Arthritis Care & Research最新文献

{"title":"Voclosporin and changes in blood pressure: an analysis of real-world data.","authors":"Eric T Roberts, Gabriela Schmajuk, Laura Plantinga, Jinoos Yazdany","doi":"10.1002/acr.80082","DOIUrl":"https://doi.org/10.1002/acr.80082","url":null,"abstract":"<p><strong>Objective: </strong>Hypertension was common in randomized controlled trials (RCTs) of voclosporin, an oral calcineurin inhibitor approved in 2021 to treat lupus nephritis (LN); however, increases in blood pressure (BP) diminished after 4 weeks. Here, we characterize BP changes in real-world data.</p><p><strong>Methods: </strong>We used electronic health record data from U.S. practices. We calculated time from first voclosporin prescription to a minimal clinically important increase (MCID) in systolic (10-mmHg) or diastolic (5-mmHg) BP, and the mean change in BP between baseline and windows of 0-1, 1-2, 2-3, 3-6, 6-9, and 9-12 months after starting treatment. Analyses were stratified by baseline BP as normal (<130 mmHg systolic and <80 mmHg diastolic), elevated (130-164 mmHg systolic or 80-104 mmHg diastolic and not high), or high (≥165 mmHg systolic or ≥105 mmHg diastolic).</p><p><strong>Results: </strong>Among 287 patients (mean age, 41.4; 83.6% women; 32.1% Black, 24.0% White, 17.1% Hispanic, and 5.6% Asian), mean baseline BP was 126/79 (SD = 16/11) mmHg. Overall, 60.3% experienced a systolic MCID within a median of 90 (95% CI: 70-102) days; 60.6% a diastolic MCID within a median of 88 days (95%CI: 72-111). Mean BP changes in the first month were 13.7 (±18.6)/6.0 (±13.8), 2.7 (±18.8)/-0.6 (±11.2), and 7.9 (±17.8)/-7.3 (±16.5) mmHg for those with normal, elevated, and high BP at baseline.</p><p><strong>Conclusions: </strong>Our results may differ because of differences in the intensity of BP management or the higher prevalence of cardiovascular risk factors in U.S.</p><p><strong>Patients: </strong>More intensive BP management with voclosporin treatment for LN might be warranted.</p>","PeriodicalId":8406,"journal":{"name":"Arthritis Care & Research","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147809969","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 Painful Truth: The Relationship between Non-Articular Pain and Patient Global Assessment before and after Initiating a New DMARD for Active Rheumatoid Arthritis.","authors":"Charis Meng, Jing Song, Lutfiyya N Muhammad, Burcu Aydemir, Julia D Caci, Tuhina Neogi, Marcy B Bolster, Wendy Marder, Clifton O Bingham, Yvonne C Lee","doi":"10.1002/acr.80081","DOIUrl":"10.1002/acr.80081","url":null,"abstract":"<p><strong>Objectives: </strong>Non-articular pain (NAP) may contribute to patient global assessment (PtGA), confound disease activity assessment, and influence treatment decisions. Our aims were to 1) evaluate the association between NAP and PtGA in adults with active RA starting a new DMARD; and 2) determine the extent this relationship is mediated by pain intensity.</p><p><strong>Methods: </strong>We enrolled adults with active RA initiating a new DMARD. Participants indicated NAP on a body pain diagram (0-19 sites) and completed assessments of PtGA and pain intensity. To evaluate the association between NAP and PtGA, adjusted multivariable linear regression was performed. Mediation analyses using linear regression models examined whether this association was mediated by pain intensity, at baseline and 3-months separately. All models were adjusted for potential confounders.</p><p><strong>Results: </strong>The 197 participants were mostly female (83.8%) with mean (sd) age of 55.1 (14.4) years, disease duration of 10.6 (12.6) years, and CDAI of 23.9 (14.6). NAP was reported by 92.9% at baseline, and 84.8% at 3-months. At baseline, each site of NAP (0-19) was associated with a 0.20-point higher PtGA (β = 0.20, 95% confidence interval (0.12-0.28). Pain intensity mediated 61.8% of this association. Similar findings were observed at 3-months.