Lancet Rheumatology最新文献

{"title":"The inclusion of Indigenous voices in health research","authors":"Katherine A Collins","doi":"10.1016/S2665-9913(24)00335-7","DOIUrl":"10.1016/S2665-9913(24)00335-7","url":null,"abstract":"","PeriodicalId":48540,"journal":{"name":"Lancet Rheumatology","volume":"7 2","pages":"Pages e75-e76"},"PeriodicalIF":15.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142796396","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Coronary polyarteritis nodosa in a young adult","authors":"Michele Marchini","doi":"10.1016/S2665-9913(24)00397-7","DOIUrl":"10.1016/S2665-9913(24)00397-7","url":null,"abstract":"","PeriodicalId":48540,"journal":{"name":"Lancet Rheumatology","volume":"7 2","pages":"Page e79"},"PeriodicalIF":15.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142967129","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Advancing personalised precision treatment for Still's disease based on molecular characteristics and disease progression","authors":"Yujie Shen MM ,&nbsp;Jinchao Jia MD ,&nbsp;Jialin Teng MD ,&nbsp;Prof Chengde Yang MD ,&nbsp;Qiongyi Hu MD","doi":"10.1016/S2665-9913(24)00225-X","DOIUrl":"10.1016/S2665-9913(24)00225-X","url":null,"abstract":"<div><div>Still's disease, a systemic autoinflammatory disorder with a classic multigenetic background, is characterised by polyarthritis, high-spiking fever, salmon-like evanescent skin rash, and hyperferritinaemia. Although the exact cause of Still's disease remains unclear, it is believed to be influenced by genetic factors, infections, and immune dysregulation. Current studies indicate that neutrophils and macrophages play crucial roles in the pathogenesis of Still's disease, along with involvement of natural killer cells, T cells, and B cells. Advances in biologic agents have expanded treatment strategies beyond conventional approaches, with cytokine-targeted agents showing promise in the management of Still's disease. Some cytokine-targeting biologic agents can be developed based on clinical manifestations, complications, immune cells, and molecular networks. Emphasis of immunophenotyping for precise clinical subtyping and targeted molecular therapies based on these findings is crucial for optimising treatment outcomes. In this Review, we discuss the latest advancements in the understanding of Still's disease pathogenesis and corresponding therapeutic approaches.</div></div>","PeriodicalId":48540,"journal":{"name":"Lancet Rheumatology","volume":"7 2","pages":"Pages e127-e140"},"PeriodicalIF":15.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142478078","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of apremilast on hand and whole-body MRI assessments of inflammation in patients with psoriatic arthritis (MOSAIC): a phase 4, multicentre, single-arm, open-label study","authors":"Prof Mikkel Østergaard MD ,&nbsp;Mikael Boesen MD ,&nbsp;Walter P Maksymowych FRCP ,&nbsp;Robert G Lambert FRCPC ,&nbsp;Michael R Bubb MD ,&nbsp;Olga Kubassova PhD ,&nbsp;Guillermo Valenzuela MD ,&nbsp;Jyotsna Reddy MD ,&nbsp;Stephen Colgan PhD ,&nbsp;Yuri Klyachkin PhD ,&nbsp;Cynthia Deignan PhD ,&nbsp;Zhenwei Zhou PhD ,&nbsp;Hamid Amouzadeh PhD ,&nbsp;Philip J Mease MD","doi":"10.1016/S2665-9913(24)00232-7","DOIUrl":"10.1016/S2665-9913(24)00232-7","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;div&gt;The Psoriatic Arthritis Magnetic Resonance Imaging Scoring System (PsAMRIS) and MRI Whole-Body Scoring System for Inflammation in Peripheral Joints and Entheses in Inflammatory Arthritis (MRI-WIPE) have not been used together to assess treatment of psoriatic arthritis in a clinical trial. We aimed to assess the effect of apremilast treatment on inflammation, with outcomes measured by PsAMRIS and MRI-WIPE.