Arthritis Care & Research最新文献

{"title":"Systematic Review of Inequitable Population Representation in Systemic Lupus Erythematosus Clinical Trials.","authors":"Seth Sims, Kaylyn Rowsey, Christian Hemmerich, Haley Howard, Jay Babek, Garrett Jones, Simran Demla, Alicia Ito Ford, Matt Vassar","doi":"10.1002/acr.25576","DOIUrl":"https://doi.org/10.1002/acr.25576","url":null,"abstract":"<p><strong>Objective: </strong>This systematic review and meta-analysis aims to evaluate the participation of historically marginalized populations in systemic lupus erythematosus (SLE) clinical trials conducted in the US.</p><p><strong>Background: </strong>SLE, a complex autoimmune disease characterized by a dysregulated immune response leading to inflammation and tissue damage in multiple organ systems, exhibits a mortality rate four times higher in historically marginalized populations compared to the general population. It is essential for clinical trials to accurately represent the disease population to effectively evaluate treatment modalities. However, the current trial design lacks appropriate representation of historically marginalized populations, limiting the generalizability of results. Our study addresses this research gap by evaluating the participant demographics in SLE clinical trials.</p><p><strong>Methods: </strong>Relevant clinical trials were obtained in a comprehensive search of MEDLINE (PubMed) and Embase (Elsevier) in May of 2024. Included trials were published in the United States between January 1, 2018, and December 31, 2023. Two reviewers independently performed screening and data extraction via a standardized Google Form.</p><p><strong>Results: </strong>Having met our inclusion criteria, 18 U.S. SLE clinical trials were evaluated for participant sex, age, racial, and ethnic data. Analysis of sex/gender revealed that the included population accurately represented the disease population. Regarding race/ethnicity participation, 11/18 (61.1%) received an overall Poor rating, and none received a Good rating. Analysis revealed that 14/18 (77.8%) of studies demonstrated statistically insignificant underrepresentation of Black, Asian, and Hispanic populations. No studies reported the inclusion of older adults in their sample, suggesting a significant need for better age representation.</p><p><strong>Conclusion: </strong>The results of this study reveal disparities in the representation of the SLE disease population in clinical trials, emphasizing insufficient inclusion of Black, Asian, and Hispanic/Latinx participants and the disproportionate overrepresentation of white participants. Our study highlights the need for the initiation of effective strategies to engage historically marginalized populations in SLE clinical trials. Addressing these gaps is necessary to prioritize the participation of inequitable populations, increase standardization of SLE treatments, and improve the relevance of SLE research.</p>","PeriodicalId":8406,"journal":{"name":"Arthritis Care & Research","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144172569","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Screening for Social Determinants of Health in Patients with Systemic Lupus Erythematosus: A Point-of-Care Feasibility Study.","authors":"S Sam Lim, Vijay R Nadipelli, Michelle Bruno, Daphne Lew, Bernard Rubin, Charmayne M Dunlop-Thomas, Kelsey Hulcher, Kristi R Mitchell, Lydia Demetriou, Jeff Berko, Jason Bao, Alfred H J Kim","doi":"10.1002/acr.25572","DOIUrl":"https://doi.org/10.1002/acr.25572","url":null,"abstract":"<p><strong>Objectives: </strong>Social determinants of health (SDoH) can impact outcomes but are not routinely screened for in US outpatient rheumatology clinics. This study determined the feasibility of routine point-of-care SDoH screening among patients with systemic lupus erythematosus (SLE), and associated barriers and facilitators at the physician, care team, and patient levels.</p><p><strong>Methods: </strong>This observational, prospective, mixed methods pilot study (GSK Study 219011) conducted in two large, academic tertiary lupus clinics in the US, screened adults with SLE for SDoH over 2 weeks (Institution 1, July-August 2023) and 7 weeks (Institution 2, August-October 2023). Patient demographics and patient-reported responses to questions covering up to eight SDoH domains chosen by participating institutions were collected, and an optional patient experience survey was conducted afterwards. Participating physicians and care teams were asked questions on screening implementation, tool usability and comprehension, clinician acceptance, and facilitators of use. Transcripts were analyzed using thematic analysis.