BMC Rheumatology最新文献

{"title":"The impact of lifestyle modification on metabolic pathways in older adults with overweight/obesity and rheumatoid arthritis: a secondary exploratory analysis of the SWET-RA study.","authors":"Grace Kim, Leanna M Ross, Alyssa M Sudnick, Johanna L Johnson, Carl F Pieper, Margery A Connelly, Olga Ilkayeva, Michael J Muehlbauer, Connie W Bales, Kathryn N Porter Starr, William E Kraus, Brian J Andonian, Kim M Huffman","doi":"10.1186/s41927-025-00525-8","DOIUrl":"10.1186/s41927-025-00525-8","url":null,"abstract":"<p><strong>Background: </strong>Rheumatoid arthritis (RA) is associated with increased cardiometabolic risk due to inflammation and traditional risk factors, both of which can be mitigated by lifestyle modifications. This study examines metabolic pathways influenced by lifestyle changes and related to improved cardiometabolic risk.</p><p><strong>Methods: </strong>This is a secondary exploratory analysis of the Supervised Weight loss and Exercise Training (SWET) study, in which twenty older adults with RA and overweight/obesity were randomized to 16 weeks of SWET or a counseling program. Baseline and post-intervention measures included mass spectrometry (MS) and nuclear magnetic resonance (NMR) metabolites and lipoproteins; cardiometabolic risk parameters; and RA clinical outcomes. Principal components analysis (PCA) reduced MS change scores into change factors. Between-group differences were assessed with t-tests and linear regression. Within-group differences were assessed with Wilcoxon-signed rank tests. Spearman's rank correlated MS change factors and NMR change scores with clinical outcomes.</p><p><strong>Results: </strong>Group differences were minimal. In all participants, improvements in metabolic syndrome score were associated with increases in PCA Factor 1 (short- and medium-chain acylcarnitines) and ketone bodies (ρ=-0.57, unadjusted p = 0.009, adjusted p = 0.04; ρ=-0.45, unadjusted p = 0.049, adjusted p = 1.00) and decreases in large low-density lipoprotein particles (LDLp) and large high-density lipoprotein particles (HDLp) (ρ = 0.48, unadjusted p = 0.03, adjusted p = 1.00; ρ = 0.48, unadjusted p = 0.03, adjusted p = 1.00). Improvements in RA disease activity (DAS-28<sub>ESR</sub>) were associated with reductions in very large triglyceride-rich lipoprotein particles (TRLp) (ρ = 0.60, unadjusted p = 0.01, adjusted p = 0.48). Improvements in patient-reported physical health were associated with reductions in HDL-c, ApoA1 concentrations, and medium HDLp (ρ=-0.50, unadjusted p = 0.03, adjusted p = 1.00; ρ=-0.47, unadjusted p = 0.04, adjusted p = 1.00; ρ=-0.45, unadjusted p = 0.047, adjusted p = 1.00). Improvements in patient-reported mental health were associated with decreases in high-density lipoprotein 6 (H6) particles (ρ=-0.60, unadjusted p = 0.03, adjusted p = 1.00), medium HDLp (ρ=-0.54, unadjusted p = 0.01, adjusted p = 0.48), and LDL size (ρ=-0.52, unadjusted p = 0.02, adjusted p = 0.96).</p><p><strong>Conclusion: </strong>In older adults with RA and overweight/obesity, both intensive supervised weight loss and exercise and lifestyle-based counseling influenced metabolic pathways, enhancing lipid metabolism (e.g., reductions in large LDLp) and metabolic flexibility (e.g., increases in fasting ketones and short- and medium-chain acylcarnitines). However, reductions in HDL-related measures should be interpreted cautiously as they may not reflect improved cardiometabolic risk.