Rheumatology最新文献

{"title":"Comment on: NETs in the spotlight: exploring NETosis markers for tracking disease activity in IgA vasculitis: Reply.","authors":"Vafa Guliyeva, Fatma Gül Demirkan, Erdem Bektaş, Rabia Deniz, Zeliha Emrence, Özlem Akgün, Selen Duygu Arık, Ayşenur Doğru, Ayşe Tanatar, Neslihan Abacı, Sema Sırma Ekmekci, Ahmet Gül, Nuray Aktay Ayaz","doi":"10.1093/rheumatology/keaf402","DOIUrl":"10.1093/rheumatology/keaf402","url":null,"abstract":"","PeriodicalId":21255,"journal":{"name":"Rheumatology","volume":" ","pages":"5582-5583"},"PeriodicalIF":4.4,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12494211/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144718268","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lung transplantation outcomes of patients with interstitial pneumonia with autoimmune features: a single-centre retrospective cohort study.","authors":"Alec Chu Ming Yu, Hyein Kim, Robert D Levy, Jennifer M Wilson, Darya S Jalaledin, James Choi, John Yee, Charles D Poirier, Sabrina Anh-Tu Hoa, Océane Landon-Cardinal, Kun Huang","doi":"10.1093/rheumatology/keaf299","DOIUrl":"10.1093/rheumatology/keaf299","url":null,"abstract":"<p><strong>Objective: </strong>Interstitial pneumonia with autoimmune features (IPAF) describes patients with interstitial lung disease (ILD) and autoimmune features without meeting criteria for a specific rheumatic disease. No longitudinal data exist on post-transplant outcomes in IPAF patients. We compared baseline demographics, pre-transplant characteristics and post-transplant outcomes between IPAF and idiopathic pulmonary fibrosis (IPF) patients undergoing double lung transplantation.</p><p><strong>Methods: </strong>We retrospectively analysed lung transplant recipients with ILD in British Columbia between 1 January 2014 and 30 April 2024. Diagnoses of IPAF and IPF were made by multidisciplinary review. Continuous variables were analysed using the Mann-Whitney U test, categorical variables with Fisher's exact test, and survival using Kaplan-Meier analysis.</p><p><strong>Results: </strong>We identified 20 IPAF and 64 IPF patients. IPAF patients were more likely female (50% vs 17%, P = 0.006), on pre-transplant immunosuppression (60% vs 6.3%, P < 0.001) and were less likely to receive antifibrotics (20% vs 64%, P < 0.001). No difference was seen in 1-year or cumulative survival, though survival curves diverged over time favouring IPAF. Post-transplant lung function, acute rejection, infection-related hospitalization, malignancy and chronic lung allograft dysfunction (CLAD) were similar, with non-usual interstitial pneumonia (UIP) IPAF exhibiting a survival advantage over IPF (100% vs 66%, P = 0.044). Explant pathology revealed more UIP patterns in IPF, while IPAF showed more non-specific interstitial pneumonia (NSIP) or unclassifiable patterns.</p><p><strong>Conclusions: </strong>Post-transplant survival, lung function and complication rates were comparable between IPAF and IPF patients at one year and the last follow-up. This is the first study to report both short- and long-term lung transplant outcomes in IPAF patients.</p>","PeriodicalId":21255,"journal":{"name":"Rheumatology","volume":" ","pages":"5338-5343"},"PeriodicalIF":4.4,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12494216/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144199950","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction to: Quantifying hospital-associated costs, and accompanying travel costs and productivity losses, before and after withdrawing TNF-α inhibitors in juvenile idiopathic arthritis.","authors":"","doi":"10.1093/rheumatology/keaf405","DOIUrl":"10.1093/rheumatology/keaf405","url":null,"abstract":"","PeriodicalId":21255,"journal":{"name":"Rheumatology","volume":" ","pages":"5563"},"PeriodicalIF":4.4,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12494205/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144967015","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predicting rapid radiographic progression in difficult-to-treat rheumatoid arthritis: insights from long-term follow-up.","authors":"Kerem Abacar,Andrea Di Matteo,Paula David,Shouvik Dass,Paul Emery,Kulveer