Clinical Rheumatology最新文献

{"title":"IL-2 detected by flow cytometry and its significance in systemic lupus erythematosus.","authors":"Yingni Li, Tingting Wang, Yuzhou Gan, Xia Zhang, Leixi Xue, Boyi Xu, Xiaolin Sun, Zhanguo Li","doi":"10.1007/s10067-025-07478-w","DOIUrl":"https://doi.org/10.1007/s10067-025-07478-w","url":null,"abstract":"<p><strong>Objective: </strong>Low-dose interleukin 2 (IL-2) administration has been shown to selectively modulate regulatory T (Treg) cell abundance and alleviate the progression of systemic lupus erythematosus (SLE). IL-2 level could be indicator of low-dose IL-2 usage in SLE patients. However, current methods for IL-2 detection are generally not sensitive to be used in clinic. This study aims to establish flow cytometry-based IL-2 detection as a feasible approach in determining IL-2 in peripheral blood of SLE patients.</p><p><strong>Methods: </strong>Flow cytometry was used to quantify the relative mean fluorescence intensity (MFI) of IL-2 in CD3⁺T cells and other lymphocyte subsets in peripheral blood mononuclear cell (PBMCs) from a cohort of 134 SLE patients and 112 healthy controls (HC). Correlations between IL-2 MFI and clinical or laboratory parameters in SLE patients were also investigated.</p><p><strong>Results: </strong>MFI of IL-2 represented IL-2 expression in CD3⁺T cells. IL-2 MFI was significantly lower in SLE patients compared to the HC group and negatively associated with anti-ribosomal protein antibodies, erythrocyte sedimentation rate (ESR), and blood urea. Conversely, it was positively correlated with IgA and hemoglobin. These associations with IgA, hemoglobin, ESR, and blood urea remained significant after adjusting for age and disease duration. IL-2 level was also positively correlated with the relative abundance of Th1, Th2, and Th17 cells. Furthermore, MFI of IL-2 recovered with effective treatment in SLE patients.</p><p><strong>Conclusions: </strong>MFI of IL-2 serves as a feasible marker of IL-2, which is significantly decreased in SLE patients and recovered with treatment, suggesting its potential for assessing short-term disease status and treatment response in SLE patients. Key Points • IL-2 MFI can be used to estimate IL-2 expression level in SLE patients.  • IL-2 MFI is significantly reduced in SLE patients. • IL-2 MFI can serve as a marker for monitoring SLE activity and short-term status.</p>","PeriodicalId":10482,"journal":{"name":"Clinical Rheumatology","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144119134","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":"Systemic secukinumab treatment in patients with ankylosing spondylitis: the relationship between systemic and tear proinflammatory cytokines and ocular surface findings-a pilot study.","authors":"Ozlem Dikmetas, Yasemin Kapucu, Semih Coşan, Nargiz Rustamova, Zehra Ozsoy, Sibel Kocabeyoglu, Umut Kalyoncu, Çağman Tan, İlhan Tezcan, Murat Irkec","doi":"10.1007/s10067-025-07492-y","DOIUrl":"https://doi.org/10.1007/s10067-025-07492-y","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Backgrounds: &lt;/strong&gt;Dry eye disease (DED) is a very common ocular surface disease that affects millions of people around the world. When we look at the pathogenesis of the disease, it is seen that inflammation plays a role. Ankylosing spondylitis (AS) is the prototype of immune-mediated inflammatory rheumatoid diseases in the spectrum of axial spondyloarthropathies. In studies, many proinflammatory cytokines (TNF-α, IL-23, IFN-γ), especially IL-17, have been shown in the etiopathogenesis of AS. Recently, anti IL-17 receptor inhibitors (secukinumab) have been using. It selectively binds to the IL-17 receptor, preventing its association with the target receptor. From this point of view, it was aimed to evaluate the blood and tear proinflammatory cytokine levels and ocular surface parameters of the patients treated with secukinumab, before and during the treatment.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This cross-sectional study included 12 patients with AS and 12 healthy individuals. The ocular surface and tear film were assessed using the Ocular Surface Disease Index (OSDI) questionnaire, tear film break-up time (TBUT), ocular surface staining, and Schirmer II test. The blood and tear samples were taken simultaneously. Signs and symptoms of DED were evaluated on the treatment day and 4 weeks, and 12 weeks after treatment. Tear and blood samples were taken once at the beginning of the study for the control group. Proinflammatory cytokine levels from collected tear and venous blood samples were examined in Pediatric Immunology laboratory. The tear levels of 30 cytokines were examined. Analyses were made with SPSS 25.0 package program.