Clinical Rheumatology最新文献

{"title":"Discontinuation of belimumab in systemic lupus erythematosus patients who achieved disease stability: a retrospective cohort study.","authors":"Yanxia Ren, Tingting Yan, Chao Wang","doi":"10.1007/s10067-025-07571-0","DOIUrl":"10.1007/s10067-025-07571-0","url":null,"abstract":"<p><strong>Objectives: </strong>To investigate the changes in various indicators of systemic lupus erythematosus (SLE) patients who discontinue belimumab after achieving disease stability, assess the potential impacts and risks of discontinuing belimumab, and provide scientific evidence and references for clinical decision-making.</p><p><strong>Methods: </strong>Pertinent data were retrospectively collected from SLE patients at the Second Affiliated Hospital of Jiaxing University who either discontinued or continued belimumab treatment after achieving disease stability. The study compared changes in disease activity, glucocorticoid usage, immunological markers, and other relevant indicators between the two groups after 6 months of follow-up.</p><p><strong>Results: </strong>After 6 months of follow-up, patients in the experimental group exhibited increased Systemic Lupus Erythematosus Disease Activity Index-2000 (SLEDAI-2000) scores, enhanced activity of immunological markers, a greater proportion of patients requiring increased glucocorticoid doses, and experienced new-onset systemic involvement. Notably, only 20% of these patients achieved low disease activity state (LLDAS). In contrast, patients in the control group experienced decreased SLEDAI-2000 scores, improved immunological markers, and a greater proportion requiring a reduction in glucocorticoid dosage, with 76.67% achieving LLDAS. The differences between the two groups were statistically significant (P < 0.05). No statistically significant difference was observed between the two groups concerning hospital readmissions due to disease activity, new organ damage, or the incidence of adverse events.</p><p><strong>Conclusions: </strong>Discontinuing belimumab in patients with stable SLE may lead to higher glucocorticoid requirements, enhanced activity of immunological markers, increased disease activity, and new-onset systemic involvement. Research in this area is necessary and can provide certain reference and guidance for clinical decision-making. Key Points • The subsequent conditions of SLE patients who discontinue belimumab after achieving disease stability warrant attention. • Discontinuing belimumab may lead to higher glucocorticoid requirements, enhanced activity of immunological markers, increased disease activity, and new-onset systemic involvement. • These findings provide crucial decision-making references and may help reduce unnecessary discontinuations.</p>","PeriodicalId":10482,"journal":{"name":"Clinical Rheumatology","volume":" ","pages":"3539-3547"},"PeriodicalIF":2.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144682161","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":"Subtyping depression in the rheumatic diseases by cluster analysis.","authors":"Yaqi Zhao, Suyan Yan, Xinya Li, Wei Xu, Baocheng Liu, Zhenzhen Ma, Qingrui Yang","doi":"10.1007/s10067-025-07586-7","DOIUrl":"10.1007/s10067-025-07586-7","url":null,"abstract":"<p><strong>Objective: </strong>Major depressive disorder (MDD) and rheumatic diseases (RD) interact to exacerbate disease outcomes. The purpose of this study was to assess the prevalence and associated factors of depression in RD patients in order to identify independent predictors of mental health disorders risk and apply cluster analysis to identify homogeneous groups in a population of approximately 47 patients with RD-MDD to achieve precise treatment and early prevention of complications.</p><p><strong>Methods: </strong>In total, 205 RD patients were included in this study. We used the Profile of Mood State (POMS) and Patient Health Questionnaire-9 (PHQ-9) to assess the patients' state of mind. A cluster analysis was applied according to six clinical and serological variables to define different subgroups of patients.