Rheumatology最新文献

{"title":"Bimekizumab efficacy in male and female patients with axial spondyloarthritis: 52-week results from the phase 3 BE MOBILE trials.","authors":"Martin Rudwaleit, Sofia Ramiro, Denis Poddubnyy, Marina Magrey, Irene E van der Horst-Bruinsma, Atul Deodhar, Vanessa Taieb, Sarah Kavanagh, Natasha de Peyrecave, Lianne S Gensler","doi":"10.1093/rheumatology/keag425","DOIUrl":"10.1093/rheumatology/keag425","url":null,"abstract":"<p><strong>Objectives: </strong>To assess sex-based differences in response to bimekizumab in patients with axial spondyloarthritis (axSpA) from two phase 3 trials.</p><p><strong>Methods: </strong>Improvements to week 52 in measures of disease activity (ASAS40, ASDAS <2.1, BASDAI) and function (BASFI), pain, fatigue, health-related quality of life (HRQoL) and objective signs of inflammation (MRI, hs-CRP) were assessed post hoc in patients with non-radiographic (nr-) and radiographic (r-)axSpA from BE MOBILE 1 (NCT03928704) and BE MOBILE 2 (NCT03928743), respectively. Comparisons were made between sexes at week 16 (bimekizumab vs placebo treatment effect) and week 52 (treatment response in bimekizumab-randomized patients only) using odds ratios for dichotomous outcomes and difference values for continuous outcomes. For hs-CRP, ratio to baseline was calculated due to skewed distribution.</p><p><strong>Results: </strong>While sex distribution was balanced in nr-axSpA (54.3% male), 72.3% of patients with r-axSpA were male. At week 16, bimekizumab-randomized male patients typically had better treatment responses vs placebo compared with female patients across ASAS40, ASDAS <2.1 and improvements in BASDAI, BASFI and measures of HRQoL. At week 52, female patients had longer-term improvements across these outcomes, though male patients continued to have numerically higher treatment responses. In contrast, active inflammation (MRI, hs-CRP) was reduced to similarly low levels in both sexes at week 16 and maintained to week 52, despite baseline differences.</p><p><strong>Conclusion: </strong>Although male patients had earlier clinical responses to bimekizumab treatment, female patients demonstrated longer-term improvements in composite and patient-reported outcomes. Both sexes had substantial improvements in objective inflammation at week 16 and 52, despite baseline differences.</p><p><strong>Trial registration: </strong>Clinicaltrials.gov; NCT03928704 and NCT03928743.</p>","PeriodicalId":21255,"journal":{"name":"Rheumatology","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13645452/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148764640","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":"Interferon-driven gene signature identifies two distinct subgroups in rheumatoid factor-positive polyarticular juvenile idiopathic arthritis.","authors":"Anna Agrusti, Clémence David, Sylvain Breton, Isabelle Melki, Pierre Quartier, Cécile Dumaine, Heloise Reumaux, Anne-Laure Jurquet, Benjamin Fournier, Luis Seabra, Gillian I Rice, Brigitte Bader-Meunier, Marie-Louise Frémond","doi":"10.1093/rheumatology/keag486","DOIUrl":"10.1093/rheumatology/keag486","url":null,"abstract":"<p><strong>Objective: </strong>To characterize the demographic, clinical, serological, genetic background, course and value of the interferon (IFN) score in a cohort of patients with rheumatoid factor (RF)-positive polyarticular juvenile idiopathic arthritis (pJIA).</p><p><strong>Methods: </strong>Monocentric retrospective study of patients with RF-positive pJIA. Demographic, clinical and laboratory data were collected. The IFN score was calculated based on the expression levels of 24 IFN stimulated genes. Whole exome sequencing was performed in 22 patients.