Therapeutic Advances in Musculoskeletal Disease最新文献

{"title":"Double positivity for anti-dsDNA and anti-Sm antibodies represents higher disease activity in systemic lupus erythematosus.","authors":"Lin Zhang, Lei Zhang, Shanshan Chen, Zhichun Liu, Leixi Xue","doi":"10.1177/1759720X251379588","DOIUrl":"https://doi.org/10.1177/1759720X251379588","url":null,"abstract":"<p><strong>Background: </strong>Several studies have shown that anti-dsDNA and anti-Sm antibodies not only contribute to the classification of systemic lupus erythematosus (SLE) but also strongly correlate with disease activity. However, the relationship between double positivity for anti-dsDNA and anti-Sm antibodies and disease activity remains unclear.</p><p><strong>Objectives: </strong>This study aimed to assess the clinical significance of double positivity for anti-dsDNA and anti-Sm antibodies in SLE.</p><p><strong>Design: </strong>A single-center retrospective study was conducted, consecutively enrolled hospitalized patients with SLE who underwent anti-dsDNA and anti-Sm antibody testing between June 2009 and December 2022.</p><p><strong>Methods: </strong>In this study, clinical data were collected from the electronic medical records of all study participants. SLE Disease Activity Index 2000 (SLEDAI 2000) scores were calculated; SLEDAI 2000 scores excluding anti-dsDNA scores were defined as modified SLEDAI 2000 (mSLEDAI 2000) scores. Severe disease activity was defined as a SLEDAI 2000 score of >12.</p><p><strong>Results: </strong>The study included 408 patients with SLE; of them, 95 were double-positive for anti-dsDNA and anti-Sm antibodies, 193 were single-positive for anti-dsDNA or anti-Sm antibodies, and 120 were double-negative. The double-positive group showed more clinical manifestations, lower C3 and C4 levels, and higher SLEDAI 2000 and mSLEDAI 2000 scores compared to the double-negative and single-positive groups. During follow-up, double-positive patients, whether converted to single-positive or double-negative, showed a significant decrease in SLEDAI 2000 and mSLEDAI 2000 scores, but the improvement in SLEDAI 2000 scores was not significant in patients with persistent double positivity. In recognizing severe disease activity, double positivity had the highest specificity, positive predictive value, positive likelihood ratio, and highest Youden index, albeit with the lowest sensitivity, compared to anti-dsDNA positivity, anti-Sm positivity, and positivity for anti-dsDNA and/or anti-Sm antibodies. Furthermore, a higher proportion of patients with double positivity were treated with high-dose or shock-dose glucocorticoids.</p><p><strong>Conclusion: </strong>Double positivity for anti-dsDNA and anti-Sm antibodies suggests higher disease activity in patients with SLE who may require more intense immunosuppressive therapy.</p>","PeriodicalId":23056,"journal":{"name":"Therapeutic Advances in Musculoskeletal Disease","volume":"17 ","pages":"1759720X251379588"},"PeriodicalIF":4.1,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12501451/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145252821","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Therapeutic strategy in psoriatic arthritis: choosing the right treatment for the right patient.","authors":"George E Fragoulis, Sizheng Steven Zhao","doi":"10.1177/1759720X251383084","DOIUrl":"10.1177/1759720X251383084","url":null,"abstract":"","PeriodicalId":23056,"journal":{"name":"Therapeutic Advances in Musculoskeletal Disease","volume":"17 ","pages":"1759720X251383084"},"PeriodicalIF":4.1,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12489188/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145233404","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of thoracic vertebrae and L1 CT attenuation in predicting osteoporosis using opportunistic chest CT.","authors":"Lilan Wu, Shunfa Huang, Liling Xu, Shengxiang Rao, Zhen Qian, Mengze Zhang, Ying Yuan, Jianjun Zhou","doi":"10.1177/1759720X251374134","DOIUrl":"10.1177/1759720X251374134","url":null,"abstract":"<p><strong>Background: </strong>Since dual-energy x-ray absorptiometry (DXA) is currently the most commonly used reference standard, most previous studies using computed tomography (CT) attenuation values to predict osteoporosis have chosen abdominal CT images. A few studies have investigated whether the thoracic vertebrae can be independently used for the identification of osteoporosis compared to the lumbar vertebrae.