RMD Open最新文献

{"title":"Assessing the <i>MUC5B</i> promoter variant in a large cohort of systemic sclerosis-associated interstitial lung disease.","authors":"Carlos Rosa-Baez, Carlos Rangel-Pelaez, Inmaculada Rodriguez-Martin, Martin Kerick, Alfredo Guillen-Del-Castillo, Carmen P Simeon-Aznar, José Luis Callejas, Alexandre E Voskuyl, Alexander Kreuter, Oliver Distler, Susanna M Proudman, Mandana Nikpour, Nicolas Hunzelmann, Jeska K De Vries-Bouwstra, Ariane L Herrick, Yannick Allanore, Lorenzo Beretta, Maureen D Mayes, Christopher P Denton, Shervin Assassi, Javier Martin, Marialbert Acosta-Herrera","doi":"10.1136/rmdopen-2025-005754","DOIUrl":"10.1136/rmdopen-2025-005754","url":null,"abstract":"<p><strong>Objective: </strong>The common gain-of-function variant rs35705950, located in the promoter of <i>MUC5B</i> gene, has been strongly associated with interstitial lung diseases (ILDs) of different aetiology, such as idiopathic pulmonary fibrosis (IPF) and rheumatoid arthritis-associated ILD (RA-ILD). In this study, we aimed to investigate the association of this variant and its nearby single nucleotide polymorphisms (SNPs) in the largest cohort of systemic sclerosis-associated ILD (SSc-ILD) to date.</p><p><strong>Methods: </strong>Samples were collected from blood/saliva, followed by DNA extraction and genotyping using SNP arrays. Data for rs35705950 and additional 903 variants within 100 Kb were obtained using genomic imputation. Subsequently, we tested their association in a meta-analysis to increase the consistency of the results, including 10 European ancestry cohorts comprising 2363 patients with SSc-ILD, 3526 SSc patients without ILD and 15 076 controls.</p><p><strong>Results: </strong>Meta-analysis showed no significant association between rs35705950 and SSc-ILD, either comparing patients with SSc with and without ILD (p value: 0.588, OR: 1.05, 95% CI: 0.87 to 1.27) nor patients with SSc-ILD with controls (p value: 0.061, OR: 1.16, 95% CI: 0.99 to 1.36). Moreover, none of the additional 903 variants tested in the genomic region reached statistical significance.</p><p><strong>Conclusion: </strong>Despite analysing the largest and most statistically powered SSc-ILD cohort to date, we found no evidence of association between the <i>MUC5B</i> promoter variant rs35705950 and its surrounding SNPs with SSc-ILD. These results suggest that the pathogenic mechanisms underlying SSc-ILD may only partially overlap with those of other similar ILDs, such as IPF or RA-ILD. This highlights the need for further studies regarding their genetic architecture.</p>","PeriodicalId":21396,"journal":{"name":"RMD Open","volume":"11 3","pages":""},"PeriodicalIF":4.7,"publicationDate":"2025-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12352244/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144848590","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Immunogenicity of adjuvanted recombinant zoster vaccine in patients with rheumatoid arthritis treated with upadacitinib: 60-week results from a randomised controlled trial substudy.","authors":"Kevin L Winthrop, Justin Klaff, Sara K Penn, Yanxi Liu, Conrado García, Eduardo Mysler, Alvin F Wells, Xianwei Bu, Irina Fish, Michael Chen, Anthony L Cunningham","doi":"10.1136/rmdopen-2025-005521","DOIUrl":"10.1136/rmdopen-2025-005521","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the immunogenicity of adjuvanted recombinant zoster vaccine (RZV) in patients with rheumatoid arthritis receiving upadacitinib 15 mg once daily (QD) with background methotrexate.</p><p><strong>Methods: </strong>Eligible patients in SELECT-COMPARE (NCT02629159) receiving upadacitinib 15 mg QD and background methotrexate received RZV at weeks 0 and 12. Antibody titres were collected at weeks 0, 4, 16 and 60 (prevaccination, 4 weeks after first dose, and 4 and 48 weeks after second dose). The primary endpoint was the proportion of patients achieving a satisfactory humoral response to RZV at week 16 (≥ 4-fold increase in prevaccination anti-glycoprotein E (gE) antibody titres). Cell-mediated immune (CMI) response to RZV (≥ 2-fold increase in prevaccination gE-specific CD4+ [2+] T-cell frequency) was assessed at each time point in a subcohort of 38 patients. Safety was assessed for 30 days after each vaccination.