Modern Rheumatology最新文献

{"title":"A consecutive 2-year increase in the modified health assessment questionnaire score is associated with subsequent fractures in patients with rheumatoid arthritis.","authors":"Yumi Arai, Naohiro Izawa, Shigeto Tohma, Toshihiro Matsui, Yuho Kadono","doi":"10.1093/mr/roag058","DOIUrl":"https://doi.org/10.1093/mr/roag058","url":null,"abstract":"<p><strong>Objectives: </strong>Rheumatoid arthritis (RA) is a well-recognised risk factor for fractures. However, short-term fracture risk factors remain unclear. This study aimed to elucidate factors useful for short-term fracture prevention.</p><p><strong>Methods: </strong>Patients were enrolled in the National Database of Rheumatic Diseases in Japan (2002-2020) were analysed. Modifiable risk factors included changes in disease activity, modified health assessment questionnaire (mHAQ) scores and oral glucocorticoid usage.</p><p><strong>Results: </strong>Of the 37,466 patients with RA enrolled, 1655 experienced a first fracture. Sex, age, disease duration, disease activity, mHAQ score and glucocorticoid usage significantly differed between patients with and without fractures. Among 734 with 4-year pre-fracture data, mHAQ scores gradually increased over consecutive years before the fracture. When classified into four groups according to mHAQ changes over 2 consecutive years, patients with continuous increases had significantly higher fracture incidence (2.13%) than those with increases only in years 1-2 (1.43%), only in years 2-3 (1.59%) or with no increase across 2 consecutive years).</p><p><strong>Conclusions: </strong>A consecutive 2-year increase in mHAQ score is associated with an increased risk of subsequent fracture in patients with RA, offering valuable insight for targeted fracture prevention strategies.</p>","PeriodicalId":18705,"journal":{"name":"Modern Rheumatology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148405304","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":"The effect of exercise program applied to patients with scleroderma on functional outcomes: A Randomized Controlled Trial.","authors":"Gizem Ozbudak, Serap Ozer, Figen Yargucu Zihni","doi":"10.1093/mr/roag052","DOIUrl":"https://doi.org/10.1093/mr/roag052","url":null,"abstract":"<p><strong>Objectives: </strong>The study aimed to investigate the effects of an exercise program applied to patients with systemic sclerosis on hand and mouth functional results and quality of life.</p><p><strong>Methods: </strong>This randomized controlled experimental study included a total of 46 patients with systemic sclerosis, divided into 23 in the intervention group and 23 in the control group using simple randomization. Data were collected using Exercise Program Multi-Purpose Digital Disc-DVD, Duruöz Hand Scale, Mouth Opening Measurement Form and World Health Organization Quality of Life-BREF (WHOQOL-BREF). Patients in the intervention group received the exercise program in addition to the standard protocol and the Exercise Program DVD was uploaded to their mobile phones after the initial interview. All patients were assessed at baseline, 4, 8 and 12 weeks.</p><p><strong>Results: </strong>Overall, 95.5% of the patients were female, with a mean age of 51.70 ± 11.11 years. The groups were homogeneous in terms of demographic characteristics (p > 0.05). Statistically significant differences were observed between the intervention and control groups in hand function, mouth function, and quality of life at the final follow-up.</p><p><strong>Conclusion: </strong>The exercise program applied to patients with systemic sclerosis had positive effects on hand and mouth functional outcomes and quality of life, demonstrating effectiveness in improving functional abilities and well-being.</p><p><strong>Trial registration: </strong>The study was registered as a randomized controlled trial in the Clinical Trial Registration Center of Turkey. Registration Number: NCT06425653. URL:  https://clinicaltrials.gov/study/NCT06425653. Registration Date: 05/22/2024.</p>","PeriodicalId":18705,"journal":{"name":"Modern Rheumatology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148412299","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 implications of Vasculitis associated with familial Mediterranean fever: a comparative study in childhood.","authors":"Büşra Başer Taşkın, Ayşenur Doğru Kılınç, Selen Duygu Arık, Özlem Akgün, Nuray Aktay Ayaz","doi":"10.1093/mr/roaf128","DOIUrl":"10.1093/mr/roaf128","url":null,"abstract":"<p><strong>Objectives: </strong>Familial Mediterranean Fever (FMF) is characterized by recurrent fever and serositis. Although not classical in FMF, vasculitis is increasingly reported, suggesting shared pathogenic mechanisms. This study aimed to evaluate clinical features and treatment responses in paediatric FMF patients with concomitant vasculitis.