Rheumatology Advances in Practice最新文献

{"title":"Analysis of advice and guidance primary care queries to rheumatology over a calendar year-a diagnostic service evaluation.","authors":"Ethan O'Shaughnessy, Ben Mulhearn, Marwan Bukhari","doi":"10.1093/rap/rkag054","DOIUrl":"10.1093/rap/rkag054","url":null,"abstract":"<p><strong>Objectives: </strong>In the UK, advice and guidance services allow general practitioners (GPs) to seek consultant assistance without formal referral, supporting decision-making and reducing unnecessary secondary care referrals. However, a significant proportion of advice and guidance queries represent frequently asked questions (FAQs), placing avoidable burden on consultants and delaying patient care while replies are awaited. This diagnostic service evaluation aimed to identify common FAQs within rheumatology advice and guidance queries at Morecambe Bay Hospitals Trust (MBHT), with the goal of developing targeted educational material for GPs. This material seeks to improve the quality of advice and guidance referrals to reduce unnecessary secondary care attendances and enhance the delivery of urgent referral pathways in line with targets that are proven to improve patient outcomes. The methodology presented in this article is a reproducible method to bring about iterative improvements to referrals to an individual department through education and behaviour change.</p><p><strong>Methods: </strong>We conducted a retrospective, qualitative content analysis of 2499 GP‑initiated rheumatology advice and guidance messages submitted between April 2024 and April 2025. Our analysis occurred in three stages. First, we used NVivo 15 to perform a word‑frequency analysis to identify common, clinically significant phrases within advice and guidance queries. Next, for each often‑occurring term in our frequency map, we drew a purposive sample of the full advice and guidance conversation in which it appeared. From these, we conducted an in‑depth, iterative coding of their content-identifying and refining subthemes-until no new themes were identified. Finally, we filtered the dataset for messages containing 'urgent', 'acute', or 'emergency' to isolate time‑sensitive queries.</p><p><strong>Results: </strong>Three major themes of FAQs were identified: interpretation of blood tests (especially incongruous blood results and the significance of inflammatory markers), management of osteoporosis (particularly medication queries) and initial treatment or diagnostic uncertainty in suspected giant cell arteritis (GCA). Queries marked as urgent were most commonly associated with GCA. The GPs' questions were frequently similar within their themes and amenable to concise, standardised advice.</p><p><strong>Conclusion: </strong>Recurring patterns in advice and guidance queries suggest an opportunity to support local GPs through focused educational material; a guidance document targeting the most common FAQs is in development. Although implementation and evaluation are pending, this low-cost, scalable approach may feasibly offer value across specialties and sites. Further study will assess its impact on advice and guidance usage and GP confidence.</p>","PeriodicalId":21350,"journal":{"name":"Rheumatology Advances in Practice","volume":"10 3","pages":"rkag054"},"PeriodicalIF":2.8,"publicationDate":"2026-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13268795/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148272835","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":"Holistic management of juvenile idiopathic arthritis across all ages: British Society for Rheumatology Guideline scope.","authors":"Sandrine Compeyrot-Lacassagne, Richard P Beesley, Lisa Bray, Angharad Bridges, Hema Chaplin, Coziana Ciurtin, Gavin Cleary, Samantha Cooray, Octavio Aragon Cuevas, Verna Cuthbert, Samundeeswari Deepak, Emily Earle, Andreia Ferreira, Lianne Kearsley-Fleet, Jo Gupta, Rebecca Houston, Ryan Malcolm Hum, Jenny H Humphreys, Hirushi S Jayasekera, Sarah Jones, Christine MacFadyen, Jennifer Nisbet, Visvalingam Arunath, Yeliz Prior, Valerie Rogers, Stephanie J W Shoop-Worrall, Ameenat Lola Solebo, Rosemary Waller, Luke Daniel Williamson, Debbie Wilson, Catherine Wright, Ethan S Sen","doi":"10.1093/rap/rkag052","DOIUrl":"10.1093/rap/rkag052","url":null,"abstract":"<p><p>What does this mean for patients? Juvenile idiopathic arthritis (JIA) is the most common type of arthritis that starts before the age of 16 years. Many children and young people (CYP) continue to be affected by JIA and may need to be on treatment when they are adults. Most CYP with JIA have swollen, stiff and painful joints for