Max Yates, Charlotte Davies, Alexander James MacGregor
{"title":"Improving polymyalgia rheumatica care: considerations for routine vascular ultrasound in clinical practice.","authors":"Max Yates, Charlotte Davies, Alexander James MacGregor","doi":"10.1016/S2665-9913(25)00031-1","DOIUrl":"https://doi.org/10.1016/S2665-9913(25)00031-1","url":null,"abstract":"<p><p>Vascular ultrasound can be useful in the diagnostic investigation of patients with suspected giant cell arteritis. The clinical overlap between polymyalgia rheumatica and giant cell arteritis raises the prospect that vascular ultrasound can be used to identify features suggestive of giant cell arteritis in polymyalgia rheumatica, and has generated debate on whether all patients with polymyalgia rheumatica should undergo vascular ultrasound. However, before this approach becomes routine practice, more careful and detailed scrutiny is needed of its clinical necessity, patient benefit, and cost-effectiveness, where data are currently lacking. We argue that the case for universal vascular ultrasound screening in polymyalgia rheumatica is speculative and there is a greater necessity to direct resources to address misdiagnosis and overtreatment with glucocorticoids, which carry risks such as osteoporosis, diabetes, ocular morbidity, and infection.</p>","PeriodicalId":48540,"journal":{"name":"Lancet Rheumatology","volume":" ","pages":""},"PeriodicalIF":15.0,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143671410","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":"JIA care under the microscope","authors":"The Lancet Rheumatology","doi":"10.1016/S2665-9913(25)00073-6","DOIUrl":"10.1016/S2665-9913(25)00073-6","url":null,"abstract":"","PeriodicalId":48540,"journal":{"name":"Lancet Rheumatology","volume":"7 4","pages":"Page e219"},"PeriodicalIF":15.0,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143671413","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}
Karen Schreiber, Silvia Aguilera, Olga Amengual, Hannah Cohen, Danieli Castro Oliveira De Andrade, Alí Duarte-García, Maria Gerosa, Catherine Nelson-Piercy, Massimo Radin, Luigi Raio, Savino Sciascia
{"title":"Diagnostic, research, and real-life effect of the 2023 EULAR-ACR classification criteria for antiphospholipid syndrome.","authors":"Karen Schreiber, Silvia Aguilera, Olga Amengual, Hannah Cohen, Danieli Castro Oliveira De Andrade, Alí Duarte-García, Maria Gerosa, Catherine Nelson-Piercy, Massimo Radin, Luigi Raio, Savino Sciascia","doi":"10.1016/S2665-9913(24)00396-5","DOIUrl":"https://doi.org/10.1016/S2665-9913(24)00396-5","url":null,"abstract":"<p><p>The role of classification criteria is particularly important in rheumatic diseases compared with other medical disorders, as the complexity and overlapping symptoms of these conditions make diagnosis challenging. Moreover, the absence of established diagnostic criteria further complicates diagnosing patients. Classification criteria can assist health-care professionals and patients as a diagnostic aid. However, classification criteria are developed for research purposes to standardise populations in clinical trials and observational studies of rheumatic diseases and not for diagnosing patients. Introduction of the 2023 American College of Rheumatology-European Alliance of Associations for Rheumatology (ACR-EULAR) antiphospholipid syndrome classification criteria underscores the important distinction between meeting these criteria and being diagnosed with the condition-a differentiation essential in both clinical practice and research. Although the 2023 ACR-EULAR antiphospholipid syndrome classification criteria improved precision in classification of pregnant individuals with antiphospholipid syndrome, which ultimately should lead to better outcomes and care for these patients, the updated criteria should not be used as diagnostic criteria in routine clinical practice. In this Personal View, we examine the possible effect of the 2023 ACR-EULAR antiphospholipid syndrome classification criteria, with a particular focus on the pregnancy-related aspects of the syndrome.</p>","PeriodicalId":48540,"journal":{"name":"Lancet Rheumatology","volume":" ","pages":""},"PeriodicalIF":15.0,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143598041","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}
