Annals of the Rheumatic Diseases最新文献

{"title":"Mitochondrial transplantation as a novel therapeutic approach in idiopathic inflammatory myopathy.","authors":"Jeong Yeon Kim, Young Cheol Kang, Min Jung Kim, Seon Uk Kim, Hae Rim Kang, Jeong Seon Yeo, Yujin Kim, Shin-Hye Yu, Byeongwook Song, Jung Wook Hwang, Yun-Sang Lee, Jung Woo Byun, Dae Hyun Yoo, Hyun Sook Kim, Kyuboem Han, Chun-Hyung Kim, Eun Young Lee","doi":"10.1016/j.ard.2024.11.005","DOIUrl":"https://doi.org/10.1016/j.ard.2024.11.005","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to investigate the efficacy of mitochondrial transplantation as a therapeutic intervention for idiopathic inflammatory myopathy (IIM). This study used a comprehensive approach, incorporating both in vitro and in vivo IIM models, and conducted a first-in-human clinical trial to assess the effectiveness and safety of mitochondria isolated from human umbilical cord mesenchymal stem cells (PN-101).</p><p><strong>Methods: </strong>Mitochondria isolated from umbilical cord mesenchymal stem cells were designated as PN-101. The efficacy of PN-101 was assessed using myoblasts derived from patients with IIM and C2C12 mouse perforin/granzyme B-treated myoblasts as an in vitro IIM model. PN-101's effect on IIM was examined using C protein-induced myositis (CIM) mice as an in vivo model. The efficacy and safety of PN-101 were evaluated in a phase 1/2a clinical trial involving 9 adult patients with refractory polymyositis or dermatomyositis.</p><p><strong>Results: </strong>The myoblasts derived from patients with IIM exhibited defects in mitochondrial function and myogenesis. PN-101 transplantation enhances muscle differentiation and mitochondrial function in IIM myoblasts. PN-101 also enhanced intracellular adenosine triphosphate content, cell viability, and myogenesis in C2C12 perforin/granzyme B-treated myoblasts. In an in vivo model, PN-101 reduced myositis severity by exhibiting anti-inflammatory effects and restoring the CIM-induced metabolic shift. In a phase 1/2a prospective clinical trial involving adult patients with refractory IIM, PN-101 demonstrated no severe adverse drug reactions and showed at least minimal improvement in the International Myositis Assessment and Clinical Studies Group (IMACS)-Total Improvement Scores (TISs) compared with baseline.</p><p><strong>Conclusions: </strong>PN-101 transplantation could serve as a novel treatment for IIM by enhancing mitochondrial repair and reducing inflammation in muscle tissues.</p>","PeriodicalId":8087,"journal":{"name":"Annals of the Rheumatic Diseases","volume":" ","pages":""},"PeriodicalIF":20.3,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143073560","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 and meta-analysis informing the EULAR points to consider on the initiation of targeted therapies in patients with inflammatory arthritis and a history of cancer.","authors":"Eden Sebbag, Juan Molina-Collada, Ramatoulaye Ndoye, Daniel Aletaha, Johan Askling, Karolina Gente, Heidi Bertheussen, Samuel Bitoun, Ertugrul Cagri Bolek, Maya H Buch, Gerd R Burmester, Helena M Canhão, Katerina Chatzidionysiou, Jeffrey R Curtis, Francois-Xavier Danlos, Vera Guimarães, Merete Lund Hetland, Florenzo Iannone, Marie Kostine, Tue Wenzel Kragstrup, Tore K Kvien, Anne Constanze Regierer, Hendrik Schulze-Koops, Nathanaël Sedmak, Lucía Silva-Fernández, Zoltan Szekanecz, Kim Lauper, Axel Finckh, Jacques-Eric Gottenberg","doi":"10.1136/ard-2024-225981","DOIUrl":"https://doi.org/10.1136/ard-2024-225981","url":null,"abstract":"<p><strong>Background: </strong>Targeted therapies have been associated with potential risk of malignancy, which is a common concern in daily rheumatology practice in patients with inflammatory arthritis (IA) and a history of cancer.