Rheumatology Advances in Practice最新文献

{"title":"'It helps me stay on track': patient experiences using a mobile app for self-management of systemic sclerosis with a focus on fatigue in women.","authors":"Yen T Chen, Alexandra E Harper, Mary Alore, Elizabeth Haro, John T Morris, Dinesh Khanna, Susan L Murphy","doi":"10.1093/rap/rkag102","DOIUrl":"10.1093/rap/rkag102","url":null,"abstract":"<p><strong>Objectives: </strong>Fatigue is common and burdensome in people with systemic sclerosis (SSc), significantly impacting daily functioning and quality of life. Yet, it remains inadequately addressed in clinical care. This study aimed to explore participants' experiences using the RENEW (Resilience-building Energy Management to Enhance Well-being) mobile app as a standalone self-paced intervention without peer coaching for fatigue self-management.</p><p><strong>Methods: </strong>Semi-structured interviews were conducted with participants with SSc following completion of the 12-week RENEW mobile app intervention. Interviews were analysed using RADaR (Rigorous and Accelerated Data Reduction) technique in combination with thematic content analysis.</p><p><strong>Results: </strong>Fifteen women were included in the analysis (mean age 56 years ± 10), which reflects the higher prevalence of SSc among women. Among participants, 53% had limited SSc, while the remaining had diffuse SSc or overlap, and 40% had been diagnosed with SSc for less than 5 years (short duration). Four themes were identified: (1) the RENEW app and its features were intuitive; (2) the RENEW app's content enhanced the learning experience; (3) the RENEW app became a partner to support SSc self-management and (4) refinements to the app could enhance the patient experience.</p><p><strong>Conclusion: </strong>The RENEW app was perceived as a relevant and user-friendly tool for supporting fatigue self-management in SSc. Findings suggest that a standalone app-based approach may offer a scalable option for fatigue self-management in SSc, while also highlighting areas for refinement to improve engagement and long-term use.</p><p><strong>Trial registration: </strong>clinicaltrials.gov, NCT07402863.</p>","PeriodicalId":21350,"journal":{"name":"Rheumatology Advances in Practice","volume":"10 3","pages":"rkag102"},"PeriodicalIF":2.8,"publicationDate":"2026-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13529363/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148866665","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Coexisting juvenile idiopathic arthritis and autoimmune hepatitis type 1 in a child.","authors":"Majd Oweidat, Sojoud H Smerat, Fawzy M Abunejma, Jihad Lehroob","doi":"10.1093/rap/rkag101","DOIUrl":"10.1093/rap/rkag101","url":null,"abstract":"","PeriodicalId":21350,"journal":{"name":"Rheumatology Advances in Practice","volume":"10 3","pages":"rkag101"},"PeriodicalIF":2.8,"publicationDate":"2026-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13525337/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148857725","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction to: Development of a clinical tool to identify patients with early inflammatory arthritis at high risk of employment loss: analysis from the National Early Inflammatory Arthritis Audit.","authors":"","doi":"10.1093/rap/rkag095","DOIUrl":"https://doi.org/10.1093/rap/rkag095","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.1093/rap/rkaf149.].</p>","PeriodicalId":21350,"journal":{"name":"Rheumatology Advances in Practice","volume":"10 3","pages":"rkag095"},"PeriodicalIF":2.8,"publicationDate":"2026-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13461212/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148713517","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Obinutuzumab as salvage anti-CD20 therapy in poly-refractory difficult-to-treat seropositive rheumatoid arthritis.","authors":"Irene Monjo-Henry, Marta Novella-Navarro, Marina Molinari, María Sanz-Jardón, M Gema Bonilla-Hernán, María Ángeles González-Fernández, Eugenio de Miguel Mendieta, Chamaida Plasencia-Rodríguez","doi":"10.1093/rap/rkag089","DOIUrl":"10.1093/rap/rkag089","url":null,"abstract":"","PeriodicalId":21350,"journal":{"name":"Rheumatology Advances in Practice","volume":"10 3","pages":"rkag089"},"PeriodicalIF":2.8,"publicationDate":"2026-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13461643/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148722358","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Scoping review of clinical, laboratory, histopathological and imaging predictors of relapse in adults with biopsy- or temporal artery ultrasound-confirmed giant cell arteritis on standard therapy with glucocorticoids alone or in combination with biologics.","authors":"Katarzyna Nowak, Sarah Black, Sarah L Mackie, Bogdan Kolarz, Ashley Elliott","doi":"10.1093/rap/rkag099","DOIUrl":"10.1093/rap/rkag099","url":null,"abstract":"<p><strong>Objective: </strong>This literature review aims to summarise current evidence on clinical, laboratory, histopathological and imaging predictors of relapse in adults with biopsy- or imaging-confirmed GCA.