</p><p><strong>Trial registration: </strong>ClinicalTrials","PeriodicalId":9150,"journal":{"name":"BMC Rheumatology","volume":"9 1","pages":"68"},"PeriodicalIF":2.1,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12147280/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144257364","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of salivary total antioxidant capacity and total oxidant status in patients with rheumatoid arthritis and systemic lupus erythematosus.","authors":"Mohadeseh Soltanian, Mohammad Hassan Kalantar Neyestanaki, Aida Mehdipour, Maryam Masoumi, Mohammad Aghaali, Ali Saleh, Mojtaba Hossein Nattaj","doi":"10.1186/s41927-025-00517-8","DOIUrl":"10.1186/s41927-025-00517-8","url":null,"abstract":"<p><strong>Background: </strong>Oxidative stress plays a critical role in the pathogenesis of autoimmune diseases, including rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE). Assessing total antioxidant capacity (TAC) and total oxidant status (TOS) in saliva offers a non-invasive method to evaluate oxidative stress and its relationship with disease severity. This study aimed to measure salivary TAC and TOS levels in RA and SLE patients and compare them with healthy controls.</p><p><strong>Methods: </strong>A cross-sectional study was conducted involving 90 participants: 30 RA patients, 30 SLE patients, and 30 healthy controls. Saliva samples were collected and analyzed using specialized TAC and TOS assay kits. Disease severity was evaluated using the Disease Activity Score-28 (DAS-28) for RA and the SLE Disease Activity Index (SLEDAI-2 K) for SLE. Statistical analyses included ANOVA, post-hoc tests, and Pearson correlation coefficients.</p><p><strong>Results: </strong>Results showed that RA and SLE patients had significantly higher oxidative stress compared to healthy controls, with lower TAC levels (RA: 298.88 ± 31.21 µM, SLE: 287.98 ± 38.07 µM, Control: 461.22 ± 158.22 µM, P < 0.001) and higher TOS levels (RA: 5.81 ± 1.28 µM, SLE: 5.80 ± 1.36 µM, Control: 3.49 ± 1.56 µM, P < 0.001). The TOS/TAC ratio was also significantly elevated in RA (1.95 ± 0.44) and SLE (2.05 ± 0.64) patients compared to controls (0.84 ± 0.44, P < 0.001). A positive correlation was observed between TOS levels and age (R = 0.256, P = 0.016), while no significant gender-based differences were detected.</p><p><strong>Conclusions: </strong>RA and SLE patients exhibit significant oxidative imbalance, as indicated by altered salivary TAC and TOS levels. These findings highlight the potential role of oxidative stress in these autoimmune diseases.</p>","PeriodicalId":9150,"journal":{"name":"BMC Rheumatology","volume":"9 1","pages":"67"},"PeriodicalIF":2.1,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12147316/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144257363","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence of osteoporosis in chronic diseases: an umbrella review of 283 observational studies from 13 systematic reviews.","authors":"Víctor Juan Vera-Ponce, Jhosmer Ballena-Caicedo, Fiorella E Zuzunaga-Montoya, Joan A Loayza-Castro, Lupita Ana Maria Valladolid-Sandoval, Luisa Erika Milagros Vásquez-Romero, Stella M Chenet, Rafael Tapia-Limonchi, Carmen Inés Gutierrez De Carrillo","doi":"10.1186/s41927-025-00520-z","DOIUrl":"10.1186/s41927-025-00520-z","url":null,"abstract":"<p><strong>Introduction: </strong>Osteoporosis is a disease characterized by decreased bone mineral density and deterioration of bone microarchitecture, which increases fracture risk. In the context of various chronic pathologies, this condition may present an even higher prevalence, impacting morbidity, mortality, and healthcare burden.</p><p><strong>Objective: </strong>To synthesize and compare available evidence from systematic reviews on the prevalence of osteoporosis across different chronic diseases.</p><p><strong>Methodology: </strong>An umbrella review following PRISMA guidelines was conducted, focusing on systematic reviews (with or without meta-analysis) reporting prevalence data of osteoporosis in adults with at least one chronic disease. Databases, including PubMed/MEDLINE, Scopus, Web of Science, and EMBASE, were searched, covering publications between 2009 and 2023, without language restrictions. Two independent reviewers performed study selection and data extraction, resolving discrepancies through consensus. A risk of bias assessment was conducted using the ROBIS tool. Prevalence estimates reported in each review were analyzed, classifying diseases according to the magnitude of the percentages found.