Rheumatology最新文献

{"title":"Severe haematological involvement in children with systemic lupus erythematosus and clinical associations.","authors":"Hakan Kisaoglu, Seher Sener, Kaan Can Demirbas, Yasemin Demir Yigit, Pinar Garipcin, Serkan Coşkun, Hatice Melisa Kacmaz, Rabia Miray Kisla Ekinci, Kubra Ozturk, Oya Koker, Kubra Ucak, Serife Tuncez, Gulsah Kilbas, Nihal Karacayir, Gulcan Ozomay Baykal, Sema Nur Taskın, Burcu Bozkaya, Ozge Baba, Selcan Demir, Ozge Basaran, Sezgin Sahin, Esra Baglan, Nihal Sahin, Vildan Gungorer, Aysenur Pac Kısaarslan, Betul Sozeri, Selcuk Yuksel, Sevcan Bakkaloglu, Ayse Balat, Metin Kaya Gurgoze, Ozgur Kasapcopur, Seza Ozen, Mukaddes Kalyoncu","doi":"10.1093/rheumatology/keae414","DOIUrl":"10.1093/rheumatology/keae414","url":null,"abstract":"<p><strong>Objectives: </strong>To investigate the severe haematological involvement in children with SLE and assess its clinical associations, treatments, outcome and damage accrual.</p><p><strong>Methods: </strong>The medical charts of children with SLE in whom haematological involvement was observed were reviewed. Severe haematological indices were defined as autoimmune haemolytic anaemia with a haemoglobin concentration <8 g/dl, thrombocyte count <30 000/µL and neutrophil count <500/µL.</p><p><strong>Results: </strong>Among the 224 patients included, 102 (45.5%) displayed severe indices, predominantly at the initial involvement, and most frequently as severe anaemia in 54 (24.1%) and severe thrombocytopenia in 45 (20.1%). Disease activity did not differ according to the presence of severe disease indices. In addition, the presence of severe indices at initial involvement did not affect the damage accrual. However, a higher rate of damage (51.1% vs 29.9%, P = 0.002) and steroid-induced damage (28.9% vs 8.2%, P < 0.001) was evident in patients with flares of the haematological system. Regression analysis revealed that rituximab treatment during the initial episode (OR: 4.5, P = 0.006) and the presence of anticardiolipin antibodies (OR: 2.3, P = 0.014) significantly increases the odds for haematological system flare. However, severe indices at initial involvement did not increase the odds of a haematological flare.</p><p><strong>Conclusion: </strong>Severe haematological indices at onset are common but not related with disease outcomes. Prevention of flares is important to improve outcomes, and a more rigorous maintenance strategy would benefit most to children who display haematological indices refractory to conventional immunosuppressants and those with anti-cardiolipin antibodies.</p>","PeriodicalId":21255,"journal":{"name":"Rheumatology","volume":" ","pages":"2153-2161"},"PeriodicalIF":4.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141875855","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Epidemiology of ANCA vasculitis in northern Spain.","authors":"Fabricio Benavides-Villanueva, Alba Herrero-Morant, Diana Prieto-Peña, Salma Al Fazazi, Vanesa Calvo-Río, Mónica Renuncio-García, Adrián Martín-Gutierrez, María Del Amparo Sánchez-Lopez, Claudia Poo-Fernandez, Clara Escagedo-Cagigas, María Rodríguez-Vidriales, Ricardo Blanco","doi":"10.1093/rheumatology/keae413","DOIUrl":"10.1093/rheumatology/keae413","url":null,"abstract":"<p><strong>Objectives: </strong>The incidence of anti-neutrophil cytoplasmic antibodies (ANCA)-associated vasculitis (AAV) shows disparate results due to variable classification criteria and heterogeneous population series. We aimed to estimate the incidence of AAV in a well-defined population with standardized classification criteria.</p><p><strong>Methods: </strong>This was a population-based study of AAV patients diagnosed from January 2000 to December 2023 in Cantabria, northern Spain. Patients were classified according to ACR/EULAR 2022 into granulomatosis with polyangiitis (GPA), microscopic polyangiitis (MPA), or unclassified vasculitis if the criteria were not met. Eosinophilic granulomatosis with polyangiitis patients were not included. The annual incidence rates were estimated by cases over 1 000 000 (106) (95% CI) including overall AVV, type of AAV, sex and year of diagnosis. A literature review was also performed.