</p><p><strong>Results: </strong>Overall, 93 patients received both RZV doses (78.5% female; mean age, 62.4 years). At baseline, 49.5% used concomitant corticosteroids (median daily dose, 5.0 mg). Satisfactory humoral responses to RZV were observed in 87.8% (95% CI 81.0 to 94.5) of patients at week 16. Age and concomitant corticosteroid use did not affect RZV antibody response. Over 60% of patients achieved a CMI response to RZV at all time points. No serious adverse events were reported. One patient developed herpes zoster 4 months after the second RZV dose.</p><p><strong>Conclusions: </strong>Most patients receiving upadacitinib 15 mg QD with background methotrexate achieved satisfactory humoral and CMI responses 4 weeks after the second RZV vaccination (week 16).</p>","PeriodicalId":21396,"journal":{"name":"RMD Open","volume":"11 3","pages":""},"PeriodicalIF":4.7,"publicationDate":"2025-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12352179/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144848593","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction: Minimally invasive ultrasound-guided biopsy of the common extensor tendon enthesis: a cadaveric study to standardise the technique.","authors":"","doi":"10.1136/rmdopen-2024-005328corr1","DOIUrl":"10.1136/rmdopen-2024-005328corr1","url":null,"abstract":"","PeriodicalId":21396,"journal":{"name":"RMD Open","volume":"11 3","pages":""},"PeriodicalIF":4.7,"publicationDate":"2025-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12352211/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144848592","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Oral enzyme combination therapy reduces systemic inflammation, urinary CTXII and pain in knee osteoarthritis: a proof-of-mechanism, randomised, crossover, double-blind, placebo-controlled trial.","authors":"Yves Henrotin, Thomas Pap, Siddhartha Lieten, Valérie Badot, Jean-Emile Dubuc, Didier Urbin-Choffray, Maximilian von Eynatten, Odd Erik Johansen, Stefanie Rau, Karl Brabants","doi":"10.1136/rmdopen-2025-005433","DOIUrl":"10.1136/rmdopen-2025-005433","url":null,"abstract":"<p><strong>Objectives: </strong>Oral enzyme combination (OEC) therapy with bromelain, trypsin and rutoside reduces pain and improves function in patients with knee osteoarthritis (OA). Here, we investigated several potential biological mechanisms underlying the clinical effects of OEC therapy in patients with established knee OA with respect to innate immunity, systemic inflammation and cartilage turnover (EudraCT 2020-003154-80, NCT05038410).</p><p><strong>Methods: </strong>Patients (age ≥40 years, body mass index (BMI) ≤35 kg/m²) with symptomatic knee OA were randomised to either placebo or OEC, administered 2×3 tablets/day, for 8 weeks before crossing over after a 4-week washout period. Different markers exploring innate immunity, inflammation and cartilage matrix degradation have been measured in the blood using immunoassays or cytometric methods. Data from the modified intention-to-treat population (mITT) were analysed using a generalised linear mixed model. No correction for multiple comparisons was made due to the exploratory nature of the study.</p><p><strong>Results: </strong>Altogether, 45 patients were randomised; 43 completed both treatment sequences (mITT; mean age: 63.3 years; mean BMI: 27.4 kg/m²; mean global Knee injury and Osteoarthritis Outcome Score (KOOS): 48.7). OEC significantly increased levels of α2-macroglobulin (p=0.038) and interleukin-10 (p<0.0001) while decreasing urinary carboxyl-terminal cross-linked telopeptide of type II collagen (p=0.038). Patients administered OEC exhibited significant improvements in KOOS Pain (p=0.0464) and Symptoms (p=0.026) subdomains but not globally. OEC was well tolerated, with no serious related adverse events reported in either group.</p><p><strong>Conclusions: </strong>One of the key findings of this proof-of-mechanism study is that OEC modulates IL-10 production, suggesting an anti-inflammatory effect in patients with knee OA. This main finding contributes to explaining the effects of OEC on pain and function in these patients.</p><p><strong>Trial registration number: </strong>NCT05038410.