Zeitschrift fur Rheumatologie最新文献

{"title":"[Update: DMARDs for MGUS].","authors":"Patrick-Pascal Strunz, Marc Schmalzing","doi":"10.1007/s00393-026-01836-y","DOIUrl":"10.1007/s00393-026-01836-y","url":null,"abstract":"","PeriodicalId":23834,"journal":{"name":"Zeitschrift fur Rheumatologie","volume":" ","pages":"648-650"},"PeriodicalIF":1.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148278731","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy and safety of pharmacological treatment for Sjögren's disease: a network meta-analysis.","authors":"Meilv Yang, Yang Lu, Shengnan Wang, Suxian Lin","doi":"10.1007/s00393-026-01824-2","DOIUrl":"10.1007/s00393-026-01824-2","url":null,"abstract":"<p><strong>Background: </strong>Sjögren's disease (SjD) is an autoimmune disease characterized by symptoms such as dry mouth and dry eyes, with potential involvement of multiple organ systems. We aimed to evaluate the efficacy and safety of oral pharmacotherapy for SjD through a network meta-analysis (NMA).</p><p><strong>Methods: </strong>PubMed, Embase, Cochrane Library, and Web of Science were searched for randomized controlled trials (RCTs) up to 9 January 2025. The Cochrane Risk of Bias Tool 2.0 was used to estimate the quality of the studies. Bayesian NMA was implemented utilizing the GEMTC package in R (version 4.5.0) to compare the results. Effect sizes were reported as mean differences (MD) or risk ratios (RR) with 95% credible intervals (CrI). Statistical significance was set at P < 0.05. Funnel plots were generated utilizing Stata 18.0 to evaluate publication bias.</p><p><strong>Results: </strong>We included 27 RCTs involving 2261 participants. Compared to the placebo (PBO) group, iscalimab (MD = -3.4, 95% CrI:-5.2,-1.6), dazodalibep (MD = -2.2, 95% CrI:-3.86,-0.53), iguratimod (MD = -1.85, 95% CrI:-2.63,-1.07), remibrutinib (MD = -2.86, 95% CrI:-4.92, -0.8), leflunomide + hydroxychloroquine (MD = -4.31, 95% CrI: -7.66, -0.94), ianalumab (MD = -1.85, 95% CrI: -3.64, -0.06), and filgotinib (MD = -1.2, 95% CrI: -1.55, -0.85) significantly reduced the European League Against Rheumatism (EULAR) Sjögren's Syndrome Disease Activity Index (ESSDAI) score. Additionally, no marked distinctions were detected between oral pharmacotherapy and PBO in the EULAR Sjögren's Syndrome Patient-Reported Index (ESSPRI) score, adverse events, or serious adverse events.</p><p><strong>Conclusion: </strong>Compared to PBO, iscalimab, dazodalibep, iguratimod, remibrutinib, leflunomide + hydroxychloroquine, ianalumab, and filgotinib significantly reduced the ESSDAI score, with no distinctions in the ESSPRI score. No significant differences in safety profiles were fond between any drugs and PBO.</p>","PeriodicalId":23834,"journal":{"name":"Zeitschrift fur Rheumatologie","volume":" ","pages":"632-641"},"PeriodicalIF":1.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147869616","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Methodological concerns and data discrepancies in the indirect treatment comparison of belimumab and anifrolumab.","authors":"Kai Wai Lee, Becky Hooper, Jason Steenkamp, Ian N Bruce","doi":"10.1007/s00393-026-01838-w","DOIUrl":"10.1007/s00393-026-01838-w","url":null,"abstract":"","PeriodicalId":23834,"journal":{"name":"Zeitschrift fur Rheumatologie","volume":" ","pages":"673-674"},"PeriodicalIF":1.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13649833/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148303296","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mitteilungen der DGRh - Veranstaltungen der Rheumaakademie.","authors":"","doi":"10.1007/s00393-026-01874-6","DOIUrl":"https://doi.org/10.1007/s00393-026-01874-6","url":null,"abstract":"","PeriodicalId":23834,"journal":{"name":"Zeitschrift fur Rheumatologie","volume":"85 8","pages":"687"},"PeriodicalIF":1.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149138370","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mitteilungen der DRL.","authors":"","doi":"10.1007/s00393-026-01883-5","DOIUrl":"https://doi.org/10.1007/s00393-026-01883-5","url":null,"abstract":"","PeriodicalId":23834,"journal":{"name":"Zeitschrift fur Rheumatologie","volume":"85 8","pages":"688"},"PeriodicalIF":1.