Lancet Rheumatology最新文献

{"title":"Evolution and trajectory of B-cell targeted therapies in rheumatic diseases","authors":"Lucy Marie Carter PhD ,&nbsp;Prof Michael R Ehrenstein PhD FRCP ,&nbsp;Prof Edward M Vital PhD","doi":"10.1016/S2665-9913(24)00338-2","DOIUrl":"10.1016/S2665-9913(24)00338-2","url":null,"abstract":"<div><div>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.</div></div>","PeriodicalId":48540,"journal":{"name":"Lancet Rheumatology","volume":"7 5","pages":"Pages e355-e367"},"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}

{"title":"Unwarranted escalation of care for back pain: a dilemma for emergency health services","authors":"Simon Vella ,&nbsp;Peter Youssef ,&nbsp;Chris Maher ,&nbsp;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":"10.1016/S2665-9913(25)00005-0","url":null,"abstract":"","PeriodicalId":48540,"journal":{"name":"Lancet Rheumatology","volume":"7 6","pages":"Pages e378-e379"},"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}

{"title":"Clinical manifestations, disease penetrance, and treatment in individuals with SOCS1 insufficiency: a registry-based and population-based study","authors":"Jerome Hadjadj MD PhD ,&nbsp;Anna Wolfers ,&nbsp;Oleg Borisov PhD ,&nbsp;Derek Hazard PhD ,&nbsp;Ronan Leahy MD PhD ,&nbsp;Marie Jeanpierre MSc ,&nbsp;Alexandre Belot MD PhD ,&nbsp;Shahrzad Bakhtiar MD ,&nbsp;Fabian Hauck MD PhD ,&nbsp;Pui Y Lee MD ,&nbsp;Stefano Volpi MD PhD ,&nbsp;Serena Palmeri MD ,&nbsp;Prof Vincent Barlogis MD PhD ,&nbsp;Nathalie Aladjidi MD ,&nbsp;Georg Ebetsberger-Dachs MD ,&nbsp;Jerome Avouac MD PhD ,&nbsp;Fabienne Charbit-Henrion MD PhD ,&nbsp;Morgane Cheminant MD PhD ,&nbsp;Jean Donadieu MD PhD ,&nbsp;Sujal Ghosh MD ,&nbsp;A.M. Maria","doi":"10.1016/S2665-9913(24)00348-5","DOIUrl":"10.1016/S2665-9913(24)00348-5","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;div&gt;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.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;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 &lt;em&gt;SOCS1&lt;/em&gt; variants; participants from the UK Biobank were included if they had any &lt;em&gt;SOCS1&lt;/em&gt; variant detected in the ESID registry cohort or any other &lt;em&gt;SOCS1&lt;/em&gt; 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.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Findings&lt;/h3&gt;&lt;div&gt;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 &lt;em&gt;SOCS1&lt;/em&gt; 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 &lt;em&gt;SOCS1&lt;/em&gt; 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 ","PeriodicalId":48540,"journal":{"name":"Lancet Rheumatology","volume":"7 6","pages":"Pages e391-e402"},"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":"Thrombotic microangiopathy as a presentation of anti-synthetase syndrome.","authors":"Yu Zuo, Guming Zou, Xiaoming Shu","doi":"10.1016/S2665-9913(25)00027-X","DOIUrl":"https://doi.org/10.1016/S2665-9913(25)00027-X","url":null,"abstract":"","PeriodicalId":48540,"journal":{"name":"Lancet Rheumatology","volume":" ","pages":""},"PeriodicalIF":15.0,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143537504","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}