</p><p><strong>Conclusion: </strong>There was a significant linear relationship between NAP and PtGA, most of which could be explained by pain intensity. These findings raise awareness of NAP and its added burden of worse perceived health status in RA. This may help prevent unnecessary DMARD treatment changes and increase specificity in treatment of different pain types.</p>","PeriodicalId":8406,"journal":{"name":"Arthritis Care & Research","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147809966","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":"Associations of lifestyle-related factors and psoriatic arthritis disease activity: the Dutch south west psoriatic arthritis study.","authors":"Batoul Hojeij, Ilja Tchetverikov, Marc R Kok, Marijn Vis, Yvonne Goekoop-Ruiterman, Jessica Bijsterbosch, Paul Baudoin, Reinhard Bos, Jos H van der Kaap, Petra Kok, Lindy-Anne Korswagen, Jolanda J Luime","doi":"10.1002/acr.80080","DOIUrl":"https://doi.org/10.1002/acr.80080","url":null,"abstract":"<p><strong>Objective: </strong>This study aims to investigate lifestyle-related factors in patients with psoriatic arthritis (PsA) and their association with disease activity measurements.</p><p><strong>Methods: </strong>This multicenter cohort included 938 patients newly diagnosed with PsA, between 2013 and 2023. A composite lifestyle risk score (range 0 to 5) was calculated using five lifestyle-related factors assessed at baseline (BMI outside normal range, abdominal obesity, current smoking, no alcohol consumption, physical inactivity). Higher scores indicate the presence of more lifestyle-related risk factors. One year disease activity outcomes included PsA Disease Activity Score (PASDAS), disease activity in PsA (DAPSA), PASDAS and DAPSA low disease activity (LDA) and remission, and minimal disease activity (MDA).</p><p><strong>Results: </strong>The rate of obesity was 33%, abdominal obesity was 51%, current smoking was 19%, and alcohol consumption was 72% with 3% of patients physically inactive. Using multivariable analyses, a higher lifestyle risk score was associated with higher PASDAS (β 0.15; 95%CI 0.08, 0.23), and lower odds for achieving PASDAS-LDA (OR 0.59; 95%CI 0.45, 0.77), and MDA (OR 0.72; 95%CI 0.57, 0.90) at one year follow-up. Similar associations were observed for DAPSA (βadj 1.18; 95%CI 0.65, 1.71) and DAPSA-LDA (OR 0.74; 95%CI 0.59, 0.92). Analysis of individual factors showed that general obesity, abdominal obesity and smoking, were significantly associated with higher PASDAS and DAPSA, and lower odds for achieving PASDAS-LDA and MDA.</p><p><strong>Conclusion: </strong>Lifestyle-related risk factors were prevalent in patients with PsA. The associations between lifestyle-related factors and PsA disease activity, mainly obesity and smoking, provide foundation to address lifestyle in PsA care.</p>","PeriodicalId":8406,"journal":{"name":"Arthritis Care & Research","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147809848","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 Usefulness of the Patient-Reported Outcomes Measurement Information System Scale v1.2 Global Health for Assessing Mental and Physical Health of Individuals With Chronic Musculoskeletal Pain, Rheumatoid Arthritis, and Hip and Knee Osteoarthritis or Undergoing Physiotherapy: Results of Factor and Item Response Theory Analyses.","authors":"Emanuele M Giusti, Leonardo Pellicciari, Martine H P Crins, Paul Dekker, Martin van der Esch, Marike van der Leeden, Willem F Lems, Joost Dekker, Maarten Boers, Dirkjan van Schaardenburg, Johan Joly, Patrick Verschueren, Kristien Van der Elst, Rene Westhovens, Caroline B Terwee, Leo D Roorda","doi":"10.1002/acr.25674","DOIUrl":"10.1002/acr.25674","url":null,"abstract":"<p><strong>Objective: </strong>This study aims to evaluate whether the 10-item Patient-Reported Outcomes Measurement Information System Scale v1.2-Global Health (PROMIS-GH) is useful to assess global mental health (GMH) and global physical health (GPH) in individuals with musculoskeletal disorders.