Arthritis & Rheumatology最新文献

{"title":"Clinical Images: A thorn injury, a sea-borne culprit, and a tenosynovitis dilemma.","authors":"Jacopo Ciaffi, Francesco Mori, Paolo Sassu, Marco Gambarotti, Alberto Righi, Eleonora Zamparini, Marco Innocenti, Marina Tadolini, Francesco Ursini","doi":"10.1002/art.70209","DOIUrl":"10.1002/art.70209","url":null,"abstract":"","PeriodicalId":129,"journal":{"name":"Arthritis & Rheumatology","volume":" ","pages":""},"PeriodicalIF":10.9,"publicationDate":"2026-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147808938","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":"Increased Risk of Intrahepatic Cholestasis of Pregnancy in SLE Women Exposed to Azathioprine.","authors":"Reem Farhat, Maria Del Carmen Zamora-Medina, Sang-Cheol Bae, Megan R W Barber, Ann E Clarke, Paul R Fortin, Zahi Touma, Carl A Laskin, Isabelle Malhamé, Giada Sebastiani, Christine Peschken, Manuel F Ugarte-Gil, Alexandra Legge, Sasha Bernatsky, Évelyne Vinet","doi":"10.1002/art.70208","DOIUrl":"https://doi.org/10.1002/art.70208","url":null,"abstract":"<p><strong>Objectives: </strong>To evaluate the risk of intrahepatic cholestasis of pregnancy (ICP) in azathioprine (AZA)-exposed versus unexposed SLE pregnancies within the multi-centre prospective Lupus in prEGnAnCY (LEGACY) cohort.</p><p><strong>Methods: </strong>LEGACY is conducted at Systemic Lupus International Collaborating Centres in Canada, South Korea, Peru, and Mexico. Pregnant women with SLE are enrolled before 17 weeks and followed in the second (20-24 weeks) and third (30-34 weeks) trimesters, and postpartum (8-12 weeks). Since ICP occurs after 20 weeks, only pregnancies with a second-trimester visit were included. Follow-up began at that visit and continued until delivery. AZA exposure was modelled as time-varying. The primary outcome was iatrogenic delivery for ICP or spontaneous preterm birth occurring after ICP diagnosis. Multivariable Cox models with frailties adjusted for relevant covariates. At the Montreal site, thiopurine metabolites and shunting were assessed.</p><p><strong>Results: </strong>Among 127 SLE pregnancies (46 AZA-exposed, 81 unexposed), 10 ICP cases occurred (each in a distinct woman): 8 among AZA-exposed (17.4%, 95% CI 9.1-30.7) and 2 among unexposed (2.5%, 95% CI 0.7-8.6). AZA exposure was associated with a substantially increased risk of ICP (adjusted HR 12.1, 95% CI 2.4-59.7). All ICP cases with metabolite data (4/4) showed second-trimester shunting. Among all pregnancies with second-trimester metabolite data (n=22), 36.4% (95% CI 19.7-57.0) were shunting, and 50.0% (95% CI 21.5-78.5) of these developed ICP.</p><p><strong>Conclusion: </strong>We observed that AZA exposure may be strongly associated with ICP in SLE pregnancies. Second-trimester thiopurine shunting may identify women at high risk, supporting the value of metabolite monitoring.</p>","PeriodicalId":129,"journal":{"name":"Arthritis & Rheumatology","volume":" ","pages":""},"PeriodicalIF":10.9,"publicationDate":"2026-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147808967","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":"ACR Presidential Address: The American College of Rheumatology in 2025 - The Strength, Resilience, and Importance of Our Rheumatology Community.","authors":"Carol A Langford","doi":"10.1002/art.70064","DOIUrl":"10.1002/art.70064","url":null,"abstract":"","PeriodicalId":129,"journal":{"name":"Arthritis & Rheumatology","volume":" ","pages":"1017-1021"},"PeriodicalIF":10.9,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13129632/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146148544","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pediatric Rheumatology Symposium 2026 Abstract Supplement.","authors":"","doi":"10.1002/art.70164","DOIUrl":"https://doi.org/10.1002/art.70164","url":null,"abstract":"<p><p>For a searchable version of these abstracts, please visit www.acrabstracts.org.