Arthritis Care & Research最新文献

{"title":"Temporal Trends and Short- and Long-Term Mortality of People With Acute Myocardial Infarction and Rheumatoid Arthritis: A Nationwide Cohort Study","authors":"Megan Butler,&nbsp;Nicholas Weight,&nbsp;Muhammad Rashid,&nbsp;Rodrigo Bagur,&nbsp;Purvi Parwani,&nbsp;Samantha Hider,&nbsp;Edward Roddy,&nbsp;Robert Butler,&nbsp;Mamas A. Mamas","doi":"10.1002/acr.70009","DOIUrl":"10.1002/acr.70009","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>We investigated whether a diagnosis of rheumatoid arthritis (RA) affects the quality of inpatient acute myocardial infarction (AMI) care and long-term mortality post-AMI.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We analyzed data from 784,091 adults, 6,047 with a diagnosis of RA, from England and Wales hospitalized with AMI between 2005 and 2019 from the Myocardial Ischaemia National Audit Project registry, linked with Office for National Statistics mortality data and hospital episode statistics. Cox regression models were used to compare risk of all-cause mortality at different time points according to the presence of RA.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>There was no difference in adjusted 30-day mortality between groups (adjusted hazard ratio [aHR] 1.09, 95% confidence interval [CI] 0.99–1.19; <i>P</i> = 0.075). Beyond this, at 1 year (aHR 1.14, 95% CI 1.07–1.21), 5 years, (aHR 1.28, 95% CI 1.23–1.33), and to the end of the study period (aHR 1.31, 95% CI 1.26–1.36), the risk of all-cause mortality was significantly higher in patients with RA (all <i>P</i> &lt; 0.001). Risk of cardiovascular mortality was not significantly different at 30 days or 1 year (aHR 1.08, 95% CI 1.00–1.17; <i>P</i> = 0.058), but it was at 5 years (aHR 1.15, 95% CI 1.08–1.23; <i>P</i> &lt; 0.001) and to the study endpoint post-AMI (aHR 1.18, 95% CI 1.11–1.24; <i>P</i> &lt; 0.001).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>We found no meaningful disparities in inpatient care according to the presence of RA; however, those with RA have elevated long-term all-cause mortality post-AMI. Our findings suggest that the mortality burden of RA post-AMI is not driven by the quality of AMI care during admission and is likely driven by the progressive nature of the comorbidities and the complications of treatments associated with RA.</p>\u0000 \u0000 <div>\u0000 <figure>\u0000 <div><picture>\u0000 <source></source></picture><p></p>\u0000 </div>\u0000 </figure>\u0000 </div>\u0000 </section>\u0000 </div>","PeriodicalId":8406,"journal":{"name":"Arthritis Care & Research","volume":"78 7","pages":"850-859"},"PeriodicalIF":4.1,"publicationDate":"2026-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/acr.70009","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145755066","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":"Disabilities and Generative Artificial Intelligence Education in Rheumatology Fellowship: Educational Module and Simulation Exercise","authors":"Sana G. Cheema,&nbsp;Matthew A. Sullivan,&nbsp;Emily Balczewski,&nbsp;Amanda S. Alexander,&nbsp;Anisha B. Dua,&nbsp;Lacey Feigl-Lenzen,&nbsp;Brian Jaros,&nbsp;Jason Kolfenbach,&nbsp;Nicholas Kortan,&nbsp;Lisa Zickuhr","doi":"10.1002/acr.70006","DOIUrl":"10.1002/acr.70006","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>People with rheumatic and musculoskeletal diseases (RMDs) can acquire disabilities that affect their participation in work and school. Generative artificial intelligence (genAI) may reduce documentation time, providing a tool for providers to efficiently write letters for accommodation and maximally advocate for people with disabilities. Therefore, fellows-in-training (FITs) must develop skills in disability advocacy and genAI for clinical care. We created an online module and simulation activity in which FITs wrote letters for accommodation using genAI. We aimed to improve FITs’ confidence implementing these skills and to identify areas needing further instruction.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>FITs completed an online module and simulation activity engineering genAI prompts for letters for accommodation. Educators scored FITs’ skills against a rubric. FITs measured their confidence conducting these skills in retrospective pre-post Likert scales that we compared with Wilcoxon signed rank tests.