Lancet Rheumatology最新文献

{"title":"Biologics first: evidence reshaping Still's disease treatment","authors":"Yi-Ming Chen , Der-Yuan Chen","doi":"10.1016/S2665-9913(25)00033-5","DOIUrl":"10.1016/S2665-9913(25)00033-5","url":null,"abstract":"","PeriodicalId":48540,"journal":{"name":"Lancet Rheumatology","volume":"7 6","pages":"Pages e381-e382"},"PeriodicalIF":15.0,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143755254","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":"First-line biological versus conventional synthetic disease-modifying antirheumatic drug therapy in adult-onset Still's disease: a multicentre, retrospective, propensity weighted cohort study","authors":"Anna Kernder MD , Tim Filla MSc , Rhea Friedrich MD , Prof Norbert Blank MD , Prof Diana Ernst MD , Prof Jörg Henes MD , Prof Gernot Keyßer MD , Philipp Klemm MD , Martin Krusche MD , Anna Meinecke MD , Jürgen Rech MD , Nils Schulz MD , Simon Michael Petzinna MD , Anne Pankow MD , Prof Valentin S Schäfer MD , Prof Alexander Pfeil MD , Sebastian Klapa MD , Prof Eugen Feist MD , Prof Stefan Vordenbäumen MD","doi":"10.1016/S2665-9913(25)00023-2","DOIUrl":"10.1016/S2665-9913(25)00023-2","url":null,"abstract":"<div><h3>Background</h3><div>Data on the efficacy of biological disease-modifying antirheumatic drug (DMARD) therapies such as anakinra, canakinumab, and tocilizumab as a primary therapeutic option in adult-onset Still's disease (AOSD) are scarce, and treatment recommendations rely mainly on data extrapolated from paediatric studies. The aim of this study was to compare the effectiveness of first-line biological DMARD therapy versus conventional synthetic DMARD therapy in AOSD.</div></div><div><h3>Methods</h3><div>This multicentre, retrospective, propensity weighted cohort study was done at 16 secondary and tertiary rheumatology centres across Germany. Eligible patients were diagnosed with AOSD, met the Yamaguchi classification criteria, and had active disease without current treatment. All patients had documented follow-up assessments at weeks 12 and 72. The primary endpoint was sustained, event-free remission; a combined endpoint of sustained remission (C-reactive protein <10 mg/L and no arthritis, rash, or fever) and absence of complications during follow up in patients treated with first-line biological DMARDs (with or without glucocorticoids) or conventional synthetic DMARDs (methotrexate or glucocorticoids). Analysis was by propensity score weighted logistic regression, thereby balancing for the initial Pouchot score, ferritin concentration, and age and sex differences between groups. Analysis was done in the per protocol population. People with lived experience were not involved in the study design. The study is registered with the ISRCTN registry, ISRCTN86135778.</div></div><div><h3>Findings</h3><div>Between Jan 1, 2007, and Sep 30, 2022, we screened 228 patients for inclusion. 142 patients were excluded, and 86 patients with AOSD who had an incident diagnosis or a flare without any maintenance treatment including glucocorticoids were enrolled and included in our analysis. 50 (58%) of 86 patients were female, 36 (42%) were male, and 84 (98%) were White. The mean age at inclusion was 39·4 years (SD 15·4). 44 (51%) of 86 had received a first-line biological DMARD and 42 (49%) received a first-line conventional synthetic DMARD. Biological DMARD therapy was associated with a greater likelihood of reaching the primary endpoint of sustained, event-free remission (OR 7·20, 95% CI 2·50–36·64; p=0·0007). At week 72, the rate of sustained, event-free remission was 50% (95% CI 34–65%; n=21) in the first-line biological DMARD group and 12% (3–23%; n=5) in the first-line conventional synthetic group. Glucocorticoid-related complications were more often described in the first-line conventional synthetic DMARD group (new-onset arterial hypertension [n=2] and glucocorticoid-related skin diseases [n=3]) versus none in the first-line biological DMARD group). Three (7%) of 42 patients in the conventional synthetic DMARD group died (two from macrophage activation syndrome, one unknown cause) versus none in the first-line biological DMARD group.