Modern Rheumatology最新文献

{"title":"Long-term safety and efficacy of voclosporin in Asian patients with lupus nephritis: A post hoc analysis of the AURORA 2 trial.","authors":"Tatsuya Atsumi, Sandra Navarra, Matt Truman, Eisuke Nakata, Haruka Matsukawa","doi":"10.1093/mr/roaf121","DOIUrl":"10.1093/mr/roaf121","url":null,"abstract":"<p><strong>Objectives: </strong>To investigate the long-term safety and efficacy of voclosporin in Asian patients with lupus nephritis who completed the AURORA 1 phase III study and enrolled in the AURORA 2 phase III continuation study.</p><p><strong>Methods: </strong>This post hoc analysis included 3 years of pooled data (AURORA 1 and AURORA 2). The double-blinded voclosporin or control treatment assigned in AURORA 1 was continued in AURORA 2. Safety and efficacy (renal response) were evaluated.</p><p><strong>Results: </strong>Sixty Asian patients were included (voclosporin, n = 30; control, n = 30). Adverse events occurred in 93.3 and 100.0% of voclosporin-treated and control patients, respectively. More patients in the voclosporin vs control group experienced decreased glomerular filtration rate (26.7 vs. 6.7%) and hypertension (33.3 vs. 10.0%); rates of study drug discontinuation due to adverse events were also lower (3.3 vs. 26.7%). Respective rates of urine protein creatinine ratio ≤0.5 mg/mg achievement were 90.0 and 56.7%; median time to achievement was significantly shorter with voclosporin (6.3 vs. 26.7 months; P = .001). Safety and efficacy were similar to the AURORA 2 overall population.</p><p><strong>Conclusions: </strong>Asian patients with active lupus nephritis had sustained proteinuria reductions and a shorter time to proteinuria reduction with voclosporin versus control; voclosporin was well-tolerated.</p>","PeriodicalId":18705,"journal":{"name":"Modern Rheumatology","volume":" ","pages":"581-587"},"PeriodicalIF":2.1,"publicationDate":"2026-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145774995","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":"Exploring brain metabolism and cognitive impairment in childhood-onset systemic lupus using fluorodeoxyglucose positron emission tomography.","authors":"Flávia Patrícia Sena Teixeira Santos, Gilda Aparecida Ferreira, Alexei Manso Machado, Jonas Jardim de Paula, Kalline Cristina Prata De Souza, Lucas Teles de Carvalho Godoy Sampaio, Marcelo Mamede, Carlos Malamut, Humberto Correa","doi":"10.1093/mr/roag017","DOIUrl":"10.1093/mr/roag017","url":null,"abstract":"<p><strong>Objectives: </strong>As biochemical and functional abnormalities often precede structural changes in disease, fluorine-18 fluorodeoxyglucose positron emission tomography (PET) may allow early detection of cerebral involvement in neuropsychiatric lupus. This study evaluated the correlation between cerebral glucose metabolism, assessed by fluorodeoxyglucose PET, and cognitive impairment in young adults with childhood-onset systemic lupus.</p><p><strong>Methods: </strong>Twenty-one patients with childhood-onset systemic lupus underwent clinical and neuropsychological assessment, followed by fluorodeoxyglucose PET brain imaging. Scans were compared with those of 22 healthy female controls. Images were non-rigidly registered to a standardized template, allowing voxel-wise analysis using adjusted t-tests. Associations between metabolism and cognitive performance were analysed using Pearson and Spearman correlation coefficients and Student's t-tests.</p><p><strong>Results: </strong>Hypometabolism was observed in the cerebellum, parietal, occipital, limbic, and frontal lobes, while hypermetabolism was observed in the sublobar region, temporal lobe, and areas of the limbic and frontal lobes. Memory deficits correlated with hypermetabolism in the left hemisphere, Brodmann area 13; attention impairments with hypermetabolism in area 20 and hypometabolism in areas 7 and 18; and executive dysfunction with hypometabolism, particularly in the left hemisphere.</p><p><strong>Conclusions: </strong>Fluorodeoxyglucose PET may assist in identifying early functional brain abnormalities related to cognitive dysfunction in childhood-onset systemic lupus.