Clinical Rheumatology最新文献

{"title":"Clinical features of anti-RNP-positive primary Sjögren's syndrome.","authors":"Fang Cheng, Yan-Ling Wang, Xiang-Yan Ai, Yang Liu, Zhen-Hang Zhu, Ke-Ke Zhang, Fu-Tao Zhao","doi":"10.1007/s10067-025-07499-5","DOIUrl":"10.1007/s10067-025-07499-5","url":null,"abstract":"<p><strong>Objective: </strong>This study sought to explore the clinical features exhibited by individuals with anti-RNP antibodies who had primary Sjögren's syndrome (pSS).</p><p><strong>Methods: </strong>Various clinical data of 410 pSS patients from our hospital between September 2018 and August 2023 were retrospectively analysed. Each individual fulfilled the 2016 American College of Rheumatology/European League Against Rheumatism (EULAR) classification criteria for pSS. Comparative analyses were conducted between pSS individuals with and without anti-RNP antibodies. Logistic regression analysis was utilized to ascertain relevant factors.</p><p><strong>Results: </strong>Among the cohort, 38 (9.3%) of pSS patients were anti-RNP positive and 372 were anti-RNP negative. Anti-RNP-positive individuals had a higher median EULAR Sjögren's syndrome disease activity index at diagnosis (p = 0.001) and more frequent extraglandular manifestations (p < 0.001), including articular, pulmonary and muscular involvement (p = 0.001, p < 0.001 and p = 0.024, respectively) and Raynaud's phenomenon (p < 0.001). Additionally, patients possessing anti-RNP antibodies had a higher frequency of hypergammaglobulinemia and positive antinuclear and anti-Ro/SSA antibodies (p < 0.001, p = 0.006 and p = 0.042, respectively), but a lower frequency of anti-centromere positivity (p = 0.010). Multivariate analysis identified anti-RNP positivity as independent variable significantly associated with interstitial lung disease (OR = 2.60, 95% CI 1.22-5.53; p = 0.014) and Raynaud's phenomenon (OR = 6.26, 95% CI 3.01-13.01; p < 0.001) in pSS patients.</p><p><strong>Conclusion: </strong>The presence of anti-RNP antibodies may defined a specific subset of pSS patients characterized by distinct phenotypic attributes, especially in terms of higher prevalence of interstitial lung disease and Raynaud's phenomenon. Key Points • Anti-RNP antibodies were detected in 9.3% of patients with primary Sjögren's syndrome (pSS), which was related to increased systemic disease activity and more frequent extraglandular manifestations. • pSS patients carrying anti-RNP antibodies displayed higher prevalence of interstitial lung disease, Raynaud's phenomenon and hypergammaglobulinemia. • Anti-RNP positivity was identified as independent predictors of interstitial lung disease and Raynaud's phenomenon in pSS.</p>","PeriodicalId":10482,"journal":{"name":"Clinical Rheumatology","volume":" ","pages":"2911-2917"},"PeriodicalIF":2.9,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144215144","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Kidney involvement in VEXAS syndrome: insights from a rare case of secondary amyloidosis and systematic review of renal biopsy-confirmed reports.","authors":"Gabriel Ştefan, Andreea Niculescu, Simona Cinca, Corina Chiriac, Adrian Zugravu, Pavel Cristina, Razvan Adrian Ionescu, Valer Mihai Pompilian, Nicoleta Petre, Cristina Căpusa, Simona Stancu","doi":"10.1007/s10067-025-07506-9","DOIUrl":"10.1007/s10067-025-07506-9","url":null,"abstract":"<p><p>VEXAS syndrome is a recently identified autoinflammatory disorder caused by somatic mutations in the UBA1 gene, leading to systemic inflammation and hematologic abnormalities. While its renal involvement remains poorly understood, reported cases suggest a diverse spectrum of kidney pathology. We present a 69-year-old male with a history of systemic inflammation who developed nephrotic syndrome and worsening kidney function. His disease course included recurrent fevers, pulmonary infiltrates, cutaneous vasculitis, and hematologic abnormalities. A kidney biopsy revealed secondary amyloidosis, indicating chronic inflammation. Genetic testing confirmed a UBA1 mutation (c.121A > G, p.Met41Val), establishing the diagnosis of VEXAS syndrome. Despite treatment with corticosteroids, cyclosporine, and interleukin-1 blockade, the patient deteriorated and ultimately succumbed to septic shock. A systematic review of biopsy-confirmed renal involvement in VEXAS syndrome identified 23 cases, with interstitial nephritis as the most frequent histopathologic finding, followed by vasculitis, IgA nephropathy, minimal change disease, and amyloidosis. Treatment responses varied, with limited efficacy of immunosuppressive therapies. This case highlights the under-recognized renal manifestations of VEXAS syndrome, demonstrating its diagnostic challenges and the need for heightened clinical suspicion. Further research is required to define optimal management strategies and improve patient outcomes.