Mankia,Benazir Saleem,Dennis McGonagle","doi":"10.1093/rheumatology/keaf515","DOIUrl":"https://doi.org/10.1093/rheumatology/keaf515","url":null,"abstract":"OBJECTIVESTo investigate the long-term trajectory of radiographic progression in difficult-to-treat rheumatoid arthritis (D2T RA) and poly-refractory RA (pr-RA) patients and to evaluate the impact of ultrasound-based persistent inflammatory refractory RA (PIRRA) and non-inflammatory refractory RA (NIRRA) classification on predicting rapid radiographic progression (RRP, ≥5 mSvdH units/year).METHODSRadiographic damage was assessed using the modified Sharp/van der Heijde (mSvdH) score in EULAR-defined D2T RA patients. PIRRA and NIRRA subgroups were classified based on a single ultrasound timepoint assessing grayscale and power Doppler synovitis. The impact of time-integrated CRP and swollen joint counts (SJC) on radiographic progression was examined.RESULTSAmong 254 D2T RA patients, 114 had serial radiographs with a mean follow-up of 9 years. The mean annual mSvdH progression was 2.8 units with both time-integrated CRP (p< 0.001) and the PIRRA patients (n = 43) having significantly greater annual radiographic progression (3.3 in PIRRA vs 2.4 units in NIRRA, p= 0.025). In multivariable analysis, older age (p= 0.017) and swollen joint count (p= 0.009) were independently associated with RRP. Additionally, RRP was observed in 50% of pr-RA patients (n = 14) vs 19.4% in other D2T RA cases (p= 0.048).CONCLUSIONAlthough an uncommon subgroup, half of pr-RA cases demonstrated RRP, emphasizing the need for more aggressive treatment approaches. In contrast, many D2T RA patients exhibited comparatively slow radiographic progression indicating that many D2T RA cases are at least partially treated. These findings underscore the heterogeneity within D2T RA and highlight the need for additional strategies for the pr-RA subgroup.","PeriodicalId":21255,"journal":{"name":"Rheumatology","volume":"19 1","pages":""},"PeriodicalIF":5.5,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145194755","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":"Unfolding dermatological spectrum of Still's disease: a cohort study from the International AIDA Network Still's Disease Registry.","authors":"Laura Calabrese,Martina D'Onghia,Alessandra Cartocci,Andrea Hinojosa-Azaola,Jiram Torres-Ruiz,Giuseppe Lopalco,Jessica Sbalchiero,Valeria Caggiano,Henrique A Mayrink Giardini,Ibrahim A Almaghlouth,Piero Ruscitti,Ilenia Di Cola,Petros P Sfikakis,Katerina Laskari,Paolo Sfriso,Lorenzo Dagna,Corrado Campochiaro,Abdurrahman Tufan,Hamit Kucuk,Riza Can Kardas,Abdulsamet Erden,Gaafar Ragab,Mohamed Tharwat Hegazy,Ahmed Hatem Laymouna,Luca Navarini,Onorina Berardicurti,Francesco Ciccia,Daniela Iacono,Flavia Riccio,Lampros Fotis,Haner Direskeneli,Joanna Makowska,Annamaria Iagnocco,Alessandro Conforti,Donato Rigante,Maissa Thabet,Florenzo Iannone,Daniele Domanico,Marcello Govoni,Maria Cristina Maggio,Emanuela Del Giudice,Francesco La Torre,Ezgi D Batu,Seza Ozen,Carla Gaggiano,Eduardo Martín-Nares,Guillermo Arturo Guaracha-Basañez,Anastasios Karamanakos,Alberto Lo Gullo,Benedetta Monosi,Elena Bartoloni,José Hernández-Rodríguez,Verónica Gómez-Caverzaschi,Giacomo Emmi,Sukran Erten,Francesco Carubbi,Maria Francesca Gicchino,Amato De Paulis,Giovanni Conti,Benson Ogunjimi,Ewa Wiesik-Szewczyk,Anna Nowakowska-Płaza,Ombretta Viapiana,Piercarlo Sarzi-Puttini,Samar Tharwat,Francesca Crisafulli,Paola Parronchi,Antonio Gidaro,Ludovico De Stefano,Luciana Breda,Lidia La Barbera,Giuliana Guggino,Albero Balistreri,Claudia Fabiani,Pietro Rubegni,Bruno Frediani,Roberto Giacomelli,Luca Cantarini,Antonio Vitale","doi":"10.1093/rheumatology/keaf512","DOIUrl":"https://doi.org/10.1093/rheumatology/keaf512","url":null,"abstract":"OBJECTIVESTo investigate cutaneous manifestations in Still's disease patients, evaluating any correlation with ethnic origin, age at disease onset, disease patterns, occurrence of MAS, and systemic activity scores.METHODSData were retrospectively drawn from the International AutoInflammatory Disease Alliance (AIDA) Network Registry dedicated to Still's disease.RESULTSA total of 518 patients (41.3% males) were enrolled. Salmon-colored