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Compared to controls, AS patients had higher OSDI (p = 0.01), similar corneal staining with fluorescein and lissamine green (p = 0.12), and lower TBUT (p = 0.04). OSDI were found to be significantly different in the AS group at the measurement times (p = 0.01). IL-1B, IL-10, IL-13, IL-6, IL-12/IL-23p40, Rantes, Eotaxin, IL-17A, MIP-1A, GM-CSF, MIP-1B, MCP-1, IL-15, IL-5, IFN-G, IFN-A, TNF-A, IL-2, IL-7, IP-10, IL-2R, MIG, IL-4, and IL-8 levels in the AS serum and tears group did not differ at the first and third months (p &gt; 0.05). IL-1RA measurements showed a significant decrease in the first and third months compared to baseline in the AS serum and tears (p = 0.04).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;The findings of this study showed that there was decreased IL-1RA in patients with AS after secukinumab treatment in tears and serum. Interestingly, lachrymal IL-17 levels were similar but not statistical significant changes with two ocular parameters TBUT and Schirmer's test, suggesting a pathological role of IL-17 in rheumatological diseases. The results suggest that the inhibition of IL-1RA obtained by systemic administration of secukinumab but does not influence the severity of DED. Key Points • Many proinflammatory cytokines (TNF-α, IL-23, IFN-γ), especially IL-17, have been sh","PeriodicalId":10482,"journal":{"name":"Clinical Rheumatology","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144109775","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":"Development and validation of ultrasound-based radiomics deep learning model to identify bone erosion in rheumatoid arthritis.","authors":"Lei Yan, Jing Xu, Xiaojian Ye, Minghang Lin, Yiran Gong, Yabin Fang, Shuqiang Chen","doi":"10.1007/s10067-025-07481-1","DOIUrl":"https://doi.org/10.1007/s10067-025-07481-1","url":null,"abstract":"<p><strong>Objective: </strong>To develop and validate a deep learning radiomics fusion model (DLR) based on ultrasound (US) images to identify bone erosion in rheumatoid arthritis (RA) patients.</p><p><strong>Methods: </strong>A total of 432 patients with RA at two institutions were collected. Three hundred twelve patients from center 1 were randomly divided into a training set (N = 218) and an internal test set (N = 94) in a 7:3 ratio; meanwhile, 124 patients from center 2 were as an external test set. Radiomics (Rad) and deep learning (DL) features were extracted based on hand-crafted radiomics and deep transfer learning networks. The least absolute shrinkage and selection operator regression was employed to establish DLR fusion feature from the Rad and DL features. Subsequently, 10 machine learning algorithms were used to construct models and the final optimal model was selected. The performance of models was evaluated using receiver operating characteristic (ROC) and decision curve analysis (DCA). The diagnostic efficacy of sonographers was compared with and without the assistance of the optimal model.</p><p><strong>Results: </strong>LR was chosen as the optimal algorithm for model construction account for superior performance (Rad/DL/DLR: area under the curve [AUC] = 0.906/0.974/0.979) in the training set. In the internal test set, DLR_LR as the final model had the highest AUC (AUC = 0.966), which was also validated in the external test set (AUC = 0.932). With the aid of DLR_LR model, the overall performance of both junior and senior sonographers improved significantly (P < 0.05), and there was no significant difference between the junior sonographer with DLR_LR model assistance and the senior sonographer without assistance (P > 0.05).</p><p><strong>Conclusion: </strong>DLR model based on US images is the best performer and is expected to become an important tool for identifying bone erosion in RA patients. Key Points • DLR model based on US images is the best performer in identifying BE in RA patients. • DLR model may assist the sonographers to improve the accuracy of BE evaluations.</p>","PeriodicalId":10482,"journal":{"name":"Clinical Rheumatology","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144101500","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":"Cancer risk in patients with Sjögren's syndrome in Lithuanian cohort study.","authors":"Gintarė Jonušienė, Augustė Kačėnienė, Vaida Gedvilaitė, Jolanta Dadonienė, Dalia Miltinienė, Giedrė Deresevičienė, Giedrė Smailytė","doi":"10.1007/s10067-025-07489-7","DOIUrl":"https://doi.org/10.1007/s10067-025-07489-7","url":null,"abstract":"<p><strong>Introduction: </strong>Sjögren's syndrome (SjS) is a systemic autoimmune disease that predominantly affects the exocrine salivary and lacrimal glands, leading to the manifestation of classic symptoms-dry mouth and eyes. This study aims to analyze cancer risk by site among patients diagnosed with SjS using a Lithuanian population-based dataset.