Annals of the Rheumatic Diseases最新文献

{"title":"Cannabidiol versus placebo in patients with fibromyalgia: a randomised, double-blind, placebo-controlled, parallel-group, single-centre trial.","authors":"Marianne Uggen Rasmussen, Robin Christensen, Eva Ejlersen Wæhrens, Marius Henriksen, Pernille Hurup Duhn, Henning Bliddal, Kirstine Amris","doi":"10.1016/j.ard.2025.07.008","DOIUrl":"https://doi.org/10.1016/j.ard.2025.07.008","url":null,"abstract":"<p><strong>Objectives: </strong>Cannabidiol (CBD) is used to alleviate fibromyalgia pain despite limited evidence for efficacy. This study assessed the efficacy and safety of CBD vs placebo in patients with fibromyalgia, hypothesising that CBD would be superior to placebo in reducing pain.</p><p><strong>Methods: </strong>In this single-centre, double-blind, randomised, placebo-controlled trial, patients diagnosed with fibromyalgia were recruited from a specialised outpatient clinic in Denmark. Eligible participants were randomised 1:1 and stratified by sex, defined as biological sex assigned at birth based on physical anatomy. Age (<45 vs ≥45), and pain level (<7 vs ≥7) on a 0 to 10 numeric rating scale (NRS) to receive 50 mg plant-derived CBD or placebo tablets. The primary outcome was change in pain intensity at week 24, assessed on the NRS pain subitem in the revised Fibromyalgia Impact Questionnaire in the intention-to-treat population. Adverse events were monitored throughout the study in the safety population.</p><p><strong>Results: </strong>Of 273 participants screened for eligibility, 200 were included and randomised to receive CBD (n = 100) or placebo (n = 100). At week 24, mean change in pain intensity was -0.4 points (95% CI: -0.82 to 0.08) in the CBD group and -1.1 points (95% CI: -1.53 to -0.63) in the placebo group, corresponding to a between-group difference of -0.7 points (95% CI: -1.2 to -0.25; P = .0028) favouring placebo. Adverse events were generally mild and evenly distributed between groups.</p><p><strong>Conclusions: </strong>The findings do not support CBD 50 mg daily as an analgesic supplement for patients with fibromyalgia.</p><p><strong>Clinicaltrials: </strong>gov number: NCT04729179.</p>","PeriodicalId":8087,"journal":{"name":"Annals of the Rheumatic Diseases","volume":" ","pages":""},"PeriodicalIF":20.6,"publicationDate":"2025-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144940161","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":"Transcriptomic profiling of Sjögren's disease salivary glands identifies signatures associated with both follicular and extrafollicular responses linked to rheumatoid factor and anti-La/SSB seropositivity.","authors":"Elena Pontarini, Davide Lucchesi, Elisabetta Sciacca, Giulia Cavallaro, Qingxuan Song, David Galbraith, Elizabeth Thomas, Annalisa Marino, Nurhan Sutcliffe, Anwar R Tappuni, Roberto Giacomelli, Alfredo Pulvirenti, Simon J Bowman, Ling-Yang Hao, Kathy Sivils, Costantino Pitzalis, Myles J Lewis, Michele Bombardieri","doi":"10.1016/j.ard.2025.07.021","DOIUrl":"https://doi.org/10.1016/j.ard.2025.07.021","url":null,"abstract":"<p><strong>Objectives: </strong>This study aims to identify salivary gland (SG) transcriptomic signatures associated with peripheral and histological biomarkers of disease activity and lymphoma risk factors to inform on Sjögren's disease (SjD) stratification.</p><p><strong>Methods: </strong>Bulk RNA-sequencing of labial SG from exploratory Queen Mary University of London (QMUL) cohort (SjD [n = 55] and non specific-chronic-sialadenitis [sicca, n = 44]) and trial for anti-B-cell therapy in Sjogren's syndrome (TRACTISS)validation cohort (SjD, n = 29) analysed integrating transcriptomic, clinical, serological, and histological data.