evanescent skin rash (n = 304, 63.9%), macules (n = 40, 7.7%), urticarial eruptions (n = 31, 5.9%), erythema (n = 27, 5.2%), and persistent pruritic papules and plaques (PPPP) (n = 25, 4.8%) accounted for the most frequent skin manifestations observed in Still's disease. Overall, atypical skin rash were described in 110 (21.2%) patients. Salmon-colored evanescent skin rash and pruritus were more common among patients aged <16 years compared with patients aged 16-60 (p= 0.002 and p= 0.008, respectively). Pruritus was significantly more frequent among White than among Arab patients (p= 0.008) and in polycyclic vs monocyclic course (p= 0.049). Hispanics showed a significantly higher rate of atypical skin manifestations compared with Arabs (p= 0.036) and White (p= 0.036). Also, macules were more frequent among Hispanics than White (p= 0.027), while PPPP was more frequent among Hispanics than Arabs (p= 0.023) and White (p= 0.002). Salmon-colored evanescent skin rash was significantly more frequent among patients with a systemic activity score ≥7 (p< 0.001).CONCLUSIONThe present study enhances dermatologists' awareness of the diverse cutaneous lesions that may represent heterogeneous manifestations of Still's disease, shedding new light on the difference related to the age at disease onset, the patients' ethnic origin and the severity of the disease.","PeriodicalId":21255,"journal":{"name":"Rheumatology","volume":"69 1","pages":""},"PeriodicalIF":5.5,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145189422","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":"Validation of Boolean 2.0 criteria for remission and quality of life prediction in Korean patients with rheumatoid arthritis receiving targeted therapy.","authors":"Soo-Kyung Cho,Se Rim Choi,Eunwoo Nam,Yoon-Kyoung Sung","doi":"10.1093/rheumatology/keaf516","DOIUrl":"https://doi.org/10.1093/rheumatology/keaf516","url":null,"abstract":"OBJECTIVETo validate the revised patient global assessment (PtGA) threshold of 2 cm in the Boolean 2.0 remission definition by assessing its agreement with index-based remission criteria and its predictive validity for quality of life (QoL) outcomes, compared with Boolean 1.0, in Korean patients with rheumatoid arthritis (RA) receiving targeted therapy.METHODSData from a multicentre prospective cohort of patients with RA initiating treatment with Janus kinase inhibitors or biologic disease-modifying anti-rheumatic drugs were analysed. Remission was assessed using Boolean 1.0, Boolean 2.0, and index-based criteria including Disease Activity Score in 28 joints calculated with erythrocyte sedimentation rate (DAS28-ESR), Clinical Disease Activity Index (CDAI), and Simplified Disease Activity Index (SDAI). Agreement between Boolean definitions and index-based criteria was evaluated using Cohen's kappa. Predictive validity was determined by comparing remission status at week 24 and patient-reported outcomes at week 48, specifically Health Assessment Questionnaire-Disability Index (HAQ-DI) ≤0.5 and EuroQoL- 5 Dimension (EQ-5D)=1.RESULTSAmong 506 enrolled patients, 414 completed the 48-week follow-up. Boolean 2.0 showed stronger agreement with DAS28-ESR remission than Boolean 1.0 (κ = 0.50 vs 0.39), but weaker agreement with CDAI (κ = 0.75 vs 0.48) and SDAI (κ = 0.76 vs 0.64). Boolean 1.0 demonstrated higher positive predictive values for HAQ-DI ≤0.5 (0.90 vs 0.82) and EQ-5D = 1 (0.38 vs 0.30) compared with Boolean 2.0.CONCLUSIONAlthough Boolean 2.0 improves concordance with DAS28-ESR, it does not enhance the prediction of long-term functional or QoL outcomes. Its broader definition of remission warrants cautious interpretation in clinical practice.","PeriodicalId":21255,"journal":{"name":"Rheumatology","volume":"31 1","pages":""},"PeriodicalIF":5.5,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145189420","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":"Disease activity and mental health symptoms in axial spondyloarthritis: concordant or discordant?","authors":"Sizheng Steven Zhao,Casper Webers,Elena Nikiphorou,Désirée van der Heijde,Jürgen Braun,Uta Kiltz,Sofia Ramiro,Annelies