The Journal of Rheumatology最新文献

{"title":"Patient Resilience is associated with Better Patient-Reported Physical and Mental/Emotional Quality of Life in Systemic Lupus Erythematosus.","authors":"Jasvinder A Singh,Mark Beasley","doi":"10.3899/jrheum.2025-0396","DOIUrl":"https://doi.org/10.3899/jrheum.2025-0396","url":null,"abstract":"OBJECTIVETo examine the association of patient resilience with health-related quality of life (HRQOL) in Systemic Lupus Erythematosus (SLE).METHODSWe used data from a prospective cohort study of patients with SLE enrolled across 15 rheumatology clinics across the U.S. who viewed a patient decision-aid for SLE management during a regular clinic visit. We examined the association of high resilience with HRQOL on PROMIS®-29 domains, using multivariable linear mixed-effects model analysis, adjusted for demographics, social determinants of health (SDOH), flare, site, time and comorbid rheumatic diseases.RESULTSOut of 874 SLE patients, 27% had high resilience with CD-RISC2 score of eight. Compared to SLE patients who had low resilience, SLE patients with high resilience were more likely to report: excellent or very good health, 39.9% versus 15.9%; lower SLE activity, 4.32 versus 5.25 on a 0 to 10 scale; higher SLE impact of 7.21 versus 6.04 on a 0 to 10 scale. We noted that high resilience was associated with a positive moderate effect size (>0.5 standard deviation) for physical functioning, social participation, anxiety, emotional distress, fatigue, pain interference, and pain intensity; and a favorable small effect size (0.2-0.49 standard deviation) for sleep disturbance, in unadjusted analyses. In a multivariable-adjusted mixed linear regression analysis, high resilience was associated with all eight HRQOL scale scores.CONCLUSIONHigh patient resilience was independently associated with better HRQOL outcomes in SLE, after adjusting for demographics, SDOH, site, time and comorbid rheumatic diseases. Interventions to promote resilience have the potential improve SLE HRQOL outcomes. (Trial Registration: NCT03735238).","PeriodicalId":501812,"journal":{"name":"The Journal of Rheumatology","volume":"104 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145068246","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical and epidemiological features of juvenile-onset systemic sclerosis from a nationwide survey in Japan.","authors":"Utako Kaneko,Takako Miyamae,Yasuhito Hamaguchi,Masaki Shimizu,Ikuko Ueda-Hayakawa,Hideki Ishikawa,Ryusuke Ae,Yoshikazu Nakamura,Yoshihide Asano,Yasushi Kawaguchi,Masataka Kuwana,Daisuke Goto,Minoru Hasegawa,Masaru Hatano,Yohei Isomura,Masatoshi Jinnin,Yasuhiro Kanatani,Atsushi Kumanogoh,Takamitsu Makino,Katsunari Makino,Takashi Matsushita,Sei-Ichiro Motegi,Naoki Mugii,Naoko Okiyama,Yoshihito Shima,Hiroki Takahashi,Sumiaki Tanaka,Toshiyuki Yamamoto,Hidekata Yasuoka,Hisataka Maki,Ayumi Yoshizaki,Manabu Fujimoto, ","doi":"10.3899/jrheum.2025-0175","DOIUrl":"https://doi.org/10.3899/jrheum.2025-0175","url":null,"abstract":"OBJECTIVETo evaluate clinical and epidemiological features of juvenile-onset systemic sclerosis (jSSc) in Japan and to identify racial and generational differences.METHODSWe surveyed patients with jSSc (developed before the age of 18 years) who visited selected facilities in Japan between January 2016 and December 2020. We estimated the number of patients with jSSc and the annual incidence rate in Japan. Thereafter, differences in clinical characteristics by disease subtype, autoantibody, and age at investigation were analyzed and compared with previous cohorts.RESULTSOf the 3,005 institutions selected for the first survey, 1,845 (61.8%) responded. The estimated number of patients with jSSc was 299, while the estimated annual incidence rate ranged from 0.98 to1.59 per 1,000,000 children (aged <18 years) from 2016 to 2020. In the second-stage survey, 130 cases were analyzed, of which 85 (65.4%) had diffuse cutaneous SSc (dcSSc), 77.7% were female, while the median ages at onset and survey was 11 and 21 years, respectively. Autoantibody positivity was 62.4% for anti-topoisomerase I antibody (ATA) and 12.9% for anti-centromere antibody, while anti-PM-Scl antibody was very rare. In total, interstitial lung disease was present in 40.8% of patients (predominantly dcSSc and ATA