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New age of Lupus Nephritis: Updates in guidelines, biomarkers, and therapies. 狼疮性肾炎的新时代：指南、生物标志物和治疗方法的更新。
IF 4.8 2区 医学
Best Practice & Research in Clinical Rheumatology Pub Date : 2026-05-06 DOI: 10.1016/j.berh.2026.102153
Malika Ibrahim, Emily He, Diana Tran, Divya Vundamati, Jennifer Grossman
{"title":"New age of Lupus Nephritis: Updates in guidelines, biomarkers, and therapies.","authors":"Malika Ibrahim, Emily He, Diana Tran, Divya Vundamati, Jennifer Grossman","doi":"10.1016/j.berh.2026.102153","DOIUrl":"https://doi.org/10.1016/j.berh.2026.102153","url":null,"abstract":"<p><p>Lupus nephritis (LN) is the most common visceral organ manifestation of systemic lupus erythematosus (SLE). It affects approximately 50% of SLE patients, accounting for significant morbidity and mortality especially in ethnic minorities. Building on decades of landmark trials, the field has continued to evolve. The 2024 American College Rheumatology (ACR) Lupus Nephritis guideline represents an important shift toward earlier triple therapy. The guideline also recommends routine proteinuria screening and reaffirms kidney biopsy as the diagnostic gold standard. In parallel, urinary biomarkers are emerging as potential tools to better track infrarenal pathology. Furthermore, the therapeutic pipeline continues to expand with emerging strategies targeting B-cells, cytokine receptors, and co-stimulatory mechanisms. In this article, we review updates from the ACR guideline, the emerging data on urinary biomarkers, and highlight novel targeted therapies in LN.</p>","PeriodicalId":50983,"journal":{"name":"Best Practice & Research in Clinical Rheumatology","volume":" ","pages":"102153"},"PeriodicalIF":4.8,"publicationDate":"2026-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147845929","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}
引用次数: 0
Complexity to clarity: Advancing the science and care of systemic sclerosis. 从复杂到清晰：推进系统性硬化症的科学和治疗。
IF 4.8 2区 医学
Best Practice & Research in Clinical Rheumatology Pub Date : 2026-05-05 DOI: 10.1016/j.berh.2026.102154
Sindhu R Johnson
{"title":"Complexity to clarity: Advancing the science and care of systemic sclerosis.","authors":"Sindhu R Johnson","doi":"10.1016/j.berh.2026.102154","DOIUrl":"https://doi.org/10.1016/j.berh.2026.102154","url":null,"abstract":"","PeriodicalId":50983,"journal":{"name":"Best Practice & Research in Clinical Rheumatology","volume":" ","pages":"102154"},"PeriodicalIF":4.8,"publicationDate":"2026-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147845859","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}
引用次数: 0
The management of rheumatic immune related adverse events. 风湿病免疫相关不良事件的处理。
IF 4.8 2区 医学
Best Practice & Research in Clinical Rheumatology Pub Date : 2026-05-04 DOI: 10.1016/j.berh.2026.102147
Pankti Reid, Namrata Singh, Tawnie Braaten, Laura C Cappelli
{"title":"The management of rheumatic immune related adverse events.","authors":"Pankti Reid, Namrata Singh, Tawnie Braaten, Laura C Cappelli","doi":"10.1016/j.berh.2026.102147","DOIUrl":"10.1016/j.berh.2026.102147","url":null,"abstract":"<p><p>Immune checkpoint inhibitors (ICI) used for the treatment of cancer can cause immune related adverse events (irAEs) when immune activation affects non-tumor tissues. Rheumatologists care for patients with a variety of rheumatic irAEs; these included inflammatory arthritis (ICI-IA), polymyalgia rheumatica (ICI-PMR), and myositis (ICI-myositis) among others. Rheumatic irAEs are commonly impactful on patients' quality of life and function and sometimes can cause significant morbidity and mortality. This review will highlight the diagnosis and assessment of rheumatic irAEs. Then treatment for individual irAEs will be discussed in depth with considerations to supportive care, corticosteroid dosing and tapering, steroid sparing immunosuppression and monitoring. Finally, the safety of immunosuppression as it relates to tumor outcomes and considerations by oncologists when selecting ICI therapy will be reviewed.</p>","PeriodicalId":50983,"journal":{"name":"Best Practice & Research in Clinical Rheumatology","volume":" ","pages":"102147"},"PeriodicalIF":4.8,"publicationDate":"2026-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147845853","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}
引用次数: 0
Management of glucocorticoid-induced osteoporosis in rheumatic diseases. 风湿性疾病中糖皮质激素所致骨质疏松症的处理。
