Advances in Rheumatology最新文献

{"title":"Reply to the letter on \"Brazilian guidelines for the management of tuberculosis infection in immune-mediated inflammatory diseases: is retesting in latent tuberculosis screening appropriate and safe?\"","authors":"Viviane Angelina de Souza, Ana Luiza Mendes Amorim Caparroz, Virginia Fernandes Moça Trevisani, Anna Carolina Faria Moreira Gomes Tavares, Ana Karla Guedes de Melo, Anete Trajman, Ana Cristina de Medeiros-Ribeiro, Marcelo de Medeiros Pinheiro, Ricardo Machado Xavier, Odirlei Andre Monticielo, Maria Fernanda Brandão de Resende Guimarães, Flavio Sztajnbok, Sidney Bombarda, Liliana Andrade Chebli, Adriana Maria Kakehasi, Ana Luiza Bierrenbach, Ana Paula Monteiro Gomides Reis, Blanca Elena Rios Gomes Bica, Claudia Diniz Lopes Marques, Cristina Flores, Denise Silva Rodrigues, Eduardo Dos Santos Paiva, Eliana Dias Matos, Fernanda Dockhorn Costa Johansen, Helio Arthur Bacha, Joana Starling de Carvalho, José Roberto Provenza, Ketty Lysie Libardi Lira Machado, Licia Maria Henrique da Mota, Lilian David de Azevedo Valadares, Marco Antônio Araújo da Rocha Loures, Margareth Maria Pretti Dalcolmo, Maria Cecilia de Carvalho Bortoletto, Max Igor Banks Ferreira Lopes, Rejane Maria Rodrigues de Abreu Vieira, Ricardo Romiti, Rogerio Saad-Hossne, Rozana Mesquita Ciconelli, Valderilio Feijó Azevedo, Valéria Maria Augusto, Vitor Alves Cruz, Gecilmara Cristina Salviato Pileggi","doi":"10.1186/s42358-025-00501-3","DOIUrl":"10.1186/s42358-025-00501-3","url":null,"abstract":"<p><p>In response to a letter addressing the Brazilian guidelines for tuberculosis infection (TBI) screening in immune-mediated inflammatory diseases (IMID), we clarify that the recommendations reflect a structured, evidence-based consensus developed by a multidisciplinary panel, in accordance with internationally accepted standards. We reaffirm the rationale for annual TBI retesting during the first three years of immunosuppressive therapy, particularly with TNF inhibitors, and the outweighed risk of tuberculosis preventive treatment (TPT), given the benefits. These recommendations are aligned with national and international public health policies and underscore the need for flexibility in clinical judgment. Nonetheless, they are conditional, reflecting the limited robustness of the available evidence. Continued dialogue is essential to ensure the safety and protection of IMID patients in high-burden settings like Brazil.</p>","PeriodicalId":48634,"journal":{"name":"Advances in Rheumatology","volume":"65 1","pages":"59"},"PeriodicalIF":2.8,"publicationDate":"2025-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13488836/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145557769","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ultrasound grayscale histogram analysis for early rheumatoid arthritis cartilage assessment.","authors":"Xiu Zheng, Yuanjiao Tang, Min Li, Bingjie Liu, Li Qiu","doi":"10.1186/s42358-025-00489-w","DOIUrl":"10.1186/s42358-025-00489-w","url":null,"abstract":"<p><p>OBJECTIVE: To evaluate the feasibility of ultrasound grayscale histogram analysis in detecting metacarpal head (MH) cartilage damage in rheumatoid arthritis (RA) and its correlation with clinical parameters. METHODS: This cross-sectional study enrolled 50 RA patients and 50 healthy controls (HCs). Bilateral MH2-5 cartilages were scanned using a Mindray Resona R9 ultrasound system. Grayscale values were quantified via histogram analysis in standardized regions of interest. Intraclass correlation coefficients (ICC) assessed reliability. Mann-Whitney U tests compared groups; Spearman correlation analyzed associations with disease duration and body mass index (BMI). RESULTS: RA patients exhibited significantly higher grayscale values in total MH (median: 48.6 vs. 44.8, P < 0.001), MH2 (46.4 vs. 42.7, P = 0.015), and MH3 (48.6 vs. 43.4, P = 0.006) compared to HCs. ICC demonstrated excellent intra- (0.905–0.945) and inter-observer (0.861–0.908) reliability. Weak correlations were observed between grayscale values and disease duration (r = 0.120, P = 0.001) or BMI (r = − 0.136, P < 0.001). CONCLUSION: Quantitative grayscale histogram analysis of the metacarpal head cartilage demonstrates promising feasibility and provides valuable imaging evidence to support the early diagnosis of rheumatoid arthritis. CLINICAL TRIAL NUMBER: Not applicable. </p>","PeriodicalId":48634,"journal":{"name":"Advances in Rheumatology","volume":"65 1","pages":"57"},"PeriodicalIF":2.8,"publicationDate":"2025-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13488821/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145507648","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Complicated grief following pregnancy loss in women with autoimmune rheumatic diseases: a comparative cross-sectional study.","authors":"Maria Eugenia Corral-Trujillo, Rodrigo Cerda-González, Anahí Carrazco-Chapa, Rodrigo Cantu-Barreda, Luis Carlos Berlanga-Muñoz, Brayan Uriel Montes-Rodriguez, Jesus Alberto Cardenas-de la Garza, Lorena Perez-Barbosa, Cassandra Michele Skinner-Taylor, Andrea Lizbeth Guajardo-Aldaco, Janett Riega-Torres, Dionicio Angel Galarza-Delgado","doi":"10.1186/s42358-025-00492-1","DOIUrl":"10.1186/s42358-025-00492-1","url":null,"abstract":"<p><p>BACKGROUND: Women with autoimmune rheumatic diseases (ARDs) present a higher rate of obstetric adverse events including perinatal losses (PL). The aim of this study is to determine the frequency of both complicated grief (CG) following PL and resilience in women with ARDs and compare it to a control group. METHODS: We performed an analytical, comparative, cross-sectional study from November 2022 to July 2024. Women with and without an ARD diagnosis with a history of PL who completed a self-report survey including the Perinatal Grief Scale (PGS) and the Wagnild and Young Resilience Scale (RS) were selected. We analyzed sociodemographic data, clinical characteristics, and scale scores with SPSS Version 25. RESULTS: Ninety participants were enrolled in this study. Thirty-three women met criteria for CG following PL, 22 (66.7%) belonged to the control group and 11 (33.3%) to the ARD group (p = 0.016). The RS median score was 138.00 (IQR 117–163). A logistic regression revealed that having an ARD is independently associated with not presenting CG (OR = 0.338; p = 0.018, 95% CI = 0.138–0.829), suggesting that women with ARDs are 2.95 times less likely to develop CG. CONCLUSIONS: Women with ARDs had a lower frequency of CG following PL than the control group. We found no significant difference between groups regarding resilience capacity. The logistic regression suggests that ARDs serve as a protective factor for developing CG following PL. Screening for CG following PL in women with and without ARDs may help optimize maternal and infant health. CLINICAL TRIAL NUMBER: Not applicable. </p>","PeriodicalId":48634,"journal":{"name":"Advances in Rheumatology","volume":"65 1","pages":"58"},"PeriodicalIF":2.8,"publicationDate":"2025-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13488759/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145507517","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Platelet-to-lymphocyte ratio: a predictive biomarker for exocrine gland involvement in Sjögren disease.","authors":"Minchao Zou, Yitian Shi, Wei Xu, Yunxia Hu, Kejia Yu, Ting Liu, Fenghong Yuan","doi":"10.1186/s42358-025-00490-3","DOIUrl":"10.1186/s42358-025-00490-3","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the relationship between the platelet-to-lymphocyte ratio (PLR) and ocular surface damage as well as labial gland pathology in patients with Sjögren disease (SjD).</p><p><strong>Methods: </strong>This retrospective study included 181 newly diagnosed SjD patients. Blood tests were used to calculate PLR, systemic immune-inflammation index (SII), neutrophil-to-lymphocyte ratio (NLR), and fibrinogen-to-albumin ratio (FAR). All patients underwent comprehensive ocular surface examinations and labial gland biopsies. Spearman correlation analysis was used to evaluate the relationships between variables, and receiver operating characteristic (ROC) curves determined optimal cutoff values for PLR in predicting tear meniscus height (TMH) abnormality and labial gland pathology positivity. Mann-Whitney U tests identified potential risk factors for labial gland pathology positivity. The significant factors (P < 0.05) from the univariate analysis were incorporated into a binary logistic regression model to determine independent risk factors.