Journal of Rheumatology最新文献

{"title":"Introducing the Global Exploration of Psoriatic Arthritis Disease Activity Assessment (EXPLORE-PsA): The First Young-GRAPPA Research Initiative.","authors":"Michelle L M Mulder, Dylan McGagh, Philip S Helliwell","doi":"10.3899/jrheum.2026-0435","DOIUrl":"10.3899/jrheum.2026-0435","url":null,"abstract":"<p><p>Despite international recommendations advocating for structured assessment of disease activity in psoriatic arthritis (PsA), the routine use of outcome measures in clinical practice remains inconsistent. Barriers such as limited time, lack of training, and restricted access to resources may be contributing to this implementation gap. To address this, the Global Exploration of Psoriatic Arthritis Disease Activity Assessment (EXPLORE-PsA) study aims to systematically evaluate how disease activity measures, including both composite and domain-specific tools, are used in PsA care across diverse global settings. This cross-sectional study will deploy a short English-language online survey targeting rheumatologists and allied health professionals involved in the assessment of people with PsA. Key objectives include the following: (1) characterizing the use of outcome measures in routine practice; (2) comparing usage patterns between academic and nonacademic settings; and (3) identifying perceived barriers and facilitators to implementation. Additional domains include preferences for digital vs paper-based tools, the inclusion of skin and nail assessments in rheumatology, the use of axial spondyloarthritis indices in axial PsA, and perspectives on treat-to-target strategies and patient-initiated follow-up. As the first research initiative led by the Young Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (Y-GRAPPA) network, EXPLORE-PsA not only aims to inform future strategies to enhance outcome assessment in PsA globally but also establishes a collaborative foundation for early career-led research in psoriatic disease. This study was presented at the GRAPPA 2025 annual meeting in Bogotá, Colombia.</p>","PeriodicalId":50064,"journal":{"name":"Journal of Rheumatology","volume":" ","pages":"61-62"},"PeriodicalIF":3.7,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148145277","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"GRAPPA Research Projects: Development of Criteria for Axial Psoriatic Arthritis and Definitions of Complex-to-Manage and Treatment-Refractory Psoriatic Arthritis.","authors":"Jean-Guillaume Letarouilly, Fabian Proft, Philip J Mease, Dafna D Gladman, Denis Poddubnyy","doi":"10.3899/jrheum.2026-0377","DOIUrl":"10.3899/jrheum.2026-0377","url":null,"abstract":"<p><p>At the Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA) 2025 congress, 2 major research initiatives in psoriatic disease were highlighted: (1) the Axial Involvement in Psoriatic Arthritis (AXIS) study, and (2) the GRAPPA consensus definitions for complex-to-manage psoriatic arthritis (C2M-PsA) and treatment-refractory PsA (TR-PsA). The AXIS study, jointly led by Assessment of SpondyloArthritis international Society (ASAS) and GRAPPA, aims to establish internationally accepted classification criteria for axial PsA. In its recently completed phase, 409 patients were recruited across 41 centers in 19 countries. A comprehensive imaging and clinical dataset were collected and analyzed. The next phase will construct and validate a PsA-specific classification instrument to support future research. In parallel, GRAPPA developed consensus definitions for C2M-PsA and TR-PsA through a transparent, multistakeholder process. C2M-PsA refers to patients with persistent symptoms despite appropriate treatment, often complicated by comorbidities or overlapping conditions. TR-PsA is defined by failure to respond to multiple therapies and by confirmed persistent inflammation. These definitions were endorsed by 95% of GRAPPA members and are supported by practical checklists for clinical use. These initiatives represent a significant advancement in PsA research, offering clinicians structured tools to improve patient stratification, guide treatment decisions, and enhance personalized care.