Seminars in arthritis and rheumatism最新文献

{"title":"Healthy dietary pattern and risk of rheumatoid arthritis: A systematic review and meta-analysis","authors":"Elena K Joerns ,&nbsp;Jeffrey A Sparks ,&nbsp;Cynthia J Chelf ,&nbsp;Cynthia S Crowson ,&nbsp;John M Davis III ,&nbsp;Vanessa L Kronzer","doi":"10.1016/j.semarthrit.2025.152825","DOIUrl":"10.1016/j.semarthrit.2025.152825","url":null,"abstract":"<div><h3>Objectives</h3><div>We aimed to determine <strong>the degree to which a healthy dietary pattern is associated with incident rheumatoid arthritis (RA)</strong>.</div></div><div><h3>Methods</h3><div>We registered this systematic review and meta-analysis in PROSPERO (CRD42025645056). Inclusion criteria were validated diet (anti-inflammatory, Mediterranean, Dietary Approaches to Stop Hypertension (DASH), and/or healthy eating index [HEI]); validated RA definition; dietary exposure preceding RA; and randomized controlled trial, cohort, or case-control design. We searched CENTRAL, Embase, MEDLINE, Scopus, Web of Science, and grey literature as of 2/3/2025. We assessed risk of bias using the Newcastle-Ottawa Scale. Meta-analyses combined adjusted odds ratios (OR) with 95 % confidence interval (CI) for incident RA using random effects models. For heterogeneity, we calculated <em>I</em>² and performed subgroup analyses. We assessed certainty of evidence using GRADE.</div></div><div><h3>Results</h3><div>We included 12 case-control and cohort studies (8 of which were independent) in the review. Three studies were low risk of bias, 3 moderate, 3 high, and 3 very high. Healthy overall dietary pattern was associated with lower risk of incident RA (OR 0.54, 95 % CI 0.32–0.91, <em>I</em>²=81 %). Including only studies with the lowest risk of bias was also associated with lower RA risk (OR 0.84, 95 % CI 0.76–0.94, <em>I</em>²=0 %). Anti-inflammatory (OR 0.56, 95 % CI 0.31–0.99), Mediterranean (OR 0.88, 95 % CI 0.78–0.99), and HEI (OR 0.60, 95 % CI 0.25–1.47) patterns all showed lower point estimates for RA. Overall level of certainty in these results was moderate due to the studies’ observational nature.</div></div><div><h3>Conclusions</h3><div>In observational studies, healthy dietary pattern is associated with reduced risk of incident RA.</div></div>","PeriodicalId":21715,"journal":{"name":"Seminars in arthritis and rheumatism","volume":"74 ","pages":"Article 152825"},"PeriodicalIF":4.4,"publicationDate":"2025-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144996664","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":"MRI versus radiography as eligibility screening tool for knee osteoarthritis clinical trials: Data from the osteoarthritis initiative","authors":"Ali Guermazi ,&nbsp;Frank W Roemer ,&nbsp;Erin L Ashbeck ,&nbsp;John Lynch ,&nbsp;C. Kent Kwoh ,&nbsp;Mohamed Jarraya","doi":"10.1016/j.semarthrit.2025.152818","DOIUrl":"10.1016/j.semarthrit.2025.152818","url":null,"abstract":"<div><h3>Objective</h3><div>To estimate the prevalence of knee structural pathologies that may warrant exclusion from disease-modifying osteoarthritis drug (DMOAD) trials, based on MRI versus radiography, among participants who would otherwise be considered eligible for enrollment based on commonly used radiographic inclusionary criteria.</div></div><div><h3>Methods</h3><div>We selected participants from the baseline visit of the Osteoarthritis Initiative that met radiographic structural and clinical eligibility criteria for a DMOAD clinical trial: Radiographic OA (Kellgren-Lawrence grade 2 or 3 with medial minimum joint space width ≥ 1.5 mm); and WOMAC knee pain score between 8 and 18 (0–20 scale). A musculoskeletal radiologist read radiographs and a shortened 3-T MRI protocol for structural pathologies that have been suggested as exclusionary from DMOAD clinical trial participation, as proposed by the Rapid Osteoarthritis MRI Eligibility Score (ROAMES), including meniscal root tears, subchondral insufficiency fractures, osteonecrosis, tumors and bone marrow infiltration, and acute traumatic changes.