Modern Rheumatology最新文献

{"title":"Clinical outcomes of biologic therapies for knee osteoarthritis: A systematic review and meta-analysis of studies with ≥12-month follow-up.","authors":"Tomohiro Oka, Takashi Kitagawa, Takafumi Nasu, Yasuyuki Kurasawa, Hayato Kunihara, Kosuke Suzuki, Norimasa Nakamura","doi":"10.1093/mr/roag010","DOIUrl":"10.1093/mr/roag010","url":null,"abstract":"<p><p>This systematic review and meta-analysis aimed to assess the clinical outcomes of biologic therapies, which include platelet-rich plasma and cell-based therapies (e.g. adipose-derived mesenchymal stem cells), on pain, physical function, and disease progression in patients with knee osteoarthritis (OA), focusing on studies with a follow-up of at least 12 months. We searched for randomized controlled trials (RCTs) posted at some stage in January 2000-May 2025. Eligible research protected the ones in adults with Kellgren-Lawrence grades I-III OA who underwent at least 12 months of follow-up. The bias risk was assessed, and the evidence certainty was evaluated. Random-effects models were used for pooled analyses. Fourteen RCTs were included. Compared with control treatments, biologic therapies significantly reduced pain and improved physical function. Potential structural benefits, including cartilage thickness preservation and favourable biochemical changes, were noted. However, substantial heterogeneity in study design and intervention protocols, along with potential publication bias, reduced the certainty of evidence to a very low level. Biologic therapies may be associated with improvements in pain and physical function at ≥12 months of follow-up, with preliminary indications of structural benefit. Nevertheless, high-quality multicentre RCTs with extended follow-up are warranted.</p>","PeriodicalId":18705,"journal":{"name":"Modern Rheumatology","volume":" ","pages":"696-704"},"PeriodicalIF":2.1,"publicationDate":"2026-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146181057","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical characteristics of giant cell arteritis with ocular involvement: A single-centre retrospective study.","authors":"Toshio Kawamoto, Michihiro Ogasawara, Shuko Nojiri, Kyuta Kato, Yuko Matsuki-Muramoto, Masakazu Matsushita, Ken Yamaji, Naoto Tamura","doi":"10.1093/mr/roag013","DOIUrl":"10.1093/mr/roag013","url":null,"abstract":"<p><strong>Objectives: </strong>To clarify the clinical characteristics of patients with ocular involvement in giant cell arteritis (GCA).</p><p><strong>Methods: </strong>This was an observational, single-centre, retrospective study of patients with GCA treated at Juntendo University Hospital between January 2012 and July 2023. The study involved 71 patients, including 21 with ocular involvement: 10 had fundus findings such as anterior ischemic optic neuropathy or central retinal artery occlusion (6 with permanent vision loss) and 11 without fundus findings. The demographic and clinical features of GCA were compared between patients with and without ocular involvement.</p><p><strong>Results: </strong>The temporal artery was found to be affected more frequently in cases with ocular involvement than in those without on positron emission tomography/computed tomography (P = .013) and vascular ultrasound (P = .02). The average number of signs and symptoms observed before diagnosis was higher in patients with ocular involvement than in those without (P < .001). The period from the appearance of ocular involvement to therapy initiation was shorter in patients with fundus findings than in those without (8.2 vs. 73.8 days; P = .032).</p><p><strong>Conclusions: </strong>Early imaging and early consultation with an ophthalmologist are important, as ocular involvement with fundus findings tended to occur earlier in GCA patients than without fundus findings.</p>","PeriodicalId":18705,"journal":{"name":"Modern Rheumatology","volume":" ","pages":"794-800"},"PeriodicalIF":2.1,"publicationDate":"2026-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146227597","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patient-reported outcomes in patients with rheumatoid arthritis treated with baricitinib: A prospective observational study in Japan.","authors":"Yuko Kaneko, Naoto Tsujimoto, Izumi Sato, Taisuke Kojima, Kei Ikeda","doi":"10.1093/mr/roag032","DOIUrl":"10.1093/mr/roag032","url":null,"abstract":"<p><strong>Objectives: </strong>This real-world study evaluated the effectiveness of baricitinib on the activities of daily living and health-related quality of life in patients with rheumatoid arthritis in Japan, and it explored the association between early pain and fatigue improvements and 12-month remission.