{"title":"Monitoring psoriatic arthritis in research and clinical practice.","authors":"Yu Heng Kwan, Ying Ying Leung","doi":"10.1097/BOR.0000000000001089","DOIUrl":"https://doi.org/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":""},"PeriodicalIF":5.2,"publicationDate":"2025-03-12","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}
{"title":"AI am the future: artificial intelligence in pediatric rheumatology.","authors":"Saverio La Bella, Latika Gupta, Vincenzo Venerito","doi":"10.1097/BOR.0000000000001087","DOIUrl":"https://doi.org/10.1097/BOR.0000000000001087","url":null,"abstract":"<p><strong>Purpose of review: </strong>There is a growing interest in the applications of artificial intelligence in pediatric rheumatology. Although concerns with training datasets, ethical considerations, and the need for a major utilization of explainable artificial intelligence are still ongoing challenges, significant advancements have been made in recent years. In this review, we explore the most recent applications of artificial intelligence in pediatric rheumatology, with a special focus on machine learning models and their outcomes.</p><p><strong>Recent findings: </strong>Supervised and unsupervised machine learning models have been largely employed to identify key biomarkers, predict treatment responses, and stratify patients based on disease presentation and progression. In addition, innovative artificial intelligence driven imaging tools and noninvasive diagnostic methods have improved diagnostic accuracy and emerged as encouraging solutions for identifying inflammation and disease activity. Large language models have been utilized for patient-based questions with promising results. Nevertheless, critical examination and human oversight are still crucial in interpreting artificial intelligence's outputs.</p><p><strong>Summary: </strong>Artificial intelligence is revolutionizing pediatric rheumatology by improving diagnosis and disease classification, patient stratification and personalized treatment. However, we are only at the beginning, and the adventure has just begun.</p>","PeriodicalId":11145,"journal":{"name":"Current opinion in rheumatology","volume":" ","pages":""},"PeriodicalIF":5.2,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143603852","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":"Human genetics of Whipple's disease.","authors":"Jérémie Rosain, Jean-Laurent Casanova, Jacinta Bustamante","doi":"10.1097/BOR.0000000000001088","DOIUrl":"10.1097/BOR.0000000000001088","url":null,"abstract":"<p><strong>Purpose of review: </strong>Whipple's disease (WD), triggered by Tropheryma whipplei ( T. whipplei ), is a rare, chronic, inflammatory, systemic infectious disease that typically manifests in adults. The most frequent initial manifestations include arthritis, followed by diarrhea, abdominal pain, and weight loss. Half the world's population is exposed to T. whipplei , but only one in a million develop WD. This suggests that acquired or inborn errors of immunity (IEI) may underlie WD. Anti-TNF treatment is a well established risk factor for flare-ups of WD.</p><p><strong>Recent findings: </strong>We have also reported two rare IEI in patients with WD. Six WD patients from two unrelated kindreds were found to have autosomal dominant IRF4 deficiency acting via a mechanism of haploinsufficiency. These patients were otherwise healthy. In addition, a single patient with a history of WD and other infections was found to have autosomal recessive CD4 deficiency.</p><p><strong>Summary: </strong>Rare IEI can underlie WD. Human genetic studies of patients with WD are warranted for the development of precision medicine for affected kindreds and to improve our understanding of the pathogenesis of this rare infectious disease.</p>","PeriodicalId":11145,"journal":{"name":"Current opinion in rheumatology","volume":" ","pages":""},"PeriodicalIF":5.2,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143585122","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":"Biomarker discovery in psoriatic disease.","authors":"Darshini Ganatra, Vinod Chandran","doi":"10.1097/BOR.0000000000001086","DOIUrl":"https://doi.org/10.1097/BOR.0000000000001086","url":null,"abstract":"<p><strong>Purpose of review: </strong>Psoriasis, a chronic skin condition, characterized by scaly erythematous plaques, is prevalent in around 2% of the population. Around 25% of psoriasis patients have psoriatic arthritis (PsA), an inflammatory musculoskeletal disease that often leads to progressive joint damage and disability. Psoriatic diseases (PsD) encompassing psoriasis and PsA, are often associated with pathophysiologically related conditions like uveitis and inflammatory bowel disease as well as comorbidities such as cardiovascular disease. Due to the heterogeneous nature of PsD, diagnosis and treatment is a challenge. Biomarkers can objectively measure variables, such as disease state, disease progress, and treatment outcomes, thus offering the possibility for better management of disease. This review focuses on some of the biomarker research that was carried out in PsD in the past year.