Scandinavian Journal of Rheumatology最新文献

{"title":"Distinct clinical outcomes of positron emission tomography/computed tomography-based subtypes in treatment-naïve Takayasu arteritis.","authors":"T Katakura, T Shirai, Y Ishii, H Sato, H Fujii","doi":"10.1080/03009742.2026.2677340","DOIUrl":"10.1080/03009742.2026.2677340","url":null,"abstract":"<p><strong>Objective: </strong>Positron emission tomography/computed tomography (PET/CT) enables the visualization of vascular inflammation in Takayasu arteritis (TAK). However, the prognostic significance of PET/CT-based arterial involvement remains unclear. This study aimed to classify the distribution patterns of vascular lesions in treatment-naïve TAK using PET/CT and evaluate their association with clinical outcomes.</p><p><strong>Method: </strong>Patients with TAK who underwent PET/CT before treatment initiation were retrospectively analysed. Hierarchical clustering was performed based on the distribution of arterial ¹⁸F-fluorodeoxyglucose uptake. The clinical outcomes, including relapse and large-vessel complications, were analysed according to the resulting clusters using survival analyses. Longitudinal changes in PET/CT findings and clinical activity were assessed.</p><p><strong>Results: </strong>Thirty patients (90% women) were included, with a median follow-up of 4.8 years and median age at diagnosis of 48 years. Three distinct PET/CT-based clusters were identified: thoracic (43%), diffuse (30%), and localized (27%). The diffuse type showed the highest relapse rate 24.1/100 person-years, p = 0.04), whereas the thoracic type tended to be associated with more vascular complications (13.9/100 person-years, p = 0.12). The Numano classification did not always correspond to PET/CT-based clusters or predict clinical outcomes. A PET Vascular Activity Score ≥ 7 was associated with relapse but not with vascular complications. PET/CT activity persisted despite clinical inactivity in some cases, which may cause future relapse.</p><p><strong>Conclusion: </strong>PET/CT-based classification suggested three distinct TAK subtypes with different clinical outcomes. The diffuse type was significantly associated with relapse, whereas the thoracic type caused vascular complications. PET/CT provided superior risk stratification compared to the conventional classification.</p>","PeriodicalId":21424,"journal":{"name":"Scandinavian Journal of Rheumatology","volume":" ","pages":"1-9"},"PeriodicalIF":1.5,"publicationDate":"2026-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148376629","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Value of the chewing gum test for the diagnosis of giant cell arteritis: a multicentre pilot study.","authors":"N Ratti, S Dumonteil, S Parreau, J Magnant, E Liozon, S Palat, H Bezanahary, E Desvaux, N Aslanbekova, C Agard, T Quemeneur, A Mekinian, V Pestre, A-L Fauchais, K-H Ly, G Gondran","doi":"10.1080/03009742.2026.2627071","DOIUrl":"10.1080/03009742.2026.2627071","url":null,"abstract":"<p><strong>Objective: </strong>Giant cell arteritis (GCA) is a vasculitis that can lead to visual impairment. Jaw claudication (JC), a key clinical feature of GCA, is associated with an increased risk of visual complications. We hypothesized that the chewing gum test (CGT) could reveal JC that is not identified through anamnesis alone.</p><p><strong>Method: </strong>We conducted a prospective multicentre study including patients with suspected GCA between October 2019 and December 2021. The CGT was performed twice, in a blinded manner, before the initiation of any corticosteroid therapy. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of the CGT were assessed.</p><p><strong>Results: </strong>In total, 48 patients were included: 33 with confirmed GCA and 15 controls. Fifteen of the 33 patients with GCA had JC identified by conventional questioning, yielding a sensitivity, specificity, PPV, and NPV of 45%, 73%, 79%, and 38%, respectively. When at least one CGT was positive, the sensitivity, specificity, PPV, and NPV were 36%, 79%, 80%, and 34%, respectively. Three cases of JC not detected by conventional questioning were identified using the CGT; however, three CGT results were false positives. The combination of conventional questioning and at least one positive CGT significantly increased sensitivity from 45% to 55% (p < 0.0001).</p><p><strong>Conclusion: </strong>Although the relatively low sensitivity of the CGT limits its stand-alone clinical applicability, its association with conventional questioning may help to identify JC in patients with suspected GCA, thereby facilitating earlier diagnosis and potentially reducing visual complications. Large-scale studies are required to confirm these findings.