Clinical Rheumatology最新文献

{"title":"Correlation of systemic immune inflammation and serum uric acid with gout: based on NHANES.","authors":"Youssef Roman","doi":"10.1007/s10067-025-07329-8","DOIUrl":"10.1007/s10067-025-07329-8","url":null,"abstract":"","PeriodicalId":10482,"journal":{"name":"Clinical Rheumatology","volume":" ","pages":"1393-1394"},"PeriodicalIF":2.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143000729","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":"Early axial spondyloarthritis versus established disease: a single-center analysis based on the new ASAS definition of early disease.","authors":"Sara Alonso, Paula Alvarez, Norma Calleja, Rubén Queiro","doi":"10.1007/s10067-025-07365-4","DOIUrl":"10.1007/s10067-025-07365-4","url":null,"abstract":"<p><strong>Objectives: </strong>The applicability of the new Assessment of Spondyloarthritis International Society (ASAS) consensus definition of early axial spondyloarthritis (axSpA) has barely been tested in clinical settings. We aimed to check the applicability of this new definition in a real clinical context.</p><p><strong>Methods: </strong>Single-center cross-sectional study involving 330 consecutive patients fulfilling axSpA criteria. Similarities and differences between patients with early (according to the new ad hoc definition) and established disease were analyzed. Logistic regression models adjusted for sex and exposure to biologic therapies were constructed to analyze the different disease outcomes between both subpopulations.</p><p><strong>Results: </strong>Of 299 patients for whom information on defining characteristics of early axSpA could be reliably collated, 45 (15%) met the ASAS definition of early axSpA, median disease duration of 1.0 year [IQR, 1.0-2.0]. Compared to established disease, these patients were younger (p = 0.001), with a similar male-to-female ratio, and a higher exposure to NSAIDs (p = 0.015) but lower to biologics (p = 0.005). Uveitis prevalence was similar between both groups (early, 15.6% and established, 16.1%). Regardless of sex and biologic therapy, inflammatory burden, disease activity and the impact on quality of life were similar in both groups. As expected, structural damage was higher among established cases. Also, regardless of disease duration and exposure to biologic therapies, men had better disease outcomes than women.</p><p><strong>Conclusion: </strong>Patients with early axSpA present similarities and differences with respect to established cases. The new ASAS definition of early disease may be applicable in real-world clinical settings.</p><p><strong>Key points: </strong>• Patients with early axial spondyloarthritis show similarities and differences with respect to established cases. • The overall burden of disease is similar in both subgroups of patients with axial SpA. • In both study groups, men showed better disease outcomes than women. • The new ASAS definition of early axial spondyloarthritis is applicable in real-life clinical settings.</p>","PeriodicalId":10482,"journal":{"name":"Clinical Rheumatology","volume":" ","pages":"1129-1134"},"PeriodicalIF":2.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143381811","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":"Electroacupuncture for juvenile idiopathic arthritis: clinical efficacy and its role in modulating pyroptosis and autophagy pathways.","authors":"Fater A Khadour, Younes A Khadour, Tao Xu","doi":"10.1007/s10067-025-07346-7","DOIUrl":"https://doi.org/10.1007/s10067-025-07346-7","url":null,"abstract":"<p><strong>Background: </strong>Juvenile idiopathic arthritis (JIA) is a common chronic inflammatory disorder in children, leading to significant physical and psychosocial challenges. Current treatments often fall short, prompting interest in complementary therapies. This study aims to evaluate the effectiveness of electroacupuncture (EA) on clinical outcomes in children with JIA, focusing on its impact on the pyroptosis pathway and autophagy function.</p><p><strong>Methods: </strong>A randomized controlled clinical trial was conducted from 7 November 2023 to 12 January 2025. A total of 106 participants were recruited and randomly assigned to receive EA or sham acupuncture (SA) for 8 weeks. Clinical assessments, including functional ability, pain scores, and quality of life, were measured at baseline, week 4, week 8, month 3, and month 6. Serum levels of pyroptosis-related proteins and autophagy markers were analyzed to elucidate the underlying mechanisms.