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Best Practice & Research in Clinical Rheumatology最新文献

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Microbiota and immune dynamics in rheumatoid arthritis: Mechanisms and therapeutic potential 类风湿关节炎的微生物群和免疫动力学：机制和治疗潜力。
IF 4.5 2区 医学
Best Practice & Research in Clinical Rheumatology Pub Date : 2025-03-01 DOI: 10.1016/j.berh.2025.102035
Jiayang Jin , Xuanlin Cai , Peishi Rao , Jun Xu , Jing Li
{"title":"Microbiota and immune dynamics in rheumatoid arthritis: Mechanisms and therapeutic potential","authors":"Jiayang Jin ,&nbsp;Xuanlin Cai ,&nbsp;Peishi Rao ,&nbsp;Jun Xu ,&nbsp;Jing Li","doi":"10.1016/j.berh.2025.102035","DOIUrl":"10.1016/j.berh.2025.102035","url":null,"abstract":"<div><div>Rheumatoid arthritis (RA) is a complex autoimmune disease with growing evidence implicating the microbiota as a critical contributor to its pathogenesis. This review explores the multifaceted roles of microbial dysbiosis in RA, emphasizing its impact on immune cell modulation, autoantibody production, gut barrier integrity, and joint inflammation. Animal models reveal how genetic predisposition and environmental factors interact with specific microbial taxa to influence disease susceptibility. Dysbiosis-driven metabolic disruptions, including alterations in short-chain fatty acids and bile acids, further exacerbate immune dysregulation and systemic inflammation. Emerging therapeutic strategies-probiotics, microbial metabolites, fecal microbiota transplantation, and antibiotics-offer innovative avenues for restoring microbial balance and mitigating disease progression. By integrating microbiota-targeted approaches with existing treatments, this review highlights the potential to revolutionize RA management through precision medicine and underscores the need for further research to harness the microbiota's therapeutic potential.</div></div>","PeriodicalId":50983,"journal":{"name":"Best Practice & Research in Clinical Rheumatology","volume":"39 1","pages":"Article 102035"},"PeriodicalIF":4.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143043266","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
Promise of rheumatoid arthritis therapy: From clinical deep remission to drug-free remission 类风湿关节炎治疗的前景：从临床深度缓解到无药。
IF 4.5 2区 医学
Best Practice & Research in Clinical Rheumatology Pub Date : 2025-03-01 DOI: 10.1016/j.berh.2024.102031
Yuke Hou , Yuanhong Peng , Jiayang Jin , Zhanguo Li
{"title":"Promise of rheumatoid arthritis therapy: From clinical deep remission to drug-free remission","authors":"Yuke Hou ,&nbsp;Yuanhong Peng ,&nbsp;Jiayang Jin ,&nbsp;Zhanguo Li","doi":"10.1016/j.berh.2024.102031","DOIUrl":"10.1016/j.berh.2024.102031","url":null,"abstract":"<div><div>Achieving clinical deep remission (CliDR) in rheumatoid arthritis (RA) is essential to prevent long-term joint damage, enhance patient quality of life, and possibly reduce and discontinue medication eventually. Recent research advances have raised the possibility of achieving deep remission and even drug-free remission. This comprehensive review examines current strategies of RA therapy, concept of deep remission, challenges, and the emerging prospects of drug-free remission. It also reviews the role of different treatments, including conventional disease-modifying antirheumatic drugs (DMARDs), biologic agents, and targeted synthetic drugs, in the journey from deep remission to drug-free remission. In addition, it emphasizes the importance of patient-centered care, early diagnosis, and individualized treatment approaches in optimizing outcomes for patients with RA.</div></div>","PeriodicalId":50983,"journal":{"name":"Best Practice & Research in Clinical Rheumatology","volume":"39 1","pages":"Article 102031"},"PeriodicalIF":4.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143434238","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
What's new on the horizon for rheumatoid arthritis management 类风湿关节炎治疗的新进展是什么？
IF 4.5 2区 医学
Best Practice & Research in Clinical Rheumatology Pub Date : 2025-03-01 DOI: 10.1016/j.berh.2025.102038
Karmtej S. Cheema , Andrew Bit Mansour , Siba P. Raychaudhuri