</p><p><strong>Results: </strong>Unsupervised gene clustering confirmed clear transcriptome segregation between sicca and SjD. The most differentially expressed genes were either common to all SjD's versus sicca or specific to SjD's glands with lymphocytic infiltrates with features of ectopic lymphoid structures (ELS). In SjD, principal component analysis identified a significant proportion of variability associated with rheumatoid factor (RF)-seropositivity, exceeding that associated with SG-ELS and anti-Ro/Sjögren's syndrome antigen-A (SSA) seropositivity. Transcriptomes of SjD-SG with ELS from patients with positivity for either RF, anti-Ro/SSA, and anti-La/SSB showed mainly genes associated with germinal centre formation. Conversely, SG without ELS from patients with either RF or double anti-Ro (SSA)/anti-La (SSB) seropositivity (unlike patients with seronegative or single anti-Ro/SSA seropositivity) displayed a unique extrafollicular B-cell gene set associated with type-I interferon (IFN), through the retinoic acid-inducible gene-I (RIG-1) endogenous RNAs (including viral) sensing pathway and E3-ubiquitin ligases. The identified IFN genes showed strong positive correlations with serum RF levels in 2 independent cohorts (QMUL and TRACTISS).</p><p><strong>Conclusions: </strong>Comprehensive SG bulk-RNA sequencing provided the first transcriptomic evidence of distinct RF and anti-La/SSB-driven SG transcriptomic signatures in patients with SjD with and without ELS. These findings suggest that both classical follicular and extrafollicular viral-associated responses contribute to the selection of autoreactive B-cells in the glands of patients with SjD.</p>","PeriodicalId":8087,"journal":{"name":"Annals of the Rheumatic Diseases","volume":" ","pages":""},"PeriodicalIF":20.6,"publicationDate":"2025-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144940177","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":"Medical gaslighting in rheumatology: listening, learning, and leading.","authors":"Viswaja Kaja, Kryss Shane, Adegbenga A Bankole, Anthony D Slonim","doi":"10.1016/j.ard.2025.07.014","DOIUrl":"https://doi.org/10.1016/j.ard.2025.07.014","url":null,"abstract":"","PeriodicalId":8087,"journal":{"name":"Annals of the Rheumatic Diseases","volume":" ","pages":""},"PeriodicalIF":20.6,"publicationDate":"2025-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144940102","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 and epigenetic dysregulation of CR1 is associated with catastrophic antiphospholipid syndrome.","authors":"Nikhil Ranjan, Michael A Cole, Gloria F Gerber, Mark A Crowther, Evan M Braunstein, Daniel Flores-Guerrero, Kathy Haddaway, Alexis Reed, Michael B Streiff, Keith R McCrae, Michelle Petri, Shruti Chaturvedi, Robert A Brodsky","doi":"10.1016/j.ard.2025.07.016","DOIUrl":"10.1016/j.ard.2025.07.016","url":null,"abstract":"<p><strong>Objectives: </strong>Catastrophic antiphospholipid syndrome (CAPS) is a complement-driven thrombotic disorder, characterised by widespread thrombosis and multiorgan failure. We identified rare germline variants including complement receptor 1 (CR1) in 50% of patients with CAPS. Here, we define CR1 dysregulation mechanisms (genetic/epigenetic) underlying complement-mediated thrombosis in CAPS and support C5 inhibition as a potential therapy.</p><p><strong>Methods: </strong>We quantified CR1 expression by flow cytometry across haematopoietic cell types. CRISPR/Cas9 genome editing of TF-1 (erythroleukaemia) cells was performed to generate CR1 'knock-out' and 'knock-in' lines with patient-specific CR1 variants. Multiomics analysis was performed to investigate the role of methylation in patients with reduced CR1 expression. Functional impact of low CR1 was assessed by complement-mediated cell killing using modified Ham assay, cell-bound complement degradation products through flow cytometry, and circulatory immune complexes in serum samples through ELISA.</p><p><strong>Results: </strong>CR1 expression in erythrocytes was markedly reduced on CAPS erythrocytes (n = 9, 21.80%) compared to healthy controls (HCs; n = 35, 84.04%), with promoter hypermethylation emerging as a plausible epigenetic mechanism for CR1 downregulation. Novel germline variant (CR1-V2125L; rs202148801) mitigated CR1 expression and increased complement-mediated cell death of knock-in cell lines. Erythrocytes from the patient with the CR1-V2125L variant had low CR1 expression. Levels of circulating immune complexes, which are bound and cleared by CR1 on erythrocytes, were higher in acute CAPS (n = 3, 25.55 µg Eq/mL) than HCs (n = 3, 7.445 µg Eq/mL). Five patients were treated with C5 inhibition which mitigated thrombosis.</p><p><strong>Conclusions: </strong>Genetic or epigenetic-mediated CR1 deficiency is a potential hallmark of CAPS and predicts response to C5 inhibition.