BMC Rheumatology最新文献

{"title":"Comparison of T cell response to vaccination in rheumatic patients treated with Janus kinase inhibitors and TNF inhibitors.","authors":"Sebastian Hüper, Florian Eisele, Johannes Duell, Marc Schmalzing, Lea Nagler, Patrick Pascal Strunz, Matthias Froehlich, Jan Portegys, Michael Gernert","doi":"10.1186/s41927-025-00542-7","DOIUrl":"10.1186/s41927-025-00542-7","url":null,"abstract":"<p><strong>Background: </strong>Janus kinase inhibitors (JAKi) represent a well-established therapeutic option for the treatment of autoimmune diseases. However, there is a paucity of evidence regarding their impact on de novo immune responses to vaccinations. T cells may confer long-lasting immunity and cross-recognise evolving epitopes of new viral variants, as evidenced by the SARS-CoV-2 vaccination. Consequently, we investigated the de novo T-cell response to SARS-CoV-2 vaccination in patients with rheumatic diseases undergoing treatment with JAK inhibitors.</p><p><strong>Methods: </strong>Cross-sectional study, conducted in an outpatient department. Patients with rheumatic disease who had received two vaccinations against SARS-CoV-2 while under therapy with JAKi (n = 22) or tumour necrosis factor-blocking biologicals (TNFi) (control group n = 16) were recruited. To evaluate the vaccine-induced T cell response, the patients' PBMCs were stimulated with SARS-CoV-2 spike protein peptides. The percentage of CD4⁺ T cells responding specifically to this stimulation by producing IFNγ was then measured using intracellular cytokine staining and flow cytometry. In addition antibody response to vaccination was assessed.</p><p><strong>Results: </strong>A specific T cell response was detected in 11 out of 22 (50.0%) of patients in the JAKi cohort, compared to 13 out of 16 (81.3%) of the TNFi cohort (p = 0.088). Patients on JAKi had a lower percentage of CD4⁺ T cells responding to stimulation with SARS-CoV-2 spike peptides than patients on TNFi (p = 0.021). The proportion of patients with an antibody response and absolute anti-spike IgG levels did not significantly differ between the cohorts.</p><p><strong>Conclusions: </strong>Patients on JAKi exhibited a compromised de novo T cell response to SARS-CoV-2 vaccination compared to TNFi patients. There is a need for further research on the effect of JAKi on T cell responses to vaccination.</p>","PeriodicalId":9150,"journal":{"name":"BMC Rheumatology","volume":"9 1","pages":"84"},"PeriodicalIF":2.1,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12239352/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144599432","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":"Low-density lipoprotein cholesterol mediates the causal association between systemic lupus erythematosus and asthma: a mediation mendelian randomization study.","authors":"Hui Yin, Tongxia Wang, Lin Liu, Zhi Hu","doi":"10.1186/s41927-025-00539-2","DOIUrl":"10.1186/s41927-025-00539-2","url":null,"abstract":"<p><strong>Background: </strong>It is well-documented that systemic lupus erythematosus (SLE) is associated with asthma. However, the causal relationship between SLE and asthma, and the potential mediator need to be explained. This study aims to confirm the cause-and-effect relationship between SLE and asthma, and evaluate the mediation effect of lipid in European ancestry.</p><p><strong>Methods: </strong>A Two-sample Mendelian randomization (MR) study was applied to analyze the causal relationships between SLE and asthma. A two-step MR design was used to explore whether low-density lipoprotein cholesterol (LDL-C) mediates the causal pathway from SLE to asthma outcome. Cochran's Q statistic methods and MR-Egger regression were used to assess heterogeneity and pleiotropy. Leave-one-out (LOO) sensitivity test was adopted to estimate the effect of removing one of the selected individual SNPs on the overall results. Funnel and forest plots were also conducted to detect the pleiotropy directly.</p><p><strong>Results: </strong>SLE was significantly associated with higher asthma risk according to inverse-variance weighted (IVW) method [OR (95%CI): 1.093 (1.024-1.166)] (P = 0.007), MR Egger method [OR (95%CI): 1.192 (1.077-1.319)] (P = 0.028) and Maximum likelihood [OR (95%CI): 1.094 (1.036-1.155)] (P = 0.001), which were robust across adequate sensitivity analysis. On the contrary, asthma has no causal relationship with SLE. In addition, LDL-C may mediate a proportion of 6.15% of the total effect between SLE and asthma.</p><p><strong>Conclusion: </strong>This study demonstrates that patients with SLE may have a higher risk of developing asthma, which may be mediated by LDL-C. Understanding this relationship provides insight into potential mechanisms underlying asthma development in SLE patients and offers a foundation for developing targeted treatment strategies to manage these risks effectively.