{"title":"Updates in juvenile dermatomyositis: pathogenesis and therapy.","authors":"Samantha L Coss, Sara E Sabbagh, Hanna Kim","doi":"10.1097/BOR.0000000000001112","DOIUrl":"https://doi.org/10.1097/BOR.0000000000001112","url":null,"abstract":"<p><strong>Purpose of review: </strong>This review provides updates on juvenile dermatomyositis pathogenesis and treatment.</p><p><strong>Recent findings: </strong>JDM pathogenesis research updates in genetic risk factors include C4 copy number. Studies clarify myositis-specific autoantibodies' (MSA) role in disease pathogenesis and more myositis-associated antibody (MAA) clinical associations. Recent studies validate an interferon (IFN)-regulated gene score and an IFN-related monocyte surface protein marker, SIGLEC-1. Vasculopathy and mitochondrial dysfunction evidence increases, both with ties to IFN. Studies point to not only T and B cells, but monocytes, macrophages, and neutrophils as dysregulated in JDM. Regarding treatment, there are growing reports of success with therapies targeting IFN-signaling (Janus kinase inhibitors), dazukibart (anti-IFN-beta), and anifrolumab (anti-IFNAR1). Chimeric antigen receptor (CAR) T-cell therapy targeting B-cells in a growing number of adult myositis patients and one JDM patient have dramatic reports of achieving drug-free remission.</p><p><strong>Summary: </strong>Growing evidence show genetic markers, MSA, IFN, vasculopathy, varied immune cells, and mitochondrial dysfunction having important roles in JDM pathogenesis. Some refractory patients show benefit with newer IFN pathway-targeted therapies and cellular CAR-T-cell therapy. Further collaborative research on disease pathogenesis, treatment targets, and innovate clinical trial design is needed to increase access to more efficacious treatments in JDM.</p>","PeriodicalId":11145,"journal":{"name":"Current opinion in rheumatology","volume":" ","pages":""},"PeriodicalIF":5.2,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144689474","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}
Luis G Alcala-Gonzalez, Monique Hinchcliff, Zsuzsanna H McMahan
{"title":"Gastrointestinal manifestations of systemic sclerosis: current approaches and emerging therapies.","authors":"Luis G Alcala-Gonzalez, Monique Hinchcliff, Zsuzsanna H McMahan","doi":"10.1097/BOR.0000000000001110","DOIUrl":"10.1097/BOR.0000000000001110","url":null,"abstract":"<p><strong>Purpose of review: </strong>This review highlights recent advances in the understanding and management of gastrointestinal manifestations in systemic sclerosis (SSc). It is intended for clinicians and researchers aiming to improve diagnostic accuracy and therapeutic strategies in managing SSc-related gastrointestinal disease.</p><p><strong>Recent findings: </strong>Gastrointestinal involvement in SSc is highly variable in terms of clinical presentation, symptom severity, progression, timing of onset, and response to treatment. Emerging research highlights early immune-mediated damage to neural and muscular gastrointestinal tissues, microbiome alterations, and vascular dysfunction - particularly in patients with late-onset gastrointestinal disease - as key factors guiding the development of personalized, precision-based approaches for well defined patient subgroups. Recent studies underscore the value of early, objective assessment of gastrointestinal motility using tools like whole-gut transit scintigraphy and abdominal vascular ultrasound. New treatment strategies are also being explored for severe manifestations, including investigating mechanisms behind acid-suppressive therapy-resistant gastroesophageal reflux disease and implementing adjunctive therapies for gastrointestinal dysmotility.</p><p><strong>Summary: </strong>Gastrointestinal involvement in SSc poses a complex clinical challenge, particularly in patients with severe dysmotility and symptoms refractory to standard management strategies. This review offers timely, evidence-based insights to support clinicians in delivering more personalized and effective patient care and highlights critical gaps to address in future research.</p>","PeriodicalId":11145,"journal":{"name":"Current opinion in rheumatology","volume":" ","pages":""},"PeriodicalIF":5.2,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12258924/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144607727","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":"Patient-reported outcomes in systemic sclerosis: insights into quality of life and disease burden.","authors":"Alain Lescoat, Yen T Chen, Dinesh Khanna","doi":"10.1097/BOR.0000000000001111","DOIUrl":"10.1097/BOR.0000000000001111","url":null,"abstract":"<p><strong>Purpose of review: </strong>Assessing the impact of active therapy on how patients 'feel and function' is considered a necessary requirement by regulatory agencies for the approval of future treatments for SSc. In this context, patient-reported outcome measures (PROMs) have become a cornerstone of therapeutic assessment in randomized controlled trials (RCTs).</p><p><strong>Recent findings: </strong>This narrative review will discuss a selection of main available PROMs used in SSc RCTs, with a specific focus on recently developed PROMs, highlight ongoing initiatives related to SSc-PROMs, and provide points to consider for future use of SSc-PROMs.</p><p><strong>Summary: </strong>Several recent initiatives include a patient-centered approach [such as the Systemic Sclerosis-Associated Raynaud's Phenomenon (ASRAP), the MCQ (Mawdsley Calcinosis Questionnaire], the COAST (Clinical Outcome Assessments for Systemic Sclerosis Clinical Trials), and the CRISTAL (Combined Response index for scleroderma trials assessing limited systemic sclerosis) initiatives] to develop new PROMs and actively involve patient partners in each step of the process. Using a combined response index incorporating PROMs as the primary outcome measure in future SSc trials, such as the CRISS index for diffuse cutaneous SSc, could ensure that the perspectives of both physicians and patients would be incorporated to assess the efficacy of future interventions.</p>","PeriodicalId":11145,"journal":{"name":"Current opinion in rheumatology","volume":" ","pages":""},"PeriodicalIF":5.2,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144607728","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}
