Best Practice & Research in Clinical Rheumatology最新文献_第4页

Global epidemiology of psoriatic arthritis 银屑病关节炎的全球流行病学。

IF 7 2区医学

Best Practice & Research in Clinical Rheumatology Pub Date : 2026-09-01 Epub 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":"10.1016/j.berh.2026.102148","url":null,"abstract":"<div><div>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.</div><div>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.</div><div>A better understanding of epidemiological trends and transition phases from PsO to PsA may support earlier identification and optimized multidisciplinary management strategies.</div></div>","PeriodicalId":50983,"journal":{"name":"Best Practice & Research in Clinical Rheumatology","volume":"40 3","pages":"Article 102148"},"PeriodicalIF":7.0,"publicationDate":"2026-09-01","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 7 2区医学

Best Practice & Research in Clinical Rheumatology Pub Date : 2026-09-01 Epub Date: 2026-04-14 DOI: 10.1016/j.berh.2026.102150

Mohamad Bittar, Yvonne C. Lee, Atul Deodhar

引用次数: 0

Renal involvement in systemic sclerosis 系统性硬化症累及肾脏。

IF 4.8 2区医学

Best Practice & Research in Clinical Rheumatology Pub Date : 2026-05-01 Epub Date: 2026-04-07 DOI: 10.1016/j.berh.2026.102138

Ibraheem M. Almani, Janet E. Pope

{"title":"Renal involvement in systemic sclerosis","authors":"Ibraheem M. Almani, Janet E. Pope","doi":"10.1016/j.berh.2026.102138","DOIUrl":"10.1016/j.berh.2026.102138","url":null,"abstract":"<div><div>Systemic sclerosis is a complex connective tissue disease characterized by immune dysregulation, widespread vasculopathy, and progressive fibrosis affecting the skin and internal organs. Among its visceral complications, renal involvement, manifesting as scleroderma renal crisis, remains organ and life-threatening if not detected. Although its mortality has markedly declined with the life-saving introduction of angiotensin-converting enzyme inhibitors, renal complications remain a major determinant of morbidity, mortality, and long-term health outcomes. Beyond scleroderma renal crisis, a spectrum of renal abnormalities, and secondary renal injury from hypertension or therapeutic agents, contribute to the overall disease burden. This chapter review synthesizes evidence to provide an in-depth analysis of renal involvement in systemic sclerosis. The epidemiology, pathophysiology, clinical presentation, diagnostic approaches, management strategies, and emerging research directions are reviewed, along with developments in precision medicine, single-cell sequencing, molecular profiling, and complement-directed therapies are also discussed, highlighting gaps and future directions to optimize positive outcomes.</div></div>","PeriodicalId":50983,"journal":{"name":"Best Practice & Research in Clinical Rheumatology","volume":"40 2","pages":"Article 102138"},"PeriodicalIF":4.8,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147635179","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

A practical clinical approach to the diagnosis and management of morphea (localized scleroderma) 一个实用的临床方法来诊断和管理morphea（局限性硬皮病）。

IF 4.8 2区医学

Best Practice & Research in Clinical Rheumatology Pub Date : 2026-05-01 Epub Date: 2026-03-20 DOI: 10.1016/j.berh.2026.102127

Caterina Matucci-Cerinic , Dan Lipsker , Clara Malattia , Giorgia Martini

{"title":"A practical clinical approach to the diagnosis and management of morphea (localized scleroderma)","authors":"Caterina Matucci-Cerinic , Dan Lipsker , Clara Malattia , Giorgia Martini","doi":"10.1016/j.berh.2026.102127","DOIUrl":"10.1016/j.berh.2026.102127","url":null,"abstract":"<div><div>Morphea, also referred to as localized cutaneous scleroderma, encompasses a heterogeneous group of inflammatory and fibrosing skin disorders characterized by variable depth of tissue involvement and different clinical course. The diagnostic delay remains common due to insidious onset, broad differential diagnosis, and lack of validated biomarkers of disease activity. Clinical assessment relies therefore on expert evaluation, supported by clinical scoring systems and selected imaging techniques. Therapeutic strategies depend on disease subtype, activity, depth, and risk of irreversible damage, ranging from topical agents for limited superficial forms to systemic immunosuppression for deep, linear, generalized, and pansclerotic variants. Methotrexate combined with systemic corticosteroids represents the current first-line systemic therapy, while mycophenolate mofetil and biologics or targeted synthetic agents are increasingly used in refractory disease. This review provides a comprehensive and updated overview of the epidemiology, clinical spectrum, diagnostic approach, and management of morphea across age groups, highlighting recent therapeutic advances, and unmet clinical needs.</div></div>","PeriodicalId":50983,"journal":{"name":"Best Practice & Research in Clinical Rheumatology","volume":"40 2","pages":"Article 102127"},"PeriodicalIF":4.8,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147494713","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 : 2026-05-01 Epub Date: 2026-04-16 DOI: 10.1016/j.berh.2026.102131

Sindhu R. Johnson , Elana J. Bernstein

引用次数: 0

Oral and maxillofacial manifestations of systemic sclerosis 系统性硬化症的口腔和颌面表现。

IF 4.8 2区医学

Best Practice & Research in Clinical Rheumatology Pub Date : 2026-05-01 Epub Date: 2026-02-14 DOI: 10.1016/j.berh.2026.102119

Saeed Almurait , Hanan Alqahtani , Savithiri Ratnapalan , Sindhu R. Johnson

引用次数: 0

Nailfold capillaroscopy and organ involvement in systemic sclerosis: a systematic review 系统性硬化症的甲襞毛细血管镜检查与器官累及：系统综述。

