Joint Bone Spine最新文献

{"title":"Current Diagnostic Pathways for Rheumatoid Arthritis-Associated Interstitial Lung Disease Result in Substantial Underdiagnosis and Excess Mortality: A Multicenter Norwegian Quality Assurance Audit.","authors":"Eirik Ikdahl, Benedikte Døskeland, Liv Turid Bertelsen, Gunnstein Bakland, Tina Therese Pedersen, Yi Hu, Phuong Phuong Diep, Lene Maria Sundbakk, Sella Aarrestad Provan, Anna-Maria Hoffmann-Vold","doi":"10.1016/j.jbspin.2026.106130","DOIUrl":"https://doi.org/10.1016/j.jbspin.2026.106130","url":null,"abstract":"<p><strong>Objective: </strong>Recent guidelines suggest risk-stratified screening for rheumatoid arthritis-associated interstitial lung disease (RA-ILD). However, the diagnostic gap between current routine care and this screening approach remains unquantified. We assessed currently detected RA-ILD in Norway, benchmarking findings against recent screening-based estimates of the true disease burden.</p><p><strong>Methods: </strong>This 10-year quality assurance audit across six centers covered 43% of the Norwegian population. RA-ILD cases identified via ICD-10 codes were confirmed by manual chart review. Prevalence was calculated relative to a registry-derived total RA background population and benchmarked against a 10% expected target derived from recent prospective studies. Mortality was compared to a 3:1 frequency-matched RA control group using Cox proportional hazards regression.</p><p><strong>Results: </strong>Among 17,305 RA patients, 188 (1.1%) had verified ILD; when benchmarked against an expected 10% prevalence, this indicates an 89% diagnostic gap in routine clinical care. Mean age at ILD detection was 67.5 years. Most cases (93.6%) possessed ≥2 established risk factors for RA-ILD: 93.6% were seropositive, 76.1% had smoking histories, while RA onset age ≥60 and persistently increased inflammatory laboratory markers were present in over half of patients. RA-ILD was associated with significantly increased mortality; 66 (4.1/100 person-years) deaths occurred in the RA-ILD group vs. 120 (2.3/100 person-years) among RA controls (HR 1.77; 95% CI: 1.31-2.39, p<0.001).</p><p><strong>Conclusion: </strong>When comparing to prevalence expectations, current routine care may leave a substantial proportion of cases undetected, primarily capturing a high-risk phenotype with excess mortality. Systematic, risk-stratified screening is needed to bridge this diagnostic gap, aiming to enable earlier intervention.</p>","PeriodicalId":54902,"journal":{"name":"Joint Bone Spine","volume":" ","pages":"106130"},"PeriodicalIF":5.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148876018","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Residual activated Th17 cells during inactive disease or low disease activity are associated with subsequent disease worsening in radiographic axial spondyloarthritis: a pilot study.","authors":"Oh Chan Kwon, Lark Kyun Kim, Min-Chan Park","doi":"10.1016/j.jbspin.2026.106131","DOIUrl":"https://doi.org/10.1016/j.jbspin.2026.106131","url":null,"abstract":"<p><strong>Objective: </strong>To investigate whether residual activated T helper 17 (Th17) cells during inactive disease or low disease activity (LDA) in radiographic axial spondyloarthritis (r-axSpA) are associated with subsequent disease instability.</p><p><strong>Methods: </strong>Patients with r-axSpA in inactive disease or LDA (Axial Spondyloarthritis Disease Activity Score [ASDAS]<2.1) were included. Peripheral blood mononuclear cells obtained at baseline were analyzed using multicolor flow cytometry. Activated Th17 cells were defined as CD3⁺CD4⁺CXCR3^-CCR6⁺CD38⁺HLA-DR⁺ cells. Patients were categorized into activated Th17-high and activated Th17-low groups according to the receiver operating characteristics-derived cut-off value of activated Th17 cells among CD4⁺ T cells. ASDAS was assessed at baseline, 3 months, and 6 months. ASDAS trajectories were analyzed using linear mixed-effects models, and the proportion of patients experiencing loss of LDA (ASDAS≥2.1) was compared between groups.