Lancet Rheumatology最新文献_第4页

Challenges in the therapeutic management of psoriatic arthritis 银屑病关节炎治疗管理的挑战。

IF 16.4 1区医学

Lancet Rheumatology Pub Date : 2025-09-03 DOI: 10.1016/S2665-9913(25)00255-3

Dafna D Gladman

引用次数: 0

Effect of a treatment strategy utilising golimumab, methotrexate and corticosteroids versus methotrexate and corticosteroids in early, untreated psoriatic arthritis (GOLMePsA): a single-centre, double-blind, parallel-group, randomised controlled trial 在早期未经治疗的银屑病关节炎（GOLMePsA）中，使用戈利单抗、甲氨蝶呤和皮质类固醇与使用甲氨蝶呤和皮质类固醇的治疗策略的效果：一项单中心、双盲、平行组、随机对照试验。

IF 16.4 1区医学

Lancet Rheumatology Pub Date : 2025-09-03 DOI: 10.1016/S2665-9913(25)00156-0

Gabriele De Marco PhD , Elizabeth M A Hensor PhD , Prof Philip S Helliwell PhD , Shabina Sultan MD , Sayam R Dubash MD , Xabier Michelena PhD , Prof Laura C Coates PhD , Prof Paul Emery PhD , Ai Lyn Tan MD , Prof Dennis McGonagle PhD , Prof Helena Marzo-Ortega PhD

{"title":"Effect of a treatment strategy utilising golimumab, methotrexate and corticosteroids versus methotrexate and corticosteroids in early, untreated psoriatic arthritis (GOLMePsA): a single-centre, double-blind, parallel-group, randomised controlled trial","authors":"Gabriele De Marco PhD , Elizabeth M A Hensor PhD , Prof Philip S Helliwell PhD , Shabina Sultan MD , Sayam R Dubash MD , Xabier Michelena PhD , Prof Laura C Coates PhD , Prof Paul Emery PhD , Ai Lyn Tan MD , Prof Dennis McGonagle PhD , Prof Helena Marzo-Ortega PhD","doi":"10.1016/S2665-9913(25)00156-0","DOIUrl":"10.1016/S2665-9913(25)00156-0","url":null,"abstract":"<div><h3>Background</h3><div>The optimal treatment strategy in early psoriatic arthritis remains unknown. We aimed to assess whether the combination of methotrexate and golimumab plus corticosteroids is superior to methotrexate plus corticosteroids in reducing disease activity in early, untreated psoriatic arthritis.</div></div><div><h3>Methods</h3><div>We did a double-blind, randomised, placebo-controlled, parallel-group, single-centre study in adults with treatment-naïve active psoriatic arthritis. Participants were required to have been diagnosed up to 24 months before enrolment and had to be naïve to conventional synthetic, biologic, or targeted synthetic disease-modifying antirheumatic drugs or systemic treatments before enrolment. Participants were randomly assigned (1:1) to receive either combination therapy of golimumab and methotrexate or placebo and methotrexate, stratified by the number of involved peripheral joints at baseline. Investigators and participants were masked to treatment allocation. At baseline, all participants received methylprednisolone (120 mg intramuscular administration, single dose) and commenced weekly methotrexate (increased to 25 mg within 28 days). Golimumab or placebo were administered by subcutaneous injections every 4 weeks. By week 24, additional methylprednisolone was permitted once (totalling up to 240 mg exposure). The primary endpoint was the difference in mean Psoriatic Arthritis Disease Activity Score (PASDAS) at week 24 in the intention-to-treat population, compared using analysis of covariance via multiple linear regression. People with lived experience of psoriatic arthritis were involved in the design and conduct the study. The study was registered with EudraCT, 2013-004122-28, and is complete.</div></div><div><h3>Findings</h3><div>Between Nov 3, 2015 and Jan 26, 2022, 106 people were assessed for eligibility, 22 were excluded, and 84 were randomly assigned (43 to the golimumab and methotrexate group and 41 to the placebo and methotrexate group). 46 (55%) participants were male and 38 (45%) were female. The mean age was 42·5 years (SD 12·4) and 61 (73%) participants were White and seven (8%) were from any Asian, Black, or other ethnic background. PASDAS did not differ between treatment groups at week 24 (unadjusted mean 3·09 [SD 1·32] in the placebo and methotrexate group and 2·70 [1·38] in the golimumab and methotrexate group; adjusted difference –0·55 [95% CI –1·12 to 0·03]; p=0·064). More participants in the placebo and methotrexate group received additional corticosteroids before week 24 (20 [49%] of 41 <em>vs</em> nine [21%] of 43; odds ratio 0·28 [95% CI 0·11 to 0·72]; p=0·009). Similar numbers of participants had adverse events (38 [93%] of 41 in the placebo and methotrexate group <em>vs</em> 41 [95%] of 43 in the golimumab and methotrexate group; risk difference 0·03 [95% CI –0·09 to 0·15]), although altered laboratory investigations and infections occurred more frequently in the golimumab ","PeriodicalId":48540,"journal":{"name":"Lancet Rheumatology","volume":"7 11","pages":"Pages e776-e788"},"PeriodicalIF":16.4,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145008592","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}

引用次数: 0

From whole-brain metrics to circuit-specific precision: advancing fMRI biomarkers for TNF inhibitor response in rheumatoid arthritis 从全脑测量到电路特异性精度：类风湿关节炎中TNF抑制剂反应的fMRI生物标志物

IF 16.4 1区医学

Lancet Rheumatology Pub Date : 2025-08-27 DOI: 10.1016/S2665-9913(25)00213-9

Aikeremujiang Muheremu , Kan Jiang

引用次数: 0

From whole-brain metrics to circuit-specific precision: advancing fMRI biomarkers for TNF inhibitor response in rheumatoid arthritis – Authors' reply 从全脑测量到电路特异性精度：类风湿关节炎中TNF抑制剂反应的fMRI生物标志物的进步

IF 16.4 1区医学

Lancet Rheumatology Pub Date : 2025-08-27 DOI: 10.1016/S2665-9913(25)00212-7

Andreas Hess , Koray Tascilar , Georg Schett , Jürgen Rech

引用次数: 0

ILD in rheumatic disease: navigating complexity 风湿疾病的ILD：导航复杂性