</p><p><strong>Results: </strong>The EA group showed significant improvements in functional ability and pain scores compared to the SA group at both week 4 and week 8. Notable reductions in serum levels of pyroptosis markers (caspase-1, GSDMD, NLRP3) and pro-inflammatory cytokines (IL-1β, IL-18) were observed in the EA group. Additionally, autophagy markers (LC3, Becline1) significantly decreased after EA treatment, suggesting enhanced autophagic activity.</p><p><strong>Conclusion: </strong>This study demonstrates that electroacupuncture is a safe and effective adjunctive treatment for improving function and reducing pain in children with JIA. The observed biological changes indicate potential anti-inflammatory effects, supporting EA's role in comprehensive JIA management. Future research should explore long-term outcomes and mechanisms for these findings further. Key Points • The study demonstrates that electroacupuncture (EA) significantly improves functional ability and pain scores in children with juvenile idiopathic arthritis (JIA) compared to sham acupuncture. • EA treatment led to notable reductions in serum levels of pyroptosis-related proteins and pro-inflammatory cytokines, indicating its potential role in modulating inflammatory pathways. • The research observed significant changes in autophagy markers post-EA treatment, suggesting that EA may enhance autophagic function in children with JIA. • EA is presented as a safe adjunctive therapy for JIA management, with implications for further research into its long-term effects and underlying mechanisms.</p>","PeriodicalId":10482,"journal":{"name":"Clinical Rheumatology","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143522305","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":"A nomogram for predicting the adverse pregnancy outcomes of systemic lupus erythematosus: a single-center study.","authors":"Wei Kong, Xin Zhang, Linyu Geng, Chen Chen, Yue Sun, Xue Xu, Shengnan Zhao, Ziyi Jin, Yang Huang, Dandan Wang, Jun Liang, Yun Zhu, Lingyun Sun","doi":"10.1007/s10067-025-07377-0","DOIUrl":"https://doi.org/10.1007/s10067-025-07377-0","url":null,"abstract":"<p><strong>Objectives: </strong>As systemic lupus erythematosus (SLE) primarily impacts women of childbearing age, a considerable number of patients have fertility needs. However, the risk of experiencing adverse pregnancy outcomes (APOs) was higher in these patients. Our study aimed to construct a predictive model to assess the risks for APOs of SLE.</p><p><strong>Method: </strong>We retrospectively analyzed the data of pregnant SLE patients hospitalized at Nanjing Drum Tower Hospital from August 2010 to April 2023. The Least Absolute Shrinkage and Selection Operator (LASSO) regression analysis was used to explore the risk factors for APOs, and a nomogram was established. Afterward, the efficacy of the nomogram was evaluated by analyzing the areas under the curves (AUCs) of Receiver Operating Characteristic (ROC), calibration curves, and Decision Curve Analysis (DCA).</p><p><strong>Results: </strong>Our study involved 259 pregnant patients with a median age of 29.00 years, and identified 129 cases of APOs, including preterm birth, low birth weight, congenital anomalies, stillbirth/miscarriage, and fetal distress. Through LASSO regression analysis, nine optimal features were selected as risk factors, including age, lupus nephritis, antepartum body mass index, antinuclear antibody, anti-U1RNP/Sm antibody, anti-ribosomal P protein antibody, platelet, albumin levels, SLEDAI scores, diabetes mellitus, rash, and the use of aspirin therapy. These factors were integrated into a predictive nomogram model, which showed good predictive accuracy, with AUC values of 0.870 and 0.830 in training and validation groups, respectively. The calibration curves and DCA also confirmed the good performance of the model.