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149138354","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Management of emergencies in rheumatology].","authors":"Philine Ritter, Stefan M Weiner","doi":"10.1007/s00393-026-01867-5","DOIUrl":"10.1007/s00393-026-01867-5","url":null,"abstract":"<p><p>Emergencies in rheumatology can present with a wide range of symptoms and findings, often requiring rapid diagnostics and treatment to prevent permanent damage or avert life-threatening conditions. This article aims to provide an overview of important differential diagnoses that should be considered in rheumatologic and/or immunosuppressed patients presenting in an emergency setting. It covers conditions such as septic arthritis, giant cell arteritis, acute adrenal insufficiency, the differential diagnosis of respiratory symptoms and acute kidney injury, macrophage activation syndrome, and catastrophic antiphospholipid syndrome. In this article, the clinical presentation, diagnostic approach, and acute management of these conditions are discussed and explained.</p>","PeriodicalId":23834,"journal":{"name":"Zeitschrift fur Rheumatologie","volume":" ","pages":"620-631"},"PeriodicalIF":1.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149017831","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Enterococcal pyomyositis in a rheumatoid arthritis patient under biologic therapy.","authors":"Dilara Bulut Gökten, Rıdvan Mercan","doi":"10.1007/s00393-026-01784-7","DOIUrl":"10.1007/s00393-026-01784-7","url":null,"abstract":"<p><p>Pyomyositis is an uncommon bacterial infection of skeletal muscle, typically associated with tropical regions but increasingly reported in temperate climates among immunocompromised individuals. Staphylococcus aureus is the most frequently identified pathogen, whereas enterococcal pyomyositis is exceedingly rare. This report describes a case of Enterococcus faecalis pyomyositis in a patient with long-standing rheumatoid arthritis (RA) receiving combined immunosuppressive therapy. The 62-year-old woman with an 8‑year history of RA presented with a 2-month history of progressive right shoulder pain, swelling, fever, and chills. She had been treated with methotrexate, adalimumab, and low-dose corticosteroids. Laboratory evaluation revealed marked leukocytosis and significantly elevated inflammatory markers. Contrast-enhanced magnetic resonance imaging demonstrated a large multiloculated abscess involving the perihumeral muscles. Surgical drainage was performed, and cultures grew Enterococcus faecalis. The patient showed rapid clinical and laboratory improvement following appropriate antibiotic therapy. This case represents the second reported instance of enterococcal pyomyositis in a patient with RA. The findings highlight the potential cumulative immunosuppressive effect of combined disease-modifying antirheumatic drugs and corticosteroids as a predisposing factor. Clinicians should maintain a high index of suspicion for rare but serious infections such as pyomyositis in immunosuppressed patients presenting with focal muscle pain and systemic symptoms, as early diagnosis and prompt intervention are crucial for favorable outcomes.</p>","PeriodicalId":23834,"journal":{"name":"Zeitschrift fur Rheumatologie","volume":" ","pages":"651-654"},"PeriodicalIF":1.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146087449","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating the comparative efficacy of belimumab vs. anifrolumab in systemic lupus erythematosus: a response.","authors":"Young Ho Lee","doi":"10.1007/s00393-026-01837-x","DOIUrl":"10.1007/s00393-026-01837-x","url":null,"abstract":"","PeriodicalId":23834,"journal":{"name":"Zeitschrift fur Rheumatologie","volume":" ","pages":"675-676"},"PeriodicalIF":1.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148303253","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Rheuma-VOR-Health economic evaluation of early rheumatological diagnosis : Summary of the G-BA report].","authors":"Juliana Rachel Hoeper, Matthias Dreher, Julian Maximilian Kohl, Marlon Grodd, Johanna Callhoff, Andreas Schwarting, Jan Zeidler","doi":"10.1007/s00393-026-01858-6","DOIUrl":"10.1007/s00393-026-01858-6","url":null,"abstract":"<p><strong>Background: </strong>Rheuma-VOR was initiated to reduce long waiting times for specialist diagnosis and guideline-based therapy initiation in rheumatoid arthritis (RA), psoriatic arthritis (PsA), and axial spondyloarthritis (axSpA).