</div></div","PeriodicalId":48540,"journal":{"name":"Lancet Rheumatology","volume":"7 6","pages":"Pages e415-e423"},"PeriodicalIF":15.0,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143755258","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":"Correction to Lancet Rheumatol 2025; published online Feb 27. https://doi.org/10.1016/S2665-9913(24)00348-5","authors":"","doi":"10.1016/S2665-9913(25)00096-7","DOIUrl":"10.1016/S2665-9913(25)00096-7","url":null,"abstract":"","PeriodicalId":48540,"journal":{"name":"Lancet Rheumatology","volume":"7 5","pages":"Page e311"},"PeriodicalIF":15.0,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143755257","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":"Correction to Lancet Rheumatol 2020; 2: e99–109","authors":"","doi":"10.1016/S2665-9913(25)00097-9","DOIUrl":"10.1016/S2665-9913(25)00097-9","url":null,"abstract":"","PeriodicalId":48540,"journal":{"name":"Lancet Rheumatology","volume":"7 5","pages":"Page e311"},"PeriodicalIF":15.0,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143755256","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":"Correction to Lancet Rheumatol 2020; 2: e418–27","authors":"","doi":"10.1016/S2665-9913(25)00098-0","DOIUrl":"10.1016/S2665-9913(25)00098-0","url":null,"abstract":"","PeriodicalId":48540,"journal":{"name":"Lancet Rheumatology","volume":"7 5","pages":"Page e311"},"PeriodicalIF":15.0,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143755255","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":"CAR T-cell therapy in autoimmune diseases: where are we and where are we going?","authors":"Marc Scherlinger MD PhD ,&nbsp;Gaetane Nocturne MD PhD ,&nbsp;Marko Radic PhD ,&nbsp;David Launay MD PhD ,&nbsp;Christophe Richez MD PhD ,&nbsp;Philippe Bousso PhD ,&nbsp;Edouard Forcade MD ,&nbsp;Prof Alain Meyer MD PhD ,&nbsp;Prof Christian Jorgensen MD PhD ,&nbsp;Camille Bigenwald MD ,&nbsp;Prof Divi Cornec MD PhD ,&nbsp;Prof Jean Sibilia MD PhD ,&nbsp;Sylvain Choquet MD ,&nbsp;Thierry Martin MD ,&nbsp;Alexandre Belot MD ,&nbsp;Maurine Jouret MD ,&nbsp;Samuel Bitoun MD ,&nbsp;Zahir Amoura MD ,&nbsp;Olivier Hermine MD ,&nbsp;Xavier Mariette MD ,&nbsp;Edouard FORCADE","doi":"10.1016/S2665-9913(24)00377-1","DOIUrl":"10.1016/S2665-9913(24)00377-1","url":null,"abstract":"<div><div>Chimeric antigen receptor (CAR)-based therapies developed for the treatment of haematological malignancies have recently been repurposed to treat refractory systemic autoimmune diseases. In this Review we critically discuss the current data available on the use of CAR-based therapy in systemic autoimmune diseases, the current challenges, and the potential next steps toward their implementation into clinical practice. Beyond the targeting of B cells via CD19, we discuss the advantages and potential pitfalls of targeting plasma cells (B-cell Maturation Antigen or CD138) and other non-immune targets, such as fibroblast activated protein, and of aiming to restore immune homeostasis using CAR T regulatory cells. Crucial points need to be addressed for CAR-based therapy to become a viable treatment option for patients with systemic autoimmune diseases.</div></div>","PeriodicalId":48540,"journal":{"name":"Lancet Rheumatology","volume":"7 6","pages":"Pages e434-e447"},"PeriodicalIF":15.0,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143743853","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)00072-4","DOIUrl":"10.1016/S2665-9913(25)00072-4","url":null,"abstract":"","PeriodicalId":48540,"journal":{"name":"Lancet Rheumatology","volume":"7 4","pages":"Page e232"},"PeriodicalIF":15.0,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143679077","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":"Improving polymyalgia rheumatica care: considerations for routine vascular ultrasound in clinical practice","authors":"Max Yates PhD ,&nbsp;Charlotte Davies PhD ,&nbsp;Prof Alexander James MacGregor PhD","doi":"10.1016/S2665-9913(25)00031-1","DOIUrl":"10.1016/S2665-9913(25)00031-1","url":null,"abstract":"<div><div>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.</div></div>","PeriodicalId":48540,"journal":{"name":"Lancet Rheumatology","volume":"7 6","pages":"Pages e448-e450"},"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}

{"title":"Diagnostic, research, and real-life effect of the 2023 EULAR−ACR classification criteria for antiphospholipid syndrome","authors":"Karen Schreiber PhD ,&nbsp;Silvia Aguilera PhD ,&nbsp;Prof Olga Amengual PhD ,&nbsp;Prof Hannah Cohen MD ,&nbsp;Prof Danieli Castro Oliveira De Andrade MD PhD ,&nbsp;Prof Alí Duarte-García MD ,&nbsp;Prof Maria Gerosa PhD ,&nbsp;Prof Catherine Nelson-Piercy MD ,&nbsp;Massimo Radin MD PhD ,&nbsp;Prof Luigi Raio MD ,&nbsp;Prof Savino Sciascia PhD","doi":"10.1016/S2665-9913(24)00396-5","DOIUrl":"10.1016/S2665-9913(24)00396-5","url":null,"abstract":"<div><div>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.</div></div>","PeriodicalId":48540,"journal":{"name":"Lancet Rheumatology","volume":"7 5","pages":"Pages e368-e376"},"PeriodicalIF":15.0,"publicationDate":"2025-03-08","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}