Arthritis Care & Research最新文献

{"title":"Fifty Years of Advocacy With Connections and Collaborations in Pediatric Rheumatology","authors":"Patience White MD, MA, MACR, MACP, FAAP","doi":"10.1002/acr.80091","DOIUrl":"10.1002/acr.80091","url":null,"abstract":"","PeriodicalId":8406,"journal":{"name":"Arthritis Care & Research","volume":"78 10","pages":"1307-1316"},"PeriodicalIF":4.1,"publicationDate":"2026-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147969998","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":"Integrating Patient-Reported Quality Measures in Systemic Lupus Erythematosus: Development of the American College of Rheumatology Implementation Guide","authors":"Catherine Nasrallah MPH, CHES,&nbsp;Cherish Wilson BS,&nbsp;Christine Hariz BS,&nbsp;Christie M. Bartels MD, MS,&nbsp;Shanthini Kasturi MD, MS,&nbsp;Wambui Machua MD,&nbsp;Amy Bennett BA,&nbsp;Kate Chiseri MPH, MCHES, PMP,&nbsp;Allison Plitman MPA,&nbsp;Starla Hairston Blanks MPH MBA,&nbsp;April Jorge MD,&nbsp;Patti Katz PhD,&nbsp;Jinoos Yazdany MD, MPH,&nbsp;Shivani Garg MD, PhD","doi":"10.1002/acr.80038","DOIUrl":"10.1002/acr.80038","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To support high-quality, patient-centered care for systemic lupus erythematosus (SLE), the American College of Rheumatology (ACR) developed evidence-based measures incorporating clinical and patient-reported outcome measures (PROMs). Using the Consolidated Framework for Implementation Research (CFIR), we conducted semistructured interviews with rheumatologists and support staff who piloted these measures. Insights from these interviews informed development of the SLE Quality Measures Implementation Guide for national dissemination.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Five rheumatology practices were selected to pilot workflows for collecting SLE PROMs recommended in recent ACR guidelines for at least 50 consecutive patients. Measures included physical function (PF) and depression. After data collection, representatives from each practice participated in virtual semistructured interviews. Interviews were recorded, transcribed verbatim, and analyzed thematically using both deductive and inductive techniques. Findings were used to develop the SLE Quality Measures Implementation Guide.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 31 clinicians across five practices participated in the pilot. Interviews with eight participants identified key themes related to innovations, resources, best practices, and challenges in collecting and using SLE PROMs, mapped to CFIR domains. Despite barriers related to workflow, engagement, and resources, PROM implementation in SLE care was well accepted and supported standardized assessment of mental health and PF through communication and electronic health records integration. These insights informed development of the SLE Quality Measures Implementation Guide, featuring guidelines, workflow recommendations, best practices, and educational resources to improve workflow efficiency and enhance patient care.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This study evaluated the implementation of ACR-recommended SLE PROMs and provides actionable recommendations and resources to address challenges through the SLE Quality Measures Implementation Guide.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8406,"journal":{"name":"Arthritis Care & Research","volume":"78 10","pages":"1467-1477"},"PeriodicalIF":4.1,"publicationDate":"2026-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/acr.80038","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147375915","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":"Minimal Important Change and Minimal Clinically Important Difference in Pain and Function With Exercise in Hip Osteoarthritis","authors":"Yareni Guerrero PhD,&nbsp;Fiona Dobson PhD,&nbsp;Venkatesha Venkatesha PhD,&nbsp;Kim Allison PhD,&nbsp;Gabrielle Knox BSc,&nbsp;Libby Spiers BSc,&nbsp;Travis Haber PhD,&nbsp;David J. Hunter PhD,&nbsp;Michelle Hall PhD","doi":"10.1002/acr.80029","DOIUrl":"10.1002/acr.80029","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>The objective of this study was to estimate the minimal important change (MIC) and minimal clinically important difference (MCID) for pain and physical function in individuals with hip osteoarthritis (OA) following a physiotherapist-guided exercise intervention.