</p><p><strong>Recent findings: </strong>Diverse biomarker types ranging from SNPs, mRNA, proteins, metabolites and immune cell profiles have been categorized as per the Biomarkers, EndpointS and other Tools (BEST) resource developed by the FDA/NIH. Some of the latest research has focused on multiomic assays and these along with advanced bioinformatic tools can help in better disease management.</p><p><strong>Summary: </strong>Recent developments in PsA biomarker research show promise in identifying markers that can help in diagnosis, assess disease activity and predict treatment response. However, most studies are in the early discovery and verification state. Large-scale studies to replicate findings and develop and validate predictive algorithms are required.</p>","PeriodicalId":11145,"journal":{"name":"Current opinion in rheumatology","volume":" ","pages":""},"PeriodicalIF":5.2,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143536825","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}
Amandine Charras, Linda T Hiraki, Laura Lewandowski, Christian M Hedrich
{"title":"Genetic and epigenetic factors shape phenotypes and outcomes in systemic lupus erythematosus - focus on juvenile-onset systemic lupus erythematosus.","authors":"Amandine Charras, Linda T Hiraki, Laura Lewandowski, Christian M Hedrich","doi":"10.1097/BOR.0000000000001072","DOIUrl":"10.1097/BOR.0000000000001072","url":null,"abstract":"<p><strong>Purpose of review: </strong>Systemic lupus erythematosus (SLE) is a severe autoimmune/inflammatory disease. Patients with juvenile disease-onset and those of non-European ancestry are most severely affected. While the exact pathophysiology remains unknown, common and rare gene variants in the context of environmental exposure and epigenetic alterations are involved. This manuscript summarizes the current understanding of genetic and epigenetic contributors to SLE risk, manifestations and outcomes.</p><p><strong>Recent findings: </strong>Though SLE is a mechanistically complex disease, we are beginning to understand the impact of rare and common gene variants on disease expression and associated outcomes. Recent trans -ancestral and multigenerational studies suggest that differential genetic and environmental impacts shape phenotypic variability between age-groups and ancestries. High genetic burden associates with young age at disease-onset, organ involvement, and severity. Additional epigenetic impact contributes to disease-onset and severity, including SLE-phenotypes caused by rare single gene variants. Studies aiming to identify predictors of organ involvement and disease outcomes promise future patient stratification towards individualized treatment and care.</p><p><strong>Summary: </strong>An improved understanding of genetic variation and epigenetic marks explain phenotypic differences between age-groups and ancestries, promising their future exploitation for diagnostic, prognostic and therapeutic considerations.</p>","PeriodicalId":11145,"journal":{"name":"Current opinion in rheumatology","volume":" ","pages":"149-163"},"PeriodicalIF":5.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11789615/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142806470","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":"Epidemiology of myositis.","authors":"Fnu Duremala, Eleni Tiniakou, James Andrews","doi":"10.1097/BOR.0000000000001076","DOIUrl":"10.1097/BOR.0000000000001076","url":null,"abstract":"<p><strong>Purpose of review: </strong>This review aims to synthesize recent developments in the epidemiology of idiopathic inflammatory myopathies (IIMs), focusing on incidence, prevalence, disease classification, and clinical outcomes.