Best Practice & Research in Clinical Rheumatology最新文献_第3页

IF 7 2区医学

Best Practice & Research in Clinical Rheumatology Pub Date : 2026-09-01 Epub Date: 2026-03-25 DOI: 10.1016/j.berh.2026.102132

Alicia Tran, Lihi Eder

引用次数: 0

The promise of biomarkers in Psoriatic Arthritis: Moving towards precision medicine 银屑病关节炎生物标志物的前景：走向精准医学。

IF 7 2区医学

Best Practice & Research in Clinical Rheumatology Pub Date : 2026-09-01 Epub Date: 2026-03-13 DOI: 10.1016/j.berh.2026.102129

Myroslava Kulyk, Kurt De Vlam

{"title":"The promise of biomarkers in Psoriatic Arthritis: Moving towards precision medicine","authors":"Myroslava Kulyk, Kurt De Vlam","doi":"10.1016/j.berh.2026.102129","DOIUrl":"10.1016/j.berh.2026.102129","url":null,"abstract":"<div><div>Psoriatic arthritis is a heterogeneous disease where delayed diagnosis and variable treatment responses remain significant challenges. This review addresses how interconnected metabolic, immunological, and genetic pathways provide opportunities for precision medicine. We examine a distinct metabolic endotype involving altered apolipoproteins and gut metabolites, alongside immunological signatures such as pathogenic tissue-resident memory T cells. Genetic and multi-omic analyses, supported by machine learning, highlight susceptibility loci and signaling pathways that refine disease heterogeneity. Clinically, cytokine profiles and extracellular matrix markers show potential for treatment stratification and monitoring. Furthermore, specific chemokines and inflammatory indices are identified as predictors of the transition from psoriasis to arthritis, enabling early intervention. Integrating these diverse domains through machine learning may facilitate earlier diagnosis and personalized therapy. By defining what is known regarding these biomarkers, this chapter outlines a path toward improved long-term outcomes for patients with psoriatic arthritis.</div></div>","PeriodicalId":50983,"journal":{"name":"Best Practice & Research in Clinical Rheumatology","volume":"40 3","pages":"Article 102129"},"PeriodicalIF":7.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147460945","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 7 2区医学

Best Practice & Research in Clinical Rheumatology Pub Date : 2026-09-01 Epub 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":"10.1016/j.berh.2026.102149","url":null,"abstract":"<div><div>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.</div></div>","PeriodicalId":50983,"journal":{"name":"Best Practice & Research in Clinical Rheumatology","volume":"40 3","pages":"Article 102149"},"PeriodicalIF":7.0,"publicationDate":"2026-09-01","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

Preface: Psoriatic Arthritis—evolving paradigms in pathogenesis and clinical management 前言：银屑病关节炎的发病机制和临床管理的演变范式。

IF 7 2区医学

Best Practice & Research in Clinical Rheumatology Pub Date : 2026-09-01 Epub Date: 2026-09-11 DOI: 10.1016/j.berh.2026.102161

Vinod Chandran, Ying Ying Leung

引用次数: 0

The promise of imaging in psoriatic arthritis 银屑病关节炎影像学的前景。

IF 7 2区医学

Best Practice & Research in Clinical Rheumatology Pub Date : 2026-09-01 Epub Date: 2026-03-19 DOI: 10.1016/j.berh.2026.102128

David A. Kellner, Illiasul K. Ibad, Janeth Yinh, Catherine Bakewell, Erin Chew, Philip Chu, Ann Cameron Barr, Howard H. Yang, Madhavi Kandagaddala, Ashish J. Mathew, Veena K. Ranganath, Gurjit S. Kaeley

