheumatol/53rkan","DOIUrl":"https://doi.org/10.55563/clinexprheumatol/53rkan","url":null,"abstract":"<p><p>Rheumatoid arthritis (RA) is a chronic inflammatory autoimmune disease characterised by joint destruction and extra-articular manifestations. A close interaction between both innate and adaptive immune systems leads to the development of the clinical features of the disease, characterised by inflammation and structural changes. Progress in the basic and clinical research in the field of RA has improved the current knowledge on the mechanisms underlying its pathogenesis. The data obtained from basic and clinical studies in RA has actively contributed to identifying new potential targets for novel therapeutic approaches to design personalised therapy of the disease.</p>","PeriodicalId":10274,"journal":{"name":"Clinical and experimental rheumatology","volume":"43 9","pages":"1533-1540"},"PeriodicalIF":3.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145111953","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}