Lancet Rheumatology最新文献

{"title":"Pregnancy outcomes in patients with systemic vasculitis in the USA from 2007 to 2022: an administrative claims-based study","authors":"Audra Horomanski MD , Amadeia Rector MPH , Prof Gary M Shaw DrPH , Julia F Simard ScD","doi":"10.1016/S2665-9913(25)00218-8","DOIUrl":"10.1016/S2665-9913(25)00218-8","url":null,"abstract":"<div><h3>Background</h3><div>Systemic vasculitides are rare, heterogeneous, inflammatory disorders associated with high morbidity and mortality. Recent therapeutic advancements have improved life expectancy and reproductive opportunities for patients with vasculitis, but research on preterm delivery, maternal pregnancy complications, and medication use is limited. We aimed to investigate pregnancy outcomes in patients with systemic vasculitis using administrative claims data.</div></div><div><h3>Methods</h3><div>In this administrative claims-based study, we identified pregnancies in patients aged 15–44 years at the time of delivery with and without (referent population) systemic vasculitis in the Merative MarketScan Commercial Databases from Jan 1, 2007, to Dec 31, 2022. The database includes de-identified inpatient and outpatient health encounters (of mostly privately insured patients) with employment-sponsored health insurance claims in the USA. For patients with vasculitis, at least two outpatient or one inpatient ICD ninth revision clinical modification or ICD tenth revision clinical modification vasculitis-coded visits occurring before or on the last menstrual period of the index pregnancy were required for inclusion in the study. Systemic vasculitis was categorised by vessel size; large, medium, small, and variable. We established the rate of adverse pregnancy outcomes, including hypertensive disorders of pregnancy, placental disorders, and preterm delivery phenotypes in both groups. We also described pregnancy characteristics, medication use, and complications in patients with systemic vasculitis stratified by parity. Outcomes were compared using minimally adjusted and propensity score-adjusted regression models. People with lived experience of vasculitis were not included in this study.</div></div><div><h3>Findings</h3><div>We included 729 pregnancies in 568 patients with vasculitis. 61 (8·4%) were in pregnancies of patients with large vessel vasculitis, 171 (23·5%) with medium vessel vasculitis, 247 (33·9%) with small vessel vasculitis, and 274 (37·6%) with variable vessel vasculitis. 8243 pregnancies in 5680 obstetric patients without vasculitis were included in the referent population. The median age at delivery was higher in the patients with vasculitis than in those in the referent population (33 years [IQR 29–36] <em>vs</em> 31 years [28–35]). Glucocorticoids were the most common treatment during pregnancy in patients with systemic vasculitis, with 159 (21·8%) receiving other immunosuppressive medications. Preterm delivery (before 37 weeks completed gestation) risk was higher in patients with vasculitis than in the referent population, with increased risk in both the minimally adjusted model (adjusted risk ratio [RR] 1·76 [95% CI 1·33–2·33]) and propensity score-adjusted model (propensity score-adjusted RR 1·52 [1·13–2·03]). Pre-eclampsia or eclampsia also occurred at a higher frequency in the population with systemic vasculitis tha","PeriodicalId":48540,"journal":{"name":"Lancet Rheumatology","volume":"8 2","pages":"Pages e88-e97"},"PeriodicalIF":16.4,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145337794","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(26)00014-7","DOIUrl":"10.1016/S2665-9913(26)00014-7","url":null,"abstract":"","PeriodicalId":48540,"journal":{"name":"Lancet Rheumatology","volume":"8 2","pages":"Page e84"},"PeriodicalIF":16.4,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146045232","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; 7: e851–63","authors":"","doi":"10.1016/S2665-9913(26)00009-3","DOIUrl":"10.1016/S2665-9913(26)00009-3","url":null,"abstract":"","PeriodicalId":48540,"journal":{"name":"Lancet