Seminars in arthritis and rheumatism最新文献

{"title":"AA amyloidosis in inflammatory joint diseases: A systematic review","authors":"Binta SAVADOGO ,&nbsp;Hanna FAHED ,&nbsp;Jérémie SELLAM ,&nbsp;Sophie GEORGIN-LAVIALLE ,&nbsp;Bruno FAUTREL ,&nbsp;Stéphane MITROVIC","doi":"10.1016/j.semarthrit.2025.152762","DOIUrl":"10.1016/j.semarthrit.2025.152762","url":null,"abstract":"<div><h3>Background</h3><div>AA amyloidosis (AAA) is a complication of chronic inflammation; the burden is expected to decrease with recent therapies. We conducted a systematic review of the incidence, prevalence, mortality and response to treatment of inflammatory joint disease (IJD)-related AAA.</div></div><div><h3>Methods</h3><div>MEDLINE, EMBASE and Cochrane library databases were searched until October 2024. Selected studies were prospective and retrospective cohorts as well as case series (≥ 10 patients) of histologically proven AAA occurring in IJD.</div></div><div><h3>Results</h3><div>From 1094 articles identified, we included 33. Substantial heterogeneity among studies was observed. Most studies (75.8 %) were published before 2010. No clear trend was identifiable in AAA incidence and mortality during the last decades. AAA prevalence rates in rheumatoid arthritis ranged from 16.7 % to 25.2 % before 2010 and decreased to 0.7 % after 2010, which suggests a potential positive role of biologic therapies. Similarly, AAA prevalence rates in ankylosing spondylitis ranged from 6.1 % to 8.5 % before 2010 and 1.1 % to 1.3 % after 2010. Immunomodulating therapies (especially biologics) seemed to improve values of AAA biomarkers, such as glomerular filtration rate and serum amyloid A level.</div></div><div><h3>Conclusions</h3><div>Our work highlights the need for more recent and comprehensive population-based epidemiological data to decipher the actual IJD-related AAA burden.</div></div>","PeriodicalId":21715,"journal":{"name":"Seminars in arthritis and rheumatism","volume":"74 ","pages":"Article 152762"},"PeriodicalIF":4.6,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144270750","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":"Recommendations issued by clinical practice guidelines for the implementation of healthy lifestyles in adult patients diagnosed with gout: a scoping review","authors":"Diego S. Morales-Gonzales ,&nbsp;Arihana A. Paredes-Valdiviezo ,&nbsp;Mariano Gallo Ruelas ,&nbsp;Milton A. Romero-Robles","doi":"10.1016/j.semarthrit.2025.152766","DOIUrl":"10.1016/j.semarthrit.2025.152766","url":null,"abstract":"<div><div><strong>Background and Objectives:</strong> Gout is the most common inflammatory arthritis and is closely related to hyperuricemia. Although pharmacological treatment is key, lifestyle changes can help in its prevention and control. This study identified the recommendations of Clinical Practice Guidelines (CPG) on healthy habits in adults with gout and the methodology used in their development.</div><div><strong>Methods:</strong> A scoping review of CPGs published in the last 5 years in databases such as PubMed, Scopus and Web of Science, as well as repositories specialized in clinical guidelines, was performed. The PRISMA-ScR guidelines and the JBI methodology were applied.</div><div><strong>Results:</strong> Nine CPGs with recommendations on diet, physical activity and alcohol consumption were identified, with differences in their approach and level of evidence. Seven CPGs used GRADE to assess the quality of evidence and two used OXFORD. Most recommend reducing consumption of foods rich in purines and fructose, moderating alcohol, and promoting weight loss in overweight patients. No specific mental health recommendations were found. <strong>Conclusions:</strong> Lifestyle recommendations in gout CPGs, though they have a useful complementary role to play, are limited, and lack consensus. More rigorous research and updated guidelines are needed to improve patients' quality of life.