</p>","PeriodicalId":21424,"journal":{"name":"Scandinavian Journal of Rheumatology","volume":" ","pages":"276-279"},"PeriodicalIF":1.5,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147699640","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Accuracy of dual-energy computed tomography (CT), ultrasound, cone-beam CT, and spectral photon-counting CT for detecting calcium crystal deposition in the osteoarthritic hand: a cross-sectional diagnostic test study.","authors":"A Døssing, L K Stamp, F Becce, C F Müller, J Bagge, P Hansen, L G Manzano, G M McCarthy, P G Conaghan, M Henriksen, R Christensen, L Terslev, K Ellegaard, N S Nielsen, L Juul, D I Radev, J D Nybing, H Bliddal, M Boesen","doi":"10.1080/03009742.2026.2627069","DOIUrl":"10.1080/03009742.2026.2627069","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the diagnostic performance of dual-energy computed tomography (DECT), ultrasound (US), cone-beam computed tomography (CBCT), and multi-energy spectral photon-counting computed tomography (SPCCT) for detecting calcium pyrophosphate (CPP) and hydroxyapatite crystal deposition.</p><p><strong>Method: </strong>We prospectively enrolled patients scheduled for finger-joint surgery due to osteoarthritis. Preoperative cross-sectional assessment included visual analogue scale pain, and in vivo index tests with DECT, US, and CBCT; the postoperative ex vivo index test was SPCCT of excised joint material. Reference tests comprised compensated polarized light microscopy of synovial fluid and histology with Alizarin Red S staining of excised joint material. Tests for crystals were scored on a binary basis. We calculated sensitivity, specificity, and likelihood ratios (LRs); a test with positive LR > 10 or negative LR < 0.1 was considered 'very good'.</p><p><strong>Results: </strong>We included 12 participants, nine of whom had at least one positive reference test for calcium crystals. None of the index tests met our predefined cut-offs for a very good test. The best sensitivity and specificity were 0.29 [95% confidence interval (CI) 0.04-0.71] and 0.67 (0.09-0.99) for DECT, 0.89 (0.52-1.00) and 1.00 (0.16-1.00) for US, 0.33 (0.07-0.70) and 0.67 (0.09-0.99) for CBCT, and 1.00 (0.66-1.00) and 0.00 (0.00-0.98) for SPCCT. Wide CIs reflected the small sample size. Participants with CPP in the synovial fluid had more pain than those without.</p><p><strong>Conclusion: </strong>SPCCT and US had high sensitivity for calcium crystal detection, although no test achieved the strict definition of a very good test.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov (NCT04585113).</p>","PeriodicalId":21424,"journal":{"name":"Scandinavian Journal of Rheumatology","volume":" ","pages":"264-275"},"PeriodicalIF":1.5,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147444890","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Severe auricular gangrene in anti-phospholipid syndrome: a clinical progression illustrated.","authors":"Amm Nilsson, J Lindhardsen, Cth Nielsen","doi":"10.1080/03009742.2025.2594343","DOIUrl":"10.1080/03009742.2025.2594343","url":null,"abstract":"","PeriodicalId":21424,"journal":{"name":"Scandinavian Journal of Rheumatology","volume":" ","pages":"300-302"},"PeriodicalIF":2.1,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145725703","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Older-onset Sjögren's disease: a multicentre study.","authors":"Ays Lee","doi":"10.1080/03009742.2026.2631239","DOIUrl":"10.1080/03009742.2026.2631239","url":null,"abstract":"","PeriodicalId":21424,"journal":{"name":"Scandinavian Journal of Rheumatology","volume":" ","pages":"311-313"},"PeriodicalIF":2.1,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147444869","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Therapeutic potential of interleukin-33 blockade in mitigating synovial inflammation and cartilage damage.","authors":"Y Feng, S Wu, D Li, Y Jiang, X Liu","doi":"10.1080/03009742.2026.2640725","DOIUrl":"10.1080/03009742.2026.2640725","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the therapeutic potential of anti-interleukin-33 (anti-IL-33) in a collagen-induced arthritis (CIA) model and its biological effects on the aggressive phenotype of rheumatoid arthritis fibroblast-like synoviocytes (RA-FLSs).