Seminars in arthritis and rheumatism最新文献

{"title":"Personalised treatment of rheumatoid arthritis based on cytokine profiles and synovial tissue signatures: potentials and challenges","authors":"Jérôme Avouac ,&nbsp;Jonathan Kay ,&nbsp;Ernest Choy","doi":"10.1016/j.semarthrit.2025.152740","DOIUrl":"10.1016/j.semarthrit.2025.152740","url":null,"abstract":"<div><h3>Background</h3><div>Rheumatoid arthritis (RA) is an autoimmune, chronic inflammatory disease that mainly affects the joints and periarticular soft tissues. Although there have been significant advances in RA treatment over the past two decades, approximately 40% of patients do not respond to first-line biological disease-modifying antirheumatic drugs (bDMARDs). Physicians often use an empirical, trial-and-error approach to select bDMARDs to treat patients with RA. This is inefficient and can be costly for healthcare systems which have limited resources. Unlike in oncology, where molecular pathology helps guide targeted therapies, reliable, predictive biomarkers for drug response in RA are yet to be identified. This narrative review aims to summarise current knowledge on novel biomarkers of disease activity and drug response in RA, with a particular focus on serum cytokine profiles and macrophage and fibroblast subsets in synovial tissue. We also highlight key areas of further research that could advance the development of targeted therapies for patients with RA.</div></div><div><h3>Methods</h3><div>We searched PubMed to identify studies pertaining to biomarkers of disease activity and drug response in the treatment of RA.</div></div><div><h3>Results</h3><div>We present a detailed overview of the key studies that have identified serum cytokine profiles and synovial macrophage and fibroblast subsets as novel biomarkers of disease activity and drug response in RA.</div></div><div><h3>Conclusion</h3><div>A novel, evidence-based approach to precision medicine in RA, which involves tailoring treatment based on cytokine profiles and synovial tissue signatures, shows promise for improving patient care. However, more research is needed to identify biomarkers that predict drug response.</div></div>","PeriodicalId":21715,"journal":{"name":"Seminars in arthritis and rheumatism","volume":"73 ","pages":"Article 152740"},"PeriodicalIF":4.6,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143911600","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":"Expanding the role of mycophenolic acid in pediatric lupus nephritis: A holistic approach to extrarenal findings, side effects, and long-term outcomes","authors":"Seher Sener","doi":"10.1016/j.semarthrit.2025.152733","DOIUrl":"10.1016/j.semarthrit.2025.152733","url":null,"abstract":"","PeriodicalId":21715,"journal":{"name":"Seminars in arthritis and rheumatism","volume":"73 ","pages":"Article 152733"},"PeriodicalIF":4.6,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143899454","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":"Non-TNFi biologic and targeted synthetic DMARDs in rheumatoid arthritis-associated interstitial lung disease: A propensity score-matched, active-comparator, new-user study","authors":"Halie Frideres ,&nbsp;Christopher S. Wichman ,&nbsp;Jianghu Dong ,&nbsp;Punyasha Roul ,&nbsp;Yangyuna Yang ,&nbsp;Joshua F. Baker ,&nbsp;Michael D. George ,&nbsp;Tate M. Johnson ,&nbsp;Jorge Rojas ,&nbsp;Brian C. Sauer ,&nbsp;Grant W. Cannon ,&nbsp;Scott M. Matson ,&nbsp;Jeffrey R. Curtis ,&nbsp;Ted R. Mikuls ,&nbsp;Bryant R. England","doi":"10.1016/j.semarthrit.2025.152735","DOIUrl":"10.1016/j.semarthrit.2025.152735","url":null,"abstract":"<div><h3>Objectives</h3><div>This study aimed to compare treatment outcomes in rheumatoid arthritis-associated interstitial lung disease (RA-ILD) between initiators of rituximab, abatacept, tocilizumab, and tofacitinib using the Target Trial Emulation Framework.</div></div><div><h3>Methods</h3><div>We emulated three trials comparing abatacept, tocilizumab, and tofacitinib with rituximab (reference). Patients fulfilling validated RA-ILD algorithms initiating one of these non-TNFi b/tsDMARDs were propensity score (PS)-matched (1:1) using national Veterans Affairs (VA) data from 2006 to 2020. PS models included demographics, comorbidities, general health status indicators, and several RA- and ILD-related severity measures. Composite study outcomes were death and respiratory-related hospitalization, ascertained by VA data and linkages to the National Death Index and Medicare, over three-year (primary) and one-year follow-up periods (secondary). Cox regression models were used to analyze study outcomes adjusting for any unbalanced variables. Several sensitivity and subgroup analyses were performed.