</p><p><strong>Objectives: </strong>To perform a systematic literature review to inform a Task Force formulating EULAR points to consider on the initiation of targeted therapies in patients with IA and a history of cancer.</p><p><strong>Methods: </strong>Specific research questions were defined within the Task Force before formulating the exact research queries with a librarian. We included studies reporting a relative risk measure of patients with a history of cancer initiating a targeted therapy or a conventional synthetic disease-modifying antirheumatic drug (csDMARD), regardless of the time since diagnosis of cancer. All relevant studies included in PubMed or Embase up to 15 July 2022 were included. Two reviewers independently performed standardised article selection, data extraction, synthesis and risk of bias assessment.</p><p><strong>Results: </strong>14 published articles and one ACR abstract fulfilled the inclusion criteria. All studies were high-quality observational studies, representing a median follow-up from treatment initiation of 4.52 years among 4428 patients and 15 062 patient-years of follow-up for new or recurrent cancer. All patients had a history of cancer, most frequently solid cancer, most frequently receiving treatment for rheumatoid arthritis and most frequently treated with tumour necrosis factor-alpha inhibitors. Across these studies, the overall HR of new incident cancer or cancer recurrence was 0.90 (95% CI 0.74 to 1.10) for patients receiving a targeted therapy versus a csDMARD.</p><p><strong>Conclusion: </strong>Overall, the targeted therapies and clinical contexts covered by the included studies were not associated with an increased risk of new incident cancer or cancer recurrence as compared with csDMARDs.</p>","PeriodicalId":8087,"journal":{"name":"Annals of the Rheumatic Diseases","volume":" ","pages":""},"PeriodicalIF":20.3,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143073571","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":"LLDAS and remission attainment with anifrolumab treatment in patients with systemic lupus erythematosus: results from the TULIP and long-term extension randomised controlled trials.","authors":"Eric F Morand, Ronald van Vollenhoven, Richard A Furie, Kenneth C Kalunian, Susan Manzi, Gabriel Abreu, Raj Tummala, Elizabeth A Duncan, Hussein Al-Mossawi, Catharina Lindholm","doi":"10.1016/j.ard.2025.01.016","DOIUrl":"https://doi.org/10.1016/j.ard.2025.01.016","url":null,"abstract":"<p><strong>Objectives: </strong>To investigate the long-term impact of anifrolumab versus placebo on lupus low disease activity state (LLDAS) and definition of remission in systemic lupus erythematosus (DORIS) attainment in patients with systemic lupus erythematosus (SLE).</p><p><strong>Methods: </strong>This post hoc analysis included patients with moderate to severe SLE who were randomly assigned to receive intravenous anifrolumab 300 mg or placebo (once every 4 weeks) in the 52-week, phase 3 TULIP-1/TULIP-2 trials and continued with the same treatment in the 3-year long-term extension. LLDAS/DORIS rates over time were analysed using a stratified Cochran-Mantel-Haenszel approach and logistic regression. Time to first LLDAS/DORIS was estimated using Cox regression. Cumulative time and percentage of time in LLDAS/DORIS were assessed using an analysis of covariance. All P values are nominal.</p><p><strong>Results: </strong>This analysis included 369 patients (anifrolumab n = 257, placebo n = 112). After 4 years of treatment (at Week 208), 36.9% of anifrolumab-treated patients versus 17.1% of placebo-treated patients were in LLDAS (odds ratio [OR], 2.7; 95% CI, 1.3-5.5; P = .0081); 30.3% versus 18.3% were in DORIS (OR, 1.9; 95% CI, 1.0-3.9; P = .0663). Time to first LLDAS and DORIS favoured anifrolumab versus placebo (LLDAS: hazard ratio, 1.56; 95% CI, 1.18-2.09; P = .0024; DORIS: hazard ratio, 1.50; 95% CI, 1.04-2.22; P = .0373). Cumulative time in LLDAS and DORIS was greater with anifrolumab than that with placebo (P = .0004 and P = .0032, respectively).