</p><p><strong>Methods: </strong>The study cohort comprised all patients with an initial entry of Sjögren's syndrome (International Classification of Diseases Australian modification, ICD-10-AM diagnosis code M35.0) in the National Health Insurance Fund (NHIF) database, with the record of at least one prescription for antirheumatic medications in the NHIF database, recorded between 1 January 2012 and 31 December 2019. To determine cancer incidence within the cohort, we linked SjS records to the Lithuanian National Cancer Registry, incorporating data from the beginning of 2012 up to 31 December 2019, using personal identification numbers assigned to all Lithuanian citizens.</p><p><strong>Results: </strong>In total, 29 males and 280 females diagnosed with SjS were included in the final analysis. The study found an increased risk of several cancers among female patients diagnosed with SjS. Notably, there was a statistically significant higher incidence rate of non-melanoma skin cancer (SIR 3.20, 95% CI [1.52-6.71]) and non-Hodgkin lymphoma (SIR 33.11, 95% CI [17.23-63.64]). Overall, the incidence of all cancers combined was also elevated (SIR 2.11, 95% CI [1.44-3.07]).</p><p><strong>Conclusions: </strong>Our study shows that there is a statistically significant increased risk of non-melanoma skin cancer and non-Hodgkin lymphoma among female patients diagnosed with Sjögren's syndrome compared to the general Lithuanian population. Key Points • The study found an increased risk of melanoma and non-Hodgkin lymphoma among female patients diagnosed with SjS. • The incidence of all cancers among female patients diagnosed with SjS was elevated. • There was an increased SIR for cancer diagnosis among patients exposed to bDMARDs during the follow-up period compared to those not exposed.</p>","PeriodicalId":10482,"journal":{"name":"Clinical Rheumatology","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144092999","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":"https://doi.org/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":""},"PeriodicalIF":2.9,"publicationDate":"2025-05-17","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":"BAricitinib in patients with SystemIC Sclerosis (BASICS): a prospective, open-label, randomised trial.","authors":"Fangfang Chen, Wenjing Ye, Qian Wang, Li Zhao, Minrui Liang, Shucong Zheng, Tianyi Zhao, Dandan Xuan, Zaihua Zhu, Yiyun Yu, Ning Kong, Li Jiang, Xue Yang, Xiaoxia Zhu, Weiguo Wan, Hejian Zou, Yu Xue","doi":"10.1007/s10067-025-07433-9","DOIUrl":"https://doi.org/10.1007/s10067-025-07433-9","url":null,"abstract":"<p><strong>Background and aims: </strong>Despite advances in approaches to treatment for patients with systemic sclerosis (SSc), the effects have been modest at best. This investigator-initiated study aimed to evaluate the therapeutic benefit, safety and the genetic characteristics related to effect of baricitinib in SSc.</p><p><strong>Methods: </strong>In this 24-week study, eligible SSc patients were randomised to baricitinib 4 mg, 2 mg or control group. The primary outcome was the change in modified Rodnan skin score (mRSS) from baseline to week 12. Secondary outcomes included changes in the American College of Rheumatology Combined Response Index in Systemic Sclerosis (ACR-CRISS) score, forced vital capacity (FVC), Systemic Sclerosis Score, tender and swollen joint counts, digital ulcers, EQ5D (EuroQol five-dimensions) and safety at week 12 and 24. Transcriptome differences in blood samples from patients before and after baricitinib treatment were compared. Gene Ontology enrichment analysis was performed to identify potential biological functions and canonical pathways.</p><p><strong>Results: </strong>Between April 2021 to January 2022, 48 patients were randomly assigned to three groups. Mean change in mRSS score from baseline to week 12 was - 8.9 in 4 mg group, - 3.8 in 2 mg group, and - 3.6 in control group (P = 0.019). At week 12, the ACR-CRISS scores were 0.5 and 0.3 in baricitinib 4 mg and 2 mg group, as compared with 0.2 among those in control group (P = 0.171). FVC (%), digital ulcers and EQ5D in 4 mg baricitinib group showed favorable responses over 24 weeks. There were no significant differences in adverse events among groups. The differentially expressed genes (DEGs) identified in our analysis were significantly enriched in gene ontology (GO) terms related to the positive regulation of cytokine production, immune response-activating signaling pathway, and activation of immune response pathway. Interleukin- 1 Receptor Like 1 (IL- 1RL1 or ST2) and synaptotagmin- 17 (SYT17) were downregulated and upregulated respectively, after baricitinib treatment.