</p><p><strong>Results: </strong>Twenty-one patients with r-axSpA were included (activated Th17-high, n=9; activated Th17-low, n=12). The activated Th17-high group showed a significantly worse ASDAS trajectory during follow-up than the activated Th17-low group (P for interaction<0.05). Loss of LDA occurred in 4 patients (44.4%) in the activated Th17-high group and in none in the activated Th17-low group (P<0.05). Baseline disease activity status (inactive disease [ASDAS<1.3] vs. LDA [1.3≤ASDAS<2.1]) was not associated with differences in ASDAS trajectories (P for interaction=non-significant) or loss of LDA (P=non-significant).</p><p><strong>Conclusion: </strong>Residual activated Th17 cells during inactive disease or LDA are associated with subsequent disease worsening in r-axSpA. Cellular immune profiling may help identify patients at risk of disease instability despite apparent clinical control.</p>","PeriodicalId":54902,"journal":{"name":"Joint Bone Spine","volume":" ","pages":"106131"},"PeriodicalIF":5.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148876158","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Plasma Metabolic and Proteomic Signatures of Mixed Exposure to Ambient Air Pollutants Associated with Incident Arthritis Subtypes.","authors":"Jin Feng, Xuena Yang, Shiqiang Cheng, Jingni Hui, Boyue Zhao, Dan He, Li Liu, Huan Liu, Bolun Cheng, Yumeng Jia, Yan Wen, Feng Zhang","doi":"10.1016/j.jbspin.2026.106129","DOIUrl":"https://doi.org/10.1016/j.jbspin.2026.106129","url":null,"abstract":"<p><strong>Objectives: </strong> The associations between ambient air pollution mixtures, related metabolic and proteomic signatures, and arthritis subtypes, including rheumatoid arthritis (RA), osteoarthritis (OA), gout, and psoriatic arthritis (PsA), remain unclear.</p><p><strong>Methods: </strong> This prospective cohort study included 401,676 UK Biobank participants free of arthritis at baseline. Air pollution mixture exposure was quantified using Weighted Quantile Sum (WQS) regression. Metabolic and proteomic signatures were derived using multivariable linear and elastic net regression. Associations with incident arthritis were evaluated using Cox proportional hazards models and generalized propensity score approaches. Causal mediation analysis was performed to assess mediating effects.</p><p><strong>Results: </strong> Over a median follow-up of 13 years, 78,188 any type of arthritis cases were identified. The primary contributors to the WQS mixture index were NOx and NO₂ for RA, PM_2.5 for OA, NOx and PM_2.5 for gout, and PM_2.5 and PM₁₀ for PsA. Higher WQS index scores and their associated metabolic and proteomic signatures were associated with increased risks of arthritis subtypes. These signatures mediated the associations between air pollution mixtures and arthritis risk, with mediation proportions ranging from 4.92% to 35.05%. Top 10 mediating metabolites and proteins showed partial overlap, alongside disease-specific profiles across arthritis subtypes.</p><p><strong>Conclusion: </strong> Air pollution mixtures were associated with increased risks of arthritis subtypes, potentially through both shared and disease-specific metabolic and proteomic pathways, highlighting the importance of considering pollutant mixtures and disease heterogeneity in arthritis research and prevention.</p>","PeriodicalId":54902,"journal":{"name":"Joint Bone Spine","volume":" ","pages":"106129"},"PeriodicalIF":5.0,"publicationDate":"2026-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148867876","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hypermobile Ehlers-Danlos Syndrome and Widespread Pain: Beyond Structural Laxity.","authors":"Asaf Weisman, Youssef Masharawi","doi":"10.1016/j.jbspin.2026.106126","DOIUrl":"https://doi.org/10.1016/j.jbspin.2026.106126","url":null,"abstract":"","PeriodicalId":54902,"journal":{"name":"Joint Bone Spine","volume":" ","pages":"106126"},"PeriodicalIF":5.0,"publicationDate":"2026-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148867894","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Beyond Uric