Boonen","doi":"10.1093/rheumatology/keaf506","DOIUrl":"https://doi.org/10.1093/rheumatology/keaf506","url":null,"abstract":"OBJECTIVEWe applied latent class and trajectory modelling to examine whether subgroups of axial spondylarthritis (axSpA) patients report discordant scores for disease activity and mental health symptoms at baseline and after treatment change.METHODSWe analysed axSpA patients from the ASAS Health Index International Validation Study. We applied latent class analysis (LCA) using generalized structural equation modelling to identify subgroups among 1292 individuals, based on baseline Hospital Anxiety and Depression Scale (HADS) subscores and ASDAS. We applied trajectory modelling in a subset (n = 206) requiring treatment change, to identify subgroups of distinct trajectories for HADS and ASDAS over 6 months. All indices were standardised. Baseline characteristics were compared across identified groups.RESULTSFor the baseline analysis, three groups were identified with concordant HADS subscores and ASDAS, with similar baseline characteristics except the high HADS/ASDAS group having more peripheral joint involvement and higher CRP levels. Trajectory analysis identified four groups with concordant HADS and ASDAS changes: 54% comparatively low baseline values, 33% medium and, of the high baseline groups, some (7%) had marked improvement (HADS-depression Δ11, HADS-anxiety Δ9, ASDAS Δ2.8), while others (6%) had limited ASDAS improvement (Δ1.4) with minimal changes in anxiety symptoms (Δ0.6).CONCLUSIONSWe did not identify the hypothesized subgroups with discordant disease activity and mental health symptoms. Instead, these domains were closely aligned at baseline and following treatment, suggesting that these symptoms influence each other. Patients with high mental health symptom burden may benefit from knowing that these symptoms often improve alongside disease activity when starting treatment.","PeriodicalId":21255,"journal":{"name":"Rheumatology","volume":"277 1","pages":""},"PeriodicalIF":5.5,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145182626","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":"Global patterns and determinants of diagnostic delay in spondyloarthritis: insights from the ASAS-PerSpA international study.","authors":"Maroun Aoun,Sherif M Gamal,Ihsane Hmamouchi,Clementina Lopez-Medina,Maxime Dougados,Bassel Elzorkany,Nelly Ziade","doi":"10.1093/rheumatology/keaf511","DOIUrl":"https://doi.org/10.1093/rheumatology/keaf511","url":null,"abstract":"OBJECTIVESDiagnostic delay (DD) is well-documented in spondyloarthritis (SpA), particularly in axial disease. This ancillary analysis from the ASAS-PerSpA study estimated DD across SpA entities, considering the presenting disease manifestation, and evaluated factors associated with DD.METHODSThis study included 4,339 patients with any SpA entity (axial (axSpA), peripheral (pSpA), psoriatic arthritis (PsA), inflammatory bowel disease-associated SpA (IBD-SpA), reactive arthritis and juvenile SpA). DD was assessed using two definitions: (1) the first included extra-musculoskeletal manifestation (EMM) if any, as possible initial symptom, and (2) the second considered strictly the first musculoskeletal manifestation (MM) as the disease onset. DD was statistically compared across disease entities, and associated factors were evaluated using multivariable linear regression models for axSpA, PsA, pSpA, and IBD-SpA.RESULTSThe analysis included 2,622 axSpA, 1,016 PsA, 424 pSpA, 110 IBD-SpA, and 167 other SpA patients. The average DD was shorter using definition 2 (4.5 ± 7.0 vs 6.6 ± 8.6 years). Based on definition 2, DD was longer for axSpA and IBD-SpA (5.6 ± 7.3 and 5.2 ± 7.7 years, respectively), where the first MM was axial, compared with PsA (2.5 ± 6.1 years), pSpA (3.1 ± 5.9 years), and others, where it was peripheral (p< 0.001). Axial first manifestation, younger age at first symptom and older age at study inclusion were associated with longer DD in the four SpA entities.CONCLUSIONDD was longer in axSpA and IBD-SpA compared with PsA, pSpA, and other forms of SpA and associated with the phenotype of the presenting symptom. SpA entities and presenting symptoms should be considered when reporting DD in