Arthritis & Rheumatology最新文献

{"title":"Ulcerated Gottron's papules in anti‐MDA5 dermatomyositis","authors":"Philipp Jud, Monica D'Orazio","doi":"10.1002/art.70397","DOIUrl":"https://doi.org/10.1002/art.70397","url":null,"abstract":"","PeriodicalId":129,"journal":{"name":"Arthritis & Rheumatology","volume":"18 1","pages":""},"PeriodicalIF":13.3,"publicationDate":"2026-11-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149374440","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Abstract Supplement ACR Convergence 2026","authors":"","doi":"10.1002/art.70373","DOIUrl":"https://doi.org/10.1002/art.70373","url":null,"abstract":"<p>For a searchable version of these abstracts, please visit www.acrabstracts.org.</p>","PeriodicalId":129,"journal":{"name":"Arthritis & Rheumatology","volume":"78 S10","pages":""},"PeriodicalIF":9.9,"publicationDate":"2026-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149356475","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Synovial Tissue-Guided Interleukin-17A Inhibition for Refractory Arthritis in a Patient With Systemic Juvenile Idiopathic Arthritis.","authors":"Indira Sriram, Tomohiro Kawabe, Hitoshi Irabu, Mariana Correia Marques, Clara Lin, Alisa Gaskell, Jun Inamo, Michael R Clay, Roselyn Fierkens, Robert C Fuhlbrigge, Jeremy D Prager, Norman R Friedman, Sarah A Gitomer, Michael J Ombrello, Kentaro Yomogida","doi":"10.1002/art.70395","DOIUrl":"https://doi.org/10.1002/art.70395","url":null,"abstract":"<p><strong>Objective: </strong>The objective of this study was to characterize the clinical, immunologic, and synovial tissue features of a patient with a systemic juvenile idiopathic arthritis (sJIA) who carries a novel heterozygous STAT5B loss-of-function variant (p.Gln139Ter) and whose arthritis responded markedly to interleukin-17A (IL-17A) inhibition.</p><p><strong>Methods: </strong>Patient blood was compared with blood from healthy donors (n = 5) for immunoblotting, phospho-flow cytometry and immune cell profiling. Patient synovial fluid was compared with synovial fluid from seronegative oligoarticular or polyarticular juvenile idiopathic arthritis (oligo/poly JIA) (n = 5-6) for immune cell profiling. Patient synovial tissue was compared with synovial tissue from children with oligo/poly JIA (n = 11) using Xenium spatial transcriptomics.</p><p><strong>Results: </strong>CD4⁺ T cells from the patient exhibited impaired STAT5 phosphorylation (z score = -11.1). Synovial fluid CD4⁺ T cells showed markedly increased IL-17A production (z score = 34.5) and reduced FOXP3 expression (z score = -2.25) in regulatory T cells. Spatial transcriptomics revealed T helper 17 (Th17) cells distributed diffusely throughout the patient's synovium, in contrast to JIA controls in which Th17 cells were largely restricted to tertiary lymphoid structures (TLS) (z score = 3.08). The patient's severe arthritis, previously refractory to IL-1 and IL-6 blockade, improved markedly after IL-17A inhibition.</p><p><strong>Conclusion: </strong>STAT5B haploinsufficiency may contribute to an sJIA phenotype characterized by Th17/IL-17 dysregulation and an altered distribution of Th17 cells outside TLS. Integrated genetic, functional, and spatial tissue analyses may help identify therapeutic targets in refractory pediatric arthritis.</p>","PeriodicalId":129,"journal":{"name":"Arthritis & Rheumatology","volume":" ","pages":""},"PeriodicalIF":9.9,"publicationDate":"2026-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149356981","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predicting Inactive Disease in Juvenile Idiopathic Arthritis: A Dynamic Machine Learning Approach.","authors":"Seungwon Lee, Marie Davidian, Marc D Natter, Bryce B Reeve, Laura E Schanberg, Eleanor Belkin, Min-Lee Chang, Yukiko Kimura, Mei-Sing Ong","doi":"10.1002/art.70394","DOIUrl":"https://doi.org/10.1002/art.70394","url":null,"abstract":"<p><strong>Background: </strong>Optimal management of juvenile idiopathic arthritis (JIA) remains challenging. The ability to predict disease progression in JIA can improve personalized treatment decisions, but few reliable predictors have been identified.</p><p><strong>Methods: </strong>Using data from the Childhood Arthritis and Rheumatology Research Alliance (CARRA) Registry (years 2015-2024), we developed machine learning models to predict attainment of inactive disease in children with non-systemic JIA. We compared three structurally distinct algorithms: Dynamic Bayesian Networks (DBN), Convolutional Neural Networks (CNN), and eXtreme Gradient Boosting (XGBoost). Using a dynamic approach, the models predicted at each timepoint whether a child would attain inactive disease approximately six months later, based on the preceding 12 months of data (demographic, clinical, and medication variables), with predictions updated as new visits accrued.