</p>","PeriodicalId":129,"journal":{"name":"Arthritis & Rheumatology","volume":"78 Suppl 3 ","pages":""},"PeriodicalIF":10.9,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147808986","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":"Romosozumab and Denosumab Combination Therapy After Denosumab in Postmenopausal Osteoporosis.","authors":"Giovanni Adami, Francesco Pollastri, Angelo Fassio, Filippo Montanari, Anna Piccinelli, Camilla Benini, Emma Pasetto, Carmen Dartizio, Davide Gatti, Maurizio Rossini, Ombretta Viapiana","doi":"10.1002/art.70002","DOIUrl":"10.1002/art.70002","url":null,"abstract":"<p><strong>Objective: </strong>Transition from long-term denosumab (Dmab) to parathyroid hormone-analogs or romosozumab (Romo) might expose patients to the risk of the so-called rebound phenomenon. Adding Romo to Dmab might represent an option in patients experiencing a fracture while on Dmab. The aim of this study was to investigate the effects of the combination of Romo to Dmab in postmenopausal osteoporosis.</p><p><strong>Methods: </strong>We did a 36-month combined retrospective and prospective study analyzed with prospective score matching. Postmenopausal women were divided into two groups: patients on Dmab who added Romo to Dmab (Dmab from baseline [M-24] to Romo initiation [M0] ➔ Dmab + Romo from M0 to M+12), and matched controls on Dmab continuing Dmab (Dmab from M-24 to M0 ➔ Dmab from M0 to M+12). Bone mineral density and bone turnover markers (CTX, P1nP) were assessed at follow-up time points.</p><p><strong>Results: </strong>A total of 50 women were included in the study: 25 patients in the Dmab ➔ Dmab + Romo group and 25 matched controls in the Dmab ➔ Dmab group. The between-group difference at M+12 was 3.3% (95% confidence interval -5.2 to 11.8), indicating a nonsignificant trend toward greater improvement with combination therapy. Adding Romo to Dmab increased P1nP significantly between M0 and M+3 (+22.5 ng/mL, SE = 8.7; P = 0.028).</p><p><strong>Conclusion: </strong>Ongoing treatment with Dmab did not blunt the anabolic response of Romo, indicating sustained modeling-based bone formation activity. Adding Romo in patients failing Dmab might be a valuable option.</p>","PeriodicalId":129,"journal":{"name":"Arthritis & Rheumatology","volume":" ","pages":"1176-1183"},"PeriodicalIF":10.9,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13129633/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145653083","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Getting It Right for Our Patients.","authors":"Marie Hudson, Daniel H Solomon","doi":"10.1002/art.70049","DOIUrl":"10.1002/art.70049","url":null,"abstract":"","PeriodicalId":129,"journal":{"name":"Arthritis & Rheumatology","volume":" ","pages":"1022-1024"},"PeriodicalIF":10.9,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145888297","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":"Kidney Hematopoietic Stem and Progenitor Cells Contribute to Myeloid Development and Pathology in Lupus Nephritis.","authors":"Hansol Yi,Seyoung Jung,Jeong Ho Joo,Young-Eun Kim,Heounjeong Go,Yong-Gil Kim,Chang-Keun Lee,Bin Yoo,Jeong Seok Lee,Seokchan Hong","doi":"10.1002/art.70201","DOIUrl":"https://doi.org/10.1002/art.70201","url":null,"abstract":"OBJECTIVESThe hematopoietic system maintains homeostasis by balancing myeloid and lymphoid cell production in the bone marrow (BM). In response to increased hematopoietic demand, extramedullary hematopoiesis (EMH) may occur in non-lymphoid organs. We investigated the role of EMH and kidney-resident hematopoietic stem and progenitor cells (HSPCs) in lupus nephritis (LN) pathogenesis.METHODSTwo murine LN models (MRL/lpr and TLR7 agonist-induced) were used to identify and characterize lineage-negative (Lin-) CD45+Sca1+ progenitor cells in the kidney. The association with disease severity was assessed using clinical parameters and histology. Single-cell RNA sequencing, including BM-to-kidney trajectory analysis and adoptive transfer experiments, evaluated lineage potential and pathogenicity. Stromal cell-derived hyaluronan (HA) was visualized by immunostaining. Urine samples from patients with LN were analyzed for hematopoietic progenitors and HA levels.RESULTSKidney Lin-CD45+Sca1+ cells were enriched in LN mice and correlated with increased proteinuria, elevated