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Twenty-three FITs participated; 18 FITs (78.6%) completed the Likert scales. On average, FITs scored 83.83% against the rubric. The strongest skill was engineering genAI prompts (95.45%), and the lowest was differentiating the scope of practice between rheumatology providers and disabilities professionals coordinating accommodations (74.55%). FITs’ confidence significantly improved across all objectives, most notably in engineering genAI prompts and finalizing letters drafted with genAI (<i>P</i> &lt; 0.0001).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Our educational materials teach FITs to incorporate genAI into writing letters for accommodation and addressing disparities from medical disabilities. Such skill development prepares FITs to enter the rheumatology workforce confident in their abilities to integrate genAI into clinical activities and deliver care to people with disabilities from RMDs.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8406,"journal":{"name":"Arthritis Care & Research","volume":"78 7","pages":"899-904"},"PeriodicalIF":4.1,"publicationDate":"2026-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145740561","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 Between Social Risk Factors and Acute-Care Use Among Patients With Rheumatic Conditions.","authors":"Haelynn Gim, Leah Santacroce, Rebecca Summit, Karli Retzel, Virginia Bills, Nancy A Shadick, Sara Schoenfeld, Candace H Feldman","doi":"10.1002/acr.80110","DOIUrl":"10.1002/acr.80110","url":null,"abstract":"<p><strong>Objective: </strong>Patients with social risk factors are more likely to have poorer health outcomes. We examined associations between social risk factors and acute-care use (emergency department [ED] visits and hospitalizations) among patients with rheumatic conditions.</p><p><strong>Methods: </strong>We identified patients with International Classification of Diseases, Tenth Revision, codes for rheumatic conditions on at least two encounters receiving rheumatology care at a multihospital system who completed social risk factor screening. We used negative binomial models, adjusted for sociodemographics and comorbidities, to estimate incidence rates and incidence rate ratios (IRRs) for ED visits and hospitalizations, as well as preventable ED visits, by social risk factor presence.</p><p><strong>Results: </strong>Among 9,590 patients, 1,614 (17%) reported at least one social risk factor. Adjusted models revealed higher rates of ED visits (IRR 1.74, 95% confidence interval [CI] 1.53-1.98) and hospitalizations (IRR 1.96, 95% CI 1.60-2.43) among patients with versus without social risk factors. Food insecurity, housing insecurity, transportation challenges, difficulties with medication costs, utility bill needs, education needs, and caregiving needs were each individually associated with higher rates of ED visits and hospitalizations. Unemployment was associated with higher rates of ED visits only; digital access needs were associated with higher rates of hospitalizations only. We found no association between the presence versus absence of social risk factors and rates of preventable ED visits.</p><p><strong>Conclusion: </strong>Among patients with rheumatic conditions, social risk factor presence was associated with higher rates of acute-care use but not with preventable ED visits. Further studies are needed to determine whether addressing social risk factors can alter care use patterns.</p>","PeriodicalId":8406,"journal":{"name":"Arthritis Care & Research","volume":" ","pages":""},"PeriodicalIF":4.1,"publicationDate":"2026-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148343578","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":"Detection of Lung Abnormalities in Patients With Rheumatoid Arthritis Who Smoke and Who Were Screened for Lung Cancer With Low-Dose Chest Computed Tomography Imaging in Routine Clinical Care: Results From a Large Multihospital System","authors":"Gregory C. McDermott,&nbsp;Mark Hammer,&nbsp;Xiaosong Wang,&nbsp;Misti L. Paudel,&nbsp;Sung Hae Chang,&nbsp;Pierre-Antoine Juge,&nbsp;Qianru Zhang,&nbsp;Jessica Lorusso,&nbsp;Amie Samuylov,&nbsp;Kathleen M. M. Vanni,&nbsp;Alene Saavedra,&nbsp;Emily N. Kowalski,&nbsp;Grace Qian,&nbsp;Katarina J. Bade,&nbsp;Kevin T. Mueller,&nbsp;Jeffrey A. Sparks,&nbsp;Suzanne Byrne","doi":"10.1002/acr.25680","DOIUrl":"10.1002/acr.25680","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Rheumatoid arthritis (RA) is associated with interstitial lung disease, bronchiectasis, rheumatoid lung nodules, and lung cancer. Recent guidelines proposed criteria for lung disease screening in RA, but the prevalence of abnormal lung findings in patients with RA is unknown.