</p><p><strong>Method: </strong>The CIA model was established in DBA/1 mice, which were treated with anti-IL-33, methotrexate, or vehicle. Arthritis severity was monitored via clinical scoring. Joint histopathology, cartilage damage, bone erosion, and synovial cell proliferation were assessed using H&E staining, Safranin O-fast green staining, and micro-computed tomography (micro-CT), respectively. In vitro, human RA-FLSs were stimulated with tumour necrosis factor-α (TNF-α) and treated with anti-IL-33. Cell proliferation, apoptosis, cell-cycle distribution, migration, invasion, and IL-6 production were evaluated using the 3-[4,5-dimethylthiazol-2-yl]-2,5-diphenyl-tetrazolium (MTT) assay, immunofluorescence assay, flow cytometry, terminal deoxynucleotidyl transferase dUTP nick end labelling (TUNEL), Transwell assays, and enzyme-linked immunosorbent assay.</p><p><strong>Results: </strong>Anti-IL-33 treatment significantly attenuated the clinical severity of arthritis and delayed disease progression in CIA mice. Histological and micro-CT analyses revealed that IL-33 blockade reduced synovial inflammation, pannus formation, and bone destruction, while preserving cartilage. In vitro, anti-IL-33 suppressed the proliferation, migration, and invasion of TNF-α-stimulated RA-FLSs. Furthermore, it promoted apoptosis, induced cell-cycle arrest at the G1 phase, and significantly down-regulated the secretion of the pro-inflammatory cytokine IL-6.</p><p><strong>Conclusion: </strong>IL-33 blockade effectively mitigates synovial inflammation and joint destruction by suppressing the proliferation, migration, and invasion of RA-FLSs while promoting their apoptosis. Targeting IL-33 may represent a promising strategy for the treatment of rheumatoid arthritis.</p>","PeriodicalId":21424,"journal":{"name":"Scandinavian Journal of Rheumatology","volume":" ","pages":"253-263"},"PeriodicalIF":2.1,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147521994","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Successful treatment association of interleukin-1 inhibitor anakinra and Janus kinase inhibitor baricitinib in Still's disease.","authors":"S F Azevedo, A Barcelos, C Mazeda","doi":"10.1080/03009742.2026.2620327","DOIUrl":"10.1080/03009742.2026.2620327","url":null,"abstract":"","PeriodicalId":21424,"journal":{"name":"Scandinavian Journal of Rheumatology","volume":" ","pages":"308-310"},"PeriodicalIF":2.1,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146182089","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Soluble programmed cell death-1 is increased in axial spondyloarthritis and present at the local site of pathology.","authors":"E Ahrenfeldt, M Hvid, A G Jurik, U Syrbe, D Poddubnyy, R Østgård, B Deleuran, S R Greisen","doi":"10.1080/03009742.2025.2599026","DOIUrl":"10.1080/03009742.2025.2599026","url":null,"abstract":"<p><strong>Objective: </strong>The combination of bone destruction and new bone formation is characteristic of spondyloarthritis. The proinflammatory cytokine interleukin-17A (IL-17A) is known to be central to the disease pathology, but immune regulatory mechanisms are poorly understood. We investigate the programmed cell death-1 (PD-1) pathway in patients with axial spondyloarthritis (axSpA) and the relationship between PD-1 and IL-17A.</p><p><strong>Method: </strong>We analysed blood and synovial fluid from patients with long-standing axSpA and newly diagnosed patients undergoing 1 year of adalimumab treatment. We measured soluble programmed cell death-1 (sPD-1) and sPD ligand-2 (sPD-L2) levels and investigated their correlation with disease activity markers. Surface expression of PD-1 on lymphocytes was determined, and production of IL-17A in the presence of recombinant human (rh) PD-1 was investigated. Facet joint biopsies from axSpA patients undergoing surgery were stained for the presence of PD-1 and C-C chemokine receptor-6 (CCR6).</p><p><strong>Results: </strong>Plasma levels of sPD-1 and sPD-L2 were increased in both early and long-standing axSpA, but unaffected by 1 year of adalimumab treatment, and levels did not correlate with disease activity scores or progression. PD-1 expression was increased on synovial fluid mononuclear cells. Compared with peripheral blood mononuclear cells from healthy controls, those from axSpA patients produced more IL-17A when cultured with rhPD-1. PD-1 and CCR6 were present in facet joint biopsies.</p><p><strong>Conclusion: </strong>We suggest a dual role for the PD-1 pathway in the pathogenesis of axSpA, acting in the inflamed microenvironment, with sPD-1 being suggestive of continued low immune activation.