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;MOSAIC was a phase 4, multicentre, single-arm, open-label study conducted at 29 sites across ten countries (Belgium, Canada, Denmark, Germany, Italy, Russia, Spain, Switzerland, the UK, and the USA). Adults aged 18 years or older with a documented diagnosis of psoriatic arthritis for a duration of 3 months to 5 years self-enrolled and were included if they met the classification criteria for active psoriatic arthritis at screening. Patients were required to have at least three swollen and three tender joints with hand involvement and at least one active enthesitis site according to the Spondyloarthritis Research Consortium of Canada enthesitis index or the Leeds enthesitis index. Patients were excluded if they had previous treatment with a biological disease-modifying antirheumatic drug or previous treatment with more than two conventional synthetic disease-modifying antirheumatic drugs. After a 5-day titration period, patients received apremilast 30 mg orally twice per day. Concomitant stable methotrexate up to 25 mg per week was permitted. The primary endpoint was change from baseline to week 24 in a composite inflammation score of bone marrow oedema, synovitis, and tenosynovitis in the hand as assessed by PsAMRIS. The full analysis set and safety population included all enrolled patients who received at least one dose of apremilast. This completed study is registered with &lt;span&gt;&lt;span&gt;ClinicalTrials.gov&lt;/span&gt;&lt;svg&gt;&lt;path&gt;&lt;/path&gt;&lt;/svg&gt;&lt;/span&gt; (&lt;span&gt;&lt;span&gt;NCT03783026&lt;/span&gt;&lt;svg&gt;&lt;path&gt;&lt;/path&gt;&lt;/svg&gt;&lt;/span&gt;).&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Findings&lt;/h3&gt;&lt;div&gt;Between Feb 6, 2019, and May 11, 2022, 123 patients were enrolled in the MOSAIC study. Of these 123 patients, 122 (99%) were treated with apremilast and included in the full analysis set and safety population. 67 (55%) of 122 patients were female, 55 (45%) were male, and 116 (95%) were White. 80 (66%) of 122 patients completed 48 weeks of treatment. The least squares mean change from baseline to week 24 in the composite inflammation score of bone marrow oedema, synovitis, and tenosynovitis as assessed by PsAMRIS was −2·32 (95% CI −4·73 to 0·09). 95 (78%) of 122 patients had at least one treatment-emergent adverse event. Six (5%) patients had a severe treatment-emergent adverse event and six (5%) patients had a serious treatment-emergent adverse event. No serious treatment-emergent adverse events were considered to be related to apremilast.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Interpretation&lt;/h3&gt;&lt;div&gt;Apremilast improved inflammation in joints and entheses on ","PeriodicalId":48540,"journal":{"name":"Lancet Rheumatology","volume":"7 2","pages":"Pages e118-e126"},"PeriodicalIF":15.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142564720","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Research in Brief","authors":"Jennifer Thorley","doi":"10.1016/S2665-9913(25)00003-7","DOIUrl":"10.1016/S2665-9913(25)00003-7","url":null,"abstract":"","PeriodicalId":48540,"journal":{"name":"Lancet Rheumatology","volume":"7 2","pages":"Page e82"},"PeriodicalIF":15.