Rheumatology最新文献

{"title":"Second pregnancy outcomes in SLE","authors":"Kushagra Gupta,Vinod Ravindran","doi":"10.1093/rheumatology/keag553","DOIUrl":"https://doi.org/10.1093/rheumatology/keag553","url":null,"abstract":"","PeriodicalId":21255,"journal":{"name":"Rheumatology","volume":"24 1","pages":""},"PeriodicalIF":5.5,"publicationDate":"2026-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149092096","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":"Impacts of socioeconomic status on ambulatory care sensitive condition hospitalizations in rheumatoid arthritis","authors":"Isabella Hoy,Dani G Contreras,Claire Barber,Cheryl Barnabe","doi":"10.1093/rheumatology/keag556","DOIUrl":"https://doi.org/10.1093/rheumatology/keag556","url":null,"abstract":"Abstract Objectives Persons with Rheumatoid Arthritis (RA) are at increased risk for ambulatory care sensitive conditions (ACSCs) hospitalisations. We assess if socioeconomic status (SES) modifies this association. Methods Individuals meeting a validated case definition for RA in a Canadian population-based administrative health dataset (years 2007-2023) were matched 1:4 by age and sex to general population controls. SES was determined using a combined material and social deprivation index derived from area-level census data and categorised into quintiles (Q1 privileged toQ5 deprived). Crude and adjusted incidence rate ratios (IRR) for ACSC admissions were estimated at 3- and 5- years following index date using zero-inflated Poisson regression models. Potential additive and multiplicative interactions were assessed. Results We identified 83,811 unique hospitalizations in 52,596 RA cases and 190,300 in 210,384 controls. ACSC-related admissions increased in frequency with greater levels of deprivation. RA cases with privilege had significantly higher rates of ACSC-related hospitalization compared with controls at 3 years (SES Q1: IRR 1.34, 95% CI 1.02–1.77; Q2: IRR 1.30, 95% CI 1.05–1.62) and 5 years (Q2: IRR 1.20, 95% CI 1.01–1.42)whereascases and controls with deprivation had similar incidence rates for ACSC admissions (3 years Q4: IRR 0.95, 95% CI 0.81–1.12; Q5: IRR 1.00, 95% CI 0.89–1.12; 5 years Q4: IRR 1.07, 95% CI 0.95–1.20; Q5: IRR 1.02, 95% CI 0.94–1.12). Interaction tests and Relative Excess Risk due to Interactions were non-significant. Conclusion Socioeconomic deprivation and RA case status independently elevate the risk of an ACSC hospitalization.","PeriodicalId":21255,"journal":{"name":"Rheumatology","volume":"6 1","pages":""},"PeriodicalIF":5.5,"publicationDate":"2026-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149089217","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":"Ultrasound in psoriatic arthritis: from detecting abnormalities to defining clinical relevance","authors":"Danila Madonna,Emilio Filippucci,Andrea Di Matteo","doi":"10.1093/rheumatology/keag555","DOIUrl":"https://doi.org/10.1093/rheumatology/keag555","url":null,"abstract":"","PeriodicalId":21255,"journal":{"name":"Rheumatology","volume":"10 1","pages":""},"PeriodicalIF":5.5,"publicationDate":"2026-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149089184","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":"Efficacy and safety of probiotic supplementation in psoriatic arthritis - a randomized controlled trial","authors":"Philipp Bosch,Angelika Lackner,Barbara Dreo,Johannes Fessler,Florentine Moazedi-Fürst,Rusmir Husic,Joana Séneca,Andreas Haidmayer,Vanessa Stadlbauer,Anirudh Subramanian Muralikrishnan,Jens Thiel,Martin Stradner","doi":"10.1093/rheumatology/keag547","DOIUrl":"https://doi.org/10.1093/rheumatology/keag547","url":null,"abstract":"Abstract Objectives To evaluate the clinical efficacy and safety of a multispecies probiotic in patients with psoriatic arthritis (PsA) in moderate disease activity. Methods In this single-centre, randomized, double-blind, placebo-controlled trial (RCT), 66 PsA patients with moderate disease activity (Psoriatic Arthritis Disease Activity Score [PASDAS] >3.2 to < 5.4) on stable immunomodulatory therapy were randomized 1:1 to receive either a multispecies (Lactobacillus, Bifidobacterium) probiotic or placebo for 12 weeks. The primary outcome was treatment response at week 12, defined as achieving low disease activity or remission (PASDAS ≤3.2) without treatment change. Secondary outcomes included gut permeability markers, immune cell and microbiome composition. Analyses were conducted per a modified intention-to-treat (only complete cases for primary outcome), with sensitivity analyses using multiple imputation, per-protocol datasets, and qPCR-based detection of the probiotic strains in stool (adherence). Results Fifty-six participants were included in the main analysis. Thirteen (43%) participants in the probiotic group and 17 (65%) in the placebo group achieved the primary outcome (p = 0.167). The corresponding odds ratio was 0.4 (95% CI 0.13 to 1.18). Patient-reported pain and global assessment were the main PASDAS components improving over time, with no between-group differences. No differences were observed