</p><p><strong>Methods: </strong>PROMIS-GH was administered to 4,295 individuals (mean ± SD age 56 ± 14 years, 70% female, chronic musculoskeletal pain [n = 1,142], rheumatoid arthritis [n = 1,987], hip/knee osteoarthritis [n = 418], and undergoing physiotherapy [n = 947]). We investigated the legitimacy of calculating a GMH and a GPH subscale score (confirmatory factor analyses) and of converting raw ordinal subscale scores to interval scores (checking item response theory [IRT] assumptions [unidimensionality, local independence, and monotonicity] and graded response model fit), the ability of the subscales to discriminate different levels of health (items' discrimination parameters α) to cover the relevant range of GMH and GPH (range of difficulty parameters β) and their precision (item- and subscale-level information), and to compare demographic and clinical subgroups (differential item functioning [DIF]).</p><p><strong>Results: </strong>It is legitimate to calculate a GMH and a GPH subscale score (comparative fit index = 0.98/0.97, Tucker-Lewis index = 0.97/0.95, root mean square error of approximation = 0.15/0.19, and standardized root mean square residual = 0.05/0.07) and to convert raw scores to interval scores (IRT assumptions met and adequate model fit). Discrimination (items' α ≥ 2), coverage (lowest β ≤ -2) and precision (reliability ≥ 0.70 for large portions of the health domain) were adequate for all items, except item Global10, underscoring that they can distinguish individuals with different levels of GMH and GPH with precision. The subscales can be used to compare demographic and clinical subgroups (no DIF).</p><p><strong>Conclusion: </strong>PROMIS-GH can be used to measure GMH and GPH in individuals with musculoskeletal disorders. Replacement or improvement of the Global10 item could be considered.</p>","PeriodicalId":8406,"journal":{"name":"Arthritis Care & Research","volume":" ","pages":"647-661"},"PeriodicalIF":3.3,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145328277","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":"Clinical Conditions Associated With a High Antinuclear Antibody Titer in Individuals Without Autoimmune Disease.","authors":"Matthew Chung, John P Shelley, Gul Karakoc, John Still, Xiaodi Ruan, Jonathan Mosley, C Michael Stein, Vivian K Kawai","doi":"10.1002/acr.25682","DOIUrl":"10.1002/acr.25682","url":null,"abstract":"<p><strong>Objective: </strong>Antinuclear antibodies (ANAs) are present at high titers in 2% of the general population, but their clinical significance in individuals without an autoimmune (AI) disease is not known. We tested the hypothesis that the presence of a high ANA titer in non-AI conditions is associated with disease.</p><p><strong>Methods: </strong>We conducted a retrospective case-control study in the Vanderbilt University Medical Center's de-identified electronic medical record system. Individuals without AI disease who had an ANA test were classified into three groups: high titer (HT; ANA ≥ 1:640), low titer (LT; ANA ≤ 1:80), and negative (NG) ANA results. The prevalence of diagnoses recorded within 90 days of the ANA test were compared among groups in a phenome-wide association study adjusting for age at ANA testing, sex, median body mass index (BMI), and reported race. A P value <5 × 10^-5 was considered significant.</p><p><strong>Results: </strong>A total of 28,781 individuals qualified for the study: 3.1% in the HT, 12.3% in the LT, and 84.6% in the NG groups. BMI was similar among groups (P value = 0.345), but individuals in the HT group were older (P = 3.9 × 10^-73). A high ANA titer increased risk of 46 and 67 clinical diagnoses when comparing the HT group with the LT and the NG groups, respectively. The most significant associations in both comparisons included liver disorders and complications and risk factors for liver disease.</p><p><strong>Conclusion: </strong>A high ANA titer in the absence of an AI disease was associated with increased risk of liver disorders and related risk factors and complications.