</p>","PeriodicalId":21396,"journal":{"name":"RMD Open","volume":"11 3","pages":""},"PeriodicalIF":4.7,"publicationDate":"2025-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12352264/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144848594","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Declaration on the use of social media for rheumatology professionals.","authors":"Latika Gupta, Elena Nikiphorou, Loreto Carmona, Cristiana Sieiro Santos, Francis Berenbaum, Christopher J Edwards","doi":"10.1136/rmdopen-2025-005917","DOIUrl":"10.1136/rmdopen-2025-005917","url":null,"abstract":"","PeriodicalId":21396,"journal":{"name":"RMD Open","volume":"11 3","pages":""},"PeriodicalIF":4.7,"publicationDate":"2025-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12352137/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144822457","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Men with psoriatic arthritis, rheumatoid arthritis and axial spondylarthritis have more children and at an earlier age than matched controls: results from a nationwide cohort.","authors":"Gudrun David Sigmo, Solveig Hauge, Hanne Brit Hetland, Marianne Wallenius, Maria Boge Lauvsnes, Kjell Åsmund Salvesen, Anne Kjersti Daltveit, Gunnstein Bakland, Bjørg-Tilde Svanes Fevang","doi":"10.1136/rmdopen-2025-005770","DOIUrl":"10.1136/rmdopen-2025-005770","url":null,"abstract":"<p><strong>Objectives: </strong>The reproductive health of men with inflammatory joint disease (IJD) has been a topic of debate in recent years, due to conflicting findings in existing research. In this study, we investigated childlessness and number of children per man, according to the joint diseases psoriatic arthritis (PsA), rheumatoid arthritis (RA) and axial spondylarthritis (axSpA). Furthermore, we studied the timing of fathering and risk factors associated with childlessness.</p><p><strong>Methods: </strong>This is a nationwide, population-based cohort study. Male patients aged 25-65 years with PsA (n=2649), RA (n=1716) and axSpA (n=2766) from the Norwegian Arthritis Registry were individually matched 1:5 with men without IJDs obtained from the National Population Register (n=35 655). Information on children was obtained from the Medical Birth Registry of Norway. Fertility rates were compared between the patient/IJD groups and matched controls.</p><p><strong>Results: </strong>In all IJD groups, fewer men were childless compared with the control groups (p<0.001). Similarly, the mean number of children per man was higher in all diagnostic groups, and this difference was evident before the IJD diagnosis (p<0.001). AxSpA patients had a slightly higher proportion of childless men compared with patients with PsA (p<0.001). Also, men with IJD were younger than the respective controls when fathering for the first time (p<0.001).</p><p><strong>Conclusion: </strong>This large nationwide study revealed that men with PsA, RA and axSpA were less childless compared with the general population, a difference that occurred before the onset of the IJD. These findings are novel, suggesting a notable difference in fertility patterns between those with and without IJDs.</p>","PeriodicalId":21396,"journal":{"name":"RMD Open","volume":"11 3","pages":""},"PeriodicalIF":4.7,"publicationDate":"2025-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12352174/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144822458","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictive factors for therapeutic response and cluster analysis in syndrome of undifferentiated recurrent fever (SURF).","authors":"Serena Palmeri, Marta Ponzano, Giada Recchi, Chiara Conti, Saverio La Bella, Diana Sutera, Marta Bustaffa, Caterina Matucci-Cerinic, Roberta Bertelli, Federica Penco, Ignazia Prigione, Riccardo Papa, Isabella Ceccherini, Stefano Volpi, Roberta Caorsi, Marco Gattorno","doi":"10.1136/rmdopen-2025-005874","DOIUrl":"10.1136/rmdopen-2025-005874","url":null,"abstract":"<p><strong>Introduction: </strong>Syndrome of undifferentiated recurrent fever (SURF) refers to a group of recurrent fevers without a clear monogenic cause. Clinical spectrum, treatment response predictors and management strategies remain unclear.</p><p><strong>Objective: </strong>This study aims to longitudinally analyse a homogeneously selected cohort of 101 SURF patients, to identify factors associated with colchicine resistance and to evaluate the efficacy of interleukin-1 (IL-1) inhibitors.</p><p><strong>Methods: </strong>Patients were enrolled in the Eurofever Registry, carefully excluding those with periodic fever, aphthous stomatitis, pharyngitis and cervical adenitis (PFAPA); familial Mediterranean fever and other known monogenic recurrent fevers. Demographic, clinical and treatment data were analysed to identify predictors of colchicine resistance and define subgroups through cluster analysis.