</p>","PeriodicalId":18705,"journal":{"name":"Modern Rheumatology","volume":" ","pages":"588-597"},"PeriodicalIF":2.1,"publicationDate":"2026-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147691215","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":"Factors associated with treatment discontinuation and age-stratified safety of abatacept in Japanese patients with rheumatoid arthritis: 5-year results of the ORIGAMI study.","authors":"Masayoshi Harigai, Eiichi Tanaka, Eisuke Inoue, Kenta Misaki, Naoto Tamura, Fuminori Hirano, Hideto Oshikawa, Taio Naniwa, Shintaro Hirata, Takaaki Komiya, Kaichi Kaneko, Yoko Suzuki, Tamami Yoshitama, Shinkichi Himeno, Shigeru Matsumoto, Yuri Yoshizawa, Hisashi Yamanaka","doi":"10.1093/mr/roaf118","DOIUrl":"10.1093/mr/roaf118","url":null,"abstract":"<p><strong>Objective: </strong>We investigated the factors associated with treatment discontinuation and safety of abatacept treatment up to 5 years as the first-line biologic in Japanese patients with rheumatoid arthritis (RA) of moderate disease activity (MDA).</p><p><strong>Methods: </strong>We analyzed 5-year data from the Orencia® Registry in Geographically Assembled Multicenter Investigation (ORIGAMI) study (UMIN000021263). We examined the factors associated with treatment discontinuation, overall and age-stratified safety, and effectiveness.</p><p><strong>Results: </strong>Among 279 analyzed patients, the cumulative incidence (95% CI) of discontinuation was 0.210 (0.158-0.262) for insufficient effectiveness and 0.266 (0.208-0.323) for adverse events (AEs). Older age (subdistribution hazard ratio [95% CI] 0.970 [0.946-0.995]; P = .018) and anti-citrullinated peptide antibody-positive status (0.284 [0.140-0.575]; P < .001) were associated with lower risk of discontinuation due to insufficient effectiveness. Presence of comorbidities was associated with greater risk of discontinuation due to AEs. The frequencies of AEs and adverse drug reactions remained stable or decreased over time. The safety was consistent with prior analyses of ORIGAMI and comparable among three age groups (<65, ≥65 to <75, and ≥75 years).</p><p><strong>Conclusions: </strong>Five-year results of the ORIGAMI study provide further evidence supporting the factors associated with long-term treatment continuation and safety of subcutaneous abatacept in patients with RA of MDA.</p>","PeriodicalId":18705,"journal":{"name":"Modern Rheumatology","volume":" ","pages":"526-536"},"PeriodicalIF":2.1,"publicationDate":"2026-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145724785","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":"Incidence and Radiographic Progression of Rheumatoid Arthritis in Anti-Citrullinated Protein Antibody-Positive Individuals: A Six-Year Population- Based Cohort Study.","authors":"Kenta Makabe, Takumi Matsumoto, Akihiro Uchio, Hiroyasu Mizuhara, Ryutaro Takeda, Toshiko Iidaka, Taro Kasai, Yasunori Omata, Sakae Tanaka, Noriko Yoshimura","doi":"10.1093/mr/roag051","DOIUrl":"https://doi.org/10.1093/mr/roag051","url":null,"abstract":"<p><strong>Objectives: </strong>Anti-citrullinated protein antibodies (ACPA) predict rheumatoid arthritis (RA) and radiographic joint destruction. However, data on long-term outcomes in ACPA-positive individuals without RA are limited. This study aimed to investigate the six-year cumulative incidence of RA and radiographic progression among ACPA-positive individuals without RA at baseline in a population-based cohort.</p><p><strong>Method: </strong>A total of 1,541 participants without RA at baseline were enrolled from the population-based cohort, of whom 28 tested positive for ACPA. Incident cases of RA were identified based on participants' self-reported physician diagnosis and medication history over a six-year follow-up period. Radiographic progression in the hands was assessed using the van der Heijde modified Sharp score.