</div></div>","PeriodicalId":21715,"journal":{"name":"Seminars in arthritis and rheumatism","volume":"74 ","pages":"Article 152766"},"PeriodicalIF":4.6,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144288897","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":"Development of a new simplified comprehensive scoring system for polymyalgia rheumatica: Integration of PET/CT findings and clinical features","authors":"Zhuoran Li,&nbsp;Kexin Chen,&nbsp;Yifeng Wu,&nbsp;Min Wu","doi":"10.1016/j.semarthrit.2025.152767","DOIUrl":"10.1016/j.semarthrit.2025.152767","url":null,"abstract":"<div><h3>Objective</h3><div>This study, based on previous single-center data, aimed to integrate [18F] Fluorodeoxyglucose positron emission tomography/computed tomography (PET/CT) findings with the 2012 ACR/EULAR classification criteria for Polymyalgia rheumatica (PMR) to develop a new simplified comprehensive scoring system and further validate its diagnostic performance.</div></div><div><h3>Methods</h3><div>We conducted a retrospective review of patients aged ≥50 years with musculoskeletal pain who underwent PET/CT examinations over the past decade. A total of 125 patients with PMR and 200 control subjects were included. The cohort was divided into a study cohort and a validation cohort. Based on PET/CT findings and clinical characteristics from the study cohort, we developed a new simplified comprehensive scoring system. The diagnostic performance of this new scoring system was further assessed in the validation cohort.</div></div><div><h3>Results</h3><div>In the discovery cohort, the new scoring system, which combines PET/CT findings with clinical criteria, demonstrated a sensitivity of 92 % for diagnosing PMR, a specificity of 86.5 % in the overall control group, and a sensitivity of 90.4 % for distinguishing patients with rheumatoid arthritis (RA). The area under the receiver operating characteristic (ROC) curve (AUC) was 0.892 for the overall control group and 0.912 for the RA group. In the validation cohort, the new criteria achieved a sensitivity of 88 % and a specificity of 83.1 %.</div></div><div><h3>Conclusions</h3><div>The new simplified comprehensive scoring system integrates PET/CT findings with the 2012 ACR/EULAR clinical classification criteria, simplifying the scoring components to improve diagnostic performance and clinical utility, thus making it more accessible and practical for rheumatologists in clinical settings.</div></div>","PeriodicalId":21715,"journal":{"name":"Seminars in arthritis and rheumatism","volume":"74 ","pages":"Article 152767"},"PeriodicalIF":4.6,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144240534","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":"AI automated radiographic scoring in rheumatoid arthritis: Shedding light on barriers to implementation through comprehensive evaluation","authors":"Alix Bird ,&nbsp;Lauren Oakden-Rayner ,&nbsp;Katrina Chakradeo ,&nbsp;Ranjeny Thomas ,&nbsp;Drishti Gupta ,&nbsp;Suyash Jain ,&nbsp;Rohan Jacob ,&nbsp;Shonket Ray ,&nbsp;Mihir D Wechalekar ,&nbsp;Susanna Proudman ,&nbsp;Lyle J. Palmer","doi":"10.1016/j.semarthrit.2025.152761","DOIUrl":"10.1016/j.semarthrit.2025.152761","url":null,"abstract":"<div><h3>Objectives</h3><div>Artificial intelligence (AI) has demonstrated the potential to improve efficiency and reliability of radiographic scoring in rheumatoid arthritis but lacks sufficient evidence to justify clinical use. We developed and rigorously validated a deep learning model to automate radiographic scoring against two external test sets, drawing upon state of the art reporting guidelines to clarify present barriers to implementation.</div></div><div><h3>Methods</h3><div>AI algorithms were trained to predict the Sharp van der Heijde score in hands and feet using a cohort of 157 patients and 1470 radiographs. External replication was undertaken in test datasets from two hospitals (n=253 patients, 589 radiographs). Alongside standard performance metrics to measure error and agreement, we reported subgroup performance, conducted an exploratory analysis of error, and demonstrated relationships with functional outcomes.</div></div><div><h3>Results</h3><div>Our AI system underperformed compared to manual scoring, with lower agreement between the AI and consensus score than between the two manual scorers. The AI system was better at ranking scores than achieving absolute agreement, with intraclass correlation coefficients ranging from 0.03 to 0.27 while Spearman’s correlation coefficients were consistently higher, ranging from 0.16 to 0.55.