Seminars in arthritis and rheumatism最新文献

{"title":"Biologic-biologic and biologic-JAK inhibitor combination therapy in refractory systemic autoinflammatory diseases.","authors":"Abdurrahman Tufan, Deborah L Stone, Tina Romeo, Patrycja Hoffmann, Lorena Wilson, Natalie T Deuitch, Christina Kozycki, Kalpana Manthiram, Sarah Hansen, Daniel L Kastner, Amanda K Ombrello","doi":"10.1016/j.semarthrit.2026.153067","DOIUrl":"https://doi.org/10.1016/j.semarthrit.2026.153067","url":null,"abstract":"<p><strong>Objectives: </strong>Systemic autoinflammatory diseases (SAIDs) arise from genetic defects in innate immunity, leading to dysregulated activation of inflammatory pathways, including interleukin (IL)-1, IL-6, TNF, and JAK/STAT. Clinical manifestations range from recurrent fever to severe complications such as encephalitis and AA amyloidosis. Management aims to control inflammation using immunosuppressive agents and targeted monotherapies (biologics or JAK inhibitors). Advanced combination therapy (ACT), defined as the use of biologics and/or JAK inhibitors in combination, has emerged as a strategy for refractory disease.</p><p><strong>Methods: </strong>In this observational retrospective longitudinal cohort study, patients with SAIDs treated with ACT were included. Demographic, clinical, treatment, and safety data were collected. Treatment response was assessed using a composite outcome incorporating corticosteroid dose, C-reactive protein (CRP), and clinical improvement and categorized as non-response, partial response, or complete response.</p><p><strong>Results: </strong>Thirty-eight patients (median age 30 years [range 4-76]) were included. The most common indications for ACT were pyogenic arthritis, pyoderma gangrenosum and acne (PAPA), mevalonate kinase deficiency (MKD), and undifferentiated SAIDs. Most patients had disease-related complications and were dependent on glucocorticoids and/or opioids to control inflammation and pain, respectively. Following multiple ACT trials, complete response was observed in 21 patients (55.3%), partial response in 12 (31.6%), and no response in 5 (13.1%). Overall, 65 ACT regimens were administered, most commonly combining IL-1 and TNF inhibitors. Thirty-nine regimens were discontinued because of lack of efficacy, secondary loss of response, or adverse events. At the final follow-up, 26 patients (68%) remained on ACT, with a median treatment duration of 60 months (range, 11-186).</p><p><strong>Conclusions: </strong>ACT offers significant clinical benefits for patients with difficult-to-treat SAIDs, though challenges such as secondary loss of efficacy and infection risks remain.</p>","PeriodicalId":21715,"journal":{"name":"Seminars in arthritis and rheumatism","volume":"80 ","pages":"153067"},"PeriodicalIF":3.8,"publicationDate":"2026-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148888594","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"CoLchicine for Treatment of OsteoArthritis of the Knee (CLOAK): Clinical and biochemical outcomes from a three-month double-blind, placebo-controlled study.","authors":"Jonathan Samuels, Katherine Tse, David Wei, Cheongeun Oh, Fernando Bomfim, Renata La Rocca Vieira, Nicole Leung, Svetlana Krasnokutsky-Samuels, Michael Toprover, Mukundan Attur, Michael H Pillinger","doi":"10.1016/j.semarthrit.2026.153066","DOIUrl":"https://doi.org/10.1016/j.semarthrit.2026.153066","url":null,"abstract":"<p><strong>Objective: </strong>Knee osteoarthritis (KOA) causes pain and progressive disability, but pharmacologic treatments are limited. Colchicine inhibits inflammation that might modulate KOA, but efficacy trials have yielded mixed results. We tested whether colchicine, without concurrent NSAIDs, improved KOA pain, function, synovial effusion size, and OA-associated inflammatory serum biomarkers.</p><p><strong>Methods: </strong>Participants with symptomatic KOA and radiographic Kellgren-Lawrence grades 2/3 were randomized to receive three months of daily colchicine or placebo in a double-blind manner, with no concurrent NSAID use. The primary outcome was between-group change in visual analog score (VAS) for index knee pain. Secondary outcomes included changes in Knee Osteoarthritis Outcome Scores (KOOS), size (depth in millimeters) of sonographically-identified effusions, acetaminophen use, and changes in OA-related serum biomarkers.