</p><p><strong>Results: </strong>The rate of depression in RD patients in our study was 22.9%. Sex (female), disease duration, and disease activity are risk factors for the development of depression. Albumin is a protective factor for MDD. RD-MDD patients were clustered in two groups. Cluster 1 (n = 30, 63.8%): patients were of older age, lower education and income levels, low disease activity, and mild depressive symptoms. Cluster 2 (n = 17, 36.2%): Young women with higher education and income levels, high disease activity, and more severe depressive symptoms.</p><p><strong>Conclusion: </strong>Our findings provide evidence indicating that RD-MDD presents varying clinical phenotypes and the treatment varies accordingly, suggesting the need for individualized treatment. Key Points • Depression is often comorbid in patients with rheumatic diseases. The two interact and aggravate the patient's condition. • The rate of depression in RD patients in our study was 22.9%. Sex (female), disease duration, and disease activity are risk factors for the development of depression. Albumin is a protective factor for MDD. • RD-MDD patients were clustered in two groups through cluster analysis in order to guide individualized treatment.</p>","PeriodicalId":10482,"journal":{"name":"Clinical Rheumatology","volume":" ","pages":"3743-3751"},"PeriodicalIF":2.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144682162","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":"Relationship between serum vitamin D levels and pro-inflammatory cytokines in patients with rheumatoid arthritis combined with cardiovascular disease.","authors":"Xuwen Zha, Menghuan Liu, Shengting Ruan, Ying Jiang, Shan Wang","doi":"10.1007/s10067-025-07587-6","DOIUrl":"10.1007/s10067-025-07587-6","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;Rheumatoid arthritis (RA) is a chronic autoimmune disorder characterized by joint inflammation and a markedly elevated risk of cardiovascular disease (CVD), which contributes to increased morbidity and mortality rates. Vitamin D deficiency and systemic inflammation have been increasingly identified as significant factors in the heightened prevalence of CVD among RA patients. However, the association between serum vitamin D levels and pro-inflammatory cytokines in RA patients with concurrent CVD remains inadequately understood.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;In this study, 50 healthy controls (HC group), 50 patients with RA (RA group), and 78 patients with RA comorbid CVD (RA + CVD group) were recruited. Four pro-inflammatory cytokines, including IL-1β, IL-6, IFN-γ, and TNF-α, were quantified. A comparative analysis was conducted to evaluate demographic characteristics, Disease Activity Score 28 (DAS-28) scores, Atherogenic Index of Plasma (AIP) index, and serum pro-inflammatory cytokine levels among the HC, RA, and RA + CVD groups. Then, participants in the RA + CVD group were divided into two groups based on their initial vitamin D levels: the vitamin D deficiency group (&lt; 20 µg/L) and the non-deficiency group (≥ 20 µg/L). A comparative analysis was conducted to evaluate demographic characteristics, DAS-28 scores, AIP index, and serum pro-inflammatory cytokine levels between the two groups. The relationship between vitamin D levels and DAS-28 scores, AIP index, and serum pro-inflammatory cytokines in patients with RA combined with CVD was assessed using Spearman's correlation analysis.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The RA + CVD group exhibited significantly lower serum vitamin D levels alongside significantly elevated AIP index and pro-inflammatory cytokine levels (IL-1β, IL-6, IFN-γ, and TNF-α) compared to the HC group (P &lt; 0.05). The RA + CVD group had significantly higher AIP index and lower serum vitamin D levels than the RA group (P &lt; 0.05). Moreover, in patients with RA comorbid CVD, the DAS-28 scores and AIP index were significantly elevated in the vitamin D deficiency group compared to the non-deficient group (P &lt; 0.05). The serum levels of IL-1β, IL-6, IFN-γ, and TNF-α were significantly higher in the vitamin D deficiency group (P &lt; 0.05). Furthermore, a positive correlation was observed between DAS-28 scores and AIP index in patients with RA combined with CVD (r = 0.295, P = 0.009). Additionally, serum vitamin D levels were negatively correlated with DAS-28 scores (r =  - 0.385, P = 0.001), AIP index (r =  - 0.387, P &lt; 0.001), and serum concentrations of IL-1β (r =  - 0.227, P = 0.046), IL-6 (r =  - 0.458, P &lt; 0.001), IFN-γ (r =  - 0.342, P = 0.002), and TNF-α (r =  - 0.392, P &lt; 0.001) in this patient population.