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Secondary analysis from a randomized controlled trial of 196 adults with hip OA allocated one of two nine-month exercise programs. Patient-reported outcomes measures for hip pain severity (Numeric Rating Scale [NRS], Western Ontario and McMaster Universities Osteoarthritis Index [WOMAC] pain subscale) and physical function (WOMAC physical function subscale, Patient-Specific Functional Scale [PSFS]) were collected at baseline and three and nine months. Global ratings of change in pain and physical function at three and nine months served as anchors.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>MIC estimates were 2.1 and 2.4 points for NRS pain at three and nine months, respectively; 2.8 and 3.0 points for WOMAC pain at three and nine months, respectively; 8.7 and 8.3 points for WOMAC physical function at three and nine months, respectively; and −2.1 and −2.0 points for PSFS at three and nine months, respectively. The MCID estimates were 2.0 and 2.4 points for NRS pain at three and nine months, respectively; 2.8 and 3.0 points for WOMAC pain at three and nine months, respectively; 9.2 and 8.3 points for WOMAC physical function at three and nine months, respectively; and −3.5 and −0.7 points for PSFS at three and nine months, respectively.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This study provides robust, context-specific MIC and MCID estimates for outcomes in hip OA following exercise. These values can inform the interpretation and design of exercise-based clinical trials for hip OA.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8406,"journal":{"name":"Arthritis Care & Research","volume":"78 10","pages":"1397-1403"},"PeriodicalIF":4.1,"publicationDate":"2026-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/acr.80029","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147281956","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":"Effects of Causal Beliefs About Gout on Public Views About Gout Management: A Randomized Experimental Study","authors":"Rachel Murdoch MBChB,&nbsp;Borislav Mihov BPhty,&nbsp;Anne Horne MBChB,&nbsp;Keith J. Petrie PhD,&nbsp;Gregory D. Gamble MSc,&nbsp;Lachlan Fleck BHSc,&nbsp;Nicola Dalbeth MD","doi":"10.1002/acr.80053","DOIUrl":"10.1002/acr.80053","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Despite well-described biologic causes, the public views unhealthy lifestyle choices as the primary cause of gout. This study investigated how causal beliefs about gout influence the public's views about its management.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>In a randomized study, 201 members of the public viewed one of two 2-minute videos about gout. The videos were identical except for a 45-second section describing the causes of gout using either a biologic explanation (including genetics, kidney disease, age, sex, and diuretic therapy) or a lifestyle explanation (including diet, alcohol, sugary drinks, and weight). Participants completed a questionnaire about gout and its management. Primary outcome was rating of “How likely is it that long-term medications would help gout?” on an 11-point Likert scale.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Participants who viewed the biologic explanation rated hereditary factors and aging as more important causes of gout than those who viewed the lifestyle explanation, and they rated poor diet, alcohol use, and the person's own behavior less highly (<i>P</i> &lt; 0.001 for all). In the biologic group, 13 of 99 (13.1%) gave diet or a specific dietary factor as the most important cause compared with 62 of 102 (60.8%) in the lifestyle group. Those in the biologic group were more likely to believe that long-term medication would help gout (mean score 7.6 vs 6.5, <i>P</i> = 0.001).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Explaining gout as caused by biologic rather than lifestyle factors affects beliefs about the benefits of long-term medication. Accurate communication about causes of gout could affect the public's beliefs about treatment strategies and may improve long-term medication uptake.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8406,"journal":{"name":"Arthritis Care & Research","volume":"78 10","pages":"1478-1486"},"PeriodicalIF":4.1,"publicationDate":"2026-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/acr.80053","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147608071","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":"Prevalence of Systemic Lupus Erythematosus in Australia, 2010–2022: A Population-Based Study Using Linked National Administrative Health Data","authors":"Lucinda Roper BMed, MD, MSc,&nbsp;Rachel Black MD, PhD, FRACP,&nbsp;Joanna Tieu MBBS, BMedSc, PhD, FRACP,&nbsp;Winnie Chen MBBS, MPH, FRACGP, PhD,&nbsp;Matthew Parker MBChB, FRACP,&nbsp;Catherine Hill MBBS, FRACP, MSc, MD,&nbsp;Natasha Nassar BEc, MPH, PhD,&nbsp;Mandana Nikpour MBBS, FRACP, FRCPA, PhD, FAHMS","doi":"10.1002/acr.80026","DOIUrl":"10.1002/acr.80026","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Systemic lupus erythematosus (SLE) is a heterogenous inflammatory condition with widely varying global prevalence estimates. The frequency of SLE in the general population of Australia has been reported to be notably lower than contemporary estimates in countries such as the United States or United Kingdom, at 19 to 39 per 100,000 as opposed to 65 to 97 per 100,000. This study aimed to develop a national SLE cohort using linked administrative data sets and to estimate prevalence using this approach.