positive), gastrointestinal lesions in 36.9%, pulmonary arterial hypertension in 7.7%, and no renal crisis.CONCLUSIONThis is the largest national survey of jSSc characteristics analyzed in detail by autoantibody and disease subtype. Japanese jSSc was characterized by very high ATA-positivity rate. However, the frequency of major organ involvement was similar to previous reports of jSSc in the west.","PeriodicalId":501812,"journal":{"name":"The Journal of Rheumatology","volume":"22 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145068315","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","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 2024 Trainee Symposium.","authors":"Clementina López-Medina,Michelle Mulder,Lihi Eder,M Elaine Husni","doi":"10.3899/jrheum.2025-0701","DOIUrl":"https://doi.org/10.3899/jrheum.2025-0701","url":null,"abstract":"The Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA) 2024 annual meeting in Seattle, Washington, began with the trainee symposium, showcasing exceptional research by dermatology and rheumatology trainees in psoriatic diseases. This summary highlights 5 oral presentations and 16 posters spanning basic, translational, clinical, and outcomes research, reflecting GRAPPA's global impact on advancing knowledge in the field.","PeriodicalId":501812,"journal":{"name":"The Journal of Rheumatology","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145068321","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Juvenile Spondyloarthritis Disease Activity Index Validation in Enthesitis-Related Arthritis and Juvenile Psoriatic Arthritis in a Prospective Clinical Trial Setting.","authors":"Pamela F Weiss,Nicolino Ruperto,Erhard Quebe-Fehling,Alexis Shew,Luminita Pricop,Christelle C Pieterse,Hermine I Brunner, ","doi":"10.3899/jrheum.2025-0294","DOIUrl":"https://doi.org/10.3899/jrheum.2025-0294","url":null,"abstract":"OBJECTIVETo investigate the validity of the Juvenile Spondyloarthritis Disease Activity Index (JSpADA) in children with enthesitis-related arthritis (ERA) or juvenile psoriatic arthritis (jPsA) in a prospective clinical trial setting.METHODSJUNIPERA (NCT03031782) is a phase 3, placebo-controlled withdrawal study investigating the safety and efficacy of secukinumab in children with ERA and jPsA. After 12 weeks of open-label treatment with secukinumab, patients were randomized 1:1 to secukinumab or placebo until disease flare or Week 52. JSpADA validity was assessed using 3 criteria: convergent validity (Spearman's correlation) at Week 12 with the Juvenile Arthritis Disease Activity Score in 10 joints (JADAS-10), clinical JADAS-10 (cJADAS-10), and physician global assessment of disease activity (PGA); discriminatory validity at Week 12 among patients with active or inactive disease and JIA ACR response criteria; and responsiveness to change in clinical disease activity from Weeks 12 to 52.RESULTSAt Week 12, mean (SD) JSpADA scores showed moderate-to-good correlation with JADAS-10, cJADAS-10, and PGA scores (all Spearman ρ > 0.4) and were higher among patients with active vs inactive disease (1.8 [1.3] vs 0.5 [0.8], P < 0.001). Patients with improved disease activity from Weeks 12 to 52 had greater improvements in JSpADA than patients with worsening disease (-0.8 [1.1] vs 0.4 [1.0], P < 0.001); patients with stable disease had minimal change in JSpADA (-0.1 [0.5]). Validity results were similar for ERA and jPsA.CONCLUSIONThese results validate JSpADA as a disease activity measure for children with ERA and jPsA in a prospective clinical trial setting.","PeriodicalId":501812,"journal":{"name":"The Journal of Rheumatology","volume":"66 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145068245","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of Treatment Changes on Health-Related Quality of Life in Canadian Children with Juvenile Idiopathic Arthritis: Results from ReACCh-Out and CAPRI.","authors":"Zoe Tsai,Adam M Huber,Kiem Oen,Jean-Philippe Proulx-Gauthier,Gaëlle Chédeville,Gilles Boire,Dax G Rumsey,Kristin M Houghton,Michelle Batthish,Roberta A Berard,Heinrike Schmeling,Y Ingrid Goh,Ciaran Duffy,Jaime Guzman, ","doi":"10.3899/jrheum.2025-0377","DOIUrl":"https://doi.org/10.3899/jrheum.2025-0377","url":null,"abstract":"OBJECTIVEWe assessed changes in health-related quality of life (HR-QoL) in