</p><p><strong>Results: </strong>Common symptoms included fever, arthralgia, abdominal pain and myalgia, with PFAPA-like features (lymphadenopathy, tonsillitis, oral aphthae) observed in one-third of cases, sporadically. Colchicine efficacy, assessed in 77 patients, revealed complete response in the majority of patients (61%). Univariable analysis identified PFAPA-like features, including aphthous stomatitis (p=0.001), cervical lymphadenopathy (p=0.012) and exudative tonsillitis (p=0.004), as associated with colchicine resistance. Multivariable analysis confirmed aphthous stomatitis as an independent predictor of resistance (p=0.014). Tonsillectomy was ineffective. IL-1 inhibitors (anakinra, canakinumab) were beneficial in refractory cases. Cluster analysis revealed three distinct subgroups with varying symptoms and colchicine responses.</p><p><strong>Conclusions: </strong>These findings provide new insights into SURF, identifying predictors of colchicine resistance and supporting the efficacy of IL-1 blockade. Cluster analysis suggests the heterogeneity within SURF, reinforcing the need for refined diagnostic criteria and personalised treatment strategies.</p>","PeriodicalId":21396,"journal":{"name":"RMD Open","volume":"11 3","pages":""},"PeriodicalIF":4.7,"publicationDate":"2025-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12336599/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144817363","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness and safety of the recombinant zoster vaccine in adult patients with systemic lupus erythematosus: a claims-based retrospective cohort study in the USA.","authors":"Sophie E Mayer, Sheryl A Kluberg, O'Mareen Spence, Driss Oraichi, Harry Seifert, Omar Ali, Huifeng Yun, Andrew L Simon, Jenice S Ko, Caroline Hugh, Meg Her, Kathleen Shattuck, Aziza Jamal-Allial, Djeneba Audrey Djibo, Kimberly Daniels, Qianli Ma, Cheryl N McMahill-Walraven, Rachel P Ogilvie, Kristin Palmsten, Mano Selvan, Najat Ziyadeh, Alexis Ogdie, Michael D George","doi":"10.1136/rmdopen-2025-005839","DOIUrl":"10.1136/rmdopen-2025-005839","url":null,"abstract":"<p><strong>Objectives: </strong>To assess vaccine effectiveness (VE) and safety of the recombinant zoster vaccine (RZV) in adults with systemic lupus erythematosus (SLE).</p><p><strong>Methods: </strong>This retrospective study using administrative claims data collected between 1 January 2018 and 30 September 2023 from the USA included two cohorts of adults aged ≥18 years with SLE insured by (1) Medicare (parts A/B/D) or (2) one of five commercial partners (including Medicare Advantage plans). In VE analyses, adults receiving two RZV doses ≥28 days apart were matched 1:4 to unvaccinated comparators on insurer, sex and age (±5 years); the outcome was incident herpes zoster (HZ) after 31 days. In safety analyses, adults receiving RZV dose 1 or 2 were matched to unvaccinated comparators as above; the outcome was severe SLE flare within 90 days. Adjusted hazard ratios (HRs) were estimated using Cox models with inverse probability of treatment weighting (IPTW).</p><p><strong>Results: </strong>VE cohorts included 2284 Medicare and 1308 commercially insured RZV-vaccinated patients; mean weighted follow-up was 1.4-1.6 person-years. Safety cohorts included 6602 RZV vaccinations (dose 1 or 2) in Medicare and 4196 in commercial insurers. Vaccinated versus unvaccinated patient characteristics were balanced after IPTW. VE was 70% (95% CI: 50% to 82%) in Medicare and 54% (95% CI: 18% to 74%) in commercially insured patients. The HR of severe SLE flare in vaccinated versus unvaccinated patients was 0.91 (95% CI: 0.75 to 1.11) in Medicare and 0.94 (95% CI: 0.72 to 1.24) in commercially insured patients.</p><p><strong>Conclusions: </strong>RZV prevented a majority of HZ cases in individuals with SLE without increasing the risk of severe SLE flare.</p>","PeriodicalId":21396,"journal":{"name":"RMD Open","volume":"11 3","pages":""},"PeriodicalIF":4.7,"publicationDate":"2025-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12336505/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144804578","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development of an enzyme-linked immunosorbent assay for the efficient detection of autoantibodies against nuclear valosin-containing protein-like protein (NVL) 2 using its manipulated cDNA.","authors":"Yuta Yamashita, Yasuhiko Yamano, Yoshinao Muro, Haruka Koizumi, Mariko Ogawa-Momohara, Satoshi Kamiya, Norika Akashi, Takuya Takeichi, Yasuhiro Kondoh, Masashi Akiyama","doi":"10.1136/rmdopen-2025-005679","DOIUrl":"10.1136/rmdopen-2025-005679","url":null,"abstract":"<p><strong>Purpose: </strong>Antinuclear valosin-containing protein-like protein (NVL) antibodies have been detected only in systemic sclerosis (SSc) patients, and diverse comorbidities have been reported in anti-NVL antibody-positive SSc patients. Any relationship between antibodies against NVL1, a minor isoform of NVL, and the clinical symptoms also remains unclear. To clarify the clinical features of anti-NVL2 antibody-positive patients, we developed an ELISA for measuring antibodies against NVL2, a major target of autoantibodies against NVL.