</p><p><strong>Results: </strong>Five participants developed RA within the first three years, including three who were ACPA-positive at baseline (all with high ACPA titers). After 3 years, additional RA cases were identified only among participants who were ACPA-negative at baseline, whereas no further cases occurred among those who were ACPA-positive at baseline. The positive predictive value (PPV) of ACPA for RA within three years was 15.0%, rising to 30.0% among those with high ACPA titers. When combined with rheumatoid factor or matrix metalloproteinase-3, the PPV further increased. Radiographic progression occurred in all participants with high-titer ACPA who developed RA (n =3) and in one ACPA-positive individual without RA, but not in ACPA-negative individuals who developed RA.</p><p><strong>Conclusions: </strong>ACPA positivity, particularly at high titers, may be associated with an increased risk of incident RA and with radiographic bone destruction, even in the absence of clinical symptoms or RA diagnosis.</p>","PeriodicalId":18705,"journal":{"name":"Modern Rheumatology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148352406","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":"FIBROMYALGIA DIAGNOSIS: From Past Paradigms to Future Directions-The State of the Art and Ongoing Controversies.","authors":"André Pontes-Silva","doi":"10.1093/mr/roag055","DOIUrl":"https://doi.org/10.1093/mr/roag055","url":null,"abstract":"<p><p>Fibromyalgia remains a contested clinical entity, characterized by persistent uncertainty regarding its definition, diagnostic boundaries, and underlying mechanisms. Over the past three decades, diagnostic frameworks have evolved from the 1990 American College of Rheumatology (ACR) classification criteria, based on widespread pain and tender point examination, to symptom-based models emphasizing patient-reported outcomes, such as the 2010 and 2016 ACR criteria. While these developments have improved feasibility and expanded clinical recognition, they have largely remained confined to biomedical and neuropsychological domains. This narrative review critically examines the historical evolution, conceptual foundations, and methodological limitations of fibromyalgia diagnostic criteria, integrating evidence from major classification systems, including ACR frameworks and the ACTTION-American Pain Society (APS) Pain Taxonomy (AAPT). Across these models, fibromyalgia is predominantly operationalized through symptom aggregation, with limited incorporation of social and contextual determinants of health. The analysis highlights persistent epistemological tensions, including diagnostic inflation, the continuum of polysymptomatic distress, and debates regarding disease legitimacy. In response, emerging proposals advocate for a biopsychosocial diagnostic framework that formally integrates biological, psychological, and social dimensions into the diagnostic core. This review also critically evaluates alternative dual-framework approaches that separate biological diagnosis from psychosocial severity assessment, emphasizing potential limitations such as fragmentation of patient experience and underestimation of psychosocial mechanisms in symptom generation. The findings suggest that future diagnostic models should move beyond static, symptom-based thresholds toward dynamic, integrative, and context-sensitive approaches. Such models may improve patient stratification, clinical decision-making, and research validity, while aligning diagnostic practice with contemporary understandings of chronic pain as a multidimensional and interactive condition.</p>","PeriodicalId":18705,"journal":{"name":"Modern Rheumatology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148339264","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":"Autoantibodies against adenosine deaminase acting on RNA1 (ADAR1) in patients with systemic lupus erythematosus: its relationship to clinical features and other autoantibodies.","authors":"Sara Komatsu, Kazuhiro Kurasawa, Aya Shimizu, Tomoka Hiyama, Azusa Kikuchi, Yuhi Yoshida, Anna Hasegawa, Tomoyuki Miyao, Ayae Tanaka, Satoko Arai, Reika Maezawa, Masafumi Arima, Kei Ikeda","doi":"10.1093/mr/roag056","DOIUrl":"https://doi.org/10.1093/mr/roag056","url":null,"abstract":"<p><strong>Objectives: </strong>Adenosine deaminase acting on RNA 1 (ADAR1) is an interferon (IFN)-inducible RNA-editing enzyme involved in the regulation of IFN signaling pathways. Although increased ADAR1 expression has been reported in systemic lupus erythematosus (SLE), the presence and clinical significance of anti-ADAR1 antibodies remain unclear.