Annals of the Rheumatic Diseases最新文献

{"title":"How to treat undifferentiated arthritis today or tomorrow? A consideration of treatment recommendations in light of current evidence.","authors":"Annette H M van der Helm-van Mil, Daniel Aletaha","doi":"10.1016/j.ard.2025.01.036","DOIUrl":"https://doi.org/10.1016/j.ard.2025.01.036","url":null,"abstract":"<p><p>Patients with undifferentiated arthritis (UA) have clinically apparent inflammatory arthritis but no evident diagnosis or classification. Considering UA as a definition 'per exclusionem' implies that the population designated by this term is affected by changes in the way other diseases, eg, rheumatoid arthritis (RA), are classified or diagnosed. Current treatment recommendations for UA are largely similar to recommendations for RA. The recommendations are based on the idea that UA is an early stage of RA and on literature generated in the 2000s before the development of the 2010 classification criteria for RA. However, conventional UA (so-called '1987-UA') is presumably different than contemporary UA ('2010-UA'). Strikingly, there are no randomised placebo-controlled trials done on '2010-UA,' and this poses questions on whether the recommendations for UA are still valid. In this absence, we assume that treatment recommendations from '1987-UA' can be extrapolated to '2010-UA' if (1) essential patient characteristics are the same, (2) long-term outcomes are similar, (3) prognostic factors are largely the same, and (4) there are indications from research other than placebo-controlled randomized clinical trials (RCTs) that disease modifying antirheumatic drug (DMARD) treatment in 2010-UA is effective. We evaluate these requirements one by one based on the literature on 2010-UA. This reveals that 2010-UA is milder in initial presentation and disease outcomes than 1987-UA. Today's UA population is >95% anticitrullinated protein antibody-negative, presents with mono- or oligoarthritis, frequently achieves spontaneous remission, and rarely progresses to RA. We suggest that 2010-UA is a distinct patient group within the early arthritis spectrum, requiring additional research, after which recommendations may need to be updated.</p>","PeriodicalId":8087,"journal":{"name":"Annals of the Rheumatic Diseases","volume":" ","pages":""},"PeriodicalIF":20.3,"publicationDate":"2025-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143432392","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictors of arthritis development in individuals at risk of rheumatoid arthritis: a 5-year follow-up study from a large cohort.","authors":"Giulia Frazzei, Robert B M Landewé, Carlijn Wagenaar, Lotte A van de Stadt, Dirkjan van Schaardenburg, Sander W Tas, Ronald F van Vollenhoven","doi":"10.1016/j.ard.2025.01.042","DOIUrl":"https://doi.org/10.1016/j.ard.2025.01.042","url":null,"abstract":"<p><strong>Objectives: </strong>The aim of this study was to predict rheumatoid arthritis (RA) development in a cohort of at-risk individuals with arthralgia positive for anti-citrullinated protein antibodies (ACPA) and/or rheumatoid factor (IgM-RF), followed for up to 5 years.</p><p><strong>Methods: </strong>In total, 617 seropositive arthralgia individuals were included in the study. The ability of clinically and biologically relevant baseline characteristics to predict RA development was assessed using Cox proportional hazard regression analysis.</p><p><strong>Results: </strong>Thirty-eight percent of study population was IgM-RF-positive, 31% was ACPA-positive, and 30% was positive for both ACPA and IgM-RF. Mean (SD) time till arthritis was 19.6 (19.0) months in 33.7% of participants; mean (SD) follow-up time of individuals who did not develop arthritis was 47.3 (24.5) months. We found that first-degree relatives of RA (hazard ratio [HR] = 1.50), individuals who had intermittent symptoms (HR = 1.64), symptoms for less than 12 months at inclusion (HR for symptom duration >12 months = 0.71), morning stiffness ≥1 hour (HR = 1.63), or reported joint swelling (HR = 1.51) independently had higher risk to develop arthritis. Moreover, individuals with high ACPA titres (HR = 4.65) or double positivity for ACPA and IgM-RF (HR = 6.83) had the highest risk of developing RA, as compared to those with only IgM-RF or low ACPA titres. The risk of developing arthritis was 58.2% when at least 3 variables were present.</p><p><strong>Conclusions: </strong>Baseline characteristics can be used to predict future RA development in seropositive arthralgia individuals. These results will aid in the identification of individuals at highest risk of developing RA, who could potentially benefit from additional follow-ups in clinical practice and recruitment in preventive trials.