</p><p><strong>Methods: </strong>The records of 1598 paediatric FMF patients followed at a tertiary paediatric rheumatology centre were reviewed retrospectively. After exclusions, 1481 patients were included: 1434 without vasculitis (Group 1) and 47 with vasculitis (Group 2). Demographic, clinical, genetic, and treatment-related data were compared between the groups, and vasculitis subtypes were characterized in detail.</p><p><strong>Results: </strong>Vasculitis was found in 3.2% of patients, most commonly IgA vasculitis and Behçet's disease. Group 2 had higher attack rates, more chest pain/myalgia, and more non-exon 10 heterozygous Mutations in the Mediterranean Fever mutations. Colchicine response and biologic therapy requirement did not differ significantly between groups. There was no statistically significant difference between groups in colchicine response (97.3 versus 74.5%) or biologic therapy requirement (2.7 versus 6.4%).</p><p><strong>Conclusions: </strong>The coexistence of vasculitis in FMF likely reflects shared inflammatory mechanisms rather than coincidence. Vasculitis occurred even in patients with milder Mutations in the Mediterranean Fever genotypes, suggesting an enhanced proinflammatory milieu. Early recognition of vasculitis in FMF may influence therapeutic strategies and improve outcomes.</p>","PeriodicalId":18705,"journal":{"name":"Modern Rheumatology","volume":" ","pages":"648-656"},"PeriodicalIF":2.1,"publicationDate":"2026-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145820210","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":"Addressing the disease burden of systemic lupus erythematosus.","authors":"Yoshiya Tanaka, Kazuya Taguchi, Yoshiyuki Yamaguchi","doi":"10.1093/mr/roaf127","DOIUrl":"10.1093/mr/roaf127","url":null,"abstract":"<p><p>Systemic lupus erythematosus (SLE) is an autoimmune disease that causes organ damage and negatively affects a patient's quality of life (QoL). Despite the recent remarkable progress in treatment, patients continue to experience a substantial disease burden. In SLE, which is more common in young people, this casts a sizable shadow over patients' social activities. Treatment goals are to control disease activity, minimise treatment-related adverse events, avoid organ damage, and optimise health-related QoL. However, optimising QoL remains challenging, as many unresolved issues remain, including subjective symptoms, which are difficult for physicians to perceive. As such, physicians must work to understand this burden from the patient's perspective and pursue improved patient QoL. In this review, we discuss issues associated with disease burden and health-related QoL faced by patients with SLE in their daily lives, along with available treatments and management practices that can be implemented to optimise them. To enable SLE patients to live a normal life, we must transform current SLE care to move beyond symptom control to drive clinical remission, assessing and addressing the disease burden patients face in daily life.</p>","PeriodicalId":18705,"journal":{"name":"Modern Rheumatology","volume":" ","pages":"491-503"},"PeriodicalIF":2.1,"publicationDate":"2026-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145804997","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":"Prospective follow-up of patients with probable Behçet's disease: first results of an inception cohort.","authors":"Özge Karakök, Seda Kutluğ-Ağaçkıran, Rabia Ergelen, Tülin Ergun, Haner Direskeneli, Fatma Alibaz-Oner","doi":"10.1093/mr/roaf123","DOIUrl":"10.1093/mr/roaf123","url":null,"abstract":"<p><strong>Objective: </strong>We aimed to follow patients classified as probable Behçet's disease (BD) prospectively, conducting an inception cohort with patients diagnosed only within the last 6 months.</p><p><strong>Methods: </strong>We included 55 patients with probable BD. Fulfilment of classification criteria, new major organ involvement, and immunosuppressive (IS) usage were assessed during follow-up.