Nature Reviews Rheumatology最新文献

{"title":"Repurposing vamifeport for lupus nephritis","authors":"Holly Webster","doi":"10.1038/s41584-026-01370-w","DOIUrl":"10.1038/s41584-026-01370-w","url":null,"abstract":"Preclinical findings indicate that vamifeport, an oral ferroportin inhibitor, could be used as an adjunct therapy for lupus nephritis.","PeriodicalId":18810,"journal":{"name":"Nature Reviews Rheumatology","volume":"22 5","pages":"282-282"},"PeriodicalIF":32.7,"publicationDate":"2026-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147530985","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":"IgG4 surge predicts relapse in IgG4-RD","authors":"Holly Webster","doi":"10.1038/s41584-026-01368-4","DOIUrl":"10.1038/s41584-026-01368-4","url":null,"abstract":"Findings suggest that changes in serum IgG4 levels over time are predictive of IgG4-related disease relapse and might identify patients amenable to preventative treatment.","PeriodicalId":18810,"journal":{"name":"Nature Reviews Rheumatology","volume":"22 5","pages":"281-281"},"PeriodicalIF":32.7,"publicationDate":"2026-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147502159","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":"SIX1 and PAI-1 emerge as therapeutic targets in systemic sclerosis","authors":"Sarah Onuora","doi":"10.1038/s41584-026-01367-5","DOIUrl":"10.1038/s41584-026-01367-5","url":null,"abstract":"Two studies highlight the potential of inhibiting the transcription factor SIX1 or its downstream mediator plasminogen activator inhibitor 1 as a strategy to limit fibrosis in systemic sclerosis.","PeriodicalId":18810,"journal":{"name":"Nature Reviews Rheumatology","volume":"22 4","pages":"218-218"},"PeriodicalIF":32.7,"publicationDate":"2026-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147439255","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":"Neurodevelopmental comorbidities in juvenile systemic autoimmune and autoinflammatory diseases","authors":"Pierre Ellul, Isabelle Melki","doi":"10.1038/s41584-026-01356-8","DOIUrl":"10.1038/s41584-026-01356-8","url":null,"abstract":"Neurodevelopmental disorders affect a substantial proportion of children and represent a major public health challenge worldwide. Emerging evidence highlights complex interactions among genetic, environmental and immune factors — particularly during the critical window of neurodevelopmental vulnerability. These insights raise the possibility that children with juvenile systemic autoimmune and autoinflammatory diseases are at an increased risk of developing neurodevelopmental disorders. Early onset and delayed treatment of these autoimmune and autoinflammatory diseases seem to increase this vulnerability. Growing awareness of these associations is transforming paediatric rheumatology, highlighting the need for early screening, multidisciplinary management, and personalized interventions that target both inflammatory disease and neurodevelopment. International research collaborations, biomarker discovery and long-term follow-up are crucial for closing knowledge gaps and subsequently advancing care and outcomes. Recognizing and tackling neurodevelopmental disorders as frequent comorbidities of juvenile systemic autoimmune and autoinflammatory diseases is vital for improving educational attainment, psychosocial wellbeing and lifelong quality of life in children with chronic inflammatory conditions. Neurodevelopmental disorders frequently co-occur with juvenile systemic autoimmune and autoinflammatory diseases, driven by immune–neurodevelopmental interactions. Early screening, multidisciplinary care and personalized interventions are essential, alongside research into mechanisms, biomarkers and long-term outcomes to improve education, psychosocial wellbeing and quality of life.","PeriodicalId":18810,"journal":{"name":"Nature Reviews Rheumatology","volume":"22 5","pages":"328-339"},"PeriodicalIF":32.7,"publicationDate":"2026-03-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147329297","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":"Bridging the gap: combining treat-to-target and difficult-to-treat strategies in the management of rheumatoid arthritis","authors":"Lilla Gunkl-Tóth, Iain B. McInnes, György Nagy","doi":"10.1038/s41584-026-01354-w","DOIUrl":"10.1038/s41584-026-01354-w","url":null,"abstract":"The treat-to-target (T2T) strategy, which involves predefined therapy objectives and a focused monitoring system, has substantially improved the management of rheumatoid arthritis (RA). These benefits probably result from a reduction in undertreatment, prevention of overtreatment and thus an improvement in long-term outcomes for both articular manifestations and comorbidities. However, T2T has also revealed a subgroup of patients who, despite following guideline-based treatment, do not reach the predefined outcomes. This finding has led to the emerging concept of ‘difficult-to-treat’ (D2T) RA. D2T-RA might reflect true pharmacological refractoriness, but D2T-RA is also increasingly recognized as having broader underlying causes, including psychosocial distress, comorbidities, chronic pain syndromes and patient or system-related barriers. If these underlying factors remain unidentified, unnecessary treatment escalation can occur, which could worsen long-term outcomes. Although T2T focuses on predefined targets and regular monitoring, which works well for the majority of patients, the structured multidomain approach characteristic of the D2T framework might provide a guide for managing patients who do not reach these targets despite guideline-based care. For this population, the D2T approach could offer better stratification and serve as a practical, precision-medicine-oriented extension of T2T by providing a more mechanism-informed, personalized management strategy. Integrating this D2T perspective into T2T practices keeps the