Current opinion in rheumatology最新文献

Targeted therapies in systemic sclerosis: a narrative review of novel drugs in clinical trials. 系统性硬化症的靶向治疗：临床试验新药的叙述性回顾。

IF 4.3 2区医学

Current opinion in rheumatology Pub Date : 2025-11-01 Epub Date: 2025-08-20 DOI: 10.1097/BOR.0000000000001121

Morgan Emokpae, Crystal Cheung, Manvitha Nadella

{"title":"Targeted therapies in systemic sclerosis: a narrative review of novel drugs in clinical trials.","authors":"Morgan Emokpae, Crystal Cheung, Manvitha Nadella","doi":"10.1097/BOR.0000000000001121","DOIUrl":"10.1097/BOR.0000000000001121","url":null,"abstract":"Purpose of review: Systemic sclerosis (SSc) remains a therapeutic challenge, with conventional immunosuppressive strategies showing inconsistent effects and no disease modifying activity. The lack of head-head trials comparing immunosuppressives with emerging antifibrotic agents further complicates treatment decisions in SSc. This review aims to provide an update on the recent advances in targeted therapies for SSc, with a focus on novel biologics and small molecules that specifically modulate key mechanisms.Recent findings: Advances in molecular profiling have revealed inflammatory and fibrotic endotypes within SSc while imaging studies support a fibroinflammatory subset, highlighting potential therapeutic targets.Summary: A literature search for clinical trials between January 2020 and April 2025 from PubMed/MEDLINE, clinicaltrials.gov, euclinicaltrials.eu databases for targeted therapies in systemic sclerosis revealed a total of 117 clinical trials, of which we described the design, methods and endpoints from 14 studies (2 conference abstracts, 11 trials and 1 case series). These study results offer hope for patients with systemic sclerosis and pave way for future studies directing the development of patient-specific guidelines.","PeriodicalId":11145,"journal":{"name":"Current opinion in rheumatology","volume":" ","pages":"392-403"},"PeriodicalIF":4.3,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144946274","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}

引用次数: 0

Calcium pyrophosphate crystal deposition: 2025 update to recent epidemiological findings. 焦磷酸钙晶体沉积：2025年最新流行病学发现。

IF 4.3 2区医学

Current opinion in rheumatology Pub Date : 2025-11-01 Epub Date: 2025-08-01 DOI: 10.1097/BOR.0000000000001117

Charlotte Jauffret, Sara K Tedeschi, Abhishek Abhishek, Augustin Latourte, Georgios Filippou, Tuhina Neogi, Tristan Pascart

{"title":"Calcium pyrophosphate crystal deposition: 2025 update to recent epidemiological findings.","authors":"Charlotte Jauffret, Sara K Tedeschi, Abhishek Abhishek, Augustin Latourte, Georgios Filippou, Tuhina Neogi, Tristan Pascart","doi":"10.1097/BOR.0000000000001117","DOIUrl":"10.1097/BOR.0000000000001117","url":null,"abstract":"Purpose of review: Our objective is to propose an expert opinion focusing on most important and recent developments in calcium pyrophosphate deposition (CPPD) epidemiology. We highlight recent findings published in the past 18 months and their potential implications for research and patient care.Recent findings: We discuss new understanding of CPPD prevalence through advances in imaging modalities, advances in synovial fluid analyses (SFA), updates on disease phenotypes, and potential sources of misdiagnosis of CPPD. We present recent data regarding extra-articular associations of CPPD, particularly cardiovascular events and osteoporotic fractures. We discuss new therapeutic options. We identify barriers to improving research in CPPD, and tools currently available to overcome certain pitfalls.Summary: Improved knowledge in the epidemiology of asymptomatic CPPD and symptomatic CPPD disease is crucial to improving recognition of this still underdiagnosed disease, and to understanding patient phenotypes and their outcomes. Future research will require prospective designs to establish the prevalence of CPPD disease phenotypes and to provide more precise data according to each phenotype, both in terms of epidemiological findings and treatment responses, to develop personalized medicine.","PeriodicalId":11145,"journal":{"name":"Current opinion in rheumatology","volume":" ","pages":"437-444"},"PeriodicalIF":4.3,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144759435","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}