</p><p><strong>Conclusions: </strong>LLDAS and DORIS remission, which are associated with favourable outcomes such as reduced damage and mortality in patients with SLE, are attainable and sustainable treatment targets with long-term anifrolumab treatment.</p>","PeriodicalId":8087,"journal":{"name":"Annals of the Rheumatic Diseases","volume":" ","pages":""},"PeriodicalIF":20.3,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143413004","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":"TEMPORARY REMOVAL: EULAR/ACR classification criteria for paediatric chronic nonbacterial osteomyelitis (CNO).","authors":"Yongdong Zhao, Melissa S Oliver, Anja Schnabel, Eveline Y Wu, Zhaoyi Wang, Achille Marino, Cassyanne L Aguiar, Jonathan D Akikusa, Ummusen Kaya Akca, Beverley Almeida, Simone Appenzeller, Erin Balay-Dustrude, Ozge Basaran, Matthew L Basiaga, Yelda Bilginer, David A Cabral, Martina Capponi, Nathan Donaldson, Bugra Han Egeli, Emily J Fox, Antonella Insalaco, Ramesh S Iyer, Annette F Jansson, Inna Kostik, Mikhail Kostik, Leonard K Kovalick, Katia Tomie Kozu, Sivia K Lapidus, Tzielan C Lee, Aleksander Lenert, Kamran Mahmood, Edoardo Marrani, Doaa Mosad Mosa, Ian Muse, Alexander Mushkin, Katherine D Nowicki, Farzana Nuruzzaman, Karen Onel, Manuela Pardeo, Trang Sophia Pham, Lauren Potts, Athimalaipet V Ramanan, Angelo Ravelli, Nathan D Rogers, Andrew W Grim, Micol Romano, Natalie Rosenwasser, Takashi Shawn Sato, Gabriele Simonini, Jennifer B Soep, Sara M Stern, Timmy Strauss, Angela Taneja Kohli, Alexander C Theos, Lori B Tucker, Leslie F Vogel, Shima Yasin, Stephen C Wong, Katerina Bouchalova, Alison M Hendry, Kevin C Cain, Hermann J Girschick, Fatma Dedeoglu, Christian M Hedrich, Ronald M Laxer, Polly J Ferguson, Raymond Naden, Seza Ozen","doi":"10.1016/j.ard.2024.11.006","DOIUrl":"https://doi.org/10.1016/j.ard.2024.11.006","url":null,"abstract":"<p><p>The publisher regrets that this article has been temporarily removed. A replacement will appear as soon as possible in which the reason for the removal of the article will be specified, or the article will be reinstated. The full Elsevier Policy on Article Withdrawal can be found at https://www.elsevier.com/about/policies/article-withdrawal.</p>","PeriodicalId":8087,"journal":{"name":"Annals of the Rheumatic Diseases","volume":" ","pages":""},"PeriodicalIF":20.3,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143447864","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":"Risk of HPV-associated precancer and cancer in women with systemic lupus erythematosus.","authors":"Kanwal Zahid Siddiqi, Louise Baandrup, Louise Diederichsen, Rasmus Hertzum-Larsen, Henrik Christian Bidstrup Leffers, Søren Jacobsen, Susanne Krüger Kjær","doi":"10.1016/j.ard.2025.01.026","DOIUrl":"https://doi.org/10.1016/j.ard.2025.01.026","url":null,"abstract":"<p><strong>Objectives: </strong>We aimed to compare the occurrence of human papillomavirus (HPV)-associated precancer and cancer in a nationwide cohort of women with systemic lupus erythematosus (SLE) with general female population rates.</p><p><strong>Methods: </strong>In the nationwide Patient Registry, we identified all women in Denmark with a first diagnosis of SLE recorded during 1996-2021 (N = 5092). The cohort was followed up in nationwide registries for HPV-associated precancer and cancer until 2022. Standardised incidence ratios (SIRs) were computed with 95% CIs overall and stratified by age at SLE diagnosis and follow-up time.