</p><p><strong>Results: </strong>Thirteen systematic reviews were evaluated (twelve included meta-analyses). The highest prevalence of osteoporosis was observed in patients with Chronic Obstructive Pulmonary Disease (up to 36.8%) and diabetes mellitus (approximately 27.7%). Other conditions, such as rheumatoid arthritis, multiple sclerosis, liver cirrhosis, and celiac disease, showed variable prevalence but were equally relevant in clinical terms. Methodological heterogeneity, both in diagnostic criteria and populations, was a notable factor.</p><p><strong>Conclusions: </strong>The results highlight the need for systematic assessment of bone health in patients with chronic diseases, particularly those with a higher prevalence of osteoporosis. These findings underscore the importance of timely screening strategies and multidisciplinary approaches to prevent fractures and optimize comprehensive care.</p><p><strong>Clinical trial number: </strong>Not applicable.</p>","PeriodicalId":9150,"journal":{"name":"BMC Rheumatology","volume":"9 1","pages":"66"},"PeriodicalIF":2.1,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12142958/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144246382","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"SPAG11B, a potential biomarker for rheumatoid arthritis: a two-sample bidirectional Mendelian randomization analysis.","authors":"Kun Lin, Qi Lin, Weifeng Lv, Yao Li, Rong Su","doi":"10.1186/s41927-025-00521-y","DOIUrl":"10.1186/s41927-025-00521-y","url":null,"abstract":"<p><strong>Background: </strong>The incidence of rheumatoid arthritis (RA) is rising. However, its pathogenesis has not been fully understood, and the current therapeutic regimens are still limited. The aim of this study was to investigate the causal effect of plasma proteins on RA using Mendelian randomization (MR) analysis.</p><p><strong>Methods: </strong>We performed MR analysis with 4907 plasma protein genetic associations used for exposure and RA genome-wide association data used as outcomes. The method was dominated by Inverse Variance Weighting, in addition to MR-Egger and Weighted Median. Meanwhile, further external validation and reverse MR analysis were conducted to systematically assess the causal relationship between plasma proteins and RA.</p><p><strong>Result: </strong>Preliminary MR analysis identified two proteins (SPAG11B and DEFB135) associated with RA, and elevated plasma levels of both proteins would reduce the risk of RA (for SPAG11B, OR = 0.49, 95% CI = 0.40-0.61, p = 1.19 × 10^- 10; for DEFB135, OR = 0.28, 95% CI = 0.15-0.52, p = 4.51 × 10^- 5, using the IVW method). In the external validation phase, the results were reproducible for SPAG11B, but not for DEFB135. Reverse MR analysis pointed out that RA exhibited reverse causality for plasma levels of SPAG11B (OR = 0.93, 95% CI = 0.89-0.98, p = 0.004), but not for DEFB135 (p = 0.93).</p><p><strong>Conclusion: </strong>The results of MR analysis in this study supported that SPAG11B as a novel biomarker for RA was worthy of further investigation.</p>","PeriodicalId":9150,"journal":{"name":"BMC Rheumatology","volume":"9 1","pages":"65"},"PeriodicalIF":2.1,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12135468/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144224293","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Canakinumab treatment patterns in sJIA, FMF, TRAPS, and MKD/HIDS: real-world insights from a Belgian non-interventional study.","authors":"Michel Moutschen, Cécile Boulanger, Joke Dehoorne, Rik Joos, Florence Roufosse, Vito Sabato, Jeroen van der Hilst, Eleonore Maury, Hilde Rabijns, Marijn Witterzeel, Carine Wouters","doi":"10.1186/s41927-025-00515-w","DOIUrl":"10.1186/s41927-025-00515-w","url":null,"abstract":"<p><strong>Background: </strong>Canakinumab, an IL-1β inhibitor, has demonstrated long-term efficacy and safety in patients with sJIA, FMF, TRAPS, and MKD/HIDS who experience inadequate disease control with conventional treatments. This non-interventional study aimed to gain insights into canakinumab use and treatment patterns for these diseases in Belgium.