Arthritis Care & Research最新文献

{"title":"Patients improve, patterns persist: longitudinal stability of RA joint involvement patterns.","authors":"Tjardo Maarseveen, Yasuo Nagafuchi, Kristina Lend, Seyam Alemyar, Herman Kasper Glas, Gerdur Gröndal, Bjorn Gudbjornsson, Espen A Haavardsholm, Kim Hørslev Petersen, Jon Lampa, Merete Lund Hetland, Dan Nordström, Mike Nurmohamed, Mikkel Østergaard, Anna Rudin, Marte Schrumpf Heiberg, Tuulikki Sokka-Isler, Till Uhlig, Josien Veris-van Dieren, Ronald van Vollenhoven, Tom Huizinga, Marcel Jt Reinders, Sytske Anne Bergstra, Erik van den Akker, Rachel Knevel","doi":"10.1002/acr.80174","DOIUrl":"https://doi.org/10.1002/acr.80174","url":null,"abstract":"<p><strong>Objective: </strong>Rheumatoid arthritis is a heterogeneous disease. Data-driven approaches, from synovial histology to joint involvement patterns (JIPs), have sought to define clinically meaningful subgroups. Whether these subgroups represent stable phenotypes or transient disease states remains unclear. We aimed to develop a novel analytical method to measure longitudinal stability of these subsets.</p><p><strong>Methods: </strong>We analyzed two randomized controlled trials, NORD-STAR (NOrdic Rheumatic Diseases Strategy Trials And Registries; n=630), BeSt (Behandel-Strategieën, n=445) and one real-world cohort (Reumazorg Zuidwest Nederland (RZWN), n=252), all treated with DMARDs under a treat-to-target strategy. Patients were assigned to previously defined JIP-subgroups based on shared clinical features. Disease progression was then tracked over one year along the two principal axes of JIP variation: overall severity (oligoarticular vs. polyarticular) and anatomical distribution (hand vs. foot). Longitudinal stability was assessed by measuring how phenotypically similar each patient remained to others sharing their initial joint pattern, quanitified using silhouette-like scores.</p><p><strong>Results: </strong>Effective treatment led to convergence toward mild disease. Nevertheless, patients sharing similar baseline JIPs maintained clustering together over time significantly more than expected by chance in BeSt (P=0.018-0.038), NORD-STAR (P=0.004-0.017), and RZWN (P<0.001), except for JIP-poly in BeSt and JIP-oligo in NORD-STAR. When stratifying by anatomical region, we found that improvement in foot involvement lagged behind hand involvement across trials.</p><p><strong>Conclusion: </strong>Patients with similar baseline joint involvement patterns maintain phenotypic similarity over time, suggesting JIP subgroups reflect distinct, stable phenotypes rather than transient disease states. Our tool is available to study the longitudinal stability of any subset.</p>","PeriodicalId":8406,"journal":{"name":"Arthritis Care & Research","volume":" ","pages":""},"PeriodicalIF":4.1,"publicationDate":"2026-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149103402","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":"Positive Affect Is Associated With Better Physical Function in Early Rheumatoid Arthritis.","authors":"Burcu Aydemir, Jing Song, Lutfiyya N Muhammad, Wendy Marder, Kevin Deane, Clifton Bingham, Lisa A Mandl, Robert Edwards, Judith T Moskowitz, Yvonne C Lee","doi":"10.1002/acr.80182","DOIUrl":"10.1002/acr.80182","url":null,"abstract":"<p><strong>Objective: </strong>This study examined the association between positive affect and physical function in individuals with early rheumatoid arthritis (RA).</p><p><strong>Methods: </strong>We analyzed baseline data from 129 adults with early RA (persistent joint symptoms for ≤24 months) and active disease enrolled in the Central Pain in RA 2 (CPIRA-2) study. Patient-reported outcome measures assessed positive affect (using the positive affect subscale of the Positive and Negative Affect Schedule), physical function, pain intensity, and other psychological factors. We constructed linear regression models to estimate unadjusted and adjusted cross-sectional associations between positive affect and physical function. Adjusted models controlled for age, sex, body mass index, swollen joint count, symptom duration, pain intensity, and depression. Further analyses were conducted to evaluate whether pain intensity modified the relationship between positive affect and physical function.</p><p><strong>Results: </strong>Greater self-reported positive affect (β for every five-unit increase = 1.4, P = 0.002) was associated with better physical function independent of pain intensity and depressive symptoms. In additional analyses, pain intensity significantly modified this relationship (interaction β = -0.5, P = 0.001), and the positive association between positive affect and physical function weakened as pain intensity increased. Findings remained consistent when controlling for alternative negative affect measures (pain catastrophizing and anxiety) in place of depression.