</p><p><strong>Results: </strong>(1) Correlation analysis showed that PLR was positively correlated with SII (r = 0.680, P < 0.001), NLR (r = 0.488, P < 0.001), FAR (r = 0.162, P = 0.031), and labial gland pathology (r = 0.159, P = 0.035), while PLR was negatively correlated with TMH (r=-0.202, P = 0.008). (2) ROC analysis revealed that PLR had an area under the curve (AUC) of 0.609 (95%CI: 0.522-0.695, p = 0.015) for predicting abnormal TMH, with a sensitivity of 48.6% and specificity of 74% at a cutoff of 151.34. For predicting labial gland pathology positivity, PLR had an AUC of 0.616 (95% CI: 0.503-0.730, p = 0.035), with a sensitivity of 65.7% and specificity of 58.8% at a cutoff of 122.92. (3) Binary logistic regression analysis showed that the high PLR group(PLR > 122.92) had 2.8 times the risk of labial gland pathology positivity compared to the low PLR group (OR = 2.842, 95%CI: 1.271-5.358, p = 0.011).</p><p><strong>Conclusion: </strong>PLR is a useful inflammatory marker for evaluating exocrine gland involvement in SjD patients.</p>","PeriodicalId":48634,"journal":{"name":"Advances in Rheumatology","volume":"65 1","pages":"56"},"PeriodicalIF":2.8,"publicationDate":"2025-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13488747/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145497234","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy of biologic DMARDs in improving the clinical response of patients with polyarticular juvenile idiopathic arthritis: a meta-analysis of RCTs.","authors":"Pedro Henrique Aquino Gil de Freitas, Mylena Maria Guedes de Almeida, Áurea Maria Salomão Simão, Ana Beatriz Bertol, Barkhá Vijendra, Bianca Lisa de Faria, Camila Maria Paiva França Telles","doi":"10.1186/s42358-025-00488-x","DOIUrl":"10.1186/s42358-025-00488-x","url":null,"abstract":"<p><strong>Background: </strong>We aimed to conduct a meta-analysis of randomized controlled trials (RCTs) to examine the efficacy of biologic DMARDs in improving the clinical response of patients with polyarticular JIA.</p><p><strong>Methods: </strong>The literature and relevant reviews were searched for published clinical studies comparing the efficacy of standard therapy without biologic DMARDs to that of biologic DMARDs in patients with polyarticular JIA. The focus was on the minimal clinical effectiveness criteria of the pediatric American College of Rheumatology (pedACR30-100), time to disease flare, remission clinical, inactive disease, and pedACR30/flare. This meta-analysis followed the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines.</p><p><strong>Results: </strong>In total, 9 randomized controlled trials were included in the study. Compared with standard therapy, treatment with biologics significantly improved PedACR70 (relative risk [RR] 1.68; 95% confidence interval [CI] 1.43-1.96; p < 0.00001). Similarly, PedACR30 (RR 1.37; CI 1.19-1.58; p < 0.0001), PedACR50 (RR 1.49; CI 1.25-1.77; p < 0.00001), PedACR90 (RR 1.67; CI 1.34-2.09; p < 0.00001) and PedACR100 (RR 1.88; CI 1.05-3.35; p = 0.03) were also significantly improved with biologic treatment. However, patients on standard therapy had worse flare outcomes, as determined by the PedACR30/Flare (RR 0.56; CI 95% 0.45-0.70; p < 0.00001). Additionally, the time to disease flare was significantly shorter with standard therapy (hazard ratio [HR] 0.38; 95% CI 0.27-0.54; p < 0.00001).</p><p><strong>Conclusion: </strong>Compared with standard therapy, biologic DMARDs lead to significant and long-term improvements in signs and symptoms in polyarticular JIA patients.</p><p><strong>Trial registration: </strong>This meta-analysis was registered in PROSPERO under the registration number CRD42023494938 on December 18, 2023.