</div></div><div><h3>Results</h3><div>Among 380 eligible participants (219 KL2 knees, 161 KL3 knees), structural pathologies that warrant exclusion from clinical trials were found in 38 knees (10 %) based on MRI, versus three knees (0.8 %) on radiography. Based on MRI, the estimated probability of an exclusionary finding in a KL2 knee was 0.06 (95 %CI: 0.03, 0.09), and 0.16 (95 %CI: 0.10, 0.21) in a KL3 knee. The most common finding was complete meniscus posterior root tear (31 knees, 8.2 %).</div></div><div><h3>Conclusion</h3><div>Structural pathologies that are unlikely to respond to investigational DMOADs were found in ∼10 % of eligible participants based on MRI screening, largely driven by complete meniscal root tears, while these findings were not visible on radiographs.</div></div>","PeriodicalId":21715,"journal":{"name":"Seminars in arthritis and rheumatism","volume":"74 ","pages":"Article 152818"},"PeriodicalIF":4.4,"publicationDate":"2025-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144996663","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":"Item selection for the development and validation of a revised classification criteria for adult and juvenile idiopathic inflammatory myopathies: MyoROC project","authors":"Didem Saygin ,&nbsp;Rachel Zeng ,&nbsp;Stefanie Glaubitz ,&nbsp;Matteo Bottai ,&nbsp;Anthony A. Amato ,&nbsp;Lorenzo Cavagna ,&nbsp;Sonye K. Danoff ,&nbsp;Marianne de Visser ,&nbsp;Mazen M. Dimachkie ,&nbsp;Manabu Fujimoto ,&nbsp;Masataka Kuwana ,&nbsp;Pedro M. Machado ,&nbsp;Merrilee Needham ,&nbsp;Clarissa Pilkington ,&nbsp;Liza Rajasekhar ,&nbsp;Lisa G. Rider ,&nbsp;Yasser Salem ,&nbsp;Samuel Katsuyuki Shinjo ,&nbsp;Jasvinder A. Singh ,&nbsp;Mohammed Tikly ,&nbsp;Ingrid E. Lundberg","doi":"10.1016/j.semarthrit.2025.152822","DOIUrl":"10.1016/j.semarthrit.2025.152822","url":null,"abstract":"<div><h3>Objective</h3><div>A revision of the 2017 EULAR-ACR myositis classification criteria, namely EULAR-ACR funded Myositis Revision of Classification (MyoROC) project, is currently underway involving a large international group of experts. In the first phase of this project, we identified additional items to be tested in the criteria.</div></div><div><h3>Methods</h3><div>We distributed an electronic survey to International Myositis Assessment and Clinical Studies (IMACS) members to identify new items. The identified items were discussed within the Steering Committee and a multi-step Delphi consensus process consisting of an open discussion and three rounds of e-voting were conducted to reach the final item list.</div></div><div><h3>Results</h3><div>The IMACS survey results revealed 24 new items. After an open discussion with Steering Committee members, 14 items were dropped and five new items were added, resulting in a total of 15 items. After three rounds of e-voting, the following variables were agreed to be tested in addition to the original items: finger flexion, knee extension ≥ hip flexion weakness, myonecrosis pattern on biopsy, magnetic resonance imaging and electromyography findings of myositis, additional rashes, skin biopsy, capillaroscopy, interstitial lung disease, arthritis, Raynaud’s phenomenon, myositis-specific (MSA) and -associated autoantibodies, enzyme elevation at ≥2 time points, and aldolase.</div></div><div><h3>Conclusion</h3><div>The new items that will be tested in the revised criteria were generated with input from a wide range of stakeholders and included, most importantly, MSA, pattern of weakness, skin changes, and additional diagnostic modalities. The next steps of the project are data collection followed by statistical analysis for development and validation of the revised criteria.