</p><p><strong>Methods: </strong>Serum samples from patients with SLE, idiopathic inflammatory myopathy (IIM), and rheumatoid arthritis (RA) were analyzed. Anti-ADAR1 antibodies were quantified using a newly developed ELISA, and specificity was confirmed by inhibition testing. Clinical and serological features were compared between antibody-positive and -negative patients. Hierarchical clustering and logistic regression analyses were performed to identify patient subsets and associated clinical features.</p><p><strong>Results: </strong>Anti-ADAR1 antibodies were detected in 38 of 76 patients with SLE (50.0%), 29 of 130 with IIM (22.3%), and 2 of 22 with RA (9.0%). In SLE, patients with anti-ADAR1 antibodies more frequently exhibited pericarditis, myocarditis, splenomegaly, elevated immunoglobulin G levels, and positivity for anti-U1RNP, anti-Sm, and anti-SSA antibodies. Cluster analysis identified three subgroups, with anti-ADAR1 antibodies enriched in a subset characterized by co-occurrence of autoantibodies against RNA-binding proteins. Exploratory analyses suggested that some clinical features showed different patterns of association with anti-ADAR1 antibody positivity and Cluster 3 membership.</p><p><strong>Conclusions: </strong>Anti-ADAR1 antibodies are frequently detected in SLE and IIM, but are rare in RA. These antibodies are enriched in a subset of SLE cases characterized by coordinated production of antibodies against RNA-binding proteins within an IFN-related immunological context. These findings suggest that anti-ADAR1 antibodies may contribute to immunological stratification of SLE.</p>","PeriodicalId":18705,"journal":{"name":"Modern Rheumatology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148339252","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":"Exploratory comparison of immune cell compositions across organs in IgG4-related disease.","authors":"Motohisa Yamamoto, Ryuta Kamekura, Masaaki Uehara, Yuta Ichii, Yujiro Kawakami, Keisuke Ishigami, Kenichi Takano, Hiroshi Nakase","doi":"10.1093/mr/roag057","DOIUrl":"https://doi.org/10.1093/mr/roag057","url":null,"abstract":"<p><strong>Objectives: </strong>IgG4-related disease (IgG4-RD) is a systemic fibroinflammatory disorder affecting multiple organs, but the extent to which immune microenvironments differ across tissues remains unclear. We compared immune cell compositions between submandibular gland and pancreatic lesions using transcriptome-based deconvolution analysis.</p><p><strong>Methods: </strong>Bulk RNA sequencing data were obtained from patients with IgG4-related submandibular sialadenitis (n = 40) and autoimmune pancreatitis (n = 8). Immune cell fractions were estimated using CIBERSORTx with the LM22 immune signature matrix. Relative immune cell compositions were compared descriptively, and exploratory Mann-Whitney U tests with false discovery rate (FDR) adjustment were performed.</p><p><strong>Results: </strong>Both tissues shared broad immune cell repertoires, including B cells, T cells, macrophages, dendritic cells, mast cells, and natural killer cells, indicating a common immune framework across IgG4-RD lesions. However, organ-specific differences in relative immune cell abundance were observed. Pancreatic lesions showed a tendency toward increased macrophage populations, particularly M1-like macrophages, together with relatively reduced naïve B-cell fractions. In contrast, submandibular gland lesions demonstrated relatively enriched B-cell populations, including naïve and memory B cells, with a more balanced macrophage distribution. These patterns were consistently observed across samples and supported by deconvolution confidence metrics.