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;These findings demonstrate a significant association between vitamin D deficiency and heightened systemic inflammation, disease activity, and atherogenic ris","PeriodicalId":10482,"journal":{"name":"Clinical Rheumatology","volume":" ","pages":"3467-3475"},"PeriodicalIF":2.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144728453","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":"Rituximab in the COVID-19 era: The impact of albumin and IgG on patients with immune-mediated inflammatory diseases.","authors":"Pei-Hsinq Lai, Cheng-Hsun Lu, Chiao-Feng Cheng, Ting-Wei Chang, Ting-Yuan Lan, Song-Chou Hsieh","doi":"10.1007/s10067-025-07598-3","DOIUrl":"10.1007/s10067-025-07598-3","url":null,"abstract":"<p><strong>Objective: </strong>To identify factors associated with COVID-19 outcomes in patients with immune-mediated inflammatory diseases (IMID) treated with rituximab (RTX) and determine candidates for RTX administration/maintenance.</p><p><strong>Methods: </strong>We conducted a case-control study of RTX-treated IMID patients with COVID-19 (May 2021-April 2023), including 32 hospitalized cases and 64 non-hospitalized controls matched by age, sex, IMID diagnosis. Logistic regression was used to analyze pre-COVID biochemical markers within 3-months and RTX-specific factors. Secondary outcomes in hospitalized cases included COVID-19 severity, viral shedding, and all-cause mortality.</p><p><strong>Results: </strong>Higher RTX exposure was associated with reduced glucocorticoid dependence and higher pre-COVID albumin levels while correlated with lower IgG levels. However, lower pre-COVID albumin (OR: 0.231, p = 0.012) and higher maintenance glucocorticoid use (OR: 1.170, p = 0.007) were independently associated with hospitalization, regardless of IgG levels or RTX exposure. Among hospitalized cases, lower admission albumin (albumin_D₀; OR: 0.029, p = 0.014) predicted severe COVID-19. Patients with albumin_D₀ < 3.45 g/dL had higher mortality, regardless of IgG_D₀ or RTX timing, and experienced prolonged viral shedding despite antiviral mono-therapy. Albumin_D₀ ≥ 3.45 g/dL and IgG_D₀ ≥ 687 mg/dL were associated with the lowest mortality risk. Timing of the last RTX dose did not influence secondary outcomes.</p><p><strong>Conclusion: </strong>Pre-COVID albumin and glucocorticoid dependence are independently associated with hospitalization regardless of RTX-specific factors. Admission albumin predicts secondary outcomes. Risk of rituximab on COVID-19 outcomes is not universal. Albumin ≥ 3.45 g/dL and IgG ≥ 687 mg/dL identify lower-risk patients, providing guidance for safer RTX administration. Key Points • Risk of rituximab on COVID-19 outcomes in immune-mediated inflammatory diseases is not universal. Serum albumin and IgG levels are critical to determine the COVID-19 outcomes. • Patients with serum albumin ≥ 3.45 g/dL and IgG ≥ 687 mg/dL demonstrate a lower risk associated with rituximab, providing guidance for its safer administration in the post-COVID-19 era amidst potential challenges from emerging infections. • Serum albumin serves as a significant prognostic marker for COVID-19 outcomes in patients receiving rituximab treatment. • The timing of the most recent rituximab infusion does not affect COVID-19 outcomes in these patients.</p>","PeriodicalId":10482,"journal":{"name":"Clinical Rheumatology","volume":" ","pages":"3753-3764"},"PeriodicalIF":2.