Rheumatology International最新文献

{"title":"Familial associations between ANCA-associated vasculitis and other immune-mediated inflammatory diseases: a case control study.","authors":"Justin Chong Meng Chua, Kevan Roy Polkinghorne, Samar Ojaimi, Jessica Ryan, Arthur Richard Kitching","doi":"10.1007/s00296-026-06259-1","DOIUrl":"10.1007/s00296-026-06259-1","url":null,"abstract":"<p><p>This study assesses the relationship between ANCA-associated vasculitis and immune-mediated inflammatory diseases (IMIDs) in first-degree relatives. People with AAV were matched 1-to-1 with control participants with no IMID in a case control study. Participants were asked whether their first-degree relatives had IMID. The likelihood of a positive family history was compared between cases and controls using conditional logistic regression. Additionally, the risk of first-degree relatives of cases having IMID was explored using generalised estimating equations. 145 AAV cases were matched with 145 controls. A family history of IMID was reported by 46.2% of those with AAV and 16.6% of controls. After adjustment for participant age and number of known family members, AAV cases were seven-times more likely to have a positive family history compared to controls (OR 7.25, 95% C.I. 3.27-16.09). 12% of first-degree relatives of AAV participants had an IMID compared to 3.5% of first-degree relatives of control participants. First-degree relatives of AAV participants were four-times more likely to have an IMID compared to a relative of a control (OR 4.03, 95% C.I. 2.46-6.62). Female first-degree relatives had double the risk of having an IMID, compared to male first-degree relatives. A history of IMID in first-degree family members is associated with an increased chance of a person developing AAV. Conversely, the presence of AAV in a first-degree relative is associated with having an increased chance of having an IMID. This implies a shared familial susceptibility between AAV and these diseases.</p>","PeriodicalId":21322,"journal":{"name":"Rheumatology International","volume":"46 8","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13400474/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148580111","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rapid pain response following intra-articular steroid injections in rheumatoid arthritis finger joints: a prospective study with daily patient self-assessment.","authors":"Marie Kebke, Emmy Adolfsson, Joakim Strömberg, Mats Dehlin","doi":"10.1007/s00296-026-06257-3","DOIUrl":"10.1007/s00296-026-06257-3","url":null,"abstract":"<p><p>Intraarticular corticosteroid injections (ISA) are frequently used in rheumatoid arthritis (RA). In spite of this there are few studies on ISA in finger joints in RA. We set out to identify patient-experienced effect of ISA in RA patients regarding pain and mobility of injected arthritic joints, predictors thereof, time span to symptom relief and effect duration. RA patients, ≥ 18 years, were asked to participate just after having received an ISA, with methylprednisolone (MP), in a metacarpophalangeal (MCP) or proximal interphalangeal (PIP) joint, due to arthritis. Patient characteristics, degree of arthritis, CRP and ESR were collected at inclusion. Pain and mobility in the injected joint were reported by the patient on day of inclusion and the following 14 days. Primary outcome was defined as Numerical Rating Scale (NRS) pain ≤ 2 (NRS-scale 0-10) in the injected joint at day 14. Secondary outcomes were NRS mobility, time span and predictors of fulfilling the primary outcome and effect duration. Three-quarters of RA patients responded to ISA regarding pain, most within four days. Mobility improved in two-thirds after 14 days. PIP joints responded better than MCP joints. The only significant predictor was injected MP volume. Among responders, effect persisted for at least three months. ISA is an effective therapy with 75% of RA patients responding over 14 days. PIP joints tend to respond better than MCP joints and the only other predictor for good outcome is volume MP injected, where response increased with volume.</p>","PeriodicalId":21322,"journal":{"name":"Rheumatology International","volume":"46 8","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13400671/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148580092","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Body mass index for the assessment of adiposity in healthy aging Caucasian women: a dual-energy X-ray absorptiometry based study.","authors":"Stavroula J Theodorou, Daphne J Theodorou, Ioannis Mitselos, Vassiliki Kigka, Andreas Fotopoulos, Andreas F Mavrogenis","doi":"10.1007/s00296-026-06193-2","DOIUrl":"10.1007/s00296-026-06193-2","url":null,"abstract":"<p><p>Accurate classification of obesity levels is of clinical importance for public health and decision making. Body mass index (BMI) is the most broadly used measure of obesity on a population scale. But, as with other diagnostic indicators, BMI can have potential pitfalls. We attempted to explore the diagnostic performance of BMI for assessing obesity. 