</p><p><strong>Results: </strong>Thirty-two patients were included. The IFN score was positive in 18 patients (56.2%) and negative in 14 patients (43.7%). An increased IFN score was associated with a significantly higher family history of autoimmunity (P = 0.0004), parental first-degree consanguinity (P = 0.05) and prevalence of antibodies to anti-cyclic citrullinated peptide (ACPA) (P = 0.01). Three patients with interstitial lung disease exhibited a positive IFN score. Conversely, demographic features and characteristics of polyarthritis did not differ between the two groups. Clinically inactive disease was achieved in 21/32 (66%) patients, with no significant difference according to the IFN score. Remission was never achieved with methotrexate alone. We identified one patient with a pathogenic de novo mutation in COPA. Additionally, ultra-rare variants in genes related to IFN and/or innate immunity were found in 21/22 (95.5%) patients.</p><p><strong>Conclusion: </strong>The IFN signature identified two distinct subgroups in RF-positive pJIA according to family history and immunological features. Our study suggests that patients with an elevated IFN score should be screened for pulmonary involvement. Future prospective studies are required to validate the use of the IFN score as a biomarker in RF-positive pJIA.</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":"148913257","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":"First-line biologic and targeted synthetic DMARDs versus methotrexate in early rheumatoid arthritis: a meta-analysis of remission outcomes.","authors":"Mark D Russell, Chun J Chan, Aran Sasitharan, Victoria Allen, Mark Gibson, Maryam A Adas, Samantha Goodliffe, Katie Bechman, Andrew P Cope, Sam Norton, Ailsa Bosworth, Peter Foxton, Elizabeth Price, Sana Sharrack, Shouvik Dass, Paul Emery, Lesley Kay, Peter Lanyon, James B Galloway","doi":"10.1093/rheumatology/keag515","DOIUrl":"10.1093/rheumatology/keag515","url":null,"abstract":"<p><strong>Objectives: </strong>To evaluate initial therapy with biologic and targeted synthetic DMARDs (b/tsDMARDs), compared with methotrexate, in patients with early RA.</p><p><strong>Methods: </strong>We systematically reviewed and meta-analysed randomized-controlled trials comparing initial b/tsDMARDs, combined with methotrexate or as monotherapy, against methotrexate in methotrexate-naïve adults with early RA. Pairwise and network meta-analysis were performed to compare DAS28 remission attainment, with the primary analysis at 6 months and secondary analyses at 3 and 12 months. Secondary outcomes included ACR50 response and CDAI remission.</p><p><strong>Results: </strong>Twenty-nine trials (13 387 participants) were included. Compared with methotrexate alone, initial b/tsDMARDs plus methotrexate significantly increased DAS28 remission at 6 months (risk ratio [RR] 1.62; 95% CI: 1.39, 1.89), 3 months (RR 1.95; 1.47, 2.57) and 12 months (RR 1.54; 1.39, 1.71), with benefits also observed for CDAI remission and ACR50 response. In network meta-analysis, all b/tsDMARD classes combined with methotrexate had higher remission rates than methotrexate alone. The benefits of b/tsDMARDs plus methotrexate were greater in studies with higher baseline disease activity and a greater proportion of rheumatoid factor-positive participants. As monotherapy, b/tsDMARDs increased DAS28 remission attainment compared with methotrexate at 6 months (RR 1.81; 1.42, 2.31), 3 months (RR 1.92; 1.31, 2.83) and 12 months (RR 1.46; 1.25, 1.71); however, at individual class level, significantly higher remission rates were observed only with tocilizumab and Janus kinase (JAK) inhibitor monotherapy.</p><p><strong>Conclusion: </strong>Initial therapy with b/tsDMARDs in combination with methotrexate is associated with higher remission rates than methotrexate alone in patients with early RA. As monotherapy, higher remission rates were observed for JAK inhibitors and tocilizumab.