Arthritis Care & Research最新文献

{"title":"Financial Distress and Its Determinants in Rheumatoid Arthritis.","authors":"Amber Brown Keebler, Yunju Im, Sofia Pedro, Ted R Mikuls, Edward S Peters, Kaleb Michaud","doi":"10.1002/acr.25670","DOIUrl":"10.1002/acr.25670","url":null,"abstract":"<p><strong>Objective: </strong>To quantify the degree of financial distress and identify its determinants in adults with rheumatoid arthritis (RA) given the frequent prolonged use of expensive disease-modifying therapies.</p><p><strong>Methods: </strong>We identified adults enrolled in the FORWARD databank with either RA or noninflammatory musculoskeletal disease (NIMSKD) completing the Functional Assessment of Chronic Illness Therapy-Comprehensive Score for Financial Toxicity (FACIT-COST) questionnaire. In this cross-sectional study, FACIT-COST was analyzed as a continuous (higher score indicates less financial distress) and binary variable (presence of financial distress with threshold <26). Least Absolute Shrinkage and Selection Operator (LASSO) was applied to linear and logistic regression to select covariates for inclusion in multivariable models.</p><p><strong>Results: </strong>Participants with RA (n = 2,277) had lower FACIT-COST scores, indicating greater financial distress, than those with NIMSKD (n = 1,340) (mean of 30.2 ± SD 9.4 vs mean of 34.0 ± SD 8.4; unadjusted P < 0.001). Assessed as a binary outcome, financial distress was more frequent in participants with RA than participants with NIMSKD (29% vs 15%; unadjusted P < 0.001). Differences in financial distress by diagnosis persisted following multivariable adjustment. Among those with RA, determinants identified in multivariable models included depression (adjusted odds ratio 1.12; 95% confidence interval 1.09-1.16) and disease severity.</p><p><strong>Conclusion: </strong>Financial distress is prevalent in adults with RA and appears to be greatest in those with comorbidities, specifically depression, identifying a potential area for intervention. Notably, expensive biologic or targeted synthetic disease-modifying antirheumatic drugs were not associated with FACIT-COST scores.</p>","PeriodicalId":8406,"journal":{"name":"Arthritis Care & Research","volume":" ","pages":"601-608"},"PeriodicalIF":3.3,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13116011/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145298315","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":"Systemic Sclerosis-Associated Myopathy in a Large Single-Center Cohort: Autoantibody Profiles, Histologic Features, and Independent Risk of Death.","authors":"Julie J Paik, Caoilfhionn M Connolly, Fredrick Wigley, Laura K Hummers","doi":"10.1002/acr.25672","DOIUrl":"10.1002/acr.25672","url":null,"abstract":"<p><strong>Objective: </strong>Skeletal myopathy is common in systemic sclerosis (SSc), but its associated clinical manifestations and long-term outcomes are poorly characterized. The purpose of this study is to characterize patients with skeletal myopathy and define its impact on survival.</p><p><strong>Methods: </strong>This retrospective cohort study included patients in the Johns Hopkins Scleroderma Center Research Registry with and without skeletal myopathy. Clinical data including autoantibody profiles and muscle histopathology were compared between those with and without myopathy. Survival analyses including Cox proportional hazards and regression analyses were performed.</p><p><strong>Results: </strong>In the cohort, 672 (17%) of 3,919 patients had a skeletal myopathy. When compared to those without a myopathy, those with myopathy were more commonly of the diffuse subtype (60.4% vs 32.6%, P < 0.0001), African American (30.4% vs 13.9%, P < 0.0001), and with shorter disease duration at first visit (mean 4.52 ± SD 6.2 years vs mean 6.5 ± SD 8.0 years, P < 0.00001). Anti-PM-Scl, U3-RNP, and anti-Ku were associated with the presence of myopathy, whereas anticentromere was protective against myopathy. Myopathy was associated with an increased risk of death in univariate Cox regression analyses (hazard ratio [HR] 1.59, 95% confidence interval [CI] 1.40-1.81, P < 0.0001). In multivariate Cox proportional regression analyses, myopathy had an independent risk of death even after controlling for other confounders (HR 1.60, CI 1.32-1.93, P < 0.0001).</p><p><strong>Conclusion: </strong>Skeletal myopathy in SSc is associated with distinct clinical and autoantibody profiles, as well as independently increased risk of death. These findings highlight the importance of early detection and further investigation into how myopathy predicts patient outcomes, with the goal of improving targeted therapies and survival in this high-risk population.