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Among all patients screened for lung cancer with low-dose chest computed tomography (CT) in the Mass General Brigham health care system between 2015 and 2023, we identified patients with and without RA. We compared the prevalence of lung nodules, “positive screen” (nodules requiring further imaging or biopsy), fibrotic lung changes, bronchiectasis, and lung cancer between patients with RA and comparators without RA using multivariable logistic regression.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among consecutive patients screened for lung cancer with clinically indicated low-dose chest CT, we identified 228 patients with RA and 14,805 comparators without RA. “Positive screens” were noted in 26.8% of patients with RA and 22.2% of patients without RA (<i>P</i> = 0.10). Lung cancer was found in 4.8% of patients with RA and 3.6% of patients without RA (<i>P</i> = 0.33). In multivariable models, RA was associated with positive screen (odds ratio [OR] 1.38, 95% confidence interval [CI] 1.02–1.87), fibrotic lung changes (OR 1.77, 95% CI 1.08–2.91), and bronchiectasis (OR 1.64, 95% CI 1.12–2.39).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Patients with RA had higher prevalence of positive screening, fibrotic changes, and bronchiectasis detected by low-dose chest CT performed for lung cancer screening. Approximately one in four patients with RA who met US Preventive Services Task Force lung cancer screening criteria had a positive screen, whereas 1 in 20 had lung cancer. These results emphasize the importance of lung cancer screening among eligible patients with RA and may inform screening strategies for other lung abnormalities.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8406,"journal":{"name":"Arthritis Care & Research","volume":"78 7","pages":"843-849"},"PeriodicalIF":4.1,"publicationDate":"2026-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145375797","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":"A Qualitative Analysis of Patient Perspectives and Preferences in Lupus Management to Guide Lupus Guidelines Development","authors":"Shivani Garg,&nbsp;Izzy Hartel,&nbsp;Lisa R. Sammaritano,&nbsp;Anca Askanase,&nbsp;Bonnie L. Bermas,&nbsp;Maria Dall'Era,&nbsp;Alí Duarte-García,&nbsp;Victoria P. Werth,&nbsp;Brad Rovin,&nbsp;Reem A. Mustafa,&nbsp;Amy S. Turner,&nbsp;Bené Williams,&nbsp;Brian L. Ung,&nbsp;Hiya Bhavsar,&nbsp;Monique C. Gore-Massy,&nbsp;Nahirannette Pulido,&nbsp;Natacha Guerrero,&nbsp;Natalie M. Smith,&nbsp;Wambui Machua,&nbsp;Linda T. Hiraki,&nbsp;Mary Beth Son","doi":"10.1002/acr.25693","DOIUrl":"10.1002/acr.25693","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>A patient-centered approach for chronic disease management, including systemic lupus erythematosus (SLE), aligns treatment with patients’ values and preferences, leading to improved outcomes. This paper summarizes how patient experiences, perspectives, and priorities informed the American College of Rheumatology (ACR) 2024 Lupus Nephritis (LN) and 2025 SLE screening, treatment guidelines.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We completed a cross-sectional qualitative study using content analysis of two Patient Panel meetings for the ACR LN and SLE guidelines. Key themes were presented by Patient Panel representatives during Voting Panel Meetings along with evidence for each recommendation, to ensure comprehensive discussions and align treatment recommendations with patients’ priorities and values.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Nineteen people (90% women) with diagnoses of SLE and/or LN participated in the Patient Panels and 17 consented to use their feedback for analysis. Thematic analysis of their discussions revealed nine patient-reported key themes in three domains: (1) treatment and monitoring of LN and SLE: medication side effects, daily function, treatment goals, and monitoring and screening; (2) clinical communication: strategies to optimize communication and provider and structural impediments to effective communication; and (3) improving transparency and information sharing: clinical trial participation, and medical costs and insurance coverage. These themes were actively incorporated into discussions during the Voting Panels for the ACR LN and SLE guidelines.