Rheumatology Advances in Practice最新文献

{"title":"Decision on Optimal Combinatorial Therapies in Immune-mediated inflammatory diseases using Systems approaches (DocTIS): protocol for a single-arm, adaptive basket trial in rheumatoid and psoriatic arthritis.","authors":"Rory Sheppard, Myrsini Gianatsi, Ian Thomas, Sophie King, David Gillespie, Philip Pallmann, Sara Marsal Barril, Ernest Choy","doi":"10.1093/rap/rkag036","DOIUrl":"10.1093/rap/rkag036","url":null,"abstract":"<p><strong>Objectives: </strong>Current treatments for rheumatoid arthritis (RA) and psoriatic arthritis (PsA) reduce disease activity but often fail to achieve sustained remission. The Decision on Optimal Combinatorial Therapies in Immune-mediated inflammatory diseases using Systems approaches (DocTIS) program has shown that additive anti-inflammatory effects in patients with arthritis can be achieved by combining tumour necrosis factor (TNF) and interleukin (IL)-6 inhibitor therapies. The goal was to provide proof-of-principle evaluation of whether combining TNF and IL-6 inhibitors shows a signal of activity on remission outcomes in RA and PsA.</p><p><strong>Methods: </strong>This is a single-arm, multicentre, adaptive basket trial recruiting 20 patients with RA and 20 with PsA and including 24 weeks of treatment and 10 weeks of safety follow-up. Eligible participants on TNF for ≥6 weeks will proceed with the addition of IL-6 inhibitor (tocilizumab) at 162 mg every 2 weeks for 8 weeks, increasing to weekly dosing in weeks 9-24 if well tolerated. The primary outcome is remission at 24 weeks (Clinical Disease Activity Index score ≤2.8 in RA and Disease Activity in PsA score <4). Secondary outcomes include safety, tolerability and disease activity assessments. Using Simon's two-stage design (80% power, one-sided α = 0.10), the trial aims to detect an increase in remission (10% to 30%). An interim futility analysis will occur after seven participants per basket reach 24 weeks.</p><p><strong>Conclusion: </strong>Findings from this proof-of-principle study will inform the feasibility and design of future randomised trials evaluating combination biologic therapy in inflammatory arthritis.</p><p><strong>Study registration: </strong>www.isrctn.com; ISRCTN50666516.</p>","PeriodicalId":21350,"journal":{"name":"Rheumatology Advances in Practice","volume":"10 2","pages":"rkag036"},"PeriodicalIF":2.8,"publicationDate":"2026-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13127746/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147820285","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 missing link in connective tissue disease care: addressing the shortage of specialist nurses in the UK.","authors":"Diana Finney, Louise Parker, Will Gregory, Angie Turner","doi":"10.1093/rap/rkag031","DOIUrl":"10.1093/rap/rkag031","url":null,"abstract":"","PeriodicalId":21350,"journal":{"name":"Rheumatology Advances in Practice","volume":"10 2","pages":"rkag031"},"PeriodicalIF":2.8,"publicationDate":"2026-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13064975/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147676300","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 dysautonomia in chronic musculoskeletal pain: a systematic review and meta-analysis.","authors":"Norah A Almutairi, Darren C Greenwood, Manoj Sivan","doi":"10.1093/rap/rkag034","DOIUrl":"10.1093/rap/rkag034","url":null,"abstract":"<p><strong>Objectives: </strong>Several chronic musculoskeletal disorders are characterized by pain, fatigue, dizziness and other associated symptoms that may be related to autonomic dysfunction. The aim of this review was to estimate the prevalence of autonomic dysfunction in chronic musculoskeletal pain conditions.</p><p><strong>Methods: </strong>MEDLINE and Embase were searched through 4 October 2024 for all peer-reviewed studies of dysautonomia in adult musculoskeletal conditions. Risk of bias was assessed using an adapted Newcastle-Ottawa Scale. The prevalence of dysautonomia and relative risk compared with healthy controls were estimated using random effects meta-analysis.