</p><p><strong>Results: </strong>Initially, no patient fulfilled the International Study Group criteria. The median follow-up duration was 48 (21-77.5) months. Initially, 45 (81.8%) patients had major organ involvement. In 51 (92.7%) patients, bilateral common femoral vein wall thickness exceeded the 0.5 mm cut-off (Bilateral median common femoral vein wall thickness: 0.7 mm (0.70-0.80)). During follow-up, new major organ involvement was observed in 16 (29.1%) patients who needed step-up treatment with ISs. Six patients (10.9%) also developed new symptoms and subsequently fulfilled one or more diagnostic criteria. Two (3.6%) patients with pulmonary artery aneurysm had deceased due to massive haemoptysis.</p><p><strong>Conclusions: </strong>According to the 48-month follow-up results of the probable BD inception cohort, the majority of BD patients who had limited clinical findings started with major organ involvement. Only six (10.9%) patients developed new manifestations during follow-up, and these patients subsequently met the International Study Group and/or International Criteria for Behçet's Disease criteria. Additionally, 16 patients (29.1%) experienced new or relapsed major organ involvement.</p><p><strong>Key messages: </strong></p>","PeriodicalId":18705,"journal":{"name":"Modern Rheumatology","volume":" ","pages":"641-647"},"PeriodicalIF":2.1,"publicationDate":"2026-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145743420","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":"Mid- to long-term outcomes of high tibial osteotomy in patients with rheumatoid arthritis.","authors":"Kazunari Kuroda, Ryuichi Nakamura, Yoshiyuki Okamoto, Kenji Fujita, Masaki Takahashi, Ryosuke Asa, Yasuo Katsuki","doi":"10.1093/mr/roaf119","DOIUrl":"10.1093/mr/roaf119","url":null,"abstract":"<p><strong>Objectives: </strong>High tibial osteotomy (HTO) has traditionally been contraindicated in patients with rheumatoid arthritis (RA) owing to concerns about progressive synovitis and poor bone quality. However, advances in pharmacological treatments have challenged this concept. We aimed to evaluate the mid- to long-term outcomes of HTO in patients with well-controlled RA disease activity.</p><p><strong>Methods: </strong>We retrospectively reviewed 13 knees in 11 patients with RA who underwent HTO between 2012 and 2022. Nine knees from seven patients with follow-up > 6 years were analyzed. Radiographic parameters included weight-bearing line percentage and medial proximal tibial angle. Bone union and clinical outcomes were assessed using the Japanese Orthopaedic Association score. Disease activity was monitored using Disease Activity Score 28. Conversion to total knee arthroplasty (TKA) was recorded.</p><p><strong>Results: </strong>At final follow-up (mean, 8.3 years), all patients maintained low disease activity or remission. Weight-bearing line percentage and medial proximal tibial angle significantly increased postoperatively. The mean Japanese Orthopaedic Association score increased from 63.3 to 86.7 (P < .001). Bone union was achieved within 18 months in all cases, and no patient required conversion to TKA.</p><p><strong>Conclusions: </strong>HTO is a viable joint-preserving option for patients with RA and controlled disease activity, providing favourable long-term outcomes.</p>","PeriodicalId":18705,"journal":{"name":"Modern Rheumatology","volume":" ","pages":"550-557"},"PeriodicalIF":2.1,"publicationDate":"2026-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145715128","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":"Long-term outcomes of total knee arthroplasty without patellar resurfacing for rheumatoid arthritis.","authors":"Sho Nojiri, Kazue Hayakawa, Yosuke Kaneko, Kohei Shibata, Nobuyuki Fujita","doi":"10.1093/mr/roag007","DOIUrl":"10.1093/mr/roag007","url":null,"abstract":"<p><strong>Objectives: </strong>Whether to resurface the patella in total knee arthroplasty for patients with rheumatoid arthritis remains controversial. This study evaluated long-term clinical and radiographic outcomes after total knee arthroplasty without patellar resurfacing.</p><p><strong>Methods: </strong>Of 100 knees in 74 patients who underwent total knee arthroplasty without patellar resurfacing, 64 knees in 49 patients were available for follow-up (mean, 13.6 years). Clinical evaluations included the presence of anterior knee pain (AKP) at final follow-up, Knee Society Score, Knee Society Functional Score, and Kujala score. Plain radiographic evaluations assessed patellar thinning and its relationship with clinical outcomes. We also compared outcomes between remission and non-remission groups based on Disease Activity Score in 28 joints using C-reactive protein at final follow-up.