</p>","PeriodicalId":8087,"journal":{"name":"Annals of the Rheumatic Diseases","volume":" ","pages":""},"PeriodicalIF":20.3,"publicationDate":"2025-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143432395","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Methotrexate osteopathy: an increasingly recognised condition manageable only through methotrexate discontinuation.","authors":"Tim Rolvien","doi":"10.1016/j.ard.2025.01.041","DOIUrl":"https://doi.org/10.1016/j.ard.2025.01.041","url":null,"abstract":"","PeriodicalId":8087,"journal":{"name":"Annals of the Rheumatic Diseases","volume":" ","pages":""},"PeriodicalIF":20.3,"publicationDate":"2025-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143424697","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Physician's global assessment of disease activity in juvenile idiopathic arthritis: consensus-based recommendations from an international task force.","authors":"Veronika Rypdal, Hermine I Brunner, Brian M Feldman, Nicolino Ruperto, Amita Aggarwal, Sheila T Angeles-Han, Maria Backström, Erin Balay-Dustrude, Claudia Bracaglia, Fabrizio De Benedetti, Pavla Doležalová, Marco Garrone, Jaime Guzman, Daniel B Horton, Ronald M Laxer, Daniel J Lovell, Tonje Løvli, Silvia Magni-Manzoni, Francesca Minoia, Esi M Morgan, Jane Munro, Ellen B Nordal, Christophe Normand, Nancy Pan, Elisa Patrone, Angelo Ravelli, Claudia Saad Magalhães, Rashmi Sinha, Joost F Swart, Maarit Tarkiainen, Marinka Twilt, Paula Vähäsalo, Sebastiaan Vastert, Jelena Vojinovic, Pamela F Weiss, Beth Gottlieb, Alessandro Consolaro","doi":"10.1016/j.ard.2025.01.013","DOIUrl":"https://doi.org/10.1016/j.ard.2025.01.013","url":null,"abstract":"<p><strong>Objectives: </strong>To develop consensus-based recommendations for physician's global assessment of disease activity (PhGA) scoring and to standardise definitions of disease activity.</p><p><strong>Methods: </strong>An international task force of 34 members was assembled, and recommendations were developed in 3 phases: (1) 2 preliminary surveys of paediatric rheumatologists and a literature review; (2) 14 videoconference meetings, informed by multicriteria decision analysis and formal anonymous voting; and (3) a 2-day in-person consensus conference using structured nominal group technique discussions and formal voting. The threshold for achieving consensus was ≥78% of voting task force members. Agreement with the final statements was rated using a numerical rating scale from 0, strongly disagree, to 10, strongly agree.</p><p><strong>Results: </strong>Eighteen points to consider were agreed upon. All statements achieved consensus (≥78%), with a level of agreement ≥9.2. Points included the definition of disease activity in juvenile idiopathic arthritis (JIA), factors to assess in nonsystemic JIA and systemic JIA, consideration of available imaging and laboratory tests, the role of extra-articular manifestations, the evaluation of treatment, and the timing of PhGA scoring.</p><p><strong>Conclusions: </strong>The task force developed consensus-based recommendations when scoring the PhGA in nonsystemic and systemic JIA. These recommendations will lead to more reliable scoring of disease activity in patients with JIA.</p>","PeriodicalId":8087,"journal":{"name":"Annals of the Rheumatic Diseases","volume":" ","pages":""},"PeriodicalIF":20.3,"publicationDate":"2025-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143424699","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Assessment of SpondyloArthritis International Society (ASAS) Consensus-Based Expert Definition of Difficult-to-Manage, including Treatment-Refractory, Axial Spondyloarthritis.","authors":"Denis Poddubnyy, Victoria Navarro-Compán, Murat Torgutalp, Suzanne Arends, Sibel Zehra Aydin, Simone Battista, Filip van den Bosch, Christine Bundy, Alberto Cauli, Jo Davies, Maxime Dougados, Tuncay Duruöz, Bassel El-Zorkany, Warren Fong, Floris van Gaalen, Rodrigo Garcia-Salinas, Marco Garrido Cumbrera, Pál Géher, Lianne Gensler, Simeon Grazio, Feng Huang, Mitsumasa Kishimoto, Robert Landewé, Ying Ying Leung, Pedro M Machado, Helena Marzo-Ortega, Bhowmik Meghnathi, Anna Molto, Elena Nikiphorou, Sofia Ramiro, Martin Rudwaleit, Carla G S Saad, Alexandre Sepriano, James Wei, Xenofon Baraliakos, Désirée van der Heijde","doi":"10.1016/j.ard.2025.01.035","DOIUrl":"https://doi.org/10.1016/j.ard.2025.01.035","url":null,"abstract":"<p><strong>Objectives: </strong>To develop a consensus-based expert definition of difficult-to-manage (D2M) axial spondyloarthritis (axSpA), incorporating treatment-refractory (TR) disease.</p><p><strong>Methods: </strong>A literature review was conducted in 2022 to identify potential definitions for D2M/TR axSpA from prior studies, followed by a 2-round Delphi consensus process conducted in 2022 and 2023 to identify components of D2M axSpA. Based on the results of the Delphi process, a draft of the D2M axSpA definition was developed and presented to the expert task force, including patient representation, and, subsequently, to the Assessment of SpondyloArthritis International Society (ASAS) membership for endorsement in January 2024.