</p><p><strong>Results: </strong>A total of 17 studies (13 fibromyalgia, 3 Ehlers-Danlos syndrome, 1 rheumatoid arthritis) were identified, including 1003 participants with musculoskeletal pain and 417 healthy controls. In people with chronic musculoskeletal pain, the pooled prevalence of dysautonomia was 64% (95% CI 51, 76; <i>I</i> ² = 93%), more than twice as likely as healthy controls [pooled risk ratio 2.28 (95% CI 1.51, 3.45); <i>I</i> ² = 24%). Most studies objectively assessed the neurocardiovascular system.</p><p><strong>Conclusion: </strong>The high prevalence of dysautonomia in patients with chronic musculoskeletal painful conditions illustrates the association between dysautonomia and chronic pain, suggesting regular screening for dysautonomia is warranted for all patients with chronic musculoskeletal pain.</p>","PeriodicalId":21350,"journal":{"name":"Rheumatology Advances in Practice","volume":"10 2","pages":"rkag034"},"PeriodicalIF":2.8,"publicationDate":"2026-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13070644/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147676303","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":"Feasibility study of a smartphone app to monitor systemic sclerosis-related digital ulcers-a potential new tool for remote clinical monitoring.","authors":"Paul New, Graham Dinsdale, Andy Vail, Joanne Manning, Michael Hughes, William G Dixon, Chris Taylor, Mark Dickinson, Ariane L Herrick, Andrea Murray","doi":"10.1093/rap/rkag035","DOIUrl":"10.1093/rap/rkag035","url":null,"abstract":"<p><strong>Objectives: </strong>To assess the feasibility, in a clinical setting, of using a smartphone app that allows 'tracking' of SSc-related digital ulcers/lesions over time and to gauge patient opinion of the app's benefits, including a newly added lesion feedback function for patients.</p><p><strong>Methods: </strong>Patients with SSc with active digital ulcers/lesions were recruited and assessed twice: on study entry and at the point of lesion healing. Participants photographed their lesions and recorded patient-reported outcome measures (PROMs) with the app twice weekly. The lesion feedback function showed lesion size (measured from the photographs) over time. Ways in which feasibility was assessed included the number of photographs and PROMS recorded via the app, data from patient questionnaires and verbal feedback.</p><p><strong>Results: </strong>A total of 10 patients were recruited: 9 (90%) female, median age 55 years, median disease duration 12 years. Nine (90%) completed the study. The median duration of study participation per 'lesion episode' was 39 days (range 18-140). A total of 210 images were returned, with a median of 12 (range 4-87) per episode, and 99 sets of visual analogue scale/pain scores were returned, with a median of 7 (range 3-24) per episode. On a scale of 1 (very easy/helpful) to 10 (very difficult/not helpful), the median score for ease of sending photographs was 1 (range 1-3) and for helpfulness of feedback it was 1.5 (range 1-8). All patients were keen to use the app again.</p><p><strong>Conclusion: </strong>The feasibility and benefits of using the smartphone app, including the feedback function, lend support to possible wider use of the app in routine clinical practice.</p>","PeriodicalId":21350,"journal":{"name":"Rheumatology Advances in Practice","volume":"10 2","pages":"rkag035"},"PeriodicalIF":2.8,"publicationDate":"2026-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13070691/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147676334","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":"Albuminuria in Lupus Nephritis: the hidden threat to cardiovascular health.","authors":"Julio Francisco Colina-García, Irene Martin Capón, María Galindo, Enrique Morales","doi":"10.1093/rap/rkag032","DOIUrl":"10.1093/rap/rkag032","url":null,"abstract":"<p><strong>Objective: </strong>Systemic lupus erythematosus often leads to cardiovascular and renal complications, particularly in patients with lupus nephritis. In clinical practice, renal treatment response is commonly assessed using the Complete Renal Response criteria defined by the Consensus document of the Spanish Group for the Study of the Glomerular Diseases. These criteria, however, rely predominantly on proteinuria while albuminuria is often overlooked. The primary objective of our study was to assess the prevalence of pathological albuminuria in patients who met Complete Renal Response criteria. Secondary objectives included evaluating whether residual albuminuria identifies patients with different clinical outcomes.