</p><p><strong>Results: </strong>The study included 69 patients with SLE across both institutions; 65 completed the patient experience survey. SDoH screening was successfully implemented with minimal disruption to clinical workflow and was viewed as valuable by physicians, care teams, and patients. Reported facilitators to successful SDoH screening included institutional leadership buy-in to address health equity and a brief screening tool format (≤5 minutes). Barriers included limited resources and insufficient time or training.</p><p><strong>Conclusion: </strong>With an appropriately resourced and trained care team, successful routine SDoH screening in lupus clinics is feasible, valuable to clinicians/care teams, and effective for connecting patients to needed social resources.</p>","PeriodicalId":8406,"journal":{"name":"Arthritis Care & Research","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144092751","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Race, Ethnicity, and Geographic Diversity in Pivotal Psoriatic Arthritis Clinical Trials: Further Progress Is Needed.","authors":"Mathieu Choufani, Joerg Ermann, Niti Goel","doi":"10.1002/acr.25574","DOIUrl":"https://doi.org/10.1002/acr.25574","url":null,"abstract":"<p><strong>Objective: </strong>We assessed race, ethnicity, and geographic diversity in pivotal trials of biologic and targeted synthetic disease-modifying antirheumatic drugs approved for psoriatic arthritis (PsA) in the United States.</p><p><strong>Methods: </strong>We conducted a descriptive epidemiological study, examining the reporting and representation of race, ethnicity, and geographic distribution of trial sites in pivotal PsA trials using data from journal publications, the Drugs@FDA database, and ClinicalTrials.gov.</p><p><strong>Results: </strong>We identified 29 pivotal PsA trials for 16 targeted therapies with start dates between 2000 and 2019. Race data were reported in 93% of trials. Race reporting was highest in journal publications (86%); however, among these, 46% reported only the proportion of White participants. Ethnicity data were available for 41% of trials, primarily from ClinicalTrials.gov, with improved reporting in recent years. Among 14,165 participants in 27 trials with race data, 92% were White, 7% Asian, and fewer than 1% were Black, American Indian/Alaska Native, or Native Hawaiian/Pacific Islander. Among 8,105 participants in 12 trials with ethnicity data, 11% were Hispanic or Latino individuals. Location data were available for 26 trials. In the U.S., trial activity was highest in Texas (24 trials), Florida and Pennsylvania (22 each), and California (20), strongly correlating with state population size (r = 0.78, p < 0.0001). Globally, trial sites were identified in 55 countries, primarily in North America and Europe, with fewer sites in Asia, Africa, and Latin America.</p><p><strong>Conclusion: </strong>Racial and ethnic diversity in pivotal PsA trials remains limited. Tailored and multifaceted strategies are needed to improve participant representativeness in future trials.</p>","PeriodicalId":8406,"journal":{"name":"Arthritis Care & Research","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144092748","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of Elevated Serum S100A8/A9 Levels and Cognitive Impairment in Systemic Lupus Erythematosus Patients.","authors":"Carolina Muñoz-Grajales, Michelle L Barraclough, Juan P Diaz-Martinez, Jiandong Su, Kathleen Bingham, Mahta Kakvan, Roberta Pozzi Kretzmann, Maria Carmela Tartaglia, Lesley Ruttan, May Y Choi, Simone Appenzeller, Sherief Marzouk, Dennisse Bonilla, Patricia Katz, Dorcas Beaton, Robin Green, Dafna D Gladman, Joan Wither, Zahi Touma","doi":"10.1002/acr.25575","DOIUrl":"https://doi.org/10.1002/acr.25575","url":null,"abstract":"<p><strong>Objectives: </strong>Cognitive impairment (CI) is common in patients with Systemic Lupus Erythematosus (SLE). Despite its prevalence, the immune mechanisms are not well understood. We previously reported elevated serum levels of S100A8/A9 and MMP-9 in SLE patients with CI. This study aims to validate those findings by examining the relationship between serum levels and CI in patients with SLE at baseline and after one year.</p><p><strong>Methods: </strong>We assessed cognitive function in 112 SLE patients using the adapted ACR-Neuropsychological Battery (ACR-NB), defining CI as impairment in two or more domains. Serum S100A8/A9 and MMP-9 levels were measured by ELISA. We compared serum levels between CI and non-CI groups, evaluated cognitive domain performance at baseline and one year, and explored associations between serum changes and cognitive status changes.