Best Practice & Research in Clinical Rheumatology最新文献

{"title":"A review on the epidemiology of rheumatoid arthritis: An update and trends from current literature","authors":"Perpetual Uke ,&nbsp;Ajesh Maharaj ,&nbsp;Adewale Adebajo","doi":"10.1016/j.berh.2025.102036","DOIUrl":"10.1016/j.berh.2025.102036","url":null,"abstract":"<div><div>Rheumatoid arthritis (RA) is a systemic, chronic autoimmune disease affecting mainly the joints, often with extra articular manifestations. This review provides an update on RA epidemiological trends and management.</div><div>PubMed and EMBASE were searched from 2014 to 2024 using rheumatoid arthritis as keyword, combined with incidence, prevalence, diagnosis, classification, and management. Emphasis was on papers published in the past 5 years.</div><div>Globally, the age-standardised prevalence and incidence rate (ASPR and ASIR) of RA increased with varying figures. The ASPR increased by 0.37%, 14.1%, and 6.4% from 1990 to 2019, 2020 and 2017 respectively; and 9% from 1980 to 2019. The ASIR increased by 0.3% and 8.2% from 1990 to 2019 and 2017 respectively; the disability-adjusted life years (DALY) figures increased 0.12% and decreased 0.36% in the same period from different authors. Reduction in ASIR were reported while ASPR varies. Disease modifying anti-rheumatic drugs (DMARDs) remain the cornerstone of treatment.</div></div>","PeriodicalId":50983,"journal":{"name":"Best Practice & Research in Clinical Rheumatology","volume":"39 1","pages":"Article 102036"},"PeriodicalIF":4.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143411469","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":"Clinical manifestations of rheumatoid arthritis, including comorbidities, complications, and long-term follow-up","authors":"Durga Prasanna Misra","doi":"10.1016/j.berh.2024.102020","DOIUrl":"10.1016/j.berh.2024.102020","url":null,"abstract":"<div><div>Symmetric inflammatory polyarthritis is the most prominent manifestation of rheumatoid arthritis (RA). However, RA can practically affect any organ system, whether hematologic, neurological, cardiac, lung, skin, eyes, or kidneys. Systemic involvement in RA can be severe when there is interstitial lung disease, scleritis, amyloidosis, pure red cell aplasia, or myelodysplasia. Cardiovascular disease is the leading cause of death in patients with RA with a similar cardiovascular risk to that with diabetes mellitus. Patients with RA are at an increased risk of infections or osteoporosis, largely due to treatment-related etiologies. Rheumatoid vasculitis is a devastating long-term complication of RA which is fortunately becoming rarer over time due to better disease activity control. While the risk of mortality overall seems to be reducing over time, the excess mortality risk with RA compared with the general population persists. Fibromyalgia, anxiety, depression, fatigue, and physical inactivity remain important comorbidities associated with RA.</div></div>","PeriodicalId":50983,"journal":{"name":"Best Practice & Research in Clinical Rheumatology","volume":"39 1","pages":"Article 102020"},"PeriodicalIF":4.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142569912","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":"Management of pregnant with rheumatoid arthritis: Preconception care, pregnancy and lactation strategies, and maternal-fetal outcomes","authors":"Takehiro Nakai ,&nbsp;Sho Fukui ,&nbsp;Hiroki Ozawa ,&nbsp;Ayako Kitada ,&nbsp;Masato Okada ,&nbsp;Mitsumasa Kishimoto","doi":"10.1016/j.berh.2024.102022","DOIUrl":"10.1016/j.berh.2024.102022","url":null,"abstract":"<div><div>Rheumatoid arthritis (RA) is a chronic inflammatory disorder that can affect women of reproductive age. In recent decades, significant advances have been made in the development of new medications, including biologic disease-modifying anti-rheumatic drugs (DMARDs) and Janus kinase (JAK) inhibitors. Women with RA are prone to infertility, with 42% experiencing a time to pregnancy exceeding 12 months. High disease activity, as well as the use of high-dose glucocorticoids and Non-Steroidal Anti-Inflammatory Drugs (NSAIDs), are associated with infertility and adverse pregnancy outcomes. Additionally, some medications, such as methotrexate, are linked to teratogenicity, highlighting the importance of providing preconception care in everyday practice.</div><div>Recent advancements in reproductive care have improved our ability to manage RA during pregnancy, leading to better pregnancy outcomes. In this review, we summarize key aspects of fertility care, pregnancy and lactation management, including medication strategies, neonatal vaccination, and long-term outcomes for offspring born to mothers with RA.</div></div>","PeriodicalId":50983,"journal":{"name":"Best Practice & Research in Clinical Rheumatology","volume":"39 1","pages":"Article 102022"},"PeriodicalIF":4.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142689582","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":"Highlights of advancement in Rheumatoid Arthritis research and clinical practice","authors":"Jing He ,&nbsp;Ajesh Basantharan Maharaj","doi":"10.1016/j.berh.2025.102040","DOIUrl":"10.1016/j.berh.2025.102040","url":null,"abstract":"","PeriodicalId":50983,"journal":{"name":"Best Practice & Research in Clinical Rheumatology","volume":"39 1","pages":"Article 102040"},"PeriodicalIF":4.