</p><p><strong>Results: </strong>Compared with general population rates, women with SLE had increased rates of cervical (SIR, 2.3; 95% CI, 2.0-2.7), vaginal (SIR, 4.3; 95% CI, 1.1-9.5), vulvar (SIR, 3.7; 95% CI, 2.3-5.5), and anal (SIR, 4.3; 95% CI, 1.7-8.1) precancers. Increased cancer rates were observed for cervix, anus, and oropharynx, but only the SIR for oropharyngeal cancer was near statistical significance (SIR, 2.5; 95% CI, 0.9-4.9). The increased SIRs for precancers and cancers sustained throughout follow-up and were higher in women diagnosed with SLE at age <50 years compared with ≥50 years, but CIs were overlapping.</p><p><strong>Conclusions: </strong>Women in this nationwide SLE cohort had twice the risk of cervical precancer (vs the general population) and up to 5-fold increased risk of the individual noncervical anogenital precancers. Rates of oropharyngeal cancer and the anogenital cancers were not statistically significantly increased; however, estimates were based on few cases.</p>","PeriodicalId":8087,"journal":{"name":"Annals of the Rheumatic Diseases","volume":" ","pages":""},"PeriodicalIF":20.3,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143073569","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":"Genetic burden of lupus increases the risk of transition from normal to preclinical autoimmune conditions via antinuclear antibody development.","authors":"Sehwan Chun, So-Young Bang, Ayeong Kwon, Chan Young Kim, Soojin Cha, Young-Chang Kwon, Young Bin Joo, Soo-Kyung Cho, Chan-Bum Choi, Yoon-Kyoung Sung, Ji-Young Han, Tae-Hwan Kim, Jae-Bum Jun, Dae Hyun Yoo, Hye-Soon Lee, Kwangwoo Kim, Sang-Cheol Bae","doi":"10.1016/j.ard.2025.01.015","DOIUrl":"https://doi.org/10.1016/j.ard.2025.01.015","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to investigate the association between the genetic burden of systemic lupus erythematosus (SLE) and the loss of tolerance to self-nuclear antigens in the preclinical stage.</p><p><strong>Methods: </strong>We analysed genetic data from 349 Korean individuals who tested positive for autoantibodies in the preclinical stage, along with 33,596 healthy controls and 2057 patients with SLE. Genome-wide and pathway-specific polygenic risk scores (PRSs) of SLE were calculated based on 180 known non-human leukocyte antigen (non-HLA) SLE loci, HLA-DRB1 classical alleles, and predefined immune-related pathways to subsequently correlate with clinical phenotypes, particularly the presence of antinuclear antibodies (ANAs) at various titre thresholds.</p><p><strong>Results: </strong>Individuals with preclinical autoimmune conditions exhibited significantly higher SLE PRSs than healthy controls (P = 2.99 × 10^-5), with a significantly upward trend between ANA titres and PRS (P = 1.12 × 10^-3). Stratification analysis revealed that preclinical-stage individuals with PRSs exceeding the means of age- and sex-matched PRSs among patients with SLE were at a significantly higher risk of ANA development (odds ratio = 2.25; P = 8.12 × 10^-3 at a dilution factor of 1:80). Pathway-specific PRS analysis identified the significant enrichment of SLE-risk effects in nine pathways, such as signalling related to reactive oxygen species production, T cell receptor, B cell receptor, and cytokines, in ANA-positive preclinical individuals (P_adjusted < 0.05).</p><p><strong>Conclusions: </strong>Our findings illustrate that the genetic burden of SLE may lead to a crucial transition from normal to preclinical autoimmune conditions prior to the pathogenic stage by increasing the susceptibility to and levels of ANAs.</p>","PeriodicalId":8087,"journal":{"name":"Annals of the Rheumatic Diseases","volume":" ","pages":""},"PeriodicalIF":20.3,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143073554","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":"Relationship between serum urate and changes in dual-energy CT monosodium urate crystal volume over 1 year in people with gout: an individual participant data analysis.","authors":"Brooke Kelly, Greg D Gamble, Anne Horne, Anthony J Doyle, Jill Drake, Opetaia Aati, Chang-Nam Son, Ramanamma Kalluru, Kieran Latto, Lisa Stamp, Nicola Dalbeth","doi":"10.1136/ard-2024-226059","DOIUrl":"10.1136/ard-2024-226059","url":null,"abstract":"<p><strong>Objectives: </strong>The dynamics of monosodium urate (MSU) crystal changes across a range of serum urate concentrations in people with gout are unknown. This study aimed to systematically examine the relationship between serum urate and changes in dual-energy CT (DECT) urate volume in people with gout and stable serum urate concentrations.