</p><p><strong>Methods: </strong>This single-centre, ambispective, observational study included 91 LN patients. Pathological albuminuria was defined as urinary albumin-creatinine ratio > 30 mg/g. Outcomes were compared between patients with and without pathological albuminuria despite achieving Complete Renal Response.</p><p><strong>Results: </strong>Among patients who met Complete Renal Response criteria, 80.5% had pathological albuminuria at the time of remission, and 55.8% continued to show it at the end of follow-up. Notably, patients with pathological albuminuria at the time of remission had significantly higher proteinuria levels both at disease onset and remission. Furthermore, persistent pathological albuminuria at follow-up was associated with more intensive antiproteinuric treatment. This therapeutic approach led to a significant reduction in both proteinuria and albuminuria titers.</p><p><strong>Conclusion: </strong>Pathological albuminuria remains common in lupus nephritis patients who meet Complete Renal Response criteria. Although cardiovascular events were infrequent during follow-up, the presence of persistent pathological albuminuria in patients meeting Complete Renal Response criteria underscores the need for close monitoring and therapeutic optimization, given its well-established association with adverse renal and cardiovascular outcomes in other glomerular diseases.</p>","PeriodicalId":21350,"journal":{"name":"Rheumatology Advances in Practice","volume":"10 2","pages":"rkag032"},"PeriodicalIF":2.8,"publicationDate":"2026-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13050262/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147623703","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":"Ten-year longitudinal assessment of entheseal ultrasound in psoriasis: limited discriminatory capacity for psoriatic arthritis.","authors":"Jeremy Genovese, Ilaria Matei, Thierry Passeron, Christian H Roux","doi":"10.1093/rap/rkag033","DOIUrl":"10.1093/rap/rkag033","url":null,"abstract":"","PeriodicalId":21350,"journal":{"name":"Rheumatology Advances in Practice","volume":"10 2","pages":"rkag033"},"PeriodicalIF":2.8,"publicationDate":"2026-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13012872/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147521959","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":"Giant cell arteritis-associated temporomandibular joint arthritis confirmed by imaging.","authors":"Miyu Wakatsuki, Hiroyuki Yamashita, Ami Isoda, Takuya Harada, Hiroshi Kaneko","doi":"10.1093/rap/rkag029","DOIUrl":"10.1093/rap/rkag029","url":null,"abstract":"","PeriodicalId":21350,"journal":{"name":"Rheumatology Advances in Practice","volume":"10 2","pages":"rkag029"},"PeriodicalIF":2.8,"publicationDate":"2026-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12996869/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147487164","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":"Novel use of anifrolumab in a young patient with Jo-1-positive juvenile dermatomyositis.","authors":"Daniel Windschall, Tanja Hinze, Sven Hardt, Duygu Aydin, Faekah Gohar","doi":"10.1093/rap/rkag017","DOIUrl":"10.1093/rap/rkag017","url":null,"abstract":"","PeriodicalId":21350,"journal":{"name":"Rheumatology Advances in Practice","volume":"10 2","pages":"rkag017"},"PeriodicalIF":2.8,"publicationDate":"2026-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13006197/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147514533","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":"Cross-cultural adaptation and psychometric testing of the Turkish Version of the Workplace Activity Limitations Scale (WALS) in people with inflammatory arthritis.","authors":"Gonca Bumin, Ezginur Gündoğmuş, Alan Tennant, Sevilay Karahan, Umut Kalyoncu, Yeliz Prior","doi":"10.1093/rap/rkag028","DOIUrl":"10.1093/rap/rkag028","url":null,"abstract":"<p><strong>Objectives: </strong>The Workplace Activity Limitations Scale (WALS) is a widely used measure to assess work-related functional limitations in individuals with rheumatologic diseases. However, no validated Turkish version of the WALS exists, limiting its applicability in Turkish-speaking populations. This study aims to conduct a cross-cultural adaptation and psychometric evaluation of the Turkish version of WALS in individuals with inflammatory arthritis (IA).