</p><p><strong>Results: </strong>From baseline to end of study of 120 enrolled participants, no significant differences were observed in improvement of VAS pain, KOOS scores or effusion size. Subsets of participants with more severe VAS pain, worse radiographic disease, or higher hsCRP or serum urate levels at baseline also showed no significant clinical benefit from colchicine compared to placebo. In contrast to the clinical outcomes, colchicine treatment was associated with significant or trending improvement in multiple OA-related serum biomarkers including hsCRP and β-NGF (p < 0.05) and PGE₂, IL-1ra, IL-8, and VEGF (p < 0.16).</p><p><strong>Conclusion: </strong>This double-blind placebo-controlled trial of colchicine for KOA failed to demonstrate improvement in pain, function, or synovial effusion size in comparison to placebo at three months. Early improvement in OA-associated inflammatory biomarkers suggests a possible longer-term clinical benefit. Clinical Trials Registration No NCT03913442.</p>","PeriodicalId":21715,"journal":{"name":"Seminars in arthritis and rheumatism","volume":"80 ","pages":"153066"},"PeriodicalIF":3.8,"publicationDate":"2026-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148876079","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Data-driven discovery of candidate predictors of future rheumatoid arthritis diagnosis in the UK biobank.","authors":"Kitty Pham, Iqbal Madakkatel, Anwar Mulugeta, Amanda Lumsden, Catherine Hill, Elina Hyppӧnen","doi":"10.1016/j.semarthrit.2026.153065","DOIUrl":"https://doi.org/10.1016/j.semarthrit.2026.153065","url":null,"abstract":"<p><strong>Background: </strong>Rheumatoid arthritis (RA) is an inflammatory autoimmune disease in which the immune system attacks joint tissues. Identifying predictors of RA diagnoses may enable earlier detection and opportunities for prevention.</p><p><strong>Methods: </strong>We applied a hypothesis-free data-driven machine learning approach using 445,515 UK Biobank participants, including 4,510 incident cases (8.4 median years follow-up, IQR 5.3 - 10.9). From 2,898 baseline input features, those identified as potentially important by the machine learning model were taken forward to logistic regression analyses, adjusting for known confounders. We used a Bonferroni corrected p-value of p<3.0 × 10^-4.</p><p><strong>Results: </strong>The model identified 200 features as potentially important for prediction of RA diagnosis. Epidemiological analyses confirmed associations with known RA risk factors (older age, female sex, smoking, and physical inactivity) and some indicators of low socioeconomic status and psychosocial well-being (e.g. highest vs lowest neuroticism score OR 1.44, 95% CI 1.24-1.67). History of joint disorder, osteoporosis, hypothyroidism, diverticular disease, and emphysema/chronic bronchitis were each associated with a 48% to 230% higher odds of RA. Markers of inflammation (e.g. C-reactive protein Q5 vs Q1 OR 1.92, 95% CI 1.71-2.16), altered liver and kidney function (e.g. cystatin C Q5 vs Q1 OR 1.55, 95% CI 1.38-1.74), and a range of blood cell markers were also found to associate with the odds of RA.</p><p><strong>Conclusion: </strong>Our data-driven analyses identified lifestyle, psychosocial, clinical and biomarker features predictive of RA years before diagnosis. While external validation is required, many identified candidate predictors likely reflect prodromal RA and may aid earlier disease detection, while modifiable lifestyles could support prevention. Further studies are required to confirm causality and clinical relevance.</p>","PeriodicalId":21715,"journal":{"name":"Seminars in arthritis and rheumatism","volume":"80 ","pages":"153065"},"PeriodicalIF":3.8,"publicationDate":"2026-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148874761","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Adequacy of trial registration and consistency in outcome reporting in rheumatology RCTs: A meta-research study","authors":"Diana Buitrago-Garcia ,&nbsp;Samia Mehouachi ,&nbsp;Thomas Agoritsas ,&nbsp;Michele Iudici ,&nbsp;Denis Mongin","doi":"10.1016/j.semarthrit.2026.152926","DOIUrl":"10.1016/j.semarthrit.2026.152926","url":null,"abstract":"<div><h3>Introduction</h3><div>Transparent reporting of randomized controlled trials (RCTs) is essential to ensure research integrity. While registration practices of RCTs are improving, concerns remain regarding the adequacy of outcome registration and the consistency of outcome reporting in publications.</div></div><div><h3>Objectives</h3><div>To evaluate the adequacy of primary outcome registration and the consistency of outcome reporting between registry entries and publications in rheumatology RCTs.