Clinical Rheumatology最新文献

{"title":"Could previous appendicectomy influence disease expression in axial spondyloarthritis?","authors":"Mariana Patela, Catarina Rua, Catarina Silva, Marta Araújo Fernandes, Romana Vieira, Tiago Meirinhos, Ana Sofia Pinto","doi":"10.1007/s10067-026-08427-x","DOIUrl":"https://doi.org/10.1007/s10067-026-08427-x","url":null,"abstract":"","PeriodicalId":10482,"journal":{"name":"Clinical Rheumatology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149015815","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":"Transition of adolescents with JIA to adult rheumatology: what is the most suitable time?","authors":"Mine Sağlam Atmaca, Rana İşgüder, Erbil Ünsal","doi":"10.1007/s10067-026-08441-z","DOIUrl":"https://doi.org/10.1007/s10067-026-08441-z","url":null,"abstract":"<p><strong>Introduction/objectives: </strong>Improved long term outcomes in juvenile idiopathic arthritis (JIA) have increased the demand for transition to adult rheumatology care [1]. There is a need for evaluation criteria that can be used in this process. In this study, the Transition Readiness Assessment Questionnaire (TRAQ) was applied to patients with JIA to identify clinical factors associated with transition readiness and determine most appropriate time frame for transition.</p><p><strong>Method: </strong>This cross-sectional study included 115 adolescents with JIA followed in the Department of Pediatric Rheumatology at Dokuz Eylül University between 2021 and 2023. Patients were divided into two age groups (14-15 and 16-18 years) to compare TRAQ scores and demographic, clinical characteristics. TRAQ scores were categorized by percentile values; multivariable logistic regression and ROC analyses were performed to identify independent predictors and the age associated with high transition readiness.</p><p><strong>Results: </strong>Among 115 adolescents with JIA, 54 (47%) were aged 14-15 years and 61 (53%) were aged 16-18 years; 58 (50.4%) were female. Total TRAQ and subscale scores were significantly higher in the 16-18 age group, except for the \"tracking health issues\" subscale. In multivariate analysis, age was the only independent predictor associated with both high and low TRAQ scores. ROC analysis identified 17.5 years as the optimal cutoff value for predicting high TRAQ scores.</p><p><strong>Conclusions: </strong>Although transition readiness increased with age and was higher in patients aged 16-18 years, initiating transition education at age 14 may support a more effective transition process, reduce transition related anxiety and improve follow-up quality. Key Points • Transition readiness was significantly higher in adolescents aged 16-18 years, with age as the strongest independent predictor of TRAQ scores. • The findings support early transition education beginning around the age of 14 years in adolescents with JIA. • ROC analysis identified 17.5 years as the age most strongly associated with higher transition readiness.</p>","PeriodicalId":10482,"journal":{"name":"Clinical Rheumatology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149024079","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":"Semiquantitative ultrasonographic grading of femoral cartilage: comparison among three knee groups with different clinical statuses.","authors":"Chia-Ling Lee, Chih-Ting Chen, Kee-Lung Chang, Yin-Chun Tien, Cheng-Wei Lin, Jiing-Yuan Su, Chia-Hsin Chen","doi":"10.1007/s10067-026-08416-0","DOIUrl":"https://doi.org/10.1007/s10067-026-08416-0","url":null,"abstract":"<p><strong>Introduction: </strong>Ultrasonography (US) can directly visualize the femoral condylar cartilage, but whether semiquantitative US grade distributions differ among knee groups with different clinical statuses in relation to total knee arthroplasty (TKA) for knee osteoarthritis (OA) remains unclear. We hypothesized that semiquantitative US grading would differ significantly among the three knee groups.</p><p><strong>Method: </strong>In this prospective cross-sectional study, 60 patients scheduled for unilateral TKA for OA and 27 healthy young adults were recruited. Group A included knees scheduled for TKA; group B included the contralateral knees of the same patients that were not scheduled for TKA, and group C included bilateral knees of healthy participants. Each knee underwent semiquantitative US grading (0-6) of the whole, medial, and lateral femoral condyles. Differences were analyzed with chi-square trend tests and Wilcoxon signed-rank tests.