</p>","PeriodicalId":21424,"journal":{"name":"Scandinavian Journal of Rheumatology","volume":" ","pages":"247-252"},"PeriodicalIF":2.1,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146030672","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Positive predictive value of a register-based method to identify polymyalgia rheumatica in primary and secondary care: a validation study in Denmark.","authors":"A O Donskov, T Gaster, E M Hauge, A De Thurah, M Nørgaard, K K Keller","doi":"10.1080/03009742.2026.2628455","DOIUrl":"10.1080/03009742.2026.2628455","url":null,"abstract":"<p><strong>Objective: </strong>Polymyalgia rheumatica (PMR) is diagnosed in both primary and secondary healthcare. However, general practitioners (GPs) do not report diagnostic codes to national health registers, limiting the representation of primary healthcare patients in register-based studies. We estimated the positive predictive value (PPV) of a register-based algorithm for identifying patients with PMR across healthcare sectors in Denmark.</p><p><strong>Method: </strong>Potential patients were aged ≥50 years between 2003 and 2024. In primary healthcare, potential patients were identified by a first-time prescription of prednisolone/prednisone (PDN) issued by a GP and ≥375 mg PDN redeemed within 1 month. If other diagnoses, treated with PDN, were registered within 3 months of identification, patients were excluded. In secondary healthcare, potential patients were identified by a PMR diagnosis code in the Danish National Patient Registry (DNPR). Diagnoses were confirmed through chart review: in primary healthcare by GPs, and in secondary healthcare at two secondary hospitals and one tertiary hospital in Central Denmark Region (2013-2024). We estimated PPV with 95% confidence intervals (CIs) using the exact binomial method.</p><p><strong>Results: </strong>PMR diagnoses were confirmed in 62% (95% CI 54-69) of patients in primary care, and 89% (95% CI 84-93) in secondary care. Among primary care patients redeeming 1000-2000 mg PDN within 2 months following diagnosis, PPV was 84% (95% CI 76-90). Among secondary care patients redeeming PDN within 2 months of diagnosis, PPV was 91% (95% CI 86-94).</p><p><strong>Conclusion: </strong>The algorithm provides a robust framework for register-based epidemiological studies of patients with PMR.</p>","PeriodicalId":21424,"journal":{"name":"Scandinavian Journal of Rheumatology","volume":" ","pages":"280-288"},"PeriodicalIF":2.1,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147444938","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of monotherapy with conventional synthetic disease-modifying anti-rheumatic drugs or glucocorticoids on radiographic progression in rheumatoid arthritis: a network meta-analysis of 64 treatment arms from 31 randomized controlled trials.","authors":"L S Guski, H Pedder, S E Andersn, A G Jurik, N Graudal, G Jürgens","doi":"10.1080/03009742.2026.2631878","DOIUrl":"10.1080/03009742.2026.2631878","url":null,"abstract":"<p><strong>Objective: </strong>In a previous network meta-analysis (NMA) of randomized controlled trials (RCTs), we analysed the effects of 27 potential conventional synthetic disease-modifying anti-rheumatic drugs (csDMARDs), glucocorticoid (GC), and placebo in patients with rheumatoid arthritis (RA), using tender joint count as the primary outcome. The purpose of the present NMA was to investigate the relative effects of csDMARDs, GC, and placebo on radiographic joint destruction.</p><p><strong>Method: </strong>We identified 31 RCTs investigating 13 csDMARDs, GC, and placebo used in monotherapy, and used WinBUGS software to conduct an NMA, metaregressions, and subgroup analyses for possible confounders. The percentage annual radiographic progression rate (PARPR) was the primary outcome, while the standardized mean difference was used in a sensitivity analysis.</p><p><strong>Results: </strong>Leflunomide, sulfasalazine, and injected gold were more favourable than placebo and neither more nor less favourable than methotrexate. Although the effect size was equivalent with methotrexate, GC was not statistically better than placebo with the PARPR method. Azathioprine was less favourable than methotrexate and the remaining drugs were either not different from placebo or insufficiently investigated for robust conclusions.</p><p><strong>Conclusion: </strong>Our study confirms that the present routine csDMARDs, methotrexate, leflunomide, and sulfasalazine, have inhibitory effects more favourable than placebo on joint destruction in RA.</p>","PeriodicalId":21424,"journal":{"name":"Scandinavian Journal of Rheumatology","volume":" ","pages":"229-235"},"PeriodicalIF":1.5,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147487122","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}