引用次数: 0

Targeting inflammation, fibrosis, and vascular dysfunction in systemic sclerosis: the role of diet and complementary and alternative medicine. 针对系统性硬化症的炎症、纤维化和血管功能障碍：饮食、补充和替代医学的作用。

IF 4.3 2区医学

Current opinion in rheumatology Pub Date : 2025-11-01 Epub Date: 2025-08-20 DOI: 10.1097/BOR.0000000000001115

Veronica Balbuena Hurtado, Monique Hinchcliff, Navya Murugesan

{"title":"Targeting inflammation, fibrosis, and vascular dysfunction in systemic sclerosis: the role of diet and complementary and alternative medicine.","authors":"Veronica Balbuena Hurtado, Monique Hinchcliff, Navya Murugesan","doi":"10.1097/BOR.0000000000001115","DOIUrl":"10.1097/BOR.0000000000001115","url":null,"abstract":"Purpose of review: Patients with systemic sclerosis (SSc) often seek advice regarding diet including functional foods, and complementary and alternative medicine (CAM) as adjunctive therapies. This review summarizes existing literature regarding these approaches.Recent findings: Study results of low Fermentable Oligosaccharides, Disaccharides, Monosaccharides, And Polyols (FODMAP), Mediterranean and ketogenic diets suggest symptom reduction and beneficial microbiota modulation in SSc, though sample sizes are small. Nitrate-rich and antioxidant supplements such as omega-3 fatty acids show promise in lowering inflammation and oxidative stress in the circulation. Herbal remedies like curcumin have demonstrated antifibrotic properties in preclinical models. Topical agents (e.g., rosemary oil, vitamin E gel) and nutritional vitamins (e.g., C, D, E) are also frequently used, though robust clinical trials are lacking.Summary: CAM, dietary interventions, and functional foods may aid in SSc management, but more rigorous research is needed to provide definitive evidence.","PeriodicalId":11145,"journal":{"name":"Current opinion in rheumatology","volume":" ","pages":"384-391"},"PeriodicalIF":4.3,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144946231","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}

引用次数: 0

Updates in juvenile dermatomyositis: pathogenesis and therapy. 青少年皮肌炎的最新进展：发病机制和治疗。

IF 4.3 2区医学

Current opinion in rheumatology Pub Date : 2025-11-01 Epub Date: 2025-07-22 DOI: 10.1097/BOR.0000000000001112

Samantha L Coss, Sara E Sabbagh, Hanna Kim

{"title":"Updates in juvenile dermatomyositis: pathogenesis and therapy.","authors":"Samantha L Coss, Sara E Sabbagh, Hanna Kim","doi":"10.1097/BOR.0000000000001112","DOIUrl":"10.1097/BOR.0000000000001112","url":null,"abstract":"Purpose of review: This review provides updates on juvenile dermatomyositis pathogenesis and treatment.Recent findings: 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.Summary: 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.","PeriodicalId":11145,"journal":{"name":"Current opinion in rheumatology","volume":" ","pages":"445-456"},"PeriodicalIF":4.3,"publicationDate":"2025-11-01","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}

引用次数: 0

Harnessing artificial intelligence to advance insights in systemic sclerosis skin and lung disease. 利用人工智能来推进系统性硬化症、皮肤和肺部疾病的研究。

IF 4.3 2区医学

Current opinion in rheumatology Pub Date : 2025-11-01 Epub Date: 2025-08-06 DOI: 10.1097/BOR.0000000000001114