</p><p><strong>Recent findings: </strong>IIM is a rare group of autoimmune diseases characterized by muscle weakness and systemic involvement, with incidence rates ranging from 0.2 to 2 cases per 100 000 person-years. The role of myositis-specific autoantibodies (MSAs) in stratifying disease risk and prognosis is increasingly recognized, such as in anti-MDA5 positive DM, which is associated with a high risk of rapidly progressive interstitial lung disease. Furthermore, patients with IIM exhibit elevated risks of comorbidities, including cardiovascular disease and malignancy.</p><p><strong>Summary: </strong>IIM diseases are complex disorders with significant health impacts, necessitating enhanced awareness and research. Improved classification and understanding of MSAs are crucial for earlier diagnosis and tailored therapeutic strategies. Continued epidemiological research is essential to elucidate underlying mechanisms and inform future interventions, ultimately aiming to enhance the quality of life and clinical outcomes for affected patients.</p>","PeriodicalId":11145,"journal":{"name":"Current opinion in rheumatology","volume":" ","pages":"121-127"},"PeriodicalIF":5.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142799667","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}
Samuel D Good, Ju Young Lee, Robert E Johnson, Elizabeth R Volkmann
{"title":"A scoping review of the epidemiology of systemic sclerosis and its organ manifestations: 2018-2024.","authors":"Samuel D Good, Ju Young Lee, Robert E Johnson, Elizabeth R Volkmann","doi":"10.1097/BOR.0000000000001063","DOIUrl":"10.1097/BOR.0000000000001063","url":null,"abstract":"<p><strong>Purpose of review: </strong>Updates from large, observational cohorts and new statistical techniques have resulted in new data on the epidemiology of systemic sclerosis (SSc). This scoping review uses data from 2018 to 2024 to describe the current understanding of the epidemiology of SSc and several of its organ- manifestations.</p><p><strong>Recent findings: </strong>Our review identified new estimates for the global incidence and prevalence of SSc (1.4-8.6 per 100 000 person-years and 17.6-18.9 per 100 000 individuals, respectively). Mortality rates remain high, though mortality at younger ages has decreased. interstitial lung disease and pulmonary arterial hypertension remain the most common causes of death for patients with SSc. Literature on gastrointestinal (GI) manifestations of SSc was scarce, and we identified significant heterogeneity in results. Furthermore, data on the epidemiology of racial, ethnic and sex-based disparities was lacking.</p><p><strong>Summary: </strong>New techniques for the evaluation of the epidemiology of SSc highlight the high morbidity and mortality of SSc, and a growing prevalence rate compared with prior eras. Further research is needed to address notable heterogeneity in the reporting of epidemiological data and understudied disease manifestations, including GI disease and health disparities in disease outcomes.</p>","PeriodicalId":11145,"journal":{"name":"Current opinion in rheumatology","volume":" ","pages":"103-112"},"PeriodicalIF":5.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11779589/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142521307","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":"Pathogenesis of psoriatic arthritis: new insights from a bone marrow perspective.","authors":"Fatima Saeed, Iannis E Adamopoulos","doi":"10.1097/BOR.0000000000001064","DOIUrl":"10.1097/BOR.0000000000001064","url":null,"abstract":"<p><strong>Purpose of review: </strong>Psoriatic arthritis is an immune-mediated disease that primarily affects the skin and joints. It falls under the umbrella term of rheumatic diseases, which describes a group of closely related yet distinct disorders with many common underlying molecular pathways. Despite the distinct clinical manifestation of each disorder, the shared therapeutic strategies attest to the commonality of cellular and molecular underpinnings. Herein we provide a concise yet comprehensive overview of the interleukin (IL)-23/IL-17 axis and its involvement in mechanistic pathways leading to the pathogenesis of this dual skin and joint clinical manifestation which is characteristic of psoriatic arthritis and other rheumatic diseases.