</p>","PeriodicalId":10482,"journal":{"name":"Clinical Rheumatology","volume":" ","pages":"3101-3108"},"PeriodicalIF":2.9,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12234580/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144186659","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy of rituximab versus cyclophosphamide in connective tissue disease‑related interstitial lung disease: a systematic review and meta-analysis.","authors":"Yan Liu, Yaoxiu Liu, Junlai Xu, Guoxing Zeng, Qingyuan Yang, Shuiming Xu","doi":"10.1007/s10067-025-07533-6","DOIUrl":"10.1007/s10067-025-07533-6","url":null,"abstract":"<p><strong>Objective: </strong>This study systematically compares the efficacy and adverse events of rituximab (RTX) and cyclophosphamide (CYC) in patients with connective tissue disease-related interstitial lung disease (CTD-ILD).</p><p><strong>Methods: </strong>The EMBASE, Cochrane, and PubMed databases were systematically searched to find all relevant studies. Quality assessment, study selection, and data extraction were independently conducted by two reviewers. The mean changes in percentage of predicted forced vital capacity (FVC%) and percentage of predicted diffusing capacity for carbon monoxide (DLco%) of the patients were selected to be primary outcome measures. RevMan 5 software was used for the pooled analysis.</p><p><strong>Results: </strong>Among 1106 titles screened from multiple databases, six studies met the inclusion criteria (two randomized controlled trials and four retrospective observational studies). Patients of four studies were systemic sclerosis-related interstitial disease(SSc-ILD), one study was anti-synthetase syndrome-related interstitial lung disease (AsyS-ILD), and one study was CTD-ILD (included idiopathic inflammatory myositis (IIM), systemic sclerosis (SSc) or mixed connective tissue disease (MCTD), rheumatoid arthritis(RA)). The summary weight mean difference of FVC% change in the RTX group compared with the CYC group was 0.86 (95% CI:-1.51,3.24; P = 0.48), and the summary weight mean difference of DLco% change in the RTX group compared with the CYC group was 6.43 (95% CI: 1.62, 11.23; P = 0.009). Our pooled analysis suggested no significant difference in FVC% improvement between RTX and CYC. RTX seems to be slightly superior to CYC in terms of DLco% improvement in our meta-analysis. However, only three out of six enrolled studies provided data on DLco% change. Therefore, the results for DLco% change should be cautiously interpreted. Studies enrolled showed that adverse events were fewer in the RTX group. RTX appears to offer a favorable balance between efficacy and safety.</p><p><strong>Conclusions: </strong>RTX demonstrated similar efficacy to CYC in improving lung function (FVC% and DLco%), with fewer adverse events.</p>","PeriodicalId":10482,"journal":{"name":"Clinical Rheumatology","volume":" ","pages":"2601-2610"},"PeriodicalIF":2.9,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144282733","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The molecular basis of all-trans retinoic acid binding to the target genes involved in rheumatoid arthritis through network pharmacology and molecular docking.","authors":"Xi Zheng, Xin Ke, Jie Gao, Zhaohui Zheng, Ping Zhu","doi":"10.1007/s10067-025-07482-0","DOIUrl":"10.1007/s10067-025-07482-0","url":null,"abstract":"<p><strong>Objective: </strong>All-trans retinoic acid (ATRA), a natural derivative of Vitamin A, plays a crucial role in cellular proliferation, differentiation, and metabolic functions. It has been reported to possess significant antioxidant and anti-inflammatory properties. However, a comprehensive investigation into its potential mechanisms within the framework of rheumatoid arthritis (RA) has yet to be adequately addressed.