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143442502","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":"The role of ultrasound and magnetic resonance imaging in the assessment of musculoskeletal involvement in systemic lupus erythematosus: A review of recent advances and insights.","authors":"Andrea Di Matteo, Patricia Corzo, Emilio Filippucci","doi":"10.1016/j.berh.2025.102042","DOIUrl":"https://doi.org/10.1016/j.berh.2025.102042","url":null,"abstract":"<p><p>Systemic lupus erythematosus (SLE) is an autoimmune disease characterized by diverse manifestations, with musculoskeletal (MSK) involvement being one of the most prevalent and debilitating. Traditional perceptions of SLE arthritis as mild and primarily non-erosive are increasingly challenged by advanced imaging techniques, such as ultrasound and magnetic resonance imaging (MRI). These modalities have revealed subclinical inflammatory changes, structural damage, and peri-articular soft tissue involvement in both symptomatic and asymptomatic patients. Ultrasound is highly sensitive in detecting synovitis, tenosynovitis, and entheseal abnormalities, also in patients without clinical arthritis, offering insights into subclinical disease activity that would otherwise remain undiagnosed. MRI, while less commonly used due to cost and accessibility, remains the gold standard for detecting bone marrow oedema, subtle erosions, and inflammatory changes. Recent studies demonstrate that subclinical synovitis and tenosynovitis, identified through imaging, may precede clinical symptoms in some patients, emphasizing the potential prognostic value of these findings. Bone erosions, once thought rare in SLE, are now observed across various arthropathy subtypes, challenging traditional classifications. Imaging has also revealed the presence of entheseal and muscle involvement, expanding the understanding of SLE-related MSK pathology. This review highlights the transformative role of ultrasound and MRI in diagnosing, monitoring, and managing MSK involvement in SLE. Incorporating imaging findings into routine practice and updated classification criteria may enable early intervention and personalized treatment. While significant advancements have been made in imaging technologies for detecting musculoskeletal involvement in SLE, challenges remain in standardizing protocols and correlating findings with disease activity and outcomes. Further research is needed to address these challenges and further explore the prognostic significance of imaging findings.</p>","PeriodicalId":50983,"journal":{"name":"Best Practice & Research in Clinical Rheumatology","volume":" ","pages":"102042"},"PeriodicalIF":4.5,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143517411","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":"Tropical pyomyositis.","authors":"Praveen Kumar Tirlangi, Anjely Sebastian, Mukhyaprana Prabhu M","doi":"10.1016/j.berh.2025.102041","DOIUrl":"https://doi.org/10.1016/j.berh.2025.102041","url":null,"abstract":"<p><p>Tropical pyomyositis is a serious infectious disease characterised by the formation of abscesses in the skeletal muscles and is primarily caused by Staphylococcus aureus, with an increasing incidence in non-tropical regions. The disease primarily affects men and young adults, often following minor trauma, with an increasing incidence in immunocompromised individuals. Immunocompromised hosts are more likely to be affected by Gram-negative organisms, Mycobacterium tuberculosis, opportunistic infections such as fungal pathogens, non-tuberculous mycobacteria, and Nocardia species. Diagnosis is complicated by non-specific symptoms and the low yield of blood cultures, so imaging studies such as Magnetic Resonance Imaging (MRI) are required for accurate identification. Treatment focuses on controlling the source through drainage, tailored antibiotic therapy, and supportive care, especially in patients with complications such as multi-organ dysfunction. Given the complex clinical manifestations, heightened awareness and a collaborative approach to education and resource provision are critical to improving outcomes in patients with tropical pyomyositis.</p>","PeriodicalId":50983,"journal":{"name":"Best Practice & Research in Clinical Rheumatology","volume":" ","pages":"102041"},"PeriodicalIF":4.5,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143460536","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":"Education and training in tropical rheumatology.","authors":"Fredrick Otieno, Ajesh Maharaj, Adewale Adebajo","doi":"10.1016/j.berh.2025.102037","DOIUrl":"https://doi.org/10.1016/j.berh.2025.102037","url":null,"abstract":"<p><p>Rheumatological and musculoskeletal diseases encompass a vast spectrum of increasingly prevalent conditions, which are associated with significant disability and socioeconomic burden. Their impact is pervasive, especially in tropical countries that are still plagued with a myriad of challenges such as limited healthcare infrastructure, workforce shortages and competing prevailing illnesses. Rheumatology education in these countries has largely lagged. Several initiatives have been undertaken to address these shortfalls in rheumatology healthcare workers. Country-specific initiatives and international collaborative efforts have been undertaken to provide education and training in tropical countries. While there is still much to be achieved, these initiatives have significantly contributed to establishing and strengthening rheumatology services in underserved and resource constrained areas.