{"title":"The promise of imaging in psoriatic arthritis","authors":"David A. Kellner, Illiasul K. Ibad, Janeth Yinh, Catherine Bakewell, Erin Chew, Philip Chu, Ann Cameron Barr, Howard H. Yang, Madhavi Kandagaddala, Ashish J. Mathew, Veena K. Ranganath, Gurjit S. Kaeley","doi":"10.1016/j.berh.2026.102128","DOIUrl":"10.1016/j.berh.2026.102128","url":null,"abstract":"<div><div>Psoriatic arthritis (PsA) is a heterogeneous inflammatory disease with variable involvement of peripheral joints, entheses, tendons, soft tissues, and the axial skeleton. While clinical assessment remains central to PsA care, it may be limited in establishing an accurate diagnosis, distinguishing inflammatory disease from common mimics, and fully characterizing disease activity over time. Musculoskeletal ultrasound (MSUS) and magnetic resonance imaging (MRI) provide complementary, noninvasive methods for visualizing inflammatory and structural pathology across these tissue domains. This review summarizes current evidence supporting the use of MSUS and MRI in the diagnosis and management of PsA, with emphasis on clinically relevant applications, and briefly discusses emerging molecular and advanced imaging techniques. We discuss the role of MSUS in early disease detection, differential diagnosis, evaluation of dactylitis and enthesitis, assessment of disease activity and remission, and guidance of treatment decisions in routine practice, and review the role of MRI with a focus on the evaluation of axial involvement and deep inflammatory and structural changes not accessible by ultrasound. Practical considerations, including scanning protocols, contextual factors affecting interpretation, and emerging scoring systems, are highlighted. When integrated with clinical assessment, these imaging modalities improve diagnostic confidence and support longitudinal disease monitoring. Continued advances in imaging methodology and standardization are expected to further refine their role in the care of patients with psoriatic disease.</div></div>","PeriodicalId":50983,"journal":{"name":"Best Practice & Research in Clinical Rheumatology","volume":"40 3","pages":"Article 102128"},"PeriodicalIF":7.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147492068","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

Definition, diagnosis, treatment for scleroderma primary heart involvement 原发性心脏受累硬皮病的定义、诊断、治疗。

IF 7 2区医学

Best Practice & Research in Clinical Rheumatology Pub Date : 2026-09-01 Epub Date: 2026-03-20 DOI: 10.1016/j.berh.2026.102134

DeAnna Baker Frost, Ryan J. Tedford, Richard Silver

{"title":"Definition, diagnosis, treatment for scleroderma primary heart involvement","authors":"DeAnna Baker Frost, Ryan J. Tedford, Richard Silver","doi":"10.1016/j.berh.2026.102134","DOIUrl":"10.1016/j.berh.2026.102134","url":null,"abstract":"<div><div>Systemic sclerosis (SSc) is an autoimmune disease characterized by chronic inflammation leading to fibrosis in the skin and organs, including the heart. It is classified as SSc-primary heart involvement (pHI), defined as heart dysfunction primarily caused by SSc, excluding other causes. Several disease manifestations, including conduction abnormalities, cardiac arrythmias, myocarditis/pericardial involvement, heart failure (systolic and diastolic) and valvular dysfunction, are categorized within SSc-pHI. SSc-pHI has a high prevalence, high mortality, and increased risk for sudden cardiac death. Serum biomarkers, high sensitivity troponin and NT-proBNP, may help in screening, with electrocardiography, echocardiography, and Holter monitoring. Cardiac magnetic resonance imaging (cMRI) can confirm SSc-pHI and is considered gold standard for diagnosis, with limited use due to cost and availability. Treatment approaches are multifaceted depending on the manifestation of SSc-pHI but often require immunosuppression at a minimum. A multidisciplinary team including rheumatologists and cardiologists offers the best approach for diagnosis, management, and monitoring.</div></div>","PeriodicalId":50983,"journal":{"name":"Best Practice & Research in Clinical Rheumatology","volume":"40 3","pages":"Article 102134"},"PeriodicalIF":7.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147494799","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}

引用次数: 0

Clinical assessment of Psoriatic Arthritis 银屑病关节炎的临床评价。

IF 7 2区医学

Best Practice & Research in Clinical Rheumatology Pub Date : 2026-09-01 Epub Date: 2026-03-01 DOI: 10.1016/j.berh.2026.102125

James Kimpton, William Tillett

引用次数: 0

Predicting and preventing clinical psoriatic arthritis 临床银屑病关节炎的预测与预防。

IF 7 2区医学

Best Practice & Research in Clinical Rheumatology Pub Date : 2026-09-01 Epub Date: 2026-03-20 DOI: 10.1016/j.berh.2026.102133

Enrique R. Soriano, Maria Laura Acosta-Felquer, Luis D. Mazzuoccolo

{"title":"Predicting and preventing clinical psoriatic arthritis","authors":"Enrique R. Soriano, Maria Laura Acosta-Felquer, Luis D. Mazzuoccolo","doi":"10.1016/j.berh.2026.102133","DOIUrl":"10.1016/j.berh.2026.102133","url":null,"abstract":"<div><div>Psoriatic arthritis (PsA) develops in up to 30% of patients with psoriasis (PsO) and causes pain, disability and impaired quality of life despite effective therapies. Because PsO usually precedes PsA, psoriasis provides an identifiable at-risk population in whom prevention and interception strategies can be tested.</div><div>This narrative review summarizes risk factors and predictors of transition from PsO to PsA, including genetic background, psoriasis severity and distribution, nail disease, obesity, mechanical stress and trauma, subclinical enthesitis, musculoskeletal symptoms and candidate biomarkers. We also discuss emerging clinical prediction tools that combine these domains to estimate individual PsA risk in psoriasis.</div><div>Finally, we review evidence for interventions that may delay or reduce PsA onset, weight loss and bariatric surgery, systemic and biologic treatment of psoriasis, and early treatment of subclinical musculoskeletal inflammation, and describe ongoing imaging-enriched randomized trials such as PAMPA that will test whether PsA interception is achievable in practice.</div></div>","PeriodicalId":50983,"journal":{"name":"Best Practice & Research in Clinical Rheumatology","volume":"40 3","pages":"Article 102133"},"PeriodicalIF":7.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147492091","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 young adult with Juvenile Idiopathic Arthritis (JIA): A clinical review of transition, complications, and psychosocial management 青少年特发性关节炎（JIA）：过渡、并发症和心理社会管理的临床回顾。