</p><p><strong>Conclusions: </strong>IgG4-RD lesions share common immunological features while exhibiting differences in relative immune cell composition across tissues. Pancreatic lesions tended to show relatively increased macrophage fractions, whereas submandibular gland lesions demonstrated a more lymphocyte-rich immune profile. These findings suggest that local tissue context may shape immune composition and contribute to clinical heterogeneity in IgG4-RD.</p>","PeriodicalId":18705,"journal":{"name":"Modern Rheumatology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148339215","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":"Risk factors and the effect of belimumab on flares during glucocorticoid tapering in systemic lupus erythematosus: A multicentre ANSWER-SLE cohort study.","authors":"Hirofumi Miyake, Akira Onishi, Hideaki Tsuji, Takuya Kotani, Yumiko Wada, Yuji Nozaki, Toshihiko Shiga, Shigeru Iwata, Takao Fujii, Yasuhiro Kato, Eri Itotagawa, Shuji Sumitomo, Hideki Oka, Wataru Yamamoto, Masao Katsushima, Motomu Hashimoto","doi":"10.1093/mr/roag053","DOIUrl":"https://doi.org/10.1093/mr/roag053","url":null,"abstract":"<p><strong>Objectives: </strong>To identify factors associated with flare after glucocorticoid (GC) reduction in systemic lupus erythematosus (SLE) and determine whether belimumab influences this risk.</p><p><strong>Methods: </strong>Using the ANSWER-SLE cohort, this retrospective multicentre study enrolled 388 patients with GC reduction from ≤5 mg/day. The primary outcome was time to overall flare (SLE Disease Activity Index 2000 [SLEDAI-2K] increase ≥3 or GC escalation). Multivariable Cox models identified factors associated with overall flare. Propensity score-based matching weights were applied, and weighted Cox models assessed the association between belimumab and flare risk.</p><p><strong>Results: </strong>During one-year follow-up, 133 overall flares occurred (1-year cumulative incidence 39.9%). Higher clinical SLEDAI (hazard ratio [HR] 1.10, 95% confidence interval [CI] 1.03-1.17), SDI (HR 1.11, 95% CI 1.01-1.22), and GC dose reduction (HR 1.40, 95% CI 1.15-1.70) were associated with increased overall flare risk. GC reductions >1 mg were associated with flare (HR 2.53, 95% CI 1.54-4.15). In weighted analyses, belimumab was not associated with overall flare (HR 0.83, 95% CI 0.51-1.34).</p><p><strong>Conclusions: </strong>In patients with SLE, carefully tapering GC doses from ≤5 mg/day according to disease activity and organ damage may be important, whereas belimumab was not associated with reduced flare risk.</p>","PeriodicalId":18705,"journal":{"name":"Modern Rheumatology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148339210","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":"Prevalence of and factors associated with radiographic sacroiliitis in Japanese patients with inflammatory bowel disease: a computed tomography-based study.","authors":"Yusuke Ohno, Shuji Asai, Takeshi Yamamura, Kenya Terabe, Mochihito Suzuki, Tsunaki Sawada, Kenji Kishimoto, Ryo Sato, Junya Hasegawa, Hiroto Yamamoto, Yuki Saito, Mitsuro Kanda, Hiroki Kawashima, Shiro Imagama","doi":"10.1093/mr/roag054","DOIUrl":"https://doi.org/10.1093/mr/roag054","url":null,"abstract":"<p><strong>Objective: </strong>To determine the prevalence of radiographic sacroiliitis-a classification feature of spondyloarthritis-and to identify associated factors in Japanese patients with inflammatory bowel disease.</p><p><strong>Methods: </strong>This retrospective study included 880 patients with ulcerative colitis or Crohn's disease who underwent abdominopelvic computed tomography at an inflammatory bowel disease centre. Sacroiliac joints were evaluated using a validated scoring system. Radiographic sacroiliitis was defined as a total erosion score ≥3 or the presence of sacroiliac joint ankylosis. Multivariate logistic regression analysis identified factors associated with radiographic sacroiliitis.