</p><p><strong>Conclusion: </strong>Positive affect was independently associated with self-reported physical function in early RA, suggesting that resilience-related psychological processes may contribute to functional outcomes during the early stages of disease. Interventions targeting positive emotional well-being may complement RA treatment approaches aimed at preserving and improving physical function.</p>","PeriodicalId":8406,"journal":{"name":"Arthritis Care & Research","volume":" ","pages":""},"PeriodicalIF":4.1,"publicationDate":"2026-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149103375","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":"Patient and Clinician Perspectives on Physical Therapy Use in Contemporary Rheumatology Care for Rheumatoid Arthritis in the United States: A Qualitative Study.","authors":"Joel R Thompson, Sharita R Thomas, Jason A Sharpe, Kelli Allen, Beth Jonas, Patti Katz, Louise M Thoma","doi":"10.1002/acr.80181","DOIUrl":"10.1002/acr.80181","url":null,"abstract":"<p><strong>Objective: </strong>Physical therapy (PT) can address functional limitations common in rheumatoid arthritis (RA) yet remains inconsistently used in rheumatology care. The purpose of this study was to explore how PT is used in routine RA care in the United States from the perspectives of patients, rheumatology clinicians, and physical therapists.</p><p><strong>Methods: </strong>We conducted a qualitative study using semistructured interviews with adults with RA (n = 24), rheumatology clinicians (n = 6), and physical therapists (n = 6) with diverse experiences. Interviews were analyzed using reflexive thematic analysis to identify key themes related to PT use across the care pathway.</p><p><strong>Results: </strong>Four themes emerged illustrating barriers to effective use of PT in RA care: first, recognizing the need for PT. Rheumatology clinicians often prioritized pharmacological management and reserved PT for later disease stages or severe functional decline, whereas patients described a desire for earlier, preventive PT. Discussion of PT: clinicians and patients reported limited discussion of PT, with conversations often occurring late in disease management and PT seen as a \"last resort.\" Interprofessional collaboration and training challenges: gaps in knowledge, interprofessional communication, and referral processes among rheumatology clinicians and limited rheumatology exposure among physical therapists impeded PT use. Use of PT: logistical challenges (cost, travel, and time), concerns about pain and adherence, and limited availability of rheumatology-focused PT clinics were barriers to use.</p><p><strong>Conclusion: </strong>Across participant accounts, PT was described as inconsistently used in routine RA care and often considered reactively. Participants described misalignment in clinician perspectives, limited communication, and inconsistent care processes as contributing to early breakdowns in the care pathway and delayed or unrealized PT access.</p>","PeriodicalId":8406,"journal":{"name":"Arthritis Care & Research","volume":" ","pages":""},"PeriodicalIF":4.1,"publicationDate":"2026-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149103364","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":"Reply.","authors":"Tracy M Frech, Charles G Frech, W David Merryman, Andrew Sternlicht, Justin Baba","doi":"10.1002/acr.80176","DOIUrl":"https://doi.org/10.1002/acr.80176","url":null,"abstract":"","PeriodicalId":8406,"journal":{"name":"Arthritis Care & Research","volume":" ","pages":""},"PeriodicalIF":4.1,"publicationDate":"2026-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149103343","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":"Correlation is not agreement: the discordance threshold for patient and physician global assessments in systemic sclerosis requires reliability-based validation: comment on the article by Romich et al.","authors":"Hefziba Lorences-Noguera, Esteban Cardenas-Duran","doi":"10.1002/acr.80179","DOIUrl":"https://doi.org/10.1002/acr.80179","url":null,"abstract":"","PeriodicalId":8406,"journal":{"name":"Arthritis Care & Research","volume":" ","pages":""},"PeriodicalIF":4.1,"publicationDate":"2026-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149103384","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":"Maybe, sometimes, the doctor really knows best: prevention