</p>","PeriodicalId":21255,"journal":{"name":"Rheumatology","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13645451/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148991180","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":"Colour Doppler US assessment of retrobulbar hemodynamics and static retinal vessel analysis in Sjögren's disease: the SICARD cohort.","authors":"Konstantinos Triantafyllias, Veronika Balaklytska, Elsa Wilma Boehm, Andreas V Goules, Elena Joerns, Paraskevi V Voulgari, Elena Bartoloni, Lorenzo Cavagna, Sarah Wagner, Mohammed Alhaddad, Andreas Schwarting","doi":"10.1093/rheumatology/keag493","DOIUrl":"10.1093/rheumatology/keag493","url":null,"abstract":"<p><strong>Objectives: </strong>To assess, for the first time, macrovascular, medium-calibre vessel and microvascular damage in Sjögren's disease (SjD) using carotid greyscale US (GSUS), retrobulbar colour Doppler ophthalmic artery (OA) US (RCDUS) and static retinal vessel analysis (SRVA). Additionally, to evaluate associations of these markers with cardiovascular (CV) risk factors, patient- and disease-related characteristics.</p><p><strong>Methods: </strong>GSUS of the common carotid arteries was performed to measure carotid intima-media thickness (cIMT) and evaluate plaque burden. RCDUS assessed OA flow velocity integral (FVI), resistive and pulsatility indices (RI, PI). SRVA quantified retinal microvasculature using central retinal arteriolar, venular equivalents (CRAE, CRVE) and the arteriovenous ratio (AVR). Imaging findings were compared between patients with SjD and healthy controls and analysed in relation to clinical parameters.</p><p><strong>Results: </strong>130 SjD patients and 100 controls were included. SjD patients showed significantly higher cIMT (Padj = 0.003), OA-RI (Padj = 0.003) and -PI (Padj < 0.001), as well as lower OA-FVI (Padj = 0.012) and CRAE (Padj = 0.013) compared with the controls. Higher OA-RI and -PI correlated with higher disease activity (ESSDAI: both; rho = 0.324, P = 0.006), and impaired renal function (rho = -0.461, P < 0.001 and rho = -0.370, P = 0.002, respectively). OA-RI associated positively with age (rho = 0.435, P < 0.001) and inversely with lung carbon monoxide diffusion (r = -0.342, P = 0.019). Lower CRAE correlated with higher mean arterial pressure (r = -0.378, P < 0.001), CRP (rho = -0.215, P = 0.046), ANA titre (rho = -0.268, P = 0.016) and disease activity (ESSDAI: rho = -0.273, P = 0.011).</p><p><strong>Conclusions: </strong>In this first comprehensive study of CV surrogate markers in SjD, patients exhibited vascular alterations across multiple vascular beds, indicating systemic vascular involvement and a possible link to increased CV and cerebrovascular risk.</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":"148921076","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":"Comorbidity and mortality in adults with juvenile idiopathic arthritis: a nationwide Norwegian register-based matched cohort study.","authors":"Imane Bardan, Lene M Sundbakk, Joe Sexton, Tore K Kvien, Øyvind Molberg, Eirik K Kristianslund, Sella A Provan, Anna-Birgitte Aga","doi":"10.1093/rheumatology/keag507","DOIUrl":"10.1093/rheumatology/keag507","url":null,"abstract":"<p><strong>Objectives: </strong>This population-based study assesses comorbidities, autoimmune conditions and all-cause mortality in [1] adults with juvenile idiopathic arthritis (JIA) against general population comparators and [2] adults with JIA with vs without recent disease-modifying anti-rheumatic drug (DMARD) exposure.</p><p><strong>Methods: </strong>We included adults who, between 2009 and 2024, had ≥2 specialist health contacts with a JIA-specific ICD-10 code in the mandatory Norwegian Patient Registry (NPR). Each case was matched randomly, by age, gender and county of residence, to 10 general population comparators at the time of receiving the second JIA diagnosis in adulthood. We compared 5-year retrospective comorbidity prevalences in descriptive analyses and prospective all-cause mortality in [1] adults with JIA vs comparators and [2] adult JIA with vs without recent DMARD exposure.