</p><p><strong>Methods: </strong>WALS was forward and backward translated, and cognitive debriefing interviews were conducted with 30 participants to assess comprehensibility and cultural relevance. Then, 200 participants completed the Turkish version of the WALS along with the Work Limitation Questionnaire-Short Form (WLQ-SF), the Rheumatoid Arthritis Work Instability Scale (RA-WIS), the Work Productivity Activity Impairment General Health V2.0 (WPAI-GH), the Health Assessment Questionnaire (HAQ) and the Rheumatoid Arthritis Impact of Disease (RAID). Of these, 79 participants also completed the WALS again 2 weeks later to assess test-retest reliability.</p><p><strong>Results: </strong>WALS showed high internal consistency (Cronbach's alpha = 0.89) and excellent test-retest reliability (ICC (2.1): 0.91). WALS met the Rasch model requirements for fit. Concurrent validity showed that the WALS total score was moderately correlated with the WLQ total score (<i>r</i> = -0.57), some parameters of the WPAI (<i>r</i> ² = 0.42; <i>r</i> ³ = 0.40; <i>r</i> ⁴ = 0.43), HAQ (<i>r</i> = 0.54) and RAID (<i>r</i> = 0.57).</p><p><strong>Conclusion: </strong>The Turkish version of the WALS is a valid and reliable instrument for assessing workplace activity limitations in individuals with IA. It can be used in clinical and research settings to assess work-related functional difficulties and guide occupational interventions for Turkish-speaking individuals with IA.</p>","PeriodicalId":21350,"journal":{"name":"Rheumatology Advances in Practice","volume":"10 1","pages":"rkag028"},"PeriodicalIF":2.8,"publicationDate":"2026-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12975718/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147444911","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":"Performance and potential impact of the IMACS cancer screening guideline in myositis: analysis in a myositis referral centre.","authors":"Francis Martin Cuenco, Shintaro Yamamoto, Akira Yoshida, Takahisa Gono, Masataka Kuwana","doi":"10.1093/rap/rkag027","DOIUrl":"10.1093/rap/rkag027","url":null,"abstract":"<p><strong>Objectives: </strong>To evaluate the performance, direct costs and radiation exposure of the cancer screening strategy proposed by the International Myositis Assessment and Clinical Studies Group (IMACS) in patients with idiopathic inflammatory myopathies (IIMs) at a myositis referral centre compared with real-world cancer screening.</p><p><strong>Methods: </strong>This is a retrospective study involving consecutive patients registered in a single-centre prospective IIM database from 2014 to 2024 who had no cancer within 3 years before IIM diagnosis. The patients were stratified into high, moderate or standard risk of cancer according to the IMACS risk stratification model and cancer events were collected within 3 years following IIM diagnosis. Cancer detection rate, direct costs and radiation exposure associated with the IMACS screening strategy were estimated.</p><p><strong>Results: </strong>We included 183 patients with a median age at IIM onset of 61 years and 66.7% being female. The IMACS risk stratification model classified 75 (41.0%), 100 (54.6%) and 8 (4.4%) patients into high, moderate and standard risk, respectively. We identified 15 (20.0%), 8 (8.0%) and 0 cancer events in each risk group, respectively. The IMACS strategy could have identified 18/22 (81.8%) of the cancer events. Direct costs and radiation exposure associated with the IMACS strategy were estimated to be higher than our real-world practice, especially in the high- and moderate-risk groups.</p><p><strong>Conclusions: </strong>The IMACS IIM-associated cancer risk stratification model and screening strategy showed satisfactory performance in a single-centre IIM cohort, while most patients would be classified into the high- and moderate-risk groups, where enhanced cancer screening is recommended.</p>","PeriodicalId":21350,"journal":{"name":"Rheumatology Advances in Practice","volume":"10 2","pages":"rkag027"},"PeriodicalIF":2.8,"publicationDate":"2026-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13070695/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147676267","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}