330 healthy Caucasian women (native Greeks) (ages, 20 to 85 years) volunteers participated in the study. Dual-energy X-ray absorptiometry (DXA) was used to measure percentage of fat mass (%FM). The diagnostic performance of BMI was assessed using the widely used indicator for obesity of %FM > 35% in women. Receiver operating characteristic (ROC) analysis was performed to evaluate the ability of BMI to discriminate obesity from non obesity. The correlation between BMI and %FM, and lean mass (LM) and %LM, was also investigated. Logistic regression was performed to assess for associations between DXA-derived fat metrics and age. BMI-defined obesity (≥ 30 kg/m²) was present in 40.3% of women, while %FM DXA-defined obesity was present in 72% of the subjects. The largest discrepancy between BMI- and DXA-defined obesity was noted in women over 80 years (p = 0.0002). A BMI ≥ 30 kg/m² had excellent sensitivity [99%, 95% confidence interval (CI), 95.8-99.9], but poor specificity [45%, 95% CI 38-52] to detect %FM-based obesity. BMI ≥ 25 kg/m² had high sensitivity (92%, 95% CI 87.5-94.8) and good specificity (79%, 95% CI 68.7-86.6). The optimal cut point for BMI in the entire cohort found to correspond closer to the criterion value of 35%FM was 26.32 kg/m² (p < 0.001). At this level, BMI had excellent sensitivity (96.7%, 95% CI 93.3-98.6) and moderate specificity (71.5%, 95% CI 62.4-79.5). In all women, BMI correlated better with %FM (r = 0.74 to 0.84, p < 0.05) than with %LM (r= -0.68 to -0.86, p < 0.05). Logistic regression analysis found age was a significant predictor of obesity (OR = 1.074, 95% CI 1.036-1.114, p < 0.05), increasing odds for excess adiposity by 7.4% each year. The diagnostic performance of BMI for assessing obesity is limited particularly in women with BMI ≥ 30 kg/m². A BMI cut point ≥ 30 kg/m² has very high sensitivity, but misclassifies as obese 55% of normal women. At the BMI cut off ≥ 25 kg/m² sensitivity was high, but 21% of women were still misclassified as obese. A BMI cut point value of 26.32 kg/m² has higher sensitivity and falsely classifies as obese 28% of the women. In light of these findings, revision of current BMI criteria for obesity screening may be warranted in white women of Mediterranean origin such as Greek women, and perhaps other populations.</p>","PeriodicalId":21322,"journal":{"name":"Rheumatology International","volume":"46 8","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13391792/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148550292","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"GLP-1 receptor agonists in osteoarthritis and psoriatic disease: the missing link between obesity and inflammation?","authors":"Andreas Angelopoulos, George E Fragoulis, Charalampos Papagoras, Dimitrios Daoussis","doi":"10.1007/s00296-026-06258-2","DOIUrl":"10.1007/s00296-026-06258-2","url":null,"abstract":"<p><p>Excessive body weight stands out as a major, well-documented risk factor for rheumatic and musculoskeletal diseases (RMDs). Indeed, high body mass index (BMI) affects disease severity, treatment response, and long-term outcomes. Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) were first developed for type 2 diabetes and obesity, but there is growing evidence that they may also have anti-inflammatory and immunomodulatory properties [1-3]. This narrative review examines the available evidence on the role of GLP-1 RAs in two conditions that are strongly associated with metabolic and mechanical factors but sit on almost opposite ends of the inflammatory spectrum: osteoarthritis (OA), a predominantly mechanically driven disease, and psoriatic disease (PsD), an immune-mediated inflammatory disease. A comprehensive narrative review of the literature was conducted to evaluate preclinical and clinical evidence regarding the effects of GLP-1 signaling in both OA and PsD. Preclinical data suggest that GLP-1 signaling may protect cartilage, reduce inflammation, and alleviate pain in OA. Early clinical evidence is encouraging, showing reductions in both joint pain and body weight. In PsD, obesity and psoriatic inflammation share several common pathways, particularly through the IL-17/IL-23 axis, which provides a theoretical biological rationale for GLP-1 RAs use in this setting, although direct clinical evidence remains limited and largely derived from studies in obese patients. Dedicated randomized controlled trials are necessary to clarify the direct immunomodulatory mechanisms involved and to define the precise position of GLP-1 RAs in rheumatological practice.