</p><p><strong>Conclusions: </strong>We developed a tool to predict APOs in SLE patients, offering personalized risk assessments and clinical decision support. As the data used to build the predictive model was obtained from a single center, the tool is currently best suited for application within our center. Further validation in diverse populations is needed to expand its generalizability. Key Points • Our study revealed the independent predictors for APOs of SLE through LASSO regression analysis. • We developed a nomogram to predict APOs in SLE based on the results of LASSO regression analysis. • The predictive model may aid clinical decision-making, enabling timely interventions to reduce the incidence of APOs.</p>","PeriodicalId":10482,"journal":{"name":"Clinical Rheumatology","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143522304","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":"Association between a history of mental illness and the risk of systemic autoimmune rheumatic diseases: a nationwide, population-based case-control study.","authors":"Hsin-Hua Chen, Wei-Min Chu, Wen-Cheng Chao","doi":"10.1007/s10067-025-07383-2","DOIUrl":"https://doi.org/10.1007/s10067-025-07383-2","url":null,"abstract":"<p><strong>Objective: </strong>Patients with systemic autoimmune rheumatic diseases (SARD) are at risk of mental illness, but whether mental illnesses are risk factors for SARD, including rheumatoid arthritis (RA), systemic lupus erythematosus (SLE), Sjögren's syndrome (SS), systemic sclerosis (SSc), dermatomyositis (DM)/polymyositis (PM), are still unknown. Therefore, we aim to address the association between a history of mental illnesses and the risk of SARD using a population-based database.</p><p><strong>Methods: </strong>We used the 2000-2020 Taiwanese National Health Insurance Research Database in this case-control study. Multivariable logistic regression was conducted to estimate the adjusted odds ratios (aORs) with 95% confidence interval (CIs). Sensitivity analyses were conducted using distinct definitions of mental illnesses and wash-out periods.</p><p><strong>Results: </strong>A total of 77,848 SARD cases and 313,392 age- and sex-matched non-SARD controls (1:4) were included for analyses. Patients with SARD were more likely to have history of mental illness (39.8% vs. 27.0%, p < 0.001). After adjusting for potential confounders, we found significant associations of between a history of mental illnesses with SARD (aOR, 1.65, 95%CI, 1.62-1.68), RA (aOR, 1.28, 95% CI, 1.24-1.32), SLE (aOR, 1.62, 95% CI, 1.54-1.71), SS (aOR, 2.35, 95% CI, 2.28-2.42), SSc (aOR, 1.40, 95% CI, 1.24-1.58), and DM/PM (aOR, 1.18, 95% CI, 1.05-1.32). The results remained robust after using various definitions of mental illnesses and wash-out periods.</p><p><strong>Conclusion: </strong>We found that a history of mental illnesses was significantly associated with incident SARD, and the strength of association tended to be strong in patients with SS, followed by SLE. More studies are warranted to clarify the underlying mechanism. Key Points • Patients with systemic autoimmune rheumatic diseases (SARD) are at risk of mental illness, but whether mental illnesses are risk factors for SARD are still unknown. • We used a population-based database to demonstrate that mental illness was associated with the risk of SARD, particularly Sjögren's syndrome and systemic lupus erythematosus. • These findings underscore the importance of integrated care approaches, including surveys for autoimmune diseases, among patients with mental illness.</p>","PeriodicalId":10482,"journal":{"name":"Clinical Rheumatology","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143514781","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":"Review of 2024 publications on the applications of artificial intelligence in rheumatology.","authors":"Mazen Al Zo'ubi","doi":"10.1007/s10067-025-07382-3","DOIUrl":"https://doi.org/10.1007/s10067-025-07382-3","url":null,"abstract":"<p><p>The integration of artificial intelligence (AI) into rheumatology has revolutionized research and clinical practice, offering transformative advancements in diagnostics, biomarker discovery, genomics, digital health technologies, and personalized medicine. This review provides a comprehensive analysis of cutting-edge AI applications in rheumatology, highlighting deep learning models for imaging diagnostics, AI-powered genomic analysis, and wearable health technologies for continuous disease monitoring. The findings demonstrate that AI