</p>","PeriodicalId":8406,"journal":{"name":"Arthritis Care & Research","volume":" ","pages":"574-581"},"PeriodicalIF":3.3,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145328196","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":"Assessment of Skin in Patients With Systemic Sclerosis Using High-Frequency Ultrasound and Shear Wave Elastography: A Comparative Study With Histology, Molecular, and Clinical Parameters.","authors":"Ruhani Desai, Filemon Tan, Minghua Wu, Jeffery L Browning, Samuel Theodore, Meng Zhang, Brian Skaug, Harshdeep Singh Chawla, Manmohan Singh, Salavat Aglyamov, Kirill V Larin, Maureen Mayes, Shervin Assassi","doi":"10.1002/acr.25658","DOIUrl":"10.1002/acr.25658","url":null,"abstract":"<p><strong>Objective: </strong>Ultrasound (US) has been proposed as a potential tool for assessing skin fibrosis in systemic sclerosis (SSc). However, a large-scale comparison of US-based assessment with histologic markers of skin fibrosis has not been reported. We evaluated US-based skin assessments for their face validity (differentiation between involved SSc and healthy control [HC] skin), construct validity (comparison to modified Rodnan skin score [mRSS]), and criterion validity (comparison to histologic and gene expression fibrosis markers).</p><p><strong>Methods: </strong>Twenty HCs and 52 patients with SSc underwent clinical and US assessment followed by a forearm skin biopsy. Predefined areas were assessed on the finger, hand, and forearm bilaterally. mRSS, US, histologic and molecular (reverse transcription quantitative polymerase chain reaction) evaluations were performed by blinded, independent assessors. Dermal thickness, echogenicity, and elastography were assessed using a high-frequency GE LOGIQ P9 US machine.</p><p><strong>Results: </strong>Except in the hand area, the US variables could not differentiate between HC and clinically affected SSc skin (face validity). There was only a weak to moderate correlation between US-based measurements and mRSS in the hand and finger areas (construct validity). US-based thickness showed moderate correlation with histologic thickness (ρ = 0.43; P = 0.002) but no statistically significant correlations with other histologic or gene expression markers of fibrosis in patients with SSc (criterion validity).</p><p><strong>Conclusion: </strong>High-frequency US assessment of SSc skin does not show consistent and strong face, construct, or criterion validity. The role of this assessment tool remains limited, underscoring the need for further development of a quantitative and accurate tool for assessing SSc skin fibrosis.</p>","PeriodicalId":8406,"journal":{"name":"Arthritis Care & Research","volume":" ","pages":"582-590"},"PeriodicalIF":3.3,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13116043/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145298327","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":"Knee crepitus after anterior cruciate ligament reconstruction: not predictive, but still pragmatic: comment on the article by Couch et al.","authors":"Shuai Chen","doi":"10.1002/acr.25678","DOIUrl":"10.1002/acr.25678","url":null,"abstract":"","PeriodicalId":8406,"journal":{"name":"Arthritis Care & Research","volume":" ","pages":"688"},"PeriodicalIF":3.3,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145328224","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":"Disparities and Reproductive Health in Rheumatic Diseases: Deficits in Counseling and Contraception Use in an Urban Female Hispanic Population in Los Angeles.","authors":"Eaman Alhassan, Laura Kobashigawa, Vanessa Ramos, Jack Rodman, Leanna Wise","doi":"10.1002/acr.25677","DOIUrl":"10.1002/acr.25677","url":null,"abstract":"<p><strong>Objective: </strong>Systemic lupus erythematosus (SLE) and inflammatory arthritis disproportionately affect reproductive-age Hispanic women, who experience more severe disease and worse outcomes. Certain factors may contribute to disparities in reproductive health counseling. This survey-based study examined the association between reproductive health counseling and contraceptive use, considering a variety of demographics and teratogenic medication use in a predominantly Hispanic population in urban Los Angeles.</p><p><strong>Methods: </strong>An anonymous survey, based on the 2020 American College of Rheumatology Reproductive Health Guideline, was administered to 304 female patients of childbearing age with SLE, rheumatoid arthritis (RA), or juvenile idiopathic arthritis (JIA). Analyses included two-sample t-tests, Pearson's chi-square test, multivariable logistic regression, and Fisher's exact tests, with significance set at P ≤0.05.