Arthritis Care & Research最新文献

{"title":"Clinical Significance of Therapeutic Drug Level Monitoring for Mycophenolate in Patients With Extrarenal Systemic Lupus Erythematosus—A Systematic Review and Meta-Analysis","authors":"Zahraa Qamhieh MD,&nbsp;Dalia Sriwi MD,&nbsp;Callie Saric BS,&nbsp;Tripti Singh MD,&nbsp;Christie M. Bartels MD, MS,&nbsp;Shivani Garg MD, PhD","doi":"10.1002/acr.80035","DOIUrl":"10.1002/acr.80035","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Clinical response to mycophenolic acid (MPA) is highly heterogeneous; thus, therapeutic drug level monitoring (TDM) may help improve treatment efficacy. This systematic review and meta-analysis examined therapeutic ranges for MPA levels associated with better outcomes and safety in patients with systemic lupus erythematosus (SLE), particularly those with extrarenal manifestations.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We performed a comprehensive search of studies evaluating associations between MPA levels and clinical SLE response. Using forest plots, we calculated pooled odds of clinical response by MPA levels and measured the weighted mean differences across outcomes. Analysis was performed in all patients with SLE and separately in patients with extrarenal manifestations.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among 459 reviewed abstracts, 24 met inclusion. Summarized evidence supported that clinical response was observed at MPA area under the curve at 0 to 12 hours (AUC_0–12) ≥30 to 35 mg hr/L or trough concentration (C_trough) ≥1.5 mg/L. At these thresholds, therapeutic MPA levels were associated with 12-fold higher odds (95% confidence interval [CI] 5.44–27.35; <i>P</i> &lt; 0.0001; I² = 41%) of overall clinical SLE response and 15-fold higher odds (95% CI 4.74–46.89; <i>P</i> &lt; 0.0001; I² = 61%) of response in patients with extrarenal manifestations. Additionally, MPA levels were 32 units higher (95% CIs 17.35–45.67) in overall responders with SLE and 39 units (95% CI 15.05–62.53) higher in patients with extrarenal manifestations. Although pooled analysis did not show a significant increase in adverse events, individual studies suggested safety concerns at MPA AUC_0–12 &gt;60 mg hr/L or C_trough ≥2.5 to 3 mg/L</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This study highlights the clinical utility of TDM to guide MPA dosing to balance efficacy versus safety in all patients with SLE, including those with extrarenal manifestations.</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":"1424-1437"},"PeriodicalIF":4.1,"publicationDate":"2026-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13499014/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147375872","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":"Retractions in Rheumatology: Trends, Causes, and Implications for Research Integrity","authors":"Anna Maria Vettori,&nbsp;Michele Iudici MD, PhD, MPH","doi":"10.1002/acr.80005","DOIUrl":"10.1002/acr.80005","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>We aimed to describe the trends and main reasons for study retraction in rheumatology literature.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We reviewed the Retraction Watch database to identify retracted articles in rheumatology. We recorded the main study characteristics, authors’ countries, reasons for retraction, time from publication to retraction, and trends over time. Reasons for retraction were classified as scientific misconduct, data/figure errors, or other reasons. Main article features and cause of retractions in rheumatology were compared with a sample of articles from other medical specialties.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 381 (79.5% original articles) rheumatology articles were retracted between 1989 and 2024. Most originated from Asia (68.5%), particularly China (50.7%). Scientific misconduct accounted for 75.3% of retractions, followed by data errors (14.9%) and other reasons (7.6%). Common misconduct types included data fabrication, fake peer review, duplication, and authorship issues. The median time from publication to retraction was 18 months (interquartile range 9–46), with one-third of articles requiring more than 36 months to be retracted. Time to retraction did not improve over time. The number of retractions steadily increased over time from 18 in 2000–2009, 117 in 2010–2019, and 207 in 2020–2023 (<i>P</i> &lt; 0.001). Compared with other medical specialties, rheumatology exhibited similar retraction patterns, differing mainly in geographic distribution.