Arthritis Care & Research最新文献

{"title":"Preferences for post-traumatic osteoarthritis prevention strategies in individuals with anterior cruciate ligament injury.","authors":"Kevin Kennedy, Lily Waddell, Adam Easterbrook, Jeffrey N Katz, Cale Jacobs, Morgan Jones, Faith Selzer, Elena Losina, Liana Fraenkel, Nick Bansback","doi":"10.1002/acr.25641","DOIUrl":"https://doi.org/10.1002/acr.25641","url":null,"abstract":"<p><strong>Objectives: </strong>There is growing interest in evaluating new strategies to delay or prevent post-traumatic osteoarthritis (PTOA) in individuals who have sustained anterior cruciate ligament (ACL) injury. This study sought to determine characteristics of potential treatments that are acceptable to patients with ACL injury.</p><p><strong>Methods: </strong>Participants with a history of ACL injury were recruited from Reddit, Facebook, and ResearchMatch.org. After consent and eligibility confirmation, participants completed a survey comprised of questions on 1) demographics, 2) PTOA perceptions, 3) perceived PTOA risk, and 4) a discrete choice experiment (DCE) task. The DCE assessed treatment attributes including risk reduction, side effects, benefits, and out-of-pocket costs. In several scenarios, participants chose between two hypothetical treatments with various attributes or no treatment. The data were analyzed with multinomial logit, mixed logit, and latent class models.</p><p><strong>Results: </strong>We enrolled 273 participants (median age 30.6 years [IQR: 27-33], 63% female, mean BMI=25.5 kg/m²). Of these, 29% experienced daily knee pain and 35% reported being very or extremely worried about knee OA. The two most influential attributes affecting treatment acceptability were monthly cost and potential mild side effects. Two preference phenotypes emerged: Class 1 members (n=162, 59%) generally favored treatment, prioritizing effectiveness and injections but were deterred by high cost. Class 2 members (n=111, 41%) were less inclined to use treatments with potential mild side effects and high cost.</p><p><strong>Conclusions: </strong>These results can be used to develop tailored recruitment messaging for future trials. Messaging should emphasize how to manage side effects and out-of-pocket costs.</p>","PeriodicalId":8406,"journal":{"name":"Arthritis Care & Research","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144940450","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":"Perceptions about asymptomatic hyperuricemia and views about urate-lowering therapy in people with asymptomatic hyperuricemia.","authors":"Nicola Dalbeth, Sarah Stewart, Gregory D Gamble, Borislav Mihov, Lisa K Stamp, Janine Haslett, William J Taylor, Tony R Merriman, Adwoa Dansoa Tabi-Amponsah, Anne Horne, Tuhina Neogi, Tristan Pascart, Mariano Andrés, Maria-Luisa Peral-Garrido, Eleonora Norkuviene, Janitzia Vazquez Mellado, Till Uhlig, Mingshu Sun, Changgui Li, Keith J Petrie","doi":"10.1002/acr.25639","DOIUrl":"https://doi.org/10.1002/acr.25639","url":null,"abstract":"<p><strong>Background/aims: </strong>Asymptomatic hyperuricemia is a precursor of gout and is also associated with cardiovascular disease and chronic kidney disease. The aim of this study was to understand perceptions about asymptomatic hyperuricemia and views about urate-lowering therapy in people with asymptomatic hyperuricemia.</p><p><strong>Methods: </strong>Participants in a multi-national study of asymptomatic hyperuricemia completed questionnaires about their perceptions of hyperuricemia, concern about hyperuricemia-associated health conditions, and willingness to take urate-lowering medication. All had a screening serum urate of ≥0.48 mmol/L (8 mg/dL) and no current or previous symptoms of gout.</p><p><strong>Results: </strong>Overall, participants perceived that hyperuricemia had no or very few consequences on their life. Dietary factors were the most reported cause, while 37% did not know the cause. Participants reported a wide range in concern about hyperuricemia and the risk of developing gout. Concern about the risk of developing kidney disease or cardiovascular disease was also highly variable but was higher than concern about elevated serum urate (P<0.001). Most did not think a urate-lowering medication was necessary and there was moderate concern about the long-term use of urate-lowering medication. Medication necessity beliefs were most strongly associated with whether participants were willing to take urate-lowering medication (partial R² =0.27, P<0.001).