</p><p><strong>Recent findings: </strong>The interconnection between activated innate immune cells and adaptive immunity has transformed current thinking to include other organs such as the bone marrow as potential tissue of disease origin. A plethora of animal models and genetic studies converge on the critical role of IL-23/IL-17 axis, and highlight the importance of myeloid cell activation as common pathways between autoinflammatory and autoimmune diseases and chronic inflammation. These findings underscore the intricate immune mechanisms involved in inflammatory arthritis and highlight molecular mechanisms in disease pathogenesis.</p><p><strong>Summary: </strong>These insights pave the way for the development of novel diagnostic and therapeutic strategies, with a focus on translating these findings into improved clinical practice.</p>","PeriodicalId":11145,"journal":{"name":"Current opinion in rheumatology","volume":" ","pages":"136-141"},"PeriodicalIF":5.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11779588/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142521309","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":"Recent advances in immunometabolism in rheumatic diseases.","authors":"Ryo Hisada, Michihito Kono","doi":"10.1097/BOR.0000000000001071","DOIUrl":"10.1097/BOR.0000000000001071","url":null,"abstract":"<p><strong>Purpose of review: </strong>Aberrant autoreactive innate and adaptive immune responses cause systemic autoimmune diseases. Autoimmunity has been linked to abnormal metabolic states, and immunometabolism has emerged as a critical field in understanding the pathogenesis of rheumatic diseases. We aimed to explore the latest research on metabolic reprogramming in various immune cell types, including T cells, B cells, neutrophils, dendritic cells, monocytes, and macrophages, in the context of rheumatic diseases.</p><p><strong>Recent findings: </strong>Each immune cell utilizes preferred metabolic pathways, and the cell activation dramatically modifies metabolic status. The inhibition of these pathways alters cell survival, differentiation, proliferation, and cytokine production - all of which contribute to rheumatic disease progression.</p><p><strong>Summary: </strong>Targeting metabolic pathways or introducing anti-inflammatory metabolites, such as itaconate, could be novel therapeutic strategies for rheumatic diseases. Further research should focus on strategies for translating basic research findings to bedside applications.</p>","PeriodicalId":11145,"journal":{"name":"Current opinion in rheumatology","volume":" ","pages":"142-148"},"PeriodicalIF":5.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142603180","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}
Mehmet Hocaoglu, Brian Jaros, Anisha B Dua, Sebastian E Sattui
{"title":"Epidemiology of systemic vasculitis.","authors":"Mehmet Hocaoglu, Brian Jaros, Anisha B Dua, Sebastian E Sattui","doi":"10.1097/BOR.0000000000001073","DOIUrl":"10.1097/BOR.0000000000001073","url":null,"abstract":"<p><strong>Purpose of review: </strong>Ongoing research contributes to our understanding of the epidemiology of vasculitis and its outcomes across the globe. This review aims to summarize important research studies published on this topic in the last 18 months.</p><p><strong>Recent findings: </strong>The implementation of rapid referral systems and use of large vessel imaging have improved the diagnosis of giant cell arteritis. A population-based study in immunoglobulin G4-related disease provides incidence and prevalence estimates for the United States for the first time. Recently published data supported viral infectious triggers for Kawasaki disease and immunoglobulin A vasculitis. Population studies in antineutrophil cytoplasmic antibody associated vasculitis report an increase in the incidence of eosinophilic granulomatosis with polyangiitis and have provided further insights into the burden of cardiovascular disease in these patients. Data on Behçet's disease continues to show increased all-cause mortality and need for better treatment strategies.</p><p><strong>Summary: </strong>Recent literature highlights the heterogeneity of the epidemiology of vasculitis in different parts of the world as well as associated outcomes, comorbidities, and potential triggers. Thought new classification criteria are being employed in some forms of vasculitis, standardization of case identification remains an unmet need in multiple other forms of vasculitis.</p>","PeriodicalId":11145,"journal":{"name":"Current opinion in rheumatology","volume":" ","pages":"113-120"},"PeriodicalIF":5.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142784492","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}