</div></div><div><h3>Conclusions</h3><div>The performance of the AI systems developed for automating radiographic scoring in RA is insufficient to justify use in research or clinical practice. Large, diverse, and thoroughly described longitudinal datasets will be indispensable in the development and rigorous evaluation of algorithms. Achieving this is key to the ongoing precise evaluation of clinical outcomes in rheumatoid arthritis to enable further improvements to patient care.</div></div>","PeriodicalId":21715,"journal":{"name":"Seminars in arthritis and rheumatism","volume":"74 ","pages":"Article 152761"},"PeriodicalIF":4.6,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144261607","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":"Similar myocardial infarction characteristics and short-term outcomes in patients with and without inflammatory joint diseases: A nationwide Norwegian study","authors":"Eirik Ikdahl ,&nbsp;Anne Kerola ,&nbsp;Prof. Peder L. Myhre ,&nbsp;Eli Sollerud ,&nbsp;Anne Grete Semb","doi":"10.1016/j.semarthrit.2025.152760","DOIUrl":"10.1016/j.semarthrit.2025.152760","url":null,"abstract":"<div><h3>Objectives</h3><div>To compare presenting symptoms, myocardial damage, acute treatment, in-hospital adverse events, short-term outcomes and secondary cardio-preventive drugs in patients with rheumatoid arthritis, axial spondyloarthritis (axSpA) and psoriatic arthritis (PsA) experiencing their first myocardial infarction (MI) versus patients without inflammatory joint diseases (IJD).</div></div><div><h3>Methods</h3><div>We analyzed register data covering the entire adult Norwegian population, examining individuals experiencing their first MI, sourced from the Norwegian MI register between January 2013 and December 2017. Only patients without known atherosclerotic cardiovascular disease were analyzed. Outcomes were compared between IJD and non-IJD groups using logistic regression and generalized linear models, in age-adjusted models stratified by sex.</div></div><div><h3>Results</h3><div>Our cohort included 981 RA patients, 314 axSpA patients, 434 PsA patients and 34,783 non-IJD individuals experiencing a first MI. Chest pain was the most common symptom in all groups, and there was no indication that IJD subgroups experienced atypical presentations more often than non-IJD. Myocardial damage indicators – ST-elevation MI rates, troponin T levels and multi-vessel disease – were not worse in IJD patients. Acute treatments were equally, or more, often performed in IJD compared to non-IJD individuals. All in-hospital adverse events and short-term mortality were similar or less common in the IJD subgroups compared to non-IJD patients. None of the secondary cardio-preventive drugs were prescribed less frequently to IJD patients than to non-IJD.</div></div><div><h3>Conclusion</h3><div>RA, axSpA and PsA patients showed comparable MI presentations, disease courses and short-term outcomes to those without IJD. These findings should provide reassurance about the short-term prognosis of IJD patients experiencing MI.</div></div>","PeriodicalId":21715,"journal":{"name":"Seminars in arthritis and rheumatism","volume":"73 ","pages":"Article 152760"},"PeriodicalIF":4.6,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144221260","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":"Statin-associated immune-mediated necrotizing myopathy in Hispanic Americans","authors":"Tam N. Dinh ,&nbsp;Sharon E. Nunez ,&nbsp;Kristin M. Gonzales ,&nbsp;Krystle L. Tapia ,&nbsp;Eric B. Garcia ,&nbsp;Roderick A. Fields ,&nbsp;Maheswari Muruganandam ,&nbsp;N. Suzanne Emil ,&nbsp;Frank X. O’Sullivan ,&nbsp;Wilmer L. Sibbitt Jr.","doi":"10.1016/j.semarthrit.2025.152759","DOIUrl":"10.1016/j.semarthrit.2025.152759","url":null,"abstract":"<div><h3>Introduction/Objectives</h3><div>Idiopathic inflammatory myopathies (IIM) are manifested by proximal muscle weakness, inflammation, and elevation of muscle enzymes. Immune-mediated necrotizing myopathy (IMNM) is a form of IIM often associated with anti-3-hydroxy-3-methylglutaryl coenzyme A reductase (anti-HMGCR) antibodies. Recently, certain regional populations have been found to have increased anti-HMGCR antibody IMNM. The present study compared the epidemiology of IIM and IMNM in the adult Hispanic and non-Hispanic Caucasians in the Southwestern USA.