</p><p><strong>Methods: </strong>Sera from 1676 patients with various conditions were included. 167 anti-nucleolar antibody (ANoA)-positive sera, 120 ANoA-negative sera and 17 healthy control sera were examined by an ELISA that uses the recombinant protein of NVL2 derived from its gene-manipulated complementary DNA clone (modified NVL2 (mNVL2)).</p><p><strong>Results: </strong>18 ANoA-positive sera subjected to indirect immunofluorescence (IIF) were positive for anti-mNVL2 ELISA. Although one ANoA-negative serum was judged false positive in our anti-mNVL2 ELISA, the above 18 anti-mNVL2 ELISA-positive sera were confirmed to be positive for anti-NVL2 antibodies by immunoprecipitation-Western blotting. Anti-NVL2 antibodies were detected in 17.0% of homogeneous nucleolar (AC-8) patterns in IIF. Six SSc patients had anti-NVL2 antibodies, whereas five with idiopathic interstitial pneumonia and seven with other diseases had anti-NVL2 antibodies. Anti-mNVL2 ELISA titres were significantly higher in the anti-NVL2 antibody-positive SSc patients than in the anti-NVL2 antibody-positive non-SSc patients (p<0.042).</p><p><strong>Conclusions: </strong>We found more anti-NVL2 antibody-positive cases than any previous study, as far as we know. Our ELISA, which showed an association between titres of these antibodies and SSc diagnosis, promises to expand knowledge about anti-NVL2 antibodies.</p>","PeriodicalId":21396,"journal":{"name":"RMD Open","volume":"11 3","pages":""},"PeriodicalIF":4.7,"publicationDate":"2025-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12336533/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144804577","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Automated ultrasound system ARTHUR V.2.0 with AI analysis DIANA V.2.0 matches expert rheumatologist in hand joint assessment of rheumatoid arthritis patients.","authors":"Bill Aplin Frederiksen, Hilde Berner Hammer, Lene Terslev, Mads Ammitzbøll-Danielsen, Thiusius Rajeeth Savarimuthu, Anders Bossel Holst Weber, Søren Andreas Just","doi":"10.1136/rmdopen-2025-005805","DOIUrl":"10.1136/rmdopen-2025-005805","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the agreement and repeatability of an automated robotic ultrasound system (ARTHUR V.2.0) combined with an AI model (DIANA V.2.0) in assessing synovial hypertrophy (SH) and Doppler activity in rheumatoid arthritis (RA) patients, using an expert rheumatologist's assessment as the reference standard.</p><p><strong>Methods: </strong>30 RA patients underwent two consecutive ARTHUR V.2.0 scans and rheumatologist assessment of 22 hand joints, with the rheumatologist blinded to the automated system's results. Images were scored for SH and Doppler by DIANA V.2.0 using the EULAR-OMERACT scale (0-3). The agreement was evaluated by weighted Cohen's kappa, percent exact agreement (PEA), percent close agreement (PCA) and binary outcomes using Global OMERACT-EULAR Synovitis Scoring (healthy ≤1 vs diseased ≥2). Comparisons included intra-robot repeatability and agreement with the expert rheumatologist and a blinded independent assessor.</p><p><strong>Results: </strong>ARTHUR successfully scanned 564 out of 660 joints, corresponding to an overall success rate of 85.5%. Intra-robot agreement for SH: PEA 63.0%, PCA 93.0%, binary 90.5% and for Doppler, PEA 74.8%, PCA 93.7%, binary 88.1% and kappa values of 0.54 and 0.49. Agreement between ARTHUR+DIANA and the rheumatologist: SH (PEA 57.9%, PCA 92.9%, binary 87.3%, kappa 0.38); Doppler (PEA 77.3%, PCA 94.2%, binary 91.2%, kappa 0.44) and with the independent assessor: SH (PEA 49.0%, PCA 91.2%, binary 80.0%, kappa 0.39); Doppler (PEA 62.6%, PCA 94.4%, binary 88.1%, kappa 0.48).</p><p><strong>Conclusions: </strong>ARTHUR V.2.0 and DIANA V.2.0 demonstrated repeatability on par with intra-expert agreement reported in the literature and showed encouraging agreement with human assessors, though further refinement is needed to optimise performance across specific joints.</p>","PeriodicalId":21396,"journal":{"name":"RMD Open","volume":"11 3","pages":""},"PeriodicalIF":4.7,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12336591/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144789836","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}