</p><p><strong>Methods: </strong>The study involved patients with rheumatoid arthritis aged ≥20 who initiated baricitinib and were followed for 12 months. Patient-reported outcomes were assessed using a visual analogue scale, the Locomo 5, the EQ-5D-5L, and the SF-36 subscales.</p><p><strong>Results: </strong>The study included 353 patients (mean age of 63.4 years). Baricitinib substantially reduced pain levels from a mean (SD) of 48.4 (26.5) mm, fatigue levels from 42.3 (28.3) mm, and morning stiffness from 51.8 (126.9) min at baseline, to 25.2 (21.4) mm, 24.3 (22.7) mm, and 15.8 (38.7) min, respectively, at 12 months. Clinically meaningful improvements were observed in activities of daily living [Locomo 5 scores: 6.9 (5.7) to 4.7 (5.3)] and health-related quality of life [EQ-5D-5L index scores: 0.700 (0.217) to 0.829 (0.166)] over 12 months. Logistic regression analysis revealed that early improvements in pain and fatigue were predictive of disease remission at 12 months.</p><p><strong>Conclusions: </strong>Baricitinib improved patient-reported outcomes in patients with rheumatoid arthritis in Japan, with early symptom relief predicting mid-term disease remission. To complement this abstract, a video abstract is available online.</p>","PeriodicalId":18705,"journal":{"name":"Modern Rheumatology","volume":" ","pages":"724-736"},"PeriodicalIF":2.1,"publicationDate":"2026-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147494230","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Validation of the Japanese version of the paediatric quality of life inventory rheumatology module.","authors":"Yujiro Tanabe, Shingo Yamanishi, Hidehiko Narazaki","doi":"10.1093/mr/roag022","DOIUrl":"10.1093/mr/roag022","url":null,"abstract":"<p><strong>Objectives: </strong>To translate and culturally adapt the Japanese version of the Paediatric Quality of Life Questionnaire (PedsQL) 3.0 Rheumatology Module (PedsQL-RM3.0JA) for children with paediatric rheumatic diseases, as well as to evaluate its reliability and validity.</p><p><strong>Methods: </strong>This study included 76 patients aged 2-18 years and their parents, who completed the Japanese PedsQL 4.0 Generic Core Scale (PedsQL-GCS4.0JA) and PedsQL-RM3.0JA. Internal consistency (Cronbach's α), intraclass correlation coefficients, and validity were analysed using SPSS 29.</p><p><strong>Results: </strong>Child self-reports and parent proxy reports had Cronbach's α coefficients ranging from 0.781 to 0.938 and 0.722 to 0.915, respectively, indicating good to excellent reliability. Intraclass correlation coefficients exceeded 0.7 for most subscales. Physical Functioning and Emotional Functioning had moderate to strong correlations with the Pain and Daily Living subscales (r = 0.442-0.749), confirming concurrent and convergent validity. The sample size of infants (2-4 years) was insufficient for evaluation. The evaluation showed limited reliability in young children (5-7 years) due to a small sample size and developmental considerations.</p><p><strong>Conclusions: </strong>The PedsQL-RM3.0JA demonstrated high reliability and validity in children aged 8 years and older, supporting its utility for evaluating health-related quality of life in paediatric rheumatic diseases in Japan.</p>","PeriodicalId":18705,"journal":{"name":"Modern Rheumatology","volume":" ","pages":"837-844"},"PeriodicalIF":2.1,"publicationDate":"2026-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147369895","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cortical bone defects at metacarpophalangeal and wrist joints in healthy individuals assessed by high-resolution peripheral quantitative computed tomography.","authors":"Takeshi Iida, Ko Chiba, Kazuteru Shiraishi, Kounosuke Watanabe, Makoto Osaki","doi":"10.1093/mr/roag016","DOIUrl":"10.1093/mr/roag016","url":null,"abstract":"<p><strong>Objective: </strong>We examined erosions occurring in the metacarpophalangeal (MCP) and wrist joints of healthy subjects using high-resolution peripheral quantitative computed tomography (HR-pQCT).