IF 7 2区医学

Best Practice & Research in Clinical Rheumatology Pub Date : 2026-09-01 Epub Date: 2026-07-01 DOI: 10.1016/j.berh.2026.102158

E.V. Rozenblyum, N.K. Gakhal

{"title":"The young adult with Juvenile Idiopathic Arthritis (JIA): A clinical review of transition, complications, and psychosocial management","authors":"E.V. Rozenblyum, N.K. Gakhal","doi":"10.1016/j.berh.2026.102158","DOIUrl":"10.1016/j.berh.2026.102158","url":null,"abstract":"<div><div>Juvenile idiopathic arthritis (JIA) is the most common chronic rheumatic disease of childhood, and up to half of patients continue to experience active disease or complications into adulthood. Despite this, adult rheumatology care remains largely oriented toward adult-onset disease, creating a mismatch in expertise for patients with childhood-onset arthritis. As a result, adult providers must address clinical challenges unique to childhood-onset disease, including persistent inflammation, temporomandibular joint (TMJ) involvement, long-term medication exposure, chronic pain, psychosocial morbidity, and extra-articular manifestations such as uveitis. Transition gaps are common and contribute to medication discontinuation, loss to follow-up, and disease flare.</div><div>This review summarizes the long-term outcomes of JIA relevant to adult rheumatologists and outlines best practices in screening and management across key domains, including uveitis, TMJ arthritis, mental health, and educational and vocational participation. The review also highlights evidence-based practical strategies for building transition-informed adult rheumatology practices.</div></div>","PeriodicalId":50983,"journal":{"name":"Best Practice & Research in Clinical Rheumatology","volume":"40 3","pages":"Article 102158"},"PeriodicalIF":7.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148363750","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

State of the art and novel treatments in psoriatic arthritis 银屑病关节炎的最新治疗方法。

IF 7 2区医学

Best Practice & Research in Clinical Rheumatology Pub Date : 2026-09-01 Epub Date: 2026-04-08 DOI: 10.1016/j.berh.2026.102135

Simon Hackett, Hussein Al-Mossawi, Laura C. Coates

{"title":"State of the art and novel treatments in psoriatic arthritis","authors":"Simon Hackett, Hussein Al-Mossawi, Laura C. Coates","doi":"10.1016/j.berh.2026.102135","DOIUrl":"10.1016/j.berh.2026.102135","url":null,"abstract":"<div><div>Psoriatic arthritis (PsA) is a heterogeneous, immune-mediated inflammatory disease characterised by multidomain clinical involvement, including peripheral arthritis, enthesitis, axial disease, dactylitis, and skin and nail manifestations, alongside a substantial burden of comorbidity. Over the recent decades, therapeutic options for PsA have expanded, with the introduction of multiple biologic and targeted compounds targeting tumour necrosis factor, the IL-23/IL-17 axis, and Janus kinase signalling. These advances have improved outcomes for many patients; however, incomplete responses, domain-specific refractory disease, treatment intolerance, and loss of efficacy remain common. In addition, current treatment strategies are largely reactive, reflecting limited ability to predict treatment response or align immune mechanism with clinical phenotype. This review summarises the current PsA treatment landscape and its limitations, and examines emerging therapeutic directions that aim to address disease heterogeneity and unmet need. These include combinatorial and sequential treatment strategies, next-generation biologics and oral agents, immunometabolic modulation, selective targeting of pathogenic immune cell populations and upstream inflammatory, immune tolerance–based approaches. It is with hope that these developments highlight a shift from incremental therapeutic expansion towards a integrated, targeted and ultimately, more informed treatment approach.</div></div>","PeriodicalId":50983,"journal":{"name":"Best Practice & Research in Clinical Rheumatology","volume":"40 3","pages":"Article 102135"},"PeriodicalIF":7.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147647177","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