</p><p><strong>Results: </strong>The incidence of AKP was 9.3%. At follow-up, Knee Society Scores and Functional Scores had improved significantly (P < .05). Although patellar thinning progressed, it did not appear to affect clinical outcomes or incidence of AKP. Disease activity did not differ significantly between groups or by presence of AKP.</p><p><strong>Conclusions: </strong>Long-term outcomes of total knee arthroplasty without patellar resurfacing in rheumatoid arthritis were favourable, indicating that this approach is acceptable.</p>","PeriodicalId":18705,"journal":{"name":"Modern Rheumatology","volume":" ","pages":"558-565"},"PeriodicalIF":2.1,"publicationDate":"2026-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146157821","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":"Serum VEGF levels may have a role in the assessment of treatment response and disease activity during TNFi therapy in patients with axSpA.","authors":"Merve Güleç Yazır, Elif Durak Ediboğlu, Kübra Kaya, Gökhan Kabadayı, Leyla Didem Kozacı, Dilek Solmaz, Mustafa Özmen, Servet Akar","doi":"10.1093/mr/roag004","DOIUrl":"10.1093/mr/roag004","url":null,"abstract":"<p><strong>Objectives: </strong>To evaluate the relationship between serum biomarkers [vascular endothelial growth factor (VEGF), matrix metalloproteinase-3, and leptin] and disease activity, and the changes in those biomarker levels during tumour necrosis factor inhibitor (TNFi) treatment in patients with axial spondyloarthritis (axSpA).</p><p><strong>Methods: </strong>Patients with axSpA initiating their first TNFi who had serum samples at baseline and the sixth month of therapy were included, and the relationship between these biomarkers and disease activity, and functional parameters was analysed.</p><p><strong>Results: </strong>A total of 74 axSpA patients [mean age (SD) 48.7 (12.8) years, 54.1% male] were included. Disease activity parameters (Bath Ankylosing Spondylitis Disease Activity Index, Ankylosing Spondylitis Disease Activity Score-based C-reactive protein, and Bath Ankylosing Spondylitis Disease Functional Index) and C-reactive protein were significantly decreased at the sixth month of TNFi therapy (all P < .001). The correlation between biomarker levels and disease activity was evaluated, and only serum matrix metalloproteinase-3 levels were found to be associated with baseline Ankylosing Spondylitis Disease Activity Score-based C-reactive protein (P = .02). Serum VEGF levels decreased compared to the baseline at the sixth month (P < .001), however, serum leptin and matrix metalloproteinase-3 levels were not affected by TNFi (P = .50). Serum VEGF levels were substantially correlated with gender, hip involvement, delay in diagnosis, and disease activity in the longitudinal analysis.</p><p><strong>Conclusions: </strong>In patients with axSpA, TNFi therapy significantly reduces serum VEGF levels and effectively reduces disease activity. VEGF has the potential to function as a dynamic biomarker that reflects the characteristics of the disease and the response to treatment.</p>","PeriodicalId":18705,"journal":{"name":"Modern Rheumatology","volume":" ","pages":"635-640"},"PeriodicalIF":2.1,"publicationDate":"2026-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146195065","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":"Multicentre development and validation of data-driven claims-based algorithms for identifying dermatomyositis and polymyositis in Japan.","authors":"Ken-Ei Sada, Yoshia Miyawaki, Ryo Yanai, Takashi Kida, Akira Onishi, Ryusuke Yoshimi, Kunihiro Ichinose, Yasuhiro Shimojima","doi":"10.1093/mr/roag005","DOIUrl":"10.1093/mr/roag005","url":null,"abstract":"<p><strong>Objective: </strong>To develop and validate data-driven algorithms for identifying patients with dermatomyositis and polymyositis using Japanese administrative claims data.</p><p><strong>Methods: </strong>This multicentre retrospective, cross-sectional study included outpatients from six university hospitals between November and December 2023. Administrative claims data covering 1 year were linked with chart-confirmed diagnoses. Twenty-six candidate variables, including diagnosis codes, laboratory tests, prescriptions, and administrative billing items, were evaluated. Three feature-selection methods were applied to identify relevant predictors. Decision tree analysis was used to construct simplified rule-based algorithms, which were validated in independent internal and external cohorts.