in secondary clinical outcomes, gut permeability markers (zonulin, calprotectin, alpha-1-antitrypsin), immune cell profiles, or stool microbiome composition between groups at week 12. No serious adverse events related to the study product were reported. Conclusion In this first RCT investigating probiotic supplementation in PsA, probiotic treatment did not show superiority over placebo in achieving treatment response, or altering gut microbiome, or permeability.","PeriodicalId":21255,"journal":{"name":"Rheumatology","volume":"6 1","pages":""},"PeriodicalIF":5.5,"publicationDate":"2026-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149089185","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":"Performance of lupus classification criteria in monogenic lupus: a national multicenter cohort study","authors":"Nergis Akay,Sezgin Sahin,Sila Atamyildiz Ucar,Aybuke Alisan,Eray Tunce,Eda Kayhan,Yasemin Ugur Es,Aysenur Alkaya,Busra Baser Taskin,Dilara Unal,Lutfiye Koru,Hatice Kubra Zora,Aslihan Uzun Bektas,Melisa Kacmaz,Halil Kazanasmaz,Sengul Caglayan,Seher Sener,Busra Acun,Gulcan Ozomay Baykal,Yasemin Yigit Demir,Suleyman Ekrem Albayrak,Burcu Bozkaya,Orhan Nurlu,Mehmet Yildiz,Amra Adrovic,Kenan Barut,Sevcan A Bakkaloglu,Metin Kaya Gurgoze,Ayse Balat,Fatih Haslak,Balahan Bora,Sara Sebnem Kilic,Mukaddes Kalyoncu,Oya Koker,Semanur Elmas,Nuray Aktay Ayaz,Seza Ozen,Banu Celikel Acar,Sumeyra Ozdemir Cicek,Sibel Balci,Aysenur Pac Kisaarslan,Rabia Miray Kisla Ekinci,Betul Sozeri,Ozgur Kasapcopur","doi":"10.1093/rheumatology/keag532","DOIUrl":"https://doi.org/10.1093/rheumatology/keag532","url":null,"abstract":"Abstract Objectives With advances in genetic testing, monogenic lupus is increasingly recognized, yet disease-specific classification criteria are lacking. We compared all three classification criteria sets in the same monogenic lupus cohort and, for the first time, evaluated their performance across distinct genetic pathways. Methods This national multicenter study included 88 genetically confirmed monogenic lupus patients from 22 pediatric rheumatology centers across Türkiye. Fulfilment of the ACR-1997, SLICC-2012, and EULAR/ACR-2019 criteria and pathway-based differences in classification performance were assessed. Results Overall, 74% (n = 65) fulfilled ACR-1997, 70.5% (n = 62) SLICC-2012 and EULAR/ACR-2019 criteria, and 62.5% (n = 55) met all three, whereas 17% (n = 15) met none. Agreement was substantial (κ = 0.63–0.73), with no significant differences between criteria (p > 0.05). Classification performance differed significantly across genetic pathways (p < 0.05), with the highest fulfilment performances in complement deficiencies and the lowest in nucleic acid metabolism and type I interferon pathway defects. Most patients who did not fulfill any classification criteria had nucleic acid metabolism and clearance defects (13/15, 86.7%). Domain-level analyses showed that classification success was mainly driven by mucocutaneous, immunologic, and renal domains. Complement and immune-regulation defects showed a more classical lupus phenotype, with most fulfilling all three criteria (78.6%, 22/28 and 77.8%, 14/18), whereas the proportion was lower in type I interferon pathway and nucleic acid metabolism and clearance defects (33.3%, 2/6 and 47.2%, 17/36). No classification criteria was superior within genetic pathways. Conclusions One-third of genetically confirmed monogenic lupus patients remained unclassified, particularly those with interferon-related and nucleic acid metabolism defects, highlighting pathway-dependent limitations of current classification criteria.","PeriodicalId":21255,"journal":{"name":"Rheumatology","volume":"1 1","pages":""},"PeriodicalIF":5.5,"publicationDate":"2026-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149089186","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":"Is checkpoint inhibitors-induced polymyalgia rheumatica really polymyalgia rheumatica?","authors":"Elvis Hysa,Marco Amedeo Cimmino,Dario Camellino","doi":"10.1093/rheumatology/keag546","DOIUrl":"https://doi.org/10.1093/rheumatology/keag546","url":null,"abstract":"","PeriodicalId":21255,"journal":{"name":"Rheumatology","volume":"480 1","pages":""},"PeriodicalIF":5.5,"publicationDate":"2026-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149089183","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":"AI at the rheumatology front door: progress, uncertainty and the case for careful evaluation","authors":"Coziana Ciurtin","doi":"10.1093/rheumatology/keag552","DOIUrl":"https://doi.org/10.1093/rheumatology/keag552","url":null,"abstract":"","PeriodicalId":21255,"journal":{"name":"Rheumatology","volume":"25 1","pages":""},"PeriodicalIF":5.5,"publicationDate":"2026-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149089226","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":"Impact of bimekizumab on CANDEN spinal MRI inflammation & structural lesions in radiographic axial spondyloarthritis: 2-year phase 3 results","authors":"Walter P Maksymowych,Robert G W Lambert,Victoria Navarro-Compán,Xenofon