Lancet Rheumatology最新文献

{"title":"Group-based cycling and education for hip osteoarthritis","authors":"Troels Kjeldsen , Inger Mechlenburg","doi":"10.1016/S2665-9913(25)00154-7","DOIUrl":"10.1016/S2665-9913(25)00154-7","url":null,"abstract":"","PeriodicalId":48540,"journal":{"name":"Lancet Rheumatology","volume":"7 11","pages":"Pages e748-e749"},"PeriodicalIF":16.4,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144776666","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":"Effect of a 1-month methotrexate delay on pneumococcal vaccine immunogenicity and disease control in patients with early rheumatoid arthritis (VACIMRA): an open-label randomised trial","authors":"Prof Jacques Morel MD , Prof Emmanuelle Dernis MD , Prof Christian Roux MD , Prof Christophe Richez MD , Olivier Brocq MD , Prof Bruno Fautrel MD , Carine Salliot MD , Prof Olivier Vittecoq MD , Prof Xavier Mariette MD , Prof Frederic Lioté MD , Slim Lassoued MD , Prof Cécile Gaujoux-Viala MD , Prof Arnaud Constantin MD , Prof Martin Soubrier MD , Prof Valérie Devauchelle-Pensec MD , Prof Vincent Goeb MD , Prof Jacques-Eric Gottenberg MD , Prof Hubert Marotte MD , Anouck Rémy Moulard MD , Prof Claire Daien MD , Jacques MOREL","doi":"10.1016/S2665-9913(25)00071-2","DOIUrl":"10.1016/S2665-9913(25)00071-2","url":null,"abstract":"<div><h3>Background</h3><div>Pneumococcal vaccination is recommended for patients with rheumatoid arthritis. Because immunosuppressant therapies for rheumatoid arthritis hinder vaccine efficacy, vaccination should be administered before initiating immunosuppressive drugs. We aimed to compare humoral responses in patients with rheumatoid arthritis receiving the pneumococcal 13-valent conjugate vaccine (PCV13) before methotrexate initiation or simultaneously.</div></div><div><h3>Methods</h3><div>In this randomised, multicentre, open-label trial, patients were recruited from 26 rheumatology departments in 22 university hospitals and four general hospitals in France. Adult patients (aged 18–80 years) with active rheumatoid arthritis (Disease Activity Score in 28 joints >3·2), who were naive to targeted disease-modifying anti rheumatic drugs (DMARDs), had not had methotrexate or leflunomide in the past 3 months, and had no previous pneumococcal vaccinations were included. Patients were excluded in case of treatment with methotrexate or with leflunomide within the previous 3 months and absolute or relative contraindications to methotrexate. Patients were vaccinated with PCV13 at randomisation, before being randomly assigned (1:1) to either the immediate group (methotrexate treatment [maximum dose 15 mg per week] initiated at the same time as PCV13 vaccine) or the delay group (methotrexate initiated 1 month after PCV13 vaccine). Randomisation was stratified by sex (self-reported) and DMARD naive status. 2 months later, patients in both groups were vaccinated with the 23-valent pneumococcal polysaccharide vaccine. Humoral responses, disease activity, infections, and adverse events were assessed at baseline and at 1, 3, 6, and 12 months after PCV13. The primary outcome was the responder rate at 1 month, defined by positive responses against at least three of five target serotypes (ie, 1, 3, 5, 7F, and 19A). Responders were defined according to a 2 or more-fold increase in IgG concentrations with ELISA or opsonophagocytic assay compared with baseline. The main analysis was performed in the modified intention-to-treat population, including all randomly assigned patients with a valid measure of the primary endpoint, analysed in their assigned group. There was no involvement of people with lived experience in the study design or implementation. The trial was registered at <span><span>ClinicalTrials.gov</span><svg><path></path></svg></span> (<span><span>NCT01942174</span><svg><path></path></svg></span>) and is completed.