</p>","PeriodicalId":8087,"journal":{"name":"Annals of the Rheumatic Diseases","volume":" ","pages":""},"PeriodicalIF":20.6,"publicationDate":"2025-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144940086","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":"Two-year efficacy and safety of anti-interleukin-5/receptor therapy for eosinophilic granulomatosis with polyangiitis.","authors":"Peter A Merkel, Parameswaran K Nair, Nader Khalidi, Benjamin Terrier, Bernhard Hellmich, Arnaud Bourdin, David R W Jayne, David J Jackson, Florence Roufosse, Christian Pagnoux, Ulrich Specks, Lena Börjesson Sjö, Calvin N Ho, Maria Jison, Christopher McCrae, Sofia Necander, Eva Rodríguez-Suárez, Anat Shavit, Claire Walton, Michael E Wechsler","doi":"10.1016/j.ard.2025.06.2131","DOIUrl":"https://doi.org/10.1016/j.ard.2025.06.2131","url":null,"abstract":"<p><strong>Objectives: </strong>To summarise the efficacy and safety of 2 years of anti-interleukin-5/receptor (anti-IL-5/R) therapy in patients with eosinophilic granulomatosis with polyangiitis (EGPA).</p><p><strong>Methods: </strong>Patients were randomised 1:1 to receive benralizumab or mepolizumab every 4 weeks during the 52-week double-blind period of the MANDARA trial. Patients entered an open-label extension (OLE) in which they continued benralizumab (benralizumab/benralizumab) or switched from mepolizumab to benralizumab (mepolizumab/benralizumab). Remission (Birmingham Vasculitis Activity Score = 0 and oral glucocorticoid [OGC] dose ≤4 mg/d), OGC use, relapse, blood eosinophil count (bEOS), and safety up to year 2 (week 104) were reported.</p><p><strong>Results: </strong>A total of 128 patients entered the OLE period (n = 66 benralizumab/benralizumab; n = 62 mepolizumab/benralizumab). At week 104, 41 (62.1%) benralizumab/benralizumab patients and 42 (67.7%) mepolizumab/benralizumab patients were in remission. During OLE year 1, 51 (77.3%) benralizumab/benralizumab patients and 42 (67.7%) mepolizumab/benralizumab patients had no relapses. By weeks 49 to 52, 27 (40.9%) benralizumab/benralizumab patients and 16 (25.8%) mepolizumab/benralizumab patients had withdrawn from OGCs, increasing to 29 (43.9%) and 27 (43.5%) at weeks 101 to 104, respectively; the median cumulative OGC dose was 950 mg and 791 mg during OLE year 1, respectively. The median bEOS among benralizumab/benralizumab-treated patients was 20 cells/µL (at weeks 52 and 100), and in mepolizumab/benralizumab-treated patients, it decreased from 70 cells/µL to 20 cells/µL 4 weeks after switching. Adverse events/serious adverse events were reported in 97.0%/22.7% of benralizumab/benralizumab and 100%/35.5% of mepolizumab/benralizumab patients.</p><p><strong>Conclusions: </strong>In patients with EGPA, treatment for 2 years with anti-IL-5/R therapies is associated with durable rates of remission, discontinuation of OGCs, bEOS depletion, and low relapse rates. Switching from mepolizumab to benralizumab enhances bEOS depletion and OGC sparing.</p>","PeriodicalId":8087,"journal":{"name":"Annals of the Rheumatic Diseases","volume":" ","pages":""},"PeriodicalIF":20.6,"publicationDate":"2025-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144803277","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 IL-6 axis in vascular inflammation: effects of IL-6 receptor blockade on vascular lesions from patients with giant-cell arteritis.","authors":"Marc Corbera-Bellalta, Farah Kamberovic, Roser Alba-Rovira, Ester Planas-Rigol, Sergio Prieto-González, Núria Farran-Centelles, Ester Tobías, Anna Jordán, Marco A Alba, Eduard Quintana, Georgina Espígol-Frigolé, Maria C Cid","doi":"10.1016/j.ard.2025.02.008","DOIUrl":"10.1016/j.ard.2025.02.008","url":null,"abstract":"<p><strong>Objectives: </strong>Blocking interleukin (IL)-6-receptor with tocilizumab has been a major advance in the treatment of giant-cell arteritis (GCA), supporting a crucial role of IL-6 receptor signalling. However, nearly half of the patients are not able to maintain glucocorticoid- free remission with tocilizumab. The impact of tocilizumab on vascular lesions of GCA is largely unknown since conflicting results have been obtained by imaging. The expression and functional role of IL-6-receptor in GCA immunopathology has not been previously investigated. This study aimed to investigate expression of IL-6 receptor in GCA and control arteries and to assess the impact of tocilizumab on ex vivo-cultured temporal arteries and aortic tissue from patients with GCA.