at least 6 weeks. JIA can also affect other parts of the body. This includes the skin, the places where tendons join bones (called entheses) and sometimes internal organs. Some young people may also develop inflammation in their eyes, called uveitis. If this is not treated, it can affect eyesight and could lead to sight loss. People with JIA often need medicines to control inflammation. They are usually cared for by a team of healthcare professionals called a multidisciplinary team. This team may include doctors, nurses, pharmacists, physiotherapists, occupational therapists, podiatrists, psychologists and youth workers. They work together to help manage symptoms and prevent long-term damage. The British Society for Rheumatology (BSR) is the main organisation in the UK for healthcare professionals who care for people with JIA. BSR writes guidelines that help healthcare teams provide high-quality care. These guidelines are written with input from experts and people with lived experience. They help make sure that everyone receives good care wherever they live, including during the move from child to adult services. This article explains how BSR will develop a new guideline to diagnose, treat and monitor children, young people and adults with JIA. The guideline will follow the BSR protocol for creating clinical guidelines.</p>","PeriodicalId":21350,"journal":{"name":"Rheumatology Advances in Practice","volume":"10 2","pages":"rkag052"},"PeriodicalIF":2.8,"publicationDate":"2026-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13235788/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148199971","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":"Shingles vaccination before targeted therapy: why clear guidance isn't enough.","authors":"Hannah Kim, Nilay Joshi, Sara Naqvi, Ania Manson, James Galloway","doi":"10.1093/rap/rkag047","DOIUrl":"10.1093/rap/rkag047","url":null,"abstract":"","PeriodicalId":21350,"journal":{"name":"Rheumatology Advances in Practice","volume":"10 2","pages":"rkag047"},"PeriodicalIF":2.8,"publicationDate":"2026-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13151879/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147869496","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":"Can SAPHO syndrome be combined with sinus swelling?","authors":"Anqi Liu, Yuqing Zhang, Fanzhang Meng, Naigang Chen, Xiujuan Hou, Ying Yang, Chen Li","doi":"10.1093/rap/rkag051","DOIUrl":"10.1093/rap/rkag051","url":null,"abstract":"","PeriodicalId":21350,"journal":{"name":"Rheumatology Advances in Practice","volume":"10 2","pages":"rkag051"},"PeriodicalIF":2.8,"publicationDate":"2026-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13171215/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147942403","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":"Better communication between rheumatologists and radiologists is key to improving MRI requesting and reporting data in axial spondyloarthritis: audit data from a single specialist centre.","authors":"Jake Weddell, Henry de Boer, Joshua Wong, Bill Pass, Philip Robinson, Andrew Barr, Claire Vandevelde, Jane E Freeston, Dennis McGonagle, Helena Marzo-Ortega","doi":"10.1093/rap/rkag053","DOIUrl":"10.1093/rap/rkag053","url":null,"abstract":"<p><strong>Objectives: </strong>The assessment of axial spondyloarthritis international society (ASAS) has published recommendations on information to include when requesting and reporting MRIs for suspected or known axSpA. In a service improvement evaluation, we aimed to audit our current practice against the newly published recommendations.</p><p><strong>Methods: </strong>MRIs of the spine and sacroiliac joints performed under the inflammatory back pain protocol at The Leeds Teaching Hospitals NHS Trust between September and December 2023 were identified. Information included in the MRI request and radiology reports was extracted from the electronic health records.</p><p><strong>Results: </strong>Overall, 158 MRIs were evaluated. Of the MRI requests, age was included in 11.8% (<i>n</i> = 18), sex in 3.8% (<i>n</i> = 6); HLA-B27 in 22.2% (<i>n</i> = 35), back pain symptom duration in 18.9% (<i>n</i> = 30) and location in 45.6% (<i>n</i> = 72) and presence of inflammatory features in 62.7% (<i>n</i> = 99). For MRI report data: osteitis/bone marrow oedema was mentioned in 81.0% (<i>n</i> = 128), erosions in 58.8% (<i>n</i> = 93) and fat metaplasia in 6.3% (<i>n</i> = 10); active inflammation was mentioned in 77.8% (<i>n</i> = 123) and structural changes in 51.2% reports (<i>n</i> = 82). Over half (62.0%; <i>n</i> = 98) included a statement as to \"whether the MRI was overall indicative of spondyloarthritis or not\".