</p><p><strong>Conclusions: </strong>The therapy with baricitinib 4 mg appeared to improve mRSS of SSc patients, probably by influencing mechanisms of immune inflammation, and had an acceptable safety profile. This study paves the way for further investigations into Janus kinase (JAK) 1/2 inhibition with baricitinib as a prospective treatment for SSc. Key Points • The baricitinib 4 mg seems to improve clinical outcomes of SSc patients with safety profiles. • The mechanism of JAK inhibitors has been confirmed to be related to anti-inflammatory pathways and molecules in clinical samples.</p>","PeriodicalId":10482,"journal":{"name":"Clinical Rheumatology","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144085904","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":"Identifying the genetic association between rheumatoid arthritis and the risk of infectious diseases.","authors":"Teng Wu, Yunan Wang, Yunfei Xia, Juan Ji, Xinyu Tao, Zhifeng Gu","doi":"10.1007/s10067-025-07485-x","DOIUrl":"https://doi.org/10.1007/s10067-025-07485-x","url":null,"abstract":"<p><strong>Background: </strong>Previous evidence suggests an association between rheumatoid arthritis (RA) and infectious diseases, but the causal relationship remains unclear. This study sought to explore causal associations between RA and five common infections: pneumonia, sepsis, urinary tract infections (UTI), skin and subcutaneous tissue infections (SSTI), and bacterial intestinal infections (BII).</p><p><strong>Methods: </strong>To identify the causal links, we adopted a Mendelian randomization (MR) design utilizing the inverse variance weighted (IVW), weighted median (WM), and MR-Egger approaches. Univariable MR (UVMR) and multivariable MR (MVMR) analyses were performed using pooled genome-wide association studies (GWAS) data. Additionally, various sensitivity analyses were conducted to ensure the reliability of the results.</p><p><strong>Results: </strong>In the UVMR analysis, RA was potentially associated with elevated risks of pneumonia (OR = 1.034, 95% CI: 1.016-1.052, P < 0.001) and sepsis (OR = 1.079, 95% CI: 1.048-1.110, P = 3.507E-07). This association remained significant after adjusting for smoking, alcohol consumption, or type 2 diabetes mellitus (T2DM) in the MVMR analysis. However, no causal links were found between RA and UTI, SSTI, and BII. Sensitivity analyses showed no detectable heterogeneity or pleiotropy, strengthening the causal inference of results.</p><p><strong>Conclusion: </strong>Our study provides strong evidence of the association between RA and increased risks of pneumonia and sepsis. Further research is required to validate these findings and elucidate the underlying mechanisms. Key Points • It remains unclear whether the increased susceptibility to infections in RA stems from a genetic predisposition or results from immunosuppressive treatments. • The MR method is employed to assess the relationship between RA and common infectious diseases. • Our MR study supports a potential causal relationship between RA and elevated risks of pneumonia and sepsis.</p>","PeriodicalId":10482,"journal":{"name":"Clinical Rheumatology","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144076626","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":"Prevalence of and risk factors for important comorbidities of systemic lupus erythematosus using data from a multicenter Chinese cohort registry: A cross-sectional study.","authors":"Minhui Wang, Jiaxin Zhou, Feng Zhan, Hui Luo, Xinwang Duan, Cheng Zhao, Zhenbiao Wu, Hongbin Li, Min Yang, Qin Li, Jian Xu, Can Huang, Jiuliang Zhao, Qian Wang, Xiaomei Leng, Xinping Tian, Yan Zhao, Xiaofeng Zeng, Heng Cao, Mengtao Li","doi":"10.1007/s10067-025-07476-y","DOIUrl":"https://doi.org/10.1007/s10067-025-07476-y","url":null,"abstract":"<p><strong>Objectives: </strong>Patients with systemic lupus erythematosus (SLE) are at high risk of cardiovascular disease (CVD), fragility fractures, and malignancies. However, data regarding these comorbidities among Chinese SLE patients are limited. We aimed to determine the prevalence of and risk factors for these three major comorbidities in a large cohort of Chinese SLE patients.</p><p><strong>Methods: </strong>In this cross-sectional study, demographic, clinical, and common comorbidity profiles were obtained from the medical records of SLE patients enrolled in the Chinese SLE Treatment and Research group (CSTAR) registry. Univariate and multivariate logistic regression analyses were performed to identify possible risk factors related to these comorbidities.