</p><p><strong>Methods: </strong>This study used a hypothesis-driven, candidate molecule transcriptomic approach using ex vivo temporal artery and aortic tissue culture, quantitative real-time polymerase chain reaction, immunofluorescence, Western Blot, immunoassay, adhesion, and chemotaxis assays.</p><p><strong>Results: </strong>IL-6 receptor protein expressed intensively in GCA compared with that in control arteries. Tocilizumab decreased expression/phosphorylation of STAT3 and reduced expression of STAT3-dependent molecules including suppressor of cytokine signalling 3, CCL-2, and ICAM-1 in cultured GCA-involved arteries and patients' peripheral blood mononuclear cells (PBMCs). A similar trend was observed in aortic tissue. Consistently, tocilizumab reduced PBMC adhesiveness to vascular smooth muscle cells and human umbilical vein endothelial cells and chemotaxis towards supernatants of tocilizumab-treated GCA arteries. In some specimens, tocilizumab increased STAT1 phosphorylation and expression of STAT1-dependent chemokines including CXCL9 and CXCL10.</p><p><strong>Conclusions: </strong>Tocilizumab has a significant impact on vascular lesions by reducing, but not abrogating, key molecules involved in PBMC recruitment. About half of the patients may activate alternative inflammatory pathways in their lesions as a potential escape mechanism to tocilizumab that deserves further investigation.</p>","PeriodicalId":8087,"journal":{"name":"Annals of the Rheumatic Diseases","volume":" ","pages":"1387-1400"},"PeriodicalIF":20.6,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143613193","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":"Pseudogout, chondrocalcinosis, CPPD et al: crystal clear… or clear as mud?-The time has come to reconsider the nomenclature of calcium pyrophosphate deposition.","authors":"Silvia Sirotti, Charlotte Jauffret, Antonella Adinolfi, Edoardo Cipolletta, Daniele Cirillo, Luca Ingrao, Alessandro Lucia, Emilio Filippucci, Tristan Pascart, Sara K Tedeschi, Robert Terkeltaub, Nicola Dalbeth, Georgios Filippou","doi":"10.1016/j.ard.2025.04.004","DOIUrl":"10.1016/j.ard.2025.04.004","url":null,"abstract":"<p><p>Scientific interest in calcium pyrophosphate deposition (CPPD) has been limited by several challenges. These include difficulties in diagnosis due to diverse clinical presentations, the lack of classification criteria, the absence of standardised diagnostic modalities, underrecognition in clinical care, and, most significantly, the lack of evidence-based treatments. Consequently, CPPD was often regarded as the 'poor cousin' of gout. Fortunately, in recent years, CPPD has garnered increased attention from the rheumatology community. Milestones such as the first American College of Rheumatology/European Alliance of Association for Rheumatology classification criteria, the European Alliance of Association for Rheumatology recommendations for the use of imaging in clinical practice, validated OMERACT ultrasound definitions and scoring system, and the OMERACT core domain sets for CPPD have significantly advanced the field. Yet, unresolved issues regarding CPPD nomenclature hold back advancement in both research and clinical practice. The terminology surrounding CPPD remains inconsistent in the scientific literature, with numerous terms and acronyms used to describe the condition and its manifestations. For example, many 'pseudosyndromes' (eg, pseudogout) and purely radiographic descriptors (eg, chondrocalcinosis) are still commonly used by clinicians and researchers interchangeably, as either the name of the condition or one of its clinical or radiographic manifestations. This lack of standardisation complicates communication among health care professionals, researchers, and between doctors and patients, creating insurmountable barriers to effective care and research advances. In this viewpoint, we highlight the value of standardised terminology, drawing parallels with other rheumatic diseases. We aimed to explore the historical evolution of CPPD nomenclature, assess the impact of previous standardisation efforts, and propose a possible way for a common language.