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143128191","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Faecal microbiota transplantation in patients with systemic sclerosis and lower gastrointestinal tract symptoms in Norway (ReSScue): a phase 2, randomised, double-blind, placebo-controlled trial","authors":"Håvard Fretheim PhD ,&nbsp;Imon Barua MD ,&nbsp;Gunnstein Bakland PhD ,&nbsp;Alvilde Dhainaut PhD ,&nbsp;Anne-Kristine Halse PhD ,&nbsp;Maylen N Carstens BSc ,&nbsp;Henriette Didriksen MSc ,&nbsp;Øyvind Midtvedt MD ,&nbsp;Prof Knut E A Lundin PhD ,&nbsp;Prof Lars Aabakken PhD ,&nbsp;Vikas K Sarna PhD ,&nbsp;Hasse K Zaré PhD ,&nbsp;Prof Dinesh Khanna MD ,&nbsp;Prof Oliver Distler MD ,&nbsp;Prof Tore Midtvedt PhD ,&nbsp;Prof Espen S Bækkevold PhD ,&nbsp;Inge C Olsen PhD ,&nbsp;Diana Domanska PhD ,&nbsp;Maiju E Pesonen PhD ,&nbsp;Prof Øyvind Molberg PhD ,&nbsp;Prof Anna-Maria Hoffmann-Vold PhD","doi":"10.1016/S2665-9913(24)00334-5","DOIUrl":"10.1016/S2665-9913(24)00334-5","url":null,"abstract":"<div><h3>Background</h3><div>Gastrointestinal tract involvement is highly prevalent in systemic sclerosis, with few treatment options. We assessed the efficacy and safety of faecal microbiota transplantation using standardised anaerobic cultivated human intestinal microbiome (ACHIM) as a novel treatment option for patients with systemic sclerosis and symptomatic lower gastrointestinal tract involvement.</div></div><div><h3>Methods</h3><div>In this phase 2, randomised, double-blind, placebo-controlled trial done at four university hospitals in Norway, we enrolled adults aged 18–85 years with systemic sclerosis and moderate-to-severe lower gastrointestinal tract symptoms (bloating or diarrhoea). Participants were randomly assigned 1:1 to intestinal infusions of placebo or ACHIM at weeks 0 and 2, stratified by worst symptom (bloating or diarrhoea). The primary endpoint was change in worst lower gastrointestinal tract symptom (bloating or diarrhoea) from week 0 to week 12, measured using the University of California Los Angeles Scleroderma Clinical Trial Consortium Gastrointestinal Tract 2.0 scoring system in the intention-to-treat population. Safety was assessed at weeks 0, 2, 4, 6, and 12 in all participants who received at least one infusion. A person with lived experience of systemic sclerosis was involved in the study planning and conduct. This trial was registered at <span><span>ClinicalTrials.gov</span><svg><path></path></svg></span>, <span><span>NCT04300426</span><svg><path></path></svg></span>.</div></div><div><h3>Findings</h3><div>Between Sept 24, 2020, and Jan 14, 2022, 67 participants were enrolled and randomly allocated to placebo (n=34) or ACHIM (n=33). Mean age was 58·91 years (SD 11·59). 62 (93%) of 67 participants were women, five (7%) were men, and 50 (75%) were anti-centromere antibody positive. Change in worst lower gastrointestinal tract symptom from week 0 to week 12 did not differ between participants who received ACHIM (–0·13, 95% CI –0·37 to 0·11) and participants who received placebo (–0·33, –0·57 to –0·09; average marginal effect 0·20, 95% CI –0·12 to 0·52; p=0·22). Adverse events, mostly mild and short-lived gastrointestinal tract symptoms, were reported by 16 (48%) of 33 participants in the ACHIM group and 19 (56%) of 34 in the placebo group. During gastroscopy, one participant had a duodenal perforation.</div></div><div><h3>Interpretation</h3><div>Faecal microbiota transplantation with ACHIM was well tolerated in participants with systemic sclerosis but did not result in an improvement in lower gastrointestinal tract symptoms.</div></div><div><h3>Funding</h3><div>KLINBEFORSK.</div></div><div><h3>Translation</h3><div>For the Norwegian translation of the abstract see Supplementary Materials section.