</p><p><strong>Results: </strong>At baseline, 48 patients (42.8%) had CI. After one year, 55% remained stable, 31.2% improved, and 13% worsened. Serum S100A8/A9 levels were significantly higher in CI patients at baseline (p = 0.0007, r = 0.413) and one year (p = 0.0045, r = 0.359), correlating inversely with multiple CI domains. The worsened group showed a significant increase in S100A8/A9 levels, while the improved group exhibited a reduction.</p><p><strong>Conclusion: </strong>In this large cohort of well-characterized SLE patients, serum S100A8/A9 levels were elevated in those with CI and showed an inverse relationship with cognitive performance across multiple domains. Changes in S100A8/A9 levels corresponded with changes in cognitive status over one year. These findings warrant further investigation into the role of S100A8/A9 in CI within the context of SLE.</p>","PeriodicalId":8406,"journal":{"name":"Arthritis Care & Research","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144092746","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The importance of thinking outside the (medical) box: the impact of lifestyle on the outcomes of rheumatic and musculoskeletal conditions and the promise of lifestyle medicine.","authors":"Patricia Katz, Brian J Andonian, Sarah L Patterson","doi":"10.1002/acr.25573","DOIUrl":"https://doi.org/10.1002/acr.25573","url":null,"abstract":"","PeriodicalId":8406,"journal":{"name":"Arthritis Care & Research","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144092754","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Endogenous lipoid pneumonia in adult autoinflammatory disease.","authors":"Katrien Slabbynck, Jo Van Dorpe, Isabelle Peene, Karin Melsens, Cedric Bosteels, Rik Joos, Dirk Elewaut, Peggy Jacques, Hans Slabbynck, Gaëlle Varkas","doi":"10.1002/acr.25570","DOIUrl":"https://doi.org/10.1002/acr.25570","url":null,"abstract":"<p><p>We describe one of the first cases of endogenous lipoid pneumonia (ELP) in an adult patient with the clinical picture of adult-onset Still disease (AOSD) and a low penetrance genetic background of tumour necrosis factor receptor-associated periodic syndrome (TRAPS). This case highlights the complex pathophysiology of lung involvement in autoinflammatory diseases, operating at the interface of the innate and adaptive immune system. This case presents a 53-year-old immunocompromised woman with treatment refractory autoinflammatory disease and history of macrophage activation syndrome (MAS), presenting to the emergency room with progressive dyspnea and fever. Upon evaluation, chest-CT showed diffuse lung disease. Extensive work-up, including bronchoscopy with bronchoalveolar lavage remained negative. Lung biopsy revealed an ELP with intra-alveolar accumulation of cholesterol crystals and foamy macrophages. In the years preceding the event, her autoinflammatory disease had shown to be refractory to both conventional systemic disease-modifying antirheumatic drugs, as well as biologic treatments including tocilizumab, anakinra and canakinumab. Because of new onset respiratory failure in the context of uncontrolled inflammation, after exclusion of infectious origin, pulse doses of systemic corticosteroids were administered before induction with cyclophosphamide, followed by maintenance therapy with tacrolimus. Upon treatment, our patient recovered, but retained severe interstitial lung disease. Only one case of ELP in adult autoinflammatory disease has been depicted in a patient diagnosed with AOSD, although the entity is more recognized in paediatric literature on systemic onset juvenile idiopathic arthritis (soJIA). METHODS: Literature review on ELP in autoinflammatory diseases was performed in PubMed, without language restrictions, and comprised publications from January 1953 until November 2024. The literature search addressed lung disease in AOSD, TRAPS and soJIA using the following MESH terms: endogenous lipoid pneumonia, pulmonary alveolar proteinosis, parenchymal lung disease, macrophage activation syndrome, adult-onset Still disease, tumour necrosis factor receptor-associated periodic syndrome and systemic onset juvenile idiopathic arthritis.</p>","PeriodicalId":8406,"journal":{"name":"Arthritis Care & Research","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144075616","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between sleep disturbance and subsequent pain interference in patients with early rheumatoid arthritis.","authors":"Burcu Aydemir, Orit Schieir, Marie-France Valois, Lutfiyya N Muhammad, Jing Song, Dorothy Dunlop, Rowland W Chang, Susan J Bartlett, Louis Bessette, Gilles Boire, Glen Hazlewood, Carol Hitchon, Janet Pope, Carter Thorne, Diane Tin, Vivian P Bykerk, Yvonne C Lee","doi":"10.1002/acr.25568","DOIUrl":"https://doi.org/10.1002/acr.25568","url":null,"abstract":"<p><strong>Objective: </strong>This study investigated whether sleep disturbance can predict the extent to which pain interferes with daily functioning in patients with early rheumatoid arthritis (RA).