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Retractions in rheumatology have risen substantially, largely due to misconduct. This trend may reflect an increase in questionable research practices or improved detection. Strengthening early-career education, institutional oversight, and ethical research culture is essential to enhance transparency and integrity in the field.</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":"1372-1379"},"PeriodicalIF":4.1,"publicationDate":"2026-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/acr.80005","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146002985","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":"Reflections on Retractions in Rheumatology Publications","authors":"Kelli D. Allen PhD","doi":"10.1002/acr.80011","DOIUrl":"10.1002/acr.80011","url":null,"abstract":"","PeriodicalId":8406,"journal":{"name":"Arthritis Care & Research","volume":"78 10","pages":""},"PeriodicalIF":4.1,"publicationDate":"2026-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146123742","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":"Three Decades of Health Care Transition in Rheumatology: Progress, Challenges, and Future Directions","authors":"Sarah D. Bayefsky MD, MSEd,&nbsp;Joyce C. Chang MD, MSCE","doi":"10.1002/acr.80101","DOIUrl":"10.1002/acr.80101","url":null,"abstract":"<p>The revolution of treatment advances for children with rheumatic diseases since the advent of pediatric rheumatology has coincided with the growing recognition that many of these children will continue to require long-term rheumatology care after reaching adulthood. Moreover, it has become evident that effective, systematic approaches are needed to help adolescents and young adults (AYAs) with pediatric rheumatic diseases learn to manage their health independently and succeed in an adult-oriented model of health care. In this narrative literature review, we provide a historical perspective on health care transition and its relevance to the field of rheumatology. Second, we review seminal literature on outcomes of transition and transition-related needs of AYAs with pediatric-onset rheumatic diseases. Third, we describe interventions designed to improve health care transition for AYAs with pediatric rheumatic diseases. Lastly, we discuss remaining knowledge gaps and future directions for the field.</p>","PeriodicalId":8406,"journal":{"name":"Arthritis Care & Research","volume":"78 10","pages":"1333-1345"},"PeriodicalIF":4.1,"publicationDate":"2026-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148249048","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":"Comparative Performance of LFA-REAL, SLEDAI, and BILAG for Detecting Clinically Meaningful Changes in Lupus Activity","authors":"Alberto Nordmann-Gomes MD,&nbsp;Leila Khalili MSN, FNP,&nbsp;Cynthia Aranow MD,&nbsp;Meggan Mackay MD, MS,&nbsp;Mimi Kim ScD,&nbsp;Diane Kamen MD, MSCR,&nbsp;Cristina Arriens MD, MSCS,&nbsp;Maya Souvignier BA,&nbsp;Wei Tang MD,&nbsp;Stephen Suh BS,&nbsp;Robert Clancy PhD,&nbsp;Cady Chen BS,&nbsp;Maria Dall'Era MD,&nbsp;Joan T. Merrill MD,&nbsp;Anca D. Askanase MD, MPH","doi":"10.1002/acr.80034","DOIUrl":"10.1002/acr.80034","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>This study aimed to compare the performance of the Lupus Foundation of America Rapid Evaluation of Activity in Lupus (LFA-REAL), British Isles Lupus Assessment Group Index (BILAG), and Systemic Lupus Erythematosus Disease Activity Index (SLEDAI) in detecting the clinician's perception of improvement and worsening disease and identifying patients requiring treatment escalation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This was a prospective, observational study conducted at four centers. Adults with systemic lupus erythematosus were evaluated at a baseline and follow-up visit. Disease activity was assessed using SLEDAI, BILAG, and LFA-REAL at both visits by the same physician. At the follow-up visit, the Clinician Global Impression of Change (CGIC) was recorded to classify patients as improved, worsened, or unchanged. Receiver operating characteristic curve analysis was used to evaluate each instrument in detecting clinician-rated change gauged by CGIC with optimal cut-off points determined using the Youden Index.