</p><p><strong>Methods: </strong>Between July 1, 2018 and June 30, 2023, this national, non-interventional, retrospective/prospective study enrolled patients aged ≥ 2 years with sJIA, FMF, TRAPS, or MKD/HIDS reimbursed for, and treated with, canakinumab in Belgium. Part 1: retrospective data collection from first canakinumab administration in the initial 6-month reimbursement period until date of study inclusion. Part 2: prospective data collection following study inclusion. Canakinumab treatment and safety data were collected throughout.</p><p><strong>Results: </strong>At data cut-off, 96 patients (7 sJIA, 70 FMF, 13 TRAPS, 6 MKD/HIDS) were enrolled, of whom 54.2% were female and 87.5% were adults (aged ≥ 18 years). Median age at first canakinumab administration was 34.0 years (20.0, 35.0, 37.0, and 42.0 years in sJIA, FMF, TRAPS, and MKD/HIDS, respectively). Eighteen patients discontinued treatment (3 sJIA, 11 FMF, 4 TRAPS), which was due to lack of efficacy (per investigator's judgment) in 10 (10.4%) patients. Median dose per administration was 289.1 mg in patients with sJIA, and 150.0 mg in patients with FMF, TRAPS, and MKD/HIDS, while median interval between two consecutive administrations was 28.0 days. Thirty-five (36.5%) patients with FMF, TRAPS, or MKD/HIDS received ≥ 1 dose increase (≥ 150 mg). No safety events were reported.</p><p><strong>Conclusions: </strong>These non-interventional study data highlight that canakinumab treatment patterns are generally aligned with the summary of product characteristics (SmPC) and reimbursement criteria in Belgium and further support the well-tolerated safety profile of canakinumab. However, Belgian reimbursement criteria require long-term glucocorticoids prior to canakinumab therapy; if it were possible to align treatment more closely with EULAR/PReS guidance, which recommends early initiation of anti-IL-1 or anti-IL-6 therapy, glucocorticoid treatment would be limited and improved outcomes for these patients would likely be possible.</p><p><strong>Clinical trial number: </strong>Not applicable.</p>","PeriodicalId":9150,"journal":{"name":"BMC Rheumatology","volume":"9 1","pages":"64"},"PeriodicalIF":2.1,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12121185/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144180637","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Real-world evidence of biological treatments in rheumatoid arthritis and spondyloarthritis in Morocco: results of the RBSMR registry.","authors":"Najlae El Ouardi, Ihsane Hmamouchi, Redouane Abouqal, Fadoua Allali, Rachid Bahiri, Imane El Bouchti, Imad Ghozlani, Hasna Hassikou, Linda Ichchou, Saadia Janani, Taoufik Harzy, Radouane Niamane, Ahmed Bezza, Abdellah El Maghraoui","doi":"10.1186/s41927-025-00510-1","DOIUrl":"10.1186/s41927-025-00510-1","url":null,"abstract":"<p><strong>Background: </strong>Regional variability in the effectiveness and safety of biologic therapies for rheumatoid arthritis (RA) and spondyloarthritis (SpA) underscores the need for comprehensive assessment. The aim of this study was to provide real-world evidence of the effectiveness and the safety of biologic for RA, SpA including psoriatic arthritis, in the daily clinical practice.</p><p><strong>Materials and methods: </strong>RBSMR registry was a multicenter, cohort study conducted in 10 university departments of rheumatology. The study included RA and SpA patients receiving biotherapy, either as an initiation or ongoing treatment, and investigated for 3 years. The statistical analysis was performed using JAMOVI software (T student test, Mann-Whitney U test, Chi-squared test, Fisher's exact test, Paired T test and Wilcoxon test).</p><p><strong>Results: </strong>223 RA and 194 SpA were eligible. After 3 years of follow-up, DAS28 CRP (3.6 ± 1.4 versus 5.8 ± 1.0 at baseline) and ASDAS CRP (1.8[1-2.4] versus 3.5[2.5-4.4] at baseline) significantly improved; 13.8% of RA patients achieved remission based on DAS28 CRP and 20.1% of SpA patients achieved remission based on ASDAS CRP. Overall, 163 and 126 adverse events were reported in RA and SpA patients respectively. Infections were the most frequently reported events with an incidence of 11.8 and 13.4/100 patients-year in RA and SpA respectively. Total incidence rate of tuberculosis was 0.80 patient/100 patients-year.