</p>","PeriodicalId":21322,"journal":{"name":"Rheumatology International","volume":"46 8","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13391457/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148550336","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hepatitis E virus infection: considerations for immunologists and rheumatologists.","authors":"Piotr Kacprzyk, Paweł Piluch, Piotr Głowacki, Maria Maślińska","doi":"10.1007/s00296-026-06251-9","DOIUrl":"10.1007/s00296-026-06251-9","url":null,"abstract":"<p><p>Globally widespread hepatitis E virus (HEV) is considered an emerging epidemiological threat, particularly dangerous for those with compromised immunity, including transplant recipients and patients with rheumatic diseases. The management of this infection involves many challenges, particularly in patients with rheumatic diseases. The aim of this review has been to provide a comprehensive, summary of the current knowledge, focusing on applicable for rheumatology practice. The review was conducted using Scopus, PubMed, and Web of Science databases. Searched terms included hepatitis E virus, HEV, rheumatology, connective tissue disease. Multiple studies suggest the underassessment of the prevalence. There are four main genotypes, HEV3 is typical for Europe, and its transmission is associated with undercooked wild boar or pork meat consumption. The disease is usually self-limiting, presenting as an acute hepatitis; chronic infections also occur, especially in immunosuppressed. Multiple extrahepatic manifestations, most often neurological, have been described. This variety of symptoms is attributed to the impact on the immune system. Diagnosis of the infection is often challenging. Treatment is not required in acute infections. Immunocompromised may need a reduction of immunosuppressants. Ribavirin off-label use is also recommended by the experts. HEV infection poses an important risk to immunosuppressed patients. Further research is required to fully reveal the mechanisms of infection and proper strategies of treatment. It is important for clinicians taking care of immunocompromised to include HEV in the differential diagnosis, even when typical signs and symptoms are not present.</p>","PeriodicalId":21322,"journal":{"name":"Rheumatology International","volume":"46 8","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13391724/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148550345","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Shedding light on sexuality in psoriatic arthritis: a 5-year prospective follow-up of an outpatient cohort.","authors":"Mateusz Wilk, Mariusz Korkosz, Glenn Haugeberg","doi":"10.1007/s00296-026-06253-7","DOIUrl":"10.1007/s00296-026-06253-7","url":null,"abstract":"<p><p>To assess sexual quality of life over 5 years in patients with psoriatic arthritis, focusing on gender differences, specific domains, and the impact of health status. Patients were recruited during baseline visits in 2013. Data collection included demographics, disease activity, treatment, and patient-reported outcome measures. Sexuality was assessed using SQoL-Female (SQoL-F) questionnaire, with detailed and composite scores calculated. Item 15 of the 15D quality of life questionnaire evaluated the influence of health on sexual activity. After 5 years, patients were reinvited for follow-up with the same clinical and questionnaire data collected. Eighty-four patients with PsA with baseline and 5-year follow-up data were included (42.9% women; mean age 49.8 years; disease duration 8.9 years; 81.9% married/cohabiting). At baseline, mean DAPSA was 15.5, PASI 2.5, mean comorbidities 0.8, and 40.5% received biologic DMARDs. Over 5 years, comorbidities increased (1.0; p < 0.01), disease activity decreased (DAPSA 12.4; p = 0.03), and biologic use increased (51.2%; p = 0.04). Most men and women reported little or no impact of health on sexual activity; severe limitations were rare. Overall SQoL-F score remained stable, though women reported worse scores on items reflecting emotional concerns and sexual avoidance; total and domain scores did not differ by gender. Fatigue was the only consistent correlate of poorer SQoL-F, exceeding pain, disability, and inflammation. Over 5 years, overall SQoL in patients with PsA remained largely stable despite aging and increasing comorbidities. Women reported higher emotional and avoidance-related concerns. Fatigue, rather than pain, disability, or inflammation, consistently associated with poorer sexual well-being.