</p><p><strong>Methods: </strong>Rheuma-VOR is a prospective, nonrandomized, multicenter network study with an embedded health economic evaluation. Using a quasi-experimental cohort design and propensity score matching, the intervention group (Rheuma-VOR) was compared with standard care (national database). Direct costs (medications, hospital, and rehabilitation) and indirect costs (productivity losses) were analyzed from a societal perspective.</p><p><strong>Results: </strong>Rheuma-VOR achieved total savings of € 3.84 million versus standard care, mainly due to fewer hospitalizations (-€ 1.15 million), reduced drug costs (-€ 2.03 million), and improved work capacity (-€ 0.70 million indirect costs). Fewer biologics were prescribed (2.4 % vs. 11.8 %). The model demonstrated a dominant cost-effectiveness profile: similar or better health-related quality of life at lower total costs (Rheuma-VOR: € 2,445.17/patient, 95 % confidence interval [CI] € 1,955.79-€ 3,041.50; standard care: € 3,107.33/patient, 95% CI € 1,958.28-€ 3,997.62). Annual coordination center costs (€ 272.35/patient) were fully offset by savings.</p><p><strong>Conclusion: </strong>Structured, cross-sectoral care models like Rheuma-VOR reduce diagnostic delays, optimize resource use, and are economically sustainable. Long-term benefits include additional savings through prevention of irreversible damage.</p>","PeriodicalId":23834,"journal":{"name":"Zeitschrift fur Rheumatologie","volume":" ","pages":"595-607"},"PeriodicalIF":1.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13649902/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149002331","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[How often do patients with Sjögren's syndrome fulfil the activity criteria for immunomodulatory treatment?]","authors":"K Karberg, C Fiebig, J Amann, C Kreiter, T Sahr, J Braun","doi":"10.1007/s00393-026-01880-8","DOIUrl":"https://doi.org/10.1007/s00393-026-01880-8","url":null,"abstract":"<p><strong>Background: </strong>Sjögren's disease belongs to the group of collagenoses, it is characterized by xerophthalmia and xerostomia and typically shows autoimmune phenomena in laboratory test parameters (mostly specific antibodies against cytoplasmic ribonucleoprotein complexes). So far there is no approved immunomodulatory treatment for Sjögren's disease but that may soon change.</p><p><strong>Aims and methods: </strong>Patients with Sjögren's disease were prospectively and consecutively included in a descriptive single-center study to be assessed with the EULAR Sjögren's disease activity index (ESSDAI) and the EULAR Sjögren's disease patient reported index (ESSPRI).</p><p><strong>Results: </strong>Within a time period of 20 weeks during the first months of 2026 a total of 70 patients with Sjögren's disease were documented (62 with primary Sjögren's disease) of whom 68 fulfilled the classification criteria for Sjögren's disease (97%). The mean age was 60.5 years (range 24-84 years), 98% were female and the mean duration of sicca symptoms was 9.7±8.2 years (range 1-25 years). Almost two thirds of the patients regularly used eyedrops and 25% were treated with hydroxychloroquine and 12% with methotrexate. The mean ESSPRI score was 5.4 and the mean ESSDAI was 9.7 points. In the former the focus was on the sicca symptoms (6.3), followed by tiredness (5.7) and pain (5). For the ESSDAI joint pain (63%) was most frequently reported, followed by gland-related (43%), constitutional symptoms (13%) and lymphadenopathy (8%), whereas for laboratory parameters biological (44%) and hematological (15%) abnormalities were reported. Overall, 42 patients had an ESSPRI score ≥5 (60.0%) and 34 had an ESSDAI score ≥5 (48.6%). Only 13 female patients had a score ≤5 in both ESSDAI and ESSPRI (18.6%). Of the patients 20 (28.6%) had an ESSPRI score ≥5 and an ESSDAI score ≥5.</p><p><strong>Discussion: </strong>This observational study shows that a not insubstantial number of patients with Sjögren's disease would fulfil the criteria for immunomodulatory treatment.</p>","PeriodicalId":23834,"journal":{"name":"Zeitschrift fur Rheumatologie","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149115594","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}