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of the 163 patients enrolled, 145 (89%) completed a follow-up visit. Based on CGIC, 23% improved, 16% worsened, and 61% remained stable. For detecting CGIC-defined improvement, LFA-REAL had an area under the curve (AUC) of 0.85 (95% confidence interval [CI] 0.77–0.92), compared to 0.75 (95% CI 0.66–0.85) for BILAG and 0.74 (95% CI 0.64–0.84) for SLEDAI. For CGIC-defined worsening, AUCs were 0.86 (95% CI 0.77–0.96), 0.79 (95% CI 0.67–0.90), and 0.76 (95% CI 0.66–0.87). Of those with CGIC-defined worsening, eight (35%) required treatment escalation. LFA-REAL identified a difference of ≥10 mm in all eight of these patients, compared to four by BILAG and two by SLEDAI.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>LFA-REAL showed comparable performance relative to SLEDAI and BILAG in detecting clinician-rated change. There was a statistically significant advantage over SLEDAI for detection of improvement. These findings support its utility as a metric for disease activity in clinical practice and research.</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":"1414-1423"},"PeriodicalIF":4.1,"publicationDate":"2026-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147375841","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":"Physician-Scientist Pipeline for Pediatric Rheumatology: The Current Landscape and Future Perspectives","authors":"Ekemini A. Ogbu MD, MSc,&nbsp;Linda T. Hiraki MD, ScD,&nbsp;Mara L. Becker MD, MSCE","doi":"10.1002/acr.80073","DOIUrl":"10.1002/acr.80073","url":null,"abstract":"<p>Over the past 50 years, the science of pediatric rheumatology has grown exponentially due to an expansion in the understanding of complex rheumatic conditions and a surge in novel targeted therapeutics. Physician-scientists in the field of pediatric rheumatology have played major roles in these advancements that have improved the care of children, adolescents, and young adults with chronic and often life-threatening systemic inflammatory diseases. Despite the critical role of the physician-scientist in discovering and translating scientific advancements from the bench to the bedside and vice versa, which have catapulted the field of pediatric rheumatology, this role remains an endangered species, with a declining pipeline due to a variety of factors. In this article, we review the current landscape of the physician-scientist pipeline for pediatric rheumatology on the fiftieth anniversary of the formalization of the specialty in North America. We review challenges to maintaining a thriving physician-scientist pipeline and discuss future perspectives.</p>","PeriodicalId":8406,"journal":{"name":"Arthritis Care & Research","volume":"78 10","pages":"1324-1332"},"PeriodicalIF":4.1,"publicationDate":"2026-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/acr.80073","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147760764","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":"Generative Artificial Intelligence Utilization and Perspectives Among Reproductive-Age Women With Systemic Autoimmune and Rheumatic Diseases.","authors":"Mariam Arif, Catherine Wright, Samantha Rodriguez, Sarah Graves, Tamar Krishnamurti, Mehret Birru Talabi","doi":"10.1002/acr.80168","DOIUrl":"10.1002/acr.80168","url":null,"abstract":"<p><strong>Objective: </strong>Reproductive-age women with systemic autoimmune and rheumatic diseases (SARDs) have unique information needs related to their SARDs and reproductive health. We sought to understand their use of and receptivity to current and hypothetical generative artificial intelligence (AI) tools for health information-seeking.</p><p><strong>Methods: </strong>We conducted a cross-sectional survey of women ages 18 to 48 years with diverse SARDs who were enrolled in a research registry. Descriptive statistics, exploratory multivariable ordinal logistic regression, and thematic analysis were used to evaluate responses.</p><p><strong>Results: </strong>Of 270 eligible women, 190 completed the survey. Participants had an average age of 34.1 (SD 6.4) years. Most were familiar with generative AI (77.4%), and nearly 90% perceived that it might benefit health care; however, only 29% had used it to answer health questions. Eighty-eight percent were willing to use a physician-recommended AI tool. Interest in a hypothetical generative AI tool for SARDs management was associated with desire for personalized recommendations (odds ration [OR] 2.89, 95% confidence interval [CI] 1.25-6.67). Approximately one-third expressed interest in using generative AI for information about medication safety during pregnancy or lactation, which was associated with younger age (OR 0.93, 95% CI 0.88-0.99), desire for timely access (OR 4.71, 95% CI 2.07-10.71), and increased information access (OR 2.56, 95% CI 1.20-5.43). In qualitative analysis, participants viewed generative AI as adjunctive to-not a replacement for-physician guidance.