</div></div><div><h3>Methods</h3><div>In this retrospective study 97 patients with IIM were self-identified as Hispanic versus non-Hispanic. Statistical comparisons were performed as to prevalence of diabetes mellitus, hyperlipidemia, statin exposure, myopathy diagnosis, muscle histology, autoimmune and myositis-specific autoantibodies, echocardiography, interstitial lung disease, therapy, and outcome.</div></div><div><h3>Results</h3><div>Sixty-two patients self-identified as Hispanic (64 %) and 35 patients as non-Hispanic (36 %). The two groups were similar in terms of baseline characteristics, autoantibody profiles, clinical outcomes, and mortality rates. However, statin-induced anti-HMGCR antibody IMNM was increased in Hispanics (22.6 % versus 5.7 %, OR: 4.81, CI: (1.03, 22.6), p=0.045) as was diabetes mellitus (46.8 % versus 25.7 %, OR: 2.54, CI: (1.02, 6.29), p=0.05). However, there was lesser cancer-associated IIM in Hispanics compared to Non-Hispanics (11.3 % versus 31.4 %, OR: 0.23CI: (0.08, 0.7), p=0.027).</div></div><div><h3>Conclusions</h3><div>Hispanics in the Southwestern USA have increased statin-induced anti-HMGCR antibody IMNM and a lesser prevalence of cancer-associated IIM compared to non-Hispanics. It is uncertain whether these respective differences in statin-induced versus malignancy-associated myositis result from specific genetic and environmental factors, or to greater statin exposure in Hispanics due to increased endemic diabetes mellitus.</div></div>","PeriodicalId":21715,"journal":{"name":"Seminars in arthritis and rheumatism","volume":"73 ","pages":"Article 152759"},"PeriodicalIF":4.6,"publicationDate":"2025-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144167324","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":"Nervous system involvement in ANCA-associated vasculitis: Single center experience from Latin America","authors":"Lina Paola Quintero-Giraldo ,&nbsp;Julian Barahona-Correa ,&nbsp;David Corredor-Orlandelli ,&nbsp;Carolina García-Alfonso ,&nbsp;Nancy Herrera-Leaño ,&nbsp;Daniel G. Fernández-Ávila","doi":"10.1016/j.semarthrit.2025.152751","DOIUrl":"10.1016/j.semarthrit.2025.152751","url":null,"abstract":"<div><h3>Introduction</h3><div>Anti-neutrophil cytoplasmic antibodies (ANCA)-associated vasculitides (AAV) present heterogeneous neurological symptoms that are often misdiagnosed, contributing to delays in identification and prompt treatment. Few studies in Latin America have described the frequency of neurological involvement in AVV; none have explicitly described the characteristics of nervous system involvement.</div></div><div><h3>Design/Methods</h3><div>This case-control study examined patient records for AVV treated at a university hospital in Colombia between 2005 and 2023. Patients with and without neurological manifestations were compared and a survival analysis was performed.</div></div><div><h3>Results</h3><div>Forty-eight cases and seventy-nine controls were included. The median age was 58 years, 57.5 % were female. The diagnosis was made in 67.7 % of cases during the hospital stay, and in-hospital mortality was 14 %. Nervous system involvement was more frequent in undifferentiated AAV (100 %), followed by eosinophilic granulomatosis with polyangiitis (75 %), microscopic polyangiitis (33.3 %), and granulomatosis with polyangiitis (25.9 %). The most common neurological manifestations were peripheral neuropathy (50 %), patient-reported symptoms of sensory dysfunction (43.7 %), and cranial neuropathy (39.6 %); headache was frequent among patients with neurological involvement. Patients with neurological manifestations presented a lower median creatinine at admission and a lower proportion of patients with a five-factor score &gt; 2. No differences in one-year all-cause mortality were observed.</div></div><div><h3>Conclusions</h3><div>This study presents an exhaustive clinical characterization of the neurological profile of patients with AAV from a single center in Latin America. Patients with nervous system involvement showed less severe renal involvement and a lower proportion of 5-year risk of mortality scores; one-year all-cause mortality was similar between groups.