</p><p><strong>Results: </strong>Adults with JIA (N = 2932) had higher prevalence than comparators (N = 29 097) of ischemic heart disease excluding myocardial infarction [JIA vs comparators (%): 1.0 vs 0.6], hypertension (3.6 vs 1.4), chronic kidney disease (0.5 vs 0.2), type 1 diabetes (1.7 vs 0.7), coeliac disease (1.4 vs 0.7), autoimmune thyroiditis (0.3 vs 0.1) and autoimmune alopecia (0.4 vs 0.1). Prospective all-cause mortality was higher in JIA than comparators (mortality rate 2.4 vs 1.8 per 1000 person-years). In adult JIA, prevalences of comorbidities and autoimmune conditions as well as all-cause mortality was similar in those with and without recent DMARD exposure.</p><p><strong>Conclusion: </strong>In this study we found an increased 5-year retrospective prevalence of several comorbidities and increased all-cause mortality in adults with JIA compared with population controls.</p>","PeriodicalId":21255,"journal":{"name":"Rheumatology","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13633849/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148978077","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":"From haematology to rheumatology: intravenous-to-subcutaneous rituximab transition in Sjögren's disease-associated cryoglobulinaemic vasculitis.","authors":"Yi-Fan Mai, Chun-Kuang Tsai, Wei-Sheng Chen","doi":"10.1093/rheumatology/keag508","DOIUrl":"10.1093/rheumatology/keag508","url":null,"abstract":"","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":"149017902","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":"Pulmonary hypertension in anti-synthetase syndrome: prevalence, comparative risk across autoimmune diseases and impact on survival.","authors":"Sangmee Sharon Bae, Daphne Rivero Gallegos, Francisca Bozan, Gianluca Sambataro, Eduardo Dourado, Giovanni Zanframundo, Iazsmin Bauer Ventura, Akira Yoshida, Sara Faghihi-Kashani, Aravinthan Loganathan, Francesco Bonella, Miguel A Gonzalez-Gay, Masataka Kuwana, Chester V Oddis, Jorge Rojas-Serrano, Latika Gupta, Upendra Rathore, Anamika Anuja, Marco Fornaro, Florenzo Iannone, Lorenzo Bianchessi, Samuel Katsuyuki Shinjo, Fernando Henrique Carlos de Souza, Renata Miossi, Fabrizio Luppi, Siamak Moghadam-Kia, Rohit Aggarwal, Lorenzo Cavagna","doi":"10.1093/rheumatology/keag543","DOIUrl":"10.1093/rheumatology/keag543","url":null,"abstract":"<p><strong>Objectives: </strong>Anti-synthetase syndrome (ASyS) is a distinct entity within the myositis spectrum characterized by interstitial lung disease (ILD) which raises the concern of increased pulmonary vascular pressures. However, the prevalence of pulmonary hypertension (PH) in real-world ASyS populations remains unclear. We investigated the prevalence and impact of PH in ASyS.</p><p><strong>Methods: </strong>Data were obtained from a worldwide, physician-reported multicentre registry based on physician-diagnosed ASyS and/or a positive anti-synthetase antibody. Comparative analyses and multivariable logistic regression assessed the odds of PH in ASyS relative to other disease groups. Cox proportional hazards models evaluated associations with all-cause mortality.</p><p><strong>Results: </strong>A total of 1868 ASyS and 2043 controls from 103 centres were analysed. Prevalence of PH was 8.9% of ASyS, which was higher than in non-ASyS myositis (3%, P < 0.001), RA (4%, P = 0.009) and interstitial pneumonia with autoimmune features (IPAF 3%, P = 0.003), but not significantly different from SSc (13%, P = 0.07) or SLE (11%, P = 0.57). ASyS had higher odds of PH compared with non-ASyS myositis (OR 1.91) and IPAF (OR 3.72), but lower odds than SSc (OR 0.62) or SLE (OR 0.24), in multivariate models adjusted for age, sex, smoking and ILD. Five-year survival in ASyS was 94%, decreasing to 88.3% in those with PH (P = 0.001). PH remained associated with increased mortality in ASyS, independent of age, sex and ILD (HR 2.52, 95% CI 1.41-4.53).</p><p><strong>Conclusion: </strong>PH occurred in 8.9% of ASyS and was independently associated with increased mortality, highlighting the importance of PH evaluation in this population.