</p>","PeriodicalId":48634,"journal":{"name":"Advances in Rheumatology","volume":"65 1","pages":"55"},"PeriodicalIF":2.8,"publicationDate":"2025-11-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13488648/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145490662","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Associations between kinesiophobia, pain, functional disability, balance confidence and transverse abdomen muscle activation in elderly individuals with chronic nonspecific low back pain: a cross-sectional study.","authors":"Ariela Torres Cruz, Priscila de Oliveira Januário, Mateus Dias Antunes, Ingred Merllin Batista de Souza, Mara Maria Lisboa Santana Pinheiro, Anice de Campos Pássaro, Elisa Frutos Bernal, Ana María Martín-Nogueras, Amelia Pasqual Marques","doi":"10.1186/s42358-025-00485-0","DOIUrl":"10.1186/s42358-025-00485-0","url":null,"abstract":"<p><p>BACKGROUND: Chronic low back pain has a high prevalence in the elderly population. Psychosocial dimensions are possible causes of pain affecting the patient’s development and prognosis. Kinesiophobia is associated with a natural response to chronic low back pain and should be considered a key treatment target for physical therapists. The aim of this study was to investigate the association between kinesiophobia and pain intensity, functional disability, balance confidence and transversus abdominis muscle activation in elderly individuals with chronic nonspecific low back pain. METHODS: Eighty elderly people with chronic nonspecific low back pain participated in this study. Kinesiophobia was assessed using the Tampa Kinesiophobia Scale, pain intensity was measured using the Numerical Pain Rating Scale, functional disability was measured using the Oswestry Disability Index, balance confidence was measured using the Activities-Specific Balance Confidence Scale, and transversus abdominis muscle activation was measured using the pressure biofeedback unit. The data were analyzed in the SPSS Statistics program using Pearson’s and Spearman’s correlation coefficients. RESULTS: The results show a correlation between kinesiophobia, pain intensity and functional disability, being negative for confidence in balance. The correlation between kinesiophobia and activation of the transversus abdominis muscle was not significant. CONCLUSION: The results suggest a positive correlation between kinesiophobia, pain intensity and functional disability and a negative correlation with balance confidence. </p>","PeriodicalId":48634,"journal":{"name":"Advances in Rheumatology","volume":"65 1","pages":"54"},"PeriodicalIF":2.8,"publicationDate":"2025-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13488750/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145453710","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessment of cognitive functions in individuals with systemic lupus erythematosus.","authors":"Juliana Rosa Pires Vieira, Andrea Toledo de Oliveira Rezende, Danilo Rocha Dias, Nilzio Antonio da Silva, Marcos Rassi Fernandes","doi":"10.1186/s42358-025-00461-8","DOIUrl":"10.1186/s42358-025-00461-8","url":null,"abstract":"<p><strong>Introduction: </strong>Neurocognitive changes may hinder the autonomy and independence of patients diagnosed with Systemic Lupus Erythematosus (SLE), being considered as one of the main negative outcomes.</p><p><strong>Objectives: </strong>To evaluate the cognitive functions of patients diagnosed with active SLE and in remission at the Rheumatology Outpatient Clinic of the Hospital das Clínicas, School of Medicine, Universidade Federal de Goiás.</p><p><strong>Methodology: </strong>This was a cross-sectional study, non-probabilistic sample and consecutive type. MiniMental State Examination (MMSE), Five Digits Test (FDT), and Rey's Complex Figures (FCR) were used in 83 patients in the period from November 2021 to May 2022. Patients with depressive disorders and users of alcohol and other drugs were excluded.