Roberta Ramonda, Giacomo Cozzi, Francesca Oliviero
{"title":"Nutritional guidance in spondyloarthritis: confronting the evidence gap.","authors":"Roberta Ramonda, Giacomo Cozzi, Francesca Oliviero","doi":"10.1097/BOR.0000000000001090","DOIUrl":"10.1097/BOR.0000000000001090","url":null,"abstract":"<p><strong>Purpose of review: </strong>to summarize current evidence on the role of specific dietary patterns in spondyloarthritis (SpA) management.</p><p><strong>Recent findings: </strong>dietary interventions may offer a novel, complementary strategy to manage symptoms and enhance overall quality of life in many rheumatic diseases, including SpA. Evidence suggests that the Mediterranean diet may have beneficial effects on inflammation and SpA symptoms. Although there is growing interest in the ketogenic diet with some promising results, data is scarce. Some SpA patients may have sensitivities or intolerances to certain foods containing gluten, which can trigger or worsen their symptoms, especially when associated with intestinal inflammation. Hypocaloric diets and weight loss can provide significant benefit in overweight and obese patients with SpA, potentially reducing systemic inflammation. Finally, while the efficacy of probiotics remains a matter of debate, periods of fasting have proven effective in reducing disease activity indices.</p><p><strong>Summary: </strong>the importance of a healthy dietary lifestyle and its potential benefits in symptom management is acknowledged by the majority of the patients. There is an increased need and demand from patients to receive nutritional counseling that should be integrated into routine SpA management to enhance patient outcomes.</p>","PeriodicalId":11145,"journal":{"name":"Current opinion in rheumatology","volume":" ","pages":"269-275"},"PeriodicalIF":5.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12144531/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143656328","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":"Rethinking spondyloarthritis: beyond lumping and splitting.","authors":"Joerg Ermann","doi":"10.1097/BOR.0000000000001094","DOIUrl":"10.1097/BOR.0000000000001094","url":null,"abstract":"<p><strong>Purpose of review: </strong>The classification of spondyloarthritis (SpA) has long been debated, with ongoing discussions about whether to \"lump\" various subtypes together or \"split\" them into smaller distinct disease categories. This review explores the evolution of the SpA concept and discusses novel approaches that move beyond traditional models of SpA classification.</p><p><strong>Recent findings: </strong>Since its introduction in the 1970s, the SpA concept has undergone substantial modifications, incorporating advances in genetics, imaging, and clinical research. The recognition of axial and peripheral SpA as distinct yet overlapping entities has reshaped classification and drug approval processes. Data-driven methodologies have provided new insights into disease heterogeneity. Recent research highlights the limitations of traditional classification systems, emphasizing the need for unbiased approaches that integrate clinical and molecular features.</p><p><strong>Summary: </strong>Current historically derived classification paradigms for SpA are largely based on clinical phenotype and fail to capture the full spectrum of disease heterogeneity. Defining SpA subsets by incorporating genetic and immunological characteristics may improve diagnostic precision and improve outcomes. Future research should focus on refining classification frameworks across the entire clinical spectrum of SpA to improve patient stratification, guide treatment decisions, and address existing gaps in SpA care.</p>","PeriodicalId":11145,"journal":{"name":"Current opinion in rheumatology","volume":" ","pages":"207-214"},"PeriodicalIF":5.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143976972","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":"Molecular imaging of psoriatic arthritis.","authors":"Sam Groothuizen, Conny Jacoba van der Laken","doi":"10.1097/BOR.0000000000001098","DOIUrl":"10.1097/BOR.0000000000001098","url":null,"abstract":"<p><strong>Purpose of review: </strong>Psoriatic arthritis (PsA) is a chronic inflammatory disease associated with psoriasis. Conventional imaging techniques are used to diagnose the disease and detect long-term structural changes. This review will assess molecular imaging in PsA, to evaluate its potential additive value over conventional and advanced anatomical imaging methods (e.g. ultrasound and MRI).</p><p><strong>Recent findings: </strong>Current research is primarily focused on the molecular imaging technique PET/computed tomography (PET/CT) imaging, in which different tracers have been investigated. Fluorodeoxyglucose (FDG) can visualize disease activity and subclinical inflammation. New tracers targeting inflammatory sites have also been studied, such as FAPI (fibroblast activation protein inhibitor). Moreover, NaF (sodium fluoride) shows promise for imaging of new bone formation. Next to PET/CT, also fluorescence imaging and multispectral optoacoustic tomography have been investigated in the context of PsA.</p><p><strong>Summary: </strong>Molecular imaging techniques hold promise for early diagnosis, monitoring and management of PsA. Future research is needed to define the role of molecular imaging relative to conventional and anatomical imaging techniques in patient care.</p>","PeriodicalId":11145,"journal":{"name":"Current opinion in rheumatology","volume":" ","pages":"282-288"},"PeriodicalIF":5.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12144547/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144076751","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}
