Current Rheumatology Reports最新文献

{"title":"Gout, Hyperuricemia and Psoriatic Arthritis: An Evolving Conundrum.","authors":"Priyanka Chandratre, Ricardo Sabido-Sauri, Sizheng Steven Zhao, Abhishek Abhishek","doi":"10.1007/s11926-025-01187-8","DOIUrl":"10.1007/s11926-025-01187-8","url":null,"abstract":"<p><strong>Purpose of review: </strong>The co-existence of gout and psoriatic disease (PD) is long standing but more recently frequently encountered in clinical settings due to increased awareness of their shared comorbidities and clinical phenotypes, often posing diagnostic and management challenges. Here we review the overlap in gout and PD focusing on shared clinical features, common inflammatory pathophysiology and comorbidities which may prompt a diagnosis of 'Psout' and lead to changes in management.</p><p><strong>Recent findings: </strong>Several epidemiological studies have highlighted the increased incidence of hyperuricemia and gout in those with PD and vice versa. Although the role of monosodium urate (MSU) crystals is well recognized in activation of innate immunity via inflammasome and NETosis, it is likely that they have a role in triggering adaptive immunity via antigen presenting cells and their autocrine effect on keratinocytes in psoriasis (PSO), ultimately leading to T cell secretion of proinflammatory cytokines such as IL17. Hyperuricemia (HU) is common in PD (up to 30%) and underpins metabolic syndrome comorbidities that are common to both gout and PD. Shared clinical phenotypes and co-morbidities are routinely observed in clinical practice yet there is a paucity of evidence evaluating the effect of treating hyperuricemia/gout on PD activity, with small scale clinical trials showing a positive effect. There were no studies to our knowledge assessing gout disease activity with concurrent treatment of PD. The association between gout and PD is likely due to shared multimorbidity and perhaps to a smaller extent, the direct role of HU in triggering the release of proinflammatory cytokines in PD. There is often a significant overlap in clinical and radiological presentation of gout and Psoriatic arthritis (PsA). In those with atypical response to standard treatments of the primary condition (either gout or PsA), it would be plausible to investigate and treat for the other 'secondary' condition. This is particularly relevant and relatively feasible in those with PsA (and features of HU and multimorbidity) who respond poorly to standard immunomodulating treatments.</p>","PeriodicalId":10761,"journal":{"name":"Current Rheumatology Reports","volume":"27 1","pages":"22"},"PeriodicalIF":5.7,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143718199","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":"Non-Pharmacological Pain Management of Rheumatoid Arthritis.","authors":"Peter Pham, Yvonne C Lee","doi":"10.1007/s11926-025-01184-x","DOIUrl":"https://doi.org/10.1007/s11926-025-01184-x","url":null,"abstract":"<p><strong>Purpose of review: </strong>Many individuals with rheumatoid arthritis (RA) continue to suffer from pain despite treatment with disease-modifying antirheumatic drugs. In this review, we aim to summarize the evidence for non-pharmacological approaches for managing pain in RA.</p><p><strong>Recent findings: </strong>Few studies have examined the effect of non-pharmacological therapies on pain in patients with RA. Of these studies, many were not designed to specifically target pain and examined pain as a secondary outcome. While most studies reported within group improvements in pain, the magnitude of improvement varied, and differences between intervention and control groups often were not statistically significant. We recommend non-pharmacologic approaches for management of RA, based primarily on data for improving pain-related outcomes (e.g., physical function, overall health), as opposed to pain itself. The evidence base for non-pharmacologic interventions for pain remains poor, and there is a critical need for large RCTs designed to specifically target pain.</p>","PeriodicalId":10761,"journal":{"name":"Current Rheumatology Reports","volume":"27 1","pages":"21"},"PeriodicalIF":5.7,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143656353","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":"Ultrasound Beyond Joints: A Review of Extra-Articular Applications in Rheumatology.","authors":"Emilio D'Ignazio, Davide Corradini, Tomas Cazenave, Riccardo Bixio, Caterina Baldi, Harjit Kaur Ubhi, Kate Smith, Richard J Wakefield, Paul Emery, Andrea Di Matteo","doi":"10.1007/s11926-025-01186-9","DOIUrl":"10.1007/s11926-025-01186-9","url":null,"abstract":"<p><strong>Purpose of review: </strong>This review highlights key ultrasound applications for evaluating extra-articular involvement in rheumatic diseases, including the lungs, vessels, salivary glands, muscles, nerves, skin, and nails. It explores recent advances, emerging areas of assessment, and future research directions. Additionally, the review examines current limitations in the routine use of ultrasound for these purposes and considers the potential of new technologies, such as shear-wave elastography, contrast-enhanced ultrasound, and artificial intelligence, to enhance the early detection and monitoring of extra-articular manifestations in rheumatic diseases.