</p><p><strong>Results: </strong>The assessed cognitive functions - attention, memory, language, and executive functions - showed mild impairments, corroborating previous studies. There was a significant difference (p > 0,05) concerning cognitive performance when comparing patients with active SLE and in remission groups. Cognitive function was not associated with time of diagnosis.</p><p><strong>Conclusion: </strong>In this sense, cognitive dysfunctions were present in patients with active SLE and remission. The results showed mild cognitive impairment in patients diagnosed with SLE.</p>","PeriodicalId":48634,"journal":{"name":"Advances in Rheumatology","volume":"65 1","pages":"53"},"PeriodicalIF":2.8,"publicationDate":"2025-11-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13488742/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145439844","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neuropathic pain and central sensitization in patients with rheumatoid arthritis attending a tertiary hospital.","authors":"Maria Nathalia Gabriela Rocha Pontes de Oliveira, Débora de Jesus Sena, Ana Karla Guedes de Melo, Danielle C Soares Egypto, Luís Fábio Barbosa Botelho, Alessandra de Sousa Braz","doi":"10.1186/s42358-025-00487-y","DOIUrl":"10.1186/s42358-025-00487-y","url":null,"abstract":"<p><strong>Background: </strong>In rheumatoid arthritis (RA), the persistence of pain despite adequate inflammatory control may indicate the involvement of nociplastic and/or neuropathic pain (NP).</p><p><strong>Objective: </strong>To investigate the presence of central sensitization (CS) and/or NP in patients with RA.</p><p><strong>Methods: </strong>This descriptive, cross-sectional study used convenience sampling and included adult patients (≥ 18 years) with RA diagnosed according to the 2010 classification criteria of the American College of Rheumatology - ACR. The following instruments were applied: Central Sensitization Inventory (CSI), PainDETECT Questionnaire (PD-Q), and the 2010/2011 ACR criteria for fibromyalgia (FM), revised in 2016 (the latter applied only to patients with CSI ≥ 40). Descriptive and predictive analyses were conducted with a significance level of 5%.</p><p><strong>Results: </strong>A total of 113 patients were included (mean age 54.3 years; 93.81% female; mean disease duration 12.11 years). CS was identified in 59.29% of patients; among them, 47.76% met FM criteria, while 52.24% did not. Among patients with CS, 53.73% reported severe pain (Numeric Rating Scale, NRS), and 44.78% had high disease activity (Clinical Disease Activity Index, CDAI). CSI was a significant predictor of both NRS and CDAI in univariate (p < 0.001) and multivariate analyses (p = 0.037 and p = 0.009, respectively). According to PD-Q, 17.70% of patients had probable NP, and PD-Q scores were predictive of CDAI, NRS, and CSI (p < 0.001). Among patients with CS, 26.87% also showed overlapping NP.</p><p><strong>Conclusions: </strong>A substantial proportion of RA patients presented with CS-related pain, even in the absence of FM, suggesting a mixed (\"top-down and bottom-up\") nociplastic pain profile. Both CS and NP were associated with higher pain levels and increased disease activity. This is the first Brazilian study to characterize the coexistence of CS-related pain (with or without FM) and NP in RA, offering relevant insights for the clinical management of chronic pain in this population. These findings reinforce that routine screening and assessment of CS and NP should be an integral and continuous component of RA management, preceding therapeutic adjustments and extending throughout follow-up.</p>","PeriodicalId":48634,"journal":{"name":"Advances in Rheumatology","volume":"65 1","pages":"52"},"PeriodicalIF":2.8,"publicationDate":"2025-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13488841/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145423246","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Brazilian Registry of Sjögren's Disease (BRAS): a full picture of Sjögren's disease in Brazil.","authors":"Valéria Valim, Samira Tatiyama Miyamoto, Fabiola Reis de Oliveira, Érica Vieira Serrano, Laura Caldas Dos Santos, Roberta de Almeida Pernambuco, Simone Appenzeller, Juliana Markus, Leandro Augusto Tanure, Maria Lúcia Lemos