</div></div><div><h3>Results</h3><div>In the primary cohort, we 1:1 matched abatacept (<em>n</em> = 150), tocilizumab (<em>n</em> = 73), and tofacitinib (<em>n</em> = 94) with equal numbers of rituximab initiators (mean age 68.1–69.4 years, 88–92 % male). There were no significant differences in the primary composite outcome among any of the comparisons (abatacept aHR: 1.03 [0.72, 1.47]; tocilizumab aHR: 1.15 [0.68, 1.93]; tofacitinib aHR: 0.89 [0.54, 1.46]). Secondary, subgroup, and sensitivity analyses supported the main findings.</div></div><div><h3>Conclusions</h3><div>We did not find significant differences in mortality or respiratory hospitalization between RA-ILD patients initiating different non-TNFi b/tsDMARDs, though estimates were imprecise, and residual confounding may be present. These findings emphasize the need for clinical trials of advanced immunomodulatory therapies in RA-ILD.</div></div>","PeriodicalId":21715,"journal":{"name":"Seminars in arthritis and rheumatism","volume":"73 ","pages":"Article 152735"},"PeriodicalIF":4.6,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143864528","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":"Reply to letter to the editor.","authors":"Catherine Deffendall, April Barnado","doi":"10.1016/j.semarthrit.2025.152732","DOIUrl":"https://doi.org/10.1016/j.semarthrit.2025.152732","url":null,"abstract":"","PeriodicalId":21715,"journal":{"name":"Seminars in arthritis and rheumatism","volume":" ","pages":"152732"},"PeriodicalIF":4.6,"publicationDate":"2025-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144015873","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":"Fatigue is common in myositis and is associated with disease activity","authors":"Tissa Bijoy George ,&nbsp;Shiri Keret ,&nbsp;Anjana Chandrasekhara Pillai ,&nbsp;Siamak Moghadam-Kia ,&nbsp;Chester V. Oddis ,&nbsp;Ren Dianxu ,&nbsp;Rohit Aggarwal","doi":"10.1016/j.semarthrit.2025.152730","DOIUrl":"10.1016/j.semarthrit.2025.152730","url":null,"abstract":"<div><h3>Background</h3><div>Fatigue is a prevalent and debilitating symptom frequently reported by patients with idiopathic inflammatory myopathies (IIM). This study investigated the reliability, validity and responsiveness of fatigue in myositis, along with its correlation with disease activity.</div></div><div><h3>Methods</h3><div>Adults with IIM were enrolled in a prospective observational study. Myositis core set measures and functional measures were collected at baseline, 3 months and 6 months, while patient-oriented outcomes were assessed monthly. Fatigue was evaluated using the energy-fatigue average component of the Short Form (SF)-36, and a 10 cm Visual Analog Scale (VAS).</div></div><div><h3>Results</h3><div>Fifty patients (60 % females, 94 % Caucasian) with a mean age of 51.6 ± 14.9 years were enrolled. The majority of patients reported moderate to severe fatigue (67 % based on fatigue VAS and 52 % through the energy-fatigue average)<strong>.</strong> Both fatigue measures showed strong test-retest reliability. Moderate to strong baseline association, along with a longitudinal correlation, was demonstrated between fatigue and various myositis outcome measures, encompassing both muscle and extra muscular disease, physician global assessment, pain, physical function, and quality of life measures. Fatigue significantly improved with improvement in myositis disease activity as assessed by 2016 ACR/EULAR response criteria as well as physician and patient-reported assessments of change in disease activity.</div></div><div><h3>Conclusion</h3><div>Fatigue is common in myositis, and demonstrates favorable psychometric properties including reliability, validity and responsiveness. Fatigue improves in conjunction with improvement in disease activity and should be regarded as an integral component of disease activity in both clinical trials and practice.