{"title":"What's new on the horizon for rheumatoid arthritis management","authors":"Karmtej S. Cheema ,&nbsp;Andrew Bit Mansour ,&nbsp;Siba P. Raychaudhuri","doi":"10.1016/j.berh.2025.102038","DOIUrl":"10.1016/j.berh.2025.102038","url":null,"abstract":"<div><div>Rheumatoid arthritis (RA) is a chronic multisystem common autoimmune disease. Joints and the whole musculoskeletal system bear the brunt of the disease. Proper adequate treatment at the early stage is the foremost necessity to protect the patients from long term disabilities and reduce patient systemic morbidities including atherosclerosis and coronary artery disease. New biologic and non-biologic antirheumatic drugs in the last two decades have brought new dimensions for treat to target strategy and array of novel therapies for RA are in the horizon. Here in this systematic review our objective is to provide an overview of current developments and potentially available therapeutic options for RA. Novel immune-based therapies has the potential to change the treatment for RA. We have discussed in detail about the new drugs for RA in the horizon and provided analyses of the future drugs in pipeline for the management of RA.</div></div>","PeriodicalId":50983,"journal":{"name":"Best Practice & Research in Clinical Rheumatology","volume":"39 1","pages":"Article 102038"},"PeriodicalIF":4.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143411407","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 RA treatment recommendations: An update from the various international societies 全球 RA 治疗建议：来自各国际学会的最新信息。
IF 4.5 2区 医学
Best Practice & Research in Clinical Rheumatology Pub Date : 2025-03-01 DOI: 10.1016/j.berh.2024.102019
Charles Cubberley , Ajesh Maharaj
{"title":"Global RA treatment recommendations: An update from the various international societies","authors":"Charles Cubberley ,&nbsp;Ajesh Maharaj","doi":"10.1016/j.berh.2024.102019","DOIUrl":"10.1016/j.berh.2024.102019","url":null,"abstract":"<div><div>Rheumatoid arthritis is a chronic inflammatory arthritis with many extra-articular manifestations and is associated with an increased risk of morbidity and mortality. This review attempts to provide an update on the treatment recommendations from various global societies and discuss some of the challenges and solutions to caring for people with rheumatoid arthritis across the world.</div><div>A search was conducted on PubMed, Google Scholar, and EMBASE from 2000 to 2024 using rheumatoid arthritis, treatment, recommendations, guidelines, management, disparities, and access as the search terms. Emphasis was placed on pertinent recommendations published in the last five years. Recent available recommendations of the American College of Rheumatology (ACR), European Alliance of Associations for Rheumatology (EULAR), Asia-Pacific League of Associations for Rheumatology (APLAR), Pan-American League of Rheumatology (PANLAR) and African League of Associations for Rheumatology (AFLAR) were concentrated on. The latest recommendations from various societies are discussed.</div></div>","PeriodicalId":50983,"journal":{"name":"Best Practice & Research in Clinical Rheumatology","volume":"39 1","pages":"Article 102019"},"PeriodicalIF":4.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142577206","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
Preclinical RA: How to halt its progression 临床前类风湿性关节炎：如何阻止其进展。
IF 4.5 2区 医学
Best Practice & Research in Clinical Rheumatology Pub Date : 2025-03-01 DOI: 10.1016/j.berh.2024.102030
Tong Wu , Yanhong Li , Yi Liu , Cong-Qiu Chu
{"title":"Preclinical RA: How to halt its progression","authors":"Tong Wu ,&nbsp;Yanhong Li ,&nbsp;Yi Liu ,&nbsp;Cong-Qiu Chu","doi":"10.1016/j.berh.2024.102030","DOIUrl":"10.1016/j.berh.2024.102030","url":null,"abstract":"<div><div>Rheumatoid arthritis (RA) is a chronic autoimmune disorder with a complex pathogenesis that evolves through various stages before clinical symptoms emerge. This review outlines the natural history of RA, starting from genetic predisposition and environmental triggers to preclinical autoimmunity and subsequent joint inflammation. Key genetic factors interact with environmental elements like smoking and infections, producing autoantibodies such as anti-citrullinated protein antibodies (ACPA) and rheumatoid factor, which precede clinical manifestations by several years. The preclinical phases offer critical opportunities for intervention aiming at halting disease progression. Preventive strategies including lifestyle modifications, dietary interventions, and targeted immune modulation may halt the progression to clinical RA in those at-risk individuals.</div></div>","PeriodicalId":50983,"journal":{"name":"Best Practice & Research in Clinical Rheumatology","volume":"39 1","pages":"Article 102030"},"PeriodicalIF":4.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142900217","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
Physiotherapy and occupational therapy in rheumatoid arthritis: Bridging functional and comorbidity gaps 类风湿性关节炎的物理治疗和职业治疗：弥合功能和合并症的差距。
IF 4.5 2区 医学
Best Practice & Research in Clinical Rheumatology Pub Date : 2025-03-01 DOI: 10.1016/j.berh.2024.102032
Nur Azizah Allameen , Yi Wye Lai , Guojie Lian , Tyrik Zhen-Yuan Lee , Saranya Selvakumaran , Rachel Yuet Teng Tan , Chuanhui Xu