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We developed an algorithm to identify SLE cases using the National Health Data Hub, a linked national administrative data asset, which includes data on medications dispensed and medical services subsidized under Australia's universal subsidized coverage schemes, hospital admissions, and deaths. These classification criteria were developed with an expert panel of rheumatologists. Individuals were classified as “certain,” “uncertain,” or “no SLE.” Cohort characteristics were described, and period prevalence (2010–2022) was calculated.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A cohort of 26,788 individuals with SLE were identified, which comprised 16,294 certain cases and 10,494 uncertain cases. The period prevalence of SLE in Australia from 2010 to 2022 was 77 to 127 per 100,000 (certain cases or overall cases). Among the certain cases, just over half had received care for SLE only in an outpatient setting.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This is the first Australian SLE study using comprehensive linked administrative health data, and it identified higher prevalence than previously reported, more closely aligning with international estimates. This algorithm may serve as a foundation for future Australian and international studies seeking to identify SLE in administrative health data sets.</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 10","pages":"1438-1448"},"PeriodicalIF":4.1,"publicationDate":"2026-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/acr.80026","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147281940","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":"Long-Term Lignan Intake, Whole Grain Foods, and the Risk of Gout: Results From Two Prospective Cohort Studies","authors":"Sharan K. Rai,&nbsp;Yang Hu,&nbsp;Ming Ding,&nbsp;Frank B. Hu,&nbsp;Molin Wang,&nbsp;Jorge E. Chavarro,&nbsp;Natalie McCormick,&nbsp;Hyon K. Choi,&nbsp;Qi Sun","doi":"10.1002/acr.25596","DOIUrl":"10.1002/acr.25596","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Multiple plant-based dietary patterns are inversely associated with gout, although the individual constituents driving this association remain unclear. Dietary lignans, a major group of phytoestrogens abundant in plant foods, are metabolized by the gut microflora and may modulate gout risk. We examined the associations between dietary lignan intake, certain whole grain foods rich in lignans, and incident gout.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We analyzed data from 122,680 individuals in the Health Professionals Follow-up Study and Nurses’ Health Study. We administered a food frequency questionnaire every two to four years. We used Cox models to evaluate associations between dietary lignans, whole grain foods, and confirmed gout.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Higher intakes of matairesinol (hazard ratio [HR] comparing extreme quintiles, 0.78; 95% confidence interval [CI], 0.69–0.90; <i>P</i> trend = 0.002) and secoisolariciresinol (HR, 0.78; 95% CI, 0.68–0.89; <i>P</i> trend = 0.002) were both associated with lower gout risk, whereas pinoresinol and lariciresinol were not associated with gout. We found inverse associations of whole grain cold breakfast cereals (HR for those consuming ≥1 serving per day, 0.62; 95% CI, 0.53–0.73), cooked oatmeal/oat bran (HR for those consuming ≥2 servings per week, 0.78; 95% CI, 0.70–0.86), and bran added to food (HR for those consuming ≥2 servings per week, 0.84; 95% CI, 0.74–0.95), but not dark breads or other cooked breakfast cereals, with gout.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Higher intakes of matairesinol and secoisolariciresinol, as well as whole grain cold breakfast cereals, oatmeal, and added bran, were each significantly associated with lower gout risk. These findings support adherence to healthful plant-based diets for gout and support a potential role of the gut microbiome in gout pathogenesis.