</p>","PeriodicalId":8406,"journal":{"name":"Arthritis Care & Research","volume":" ","pages":"662-669"},"PeriodicalIF":3.3,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13116006/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145290822","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Building Consensus on the Essential Elements of the Musculoskeletal Physical Examination During Rheumatology Telehealth Encounters.","authors":"Lisa Zickuhr, Alberto Sobrero, Daniel Albert, Amanda S Alexander, Tami Bonnett-Admi, Sarah Dill, Sharon Dowell, Elizabeth D Ferucci, Connie Herndon, Bharat Kumar, David Leverenz, Jennifer Mandal, Irene J Tan, Swamy Venuturupalli, Tiffany Westrich-Robertson, Marcy B Bolster, Jason Kolfenbach","doi":"10.1002/acr.25669","DOIUrl":"10.1002/acr.25669","url":null,"abstract":"<p><strong>Objective: </strong>Patients and providers encounter challenges when conducting virtual musculoskeletal physical examinations (PEs) during rheumatology telehealth encounters. Guidance for a structured virtual PE could enhance the quality of clinical information gleaned and management decisions made during rheumatology telehealth visits. This study aims to build expert consensus and identify the most essential elements as the first step in defining the virtual rheumatology musculoskeletal PE.</p><p><strong>Methods: </strong>A team with expertise in rheumatology telehealth, consisting of rheumatology attending physicians, educators, and a patient with rheumatic disease, conducted a modified Delphi to achieve consensus on the items determined to be most essential to the virtual rheumatology musculoskeletal PE. The modified Delphi consisted of two online surveys and a virtual meeting.</p><p><strong>Results: </strong>The team identified seven items essential to the rheumatology musculoskeletal telehealth PE. These items describe elements in a focused joint examination as well as the assessment for level of activity of inflammatory arthritis. The modified Delphi method excluded maneuvers related to assessment of muscle strength and widespread pain syndromes, determining that these elements were better conducted in person.</p><p><strong>Conclusion: </strong>A list of PE items most essential to rheumatology musculoskeletal telehealth encounters, supported by expert opinion and established evidence, marks the first step toward standardizing, evaluating, and teaching the virtual rheumatology PE. These items, alongside anticipated future revisions and improvements, promise to enhance the quality of telehealth care delivered to people with rheumatic diseases.</p>","PeriodicalId":8406,"journal":{"name":"Arthritis Care & Research","volume":" ","pages":"683-687"},"PeriodicalIF":3.3,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145372107","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":"Development of the 2023 ACR/EULAR Antiphospholipid Syndrome Classification Criteria, Phase III-C Report: Assessment of Patient Scenarios (Derivation Cohort) and Refinement of Definitions.","authors":"Medha Barbhaiya, Stephane Zuily, Deanna Jannat-Khah, Mary-Carmen Amigo, Danieli Andrade, Tadej Avcin, Maria L Bertolaccini, D Ware Branch, Nathalie Costedoat-Chalumeau, Guilherme Ramires de Jesús, Katrien M J Devreese, David Garcia, Jose A Gomez Puerta, Francis Guillemin, Steven R Levine, Roger A Levy, Michael D Lockshin, Thomas L Ortel, Michelle Petri, Giovanni Sanna, Savino Sciascia, Surya V Seshan, Maria Tektonidou, Denis Wahl, Rohan Willis, Cecile Yelnik, Alison Hendry, Ray Naden, Karen H Costenbader, Doruk Erkan","doi":"10.1002/acr.25599","DOIUrl":"10.1002/acr.25599","url":null,"abstract":"<p><strong>Objective: </strong>The 2023 American College of Rheumatology (ACR)/EULAR antiphospholipid syndrome (APS) classification criteria aim to identify patients with a high likelihood of APS for research. Phases I/II of our four-phase methodologic approach resulted in 27 candidate criteria organized in clinical and laboratory domains. Here, we summarize phase III efforts to reduce and refine criteria using patient scenarios.