</p><p><strong>Methods: </strong>Data were from adults with early RA (joint symptoms ≤12 months) enrolled in the Canadian Early Arthritis Cohort between 2016-2023. Participants underwent standardized clinical assessments and completed PROMIS-29 (Patient-Reported Outcomes Measurement Information System) measures at 0, 6-, 12-, 18-, and 24-months to assess sleep disturbance (primary predictor) and pain interference (primary outcome). Linear mixed effects models were used to estimate crude and adjusted (age, sex, BMI, education, income, smoking status, comorbidities, disease activity, treatment, and depression) effects of sleep disturbance on pain interference over the 24-month study period. The analysis was lagged so that repeat measures of sleep disturbance at 0-, 6-, 12- and 18-months were evaluated as predictors of pain interference 6-months later at 6-,12-, 18- and 24-months follow up.</p><p><strong>Results: </strong>The analysis included 502 patients with early RA. At baseline, the sample was 68% female, 81% White, with a mean (SD) age of 56 (14) years, and disease duration of 5.4 (2.9) months. The unadjusted and adjusted linear mixed effects models revealed a significant association between sleep disturbance and subsequent pain interference scores, indicating that worse sleep 6-months prior was associated with greater pain interference at the following 6-month evaluation.</p><p><strong>Conclusion: </strong>These findings underscore the importance of addressing sleep disturbances as part of pain management strategies soon after RA diagnosis. Identifying and targeting problematic sleep disturbances early on may help improve long-term pain outcomes.</p>","PeriodicalId":8406,"journal":{"name":"Arthritis Care & Research","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143974950","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence of Pain and Factors Associated with Pain in Patients with Idiopathic Inflammatory Myopathies.","authors":"Didem Saygin, Anne-Marie Malfait, Ethan M Ritz, Kristin Wipfler, Kaleb Michaud, Yvonne C Lee","doi":"10.1002/acr.25571","DOIUrl":"https://doi.org/10.1002/acr.25571","url":null,"abstract":"<p><strong>Objective: </strong>Pain is an often overlooked and understudied symptom in inflammatory myopathies (IIM). In this study, our goal is to examine the prevalence of pain and factors associated with pain in adults with IIM.</p><p><strong>Methods: </strong>FORWARD is a US-based prospective registry of adults with rheumatic diseases recruited from rheumatology clinics. Participants had physician diagnosis of IIM and completed questionnaires on pain, fatigue, physical function, disease activity, and sociodemographic variables. Pain prevalence was examined in demographic and disease subgroups. Regression models were performed to identify any factors associated with higher levels of pain (>3 pain on visual analog scale). The relationship between pain and outcome variables was examined through Pearson correlations, t-test and chi-square test.</p><p><strong>Results: </strong>A total of 189 IIM patients (age 55 years ± 14, 78% women) from FORWARD Databank were included in the study. Approximately 86% reported pain with an average of 3.5 on a 10-point visual analog scale. One in four patients were on opioids. Approximately 62-63% reported joint and muscle pain, respectively. Pain prevalence was similar across subgroups of disease subtype, sex, race, smoking, and obesity. Patient global disease activity was significantly associated with higher pain levels in multivariable models. Pain was significantly associated with worse physical function, fatigue, quality of life and health satisfaction.</p><p><strong>Conclusion: </strong>Pain is prevalent and associated with poor outcomes in patients with IIM. Pain is closely linked with patient global disease activity. Results highlight the critical need to better understand the pain experienced by these patients to best address their needs.