</div></div>","PeriodicalId":21715,"journal":{"name":"Seminars in arthritis and rheumatism","volume":"74 ","pages":"Article 152822"},"PeriodicalIF":4.4,"publicationDate":"2025-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144925749","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":"Serological clusters in systemic lupus erythematosus and its clinical and prognostic implications: A longitudinal cohort study","authors":"Oihane Ibarguengoitia-Barrena ,&nbsp;Leyre Riancho-Zarrabeitia ,&nbsp;Zulema Plaza ,&nbsp;Íñigo Rúa-Figueroa ,&nbsp;Karen Roberts ,&nbsp;Víctor Martínez-Taboada ,&nbsp;Raúl Menor-Almagro ,&nbsp;Belén Serrano-Benavente ,&nbsp;Paula Rubio-Muñoz ,&nbsp;María Galindo-Izquierdo ,&nbsp;Antonio Fernández-Nebro ,&nbsp;M.E. Ruiz-Lucea ,&nbsp;Jaime Calvo-Alén ,&nbsp;Eva G. Tomero-Muriel ,&nbsp;Esther Uriarte-Isacelaya ,&nbsp;Angela Pecondon-Españo ,&nbsp;Mercedes Freire ,&nbsp;Javier García-Fernández ,&nbsp;Lorena Expósito ,&nbsp;Mónica Ibañez-Barceló ,&nbsp;José M. Pego-Reigosa","doi":"10.1016/j.semarthrit.2025.152819","DOIUrl":"10.1016/j.semarthrit.2025.152819","url":null,"abstract":"<div><h3>Introduction</h3><div>Systemic lupus erythematosus (SLE) is a heterogeneous autoimmune disorder characterized by multi-organ involvement and variable clinical manifestations. Recurrent clinical patterns suggest distinct phenotypes, where cluster analysis of autoantibodies could identify prognostic subtypes.</div></div><div><h3>Objectives</h3><div>To define and describe serological clusters and their clinical-epidemiological characteristics, as well as their association with comorbidities, disease activity measures, severity, and damage.</div></div><div><h3>Materials and methods</h3><div>Descriptive, observational, and multicenter study including SLE patients from the Spanish Registry RELESSER. Gower distance was used for cluster analysis.</div></div><div><h3>Results</h3><div>A total of 1,740 patients from the cross-sectional phase and 718 from the prospective phase with a four-year follow-up were included. Four serological clusters were identified. Cluster 1 (negative for extractable nuclear antigen [ENA]) was characterized by a lower frequency of vasculitis, leukopenia, and lymphopenia. Cluster 2 (positive antiphospholipid antibodies) more frequently presented haemolytic anaemia, thrombocytopenia, vasculitis and visual alterations and required greater use of immunoglobulins and oral anticoagulants. Cluster 3 (positive anti-SSA/Ro and anti-SSB/La) had a lower incidence of lupus nephritis. Cluster 4 (positive anti-Sm and anti-ribonucleoproteins) was characterized by higher rates of lupus nephritis, leukopenia, lymphopenia, hypocomplementemia, myositis and cutaneous manifestations and greater use of glucocorticoids and immunosuppressants. Patients in cluster 2 had higher baseline damage scores measured by the SLICC/ACR DI (Systemic Lupus International Collaborating Clinics/American College of Rheumatology Damage Index), while patients in cluster 4 had higher severity scores measured by the Katz Index. These differences among clusters persisted over the four-year of follow-up.</div></div><div><h3>Conclusion</h3><div>In our SLE patient population, the serological profile is key not only for clinical stratification but also for prognostic value.