</p><p><strong>Results: </strong>Of 304 patients, English speakers were significantly more likely to receive contraception counseling than Spanish speakers (odds ratio [OR] 3.36; 95% confidence interval [CI] 1.52-7.40; P < 0.01). Older age was associated with lower odds of receiving counseling (OR 0.95; 95% CI 0.91-0.98; P = 0.01). Among those on teratogenic medications not desiring pregnancy, contraception counseling was linked to higher odds of using long-acting reversible contraception (OR 5.12; 95% CI 1.26-20.71; P = 0.02). Younger patients, those with SLE (vs RA or JIA), and English speakers had higher odds of perceiving their physician as knowledgeable about reproductive health (all P < 0.05).</p><p><strong>Conclusion: </strong>Reproductive health counseling was inadequate for Spanish-speaking and older patients. However, reproductive health counseling was positively associated with effective contraception use among patients on teratogenic medications. Clinicians should be aware of these disparities and the potential benefit of counseling to improve highly effective contraception use.</p>","PeriodicalId":8406,"journal":{"name":"Arthritis Care & Research","volume":" ","pages":"639-646"},"PeriodicalIF":3.3,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145375868","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":"Accuracy of Diagnostic Codes and Algorithms Used to Identify Rheumatoid Arthritis and Juvenile Idiopathic Arthritis in Administrative Claims and Electronic Health Records: Systematic Review and Meta-Analysis.","authors":"Constanza Saka-Herrán, Jessica Bennett, Yara Alkabti, Muhammad Fatir, Barbara Clyne, Caroline McCarthy, Gráinne Tynan, Nikki Dunne, Michelle Flood, Eoghan McCarthy, Frank Moriarty","doi":"10.1002/acr.25662","DOIUrl":"10.1002/acr.25662","url":null,"abstract":"<p><strong>Objective: </strong>This systematic review aimed to assess the diagnostic accuracy of algorithms used to identify rheumatoid arthritis and juvenile idiopathic arthritis in electronic health records.</p><p><strong>Methods: </strong>We searched Medline, Embase, and Cochrane Central Register for Controlled Trials databases and included studies that validated case definitions against a reference standard, such as rheumatologist-confirmed diagnosis or American College of Rheumatology/EULAR classification criteria. Title and abstract screening, full-text review, data extraction, and quality assessment were all completed in duplicate. Results were synthesized narratively and using a bivariate random-effects meta-analysis of sensitivity and specificity.</p><p><strong>Results: </strong>A total of 35 studies were included. Algorithms varied widely in complexity, ranging from single International Classification of Diseases (ICD) codes to combinations including disease-modifying antirheumatic drugs (DMARDs), hospitalization records, and specialist diagnosis. Algorithms combining ICD codes with DMARD prescriptions (pooled sensitivity 0.79 [95% confidence interval (CI) 0.61-0.90], specificity 0.96 [95% CI 0.72-1.00], positive predictive value [PPV] 0.78 [95% CI 0.63-0.88]) or requiring an ICD code assigned by a rheumatologist (pooled sensitivity 0.91 [95% CI 0.70-0.98], specificity 0.94 [95% CI 0.49-1.00], PPV 0.70 [95% CI 0.64-0.75]) showed the highest accuracy, with balanced sensitivity, specificity, and PPV. Less restrictive algorithms demonstrated high sensitivity but lower PPV. Substantial heterogeneity was observed across studies, likely due to differences in algorithm structure, data sources, and validation methods. Despite this variability, we used conceptually coherent categories to allow for meaningful synthesis, prioritizing clinical interpretability.</p><p><strong>Conclusions: </strong>These findings support the use of more specific algorithms when diagnostic certainty is essential and highlight the need for further validation of high-performing algorithms across diverse health care systems.</p>","PeriodicalId":8406,"journal":{"name":"Arthritis Care & Research","volume":" ","pages":"670-682"},"PeriodicalIF":3.3,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13116055/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145298288","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":"Reply.","authors":"Jamon L Couch, Brooke E Patterson, Kay M Crossley, Danilo De Oliveira Silva, Michael A Girdwood, Adam G Culvenor, Ali Guermazi, Matthew G King, Jackie L Whittaker","doi":"10.1002/acr.25681","DOIUrl":"10.1002/acr.25681","url":null,"abstract":"","PeriodicalId":8406,"journal":{"name":"Arthritis Care & Research","volume":" ","pages":"689-690"},"PeriodicalIF":3.3,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145375874","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":"Diffusion-Weighted Imaging for the Evaluation of the Sacroiliac Joint in Pediatric Patients.","authors":"Michael L Francavilla, Timothy G Brandon, Dmitry Khrichenko, Rui Xiao, Nancy A Chauvin, Asef Khwaja, Pamela F Weiss","doi":"10.1002/acr.25661","DOIUrl":"10.1002/acr.25661","url":null,"abstract":"<p><strong>Objective: </strong>Maturational signal in the sacroiliac joint (SIJ) of skeletally immature youth is often misinterpreted as inflammation. Diagnostic tools that improve specificity are greatly needed. Apparent diffusion coefficient (ADC) values from diffusion-weighted imaging (DWI), when used with standard imaging, may enhance diagnostic accuracy. We aimed to define normative pediatric ADC values and establish thresholds to distinguish normal from inflammatory SIJ signals.