Current Rheumatology Reports最新文献

{"title":"Autoinflammatory Syndromes of Hidradenitis Suppurativa: Updates in Clinical Features, Emerging Associations, and Management.","authors":"Jade Y Ho, Andrew L Liang, Carlo Alberto Maronese, Angelo Valerio Marzano, John M Davis, Vincent Piguet, Afsaneh Alavi","doi":"10.1007/s11926-026-01232-0","DOIUrl":"https://doi.org/10.1007/s11926-026-01232-0","url":null,"abstract":"<p><strong>Purpose of review: </strong>To summarize and critically evaluate recent literature on autoinflammatory syndromes of hidradenitis suppurativa (HS).</p><p><strong>Recent findings: </strong>HS-associated autoinflammatory syndromes traditionally encompass pyoderma gangrenosum (PG), acne, and HS (PASH); pyogenic arthritis, PG, acne, and HS (PAPASH); psoriatic arthritis, PG acne, and HS (PsAPASH); and PG, acne, HS and ankylosing spondylitis (PASS). However, this spectrum continues to expand, with recent literature considering the inclusion of additional autoinflammatory diseases such as HS associated with SAPHO, including synovitis, acne, pustulosis, hyperostosis, and osteitis (SAPHO); and Hyperimmunoglobulin D Syndrome (HIDS). HS-associated autoinflammatory syndromes are thought to be driven by dysregulation of the innate immune system and the subsequent overexpression of key inflammatory cytokines such as IL-1, and targeted IL-1 therapies have demonstrated particularly brisk and efficacious response. Multiple genes related to follicular keratinization or inflammatory regulation have been implicated, and sequencing methods such as whole-exome sequencing and variant enrichment analysis continue to identify novel genetic variants and are being used to further elucidate genotype-phenotype correlations. HS-associated autoinflammatory syndromes are an evolving spectrum of rare, severe, diseases in which HS coexists with other autoinflammatory conditions, most commonly PASH and related syndromes. They are driven by innate immune dysregulation and pathogenic genetic variants, with whole-exome sequencing aiding diagnosis and genotype-phenotype correlation. Management is often challenging and highly individualized, with targeted biologic therapies such as IL-1 inhibitors showing the most consistent and rapid clinical benefit.</p>","PeriodicalId":10761,"journal":{"name":"Current Rheumatology Reports","volume":"28 1","pages":""},"PeriodicalIF":4.9,"publicationDate":"2026-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148764571","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bone Health in Rheumatoid Arthritis: An Update.","authors":"Faidra Laskou, Elaine Dennison","doi":"10.1007/s11926-026-01230-2","DOIUrl":"10.1007/s11926-026-01230-2","url":null,"abstract":"<p><strong>Purpose of review: </strong>Rheumatoid arthritis (RA) affects approximately 1% of the global population and is the most common inflammatory arthritis in adults. RA is well established as a significant risk factor for secondary osteoporosis (OP). Bone loss in RA occurs at three anatomically distinct levels: periarticular osteopenia, marginal erosions at the joint periphery, and generalised systemic OP. Understanding the complex mechanism underlying osteoclast-mediated bone loss in RA is essential for the development of targeted interventions, while identification of individuals at risk of OP and fracture remains paramount. This review will highlight recent advances in these areas.</p><p><strong>Recent findings: </strong>The cornerstone of bone loss management and prevention in RA remains disease activity control and reduction of inflammation. In this review, we will discuss the most recent advances in understanding the mechanism of bone loss in RA, the skeletal effects of current RA and anti-OP therapies in the RA population. We also highlight areas where future research may be focused to inform best management of bone health in these patients. RA associated bone loss remains a substantial contributor to morbidity, highlighting the need for improved fracture risk stratification, optimisation of therapeutic approaches, and greater standardisation of monitoring strategies. Critical evidence gaps persist, including the absence of validated RA specific fracture risk thresholds to guide treatment decisions and the lack of prospective randomised trials comparing bone protective agents in RA associated osteoporosis. Data in men with RA remain limited, and further work is required to delineate the relative skeletal effects of biologic therapies. Additionally, optimal DXA monitoring intervals for patients with stable disease on DMARD therapy are not well defined, contributing to considerable variation in clinical practice. Addressing these unmet needs will be essential to advancing bone health management and reducing fracture burden in individuals with RA.