</p><p><strong>Methods: </strong>Twenty healthy women were included. The second and third MCP and wrist joints were scanned using HR-pQCT. The number, volume, and anatomical distribution of erosions were measured, and the correlation between erosion number and age was analysed.</p><p><strong>Results: </strong>An average of 4.0 erosions were found in the MCP joints, 30.8 in the carpal bones, and 7.9 in the distal radius and ulna. Most erosions (69.3%) were <0.5 mm3. Larger erosions (>0.5 mm3) were mainly seen in the carpal bones, with an average of 12.1 in total, especially the capitate and lunate (3.9 and 2.2, respectively). The number of carpal erosions correlated with age, especially for erosions < 0.5 mm3 (R = 0.48).</p><p><strong>Conclusions: </strong>Numerous bone erosions were identified in the MCP and wrist joints of healthy individuals. Relatively well-defined erosions measuring ≥0.5 mm3 were frequently observed in specific carpal bones, particularly the capitate and lunate. Additionally, erosions <0.5 mm3 showed a positive correlation with age, suggesting that numerous small cortical bone defects may represent age-related physiological changes. These findings provide important context when interpreting erosive changes associated with joint diseases in clinical practice.</p>","PeriodicalId":18705,"journal":{"name":"Modern Rheumatology","volume":" ","pages":"852-859"},"PeriodicalIF":2.1,"publicationDate":"2026-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147271510","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Real-world efficacy, safety, and drug retention of anakinra and canakinumab in paediatric colchicine-resistant familial Mediterranean fever: Insights from a single-centre cohort.","authors":"Şengül Çağlayan, Taner Coşkuner, Kadir Ulu, Ramazan Emre Yiğit, Şeyma Türkmen, Gülcan Özomay Baykal, Eray Tunce, Sıla Atamyıldız Uçar, Betül Sözeri","doi":"10.1093/mr/roag015","DOIUrl":"10.1093/mr/roag015","url":null,"abstract":"<p><strong>Background: </strong>This study evaluated the efficacy, safety, and drug retention of anakinra and canakinumab in paediatric patients with colchicine-resistant familial Mediterranean fever (cr-FMF) within a real-world cohort.</p><p><strong>Methods: </strong>This retrospective cohort study was conducted from June 2016 to April 2024, including 86 patients diagnosed with cr-FMF. Clinical and laboratory parameters, including attack frequency, C-reactive protein, serum amyloid A, and autoinflammatory disease activity index (AIDAI) scores, were recorded at baseline and during follow-up.</p><p><strong>Results: </strong>A total of 86 patients (50 females, 36 males) were included in the study. All carried exon 10 MEFV mutations, with 69 patients (80.2%) having the M694V/M694V genotype. Anakinra was initiated in 36 patients (41.9%), and canakinumab in 50 patients (58.1%). The median treatment duration was significantly longer for canakinumab (48 months) compared to anakinra (7 months) (P < .001). Both treatments significantly reduced attack frequency, AIDAI scores, C-reactive protein, and serum amyloid A levels compared to baseline (P < .001). While the reduction in attack frequency was comparable between the groups, patients treated with canakinumab achieved significantly lower mean AIDAI scores at 12 months compared to the anakinra group (P = .021). Anakinra provided a more rapid onset of symptom control but was commonly discontinued due to injection site reactions (44.4%). Canakinumab was associated with sustained long-term disease control with fewer local side effects. However, rare serious events, including acute myeloid leukaemia and inflammatory bowel disease, were observed, though causality with treatment could not be established.</p><p><strong>Conclusions: </strong>In this paediatric cohort of cr-FMF patients, both anakinra and canakinumab were effective in reducing disease activity and inflammation. Anakinra offered rapid symptom relief but had frequent injection site reactions. Canakinumab provided sustained control with fewer local side effects but required monitoring for rare complications.