RMD Open最新文献

{"title":"Multimorbidity burden predicts lower likelihood of remission and higher likelihood of disease flare in patients with rheumatoid arthritis.","authors":"Daniel Montes, Elena Myasoedova, Chanakya Kodishala, Roslin Jose George, Andrew C Hanson, Vanessa L Kronzer, John M Davis, Cynthia S Crowson","doi":"10.1136/rmdopen-2025-005577","DOIUrl":"10.1136/rmdopen-2025-005577","url":null,"abstract":"<p><strong>Objectives: </strong>To examine associations between multimorbidity, the social determinants of health (SDoHs) and rheumatoid arthritis (RA) flare and remission.</p><p><strong>Methods: </strong>All patients aged ≥18 years in Olmsted County, Minnesota, with incident RA in 1999-2014 were identified. Using a list of 55 chronic medical conditions, multimorbidity was defined as the presence of ≥2 conditions and substantial multimorbidity as ≥5 conditions. The Area Deprivation Index and Social Vulnerability Index (SVI) were used as proxies for adverse SDoH burden. Flare and remission were defined using Outcome Measures in Rheumatoid Arthritis Clinical Trials definitions. Mixed effects models were used to assess associations between flare/remission and multimorbidity, adverse SDoH burden and other patient characteristics.</p><p><strong>Results: </strong>This study included 659 patients with incident RA. Multimorbidity and substantial multimorbidity predicted 29% (OR:1.29, 95% CI:1.04 to 1.59) and 26% (OR:1.26, 95% CI:1.03 to 1.53) higher odds of flare, respectively. Both were associated with 34% (OR:0.66, 95% CI:0.49 to 0.90) and 33% (OR:0.67, 95% CI:0.51 to 0.90) lower odds of remission, respectively. SVI predicted 8% lower odds of remission for every 0.1 increase above 0.3 (OR:0.92, 95% CI:0.85 to 0.99). Flare was also associated with female sex, smoking, younger age and shorter disease duration, but not seropositivity. Remission was also associated with male sex, never smoking, older age and longer disease duration, but not seropositivity.</p><p><strong>Conclusions: </strong>Multimorbidity predicts higher odds of RA flare and lower odds of remission. Adverse SDoH burden predicts lower odds of remission. These findings have the potential to inform disease prognostication and clinician interventions.</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/PMC12336466/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144789837","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":"Deciphering differential biomarkers for anti-interleukin-6 receptor and anti-tumour necrosis factor-α treatment response in rheumatoid arthritis by multiomics analysis.","authors":"Inoncent Agueusop, Daniel Margerie, Anne Remaury, Raphaël Brard, Francesca Frau, Emilie Gerard, Gilbert Thill, Yaligara Veeranagouda, Michel Didier, Markus Kohlmann, Matthias Herrmann, Nadine Biesemann","doi":"10.1136/rmdopen-2025-005556","DOIUrl":"10.1136/rmdopen-2025-005556","url":null,"abstract":"<p><strong>Objective: </strong>To identify blood-based predictive and pharmacodynamic biomarkers at different timepoints in patients with active rheumatoid arthritis (RA) treated with anti-interleukin-6 receptor (anti-IL-6R) and anti-tumour necrosis factor-α (anti-TNF-α).</p><p><strong>Methods: </strong>This study used blood samples from the MONARCH trial (NCT02332590), a randomised, double-blind, phase III trial that compared the safety and efficacy of sarilumab (anti-IL-6R) and adalimumab (anti-TNF-α) monotherapy in patients with RA who were intolerant/inadequate responders to methotrexate. The study evaluated predictive biomarkers to anti-IL-6R and anti-TNF-α treatments at baseline and week 2 and pharmacodynamic biomarkers at week 2 and week 24 using Olink proteomics analysis (n=804 serum samples from 268 patients). Change in gene expression levels (n=522 peripheral blood samples from 261 patients) by both treatments was assessed using RNA sequencing analysis.