Acid: Allantoin Reflects Oxidative Stress, Disease Burden, and Cardiovascular Comorbidities in Hyperuricemia and Gout.","authors":"Lenka Hasikova, Petr Kozlik, Kveta Kalikova, Marketa Pavlíkova, Blanka Stiburkova","doi":"10.1016/j.jbspin.2026.106128","DOIUrl":"https://doi.org/10.1016/j.jbspin.2026.106128","url":null,"abstract":"<p><strong>Objectives: </strong>Uric acid (UA) can be non-enzymatically oxidized to allantoin and other products by reactive oxygen species under conditions of increased oxidative stress. This study assessed serum allantoin levels and the allantoin/UA ratio in patients with gout and asymptomatic hyperuricemia, with respect to disease severity and cardiovascular comorbidities.</p><p><strong>Methods: </strong>Clinical and biochemical data were collected from 154 patients with gout, 55 individuals with asymptomatic hyperuricemia, and 47 healthy controls. Allantoin was quantified using a fully validated UHPLC-MS/MS method. Associations with clinical outcomes were evaluated using logistic regression adjusted for eGFR, age, and sex.</p><p><strong>Results: </strong>Serum allantoin levels and the allantoin/UA ratio were significantly higher in patients compared to controls (p < 0.001), with no difference between the gout and hyperuricemia groups. Allantoin correlated with renal function (eGFR: r = -0.25, p < 0.001) and CRP (r = 0.22, p = 0.001), both of which remained independent predictors in multivariable analysis, whereas UA did not (p = 0.14). In adjusted logistic regression, allantoin was independently associated with tophi (OR 2.34, p = 0.050) and arterial hypertension (OR 2.26, p = 0.046), with a borderline association with gout flares (OR 2.52, p = 0.053). These estimates remained unchanged after additional adjustment for UA, indicating that allantoin reflects oxidative processes beyond substrate availability.</p><p><strong>Conclusion: </strong>Serum allantoin and the allantoin/UA ratio are elevated in hyperuricemia and gout, particularly in patients with tophaceous disease or concomitant arterial hypertension. After adjustment for renal function, age, and sex, allantoin remains independently associated with disease severity and cardiovascular comorbidity, supporting its role as a marker of oxidative stress burden.</p>","PeriodicalId":54902,"journal":{"name":"Joint Bone Spine","volume":" ","pages":"106128"},"PeriodicalIF":5.0,"publicationDate":"2026-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148851805","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A comparison of meta-analyses on articular treatments for knee osteoarthritis-related pain, indexed in PubMed until March 2025.","authors":"Sylvain Mathieu, Fabien Rondepierre, Isabelle Jalenques, Bruno Pereira","doi":"10.1016/j.jbspin.2026.106127","DOIUrl":"https://doi.org/10.1016/j.jbspin.2026.106127","url":null,"abstract":"<p><strong>Objectives: </strong>To identify meta-analyses (MAs) evaluating local treatments for knee osteoarthritis (KOA)-related pain, assess registration practices, and compare overlapping MAs to evaluate consistency, reproducibility, and potential redundancy.</p><p><strong>Methods: </strong>MEDLINE (via PubMed®) was searched from inception to March 2025 for MAs that were grouped according to treatment. Pairwise comparisons were performed between MAs investigating the same intervention, evaluating registration status, databases searched, search strategies, included studies, and pain outcome results.</p><p><strong>Results: </strong>Eighty-one MAs were included, generating 566 pairwise comparisons across 15 treatment themes. Twenty-seven MAs were registered, including 26 in PROSPERO. Registration frequency increased significantly over time, reaching 65.4% among MAs published between 2022 and 2025 (p<0.001). The search strategy was unavailable in 18.2% of pairwise comparisons and identical in only two cases (0.4%). Database searches were identical in 6.9% of comparisons. Of the 113 possible comparisons of pain outcomes, only 32 (28.3%) yielded identical results, while 36 (31.9%) were completely different. Registration status, methodological quality, journal impact factor, and publication year were not associated with greater concordance between MAs.