</p><p><strong>Conclusion: </strong>Despite the retrospective nature of this audit performed against newly published guidance, these results provide awareness, identifying key areas in need of improvement at our centre. Further, this exercise has strengthened the collaboration between rheumatologists and radiology colleagues, illustrating the value of the recent ASAS recommendations as a benchmark to guide further training and education for rheumatologists and radiologists, and improve clinical care provision in axSpA.</p>","PeriodicalId":21350,"journal":{"name":"Rheumatology Advances in Practice","volume":"10 2","pages":"rkag053"},"PeriodicalIF":2.8,"publicationDate":"2026-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13163155/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147932995","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":"Management of interstitial lung disease in systemic autoimmune rheumatic diseases: a survey of rheumatologists and pulmonologists.","authors":"Genna Braverman, Kerri I Aronson, Charlene Thomas, Robert Spiera","doi":"10.1093/rap/rkag050","DOIUrl":"10.1093/rap/rkag050","url":null,"abstract":"<p><strong>Objectives: </strong>To determine whether rheumatologists and pulmonologists have distinct disciplinary approaches to the management of systemic autoimmune rheumatic disease (SARD)-interstitial lung disease (ILD).</p><p><strong>Methods: </strong>This was a cross-sectional survey study of US rheumatologists and pulmonologists. Surveys were electronically distributed to physicians identified through professional societies and social media. Surveys contained case questions on SARD-ILD management for patients with mixed connective tissue disease, idiopathic inflammatory myopathy, rheumatoid arthritis, systemic sclerosis and Sjogren's with varying ILD severity (asymptomatic, symptomatic, progressive). Respondents also answered questions on treatment decision-making, comfort with pharmacologic modalities and opinions about interdisciplinary co-management. We analyzed responses submitted 5-9/2024. We compared specialists' responses via univariate logistic regression, Chi-squared or Fisher's exact tests; we performed multivariable logistic regression of case questions controlling for practice setting, clinical experience and geographic region.</p><p><strong>Results: </strong>Analyses included 309 participants (rheumatologists = 184, pulmonologists = 125). Compared with pulmonologists, rheumatologists were less likely to treat asymptomatic and symptomatic ILD with corticosteroids for all SARD except asymptomatic systemic sclerosis (odds ratios [OR] 0.14-0.45), and to treat progressive ILD with antifibrotics (OR 0.26-0.30). Conversely, rheumatologists were more likely than pulmonologists to either add or modify immunomodulation/immunosuppression for all symptomatic and progressive SARD-ILD (OR 1.82-5.44). There were disciplinary differences in the relative importance of clinical variables to treatment approaches. Specialists reported ownership over different domains of treatment decision-making and healthcare maintenance.</p><p><strong>Conclusion: </strong>This national study suggests distinct disciplinary approaches to management of SARD-ILD, and highlights opportunities to leverage complementary expertise through a co-management paradigm.</p>","PeriodicalId":21350,"journal":{"name":"Rheumatology Advances in Practice","volume":"10 2","pages":"rkag050"},"PeriodicalIF":2.8,"publicationDate":"2026-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13143425/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147842280","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":"Metabolic syndrome and knee osteoarthritis: associations with disease stage and pain.","authors":"Jami Kronick, Trevor B Birmingham, Surim Son, Andrew J E Appleton, C Thomas Appleton","doi":"10.1093/rap/rkag048","DOIUrl":"10.1093/rap/rkag048","url":null,"abstract":"<p><strong>Objectives: </strong>Metabolic Syndrome (MetS) is associated with OA progression and pain. However, its relationship with outcomes in early-stage disease remains unclear. We assessed associations of MetS with radiographic stage and knee pain in individuals with symptomatic knee OA.</p><p><strong>Methods: </strong>We analysed cross-sectional baseline data from 251 participants in the Western Ontario Registry for Early Osteoarthritis (WOREO) Knee Study. Associations between MetS and radiographic stage were assessed using modified Poisson regression. Associations with knee pain, measured by the Knee Injury and Osteoarthritis Outcome Score (KOOS) pain scale, were evaluated using multiple linear regression accounting for within-participant correlation. Analyses were stratified by OA stage and adjusted for body mass index (BMI).