</p><p><strong>Results: </strong>We included 152 patients [80M/72F; mean age 70.6 (13.18) years]. They were classified as MPA (67; 44%), GPA (64; 42.2%), and unclassified vasculitis (21; 13.8%). Annual incidence was 13.4 (95% CI: 10, 16.8)/106 [male 14.5 (95% CI: 10.5, 18.5); female 12.1 (95% CI: 8.7, 15.6)]. The Annual incidence of MPA was 5.9 (95% CI: 4, 7.8)/106 and GPA 5.6 (95% CI: 3.9, 7.3)/106. The mean annual incidence increased from 6.1 (95% CI: 4.5, 7.7)/106 to 16.5 (595% CI: .6, 27.4)/106 in the last 3 years, particularly in GPA from 2.3 (95% CI: 0.3, 4.9)/106 to 8.2 (95% CI: 2, 14.5)/106. The prevalence of AAV was 184.7 (95% CI: 181, 188)/106.</p><p><strong>Conclusion: </strong>During a 20-year period we found that the incidence of AAV (GPA and MPA) in northern Spain was higher than in southern Spain, but lower than northern European countries. An increase in the incidence was observed in the last years.</p>","PeriodicalId":21255,"journal":{"name":"Rheumatology","volume":" ","pages":"1999-2007"},"PeriodicalIF":4.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141898082","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence and prognostic relevance of electrocardiographic abnormalities among patients with ANCA-associated vasculitis.","authors":"Louis Nygaard, Caroline Hundborg Liboriussen, Nicholas Carlson, Karl Emil Nelveg-Kristensen, Salome Kristensen, Mikkel Porsborg Andersen, Helle Collatz Christensen, Kristian Kragholm, Claus Graff, Christian Torp-Pedersen, Per Ivarsen, My Svensson, Jon Waarst Gregersen, Christoffer Polcwiartek","doi":"10.1093/rheumatology/keae434","DOIUrl":"10.1093/rheumatology/keae434","url":null,"abstract":"<p><strong>Objectives: </strong>Current guidelines provide limited evidence for cardiovascular screening in ANCA-associated vasculitis (AAV). This study aimed to investigate the prevalence of ECG abnormalities and associations between no, minor or major ECG abnormalities with cardiovascular mortality in AAV patients compared with matched controls.</p><p><strong>Methods: </strong>Using a risk-set matched cohort design, patients diagnosed with granulomatosis with polyangiitis or microscopic polyangiitis with digital ECGs were identified from Danish registers from 2000 to 2021. Patients were matched 1:3 to controls without AAV on age, sex and year of ECG measurement. Associated hazards of cardiovascular mortality according to ECG abnormalities were assessed in Cox regression models adjusted for age, sex and comorbidities, with subsequent computation of 5-year risk of cardiovascular mortality standardized to the age- and sex-distribution of the sample.</p><p><strong>Results: </strong>A total of 1431 AAV patients were included (median age: 69 years, 52.3% male). Median follow-up was 4.8 years. AAV was associated with a higher prevalence of left ventricular hypertrophy (17.5% vs 12.5%), ST-T deviations (10.1% vs 7.1%), atrial fibrillation (9.6% vs 7.5%) and QTc prolongation (5.9% vs 3.6%). Only AAV patients with major ECG abnormalities demonstrated a significantly elevated risk of cardiovascular mortality [HR 1.99 (1.49-2.65)] compared with controls. This corresponded to a 5-year risk of cardiovascular mortality of 19.14% (16-22%) vs 9.41% (8-11%).</p><p><strong>Conclusion: </strong>Patients with AAV demonstrated a higher prevalence of major ECG abnormalities than controls. Notably, major ECG abnormalities were associated with a significantly increased risk of cardiovascular mortality. These results advocate for the inclusion of ECG assessment into routine clinical care for AAV patients.</p>","PeriodicalId":21255,"journal":{"name":"Rheumatology","volume":" ","pages":"2008-2018"},"PeriodicalIF":4.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141917409","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"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 long-term opioid use among patients with axial spondyloarthritis or psoriatic arthritis who initiate opioids.","authors":"Yun-Ting Huang, David A Jenkins, Belay Birlie Yimer, Meghna Jani","doi":"10.1093/rheumatology/keae444","DOIUrl":"10.1093/rheumatology/keae444","url":null,"abstract":"<p><strong>Objective: </strong>Up to one in five patients with axial spondyloarthritis (AxSpA) or psoriatic arthritis (PsA) newly initiated on opioids transition to long-term use within the first year. This study aimed to investigate individual factors associated with long-term opioid use among opioid new users with AxSpA/PsA.