</p><p><strong>Results: </strong>Consensus was reached on a D2M definition encapsulating treatment failure (treatment according to the ASAS-European Alliance of Associations for Rheumatology recommendations and failure of ≥2 biological or targeted synthetic disease-modifying antirheumatic drugs with different mechanisms of action unless contraindicated), suboptimal disease control, and physician or patient acknowledgement of problematic signs/symptoms in patients diagnosed with axSpA by the rheumatologist. This definition represents a broad concept that includes various reasons that lead to an unsatisfactory treatment outcome. TR axSpA is covered by the D2M definition but requires a history of treatment failure, the presence of objective signs of inflammatory activity, and the exclusion of noninflammatory reasons for nonresponse. The proposed D2M definition incorporating TR disease was endorsed by ASAS at the annual meeting in January 2024, with 89% votes (109/123) in favour of it.</p><p><strong>Conclusions: </strong>The ASAS D2M axSpA definition, including TR disease, allows for identifying patients with unmet needs, paving the way for further research in this condition and its clinical care improvement.</p>","PeriodicalId":8087,"journal":{"name":"Annals of the Rheumatic Diseases","volume":" ","pages":""},"PeriodicalIF":20.3,"publicationDate":"2025-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143424700","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Anti-myxovirus resistance protein 1: a novel biomarker for autoimmune myositis and interstitial lung disease in systemic lupus erythematosus.","authors":"Eugene Krustev, Marvin J Fritzler, Sasha Bernatsky, Yvan St Pierre, Paul J Sciore, Evelyne Vinet, Christian A Pineau, Arielle Mendel, Fares Kalache, Louis-Pierre Grenier, Thaisa Cotton, Omid Zahedi Niaki, May Y Choi","doi":"10.1016/j.ard.2025.01.031","DOIUrl":"https://doi.org/10.1016/j.ard.2025.01.031","url":null,"abstract":"","PeriodicalId":8087,"journal":{"name":"Annals of the Rheumatic Diseases","volume":" ","pages":""},"PeriodicalIF":20.3,"publicationDate":"2025-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143412989","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Deep learning-based clustering for endotyping and post-arthroplasty response classification using knee osteoarthritis multiomic data.","authors":"Jason S Rockel, Divya Sharma, Osvaldo Espin-Garcia, Katrina Hueniken, Amit Sandhu, Chiara Pastrello, Kala Sundararajan, Pratibha Potla, Noah Fine, Starlee S Lively, Kim Perry, Nizar N Mahomed, Khalid Syed, Igor Jurisica, Anthony V Perruccio, Y Raja Rampersaud, Rajiv Gandhi, Mohit Kapoor","doi":"10.1016/j.ard.2025.01.012","DOIUrl":"https://doi.org/10.1016/j.ard.2025.01.012","url":null,"abstract":"<p><strong>Objectives: </strong>Primary knee osteoarthritis (KOA) is a heterogeneous disease with clinical and molecular contributors. Biofluids contain microRNAs and metabolites that can be measured by omic technologies. Multimodal deep learning is adept at uncovering complex relationships within multidomain data. We developed a novel multimodal deep learning framework for clustering of multiomic data from 3 subject-matched biofluids to identify distinct KOA endotypes and classify 1-year post-total knee arthroplasty (TKA) pain/function responses.</p><p><strong>Methods: </strong>In 414 patients with KOA, subject-matched plasma, synovial fluid, and urine were analysed using microRNA sequencing or metabolomics. Integrating 4 high-dimensional datasets comprising metabolites from plasma and microRNAs from plasma, synovial fluid, or urine, a multimodal deep learning variational autoencoder architecture with K-means clustering was employed. Features influencing cluster assignment were identified and pathway analyses conducted. An integrative machine learning framework combining 4 molecular domains and a clinical domain was then used to classify Western Ontario and McMaster Universities Arthritis Index (WOMAC) pain/function responses after TKA within each cluster.</p><p><strong>Results: </strong>Multimodal deep learning-based clustering of subjects across 4 domains yielded 3 distinct patient clusters. Feature signatures comprising microRNAs and metabolites across biofluids included 30, 16, and 24 features associated with clusters 1 to 3, respectively. Pathway analyses revealed distinct pathways associated with each cluster. Integration of 4 multiomic domains along with clinical data improved response classification performance, surpassing individual domain classifications alone.