</p><p><strong>Conclusion: </strong>Participants expressed interest in using generative AI for health information-seeking but preferred tools endorsed by rheumatologists. A generative AI tool codeveloped with rheumatologists and adjunctive to the patient-physician relationship could address information needs in this population.</p>","PeriodicalId":8406,"journal":{"name":"Arthritis Care & Research","volume":" ","pages":""},"PeriodicalIF":4.1,"publicationDate":"2026-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149036432","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 Nutrition for OUR Immune System Health Autoimmunity Challenge: A Framework for Crowdsourcing Solutions Focused on the Role of Nutrition in Autoimmune Disease.","authors":"Carmen Ufret-Vincenty, Xinrui Li, C Taylor Gilliland, Grace McCarthy, Victoria K Shanmugam","doi":"10.1002/acr.80170","DOIUrl":"10.1002/acr.80170","url":null,"abstract":"<p><strong>Objective: </strong>The objective of this brief report is to inform the autoimmune research community about the engagement and ideas generated through the Nutrition for OUR Immune System Health (NOURISH): Autoimmunity Challenge.</p><p><strong>Methods: </strong>Building on gaps identified during a 2024 NIH workshop on diet, mucosal immunity, and immune-mediated disease, the Office of Autoimmune Disease Research in the Office of Research on Women's Health launched a public ideation challenge on September 2, 2025. The challenge solicited feasible, testable, scalable, and high-impact concepts to advance diet and nutrition research across autoimmune diseases. Outreach included a public webinar, social media dissemination, and office hours for participants. Submissions were evaluated by NIH judges using five criteria: understanding of the problem and scientific rationale, engagement, potential impact, feasibility, and innovation.</p><p><strong>Results: </strong>The challenge received 44 eligible submissions from 15 individuals, 9 teams, and 17 entities. Fifteen winning entries and 3 honorable mentions were recognized. Winning concepts clustered into four cross-cutting themes: (1) effectiveness of dietary interventions in autoimmune disease; (2) microbiome, immune, and multiomics mechanisms; (3) personalized, data-driven, and predictive nutrition; and (4) community voice, landscape assessment, and patient-centered frameworks. Proposed approaches spanned randomized dietary interventions, biomarker and microbiome studies, real-world nutrition tracking, predictive modeling, and patient-centered frameworks. A prominent unmet need across submissions was for digital health tools to capture diet, symptoms, flares, medications, sleep, physical activity, physiologic signals, and patient-reported outcomes in real time.</p><p><strong>Conclusion: </strong>The NOURISH challenge demonstrates that crowdsourcing can effectively engage patients, advocates, clinicians, researchers, and innovators to identify actionable research opportunities at the intersection of nutrition and autoimmunity while highlighting digital health as a key future scientific opportunity.</p>","PeriodicalId":8406,"journal":{"name":"Arthritis Care & Research","volume":" ","pages":""},"PeriodicalIF":4.1,"publicationDate":"2026-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149036348","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":"Prevalence of Dietary Supplement Use and Potential Medication Interactions Among Adults With Systemic Lupus Erythematosus.","authors":"Sarah L Patterson, Russell Ellyson, Jessica Fitzpatrick, Ghizlane Yaakoubi, Bradley Pearce, S Sam Lim, Jinoos Yazdany, Laura C Plantinga","doi":"10.1002/acr.80165","DOIUrl":"10.1002/acr.80165","url":null,"abstract":"<p><strong>Objective: </strong>The aim of this study was to characterize the prevalence and correlates of dietary supplement use, identify commonly used supplements, and evaluate potential supplement-medication interactions among adults with systemic lupus erythematosus (SLE).