</p>","PeriodicalId":50064,"journal":{"name":"Journal of Rheumatology","volume":" ","pages":"58-60"},"PeriodicalIF":3.7,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147950114","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"GRAPPA Debate: Is Plain Radiography in Psoriatic Disease Still Necessary?","authors":"Isaac T Cheng, Arthur Kavanaugh, William Tillett","doi":"10.3899/jrheum.2026-0376","DOIUrl":"10.3899/jrheum.2026-0376","url":null,"abstract":"<p><p>Plain radiographs have been widely used in psoriatic disease (PsD) for diagnosis, classification, and monitoring of structural damage. However, with the emergence of other imaging modalities such as ultrasound, magnetic resonance imaging, and computed tomography, the necessity of plain radiographs in PsD is debatable. At the Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA) 2025 annual meeting in Bogotá, Colombia, Drs. William Tillett and Arthur Kavanaugh were invited to debate the topic \"Plain radiography in psoriatic disease: is it still necessary?\" Each presented evidence-based arguments, incorporating multiple data sources, including clinical trials, to support their positions for and against the topic, respectively. This article summarizes their debate for the broader PsD community.</p>","PeriodicalId":50064,"journal":{"name":"Journal of Rheumatology","volume":" ","pages":"55-57"},"PeriodicalIF":3.7,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147950106","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Transforming Psoriatic Disease Care Through Innovation and Real-World Data: GRAPPA 2025 Soapbox Highlights.","authors":"Keith Colaco, Juan Raul Castro-Ayarza, Vasileios Charisis, Rodrigo García-Salinas","doi":"10.3899/jrheum.2026-0371","DOIUrl":"10.3899/jrheum.2026-0371","url":null,"abstract":"<p><p>The Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA) 2025 annual meeting, held in Bogotá, Colombia, featured soapbox presentations highlighting innovative approaches to psoriatic disease (PsD) care. Dr. Vasileios Charisis presented the Psoriatic Arthritis Inflammation Explained Through Multi-Source Data Analysis Guiding a Novel Personalised Digital Care Ecosystem (iPROLEPSIS) project, which applies digital phenotyping and explainable artificial intelligence to monitor psoriatic arthritis (PsA) using smartphone-based typing dynamics and hand motion tracking. Pilot data demonstrated high accuracy in detecting functional impairments, underscoring the potential of digital biomarkers for personalized disease management. Dr. Rodrigo García-Salinas reported consensus recommendations from the Red de Excelenciaen Artritis para la América Latina-Pan American League of Associations for Rheumatology (REAL-PANLAR) group to establish PsD Centers of Excellence (CoEs) in Latin America. Through a Delphi process, experts from 12 countries defined structural, process, and outcome standards, resulting in 2 adaptable models-optimal and model-designed to reduce diagnostic delays, enhance multidisciplinary collaboration, and improve outcomes. Dr. Juan Raul Castro-Ayarza summarized real-world evidence on biologic drug survival in Latin America, emphasizing fragmented data and variability across national cohorts. Findings from Venezuela, Brazil, Argentina, and Colombia revealed differences in treatment persistence and predictors of discontinuation, reinforcing the need for a standardized regional registry. Collectively, these initiatives demonstrate the value of digital health tools, region-specific care frameworks, and real-world evidence in advancing PsD management globally.</p>","PeriodicalId":50064,"journal":{"name":"Journal of Rheumatology","volume":" ","pages":"23-27"},"PeriodicalIF":3.7,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147950142","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Beyond Pain Intensity: The Relationship Between Pain Catastrophizing and Quality of Life in Psoriatic Arthritis.","authors":"Kyra Chen, Uma Scher, Jose U Scher, Rebecca H Haberman","doi":"10.3899/jrheum.2026-0128","DOIUrl":"10.3899/jrheum.2026-0128","url":null,"abstract":"","PeriodicalId":50064,"journal":{"name":"Journal of Rheumatology","volume":" ","pages":"1045-1046"},"PeriodicalIF":3.7,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13524126/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148145246","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Overall and Sex-Specific Predictors of Secukinumab Effectiveness in European Patients With Psoriatic Arthritis: Results From the EuroSpA Collaboration.","authors":"Jette Heberg, Stylianos Georgiadis, Zohra Faizy Ahmadzay, Bente Glintborg, Isabel Castrejón, Mehrdad Shoae Kazemi, Anne Gitte Loft, Brigitte Michelsen, Simon Horskjær Rasmussen, Karin Laas, Sigrid Vorobjov, Fernando Sánchez-Alonso, Ziga Rotar, Katja Perdan Pirkmajer, Ladislav Šenolt, Bjorn Gudbjornsson, Gerdur Gröndal, Catalin Codreanu, Florenzo Iannone, Fabiola Atzeni, Heřman Mann, Dan Nordström, Anna-Mari Hokkanen, Jorge Garcia, Filipe Barcelos, Pawel Mielnik, Tore K Kvien, Gokce Kenar-Artin, Marleen van de Sande, Michael J Nissen, Burkhard Möller, Tor Olofsson, Johan K Wallman, Merete Lund Hetland, Mikkel Østergaard, Lykke Midtbøll Ørnbjerg","doi":"10.3899/jrheum.2025-1023","DOIUrl":"10.3899/jrheum.2025-1023","url":null,"abstract":"<p><strong>Objective: </strong>Identifying patient characteristics that predict treatment response in psoriatic arthritis (PsA) may help optimize treat-to-target strategies. We aimed to explore overall and sex-specific predictors of secukinumab (SEC) effectiveness in European patients with PsA treated in routine care.