</p><p><strong>Methods: </strong>ADC values were measured using circular regions of interest (ROIs) on the anterior, central, and posterior slices of the cartilaginous SIJs (36 total ROIs). Mean ADCs were analyzed by age group, bone (iliac or sacral), and joint height (superior, mid, inferior), accounting for within-patient clustering. In sacroiliitis cases, ROIs were placed on DWI at sites of increased signal on fluid-sensitive sequences. Thresholds differentiating normal and inflammatory signals were derived by age, bone, and joint height (ilium only) and assessed by area under the receiver operating characteristic (AUROC) and specificity.</p><p><strong>Results: </strong>The reference group included 86 youth. Inferior ilium ADC values were higher than mid and superior regions in all immature age groups (all P < 0.0001) and decreased with age (P = 0.0001). Sacral ADCs also declined with age (P = 0.0001). No age trend was observed in the superior or mid ilium (P = 0.14). ADC thresholds distinguished normal from inflammatory signals with AUROC ≥0.90 in most iliac regions, except the peripubertal inferior ilium (AUROC 0.78). Sacral thresholds performed acceptably (AUROC ≥ 0.77), though they were lower in the prepubertal group (AUROC 0.68).</p><p><strong>Conclusion: </strong>Age- and bone-specific ADC reference values were established and effectively differentiated normal from inflammatory SIJ signals.</p>","PeriodicalId":8406,"journal":{"name":"Arthritis Care & Research","volume":" ","pages":"630-638"},"PeriodicalIF":3.3,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13116032/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145205296","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":"Reply.","authors":"H Berk Degirmenci, Jean W Liew","doi":"10.1002/acr.80078","DOIUrl":"10.1002/acr.80078","url":null,"abstract":"","PeriodicalId":8406,"journal":{"name":"Arthritis Care & Research","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147760851","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":"Neighborhood Socioeconomic Status and Short-Term Functional Outcomes in Systemic Lupus Erythematosus.","authors":"Baljeet Rai, Jessica Fitzpatrick, Jing Li, Eric Roberts, Patricia Katz, Laura Plantinga, Gabriela Schmajuk, Jinoos Yazdany","doi":"10.1002/acr.80074","DOIUrl":"https://doi.org/10.1002/acr.80074","url":null,"abstract":"<p><strong>Objective: </strong>Individuals with SLE can accumulate functional status (FS) impairment. We evaluated the association between neighborhood socioeconomic disadvantage, as measured by the area deprivation index (ADI), and FS in a national SLE sample.</p><p><strong>Methods: </strong>Data were derived from RISE, a national electronic health record-based registry. Individuals aged 18+ with ≥ 2 visits for SLE ≥ 30 days apart and at least 1 functional status assessment measure (FSAM) in 2016-2022 were included. ADI was grouped into quintiles. Cross-sectionally, mean FS scores were compared across ADI quintiles, and multi-level regression models were used to examine the association between ADI and FS score. Similarly, a multi-level model was used to assess the association between ADI and FS decline.</p><p><strong>Results: </strong>Mean age in the cross-sectional cohort (N=20,620) was 56.0 (SD 15.5) years; 91.4% were female, and 57.6% were non-Hispanic White. Baseline characteristics were similar in the longitudinal cohort (N=10,604). Adjusted mean FS scores were higher (worse) among those with higher ADI (ADI quintile 1 (highest SES): 1.53 [1.28-1.77]; quintile 5 (lowest SES): 1.90 [1.63-2.16]). 15.7% in the longitudinal cohort experienced FS decline. The proportion of patients with FS decline was greater with decreases in ADI (quintile 1: 11.4% [9.3%-13.5%]; quintile 5: 17.0% [13.7%-20.2%]).</p><p><strong>Conclusions: </strong>In this national sample of adults with SLE, greater neighborhood deprivation was associated with worse physical function and a higher likelihood of short-term functional decline. Clinical efforts to improve outcomes should include routine assessment of function and patient-centered interventions that acknowledge and help mitigate social and structural barriers to health.</p>","PeriodicalId":8406,"journal":{"name":"Arthritis Care & Research","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147760776","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}