Kimberly S Lakin, Michael Parides, Jessica K Gordon

{"title":"Harnessing artificial intelligence to advance insights in systemic sclerosis skin and lung disease.","authors":"Kimberly S Lakin, Michael Parides, Jessica K Gordon","doi":"10.1097/BOR.0000000000001114","DOIUrl":"10.1097/BOR.0000000000001114","url":null,"abstract":"Purpose of review: The purpose of this review is to summarize the uses of artificial intelligence for advancing systemic sclerosis (SSc) skin and lung disease research through 2024.Recent findings: Applications of AI in SSc research have expanded markedly in recent years. The most common artificial intelligence method identified was supervised machine learning for predictive modeling. Supervised machine learning uses input data labeled with a known outcome to train a model to predict outcomes when encountering new data. Using machine learningassisted feature selection and posttraining feature importance techniques also highlighted key predictors within complex datasets, informing possible mechanisms underlying heterogeneous patient outcomes. Additionally, unsupervised machine learning approaches have been used to identify patient subsets with distinct clinical trajectories. Unsupervised machine learning identifies groups with similar characteristics within a dataset, without considering a specific outcome. Digital image analysis using deep learning has also been undertaken in lung imaging studies to quantify interstitial lung disease (ILD) extent and automate ILD subtype classification, as well as skin biopsy analysis to quantify histologic changes. These scalable tools could efficiently automate prognostic assessments for use across centers of varying local expertise.Summary: Artificial intelligence represents a tool for analyzing high-dimensional, complex datasets to derive robust results, even within relatively small SSc cohorts. To date, artificial intelligence driven insights to SSc skin and lung disease have focused on identifying patient subsets, quantifying disease severity, and building predictive models to inform personalized patient care.","PeriodicalId":11145,"journal":{"name":"Current opinion in rheumatology","volume":" ","pages":"353-364"},"PeriodicalIF":4.3,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144788531","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}

引用次数: 0

A comprehensive review of systemic sclerosis-primary biliary cholangitis overlap: emerging evidence for a distinct clinical subtype. 系统性硬化症-原发性胆管炎重叠的综合综述：一个独特临床亚型的新证据。

IF 4.3 2区医学

Current opinion in rheumatology Pub Date : 2025-11-01 Epub Date: 2025-09-05 DOI: 10.1097/BOR.0000000000001127

Areeka Memon, Manvitha Nadella, Morgan Emokpae, David N Assis

{"title":"A comprehensive review of systemic sclerosis-primary biliary cholangitis overlap: emerging evidence for a distinct clinical subtype.","authors":"Areeka Memon, Manvitha Nadella, Morgan Emokpae, David N Assis","doi":"10.1097/BOR.0000000000001127","DOIUrl":"10.1097/BOR.0000000000001127","url":null,"abstract":"Purpose of review: To synthesize current knowledge on the genetic, immunopathogenic, and clinical presentations of systemic sclerosis (SSc) and primary biliary cholangitis (PBC) with a focus on their co-occurrence as a clinically relevant overlap syndrome. This narrative review summarizes preclinical and clinical studies addressing SSc-PBC overlap.Recent findings: Genomic studies highlight shared susceptibility loci between SSc and PBC. Furthermore, SSc-PBC overlap patient sera reveals anticentromere antibodies which cross-react with an antigenic motif on pyruvate dehydrogenase-E2 (structural core of pyruvate dehydrogenase complex catalyzing formation of acetyl coA), the most common target of antimitochondrial antibodies in PBC. Similar profibrotic cytokines and T regulatory cell profiles are identified in sera and skin and liver biopsies of patients with SSc and PBC respectively. Analysis of clinical phenotypes reveals that SSc-PBC overlap patients have reduced incidence of pulmonary fibrosis and pulmonary arterial hypertension compared to SSc alone, and less severe hepatic involvement compared to PBC alone.Summary: SSc-PBC overlap remains an understudied disease process. This review summarizes current knowledge and outlines future directions to guide research and improve care for patients with this distinct clinical overlap.","PeriodicalId":11145,"journal":{"name":"Current opinion in rheumatology","volume":" ","pages":"413-421"},"PeriodicalIF":4.3,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145014108","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}

引用次数: 0

Patient-reported outcomes in systemic sclerosis: insights into quality of life and disease burden. 系统性硬化症患者报告的结果：对生活质量和疾病负担的见解

IF 4.3 2区医学

Current opinion in rheumatology Pub Date : 2025-11-01 Epub Date: 2025-07-11 DOI: 10.1097/BOR.0000000000001111

Alain Lescoat, Yen T Chen, Dinesh Khanna

{"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":"Purpose of review: 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).Recent findings: 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.Summary: 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.","PeriodicalId":11145,"journal":{"name":"Current opinion in rheumatology","volume":" ","pages":"335-342"},"PeriodicalIF":4.3,"publicationDate":"2025-11-01","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}

引用次数: 0

Gouty inflammation: genetic mechanisms towards flare therapy. 痛风炎症：耀斑治疗的遗传机制。

IF 4.3 2区医学

Current opinion in rheumatology Pub Date : 2025-11-01 Epub Date: 2025-08-20 DOI: 10.1097/BOR.0000000000001119