</p><p><strong>Objective: </strong>To investigate whether the attenuation values of thoracic vertebrae measured using artificial intelligence (AI) on chest CT would independently predict osteoporosis identification, considering central DXA as a reference standard.</p><p><strong>Design: </strong>This was a cross-sectional study.</p><p><strong>Methods: </strong>A total of 553 participants (353 men and 200 women) who underwent chest CT and DXA within 1 day were included. The attenuation values (HU) of the T7-12 vertebrae and L1 vertebra were obtained by AI. The effects of the clinical baseline data and attenuation values among the normal, osteopenia, and osteoporosis groups were compared. The correlation between attenuation and bone mineral density (BMD) values was analyzed, and the diagnostic performance of thoracic and first lumbar vertebrae attenuation values for diagnosing osteopenia or osteoporosis was further explored.</p><p><strong>Results: </strong>The CT attenuation values of T7-12 and L1 vertebrae showed positive correlation with <i>T</i>-score (<i>R</i> = 0.58-0.61, <i>p</i> < 0.01). T12 attenuation >184.8 HU was 84.1% sensitive and 70.6% specific for distinguishing normal BMD, while T12 attenuation <146.2 HU was 61.4% specific and 75.6% sensitive for distinguishing osteoporosis from osteopenia. There were no significant differences between the T10-12 and L1 groups in distinguishing the normal, osteopenia, and osteoporosis groups. Moreover, the diagnostic efficacy among the T10, T11, T12, and L1 vertebral bodies was not statistically significantly different among the three groups.</p><p><strong>Conclusion: </strong>Opportunistic screening is a valid method for predicting osteopenia or osteoporosis. As a rapid and effective tool, T10-12 vertebral attenuation measures can be incorporated to predict osteoporosis and identify patients who may benefit from further investigations using DXA based on routine clinical chest CT examinations.</p>","PeriodicalId":23056,"journal":{"name":"Therapeutic Advances in Musculoskeletal Disease","volume":"17 ","pages":"1759720X251374134"},"PeriodicalIF":4.1,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12432313/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145065521","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between impaired lung function and risk of spondyloarthritis: a cross-sectional study in the UK Biobank.","authors":"Ying Zhu, Zijian Kang, Chen Zhu, Dajiang Du, Jianzheng Zhang, Qiang Tong","doi":"10.1177/1759720X251371112","DOIUrl":"10.1177/1759720X251371112","url":null,"abstract":"<p><strong>Background: </strong>Impaired lung function has been noted in individuals with spondyloarthritis (SpA). However, a comprehensive summary of the existing evidence related to these conditions is still lacking.</p><p><strong>Objective: </strong>The aim of the study is to explore the association between impaired lung function and the prevalence and incidence of SpA, utilizing data from the UK Biobank.</p><p><strong>Methods: </strong>A total of 411,780 participants with complete spirometry data were included in the study. Logistic regression and Cox regression models were employed to investigate the association between impaired lung function and the prevalence/incidence of SpA. In addition, restricted cubic spline (RCS) analysis was applied to evaluate the nonlinear relationships between forced expiratory volume in 1 s (FEV1) and/or forced vital capacity of the predicted value and SpA incidence.</p><p><strong>Design: </strong>A cross-sectional study was conducted by using UK Biobank data from 411,780 participants with complete lung function records and HLA-B27 genotype. In addition, a prospective cohort of 409,069 individuals without baseline SpA and lost follow-up was followed longitudinally to assess incident SpA risk.</p><p><strong>Result: </strong>The prevalence of SpA was significantly higher in individuals with preserved ratio impaired spirometry (PRISm) compared to those with normal spirometry, as evidenced by adjusted odds ratio (OR; 95% confidence interval (CI)) of 1.538 (1.409-1.680) for SpA. Over a median follow-up period of 14.64 years, 1637 participants (0.40%, 1637/409,069) developed SpA, with PRISm associated with an elevated risk for incident SpA (adjusted hazard ratio (95% CI): 1.249 (1.098-1.420)) when compared to normal spirometry. Furthermore, RCS analysis revealed a nonlinear relationship between FEV1 %pred and the risk of developing SpA (overall <i>p</i> < 0.001 and nonlinear <i>p</i> = 0.011).