</p><p><strong>Conclusions: </strong>Most participants perceived minimal consequences of asymptomatic hyperuricemia. Hyperuricemia was not well understood by participants, and biological causes were generally under-recognised. Despite a range of concerns about hyperuricemia-associated conditions, particularly kidney disease and cardiovascular disease, a urate-lowering medication for asymptomatic hyperuricemia was not considered necessary, which aligns with most current management guidelines.</p>","PeriodicalId":8406,"journal":{"name":"Arthritis Care & Research","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144940429","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":"Knee crepitus and osteoarthritis features in young adults following traumatic knee injury.","authors":"Jamon L Couch, Brooke E Patterson, Kay M Crossley, Ali Guermazi, Matthew G King, Danilo De Oliveira Silva, Jackie L Whittaker, Michael A Girdwood, Adam G Culvenor","doi":"10.1002/acr.25637","DOIUrl":"https://doi.org/10.1002/acr.25637","url":null,"abstract":"<p><strong>Objective: </strong>This study explored the association between knee crepitus and the presence, and worsening, of structural osteoarthritis features and self-reported outcomes in young adults following traumatic knee injury.</p><p><strong>Methods: </strong>One-year following anterior cruciate ligament reconstruction (ACLR), 112 participants (41 female participants; median age 28 years) self-reported the presence/absence of knee crepitus using an item from the Knee injury and Osteoarthritis Outcome Score (KOOS). Patellofemoral and tibiofemoral osteoarthritis features (i.e. cartilage lesions, osteophytes, bone marrow lesions) were assessed from MRIs at 1- and 5-years post-ACLR. Self-reported outcomes were assessed with two KOOS subscales (pain, quality of life [QoL]) and the International Knee Documentation Committee subjective evaluation form (i.e. self-reported function). Poisson regression evaluated the relationship between self-reported crepitus and the presence/worsening of structural osteoarthritis features. General linear models explored the relationship between crepitus and self-reported outcomes.</p><p><strong>Results: </strong>Self-reported crepitus was associated with full-thickness patellofemoral cartilage lesions 1-year post-ACLR (prevalence ratio 2.70, 95%CI 1.41, 6.39) but not the risk of worsening structural osteoarthritis features between 1- and 5-years post-ACLR. Those with crepitus reported worse pain (β -6.42, 95%CI -10.47, -2.36), QoL (β -10.39, 95%CI -18.58, -2.20) and function (β -5.49, 95%CI -10.92, -0.06) 1-year post-ACLR, but greater improvement in pain and function between 1- and 5-years.</p><p><strong>Conclusion: </strong>Self-reported knee crepitus was associated with the presence of full-thickness patellofemoral cartilage defects 1-year post-ACLR, but was not associated with a greater risk of worsening structural osteoarthritis features up to 5-years post-ACLR. One-year post-ACLR, those with crepitus reported worse pain, knee-related QoL, and function.</p>","PeriodicalId":8406,"journal":{"name":"Arthritis Care & Research","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144940433","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 High-Impact Solutions to Address Racial and Ethnic Health Disparities in Lupus: A Consensus-Based Approach.","authors":"Joy Buie, Michael P Fisher, Kristen Backor, Hannah Tyldsley, Ashira Blazer, Candace Feldman, Andrea Knight, S Sam Lim, Barbara Ann Polk, Ed Yelin, Edith Williams, Karen H Costenbader","doi":"10.1002/acr.25635","DOIUrl":"https://doi.org/10.1002/acr.25635","url":null,"abstract":"<p><strong>Objective: </strong>We conducted formative research aimed at identifying solutions that address inequitable health outcomes in lupus due to adverse social determinants of health.</p><p><strong>Methods: </strong>We conducted a search for keywords which provided insights into potential solutions and initiatives underway. An advisory panel of lupus experts iteratively reviewed the list of literature-scoped solutions in working sessions, filling knowledge gaps, which allowed for further defining and classifying solutions based on area of focus, feasibility, and impact. Seven-in-depth semi-structured discussions and a modified Delphi survey approach were leveraged to align the advisory panel based on feasibility, impact, and costs of the proposed solutions.