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This work supported the integration of patient experiences in the clinical practice guideline development process and aligned recommendations with real-world patient experiences and priorities, thereby enhancing the clinical applicability of the ACR LN and SLE guidelines.</p>\u0000 \u0000 <div>\u0000 <figure>\u0000 <div><picture>\u0000 <source></source></picture><p></p>\u0000 </div>\u0000 </figure>\u0000 </div>\u0000 </section>\u0000 </div>","PeriodicalId":8406,"journal":{"name":"Arthritis Care & Research","volume":"78 7","pages":"925-935"},"PeriodicalIF":4.1,"publicationDate":"2026-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/acr.25693","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145436827","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":"Clinical Practice Guideline for Evaluation and Management of Peripheral Nervous System Manifestations in Sjögren's Disease","authors":"Anahita Deboo MD,&nbsp;Robert Fox MD, PhD,&nbsp;Katherine M. Hammitt MA,&nbsp;Julie Frantsve-Hawley PhD,&nbsp;Matthew C. Baker MD, MS,&nbsp;Stamatina Danielides MD,&nbsp;Eduardo De Sousa MD,&nbsp;Brent P. Goodman MD,&nbsp;Jennifer K. King MD, PhD,&nbsp;Steven Mandel MD,&nbsp;Ghaith Noaiseh MD,&nbsp;Pantelis P. Pavlakis MD, PhD,&nbsp;George Sarka MD, DrPH,&nbsp;R. Hal Scofield MD,&nbsp;Arun Varadhachary MD, PhD,&nbsp;Daniel J. Wallace MD,&nbsp;Matt Makara MPH,&nbsp;Nancy Carteron MD,&nbsp;Steven Carsons MD,&nbsp;in collaboration with the Consensus Expert Panel (CEP) members","doi":"10.1002/acr.70004","DOIUrl":"10.1002/acr.70004","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Sjögren's disease is an autoimmune disorder that can impact multiple organ systems, including the peripheral nervous system (PNS). PNS manifestations, which can exist concurrently, include mononeuropathies, polyneuropathies, and autonomic nervous system neuropathies. To help patients and providers in the decision-making process, we developed an evidence-based clinical practice guideline for the evaluation and management of PNS manifestations in patients with Sjögren's disease.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A Topic Review Group, comprising experts in rheumatology, neurology, and guideline methodology, developed Patient, Intervention, Comparison, and Outcome questions and conducted a systematic review to identify the current best evidence on management of PNS manifestations of Sjögren's disease. PubMed and Embase were searched for evidence published up to July 22, 2025. Literature screening, data extraction, and critical appraisal were performed in duplicate. Six case series, one retrospective cohort, and two prospective cohort studies lacking a comparison group met the inclusion criteria.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>We developed an aligned nomenclature of PNS terms that can be used across disciplines, 31 good practices for evaluation of suspected PNS manifestations, and 20 evidence-based treatment recommendations, the latter of which were rated as conditional or strong based on the Grading of Recommendations Assessment, Development, and Evaluation methodology. Because of the scarcity of high-level evidence, this guideline predominantly derives from expert opinion.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This clinical practice guideline on PNS manifestations of Sjögren's disease provides clinicians a rigorous, evidence-based resource, developed through an expert consensus-based process, for the assessment, diagnosis, and treatment of peripheral neuropathy in patients with Sjögren's disease. Recommendations were rated as strong when the benefits significantly outweighed potential harms, creating a scenario in which most patients would prefer the advised action.</p>\u0000 \u0000 <div>\u0000 <figure>\u0000 <div><picture>\u0000 <source></source></picture><p></p>\u0000 </div>\u0000 </figure>\u0000 </div>\u0000 </section>\u0000 </div>","PeriodicalId":8406,"journal":{"name":"Arthritis Care & Research","volume":"78 7","pages":"860-874"},"PeriodicalIF":4.1,"publicationDate":"2026-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/acr.70004","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145653265","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":"2025 American College of Rheumatology (ACR) Guideline for the Treatment of Systemic Lupus Erythematosus","authors":"Lisa R. Sammaritano,&nbsp;Anca Askanase,&nbsp;Bonnie L. Bermas,&nbsp;Maria Dall'Era,&nbsp;Alí Duarte-García,&nbsp;Linda T. Hiraki,&nbsp;Mary Beth F. Son,&nbsp;Victoria P. Werth,&nbsp;Cynthia Aranow,&nbsp;April