</p><p><strong>Conclusion: </strong>The study unveiled a significant association between impaired lung function and the prevalence of SpA. Individuals with PRISm may have an elevated risk of incident SpA.</p>","PeriodicalId":23056,"journal":{"name":"Therapeutic Advances in Musculoskeletal Disease","volume":"17 ","pages":"1759720X251371112"},"PeriodicalIF":4.1,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12402665/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144993372","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness of high-frequency repetitive transcranial magnetic stimulation combined with quadriceps strength training in the treatment of knee osteoarthritis: a randomized controlled trial.","authors":"Yifan Wang, Wei Feng, Kun Yang, Yuwu Ding, Bitao Ma, Liming Jiang","doi":"10.1177/1759720X251370979","DOIUrl":"10.1177/1759720X251370979","url":null,"abstract":"<p><strong>Background: </strong>Knee osteoarthritis (KOA) is associated with decreased quadriceps strength and decreased activation of central motor cortex. It is necessary to investigate intervention strategies that combine central and peripheral treatments.</p><p><strong>Objective: </strong>To assess the effectiveness of high-frequency repetitive transcranial magnetic stimulation (rTMS) in conjunction with quadriceps strength training for 12 weeks in the treatment of KOA.</p><p><strong>Design: </strong>Prospective, randomized, single-blind, comparative effectiveness study.</p><p><strong>Methods: </strong>In this 12-week randomized controlled clinical trial, 48 eligible patients were randomly allocated to either an experimental group or a control group. The experimental group underwent high-frequency rTMS in conjunction with quadriceps strength training, whereas the control group received sham rTMS alongside quadriceps strength training. The primary outcome measure was the visual analog scale (VAS), while secondary outcome measures included the University of Western Ontario and McMaster University Osteoarthritis Index (WOMAC), the peak torque of the extensor muscles, the peak torque of the flexor muscles, and the flexion-extension ratio. A two-way repeated measures analysis of variance with group as a group factor and time factor was used to calculate the effects of the interventions on all outcome measures.</p><p><strong>Results: </strong>Forty-four of the 48 patients who were allocated at random finished the study. Twelve weeks later, the VAS index in the experimental group decreased from 3.14 ± 1.13 to 1.36 ± 0.85, and that in the control group decreased from 3.23 ± 1.15 to 2.18 ± 1.40 (<i>p</i> < 0.05). At the same time, the WOMAC score, the peak torque of the extensor muscles, the peak torque of the flexor muscles, and the flexion-extension ratio were improved in the two groups (<i>p</i> < 0.05), and the experimental group was significantly better than the control group (<i>p</i> < 0.05).</p><p><strong>Conclusion: </strong>High-frequency rTMS combined with quadriceps strength training for 12 weeks can effectively improve pain, muscle strength and joint function in patients with KOA.</p><p><strong>Trial registration: </strong>Chinese Clinical Trial Registry (https://www.chictr.org.cn/) ChiCTR2300067617.</p>","PeriodicalId":23056,"journal":{"name":"Therapeutic Advances in Musculoskeletal Disease","volume":"17 ","pages":"1759720X251370979"},"PeriodicalIF":4.1,"publicationDate":"2025-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12399846/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144993292","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Orthopaedic physicians' awareness, diagnostic challenges and referral barriers in axial spondyloarthritis: insights from a nationwide survey in Germany.","authors":"Fabian Proft, Angela Patricia Moissl, Natalia Kirsten, Alexander Pfeil, David Simon, Igor Bibi, Victor Olsavszky, Anastasia Fleyder, Marina Otten, Milena Pachowsky, Jan Leipe","doi":"10.1177/1759720X251360162","DOIUrl":"10.1177/1759720X251360162","url":null,"abstract":"<p><strong>Background: </strong>Axial spondyloarthritis (axSpA) is a chronic inflammatory disease primarily affecting the spine and sacroiliac joints, potentially leading to pain, stiffness and disability. Despite diagnostic advances, delays persist. Orthopaedic physicians, often the first specialists consulted for back pain, play a crucial role in early detection and referral to rheumatologists.