</p><p><strong>Results: </strong>MetS was associated with a higher prevalence of late-stage knee OA [adjusted prevalence ratio 1.45 (95% CI 1.16, 1.81)]. After BMI adjustment, hypertension and haemoglobin A1c remained associated with late-stage disease. Participants with MetS reported worse knee pain, with lower KOOS pain scores [β = -14.70 (95% CI -20.92, -8.47)], particularly in early-stage disease [β = -14.15 (95% CI -20.37, -7.93)]. Dyslipidaemia (elevated triglycerides and reduced high-density lipoprotein cholesterol were also associated with worse pain in early-stage disease.</p><p><strong>Conclusion: </strong>MetS and its components are associated with greater radiographic severity and clinically meaningful worsening of pain, especially in early-stage knee OA, independent of BMI. These findings suggest that early identification and management of metabolic disease may represent a modifiable target to improve OA outcomes.</p>","PeriodicalId":21350,"journal":{"name":"Rheumatology Advances in Practice","volume":"10 2","pages":"rkag048"},"PeriodicalIF":2.8,"publicationDate":"2026-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13185147/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147982956","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":"Health literacy and control of inflammatory activity in patients with recent-onset rheumatoid arthritis.","authors":"Javier Bachiller-Corral, María Auxiliadora Martin-Martínez, Diana Botello-Corzo, José L Morell-Hita, Mónica Vázquez-Díaz","doi":"10.1093/rap/rkag049","DOIUrl":"10.1093/rap/rkag049","url":null,"abstract":"<p><strong>Objective: </strong>To determine the association between health literacy (HL) and disease activity in patients with recent-onset rheumatoid arthritis.</p><p><strong>Methods: </strong>Cross-sectional study of patients with rheumatoid arthritis (RA) of ≤ 5 years' duration. Demographic, clinical and laboratory data were collected during routine follow-up visits. HL was assessed using the SAHLSA questionnaire, a validated measure of functional health literacy. A multivariate model was developed to evaluate the association between HL level and disease activity, measured by DAS28.</p><p><strong>Results: </strong>A total of 210 patients (81% women) were included with a mean age of 53.9 (14.1) years and a median disease duration of 1.6 [0.4-4.28] years. Low health literacy scores (SAHLSA ≤37) were identified in 10.9% (<i>n</i> = 23) of patients. These individuals showed significantly higher disease activity compared with those with higher SAHLSA scores: DAS28-ESR 3.9 (1.6) vs 2.8 (1.4) (<i>P</i> = 0.006), and DAS28-CRP 3.7 (1.4) vs 2.7 (1.2) (<i>P</i> < 0.000). Other measures-physician global assessment (VAS), tender and swollen joint counts, CRP, SDAI, CDAI, and SF-36-were also significantly worse in patients with low HL. In the multivariate analysis, compared with those with higher SAHLSA scores (OR 0.030; 95% CI 0.002-0.396; <i>P</i> = 0.008).</p><p><strong>Conclusion: </strong>Low SAHLSA health literacy scores are independently associated with poorer control of inflammatory activity in patients with RA of ≤5 years' duration. Adapting healthcare communication and support strategies to patients' health literacy needs early in the disease course may contribute to improved RA management and outcomes.</p>","PeriodicalId":21350,"journal":{"name":"Rheumatology Advances in Practice","volume":"10 2","pages":"rkag049"},"PeriodicalIF":2.8,"publicationDate":"2026-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13152652/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147869469","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":"The prevalence of interstitial lung disease in rheumatoid arthritis: a systematic review.","authors":"Marie Vermant, Thomas Pauwels, Tine Follet, Laurens J De Sadeleer, Nico De Crem, Barbara Neerinckx, Alexandros Kalkanis, Wim A Wuyts, Patrick Verschueren","doi":"10.1093/rap/rkag045","DOIUrl":"10.1093/rap/rkag045","url":null,"abstract":"<p><strong>Objectives: </strong>Interstitial lung disease (ILD) is an important comorbidity in RA. Its true prevalence remains unclear. We assessed reported prevalences across different diagnostic approaches.