Barnado,&nbsp;Anna Broder,&nbsp;Hermine I. Brunner,&nbsp;Benjamin F. Chong,&nbsp;Vaidehi R. Chowdhary,&nbsp;Aimee O. Hersh,&nbsp;Peter M. Izmirly,&nbsp;Marimee Jules,&nbsp;Kenneth Kalunian,&nbsp;Diane Kamen,&nbsp;Tamar B. Rubinstein,&nbsp;Benjamin J. Smith,&nbsp;Natalie M. Smith,&nbsp;Asha Thomas,&nbsp;Homa Timlin,&nbsp;Daniel J. Wallace,&nbsp;Muayad Azzam,&nbsp;Christie M. Bartels,&nbsp;Joanne S. Cunha,&nbsp;Kimberly DeQuattro,&nbsp;Andrea Fava,&nbsp;Gabriel Figueroa-Parra,&nbsp;Shivani Garg,&nbsp;Lais Lopes Almeida Gomes,&nbsp;Maria C. Cuéllar-Gutiérrez,&nbsp;Priyanka Iyer,&nbsp;Andrew S. Johannemann,&nbsp;April Jorge,&nbsp;Shanthini Kasturi,&nbsp;Hassan Kawtharany,&nbsp;Jana Khawandi,&nbsp;Alexandra Legge,&nbsp;Kimberly P. Liang,&nbsp;Megan M. Lockwood,&nbsp;Alain Sanchez-Rodriguez,&nbsp;Marat Turgunbaev,&nbsp;Jessica N. Williams,&nbsp;Amy S. Turner,&nbsp;Reem A. Mustafa","doi":"10.1002/acr.25690","DOIUrl":"10.1002/acr.25690","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To provide evidence-based and expert guidance for the treatment and management of non-renal systemic lupus erythematosus (SLE); treatment and management of lupus nephritis are addressed in a separate guideline.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Clinical questions for treatment and management of SLE were developed in the PICO format (population, intervention, comparator, and outcome). Systematic literature reviews were developed for each PICO question, and the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) methodology was used to assess evidence quality and formulate recommendations. The Voting Panel achieved a consensus of ≥70% agreement on the direction (for or against) and strength (strong or conditional) of each recommendation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>We present recommendations and ungraded, consensus-based good practice statements for the treatment and management of SLE that are applicable to pediatric and adult patients. Recommendations emphasize uniform treatment with hydroxychloroquine, limiting duration of glucocorticoid use, and early introduction of conventional and/or biologic immunosuppressive therapies to achieve and maintain control of SLE inflammation (remission or a low level of disease activity), reduce SLE-related morbidity and mortality, and minimize medication-related toxicities.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This guideline presents direction regarding treatment and management of SLE and provides a foundation for well-informed, shared clinician–patient decision-making. These recommendations should not be used to limit or deny access to therapies, as treatment decisions may vary due to the unique clinical situation and personal preferences of each person with SLE.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8406,"journal":{"name":"Arthritis Care & Research","volume":"78 7","pages":"815-839"},"PeriodicalIF":4.1,"publicationDate":"2026-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/acr.25690","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145436813","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":"Diagnostic Use of Testing for Novel Murine Autoantibodies for Sjögren Disease in the Rheumatology Outpatient Setting","authors":"Chadwick R. Johr,&nbsp;Michael D. George,&nbsp;Vatinee Y. Bunya,&nbsp;Nora Sandorfi,&nbsp;Mina Massaro-Giordano,&nbsp;Frederick B. Vivino","doi":"10.1002/acr.70005","DOIUrl":"10.1002/acr.70005","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>The goal was to assess the diagnostic performance of three novel autoantibodies (NA) for Sjögren disease (SjD) by comparing NA prevalence in patients with SjD, other autoimmune rheumatic diseases (ARDs), nonspecific chronic sialadenitis (CS), and controls.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We identified rheumatology outpatients with confirmed SjD, systemic lupus erythematosus (SLE), rheumatoid arthritis (RA), systemic sclerosis (SSc), CS, and healthy controls. Participants underwent serum testing for antibodies to salivary gland protein 1 (SP-1), parotid secretory protein, and carbonic anhydrase-6 (CA-6). Participants with SjD, CS, and controls also underwent testing of saliva. Receiver operating characteristic (ROC) curve C-statistics along with sensitivity, specificity, positive, and negative likelihood ratios were calculated for each serum autoantibody for SjD vs CS or controls.