</p>","PeriodicalId":21255,"journal":{"name":"Rheumatology","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13671755/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149081890","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 relapse and infection to optimize patient outcomes in ANCA-associated vasculitis: data from the MAINRITSAN trials cohort.","authors":"Florence Delestre, Pierre Charles, Maxime Samson, Antoine Néel, Stanislas Faguer, Alexandre Karras, François Lifermann, Pascal Godmer, Catherine Hanrotel-Saliou, Nicolas Martin-Silva, Grégory Pugnet, François Maurier, Thomas Le Gallou, Thomas Quéméneur, Nadine Meaux-Ruault, Jean-François Viallard, Eric Hachulla, Xavier Puéchal, Loïc Guillevin, Raphaël Porcher, Benjamin Terrier","doi":"10.1093/rheumatology/keag542","DOIUrl":"10.1093/rheumatology/keag542","url":null,"abstract":"<p><strong>Objectives: </strong>Long-term follow-up of the MAINRITSAN trials confirmed the efficacy of rituximab (RTX) in preventing relapses in ANCA-associated vasculitis (AAV). Extending RTX maintenance beyond 18 months may benefit high-risk patients. The aim of this study was to validate relapse and infection prediction models to guide individualized RTX extension decisions.</p><p><strong>Methods: </strong>Data from 217 patients in the MAINRITSAN1 and MAINRITSAN2 trials treated with RTX for 18 months with follow-up through December 2020 were analysed. We externally validated relapse and infection prediction models from McClure et al. Primary endpoints were relapse-free survival and serious infection-free survival.</p><p><strong>Results: </strong>Relapse occurred in 76 patients, with a 72-month relapse-free survival rate of 55% (95% CI 48-64). Serious infections occurred in 33 patients, with a cumulative 72-month incidence of 20%. The relapse model (factors: male sex, age >60 years, ANCA positivity, relapsing disease, ENT involvement, prednisone dose) predicted major relapse (coefficient 1.34, P = 0.04) and identified high-risk patients with shorter major relapse-free survival (HR 1.91, 95% CI 0.97-3.76, P = 0.059). The relapse score was associated with major relapse risk predominantly within the PR3-ANCA subgroup (coefficient 2.76, P = 0.01). The infection model (factors: male sex, structural lung disease, diabetes, occurrence of infections during maintenance therapy and gammaglobulin level) identified high-risk patients with shorter serious infection-free survival (HR 2.93, 95% CI 1.28-6.72, P = 0.011).</p><p><strong>Conclusion: </strong>The relapse prediction model demonstrated reproducible performance in this external validation cohort and may contribute to clinically relevant risk stratification, especially in PR3-ANCA patients. The infection model showed stronger predictive performance and may support individualized discussions regarding RTX extension.</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":"149070091","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":"Recurrence of sarcoidosis after heart and lung transplantation: a retrospective single-centre cohort study.","authors":"Samantha Pickell, Lakshmi Jayaram, Yuhan Liu, Matthew C Baker","doi":"10.1093/rheumatology/keag567","DOIUrl":"10.1093/rheumatology/keag567","url":null,"abstract":"<p><strong>Objectives: </strong>To determine the incidence of sarcoidosis recurrence following heart or lung transplantation and to characterize recurrence patterns and clinical features in a single-centre cohort.</p><p><strong>Methods: </strong>We conducted a retrospective cohort study using the Stanford Medicine Research Data Repository from 2008 to 2022. Adult patients with pulmonary or cardiac sarcoidosis who underwent lung or heart transplantation were identified using International Classification of Diseases codes and confirmed by manual chart review. Clinical characteristics, treatment history and outcomes were extracted. The primary outcome was recurrence of sarcoidosis in the transplanted organ. Secondary outcomes included recurrence in non-transplanted organs, graft loss, rejection and mortality. Time to recurrence was evaluated using Kaplan-Meier analysis.