of pain due to secondary Raynaud phenomenon: comment on the article by Frech et al.","authors":"Michael R Bubb","doi":"10.1002/acr.80175","DOIUrl":"https://doi.org/10.1002/acr.80175","url":null,"abstract":"","PeriodicalId":8406,"journal":{"name":"Arthritis Care & Research","volume":" ","pages":""},"PeriodicalIF":4.1,"publicationDate":"2026-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149103369","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":"Identifying Incident Medication-Related Osteonecrosis of the Jaw and Antiresorptive Drug Holidays Using Natural Language Processing on Clinical Notes in Men and Women Prescribed Bisphosphonates or Denosumab for Fracture Prevention.","authors":"Emily Budde, Rachel E Elam, Laura D Carbone, Brian Le, Thomas B Dodson, Peter J Gerngross, Howard A Fink, Robert A Adler, Joan C Lo, John T Schousboe, Frances Weaver, Dezon Finch","doi":"10.1002/acr.80173","DOIUrl":"10.1002/acr.80173","url":null,"abstract":"<p><strong>Objective: </strong>Medication-related osteonecrosis of the jaw (MRONJ) is a rare complication of antiresorptive therapy for osteoporosis, with risk potentially influenced by \"drug holidays\" around dentoalveolar procedures. MRONJ risk is higher in rheumatic diseases. Epidemiologic studies are limited by poor administrative code performance for MRONJ identification and lack of structured pharmacy data capturing drug holidays. We developed and validated a natural language processing (NLP) algorithm to classify MRONJ and detect drug holidays from free-text clinical notes in electronic health records (EHRs).</p><p><strong>Methods: </strong>Using US Veterans Health Administration EHRs, we identified adults aged ≥50 years old with at least one filled prescription for a bisphosphonate or denosumab for fracture prevention (October 1, 1999, to December 31, 2022). An NLP codebook defined 11 targets with 16 attributes. Two annotators independently labeled notes to create a reference set (n = 870; 200 held out for validation) and an independent validation set (n = 100) for performance assessment (precision, recall, and F-measure). A decision tree-based machine-learning model used NLP-extracted features to classify MRONJ. Drug holiday was an NLP target directly.</p><p><strong>Results: </strong>The reference set included 6,421 annotations, informing a curated vocabulary of >1,350 terms. For MRONJ classification excluding unclassifiable outputs across all validation notes, precision was 1.00 (95% confidence interval [CI] 0.86-1.00), recall 0.96 (95% CI 0.80-1.00), and F-measure 0.95 (95% CI 0.88-1.00). For drug holiday detection in the held-out validation set, precision was 0.90 (95% CI 0.83-0.95), recall 0.98 (95% CI 0.93-1.00), and F-measure 0.94.</p><p><strong>Conclusion: </strong>We developed an NLP algorithm that is sufficiently accurate in classifying MRONJ and detecting drug holidays to be a promising tool for future studies, including in people with rheumatic diseases.</p>","PeriodicalId":8406,"journal":{"name":"Arthritis Care & Research","volume":" ","pages":""},"PeriodicalIF":4.1,"publicationDate":"2026-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13660422/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149103396","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":"Cumulative Social Disadvantage and Disease Activity in Juvenile Idiopathic Arthritis: A Childhood Arthritis and Rheumatology Research Alliance Registry Study.","authors":"William Daniel Soulsby, John Boscardin, Andrea Knight, Daniel B Horton, Karine Toupin-April, Emily von Scheven","doi":"10.1002/acr.80051","DOIUrl":"10.1002/acr.80051","url":null,"abstract":"<p><strong>Objective: </strong>Social determinants of health (SDOH) contribute to juvenile idiopathic arthritis (JIA) disparities, but most studies have assessed SDOH independently rather than cumulatively across individual, family, and neighborhood levels. Using a socioecological framework, we investigated the relationship among cumulative social disadvantage, neighborhood disadvantage, and JIA disease activity.</p><p><strong>Methods: </strong>We conducted a retrospective cohort study using the Childhood Arthritis and Rheumatology Research Alliance (CARRA) Registry (2015-2022). Individual- and family-level SDOH were combined into a cumulative social disadvantage score (range: 0-3), with one point each for public or no insurance, family income less than $50,000 per year, and guardian education of high school level or less. Neighborhood disadvantage was measured using Area Deprivation Index (quartiles). The primary outcome was active disease by clinical Juvenile Arthritis Disease Activity-10 (cJADAS-10). Mixed effects models were generated to assess associations adjusted for demographic and clinical covariates, and causal mediation analysis evaluated whether cumulative social disadvantage mediated the relationship between neighborhood disadvantage and disease activity.