</p><p><strong>Results: </strong>US grading differed significantly across the three groups at the whole, medial, and lateral femoral condyles (all P < 0.0001). Groups A and B each differed significantly from group C at all three regions (all P < 0.0001). Between groups A and B, grading differed significantly at the whole (P = 0.0222) and medial (P = 0.0017) femoral condyles, but not laterally (P = 0.1792). Medial grading was significantly higher than lateral grading in all groups (all P < 0.0001).</p><p><strong>Conclusions: </strong>Semiquantitative US grading of femoral condylar cartilage differed among three groups representing different clinical statuses in relation to TKA for knee OA. Grades at the medial femoral condyle were higher than those at the lateral femoral condyle in all three groups. Key Points • Semiquantitative ultrasonographic grading of the femoral condylar cartilage differed at the whole, medial, and lateral femoral condyles among three groups representing different clinical statuses. • The grading differed between knees scheduled for TKA and the contralateral knees of the same patients at the whole and medial femoral condyles, but not at the lateral femoral condyle. • Semiquantitative US grades were higher at the medial than at the lateral femoral condyle in all three groups. • Semiquantitative US grading is a non-invasive method for comparing femoral cartilage morphology among three groups representing different clinical statuses.</p>","PeriodicalId":10482,"journal":{"name":"Clinical Rheumatology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149015867","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":"Maternal and paternal perceptions of child vulnerability in children with familial mediterranean fever: a cross-sectional study.","authors":"Tuğba Karaca Ahat, Sema Nur Taşkın","doi":"10.1007/s10067-026-08444-w","DOIUrl":"https://doi.org/10.1007/s10067-026-08444-w","url":null,"abstract":"<p><strong>Objectives: </strong>Familial Mediterranean fever (FMF) is a chronic autoinflammatory disease that may affect not only children but also parental psychological well-being. This study aimed to evaluate parental perceptions of child vulnerability in children with FMF and to investigate factors associated with maternal and paternal vulnerability scores.</p><p><strong>Methods: </strong>This cross-sectional study included 64 children aged 3-17 years with FMF who were followed in a pediatric rheumatology outpatient clinic and their parents. All patients were evaluated during attack-free periods. Parents completed the Child Vulnerability Scale (CVS). Demographic and clinical characteristics, including sex, age group, M694V mutation status, colchicine treatment, family history, and concomitant periodic fever, aphthous stomatitis, pharyngitis, and adenitis (PFAPA), were recorded. Paired- and independent-sample t-tests, Pearson's correlation analysis, and categorical analyses were used as appropriate.</p><p><strong>Results: </strong>High maternal vulnerability scores (≥ 10) were present in 54.7% of mothers, while high paternal vulnerability scores were detected in 43.8% of fathers. Mean maternal CVS scores were significantly higher than paternal scores (10.83 ± 5.37 vs. 8.31 ± 4.60, p < 0.001). Maternal and paternal vulnerability scores demonstrated a moderate positive correlation (r = 0.393, p = 0.001). M694V mutation status and family history were not associated with parental vulnerability scores. Concomitant PFAPA was significantly associated with higher paternal vulnerability scores (11.55 ± 5.26 vs 7.64 ± 4.20, p = 0.009), whereas no significant association was found for maternal scores.</p><p><strong>Conclusion: </strong>Parents of children, particularly mothers, frequently perceive their children as vulnerable. The positive correlation between maternal and paternal scores suggests shared psychosocial responses within the family environment. Assessment of parental vulnerability perceptions may contribute to family-centered care in pediatric FMF follow-up. Key Points • Mothers of children with FMF had higher vulnerability perception scores than fathers. • Coexisting PFAPA diagnosis was associated with higher paternal vulnerability scores. • M694V mutation and family history were not associated with parental vulnerability perception. • Psychosocial evaluation of parents may be important in the multidisciplinary follow-up of children with FMF.