</p>","PeriodicalId":10761,"journal":{"name":"Current Rheumatology Reports","volume":"28 1","pages":""},"PeriodicalIF":4.9,"publicationDate":"2026-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13461950/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148711486","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sexual Dysfunction in Women with Axial Spondyloarthritis: A Narrative Review Integrating Quantitative Evidence.","authors":"Gabriela Stutz F Moreira, Hemerli de Cinque Almeida Esteves, Lucas M Barbosa, Lucas A S Alencar, Lara Guedes, Maryah C Stutz Martins, Victoria Navarro-Compán","doi":"10.1007/s11926-026-01231-1","DOIUrl":"https://doi.org/10.1007/s11926-026-01231-1","url":null,"abstract":"<p><strong>Purpose of review: </strong>Sexual dysfunction is an underrecognized but clinically relevant manifestation in women with axial spondyloarthritis (axSpA), with significant implications for quality of life. This review aims to provide a comprehensive synthesis of the biological, clinical, and psychosocial mechanisms underlying sexual dysfunction in axSpA, integrating available literature with supportive quantitative evidence.</p><p><strong>Recent findings: </strong>Emerging evidence demonstrates that sexual dysfunction in axSpA is common and multifactorial. Chronic inflammation may contribute to endothelial dysfunction, neuroendocrine alterations, and fatigue, which may indirectly affect physiological components of sexual response. Clinical factors such as pain, functional limitation, and reduced mobility further compromise sexual activity, while psychological burden; including depression, anxiety, and body image disturbance; plays a critical mediating role. Structural changes, including genital atrophy associated with disease duration, may also contribute to persistent dysfunction. Quantitative data from a meta-analysis involving 547 women suggest that there may be lower Female Sexual Function Index scores in patients with axSpA compared to healthy controls, despite the low-to-moderate certainty of evidence. This seems particularly evident in areas such as arousal, lubrication, orgasm, pain, and desire. Sexual dysfunction in women with axSpA appears to involve a complex interplay between inflammatory, physical, psychological, and structural factors. A multidisciplinary approach might be beneficial for improving patient outcomes, and systematic assessment of sexual health should be considered into routine care.</p>","PeriodicalId":10761,"journal":{"name":"Current Rheumatology Reports","volume":"28 1","pages":""},"PeriodicalIF":4.9,"publicationDate":"2026-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148705769","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Adipose-Joint Crosstalk in Obesity-Induced Osteoarthritis: Mechanisms, Biomarkers, and Translational Therapeutic Opportunities.","authors":"Wei Hang, Kathy Triantafilou, You Zhou","doi":"10.1007/s11926-026-01229-9","DOIUrl":"10.1007/s11926-026-01229-9","url":null,"abstract":"<p><strong>Purpose of review: </strong>Obesity-induced osteoarthritis (OA) is emerging as a distinct metabolic phenotype fundamentally different from mechanically driven OA. Current therapies largely target downstream joint damage and fail to address underlying adipose-joint pathological interactions. This review synthesises recent advances in understanding how systemic metabolic dysfunction, adipose tissue inflammation, and cellular heterogeneity revealed by single-cell analyses drive OA pathogenesis, and highlights emerging strategies targeting metabolic dysfunction and chronic inflammation.</p><p><strong>Recent findings: </strong>We critically summarised human and experimental studies investigating the role of dysfunctional adipose depots, including visceral, subcutaneous, and infrapatellar fat, in joint degeneration. Mechanistic findings on adipokine signalling, immune activation, and metabolic stress were integrated with recent single-cell insights and therapeutic interventions addressing systemic metabolism and inflammation. Obesity promotes adipose tissue hypertrophy, hypoxia, and inflammatory adipokine secretion, which remodel systemic metabolism and alter the function of joint-resident cells. Crosstalk between adipocytes, macrophages, fibroblasts, and chondrocytes sustains chronic low-grade inflammation, oxidative stress, and extracellular matrix degradation. Single-cell analyses have revealed fibroblast and macrophage subsets that mediate depot-specific inflammatory circuits. Recent findings also point to metabolic modulators (GLP-1 receptor agonists), anti-adipokine agents, and regenerative strategies as promising interventions to modify disease progression. Obesity-induced OA arises from multi-level metabolic and inflammatory crosstalk between adipose and joint tissues. Deciphering adipose-joint crosstalk provides a foundation for precision therapies that address the upstream metabolic and inflammatory drivers of joint degeneration.</p>","PeriodicalId":10761,"journal":{"name":"Current Rheumatology Reports","volume":"28 1","pages":""},"PeriodicalIF":4.9,"publicationDate":"2026-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13452861/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148697143","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Type I Interferonopathies: Fifteen Years On, From Concept to Therapeutic Perspectives.","authors":"Dilara Ünal, Isabelle Melki, Marie-Louise Frémond","doi":"10.1007/s11926-026-01228-w","DOIUrl":"https://doi.org/10.1007/s11926-026-01228-w","url":null,"abstract":"<p><strong>Purpose of review: </strong>Fifteen years after the initial description of type I interferonopathies, this review aims to provide an updated overview of the field by integrating recent genetic and mechanistic advances. It also seeks to outline practical diagnostic approaches and highlight current and emerging targeted therapeutic strategies.