Best Practice & Research in Clinical Rheumatology最新文献

{"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":"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}

{"title":"Genetics of rheumatoid arthritis","authors":"Seema D. Sharma ,&nbsp;Shek H. Leung ,&nbsp;Sebastien Viatte","doi":"10.1016/j.berh.2024.101968","DOIUrl":"10.1016/j.berh.2024.101968","url":null,"abstract":"<div><div>In the past four decades, a plethora of genetic association studies have been carried out in cohorts of patients with rheumatoid arthritis. These studies have highlighted key aspects of disease pathogenesis and suggested causal mechanisms. In this review, we discuss major advances in our understanding of the genetic architecture of rheumatoid arthritis susceptibility, severity and treatment response and explain how genetics supports current models of disease pathogenesis and outcome. We outline future research directions, like Mendelian randomisation, and present a number of potential avenues for clinical translation, including risk and outcome prediction, patient stratification into treatment response groups and pharmacological applications.</div></div>","PeriodicalId":50983,"journal":{"name":"Best Practice & Research in Clinical Rheumatology","volume":"38 4","pages":"Article 101968"},"PeriodicalIF":4.5,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141494185","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}

{"title":"Insights into the genetic landscape of systemic sclerosis","authors":"Ali El-Halwagi,&nbsp;Sandeep K. Agarwal","doi":"10.1016/j.berh.2024.101981","DOIUrl":"10.1016/j.berh.2024.101981","url":null,"abstract":"<div><div>Systemic sclerosis (SSc) is a complex autoimmune disease that clinically manifests as progressive fibrosis of the skin and internal organs. Autoimmunity and endothelial dysfunction play important roles in the development of SSc but the causes of SSc remain unknown. Accumulating evidence, first from familial aggregation studies and subsequently from candidate gene association studies and genome wide association studies underscore the crucial contributions of genetics to the development of SSc. The identification of polymorphisms in the HLA region as well as non-HLA loci is important for understanding the risks of developing SSc but can also provide important pathogenic insight in SSc. While not translating into clinic practice yet, understanding the genetic landscape of SSc will hopefully assist in the diagnosis and management of patients with and/or at risk of developing SSc in the future. Herein we review the studies that investigate genetic risks of SSc susceptibility.</div></div>","PeriodicalId":50983,"journal":{"name":"Best Practice & Research in Clinical Rheumatology","volume":"38 4","pages":"Article 101981"},"PeriodicalIF":4.5,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141789824","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":"Preface to genomics of rheumatic disease","authors":"Anne Barton,&nbsp;Proton Rahman","doi":"10.1016/j.berh.2024.102005","DOIUrl":"10.1016/j.berh.2024.102005","url":null,"abstract":"","PeriodicalId":50983,"journal":{"name":"Best Practice & Research in Clinical Rheumatology","volume":"38 4","pages":"Article 102005"},"PeriodicalIF":4.5,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142300236","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":"Pharmacogenetics of therapies in rheumatoid arthritis: An update","authors":"Mohamed H. Babiker-Mohamed ,&nbsp;Sambhawana Bhandari ,&nbsp;Prabha Ranganathan","doi":"10.1016/j.berh.2024.101974","DOIUrl":"10.1016/j.berh.2024.101974","url":null,"abstract":"<div><div>Rheumatoid arthritis (RA) is a systemic autoimmune inflammatory arthritis. Despite many treatment advances, achieving remission or low-disease activity in RA remains challenging, often requiring trial and error approaches with numerous medications. Precision medicine, particularly pharmacogenomics, explores how genetic factors influence drug response in individual patients, and incorporates such factors to develop personalized treatments for individual patients. Genetic variations in drug-metabolizing enzymes, transporters, and targets may contribute to inter-individual differences in drug efficacy and toxicity. Advancements in molecular sequencing have allowed rapid identification of such variants, including single nucleotide polymorphisms (SNPs). This review highlights recent major findings in the pharmacogenetics of therapies in RA, focusing on key genes and SNPs to provide insights into current trends and developments in this field.</div></div>","PeriodicalId":50983,"journal":{"name":"Best Practice & Research in Clinical Rheumatology","volume":"38 4","pages":"Article 101974"},"PeriodicalIF":4.5,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141735577","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}

{"title":"Use of Mendelian randomization to assess the causal status of modifiable exposures for rheumatic diseases","authors":"Sizheng Steven Zhao ,&nbsp;Stephen Burgess","doi":"10.1016/j.berh.2024.101967","DOIUrl":"10.1016/j.berh.2024.101967","url":null,"abstract":"<div><div>The explosion in Mendelian randomization (MR) publications is hard to ignore and shows no signs of slowing. Clinician readers, who may not be familiar with jargon-ridden methods, are expected to discern the good from the many low-quality studies that make overconfident claims of causality or stretch the plausibility of what MR can investigate. We aim to equip readers with foundational concepts, contextualized using examples in rheumatology, to appraise the many MR papers that are or will appear in their journals. We highlight the importance of assessing whether exposures are under plausibly specific genetic influence, whether the hypothesized causal pathways make biological sense, and whether results stand up to replication and use of control outcomes. Quality of research can vary substantially using MR as with any design, and all methods have inherent limitations. MR studies have provided and can still contribute valuable insights in the context of evidence triangulation.</div></div>","PeriodicalId":50983,"journal":{"name":"Best Practice & Research in Clinical Rheumatology","volume":"38 4","pages":"Article 101967"},"PeriodicalIF":4.5,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7616521/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141477909","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}