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144759360","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical presentation of children with lupus nephritis from a low- and middle-income country (LMIC): an initial report from the Indian pSLE Nephritis Registry.","authors":"Sanjukta Poddar, Deblina Dasgupta, Subal Pradhan, Sangeetha Perungo, Mahesh Janarthanan, Kinnari Vala, Priya Pais, Susan Uthup, Jyoti Singhal, Suparna Guha, Sumantra Raut, Shakil Akhtar, Jigna Bathia, Suma Balan, Priyankar Pal, Rajiv Sinha","doi":"10.1007/s10067-025-07576-9","DOIUrl":"10.1007/s10067-025-07576-9","url":null,"abstract":"<p><strong>Introduction: </strong>Limited prospective data exist on pediatric LN (pLN) from low- and middle-income countries (LMIC), where ethnicity, socioeconomic factors, and healthcare access are likely to differ from high-income countries.</p><p><strong>Methods: </strong>The Indian Pediatric Lupus Nephritis registry has been running since 2020 across multiple centers in India. Children (≤ 18 years) diagnosed with lupus (as per 2012 SLICC criteria), presenting with nephritis, and confirmed by kidney biopsy are being prospectively enrolled. Clinical data, laboratory investigations, kidney biopsy results, and treatment responses have been documented prospectively. The current report documents their initial presentation.</p><p><strong>Results: </strong>A total of 154 children (75% female, median age 12 years-IQR 10-14 years) with biopsy-proven LN were enrolled by July 2024. Nearly two-thirds had LN at SLE diagnosis, and the rest developed within a maximum of 5 years of initial presentation. Common manifestations at presentation included edema (75%), hypertension (54%), and proteinuria (98%), of which 68% presented with nephrotic-range proteinuria. Acute kidney injury (AKI) was observed in 43%, with 20% in stage 3. Ninety-four percent of our cohort had low complements (C3, C4, or both), and 96% were ANA-positive. Class IV LN was the most common (45%) histopathological type and had significantly lower estimated glomerular filtration rate in comparison to Class V LN.</p><p><strong>Conclusion: </strong>Kidneys are often involved in the initial presentation of childhood lupus, and the majority have proliferative nephropathy leading to AKI, hypertension, and significant proteinuria. Children enrolled in the registry are under active follow-up to assess the renal responses which will help optimize the management of pLN in LMICs. Key Points •It is a well-known fact that kidney involvement is more common in pediatric lupus and is among one of the most important long-term prognostic factors. •There is scarcity of data on pediatric lupus nephritis (pLN) particularly from low- and middle-income countries (LMIC), and even among them, the majority of the studies are retrospective and limited by a small cohort size. •Through this prospective registry from a LMIC, we demonstrated that 2/3rd of children with lupus have kidney involvement at presentation and almost all (90%) develop LN within 2 years of the diagnosis of lupus. •Acute kidney injury (AKI) is known to increase mortality/morbidity risks independently. Many of the previous studies have under-reported AKI in pLN, probably because the data was collected retrospectively. On the other hand, we found AKI to be very common and to be present in about half of the cases at presentation.</p>","PeriodicalId":10482,"journal":{"name":"Clinical Rheumatology","volume":" ","pages":"3679-3686"},"PeriodicalIF":2.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144642013","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 impact of aging and glucocorticoid use on physical function of older rheumatoid arthritis in remission: analysis of a National Database of Rheumatic Disease in Japan.","authors":"Yoji Komiya, Takahiko Sugihara, Tatsuro Ishizaki, Naoki Kimura, Mari Kamiya, Fumio Hirano, Takumi Matsumoto, Hirokazu Sasaki, Tadashi Hosoya, Shigeto Tohma, Shinsuke Yasuda, Toshihiro Matsui","doi":"10.1007/s10067-025-07599-2","DOIUrl":"10.1007/s10067-025-07599-2","url":null,"abstract":"<p><strong>Objective: </strong>To investigate clinical features and physical function in rheumatoid arthritis (RA) in remission with and without glucocorticoid (GC).