</p><p><strong>Conclusions: </strong>Substantial discrepancies exist between overlapping MAs evaluating local treatments for KOA-related pain. These discrepancies appear largely related to differences in search strategies, study selection, outcome definitions, and reporting practices. Although PROSPERO registration has increased over time, it remains underused and does not ensure greater concordance between MAs. PROSPERO consultation before starting SR, prospective registration of SR, transparent reporting of search strategies, and greater standardization of outcome reporting may improve the reproducibility and usefulness of evidence synthesis.</p>","PeriodicalId":54902,"journal":{"name":"Joint Bone Spine","volume":" ","pages":"106127"},"PeriodicalIF":5.0,"publicationDate":"2026-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148851729","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-term sequelae in patients with spondylodiscitis: independent predictors.","authors":"Fatma Hammami, Makram Koubaa, Fatma Kolsi, Khaoula Rekik, Chakib Marrakchi, Mounir Ben Jemaa","doi":"10.1016/j.jbspin.2026.106125","DOIUrl":"https://doi.org/10.1016/j.jbspin.2026.106125","url":null,"abstract":"<p><strong>Objectives: </strong>To identify independent predictors of long-term sequelae in patients with infectious spondylodiscitis.</p><p><strong>Methods: </strong>We conducted a retrospective cohort study including 215 patients hospitalized for infectious spondylodiscitis between 2010 and 2024. Clinical, biological, and radiological data were collected. Factors associated with long-term sequelae were analyzed using multivariate logistic regression.</p><p><strong>Results: </strong>Long-term sequelae occurred in 99 patients (46%). The most common sequelae were persistent back pain (34.9%), spinal deformity (14.9%), and radicular pain (6.5%). The prevalence of sequelae differed across etiological groups, with the highest frequency observed in tuberculous spondylodiscitis (p < 0.05). Patients with sequelae were younger (50 ± 17 vs 55 ± 17 years; p < 0.05) and more likely to present with constitutional symptoms, neurological deficit, elevated erythrocyte sedimentation rate (ESR), and radiological findings such as psoas abscesses, spinal epidural abscesses, and spinal cord compression. On multivariate analysis, younger age (adjusted odds ratio [aOR]=0.97 per year increase; p < 0.01), elevated ESR (aOR=1.012 per mm/h; p < 0.01), neurological deficit (aOR=2.72; p <0.01), psoas abscess (aOR=5.27; p<0.001), and spinal epidural abscess (aOR=2.40; p < 0.05) were independently associated with long-term sequelae.</p><p><strong>Conclusion: </strong>Infectious spondylodiscitis is associated with a high rate of long-term sequelae. Younger age, neurological deficit, elevated ESR, and specific radiological findings, particularly psoas and spinal epidural abscesses, were independent predictors of sequelae. Early identification of high-risk patients may help optimize management and improve outcomes.</p>","PeriodicalId":54902,"journal":{"name":"Joint Bone Spine","volume":" ","pages":"106125"},"PeriodicalIF":5.0,"publicationDate":"2026-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148851827","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Distinct Cardiac Profiles in Psoriatic Arthritis and Rheumatoid Arthritis: Insights from Echocardiographic Findings.","authors":"Fabiola Atzeni, Katie Bechman, Angelo Tropea, Francesca Cracò, Alessandra Burgio, Antonio Pezzano, James Galloway, Alessandra Alciati","doi":"10.1016/j.jbspin.2026.106124","DOIUrl":"https://doi.org/10.1016/j.jbspin.2026.106124","url":null,"abstract":"<p><strong>Objective: </strong>Cardiovascular disease contributes to morbidity and mortality in rheumatoid arthritis (RA) and psoriatic arthritis (PsA). Systemic inflammation drives risk in RA, while PsA may involve additional immune-metabolic mechanisms, potentially resulting in distinct cardiac phenotypes. Comparative data on subclinical cardiac involvement are limited.