Lucy Marie Carter, Michael R Ehrenstein, Edward M Vital
{"title":"Evolution and trajectory of B-cell targeted therapies in rheumatic diseases.","authors":"Lucy Marie Carter, Michael R Ehrenstein, Edward M Vital","doi":"10.1016/S2665-9913(24)00338-2","DOIUrl":"https://doi.org/10.1016/S2665-9913(24)00338-2","url":null,"abstract":"<p><p>Aberrant B-cell function, which could arise from various underlying causes, is central to the pathogenesis of diverse autoimmune rheumatic diseases. B cells remain the only cell type to be specifically therapeutically targeted through depletion and have the only therapy with a routinely available flow cytometric biomarker of treatment. Since first use and subsequent licensing for rheumatoid arthritis, rituximab has had a transformative impact on patients globally and across the rheumatic diseases. Further insights from B-cell-activating factor (BAFF) blockade with belimumab in systemic lupus erythematosus have followed. Examination of B-cell depletion, clinical outcomes, and re-emergent disease after treatment have deepened our understanding of the identity, detailed phenotype, biology, and kinetics of the B-cell subsets that are central to disease. This Review reflects on 20 years of clinical and translational insights drawn from B-cell targeted therapies for adult autoimmune rheumatic diseases, and highlights how these therapies have informed an exciting new era of future therapeutic developments.</p>","PeriodicalId":48540,"journal":{"name":"Lancet Rheumatology","volume":" ","pages":""},"PeriodicalIF":15.0,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143587671","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}
Simon Vella , Peter Youssef , Chris Maher , Gustavo Machado
{"title":"Unwarranted escalation of care for back pain: a dilemma for emergency health services","authors":"Simon Vella , Peter Youssef , Chris Maher , Gustavo Machado","doi":"10.1016/S2665-9913(25)00059-1","DOIUrl":"10.1016/S2665-9913(25)00059-1","url":null,"abstract":"","PeriodicalId":48540,"journal":{"name":"Lancet Rheumatology","volume":"7 4","pages":"Pages e229-e231"},"PeriodicalIF":15.0,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143587712","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":"The same genotype gives rise to a spectrum of disorders.","authors":"Qingping Yao","doi":"10.1016/S2665-9913(25)00005-0","DOIUrl":"https://doi.org/10.1016/S2665-9913(25)00005-0","url":null,"abstract":"","PeriodicalId":48540,"journal":{"name":"Lancet Rheumatology","volume":" ","pages":""},"PeriodicalIF":15.0,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143536982","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}
Jerome Hadjadj, Anna Wolfers, Oleg Borisov, Derek Hazard, Ronan Leahy, Marie Jeanpierre, Alexandre Belot, Shahrzad Bakhtiar, Fabian Hauck, Pui Y Lee, Stephano Volpi, Serena Palmeri, Vincent Barlogis, Nathalie Aladjidi, Georg Ebetsberger-Dachs, Jerome Avouac, Fabienne Charbit-Henrion, Morgane Cheminant, Jean Donadieu, Sujal Ghosh, David P Hoytema van Konijnenburg, Julia Körholz, Jacinta Bustamante, Jeremie Rosain, Lisa Forbes Satter, Ingrid Selmeryd, Georgios Sogkas, Benedicte Neven, Frederic Rieux-Laucat, Stephan Ehl
