Lancet Rheumatology最新文献

{"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}

{"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}