</p><p><strong>Results: </strong>Thirty-three solutions were identified and classified into four key categories: Financial Safety Net, Patient Education and Shared Decision-Making, Physician Education, and Other Solutions. High-impact solutions that were prioritized included \"Collecting granular information like patient-reported outcomes to provide personalized care and accelerate development of new products,\" \"Expanding Medicaid coverage via infrastructure,\" and \"Supporting people living with lupus in applying and getting approval for disability.\"</p><p><strong>Conclusion: </strong>Addressing health and healthcare disparities linked to negative social determinants of health is a key goal in the management of lupus, as disparities in outcomes can be stark. Increasing the visibility of potential solutions and aligning the community on top priorities can enable more efficient and effective contributions to healthcare equity and ultimately better health outcomes for people living with lupus.</p>","PeriodicalId":8406,"journal":{"name":"Arthritis Care & Research","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144940426","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":"Uses of artificial intelligence in non-pharmacological rheumatology care: What we know, what we need to learn, and what its limitations are.","authors":"Travis Haber, Rana S Hinman, Mark Merolli","doi":"10.1002/acr.25638","DOIUrl":"https://doi.org/10.1002/acr.25638","url":null,"abstract":"","PeriodicalId":8406,"journal":{"name":"Arthritis Care & Research","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144940431","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":"Considerations for Issues of Regression to the Mean and Contextual Effects in Clinical Trials for Pain in Rheumatic Diseases.","authors":"Yen T Chen, Guohao Zhu, Afton L Hassett, Daniel Clauw, Susan L Murphy","doi":"10.1002/acr.25636","DOIUrl":"10.1002/acr.25636","url":null,"abstract":"<p><p>Recently, there has been growing discussion about how to best assess pain in clinical trials in rheumatic diseases. Reliable measurement of pain outcomes is essential for accurately determining the effectiveness of treatments. Although pain intensity is the most common measure of change in pain trials, other pain-related measures, such as pain interference, are also frequently assessed. Interpreting treatment effects on these outcomes can be complicated due to statistical phenomena, particularly regression to the mean and contextual effects. These issues can substantially distort clinical trial findings, potentially leading to inaccurate conclusions about the efficacy of interventions. The present article provides an overview of regression to the mean and contextual effects, emphasizing their implications for internal validity, clinical decision-making, and ethical considerations in trials. Additionally, this article highlights key study design and analysis considerations, including methodologic and statistical approaches, that researchers can implement to mitigate or better account for these challenges. Practical recommendations are offered to enhance the rigor of pain assessment, with specific attention to osteoarthritis as a representative example within rheumatic disease research. By recognizing and addressing regression to the mean and contextual effects proactively, researchers can strengthen trial outcomes, improve clinical interpretations, and support the identification of effective treatments.</p>","PeriodicalId":8406,"journal":{"name":"Arthritis Care & Research","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144871123","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":"Virtual or in-person: does it matter? Comparing pain, function, quality of life, self-efficacy and physical function outcomes of virtual, hybrid and in-person GLA:D Canada participants.","authors":"Jill Van Damme, Vanina Dal Bello-Haas, Ayse Kuspinar, Patricia Strachan, Michael Zywiel, James Young, Rhona McGlasson, Lisa C Carlesso","doi":"10.1002/acr.25628","DOIUrl":"10.1002/acr.25628","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to determine if program format (in-person, virtual, hybrid) results in differences in three-month outcomes of pain, function, quality of life, self-efficacy and chair stands in a hip/knee osteoarthritis management program.