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8406,"journal":{"name":"Arthritis Care & Research","volume":"78 10","pages":"1487-1499"},"PeriodicalIF":4.1,"publicationDate":"2026-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144574749","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":"Advancements in Diagnosis and Care for Immune Dysregulation and Inborn Errors of Immunity in Pediatric Rheumatology: Our 50-Year Journey","authors":"Megan Day-Lewis RN, MSN, CPNP,&nbsp;Jennifer L. Cheng BA,&nbsp;Edward Behrens MD,&nbsp;Melissa M. Hazen MD,&nbsp;Erin M. Janssen MD, PhD,&nbsp;Pui Y. Lee MD, PhD,&nbsp;Tiphanie P. Vogel MD, PhD,&nbsp;Stefano Volpi MD, PhD,&nbsp;Megan A. Cooper MD, PhD,&nbsp;Scott W. Canna MD,&nbsp;Lauren A. Henderson MD, MMSc","doi":"10.1002/acr.80127","DOIUrl":"10.1002/acr.80127","url":null,"abstract":"<p>Caring for children with complex immune disorders is part of the heritage of pediatric rheumatology that extends back to the original founders of the field. Over the past 50 years, pediatric rheumatologists have been central to advancing discovery and pioneering innovative treatment approaches for pediatric patients with multifaceted immune dysfunction. This includes dissecting disease mechanisms and identifying novel genes associated with inflammasome activation, IL-18 opathies, type I interferonopathies, monogenic mosaic disorders, and other forms of immune dysregulation. Pediatric rheumatologists have made foundational contributions to the management of patients with these conditions by leveraging their expertise in existing immunomodulatory medications and recognizing new drug targets. In the next 50 years, scientists and clinicians in the field are poised to make substantial innovations in understanding the causes and biomarkers of immune dysregulation. By harnessing the power of precision medicine, cellular therapies, and immune multidisciplinary teams, pediatric rheumatologists will continue to drive discoveries that will improve outcomes for patients with immune dysregulation.</p>","PeriodicalId":8406,"journal":{"name":"Arthritis Care & Research","volume":"78 10","pages":"1358-1370"},"PeriodicalIF":4.1,"publicationDate":"2026-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148629292","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":"Juvenile Myositis: Insights on Classification, Pathogenesis, and Therapies Over the Past 50 Years","authors":"Lucy R. Wedderburn MD, PhD,&nbsp;Brian M. Feldman MD, MSc, FRCPC,&nbsp;Lisa G. Rider MD","doi":"10.1002/acr.80115","DOIUrl":"10.1002/acr.80115","url":null,"abstract":"<p>The juvenile idiopathic inflammatory myopathies (JIIMs) are rare, serious, multisystem autoimmune diseases affecting children and young people. Fifty years ago, the prognosis for these conditions was poor, with high morbidity and mortality, and very few treatments were available. Since then, there has been major growth in our understanding of the pathogenesis and evidence basis for treatment. Early descriptions considered juvenile dermatomyositis (JDM) to be essentially one disease. Our modern understanding has shown that there are different types of JIIMs, and that although JDM remains the most prevalent, even JDM itself is highly heterogenous. Much progress has been made possible through concomitant growth in the research community with a focus on JIIMs and the fact that the myositis research and clinical communities are highly collaborative internationally. Here, we review the growing understanding of the different types of childhood myositis; the developments in classification, driven in part by recognition of associations of particular phenotypes with specific myositis autoantibodies; the novel insights into pathogenesis of the JIIMs; the therapeutic targets that these have revealed; and the evidence for, and development of, modern treatment care pathways, which have changed radically in recent decades. This has resulted in improved outcomes for children and young people with JIIMs and hope for further groundbreaking developments.</p>","PeriodicalId":8406,"journal":{"name":"Arthritis Care & Research","volume":"78 10","pages":"1346-1357"},"PeriodicalIF":4.1,"publicationDate":"2026-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148429706","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":"Maternal and Personal Smoking, Genetic Susceptibility, and Risk of Osteoarthritis: A Population-Based Prospective Cohort Study","authors":"Junjie Wang PhD,&nbsp;Jianqiao Wang MS,&nbsp;Xiaoyue Zhang PhD,&nbsp;Xusheng Cheng MS,&nbsp;Xing Xing BS,&nbsp;Hanyuan Zhang PhD,&nbsp;Guoqi Cai PhD","doi":"10.1002/acr.80064","DOIUrl":"10.1002/acr.80064","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To investigate the associations of maternal and personal smoking with the risk of knee, hip, hand, and overall osteoarthritis (OA) and the role of genetic predisposition to OA.