</p><p><strong>Methods: </strong>We conducted a systematic literature review and meta-analysis to assess RA-ILD prevalence. Embase, MEDLINE (PubMed), Cochrane Library and Web of Science were searched (from inception to 2022). Heterogeneity was assessed (<i>I</i> ²). Subgroup differences were assessed (Q-test). Bias appraisal was performed via a funnel plot and Egger's test. Individual studies were evaluated for the presence of bias using the AXIS score. Mixed effects meta-regression explored sample size, diagnostic modality, geography and AXIS score as moderators.</p><p><strong>Results: </strong>We included 74 studies and obtained an overall random effects pooled prevalence of 20.6% (95% CI 18.3, 23.2; <i>I</i> ² = 99.7%). The random effects pooled prevalence varied by diagnostic method: 31% (95% CI 25, 38; <i>I</i> ² = 97%) when using high-resolution CT, 21% (95% CI 14, 31; <i>I</i> ² = 95%) with pulmonary function tests, 13% (95% CI 5, 30; <i>I</i> ² = 99%) when combining multiple diagnostic tools, 12% (95% CI 7, 20; <i>I</i> ² = 96%) with chest X-ray and 5% (95% CI 4, 8; <i>I</i> ² = 100%) when based on International Classification of Diseases codes. Low-bias recent studies (AXIS >16; 2013-2022) yielded a pooled prevalence of 10.1% (95% CI 6.2, 16.3; <i>I</i> ² = 99.9%). Prevalences significantly differed between tools (Q = 73.16, df = 4, <i>P</i> < 0.0001). The meta-regression model (QM = 89.96, df = 11, <i>P</i> < 0.0001) had a moderate explanatory value (<i>R</i> ² = 47.82%). The asymmetric funnel plot (<i>t</i> = 2.59, df = 98, <i>P</i> = 0.011) pointed to significant bias (estimate of 4.86, SE = 1.88).</p><p><strong>Conclusion: </strong>Due to extreme heterogeneity and evidence of small-study effects, the overall pooled random effects prevalence (20%) should be interpreted cautiously and primarily reflects the wide variation in diagnostic approaches. Estimates derived from low-bias and multimodal diagnostic studies (≈10-13%) may provide a more clinically meaningful approximation, although they remain informed estimates rather than definitive prevalence rates.</p>","PeriodicalId":21350,"journal":{"name":"Rheumatology Advances in Practice","volume":"10 2","pages":"rkag045"},"PeriodicalIF":2.8,"publicationDate":"2026-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13130208/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147820238","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":"The prevalence of pulmonary airway lesions is high in HTLV-1-positive rheumatoid arthritis: a cross-sectional observational study.","authors":"Chihiro Iwao, Kunihiko Umekita, Masatoshi Kimura, Masayuki Murai, Kosho Iwao, Risa Kudou, Takeshi Kawaguchi, Yayoi Hashiba, Michikazu Nakai, Toshihiko Hidaka, Taiga Miyazaki","doi":"10.1093/rap/rkag046","DOIUrl":"10.1093/rap/rkag046","url":null,"abstract":"<p><strong>Objective: </strong>To investigate whether human T cell leukaemia virus type 1 (HTLV-1) infection increases the risk of respiratory complications in patients with RA, focusing on high-resolution computed tomography (HRCT) findings and clinical features.</p><p><strong>Methods: </strong>We retrospectively analysed 30 HTLV-1-positive patients with RA enrolled in the HTLV-1 RA Miyazaki Registry who had undergone chest HRCT. For each patient, three age- and sex-matched HTLV-1-negative RA patients (<i>n</i> = 90) were recruited as controls. We compared pulmonary abnormalities on HRCT, RA disease activity, medication use and systemic complications between the groups. In the HTLV-1-positive group, we also assessed the relationship between HTLV-1 proviral load (PVL) and pulmonary findings.</p><p><strong>Results: </strong>Although age and disease duration were similar between groups at the time of HRCT, HTLV-1-positive patients had significantly higher disease activity (CDAI: 6.4 <i>vs</i> 3.3, <i>P</i> = 0.01; SDAI: 7.28 <i>vs</i> 3.46, <i>P</i> = 0.01), greater glucocorticoid use (70% <i>vs</i> 36%) and lower biologics use (33% <i>vs</i> 61%). Abnormal pulmonary findings were observed in ≈50% of both groups; however, bronchiolitis was more frequent in HTLV-1-positive patients, while interstitial lung disease patterns were comparable. HTLV-1 PVL did not differ significantly based on the presence or absence of pulmonary lesions.</p><p><strong>Conclusion: </strong>HTLV-1 infection may link to an increased prevalence of airway lesions, such as bronchiolitis and bronchiectasis, in RA patients. These findings suggest that screening for HTLV-1 should be considered in RA patients, especially those with respiratory symptoms or complications.</p>","PeriodicalId":21350,"journal":{"name":"Rheumatology Advances in Practice","volume":"10 2","pages":"rkag046"},"PeriodicalIF":2.8,"publicationDate":"2026-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13134664/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147820299","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}