</p>","PeriodicalId":8087,"journal":{"name":"Annals of the Rheumatic Diseases","volume":" ","pages":"1287-1292"},"PeriodicalIF":20.6,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143960463","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":"Radiographic structural damage in axial spondyloarthritis: is there a preferred way to quantify progression over time? Comparison of blinded versus unblinded mSASSS scoring.","authors":"Xenofon Baraliakos, Mikhail Protopopov, Valeria Rios Rodriguez, Murat Torgutalp, Ani Dilbaryan, Hildrun Haibel, Joachim Sieper, Juergen Braun, Martin Rudwaleit, Denis Poddubnyy","doi":"10.1016/j.ard.2025.03.017","DOIUrl":"10.1016/j.ard.2025.03.017","url":null,"abstract":"<p><strong>Objectives: </strong>Structural progression in spine in axial spondyloarthritis (axSpA) is assessed by conventional radiographs and quantified by the modified Stoke Ankylosing Spondylitis Spine Score (mSASSS). Blinded mSASSS scoring might be associated with 'background noise,' and for assessing a slow-progressing disease such as axSpA, high sensitivity to change without loss of specificity is crucial. The aim of this study was to compare the sensitivity to change of blinded vs unblinded application of mSASSS for identification of a preferred way of assessing radiographic damage in axSpA over time.</p><p><strong>Methods: </strong>Cervical and lumbar radiographcs of axSpA patients participating in a national inception cohort (GErman SPondyloarthritis Inception Cohort) obtained at baseline and after 2 years were scored using the mSASSS by 5 experienced readers, 2 blinded and 3 unblinded to chronology. Mean scores were used for calculations.</p><p><strong>Results: </strong>Overall, 210 patients (37.3 years, 51% male, 79% human leukocyte antigen B27 positive) were included. The mean baseline mSASSS was 4.2 ± 8.3 vs 3.4±7.9 and mean mSASSS progression was 0.7 ± 2.3 vs 1.0 ± 1.9 for the blinded vs unblinded scoring method, respectively (P = .005). Progression of ≥2 mSASSS units was found in 30 (14.3%) vs 37 (17.6%) patients in blinded and unblinded scoring. In the shift analysis, mSASSS worsening was found in 35 (0.8%) vs 109 (2.2%) and improvement in 4 (0.1%) vs 2 (0.04%) of a total of 4.373 and 4914 vertebral edges in the blinded vs unblinded group, respectively. The majority of progression was found for the development of syndesmophytes in both groups.</p><p><strong>Conclusions: </strong>More mSASSS progression was detected using unblinded vs blinded scoring. Scoring spinal radiographs with known chronological order seems to be more sensitive to changes.</p>","PeriodicalId":8087,"journal":{"name":"Annals of the Rheumatic Diseases","volume":" ","pages":"1335-1341"},"PeriodicalIF":20.6,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144085675","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":"A cross-sectional observational study of patients with sicca with salivary autoantibodies defines a potential new phenotype of Sjögren's disease.","authors":"Martha Tsaliki, Joshua Cavett, Biji T Kurien, Christina Bruxvoort, Valerie M Lewis, John A Ice, Devavrat Dave, Sina Khosravani, Kiely Grundahl, Christopher J Lessard, Astrid Rasmussen, Kathy L Sivils, Amy Darise Farris, Kristi A Koelsch, Robert Hal Scofield","doi":"10.1016/j.ard.2025.03.012","DOIUrl":"10.1016/j.ard.2025.03.012","url":null,"abstract":"<p><strong>Objectives: </strong>Diagnosis of Sjögren's disease (SjD) consists of clinical examinations that include invasive studies such as lower lip biopsies and blood collection to identify presence of serum autoantibodies. Salivary glands of patients with SjD are sites where antibody-secreting cells accumulate and secrete immunoglobulins. Many patients with dry manifestations who do not meet classification criteria are grouped as non-Sjögren's sicca (NSS) and are heavily understudied. We undertook this cross-sectional observational study to investigate the role of salivary autoantibodies as a diagnostic tool and determine presence of salivary autoantibodies in patients with NSS.