{"title":"Research in Brief","authors":"Jennifer Thorley","doi":"10.1016/S2665-9913(25)00036-0","DOIUrl":"10.1016/S2665-9913(25)00036-0","url":null,"abstract":"","PeriodicalId":48540,"journal":{"name":"Lancet Rheumatology","volume":"7 3","pages":"Page e162"},"PeriodicalIF":15.0,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143479241","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":"A new era of non-opioid analgesics?","authors":"The Lancet Rheumatology","doi":"10.1016/S2665-9913(25)00035-9","DOIUrl":"10.1016/S2665-9913(25)00035-9","url":null,"abstract":"","PeriodicalId":48540,"journal":{"name":"Lancet Rheumatology","volume":"7 3","pages":"Page e145"},"PeriodicalIF":15.0,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143478523","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 The Lancet Rheumatology's peer reviewers in 2024","authors":"The Lancet Rheumatology Editors","doi":"10.1016/S2665-9913(25)00038-4","DOIUrl":"10.1016/S2665-9913(25)00038-4","url":null,"abstract":"","PeriodicalId":48540,"journal":{"name":"Lancet Rheumatology","volume":"7 3","pages":"Pages e155-e158"},"PeriodicalIF":15.0,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143478522","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 effect of ixekizumab treatment on MRI sacroiliac joint structural lesions in patients with radiographic axial spondyloarthritis: post-hoc analysis of a 52-week, randomised, placebo-controlled trial with an active reference arm","authors":"Prof Walter P Maksymowych MD ,&nbsp;Prof Robert G W Lambert MD ,&nbsp;Rebecca J Bolce Ms ,&nbsp;Natalia Bello MD ,&nbsp;Baojin Zhu PhD ,&nbsp;Jeffrey R Lisse MD ,&nbsp;Prof Mikkel Østergaard MD","doi":"10.1016/S2665-9913(24)00312-6","DOIUrl":"10.1016/S2665-9913(24)00312-6","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;div&gt;The effect of biological disease-modifying antirheumatic drugs (DMARDs) on sacroiliac joint lesions over 52 weeks in biological DMARD-naive patients with radiographic axial spondyloarthritis is unknown. This post-hoc analysis evaluated the effect of ixekizumab and adalimumab versus placebo on structural lesions in sacroiliac joints assessed by MRI in patients naive to biological DMARDs with radiographic axial spondyloarthritis from the COAST-V study.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;COAST-V was a phase 3, multicentre, randomised, double-blind, placebo-controlled trial with an active reference arm done over 52 weeks at 84 sites in 12 countries. Eligible patients were adults (aged ≥18 years) naive to biological DMARDs with active radiographic axial spondyloarthritis, radiographic evidence of sacroiliitis, and an inadequate response or intolerance to non-steroidal anti-inflammatory drugs. Patients were randomly assigned (1:1:1:1) to 80 mg ixekizumab every 2 weeks (Q2W) or every 4 weeks (Q4W), 40 mg adalimumab Q2W, or placebo. At week 16, patients receiving placebo or adalimumab were randomly assigned (1:1) again to ixekizumab Q2W or ixekizumab Q4W. Post-hoc analyses of patients with MRI available at baseline, 16 weeks, and 52 weeks are reported. MRIs were scored using the Spondyloarthritis Research Consortium of Canada sacroiliac joint structural scores for erosion, backfill, fat lesions, and ankylosis. ANCOVA was used for treatment comparisons in observed cases adjusting for baseline values, bone marrow oedema, and stratification factors. Subgroup analyses by sex, HLA-B27, and baseline bone marrow oedema were done.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Findings&lt;/h3&gt;&lt;div&gt;Between June 20, 2016, and Aug 22, 2017, 341 patients were enrolled in the COAST-V study. MRI scans were available for 325 (95%) of 341 patients at baseline and week 16, and for 301 (88%) patients at week 52. 264 (81%) of 325 patients were male and 61 (19%) were female, and the mean age was 41·5 years (SD 11·6). At week 16, erosion significantly decreased versus placebo in the ixekizumab Q2W group (least squares mean –0·91 [SE 0·19] &lt;em&gt;vs&lt;/em&gt; 0·10 [0·18]; p&lt;0·0001) and the ixekizumab Q4W group (–0·57 [SE 0·19]; p=0·0086]); the effect of adalimumab was similar. Backfill significantly increased from baseline to week 16 in ixekizumab Q2W versus placebo (0·52 [0·12] &lt;em&gt;vs&lt;/em&gt; 0·04 [0·12]; p=0·0042). At week 16, decreases in erosion differed significantly between the placebo group and ixekizumab Q2W or Q4W groups, and differences were seen by sex, HLA-B27 status, and baseline bone marrow oedema score. At week 52, at both ixekizumab doses, further changes were observed in erosion and backfill, which were greatest with continuous ixekizumab Q2W (mean erosion –1·50 [SD 2·70], mean backfill 0·76 [SD 2·09]). A decrease in erosion was also noted in patients switching from adalimumab to ixekizumab at week 16. COAST-V was registered with &lt;span&gt;&lt;span&gt;ClinicalTrials.gov&lt;/span","PeriodicalId":48540,"journal":{"name":"Lancet Rheumatology","volume":"7 5","pages":"Pages e314-e322"},"PeriodicalIF":15.0,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143473360","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}