</div></div>","PeriodicalId":21715,"journal":{"name":"Seminars in arthritis and rheumatism","volume":"73 ","pages":"Article 152730"},"PeriodicalIF":4.6,"publicationDate":"2025-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143858802","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":"Reply to: Expanding the role of mycophenolic acid in pediatric lupus nephritis: A holistic approach to extrarenal findings, side effects, and long-term outcomes.","authors":"Lu Zhang, Lizhi Chen, Baojing Liu, Xiaohong Liu, Zhijun Huang, Kejing Tang, Xiaoyun Jiang, Pan Chen","doi":"10.1016/j.semarthrit.2025.152734","DOIUrl":"https://doi.org/10.1016/j.semarthrit.2025.152734","url":null,"abstract":"","PeriodicalId":21715,"journal":{"name":"Seminars in arthritis and rheumatism","volume":" ","pages":"152734"},"PeriodicalIF":4.6,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144024306","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 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;Gregory C. McDermott ,&nbsp;Qianru Zhang ,&nbsp;Sho Fukui ,&nbsp;Minuk Kim ,&nbsp;You-Jung Ha ,&nbsp;Jeong Seok Lee ,&nbsp;Sung Won Lee ,&nbsp;Chan Ho Park ,&nbsp;Ji-Won Kim ,&nbsp;Jang Woo Ha ,&nbsp;Sang Wan Chung ,&nbsp;Eun Ha Kang ,&nbsp;Yeon-Ah Lee ,&nbsp;Yong-Beom Park ,&nbsp;Jung-Yoon Choe ,&nbsp;Eun Young Lee ,&nbsp;Jeffrey A. Sparks","doi":"10.1016/j.semarthrit.2025.152729","DOIUrl":"10.1016/j.semarthrit.2025.152729","url":null,"abstract":"<div><h3>Objective</h3><div>To develop a prediction model for rheumatoid arthritis-associated interstitial lung disease (RA-ILD) progression.</div></div><div><h3>Methods</h3><div>We investigated predictors of RA-ILD progression in the Korean RA-ILD (KORAIL) cohort, a prospective study that enrolled patients with RA meeting ACR/EULAR criteria and ILD on chest computed tomography (CT) scans and followed for 3 years. Pulmonary function tests (PFTs) and chest CT scans were conducted annually. RA-ILD progression was defined as both physiological and radiological worsening, adapted from the 2023 ATS/ERS/JRS/ALAT definition of progressive pulmonary fibrosis. Baseline factors included clinical factors and biomarkers (autoantibodies, inflammatory markers, and pulmonary damage markers).</div></div><div><h3>Results</h3><div>We analyzed 138 RA-ILD patients (mean age 66.4 years, 30.4 % male, 60.1 % usual interstitial pneumonia [UIP] pattern). During a median follow-up of 2.9 years, 34.8 % (<em>n</em> = 48) had RA-ILD progression. Baseline associations with progression included: UIP pattern, ILD extent &gt;10 %, DLCO %pred., anti-cyclic citrullinated peptide (anti-CCP), Krebs von den Lungen-6 (KL-6), and human surfactant protein D. We developed prediction models using UIP pattern, ILD extent, DLCO % pred., and anti-CCP titer with or without serum KL-6 levels. The models had areas under the curve (AUCs) of 0.73 and 0.75, respectively. The high-risk group had a positive predictive value for progression of 85.7 %, while the low-risk group had a negative predictive value of 94.7 %.</div></div><div><h3>Conclusion</h3><div>In this prospective cohort, UIP pattern, ILD extent, lower DLCO, RA disease activity, anti-CCP levels, and pulmonary damage biomarkers were associated with RA-ILD progression. We developed prediction models that may be clinically useful to risk stratify once externally validated.</div></div>","PeriodicalId":21715,"journal":{"name":"Seminars in arthritis and rheumatism","volume":"73 ","pages":"Article 152729"},"PeriodicalIF":4.6,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143877191","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 in psoriatic arthritis: Insights from real-world data and key risk factors","authors":"Amir Haddad ,&nbsp;Nili Stein ,&nbsp;Ilan Feldhamer ,&nbsp;Arnon Dov Cohen ,&nbsp;Walid Saliba ,&nbsp;Devy Zisman","doi":"10.1016/j.semarthrit.2025.152737","DOIUrl":"10.1016/j.semarthrit.2025.152737","url":null,"abstract":"<div><h3>Background</h3><div>Psoriatic arthritis (PsA) is a chronic, heterogeneous inflammatory condition requiring personalized treatment strategies. Biologic therapy switching reflects the disease's dynamic nature and aims to optimize disease control while balancing efficacy, safety, and patient-specific factors.</div></div><div><h3>Objective</h3><div>To analyze real-world switching patterns of biologic disease-modifying antirheumatic drugs (bDMARDs) in PsA patients, identify associated risk factors, and provide insights into predictors of mode-of-action switching.</div></div><div><h3>Methods</h3><div>This retrospective cohort study utilized the Clalit Health Services database (2005–2023), encompassing 9607 PsA patients in Israel. Patients initiating bDMARDs were tracked for therapy switches. Clinical, demographic, and socioeconomic variables were extracted, and statistical analyses compared characteristics between switchers and non-switchers. Patterns of switching were stratified by the number of switches and study periods (2005–2014, 2015–2023).