</p>","PeriodicalId":9150,"journal":{"name":"BMC Rheumatology","volume":"9 1","pages":"85"},"PeriodicalIF":2.1,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12239405/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144599433","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":"Minimal important differences of measurement instruments used in rheumatoid arthritis: a scoping review.","authors":"Sally Yaacoub, Anas El Zouhbi, Michella Abi Zeid Daou, Vicky Nahra, Abir Mokbel, Layal Hneiny, Liana Fraenkel, Bradley C Johnston, Elie A Akl","doi":"10.1186/s41927-025-00524-9","DOIUrl":"10.1186/s41927-025-00524-9","url":null,"abstract":"<p><strong>Background: </strong>Many outcomes relevant to rheumatoid arthritis are measured as continuous variables. Judging whether the results of those measurements are clinically significant requires determining the minimal important difference (MID) estimate. Therefore, valid MID estimate(s) are essential for the purposes of clinical decision-making and developing clinical recommendations. Our objective is to present the MID estimates for instruments used to measure outcomes in rheumatoid arthritis studies.</p><p><strong>Methods: </strong>We conducted a scoping review. We included original research reports on MID of instruments used to measure outcomes in rheumatoid arthritis, using distribution- or anchor-based methods. We excluded conference abstracts. We searched MEDLINE (OVID) and EMBASE (OVID) databases on January 6, 2025 and scanned the reference lists of included studies and of identified relevant systematic reviews. Reviewers screened the titles and abstracts and full-texts, then abstracted data in duplicate and independently. They resolved disagreements by discussion or by consulting a third reviewer. We summarized the data narratively and in tabular formats.</p><p><strong>Results: </strong>We identified 35 eligible studies reporting on a total of 144 MID estimates for 72 instruments used in rheumatoid arthritis. The most common constructs measured were physical function (26%), disease activity (18%), health status (17%) and fatigue (14%). The majority of measurement instruments were generic (60%). The most common instrument with MID estimates was the Health Assessment Questionnaire Disability Index (7%). The majority of MID estimates were calculated using anchor-based methods (72%). We did not critically appraise the included studies.</p><p><strong>Conclusions: </strong>We identified the MID estimates for a substantive number of measurement instruments used in rheumatoid arthritis. There was considerable variability in the findings for the same instrument within and across studies.</p>","PeriodicalId":9150,"journal":{"name":"BMC Rheumatology","volume":"9 1","pages":"83"},"PeriodicalIF":2.1,"publicationDate":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12235810/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144583007","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":"Effects of high-intensity interval training on patients with inflammatory arthritis: a systematic review.","authors":"Christopher Sutherland, Tadesse Gebrye, Adekola Ademoyegun, Francis Fatoye, Chidozie Mbada","doi":"10.1186/s41927-025-00540-9","DOIUrl":"10.1186/s41927-025-00540-9","url":null,"abstract":"<p><strong>Background: </strong>Despite reports of clinical benefits, concerns persist about the stress associated with high-intensity interval training (HIIT) in patients with inflammatory arthritis (IA). This review aimed to assess the effects of HIIT on disease activity, immune function, symptoms, cardiorespiratory fitness (CRF), and overall health-related quality of life (HRQoL) in patients with IA.</p><p><strong>Methods: </strong>The PubMed, CINAHL, Cochrane Library, Web of Science, and Scopus databases were searched for eligible randomised controlled trials (RCTs). Data were extracted on the impacts of HIIT on IA conditions (i.e. rheumatoid arthritis (RA), psoriatic arthritis (PsA), and axial spondyloarthritis (axSpA)). Cochrane risk of bias tool 2.0 and PEDro scale were used in this review. This review was registered with PROSPERO (CRD42024577039).</p><p><strong>Results: </strong>Of 117 initial records, nine studies met the inclusion criteria, comprising 586 IA patients (HIIT = 285; controls = 301). Most studies (n = 8) reported stable disease activity, but one showed a slight decrease. Of four studies reporting pain/fatigue, pain scores remained unchanged in most studies (n = 3), except in one where there was a significant reduction in pain in the HIIT group (p < 0.05), and two studies reported a decrease in fatigue (p < 0.05). All studies evaluating CRF reported improvements, with one also indicating enhanced HRQoL. Body composition measures showed either reductions or no change, while imaging assessments in two studies revealed no significant differences.</p><p><strong>Conclusion: </strong>HIIT appears safe for patients with IA and does not exacerbate disease activity. HIIT resulted in improvement in CRF parameters, alongside positive changes in HRQoL. However, more high-quality RCTs are needed due to limited research in this area.