</p><p><strong>Recent findings: </strong>Extra-articular manifestations in patients with rheumatic diseases are crucial for diagnosis, management (including treatment strategies), and prognosis, making accurate assessment essential. Growing evidence supports the role of ultrasound in assessing these manifestations for diagnosis, monitoring, and gaining insights into disease pathogenesis. Recent studies emphasize the significant utility of ultrasound in evaluating extra-articular involvement across various organ systems, including the lungs, vessels, salivary glands, muscles, nerves, skin, and nails. Technological advances, such as shear-wave elastography, contrast-enhanced ultrasound, and artificial intelligence, are expanding the scope and precision of ultrasound applications. Despite its potential, challenges such as operator dependency, lack of standardized protocols, and the need for specialized training hinder its widespread adoption. Ultrasound is a non-invasive, cost-effective, and radiation-free imaging modality with high diagnostic accuracy, making it a valuable tool for assessing extra-articular manifestations in rheumatic diseases. Emerging technologies may further enhance its clinical utility. However, efforts to standardize techniques and improve accessibility are necessary to optimize its integration into routine practice.</p>","PeriodicalId":10761,"journal":{"name":"Current Rheumatology Reports","volume":"27 1","pages":"20"},"PeriodicalIF":5.7,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11880079/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143540470","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":"Non-Pharmacological Pain Management for Osteoarthritis: Review Update.","authors":"Kelli D Allen, Kirsten R Ambrose, Staja Q Booker, Ashley N Buck, Katie F Huffman","doi":"10.1007/s11926-025-01185-w","DOIUrl":"https://doi.org/10.1007/s11926-025-01185-w","url":null,"abstract":"<p><strong>Purpose of review: </strong>To summarize the state of research and recent studies on non-pharmacological therapies for osteoarthritis (OA).</p><p><strong>Recent findings: </strong>High intensity interval training is an exercise-based intervention with some new, promising findings for people with OA. Among mind-body therapies, Tai Chi has the strongest evidence base to date. Diet + exercise has the strongest evidence for weight management in OA, with recent research focusing on maintenance of weight loss and non-calorie restrictive dietary patterns. Among psychological interventions, Cognitive Behavioral Therapy has the strongest evidence base, with some support for Acceptance and Commitment Therapy and mindfulness-based interventions. There is a clear role for non-pharmacological therapies for OA. Future research should address the effectiveness of interventions for which evidence is still limited, strategies for maintenance, heterogeneity of patients' responses to these therapies, and implementation in clinical and community settings.</p>","PeriodicalId":10761,"journal":{"name":"Current Rheumatology Reports","volume":"27 1","pages":"19"},"PeriodicalIF":5.7,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143448252","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":"Unraveling the Challenges of Difficult-to-Treat Spondyloarthritis: SPARTAN 2024 Annual Meeting Proceedings.","authors":"Andre L Ribeiro, Fabian Proft","doi":"10.1007/s11926-025-01183-y","DOIUrl":"10.1007/s11926-025-01183-y","url":null,"abstract":"<p><strong>Purpose of review: </strong>This review aims to explore the emerging concept of difficult-to-treat axial spondyloarthritis (D2T-axSpA), including its definitions, clinical challenges, and management strategies. The objective, as presented at the SPARTAN 2024 Annual Meeting, is to delineate the evolving framework for identifying and addressing D2T-axSpA, with a focus on inflammatory and non-inflammatory mechanisms of treatment failure and the implications for clinical practice.</p><p><strong>Recent findings: </strong>Studies have highlighted a prevalence of D2T-axSpA ranging from 19.5 to 28.3% in real-world cohorts, with associated risk factors including peripheral arthritis, comorbidities, and female gender. Recent advances include the Assessment of SpondyloArthritis International Society's (ASAS) preliminary definition of \"difficult-to-manage axSpA\" (D2M-axSpA), which encompasses treatment-refractory cases and broader management challenges and `treatment refractory axSpA´ where objective evidence of ongoing inflammation is mandatory.  D2T-axSpA presents significant challenges due to persistent disease activity and the interplay of inflammatory and non-inflammatory drivers. The emerging definitions and research into personalized treatment strategies promise to refine clinical management. Future directions emphasize biomarker-driven precision medicine, novel therapeutic combinations, and holistic care models to improve outcomes in this complex patient population.