enhances diagnostic precision, facilitates early disease detection, and enables personalized therapeutic strategies. However, significant challenges remain, including limited clinician adoption, ethical concerns, data privacy issues, and the need for robust model validation. A recent survey revealed that 73% of rheumatologists have never used AI in clinical practice, emphasizing the urgent need for targeted training and interdisciplinary collaboration. Additionally, AI is reshaping rheumatology research by optimizing drug discovery, clinical trial designs, and predictive analytics. Overcoming current barriers requires a multidisciplinary approach involving rheumatologists, AI specialists, and regulatory bodies to ensure the ethical, scalable, and effective implementation of AI-driven solutions in rheumatology.</p>","PeriodicalId":10482,"journal":{"name":"Clinical Rheumatology","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143514906","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":"Risk factors for poor prognosis in ANCA-associated vasculitis with interstitial lung disease: a systematic review and meta-analysis.","authors":"Xing He, Weiwei Yuan, Yahui Yang, Jiaqi Ji, Xixi Chen","doi":"10.1007/s10067-025-07378-z","DOIUrl":"https://doi.org/10.1007/s10067-025-07378-z","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;Antineutrophil cytoplasm antibody-associated vasculitis (AAV) with interstitial lung disease (AAV-ILD) is the main manifestation of AAV involving the lung, further increasing the risk of poor prognosis in patients with AAV. This study aimed to investigate the risk factors associated with mortality in patients with AAV-ILD.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;In Web of Science, PubMed, Embase and Scopus databases, a comprehensive search was performed for English studies on AAV and ILD published from inception date until May 17, 2024. Hazard ratios (HR) and 95% confidence intervals (CI) of mortality-related risk factors in AAV-ILD were collected, and subgroup analyses were carried out based on different candidate risk factors. Cochran's Q statistic and inconsistency value were utilized to assess the heterogeneity of included studies. Sensitivity analysis was executed using one-by-one elimination method, and publication bias was evaluated with Egger's test and the trim-and-fill method.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;A total of 654 patients with AAV-ILD in eight studies were included for the pooled analysis of mortality risk factors. The results showed that age (HR = 1.06, 95%CI: 1.04, 1.08), ever smoker (HR = 1.61, 95%CI: 1.13, 2.29), usual interstitial pneumonia pattern (HR = 2.07, 95%CI: 1.43, 3.00), acute exacerbation (HR = 2.73, 95%CI: 1.70, 4.40) and microscopic polyangiitis (HR = 4.03, 95%CI: 1.70, 9.55) were associated with an increased risk of AAV-ILD mortality. Conversely, percent predicted forced vital capacity (HR = 0.97, 95%CI: 0.96, 0.99) and immunosuppressant for induction (HR = 0.40, 95%CI: 0.28, 0.58) were associated with a reduced risk of AAV-ILD mortality. Male (HR = 1.27, 95%CI: 0.90, 1.80), nervous system involvement (HR = 0.99, 95%CI: 0.65, 1.52), renal involvement (HR = 1.24, 95%CI: 0.97, 1.95) and five factor score ≥ 1 (HR = 1.00, 95%CI: 0.67, 1.48) showed no significant correlation with mortality risk in patients with AAV-ILD. Heterogeneity test indicated no significant heterogeneity among the pooled studies. The results of sensitivity analysis, Egger's test and the trim-and-fill method revealed that the pooled findings were stable and reliable.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;The pooled analyses demonstrated that age, ever smoker, usual interstitial pneumonia pattern, acute exacerbation and microscopic polyangiitis were risk factors for mortality in patients with AAV-ILD, while percent predicted forced vital capacity and immunosuppressant therapy for induction serve as protective factors against mortality. A systematic understanding of the risk factors for AAV-ILD may provide clues for developing effective interventions and managements to improve poor prognosis in patients. Key Points • Increase of age, ever smoker, usual interstitial pneumonia pattern, acute exacerbation and microscopic polyangiitis were risk factors for poor prognosis