strengths of T2T while also offering individualized care for patients with more complex disease trajectories, representing an unmet need. In this Perspective, the authors discuss how integrating difficult-to-treat into the treat-to-target strategy could improve outcomes for those patients with rheumatoid arthritis who do not follow the standard treat-to-target trajectory. The proposed strategy is aimed at providing a more personalized approach to disease management for those patients with difficult-to-treat disease.","PeriodicalId":18810,"journal":{"name":"Nature Reviews Rheumatology","volume":"22 5","pages":"319-327"},"PeriodicalIF":32.7,"publicationDate":"2026-03-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147329298","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":"Identifying fibromyalgia phenotypes based on psychological symptom burden","authors":"Ana Margarida Pinto, José A. P. da Silva","doi":"10.1038/s41584-026-01362-w","DOIUrl":"10.1038/s41584-026-01362-w","url":null,"abstract":"Psychological symptoms have a pivotal role in determining the severity of fibromyalgia. Findings now show that identifying and managing these symptoms during the early stages of disease could reveal disease phenotypes and improve the management of fibromyalgia.","PeriodicalId":18810,"journal":{"name":"Nature Reviews Rheumatology","volume":"22 5","pages":"283-284"},"PeriodicalIF":32.7,"publicationDate":"2026-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147308283","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":"What rheumatology can learn from oncology: a patient’s perspective","authors":"Sarah Sisbot","doi":"10.1038/s41584-026-01364-8","DOIUrl":"10.1038/s41584-026-01364-8","url":null,"abstract":"Drawing on my contrasting experiences as a patient in oncology and rheumatology, I have seen how the lack of precision-based diagnostics and meaningful endpoints limits progress in rheumatic disease. I believe biologically grounded classification systems and greater patient involvement are essential for more effective and responsive care.","PeriodicalId":18810,"journal":{"name":"Nature Reviews Rheumatology","volume":"22 5","pages":"279-280"},"PeriodicalIF":32.7,"publicationDate":"2026-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147278815","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":"Metabolic masqueraders of paediatric and adult rheumatic diseases","authors":"Steven H. Lang, Cher Sha, Chelsi M. Rose, V. Reid Sutton, Tiphanie P. Vogel, Lindsay C. Burrage","doi":"10.1038/s41584-026-01352-y","DOIUrl":"10.1038/s41584-026-01352-y","url":null,"abstract":"Inborn errors of metabolism comprise a clinically diverse group of conditions that arise from the decreased activity of an enzyme or metabolite transporter and subsequent blockade in a metabolic pathway. These disorders are typically considered in the differential diagnosis of critically ill neonates or young children presenting with hypoglycaemia, metabolic acidosis or hyperammonaemia. However, beyond these classic presentations, a broader group of inborn errors of metabolism can manifest more subtly, with progressive articular and multi-systemic involvement that mimics or overlaps with typical features of rheumatological disease. Consequently, these conditions might be misdiagnosed for years as rheumatological diseases, including juvenile idiopathic arthritis, systemic sclerosis, idiopathic inflammatory myopathies and systemic lupus erythematosus. Moreover, these disorders provide unique opportunities to understand the complex interplay between metabolism and immune function. With the growing availability of disease-modifying therapies for inborn errors of metabolism, rheumatologists must be able to recognize these disorders, particularly in patients with atypical features or treatment-refractory disease. Inborn errors of metabolism are a diverse group of disorders that can mimic rheumatological disease, often presenting with progressive joint and systemic involvement. This Review serves as a primer for rheumatologists, covering clinical aspects and potential mechanisms by which these metabolic alterations cause immune dysregulation.","PeriodicalId":18810,"journal":{"name":"Nature Reviews Rheumatology","volume":"22 4","pages":"239-255"},"PeriodicalIF":32.7,"publicationDate":"2026-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147278811","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":"Author Correction: Inflammation and pain as interconnected targets in axial spondyloarthritis","authors":"Xenofon Baraliakos, Victoria Navarro-Compán, Nelly Ziade, Denis Poddubnyy","doi":"10.1038/s41584-026-01363-9","DOIUrl":"10.1038/s41584-026-01363-9","url":null,"abstract":"","PeriodicalId":18810,"journal":{"name":"Nature Reviews Rheumatology","volume":"22 3","pages":"213-213"},"PeriodicalIF":32.7,"publicationDate":"2026-02-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.nature.comhttps://www.nature.com/articles/s41584-026-01363-9.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146205107","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":"Immune reset and immune retune: approaching cure?","authors":"John D. Isaacs","doi":"10.1038/s41584-026-01357-7","DOIUrl":"10.1038/s41584-026-01357-7","url":null,"abstract":"The emergence of potent depletion therapies for the treatment of refractory autoimmunity has led to the concept of immune reset. Understanding whether immune reset equates to cure, and whether cure is achievable through non-depleting approaches, depends on the identification of immune biomarkers for measuring healthy and pathological immunity.","PeriodicalId":18810,"journal":{"name":"Nature Reviews Rheumatology","volume":"22 4","pages":"215-217"},"PeriodicalIF":32.7,"publicationDate":"2026-02-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146205108","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}