</p><p><strong>Results: </strong>Serum biomarkers most predictive to anti-IL-6R were different from those of anti-TNF-α; predictive biomarkers for anti-IL-6R were correlated with innate immune activation and synovial inflammation, while predictive biomarkers for anti-TNF-α seemed to be more T-cell and neutrophil-related. For baseline predictive biomarkers, we had to focus on relative prediction as the absolute prediction performance of single and combination biomarkers using cross-validation was limited. Additionally, the pharmacodynamic effects of anti-IL-6R and anti-TNF-α on biomarkers as well as pathway signatures were distinct.</p><p><strong>Conclusion: </strong>The unbiased analysis of serum proteins identified biomarkers most predictive of anti-IL-6R and anti-TNF-α at different timepoints that could explain the difference in the response rate in patients with RA. Further, both biomarker and pathway results highlighted a differentiated mode of action of both treatments.</p>","PeriodicalId":21396,"journal":{"name":"RMD Open","volume":"11 3","pages":""},"PeriodicalIF":4.7,"publicationDate":"2025-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12323545/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144785174","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":"TNF inhibitors affect the induction and maintenance of spike-specific B-cell responses after mRNA vaccination.","authors":"Laura Yl Kummer, Lisan H Kuijper, Laura Fernández Blanco, Amélie Bos, Christine Kreher, Niels Jm Verstegen, Mariël C Duurland, Veronique Al Konijn, Tineke Jorritsma, Maryse Tempert, Charlotte Menage, Maurice Steenhuis, Marit J van Gils, Mathieu Claireaux, Juan J Garcia-Vallejo, Geert Ram D'Haens, Mark Löwenberg, Adriaan G Volkers, Koos Pj van Dam, Eileen W Stalman, Luuk Wieske, Sander W Tas, Laura Boekel, Gertjan Wolbink, Theo Rispens, Taco W Kuijpers, Filip Eftimov, S Marieke van Ham, Anja Ten Brinke","doi":"10.1136/rmdopen-2025-005724","DOIUrl":"10.1136/rmdopen-2025-005724","url":null,"abstract":"<p><strong>Objectives: </strong>Tumour necrosis factor inhibitors (TNFi) are widely used and effective as treatment for immune-mediated inflammatory diseases (IMIDs). However, TNFi therapy causes a faster waning of antibody responses following vaccination. The underlying cause by which TNFi affect humoral immunity remains to be elucidated. The formation of long-lasting, high-affinity antibodies after vaccination results from germinal centre (GC)-derived, T cell-dependent B-cell responses. Therefore, this study investigated how TNFi affect the formation and maintenance of antigen-specific B- and CD4+ T-cell responses following SARS-CoV-2 mRNA vaccination.</p><p><strong>Methods: </strong>SARS-CoV-2 spike-specific B-cell responses were characterised using spectral flow cytometry. Spike-specific CD4+ T cells were measured using an activation-induced marker assay. 15 patients with inflammatory bowel disease (IBD) treated with TNFi were compared with 9 IBD patients without systemic immunosuppression and 10 healthy controls.</p><p><strong>Results: </strong>Spike-specific CD4+T-cell frequency and phenotype, including T follicular helper cells, were not affected by TNFi. Total spike-specific B-cell frequencies were reduced in TNFi-treated patients. Deep phenotyping revealed lower IgG+memory B-cell frequencies in TNFi-treated patients 3-6 months after vaccination. These data were confirmed in TNFi-treated rheumatoid arthritis patients. Interestingly, already at day 7 after the second vaccination, TNFi therapy reduced the induction of class-switched CD11c- CD71+activated B cells, which are believed to be GC-derived. Conversely, CD11c+B cells, associated with extrafollicular B-cell responses, were not affected by TNFi therapy.</p><p><strong>Conclusions: </strong>These data suggest that TNFi therapy affects the differentiation of GC-derived B cells, which may explain its effect on humoral immune responses.</p>","PeriodicalId":21396,"journal":{"name":"RMD Open","volume":"11 3","pages":""},"PeriodicalIF":4.7,"publicationDate":"2025-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12323530/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144785175","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":"The equivocal opposite effects of lower and higher body mass index at diagnosis on radiographic joint damage progression in early rheumatoid arthritis: an inception cohort study over 15 years.","authors":"Sofia Ajeganova, Kristina Forslind, Ingiäld Hafström","doi":"10.1136/rmdopen-2025-005784","DOIUrl":"10.1136/rmdopen-2025-005784","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the effect of Body Mass Index (BMI) on long-term radiographic damage in an inception rheumatoid arthritis (RA) cohort.