</p><p><strong>Methods: </strong>Individual participant data were analysed from three studies of people with gout. The time periods for the analysis were selected to identify study participants with serial DECT scans of both feet over a 12-month epoch of stable urate-lowering therapy and serum urate concentrations. Data from 251 study participants were analysed using a mixed models analysis of covariance approach according to mean serum urate cut-points and mean serum urate bands.</p><p><strong>Results: </strong>For all mean serum urate cut-points assessed (0.24, 0.30, 0.36, 0.42 and 0.48 mmol/L), reductions in DECT urate volumes were observed below the cut-point. Increased DECT urate volumes were observed at or above the 0.48 mmol/L mean serum urate cut-point. Differences in the change in DECT volume were observed for the 0.42 mmol/L cut-point (p=0.0044) and the 0.48 mmol/L cut-point (p<0.0001). Significantly reduced DECT urate volumes were observed for the mean serum urate bands<0.24 mmol/L and 0.24-0.29 mmol/L and increased DECT urate volume was observed for the mean serum urate band≥0.48 mmol/L.</p><p><strong>Conclusions: </strong>Over 1 year, MSU crystal dissolution, as measured by DECT, occurs with mean serum urate bands of<0.24 mmol/L and 0.24-0.29 mmol/L while MSU crystal formation occurs with mean serum urate≥0.48 mmol/L.</p>","PeriodicalId":8087,"journal":{"name":"Annals of the Rheumatic Diseases","volume":"84 1","pages":"136-142"},"PeriodicalIF":20.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143057839","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":"EULAR recommendations for the treatment of systemic sclerosis: 2023 update.","authors":"Francesco Del Galdo, Alain Lescoat, Philip G Conaghan, Eugenia Bertoldo, Jelena Čolić, Tânia Santiago, Yossra A Suliman, Marco Matucci-Cerinic, Armando Gabrielli, Oliver Distler, Anna-Maria Hoffmann-Vold, Ivan Castellví, Alexandra Balbir-Gurman, Madelon Vonk, Lidia Ananyeva, Simona Rednic, Anna Tarasova, Pedrag Ostojic, Vladimira Boyadzhieva, Khadija El Aoufy, Sue Farrington, Ilaria Galetti, Christopher P Denton, Otylia Kowal-Bielecka, Ulf Mueller-Ladner, Yannick Allanore","doi":"10.1136/ard-2024-226430","DOIUrl":"10.1136/ard-2024-226430","url":null,"abstract":"<p><strong>Objectives: </strong>To update the 2017 European Alliance of Associations for Rheumatology (EULAR) recommendations for treatment of systemic sclerosis (SSc), incorporating new evidence and therapies.</p><p><strong>Methods: </strong>An international task force was convened in line with EULAR standard operating procedures. A nominal group technique exercise was performed in two rounds to define questions underpinning a subsequent systematic literature review. The evidence derived was discussed and overarching principles, recommendations and future research agenda were iteratively developed with voting rounds.</p><p><strong>Results: </strong>The task force agreed on 22 recommendations covering 8 clinical/organ domains including Raynaud's phenomenon, digital ulcers, pulmonary arterial hypertension, scleroderma renal crisis, skin fibrosis, interstitial lung disease (ILD), gastrointestinal manifestations and arthritis. Most new recommendations are related to skin fibrosis and ILD. These included novel recommendations for the use of mycophenolate mofetil, nintedanib, rituximab and tocilizumab for the treatment of these crucial disease manifestations. The recommendations also included first-line and second-line interventions, providing increased utility for rheumatology practitioners. Important additions to the future research agenda included consideration of novel interventions for the management of vascular, musculoskeletal and gastrointestinal manifestations and calcinosis, as well as for the local management of digital ulcers.