</p>","PeriodicalId":9150,"journal":{"name":"BMC Rheumatology","volume":"9 1","pages":"82"},"PeriodicalIF":2.1,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12232866/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144583006","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":"Perioperative management with DMARDs in rheumatic diseases: a scoping review of clinical guidelines.","authors":"Alice Terrett, Athena Chin, Mihye Kwon, Samuel Whittle, Catherine Hill","doi":"10.1186/s41927-025-00522-x","DOIUrl":"10.1186/s41927-025-00522-x","url":null,"abstract":"<p><strong>Objective: </strong>Patients with autoimmune rheumatic diseases have high rates of surgical procedures including joint replacements despite the use of disease-modifying anti-rheumatic drugs (DMARDs). This scoping review compares clinical practice guideline recommendations for the perioperative management of DMARDs in such patients.</p><p><strong>Methods: </strong>Medline and EMBASE were searched, and a hand search of references was performed to obtain guidelines published since 2014 by national/international academic societies in rheumatology addressing perioperative management of DMARDs in any of adult rheumatoid arthritis (RA), ankylosing spondylitis (AS), psoriatic arthritis (PsA), juvenile idiopathic arthritis (JIA) or systemic lupus erythematosus (SLE). Data extraction was performed in duplicate by two authors.</p><p><strong>Results: </strong>Twelve guidelines were included - 10 (83%) incorporated a perioperative recommendation within a broader guideline. RA was the sole rheumatic condition in 6 (50%) guidelines. Low-moderate quality evidence supported these recommendations, based on evidence from studies of participants undergoing elective orthopaedic surgery. Guidelines varied in development process, format, the choice of evidence system, level of evidence, strength of recommendation and recommendations for biologic DMARD (bDMARD) use and timing of surgery.</p><p><strong>Conclusion: </strong>Although guidelines for the use of DMARDs in the perioperative period are widely available, the development process and recommendations vary between guidelines. There is a lack of high quality evidence to support recommendations for non-elective, non-orthopaedic surgery cases. Variations in recommendations for bDMARDs in the perioperative period were common, potentially leading to more practice variation in bDMARD use in the perioperative period. Continued accrual and review of evidence will provide greater support for recommendations in this clinical setting.</p>","PeriodicalId":9150,"journal":{"name":"BMC Rheumatology","volume":"9 1","pages":"81"},"PeriodicalIF":2.1,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12224603/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144559152","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":"Beliefs, preferences, and informational needs of patients with rheumatoid arthritis and concomitant cancer: a qualitative study.","authors":"Juan I Ruiz, Sheneze T Madramootoo, Maria A Lopez-Olivo, Namrata Singh, Maria E Suarez-Almazor","doi":"10.1186/s41927-025-00526-7","DOIUrl":"10.1186/s41927-025-00526-7","url":null,"abstract":"<p><strong>Background: </strong>Treatment of rheumatoid arthritis (RA) with biologic drugs in patients with cancer could potentially result in poor cancer outcomes. This study aimed to identify the beliefs, preferences, and informational needs of patients with RA and cancer regarding the harms, benefits, and uncertainties surrounding the use of RA therapy with respect to cancer.</p><p><strong>Methods: </strong>We interviewed 20 patients with RA and cancer recruited from a cancer center using a semi-structured guide. We explored patients' discussions with physicians, beliefs, preferences about RA treatment, and decision-making issues. Using a deductive approach, patients' responses were grouped according to the explored themes.</p><p><strong>Results: </strong>Fifteen (75%) patients were women; mean age was 59.9 years (standard deviation, 9.8). Patients discussed RA symptoms, adverse events, drug interactions, and discontinuation of RA treatment after cancer diagnosis; most felt their concerns were clarified after the discussion with their physicians. Some patients were concerned about the risk of cancer development or recurrence due to RA treatment; few were concerned about the interaction between RA and cancer treatment. Patients were concerned about the impact of cancer treatment on RA and potential immunosuppression. Patients relied on discussions with their physician and their own previous experiences to make decisions. Most patients would consider taking a drug for RA even when its impact on cancer is unknown. Patients wanted to receive information about drugs' efficacy and adverse effects, drug interactions, impact of RA drugs on cancer, and costs.</p><p><strong>Conclusions: </strong>Our findings on informational needs, concerns, information delivery preferences, and desired level of involvement in the treatment-related decisions of patients with RA and cancer can facilitate the development of educational material that can help with shared decision-making in patients with RA and cancer. We identified important aspects related to the informational needs and concerns of patients with RA and cancer, including worries about not being able to receive RA treatment.