Rheumatology","volume":"8 2","pages":"Page e83"},"PeriodicalIF":16.4,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146045231","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":"Gout and power: the history of five political figures shaped by the disease","authors":"Emmanuel Drouin , Tristan Pascart","doi":"10.1016/S2665-9913(26)00010-X","DOIUrl":"10.1016/S2665-9913(26)00010-X","url":null,"abstract":"","PeriodicalId":48540,"journal":{"name":"Lancet Rheumatology","volume":"8 2","pages":"Pages e85-e87"},"PeriodicalIF":16.4,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146045288","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":"Transcutaneous auricular vagus nerve stimulation versus sham stimulation in patients with erosive hand osteoarthritis (ESTIVAL): a randomised, multicentre, double-blind, sham-controlled trial","authors":"Alice Courties MD PhD ,&nbsp;Sophie Tuffet MSc ,&nbsp;Grégoire Cormier MD ,&nbsp;Prof Christian H Roux MD PhD ,&nbsp;Prof Paul Ornetti MD PhD ,&nbsp;Prof Yves-Marie Pers MD PhD ,&nbsp;Prof Jacques-Éric Gottenberg MD PhD ,&nbsp;Eric Lespessailles MD ,&nbsp;Prof Roland Chapurlat MD PhD ,&nbsp;Denis Arniaud MD ,&nbsp;Prof François Rannou MD PhD ,&nbsp;Prof Daniel Wendling MD PhD ,&nbsp;Prof Florent Eymard MD PhD ,&nbsp;Prof Sylvain Mathieu MD PhD ,&nbsp;Prof Pascal Richette MD PhD ,&nbsp;Prof Alain Saraux MD PhD ,&nbsp;Prof Hubert Marotte MD PhD ,&nbsp;Nicolas Poursac MD ,&nbsp;Prof Anne-Christine Rat PhD ,&nbsp;Prof Jean-Philippe Bastard MD PhD ,&nbsp;Prof Jérémie Sellam MD PhD","doi":"10.1016/S2665-9913(25)00226-7","DOIUrl":"10.1016/S2665-9913(25)00226-7","url":null,"abstract":"<div><h3>Background</h3><div>Erosive hand osteoarthritis is a painful and inflammatory disease without effective treatments. In this study we aimed to investigate the efficacy of transcutaneous auricular vagus nerve stimulation (taVNS) compared with sham stimulation in patients with inflammatory erosive hand osteoarthritis.</div></div><div><h3>Methods</h3><div>ESTIVAL was a multicentre, randomised, double-blind, sham-controlled trial done in 18 French hospital centres (two secondary and 16 tertiary centres). Adults (aged ≥18 years), fulfilling the American College of Rheumatology criteria for hand osteoarthritis with at least one erosive interphalangeal joint and ultrasound-confirmed synovitis were randomly assigned (1:1), stratified by site, using centralised web-based randomisation with computer-generated allocation, to receive either daily 20-min taVNS (VAGUSTIM, Schwa Medico, Rouffach, France) or sham stimulation (sham group; no electrical current) for 12 weeks. The primary endpoint was change in hand pain on a visual analogue scale (VAS) from baseline to week 12. Safety was assessed by recording adverse events and serious adverse events at each visit using a standardised form completed by investigators. The primary outcome and safety were analysed in the intention-to-treat population. The trial was registered with <span><span>ClinicalTrials.gov</span><svg><path></path></svg></span>, <span><span>NCT04520516</span><svg><path></path></svg></span>, and is completed. No individuals with lived experience of hand osteoarthritis were involved in the design or conduct of the study.</div></div><div><h3>Findings</h3><div>Between April 8, 2021, and March 29, 2022, 148 patients were enrolled in the study and 142 (96%) were randomly assigned (73 [51%] to the taVNS group and 69 [49%] to the sham group). Overall, the mean age was 66·5 years (SD 8·4), 125 (88%) of 142 participants were female, and 17 (12%) were male. At week 12, 63 (86%) of 73 participants in the taVNS group and 64 (93%) of 69 participants in the sham group provided primary outcome data. Median change in VAS hand pain was –16·0 mm (IQR –32·0 to 5·0) in the taVNS group versus –6·0 mm (–27·0 to 7·0) in the sham group, giving an adjusted between-group difference of –10·0 mm (95% CI –23·0 to 2·0; p=0·22) at week 12; the primary endpoint was not met. No serious adverse events occurred. Adverse events were reported by 22 (30%) of 73 participants in the taVNS and 16 (23%) and 69 participants in the sham group, with no emerging safety concerns.