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among the 468 patients screened, 444 were analyzed, including cohorts with SjD (n = 149), SLE (n = 70), SSc (n = 56), RA (n = 73), CS (n = 31), and control patients (n = 65). There was no statistical difference (<i>P</i> = 0.80) in the presence of one or more NA in the serum of patients with SjD compared with participants with other ARDs, CS, or control patients. ROC curves demonstrated poor discriminative ability for SjD versus CS or control patients for any positive NA (0.47) or any individual NA (range 0.44–0.53). The positive likelihood ratio for having any positive novel autoantibody was 1.04 and 0.83 for SjD vs CS or control patients, respectively.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Testing serum for NA demonstrated a poor ability to distinguish patients with SjD from control patients or those with CS or other ARDs. This serum autoantibody panel is not likely to be useful as a diagnostic test for SjD.</p>\u0000 \u0000 <div>\u0000 <figure>\u0000 <div><picture>\u0000 <source></source></picture><p></p>\u0000 </div>\u0000 </figure>\u0000 </div>\u0000 </section>\u0000 </div>","PeriodicalId":8406,"journal":{"name":"Arthritis Care & Research","volume":"78 7","pages":"875-882"},"PeriodicalIF":4.1,"publicationDate":"2026-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/acr.70005","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145628238","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":"Methodologic and conceptual limitations in moderator and mediator analyses of knee osteoarthritis trials: comment on the article by Farivar et al","authors":"Yao Liu,&nbsp;DuJiang Yang,&nbsp;GuoYou Wang","doi":"10.1002/acr.70014","DOIUrl":"10.1002/acr.70014","url":null,"abstract":"","PeriodicalId":8406,"journal":{"name":"Arthritis Care & Research","volume":"78 7","pages":""},"PeriodicalIF":4.1,"publicationDate":"2026-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145740573","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":"Sex Differences in Medication Discontinuation in Axial Spondyloarthritis","authors":"Rachael Stovall,&nbsp;Cinthia Blat,&nbsp;Eric Roberts,&nbsp;Jean W. Liew,&nbsp;Katherine Wysham,&nbsp;Namrata Singh,&nbsp;Janna Friedly,&nbsp;Lianne S. Gensler,&nbsp;Gabriela Schmajuk,&nbsp;Jinoos Yazdany","doi":"10.1002/acr.70001","DOIUrl":"10.1002/acr.70001","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>We examined sex differences in medication discontinuation among patients with axial spondyloarthritis (axSpA) initiating tumor necrosis factor inhibitors (TNFi), interleukin-17 inhibitors (IL-17i), or JAK inhibitors (JAKi).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Using data from the Rheumatology Informatics System for Effectiveness (RISE) Registry (2003–2025), we assessed medication discontinuation by sex among new users of TNFi, IL-17i, and JAKi. Cox regression models were used to evaluate associations between sex and treatment discontinuation, adjusting for sociodemographic and clinical factors. We also examined medication continuation by sex and age group (18–64 vs ≥65 years) using Kaplan-Meier curves and tested for interactions between sex and age, race, and area deprivation index (ADI).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among 7,200 individuals, the mean ± SD age was 52.7 ± 14.7 years; 58.3% were female and 68.7% were non-Hispanic White. Among TNFi users (N = 6,256), women had a 24% higher risk of discontinuation compared to men (hazard ratio [HR]: 1.24; 95% confidence interval [CI]: 1.16–1.32). Among IL-17i users (n = 693), women had a 25% higher risk of discontinuation (HR: 1.25; 95% CI: 1.01–1.54). No significant sex differences were observed among JAKi users (N = 251). Among TNFi users, women under 65 years had the lowest probability of treatment continuation. There was no statistically significant interaction between sex and age, race or ADI.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>In a large US registry, women with axSpA were more likely to discontinue TNFi and IL-17i than men. Larger studies with longer follow-up since treatment approval are needed to confirm the lack of sex differences in JAKi discontinuation as this group could be underpowered.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8406,"journal":{"name":"Arthritis Care & Research","volume":"78 7","pages":"914-924"},"PeriodicalIF":4.1,"publicationDate":"2026-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/acr.70001","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145653179","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}