IF 4.8 2区 医学
Best Practice & Research in Clinical Rheumatology Pub Date : 2026-04-29 DOI: 10.1016/j.berh.2026.102151
Pritee Shrestha, Sowmya B Popuri, Colton Hoffer, Anam Qureshi, Joshua Barzilay, Eunice Adu Dapaah, Laura D Carbone
{"title":"Management of glucocorticoid-induced osteoporosis in rheumatic diseases.","authors":"Pritee Shrestha, Sowmya B Popuri, Colton Hoffer, Anam Qureshi, Joshua Barzilay, Eunice Adu Dapaah, Laura D Carbone","doi":"10.1016/j.berh.2026.102151","DOIUrl":"https://doi.org/10.1016/j.berh.2026.102151","url":null,"abstract":"<p><p>Glucocorticoid-induced osteoporosis (GIOP) and its attendant fractures are a major concern for patients with rheumatic diseases. This 2025 review highlights preventive and treatment strategies for GIOP. An overview of the epidemiology and pathogenesis of GIOP is discussed. Key questions considered are. (1) What are the optimum risk factor assessment strategies to identify patients with GIOP at fracture risk, including the role of clinical risk factors, imaging modalities and fracture risk calculators? (2). What are the preventive strategies for GIOP incorporating information on steroid-sparing agents for the treatment of rheumatic diseases, the role of calcium and vitamin D intake, and exercise ? (3). What are treatment strategies for GIOP with a focus on clinical trial data for FDA-approved therapies that have been studied in patients with rheumatic diseases? Clinical practice guidelines are discussed. Future directions for the prevention and treatment of GIOP in persons with rheumatic diseases are considered.</p>","PeriodicalId":50983,"journal":{"name":"Best Practice & Research in Clinical Rheumatology","volume":" ","pages":"102151"},"PeriodicalIF":4.8,"publicationDate":"2026-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147823210","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}
引用次数: 0
Screening, monitoring and treatment of interstitial lung disease in systemic sclerosis. 系统性硬化症间质性肺疾病的筛查、监测和治疗。
IF 4.8 2区 医学
Best Practice & Research in Clinical Rheumatology Pub Date : 2026-04-15 DOI: 10.1016/j.berh.2026.102131
Sindhu R Johnson, Elana J Bernstein
{"title":"Screening, monitoring and treatment of interstitial lung disease in systemic sclerosis.","authors":"Sindhu R Johnson, Elana J Bernstein","doi":"10.1016/j.berh.2026.102131","DOIUrl":"https://doi.org/10.1016/j.berh.2026.102131","url":null,"abstract":"<p><p>Interstitial lung disease (ILD) is a major source of morbidity and the leading cause of mortality in people with systemic sclerosis (SSc). There have been advancements in the treatment of ILD. In this article, we review the American College of Rheumatology (ACR) and the American College of Chest Physicians (CHEST) guidelines for the screening, monitoring and treatment of SSc-ILD. We highlight additional pharmacologic and non-pharmacologic interventions that should be considered in those with SSc-ILD. Finally, we summarize the ACR guidelines for vaccinations in those with SSc-ILD, and recommendations for holding immunosuppressive therapies to maximize immunogenicity of the vaccines.</p>","PeriodicalId":50983,"journal":{"name":"Best Practice & Research in Clinical Rheumatology","volume":" ","pages":"102131"},"PeriodicalIF":4.8,"publicationDate":"2026-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147700370","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}
引用次数: 0
Physical rehabilitation interventions for hand function in people with systemic sclerosis. 系统性硬化症患者手部功能的物理康复干预。
IF 4.8 2区 医学
Best Practice & Research in Clinical Rheumatology Pub Date : 2026-04-15 DOI: 10.1016/j.berh.2026.102122
Michael Denton, Amanda Steiman, Sindhu R Johnson
{"title":"Physical rehabilitation interventions for hand function in people with systemic sclerosis.","authors":"Michael Denton, Amanda Steiman, Sindhu R Johnson","doi":"10.1016/j.berh.2026.102122","DOIUrl":"https://doi.org/10.1016/j.berh.2026.102122","url":null,"abstract":"<p><p>Systemic sclerosis (SSc) is a complex systemic autoimmune rheumatic disease with marked clinical heterogeneity. Cutaneous manifestations affecting the hands and wrists include vascular insufficiency, early edema (puffy fingers), followed by progressive skin fibrosis and atrophy (sclerodactyly). This progressive skin tightening results in joint stiffness, deformity, functional impairment and reduced quality of life. Beyond skin changes, hand involvement may also include inflammatory arthritis, joint contractures, tendon friction rubs, Raynaud phenomenon, digital ulcers, acro-osteolysis, and calcinosis, all of which can further impair hand function, significantly affecting individuals' ability to perform routine occupational and daily tasks requiring grasping, gripping, and fine motor dexterity. In this article, we synthesize the evidence evaluating manual therapy, prescribed hand exercises, self-administered hand exercise protocols, telerehabilitation, paraffin wax, therapeutic ultrasound, manual lymphatic drainage, and dynamic splinting to improve hand function in people with SSc.