</p>","PeriodicalId":10482,"journal":{"name":"Clinical Rheumatology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149015762","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":"Persistent foot and ankle pain in rheumatoid arthritis remission: what is the treatment target?","authors":"Guangbing Yang, Ping Zhao, Jie Jia","doi":"10.1007/s10067-026-08434-y","DOIUrl":"10.1007/s10067-026-08434-y","url":null,"abstract":"","PeriodicalId":10482,"journal":{"name":"Clinical Rheumatology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149015807","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 microvascular footprint of lupus: nailfold capillaroscopy findings in Egyptian SLE patients and their link to disease activity, autoantibodies, and digital ischemia.","authors":"Samar Tharwat, Leila Bakr, Ola Youssef, Ghada Moner, Mohamed Ali Eltamaly, Rahma A Elziaty","doi":"10.1007/s10067-026-08404-4","DOIUrl":"https://doi.org/10.1007/s10067-026-08404-4","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Microvascular injury is central in systemic lupus erythematosus (SLE), and nailfold capillaroscopy (NFC) can noninvasively visualize this damage, but data in Egyptian patients are limited.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objectives: &lt;/strong&gt;To characterize NFC patterns in Egyptian SLE versus healthy controls, and to relate capillaroscopic abnormalities to disease activity and major clinical/serologic features.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;In a case-control, cross-sectional study, 106 adult SLE patients and 106 age- and sex-matched controls from two Egyptian tertiary centers underwent standardized NFC (× 200) of eight fingers. Quantitative (density and loop width) and qualitative (morphology, hemorrhages, avascular areas, neoangiogenesis, architecture) parameters were recorded. Associations with disease activity, autoantibodies and digital ischemic lesions were analyzed.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Capillary density was reduced in SLE versus controls (median 8 vs. 9 loops/mm; p &lt; 0.001), with greater loop width (21 vs. 15 µm; p &lt; 0.001). Tortuous (68.9% vs. 16.0%) and branched capillaries (12.3% vs 0%) were more frequent in SLE (all p &lt;  &lt; 0.001), as were enlarged/giant capillaries and microhemorrhages (p ≤ 0.004); disturbed architecture, avascular areas, and neoangiogenesis were largely confined to SLE, and subpapillary plexus visibility was higher (45.3% vs 26.4%; p = 0.002). Higher disease activity correlated with lower density (r = -0.309, p = 0.002), more microhemorrhages (r = 0.470, p = 0.001), avascular areas (p = 0.002), and neoangiogenesis (2.4% vs 8% vs. 35.7% across mild, moderate, and severe; p = 0.001). Anti-dsDNA and antiphospholipid antibodies were associated with lower density (r = -0.261, p = 0.024; r = -0.273, p = 0.005) and more microhemorrhages (r = 0.249, p = 0.035; r = 0.510, p = 0.001); digital ulcers correlated strongly with microhemorrhages (r = 0.476, p &lt; 0.001).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;Egyptian SLE patients exhibit characteristic NFC abnormalities that correlate with disease activity, autoantibody profiles, and digital ischemia, supporting NFC as a potential adjunct for risk stratification and monitoring in this population. Key Points • Compared with healthy controls, Egyptian SLE patients showed widespread nailfold capillary changes affecting density, morphology, and vascular architecture, confirming that microvascular injury is a consistent feature of the disease in this population. • The extent of capillary damage paralleled SLE disease activity, with more pronounced abnormalities, including lower capillary density and greater microhemorrhages, avascular areas, and neoangiogenesis, seen in patients with higher disease activity. • Capillaroscopic abnormalities also tracked with autoantibody status and digital ischemic disease, linking anti-dsDNA and antiphospholipid antibodies, as well as Raynaud's phenomenon and digital ulcers, to greater microvascular injury. • The study highlights na","PeriodicalId":10482,"journal":{"name":"Clinical Rheumatology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149007909","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":"Pain-inflammation discordance in rheumatoid arthritis: fibromyalgia, psychological, and functional correlates of a continuous