</p><p><strong>Objectives: </strong>To evaluate orthopaedic physicians' awareness and management of axSpA and factors that might affect appropriate management.</p><p><strong>Design: </strong>An online nationwide survey was conducted among orthopaedic physicians in Germany to assess their axSpA knowledge, diagnostic and therapeutic practices and referral behaviours.</p><p><strong>Methods: </strong>Descriptive statistics were used to summarize participant characteristics and management practices. Machine learning and subgroup analyses identified factors influencing clinical practices.</p><p><strong>Results: </strong>Among 103 orthopaedic physicians (mean age 49.2 ± 11.4 years; 46.6% female), 48.5% practised in both conservative and surgical settings, and 20% held additional qualifications in orthopaedic rheumatology. While 92% regularly treated chronic back pain, only 11.0% estimated the prevalence of inflammatory back pain (IBP) at ⩾5%. Human leucocyte antigen (HLA)-B27 testing was always used by 17.5%, magnetic resonance imaging (MRI) by 14.6% and IBP classification criteria by 22.5%. Nonsteroidal anti-inflammatory drugs were the most common treatment (77%), while 72.1% never used biological disease-modifying antirheumatic drugs. Digital health applications were rarely recommended (14.6%). The majority of physicians (63%) directly referred suspected axSpA cases to rheumatologists, 29% collaborated with rheumatologists and 12% managed cases independently. Referral barriers included long waiting times (66%) and limited appointment availability (33%), while timely appointments (59%) and better referral knowledge (58%) facilitated referrals. Higher self-reported axSpA knowledge was associated with attending ⩾2 rheumatology seminars, conservative orthopaedics settings, regular HLA-B27 testing and familiarity with axSpA MRI results.</p><p><strong>Conclusion: </strong>This study reveals substantial opportunities to improve axSpA awareness, management and referrals among orthopaedic physicians. Targeted education and streamlined referral systems, including easier access to rheumatology appointments, could enable earlier diagnosis and better axSpA management.</p>","PeriodicalId":23056,"journal":{"name":"Therapeutic Advances in Musculoskeletal Disease","volume":"17 ","pages":"1759720X251360162"},"PeriodicalIF":4.1,"publicationDate":"2025-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12394871/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144970076","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The genetics of gout: translation into clinical practice.","authors":"Tony R Merriman, Fiorella Rosas-Chavez, Lisa K Stamp","doi":"10.1177/1759720X251366360","DOIUrl":"10.1177/1759720X251366360","url":null,"abstract":"<p><p>Gout results from an innate immune response to monosodium urate crystals deposited in joints in people with hyperuricemia. Central to this is activation of the NLRP3 inflammasome and secretion of interleukin-1β. The pathogenic mechanism of NLRP3 inflammasome activation in gout is not well understood. However, recent genome-wide association studies (GWAS) in gout have revealed new pathogenic pathways, for example, genes involved in NLRP3 inflammasome activation and activity, and genes involved in clonal hematopoiesis of indeterminate potential. Genetic risk variants identified by GWAS are being used in Mendelian randomization studies to understand putative causal relationships between gout and co-morbid conditions (e.g., insulin resistance is causal of hyperuricemia). The genetic risk variants can also be combined into a genetic risk score to predict outcome in gout. Finally, inherited genetic variants influence response to allopurinol, in particular the p.Gln141Lys variant in ABCG2.</p>","PeriodicalId":23056,"journal":{"name":"Therapeutic Advances in Musculoskeletal Disease","volume":"17 ","pages":"1759720X251366360"},"PeriodicalIF":4.1,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12378317/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144970142","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A systematic literature review of the impact and measurement of mobility impairment in rare bone diseases.","authors":"Inês Alves, Ingunn Westerheim, Edward C Hsiao, Jaymin Upadhyay, Luca Sangiorgi, Alexander Artyomenko, Kim Croskery, Juliet Johns, Emma Warnants, Gabor Barton","doi":"10.1177/1759720X251369963","DOIUrl":"10.1177/1759720X251369963","url":null,"abstract":"<p><strong>Background: </strong>Although rare bone diseases (RBDs) present mobility challenges, there is little consolidated evidence on evaluated mobility measurement tools or how mobility impairments impact daily activities and quality of life (QoL).