</p><p><strong>Methods: </strong>A comprehensive search of Ovid MEDLINE ALL and Embase databases identified 1030 articles. After screening, 58 studies met inclusion criteria. Data were extracted and thematically analysed across four domains: clinical, laboratory, imaging and histopathology characteristics.</p><p><strong>Results: </strong>Relapse occurs in >40% of patients on glucocorticoid monotherapy and ≈20% on tocilizumab, most commonly within 2 years from diagnosis. PMR symptoms and headache are the most common clinical manifestations at relapse. Laboratory markers such as ESR and CRP are widely used but lack specificity. Higher inflammatory burden at diagnosis, reflected by anaemia or thrombocytosis, correlates with future relapse. Emerging biomarkers-including calprotectin, osteopontin, IL-6, angiopoietin-2 and circulating T peripheral helper cells-show promise but require validation. Temporal artery ultrasound findings such as higher baseline halo counts, delayed ultrasound remission and limited improvement in quantitative scores are the most reliable relapse predictors. Fluorodeoxyglucose PET has limited value in predicting relapse. MRI vessel wall enhancement may correlate with relapse, but evidence remains limited to small cohorts. Histological features such as greater arterial inflammation, higher giant cell density and intraluminal thrombosis are linked to a more relapsing disease course.</p><p><strong>Conclusion: </strong>Relapse in GCA is multifactorial and cannot be predicted by a single parameter. Integrating clinical, laboratory, imaging and histological data may improve risk stratification. Prospective studies are needed to validate predictive models and enable personalised treatment approaches.</p>","PeriodicalId":21350,"journal":{"name":"Rheumatology Advances in Practice","volume":"10 3","pages":"rkag099"},"PeriodicalIF":2.8,"publicationDate":"2026-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13529366/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148866750","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Perspectives of sedentary behaviour, physical activity and health messaging among people with fibromyalgia: a qualitative study.","authors":"Rachel Bolton, Fliss Smith, Jennifer S Lewis, Jennifer Pearson","doi":"10.1093/rap/rkag081","DOIUrl":"10.1093/rap/rkag081","url":null,"abstract":"<p><strong>Objectives: </strong>To explore how individuals with fibromyalgia (FM) perceive physical activity (PA), sedentary behaviour (SB) and related health messaging.</p><p><strong>Methods: </strong>UK-based adults (18+) with FM were recruited using maximum variation sampling from charities, social media support groups and research contacts. A constructivist qualitative approach was adopted, recognizing that experiences and meanings are constructed through social context and interpretation. Semi-structured interviews were conducted virtually, informed by a behavioural model of Capability, Opportunity and Motivation (COM-B) and the Theoretical Domains Framework (TDF). A patient and public involvement (PPI) contributor informed the development of the interview guide. Data were analysed using a reflexive thematic analysis to explore how participants interpreted SB, PA and health messaging.</p><p><strong>Results: </strong>Fifteen participants (13 female, 2 male) aged 21-73 years (mean = 50.87, SD = 15.47) described complex, often conflicting experiences of PA and SB. Emotional responses like guilt, fear, and frustration influenced engagement with PA. Rest and activity were viewed as beneficial; however, balancing movement and rest was an ongoing challenge, influenced by fluctuating symptoms and external expectations. Participants highlighted a disconnect between clinical advice and lived experience, with terms like 'sedentary' often perceived as unrelatable or stigmatizing. Socioeconomic factors, including limited access to personalized support and social rules, impacted engagement and contributed to feelings of stigma.</p><p><strong>Conclusion: </strong>Participants reported emotional and practical challenges in balancing PA and SB, influenced by fluctuating symptoms, expectations and limited or unrelatable clinical advice. These findings highlight the need for personalized, inclusive, and context-sensitive movement advice that reflects lived experience to improve relevance and uptake.</p>","PeriodicalId":21350,"journal":{"name":"Rheumatology Advances in Practice","volume":"10 3","pages":"rkag081"},"PeriodicalIF":2.8,"publicationDate":"2026-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13456962/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148707579","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Slow march to surgery: using the COM-B model to explore the lived experience of individuals with knee osteoarthritis, awaiting joint replacement surgery.","authors":"Nathan Brookes, Yeliz Prior, Stephen Preece, Jennifer Parker, Simone Battista","doi":"10.1093/rap/rkag100","DOIUrl":"10.1093/rap/rkag100","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to explore the lived experiences of people with knee osteoarthritis (KOA) awaiting Total Knee Replacement (TKR).