metric.","authors":"Adel Ibrahim Azzam, Ahmed Mohamed Khalifa","doi":"10.1007/s10067-026-08411-5","DOIUrl":"https://doi.org/10.1007/s10067-026-08411-5","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background and objective: &lt;/strong&gt;Pain-inflammation discordance (PID) - a state in which perceived pain substantially exceeds the level expected from objective inflammatory markers - is clinically important in rheumatoid arthritis (RA) but has been studied predominantly using arbitrary categorical thresholds. We developed a continuous, sample-relative z-score-based PID metric, evaluated preliminary construct validity evidence, and identified associated psychological, functional, and disease-related correlates in a cohort of 200 Egyptian RA patients (mean age 38.5 ± 9.2 years; 91% female; 40% with comorbid fibromyalgia; 88% with moderate-to-high disease activity). The metric is derived from within-sample z-standardization and should be regarded as a research tool rather than a directly portable clinical instrument.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Two hundred consecutive RA patients (2010 ACR/EULAR criteria) were cross-sectionally assessed. The PID score was computed as the difference between z-standardized pain VAS and z-standardized ESR, both standardized within this sample (VAS pain: mean 50.3 ± 26.2 mm; ESR: mean 46.0 ± 24.4 mm/h). Preliminary construct validity was evaluated through known-groups comparisons (fibromyalgia status), discriminant validity testing (tender vs. swollen joint counts), and distributional normality. Fibromyalgia was assessed using the 1990 ACR criteria in a single-examiner setting, with acknowledged limitations of tender-point overlap with active synovitis. Psychological instruments included BDI-II, HAM-A, PSQI, and MAF (Cronbach's α 0.79-0.91) in validated Arabic translations. Benjamini-Hochberg FDR correction was applied across 12 empirical correlational tests; the mathematically predetermined ESR-PID correlation was excluded from the FDR pool.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The PID score was normally distributed (SD = 1.29; range - 4.20 to + 3.08; Shapiro-Wilk p = 0.41). Known-groups comparison showed higher PID in fibromyalgia-positive versus fibromyalgia-negative patients (0.65 ± 1.15 vs. - 0.44 ± 1.19; Cohen's d = 0.93), though this comparison carries inherent circularity. The strongest validity evidence was the discriminant TJC/SJC dissociation: TJC correlated with PID (r = 0.233, p_FDR = 0.004) while SJC did not survive FDR correction (r = 0.149, p_FDR = 0.059). After FDR correction, significant correlates included fibromyalgia (r = 0.415), TJC (r = 0.233), sleep quality (r = 0.215), morning stiffness (r = 0.189), depression (r = 0.174), and anxiety (r = 0.174). Fibromyalgia explained 17.3% of PID variance; 82.7% remained unexplained. DAS28 showed no association with PID (r =  - 0.005, p = 0.949), a finding that is partly explained by the opposing mathematical relationships of DAS28 components with PID. Fibromyalgia's association with PID was consistent across moderate and high disease activity strata; evidence within the remission (n = 7) and low-activity (n = 17) strata is underpowered and should ","PeriodicalId":10482,"journal":{"name":"Clinical Rheumatology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148988377","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":"Exaggerated axial osteoproliferation in patients with spondyloarthritis accompanying chronic kidney disease.","authors":"Güllü Sandal Uzun, Aslıhan Ezgi Apaydın Rollas, Güldehan Haberal, Hasan Hacı Yeter, Gizem Ayan, Yunus Erdem, Levent Kılıç, Sedat Kiraz, Ali İhsan Ertenli, Umut Kalyoncu","doi":"10.1007/s10067-026-08422-2","DOIUrl":"https://doi.org/10.1007/s10067-026-08422-2","url":null,"abstract":"<p><strong>Introduction: </strong>Axial spondyloarthritis (axSpA) is a chronic inflammatory disease characterized by entheseal inflammation, pathological new bone formation and structural lesions on spinal radiography. Chronic kidney disease (CKD) especially in its moderate to advanced stages manifests with abnormalities such as secondary hyperparathyroidism, renal osteodystrophy and vascular or ligamentous calcifications. This study aimed to compare radiographic spinal abnormalities in axSpA patients with CKD, axSpA patients without CKD, and CKD patients without inflammatory arthritis.