</div></div>","PeriodicalId":48540,"journal":{"name":"Lancet Rheumatology","volume":"7 5","pages":"Pages e323-e332"},"PeriodicalIF":15.0,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143123765","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Is faecal microbiota transplantation ready for prime time in systemic sclerosis?","authors":"Shu Wen Tay ,&nbsp;Andrea Hsiu Ling Low","doi":"10.1016/S2665-9913(24)00376-X","DOIUrl":"10.1016/S2665-9913(24)00376-X","url":null,"abstract":"","PeriodicalId":48540,"journal":{"name":"Lancet Rheumatology","volume":"7 5","pages":"Pages e305-e307"},"PeriodicalIF":15.0,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143123780","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Safety of CAR T-cell therapy for cancer in pre-existing autoimmune or inflammatory disease: a retrospective comparative cohort study","authors":"Kathleen M M Vanni ,&nbsp;Kaitlin R McCarter ,&nbsp;Xiaosong Wang ,&nbsp;Caitlyn Duffy ,&nbsp;Jamie P Dela Cruz ,&nbsp;Holly Wobma ,&nbsp;Sarah Nikiforow ,&nbsp;Elena M Massarotti ,&nbsp;Karen H Costenbader ,&nbsp;Jessica S Little ,&nbsp;Ellen M Gravallese ,&nbsp;Gregory C McDermott ,&nbsp;Caron A Jacobson ,&nbsp;Jeffrey A Sparks","doi":"10.1016/S2665-9913(24)00402-8","DOIUrl":"10.1016/S2665-9913(24)00402-8","url":null,"abstract":"","PeriodicalId":48540,"journal":{"name":"Lancet Rheumatology","volume":"7 4","pages":"Pages e226-e229"},"PeriodicalIF":15.0,"publicationDate":"2025-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143075971","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Performance of large language models in rheumatology board-like questions: accuracy, quality, and safety","authors":"Jaime Flores-Gouyonnet ,&nbsp;María C Cuéllar-Gutiérrez ,&nbsp;Gabriel Figueroa-Parra ,&nbsp;Bradly Kimbrough ,&nbsp;Elena K Joerns ,&nbsp;Erika Navarro-Mendoza ,&nbsp;Cynthia S Crowson ,&nbsp;Ryan J Lennon ,&nbsp;Mario Bautista-Vargas ,&nbsp;Mariana González-Treviño ,&nbsp;Alain Sanchez-Rodriguez ,&nbsp;Alí Duarte-García","doi":"10.1016/S2665-9913(24)00400-4","DOIUrl":"10.1016/S2665-9913(24)00400-4","url":null,"abstract":"","PeriodicalId":48540,"journal":{"name":"Lancet Rheumatology","volume":"7 3","pages":"Pages e152-e154"},"PeriodicalIF":15.0,"publicationDate":"2025-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143042418","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Takayasu arteritis: a geographically distant but immunologically proximal MHC-I-opathy","authors":"Kerem Abacar MD ,&nbsp;Tom Macleod PhD ,&nbsp;Prof Haner Direskeneli MD ,&nbsp;Prof Dennis McGonagle FRCPI PhD","doi":"10.1016/S2665-9913(24)00307-2","DOIUrl":"10.1016/S2665-9913(24)00307-2","url":null,"abstract":"<div><div>Takayasu arteritis, a granulomatosis vasculitis with a pathogenesis that is poorly defined but known to be associated with <em>HLA-B*52</em>, shares many features with other MHC-I-opathies. In addition to the shared clinical features of inflammatory bowel diseases, cutaneous inflammation, and <em>HLA-B*52</em>, is shared association of an <em>IL12B</em> single- nucleotide polymorphism encoding the common IL-12 and IL-23 p40 subunit, which might affect not only type 17 cytokine responses, but also IFNγ and TNF production—the cardinal type 1 cytokines in granuloma formation. Considering the translational context of responses to TNF inhibition in Takayasu arteritis, in this Personal View we propose Takayasu arteritis as a type 1 MHC-I-opathy. Additionally, type 1 and type 17 T-cell immune responses show immune plasticity, which connects the overlapping features of Takayasu arteritis and spondyloarthritis spectrum disorders, providing a basis for shared anti-TNF responses, and points to p40 and IFNγ cytokine antagonism and potential selective CD8 T-cell repertoire ablation.</div></div>","PeriodicalId":48540,"journal":{"name":"Lancet Rheumatology","volume":"7 4","pages":"Pages e290-e302"},"PeriodicalIF":15.0,"publicationDate":"2025-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143042459","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}