</p><p><strong>Methods: </strong>In this cross-sectional observational study, we screened whole unstimulated saliva from 446 subjects by direct enzyme-linked immunosorbent assays and capillary western blotting for anti-Ro60, anti-La, and rheumatoid factor (immunoglobulin (Ig)G and IgA) antibodies. All subjects were classified following the ACR/EULAR classification at the Oklahoma Medical Research Foundation Sjögren's Research Clinic.</p><p><strong>Results: </strong>Patients with SjD were significantly more likely to have salivary antibodies compared with those with NSS and healthy control subjects. In this cohort, there were 88 subjects with NSS with seronegative profiles who had detectable salivary autoantibodies and objective measures of dryness.</p><p><strong>Conclusions: </strong>Of these 88 subjects with NSS, we identified 75 subjects that had positive objective examinations of dryness and could belong to an early-onset SjD group. Alternatively, these 75 subjects with NSS could belong to a distinct phenotype of SjD that will remain seronegative while being saliva positive for anti-Ro60. These data showed a relationship between ocular and oral dryness and the presence of salivary anti-Ro60 antibodies in subjects with NSS.</p>","PeriodicalId":8087,"journal":{"name":"Annals of the Rheumatic Diseases","volume":" ","pages":"1354-1362"},"PeriodicalIF":20.6,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143963872","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":"Evaluation of instruments assessing peripheral arthritis in spondyloarthritis: an analysis of the ASAS-PerSpA study.","authors":"Dafne Capelusnik, Clementina Lopez-Medina, Désirée van der Heijde, Robert Landewé, Maxime Dougados, Joachim Sieper, Anna Molto, Sofia Ramiro","doi":"10.1016/j.ard.2025.02.011","DOIUrl":"10.1016/j.ard.2025.02.011","url":null,"abstract":"<p><strong>Objectives: </strong>To assess construct validity, including known-group discrimination, of the currently available disease activity instruments assessing peripheral arthritis in spondyloarthritis (SpA).</p><p><strong>Methods: </strong>In this analysis from the Assessment of SpondyloArthritis International Society (ASAS)-PerSpA study, patients with a diagnosis of axial SpA, peripheral SpA, or psoriatic arthritis (PsA) were included. The disease activity instruments evaluated were the Patient Global Assessment (PGA), Bath Ankylosing Spondylitis Disease Activity Index, Axial Spondyloarthritis Disease Activity Score, Disease Activity Index for PsA (DAPSA), Swollen Joint Count (SJC), Tender Joint Count, Disease Activity Score (DAS) 28, DAS44, and C-reactive protein (CRP). Construct validity was assessed through correlations with external constructs (Bath Ankylosing Spondylitis Functional Index, ASAS Health Index, and Euro Quality of Life 5 Dimensions) and known-group discrimination (active/inactive disease based on a combination of PGA [≥5/<5]), and SJC (≥1/0 and ≥2/<2) was analysed using standardised mean differences (SMDs).</p><p><strong>Results: </strong>In total, 4121 patients were included (mean age 45 [SD, 14] years, 61% males). When assessing the construct validity through correlations with external constructs, all instruments performed excellently (100% hypotheses confirmed). When assessing known-group discrimination, all disease activity measures, except CRP, presented SMDs ≥ 0.8 (good discrimination), with higher SMDs observed for DAS28 followed by DAPSA. Results were similar across disease phenotypes. Considering all combinations of PGA and SJC to discriminate between active/inactive disease, a better performance was observed for the composite scores, including joint counts.</p><p><strong>Conclusions: </strong>In our construct validity analysis, all disease activity instruments assessing peripheral arthritis had a good performance as reflected in the correlations with external constructs and the known-group discrimination. The highest discriminatory capacity to distinguish between 'active/inactive disease' was observed for composite scores, including joint counts, like DAS28 and DAPSA.</p>","PeriodicalId":8087,"journal":{"name":"Annals of the Rheumatic Diseases","volume":" ","pages":"1324-1334"},"PeriodicalIF":20.6,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143656034","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}