</div></div>","PeriodicalId":21715,"journal":{"name":"Seminars in arthritis and rheumatism","volume":"74 ","pages":"Article 152819"},"PeriodicalIF":4.4,"publicationDate":"2025-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144988124","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":"Physical activity in patients with Sjögren’s disease: Compliance with World Health Organization recommendations and relationship with health-related quality of life","authors":"Noa S. Ausma ,&nbsp;Daphne H. Harmsen ,&nbsp;Marlies J.G. Carbo ,&nbsp;Davy Paap ,&nbsp;Hendrika Bootsma ,&nbsp;Suzanne Arends","doi":"10.1016/j.semarthrit.2025.152820","DOIUrl":"10.1016/j.semarthrit.2025.152820","url":null,"abstract":"<div><h3>Objective</h3><div>Physical activity (PA) can be beneficial for disease-related outcomes. Our aim was to investigate the types of PA performed, how many patients complied with the World Health Organization (WHO) PA recommendations and the association of PA levels with health-related quality of life (HR-QoL) in patients with Sjögren’s disease (SjD).</div></div><div><h3>Methods</h3><div>Consecutive patients from the RESULT cohort were included. The modified Short QUestionnaire to ASsess Health enhancing physical activity (mSQUASH) was used to determine the types of PA and compliance with WHO PA recommendations, consisting of aerobic PA (≥150 min), muscle strengthening (≥2 times/week) and functional balance (≥3 times/week) components. The associations between PA and HR-QoL (SF-36 domains) were analyzed using linear regression.</div></div><div><h3>Results</h3><div>245 SjD patients were included. Most frequently reported PA were household activities (91 %), walking (88 %) and cycling (62 %). Sports and exercise were performed by 55 % of patients; most often fitness, physiotherapy/sport, group lessons, swimming and yoga. In total, 92 % of patients fulfilled the aerobic PA component, 31 % the muscle strengthening component and 7 % the functional balance component. mSQUASH scores showed significant associations with SF-36 domain scores, with the strongest association for physical functioning (R² = 0.19) and role limitations due to physical health (R² = 0.17). These associations remained significant after correcting for age, sex, BMI, ESSPRI, ESSDAI and current immunosuppressive medication use.</div></div><div><h3>Conclusion</h3><div>Almost all patients with SjD performed aerobic PA, but patients could integrate more muscle strengthening and functional balance activities according to the WHO PA recommendations. Higher levels of PA were significantly associated with better HR-QoL.</div></div>","PeriodicalId":21715,"journal":{"name":"Seminars in arthritis and rheumatism","volume":"74 ","pages":"Article 152820"},"PeriodicalIF":4.4,"publicationDate":"2025-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144931883","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":"Entheseal structural damage according to OMERACT definitions unveils distinct ultrasound phenotypes in SpA: findings from the DEUS multicentre study","authors":"Stefano Di Donato ,&nbsp;Gianluca Smerilli ,&nbsp;Andrea Becciolini ,&nbsp;Federica Camarda ,&nbsp;Alberto Cauli ,&nbsp;Tomás Cazenave ,&nbsp;Edoardo Cipolletta ,&nbsp;Davide Corradini ,&nbsp;Juan Jose de Agustin de Oro ,&nbsp;Giulia Maria Destro Castaniti ,&nbsp;Eleonora Di Donato ,&nbsp;Emine Duran ,&nbsp;Bayram Farisogullari ,&nbsp;Marco Fornaro ,&nbsp;Francesca Francioso ,&nbsp;Pamela Giorgis ,&nbsp;Amelia Granel ,&nbsp;Cristina Hernandez Diaz ,&nbsp;Rudolf Horvath ,&nbsp;Jana Hurnakova ,&nbsp;Andrea Di Matteo","doi":"10.1016/j.semarthrit.2025.152823","DOIUrl":"10.1016/j.semarthrit.2025.152823","url":null,"abstract":"<div><h3>Objectives</h3><div>To explore the prevalence and distribution of ultrasound-detected lesions indicating structural damage at the enthesis (e.g., bone erosions, enthesophytes, and calcifications) in patients with spondyloarthritis (SpA), comparing those with axial spondyloarthritis (axSpA) and psoriatic arthritis (PsA), and to investigate the demographic, clinical, and metabolic factors linked to these lesions.