</p>","PeriodicalId":50983,"journal":{"name":"Best Practice & Research in Clinical Rheumatology","volume":" ","pages":"102122"},"PeriodicalIF":4.8,"publicationDate":"2026-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147700406","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}
引用次数: 0
Global epidemiology of psoriatic arthritis. 银屑病关节炎的全球流行病学。
IF 4.8 2区 医学
Best Practice & Research in Clinical Rheumatology Pub Date : 2026-04-14 DOI: 10.1016/j.berh.2026.102148
Umut Kalyoncu, Gizem Ayan
{"title":"Global epidemiology of psoriatic arthritis.","authors":"Umut Kalyoncu, Gizem Ayan","doi":"10.1016/j.berh.2026.102148","DOIUrl":"https://doi.org/10.1016/j.berh.2026.102148","url":null,"abstract":"<p><p>Psoriatic arthritis (PsA) is a chronic inflammatory musculoskeletal disease that develops in a substantial proportion of patients with psoriasis (PsO). Understanding its epidemiology is essential for improving early recognition, risk stratification, and preventive strategies. This review summarizes current evidence on the global prevalence and incidence of PsA in both the general population and among individuals with PsO. Population-based studies estimate PsA prevalence at approximately 0.1-0.2%, with considerable geographic variability. Among patients with PsO, approximately 20% develop PsA, although this proportion varies according to age, disease severity, classification criteria, and region. Incidence rates in the general population range from 3 to 41 per 100,000 person-years, with evidence of increasing prevalence over time in several countries, likely reflecting improved recognition and diagnostic practices. Risk factors for PsA development include severe PsO, nail involvement, obesity, and the presence of musculoskeletal symptoms, particularly inflammatory arthralgia. Emerging data suggest that advanced systemic therapies for PsO may influence future PsA incidence, although prospective evidence is still needed. Significant heterogeneity in epidemiological estimates is driven by methodological differences, diagnostic criteria, healthcare systems, and underdiagnosis. A better understanding of epidemiological trends and transition phases from PsO to PsA may support earlier identification and optimized multidisciplinary management strategies.</p>","PeriodicalId":50983,"journal":{"name":"Best Practice & Research in Clinical Rheumatology","volume":" ","pages":"102148"},"PeriodicalIF":4.8,"publicationDate":"2026-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147693444","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}
引用次数: 0
Decoding pain in axial spondyloarthritis: Mechanisms, management, and future directions. 轴性脊柱炎的疼痛解码：机制、管理和未来方向。
IF 4.8 2区 医学
Best Practice & Research in Clinical Rheumatology Pub Date : 2026-04-14 DOI: 10.1016/j.berh.2026.102150
Mohamad Bittar, Yvonne C Lee, Atul Deodhar
{"title":"Decoding pain in axial spondyloarthritis: Mechanisms, management, and future directions.","authors":"Mohamad Bittar, Yvonne C Lee, Atul Deodhar","doi":"10.1016/j.berh.2026.102150","DOIUrl":"https://doi.org/10.1016/j.berh.2026.102150","url":null,"abstract":"<p><p>Axial spondyloarthritis (axSpA) is an immune-mediated inflammatory condition that is associated with significant disease burden. While the use of biologic and targeted synthetic disease modifying antirheumatic drugs have led to significant improvements in disease outcomes, a substantial proportion of patients continue to face challenges with pain despite effective control of their inflammatory state. Chronic pain is one of the leading causes of disability and remains an unmet research and clinical need in axSpA. Phenotyping pain is essential to understand the etiology of symptoms and to aid in selecting the appropriate management plan in axSpA. In this review, we aim to highlight the mechanisms of pain, its phenotypes, and novel assessment tools. We also review our approach to managing chronic pain in axSpA and discuss future directions in this field.</p>","PeriodicalId":50983,"journal":{"name":"Best Practice & Research in Clinical Rheumatology","volume":" ","pages":"102150"},"PeriodicalIF":4.8,"publicationDate":"2026-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147693451","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}