</p><p><strong>Methods: </strong>Fifteen semi-structured interviews were conducted with participants with a diagnosis of KOA. Transcripts were first analysed inductively with reflexive thematic analysis. Inductive themes were deductively aligned to the COM-B model ('Capability', 'Opportunity', 'Motivation' and 'Behaviour') to provide additional understanding of how people navigate the management of KOA and their experiences while awaiting surgery.</p><p><strong>Results: </strong>Four inductive themes were generated and mapped into the COM-B component. (1) 'Altered health beliefs drive a biomedical focus on KOA management' (Capability): participants largely understood KOA as an inevitably degenerative condition culminating in surgery. (2) 'Interactions with healthcare professionals reinforce surgical inevitability' (Opportunity): participants described clinical encounters that strengthened their biomedical interpretations and shaped expectations of surgery as the primary solution. (3) 'The emotional burden of KOA' (Motivation): emotional strain contributed to decisions to pursue surgery. (4) 'Coping strategies for managing KOA pain' (Behaviour): participants employed a range of self-directed strategies to manage symptoms while awaiting surgery, often with limited guidance.</p><p><strong>Conclusion: </strong>This study provides a novel, theory-informed understanding of how people awaiting TKR make sense of, engage with, and manage KOA. Using the COM-B model to map these experiences illustrates how current pathways can unintentionally weaken motivation and opportunity to engage with evidence-based first-line interventions like exercise. These findings indicate the value of supporting people with KOA to better understand and access first-line options before considering surgery.</p>","PeriodicalId":21350,"journal":{"name":"Rheumatology Advances in Practice","volume":"10 3","pages":"rkag100"},"PeriodicalIF":2.8,"publicationDate":"2026-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13509947/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148831948","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rapid versus conventional glucocorticoid tapering in pure membranous LN: a multicentre retrospective study.","authors":"Hidekazu Ikeuchi, Keiju Hiromura, Yoshiya Tanaka, Hiroko Sato, Koichiro Ohmura, Hiroki Hayashi, Kazuoto Hiramoto, Akiho Iwashita, Shinsuke Yasuda, Shinya Kaname, Yutaka Kawahito, Hiromi Shimada, Tomohiro Koga, Isao Matsumoto, Masahiro Ayano, Kazuro Kamada, Shoichi Maruyama, Tomonori Ishii, Satoshi Kubo, Shingo Nakayamada, Hayato Shimizu, Shuji Sumitomo, Yukio Yuzawa, Yuko Kaneko, Hironari Hanaoka, Akira Onishi, Akio Morinobu, Tadashi Hosoya, Taiki Yamaguchi, Takahisa Kawakami, Aki Sakashita, Takahiro Seno, Takashi Kida, Hiroaki Dobashi, Takuya Tomokawa, Atsushi Kawakami, Yuya Kondo, Hiroaki Niiro, Michihito Kono, Sawako Kato, Kayaho Maeda, Tatsuya Atsumi","doi":"10.1093/rap/rkag096","DOIUrl":"10.1093/rap/rkag096","url":null,"abstract":"<p><strong>Objectives: </strong>While recent guidelines recommend early glucocorticoid (GC) tapering for LN, supporting evidence for pure membranous LN remains limited. The present study investigated the impact of rapid GC tapering on renal outcomes in this population.</p><p><strong>Methods: </strong>We performed a multicentre retrospective study across 16 centres in Japan, including 67 patients with biopsy-proven pure membranous LN who initiated GC therapy between 2003 and 2023. Patients were classified into rapid tapering (GC dose ≤7.5 mg/day at 6 months) and conventional tapering (>7.5 mg/day at 6 months) groups. The primary endpoint was the partial renal response (PRR) at 12 months. Secondary endpoints included the complete renal response (CRR), relapse and severe adverse events (SAEs). Adjusted risk ratios (aRRs) were estimated using modified Poisson regression models for failure to achieve PRR/CRR.</p><p><strong>Results: </strong>Fifteen patients underwent rapid tapering and 52 conventional tapering. Baseline characteristics were generally comparable. At 12 months, PRR was achieved in 85.7% of the rapid group and 84.3% of the conventional group (aRR for failure 1.04; 95% CI 0.17-6.39). CRR rates at 12 months were 64.3% and 56.9%, respectively (aRR for failure 0.90; 95% CI 0.40-2.02). At 24 months, PRR and CRR did not differ statistically between groups. Relapse occurred in 20.0% versus 7.7% (<i>P</i> = 0.185). No SAEs were reported in the rapid group, while three occurred in the conventional group.</p><p><strong>Conclusions: </strong>Rapid GC tapering to ≤7.5 mg/day at 6 months appeared feasible in a subset of patients with pure membranous LN, but the findings are preliminary and should be interpreted cautiously because of the small rapid-taper group and imprecise estimates.