</p>","PeriodicalId":18705,"journal":{"name":"Modern Rheumatology","volume":" ","pages":"817-825"},"PeriodicalIF":2.1,"publicationDate":"2026-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146258520","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A case series of rheumatoid arthritis patients exposed to an etanercept biosimilar during pregnancy: Evidence from an increasingly accepted treatment option.","authors":"Ayako Kitada, Chinatsu Takai, Akitsu Higuchi, Eiko Miyagawa, Nobuaki Ozawa, Kohei Ogawa, Nagayoshi Umehara, Atsuko Murashima, Kayoko Kaneko","doi":"10.1093/mr/roag021","DOIUrl":"10.1093/mr/roag021","url":null,"abstract":"<p><strong>Objective: </strong>To assess pregnancy and neonatal outcomes in women with rheumatoid arthritis treated with an etanercept biosimilar, and to provide real-world safety evidence.</p><p><strong>Methods: </strong>This retrospective, single-centre study included 11 pregnant women with rheumatoid arthritis who received an etanercept biosimilar at the National Center for Child Health and Development (Tokyo) between October 2018 and March 2022. The clinical characteristics, disease activity, medications, delivery outcomes, and neonatal health were reviewed.</p><p><strong>Results: </strong>All 11 pregnancies were live births. The median maternal age was 34 years, the gestational age at delivery was 39.7 weeks, and the birth weight was 2929 g. One preterm birth (9.1%) and two caesarean deliveries (18.2%) occurred. No cases of low birth weight or neonatal intensive care unit admission were reported. One case of patent foramen ovale was noted. All neonates had 5-minute Apgar scores of ≥9. The etanercept biosimilar was discontinued before delivery in four cases to allow for infant vaccination.</p><p><strong>Conclusion: </strong>Use of the etanercept biosimilar during pregnancy was associated with favourable outcomes, supporting its safety and utility in managing rheumatoid arthritis during pregnancy.</p>","PeriodicalId":18705,"journal":{"name":"Modern Rheumatology","volume":" ","pages":"747-752"},"PeriodicalIF":2.1,"publicationDate":"2026-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147365776","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rheumatoid arthritis at a turning point in the era of targeted therapies.","authors":"Satoshi Kubo","doi":"10.1093/mr/roag033","DOIUrl":"10.1093/mr/roag033","url":null,"abstract":"<p><p>The expansion of targeted therapies and the widespread adoption of treat-to-target strategies have substantially improved outcomes for rheumatoid arthritis (RA). However, patient populations remain highly heterogeneous in routine clinical practice. This diversity makes risk-stratified therapeutic selection and shared decision-making essential, particularly when accounting for infection risk, cardiovascular disease, malignancy, thromboembolism, and reproductive considerations. This paper reviews current standard-of-care management and unmet needs while highlighting three priority challenges that may represent future inflection points. First, it proposes a framework for reappraising the pathophysiology of treatment-refractory disease. This model captures the discordance between inflammation and symptoms through persistent inflammatory refractory RA and non-inflammatory refractory RA constructs, while explicitly incorporating reasons for treatment discontinuation. Second, the text addresses the identification of high-risk populations across the continuum from preclinical to early RA and discusses monitoring strategies designed to minimize the risk of overtreatment. Finally, it delineates barriers to implementing precision medicine, including limited access to local biospecimens, challenges in outcome definitions, and complexities in trial design. The paper then outlines a pragmatic, phased roadmap to overcome these hurdles. Translating these concepts into clinical practice would extend and refine conventional treat-to-target paradigms. This approach offers a pathway toward more optimized and individualized therapeutic strategies.