</div></div><div><h3>Findings</h3><div>Between Sept 27, 2013, and Oct 10, 2019, 276 patients with rheumatoid arthritis were randomly assigned. 27 patients were excluded, of whom four patients dropped out, and 249 patients were included in the modified intention-to-treat population (126 [51%] in the delay group and 123 [49%] in the immediate group). 174 (70%) patients were female and 75 (30%) were male, the mean age at enrolment was 55·6 year","PeriodicalId":48540,"journal":{"name":"Lancet Rheumatology","volume":"7 10","pages":"Pages e675-e686"},"PeriodicalIF":16.4,"publicationDate":"2025-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144765676","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":"Optimising pneumococcal vaccine efficacy in rheumatoid arthritis: a strategic delay in methotrexate initiation","authors":"Katie Bechman , James Galloway","doi":"10.1016/S2665-9913(25)00093-1","DOIUrl":"10.1016/S2665-9913(25)00093-1","url":null,"abstract":"","PeriodicalId":48540,"journal":{"name":"Lancet Rheumatology","volume":"7 10","pages":"Pages e660-e661"},"PeriodicalIF":16.4,"publicationDate":"2025-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144765677","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":"Oligoarthritis, hypomagnesaemia, and primary amenorrhea in a patient with diabetes.","authors":"Surasak Faisatjatham, Yada Siriphannon, Nattakarn Suwansaksri, Jutasinee Paiboon","doi":"10.1016/S2665-9913(25)00162-6","DOIUrl":"https://doi.org/10.1016/S2665-9913(25)00162-6","url":null,"abstract":"","PeriodicalId":48540,"journal":{"name":"Lancet Rheumatology","volume":" ","pages":""},"PeriodicalIF":16.4,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144734089","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":"Effectiveness of treat-to-target tapering of TNF inhibitors for psoriatic arthritis and axial spondyloarthritis in the Netherlands: 24-month follow-up of the DRESS-PS trial","authors":"Amy C D Peeters MD ,&nbsp;Celia A J Michielsens MD PhD ,&nbsp;Elien A M Mahler MD PhD ,&nbsp;Lise M Verhoef PhD ,&nbsp;Alfons A den Broeder MD PhD ,&nbsp;Nathan den Broeder PhD ,&nbsp;Noortje van Herwaarden MD PhD","doi":"10.1016/S2665-9913(25)00070-0","DOIUrl":"10.1016/S2665-9913(25)00070-0","url":null,"abstract":"<div><h3>Background</h3><div>Results of the DRESS-PS trial showed that a tapering strategy with TNF inhibitors is non-inferior to continuation of the same TNF inhibitor dose for up to 12 months in patients with psoriatic arthritis and axial spondyloarthritis. This study aimed to describe the effectiveness of TNF inhibitor tapering for up to 24 months in patients who participated in the DRESS-PS trial.</div></div><div><h3>Methods</h3><div>This study was a 12-month observational extension of the original 12-month, open-label, non-inferiority DRESS-PS trial conducted at the Sint Maartenskliniek, Nijmegen and Woerden, the Netherlands. Patients aged 16 years and older with psoriatic arthritis or axial spondyloarthritis and stable low disease activity for at least 6 months participated in the original DRESS-PS trial. Patients were randomly assigned to either a treat-to-target tapering strategy (the intervention group), which involved extending the interval between TNF inhibitor doses, resulting in doses of 100%, 66%, 50%, or 0% of the defined daily dose, or to a treat-to-target strategy without tapering (the control group). All patients who participated in the DRESS-PS trial were eligible to participate in this extension study, in which treat-to-target tapering was allowed for all patients, and treatment decisions were made through shared decision making between physicians and patients. The primary outcome was the difference between the original intervention and control groups in the proportion of patients with low disease activity at 24 months; this difference (adjusted for stratification factors at randomisation) was compared, without and with imputation, with the prespecified non-inferiority margin of 20% from the original DRESS-PS trial, and non-inferiority was determined from the adjusted 95% CIs. There was no involvement of people with lived experience of psoriatic arthritis or axial spondyloarthritis in the design, recruitment, conduct, analysis, or reporting of this extension study. The DRESS-PS trial was registered with the Dutch Trial Register, NL6771.