</div></div><div><h3>Methods</h3><div>A cross-sectional analysis was conducted using data from the DEUS study, a multicentre investigation involving 20 rheumatology centres and including 413 patients with SpA (224 with axSpA and 189 with PsA). All participants underwent standardized clinical and ultrasound assessment of the large lower limb entheses (quadriceps tendon, proximal and distal patellar tendons, Achilles tendon, and plantar fascia). Entheseal structural lesions were explored by ultrasound and classified according to OMERACT definitions. Bivariate analyses and multivariate logistic regression were used to assess associations between ultrasound lesions and SpA patients’ characteristics.</div></div><div><h3>Results</h3><div>In SpA patients, enthesophytes were the most common lesion (78.7 %), followed by calcifications (43.6 %) and bone erosions (24.9 %). Enthesophytes were more prevalent in PsA (86.8 %) compared to axSpA (71.9 %) (<em>p</em> &lt; 0.001), with no significant differences in erosions and calcifications. However, lesion distribution varied across different entheses.</div><div>Multivariate analysis revealed that entheseal erosions were significantly associated with inflammatory markers, HLA-B27 positivity, clinical enthesitis, and longer disease duration. Enthesophytes were significantly linked to PsA, psoriasis, clinical enthesitis, and longer disease duration. Calcifications were positively associated with hypertension, metabolic syndrome, and obesity. All lesions were associated with biologic DMARD use.</div></div><div><h3>Conclusions</h3><div>This study reveals a high prevalence of ultrasound-detected structural damage at the enthesis and identifies distinct SpA phenotypes based on these findings.</div></div>","PeriodicalId":21715,"journal":{"name":"Seminars in arthritis and rheumatism","volume":"74 ","pages":"Article 152823"},"PeriodicalIF":4.4,"publicationDate":"2025-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144996665","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":"Optimising fibromyalgia criteria: evidence from the UK Biobank","authors":"Jungwoo Kang ,&nbsp;Kate A Timmins ,&nbsp;Marcus Beasley","doi":"10.1016/j.semarthrit.2025.152824","DOIUrl":"10.1016/j.semarthrit.2025.152824","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate the performance of the 2016 revisions to the modified fibromyalgia criteria (FM2016) in identifying individuals with self-reported fibromyalgia in a large population sample, and to test whether simplified symptom thresholds and alternative definitions of widespread pain improve case-finding utility.</div></div><div><h3>Methods</h3><div>We used data from 167,184 UK Biobank participants who completed an “Experience of Pain” online questionnaire. Logistic regression and clinical utility indices (CUI+ and CUI−) were used to assess the performance of the FM2016 criteria and alternative modifications in case-finding and screening self-reported fibromyalgia diagnoses. Cut-off combinations for the scales of the FM2016, the Widespread Pain Index (WPI), Symptom Severity Scale (SSS), and the Polysymptomatic Distress Scale (PSD) were iteratively optimised. We also compared different definitions of widespread pain, including a single self-reported item on “pain all over the body”.</div></div><div><h3>Results</h3><div>The FM2016 criteria showed high specificity (98·4 %) but low sensitivity (37·0 %) and case-finding utility (CUI+=0·111). A simplified set of criteria, WPI≥4, SSS≥4, and PSD≥12, conditional on self-reported chronic pain all over the body, improved case-finding utility (CUI+=0·163) while maintaining high screening ability (CUI−=0·974). Other definitions of widespread pain performed less well.</div></div><div><h3>Conclusion</h3><div>In this large population-based study, simplified criteria incorporating a single question on widespread pain and easier-to-apply symptom cut-offs performed marginally better in identifying those with a diagnosis of FM.