blood urea nitrogen, and kidney histological severity. These cells demonstrated a myeloid differentiation potential and shared transcriptional features with BM progenitors. Trajectory analysis indicated that BM-derived progenitors migrate to the kidneys and undergo local maturation. Adoptive transfer of LN-derived BM HSPCs induced kidney damage and myeloid infiltration, particularly under TLR7 stimulation. Kidney Sca1+ cells expressed CD44 and localized near HA-producing stromal cells in the renal pelvis. In human LN, urinary progenitor cells correlated with kidney dysfunction and HA levels.CONCLUSIONSEMH occurs in the kidneys during LN and contributes to disease progression through local myeloid cell expansion. Targeting kidney progenitors may offer novel therapeutic strategies to control local inflammation in LN.","PeriodicalId":129,"journal":{"name":"Arthritis & Rheumatology","volume":"1 1","pages":""},"PeriodicalIF":13.3,"publicationDate":"2026-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147754717","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":"Differences in SARS-CoV-2 antigen persistence in individuals with systemic autoimmune rheumatic diseases compared to the general population: A RECOVER-Adult Cohort Study.","authors":"Naomi J Patel,Zoe Swank,Jiaqi Wang,Xiaosong Wang,Lauren A O'Keeffe,Madison Negron,Liya S Getachew,Louise L Hansen,Grace Qian,Alene A Saavedra,Kevin T Mueller,Natalie A Davis,Kathleen M M Vanni,Sandria Savage,Julie S Lam,Zachary S Wallace,David R Walt,Jeffrey A Sparks, ","doi":"10.1002/art.70205","DOIUrl":"https://doi.org/10.1002/art.70205","url":null,"abstract":"BACKGROUNDIndividuals with systemic autoimmune rheumatic diseases (SARDs) are at risk for worse acute and post-acute COVID-19 outcomes, though whether individuals with SARDs have longer persistence of viral antigens after COVID-19 has not been studied.METHODSThis retrospective cohort study evaluated post-COVID-19 differences in SARS-CoV-2 antigen (spike, S1, and nucleocapsid) positivity between individuals with SARDs (RheumCARD) and without SARDs (RECOVER-Adult). SARS-CoV-2 antigens were measured in collected samples using a validated ultra-sensitive single molecule array. This digital enzyme-linked immunosorbent assay used antibody-coated magnetic beads to capture antigen molecules, which were loaded into microwell arrays and detected through enzymatic cleavage of a fluorescent substrate. We used logistic regression to estimate unadjusted and adjusted (for age, sex, infection year, vaccination status, and COVID-19 treatment) odds ratios for SARS-CoV-2 antigen positivity at months 3 and 6 following COVID-19.RESULTSAmong 210 individuals with SARDs in RheumCARD and 348 individuals without SARDs in RECOVER-Adult, any SARS-CoV-2 antigen positivity was more common in those with SARDs (36.7% in RheumCARD vs. 18.9% in RECOVER-Adult; p<0.001). Those with SARDs had higher odds of nucleocapsid antigen positivity (adjusted OR 3.73, 95% CI: 1.28-10.85) or any antigen positivity (adjusted OR 2.89, 95% CI: 1.43-5.85) 3 months after COVID-19 infection and higher odds of nucleocapsid antigen positivity (adjusted OR 6.62, 95% CI: 1.09-40.30) 6 months after COVID-19 infection.CONCLUSIONIndividuals with SARDs were more likely to have SARS-CoV-2 antigen positivity at months 3 and 6 following COVID-19 infection compared with individuals without SARDs, not explained by demographics, variant, vaccination, or treatment.","PeriodicalId":129,"journal":{"name":"Arthritis & Rheumatology","volume":"25 1","pages":""},"PeriodicalIF":13.3,"publicationDate":"2026-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147753287","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":"Determinants of Difficult-to-Manage and Treatment-Refractory Axial Spondyloarthritis: A Cross-Sectional Analysis within a Longitudinal Cohort.","authors":"Patricia Remalante-Rayco,Laura Passalent,Tina Chim,Hannah Vijayan,Manal Alnasser,Zeynep Baskurt,Robert D Inman,Nigil Haroon,Denis Poddubnyy","doi":"10.1002/art.70202","DOIUrl":"https://doi.org/10.1002/art.70202","url":null,"abstract":"OBJECTIVETo estimate the prevalence of