</p><p><strong>Methods: </strong>Adult patients with AxSpA/PsA and without prior cancer who initiated opioids between 2006 and 2021 were included from Clinical Practice Research Datalink Gold, a national UK primary care database. Long-term opioid use was defined as having ≥3 opioid prescriptions issued within 90 days, or ≥90 days of opioid supply, in the first year of follow-up. Individual factors assessed included sociodemographic, lifestyle factors, medication use and comorbidities. A mixed-effects logistic regression model with patient-level random intercept was used to examine the association of individual characteristics with the odds of long-term opioid use.</p><p><strong>Results: </strong>In total, 10 300 opioid initiations were identified from 8212 patients (3037 AxSpA; 5175 PsA). The following factors were associated with long-term opioid use: being a current smoker (OR: 1.62; 95%CI: 1.38,1.90), substance use disorder (OR: 2.34, 95%CI: 1.05,5.21), history of suicide/self-harm (OR: 1.84; 95%CI: 1.13,2.99), co-existing fibromyalgia (OR: 1.62; 95%CI: 1.11,2.37), higher Charlson Comorbidity Index (OR: 3.61; 95%CI: 1.69,7.71 for high scores), high MME/day at initiation (OR: 1.03; 95%CI: 1.02,1.03) and gabapentinoid (OR: 2.35; 95%CI: 1.75,3.16) and antidepressant use (OR: 1.69; 95%CI: 1.45,1.98).</p><p><strong>Conclusions: </strong>In AxSpA/PsA patients requiring pain relief, awareness of lifestyle, sociodemographic and prescribing characteristics associated with higher risk of long-term opioid use can prompt timely interventions such as structured medication reviews and smoking cessation to promote safer prescribing and better patient outcomes.</p>","PeriodicalId":21255,"journal":{"name":"Rheumatology","volume":" ","pages":"1844-1852"},"PeriodicalIF":4.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141988725","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Antibiotics in inflammatory arthritis and background population one year before and after diagnosis: a nationwide drug utilization study.","authors":"Maja S Kragsnaes, Nickolaj Risbo, Jens Kristian Pedersen, Niels Obel, Axel Finckh, Alma B Pedersen, Torkell Ellingsen","doi":"10.1093/rheumatology/keae396","DOIUrl":"10.1093/rheumatology/keae396","url":null,"abstract":"<p><strong>Objectives: </strong>To describe antibiotic use in patients with inflammatory arthritis (IA) and in the background population (BP) within one year before and after IA diagnosis.</p><p><strong>Methods: </strong>Using data from Danish nationwide registries, we identified all adults with a first-time diagnosis of RA, PsA, or AS/spondyloarthritis (AS/SpA) from 2010 through 2018. For each IA patient, we randomly sampled 10 persons from the BP, matched on sex and birthdate. We calculated the prevalence (n [%]) of any antibiotic dispensing and the total antibiotic dispensing in the year before and after diagnosis.</p><p><strong>Results: </strong>We identified 28 504 new-onset IA patients (RA, n = 16 130; PsA, n = 5988; AS/SpA, n = 6386) and 285 040 BP individuals. Within one year before diagnosis, the total amount of dispensed antibiotics was higher in both RA, PsA and As/SpA compared with the BP (prevalence rate ratios [PRR], 1.48 [1.46; 1.51]; 1.67 [1.62; 1.72]; 1.52 [1.47; 1.56], respectively). The amount increased with 22% in IA patients three months before diagnosis compared with the preceding three-month period.  Although the prevalence of any antibiotic dispensing in IA patients decreased in the year following the diagnosis (IA; 40.6%), the total one-year antibiotic dispensing remained constant in RA (PRR 0.99 [0.97; 1.01]), decreased in PsA (0.91 [0.87; 0.94]) and increased in AS/SpA (1.08 [1.04; 1.12]) patients after diagnosis compared with before.</p><p><strong>Conclusion: </strong>Antibiotics are more frequently dispensed to individuals developing IA compared with the BP. Antibiotic utilization patterns change after IA diagnosis with marked differences among IA subgroups.</p>","PeriodicalId":21255,"journal":{"name":"Rheumatology","volume":" ","pages":"1705-1714"},"PeriodicalIF":4.