</p>","PeriodicalId":8406,"journal":{"name":"Arthritis Care & Research","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143969504","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Avoidant Restrictive Food Intake Disorder Symptoms in Adults with Systemic Sclerosis: A Nationwide Study in Spain.","authors":"Luis G Alcala-Gonzalez, Helen Burton-Murray, Micaela Atkins, Alfredo Guillen-Del-Castillo, Carolina Malagelada, Michael Hughes, Zsuzsanna H McMahan, Carmen P Simeón-Aznar","doi":"10.1002/acr.25569","DOIUrl":"https://doi.org/10.1002/acr.25569","url":null,"abstract":"<p><strong>Objective: </strong>Patients with systemic sclerosis (SSc) may restrict food intake to manage their symptoms (particularly gastrointestinal). Whether some patients may develop nutritional and/or quality of life impairments indicative of an eating disorder, avoidant/restrictive food intake disorder (ARFID), is unknown. We aimed to: (1)identify the prevalence and characteristics of ARFID symptoms in patients with SSc and, (2)explore the relationship between ARFID symptoms, GI symptom burden and health-related quality of life METHODS: Cross-sectional internet survey nationwide in Spain, patients with SSc completed the Spanish Nine-Item ARFID Screen and assessments of gastrointestinal symptom burden (UCLA SCTC GIT 2.0) and health-related quality of life (SF-12).</p><p><strong>Results: </strong>Of 200 patients with SSc, 99 (49.5%) screened positive for ARFID. Just over half of those who screened positive for ARFID (n=53) screened positive based on having a fear of aversive consequences around eating (e.g., GI discomfort). A positive ARFID screen was associated with a greater frequency of self-reported enteral nutrition, weight loss, and self-initiated (vs provider-monitored) diet restrictions. ARFID symptoms were moderately associated with worse GI symptom severity by UCLA GIT 2.0 total score (r=0.408, p<0.001), but not for the reflux subscale (r=0.058, p=0.420) and constipation subscale (r=0.090, p=0.209). worse health-related quality of life, in all domains and both the physical and mental components of by SF-12 (all p<0.05).</p><p><strong>Conclusions: </strong>ARFID symptoms were relatively common in patients with SSc. Future research is needed to identify when a positive screen for ARFID reflects an adaptive response to disease or versus pathological restriction indicative of ARFID warranting behavioral treatment.</p>","PeriodicalId":8406,"journal":{"name":"Arthritis Care & Research","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143963615","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Carpal Tunnel Syndrome (CTS) is an Early Underrecognized Feature of Rheumatoid Arthritis (RA): A Population-Based Study of CTS Occurrence Before and After RA Incidence.","authors":"Roslin Jose George, Noah Frechette, Manuela Oviedo, Iqra Javed, Sara J Achenbach, Ryan J Lennon, Bradley Alex Kimbrough, Elena K Joerns, Vanessa L Kronzer, Anne Gingery, John M Davis, Cynthia S Crowson, Elena Myasoedova","doi":"10.1002/acr.25566","DOIUrl":"https://doi.org/10.1002/acr.25566","url":null,"abstract":"<p><strong>Objective: </strong>We aimed to assess the occurrence of Carpal Tunnel Syndrome (CTS) before and after rheumatoid arthritis (RA) incidence and by serological status.</p><p><strong>Methods: </strong>This population-based study included residents of a geographically defined area meeting the 1987 ACR classification criteria for RA in 1980-2019, matched 1:1 with non-RA individuals. At least two diagnosis codes ≥ 30 days apart were used to identify CTS. Cumulative incidence of CTS adjusting for competing risk of death was assessed. Logistic regression and Cox proportional hazard models were used, adjusting for age, sex, calendar year, smoking, obesity, diabetes, and hypothyroidism.</p><p><strong>Results: </strong>We included 1335 patients with RA and 1331 individuals without RA. The overall prevalence of CTS prior to or on RA incidence/index was 179 (13%) and 85 (6%), respectively: OR 2.23; 95% CI 1.69-2.94. Most prior incidence of CTS occurred ≥ 2 years prior to index date (112 and 75 events, respectively). Following RA incidence/index, individuals with RA (versus without RA) had ~80%-higher risk of CTS (HR 1.78; 95%CI 1.38-2.30). The risk estimates of CTS in patients with seronegative (vs seropositive) RA were OR 1.33; 95%CI 0.96-1.84 prior to RA incidence and HR: 1.37, 95%CI 0.99-1.88 after RA incidence. In RA, obesity (HR 1.42, 95% CI 1.02-1.99) and seronegative CCP-antibody status (HR 1.79, 95% CI 1.07-2.99), but not other risk factors, were associated with increased CTS risk.</p><p><strong>Conclusion: </strong>We found an over 2-fold increase in risk of CTS in years preceding RA, and 1.8-fold increased risk of incident CTS following RA onset.</p>","PeriodicalId":8406,"journal":{"name":"Arthritis Care & Research","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143970308","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}