</p><p><strong>Methods: </strong>A secondary analysis of the GLA:D^TM Canada database was completed. Multiple linear regression was completed for pain and function, analysis of covariance for quality of life and self-efficacy, and negative binomial regression was completed to analyze chair stands. Outcome measures included the 12-item Knee/Hip Injury and Osteoarthritis Outcome Score (pain, quality of life and physical function subscales), Arthritis Self-efficacy Scale (self-efficacy), and 30-second chair stand test. Models were adjusted for different covariates. .</p><p><strong>Results: </strong>The analyses included 5062 individuals with knee and/or hip osteoarthritis who completed the program between January 2019- March 2024 (76.7% female sex, mean age = 67.27 years, mean BMI = 29.51 kg/m²). When compared to in-person formats, there was no difference in virtual or hybrid formats at three months for pain, quality of life, or self-efficacy. When compared to in-person, the virtual format resulted in lower function scores B=-1.71 95% CI (-2.78, -0.63) and the hybrid format performed 3% fewer chair stands at 3-months incidence rate ratio = 0.97 95% CI (0.93, 0.99), which is not a clinically important change.</p><p><strong>Conclusions: </strong>The GLA:D^TM Canada program appears effective in virtual, hybrid and in-person formats. With the known barriers of strictly in-person formats, these results provide further support for research and implementation of virtual and hybrid approaches for helping individuals manage osteoarthritis.</p>","PeriodicalId":8406,"journal":{"name":"Arthritis Care & Research","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144871159","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 Economic Burden of Rheumatoid Arthritis in Low- and Middle-Income Countries: Systematic Review and Meta-Analysis.","authors":"Tadesse Gebrye, Chidozie E Mbada, Clara T Fatoye, Faatihah Niyi-Odumosu, Ushotanefe Useh, Zalmai Hakimi, Francis Fatoye","doi":"10.1002/acr.25627","DOIUrl":"10.1002/acr.25627","url":null,"abstract":"<p><strong>Objective: </strong>The aim of this systematic review was to synthesise the economic impact of rheumatoid arthritis (RA) on households, health systems, and society in low- and middle-income countries (LMICs).</p><p><strong>Methods: </strong>Electronic databases such as PubMed, Web of Science, and CINAHL were searched using keywords related to RA and cost of illness. Eligible studies were required to report RA-related costs, conducted in LMICs, and published in English. Quality appraisal of the included studies was carried out using the Newcastle-Ottawa Scale (NOS) for cohort studies. A narrative synthesis and meta-analysis of findings was carried out.</p><p><strong>Result: </strong>A total of 5,134 studies were initially identified for screening. After removing 1,028 duplicates, 50 studies were selected for full-text review, and 15 met the eligibility criteria and were therefore included in the review. These studies, published between 2007 and 2024, were conducted in various countries, including Turkey (n=3), China (n=2), and one study each from Thailand, Hungary, Mexico, Colombia, Morocco, Pakistan, India, Romania, Brazil, and Argentina. Nine studies adopted a societal perspective, while six used a healthcare perspective. The total sample size was 218,575 participants, with individual study sizes ranged from 62 to 209,292. Average annual direct costs per patient ranged from US$523 to US$2837.9, and indirect costs ranged from US$81.8 to US$2463.4. The pooled average annual cost for outpatients, inpatient and medical costs were US$517.72 (95% CI $3.35 to $1,032.09), US$543.88 (95% CI US$499.51 - US$588.24), and US$3,379.83 (95% CI US$3,137.58 - US$3,622.08, respectively.</p><p><strong>Conclusion: </strong>RA poses a significant economic challenge in LMICs, where limited healthcare resources and high treatment costs make care unaffordable for many. This review uniquely underscores that enhancing treatment access and optimising resource use can reduce both medical and productivity losses, improving patient outcomes and strengthening economic resilience.</p>","PeriodicalId":8406,"journal":{"name":"Arthritis Care & Research","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144871158","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":"Cost-effectiveness of low dose colchicine prophylaxis when starting allopurinol using the \"start-low go-slow\" approach for gout: evidence from a non-inferiority randomised double-blind placebo-controlled trial.","authors":"Yana Pryymachenko, Ross Wilson, Nicola Dalbeth, J Haxby Abbott, Lisa Stamp","doi":"10.1002/acr.25631","DOIUrl":"10.1002/acr.25631","url":null,"abstract":"<p><strong>Objective: </strong>The aim of this study was to investigate the cost-effectiveness of low-dose colchicine prophylaxis for preventing gout flares when starting allopurinol using the \"start-low go-slow\" approach.