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142073803","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A case of anti-CD320 antibody-positive cutaneous arteritis accompanied by multiple cranial nerve symptoms.","authors":"Akiko Hasegawa, Kazuki M Matsuda, Hirohito Kotani, Ai Kuzumi, Asako Yoshizaki-Ogawa, Ayumi Yoshizaki, Shinichi Sato","doi":"10.1093/rheumatology/keae528","DOIUrl":"10.1093/rheumatology/keae528","url":null,"abstract":"","PeriodicalId":21255,"journal":{"name":"Rheumatology","volume":" ","pages":"2309-2311"},"PeriodicalIF":4.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142352924","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Glucocorticoid sparing effect of Janus kinase inhibitors compared to biologic disease modifying anti-rheumatic drugs in rheumatoid arthritis, a single-centre retrospective analysis.","authors":"Giovanni Adami, Riccardo Bixio, Giulia Virelli, Isotta Galvagni, Francesca Mastropaolo, Andrea Morciano, Francesca Ruzzon, Valeria Messina, Elena Fracassi, Davide Gatti, Ombretta Viapiana, Antonio Carletto, Maurizio Rossini","doi":"10.1093/rheumatology/keae455","DOIUrl":"10.1093/rheumatology/keae455","url":null,"abstract":"<p><strong>Background: </strong>Glucocorticoid sparing in rheumatoid arthritis (RA) treatment is crucial to minimizing adverse effects associated with long-term use. Janus kinase inhibitors (JAKi) could potentially offer a more potent glucocorticoid-sparing effect than biologic DMARDs (bDMARDs).</p><p><strong>Material and methods: </strong>This is a single-centre retrospective analysis of RA patients treated with JAKi or bDMARDs. Glucocorticoid tapering, rescue therapy and discontinuation were analysed through mixed-effects models, Poisson regression and multivariable logistic regression, respectively, adjusting for baseline disease activity, demographic factors and treatment line.</p><p><strong>Results: </strong>A total of 716 RA patients treated with JAKi (n = 156) or bDMARDs (n = 560) were evaluated. JAKi treatment was associated with a more rapid reduction in glucocorticoid dose within the first 6 months and 60% higher odds of discontinuation compared with bDMARDs (adjusted odds ratio 1.63; 95% CI: 1.02, 2.60, P = 0.039). Despite a higher baseline glucocorticoid dose, over 50% of JAKi-treated patients discontinued glucocorticoids after 12 months, vs ∼40% for bDMARDs. The need for glucocorticoid rescue therapy was significantly higher in the bDMARD group (rate ratio 2.66; 95% CI: 1.88, 3.74).</p><p><strong>Conclusion: </strong>Our findings indicate that JAKi facilitate more rapid glucocorticoid tapering compared with bDMARDs in RA patients. These results underscore the potential of JAKi to reduce long-term glucocorticoid exposure, highlighting their value in RA management strategies, including minimizing glucocorticoid-related adverse effects.</p>","PeriodicalId":21255,"journal":{"name":"Rheumatology","volume":" ","pages":"1698-1704"},"PeriodicalIF":4.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142018496","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Multimodal imaging of structural damage and inflammation in psoriatic arthritis: a comparison of DMARD-naive and DMARD-failure patients.","authors":"Nağme Ö Renkli, Nienke J Kleinrensink, Julia Spierings, Simon Mastbergen, Harald E Vonkeman, Shasti C Mooij, Lydia G Schipper, Amin Herman, Iris Ten Katen, Frank J Nap, Marjolein E Hol, Pim A de Jong, Mylène P Jansen, Wouter Foppen","doi":"10.1093/rheumatology/keae450","DOIUrl":"10.1093/rheumatology/keae450","url":null,"abstract":"<p><strong>Objectives: </strong>To compare inflammatory and structural differences in active PsA between DMARD-naive and DMARD-failure patients using diverse imaging approaches for future analyses. Additionally, to explore the influence of patient characteristics (clinical and demographic variables) on imaging findings.</p><p><strong>Methods: </strong>Of the 80 patients included from the first cohort of the ongoing multicentre TOFA-PREDICT trial, 40 were DMARD-naive and 40 were DMARD-failure (csDMARD failure; one prior bDMARD excluding etanercept was allowed), all meeting classification criteria for PsA with a minimum disease duration of eight weeks. Baseline conventional radiographs of hands and feet, MRIs of both ankles, and whole-body [18F]-fluorodeoxyglucose PET/CT (18F-FDG PET/CT) were evaluated for inflammatory and structural imaging parameters, including Sharp-van der Heijde (SHS), Heel Enthesitis Magnetic Resonance Imaging Scoring System (HEMRIS) and Deauville synovitis scoring. Differences between groups and the influence of patient characteristics were examined with multiple linear regression.