</p><p><strong>Methods: </strong>This study aimed to identify potential targets of ATRA by employing databases such as DrugBank and SwissTargetPrediction. Furthermore, disease-associated genes relevant to rheumatoid arthritis were sourced from DisGeNET and GeneCards. Analyses of Gene Ontology (GO) and the Kyoto Encyclopedia of Genes and Genomes (KEGG) pathways were conducted. Drug-target-pathway networks were developed, and significant hub genes were identified. In addition, molecular docking studies were performed to assess the binding affinity of ATRA.</p><p><strong>Results: </strong>The results indicated that ATRA engages with 127 identified target genes, of which 85 are linked to rheumatoid arthritis (RA). Analyses employing Gene Ontology (GO), Kyoto Encyclopedia of Genes and Genomes (KEGG), and network approaches suggested that these targets participate in inflammatory pathways and metabolic processes pertinent to RA. Additionally, molecular docking studies revealed a significant binding affinity between ATRA and the proteins CYP1A1 and CYP2B6.</p><p><strong>Conclusion: </strong>ATRA is anticipated to engage with various proteins and pathways associated with rheumatoid arthritis, suggesting its potential utility in the clinical management of this disorder. Key Points • All-trans retinoic acid (ATRA) has been shown to interact with 85 specific genes in patients with RA, among which 10 key hub genes have been identified. • Molecular docking studies indicate that ATRA exhibits the lowest binding affinity with the genes CYP1 A1 and CYP2B6.</p>","PeriodicalId":10482,"journal":{"name":"Clinical Rheumatology","volume":" ","pages":"2621-2634"},"PeriodicalIF":2.9,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144085912","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring the clinical characteristics and long-term outcome of serologically active clinically quiescent IgG4-related disease: knowledge from a prospective cohort.","authors":"Jingna Li, Yuxue Nie, Fei Teng, Linyi Peng, Jie Meng, Qinhuan Luo, Nianyi Zhang, Jialei Zhang, Xinli Yang, Yifei Wang, Yunyun Fei, Jiaxin Zhou, Wen Zhang","doi":"10.1007/s10067-025-07507-8","DOIUrl":"10.1007/s10067-025-07507-8","url":null,"abstract":"<p><strong>Objective: </strong>In the long-term management of IgG4-related disease (IgG4-RD), it is common to observe clinical remission accompanied by elevated IgG4 levels, namely, serologically active clinically quiescent (SACQ). We aimed to determine and characterize the SACQ status in IgG4-RD and evaluate its prognosis.</p><p><strong>Methods: </strong>We performed this single-center study based on a prospective IgG4-RD cohort. SACQ and serologically quiescent clinically quiescent (SQCQ) were defined as clinical remission with elevated but steady (for SACQ)/normal (for SQCQ) serum IgG4 for at least two years. Characteristics and prognoses between the SACQ and SQCQ groups were compared. Univariate and multivariate Cox regressions were used to investigate risk factors for relapse in SACQ patients.</p><p><strong>Results: </strong>The study included 268 SACQ and 108 SQCQ patients with IgG4-RD. Compared to the SQCQ group, the SACQ group had higher baseline levels of IgG4 and a greater prevalence of proliferative subtype (both P < 0.001). Plasmablasts were increased, while unswitched memory B cells and regulatory B cells were decreased in SACQ patients compared with SQCQ patients. Both groups experienced glucocorticoid (GC) tapering and had similar relapse rates (P = 0.659) during an average follow-up of 55 months, although the SACQ group was at a higher GC maintenance dose. In the SACQ group, serum IgG4 level re-elevation to ≥ 1.269 times the start of SACQ status was associated with relapse (HR 1.40, 95% CI: 1.16-1.42, P < 0.001; AUC = 0.791).</p><p><strong>Conclusion: </strong>SACQ patients achieved outcomes similar to SQCQ with cautious GC tapering. Monitoring serum IgG4 re-elevation might be useful for predicting relapses in the long-term management of SACQ status in IgG4-RD. Key Points • During clinical remission in IgG4-RD, a considerable proportion of patients still have elevated serum IgG4, which we first define as serologically active and clinically quiescent (SACQ). • SACQ patients achieved relapse rates similar to SQCQ patients with cautious glucocorticoid tapering. • Monitoring serum IgG4 re-elevation might help predict relapses in the long-term management of IgG4-RD SACQ patients.