</p><p><strong>Conclusion: </strong>These updated recommendations include the first set of synthetic and biological targeted therapies recommended for key fibrotic manifestations of SSc as well as first-line combination treatment for newly diagnosed pulmonary artery hypertension and prioritise a new research agenda for the coming years.</p>","PeriodicalId":8087,"journal":{"name":"Annals of the Rheumatic Diseases","volume":"84 1","pages":"29-40"},"PeriodicalIF":20.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143057826","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":"More than meets the eye.","authors":"Elise Siegert, Werner Stenzel, David Sinan Koca, Gerhard Krönke, Robert Biesen","doi":"10.1136/ard-2024-226168","DOIUrl":"10.1136/ard-2024-226168","url":null,"abstract":"","PeriodicalId":8087,"journal":{"name":"Annals of the Rheumatic Diseases","volume":"84 1","pages":"150-151"},"PeriodicalIF":20.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143057833","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":"Performance analysis of a deep-learning algorithm to detect the presence of inflammation in MRI of sacroiliac joints in patients with axial spondyloarthritis.","authors":"Joeri Nicolaes, Evi Tselenti, Theodore Aouad, Clementina López-Medina, Antoine Feydy, Hugues Talbot, Bengt Hoepken, Natasha de Peyrecave, Maxime Dougados","doi":"10.1136/ard-2024-225862","DOIUrl":"10.1136/ard-2024-225862","url":null,"abstract":"<p><strong>Objectives: </strong>To assess the ability of a previously trained deep-learning algorithm to identify the presence of inflammation on MRI of sacroiliac joints (SIJ) in a large external validation set of patients with axial spondyloarthritis (axSpA).</p><p><strong>Methods: </strong>Baseline SIJ MRI scans were collected from two prospective randomised controlled trials in patients with non-radiographic (nr-) and radiographic (r-) axSpA (RAPID-axSpA: NCT01087762 and C-OPTIMISE: NCT02505542) and were centrally evaluated by two expert readers (and adjudicator in case of disagreement) for the presence of inflammation by the 2009 Assessment of SpondyloArthritis International Society (ASAS) definition. Scans were processed by the deep-learning algorithm, blinded to clinical information and central expert readings.</p><p><strong>Results: </strong>Pooling the patients from RAPID-axSpA (n=152) and C-OPTIMISE (n=579) yielded a validation set of 731 patients (mean age: 34.2 years, SD: 8.6; 505/731 (69.1%) male), of which 326/731 (44.6%) had nr-axSpA and 436/731 (59.6%) had inflammation on MRI per central readings. Scans were obtained from over 30 scanners from 5 manufacturers across over 100 clinical sites. Comparing the trained algorithm with the human central readings yielded a sensitivity of 70% (95% CI 66% to 73%), specificity of 81% (95% CI 78% to 84%), positive predictive value of 84% (95% CI 82% to 87%), negative predictive value of 64% (95% CI 61% to 68%), Cohen's kappa of 0.49 (95% CI 0.43 to 0.55) and absolute agreement of 74% (95% CI 72% to 77%).</p><p><strong>Conclusion: </strong>The algorithm enabled acceptable detection of inflammation according to the 2009 ASAS MRI definition in a large external validation cohort.</p>","PeriodicalId":8087,"journal":{"name":"Annals of the Rheumatic Diseases","volume":"84 1","pages":"60-67"},"PeriodicalIF":20.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143057836","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}