</div></div>","PeriodicalId":21715,"journal":{"name":"Seminars in arthritis and rheumatism","volume":"74 ","pages":"Article 152824"},"PeriodicalIF":4.4,"publicationDate":"2025-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144988074","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 subtypes in rheumatoid arthritis","authors":"Tate M. Johnson ,&nbsp;Yangyuna Yang ,&nbsp;Punyasha Roul ,&nbsp;Halie Frideres ,&nbsp;Joshua F. Baker ,&nbsp;Brian C. Sauer ,&nbsp;Grant W. Cannon ,&nbsp;Gary A. Kunkel ,&nbsp;Kaveh R. Bookani ,&nbsp;Ted R. Mikuls ,&nbsp;Bryant R. England","doi":"10.1016/j.semarthrit.2025.152816","DOIUrl":"10.1016/j.semarthrit.2025.152816","url":null,"abstract":"<div><h3>Objective</h3><div>Evaluate the risk and temporal trends of heart failure (HF) with preserved (HFpEF) and reduced ejection fraction (HFrEF) in rheumatoid arthritis (RA).</div></div><div><h3>Methods</h3><div>We performed a retrospective, matched cohort study using Veterans Health Administration (VHA) administrative and health record data from 2000 to 2019. Patients with RA were matched up to 10 non-RA controls on age, sex, and VHA enrollment year. Incident HF and HF-related death were queried, classifying HFpEF and HFrEF using left ventricular EF data from a validated natural language processing tool. HF risk was evaluated using conditional Cox regression, adjusting for demographics, body mass index, smoking, rurality, healthcare utilization, and comorbidity burden. Trends in HF risk were evaluated, stratifying models by RA diagnosis period (2000-2005, 2006-2011, 2012-2017).</div></div><div><h3>Results</h3><div>We matched 67,850 patients with RA (mean age 62.5, 87.1 % male) to 570,933 non-RA controls (mean age 61.1, 85.8 % male). HF prevalence increased in both groups over time. Over 5,663,151 person-years of follow-up, 77,440 incident HF diagnoses occurred. RA was associated with an increased risk of HFpEF (aHR 1.51, 95 % CI 1.46-1.57) and HFpEF-related death (2.05, 1.76-2.39), as well as HFrEF (1.34, 1.30-1.38) and HFrEF-related death (1.45, 1.29-1.63). HF risk was accentuated in RA patients with elevated inflammation and seropositive RA. No improvements in HF risk were observed over time (linear p-for-trend &gt;0.05 for all outcomes).</div></div><div><h3>Conclusion</h3><div>RA was most strongly associated with HFpEF and HFpEF-related death in this national-level, observational dataset. Heightened risks of HF subtypes have not improved despite advances in RA treatment. Prospective research is needed to support the development ofprevention and management strategies to mitigate HF risk in RA.</div></div>","PeriodicalId":21715,"journal":{"name":"Seminars in arthritis and rheumatism","volume":"74 ","pages":"Article 152816"},"PeriodicalIF":4.4,"publicationDate":"2025-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144885398","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":"Longitudinal changes on cranial magnetic resonance imaging in relapsing giant cell arteritis","authors":"Ruoheng Zeng ,&nbsp;Ryan Rebello ,&nbsp;Konstanze V. Guggenberger ,&nbsp;Joshua F. Baker ,&nbsp;Shubhasree Banerjee ,&nbsp;Robert Kurtz ,&nbsp;Naomi Amudala ,&nbsp;Peter A. Merkel ,&nbsp;Rennie L. Rhee","doi":"10.1016/j.semarthrit.2025.152815","DOIUrl":"10.1016/j.semarthrit.2025.152815","url":null,"abstract":"<div><h3>Objective</h3><div>There is a need for better tools to monitor disease activity in giant cell arteritis (GCA). Prior studies demonstrated that vascular enhancement on cranial vessel wall magnetic resonance imaging (vw-MRI) decreases with treatment of GCA, but whether enhancement increases during relapse is not well known. This study examined changes on vw-MRI during relapse of cranial GCA.</div></div><div><h3>Methods</h3><div>Patients with active GCA acquired cranial vw-MRIs at enrollment and months 1, 6, and 12 and if suspected relapse occurred. Neuroradiologists graded vw-MRI enhancement for several structures. Changes in MRI scores were compared with clinically-determined disease activity and acute phase reactants (APR).