</p><p><strong>Methods: </strong>This retrospective study used data from the HURBIO registry, including 3207 bDMARD-treated patients with spondyloarthritis (SpA). Patients with axSpA and CKD (axSpA-CKD group, n = 28, 0.87% of the cohort) were compared with 56 age- and sex-matched axSpA patients without CKD (axSpA-nonCKD group) and 38 CKD patients without SpA (non-SpA CKD group). Cervical/lumbar and pelvic radiographs were evaluated for vertebral erosion, squaring, sclerosis, syndesmophyte (any), bamboo spine, and mSASSS scores.</p><p><strong>Results: </strong>The prevalence of syndesmophytes was significantly higher in axSpA-CKD patients compared with axSpA-nonCKD patients (64.2% vs. 25.0%, p = 0.002). Syndesmophyte-like osteoproliferative changes in the axial spine were observed in eight (21.0%) non-SpA CKD patients. Higher total mSASSS scores were independently associated with the presence of CKD (β = 18.5, 95% CI 9.03-28.06, p < 0.001), independent of age at bDMARD initiation, sex, disease duration, smoking, and HLA-B27 positivity, and this association remained significant after further adjustment for BASDAI scores as well as for the presence of amyloidosis and uveitis (all models, p ≤ 0.017).</p><p><strong>Conclusion: </strong>The results suggest that enthesial changes in the axial spine are more frequent and severe in axSpA patients with CKD compared to matched axSpA patients without CKD. In patients with axSpA-CKD, the contribution of CKD to new bone formation should be considered in the evaluation of radiographic damage.</p>","PeriodicalId":10482,"journal":{"name":"Clinical Rheumatology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148988385","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":"Meteorological factors and primary care consultation patterns in rheumatoid arthritis and axial spondyloarthritis: a 14-year population-based time-series study.","authors":"Juan Nicolás Cuenca-Zaldívar, Carmen Corral Del Villar, Silvia García Torres, Rafael Araujo Zamora, Paula Gragera Peña, Camilo Corbellini, Rafael Rousseau Yera, Pedro Martínez-Lozano, Eleuterio A Sánchez-Romero","doi":"10.1007/s10067-026-08415-1","DOIUrl":"https://doi.org/10.1007/s10067-026-08415-1","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Weather-related symptom fluctuations are frequently reported in patients with inflammatory and rheumatic diseases. However, evidence regarding the influence of meteorological conditions on healthcare utilization remains inconsistent, and long-term population-based studies are scarce.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;To investigate the association between meteorological variables and primary care consultation frequency for rheumatoid arthritis (RA) and axial spondyloarthritis (axSpA) over a 14-year period and evaluate the influence of demographic factors on healthcare-seeking behavior.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A retrospective population-based time-series study was conducted using anonymized electronic health records from three primary care centers in the Community of Madrid (Spain) between 2010 and 2023. Weekly consultations for RA and axSpA were identified using the International Classification of Primary Care, Second Edition (ICPC-2) diagnostic codes. Meteorological data obtained from the Spanish State Meteorological Agency included temperature-related variables, precipitation, wind characteristics, sunshine duration, and barometric pressure. Associations were analyzed using generalized additive models (GAMs) with a Poisson distribution, accounting for repeated observations and temporal trends.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Among 1,175 unique patients (mean age, 60.55 ± 17.03 years; 73.11% female), 1,677 consultations were analyzed: 1,461 (87.12%) for RA and 216 (12.88%) for axSpA. Greater average rainfall was associated with lower consultation frequency in RA (p = 0.010) and the overall cohort (p = 0.009). Longer sunshine duration was associated with lower consultation frequency in axSpA (p = 0.027) and overall (p = 0.018), whereas higher average temperature was associated with higher consultation frequency in axSpA (p = 0.041). Wind direction showed nonlinear associations in RA (p = 0.004) and overall (p = 0.022), but not in axSpA (p = 0.058). Age and sex were not independently associated with consultation frequency.