</p><p><strong>Methods: </strong>Data from 2078 RA patients aged 55-84 years in remission (simplified disease activity index (SDAI) ≤ 3.3) and at stage I/II according to the Steinbrocker classification were extracted from the National Database of Rheumatic Diseases in Japan (NinJa) which includes 11,036 patients from 2017 to 2018 before the coronavirus pandemic. Patients were stratified into six groups: RA aged 55-64, aged 65-74, and aged 75-84 with or without GCs. The primary outcome was the health assessment questionnaire disability index (HAQ-DI) > 0.5, and interactions of age and GC use on the HAQ-DI > 0.5 were examined by multivariable logistic regression.</p><p><strong>Results: </strong>GC use in patients in remission increased with age. Methotrexate and biological disease-modifying antirheumatic drug prescriptions were similar in patients aged 75-84 with and without GC. Significantly more GC users aged 75-84, but not aged 65-74 and 55-64, had a HAQ-DI > 0.5 than GC non-users (23.9% vs. 14.8%, P = 0.015). An interaction between age and GC use for HAQ-DI > 0.5 was observed, and the adjusted odds ratios (ORs) relative to GC non-users aged 55-64 for HAQ-DI > 0.5 increased to 4.72 (95% CI 2.49-8.96, P < 0.001) for GC non-users aged 75-84 and 7.62 (95% CI 3.70-15.7, P < 0.001) for GC users aged 75-84.</p><p><strong>Conclusions: </strong>Decline in physical function among GC users was observed in patients aged 75-84, and increasing age and GCs were mutually associated with physical dysfunction of patients in remission. Key Points • The proportion of patients who were in remission but still using glucocorticoids increased with age. • Proportions of patients in remission with HAQ-DI > 0.5 were significantly higher in the patients aged 75-84 with GCs than those without GCs but not in the patients aged 55-64 and 65-74. • Glucocorticoid use for patients in remission was more strongly associated with impaired physical function in patients aged 75-84 than in patients aged 55-74 years.</p>","PeriodicalId":10482,"journal":{"name":"Clinical Rheumatology","volume":" ","pages":"3477-3486"},"PeriodicalIF":2.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144752619","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":"Treatment effectiveness of hydroxychloroquine in patients with primary Sjögren's syndrome: a real-world Study.","authors":"Kexin Zhu, Xueyi Zhang, Guangcai Chen, Ying Zhu, Kai Wang, Qing Zhang, Ziyi Jin, Qing Shu, Xiaojun Tang, Hongwei Chen, Dandan Wang, Wei Shen, Lingyun Sun","doi":"10.1007/s10067-025-07583-w","DOIUrl":"10.1007/s10067-025-07583-w","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to evaluate the effectiveness of hydroxychloroquine (HCQ) in reducing disease activity and explore its optimal dosing and combination therapies in patients with primary Sjögren's syndrome (pSS).</p><p><strong>Methods: </strong>We conducted a retrospective study of 1089 hospitalized pSS patients. Multivariable logistic regression was used to estimate adjusted odds ratios (ORs) with 95% confidence intervals (CIs). Propensity score matching (PSM) was performed to assess robustness.</p><p><strong>Results: </strong>Compared to non-users, patients receiving HCQ at daily doses of 300 mg (OR = 2.50, 95% CI 1.08-5.77), 400 mg (OR = 1.66, 95% CI 1.21-2.27), or > 5 mg/kg (OR = 1.71, 95% CI 1.25-2.34) showed higher response rates. Subgroup analyses suggested greater HCQ effectiveness in patients aged ≤ 50 years, without hypertension or diabetes, with SSA/RF seropositivity, no prior HCQ exposure, baseline ESSDAI scores of 5-13, concomitant glucocorticoids (GCs) use (> 20 mg/day), normal C3 level, or low C4 levels. The combination of GCs, cyclosporin A, and HCQ demonstrated a numerically higher response rate than GCs plus cyclosporin A alone (OR = 3.73, 95% CI 1.19-11.72). HCQ was associated with improved outcomes in thrombocytopenia (OR = 1.81, 95% CI 1.01-3.25), hypoalbuminemia (OR = 1.72, 95% CI 1.24-2.38), and elevated erythrocyte sedimentation rate (ESR) (OR = 2.25, 95% CI 1.42-3.58).