</div></div><div><h3>Methods</h3><div>We conducted a meta-research study including primary reports of RCTs in rheumatology published from 2009 to 2022. We assessed whether primary outcomes were adequately registered (presence of SPIRIT-based criteria: measurement, analysis metric, and time points). For adequately registered outcomes, we evaluated consistency between the registry and the published report. Logistic regression was used to explore factors associated with inadequate registration and inconsistent reporting.</div></div><div><h3>Results</h3><div>We analyzed 947 RCTs involving 1679 primary outcomes. Only 38% of trials adequately described all their primary outcomes in the registry. Of these adequately registered trials, 67% reported their primary outcomes consistently in the corresponding publication, meaning just 25% of trials met both criteria. The most common gap in outcome description was missing participant-level analysis metric, while the most prevalent inconsistency was related to changes in the timing of outcome assessment.</div><div>Registration of adequately described primary outcome improved between 2009 and 2013 before plateauing, while consistency in reporting showed no improvement over time.</div></div><div><h3>Conclusion</h3><div>Despite improvements in trial registration practices, major gaps persist in outcome specification and reporting consistency in rheumatology RCTs.</div></div>","PeriodicalId":21715,"journal":{"name":"Seminars in arthritis and rheumatism","volume":"77 ","pages":"Article 152926"},"PeriodicalIF":4.4,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146078674","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Biologic switching challenges in psoriatic arthritis: A pediatric reflection, letter to \"biologic switching in psoriatic arthritis: Insights from real-world data and key risk factors\"","authors":"Sıla Atamyıldız Uçar,&nbsp;Eray Tunce,&nbsp;Betül Sözeri","doi":"10.1016/j.semarthrit.2025.152910","DOIUrl":"10.1016/j.semarthrit.2025.152910","url":null,"abstract":"","PeriodicalId":21715,"journal":{"name":"Seminars in arthritis and rheumatism","volume":"77 ","pages":"Article 152910"},"PeriodicalIF":4.4,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145927942","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The efficacy of metformin for pain, function, and quality of life in knee osteoarthritis: A systematic review and meta-analysis","authors":"Chi-Lan Kao ,&nbsp;Shih-Ming Chen ,&nbsp;Chih-Cheng Hsieh ,&nbsp;Tzu-Rong Peng ,&nbsp;Pei-Yun Tsai ,&nbsp;Chia-Yu Lin ,&nbsp;Ming-Chia Lee","doi":"10.1016/j.semarthrit.2025.152908","DOIUrl":"10.1016/j.semarthrit.2025.152908","url":null,"abstract":"<div><h3>Background</h3><div>Knee osteoarthritis (KOA) is a leading cause of disability worldwide; however current therapies offer only symptomatic relief. Metformin, a widely used antidiabetic agent, has been demonstrated to have anti-inflammatory and chondroprotective effects in preclinical models, suggesting its KOA modifying properties.</div></div><div><h3>Methods</h3><div>We conducted a systematic review and meta-analysis of randomized controlled trials evaluating the effects of metformin in patients with KOA. A comprehensive search of PubMed, Embase, and Cochrane Library was performed up to May 2025. Two reviewers independently screened studies and extracted data. Statistical analyses were conducted using a random-effects model to account for between-study heterogeneity. Subgroup analyses based on formulation, treatment duration, and nonsteroidal anti-inflammatory drugs (NSAIDs) co-administration were also performed.</div></div><div><h3>Results</h3><div>Five studies (<em>n</em> = 337) were included. Metformin significantly reduced pain scores (standardized mean difference [SMD] = −1.295; 95 % confidence interval [CI]: −2.063 to −0.526) and stiffness (SMD = −0.746; 95 % CI: −1.385 to −0.107), improved physical function (SMD = −2.042; 95 % CI: −3.372 to −0.712), and health-related quality of life (SMD = −1.505; 95 % CI: −2.896 to −0.115). Effects were consistent regardless of oral or topical metformin use, treatment duration, and NSAID use, although the benefits were greater when metformin was combined with NSAIDs.</div></div><div><h3>Conclusion</h3><div>While metformin demonstrated consistent benefits in pain and functional outcomes, these findings should be interpreted as symptomatic and adjunctive effects rather than definitive disease modification. Future trials incorporating structural endpoints are needed to confirm disease-modifying potential.