Canadian patients with juvenile idiopathic arthritis (JIA), comparing inception cohorts from 2017-2023 and 2005-2010.METHODSWe included newly-diagnosed patients who completed the Juvenile Arthritis Quality of Life Questionnaire (JAQQ) at both enrollment and one-year later. Mean changes in JAQQ domain scores from baseline to one year were compared between cohorts using Mann-Whitney U-tests. Multivariable linear regression was used to adjust for baseline imbalances between the cohorts. We also compared changes in treatments, the Quality of My Life scale, arthritis pain, Childhood Health Assessment Questionnaire Disability Index, and physician and parent global assessments.RESULTSWe included 478 and 663 patients from the 2017-2023 and 2005-2010 cohorts, respectively. By one year, a greater proportion of patients in 2017-2023 cohort had used conventional and biologic DMARDs compared to the 2005-2010 cohort (57.9% vs. 46.2%, and 27.2% vs. 6.3%, respectively). Improvements in total JAQQ score from baseline to one year were similar between the 2017-2023 (0.97; 95% CI 0.85 to 1.09) and 2005-2010 (0.92; 95% CI 0.82 to 1.02) cohorts, with no significant difference observed across JAQQ domains. Pain scores, however, improved significantly (-2.07 vs. -1.62, p=0.03). After adjusting for baseline imbalances, greater improvements were observed in 2017-2023 cohort for all JAQQ domains in patients with ≥5 active joints (β=0.28 for JAQQ psychosocial to 0.62 for Gross Motor).CONCLUSIONFirst-year improvements in HR-QoL measured by JAQQ were similar in 2017-2023 and 2005-2010 cohorts, but adjustment for baseline imbalances suggests greater HR-QoL improvements in those with more severe disease in the later cohort.","PeriodicalId":501812,"journal":{"name":"The Journal of Rheumatology","volume":"20 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145068275","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of Knee Extensor Power on Knee Pain in Adults With or at Risk for Osteoarthritis: The Multicenter Osteoarthritis Study.","authors":"Chun-Hao Huang,Neil A Segal,David T Felson,David A Sherman,Cara L Lewis,Kathryn L Bacon,John Lynch,Cora E Lewis,Joshua Stefanik","doi":"10.3899/jrheum.2025-0621","DOIUrl":"https://doi.org/10.3899/jrheum.2025-0621","url":null,"abstract":"OBJECTIVEKnee extensor power declines rapidly with aging and may contribute to knee pain. We evaluated the relationship between knee extensor power and changes in knee pain over 2 years in adults with or at risk for knee osteoarthritis (OA).METHODSWe used data from the Multicenter Osteoarthritis Study. Knee extensor power was measured at baseline using isotonic contractions at 40% of one-repetition maximum. Pain severity (Western Ontario and McMaster Universities Osteoarthritis Index; WOMAC) and frequent knee pain (FKP; pain on most days in the past 30 days) were assessed at baseline, 8, 16, and 24 months in each knee. We examined the association between baseline sex-specific quartiles of knee extensor power and two outcomes-worsening WOMAC pain and incident FKP-using logistic regression with generalized estimating equations to account for within-subject correlations between knees.RESULTSCompared to the strongest quartile, the weakest quartile of knee extensor power had 1.35 (95% CI: 0.98-1.86; p for linear trend = 0.04) times the odds of worsening knee pain severity and 1.93 (95% CI: 1.22-3.05; p for linear trend < 0.05) times the odds of incident FKP.CONCLUSIONLower knee extensor power may be a risk factor for both worsening knee pain severity and the development of frequent knee pain in adults with or at risk for knee OA. Interventions targeting knee extensor power may reduce the risk for incident and progressive knee pain.","PeriodicalId":501812,"journal":{"name":"The Journal of Rheumatology","volume":"72 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145068274","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of CD19 CAR T-cell therapy on quality of life and direct health care costs in SLE: a preliminary analysis.","authors":"Jule Taubmann,Melanie Hagen,Fabian Müller,Andreas Wirsching,Alp Temiz,Simon Völkl,Michael Aigner,Ricardo Grieshaber-Bouyer,Andreas Mackensen,Georg Schett","doi":"10.3899/jrheum.2024-1301","DOIUrl":"https://doi.org/10.3899/jrheum.2024-1301","url":null,"abstract":"OBJECTIVEPatients