</div></div>","PeriodicalId":21715,"journal":{"name":"Seminars in arthritis and rheumatism","volume":"73 ","pages":"Article 152751"},"PeriodicalIF":4.6,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144114906","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":"Does baseline nephrotic range proteinuria determine the long-term outcomes of membranous lupus nephritis patients?","authors":"Fadi Kharouf,&nbsp;Pankti Mehta,&nbsp;Virginia Carrizo Abarza,&nbsp;Qixuan Li,&nbsp;Laura P Whittall Garcia,&nbsp;Dafna D Gladman,&nbsp;Zahi Touma","doi":"10.1016/j.semarthrit.2025.152756","DOIUrl":"10.1016/j.semarthrit.2025.152756","url":null,"abstract":"<div><h3>Objectives</h3><div>Management strategies for membranous lupus nephritis (MLN) are generally based on the severity of proteinuria. However, long-term outcomes comparing subnephrotic and nephrotic range proteinuria remain understudied. We explored whether baseline proteinuria level, subnephrotic or nephrotic, impacts long-term outcomes.</div></div><div><h3>Methods</h3><div>We conducted a retrospective study identifying patients with biopsy-proven MLN. Patients were categorized based on baseline proteinuria: subnephrotic (&lt;3.5 g/day) or nephrotic (≥3.5 g/day). Long-term outcomes, including an adverse composite outcome (end-stage kidney disease, sustained ≥30 % decline in eGFR, or death) and LN flares, were analyzed. Time-to-event outcomes were assessed using Kaplan-Meier curves, and associations were evaluated using Cox regression.</div></div><div><h3>Results</h3><div>88 patients were included, with 49 (55.7 %) in the subnephrotic group (median 1.5 g/day) and 39 (44.3 %) in the nephrotic group (median 4.7 g/day). At baseline, the subnephrotic group had a longer time to LN onset, less frequent hyperlipidemia, higher serum albumin, less diffuse podocyte effacement, and less frequent cyclophosphamide treatment. No significant differences were noted in kidney function, urine sediment abnormalities, or histopathology. 38 patients (43.2 %) experienced the adverse composite outcome, with no difference between groups (40.8 % in the subnephrotic group vs. 46.2 % in the nephrotic group, <em>p</em> = 0.78]. Flares occurred in 35 patients (39.8 %), with no difference between groups (38.8 % in the subnephrotic group vs. 41.0 % in the nephrotic group, <em>p</em> = 1.00).</div></div><div><h3>Conclusions</h3><div>No significant differences in renal disease characteristics or long-term outcomes were found between MLN patients with nephrotic and subnephrotic baseline proteinuria. These findings challenge current practices, suggesting a need for more individualized immunosuppressive treatment in MLN.</div></div>","PeriodicalId":21715,"journal":{"name":"Seminars in arthritis and rheumatism","volume":"73 ","pages":"Article 152756"},"PeriodicalIF":4.6,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144105725","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":"Strong correlation between SLEDAI and SLE-DAS in the Spanish population: Assessment of discordant patients","authors":"Elena Heras-Recuero ,&nbsp;Antía García-Fernández ,&nbsp;Teresa Blázquez-Sánchez ,&nbsp;Cristina Gómez-Moreno ,&nbsp;Iván Ferraz-Amaro ,&nbsp;Javier Llorca ,&nbsp;Miguel A González-Gay","doi":"10.1016/j.semarthrit.2025.152758","DOIUrl":"10.1016/j.semarthrit.2025.152758","url":null,"abstract":"<div><h3>Background</h3><div>Assessing disease activity in systemic lupus erythematosus (SLE) is essential for effective treatment. SLEDAI-2 K uses dichotomous items, while SLE-DAS incorporates both dichotomous and continuous variables,</div></div><div><h3>Objectives</h3><div>To analyze the correlation between SLEDAI-2 K and SLE-DAS in SLE patients from central Spain and analyze factors leading to discordance in disease activity classification.</div></div><div><h3>Methods</h3><div>Retrospective assessment of 324 SLE patients followed up from 2010 to 2024 at Madrid's Fundación Jiménez Díaz Hospital (Spain). Data were collected from the patients' most recent visits and disease activity was evaluated using SLEDAI-2 K and SLE-DAS, and discordant classifications between the tools were analyzed.