</div></div><div><h3>Findings</h3><div>Between Jan 8, 2020, and Oct 10, 2022, 114 of the 122 patients from the DRESS-PS trial participated in this extension study: 79 from the original intervention group (40 with psoriatic arthritis, 39 with axial spondyloarthritis) and 35 from the original control group (18 with psoriatic arthritis, 17 with axial spondyloarthritis). Mean age was 50·0 years (SD 14·5). 70 (61%) patients were men and 44 (39%) were women. The proportion of patients with low disease activity at 24 months was 67% (45 of 67 patients) in the intervention group and 72% (23 of 32 patients) in the control group, with an adjusted difference of 5% (95% CI –15 to 24; p=0·64), which exceeded the prespecified non-inferiority margin. With imputation of missing data, the adjusted difference was 2% (–18 to 16; p=0·85), which fell within the non-inferiority margin. 78 (99%) of 79 patients in the i","PeriodicalId":48540,"journal":{"name":"Lancet Rheumatology","volume":"7 9","pages":"Pages e642-e651"},"PeriodicalIF":16.4,"publicationDate":"2025-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144734088","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":"Expanding the rheumatology lens: should we embrace POTS and post-infectious syndromes?","authors":"Brittany L Adler","doi":"10.1016/S2665-9913(25)00190-0","DOIUrl":"10.1016/S2665-9913(25)00190-0","url":null,"abstract":"","PeriodicalId":48540,"journal":{"name":"Lancet Rheumatology","volume":"7 10","pages":"Pages e673-e674"},"PeriodicalIF":16.4,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144718911","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":"Lipodystrophy in juvenile-onset dermatomyositis.","authors":"Soumya Chatterjee","doi":"10.1016/S2665-9913(25)00163-8","DOIUrl":"https://doi.org/10.1016/S2665-9913(25)00163-8","url":null,"abstract":"","PeriodicalId":48540,"journal":{"name":"Lancet Rheumatology","volume":" ","pages":""},"PeriodicalIF":15.0,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144718912","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":"EULAR 2025","authors":"Anna Clark","doi":"10.1016/S2665-9913(25)00193-6","DOIUrl":"10.1016/S2665-9913(25)00193-6","url":null,"abstract":"","PeriodicalId":48540,"journal":{"name":"Lancet Rheumatology","volume":"7 8","pages":"Pages e530-e531"},"PeriodicalIF":15.0,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144678895","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":"Reassessing antimalarial use in long-term SLE clinical trials","authors":"David Bernal-Bello ,&nbsp;Alejandro Morales-Ortega ,&nbsp;Jaime García de Tena","doi":"10.1016/S2665-9913(25)00155-9","DOIUrl":"10.1016/S2665-9913(25)00155-9","url":null,"abstract":"","PeriodicalId":48540,"journal":{"name":"Lancet Rheumatology","volume":"7 8","pages":"Page e527"},"PeriodicalIF":15.0,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144679131","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":"Reassessing antimalarial use in long-term SLE clinical trials – Authors' reply","authors":"Vibeke Strand ,&nbsp;Kenneth C Kalunian ,&nbsp;Kai Wai Lee ,&nbsp;Caroline Seo ,&nbsp;Gabriel Abreu ,&nbsp;Raj Tummala ,&nbsp;Hussein Al-Mossawi ,&nbsp;Elizabeth A Duncan ,&nbsp;Catharina Lindholm","doi":"10.1016/S2665-9913(25)00182-1","DOIUrl":"10.1016/S2665-9913(25)00182-1","url":null,"abstract":"","PeriodicalId":48540,"journal":{"name":"Lancet Rheumatology","volume":"7 8","pages":"Pages e527-e528"},"PeriodicalIF":15.0,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144679130","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}