with systemic lupus erythematosus (SLE) require long-term treatment and experience reduced quality of life (QoL). CD19 chimeric antigen receptor (CAR) T-cell therapy can achieve sustained drug-free remission in patients with SLE. The impact of CAR T-cell therapy on QoL and direct health care costs has not been evaluated. Here, we analyzed longitudinal QoL before and after CAR T-cell therapy and performed an assessment of direct health care costs.METHODSPhysical and mental health was assessed using the standardized Short Form (SF)-36 before and one year after treatment. Annual direct health care costs were analyzed based on inpatient admissions, emergency department visits, outpatient visits and prescription drug costs in the German health care service.RESULTSA preliminary analysis was conducted on 8 patients with SLE (7 women, 1 man; age range 19-38 years) who received CAR T-cell therapy and were followed for over two years. CAR T-cell therapy resulted in improvement in the QoL in all patients. The most notable improvement was observed in physical health (from 22.4% to 75.5%), while mental health also improved (from 24.7% to 63.0%). QoL values rose to the level of a healthy comparison cohort. Additionally, CAR T-cell therapy led to a substantial decrease in annual direct health care costs from 29.672 €/year to 3.094 €/year after treatment.CONCLUSIONIn addition to clinical efficacy, in this preliminary cohort CD19 CAR T-cell treatment improves Qol in SLE patients and may substantially reduces the direct socioeconomic burden associated with active disease by over 90%.","PeriodicalId":501812,"journal":{"name":"The Journal of Rheumatology","volume":"19 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145068276","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"World Café Report From the GRAPPA 2024 Annual Meeting and Trainee Symposium: Exploring GRAPPA's Future Priorities.","authors":"Shikha Singla,Stephen R Pennington,Sam T Hwang,Jessica A Walsh","doi":"10.3899/jrheum.2025-0702","DOIUrl":"https://doi.org/10.3899/jrheum.2025-0702","url":null,"abstract":"The Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA) annual meeting, held in Seattle, Washington, USA, in July 2024, included a World Café session in which attendees addressed the following question, \"In the forthcoming five to ten years, what specific areas of unmet need should GRAPPA prioritize and how should we do so?\" The World Café session was attended by rheumatologists, dermatologists, patient research partners, corporate partners, nonclinician scientists, advanced practice practitioners, and trainees. Following an introduction to the World Café process, the session took place in 10 rooms, with each room accommodating approximately 20 participants with an assigned room leader, a moderator, and a young GRAPPA member (members of whom are young clinicians and early career researchers from across the globe interested in the field of psoriatic disease [PsD]) scribe. The World Café session discussion highlighted that in the next 5 to 10 years, the most reported unmet need is research, followed by clinical, educational, and administrative priorities. Many groups identified similar specific unmet needs, including research to discover novel biomarkers; further research to address (and possibly predict) transition from psoriasis to psoriatic arthritis; multispecialty collaboration in clinical practice for the management of comorbidities; cross-specialty education for a greater understanding of PsD and its comorbidities; and the expansion of the reach and impact of GRAPPA's educational materials, recommendations, and advocacy. Ideas generated by World Café participants will inform prioritization, planning, and implementation of the 5- to 10-year organizational vision of GRAPPA.","PeriodicalId":501812,"journal":{"name":"The Journal of Rheumatology","volume":"65 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145068277","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Differences in Cause-Specific Mortality in Patients with Rheumatoid Arthritis by Sex and Seropositivity.","authors":"Elena K Joerns,Andrea Lopez-Ruiz,Ryan J Lennon,Cynthia S Crowson,Roslin Jose George,Vanessa L Kronzer,John M Davis,Elena Myasoedova","doi":"10.3899/jrheum.2025-0361","DOIUrl":"https://doi.org/10.3899/jrheum.2025-0361","url":null,"abstract":"OBJECTIVEOur