in patients with AAV-ILD. • High level of percent predicte","PeriodicalId":10482,"journal":{"name":"Clinical Rheumatology","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143514915","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":"Application of metabolomics in the classification of traditional Chinese medicine syndromes in rheumatoid arthritis.","authors":"Yao Li, Shuqi Zhong, Shengchun Huang, Wanying Zhong, Baolin Zheng, Qihong Guo, Jihong Liu, Xueyan Guo, Rong Su","doi":"10.1007/s10067-025-07373-4","DOIUrl":"https://doi.org/10.1007/s10067-025-07373-4","url":null,"abstract":"<p><strong>Objective: </strong>Rheumatoid arthritis (RA) is frequently treated with traditional Chinese medicine (TCM), where patients are classified into distinct syndromes, such as heat-dampness syndrome (HD) and kidney-liver deficiency syndrome (KLD). However, an objective and systematic approach to differentiate these TCM syndromes remains lacking. This study is aimed at analyzing serum metabolomics to identify differential metabolites and pathways associated with HD and GS syndromes in RA patients and at evaluating their potential as diagnostic biomarkers.</p><p><strong>Methods: </strong>Serum samples from RA patients classified into HD and KLD groups were analyzed using metabolomics. Partial least squares discriminant analysis was employed to identify significant metabolites, while pathway analysis was conducted using the Kyoto Encyclopedia of Genes and Genomes database. Receiver operating characteristic (ROC) curve analysis was performed to assess the diagnostic potential of key metabolites.</p><p><strong>Results: </strong>Fifteen differential metabolites and two perturbed pathways-sphingolipid and D-amino acid metabolism-were identified between the KLD and HD groups. Notably, several metabolites, including C17-sphinganine and leucyl-alanine, demonstrated high diagnostic efficacy, with area under the curve (AUC) values exceeding 0.90. Correlation analysis revealed significant associations between certain metabolites and clinical indices, further substantiating their role in syndrome differentiation.</p><p><strong>Conclusion: </strong>This study presents a comprehensive analysis of serum metabolites in RA patients under different TCM syndromes. The identified metabolites hold potential as biomarkers for distinguishing HD and KLD groups, paving the way for more objective and evidence-based diagnostic approaches in TCM. Key Points • Differential metabolites were identified in the serum of RA patients with heat-dampness syndrome and kidney-liver deficiency syndrome, with their metabolic pathways primarily involving sphingolipid metabolism and D-amino acid metabolism. • Serum metabolites demonstrate high efficacy in distinguishing RA patients with different TCM syndromes. • Significant correlations were observed between serum differential metabolites and clinical indicators in RA patients with varying TCM syndromes.</p>","PeriodicalId":10482,"journal":{"name":"Clinical Rheumatology","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143514779","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":"A cross-sectional study on white matter hyperitensity in patients at the initial diagnosis of neuropsychiatric SLE: Correlation with Clinical and Laboratory Findings.","authors":"Shiyang Wang, Zhihu Xu, Jiaxi Li, Zhanhong Lai, Chuan Shi, Jing He","doi":"10.1007/s10067-025-07379-y","DOIUrl":"https://doi.org/10.1007/s10067-025-07379-y","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to investigate the differences between neuropsychiatric systemic lupus erythematosus (NPSLE) patients with and without white matter hyperintensity (WMH) on magnetic resonance imaging (MRI) and to identify factors independently associated with the development of WMH in NPSLE.</p><p><strong>Method: </strong>A comparative analysis was conducted on 84 NPSLE patients hospitalized at Peking University People's Hospital from 2015 to 2022 at the initial diagnosis of NPSLE. Patients were categorized based on the presence of WMH on brain MRI scans. Demographic data, clinical characteristics, and laboratory parameters were reviewed and statistically analyzed.