</p><p><strong>Objectives: </strong>To compare subclinical cardiac abnormalities in RA and PsA using transthoracic echocardiography and identify disease-specific factors associated with cardiac changes.</p><p><strong>Methods: </strong>We conducted a cross-sectional, single-centre study of 92 RA and 78 PsA patients.</p><p><strong>Inclusion criteria: </strong>age >18 years and fulfilment of 2010 ACR/EULAR (RA) or CASPAR (PsA) criteria. Patients with known cardiac disease or poor imaging quality were excluded. Clinical data included demographics, disease duration, cardiovascular risk factors, and treatments. Disease activity was assessed using DAS28-CRP in RA and DAPSA in PsA. Echocardiography assessed ventricular function, diastolic parameters, pulmonary pressures, valvular abnormalities, and pericardial effusion.</p><p><strong>Results: </strong>RA patients were older (60.9±13.5 vs 55.2±12.5 years, p=0.006) and had higher BMI (26.0±6.4 vs 24.0±2.8 kg/m², p=0.011). PsA patients had more hypertension (55% vs 39%, p=0.037) and higher biologic/tsDMARD exposure (97% vs 79%, p<0.001). Mean DAPSA in PsA was 21.8±7.3, indicating predominantly moderate disease activity. Compared with RA, PsA patients showed lower tricuspid annular plane systolic excursion (TAPSE )(19.2±1.8 vs 20.7±1.8 mm, p<0.001), higher left atrial volume index (34.7±3.4 vs 33.3±3.5 mL/m², p=0.009), higher prevalence of pericardial effusion (49% vs 23%, p<0.001), and any cardiac abnormality (72% vs 38%, p<0.001). Multivariable analysis identified PsA as independently associated with left ventricular hypertrophy, reduced TAPSE, reduced ejection fraction (EF), pericardial effusion, and overall cardiac abnormalities.</p><p><strong>Conclusions: </strong>PsA is associated with a higher burden of subclinical cardiac abnormalities than RA, involving both ventricles and the pericardium, after adjustment for measured traditional cardiovascular risk factors, although residual confounding cannot be excluded. These hypothesis-generating findings support consideration of disease-specific cardiovascular monitoring in PsA.</p>","PeriodicalId":54902,"journal":{"name":"Joint Bone Spine","volume":" ","pages":"106124"},"PeriodicalIF":5.0,"publicationDate":"2026-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148801972","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evolving Economic Burden of Spondyloarthritis (2015-2023): A Nationwide Analysis of Direct and Indirect Costs.","authors":"Renaud Felten, Laurent Arnaud","doi":"10.1016/j.jbspin.2026.106123","DOIUrl":"https://doi.org/10.1016/j.jbspin.2026.106123","url":null,"abstract":"<p><strong>Objective: </strong>To assess temporal changes in the direct and indirect economic burden of spondyloarthritis (SpA), including psoriatic arthritis (PsA), in France between 2015 and 2023 using nationwide healthcare data.</p><p><strong>Methods: </strong>We conducted a retrospective population-based study using the French National Health Data System (SNDS). Patients with SpA/PsA were identified through validated administrative algorithms based on ICD-10 codes, long-term disease status, and hospitalization records. Direct medical costs included all reimbursed expenditures related to hospitalizations and outpatient care. Indirect costs were estimated using reimbursed daily allowances for sick leave and work-related injuries, disability benefits, and annuities. Costs were aggregated annually and changes analyzed over time.</p><p><strong>Results: </strong>In 2023, 270,290 individuals with SpA/PsA were identified, accounting for euro1.19 billion in total reimbursed expenditures (euro4,418 per patient). Outpatient care represented the largest share (66.1%), largely driven by medications (euro633.6 million), while hospital-based care accounted for 12.9%. Indirect costs reached euro250.6 million (21.0%). Between 2015 and 2023, the number of patients increased by 45.1%, and total expenditures rose by 52.2%. Medication costs showed the most pronounced growth (+60.7%), alongside a marked increase in outpatient care (+61.3%), reflecting a shift toward ambulatory management. In contrast, the relative contribution of hospital-based care declined, with a substantial decrease in high-cost inpatient drug expenditures. Indirect costs increased by 78.5%, despite stable proportions of beneficiaries receiving sick leave (16.4% to 16.8%) and disability benefits (9.6% to 10.6%), suggesting increased duration or severity of work impairment.