</p>","PeriodicalId":21350,"journal":{"name":"Rheumatology Advances in Practice","volume":"10 3","pages":"rkag096"},"PeriodicalIF":2.8,"publicationDate":"2026-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13509950/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148832041","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of analgesics prescription with incident comorbidities in people with osteoarthritis-a UK primary care database cohort study.","authors":"Subhashisa Swain, Carol Coupland, Andrea Dell' Isola, Danielle E Robinson, Anne Kamps, Marta Pineda Moncusi, Jos Runhaar, Christian Mallen, Chang Fu Kuo, Daniel Prieto-Alhambra, Martin Englund, Sita Bierma-Zeinstra, Michael Doherty, Weiya Zhang","doi":"10.1093/rap/rkag098","DOIUrl":"10.1093/rap/rkag098","url":null,"abstract":"<p><strong>Objective: </strong>We examined the independent risk of incident comorbidities associated with prescribed oral paracetamol, NSAIDs and opioids and their interaction and mediation with OA.</p><p><strong>Methods: </strong>Exposure of these analgesics and the association with nine systemic groups of incident comorbidities were examined in this 5-year cohort study of 261 273 people with incident OA and 261 273 age-, sex- and practice-matched controls (no OA) in the large UK primary care database. A propensity score-adjusted time-varying exposure analysis was undertaken using multivariable Cox models to estimate the hazard ratios (HRs) for incident comorbidities associated with OA and analgesics. Interaction was defined when the combined term for OA and analgesic was significant. The proportion of the risk associated with OA mediated by analgesics was also calculated.</p><p><strong>Results: </strong>The mean age of the cohort was 60 years and 57.7% were female. NSAIDs and opioids were independently associated with all comorbidities. Paracetamol interacted with OA leading to an extra risk of renal comorbidities [multiplicative HR (mHR) 1.14 (95% CI 1.06, 1.22)]. NSAIDs and opioids interacted with OA with extra risk of cardiovascular [mHR 1.05 (95% CI 1.01, 1.11) and mHR 1.06 (95% CI 1.02, 1.11)] and endocrine [mHR 1.11 (95% CI 1.05, 1.17) and mHR 1.08 (95% CI 1.02, 1.13)] comorbidities. About 16% and 7% risk from OA to psychological comorbidities were indirectly mediated by NSAIDs and opioids, respectively.</p><p><strong>Conclusion: </strong>Our findings suggest that in people with OA, analgesic prescriptions may be associated with increased risk of certain incident comorbidities, particularly in long-term use.</p>","PeriodicalId":21350,"journal":{"name":"Rheumatology Advances in Practice","volume":"10 3","pages":"rkag098"},"PeriodicalIF":2.8,"publicationDate":"2026-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13529369/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148866744","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Current and future advances in practice: polyarteritis nodosa and related vasculitides.","authors":"Richard A Watts","doi":"10.1093/rap/rkag083","DOIUrl":"10.1093/rap/rkag083","url":null,"abstract":"<p><p>Polyarteritis nodosa (PAN) is a rare vasculitis affecting predominately medium-sized vessels. Our evolving understanding of PAN, including the role of HBV and discovery of monogenic variants such as deficiency of adenosine deaminase 2 (DADA2), has resulted in idiopathic PAN becoming a very rare condition with an annual incidence of 0.6-19.9/million. The investigative approach is to assess organ involvement and confirm the diagnosis either by imaging or biopsy. Conventional catheter angiography is being replaced by CT or MR angiography, which provide increasingly good resolution of the typical fusiform narrowing and aneurysm. ANCA-associated vasculitis (AAV) should be excluded. DADA2 is being more frequently identified as causing a PAN-like illness, especially in children; cases presenting in adulthood are now recognised. In children and most adults, genotyping for DADA2 should be undertaken. There are no high-quality randomised controlled trials of treatment in idiopathic PAN. Current approaches have been adapted from those used to treat other types of vasculitis. The five-factor score may be used to stratify patients to identify those needing intensive therapy with glucocorticoids combined with CYC. In order to reduce the burden of glucocorticoid toxicity, the ACR has advocated the use of immunosuppressive drugs in addition to steroids in those not initially receiving CYC. Unlike AAV, there appears to be little role for rituximab in the treatment of idiopathic PAN, although it is occasionally used as salvage therapy. HBV-associated PAN is treated with immunosuppression and antiviral therapy. There is reasonably good evidence to support the use of anti-TNF to treat DADA2.</p>","PeriodicalId":21350,"journal":{"name":"Rheumatology Advances in Practice","volume":"10 3","pages":"rkag083"},"PeriodicalIF":2.8,"publicationDate":"2026-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13441179/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148679759","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}