</p><p><strong>Methods: </strong>The study population, n=1813, originated from the observational Better AntiRheumatic FarmacoTherapy cohort. X-rays of hands and feet at inclusion, 1, 2, 5, 8 and 15 years were quantified for erosion score (ES), joint space narrowing (JSN) and the sum of modified Sharp-van der Heijde total score (mTSS). Patients were grouped by baseline BMI categories, including additional cut-off BMI ≥27 kg/m². Curve estimation regression analysis and multivariate mixed models were performed.</p><p><strong>Results: </strong>Inverse relationship between BMI and log-transformed mTSS was identified. In general, patients with higher BMI, compared with normal weight and/or underweight patients, had more favourable radiographic outcomes defined by annualised progression rates of mTSS, ES and JSN, less frequent rapid and clinically relevant radiographic progression, and maintained structural integrity. In contrast to consistently higher 28-joint Disease Activity Score (DAS28) levels, BMI ≥30 kg/m² was associated with less severe mTSS progression, beta=0.946 (95% CI 0.902 to 0.995) per year, p=0.029, while BMI ≤20 kg/m² with more joint damage, beta=1.091 (1.019-1.169) per year, p=0.014. The findings were confirmed in separate analyses regarding ES and JSN, and in anticitrullinated protein antibody-positive patients. The effect sizes of association between mTSS change and over time levels of C-reactive protein, erythrocyte sedimentation rate and DAS28 declined over time and varied across BMI strata. The latter finding indicates effect modification by BMI. The results in BMI ≥27 kg/m² group largely mirrored those in BMI ≥30 kg/m².</p><p><strong>Conclusions: </strong>BMI is one of the determinants of radiographic progression in early RA. Lower and higher BMI have opposite effects on radiographic progression.</p>","PeriodicalId":21396,"journal":{"name":"RMD Open","volume":"11 3","pages":""},"PeriodicalIF":4.7,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12314950/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144765344","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":"Trajectory analysis of glucocorticoid treatment highlights issues in the current tapering strategy for polymyalgia rheumatica.","authors":"Yoshiya Tanaka, Toshiya Takahashi, Toshiki Fukasawa, Shoichiro Inokuchi, Hidetoshi Uenaka, Akiko Fujita, Koji Shimamoto, Kazuhito Sakamoto","doi":"10.1136/rmdopen-2025-005650","DOIUrl":"10.1136/rmdopen-2025-005650","url":null,"abstract":"<p><strong>Objectives: </strong>To identify glucocorticoid (GC) treatment patterns in patients with polymyalgia rheumatica (PMR) and explore patient profiles that may benefit from GC-sparing interventions.</p><p><strong>Methods: </strong>This descriptive study was conducted using an electronic medical record database in Japan. We identified patients with PMR aged ≥50 years who were initiated 5-<30 mg/day of GCs with increased inflammatory markers. Group-based trajectory modelling (GBTM) was used to characterise GC treatment patterns over 52 weeks. We analysed clinical characteristics, including changes in GC doses, longitudinal C-reactive protein levels, immunosuppressant use and GC-related toxicities.</p><p><strong>Results: </strong>Among 452 eligible patients with PMR, four treatment trajectories were identified: rapidly-declining (19.0%), low-dose (36.9%), intermediate-dose (32.5%) and high-dose (11.5%). The rapidly declining and low-dose groups had more patients aged ≥80 years and with comorbidities. The median doses at week 52 in the low-dose, intermediate-dose and high-dose groups were 3.0, 4.0 and 7.5 mg/day, respectively. These groups had higher cumulative doses and greater GC-related toxicities compared with the rapidly declining group, which was reduced to 0 mg/day by week 8. The cumulative incidence of immunosuppressant use at week 52 was 6.1%-10.5%, even in the high-dose group.