</p>","PeriodicalId":10761,"journal":{"name":"Current Rheumatology Reports","volume":"27 1","pages":"18"},"PeriodicalIF":5.7,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11790757/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143078871","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":"Screening for Spondyloarthritis in Patients with Inflammatory Bowel Disease - SPARTAN 2024 Annual Meeting Proceedings.","authors":"Reem Jan, Simon J Hong, Joerg Ermann","doi":"10.1007/s11926-025-01181-0","DOIUrl":"https://doi.org/10.1007/s11926-025-01181-0","url":null,"abstract":"<p><strong>Purpose of review: </strong>There is an unmet need to adequately identify, describe and treat the musculoskeletal manifestations of patients with inflammatory bowel disease (IBD). At the 2024 SPARTAN annual meeting, we reviewed the current literature on the prevalence and presentation of spondyloarthritis in patients with IBD and discussed screening strategies to select symptomatic patients for further study. The primary goal is to improve understanding and recognition of spondyloarthritis in this patient population.</p><p><strong>Recent findings: </strong>In a unique collaboration between U.S. gastroenterologists and rheumatologists, the Gastroenterology and Rheumatology assessment of Spondyloarthritis in Inflammatory Bowel Disease (GRaSp-IBD) study group designed and executed a multi-center study across six institutions that applied a hybrid screening tool to identify patients with musculoskeletal symptoms suggestive of spondyloarthritis. The data was analyzed for confirmed rheumatic disease, treatment history, patient and IBD characteristics. Of the patients that screened positive, the majority (69%) had not seen a rheumatologist within the past year. IBD phenotype did not seem to increase the risk of a positive screen, but a higher number of biologic exposures proved significant. IBD patients report musculoskeletal pain at a high rate but a minority of these patients are seen by rheumatologists. Further study is needed to determine how to optimize screening for IBD arthritis, and to improve referral rates and clinical outcomes.</p>","PeriodicalId":10761,"journal":{"name":"Current Rheumatology Reports","volume":"27 1","pages":"17"},"PeriodicalIF":5.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143074134","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":"An Update on Multi-System Inflammatory Syndrome in Children.","authors":"Anurag Ratan Goel, Ali Yalcindag","doi":"10.1007/s11926-025-01182-z","DOIUrl":"https://doi.org/10.1007/s11926-025-01182-z","url":null,"abstract":"<p><strong>Purpose: </strong>To summarize the latest research on the epidemiology, pathogenesis, diagnosis, and treatment of multisystem inflammatory syndrome in children (MIS-C).</p><p><strong>Recent findings: </strong>The epidemiology of MIS-C has been dynamic since its initial description. The pathogenesis remains poorly understood. Case definitions of MIS-C have evolved over time, and practice patterns for treating MIS-C are variable with generally positive long-term outcomes yet persistent changes noted. MIS-C has become less prevalent and less severe over time, yet racial and ethnic disparities persist, and vaccination against COVID-19 is highly effective in preventing this disease. The link between acute infection and subsequent inflammation is not well understood, with growing evidence describing its immunologic signature. Newer case definitions require excluding other inflammatory conditions, including Kawasaki Disease (KD), before diagnosing MIS-C. Corticosteroid monotherapy may be non-inferior to IVIg alone or combination IVIg plus corticosteroids for initial treatment, distinguishing the approaches to MIS-C and KD. A wide range of biologic therapies have been employed for rescue therapy with general success and no clear benefit of one over another. Despite reports of a high rate of coronary artery abnormality regression and resolution of heart failure, long-term studies suggest persistent changes to cardiac function. The long-term effects of MIS-C continue to be active areas of research.</p>","PeriodicalId":10761,"journal":{"name":"Current Rheumatology Reports","volume":"27 1","pages":"16"},"PeriodicalIF":5.7,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143064312","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":"Fast, Present and Future of the Concept of Spondyloarthritis.","authors":"J Braun","doi":"10.1007/s11926-024-01179-0","DOIUrl":"https://doi.org/10.1007/s11926-024-01179-0","url":null,"abstract":"<p><strong>Purpose of review: </strong>Axial spondyloarthritis (axSpA) is a rather prevalent chronic inflammatory rheumatic disease that affects already relatively young patients. It has been known better since the end of the nineteenth century but quite a lot has been learned since the early 60ies when the first classification (diagnostic) criteria for ankylosing spondylitis (AS) were agreed on. I have been part of many developments in the last 30 years, and I'm happy to have been able to contribute to the scientific progress in terms of diagnosis, imaging, pathophysiology and therapy. When I was asked to write a manuscript about the SpA concept I felt honored. Thus, the purpose of this extensive review was, on the one hand, to describe the history of AS and axSpA, and on the other hand, to reason about the concept and the gestalt of axSpA, and finally to deliver some ideas what future researchers could possibly do to further study the disease.