Lancet Rheumatology最新文献

{"title":"The Nobel celebrates tolerance","authors":"Heather Van Epps","doi":"10.1016/S2665-9913(25)00311-X","DOIUrl":"10.1016/S2665-9913(25)00311-X","url":null,"abstract":"","PeriodicalId":48540,"journal":{"name":"Lancet Rheumatology","volume":"7 12","pages":"Page e839"},"PeriodicalIF":16.4,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145532680","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 global, regional, and national burden attributable to low bone mineral density, 1990–2020: an analysis of a modifiable risk factor from the Global Burden of Disease Study 2021","authors":"","doi":"10.1016/S2665-9913(25)00105-5","DOIUrl":"10.1016/S2665-9913(25)00105-5","url":null,"abstract":"<div><h3>Background</h3><div>Fractures related to osteoporosis and low bone mineral density lead to substantial morbidity, mortality, and cost to individuals and health systems. Here we present the most up-to-date global, regional, and national estimates of the contribution of low bone mineral density to the burden of fractures from falls and additional categories of injuries from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021.</div></div><div><h3>Methods</h3><div>The burden of low bone mineral density was estimated from 1990 to 2020 in terms of years lived with disability (YLDs), disability-adjusted life years (DALYs), and deaths, for individuals aged 40 years and older, using data from population-based studies from 48 countries or territories (169 unique sources). Mean standardised femoral neck bone mineral density values were estimated by GBD location, age, and sex by meta-regression. Based on a separate meta-analysis of population-based studies from nine countries (12 unique sources), we also estimated the pooled relative risk of fractures per unit decrease in bone mineral density (g/cm<sup>2</sup>). The population-attributable fraction for low bone mineral density was calculated by comparing the observed distributions of standardised femoral neck bone mineral density to an age-specific and sex-specific counterfactual distribution, defined as the 99th percentile of five rounds of the National Health and Nutrition Examination Survey in the USA, by 5-year age group and sex. Hospital and emergency department data were used to derive the incidence of fractures for six categories of injury (road injuries, other transport injuries, falls, non-venomous animal contact, exposure to mechanical forces, and physical interpersonal violence) using ICD codes. Deaths due to fractures were estimated as the proportion of in-hospital deaths due to the specified injury causes for which a fracture (nature of injury code) was more severe than the cause of injury code. YLDs and DALYs attributable to low bone mineral density by cause of injury were also determined according to previous GBD methods.</div></div><div><h3>Findings</h3><div>In 2020, 8·32 million (95% UI 5·58–10·84) YLDs, 17·2 million (14·1–20·2) DALYs, and 477 000 (411 000–536 000) deaths were attributable to low bone mineral density globally in individuals aged 40 years and older. Between 1990 and 2020, global YLDs, DALYs, and deaths attributable to low bone mineral density increased by 91·8% (88·5–95·1), 89·8% (81·5–99·0), and 127·1% (108·5–144·5), respectively. Over this period, the age-standardised global rates of YLDs, DALYs, and deaths attributable to low bone mineral density showed modest decreases. In 2020, falls accounted for 76·2% (95% UI 74·2–78·3) of YLDs, 65·2% (62·9–67·6) of DALYs, and 71·0% (67·4–72·8) of deaths attributable to low bone mineral density, and road injuries largely accounted for the remaining amount: 12·4% (11·1–13·6) of YLDs, 24·6% (22·5–27·1) of ","PeriodicalId":48540,"journal":{"name":"Lancet Rheumatology","volume":"7 12","pages":"Pages e873-e894"},"PeriodicalIF":16.4,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145092803","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)00318-2","DOIUrl":"10.1016/S2665-9913(25)00318-2","url":null,"abstract":"","PeriodicalId":48540,"journal":{"name":"Lancet Rheumatology","volume":"7 12","pages":"Page e838"},"PeriodicalIF":16.4,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145532679","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":"Risk factors for interstitial lung disease in early rheumatoid arthritis and external validation of screening strategies: a