</p><p><strong>Conclusion: </strong>Despite major therapeutic advances, the economic burden of SpA in France increased substantially between 2015 and 2023, driven by rising outpatient, medication-related, and indirect costs. These findings highlight the persistent societal impact of SpA and underscore the importance of integrating both healthcare utilization and work-related outcomes when informing healthcare policies and evaluating long-term disease burden.</p>","PeriodicalId":54902,"journal":{"name":"Joint Bone Spine","volume":" ","pages":"106123"},"PeriodicalIF":5.0,"publicationDate":"2026-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148801977","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Atopy is associated with osteoarthritis severity: results from the KHOALA cohort.","authors":"Kimberley Dolium, Ramez Mebrouk, Marie Binvignat, Alexandra Rousseau, Augustin Latourte, Alice Courties, Angèle Soria, Francis Berenbaum, Francis Guillemin, Anne-Christine Rat, Jérémie Sellam","doi":"10.1016/j.jbspin.2026.106122","DOIUrl":"https://doi.org/10.1016/j.jbspin.2026.106122","url":null,"abstract":"<p><strong>Objective: </strong>Atopy has been identified as a risk factor for osteoarthritis, but without specifying its impact on disease severity. We sought to investigate the association between atopy and the symptomatic and structural severity of knee and hip osteoarthritis.</p><p><strong>Methods: </strong>We used data from KHOALA, a French multicentre cohort of patients with knee and/or hip osteoarthritis (OA) investigating \"atopic\" subjects, defined as those with history of asthma and/or atopic dermatitis (AD) compared to \"non-atopic\" subjects. We compared: WOMAC pain, stiffness and function scores; and the proportion of having end-stage knee and/or hip radiographic OA (Kellgren Lawrence grade 4). Besides, we studied the cumulative incidence of total knee replacement (TKR) over 7 years of follow-up in patients with knee osteoarthritis in atopic versus non-atopic patients. Linear regression analyses of WOMAC sub-scores were adjusted for age, sex, BMI and GHQ-28 score (psychological well-being), whereas logistic regression and Cox regression analyses of radiographic end-stage disease and TKR were adjusted for age, sex and BMI.</p><p><strong>Results: </strong>The cohort comprised 66 atopic subjects (46 with asthma, 16 with AD and 4 having both) and 651 non-atopic subjects with a mean age of 65.2 years, 68% of whom were women, and a mean BMI of 29.3 kg/m². Atopy was associated with an increased risk of end-stage radiographic OA (adjusted OR 2.46 (1.42 to 4.25), P = 0.001), with 42% of atopic patients having Kellgren Lawrence grade 4 compared with 24% of non-atopic patients. Furthermore, over a 7-year follow-up period, atopy was associated with a two-fold increase in the risk of TKR, with an HR of 1.99 (95% CI: 1.15 to 3.45; P =0.01). Atopy was significantly associated with an increase in WOMAC pain score (7.6/20 ± 3.8 versus 6.4/20 ± 4; P < 0.05) but this association became non-significant after adjustment. Atopy was not associated with worse functional limitations or stiffness.</p><p><strong>Conclusion: </strong>Atopy appears to be associated with the radiographic OA severity and increased requirement of knee joint replacement. These results invite us to consider atopy as a potential new determining factor in the OA disease severity.</p>","PeriodicalId":54902,"journal":{"name":"Joint Bone Spine","volume":" ","pages":"106122"},"PeriodicalIF":5.0,"publicationDate":"2026-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148801920","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}