</p><p><strong>Results: </strong>Radiographic sacroiliitis was identified in 98 patients (11%), including 41 patients (5%) with complete ankylosis. Crohn's disease (vs. ulcerative colitis; odds ratio [OR] 2.14; 95% confidence interval [CI], 1.17-3.89), male sex (OR 3.85; 95% CI 1.96-7.56), and older age (OR 1.07 per year; 95% CI 1.05-1.09) were independently associated with radiographic sacroiliitis. In subgroup analysis, obesity was associated with radiographic sacroiliitis in Crohn's disease (OR 2.15; 95% CI 1.01-4.59).</p><p><strong>Conclusions: </strong>Radiographic sacroiliitis was present in approximately 10% of Japanese patients with inflammatory bowel disease. Evaluation of sacroiliac joints on routine abdominopelvic computed tomography may help identify patients warranting further evaluation for coexisting spondyloarthritis, particularly in older men with Crohn's disease.</p>","PeriodicalId":18705,"journal":{"name":"Modern Rheumatology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148339226","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":"Nervous system involvement in primary Sjögren's syndrome: analysis from the Sjögrenser registry.","authors":"Ximena Larco-Rojas, Mónica Fernández Castro, Carlos Sánchez-Piedra, Víctor Martínez Taboada, Alejandro Olivé, José Rosas, Raúl Menor, Beatriz Rodríguez, Ángel García-Aparicio, Francisco Javier López Longo, Sara Manrique- Arija, Jesús Alberto García Vadillo, Susana Gil Barato, Ruth López Gonzalez, Francisco Javier Narváez, Carlos Galisteo, Jorge Gonzalez Martín, Esther Ruiz Lucea, Antonio Naranjo, Óscar Illera, Sheila Melchor, Begoña Moreira, Enrique Raya, José Luis Puga Guzmán, Natalia Cid, Enrique Júdez, Clara Moriano, Vicente Torrente-Segarra, Héctor Corominas, Blanca García Magallón, Carlos Guillén Astete, Ivan Castellvi, Cristina Bohórquez, Javier Loricera, Nerea Alcorta Lorenzo, Jose Luis Andreu","doi":"10.1093/mr/roag050","DOIUrl":"https://doi.org/10.1093/mr/roag050","url":null,"abstract":"<p><strong>Objective: </strong>This study aims to describe the clinical characteristics of nervous system involvement in a cohort of patients from the SjögrenSER registry.</p><p><strong>Methods: </strong>All patients included in the SjögrenSER study, a Spanish multicenter randomized cohort containing demographic, clinical, and histologic data, were retrospectively analyzed. Patients were classified based on the presence of neurological involvement (central and peripheral nervous systems). We performed descriptive statistical analyses, clinical associations, Student's t test or χ2 test, and uni- and multivariate logistic regression.</p><p><strong>Results: </strong>The registry included 437 patients, with peripheral nervous system involvement observed in 39 patients (8.9%) and central nervous system involvement in 34 patients (7.8%). Stroke and ischemic cardiovascular disease were common comorbidities in patients with Sjögren's disease (SjD) and neurological involvement (p < 0.05). Neurological involvement was also frequently associated with other systemic manifestations, including renal involvement (p = 0.015), particularly glomerulonephritis with cryoglobulinemia (p = 0.021), and myositis (p = 0.002). Fatigue was significantly associated with neurological involvement (p = 0.012).Patients with nervous system involvement more frequently received glucocorticoids, antimalarials, immunosuppressants, intravenous immunoglobulins, and biologic therapies. Notably, steroids and cyclophosphamide were used more often than other medications (OR = 3.33; 1.54-7.18 and OR = 6.80; 1.49-30.96, respectively).</p><p><strong>Conclusions: </strong>In this cohort, neurological involvement was commonly associated with other systemic manifestations of SjD, such as myositis, suggesting a more severe disease phenotype that often requires immunosuppressants and biologic therapy.</p>","PeriodicalId":18705,"journal":{"name":"Modern Rheumatology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148308734","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}