</p><p><strong>Methods: </strong>Using standardized definitions for candidate criteria, the Steering Committee collected antiphospholipid antibody (aPL)-positive cases referred for \"suspected APS.\" Treating physicians assessed APS case likelihood using a Likert scale. Poisson regression calculated risk ratios (RRs) and 95% confidence intervals (CIs) to quantify the direction and size of the association of candidate criteria with \"highly likely\" versus \"equivocal or unlikely\" APS, which guided Steering Committee candidate criteria refinement and organization.</p><p><strong>Results: </strong>We collected 314 suspected APS cases (137 [44%] highly likely and 177 [56%] equivocal/unlikely APS). Provoking venous thromboembolism (VTE) or arterial thrombosis (AT) risk factors reduced the size of the association with highly likely APS (RR 4.31 [95% CI 2.11-8.78] to RR 1.56 [95% CI 0.89-2.75] for VTE and RR 3.48 [95% CI 1.91-6.32] to RR 1.64 [95% CI 0.77-3.51] for AT). Persistent lupus anticoagulant, anticardiolipin IgG antibody ≥40 U, and anti-β₂-glycoprotein-I IgG antibody ≥40 U were positively associated with highly likely APS (all P < 0.05). Eventually, items within eight additive and independent clinical and laboratory domains were refined.</p><p><strong>Conclusion: </strong>Referred suspected APS cases provided insight into associations of individual candidate criteria with APS likelihood. RR analyses helped refine items and organize the draft classification system into eight additive and independent clinical and laboratory domains.</p>","PeriodicalId":8406,"journal":{"name":"Arthritis Care & Research","volume":" ","pages":"563-573"},"PeriodicalIF":3.3,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144574748","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":"Testing a Personalized Approach to Chronic Low Back Pain: A Randomized Controlled Trial in Older Veterans.","authors":"Debra K Weiner, Angela Gentili, Meika A Fang, Edward Garay, Laura Lawson, Lenore Joseph, Cathy C Lee, Michelle I Rossi, Beverly Thorn, Subashan Perera","doi":"10.1002/acr.25671","DOIUrl":"10.1002/acr.25671","url":null,"abstract":"<p><strong>Objective: </strong>We aimed to test the efficacy of personalized treatment of older veterans with chronic low back pain (CLBP) delivered by Aging Back Clinics (ABCs) as compared with usual care (UC).</p><p><strong>Methods: </strong>Two hundred ninety-nine veterans aged 65 to 89 with CLBP from three Veterans Affairs (VA) medical centers underwent baseline testing, randomization to ABC or UC, and 12 months of follow-up. ABC care was guided by trained physicians and published algorithms targeting key conditions contributing to CLBP (eg, hip osteoarthritis, depression, fibromyalgia). UC was guided by the participant's primary care provider. The primary outcome was six-month change in the Oswestry Disability Index (ODI). Among multiple secondary outcomes were pain intensity, quality of life (Patient-Reported Outcomes Measurement Information System [PROMIS]-Global Health), self-reported physical function (PROMIS-29), falls, life space, and health care utilization collected at 3, 6, 9, and 12 months. Analyses were conducted according to intention-to-treat.</p><p><strong>Results: </strong>There were no significant group differences in ODI change. Greater improvement with ABC in the PROMIS-29 physical function scale was observed at 12 months (1.7 vs -0.4 points), PROMIS Global physical health at 6 (1.3 vs -1.2) and 12 months (0.7 vs -1.5), PROMIS Global mental health at 6 months (0.2 vs -2.3), and present and prior week average/worst pain over 12 months (all P < 0.05). There were marginally fewer falls over 12 months (P = 0.0527).</p><p><strong>Conclusion: </strong>We did not find confirmatory evidence that personalized care (ABC) was superior with respect to ODI. We did find preliminary evidence that ABC was superior in other respects including improved self-reported physical health, less pain, and fewer falls.