</p><p><strong>Conclusion: </strong>HCQ at daily doses of 300 mg, 400 mg, or > 5 mg/kg may reduce disease activity in pSS patients, particularly in specific subgroups. The combination of GCs, cyclosporin A, and HCQ warrants further investigation as a potential therapeutic strategy. HCQ might also benefit patients with thrombocytopenia, hypoalbuminemia, or elevated ESR. Key Points • A daily HCQ dosage of 300 mg, 400 mg or >5 mg/kg effectively reduced disease activity in pSS patients. • HCQ demonstrated therapeutic efficacy in specific pSS patient subgroups. • Glucocorticoids, cyclosporin A and HCQ may be a promising drug combination.</p>","PeriodicalId":10482,"journal":{"name":"Clinical Rheumatology","volume":" ","pages":"3591-3603"},"PeriodicalIF":2.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144768515","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":"Effects of telerehabilitation and YouTube platform-based exercise videos in patients with axial spondyloarthritis: a randomized controlled study.","authors":"Songul Baglan Yentur, Irem Sıla Boyrazlı, Muhammed Sahin Elbastı, Suleyman Serdar Koca","doi":"10.1007/s10067-025-07591-w","DOIUrl":"10.1007/s10067-025-07591-w","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Introduction: &lt;/strong&gt;Exercise is an important part of the treatment for axial spondyloarthritis (axSpA). Telerehabilitation (TR) may be a good alternative for the patient group who cannot access face-to-face exercise. In addition, with the developing technology, social media platforms are used in rehabilitation. The aim of this study was to compare the effects of TR and YouTube®-based exercises on disease activity, function, mobility, quality of life, and posture in patients with AS.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;The study included 44 patients with axSpA. The patients were randomly divided into two groups. The first group practised TR via video conferencing, while the other group was recommended high-quality videos on YouTube® according to the Global Quality Scoring for 8 weeks. Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), Bath Ankylosing Spondylitis Function Index (BASFI), Bath Ankylosing Spondylitis Metrology Index (BASMI), Ankylosing Spondylitis Quality of Life, and PostureScreen application were used to evaluate disease activity, function, mobility, quality of life, and posture, respectively.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The study was completed with 39 axSpA patients. There was no significant difference between TR and YouTube® groups in evaluation parameters (p &gt; 0.05). A significant difference was obtained in head tilt forward (p = 0.03), but no significant difference was obtained in other parameters (p &gt; 0.05) between groups after treatment. In addition, significant differences were concluded in disease activity (p = 0.003), function (p = 0.029), and mobility (p = 0.001) at comparison of before and after treatment in TR group, while no significant difference was found in the YouTube®-based exercise group (p &gt; 0.05). A significant difference was obtained in the TR group in head tilt forward (p = 0.009) and shoulder angle right side (p = 0.028) in the lateral posture analysis before and after treatment.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;It was concluded that TR was effective on disease activity, mobility, and function in patients with axSpA. TR and YouTube® exercises can be safely applied in patients with axSpA. Studies comparing face-to-face and supervised exercises with TR applications are needed.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Trial registration: &lt;/strong&gt;The trial registration number is NCT06392620, date of registration (2024/03-08). Key Points • Telerehabilitation (TR) significantly improved disease activity, function, and mobility in patients with axial Spondyloarthritis (axSpA), demonstrating its effectiveness as a remote therapeutic option.. • YouTube®-based exercise videos showed some improvement in patients with axSpA, but the results were not statistically significant, highlighting the importance of supervised guidance for optimal outcomes. • The study provides evidence that TR is a safe and feasible alternative for axSpA patients who cannot access face-to-face rehabilitation, with high adherence rates and no comp","PeriodicalId":10482,"journal":{"name":"Clinical Rheumatology","volume":" ","pages":"3561-3571"},"PeriodicalIF":2.