</p><p><strong>Methods: </strong>We analyzed cross-sectional data from 451 adults in the Approaches to Positive, Patient-Centered Experiences of Aging With Lupus study, an ancillary study of the population-based Georgians Organized Against Lupus cohort. Participants reported dietary supplement and medication use during a single study visit. Sociodemographic and clinical correlates of supplement use were assessed using descriptive statistics and logistic regression. Potential interactions between commonly used supplements and prescription medications were identified using the NatMed Pro database.</p><p><strong>Results: </strong>Overall, 80.9% of participants used at least one supplement and 55.9% used at least two. The most used supplements were vitamin D (64.1%), multivitamins (45.2%), calcium (29.7%), vitamin B12 (10.6%), and iron (9.3%). Nearly one-third (29.5%) of participants were taking a supplement-medication combination with potential for an interaction. Use of at least two supplements was more common among participants who were older, had higher educational attainment, used at least five prescription medications, or had greater health care use. Potential drug interactions were more frequent among those with polypharmacy, greater SLE disease damage, and recent primary care visits.</p><p><strong>Conclusion: </strong>In this large SLE cohort, dietary supplement use was highly prevalent, and nearly one-third of participants had a potential supplement-medication interaction. These findings underscore the need for routine assessment of supplement use and strategies to support safe, informed use of supplements in people with SLE.</p>","PeriodicalId":8406,"journal":{"name":"Arthritis Care & Research","volume":" ","pages":""},"PeriodicalIF":4.1,"publicationDate":"2026-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149015341","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 Scoping Review and Meta-Analysis of Proportions of Central Nervous System Manifestations Reported in Patients with Sjögren's Disease.","authors":"Arun Varadhachary, Ghaith Noaiseh, Julie Frantsve-Hawley, Frederick B Vivino, Jennifer A McCombe, Shamik Bhattacharyya, E Sherwood Brown, Andrew R Carey, Robert Fox, Thomas Grader-Beck, Janet E Lewis, Stephen Maitz, Steven Mandel, Astrid Rasmussen, George Sarka, R Hal Scofield, Daniel J Wallace, Rochelle Zak, Kristie Cox, Katherine M Hammitt, Steven Carsons, Nancy Carteron","doi":"10.1002/acr.80166","DOIUrl":"10.1002/acr.80166","url":null,"abstract":"<p><strong>Objective: </strong>The objective of this scoping review was to synthesize evidence on the proportion of individuals living with Sjögren's disease who experience central nervous system (CNS) manifestations.</p><p><strong>Methods: </strong>We searched MEDLINE (via PubMed) and Embase from 1980 through January 29, 2026, and the ECRI Guidelines Trust from 2020 through January 29, 2026. Title and abstract screening, followed by full-text review, were performed in duplicate using prespecified inclusion and exclusion criteria. One reviewer extracted data, with an independent audit completed by one of the project coleads. Meta-analyses of proportions were conducted. Sensitivity analyses were planned a priori to evaluate the influence of statistical outliers.</p><p><strong>Results: </strong>We identified 22,857 citations, of which 108 met the inclusion criteria. Pooled proportion estimates were generated for 23 CNS manifestations. Several manifestations occurred at frequencies exceeding those reported in the general population, including depression, migraine, insomnia, cognitive dysfunction, psychosis, movement disorders, aseptic meningoencephalitis, neuromyelitis optica spectrum disorder, optic neuritis, multiple sclerosis, cerebral vasculitis, cerebellar syndrome, spinal cord involvement, and non-localizing somatosensory complaints. The degree of increased frequency differed substantially across manifestations, and several estimates were highly influenced by individual studies, as indicated by sensitivity analyses.</p><p><strong>Conclusion: </strong>The spectrum of CNS involvement in Sjögren's disease is broad and heterogeneous. Attributing CNS manifestations to direct Sjögren's disease involvement or coexisting conditions remains unclear and cannot be assumed to be causally linked. Our findings underscore the complexity of CNS manifestations in Sjögren's disease and highlight the need for evidence-informed guidance to support accurate diagnosis, attribution, and management of neurologic manifestations.</p>","PeriodicalId":8406,"journal":{"name":"Arthritis Care & Research","volume":" ","pages":""},"PeriodicalIF":4.1,"publicationDate":"2026-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149011777","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}