</div></div>","PeriodicalId":21715,"journal":{"name":"Seminars in arthritis and rheumatism","volume":"77 ","pages":"Article 152908"},"PeriodicalIF":4.4,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145928550","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk and temporal trends of heart failure subtype risk in Rheumatoid Arthritis","authors":"Tate M. Johnson ,&nbsp;Bryant R. England","doi":"10.1016/j.semarthrit.2025.152905","DOIUrl":"10.1016/j.semarthrit.2025.152905","url":null,"abstract":"","PeriodicalId":21715,"journal":{"name":"Seminars in arthritis and rheumatism","volume":"77 ","pages":"Article 152905"},"PeriodicalIF":4.4,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145872463","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correspondence to 'Nailfold capillaroscopy as a predictor of major cardiovascular events and mortality in systemic sclerosis'","authors":"Yanxia Chen ,&nbsp;Jinlin Liu","doi":"10.1016/j.semarthrit.2026.152915","DOIUrl":"10.1016/j.semarthrit.2026.152915","url":null,"abstract":"","PeriodicalId":21715,"journal":{"name":"Seminars in arthritis and rheumatism","volume":"77 ","pages":"Article 152915"},"PeriodicalIF":4.4,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145978978","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring the association between adiposity, pain intensity, and effusion-synovitis in people with knee osteoarthritis: A cross-sectional study","authors":"YV Raghava Neelapala ,&nbsp;C Thomas Appleton ,&nbsp;Luciana Macedo ,&nbsp;Steve Hanna ,&nbsp;Dylan Kobsar ,&nbsp;Trevor B Birmingham ,&nbsp;Lisa C. Carlesso","doi":"10.1016/j.semarthrit.2026.152913","DOIUrl":"10.1016/j.semarthrit.2026.152913","url":null,"abstract":"<div><h3>Objectives</h3><div>To examine (i) the association of adiposity with pain intensity and/or effusion-synovitis in people with knee osteoarthritis (OA), adjusting for body mass index (BMI), and (ii) whether indicators of systemic immune inflammation (i.e., the systemic immune-inflammation index (SII) and the systemic immune response index (SIRI)) moderate the above associations.</div></div><div><h3>Methods</h3><div>Individuals with knee OA were sampled from the Western Ontario Registry for Early Osteoarthritis Knee Study. Total body and visceral fat percentages were measured using bioimpedance analysis, and effusion-synovitis was graded using knee ultrasonography. Multiple regression models with interaction terms were used to examine the association between fat percentages and pain intensity (linear)/effusion-synovitis (logistic), and the interaction effect of fat and SII/SIRI on pain intensity/effusion-synovitis. The analyses were adjusted for confounders (age, sex, BMI, radiographic severity of the opposite knee, and anxio-depressive symptoms).</div></div><div><h3>Results</h3><div>Data from 225 participants (mean age: 61.1 (10.9), 68% female, mean BMI: 31.7 (7.7)) were analyzed. The associations for adjusted fat and pain intensity models were as follows: total body fat: β): - 0.03 (-0.54 to 0.46) and visceral fat: β (: -0.25 (-1.03 to 0.51)., The odds ratios for adjusted fat and effusion-synovitis models were total body fat: OR): 0.98 (0.92 to 1.05) and visceral fat: OR (): 1.01 (0.91 to 1.11)). Neither the main nor the interaction effects were significant.</div></div><div><h3>Conclusion</h3><div>Our preliminary results do not support an association of adiposity and its interaction with generalized inflammation with pain/effusion-synovitis adjusted for BMI. Further studies are needed.</div></div>","PeriodicalId":21715,"journal":{"name":"Seminars in arthritis and rheumatism","volume":"77 ","pages":"Article 152913"},"PeriodicalIF":4.4,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145928552","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Response to Wang regarding correspondence to “Development of a prediction model for progression of rheumatoid arthritis-associated interstitial lung disease using serologic and clinical factors: The prospective KORAIL cohort”","authors":"Sung Hae Chang ,&nbsp;Misti L. Paudel ,&nbsp;Eun Young Lee ,&nbsp;Jeffrey A. Sparks","doi":"10.1016/j.semarthrit.2026.152931","DOIUrl":"10.1016/j.semarthrit.2026.152931","url":null,"abstract":"","PeriodicalId":21715,"journal":{"name":"Seminars in arthritis and rheumatism","volume":"77 ","pages":"Article 152931"},"PeriodicalIF":4.4,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146078675","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}