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Meteorological associations with healthcare utilization were selective and diagnosis-specific. These findings concern consultation patterns, do not establish corresponding changes in disease activity or causality, and indicate that weather alone is insufficient to predict healthcare demand. Key Points • In this 14-year population-based analysis, most meteorological variables were not significantly associated with primary care consultation frequency for rheumatoid arthritis and axial spondyloarthritis, and neither sex nor age was independently associated with consultation frequency after adjustment for meteorological variables, patient-level clustering, and temporal trends. • Greater rainfall was associated with lower consultation frequency in rheumatoid arthritis and the overall cohort, while wind direction showed significant nonlinear associations in th","PeriodicalId":10482,"journal":{"name":"Clinical Rheumatology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148975882","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":"Regional patterns of advanced therapy use and unmet disease control in axial spondyloarthritis across Latin America: a report from the ESPALDA-PANLAR registry.","authors":"Rodrigo García-Salinas, Fernando Sommerfleck, Wilson Bautista-Molano, Guillermo Guaracha Basañez, Julio César Casasola Vargas, Daniel Fernández-Ávila, Diego Vila, María Lorena Brance, Jossiell Then Báez, Francisco Zevallos Miranda, Lysseth Macías Oviedo, Marilú Mestanza Peralta, Daisy Yelena Sánchez Cantos, Lyn Chinchay, Patricia Melgarejo, Ángel Castillo Ortiz, Gimena Gómez, Leandro Ferreyra Garrot, Dora Candia Zúñiga, Gustavo Medina, María Fernanda Egüez Del Pozo, Einer Sánchez Prado, Daniel Palleiro, Nicolas Marín-Zucaro, John Londoño","doi":"10.1007/s10067-026-08393-4","DOIUrl":"https://doi.org/10.1007/s10067-026-08393-4","url":null,"abstract":"<p><strong>Objectives: </strong>To evaluate regional patterns of current biologic/targeted synthetic DMARD use in patients with axSpA across Latin America, explore clinical differences between patients receiving and not receiving b/tsDMARDs, and quantify disease activity among patients not receiving b/tsDMARDs.</p><p><strong>Methods: </strong>Observational, cross-sectional analysis of the PANLAR-ESPALDA registry. Adults fulfilling the ASAS 2009 criteria were included from nine countries and grouped into South (Argentina, Chile, Uruguay, Paraguay), Andean (Colombia, Peru, Venezuela, Ecuador), and North (Mexico) regions. Current b/tsDMARD use, drug class (TNFi, IL-17i, JAKi), and treatment line were recorded. Disease activity was assessed by BASDAI and ASDAS-CRP; unmet disease control was described among patients not receiving b/tsDMARDs.</p><p><strong>Results: </strong>Among 419 patients, 198 (45%) were receiving b/tsDMARDs (70% TNFi, 20% IL-17i, 10% JAKi); 66% were on first-line, 20% on second-line, and 13% on third-line b/tsDMARD therapy. Overall, treated patients more frequently had uveitis (59% vs 41%; p = 0.04), chronic MRI changes (56% vs 44%; p = 0.01), and a younger age at back pain onset (median 30 vs 36 years; p = 0.02). b/tsDMARD use varied by region (South 44%, Andean 43%, North 56%) with region-specific correlates. Among patients not receiving b/tsDMARDs (n = 206), BASDAI > 4 was observed in 50% across regions; ASDAS moderate/high disease activity remained common (South 42%/29%; Andean 37%/20%; North 39%/16%). Extra-musculoskeletal manifestations were frequent among patients not receiving b/tsDMARDs.</p><p><strong>Conclusions: </strong>In this Latin American registry, current b/tsDMARD use varied across participating regions, while substantial disease activity persisted among many patients not receiving advanced therapies. These findings suggest potential unmet disease control in routine care, although treatment eligibility and factors influencing treatment decisions were not systematically captured. Key Points • Current b/ts DMARD use in ESPALDA varied across Latin American regions, ranging from 44 to 56%. • Patients receiving b/ts DMARDs more frequently had uveitis and chronic MRI changes and had earlier back pain onset. • Among patients not receiving b/tsDMARDs, half had BASDAI > 4 and many had moderate or high ASDAS disease activity, indicating persistent disease activity and potential unmet disease control.</p>","PeriodicalId":10482,"journal":{"name":"Clinical Rheumatology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148976005","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}