</p><p><strong>Conclusions: </strong>The RBSMR registry provides real-world insights into the effectiveness of biologics in the practice of rheumatology for RA and SpA patients in Morocco. It underscores the critical need for continued vigilance in monitoring and addressing adverse events, with a particular focus on tuberculosis infection.</p>","PeriodicalId":9150,"journal":{"name":"BMC Rheumatology","volume":"9 1","pages":"62"},"PeriodicalIF":2.1,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12107801/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144156966","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Does osteoarthritis physiotherapy research in South Korea align with the National Institute for Health and Care Excellence guidelines: a systematic review of English and Korean literature.","authors":"Mi La Park, Nico Magni, Daniel W O'Brien","doi":"10.1186/s41927-025-00496-w","DOIUrl":"10.1186/s41927-025-00496-w","url":null,"abstract":"<p><strong>Background: </strong>Osteoarthritis (OA) is a leading cause of lower limb disability worldwide, imposing significant socioeconomic and personal burden. Thus, many internationally recognised organisations have developed management guidelines for this condition. Among these, the National Institute for Health and Care Excellence (NICE) recommends four first-line approaches to osteoarthritis management: education, exercise, self-management, and weight management. Despite the development of guidelines, adherence to OA management recommendations appears to be suboptimal internationally, and little is known about guideline adherence in South Korea. This study aimed to explore whether research-based physiotherapy interventions for OA in South Korea align with the NICE guidelines.</p><p><strong>Methods: </strong>A comprehensive search was conducted across multiple Korean and English electronic databases, including the Korea Citation Index (KCI), Korean Studies Information Service System (KISS), MEDLINE, EMBASE, CINAHL, SPORTDiscus SCOPUS, and Google Scholar. Twelve randomized controlled trials conducted in South Korea met the inclusion criteria, with sample sizes ranging from 20 to 60 participants. Participants' mean age ranged from 57 to 75 years, and their Body Mass Index (BMI) varied from 23.00 to 25.68 kg/m². The primary outcome measure was the alignment of interventions with NICE OA guidelines, assessed using a scoring system (0-2 points per study) developed specifically for this review. Additionally, the methodological quality of included studies was evaluated using the Physiotherapy Evidence Database (PEDro) scale.</p><p><strong>Results: </strong>Most studies had poor methodological quality (PEdro scale range: 3-5). Only 42% of the Korean studies aligned with the NICE OA recommendations. Commonly applied interventions were predominantly passive, such as heat therapy, electrotherapy, and kinesiology taping, none of which are recommended by NICE.</p><p><strong>Conclusions: </strong>A discrepancy was found between research-based physiotherapy interventions for osteoarthritis in South Korea and the therapeutic approaches recommended by the National Institute for Health and Care Excellence guidelines. Factors such as a lack of evidence-based education, research, healthcare funding in South Korea, and cultural health experiences and expectations of the patients may have contributed to these findings. These results could help develop new strategies for improving osteoarthritis management in South Korea.