</p><p><strong>Results: </strong>At baseline, patient characteristics were similar between groups. Imaging parameters showed limited inflammation and structural damage. Inflammatory imaging parameters were not significantly different (P > 0.200). Among structural parameters, only HEMRIS Achilles tendon structural damage was significantly different (P = 0.024, R2 = 0.071) and SHS Joint Space Narrowing was not statistically significant (P = 0.050, R2 = 0.048) with higher values for both in DMARD failures. After correction of patient characteristics, these differences in imaging disappeared (both P > 0.600).</p><p><strong>Conclusion: </strong>At baseline, PsA patient groups were comparable concerning structural and inflammatory imaging parameters, especially after correcting for patient characteristics. Thus, DMARD-naive and DMARD-failure patient groups may be combined in future PsA progression and treatment decision studies.</p><p><strong>Trial registration: </strong>www.clinicaltrialsregister.eu. EudraCT: 2017-003900-28.</p>","PeriodicalId":21255,"journal":{"name":"Rheumatology","volume":" ","pages":"1760-1769"},"PeriodicalIF":4.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141996351","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Polymyalgia rheumatica and giant cell arteritis: are these two sides of the same coin?","authors":"Morgan Lowe, Alwin Sebastian","doi":"10.1093/rheumatology/keae651","DOIUrl":"10.1093/rheumatology/keae651","url":null,"abstract":"","PeriodicalId":21255,"journal":{"name":"Rheumatology","volume":" ","pages":"1583-1584"},"PeriodicalIF":4.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142807909","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ex vivo cell-based assay for assessment of response to TNF inhibitors in patients with rheumatic diseases.","authors":"Smadar Gertel, May Rokach, Ari Polachek, David Levartovsky, Adi Broyde, Victoria Furer, Tali Ofir Dovrat, Jonathan Wollman, Sara Pel, Yoram Neufeld, Ori Elkayam","doi":"10.1093/rheumatology/keae309","DOIUrl":"10.1093/rheumatology/keae309","url":null,"abstract":"<p><strong>Objective: </strong>There are five TNF inhibitors (TNFis), whose structure and signalling differ. An individual patient with a rheumatic disease may respond to one TNFi but not to another. In addition, 30-40% of patients with rheumatic diseases may respond inadequately to TNFis. The downstream signalling of the various TNFis may determine their clinical efficacy. Several reports have shown that the different TNFis exhibited differential effects on Th17 cells. We analysed the effects of the various TNFis on IL-17A expression in peripheral blood mononuclear cells (PBMCs) of patients with rheumatic diseases, in order to evaluate the possibility of predicting responses in an ex vivo setting.</p><p><strong>Methods: </strong>PBMCs were co-cultured with the various TNFis or medium (control), and IL-17A mRNA levels were analysed by quantitative PCR. IL-17A expression levels in response to four TNFis (not including certolizumab pegol) were compared with that of the control. The IL-17A expression level as determined by the assay was correlated with the clinical response. The assay sensitivity and specificity for distinguishing responders from non-responders was calculated by receiver-operating characteristic (ROC) analysis.</p><p><strong>Results: </strong>The results of the assay for a retrospective cohort of patients with rheumatic diseases (n = 82) correlated with their therapeutic responses to the various TNFis with 89.5% accuracy. Our results indicated that the assay predicted the responses of a prospective cohort (n = 54) to specific TNFis with 79% accuracy.</p><p><strong>Conclusion: </strong>This functional assay could assist in predicting the odds for response to TNFi therapy, indicating whether a given patient is likely to respond to a specific TNFi.</p>","PeriodicalId":21255,"journal":{"name":"Rheumatology","volume":" ","pages":"2233-2241"},"PeriodicalIF":4.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141155297","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}