</p><p><strong>Recent findings: </strong>The last 3 decades were full of innovations for both, classification and treatment of axSpA which also helped us to learn about the pathophysiology. Thus, TNFa, IL-17, IL-23 and Janus kinase are established targets to reduce inflammation. IL-17 and IL-23 are very special in that regard because they both work for psoriasis but only anti-IL-17 agents which don't work in IBD are approved for axSpA, while IL 23 inhibitors are approved for both, psoriasis and IBD, but they don't work in axSpA. New imaging techniques such as low dose CT and synthetic MRI are likely to improve the detection of both active and structural lesions of axSpA. This manuscript tries to describe the most important findings about axSpA. The main aim of research remains to discover the pathophysiology and to further improve treatment options in order to reduce and abolish inflammation and prevent new bone formation to increase the quality of life of our patients. The differences between male and female disease and the role of the immune system in axSpA are now the main challenges, and the role of special T-cell receptors seem to deserve special interest.</p>","PeriodicalId":10761,"journal":{"name":"Current Rheumatology Reports","volume":"27 1","pages":"15"},"PeriodicalIF":5.7,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143045706","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":"T Cell Dysregulation in Rheumatoid Arthritis: from Genetic Susceptibility to Established Disease.","authors":"Athena Chin, Annabelle Small, Soon Wei Wong, Mihir D Wechalekar","doi":"10.1007/s11926-025-01180-1","DOIUrl":"10.1007/s11926-025-01180-1","url":null,"abstract":"<p><strong>Purpose of review: </strong>Rheumatoid arthritis (RA) is a complex autoimmune disease characterized by chronic inflammation of the synovial tissue, where T cells play a central role in pathogenesis. Recent research has identified T peripheral helper (Tph) cells as critical mediators of local B cell activation in inflamed tissues. This review synthesizes the latest advancements in our understanding the of the role of T cells in RA, from initiation to established disease.</p><p><strong>Recent findings: </strong>We explore recent advances regarding the genetic and epigenetic factors that predispose individuals to RA, the mechanisms of T cell activation and differentiation, and the interactions between T cells and other immune and stromal cells within the synovial microenvironment. The emergence of Tph cells as key drivers of RA pathobiology is highlighted, along with their potential as therapeutic targets. We also discuss the heterogeneity of T cell responses and their interplay with synovial cells, while addressing critical research gaps such as the drivers of T cell recruitment and the plasticity of synovial phenotypes. A deeper understanding of T cell dynamics in RA will provide valuable insights for developing targeted therapies to modulate T cell-mediated inflammation and improve patient outcomes.</p>","PeriodicalId":10761,"journal":{"name":"Current Rheumatology Reports","volume":"27 1","pages":"14"},"PeriodicalIF":5.7,"publicationDate":"2025-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11762599/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143037085","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":"Unconventional Imaging Methods in Psoriatic Arthritis.","authors":"Ioanna Minopoulou, Filippo Fagni, Armin Atzinger, Fredrik Albach, Georg Schett, Gerhard Krönke, Arnd Kleyer, David Simon","doi":"10.1007/s11926-024-01174-5","DOIUrl":"10.1007/s11926-024-01174-5","url":null,"abstract":"<p><strong>Purpose of review: </strong>Psoriatic arthritis (PsA) is a complex heterogeneous inflammatory disease that affects about one-third of patients with psoriasis. PsA leads to significant physical impairment and reduced quality of life. Therefore, early diagnosis and intervention are critical for improving long-term outcomes. The purpose of this review is to highlight the advantages of unconventional imaging methods in the diagnosis and management of PsA and to discuss recent advancements in imaging technology.</p><p><strong>Recent findings: </strong>Conventional imaging methods, such as radiography, musculoskeletal ultrasound, and magnetic resonance imaging, have been instrumental in detecting structural joint damage and inflammation. However, these imaging modalities have several limitations, resulting in their inability to detect early disease changes. Recent advancements in imaging technology have led to the development of novel imaging modalities capable of characterizing not only early structural but also molecular aspects of disease activity. These cutting-edge approaches have been lately applied to both psoriasis and PsA patients, offering new insights into disease progression, the transition from psoriasis to PsA, and treatment responses. By providing more detailed and individualized assessments, unconventional imaging modalities may bring us closer to realizing the potential of personalized medicine in the management of PsA.</p>","PeriodicalId":10761,"journal":{"name":"Current Rheumatology Reports","volume":"27 1","pages":"13"},"PeriodicalIF":5.7,"publicationDate":"2025-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11723843/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142946011","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}