</p><p><strong>Results: </strong>The study included 84 NPSLE patients, 50% exhibiting WMH (NPSLE-WMH +). At the initial diagnosis of NPSLE, the NPSLE-WMH + group showed significantly higher levels of antinuclear antibody (ANA) titer, anti-double-stranded DNA antibody (anti-dsDNA), anti-nucleosome antibody (ANuA), and lower serum C3 levels. The proportion of patients with reduced WBC, elevated anti-dsDNA, elevated ANuA, elevated anticardiolipin antibody (ACA), positive urinary protein (UPR), and positive ANA was higher in the NPSLE-WMH + group. Univariate and multivariate analyses revealed that positive UPR (p = 0.040), positive ANA (p = 0.025), elevated anti-dsDNA (0.047), and elevated ACA (p = 0.025) were potentially independent factors associated with WMH development in NPSLE patients.</p><p><strong>Conclusions: </strong>This study provides novel insights into the clinical and laboratory differences between NPSLE patients with and without WMH, identifying specific independently associated factors for WMH development. These findings may contribute to a better understanding of this intricate disease. Key Points • Although WMH is one of the most frequently observed lesions on MRI in patients with NPSLE, previous literature has given limited attention to it. This study focuses on the differences between NPSLE patients with and without WMH, unveiling independently associated factors for developing WMH in this disease.</p>","PeriodicalId":10482,"journal":{"name":"Clinical Rheumatology","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143499631","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":"Differences in rates of remission between rheumatoid factor positive and negative rheumatoid arthritis patients: experience from a resource-limited setting.","authors":"Abel Tenaw Tasamma, Bethesaida Zerihun Eshetu, Alazar Tesfamariam Seyoum, Senay Admasu Woldegiorgis, Melatework Assefa Wolle, Getachew Wuhib Shumye, Tsegabrhan Gebrewahid Weldegiorgis, Aron Berhanu Gudetta, Berhanu Moges Abera","doi":"10.1007/s10067-025-07370-7","DOIUrl":"https://doi.org/10.1007/s10067-025-07370-7","url":null,"abstract":"<p><strong>Background: </strong>Rheumatoid arthritis (RA) is an autoimmune disease of the joints with occasional involvement of extra-articular organs. Although rheumatoid factor (RF) is associated with more severe baseline disease severity and a higher incidence of extraarticular diseases, whether it predicts response to treatment in patients taking conventional disease-modifying antirheumatic drugs (DMARDs) is unclear as evidence has so far been conflicting.</p><p><strong>Methods: </strong>A 3-year (January 2021 to December 2023) multicenter retrospective cohort study was done at 1 public and 4 private hospitals in Addis Ababa, Ethiopia. After categorizing eligible patients into RF-positive and RF-negative, they were retrospectively followed for 12 months. A disease activity score in 28 joints (DAS-28) score of less than 2.6 was used to define remission. The time-to-remission between the two groups was compared using the Kaplan-Meier survival function. In order to control for potential confounders, the Cox regression model was used to calculate adjusted hazard ratios (AHR).</p><p><strong>Results: </strong>After screening a total of 676 patients, 207 were found to be eligible for the study. The median (interquartile range (IQR)) age at diagnosis was 46 (36 - 58) years, and 171 (82.6%) were female. At 12 months of follow-up, remission occurred in 39.4% of RF-positive patients and 60.0% of RF-negative patients (AHR, 0.57; 95% confidence interval (CI), (0.368-0.88; P = 0.012). The overall remission rate was 47.3%.</p><p><strong>Conclusion: </strong>In this study, among patients taking conventional DMARDs, RF-negative RA patients achieved better remission rates compared to RF-positive patients. The study provides insight into the association between RF status and treatment outcome among RA patients in a resource-limited setting. Key Points • Our work adds to the existing body of knowledge regarding the relationship between RF positivity and response to treatment in patients with RA. It is also the first study to examine this association in a previously understudied population of Sub-Saharan Africa.</p>","PeriodicalId":10482,"journal":{"name":"Clinical Rheumatology","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143499738","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}