</p>","PeriodicalId":8406,"journal":{"name":"Arthritis Care & Research","volume":" ","pages":"609-619"},"PeriodicalIF":3.3,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13116040/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145343094","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Climate Change, Environmental Risk Factors, and Gout.","authors":"Mary L Guan, Tamiko R Katsumoto, Michael Toprover, Nidaa Rasheed, Shuchi Anand, Michael H Pillinger, Michael H Weisman, Suzanne R Tamang","doi":"10.1002/acr.25673","DOIUrl":"10.1002/acr.25673","url":null,"abstract":"<p><p>Worldwide, gout is increasing at a rapid rate. Although genetics and diet play primary roles in gout development, emerging evidence suggests that environmental risk factors may also play a significant contributory role. In this review, we examine the evidence linking environmental exposures to gout risk, summarize potential pathophysiologic mechanisms, and highlight key knowledge gaps and underexplored areas. In particular, we highlight the impact of air pollution, ambient temperature, water contamination with heavy metals, chronic kidney disease (as it relates both to gout and climate change), dietary factors such as ultraprocessed food consumption, and various other pollutants in increasing the risk of gout.</p>","PeriodicalId":8406,"journal":{"name":"Arthritis Care & Research","volume":" ","pages":"620-629"},"PeriodicalIF":3.3,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145328145","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":"Exploring Factors Associated With Cognitive Impairment in Rheumatoid Arthritis.","authors":"Raquelle Dawood, Hannah F Brubeck, Kylie E Riggles, Sebastian E Sattui, Elena Myasoedova, Una E Makris, Dolores M Shoback, Jose M Garcia, Ariela R Orkaby, Joshua F Baker, Patricia P Katz, Katherine D Wysham","doi":"10.1002/acr.25676","DOIUrl":"10.1002/acr.25676","url":null,"abstract":"<p><strong>Objective: </strong>Cognitive impairment is prevalent in rheumatoid arthritis (RA), yet risk factors are not well understood. We explored associations between clinical characteristics and cognitive impairment in an RA cohort.</p><p><strong>Methods: </strong>Data were from a longitudinal RA cohort at Veterans Affairs Puget Sound Health Care System. Cognition was evaluated using the Saint Louis University Mental Status (SLUMS) examination. Demographics and health factors, objectively measured physical function, participant-reported symptoms, RA disease characteristics, and comorbidities were evaluated. Univariable linear regressions explored the association between clinical factors and SLUMS scores. Those with P < 0.1 in the univariable models were evaluated in separate multivariable linear regressions controlling for age, sex, and years of education.</p><p><strong>Results: </strong>A total of 145 participants with RA were included, with a mean age of 64.5 (SD 11.6) years, and were predominantly male (74%). Using SLUMS, 42 participants (29%) had normal cognition, 83 (57%) had mild cognitive impairment, and 20 (14%) had dementia. Physical performance (aβ: 0.35, confidence interval [CI] 0.11 to 0.59), self-reported exhaustion (aβ: -2.22, CI -3.44 to -0.99), pain (aβ: -0.25, CI -0.50 to -0.00), disability (aβ: -1.79, CI -3.16 to -0.42), and trouble falling asleep (aβ: -2.57, CI -4.00 to -1.14) were all independently associated with a lower SLUMS score (all P < 0.05).</p><p><strong>Conclusion: </strong>Cognitive impairment was prevalent in our cohort of veterans with RA and was associated with several modifiable clinical factors. Future longitudinal studies are needed to determine the directionality of these associations and evaluate interventions for modifiable risk factors that may mitigate cognitive dysfunction.</p>","PeriodicalId":8406,"journal":{"name":"Arthritis Care & Research","volume":" ","pages":"591-600"},"PeriodicalIF":3.3,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12710508/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145375844","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}