</p><p><strong>Recent findings: </strong>Type I interferonopathies are a group of monogenic autoinflammatory diseases caused by inappropriate activation of type I interferon signaling. Multiple pathogenic mechanisms have been identified, including abnormalities in nucleic acid metabolism or sensing, constitutive activation of innate immune pathways, proteasome dysfunction, endosomal Toll-like receptor hyperactivation, and impaired negative regulation of IFNAR signaling. These mechanisms result in overlapping neuroinflammatory, cutaneous, and systemic manifestations, with variable severity and often significant morbidity and mortality. Advances in the understanding of the molecular basis of type I interferonopathies have refined their classification and improved diagnostic strategies. These insights are paving the way for more precise, mechanism-based treatments, offering promising perspectives for patient management despite the persistent severity of these disorders.</p>","PeriodicalId":10761,"journal":{"name":"Current Rheumatology Reports","volume":"28 1","pages":""},"PeriodicalIF":4.9,"publicationDate":"2026-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148387436","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intensive Care Management of ANCA-associated Vasculitides: a Narrative Review.","authors":"Elisa Bazin, Lucas Morand, Nihal Martis","doi":"10.1007/s11926-026-01227-x","DOIUrl":"https://doi.org/10.1007/s11926-026-01227-x","url":null,"abstract":"<p><strong>Purpose of review: </strong>Anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitides, particularly granulomatosis with polyangiitis and microscopic polyangiitis, are rare but severe systemic diseases frequently requiring intensive care unit (ICU) admission due to life-threatening renal and pulmonary involvement. Despite advances in immunosuppressive therapy, these patients remain at high risk of mortality and end-stage kidney disease, with prognosis driven by organ failure (notably diffuse alveolar haemorrhage [DAH]) and treatment-related complications such as infection. ICU management is complex and relies on rapid diagnosis, aggressive induction therapy, and tailored organ support.</p><p><strong>Recent findings: </strong>Current remission-induction strategies centre on high-dose glucocorticoids combined with cyclophosphamide or rituximab, with growing emphasis on minimizing steroid exposure. Plasma exchange (PLEX), once widely used for severe renal disease and DAH, remains debated, although selected high-risk subgroups may still derive benefit. Optimal management in the ICU requires a multidisciplinary approach, including careful selection of immunosuppressive regimens, individualized use of adjunctive therapies such as PLEX and the management of infectious complications. Advances in supportive care, including lung-protective ventilation, renal replacement therapy, and extracorporeal support, have improved short-term outcomes. However, significant uncertainty persists regarding optimal therapeutic strategies in the critically ill populations, highlighting the need for further research and phenotype-driven approaches.</p>","PeriodicalId":10761,"journal":{"name":"Current Rheumatology Reports","volume":"28 1","pages":""},"PeriodicalIF":4.9,"publicationDate":"2026-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148338135","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Role of Musculoskeletal Ultrasound in Psoriatic Arthritis: From Preclinical Detection to Treatment Monitoring.","authors":"Emilio D'Ignazio, Didem Sahin, Caterina Baldi, Paul Emery, Dennis McGonagle, Richard Wakefield, Helena Marzo-Ortega, Alen Zabotti, Emilio Filippucci, Katya Meridor, Andrea Di Matteo","doi":"10.1007/s11926-026-01225-z","DOIUrl":"10.1007/s11926-026-01225-z","url":null,"abstract":"<p><strong>Purpose of review: </strong>Psoriatic arthritis (PsA) is a chronic, immune-mediated inflammatory disease with highly heterogeneous clinical manifestations associated with psoriasis (PsO). The wide variability in presentation, together with the absence of definitive serological biomarkers, makes early diagnosis particularly challenging. This review evaluates the role of ultrasound in identifying and characterising musculoskeletal involvement across the psoriatic disease (PsD) continuum-from asymptomatic PsO to established PsA.