</p><p><strong>Clinical trial number: </strong>Not applicable.</p>","PeriodicalId":9150,"journal":{"name":"BMC Rheumatology","volume":"9 1","pages":"79"},"PeriodicalIF":2.1,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12220157/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144538787","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":"Examining how resistance training affects bone strength in older adults with rheumatic diseases: a systematic review.","authors":"Mira Channaoui, MinHyuk Kwon, Edward Jo, Srdjan Lemez","doi":"10.1186/s41927-025-00531-w","DOIUrl":"10.1186/s41927-025-00531-w","url":null,"abstract":"<p><strong>Background: </strong>Rheumatic diseases significantly impact global healthcare through disability, lost productivity, and reduced quality of life, making them an important focus for researchers. As physiological changes associated with aging decrease bone mineral density, rheumatic diseases further elevate fracture risk in older adults. Resistance training has been shown to counteract age-related declines through increases in muscle, strength, and bone mineral density, demonstrating its potential for mitigating bone mineral density loss. This systematic review examines the effectiveness of resistance training interventions in maintaining or improving bone mineral density in older adults with rheumatic diseases, an issue of relevance given impaired skeletal integrity linked to these diseases.</p><p><strong>Methods: </strong>Articles were included if written in English, published after December 31, 1999, and in peer-reviewed journals with full-text, examined adults aged 65 years and above with diagnosed rheumatic disease, and used prospective longitudinal resistance training interventions on bone mineral density outcomes. Through the Web of Science Core Collection, SPORTDiscus (EBSCOhost), PubMed, ScienceDirect, and Wiley Online Library databases, the search yielded 17 eligible studies, of which 12 were deemed high-quality using the PEDro scale.</p><p><strong>Results: </strong>Results were organized into four themes: (1) Resistance training alone on bone mineral density, (2) Combining resistance training with supplement intake, (3) Pairing resistance training with other exercises, and (4) How resistance training influences balance and fall risk. While most studies showed that resistance training positively impacts bone health, interpretations are limited as supplements or additional exercises were often combined with resistance training.</p><p><strong>Conclusion: </strong>Resistance training interventions appear to be well tolerated in older individuals and generally have a positive impact on bone health. Nevertheless, we propose that future research should focus more on longitudinal resistance training-only interventions to isolate the specific effects of resistance training on bone mineral density, in addition to prioritizing high-quality randomized controlled trials to strengthen the evidence base.</p>","PeriodicalId":9150,"journal":{"name":"BMC Rheumatology","volume":"9 1","pages":"78"},"PeriodicalIF":2.1,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12219766/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144538800","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":"Diagnostic and therapeutic insights from a cohort of chronic recurrent multifocal osteomyelitis (CRMO) patients.","authors":"Kosar Asna Ashari, Mahdieh Mousavi, Fatemeh Tahghighi Sharabian, Raheleh Assari, Seyyed Reza Raeeskarami, Vahid Ziaee","doi":"10.1186/s41927-025-00537-4","DOIUrl":"10.1186/s41927-025-00537-4","url":null,"abstract":"<p><strong>Background: </strong>Chronic recurrent multifocal osteomyelitis (CRMO) is a sporadic form of autoinflammatory bone disorders (ABDs) presenting with sterile chronic and/or recurrent and multiple sites of bone involvement. We aimed to describe our 10-year cohort of CRMO patients and analyze the characteristics and treatment approaches.</p><p><strong>Methods: </strong>We retrospectively analyzed the data on patients with bone diseases at Children's Medical Center, Tehran University of Medical Sciences, Iran in the previous 10 years. The criteria for inclusion of patients as CNO/CRMO were mono-, oligo- or multifocal inflammatory bone lesions (osteomyelitis, osteitis, osteosclerosis) by imaging techniques; duration of complaints for > 6 weeks; and onset before 18 years of age.</p><p><strong>Results: </strong>Thirty-nine patients were enrolled. Diagnosis of five patients were found compatible with monogenic ABDs. There were four sites of bone involvement per patient. The most common sites were vertebrae, pelvis, and tibia. Eight patients (23%) had dermatologic manifestations, including three psoriasis cases and one palmar pustulosis. All patients received NSAIDs, and 85% received it as first-line. Treatment was escalated to methotrexate or prednisolone when response was suboptimal. Out of 17 patients primarily treated only with NSAIDs, 47% remitted. In general, 84% of our patients are in remission: 36% without medication and 48% with medication.