</p>","PeriodicalId":21322,"journal":{"name":"Rheumatology International","volume":"46 8","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148520900","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Moderate-to-substantial agreement of ChatGPT-5 for Kellgren-Lawrence grading on synthetic knee radiographs: a controlled cross-sectional observer agreement study.","authors":"Öner Kılınç, Elif Altunel Kılınç, Neşe Çabuk Çelik","doi":"10.1007/s00296-026-06252-8","DOIUrl":"10.1007/s00296-026-06252-8","url":null,"abstract":"<p><p>AI models are increasingly explored for radiographic assessment of knee osteoarthritis, but their reliability as an experimental model for KL grading remains uncertain. This study evaluated ChatGPT-5 agreement with expert consensus for KL grading and compared its performance with a secondary AI model. This controlled cross-sectional observer agreement analysis used 630 hand-compiled synthetic posteroanterior fixed flexion knee radiographs selected for technical adequacy, anatomical suitability, and interpretability. Three experienced clinicians, one orthopedic surgeon and two rheumatologists, independently graded all images, and a three-rater majority-consensus expert reference standard was established. ChatGPT-5 assessed the same images using a standardized prompt and image-level protocol. Gemini 2.5 Flash assessed a 112-image subset. Agreement was analyzed using weighted Cohen's κ, Gwet's AC2, and mean absolute error (MAE). Binary classification behavior was evaluated at the KL ≥ 2 threshold. Inter-rater agreement before consensus formation was high: Fleiss' κ was 0.884, Gwet's AC2 was 0.921, and pairwise weighted κ ranged from 0.902 to 0.929. Complete three-rater agreement was observed in 520 radiographs (82.5%), and only 14 cases (2.2%) required adjudication. Compared with the expert reference standard, ChatGPT-5 showed moderate-to-substantial agreement, with weighted κ = 0.680 (95% CI 0.616-0.737), MAE = 0.589, and 60.9% exact five-grade agreement. Exact agreement was highest for KL 0 (81.5%) and KL 4 (66.9%) and lower for intermediate grades. For binary KL ≥ 2 classification, ChatGPT-5 correctly classified 513/630 radiographs, with 81.4% accuracy (95% CI 78.2-84.3), 82.1% sensitivity, 80.3% specificity, 87.6% PPV, and 72.6% NPV. A small but significant shift toward higher grading was observed (p = 0.013), with up-grading more frequent in KL 0-1 and down-grading more frequent in KL 3-4. In the 112-image exploratory subset, Gemini 2.5 Flash showed limited agreement with the expert reference standard (weighted κ = 0.23, MAE = 0.66, exact agreement = 50.0%) and poor agreement with ChatGPT-5 (weighted κ = 0.06). For KL ≥ 2 classification, Gemini achieved 87.5% accuracy, 100% sensitivity, 0% specificity, and 87.5% PPV; NPV was not estimable because no KL < 2 classifications were generated. In this controlled synthetic radiograph study, ChatGPT-5 showed moderate-to-substantial agreement with expert consensus under standardized experimental conditions. However, the curated synthetic dataset, limited technical reproducibility of web-based inference, systematic grading tendencies, exploratory nature of the secondary-model analysis, and limited ecological validity preclude any inference of clinical readiness or real-world diagnostic performance without validation on real-world, multicenter, prevalence-based knee radiograph datasets.</p>","PeriodicalId":21322,"journal":{"name":"Rheumatology International","volume":"46 8","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148520848","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Liver stiffness in fibrotic ILD: a CTD-ILD biomarker or a phenotype-dependent signal of systemic fibrosis?","authors":"Yiman Pei","doi":"10.1007/s00296-026-06248-4","DOIUrl":"10.1007/s00296-026-06248-4","url":null,"abstract":"","PeriodicalId":21322,"journal":{"name":"Rheumatology International","volume":"46 8","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148497855","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Favorable clinical outcomes of biologic and targeted therapies in refractory eosinophilic fasciitis: a case-based systematic review.","authors":"Wiktoria Niebudek, Michał Krupa, Martyna Dziewit, Marzena Olesińska, Maria Maślińska","doi":"10.1007/s00296-026-06256-4","DOIUrl":"10.1007/s00296-026-06256-4","url":null,"abstract":"<p><p>Eosinophilic fasciitis (EF) is a rare autoimmune disease characterized by fascial inflammation, skin induration, eosinophilia, and progressive functional impairment. Although glucocorticosteroids (GCs) remain the first-line therapy, some patients develop refractory or steroid-dependent disease, highlighting the need for alternative treatment strategies. This case-based review summarizes current evidence on biologic and targeted therapies in severe EF and presents a case of successful treatment with tocilizumab (TCZ). A systematic review of PubMed, Scopus, and Web of Science databases identified 35 eligible articles published between 2008 and 2026. Qualitative synthesis