</p><p><strong>Objectives and design: </strong>This systematic literature review investigated: (1) the impacts of mobility impairment on daily activities/QoL; (2) the suitability/comprehensiveness of tools measuring mobility.</p><p><strong>Data sources and methods: </strong>MEDLINE/Embase databases (January 19, 2022) and Google (October 19, 2022) were searched for articles published between 2011 and 2022; conference proceedings from 2020 to 2021 were hand-searched. Included articles reported on how mobility impairments impact daily activities/QoL, or the use of tools for measuring mobility, in RBDs. A narrative analysis using descriptive statistics was conducted. Studies were assessed for risk of bias using The Alberta Heritage Foundation for Medical Research Quality Assessment Criteria and National Institute of Health Quality Assessment Tool for Case Series Studies.</p><p><strong>Results: </strong>Inclusion criteria were met by 113 articles, investigating 39 RBDs (sample sizes: <i>N</i> = 1-959). Mobility impairments, commonly joint function/gait disturbances, negatively impacted daily activities (<i>n</i> = 47 cohorts; frequently walking (27/47; 57.4%)) and QoL (<i>n</i> = 36 cohorts; commonly pain (30/36; 83.3%; Objective 1). There were 34 functional assessments, 22 questionnaires, and 5 technologies described. Only nine functional assessments/questionnaires were reported to have good validity/reliability/responsiveness for an RBD (not reported for technologies); none comprehensively captured daily living/QoL impacts of mobility impairment. The quality of studies was moderate, though many were case studies/series, which are at inherent risk of bias.</p><p><strong>Conclusion: </strong>Few tools comprehensively captured mobility impairments and associated impacts on daily activities/QoL. Consistent reporting of tools' validity/reliability/responsiveness would support clinicians in selecting methods for use across RBD populations. Used remotely, wearables could support understanding of real-world mobility challenges. Since searches were conducted, additional technologies (e.g., remote gait analysis) have been tested in RBDs, although validation is required.</p><p><strong>Protocol prospero registration: </strong>CRD42022311513. Sponsored by Ipsen.</p>","PeriodicalId":23056,"journal":{"name":"Therapeutic Advances in Musculoskeletal Disease","volume":"17 ","pages":"1759720X251369963"},"PeriodicalIF":4.1,"publicationDate":"2025-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12374048/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144970098","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cardio-rheumatology: integrated care and the opportunities for personalized medicine.","authors":"Tania Ruiz Maya, Ashley Ciosek, Tracy Frech, Genessis Maldonado, Kevin Myers, Erin Chew, Justin Baba, Anthony Donato, Deepak Gupta, Laura Ross","doi":"10.1177/1759720X251357188","DOIUrl":"10.1177/1759720X251357188","url":null,"abstract":"<p><p>While severe vasculopathic manifestations of systemic sclerosis (SSc) are well-recognized, characterization of subclinical progressive vasculopathy contributing to cardiac involvement remains an unmet clinical need. This review highlights the evolving understanding of SSc heart involvement (SHI), including current standard clinical cardiac evaluation methods, prevalence of various cardiac manifestations of SHI, and advances at the forefront of precision medicine. Informed by this growing body of literature, we describe the development of a novel interdisciplinary cardio-rheumatology clinic at the Vanderbilt University Medical Center. Utilizing advances in imaging techniques and systemic retrieval and analysis of complex data sets, our dedicated cardio-rheumatology clinic offers opportunities for therapeutic advances and personalized medicine through mechanistic disease phenotyping in SSc. Nailfold capillaroscopy, thermography, and hand ultrasound with Doppler are acquired to characterize small vessel vasculopathy, while echocardiogram, ambulatory cardiac rhythm monitoring, cardiac magnetic resonance imaging, and cardiac positron emission tomography/computed tomography