{"title":"Physiotherapy and occupational therapy in rheumatoid arthritis: Bridging functional and comorbidity gaps","authors":"Nur Azizah Allameen ,&nbsp;Yi Wye Lai ,&nbsp;Guojie Lian ,&nbsp;Tyrik Zhen-Yuan Lee ,&nbsp;Saranya Selvakumaran ,&nbsp;Rachel Yuet Teng Tan ,&nbsp;Chuanhui Xu","doi":"10.1016/j.berh.2024.102032","DOIUrl":"10.1016/j.berh.2024.102032","url":null,"abstract":"<div><div>Rheumatoid arthritis (RA) is a chronic, systemic inflammatory disease affecting a significant portion of the global population. Despite advancements in pharmacological treatments, the management of RA remains complex, particularly in regard to comorbidities such as cardiovascular disease and osteoporosis. Physiotherapy (PT) and occupational therapy (OT) are non-pharmacological approaches that play a critical role in the management of RA. This review explores the impact of PT and OT in improving joint function, reducing pain and fatigue, and enhancing the overall quality of life in RA patients. It also addresses the role of these therapies in managing RA-related comorbidities, with an emphasis on exercise therapy, manual techniques, patient education and emerging digital interventions. Evidence supports the inclusion of tailored exercise regimens, such as cardiorespiratory training, resistance exercises and neuromotor activities, as vital components of RA management. By incorporating PT and OT, healthcare providers can better address the multifaceted needs of RA patients, complementing pharmacological treatments and improving long-term outcomes.</div></div>","PeriodicalId":50983,"journal":{"name":"Best Practice & Research in Clinical Rheumatology","volume":"39 1","pages":"Article 102032"},"PeriodicalIF":4.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142916194","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
Novel biomarkers in RA: Implication for diagnosis, prognosis, and personalised treatment RA 中的新型生物标记物：对诊断、预后和个性化治疗的影响。
IF 4.5 2区 医学
Best Practice & Research in Clinical Rheumatology Pub Date : 2025-03-01 DOI: 10.1016/j.berh.2024.102021
Marcelo Neto , Beatriz Mendes , Fernando Albuquerque , José António P. da Silva
{"title":"Novel biomarkers in RA: Implication for diagnosis, prognosis, and personalised treatment","authors":"Marcelo Neto ,&nbsp;Beatriz Mendes ,&nbsp;Fernando Albuquerque ,&nbsp;José António P. da Silva","doi":"10.1016/j.berh.2024.102021","DOIUrl":"10.1016/j.berh.2024.102021","url":null,"abstract":"<div><div>Over the past decades our understanding of rheumatoid arthritis (RA) pathogenesis has improved remarkably and major breakthroughs in the treatment of RA were made with the advent of numerous targeted therapies and new treatment strategies. Despite these advances, several unmet needs remain, namely in achieving earlier and more accurate diagnosis, monitoring disease activity, predicting disease prognosis and optimizing treatment.</div><div>To address these gaps, recent research has focused on identifying biomarkers that may enhance diagnostic precision, predict disease prognosis, and optimize treatment strategies.</div><div>In this narrative review we will describe recent developments in RA biomarkers with demonstrated or promising clinical relevance.</div></div>","PeriodicalId":50983,"journal":{"name":"Best Practice & Research in Clinical Rheumatology","volume":"39 1","pages":"Article 102021"},"PeriodicalIF":4.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142645113","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
A review on the epidemiology of rheumatoid arthritis: An update and trends from current literature 类风湿关节炎的流行病学综述：最新的文献和趋势。
IF 4.5 2区 医学
Best Practice & Research in Clinical Rheumatology Pub Date : 2025-03-01 DOI: 10.1016/j.berh.2025.102036
Perpetual Uke , Ajesh Maharaj , Adewale Adebajo
{"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}
引用次数: 0
Clinical manifestations of rheumatoid arthritis, including comorbidities, complications, and long-term follow-up 类风湿性关节炎的临床表现，包括合并症、并发症和长期随访。
IF 4.5 2区 医学
Best Practice & Research in Clinical Rheumatology Pub Date : 2025-03-01 DOI: 10.1016/j.berh.2024.102020
Durga Prasanna Misra
{"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}
引用次数: 0
Management of pregnant with rheumatoid arthritis: Preconception care, pregnancy and lactation strategies, and maternal-fetal outcomes 类风湿性关节炎孕妇的管理：孕前保健、孕期和哺乳期策略以及母胎结局。
IF 4.5 2区 医学
Best Practice & Research in Clinical Rheumatology Pub Date : 2025-03-01 DOI: 10.1016/j.berh.2024.102022
Takehiro Nakai , Sho Fukui , Hiroki Ozawa , Ayako Kitada , Masato Okada , Mitsumasa Kishimoto
{"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}
引用次数: 0
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