</p>","PeriodicalId":18705,"journal":{"name":"Modern Rheumatology","volume":" ","pages":"665-672"},"PeriodicalIF":2.1,"publicationDate":"2026-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147581642","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Umbilical cord-derived mesenchymal stem cell therapy for knee osteoarthritis and cartilage repair: Current evidence and clinical applications.","authors":"Jin Kyu Lee, Norimasa Nakamura","doi":"10.1093/mr/roag034","DOIUrl":"10.1093/mr/roag034","url":null,"abstract":"<p><p>Osteoarthritis is fundamentally a whole-joint disease, and a critical pathological feature is the limited capacity of articular cartilage for self-regeneration, leading to accelerated joint degeneration once breakdown begins. Current therapeutic strategies are primarily palliative, and conventional marrow stimulation procedures, such as microfracture, often yield suboptimal, short-lived outcomes. Stem cell-based biologic augmentation using mesenchymal stem cells (MSCs) has emerged as a promising approach through direct chondrocyte differentiation, paracrine stimulation, and immunomodulation. Umbilical cord-derived MSCs offer a robust proliferative capacity, enhanced biological potency, and lower immunogenicity than adult MSCs, and they can be obtained with minimal ethical concerns. Clinical trials of human umbilical cord blood-derived MSCs combined with a hyaluronic acid hydrogel (CARTISTEM®) have demonstrated excellent safety, improved patient-reported outcomes, and durable hyaline-like cartilage regeneration. Emerging evidence further suggests that combining a high tibial osteotomy with a human umbilical cord blood-derived mesenchymal stem-cells-based cartilage regeneration for medial compartment osteoarthritis with varus malalignment creates a synergistic biological and mechanical environment that promotes structural cartilage repair. In conclusion, surgically transplanted human umbilical cord blood-derived MSCs show therapeutic potential in arthritic knees, although the roles of intra-articular injections and the optimal indications for combined high tibial osteotomy remain to be clarified.</p>","PeriodicalId":18705,"journal":{"name":"Modern Rheumatology","volume":" ","pages":"689-695"},"PeriodicalIF":2.1,"publicationDate":"2026-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147593334","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Inebilizumab treatment in Japanese patients with IgG4-related disease: A subgroup analysis of a randomized, double-blind, placebo-controlled, phase 3 trial (MITIGATE).","authors":"Yoshiya Tanaka, Hisanori Umehara, Hirokazu Sato, Kosuke Uchima, Kouji Kawai, Kazuichi Okazaki","doi":"10.1093/mr/roag020","DOIUrl":"10.1093/mr/roag020","url":null,"abstract":"<p><strong>Objectives: </strong>This subgroup analysis of the MITIGATE study aimed to evaluate whether the efficacy and safety of inebilizumab in Japanese patients with IgG4-related disease are consistent with those observed in the overall trial population.</p><p><strong>Methods: </strong>MITIGATE was a randomized, double-blind, placebo-controlled, phase 3 study conducted in 22 countries, and this subgroup analysis included the Japanese patients enrolled in that trial.</p><p><strong>Results: </strong>In total, 27 Japanese patients (inebilizumab, N = 20; placebo, N = 7) were included in this subgroup analysis. The organs most frequently affected were the submandibular gland (66.7%), lacrimal gland (59.3%), and pancreas (51.9%). Despite the discontinuation of glucocorticoids within 8 weeks of study initiation, there were no adjudication committee-determined flares requiring treatment in the inebilizumab group. Flares were observed in four patients (57.1%) in the placebo group, with a median time to the first flare of 246.0 days. Inebilizumab reduced the annualized flare rate, increased flare-free complete remission, and lowered glucocorticoid use. Safety profiles were similar between treatment groups; most treatment-emergent adverse events were non-serious.</p><p><strong>Conclusions: </strong>Inebilizumab reduced flare risk and glucocorticoid exposure, and it was well tolerated in Japanese patients with IgG4-related disease, which is consistent with the overall MITIGATE results.</p><p><strong>Trial registration: </strong>NCT04540497.</p>","PeriodicalId":18705,"journal":{"name":"Modern Rheumatology","volume":" ","pages":"801-808"},"PeriodicalIF":2.1,"publicationDate":"2026-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147365748","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}