</p><p><strong>Results: </strong>Fifty-eight sarcoidosis patients met inclusion criteria (22 pulmonary, 36 cardiac). Recurrence in the transplanted organ occurred in seven of 58 patients (12.1%): one of 22 lung transplant recipients (4.5%) and six of 36 heart transplant recipients (16.7%). Recurrence in non-transplanted organs occurred in one pulmonary recipient (4.5%) and five cardiac recipients (13.9%). One cardiac recipient experienced recurrence in both transplanted and extra-transplant sites. Among heart transplant recipients, patients with recurrence were older (mean 60.8 vs 55.2 years), whereas comorbidities, pre-transplant therapies and post-transplant immunosuppressive regimens were similar. Mean follow-up was 5.7 vs 6.2 years for pulmonary and cardiac recipients, respectively.</p><p><strong>Conclusion: </strong>Sarcoidosis recurrence occurred after both lung and heart transplantation and was more common after heart transplantation in this cohort. Recurrence despite standard immunosuppression supports ongoing surveillance and further study of recurrence mechanisms and prevention 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":"149149327","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":"Digital home monitoring in patients with juvenile idiopathic arthritis to increase intervals of hospital visits.","authors":"Anne Jasmijn Sellies, Joeri W van Straalen, Gerrie C J de Joode-Smink, Martijn J H Doeleman, Marc H A Jansen, Erika Van Nieuwenhove, Annet van Royen-Kerkhof, Bas J Vastert, Nico M Wulffraat, Sytze de Roock, Joost F Swart","doi":"10.1093/rheumatology/keag444","DOIUrl":"10.1093/rheumatology/keag444","url":null,"abstract":"<p><strong>Objectives: </strong>Juvenile Idiopathic Arthritis (JIA) patients attend routine hospital check-ups, even when disease activity is low. These visits are time-consuming and costly. Replacing visits with home monitoring may reduce costs but should not affect safety and (perceived) quality of care. This non-inferiority study tested whether patients with inactive JIA could safely prolong visit-intervals by home monitoring disease activity using EuroQol EQ-5D-Y-5L and Juvenile Arthritis Multidimensional Assessment Report questionnaires.</p><p><strong>Methods: </strong>One regular 3-monthly visit was replaced by home monitoring. Healthcare professionals evaluated responses to determine whether patients could safely prolong their visit-interval or needed a doctor's consultation. Flare percentages over the total study period and 6 months after baseline were compared with a historical flare percentage and with matched JIA patients using relative risks (RR) and a non-inferiority margin of 15%. Secondary outcomes were number of reminders, number of patients not completing home monitoring and patient satisfaction.</p><p><strong>Results: </strong>Eighty-four patients aged between 6 and 20 years participated in the study. Eighteen patients had a visit before or after evaluation of the questionnaires. Sixty-three had a prolonged interval, of whom seven experienced a flare. The study-wide flare percentage was 18.5%, the historical flare percentage was 18.4% (including non-inferiority margin). The RR for study-wide flares was 0.50 (95%CI: 0.29-0.86), showing non-inferiority. The study was underpowered for comparing flares after prolonged visit-intervals (RR: 0.77, 0.30-1.93). Overall, 92% showed interest in home monitoring more often.</p><p><strong>Conclusion: </strong>No clear evidence was found that increased visit-intervals with home monitoring poses a risk for missing disease flares. Reminders were necessary and patient satisfaction was high.</p><p><strong>Trial registration: </strong>Clinicaltrials.gov.uk; NCT05603286.</p>","PeriodicalId":21255,"journal":{"name":"Rheumatology","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13649185/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148970998","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}