</p><p><strong>Conclusions: </strong>GBTM analysis indicates that many patients who do not discontinue GC use within 1 year are exposed to high cumulative GC doses, which are associated with an elevated risk of GC-related toxicities. Our findings highlight the need to reconsider treatment strategies for patients with PMR, including the use of GC-sparing agents.</p>","PeriodicalId":21396,"journal":{"name":"RMD Open","volume":"11 3","pages":""},"PeriodicalIF":4.7,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12306314/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144718282","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 of ixekizumab in 709 real-world patients with axial spondyloarthritis and psoriatic arthritis: a nationwide cohort study.","authors":"Kasper Yde Jensen, Kathrine Lederballe Grøn, Merete Lund Hetland, Bente Glintborg","doi":"10.1136/rmdopen-2025-005806","DOIUrl":"10.1136/rmdopen-2025-005806","url":null,"abstract":"<p><strong>Objectives: </strong>To explore real-world effectiveness of ixekizumab in Danish patients with axial spondyloarthritis (axSpA) and psoriatic arthritis (PsA).</p><p><strong>Methods: </strong>Observational cohort study based on data from the Danish nationwide quality registry, DANBIO. Patients with axSpA and PsA initiating ixekizumab (an interleukin 17 inhibitor (IL-17i)) between 2017 and 2024 were included. Outcomes were 6-, 12- and 24-month retention rates and low disease activity (LDA)/remission after 6 months (axSpA: Axial Spondyloarthritis Disease Activity Score (ASDAS) <2.1/<1.3, PsA: Disease Activity index for Psoriatic Arthritis (DAPSA28) ≤14/≤4, respectively). Clinical factors associated with retention were explored (multivariable Cox regression analyses with adjusted HRs (aHRs)).</p><p><strong>Results: </strong>709 patients were included (axSpA: 231, PsA: 478). Most patients were bio-experienced (axSpA: 97%, PsA: 91%). The 6-, 12- and 24-month retention rates were for axSpA: 69% (95% CI 63; 76), 53% (46; 60) and 40% (33; 49); for PsA: 75% (71; 79), 63% (58; 67) and 51% (46; 57), respectively. Patients previously treated with another IL-17i (axSpA 36%, PsA 34%) had an increased risk of withdrawal (aHR: axSpA 1.48 (1.01; 2.17), PsA 2.38 (1.79; 3.15)). Smoking, radiographic status (axSpA) or concomitant methotrexate (PsA) were not associated with withdrawal. After 6 months, 24% of axSpA patients had ASDAS-LDA, and 5% were in ASDAS-remission. For PsA, DAPSA28-LDA was achieved in 43% and DAPSA28-remission in 10%, respectively.</p><p><strong>Conclusion: </strong>In this nationwide observational study, ixekizumab was primarily prescribed in patients who had failed multiple biological and targeted synthetic disease-modifying antirheumatic drugs (b/tsDMARDs), including other IL-17i. Retention rates were somewhat lower for axSpA than for PsA. For both axSpA and PsA, prior IL-17i treatment was associated with an increased risk of withdrawal, yet the relatively high retention rate and improvement in all disease activity outcomes suggest ixekizumab as a viable option for patients with multiple b/tsDMARD failures.</p>","PeriodicalId":21396,"journal":{"name":"RMD Open","volume":"11 3","pages":""},"PeriodicalIF":4.7,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12306273/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144699371","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":"Safety of mycophenolate mofetil in systemic lupus erythematosus maintenance therapy: insights from the LUNA registry in a nationwide prospective cohort study.","authors":"Naoki Matsuoka, Nobuyuki Yajima, Eisuke Inoue, Shuzo Sato, Shotaro Ogawa, Yuya Sumichika, Kenji Saito, Shuhei Yoshida, Haruki Matsumoto, Jumpei Temmoku, Yuya Fujita, Tomoyuki Asano, Jumpei Fukita, Ken-Ei Sada, Kunihiro Ichinose, Ryusuke Yoshimi, Shigeru Ohno, Hiroshi Kajiyama, Yasuhiro Shimojima, Michio Fujiwara, Takashi Kida, Yoshia Miyawaki, Yusuke Matsuo, Takahisa Onishi, Keisuke Nishimura, Kiyoshi Migita","doi":"10.1136/rmdopen-2025-005558","DOIUrl":"10.1136/rmdopen-2025-005558","url":null,"abstract":"<p><strong>Objective: </strong>We aimed to compare the incidence of severe infections between mycophenolate mofetil (MMF) and other immunosuppressants in patients with systemic lupus erythematosus (SLE) on maintenance therapy using data from the Lupus Registry of Nationwide Institutions in Japan.