aims were to investigate the trends in observed versus expected all-cause mortality and the effects of serostatus and sex on all-cause and cause-specific mortality in individuals with rheumatoid arthritis (RA) in a large community-based longitudinal cohort study.METHODSThis retrospective cohort study evaluated all-cause and cause-specific mortality in RA using a community population-based inception cohort of adult residents of Olmsted County, MN with incident RA from 1980-2019 meeting American College of Rheumatology 1987 criteria, and non-RA residents matched 3:1 to patients with RA by age and sex. Underlying cause of death was obtained from death certificates. Competing risks/cumulative incidence methods were used to compare cause-specific mortality incidence between individuals with and without RA. Cox models estimated the effect of RA on risk of cause-specific mortality, adjusting for sex, age and calendar year of index. Interactions for RA with sex, age, seropositivity, and calendar year were examined.RESULTSThe study included 1,337 patients with RA and 4,011 non-RA comparators. All-cause mortality was significantly increased in both females and males with RA, specifically in seropositive RA and declined after the 1980s. The increased risk of death due to respiratory causes in patients with RA was significantly different depending on seropositive versus seronegative status (HR 2.26 [1.56-3.26] vs 0.52 [0.24-1.13], interaction p<0.001). There were no significant differences in cause-specific mortality based on sex.CONCLUSIONSeropositivity in persons with RA associates with a significantly increased risk of death, particularly due to respiratory causes, while no increased risk was found in seronegative patients.","PeriodicalId":501812,"journal":{"name":"The Journal of Rheumatology","volume":"83 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145068278","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Understanding patient and physician perspectives regarding innovative research in rheumatoid arthritis.","authors":"Melanie C Baniña,Radhika Prabhune,Catney Charles,Inés Colmegna,Marie Hudson,Sasha Bernatsky,Sandra Peláez","doi":"10.3899/jrheum.2025-0510","DOIUrl":"https://doi.org/10.3899/jrheum.2025-0510","url":null,"abstract":"OBJECTIVEThe optimal treatment choice for an individual with rheumatoid arthritis (RA) is yet unknown. While novel approaches such as pragmatic randomized clinical trials (pRCT) and biomarker-driven trials are needed to advance personalized RA care, end user views of these approaches have not been extensively studied. This study aimed to gain insight into patients' and physicians' perspectives to enhance the success of future RA research innovations.METHODSAs part of a larger pRCT, we conducted three focus groups with 17 patients with RA and one focus group with five rheumatologists from two major university hospitals. The discussions, which revolved around the challenges of innovative research, were verbatim transcribed and thematically analyzed adopting a self-management framework aligned with a patient engagement perspective.RESULTSPatients' discussions revolved around three themes: (a) patients' preferences for information related to medical management decision-making; (b) necessary behavior change due to treatment-related challenges; and (c) patient-physician relationship as a foundation for constructively approaching shared decision-making. As for physicians, their discussion was organized into three themes: (a) the impact of research on medical management of a patient; (b) feasibility of pRCT and biomarker-driven trials; and (c) how randomization could challenge shared decision-making with patients.CONCLUSIONPatients and physicians shared their concerns regarding how being part of research in the setting of clinical care could disrupt day-to-day activities and threaten shared decision-making. Understanding patients' and physicians' perspectives regarding pRCT and biomarker-driven trials is key to enhance the success of these research innovations.","PeriodicalId":501812,"journal":{"name":"The Journal of Rheumatology","volume":"51 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145068281","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}