</p>","PeriodicalId":50983,"journal":{"name":"Best Practice & Research in Clinical Rheumatology","volume":" ","pages":"102037"},"PeriodicalIF":4.5,"publicationDate":"2025-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143400684","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":"Musculoskeletal manifestations in leprosy.","authors":"Vitor Alves Cruz, Anna Carolina Faria Moreira Gomes Tavares, Andréa Monteiro de Araújo, Maria Stella Cochrane Feitosa, Joana Starling de Carvalho, Ciro Martins Gomes, Viviane Angelina de Souza, Licia Maria Henrique da Mota","doi":"10.1016/j.berh.2025.102039","DOIUrl":"https://doi.org/10.1016/j.berh.2025.102039","url":null,"abstract":"<p><p>Leprosy, a chronic infectious disease caused by Mycobacterium leprae and Mycobacterium lepromatosis, primarily targets the skin and peripheral nerves, frequently leading to dermatological, neurological, and musculoskeletal complications. This review highlights the spectrum of musculoskeletal manifestations in leprosy, including acute arthritis during Type 2 reactions, chronic arthritis mimicking autoimmune diseases like rheumatoid arthritis, and neuropathic arthropathy. These manifestations underscore the complex interplay of inflammatory and immune mechanisms. Acute arthritis often involves both small and large joints, while chronic forms may present diagnostic challenges due to their resemblance to other inflammatory arthritides. Clinical management centers on multidrug therapy (MDT) for infection control, complemented by immunosuppressive or anti-inflammatory agents for reactional episodes. Recent advancements, such as biologics and synthetic immunosuppressants, have demonstrated efficacy in refractory cases, offering new therapeutic avenues. Heightened clinician awareness is essential for timely diagnosis and integrated management, particularly in endemic regions, to mitigate long-term disabilities and improve patient outcomes.</p>","PeriodicalId":50983,"journal":{"name":"Best Practice & Research in Clinical Rheumatology","volume":" ","pages":"102039"},"PeriodicalIF":4.5,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143366503","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":"Musculoskeletal complications in sickle cell disease: Pathophysiology, diagnosis and management.","authors":"Parul Gupta, Suyesh Shrivastava, Ravindra Kumar","doi":"10.1016/j.berh.2025.102033","DOIUrl":"https://doi.org/10.1016/j.berh.2025.102033","url":null,"abstract":"<p><p>Sickle cell disease (SCD) is a mono-genic disorder causing chronic hemolysis, anemia, and vaso-occlusion, leading to musculoskeletal complications such as osteonecrosis, osteoporosis, and bone fractures affecting 50-70% SCD patients. These complications result from a complex interplay of genetic and physiological factors, including abnormal hemoglobin production, chronic inflammation, and oxidative stress. This review discusses the pathophysiology, pre-clinical symptoms, and clinical manifestations of musculoskeletal complications in SCD, as well as current treatment options, including pharmacological interventions, surgical procedures, and bone marrow transplantation. Early detection of pre-clinical symptoms is crucial to prevent progression. Pharmacological interventions (analgesics, anti-inflammatory agents, bone-modifying agents and hydroxyurea), surgical interventions (core decompression, bone grafting, joint replacement and osteotomy) and supportive measures enhance mobility, strength and well-being. A multidisciplinary approach is essential for optimal care, and early diagnosis and management are crucial to prevent long-term damage and improve outcomes. Future research directions include targeted therapies, biomarker investigation and infrastructure development to improve outcomes for SCD individuals with musculoskeletal complications.</p>","PeriodicalId":50983,"journal":{"name":"Best Practice & Research in Clinical Rheumatology","volume":" ","pages":"102033"},"PeriodicalIF":4.5,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143015752","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":"Utility of polygenic risk scores to aid in the diagnosis of rheumatic diseases","authors":"Lucía Santiago-Lamelas ,&nbsp;Raquel Dos Santos-Sobrín ,&nbsp;Ángel Carracedo ,&nbsp;Patricia Castro-Santos ,&nbsp;Roberto Díaz-Peña","doi":"10.1016/j.berh.2024.101973","DOIUrl":"10.1016/j.berh.2024.101973","url":null,"abstract":"<div><div><span>Rheumatic diseases (RDs) are characterized by autoimmunity and autoinflammation and are recognized as complex due to the interplay of multiple </span>genetic<span>, environmental, and lifestyle factors in their pathogenesis. The rapid advancement of genome-wide association studies (GWASs) has enabled the identification of numerous single nucleotide polymorphisms<span> (SNPs) associated with RD susceptibility. Based on these SNPs, polygenic risk scores (PRSs) have emerged as promising tools for quantifying genetic risk in this disease group. This chapter reviews the current status of PRSs in assessing the risk of RDs and discusses their potential to improve the accuracy of the diagnosis of these complex diseases through their ability to discriminate among different RDs. PRSs demonstrate a high discriminatory capacity for various RDs and show potential clinical utility. As GWASs continue to evolve, PRSs are expected to enable more precise risk stratification by integrating genetic, environmental, and lifestyle factors, thereby refining individual risk predictions and advancing disease management strategies.</span></span></div></div>","PeriodicalId":50983,"journal":{"name":"Best Practice & Research in Clinical Rheumatology","volume":"38 4","pages":"Article 101973"},"PeriodicalIF":4.5,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141602126","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}