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A total of 321,075 UK Biobank participants (mean age 56 years, 55% women) without OA at baseline were included; 29.9% reported maternal smoking, 24.3% reported former smoking, and 9.5% reported current smoking. Maternal smoking around childbirth (yes or no) and personal smoking status (never, former, or current) and dose (pack-years) were self-reported by the participants. Cox proportional hazards models were used to explore the associations of maternal and personal smoking status and personal smoking dose with the risk of OA. Genetic susceptibility of OA was assessed using polygenic risk scores (PRS).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>During follow-up, 18,470 (5.8%), 12,064 (3.8%), 6,605 (2.1%), and 52,853 (16.5%) participants developed knee, hip, hand, and overall OA, respectively. Both maternal and personal smoking were positively associated with the risk of knee, hip, hand, and overall OA (maternal smoking hazard ratio [HR] = 1.08–1.23; personal smoking HR = 1.18–1.40). There were significant dose-responsive associations between personal smoking dose and OA risk (<i>P</i> for trend &lt;0.05). The association between maternal and personal smoking and OA risk was similar across different PRS strata.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Both maternal and personal smoking are independently associated with an elevated risk of OA. These associations are universal across different genetic susceptibility of OA.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8406,"journal":{"name":"Arthritis Care & Research","volume":"78 10","pages":"1404-1413"},"PeriodicalIF":4.1,"publicationDate":"2026-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147670009","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 Rheumatoid Arthritis Training Program for Primary Care Providers on the Navajo Nation","authors":"Jennifer Mandal MD,&nbsp;Tabitha Carroway MPH,&nbsp;Gwendolyn Grant MD,&nbsp;Mary Margaretten MD,&nbsp;Starla H. Blanks MBA, MPH,&nbsp;Nataya Cabrera BA,&nbsp;Jeannie Hong PharmD, MPH, BCPS,&nbsp;Zara Izadi MPharm, PhD,&nbsp;Marita Jones MPH,&nbsp;Tina Tso,&nbsp;Jinoos Yazdany MD, MPH","doi":"10.1002/acr.80044","DOIUrl":"10.1002/acr.80044","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>The Navajo Nation, the largest Native American reservation, faces a high prevalence of rheumatoid arthritis (RA) and a critical shortage of rheumatology providers. To address this gap, we developed an RA training program for primary care providers (PCPs) using the Project Extension for Community Healthcare Outcomes (ECHO) telementorship model. This study evaluates the impact of the RA ECHO curriculum on PCPs’ knowledge, confidence, and self-reported clinical behaviors.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We designed a 12-week RA curriculum of weekly 60-minute Zoom sessions with expert-led didactics and case discussions. Content was informed by a needs assessment and input from Navajo cultural interpreters. PCPs completed precourse, postcourse, and one-year follow-up surveys assessing medical knowledge (multiple-choice test) and self-reported confidence (five-point Likert scale) in RA diagnosis and treatment. The one-year follow-up also assessed changes in self-reported clinical behaviors. Paired <i>t</i>-tests were used to assess score changes over time.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 46 clinicians completed the program across three cohorts. Knowledge scores improved from 46% to 71% postcourse (+25%, 95% confidence interval [CI] 7%–43%, <i>P</i> = 0.009) and remained 69% after one year. Confidence scores increased from 2.9 (“neutral”) to 3.9 (“somewhat comfortable”; +1.0, 95% CI 0.23–1.74, <i>P</i> = 0.01), sustained at one year. One year later, participants reported favorable changes in clinical behaviors including performing more detailed joint examinations and ordering preimmunosuppression laboratory tests and vaccines.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The RA ECHO curriculum improved PCPs’ knowledge, confidence, and self-reported clinical behaviors in RA care in the Navajo Nation. This culturally grounded, disease-focused model demonstrates feasibility, acceptability, and scalability as a workforce expansion strategy in settings with limited rheumatology access.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8406,"journal":{"name":"Arthritis Care & Research","volume":"78 10","pages":"1380-1386"},"PeriodicalIF":4.1,"publicationDate":"2026-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147497576","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}