</div></div><div><h3>Interpretation</h3><div>In participants with erosive hand osteoarthritis, taVNS was safe and well tolerated. Although the primary endpoint was not met, the consistent pain reduction observed in patients with greater synovial inflammation suggests that taVNS merits further investigation in this erosive hand osteoarthritis population.</div></div><div><h3>Funding</h3><div>French Ministry of Health.</div></div>","PeriodicalId":48540,"journal":{"name":"Lancet Rheumatology","volume":"8 2","pages":"Pages e98-e107"},"PeriodicalIF":16.4,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145745064","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 2026; 8: e5–6","authors":"","doi":"10.1016/S2665-9913(25)00373-X","DOIUrl":"10.1016/S2665-9913(25)00373-X","url":null,"abstract":"","PeriodicalId":48540,"journal":{"name":"Lancet Rheumatology","volume":"8 2","pages":"Page e83"},"PeriodicalIF":16.4,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145844423","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 2024; 6: e237–46","authors":"","doi":"10.1016/S2665-9913(25)00375-3","DOIUrl":"10.1016/S2665-9913(25)00375-3","url":null,"abstract":"","PeriodicalId":48540,"journal":{"name":"Lancet Rheumatology","volume":"8 2","pages":"Page e83"},"PeriodicalIF":16.4,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145811884","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":"Skin cancer in inflammatory arthritis: should we advise screening?","authors":"Konstantinos D Vassilakis MD ,&nbsp;Kyriaki Lampadaki MD ,&nbsp;Elena Nikiphorou MD PhD ,&nbsp;George E Fragoulis MD PhD","doi":"10.1016/S2665-9913(25)00312-1","DOIUrl":"10.1016/S2665-9913(25)00312-1","url":null,"abstract":"<div><div>Inflammatory arthritis refers to a group of related clinical entities marked mainly by inflammation of the joints, the spine, or both. Rheumatoid arthritis and spondyloarthritis (which includes psoriatic arthritis and axial spondyloarthritis) are the most common forms of inflammatory arthritis. As more studies are conducted, there are accumulating data suggesting the elevated risk of skin cancer, including both melanoma and non-melanoma skin cancer, in inflammatory arthritis compared with the general population. In this context, the question of whether screening for skin cancer should be recommended in individuals with inflammatory arthritis is more relevant than ever. In this Review, we discuss the current knowledge on the risk and possible associations of melanoma and non-melanoma skin cancer in inflammatory arthritis with the aim of raising awareness within the rheumatology community about the risk of skin cancer, screening, and guidance.</div></div>","PeriodicalId":48540,"journal":{"name":"Lancet Rheumatology","volume":"8 2","pages":"Pages e127-e143"},"PeriodicalIF":16.4,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145679158","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":"Vasculitis management remains a challenge during pregnancy","authors":"Sebastian Klapa ,&nbsp;Peter Lamprecht","doi":"10.1016/S2665-9913(25)00263-2","DOIUrl":"10.1016/S2665-9913(25)00263-2","url":null,"abstract":"","PeriodicalId":48540,"journal":{"name":"Lancet Rheumatology","volume":"8 2","pages":"Page e76"},"PeriodicalIF":16.4,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145337795","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 2025","authors":"The Lancet Rheumatology Editors","doi":"10.1016/S2665-9913(26)00012-3","DOIUrl":"10.1016/S2665-9913(26)00012-3","url":null,"abstract":"","PeriodicalId":48540,"journal":{"name":"Lancet Rheumatology","volume":"8 2","pages":"Page e78"},"PeriodicalIF":16.4,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146045229","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}