</div></div><div><h3>Results</h3><div>Fourteen patients with GCA were included: 4 patients experienced a cranial or ocular relapse; 2 patients experienced a relapse with polymyalgia rheumatica (PMR) without cranial symptoms; and 8 patients were in sustained remission. All 4 patients who experienced cranial or ocular relapse had increased vw-MRI enhancement in at least one cranial structure. Two patients experiencing relapse of PMR had persistent but not increased enhancement, while 7 of 8 patients in sustained remission had decreased or normal enhancement on follow-up. Cranial structures that showed increased enhancement at relapse included the occipital artery, optic nerve sheath, and maxillary artery. APR levels remained normal in most relapses, likely impacted by use of tocilizumab.</div></div><div><h3>Conclusion</h3><div>During relapse of cranial GCA, increased contrast enhancement of cranial structures is observed on vw-MRI even when APR levels remained normal. These data offer proof-of-concept that vw-MRI has potential for longitudinal disease monitoring of GCA.</div></div>","PeriodicalId":21715,"journal":{"name":"Seminars in arthritis and rheumatism","volume":"74 ","pages":"Article 152815"},"PeriodicalIF":4.4,"publicationDate":"2025-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144885399","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":"Concordance of relapse symptoms in patients with giant cell arteritis","authors":"Max Guarda ,&nbsp;Andrew C. Hanson ,&nbsp;Hannah E. Langenfeld ,&nbsp;Cynthia S. Crowson ,&nbsp;Jigisha Rakholiya ,&nbsp;Cristian Labarca ,&nbsp;Cornelia M. Weyand ,&nbsp;Kenneth J. Warrington ,&nbsp;Matthew J. Koster","doi":"10.1016/j.semarthrit.2025.152814","DOIUrl":"10.1016/j.semarthrit.2025.152814","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate concordance of symptoms between initial presentation, first relapse, and second relapse in patients with giant cell arteritis (GCA).</div></div><div><h3>Methods</h3><div>We analyzed three GCA cohorts: a 286-patient biopsy-proven cohort treated without tocilizumab (C1), a 110-patient biopsy-negative cohort treated without tocilizumab (C2), a 114-patient biopsy- or imaging-proven cohort that was treated with tocilizumab (C3), and an aggregate of these three cohorts (C4). We calculated odds ratios and conditional probabilities to evaluate concordance of symptoms from baseline presentation features to first relapse, baseline presentation to second relapse, and first relapse to second relapse.</div></div><div><h3>Results</h3><div>The study included a total of 510 patients (C4) diagnosed with GCA who were followed for a median of 5.3 (inter-quartile range: 3.1–8.7) years. Overall, 303 patients experienced at least 1 relapse (5-year first relapse rate 66%; 95% confidence interval [CI]: 60–70%) and 160 experiencing at least 2 relapses (5-year second relapse rate: 36%; 95% CI: 31–41%). Approximately 20% of patients relapsed with a symptom category that was absent at baseline. Baseline large vessel (LV) involvement provided higher risk of LV involvement on first and second relapse. Risk of visual symptoms on either first or second relapse was high if present at a previous stage, but low if either cranial or visual symptoms were absent at a previous stage.</div></div><div><h3>Conclusion</h3><div>Patients and providers should be educated on the spectrum of GCA symptoms to be aware of, even beyond those present at a patient’s initial presentation.</div></div>","PeriodicalId":21715,"journal":{"name":"Seminars in arthritis and rheumatism","volume":"74 ","pages":"Article 152814"},"PeriodicalIF":4.4,"publicationDate":"2025-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144907777","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}