</p>","PeriodicalId":9150,"journal":{"name":"BMC Rheumatology","volume":"9 1","pages":"63"},"PeriodicalIF":2.1,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12107800/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144156964","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between hepatitis C virus infection and rheumatoid arthritis: a nationwide cross-sectional study.","authors":"Lin Tang, Lei Zhang, Zhonghai Ding, Wenying Xu, Yu Liu, Zhenghong Yu","doi":"10.1186/s41927-025-00513-y","DOIUrl":"10.1186/s41927-025-00513-y","url":null,"abstract":"<p><strong>Background: </strong>Patients infected with Hepatitis C Virus (HCV) often present with rheumatic symptoms, but its link to rheumatoid arthritis (RA) remains unclear. The purpose of this cross-sectional study was to investigate whether HCV infection is related to the risk for RA in adults.</p><p><strong>Methods: </strong>We analyzed data from the 2017-2020 National Health and Nutrition Examination Survey (NHANES). HCV infection and RA status were determined through questionnaires. Covariates included gender, age, race, marital status, body mass index (BMI), high-sensitivity C-reactive protein (hs-CRP), and diabetes status. Multivariate logistic regression and subgroup analyses were used to assess the relationship between HCV infection and RA risk.</p><p><strong>Results: </strong>In this population-based study involving 5,825 participants aged 18-80 years (including 485 RA patients), we observed a significantly higher prevalence of HCV infection in the RA group compared with non-RA controls. After adjusting for covariates, multivariate logistic regression showed that HCV infection was associated with an increased risk of RA (OR = 1.93; 95%CI = 1.07-3.50, p < 0.05).</p><p><strong>Conclusion: </strong>This study demonstrates that HCV infection is associated with the risk of RA in adults, underscoring the potential value of HCV screening in RA patients for improved disease management. However, causal interpretation is limited by the cross-sectional design and reliance on self-reported data.</p>","PeriodicalId":9150,"journal":{"name":"BMC Rheumatology","volume":"9 1","pages":"61"},"PeriodicalIF":2.1,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12105305/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144149116","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Personalized dose reduction strategies for biologic disease-modifying antirheumatic drugs for treating axial spondyloarthritis: a clinical and economic evaluation with predictive modeling.","authors":"Bui Hai Binh, Nguyen Thi Thu Phuong, Vu Thi Thanh Hang, Ngo Thi Thuc Nhan, Nguyen Thi Nhu Hoa, Hoang Van Dung","doi":"10.1186/s41927-025-00516-9","DOIUrl":"10.1186/s41927-025-00516-9","url":null,"abstract":"<p><strong>Background: </strong>Axial spondyloarthritis (AS) is a chronic inflammatory disease that significantly affects quality of life and imposes a high economic burden on patients due to the cost of biologic disease-modifying antirheumatic drugs (bDMARDs). Dose reduction strategies for bDMARDs may offer a feasible approach to maintaining clinical efficacy while reducing costs. This study aimed to evaluate the clinical effectiveness and cost-efficiency of bDMARD dose reduction in patients with AS and apply machine learning to identify key factors influencing disease control.</p><p><strong>Methods: </strong>This 12-month prospective study, 368 AS patients receiving ≥ 3 months of full-dose bDMARDs were included. Among 215 initial responders (ASDAS < 2.1), 146 underwent dose reduction while 69 continued full-dose therapy. Clinical outcomes such as C-reactive protein (CRP) levels, the Bath ankylosing spondylitis disease activity index (BASDAI) and ankylosing spondylitis disease activity score (ASDAS) were assessed, along with cost effectiveness using incremental cost effectiveness ratios (ICER). Random forest models were developed to predict the achievement of inactive disease (ASDAS < 1.3) and to identify key predictors.</p><p><strong>Results: </strong>The dose reduction group demonstrated significantly greater improvements in CRP (-4.05 vs. +2.83 mg/L, p < 0.001), BASDAI (-3.00 vs. +0.89, p < 0.001), and ASDAS (-1.42 vs. +0.09, p < 0.001) compared to the full dose group. A greater proportion of patients in the reduced dose group achieved ASDAS < 1.3 at 12 months (93.2% vs. 33.3%, p < 0.001), with a shorter median time to response (4.20 vs. 4.70 months, p < 0.001). The ICER for achieving ASDAS < 1.3 was favorable (-$6,209.78; 95% CI:-$9,048.35 to-$4,015.78), supporting the cost-effectiveness of dose reduction. A random forest model identified reduced dose strategy, baseline ASDAS, BASDAI, treatment duration, and CRP as key predictors of ASDAS < 1.3, achieving an AUC of 0.845 and F1-score of 0.774.