</p><p><strong>Results: </strong>A total of 8,093 participants were included. On an independent test cohort, all 3 models achieved comparable discrimination (AUC 0.76-0.79). Predicted probabilities were well-calibrated (Expected Calibration Error ≤0.03). Disease activity levels in the preceding 12 months, presence of enthesitis and uveitis were the strongest predictors. The dependency structure learned by the DBN indicated that treatment decisions were primarily reactive to disease activity and shaped by JIA category and step-therapy requirements.</p><p><strong>Conclusions: </strong>Machine learning approaches can predict attainment of inactive disease over time with moderate discriminative performance, offering potential to support early identification of children with JIA at risk for unfavorable outcomes. The suboptimal care patterns and systems-level barriers identified through our analyses highlight priority targets for quality improvement initiatives and policy interventions to reduce gaps in JIA care.</p>","PeriodicalId":129,"journal":{"name":"Arthritis & Rheumatology","volume":" ","pages":""},"PeriodicalIF":9.9,"publicationDate":"2026-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149356980","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Abstract Supplement ACR Convergence 2026","authors":"","doi":"10.1002/art.70373","DOIUrl":"https://doi.org/10.1002/art.70373","url":null,"abstract":"<p>For a searchable version of these abstracts, please visit www.acrabstracts.org.</p>","PeriodicalId":129,"journal":{"name":"Arthritis & Rheumatology","volume":"78 S10","pages":""},"PeriodicalIF":9.9,"publicationDate":"2026-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149356327","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of a Smartphone-Enabled, Physician-Supervised Treat-to-Target Model for Gout Management: A 12-Month Randomized Controlled Trial.","authors":"Yining Gao, Zhiwei Cao, Zijun Xu, Ruizhi Liu, Shuang Liu, Le Yan, Chuchu Liu, Qi Chen, Cuiling Zhu, Yueye Huang, Xiaoyun Cheng, Zhenchun Miao, Jie Li, Lu Wang, Nicola Dalbeth, Haibing Chen","doi":"10.1002/art.70387","DOIUrl":"https://doi.org/10.1002/art.70387","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate whether an integrated, smartphone-enabled, physician-supervised treat-to-target (T2T) care model improves serum urate (SUA) target attainment compared with usual care, and to explore its effects on gout flares and systemic metabolic parameters.</p><p><strong>Methods: </strong>This 12-month, single-center, open-label, superiority randomized controlled trial enrolled 280 men with gout. Participants were randomized (1:1) to an integrated digitally supported care model (the \"1CARE\" platform combining automated behavioral reminders, tiered education, remote SUA monitoring, and weekly physician review) or Usual Care. The primary outcome was the proportion of patients achieving serum urate (SUA) <360μmol/L. Secondary outcomes included gout flares and metabolic parameters.</p><p><strong>Results: </strong>At 12 months, 85.0% (119/140) of participants in the App-Led group achieved the primary therapeutic target of SUA<360μmol/L, compared with 48.6% (68/140) in the Usual Care group (risk ratio 1.75 [95% CI 1.46 to 2.10]; P < 0.0001). The App-Led Care group also showed a significantly lower annualized gout flare frequency (0.02 vs 0.10 flares/year; P < 0.01). Exploratory metabolic outcomes favored the App-Led Care group, with greater reductions in fasting plasma glucose, HbA1c, total cholesterol, and LDL cholesterol (all P < 0.05), alongside higher medication adherence. Adverse event rates were comparable between the two groups.</p><p><strong>Conclusion: </strong>An integrated, physician-supervised, digitally supported T2T care model significantly improved SUA target attainment and reduced gout flares compared with usual care over 12 months. Multi-center trials will be needed to fully evaluate the generalizability, cost-effectiveness, and optimal configuration of this approach.</p>","PeriodicalId":129,"journal":{"name":"Arthritis & Rheumatology","volume":" ","pages":""},"PeriodicalIF":9.9,"publicationDate":"2026-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149316342","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Spatial Proteomics Identifies Distinct Synovial Microenvironments in Hip and Knee Osteoarthritis.","authors":"Peng Xie, Antonia R Sun, Zhengtan Zheng, Yunkun Qu, Feng Gao, Christina Theodoropoulos, Nicholas Matigian, Zhiyong Li, Ross Crawford, Indira Prasadam","doi":"10.1002/art.70390","DOIUrl":"https://doi.org/10.1002/art.70390","url":null,"abstract":"<p><strong>Objective: </strong>Osteoarthritis (OA) is a heterogeneous joint disease, yet mechanistic insights derive predominantly from knee OA and are often extrapolated to other joints. We investigated joint-associated differences in the spatial molecular organization of hip and knee OA synovium.</p><p><strong>Methods: </strong>Synovial tissues from patients undergoing arthroplasty for primary hip or knee OA were analyzed by histology (hip, n=10; knee, n=10), mass spectrometry-based bulk proteomics (hip, n=10; knee, n=8), and NanoString GeoMx Digital Spatial Profiling (hip, n=5; knee, n=5). Spatial proteomic profiling was performed across intimal and subintimal regions segmented into CD45⁺ immune and CD45^- non-immune compartments.