</p><p><strong>Methods: </strong>This study employed a prospective cohort design, including patients with SLE undergoing maintenance therapy. Exposure was defined as MMF treatment, and the control group included individuals who received other immunosuppressants (non-MMF) treatments. Severe infections requiring hospitalisation were the primary outcomes, whereas secondary outcomes included all-cause hospitalisation, changes in prednisolone dosage, disease activity and organ damage. Statistical analyses employed marginal structural models with stabilised inverse probability of treatment weighting to adjust for confounders.</p><p><strong>Results: </strong>The analysis included 1004 patients; the incidence of severe infections was 6.5% in the MMF group and 7.5% in the non-MMF group, with no significant difference (OR 0.69, 95% CI 0.34 to 1.39). Similarly, all-cause hospitalisation rates were comparable between the groups (OR 0.72, 95% CI 0.47 to 1.09). Prednisolone dosage was significantly reduced in the MMF group (-0.66 mg/day, 95% CI -1.09 to -0.23). The organ damage score was modestly reduced in the MMF group (-0.19 points, 95% CI -0.37 to -0.01), whereas the change of disease activity score was comparable between the groups (-0.10 points, 95% CI -0.74 to 0.55).</p><p><strong>Conclusions: </strong>MMF does not significantly increase the risk of severe infections compared with other immunosuppressants in SLE maintenance therapy. MMF may contribute to reducing the dose of prednisolone.</p>","PeriodicalId":21396,"journal":{"name":"RMD Open","volume":"11 3","pages":""},"PeriodicalIF":4.7,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12306299/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144699372","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":"Persistent-relapsing SARS-CoV-2 infection following rituximab treatment for autoimmune rheumatic diseases: diagnosis and outcomes.","authors":"Katerina Chavatza, Elisavet Mastrostamati, Charalampos Charalampidis, Elvira-Markela Antonogiannaki, Ioannis Grigoropoulos, Emmanouil Karofylakis, Foteini Gkolemi, Georgios Koromvokis, Electra Kalara, Eleni Sambatakaki, Antonis Fanouriakis, Konstantinos Thomas","doi":"10.1136/rmdopen-2025-005756","DOIUrl":"10.1136/rmdopen-2025-005756","url":null,"abstract":"<p><strong>Background: </strong>COVID-19 may persist or relapse in patients on B-cell depleting biologic therapies.</p><p><strong>Objective: </strong>To examine the rate and outcome of persistent-relapsing COVID-19 (prCOVID-19) in patients with autoimmune rheumatic diseases (AIRD) treated with rituximab (RTX).</p><p><strong>Methods: </strong>Single-centre, retrospective cohort study of patients diagnosed with prCOVID-19 (June 2021 to January 2025). prCOVID-19 was defined as persistence of symptoms and lung imaging findings for >30 days, along with persistently positive or PCR-based conversion in upper or lower respiratory tract samples.</p><p><strong>Results: </strong>26 out of 225 (11.6%) AIRD patients, previously diagnosed with COVID-19 during RTX treatment period, developed 27 prCOVID-19 events (females: 20 (76.9%), median age: 61 years, median disease duration: 5.5 years, ≥3 COVID-19 vaccine doses: 20 (76.9%)). No prCOVID-19 infection in a control sample of 661 patients treated with other biologic/targeted synthetic/conventional synthetic disease-modifying antirheumatic drugs was documented. Median cumulative RTX dose was 12 g, while in 17 (68%) prCOVID-19 events, IgG levels were below 700 mg/L. Median duration of prCOVID-19 infection was 65 (IQR 74) days and median duration of hospitalisation 10.5 (IQR 14) days. 11 patients (42.3%) had ≥2 hospitalisations, 3 patients needed mechanical ventilation and 4 deaths were recorded. 