included 49 patients treated with biologic or targeted agents, most commonly rituximab (n = 14), tocilizumab (n = 9), infliximab (n = 7), and mepolizumab (n = 5). Partial or complete response was achieved in 47 of 49 (96%) patients across all treatment groups. Biologic therapy was associated with a pronounced steroid-sparing effect, enabling GCs dose reduction or complete withdrawal in the majority of refractory patients. Furthermore, we describe a 28-year-old man with progressive, treatment-resistant EF who failed to respond adequately to GCs and methotrexate. Following initiation of weekly subcutaneous TCZ, the patient showed marked clinical, laboratory, and radiological improvement, with normalization of inflammatory markers, regression of fascial edema on MRI, and substantial functional recovery. Available case-based evidence suggests that biologic and targeted therapies, including IL-6 inhibition, may be promising options in selected patients with severe, refractory, or GC-dependent EF. However, considering the high risk of publication bias and reliance on case reports, prospective multicenter studies are required to establish standardized treatment recommendations.</p>","PeriodicalId":21322,"journal":{"name":"Rheumatology International","volume":"46 8","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148497889","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development and internal validation of an interpretable machine learning model using routine laboratory data for systemic sclerosis-associated pulmonary arterial hypertension.","authors":"Yunchao Zhang, Siyu Feng, Yonglin Zhang, Jiesi Luo","doi":"10.1007/s00296-026-06255-5","DOIUrl":"10.1007/s00296-026-06255-5","url":null,"abstract":"<p><p>This study aimed to develop and validate an interpretable machine learning (ML) model using routine laboratory data to support clinical decision-making and deliver personalized care-with a specific focus on optimizing the utilization of diagnostic resources for patients with systemic sclerosis-associated pulmonary arterial hypertension (SSc-PAH). Clinical and demographic data were retrieved from patients with SSc at a tertiary hospital in China. The diagnosis of SSc-PAH was confirmed by right heart catheterization in all relevant patients. The cohort was split into a training set (n = 367) and an independent test set (n = 158). A total of 39 routinely accessible laboratory test indicators and demographic variables were extracted from electronic health records (EHRs). Seven ML algorithms were developed, and their predictive performance was compared. The Least Absolute Shrinkage and Selection Operator (LASSO) technique was employed to screen for the most informative feature subset, thereby enhancing model performance and interpretability. The discriminative ability of the models was evaluated using the area under the receiver operating characteristic curve (AUC) and the area under the precision-recall curve (AP). Meanwhile, SHapley Additive exPlanations (SHAP) values were used to analyze feature importance and interpret individual prediction results. Potential as a preliminary screening tool was assessed via Decision Curve Analysis (DCA) were applied to further explore the potential associations between features and outcomes. Among the seven evaluated ML algorithms, the Adaptive Boosting (AdaBoost) classifier exhibited the optimal predictive performance. Following the screening of the top five most important features, an interpretable AdaBoost model was constructed. This final model demonstrated excellent discriminative ability in both the training set (AUC = 0.892, 95% confidence interval [CI]: 0.824-0.942) and the test set (AUC = 0.968, 95% CI: 0.930-0.996). DCA results indicated that, compared with the \"treat all\" or \"treat none\" strategies, this model delivered a higher net clinical benefit across the entire range of predictive probability thresholds. Further analysis using SHAP values revealed that N-terminal pro-brain natriuretic peptide (NT-proBNP), anti-triiodothyronine (rT₃), lactate dehydrogenase (LDH), Human Immunodeficiency Virus Antigen and Antibody (HIV Ag Ab), Ca, and creatine kinase-MB (CK-MB) were the most influential features impacting the prediction of SSc-PAH risk. We used AdaBoost to construct a risk prediction model for patients with SSc-PAH. This model has good clinical practicality and can be used for clinical guidance. It enables early screening and early diagnosis, reduces the disease burden on patients, improves the quality of life of patients, and enhances the utilization rate of medical resources.</p>","PeriodicalId":21322,"journal":{"name":"Rheumatology International","volume":"46 8","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148472449","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}