</p><p><strong>Conclusions: </strong>In this cohort, bDMARD dose reduction was associated with preserved clinical outcomes and lower costs, suggesting it may be a viable strategy for selected patients under close clinical supervision. Predictive modeling provided actionable insights to optimize personalized treatment strategies, balancing efficacy and economic sustainability. These findings support further evaluation of dose reduction strategies, especially in resource-limited settings, to inform potential integration into routine practice.</p>","PeriodicalId":9150,"journal":{"name":"BMC Rheumatology","volume":"9 1","pages":"60"},"PeriodicalIF":2.1,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12105312/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144149149","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rheumatologic manifestations in children with underlying inborn errors of immunity.","authors":"Zohreh Saeidi, Sina Fadai, Mehrnaz Mesdaghi, Azadeh Zeinab Mirzaee, Samin Sharafian, Khosro Rahmani, Narges Eslami, Vadood Javadi Parvaneh, Mahsa Talebi, Zahra Chavoshzadeh, Reza Shiari","doi":"10.1186/s41927-025-00508-9","DOIUrl":"10.1186/s41927-025-00508-9","url":null,"abstract":"<p><strong>Background and objective: </strong>In recent years, many studies have been conducted on the possible link between rheumatologic diseases and inborn errors of immunity. Rheumatologic diseases may occur as manifestations of an underlying immunodeficiency disorder, and may appear before the more-common infectious manifestations more typically seen in immunodeficiency disorders. In this study, we have attempted to study such symptoms and uncover their relationship with inborn errors of immunity.</p><p><strong>Methodology: </strong>In this retrospective descriptive-analytical study, 381 cases of IEIs in children that were referred to Mofid Children's Hospital clinic between 2015 and 2019 were evaluated for eligibility to be enrolled in the study. Of these patients, 20 that had confirmed rheumatologic diagnoses were entered into the study. Patients' demographic and medical data, including age at disease onset, age at diagnosis and type of diagnosed rheumatologic and immunodeficiency disorders, parental consanguinity rate, and relevant laboratory findings were retrieved for study and analyzed.</p><p><strong>Results: </strong>Among 20 eligible patients, half of which were female and half were male, the average age at disease onset, average age at diagnosis of the underlying immunodeficiency disease and average age at diagnosis of the rheumatologic disease were 2.98 ± 1.56, 5.26 ± 3.45 and 3.58 ± 2.97, respectively. JIA made up 10 of the observed rheumatic diseases (\"the JIA group\"); the remaining 10 patients included SLE (3), FMF (2), juvenile dermatomyositis (2), MCTD (1), GPA (1) and reactive arthritis (1) (\"the non-JIA group\"). As for the underlying immunodeficiency disorders, CID was seen in 8 patients, followed by CVID (5), XLA (4), SIgAD (2) and CGD (1). The average age at onset of the disease and the average age at diagnosis of the rheumatologic disease were significantly lower in the JIA group than in the non-JIA group (p < 0.05).</p><p><strong>Conclusions: </strong>A plethora of rheumatologic manifestations may be observed in patients with IEIs; such manifestations should be actively sought out and treated in IEI patients.</p><p><strong>Clinical trial number: </strong>Not applicable.</p>","PeriodicalId":9150,"journal":{"name":"BMC Rheumatology","volume":"9 1","pages":"57"},"PeriodicalIF":2.1,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12100983/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144132126","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}