</p><p><strong>Recent findings: </strong>Ultrasound can detect subclinical synovitis, enthesitis, peritendonitis, tenosynovitis, bursitis, and structural damage in PsD. Evidence highlights its value in the early identification of musculoskeletal changes in patients with PsO who are at risk of progressing to PsA, with important implications for disease interception and prevention. Additional applications include differential diagnosis; assessment of enthesitis and distinction between inflammatory and non-inflammatory disease; and monitoring of therapeutic response, including in refractory disease. Ultrasound also demonstrates prognostic utility by detecting subclinical inflammation, predicting flares and future structural damage, and supporting personalized treatment strategies. Standardized ultrasound scoring systems and emerging methods for evaluating small hand entheses and dactylitis are also discussed. Ultrasound is an important tool for early detection, prognostic assessment, and management guidance in PsA, offering potential to prevent disease progression and inform precision medicine approach.</p>","PeriodicalId":10761,"journal":{"name":"Current Rheumatology Reports","volume":"28 1","pages":""},"PeriodicalIF":4.9,"publicationDate":"2026-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13260301/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148223862","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction to: Is Gout and Autoinflammatory Disease?","authors":"Naomi Schlesinger, Dan Kaufmann","doi":"10.1007/s11926-026-01226-y","DOIUrl":"10.1007/s11926-026-01226-y","url":null,"abstract":"","PeriodicalId":10761,"journal":{"name":"Current Rheumatology Reports","volume":"28 1","pages":""},"PeriodicalIF":4.9,"publicationDate":"2026-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148210066","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risks and Management of Glucocorticoid Therapy for Patients with Rheumatic Disease Having Surgery.","authors":"Kunjam Modha, Christopher Whinney","doi":"10.1007/s11926-026-01221-3","DOIUrl":"10.1007/s11926-026-01221-3","url":null,"abstract":"<p><strong>Purpose of review: </strong>The purpose of this review was to identify and characterize the diverse risks and benefits of glucocorticoid use in the perioperative period in patients with rheumatic diseases.</p><p><strong>Recent findings: </strong>Glucocorticoids increase the risk of surgical site infection, wound dehiscence, pneumonia, unplanned intubation and readmissions. The risk of perioperative adrenal insufficiency is rare. Guidelines specifically for knee and hip arthroplasties do not recommend stress dosing of steroids. Continuation of home doses of glucocorticoids is adequate for most patients. Stress dosing of glucocorticoids should be reserved for patients with biochemically confirmed adrenal dysfunction or are receiving supraphysiologic doses of glucocorticoids going for moderate to high-risk surgeries.</p>","PeriodicalId":10761,"journal":{"name":"Current Rheumatology Reports","volume":"28 1","pages":""},"PeriodicalIF":4.9,"publicationDate":"2026-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13233973/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148155864","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Perioperative Management Considerations for Patients with Systemic Lupus Erythematosus.","authors":"Sofia Flouda, Romy Kallas, Kyriakos A Kirou","doi":"10.1007/s11926-026-01222-2","DOIUrl":"10.1007/s11926-026-01222-2","url":null,"abstract":"<p><strong>Purpose of review: </strong>Systemic lupus erythematosus (SLE) patients are complex with multisystem organ involvement and often organ damage due to the disease and its treatment. This review aims to shed light on surgical outcomes in SLE patients and how these can be optimized in the perioperative setting.</p><p><strong>Recent findings: </strong>SLE patients often require various surgical procedures as a direct result of their disease. Several studies, the majority orthopedic, have reported the often-increased incidence of infectious, thrombotic, hemorrhagic and other postoperative outcomes in SLE patients compared to controls, as well as the role of lupus activity, severity, comorbidities, and glucocorticoids (GC) in predicting poor outcomes. Unfortunately, most publications are limited by retrospective design, small numbers or lack of granular information on lupus activity and its treatment. Nevertheless, recent guidelines for the treatment of SLE and the perioperative management of immunosuppressive therapies (IST) in patients with rheumatic diseases undergoing hips/knee arthroplasty have been published and have filled an important gap in the management of these patients. Achievement of remission or low lupus activity by escalating IST and GC taper to prednisone doses ≤ 5-7.5 mg/day is recommended in general and in the perioperative setting. Severe SLE patients actively treated for organ involvement may be allowed to continue IST perioperatively, but others may withhold IST. Careful multidisciplinary planning of elective surgeries, considering disease activity, severity, and comorbidities, as well as prudent perioperative GC, IST and anticoagulant management, should optimize outcomes in SLE patients. Large prospective studies of SLE patients undergoing common surgeries should facilitate further progress.</p>","PeriodicalId":10761,"journal":{"name":"Current Rheumatology Reports","volume":"28 1","pages":""},"PeriodicalIF":4.9,"publicationDate":"2026-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147863778","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}