</p><p><strong>Results: </strong>Among 8199 training, 3512 testing, and 1827 external validation patients, 576 (7.0%), 244 (6.9%), and 136 (4.2%) carried diagnosis codes for dermatomyositis/polymyositis, of whom 352, 150, and 98 were confirmed as true cases, respectively. The performance of diagnosis codes alone yielded positive predictive values of 0.602 in the testing set and 0.713 in the external validation set. Anti-double-stranded DNA antibody testing, intractable disease management fees, and diagnosis codes for Sjögren's syndrome were identified as key discriminative variables. The optimal algorithm demonstrated a sensitivity of 0.878, a specificity of 0.984, a positive predictive value of 0.761, and an F1-score of 0.815 in the external validation cohort, providing superior accuracy compared to the use of International Classification of Diseases-10 codes alone.</p><p><strong>Conclusions: </strong>International Classification of Diseases-10 codes alone were insufficient for the accurate identification of dermatomyositis/polymyositis in Japanese claims data. Integrating laboratory tests and administrative information substantially improved the positive predictive value, providing a practical and generalizable framework for claims-based research in Japan.</p>","PeriodicalId":18705,"journal":{"name":"Modern Rheumatology","volume":" ","pages":"598-603"},"PeriodicalIF":2.1,"publicationDate":"2026-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146157734","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":"Joint involvement patterns and patient-reported satisfaction in difficult-to-treat rheumatoid arthritis: results from the multicentre observational cohort, FRANK Registry.","authors":"Shinkichi Arisumi, Toshifumi Fujiwara, Hidetoshi Tsushima, Masakazu Kondo, Hisakata Yamada, Eiichi Suematsu, Tomoya Miyamura, Motoko Ishida, Masataka Nakamura, Jun-Ichi Fukushi, Koji Sakuraba, Yasushi Inoue, Tomomi Tsuru, Toshihide Shuto, Seiji Yoshizawa, Masanobu Ohishi, Kenta Kamo, Akira Maeyama, Masahiro Ayano, Hiroaki Niiro, Daisuke Hara, Ryosuke Yamaguchi, Yukio Akasaki, Ryosuke Tsurui, Keitaro Yasumoto, Takahiro Natori, Toshiaki Sugita, Yasuharu Nakashima","doi":"10.1093/mr/roaf122","DOIUrl":"10.1093/mr/roaf122","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to characterize patterns of joint involvement and clinical features in patients with difficult-to-treat rheumatoid arthritis (D2T RA).</p><p><strong>Methods: </strong>A cross-sectional analysis was conducted using the FRANK Registry, a multicentre cohort (n = 3770). D2T RA was defined based on the 2021 European Alliance of Associations for Rheumatology criteria. Propensity score matching by age and disease duration was applied to compare D2T RA patients with matched non-D2T RA. Joint involvement was assessed using 28-joint counts and Paired Joint Pathology Scores. Patient satisfaction was evaluated across four domains: treatment efficacy, cost, activities of daily living, and global treatment.</p><p><strong>Results: </strong>Among 3770 patients, 108 (2.9%) fulfilled the criteria for D2T RA. Compared with matched controls, D2T RA patients had significantly higher anti-cyclic citrullinated peptide antibody titres, more frequent use of targeted synthetic disease-modifying antirheumatic drugs, and a higher prevalence of herpes zoster and methotrexate-associated lymphoproliferative disorder. Joint-level analysis revealed significantly greater involvement of the acromioclavicular, elbow, wrist, second finger proximal interphalangeal, and knee joints. Patient satisfaction scores were significantly lower in D2T RA, particularly regarding treatment cost and daily functioning.</p><p><strong>Conclusions: </strong>D2T RA is associated with distinctive joint involvement, as well as reduced patient satisfaction. A joint-focused and patient-centred management approach is essential to improve outcomes in this challenging RA subset.</p>","PeriodicalId":18705,"journal":{"name":"Modern Rheumatology","volume":" ","pages":"516-525"},"PeriodicalIF":2.1,"publicationDate":"2026-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145743380","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}