</p>","PeriodicalId":10482,"journal":{"name":"Clinical Rheumatology","volume":" ","pages":"2929-2940"},"PeriodicalIF":2.9,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144186657","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reply to \"Letter to the Editor\": radiographic entheseal lesions of the pelvic region are more prevalent in radiographic axSpA than in age- and sex-matched controls and are associated with more severe spinal disease.","authors":"F R Wink, S Arends, A Spoorenberg","doi":"10.1007/s10067-025-07515-8","DOIUrl":"10.1007/s10067-025-07515-8","url":null,"abstract":"","PeriodicalId":10482,"journal":{"name":"Clinical Rheumatology","volume":" ","pages":"3137-3138"},"PeriodicalIF":2.9,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144246790","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical and prognostic profiles in immune-mediated hypertrophic meningitis: a retrospective analysis of 92 cases.","authors":"Yifei Wang, Yuyan Yang, Xuemei Guo, Hui You, Manqing Xie, Shangzhu Zhang, Yunjiao Yang, Di Wu, Linyi Peng, Yunyun Fei, Xinping Tian, Mengtao Li, Yan Zhao, Xiaofeng Zeng, Wen Zhang, Jiaxin Zhou","doi":"10.1007/s10067-025-07531-8","DOIUrl":"10.1007/s10067-025-07531-8","url":null,"abstract":"<p><strong>Objectives: </strong>Immune-mediated hypertrophic pachymeningitis (HP) is an inflammatory disorder with diverse neurological manifestations. Considering its various etiology and rarity, HP remains a diagnostic challenge. Comparisons of clinical and prognostic profiles across different etiologies remain insufficiently explored. We analyzed the clinical characteristics, treatment approaches, and outcomes of immune-mediated HP patients from a single center in China.</p><p><strong>Method: </strong>A retrospective study was conducted at Peking Union Medical College Hospital, analyzing immune-mediated HP cases from December 2003 to September 2021. We evaluated patients' neurological symptoms, systemic involvement, image findings, and baseline laboratory results, and compared these features among three predominant etiologies: antineutrophil cytoplasmic antibody (ANCA)-related HP, idiopathic HP, and IgG4-related disease (IgG4-RD). The treatment approaches and outcomes were also reviewed.</p><p><strong>Results: </strong>The study included 92 patients, 49 (53.3%) male and 43 (46.7%) female. ANCA-related HP was the leading cause of immune-mediated HP (n = 42, 45.6%), followed by idiopathic HP (n = 28, 30.4%), IgG4-RD (n = 12, 13.0%), and other underlying causes (n = 10, 10.9%). Despite different etiologies, similar patterns of cranial nerve and brain region involvement were observed. Large doses of glucocorticoids combined with immunosuppressants were the most common treatment across all etiologies. Kaplan-Meier analysis (mean follow-up time: 4.1 years) showed no significant differences in relapse-free survival rates among the three subgroups.</p><p><strong>Conclusions: </strong>ANCA-related HP, idiopathic HP, and IgG4-RD HP were the three predominant causes of immune-mediated HP in this Chinese cohort. The three etiologies exhibited similar clinical manifestations, imaging findings, and long-term prognoses, indicating that a standardized management strategy may benefit HP patients regardless of etiology. Key Points • Immune-mediated hypertrophic pachymeningitis (HP) is a rare disorder with diverse etiologies, and research comparing clinical and prognostic profiles across different causes remains limited. • This study involved 92 immune-mediated HP patients, comparing clinical characteristics, imaging findings, treatment approaches, and outcomes among ANCA-related, idiopathic, and IgG4-related HP. • The three predominant etiologies of HP showed similar clinical features and similar relapse-free survival rates. • Regardless of the underlying etiology, HP patients may benefit from a uniform management approach.