</p><p><strong>Results: </strong>Among 9,609 children with JIA with a median follow-up time of 2.1 (interquartile range 0.3-5.8) years, 39.1% had a cumulative social disadvantage score greater than 0 with higher scores correlating with greater neighborhood disadvantage. In adjusted analysis, cumulative social disadvantage was associated with higher odds of active disease (adjusted odds ratio 2.10, 95% confidence interval [CI] 1.73-2.53 for a score of 3 vs 0). A total of 87% (95% CI 38-100) of the effect of neighborhood disadvantage was mediated through cumulative social disadvantage.</p><p><strong>Conclusion: </strong>Cumulative social disadvantage is strongly associated with active JIA and mediates much of the effect of neighborhood disadvantage. Interventions addressing multilevel SDOH will be essential to reducing JIA health disparities.</p>","PeriodicalId":8406,"journal":{"name":"Arthritis Care & Research","volume":" ","pages":"1552-1563"},"PeriodicalIF":4.1,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13613256/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147608049","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":"Adverse Pregnancy Outcomes in Adult Patients With Idiopathic Inflammatory Myopathy: A Systematic Review and Meta-Analysis.","authors":"Yang Yang, Danli Meng, Rongxiu Huo, Yijia Huang, Xinxiang Huang, Jinying Lin","doi":"10.1002/acr.80048","DOIUrl":"10.1002/acr.80048","url":null,"abstract":"<p><strong>Objective: </strong>Studies of the impact of idiopathic inflammatory myopathy (IIM) and its pregnancy complications have yielded controversial results. The purpose of this study was to perform a systematic literature review and meta-analysis to evaluate the association between IIM and adverse pregnancy outcomes.</p><p><strong>Methods: </strong>PubMed, Embase, and Web of Science databases were searched to identify reports of interest. The databases were searched from establishment to May 15, 2025. Two investigators independently screened literature and extracted data according to inclusion and exclusion criteria. The Newcastle-Ottawa Scale was used for quality assessment. A random-effects model with inverse-variance weighting was selected to estimate the pooled odds ratio (OR) and 95% confidence interval (CI). Data analysis was performed using Review Manager 5.3.</p><p><strong>Results: </strong>This analysis included five population-based retrospective cohorts, predominantly comprising patients with dermatomyositis or polymyositis; thus, the pooled estimates primarily reflect these subtypes. Compared to pregnant patients without IIM, patients with IIM had significantly higher risks of hypertensive disorders of pregnancy (OR 2.73 [95% CI 1.76-4.23]; I² = 70%, Cochran's Q P = 0.01, overall effect P < 0.00001) and cesarean section (OR 2.03 [95% CI 1.37-3.00]; I² = 79%, Cochran's Q P = 0.002, overall effect P = 0.004). Infants born to birthing parents with IIM also had notably higher rates of being born preterm (OR 3.71 [95% CI 2.35-5.85]; I² = 60%, Cochran's Q P = 0.06, overall effect P < 0.00001) and being small for gestational age or having intrauterine growth restriction (OR 1.90 [95% CI 1.03-3.51]; I² = 43%, Cochran's Q P = 0.15, overall effect P = 0.04).</p><p><strong>Conclusion: </strong>Our meta-analysis showed IIM to be associated with increased risk of hypertensive disorders of pregnancy, cesarean section, preterm birth, and infants who are small for gestational age or had intrauterine growth restriction, although residual confounding by disease activity and treatment may contribute.</p>","PeriodicalId":8406,"journal":{"name":"Arthritis Care & Research","volume":" ","pages":"1500-1509"},"PeriodicalIF":4.1,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147497629","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":"Limitations of ultrasonography in the assessment of aortic involvement in giant cell arteritis: comment on the article by Bull Haaversen et al.","authors":"Mahmut S Kaymakci, Haner Direskeneli, Amr H Sawalha","doi":"10.1002/acr.80062","DOIUrl":"10.1002/acr.80062","url":null,"abstract":"","PeriodicalId":8406,"journal":{"name":"Arthritis Care & Research","volume":" ","pages":"1574-1575"},"PeriodicalIF":4.1,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147670040","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}