IF 4.8 2区医学

Best Practice & Research in Clinical Rheumatology Pub Date : 2026-05-01 Epub Date: 2026-03-13 DOI: 10.1016/j.berh.2026.102130

C. Ickinger , R. Campitiello , T. Du Four , E. Gotelli , E. Hysa , R. Govender , M. Cutolo , V. Smith

{"title":"Nailfold capillaroscopy and organ involvement in systemic sclerosis: a systematic review","authors":"C. Ickinger , R. Campitiello , T. Du Four , E. Gotelli , E. Hysa , R. Govender , M. Cutolo , V. Smith","doi":"10.1016/j.berh.2026.102130","DOIUrl":"10.1016/j.berh.2026.102130","url":null,"abstract":"<div><div>Systemic sclerosis (SSc) is connective tissue disease characterised by early microvascular damage and tissue fibrosis. Nailfold videocapillaroscopy (NVC) enables direct assessment of the microangiopathy and classification into “scleroderma patterns”, offering potential prognostic value. This systematic review aims to analyse the most updated evidence linking NVC findings with organ-specific involvement in SSc. Uniquely, only longitudinal studies, with centralised reading using the European Alliance of Associations for Rheumatology (EULAR) Study Group on Microcirculation in Rheumatic Diseases consensus framework for nailfold capillaroscopy reporting, and published in the last 10 years were selected. Risk-of-bias assessment was assessed by 3 reviewers using the “QUality In Prognosis Studies” (QUIPS) risk-of-bias tool. In total, 14 manuscripts with low to moderate risk of bias were selected and critically analysed. Reduced capillary density (<7 capillaries/mm) and “Active/Late” scleroderma patterns, consistently predicted disease progression. Low capillary density and both “Active” and “Late” scleroderma patterns were strongly associated with more severe skin fibrosis, digital ulcers and calcinosis, pulmonary (arterial) hypertension and interstitial lung disease. A lowered capillary density further predicted major cardiovascular events and gastrointestinal dysmotility, and linked with subclinical renal vasculopathy. In Early SSc, “Active” or “Late” patterns increased the probability of progression to definite SSc. Finally, reduced capillary density reflects a globally more severe phenotype with worse prognosis. Integrating NVC into routine assessment may enable earlier identification of high-risk patients and promote timely intervention to prevent irreversible organ damage.</div></div>","PeriodicalId":50983,"journal":{"name":"Best Practice & Research in Clinical Rheumatology","volume":"40 2","pages":"Article 102130"},"PeriodicalIF":4.8,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147460937","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 : 2026-05-01 Epub 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":"10.1016/j.berh.2026.102122","url":null,"abstract":"<div><div>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.</div></div>","PeriodicalId":50983,"journal":{"name":"Best Practice & Research in Clinical Rheumatology","volume":"40 2","pages":"Article 102122"},"PeriodicalIF":4.8,"publicationDate":"2026-05-01","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

Systemic sclerosis: A comprehensive systematic review of global epidemiology, sex and ethnic disparities, disease burden, and organ-specific involvement 系统性硬化症：全球流行病学、性别和种族差异、疾病负担和器官特异性受累的全面系统综述。

IF 4.8 2区医学

Best Practice & Research in Clinical Rheumatology Pub Date : 2026-05-01 Epub Date: 2026-05-25 DOI: 10.1016/j.berh.2026.102156

Carlos Enrique Toro-Gutierrez , Gerardo Quintana-Lopez , Janet Pope

{"title":"Systemic sclerosis: A comprehensive systematic review of global epidemiology, sex and ethnic disparities, disease burden, and organ-specific involvement","authors":"Carlos Enrique Toro-Gutierrez , Gerardo Quintana-Lopez , Janet Pope","doi":"10.1016/j.berh.2026.102156","DOIUrl":"10.1016/j.berh.2026.102156","url":null,"abstract":"<div><div>The global epidemiology, regional variation, sex- and ethnicity-based disparities, disease burden, and organ-specific involvement in systemic sclerosis were reviewed. A qualitative systematic search of PubMed/MEDLINE, EMBASE, SciELO, and the Cochrane Library was conducted following PRISMA 2020 guidelines.</div><div>Forty-seven studies reporting incidence, prevalence, organ involvement, mortality, or quality of life were included. Global prevalence ranged from 0.9 to 37.9 per 100,000 and incidence from 0.05 to 4.1 per 100,000 person-years, with marked geographic heterogeneity across the globe.</div><div>Women were predominantly affected (4-6:1), whereas men showed more severe disease and higher mortality.</div><div>African-descent, Indigenous American, and some South Asian populations had higher frequencies of diffuse cutaneous systemic sclerosis, interstitial lung disease, and reduced survival. Pulmonary involvement accounted for most disease burden, with interstitial lung disease in 35-55% and pulmonary arterial hypertension in 6-12%.</div><div>These findings highlight substantial epidemiologic heterogeneity and the need for early detection and standardized care in expert centers.</div></div>","PeriodicalId":50983,"journal":{"name":"Best Practice & Research in Clinical Rheumatology","volume":"40 2","pages":"Article 102156"},"PeriodicalIF":4.8,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148018709","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

Scleromyositis – The new frontier 硬化肌炎——新领域。

IF 4.8 2区医学

Best Practice & Research in Clinical Rheumatology Pub Date : 2026-05-01 Epub Date: 2026-03-06 DOI: 10.1016/j.berh.2026.102126

Marie Hudson , Yves Troyanov , Océane Landon-Cardinal

引用次数: 0