</div></div><div><h3>Results</h3><div>Among 3851 patients initiating bDMARDs, 1848 (48 %) switched therapy at least once. Anti-TNF therapy was the dominant first-line choice, but switching to anti-IL17 therapy became prevalent as the first switch in both single-switch and multi-switch scenarios. Subsequent switches often involved cycling back to anti-TNF or transitioning to other modes of action, such as anti-IL23 or JAK inhibitors. Switching patterns remained consistent across study periods<strong>.</strong> Switchers were more likely to be female (56.5 vs. 50.6 %, <em>p</em> &lt; 0.001), obese (28.1 vs. 22.6 %, <em>p</em> &lt; 0.001), smokers (41.6 vs. 37.1 %, <em>p</em> = 0.005), and from lower socioeconomic backgrounds (34.1 vs 31.4 %, <em>p</em> = 0.04). These factors were all independently associated with switching in mechanism of action on multivariate analysis.</div></div><div><h3>Conclusion</h3><div>Cross class biologic switching is common in PsA management (48 %) and influenced by patient demographics and comorbidities. Switching patterns were consistent across time periods despite expanding therapeutic options.</div></div>","PeriodicalId":21715,"journal":{"name":"Seminars in arthritis and rheumatism","volume":"73 ","pages":"Article 152737"},"PeriodicalIF":4.6,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143855788","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":"Factors associated with thrombosis in Behçet Syndrome: A systematic review and meta-analysis","authors":"Gul Guzelant-Ozkose ,&nbsp;Berna Yurttas ,&nbsp;Sinem Nihal Esatoglu ,&nbsp;Muhlis Cem Ar ,&nbsp;Vedat Hamuryudan ,&nbsp;Gulen Hatemi","doi":"10.1016/j.semarthrit.2025.152736","DOIUrl":"10.1016/j.semarthrit.2025.152736","url":null,"abstract":"<div><h3>Objectives</h3><div>Thrombosis is an important component of vascular involvement in Behçet syndrome (BS). Inflammation seems to be the main cause, while the contribution of factors associated with thrombosis is debated.</div></div><div><h3>Methods</h3><div>We searched PubMed and EMBASE for studies that assessed factors associated with thrombosis in patients with BS. We separately analyzed studies that compared BS patients with thrombosis to BS patients without thrombosis and studies that compared BS patients with thrombosis to non-BS patients with thrombosis. The pooled odds ratios with 95%CI were calculated for binary outcomes and standardized mean differences were calculated for continuous outcomes.</div></div><div><h3>Results</h3><div>A total of 87 factors were compared between BS patients with thrombosis and BS patients without thrombosis in 101 studies. Having a Factor V Leiden mutation increased the risk of thrombosis 2.58 times (95% CI 1.76 to 3.78) among patients with BS. Homocysteine levels and factor VIII levels were also significantly higher among BS patients with thrombosis. There were only 6 studies including 14 factors that compared BS patients with thrombosis to non-BS patients with thrombosis. The frequencies of JAK-2 mutation, activated protein C resistance, levels of tissue plasminogen activator (tPA) and activity of tPA were significantly higher among non-BS patients with thrombosis.</div></div><div><h3>Conclusion</h3><div>Prothrombotic factors do not seem to be the main driver of thrombosis in BS, but may pose an additional risk when present. Screening BS patients with thrombosis for common prothrombotic factors may be reasonable, especially in patients with unusual clinical and demographic features for vascular involvement of BS.</div></div>","PeriodicalId":21715,"journal":{"name":"Seminars in arthritis and rheumatism","volume":"73 ","pages":"Article 152736"},"PeriodicalIF":4.6,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143874148","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":"Advances in immune mediated inflammatory diseases","authors":"Tom W.J. Huizinga ,&nbsp;Reinhard E. Voll","doi":"10.1016/j.semarthrit.2025.152706","DOIUrl":"10.1016/j.semarthrit.2025.152706","url":null,"abstract":"","PeriodicalId":21715,"journal":{"name":"Seminars in arthritis and rheumatism","volume":"72 ","pages":"Article 152706"},"PeriodicalIF":4.6,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143828911","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}