are utilized to characterize cardiac disease. By correlating vasculopathy imaging with cardiac manifestations, our cardio-rheumatology clinic aims to identify patients with SSc who would benefit from additional cardiac investigation even in the absence of cardiac symptomatology. This interdisciplinary collaboration may allow earlier detection of primary SHI, which is a common cause of death in SSc patients, resulting from both morpho-functional and electrical cardiac abnormalities. Our shared model of care and robust data acquisition facilitate clinical investigation by utilizing technological advances in data management. Using deep learning and pattern recognition, artificial intelligence (AI) offers opportunities to integrate data from imaging and monitoring techniques outlined in this report to provide quantifiable markers of disease progression and treatment efficacy. Given the potential for extensive AI data processing but the low prevalence of SSc, developing a multicenter cloud-based image sharing platform would accelerate clinical investigation in the field. Ultimately, we aim to tailor therapeutic decisions and risk mitigation strategies to improve SSc patient outcomes.</p>","PeriodicalId":23056,"journal":{"name":"Therapeutic Advances in Musculoskeletal Disease","volume":"17 ","pages":"1759720X251357188"},"PeriodicalIF":4.1,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12319188/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144785387","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between cumulative TNF inhibitor dose and spinal radiographic progression in radiographic axial spondyloarthritis in patients with modified stoke ankylosing spondylitis spinal score ⩽24.","authors":"Tae-Hwan Kim, Seo Young Park, Ji Hui Shin, Seunghun Lee, Kyung Bin Joo, Bon San Koo","doi":"10.1177/1759720X251358022","DOIUrl":"10.1177/1759720X251358022","url":null,"abstract":"<p><strong>Background: </strong>Tumor necrosis factor inhibitors (TNFi) effectively manage radiographic axial spondyloarthritis (SpA), and dose reduction is often used for stable patients. However, its long-term impact on radiographic progression remains unclear.</p><p><strong>Objective: </strong>To analyze the correlation between cumulative TNFi dose and radiographic progression in radiographic axial SpA.</p><p><strong>Design: </strong>Single-center retrospective chart review.</p><p><strong>Methods: </strong>Electronic medical records of patients with radiographic axial SpA from January 2001 to December 2018 were screened. The TNFi percentage dose was calculated as the total prescribed dose divided by the standard dose at 2-year intervals. The relationship between TNFi percentage dose and modified Stokes Ankylosing Spondylitis Spinal Score (mSASSS) changes was assessed using linear mixed models, separated into three baseline mSASSS groups: mSASSS ⩽24, mSASSS >24 to ⩽48, and mSASSS >48.</p><p><strong>Results: </strong>In the initial linear mixed model, radiographic progression, defined as the change in mSASSS over 2-year intervals, was examined in three baseline mSASSS groups. In the baseline mSASSS ⩽24 group, the cumulative TNFi dose showed a negative correlation with radiographic progression (β = -0.888, 95% confidence interval (CI): -1.793 to 0.017, <i>p</i> = 0.055). In the group with 24 < baseline mSASSS ⩽ 48, a positive but nonsignificant association was observed (β = 1.688, 95% CI: -2.119 to 5.495, <i>p</i> = 0.379). Similarly, for the baseline mSASSS >48 group, no significant correlation was found (β = 0.182, 95% CI: -0.832 to 1.196, <i>p</i> = 0.715). In the multivariable model of the baseline mSASSS ⩽24 group adjusted for age and sex, the cumulative TNFi dose was negatively correlated with the mSASSS change (beta = -1.871, 95% CI: -1.871 to -0.059, <i>p</i> = 0.037).</p><p><strong>Conclusion: </strong>In patients with radiographic axial SpA and baseline mSASSS ⩽24, the cumulative TNFi dose was negatively correlated with radiographic progression. Maintaining a standard TNFi dose may slow the progression of spinal structural changes in early stage SpA.</p>","PeriodicalId":23056,"journal":{"name":"Therapeutic Advances in Musculoskeletal Disease","volume":"17 ","pages":"1759720X251358022"},"PeriodicalIF":4.1,"publicationDate":"2025-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12304511/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144745133","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}