difficult-to-manage (D2M) and treatment-refractory (TR) axSpA and to identify factors associated with D2M/TR disease in a longitudinal cohort.METHODSWe performed a cross-sectional analysis on data from the Schroeder Arthritis Institute Spondylitis Program cohort. Assessment of SpondyloArthritis International Society (ASAS) definitions for D2M and TR disease were applied to axSpA patients. Sociodemographic and disease-related characteristics were compared between groups, and multivariable logistic regression was performed to estimate odds ratios (ORs) for factors associated with D2M.RESULTSAmong 536 patients, 49 (9.1%) met the ASAS D2M definition and 12 (2.2%) were classified as TR. Compared with non-D2M patients, those with D2M exhibited higher disease activity, worse function and spinal mobility, and a higher prevalence of comorbidities, degenerative spine disease, and fibromyalgia. TR patients showed greater disease burden and were more often male, HLA-B27-positive, and had radiographic axSpA, but were less affected by non-inflammatory pain contributors. In multivariable analysis, higher spinal pain scores (OR 1.48, 95% CI 1.29 to 1.70) and fibromyalgia (OR 3.09, 95% CI 1.33 to 7.15) were independently associated with D2M.CONCLUSIONApproximately one in ten axSpA patients in this cohort fulfilled the ASAS D2M definition, with a smaller proportion classified as TR. D2M status was associated with higher spinal pain and fibromyalgia, whereas TR patients had active disease with less non-inflammatory pain contributors. These findings support the clinical relevance of the D2M construct and highlight the need for a tailored management approach in clinical practice.","PeriodicalId":129,"journal":{"name":"Arthritis & Rheumatology","volume":"25 1","pages":""},"PeriodicalIF":13.3,"publicationDate":"2026-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147753288","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":"Higher complement C4 gene copy number constitutes a shared genetic risk factor for giant cell arteritis and IgA vasculitis.","authors":"Laura Martínez-Gutiérrez,Gonzalo Borrego-Yaniz,José Hernández-Rodríguez,Carlo Salvarani,María Cinta Cid,Ann W Morgan, , ,Miguel Ángel González-Gay,Javier Martín,Ana Márquez,Martin Kerick","doi":"10.1002/art.70203","DOIUrl":"https://doi.org/10.1002/art.70203","url":null,"abstract":"OBJECTIVELow copy number (CN) of complement C4 isoforms and high CN of retroviral HERV-K elements are known risk factors for many immune-mediated inflammatory diseases (IMIDs), often showing sex-biased effects. Here, we assessed whether CN variation within the C4 gene contributes to giant cell arteritis (GCA) and IgA vasculitis (IgAV), two complex vasculitides involving complement dysregulation.METHODSC4A, C4B and HERV-K CNs were imputed from genotypic data of 3,498 GCA patients, 284 IgAV patients and 16,867 controls. We evaluated their associations with vasculitis risk overall and stratified by sex (inferred from genetic data), alongside classical human leukocyte antigen (HLA) alleles.RESULTSContrary to other IMIDs, we identified higher C4 CN to confer risk to GCA and IgAV. Specifically, in GCA, higher C4B CN conferred risk in male patients (OR = 1.23 (1.07 - 1.42), p = 4.52 x 10-3, pFDR = 1.40 x 10-2). In IgAV, elevated C4A CN was significantly associated with disease susceptibility in the overall cohort (OR = 1.68 (1.22 - 2.30), p = 1.49 x 10-3, pFDR = 4.48 x 10-3), while C4B CN showed a male-biased trend, as observed in GCA (OR = 1.46 (1.02 -2.08), p = 3.88 x 10-2, pFDR = 5.80 x 10-2). Conditional analyses confirmed that these associations were independent of classical HLA alleles.CONCLUSIONThis study reveals sex-dependent variation in C4 CN as a novel genetic risk factor for GCA and IgAV, suggesting shared biological mechanisms involving complement dysregulation, sustained inflammation and vascular damage.","PeriodicalId":129,"journal":{"name":"Arthritis & Rheumatology","volume":"1 1","pages":""},"PeriodicalIF":13.3,"publicationDate":"2026-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147753286","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}