</p>","PeriodicalId":10482,"journal":{"name":"Clinical Rheumatology","volume":" ","pages":"3073-3081"},"PeriodicalIF":2.9,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144274325","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Letter to the Editor: Assessing early therapeutic drug monitoring of adalimumab as a predictor of treatment efficacy and immunogenicity in rheumatic diseases: \"early therapeutic drug monitoring of adalimumab\".","authors":"Syeda Hani Ammad, Tayyaba Malik, Waleed Ahmad","doi":"10.1007/s10067-025-07516-7","DOIUrl":"10.1007/s10067-025-07516-7","url":null,"abstract":"","PeriodicalId":10482,"journal":{"name":"Clinical Rheumatology","volume":" ","pages":"3133-3134"},"PeriodicalIF":2.9,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144186660","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cutaneous lesions and articular manifestations in multicentric reticulohistiocytosis: a diagnostic challenge.","authors":"Carlos Marques-Gomes, Inês Rodrigues, Catarina Rua, Rúben Costa, Mariana Lopes, Gilberto Rosa, Sofia Magina, José Manuel Lopes, Iva Brito","doi":"10.1007/s10067-025-07522-9","DOIUrl":"10.1007/s10067-025-07522-9","url":null,"abstract":"<p><p>A 56-year-old woman presented with a one-year history of polyarthralgia and skin lesions. Examination revealed polyarthritis and reddish-brown nodules on interphalangeal (IF) joints. Histopathology confirmed a diagnosis of multicentric reticulohistiocytosis (MRH) with characteristic histiocytes and multinucleated giant cells positive for PAS, PASD, CD45, and CD68. Imaging showed periarticular osteopenia and erosions. Immunosuppressive therapy with prednisolone (PDN) and methotrexate (MTX) led to significant improvement in symptoms within two months. MRH, a rare non-Langerhans cell histiocytosis, is marked by papulonodular skin lesions and symmetric polyarthritis, potentially erosive. It may be associated with rheumatic diseases and necessitates malignancy screening. Diagnosis is based on clinical and histological findings due to the absence of specific biomarkers. Immunosuppressive treatment remains the cornerstone of management.</p>","PeriodicalId":10482,"journal":{"name":"Clinical Rheumatology","volume":" ","pages":"3127-3129"},"PeriodicalIF":2.9,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144215145","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Demographic and clinical characteristics of spondyloarthritis patients in Jordan: A cross-sectional study.","authors":"Fatima Alnaimat, Zaid Al-Ghazawi, Moayad Shaf'ei, Ayman AbuHelal, Omar Hamdan, Hanan Barukba, Muath Alalawneh, Mutasim A Al-Ghazawi, Khaldoon M Alawneh","doi":"10.1007/s10067-025-07487-9","DOIUrl":"10.1007/s10067-025-07487-9","url":null,"abstract":"<p><strong>Background/aim: </strong>Spondyloarthritis (SpA) is a group of chronic inflammatory rheumatic diseases with various subtypes. Given the limited research on SpA demographics and characteristics in the region, this study aims to provide insight into SpA in Jordan.</p><p><strong>Methods: </strong>A cross-sectional study of patients diagnosed with SpA according to the Assessment of SpondyloArthritis International Society (ASAS) criteria who attended rheumatology clinics at two tertiary care centers between January and September 2023. Data on clinical, laboratory, and imaging findings were collected, and the prevalence of fibromyalgia was assessed using the FiRST tool.</p><p><strong>Results: </strong>Among 155 patients, 51% were male, with a mean age of 43.8 ± 12.7 years and a disease duration of 8.12 ± 8.7 years. The diagnostic delay averaged 4.49 ± 5.6 years. Ankylosing spondylitis was diagnosed in 43.2%, non-radiographic axial SpA in 7.7%, and psoriatic arthritis in 58%. Six patients (3.9%) had undergone hip replacement. Fibromyalgia was present in 25.3%, significantly linked to enthesitis (P < 0.001). Biological DMARDs (B-DMARDs) were used by 68.4% of patients, and conventional synthetic DMARDs (Cs-DMARDs) by 46.5%. Males were more likely to have elevated CRP levels (P = 0.041), while females had a higher prevalence of enthesitis (P = 0.013) and were more likely to use CS-DMARDs (P = 0.001).</p><p><strong>Conclusion: </strong>SpA was associated with gender differences, with males having higher CRP levels and females experiencing more enthesitis and greater Cs-DMARD use. Diagnostic delay remains an issue and may have contributed to disease progression, leading to hip replacement in some patients. Further research is necessary to elucidate these distinctions more precisely.</p>","PeriodicalId":10482,"journal":{"name":"Clinical Rheumatology","volume":" ","pages":"2763-2774"},"PeriodicalIF":2.9,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144076625","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}