</p><p><strong>Results: </strong>A total of 38,105 SLE patients were included (92.2% women). The median age at registration was 34.0 years (interquartile range, 27.0-46.0 years). The prevalence rates of the three important comorbidities at baseline were as follows: CVD, 1.9% (95% confidence interval [CI]: 1.8-2.0%); fragility fractures, 0.7% (95% CI: 0.6-0.8%); and malignancies, 0.7% (95% CI: 0.6-0.8%). In the multivariable-adjusted model, lupus anticoagulant, anticardiolipin antibody, anti-β2GP1 antibody, neuropsychiatric involvement, and hematological involvement were positively associated with CVD in SLE patients. Mucocutaneous manifestations, hyperimmunoglobulinemia, hypocomplementemia, anti-dsDNA, anti-Sm, and anti-nRNP/U1RNP antibody, and hydroxychloroquine therapy were negatively associated with CVD. The multivariate analysis revealed that age older than 50 years and hypocomplementemia were associated with fragility fractures and malignancies.</p><p><strong>Conclusion: </strong>CVD, fragility fractures, and malignancies commonly occur in SLE patients. Patients with traditional and SLE-related factors should be more carefully monitored for these important comorbidities. Key Points • SLE patients have an increased risk of cardiovascular disease, fragility fractures, and malignancy. However, data regarding these comorbidities among Chinese SLE patients are limited. • Several associated risk factors for these three comorbidities of SLE were identified.Characteristics, symptom severity, and QOL differ in different age groups. • Lupus patients with traditional and SLE-related factors should be more carefully monitored for the presence of these comorbidities.</p>","PeriodicalId":10482,"journal":{"name":"Clinical Rheumatology","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144076627","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":"https://doi.org/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":""},"PeriodicalIF":2.9,"publicationDate":"2025-05-16","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}

{"title":"The potential of semi-quantitative and quantitative methods in predicting progression in rheumatoid arthritis-associated interstitial lung disease.","authors":"Duygu Temiz Karadag, Sevtap Dogan, Ozgur Cakir, Yusuf Altıntas, Seyma Yilmaz, Neslihan Gökcen, Ayten Yazici, Ayse Cefle","doi":"10.1007/s10067-025-07443-7","DOIUrl":"https://doi.org/10.1007/s10067-025-07443-7","url":null,"abstract":"<p><strong>Introduction: </strong>Rheumatoid arthritis-associated interstitial lung disease (RA-ILD) presents with variable severity and progression, highlighting the need for effective tools to identify patients at risk. Although CT imaging plays a vital role in the management of RA-ILD, there is a lack of objective methods to predict disease progression. This study investigates the association between semi-quantitative and quantitative CT scoring methods and disease progression in early-stage RA-ILD.</p><p><strong>Methods: </strong>This observational study analyzed baseline and the first technically evaluable follow-up CT scans of patients who met the 2010 ACR/EULAR classification criteria for RA and were diagnosed with ILD. Only patients with ≤ 5 years between baseline and follow-up scans were included. Semi-quantitative assessments were conducted using the Goh and Warrick scoring systems, while quantitative analyses utilized Vitrea software to measure mean lung attenuation (MLA) and low-, medium-, and high-density lung volumes. Progression risk factors were evaluated using binary logistic regression, with progression defined by changes in CT parameters over time.</p><p><strong>Results: </strong>A total of 77 RA-ILD patients (45 females, 32 males) were included, with a median follow-up period of 20 months (interquartile range: 7.4-46 months). Disease progression was observed in 34 patients (44.2%). Baseline medium-density volume (MDV), follow-up mean lung attenuation (MLA), and low-density volume (LDV) differed significantly between the progression and non-progression groups (p < 0.05). Quantitative CT parameters demonstrated strong correlations with both the Goh and Warrick scoring systems. Binary logistic regression analysis identified the usual interstitial pneumonia (UIP) pattern on baseline imaging as the only independent predictor of disease progression (odds ratio: 3.1; 95% confidence interval: 1.1-12.4).</p><p><strong>Conclusion: </strong>In this study of early-stage RA-ILD patients, only the usual interstitial pneumonia (UIP) pattern on baseline HRCT independently predicted disease progression. Neither semi-quantitative scores nor quantitative CT parameters were predictive of progression. However, quantitative CT metrics demonstrated strong correlations with traditional scoring systems, supporting their utility in objectively assessing disease extent.</p>","PeriodicalId":10482,"journal":{"name":"Clinical Rheumatology","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144074996","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}