</p><p><strong>Conclusions: </strong>We developed a multimodal deep learning-based clustering model capable of integrating complex multifluid, multiomic data to assist in uncovering biologically distinct patient endotypes and enhance outcome classifications to TKA surgery, which may aid in future precision medicine approaches.</p>","PeriodicalId":8087,"journal":{"name":"Annals of the Rheumatic Diseases","volume":" ","pages":""},"PeriodicalIF":20.3,"publicationDate":"2025-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143413017","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Why the term nr-axSpA should not be used for diagnosis.","authors":"Juergen Braun","doi":"10.1016/j.ard.2024.11.003","DOIUrl":"https://doi.org/10.1016/j.ard.2024.11.003","url":null,"abstract":"","PeriodicalId":8087,"journal":{"name":"Annals of the Rheumatic Diseases","volume":" ","pages":""},"PeriodicalIF":20.3,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143405517","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Systematic literature review informing the EULAR points to consider for patient education in physical activity and self-management of pain during transitional care.","authors":"Javier Courel-Ibáñez, Rafael Prieto-Moreno, Erica Briones-Vozmediano, Patrocinio Ariza-Vega, Saskya Angevare, Jordi Anton, Ilaria Bini, Daniel Clemente, Matilde Correia, Wendy Costello, Diederik De Cock, Andrea Domjan, Leticia Leon, Andrea Marques, Kirsten Minden, Ana Filipa Mourão, Aurelie Najm, Seza Özen, Georgina Pimentel, Zainab Saleem, Tomas Vetrovsky, Nico Wulffraat, Andrea Zacarias, Yeliz Prior, Loreto Carmona, Fernando Estévez-López","doi":"10.1016/j.ard.2025.01.017","DOIUrl":"https://doi.org/10.1016/j.ard.2025.01.017","url":null,"abstract":"<p><strong>Objectives: </strong>To synthesise existing evidence on transitional care programmes for young people with juvenile-onset rheumatic and musculoskeletal diseases (jRMDs), focusing on their structure and implementation, the qualitative experiences and perceptions of those involved, and the quantitative outcomes associated with these programmes. Together with additional information, these insights have informed the European Alliance of Associations for Rheumatology (EULAR) Points to Consider for patient education in physical activity and self-management of pain in jRMDs during transitional care.</p><p><strong>Methods: </strong>A systematic literature review was conducted with a broadened scope beyond patient education in physical activity and self-management of pain to provide a comprehensive overview of transitional care in rheumatology, aiming to optimise current strategies, support evidence-based approaches, and identify areas for clinical improvement. The search was conducted in PubMed and the Cochrane Library from inception until November 1, 2023. Descriptive, qualitative, and quantitative studies were included. Two researchers independently conducted the search, screening, data extraction, and quality assessment.</p><p><strong>Results: </strong>From 31 studies, we identified 18 transitional care programmes with key approaches, including individualised and developmentally appropriate plans that often integrate educational strategies. These programmes, which generally aim to increase readiness to transfer, health-related quality of life, and continuity of care, frequently involved multidisciplinary teams and early intervention strategies. Young people with jRMDs and their families reported satisfaction with these transitional care experiences, particularly valuing early self-management support. While these programmes showed potential in promoting positive health outcomes and clinical practices, quantitative evidence supporting their effectiveness is limited, with few experimental studies confirming consistent benefits.</p><p><strong>Conclusions: </strong>This systematic review highlights the diverse yet fragmented approaches in transitional care for jRMDs, emphasising the need for stronger quantitative evidence. Thus, it is important to conduct further experimental research to optimise existing programmes or develop new ones, ultimately contributing to a smoother transition to adult care and improved long-term outcomes.</p>","PeriodicalId":8087,"journal":{"name":"Annals of the Rheumatic Diseases","volume":" ","pages":""},"PeriodicalIF":20.3,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143405514","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clarifying responsibility in AI-assisted healthcare: a closer look at ChatGPT's role.","authors":"Yuanbin Huang, Hongjin Wang, Xinmiao Ma","doi":"10.1016/j.ard.2024.12.001","DOIUrl":"https://doi.org/10.1016/j.ard.2024.12.001","url":null,"abstract":"","PeriodicalId":8087,"journal":{"name":"Annals of the Rheumatic Diseases","volume":" ","pages":""},"PeriodicalIF":20.3,"publicationDate":"2025-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143397800","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}