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144728452","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":"IgG4-related disease presenting as hypertrophic pachymeningitis.","authors":"Francesco Gavioli, Anna Capogna, Riccardo Terribili, Claudia Fabiani, Edoardo Conticini, Luca Cantarini, Bruno Frediani","doi":"10.1007/s10067-025-07585-8","DOIUrl":"10.1007/s10067-025-07585-8","url":null,"abstract":"","PeriodicalId":10482,"journal":{"name":"Clinical Rheumatology","volume":" ","pages":"3773-3774"},"PeriodicalIF":2.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144636452","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":"Utilization of disease activity scores and acute phase reactants in predicting colchicine response assessed by FMF50: a retrospective cohort study in children with Familial Mediterranean Fever.","authors":"Eda Nur Dizman, Feray Kaya, Elif Kucuk, Lutfiye Koru, Zelal Aydin, Hatice Kubra Dursun, Merve Ozen Balci, Fatih Haslak, Kubra Ozturk","doi":"10.1007/s10067-025-07567-w","DOIUrl":"10.1007/s10067-025-07567-w","url":null,"abstract":"<p><strong>Objectives: </strong>Monitoring disease activity in Familial Mediterranean Fever (FMF) patients might be challenging, mainly due to accompanying inflammatory conditions. This study assessed disease activity and colchicine response in children with FMF, using Auto-Inflammatory Diseases Activity Index (AIDAI), Pras, Mor, International Severity Score for FMF (ISSF), and FMF50 scores, and examined their acute phase reactant (APR) predictive value for FMF50 response.</p><p><strong>Methods: </strong>FMF patients meeting Eurofever/PRINTO criteria and receiving colchicine for ≥ 6 months were included. Patients without exon 10 mutations and with poor adherence were excluded. Disease activity was assessed using AIDAI, Pras, Mor, and ISSF scores, while FMF50 evaluated treatment response. Concordance among activity scores was analyzed using Cohen's and Fleiss's Kappa. Patients were grouped as FMF50 responders or non-responders. Logistic regression identified FMF50 response predictors.</p><p><strong>Results: </strong>A total of 117 pediatric FMF patients (44.4% female) were included. ISSF, AIDAI, and Pras scores were significantly higher in non-responders compared to responders (p < 0.001). Elevated CRP (OR 1.035, 95% CI 1.002-1.070, p < 0.05), ISSF (OR 1.703, 95% CI 1.135-2.557, p < 0.05), and AIDAI scores (OR 1.253, 95% CI 1.053-1.491, p < 0.05) at 3 months predicted FMF50 non-response at 6 months. Multivariate analysis identified high ISSF (OR 1.745, 95% CI 1.129-2.698, p < 0.05) and AIDAI scores (OR 1.265, 95% CI 1.056-1.514, p < 0.05) as independent predictors. APRs were correlated with ISSF, Pras, and AIDAI scores. Kappa analyses revealed poor agreement among activity scores (Kappa values 0.157 to - 0.048).</p><p><strong>Conclusion: </strong>ISSF, AIDAI scores, and CRP can predict FMF50 response three months in advance and recommend earlier evaluation of further therapies in non-responders. Key Points • This study is the only investigation in the literature that evaluates all disease activity scores and examines the correlations between these scores and APRs. • As the second study to utilize the FMF50 score in assessing colchicine response, it contributes significantly to the literature with a larger patient cohort. • Elevated CRP values, along with high ISSF and AIDAI scores at the third month, play a critical role in predicting the FMF50 response at the sixth month, indicating the necessity for early evaluation of advanced treatment options.</p>","PeriodicalId":10482,"journal":{"name":"Clinical Rheumatology","volume":" ","pages":"3667-3677"},"PeriodicalIF":2.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144636453","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}