Daniel Lyth, Megan Leask

引用次数: 0

Updates in uricase therapy for gout. 痛风尿酸酶治疗的最新进展。

IF 4.3 2区医学

Current opinion in rheumatology Pub Date : 2025-11-01 Epub Date: 2025-09-03 DOI: 10.1097/BOR.0000000000001122

Naomi Schlesinger, Dan Kaufmann

{"title":"Updates in uricase therapy for gout.","authors":"Naomi Schlesinger, Dan Kaufmann","doi":"10.1097/BOR.0000000000001122","DOIUrl":"10.1097/BOR.0000000000001122","url":null,"abstract":"Purpose of review: Urate-lowering therapy (ULT) plays a pivotal role in treating gout patients. Unfortunately, some patients receiving oral ULT fail to achieve the target serum urate levels of < 6.8 mg/dl, the solubility level of uric acid. Exogenous uricases, considered \"enzyme replacement therapy,\" are a therapeutic option for patients with uncontrolled gout in whom oral ULT has not been efficacious, is not tolerated, or is contraindicated, in some due to underlying comorbidities. Currently, two uricases are available: pegloticase and rasburicase. Pegloticase is indicated for treating uncontrolled gout, while rasburicase is used to prevent tumor lysis syndrome.Recent findings: The main limitations of pegloticase include gout flares and infusion reactions, which are linked to the formation of antidrug antibodies. Immunomodulation and anti-inflammatory prophylaxis can help reduce these issues. New PEGylated uricases, including nanoencapsulated sirolimus combined with pegadricase (NASP) and PRX-115, are being developed and may offer improved options.Summary: Exogenous uricases available and those under development are discussed, focusing on immunomodulation and anti-inflammatory prophylaxis to reduce flares, prevent antidrug antibody formation and infusion reactions, and mitigate loss of efficacy in patients with uncontrolled gout needing uricase replacement therapy.","PeriodicalId":11145,"journal":{"name":"Current opinion in rheumatology","volume":" ","pages":"422-429"},"PeriodicalIF":4.3,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145014086","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}

引用次数: 0

Decoding vascular dysfunction in systemic sclerosis: from endothelial damage to clinical implications. 解读系统性硬化症血管功能障碍：从内皮损伤到临床意义。

IF 4.3 2区医学

Current opinion in rheumatology Pub Date : 2025-11-01 Epub Date: 2025-09-03 DOI: 10.1097/BOR.0000000000001126

Ryan Massay, Carleigh Zahn, Pei-Suen Tsou

{"title":"Decoding vascular dysfunction in systemic sclerosis: from endothelial damage to clinical implications.","authors":"Ryan Massay, Carleigh Zahn, Pei-Suen Tsou","doi":"10.1097/BOR.0000000000001126","DOIUrl":"10.1097/BOR.0000000000001126","url":null,"abstract":"Purpose of review: This review explores the evolving understanding of vascular dysfunction in systemic sclerosis (SSc), from early endothelial injury to clinical manifestations and emerging therapeutic strategies.Recent findings: Endothelial cell (EC) injury, senescence, and endothelial-to-mesenchymal transition are central to SSc vasculopathy. Single-cell and spatial omics have revealed distinct EC subtypes and dysregulated pathways, including interferon signaling and chromatin remodeling. Immune-mediated damage, viral triggers, and autoantibodies contribute to vascular pathology. Clinically, complications such as Raynaud's phenomenon, digital ulcers, pulmonary arterial hypertension, and renal crisis drive morbidity and healthcare burden. Diagnostic tools such as nailfold capillaroscopy enable early detection of microvascular changes. Novel therapies including CAR-T therapy, JAK inhibitors, and complement blockade, are under investigation.Summary: Vascular dysfunction is a hallmark of SSc and a key driver of disease progression. Advances in molecular profiling and imaging have improved our understanding of its mechanisms and opened new avenues for targeted intervention. Early diagnosis, biomarker-guided care, and multidisciplinary management are essential to improving outcomes.","PeriodicalId":11145,"journal":{"name":"Current opinion in rheumatology","volume":" ","pages":"373-383"},"PeriodicalIF":4.3,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145014131","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}

引用次数: 0