</p><p><strong>Methods: </strong>We analyzed data from 14 registries in the European Spondyloarthritis (EuroSpA) Research Collaboration. Patients aged ≥ 18 years at diagnosis, initiating SEC treatment from January 2015 to January 2021, were included. Multiple imputation was used for missing covariates at treatment start (baseline) and Disease Activity Index for Psoriatic Arthritis based on 28 joints (DAPSA28) at 6 months. Overall and sex-stratified analyses were performed by logistic and Cox regressions to identify baseline predictors of the following treatment outcomes: (1) DAPSA28 low disease activity (LDA; DAPSA28 ≤ 14) at 6 months, (2) DAPSA28 moderate response at 6 months, and (3) SEC discontinuation within 12 months.</p><p><strong>Results: </strong>In total, 2790 patients (43% male) were included. Median age was 43 years (IQR 34-52), and SEC was the first-line biologic/targeted synthetic disease-modifying antirheumatic drug (b/tsDMARD) in 665 patients (24%). Positive predictors for both DAPSA28 LDA and DAPSA28 moderate response were male sex, fewer previous b/tsDMARDs, C-reactive protein (CRP) > 10 mg/L, and lower Health Assessment Questionnaire (HAQ) score. Absence of psoriasis, higher patient fatigue, and tender joint counts predicted SEC discontinuation within 12 months. For some outcomes, sex-specific predictors were fewer previous b/tsDMARDs and CRP > 10 mg/L among male patients and lower patient fatigue score among female patients.</p><p><strong>Conclusion: </strong>We identified overall and sex-specific predictors of SEC effectiveness in European patients with PsA. Our findings may support personalized treatment decisions.</p>","PeriodicalId":50064,"journal":{"name":"Journal of Rheumatology","volume":" ","pages":"977-985"},"PeriodicalIF":3.7,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148260336","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"ChatGPT and Other Large Language Models in Inflammatory Arthritis: A Systematic Review Across Clinical Tasks.","authors":"Yosef Adiniaev, Mahmud Omar, Tohar M Timor, Yiftach Barash, Olga R Brook, Mohammad E Naffaa, Alon Gorenshtein, Eyal Klang","doi":"10.3899/jrheum.2026-0444","DOIUrl":"10.3899/jrheum.2026-0444","url":null,"abstract":"<p><strong>Objective: </strong>Large language models (LLMs) are increasingly evaluated for rheumatology tasks, but their performance in inflammatory arthritis (IA) remains unclear. We systematically reviewed LLM performance across clinical tasks in IA.</p><p><strong>Methods: </strong>We conducted a systematic review (PROSPERO: CRD420261359100), searching PubMed, Scopus, and PubMed Central from January 2022 to April 2026 for studies evaluating LLM performance on clinical tasks in IA. Two reviewers (YA, AG) screened 113 records.</p><p><strong>Results: </strong>Eighteen studies covered rheumatoid arthritis (n = 3), axial spondyloarthritis (n = 7), psoriatic arthritis (n = 2), gout (n = 1), juvenile idiopathic arthritis (n = 1), and multiple diseases (n = 4). Most diseases and tasks were represented by only 1 to a few studies, and the evidence base remains early stage and uneven across conditions. Over 20 distinct LLMs were evaluated, including ChatGPT-3.5 to ChatGPT-4o, Gemini 2.0, DeepSeek-R1/V3, Claude, and Perplexity; ChatGPT/GPT variants were the most frequently tested models (16/18 studies), so the current evidence base is predominantly ChatGPT/GPT-based. Findings spanned patient education (n = 11), guideline adherence (n = 6), clinical reasoning (n = 3), and other applications (n = 1). All readability assessments exceeded the recommended thresholds. Guideline concordance ranged from 48% to 96%. Accuracy was lower for case-based clinical scenarios (4.24/6) than for frequently asked questions and guideline-based questions (5.32-5.36/6; <i>P</i> = 0.04). When compared with real clinical data, agreement was poor (Cohen and Fleiss κ ≈ 0).