John L Medamana, Joel M Gelfand, Brittany N Weber, Michael S Garshick
{"title":"Cardiovascular disease risk in psoriatic disease: mechanisms and implications for clinical practice.","authors":"John L Medamana, Joel M Gelfand, Brittany N Weber, Michael S Garshick","doi":"10.1097/BOR.0000000000001092","DOIUrl":"10.1097/BOR.0000000000001092","url":null,"abstract":"<p><strong>Purpose of review: </strong>Psoriasis is an immune-mediated pro-inflammatory skin condition that is associated with an increase in risk factors for cardiovascular disease, risk of ischemic heart disease, and cardiovascular death. Despite this, traditional modifiable atherosclerotic cardiovascular disease (ASCVD) risk factors are underdiagnosed and undertreated in patients with psoriasis.</p><p><strong>Recent findings: </strong>At a cellular level, psoriasis and atherosclerosis are driven by a host of shared inflammatory pathways, such as pro-inflammatory cytokines (TNF, IL-6), immune cells, and platelets which act synergistically to drive endothelial damage and atherosclerosis progression.</p><p><strong>Summary: </strong>Optimal prevention of cardiovascular disease in psoriasis centers around modifying known risk factors for the development of ASCVD and emerging data highlight the promise of treating inflammation to further decrease the risk of ASCVD.</p>","PeriodicalId":11145,"journal":{"name":"Current opinion in rheumatology","volume":" ","pages":"261-268"},"PeriodicalIF":5.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12167429/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143986929","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}
Peggy M Randon, Johann E Gudjonsson, Nicole L Ward
{"title":"What are mice teaching us about psoriatic arthritis?","authors":"Peggy M Randon, Johann E Gudjonsson, Nicole L Ward","doi":"10.1097/BOR.0000000000001093","DOIUrl":"10.1097/BOR.0000000000001093","url":null,"abstract":"<p><strong>Purpose of review: </strong>This review summarizes important mouse models of psoriatic arthritis (PsA), shedding light on their advantages and disadvantages in modeling human disease.</p><p><strong>Recent findings: </strong>Two newly created mouse models of PsA validate NF-κB signaling as disease-causing and identify pathogenic roles for CD8 + and CD4 + FoxP3 + T cells in the development of specific PsA phenotypes. The IkbkbGoF/GoF model demonstrates that homozygosity for a gain-of-function mutation in Ikbkb results in expansion of FoxP3 + CD25 + IL-17A + Tregs that lead to the development of dactylitis, spondylitis and PsA-like changes to the nails and skin, and when transferred to wildtype mice, reproduce these outcomes. The humanized mouse PsA model (Hu-PsA) establishes that introduction of PsA patient sera and PBMCs into NSG-SGM3 mice has the capacity to elicit distinct subtypes of PsA and identifies a critical role for CD8 + IL-32 + CXCL14 + T cells and immunoglobulins in disease development.</p><p><strong>Summary: </strong>Mouse models of PsA are powerful research tools for elucidating pathogenesis of disease, biomarker identification and may assist in the discovery of a cure.</p>","PeriodicalId":11145,"journal":{"name":"Current opinion in rheumatology","volume":" ","pages":"243-253"},"PeriodicalIF":5.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12119223/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143973557","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":"Monitoring psoriatic arthritis in research and clinical practice.","authors":"Yu Heng Kwan, Ying Ying Leung","doi":"10.1097/BOR.0000000000001089","DOIUrl":"10.1097/BOR.0000000000001089","url":null,"abstract":"<p><strong>Purpose of review: </strong>To discuss the varies outcome measure instruments for the assessment of different domains for psoriatic arthritis (PsA) both in trial and clinical practice settings.</p><p><strong>Recent findings: </strong>PsA is a multifaceted chronic inflammatory disease with diverse manifestations. This pose challenges of comprehensive assessment of the outcome of PsA. The Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA) had developed the core domain set and in the progress of selecting the core outcome measurement set for trials and clinical practice for PsA, using the framework set by Outcome Measures in Rheumatology (OMERACT). In brief, the core set of \"what to measure\" has been endorsed, and a standardized way of \"how to measure\" them are under review. Composite outcome measures for PsA may provide a solution to measuring multiple domains in a nutshell for various purposes in trials and clinical practice.</p><p><strong>Summary: </strong>This provides a succinct summary of the current state of outcome measurement in PsA and provides a quick and comprehensive perspective to select relevant outcome measure to use in busy rheumatology clinical settings.</p>","PeriodicalId":11145,"journal":{"name":"Current opinion in rheumatology","volume":" ","pages":"233-242"},"PeriodicalIF":5.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143604074","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}