</div></div><div><h3>Results</h3><div>The number of patients in each disease activity category was as follows: Remission (Clinical SLEDAI-2 <em>K</em> = 0, <em>n</em> = 254 [78.4 %] vs. clinical SLE-DAS =0, regardless of serology, and prednisone up to 5 mg/day, <em>n</em> = 253 [78.3 %]); Low activity (SLEDAI-2 K 1–4 and prednisone dose ≤ 5 mg/day, <em>n</em> = 42 [13.0 %] vs. SLE-DAS &gt;0 and ≤ 2.48 with prednisone dose ≤ 7.5 mg/day, <em>n</em> = 14 [4.3 %]); Mild activity (SLEDAI-2 K 1–4 and prednisone dose &gt; 5 mg/day or score 5–6, <em>n</em> = 19 [5.9 %] vs. SLE-DAS &gt;0 and ≤ 2.48 with prednisone dose &gt; 7.5 mg/day or score &gt;2.48 and ≤7.64, <em>n</em> = 46 [14.2 %]); Moderate (SLEDAI-2 K 7–12 <em>n</em> = 7 [2.2 %] vs. SLE-DAS &gt;7.64 and ≤9.9,<em>n</em> = 3 [0.9 %]); Severe SLEDAI-2 <em>K</em> &gt; 12 (<em>n</em> = 2 [0.6 %] vs. SLE-DAS &gt;9.9,<em>n</em> = 7 [2.2 %]). SLEDAI-2 K and SLE-DAS showed strong correlation (ρ=0.970, <em>p</em> &lt; 0.001), with high concordance (linearly weighted Kappa index=0.7715, <em>p</em> &lt; 0.001). Forty-four patients were discordant in terms of disease activity categorization. Of these, 39 were discordant at only one level of disease activity. Notably, in 37 of the 44 cases, SLE-DAS classified patients as having a higher degree of disease activity compared to SLEDAI-2 K. Patients with skin and hematological manifestations were more commonly discordant in terms of disease activity.</div></div><div><h3>Conclusion</h3><div>SLEDAI-2 K and SLE-DAS demonstrate a strong correlation and high reproducibility for assessing disease activity in the Spanish population. However, SLE-DAS offers additional information, particularly in patients with hematologic and skin involvement, enabling a more precise evaluation of disease activity in SLE patients</div></div>","PeriodicalId":21715,"journal":{"name":"Seminars in arthritis and rheumatism","volume":"73 ","pages":"Article 152758"},"PeriodicalIF":4.6,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144105724","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":"Infectious complications of Belimumab with standard care in systemic lupus erythematosus: a systematic review and meta-analysis","authors":"Yu Zhao ,&nbsp;Gerald Chi ,&nbsp;Shujun Xia ,&nbsp;Xinchang Wang ,&nbsp;Yongsheng Fan ,&nbsp;Chenhang Ma ,&nbsp;James Cheng-Chung Wei ,&nbsp;Weijie Wang","doi":"10.1016/j.semarthrit.2025.152754","DOIUrl":"10.1016/j.semarthrit.2025.152754","url":null,"abstract":"<div><h3>Objectives</h3><div>We aimed to evaluate the risk of infectious complications of Belimumab with standard care in systemic lupus erythematosus (SLE).</div></div><div><h3>Methods</h3><div>We searched PubMed, Web of Science, EMBASE, and Cochrane databases for studies on SLE and Belimumab and evaluated the study quality using the Cochrane Collaboration tool (ROB 2). A random-effect model was employed to analyze the results. To evaluate publication bias, Egger's tests were used. We also performed subgroup analysis based on the Systemic Lupus Erythematosus Disease Activity Index (SLEDAI) and British Isles Lupus Assessment Group(BILAG). The study protocol has been registered in PROSPERO (CRD42023421255).</div></div><div><h3>Results</h3><div>Eight studies involving 8545 patients were included, of which four studies had a high attrition bias. The present study suggested that the risks of infectious complications including infection (RR=1.02, 95 %CI=(0.97,1.08), I²=7.7 %) or serious infections (RR=0.94, 95 %CI=(0.77,1.15), I²=0 %), nasopharyngitis(RR=1.02, 95 %CI=(0.79,1.33), I²=36 %), upper respiratory tract infection(RR=0.97, 95 %CI=(0.83,1.14), I²=20.6 %), urinary tract infection(RR=1.09, 95 %CI=(0.91,1.32), I²=0 %), herpes zoster (RR=0.75, 95 %CI=(0.54,1.05), I²=0 %)and influenza(RR=0.98, 95 %CI=(0.69,1.39), I²=0 %) were not significantly increased in patients who received Belimumab with standard care, except for bronchitis (RR=1.51, 95 %CI=(0.98,2.33), I²=23.7 %). Additionally, the subgroup analysis of SLEDAI and the proportion of patients with BILAG 1A/2B did not show any significant impact on infectious complications.</div></div><div><h3>Conclusion</h3><div>Meta-analysis results demonstrated that intravenous (IV) Belimumab(≤10 mg/kg), along with standard care, did not significantly increase the risk of infectious complications in SLE patients having mild-to-moderate disease activity, except for bronchitis. Baseline disease activity and organ damage did not impact the risk of infectious complications.</div></div>","PeriodicalId":21715,"journal":{"name":"Seminars in arthritis and rheumatism","volume":"73 ","pages":"Article 152754"},"PeriodicalIF":4.6,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144105722","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}