引用次数: 0
Cellular and molecular mechanisms of systemic sclerosis: Translation to targeted therapies and clinical practice. 系统性硬化症的细胞和分子机制：转化为靶向治疗和临床实践。
IF 4.8 2区 医学
Best Practice & Research in Clinical Rheumatology Pub Date : 2026-04-12 DOI: 10.1016/j.berh.2026.102137
Diane Documet, Sophia Ruser, Crystal Cheung, Monique Hinchcliff, Manvitha Nadella
{"title":"Cellular and molecular mechanisms of systemic sclerosis: Translation to targeted therapies and clinical practice.","authors":"Diane Documet, Sophia Ruser, Crystal Cheung, Monique Hinchcliff, Manvitha Nadella","doi":"10.1016/j.berh.2026.102137","DOIUrl":"https://doi.org/10.1016/j.berh.2026.102137","url":null,"abstract":"<p><p>Systemic sclerosis (SSc) is characterized by profound clinical heterogeneity due to dysregulated communication between vascular, immune, and stromal compartments. This review synthesizes genetic and epigenetic determinants of SSc with observations from transcriptomic, proteomic, and metabolomic studies. We highlight emerging cellular- and molecular-level insights into vasculopathy, immune dysregulation, and fibroblast activation in SSc. Finally, we discuss how these mechanistic discoveries inform the development of targeted, precision-medicine based therapeutic approaches in SSc.</p>","PeriodicalId":50983,"journal":{"name":"Best Practice & Research in Clinical Rheumatology","volume":" ","pages":"102137"},"PeriodicalIF":4.8,"publicationDate":"2026-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147678436","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}
引用次数: 0
Difficult to treat disease in psoriatic arthritis- is it different from axial spondyloarthritis? 银屑病关节炎难治——与轴性脊柱炎不同吗？
IF 4.8 2区 医学
Best Practice & Research in Clinical Rheumatology Pub Date : 2026-04-10 DOI: 10.1016/j.berh.2026.102149
Jean-Guillaume Letarouilly, André L Ribeiro, Murat Torgutalp, Denis Poddubnyy, Fabian Proft
{"title":"Difficult to treat disease in psoriatic arthritis- is it different from axial spondyloarthritis?","authors":"Jean-Guillaume Letarouilly, André L Ribeiro, Murat Torgutalp, Denis Poddubnyy, Fabian Proft","doi":"10.1016/j.berh.2026.102149","DOIUrl":"https://doi.org/10.1016/j.berh.2026.102149","url":null,"abstract":"<p><p>Despite major therapeutic advances, a substantial proportion of patients with spondyloarthritis (SpA), including psoriatic arthritis (PsA) and axial spondyloarthritis (axSpA), experience persistent symptoms, functional limitations, and reduced quality of life. Historically, heterogeneous terminology has limited comparability across studies for this population. To address this gap, three international initiatives, GRAPPA, EULAR, and ASAS, have proposed consensus definitions for two nested states: a broad category of \"difficult-to-manage\" (D2M) or \"complex-to-manage\" (C2M) disease and a more stringent \"treatment-refractory\" (TR) subset requiring objective inflammation and multi-mechanism therapeutic failure. This review synthesises these frameworks, highlighting shared principles and key differences. While all definitions adopt a dual-tiered structure, PsA-specific definitions reflect its multidomain nature, incorporating peripheral joints, entheses, skin, nails, axial involvement, and comorbidities; conversely, axSpA definitions are axial-centric, while other domains may play a role in determining D2M/TD disease as well. These distinctions have implications for trial design, biomarker discovery, and management strategies. Harmonisation, prospective validation, and biomarker-driven stratification remain essential to optimise outcomes and advance precision medicine.</p>","PeriodicalId":50983,"journal":{"name":"Best Practice & Research in Clinical Rheumatology","volume":" ","pages":"102149"},"PeriodicalIF":4.8,"publicationDate":"2026-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147678414","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}
引用次数: 0
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