</p><p><strong>Conclusion: </strong>LLMs may support patient education, factual medication queries, and structured guideline questions when used under clinician review, but should not be used for case-based reasoning, treatment selection, or autonomous clinical decisions. None of the 18 included studies evaluated retrieval-augmented or agent-based systems, and none prospectively validated LLMs in clinical workflows. Safe integration in rheumatology will require purpose-built, knowledge-grounded systems and prospective evaluation before routine clinical use.</p>","PeriodicalId":50064,"journal":{"name":"Journal of Rheumatology","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148655004","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Advancing Psoriatic Disease Knowledge: Highlights From the GRAPPA 2025 Trainee Symposium.","authors":"M Elaine Husni, Sibel Z Aydin, Fabian Proft, Lihi Eder","doi":"10.3899/jrheum.2026-0370","DOIUrl":"10.3899/jrheum.2026-0370","url":null,"abstract":"<p><p>The Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA) 2025 annual meeting, held in Bogotá, Colombia, opened with a dedicated trainee symposium that underscored the depth and breadth of emerging talent in psoriatic disease research. This report summarizes the 5 oral presentations and 17 posters encompassing basic, translational, clinical, and outcomes research projects. Together, these works illustrate not only the scientific rigor of the next generation of dermatology and rheumatology investigators but also GRAPPA's expanding global role in driving innovation and advancing the understanding and management of psoriatic diseases.</p>","PeriodicalId":50064,"journal":{"name":"Journal of Rheumatology","volume":" ","pages":"19-22"},"PeriodicalIF":3.7,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147950062","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Early-Onset Calcium Pyrophosphate Disease Associated With Genetic Hypomagnesemia: Beyond Gitelman Syndrome.","authors":"Shay Brikman, Yoav Zehavi, Stavit Allon Shalev, Amir Bieber","doi":"10.3899/jrheum.2026-0332","DOIUrl":"10.3899/jrheum.2026-0332","url":null,"abstract":"","PeriodicalId":50064,"journal":{"name":"Journal of Rheumatology","volume":" ","pages":"1049-1052"},"PeriodicalIF":3.7,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148260323","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Understanding the Effect of Meeting Performance Measures on the Outcomes of Joint Replacement in Rheumatoid Arthritis: A Population-Based Study in British Columbia, Canada.","authors":"Claire E H Barber, Hui Xie, Yufei Zheng, Jessica Widdifield, Cheryl Barnabe, Jason Werle, Diane Lacaille","doi":"10.3899/jrheum.2026-0352","DOIUrl":"10.3899/jrheum.2026-0352","url":null,"abstract":"<p><strong>Objective: </strong>Canadian performance measures (PMs) evaluate the quality of rheumatoid arthritis (RA) care; however, limited evidence exists linking these process measures to long-term patient outcomes. This research evaluated the effect of meeting PMs in early RA on 10-year risk of total joint replacement (TJR) of any joint.</p><p><strong>Methods: </strong>This was a retrospective propensity score-matched population-based cohort study in people with RA diagnosed between 2000 and 2008 who were followed until 2019. The exposure of interest was meeting the PMs within 2 years of diagnosis. Cox proportional hazard models were developed to examine the 10-year risk of TJR in 4 matched cohorts where PMs were met vs not met. PMs included access to rheumatology care, retention in care, early disease-modifying antirheumatic drug (DMARD) use, and ongoing DMARD therapy.</p><p><strong>Results: </strong>Among 19,765 individuals with RA, 44.78% had access to a rheumatologist within 1 year of diagnosis and 24.91% were retained in care; only 24.30% were dispensed a DMARD within 30 days, and 32.66% received a DMARD annually for the first 2 years. Meeting the PMs was associated with a neutral effect on risk of TJR at 10 years in our propensity score-matched analysis for 3 of the PMs, whereas a slightly elevated risk (hazard ratio 1.19, 95% CI 1.03-1.37) was shown for those receiving a DMARD at least annually.</p><p><strong>Conclusion: </strong>There were deficits in RA care identified at a population level; however, no clear protective effect of adherence to PMs was found. Future measure development efforts should focus on PMs with a greater effect on patient outcomes.</p>","PeriodicalId":50064,"journal":{"name":"Journal of Rheumatology","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148654990","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}