Baraliakos,Jason Coarse,Natasha de Peyrecave,Mikkel Østergaard","doi":"10.1093/rheumatology/keag484","DOIUrl":"https://doi.org/10.1093/rheumatology/keag484","url":null,"abstract":"Abstract Objectives To evaluate the impact of 2-year treatment with bimekizumab, a dual IL-17A and IL-17F inhibitor, on spinal MRI inflammatory and structural lesions in patients with radiographic axial spondyloarthritis (r-axSpA) in BE MOBILE 2 and its open-label extension (OLE) using Canada-Denmark (CANDEN) scoring. Methods Patients in BE MOBILE 2 and its OLE with spinal MRIs at baseline, Weeks 16, 52 and 104 were included. MRIs were evaluated using CANDEN scores/subscores for inflammation, fat lesions, erosions and new bone formation; mean change from baseline (CfB) is reported. All data are observed case. Results Of 332 patients in BE MOBILE 2, 102 had MRIs eligible for CANDEN scoring at all four timepoints. Mean reductions from baseline in total inflammation score were observed with bimekizumab at Week 16 (CfB: –7.3), with minimal further change at Week 104 (–6.6). Largely similar patterns were observed in inflammation subscores to Week 104, including the posterolateral inflammation subscore. In bimekizumab-randomised patients, total fat lesions score increased from baseline to Week 16 (CfB: 1.6), with minimal further change at Week 104 (1.8). These increases were reflected in patients with baseline inflammation; those without baseline inflammation had minimal change at all timepoints. Minimal changes were observed in total erosions and new bone formation scores. Conclusions In bimekizumab-treated patients with r-axSpA, comprehensive MRI CANDEN scoring showed reductions in spinal inflammation at all anatomical locations at Week 16, sustained at two years, initial increases in fat lesions with minimal subsequent change and minimal changes in erosions and new bone formation.","PeriodicalId":21255,"journal":{"name":"Rheumatology","volume":"295 1","pages":""},"PeriodicalIF":5.5,"publicationDate":"2026-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149092094","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":"Can parent‑reported composites replace physician assessment in juvenile dermatomyositis?","authors":"Martina Rossano,Giovanni Filocamo","doi":"10.1093/rheumatology/keag549","DOIUrl":"https://doi.org/10.1093/rheumatology/keag549","url":null,"abstract":"","PeriodicalId":21255,"journal":{"name":"Rheumatology","volume":"1 1","pages":""},"PeriodicalIF":5.5,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149089233","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":"Drug survival of adalimumab across different manifestations of Behçet's syndrome: a retrospective analysis in 335 patients.","authors":"Ozge Sonmez, Sinem Nihal Esatoglu, Didar Ucar, Elif Kaymaz, Yesim Ozguler, Serdal Ugurlu, Emire Seyahi, Melike Melikoglu, Izzet Fresko, Ugur Uygunoglu, Muazzez Cigdem Oba, Zekayi Kutlubay, Ali Ibrahim Hatemi, Aykut Ferhat Celik, Vedat Hamuryudan, Gulen Hatemi","doi":"10.1093/rheumatology/keag510","DOIUrl":"10.1093/rheumatology/keag510","url":null,"abstract":"<p><strong>Objectives: </strong>Studies on drug survival provide real-world data on efficacy as well as safety. We aimed to evaluate the long-term drug survival of adalimumab (ADA) in a large cohort of patients with Behçet's syndrome (BS).</p><p><strong>Methods: </strong>We conducted a retrospective chart review of 335 BS patients who started ADA between 2008 and 2023. All treatment discontinuations were considered as events, regardless of the underlying reason, to reflect overall treatment persistence in a real-world setting.</p><p><strong>Results: </strong>ADA retention rates at 6, 12 and 24 months were 88.9%, 78.3% and 67.1%, respectively. Over a mean follow-up of 26.6 (23) months, 137 patients (41%) discontinued ADA. The most common reason for discontinuation was inefficacy, followed by adverse events, non-compliance, remission and other reasons. No significant associations were observed between treatment discontinuation and age, sex, disease duration, prior tumour necrosis factor inhibitor exposure, concomitant disease-modifying antirheumatic drug use or major organ involvement. Dose interval extension was performed in 36 patients, with relapse or flare occurring in five (14%), all of whom achieved remission after dose re-adjustment. Dose intensification was applied in 30 patients, resulting in remission in 17 (56.6%).</p><p><strong>Conclusion: </strong>ADA showed a good retention rate at month 6, followed by a gradual decline in drug retention over time. Secondary inefficacy was the most common reason for treatment discontinuation, followed by adverse events and non-compliance, whereas primary inefficacy was uncommon. Dose intensification to achieve active disease control and dose de-escalation in patients with sustained remission may be feasible management strategies.</p>","PeriodicalId":21255,"journal":{"name":"Rheumatology","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148983640","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}