</p><p><strong>Methods: </strong>Participants with gout, fulfilling the American College of Rheumatology recommendations for starting urate-lowering therapy and with serum urate ≥0.36 mmol/L (6mg/dL), were randomly allocated (1:1) to either colchicine (0.5 mg daily) or placebo for six months with a further six-month follow-up. All participants received allopurinol, with monthly increase in dose to achieve target urate <0.36 mmol/L. The primary outcomes were incremental cost-effectiveness at 6-month and 1-year follow-up from the health system perspective, measured by incremental net monetary benefit (INMB) at a willingness-to-pay threshold equivalent to gross domestic product per capita.</p><p><strong>Results: </strong>Two hundred participants were randomized to either colchicine (n=100) or placebo (n=100). Mean costs were higher in the colchicine group over both 6 months and 1 year (adjusted mean difference $1 848 [95%CI -321 to 4 017] and $2 282 [95%CI -173 to 4 737], respectively). Quality-adjusted life years were slightly higher in the colchicine group over 6 months (adjusted mean difference 0.008 [95%CI -0.020 to 0.035]), but lower over 1 year (-0.015, [95%CI -0.039 to 0.010]). Treatment with colchicine was not found to be cost-effective at either 6-months or 12-months (INMB -$1 373 (95%CI -4 287 to 1 542) and -$3 191 (95%CI -6 274 to -107), probability of cost-effectiveness 17.7% and 1.5%, respectively). Similar results were obtained from a societal perspective.</p><p><strong>Conclusion: </strong>Six months of low-dose colchicine prophylaxis when starting allopurinol using the \"start-low go-slow\" approach is unlikely to be cost-effective over 12 months.</p>","PeriodicalId":8406,"journal":{"name":"Arthritis Care & Research","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144871124","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":"Adipokines and Associations with Incident Osteoporotic Fracture in Patients with Rheumatoid Arthritis.","authors":"Joshua F Baker, Bryant R England, Michael D George, Hannah Brubeck, Brian Sauer, Aleksander Lenert, Punyasha Roul, Geoffrey M Thiele, Ted R Mikuls, Katherine D Wysham","doi":"10.1002/acr.25632","DOIUrl":"10.1002/acr.25632","url":null,"abstract":"<p><strong>Purpose: </strong>We assessed whether circulating adipokines are associated with incident fractures in patients with rheumatoid arthritis (RA).</p><p><strong>Methods: </strong>Three adipokines (adiponectin, leptin, fibroblast growth factor [FGF]-21) were measured using banked enrollment serum from participants in a longitudinal RA cohort. Adipokine levels were dichotomized as high/low using median values. Incident osteoporotic fracture was defined based on published algorithms using diagnostic codes and confirmed by chart review. Cox proportional hazard models evaluated adipokines and incident fracture risk adjusting for age, sex, race, smoking status, body mass index, prednisone use, disease activity, comorbidity score, calendar year, osteoporosis history, and prior fracture.</p><p><strong>Results: </strong>A total of 2527 participants were included (89% male, mean age 72 years). There were 228 incident fractures over 27,540 person-years of follow-up (8.3 fractures per 1000 person-years). After adjustment, the risk of incident fracture was increased for high levels of leptin [HR: 1.47 (95% CI: 1.15, 1.90) p=0.003], FGF-21 [HR: 1.39 (95% CI: 1.16, 1.67) p<0.001], and adiponectin [HR: 1.21 (95% CI: 0.94, 1.55)], the latter not achieving significance (p=0.13). Participants who had elevated levels of all three adipokines experienced twice the risk of fracture compared to those in whom none was elevated [HR: 2.17 (95% CI: 1.27, 3.70) p=0.005].</p><p><strong>Conclusions: </strong>Elevations in adipokines are associated with an increased risk of fracture in patients with RA, independent of other established risk factors including body mass, smoking, and prednisone use. This supports further investigation understanding whether this association is related to altered body composition or disrupted metabolic pathways.</p>","PeriodicalId":8406,"journal":{"name":"Arthritis Care & Research","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144871122","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}