cross-sectional analysis of the prospective SAIL-RA cohort in the USA","authors":"Gregory C McDermott MD , Ritu Gill MD , Suzanne Byrne MD , Staci Gagne MD , Xiaosong Wang MSc , Misti L Paudel PhD , Emily Kowalski BS , Grace Qian BA&Sc , Katarina Bade BS , Kevin Mueller BS , Alene Saavedra BA , Kathleen M M Vanni BA , Liya S Getachew MD , Caleb Bolden BA , Lauren A O'Keeffe BS , Natalie A Davis MSc , Alison Puri BA , Tina Mahajan MD , Erica Mulcaire-Jones MD , Neda Kortam BA , Jeffrey A Sparks MD","doi":"10.1016/S2665-9913(25)00158-4","DOIUrl":"10.1016/S2665-9913(25)00158-4","url":null,"abstract":"<div><h3>Background</h3><div>Evaluation of risk factors and screening strategies for rheumatoid arthritis-associated interstitial lung disease (ILD) in patients with early rheumatoid arthritis has been scarce. We investigated the prevalence of rheumatoid arthritis-associated ILD, risk factors, and the performance of proposed screening methods for rheumatoid arthritis-associated ILD in patients with early rheumatoid arthritis.</div></div><div><h3>Methods</h3><div>We performed a cross-sectional analysis of the prospective Study of Inflammatory Arthritis and Interstitial Lung Disease in Early RA (SAIL-RA). Study participants were eligible for inclusion if diagnosed with early rheumatoid arthritis, defined as being within 2 years of a diagnosis. Exclusions were pregnancy at enrolment or inability or unwillingness to obtain high-resolution CT (HRCT) chest imaging. Participants were enrolled at five academic health-care centres in the USA and assessed through surveys, medical history, HRCT chest imaging, pulmonary function tests, and laboratory testing for autoantibodies. Rheumatoid arthritis-associated ILD was identified through independent review of HRCTs by thoracic radiologists. We investigated risk factors for rheumatoid arthritis-associated ILD using multivariable logistic regression and reported the predictive performance of screening strategies for rheumatoid arthritis-associated ILD (from the ANCHOR-RA study; the 2023 guidelines from the American College of Rheumatology and American College of Chest Physicians [ACR–CHEST]; a four-factor risk score proposed in 2023; Sociedad Española de Reumatología and Sociedad Española de Neumología y Cirugía Torácica criteria; criteria proposed by Paulin and colleagues; and criteria derived from the ESPOIR cohort). The primary outcome was the presence of rheumatoid arthritis-associated ILD.</div></div><div><h3>Findings</h3><div>Participants were recruited between May 1, 2017, and Feb 22, 2024. Of 191 patients who were assessed for eligibility and included in the SAIL-RA cohort, 172 completed HRCT chest imaging and were included in this analysis: 128 (74%) were female, 44 (26%) were male, mean age was 55·3 years (SD 13·7), 126 (74%) of 171 were anti-cyclic citrullinated peptide (CCP) positive, 116 (68%) of 170 were rheumatoid factor positive, and median rheumatoid arthritis duration was 0·79 years (IQR 0·36–1·60); 19 (11%) had rheumatoid arthritis-associated ILD on HRCT. Factors associated with rheumatoid arthritis-associated ILD included moderate or high rheumatoid arthritis disease activity, determined by Disease Activity Score using 28 joints with erythrocyte sedimentation rate more than or equal to 3·2 (adjusted odds ratio [aOR] 7·00 [95% CI 1·95–25·13] <em>vs</em> remission or low disease activity) and age of 60 years or older (aOR 3·87 [1·33–11·27] <em>vs</em> age <60 years). Sensitivity of screening strategies ranged from 0·05 (95% CI 0·00–0·15) with the Paulin criteria (four-point cutoff) to 1·00 (","PeriodicalId":48540,"journal":{"name":"Lancet Rheumatology","volume":"7 12","pages":"Pages e851-e863"},"PeriodicalIF":16.4,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145313924","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 Oct 15. https://doi.org/10.1016/S2665-9913(25)00248-6","authors":"","doi":"10.1016/S2665-9913(25)00291-7","DOIUrl":"10.1016/S2665-9913(25)00291-7","url":null,"abstract":"","PeriodicalId":48540,"journal":{"name":"Lancet Rheumatology","volume":"7 12","pages":"Page e837"},"PeriodicalIF":16.4,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145532194","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":"Anti-BCMA CAR-T for the treatment of IgG4-related disease: clinical assessment and single-cell transcriptomic analysis","authors":"Shaozhe Cai , Yu Chen , Cong Ye , Umehara Hisanori , Jishuai Zhang , Ziwei Hu , Wei Sun , Lingli Dong","doi":"10.1016/S2665-9913(25)00215-2","DOIUrl":"10.1016/S2665-9913(25)00215-2","url":null,"abstract":"","PeriodicalId":48540,"journal":{"name":"Lancet Rheumatology","volume":"7 12","pages":"Pages e834-e836"},"PeriodicalIF":16.4,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145318699","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: e747","authors":"","doi":"10.1016/S2665-9913(25)00314-5","DOIUrl":"10.1016/S2665-9913(25)00314-5","url":null,"abstract":"","PeriodicalId":48540,"journal":{"name":"Lancet Rheumatology","volume":"7 12","pages":"Page e837"},"PeriodicalIF":16.4,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145426930","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":"ILD risk prediction in routine care for rheumatoid arthritis","authors":"Javier Narváez","doi":"10.1016/S2665-9913(25)00183-3","DOIUrl":"10.1016/S2665-9913(25)00183-3","url":null,"abstract":"","PeriodicalId":48540,"journal":{"name":"Lancet Rheumatology","volume":"7 12","pages":"Pages e827-e829"},"PeriodicalIF":16.4,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145313971","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":"Can AI be used to classify the focus score in Sjögren's disease?","authors":"Tamandeep K Bharaj , Kathrine Skarstein","doi":"10.1016/S2665-9913(25)00258-9","DOIUrl":"10.1016/S2665-9913(25)00258-9","url":null,"abstract":"","PeriodicalId":48540,"journal":{"name":"Lancet Rheumatology","volume":"7 12","pages":"Pages e829-e830"},"PeriodicalIF":16.4,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145214190","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":"Exploiting a unified vascular framework to predict organ-specific complications and accomplish disease modification in systemic sclerosis","authors":"John D Pauling PhD ,&nbsp;Prof Yannick Allanore PhD ,&nbsp;Prof Maya H Buch PhD ,&nbsp;Prof Maurizio Cutolo PhD ,&nbsp;Prof Francesco Del Galdo PhD ,&nbsp;Prof Christopher P Denton PhD ,&nbsp;Stefano Di Donato MSc ,&nbsp;Robyn T Domsic MD ,&nbsp;Tracy Frech MD ,&nbsp;Prof Ariane L Herrick MD ,&nbsp;Prof Marco Matucci-Cerinic PhD ,&nbsp;Prof Vanessa Smith PhD ,&nbsp;Prof Marie-Elise Truchetet PhD ,&nbsp;Michael Hughes PhD","doi":"10.1016/S2665-9913(25)00251-6","DOIUrl":"10.1016/S2665-9913(25)00251-6","url":null,"abstract":"<div><div>Immune-mediated vascular endothelial injury is considered one of the earliest pathological features in systemic sclerosis and is thought to occur simultaneously within a broad range of organs, although typically clinically manifesting only as Raynaud's phenomenon in the early stages. Overt vascular systemic sclerosis manifestations include Raynaud's phenomenon, abnormal nailfold capillary morphology, digital ulcers, pulmonary arterial hypertension, cardiovascular disease (primary and coronary), telangiectasia, renal crisis, and gastric antral vascular ectasia. Tissue ischaemia might also contribute to aberrant tissue remodelling, resulting in calcinosis and fibrosis. Recognition of the substantial inter-relationship between these vascular complications is growing; examples of vascular treatment interventions targeting digital vasculopathy having off-target vascular benefits in other organs have been reported. In general, treatment of life-threatening vascular complications, such as pulmonary arterial hypertension, is not commenced until classifiable organ disease has occurred; however, the identification of robust prognostic biomarkers might allow such complications to be averted with preventative disease modification. In this Personal View, we describe the inter-relationship between vascular features of systemic sclerosis. We consider how these features might be exploited to establish a unified vascular conceptual framework that can inform the development of both predictive composite indices to guide preventative intervention, and a unified vascular composite endpoint model that can effectively capture clinically meaningful disease modification in future clinical trials of vasoactive treatments in systemic sclerosis.</div></div>","PeriodicalId":48540,"journal":{"name":"Lancet Rheumatology","volume":"7 12","pages":"Pages e895-e906"},"PeriodicalIF":16.4,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145313911","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}