Lopes, Rafael Coradin, Aysa César Pinheiro, Vanessa Hax, Aiessa Zanchett Fedrigo, Sandra Lúcia Euzébio Ribeiro, Karina Gatz Capobianco, Giovanna Sant'Ana Petterle, Alisson Pugliesi, Débora Cerqueira Calderaro, Ketty Lysie Libardi Lira Machado, Paula Regina Toche Dos Santos, Nathalia de Carvalho Sacilotto, Anna Maria de Senna Migueletto, Diego Ustárroz Cantali, Vitalina de Souza Barbosa, Mateus Maia Marzola, Eduardo Melani Rocha, Ricardo Machado Xavier, Virgínia Fernandes Moça Trevisani","doi":"10.1186/s42358-025-00481-4","DOIUrl":"10.1186/s42358-025-00481-4","url":null,"abstract":"<p><p>Cohort studies are essential for elucidating disease progression, guiding research priorities, and identifying gaps in diagnosis and treatment. This manuscript presents the protocol and preliminary findings of the Brazilian Registry on Sjögren’s Disease (BRAS), a national, prospective cohort supported by the Brazilian Society of Rheumatology (SBR). BRAS aims to collect comprehensive data on patients with Sjögren’s Disease (SjD) who meet the 2002 AECG and/or 2016 ACR-EULAR classification criteria, fostering high-quality research initiatives. Data collection is conducted via REDCap and includes demographic, laboratory, and clinical parameters such as disease activity (ESSDAI), damage (SSDDI), comorbidities, cardiovascular risk (Framingham score), labial salivary gland biopsy, salivary gland ultrasound, and therapeutic approaches. Patient-reported outcome measures (PROMs) include ESSPRI, PROFAD, HADS, ESE, IPAQ-SF, and EQ-5D. To date, 1,082 patients have been enrolled (mean age 55.3 ± 13.3 years; 96.6% women). Major findings include xerostomia (93%), xerophthalmia (92%), positive lip biopsy (83.6%), anti-Ro/SSA antibodies (77%), anti-La/SSB (43%), systemic manifestations (71.3%, ESSDAI 4.8 ± 5.8), and organ damage (86.9%, SSDDI 2.3 ± 1.6). Average disease duration was 7 ± 6.3 years with a diagnostic delay of 3.7 years. Treatments included corticosteroids (18%), hydroxychloroquine (46%), immunosuppressants (38%), and rituximab (6.5%). Common comorbidities were hypertension (34.9%), obesity (30.2%), dyslipidemia (29.7%), fibromyalgia (26%), osteoarthritis (24%), hypothyroidism (23.6%), diabetes (12.9%), and cancer (12.7%). Patients reported high symptom burden (ESSPRI 5.4 ± 2.4), anxiety (48%), depression (40%), low quality of life (63.6 ± 22.2), and insufficient physical activity (only 32.7% exercised regularly). Findings highlight the need for a multidisciplinary care program. The findings reveal diagnostic delays, limited healthcare access, high symptom burden, systemic involvement, poor mental health and highlight the need for a multidisciplinary care program. The next phase involves establishing a biorepository for biological samples. Clinical trial number Not applicable.</p>","PeriodicalId":48634,"journal":{"name":"Advances in Rheumatology","volume":"65 1","pages":"51"},"PeriodicalIF":2.8,"publicationDate":"2025-10-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13488826/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145379414","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"No flare after pre-exposure prophylaxis with monoclonal antibodies against SARS-COV2 in patients with immune-mediated rheumatic diseases: a Brazilian experience.","authors":"Maria Fernanda Zacarin, Carolina Wonhnrath Menuzzo, Debora Pessoa De Souza, Regis Suwa Marques, Rodrigo Da Rocha Jorge, Vitor de Castro Grotti, Thiago Junqueira Trevisan, Lilian Tiemi Hirata, Marília Paula Souza Dos Santos, Juliana Zonzini Gaino Borghi, Michel Alexandre Yazbek, Ana Paula Toledo Del Rio, Lilian Tereza Lavras Costallat, Zoraida Sachetto, Manoel Barros Bertolo, Alisson Pugliesi","doi":"10.1186/s42358-025-00486-z","DOIUrl":"10.1186/s42358-025-00486-z","url":null,"abstract":"","PeriodicalId":48634,"journal":{"name":"Advances in Rheumatology","volume":"65 1","pages":"49"},"PeriodicalIF":2.8,"publicationDate":"2025-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13488779/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145369049","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}