</p><p><strong>Results: </strong>Hip OA synovium exhibited greater vessel density than knee OA synovium (P < 0.001), whereas histological synovitis severity did not differ significantly. Bulk proteomics showed enrichment of angiogenesis in hip OA (FDR q=0.001) and fatty acid metabolism in knee OA (FDR q<0.001). Spatial proteomic profiling revealed a vascular-stromal remodeling signature in the hip OA subintimal CD45^- compartment, with higher abundance of VEGFR2, vWF, α-SMA, PDGFB, and YAP1. Hip OA also showed higher CD3E/CD3G abundance in the subintimal CD45⁺ compartment and higher calreticulin abundance across multiple compartments. In contrast, knee OA exhibited a GLP-1/GLP-1R-associated metabolic signature in the intimal CD45⁺ compartment. The knee OA subintimal CD45^- compartment also showed higher HK2 abundance and enrichment of lipid-associated LXR/RXR signaling.</p><p><strong>Conclusion: </strong>Hip and knee OA synovium exhibit distinct spatially organized molecular phenotypes, highlighting the importance of joint-specific context in OA pathobiology.</p>","PeriodicalId":129,"journal":{"name":"Arthritis & Rheumatology","volume":" ","pages":""},"PeriodicalIF":9.9,"publicationDate":"2026-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149316343","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Image: B-cell lymphoma mimicking myositis.","authors":"Mariana Manoel Oku, Joanna C Dalland, Aikaterini Thanou, Margherita Milone","doi":"10.1002/art.70392","DOIUrl":"https://doi.org/10.1002/art.70392","url":null,"abstract":"","PeriodicalId":129,"journal":{"name":"Arthritis & Rheumatology","volume":" ","pages":""},"PeriodicalIF":9.9,"publicationDate":"2026-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149316367","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Differentiation and Pathological Significance of Tissue-Resident Memory-Like CD8⁺ T Cells in Systemic Lupus Erythematosus.","authors":"Yuya Fujita, Kaoru Yamagata, Satoshi Kubo, Ippei Miyagawa, Koshiro Sonomoto, Yurie Satoh-Kanda, Masanobu Ueno, Shumpei Kosaka, Aya Nawata, Yoshiya Tanaka, Shingo Nakayamada","doi":"10.1002/art.70389","DOIUrl":"https://doi.org/10.1002/art.70389","url":null,"abstract":"<p><strong>Objective: </strong>Tissue-resident memory T (T_RM) cells have been implicated in organ-specific immune pathology; however, the pathological relevance of T_RM-like CD8⁺ T cells in systemic lupus erythematosus (SLE) remains unclear. We investigated their differentiation mechanisms and pathological significance in SLE, including associations with disease activity and organ involvement.</p><p><strong>Methods: </strong>Peripheral blood samples from 30 treatment-naïve patients with SLE, 40 patients with rheumatoid arthritis (RA), and 30 healthy donors (HDs) were analyzed by flow cytometry. Renal biopsy specimens from 20 patients with SLE were examined by immunofluorescence. Naïve CD8⁺ T cells from HDs were stimulated with cytokines to induce T_RM-like differentiation, followed by phenotypic, functional, transcriptional, and metabolic analyses. The effects of Janus kinase (JAK) inhibitors were assessed.</p><p><strong>Results: </strong>Circulating CD8⁺CD69⁺CD103⁺ T_RM-like cells were more frequent in SLE than in RA and HDs (P=0.022 and P<0.001, respectively) and correlated with anti-dsDNA antibodies (rs=0.468, P=0.016) and CH50 (rs=-0.397, P=0.045). Patients with active kidney involvement (renal BILAG A/B; n=17) had higher T_RM-like cell proportions than those without active kidney involvement (n=13; P<0.05). CD3⁺CD103⁺ cells in renal lesions expressed granzyme B or interferon-γ. Patients with baseline T_RM-like cell proportions ≥0.40% had higher urine protein-to-creatinine ratios and SELENA-SLEDAI scores at week 24 (both P<0.05). IL-15 plus TGF-β1 induced T_RM-like differentiation with effector, transcriptional, survival, and metabolic features, whereas JAK inhibition suppressed differentiation and granzyme B expression.</p><p><strong>Conclusion: </strong>Circulating T_RM-like CD8⁺ T cells were associated with SLE activity and kidney involvement. IL-15/TGF-β1-dependent differentiation partly involved JAK/STAT signaling, supporting further evaluation as a biomarker and therapeutic target.</p>","PeriodicalId":129,"journal":{"name":"Arthritis & Rheumatology","volume":" ","pages":""},"PeriodicalIF":9.9,"publicationDate":"2026-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149316341","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Booster dilemma: Balancing COVID-19 protection and vaccine fatigue in the rheumatology population.","authors":"Ai Li Yeo, Kevin L Winthrop","doi":"10.1002/art.70391","DOIUrl":"https://doi.org/10.1002/art.70391","url":null,"abstract":"","PeriodicalId":129,"journal":{"name":"Arthritis & Rheumatology","volume":" ","pages":""},"PeriodicalIF":9.9,"publicationDate":"2026-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149316344","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}