SpA.","PeriodicalId":21255,"journal":{"name":"Rheumatology","volume":"41 1","pages":""},"PeriodicalIF":5.5,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145140124","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":"Choosing treatment and targeted therapy in axial Spondyloarthritis.","authors":"Kalliopi Klavdianou,Xenofon Baraliakos","doi":"10.1093/rheumatology/keaf513","DOIUrl":"https://doi.org/10.1093/rheumatology/keaf513","url":null,"abstract":"Pharmacological management in the axial spondyloarthritis (axSpA) field has advanced in the last years. Accumulating evidence on long-term efficacy and safety of biological agents targeting TNFa and IL-17, as well as data on JAK inhibitors is now available. Rheumatologists have currently more options for treatment as compared with 20 years ago, but choosing the best therapeutical approach for a single patient remains a challenge. Despite generalized treatment recommendations provided by international societies, patients present with a heterogeneity of symptoms and treatment responses. In the context of personalised medicine, understanding the disease phenotype in combination with extra-musculoskeletal manifestations is a core step for treatment decision making. Beyond disease-related aspects, comorbidities could also be particularly relevant in the selection of the most appropriate drug, given their different efficacy and safety profiles. AxSpA patient's fertility and pregnancy outcomes with regard to therapy also form a consideration, since symptom onset usually falls into the child-bearing age. This article will discuss the selective effect of the approved treatment modalities on the different axSpA manifestations and co-existing conditions.","PeriodicalId":21255,"journal":{"name":"Rheumatology","volume":"19 1","pages":""},"PeriodicalIF":5.5,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145140123","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":"Cartilage turnover, but not novel synovial collagen marker, is associated with joint damage progression in osteoarthritis patients.","authors":"Patrick Garnero,Francis Guillemin,Willy Ngueyon Sime,Evelyne Gineyts,Roland Chapurlat,Christian Roux","doi":"10.1093/rheumatology/keaf510","DOIUrl":"https://doi.org/10.1093/rheumatology/keaf510","url":null,"abstract":"OBJECTIVETo investigate the relative contribution of cartilage and synovial turnover to predict progression in patients with knee or hip osteoarthritis (OA).METHODS449 patients with symptomatic knee or hip OA (mean age: 62 yr, 62% women) with a Kellgren-Lawrence (KL) score > =2 from the prospective KHOALA cohort study were investigated. Progression was defined as a one-point increase in the KL scores from knee or hip radiographs and/or a joint replacement during 5 years follow-up. The association of baseline urinary CTX-II and serum Col 3-4, biochemical markers of cartilage and synovial turnover, respectively, with progression was assessed by multivariable discrete-time survival models.RESULTSIncreased baseline CTX-II levels were associated with an increased risk of knee and/or hip OA progression, patients with levels in the fourth quartile having an odds-ratio (OR; 95%CI) of 2.57 (1.57-4.18) compared with subjects with levels in first quartile, after adjustment for demographical and OA clinical variables and KL scores. When analyses were restricted to patients with knee or hip OA progression only, similar findings were obtained with corresponding ORs (95% CI) of 2.36 (1.32-4.21) and 3.39 (1.42-8.11), respectively. There was no significant association of baseline Col 3-4 and the risk of knee or hip progression.CONCLUSIONSIncreased urinary CTX-II, but not Col 3-4, is independently associated with a higher risk of structural progression in patients with knee or hip OA. Cartilage turnover may play a more important role than synovial activity as assessed with Col 3-4 to mediate joint damage in established OA.CLINICAL TRIAL REGISTRATIONClinicalTrials.gov; NCT00481338.","PeriodicalId":21255,"journal":{"name":"Rheumatology","volume":"154 1","pages":""},"PeriodicalIF":5.5,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145140181","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}