59 of 113 (52.2%) nasopharyngeal PCR samples (NPS) and 12/17 (70.6%) bronchoalveolar lavage (BAL) PCR samples were positive during prCOVID-19. Bronchoscopy established the diagnosis of prCOVID-19 in 33% of events.</p><p><strong>Conclusion: </strong>AIRD patients treated with RTX are at risk for prCOVID-19. In such patients, the diagnostic accuracy of NPS PCR is suboptimal, necessitating PCR testing in BAL when prCOVID-19 is highly suspected.</p>","PeriodicalId":21396,"journal":{"name":"RMD Open","volume":"11 3","pages":""},"PeriodicalIF":4.7,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12281322/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144691350","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":"Performance in adults of the EULAR/PRINTO/PRES (Ankara 2008) classification criteria for IgA vasculitis.","authors":"Yagmur Bayindir, Peter C Grayson, Katherine B Gribbons, Selcan Demir, Alexandra Audemard-Verger, Cristina Ponte, Joanna C Robson, Ravi Suppiah, Cemal Bes, Bugu Bulat, Fatih Yildirim, Omer Karadag, Raashid Ahmed Luqmani, Richard A Watts, Peter A Merkel, Seza Ozen","doi":"10.1136/rmdopen-2025-005728","DOIUrl":"10.1136/rmdopen-2025-005728","url":null,"abstract":"<p><strong>Objective: </strong>To examine the performance in adults of the European Alliance of Associations for Rheumatology (EULAR)/Pediatric Rheumatology European Society (PReS)-endorsed Ankara 2008 classification criteria for IgA vasculitis (IgAV).</p><p><strong>Methods: </strong>The EULAR/PReS/Ankara 2008 classification criteria for IgAV were applied to patients enrolled in an international observational cohort which included patients with IgAV and comparators with other forms of small-vessel and medium-vessel vasculitis. After the initial assessment of the performance of the criteria, possible revisions to increase the performance were tested. The revised criteria were then assessed in an independent validation cohort within a multicentre Turkish vasculitis registry.</p><p><strong>Results: </strong>The dataset consisted of 178 IgAV cases and 1705 comparators. The Ankara 2008 criteria require skin involvement plus one of the following four criteria: abdominal pain, a biopsy showing IgA deposition, arthritis or arthralgia, or renal involvement (any haematuria and/or proteinuria). The specificity of the criteria improved when a positive test for anti-neutrophil cytoplasmic autoantibody or blood cryoglobulins was considered an exclusion criterion. The revised criteria had a sensitivity of 76.4% (95% CI 69.8% to 82.2%) and a specificity of 94.5% (95.0% CI 93.4% to 95.1%). In the validation set, the sensitivity and specificity of the revised criteria were 97.8% (95% CI 94.0% to 99.0%) and 85.0% (95.0% CI 78.0% to 90.0%), respectively.</p><p><strong>Conclusion: </strong>The revised EULAR/PReS-endorsed Ankara 2008 IgAV classification criteria perform well in adults with IgAV and are appropriate for use in clinical research.</p>","PeriodicalId":21396,"journal":{"name":"RMD Open","volume":"11 3","pages":""},"PeriodicalIF":4.7,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12281324/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144691349","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":"When generative artificial intelligence answers to Google Trends about spondyloarthritis: what does a French expert panel think about it?","authors":"Frank Verhoeven, Olivier Fakih, Corinne Miceli-Richard, Thao Pham, Hubert Marotte, Philippe Goupille, Renaud Felten, Maxime Breban, Thierry Lequerre, Adeline Ryussen-Witrand, Anne Tournadre, Laura Pina Vegas, Pascal Claudepierre, Athan Baillet, Damien Loeuille, Félicie Costantino, Cédric Lukas, Emmanuelle Dernis, Daniel Wendling, Clement Prati","doi":"10.1136/rmdopen-2025-005727","DOIUrl":"10.1136/rmdopen-2025-005727","url":null,"abstract":"","PeriodicalId":21396,"journal":{"name":"RMD Open","volume":"11 3","pages":""},"PeriodicalIF":5.1,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12278117/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144668267","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}