{"title":"Clinical manifestations, disease penetrance, and treatment in individuals with SOCS1 insufficiency: a registry-based and population-based study.","authors":"Jerome Hadjadj, Anna Wolfers, Oleg Borisov, Derek Hazard, Ronan Leahy, Marie Jeanpierre, Alexandre Belot, Shahrzad Bakhtiar, Fabian Hauck, Pui Y Lee, Stephano Volpi, Serena Palmeri, Vincent Barlogis, Nathalie Aladjidi, Georg Ebetsberger-Dachs, Jerome Avouac, Fabienne Charbit-Henrion, Morgane Cheminant, Jean Donadieu, Sujal Ghosh, David P Hoytema van Konijnenburg, Julia Körholz, Jacinta Bustamante, Jeremie Rosain, Lisa Forbes Satter, Ingrid Selmeryd, Georgios Sogkas, Benedicte Neven, Frederic Rieux-Laucat, Stephan Ehl","doi":"10.1016/S2665-9913(24)00348-5","DOIUrl":"10.1016/S2665-9913(24)00348-5","url":null,"abstract":"<p><strong>Background: </strong>Suppressor of cytokine signalling 1 (SOCS1) insufficiency is an inborn error of immunity affecting the negative regulation of cytokine and growth factor signalling. We aimed to enhance the understanding of clinical manifestations, disease trajectories, disease penetrance, and the effect of Janus kinase (JAK) inhibition in individuals with SOCS1 insufficiency.</p><p><strong>Methods: </strong>This study used data from two independent cohorts: the European Society for Immunodeficiencies (ESID) registry and the UK Biobank. Participants from the ESID registry were from nine European countries (Austria, Belgium, France, Germany, Ireland, Italy, Portugal, Sweden, and Ukraine), China, Taiwan, and the USA. Participants from the ESID registry were eligible if they had heterozygous, functionally validated SOCS1 variants; participants from the UK Biobank were included if they had any SOCS1 variant detected in the ESID registry cohort or any other SOCS1 variant that was classed as high-impact. Clinical manifestations of the underlying SOCS1 insufficiency were documented and summarised into nine subgroups, with ICD-10 diagnosis codes collected for participants from the UK Biobank. Participants from the ESID registry were tested for relevant autoantibodies in their local laboratory. Responses to JAK inhibitor treatment in participants from the ESID registry were assessed by the treating physician using a visual analogue scale. Descriptive statistics were used for analysis. People with lived experience were not involved in the study design.</p><p><strong>Findings: </strong>We included 119 participants with SOCS1 insufficiency: 67 from the ESID registry, enrolled between Feb 15, 2021, and Dec 31, 2023, and 52 from the UK Biobank. Of the 67 participants from the ESID registry, 39 (58%) were female, 28 (42%) were male, and the median age was 28 years (IQR 15-44, range 2-85). 27 different monoallelic SOCS1 variants were identified in these participants. 62 (93%) of the 67 participants in the ESID registry cohort were symptomatic and five (7%) were asymptomatic family members; of the 62 participants with symptoms, allergy (33 [50%]), inflammatory gastrointestinal (22 [36%]) and skin (18 [29%]) manifestations, autoimmune cytopenia (24 [39%]), and lymphoproliferation (23 [37%]) were most frequent. Rheumatological manifestations (23 [37%]) included systemic lupus erythematosus, Sjögren's disease, and rheumatoid arthritis, with typical autoantibody profiles. 42 (68%) of the 62 symptomatic participants had at least three different manifestations. In the UK Biobank we found 52 participants carrying high-impact SOCS1 variants; 29 (56%) were female, 23 (44%) were male, and the median age was 72 years (65-78, 57-86). Only 30 (58%) of these participants had developed manifestations that were potentially related to SOCS1 insufficiency. Allergy and rheumatological manifestations were more common in participants from the UK Biobank than the ESID re","PeriodicalId":48540,"journal":{"name":"Lancet Rheumatology","volume":" ","pages":""},"PeriodicalIF":15.0,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143536736","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":"Thank you to our contributors and peer reviewers in 2024","authors":"The Lancet Rheumatology Editors","doi":"10.1016/S2665-9913(25)00037-2","DOIUrl":"10.1016/S2665-9913(25)00037-2","url":null,"abstract":"","PeriodicalId":48540,"journal":{"name":"Lancet Rheumatology","volume":"7 3","pages":"Pages e154-e155"},"PeriodicalIF":15.0,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143478521","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}