</p><p><strong>Conclusion: </strong>Our CRMO patients showed an acceptable remission response to the current treatment regimen. Results of bone scintigraphy in suspected CRMO patients should be interpreted cautiously as an adjunct to clinical investigations. Special attention should be paid to extraosseous manifestations in suspected CRMO patients to avoid overlooking monogenic ABDs.</p><p><strong>Clinical trial number: </strong>Not applicable.</p>","PeriodicalId":9150,"journal":{"name":"BMC Rheumatology","volume":"9 1","pages":"70"},"PeriodicalIF":2.1,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12218946/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144538788","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":"Disease knowledge and quality of life among rheumatoid arthritis patients: a cross-sectional study.","authors":"Lara Albiss, Suhaib Muflih, Bushra Hijazi, Osama Y Alshogran, Walid Al-Qerem, Manar Abu Khurmah, Ahmad Al-Azayzih, Hani Shatnawi, Yazan Shakatira","doi":"10.1186/s41927-025-00523-w","DOIUrl":"10.1186/s41927-025-00523-w","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to predict the knowledge of disease, quality of life, and related factors among rheumatoid arthritis patients.</p><p><strong>Methodology: </strong>In this cross-sectional study, a total of 225 participants were recruited by convenience sampling from the RA outpatient clinics at Princess Basma Hospital and King Abdullah University Hospital in the north of Jordan between October 2023 and January 2024. The knowledge of RA was assessed using the adapted Rheumatoid Arthritis Knowledge Assessment Scale (RAKAS). Health-related quality of life (HRQoL) was evaluated using the generic EQ-5D-3 L instrument. Disease activity and remission were measured by DAS-28 ESR, which involved patient global assessment, ESR, and the number of swollen and tender joints. Data collection was achieved by face-to-face interviews and reviewing medical records. Predictors of disease knowledge and QoL were identified using quantile regression, One-way ANOVA, and multiple linear regression.</p><p><strong>Results: </strong>The mean age of participants was 51.9 years, with 86.2% being female. Only 9.3% and 20.9% of patients, respectively, had \"poor\" or \"low\" knowledge, while 42.7% and 27.1% of patients, respectively, had \" adequate \" or \"excellent\" knowledge. Significant correlations of RA knowledge were observed with age, education level, duration of RA, and income. Specifically, younger patients, those with longer disease duration, higher education levels, and higher income demonstrated better knowledge of RA. Income and DAS score were significantly associated with the utility. Higher income levels were associated with an increase in utility. There was no association between disease knowledge and QoL in RA patients.</p><p><strong>Conclusion: </strong>Adequate knowledge of the disease is prevalent among RA patients. Education level significantly affected both disease knowledge and quality of life. Interventions to enhance patient education and proper medication management are essential to improve health outcomes.</p><p><strong>Clinical trial number: </strong>Not applicable.</p>","PeriodicalId":9150,"journal":{"name":"BMC Rheumatology","volume":"9 1","pages":"77"},"PeriodicalIF":2.1,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12220810/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144538789","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":"Exploring the role of gut microbiota in rheumatoid arthritis: the effects of diet and drug supplementation.","authors":"Destina Ekingen Genc, Ozlem Ozbek, Kutlu O Ulgen","doi":"10.1186/s41927-025-00541-8","DOIUrl":"10.1186/s41927-025-00541-8","url":null,"abstract":"<p><p>Rheumatoid Arthritis (RA) is a chronic autoimmune disease that mostly breaks out at the joints. It further causes bone erosion and decreased life quality due to severe pain. Current drugs are mainly focused on reducing pain, but unable to terminate the disease progression. This study aims to determine the effect of diet types (Western, Vegan and Mediterranean) on RA progression. Some dietary supplements and drug administration (Huayu-Qiangshen-Tongbi formula or Leflunomide plus Methotrexate) in a six-month-period were also simulated to elucidate their effects on gut microbiota growth and exchange metabolite fluxes. The computational analyses showed that Haemophilus parainfluenzae had the highest growth rate in the RA community with the Western diet. Enterococcus faecalis was the most notable bacterial species considering butyrate exchange rates without any dependency on the diet; however diet type became important for Clostridium celatum for acetate and formate exchanges. Focal interactions for RA communities signify Mediterranean diet had the most homogeneous exchange flux distribution. With iron and ornithine supplementation, Clostridium celatum outshined the rest of the bacteria in the RA community with the potential being an RA biomarker. The Mediterranean diet could be studied further for drug administration studies since the bacterial species under this diet exhibited different outputs. In the near future, by utilizing the potential of the gut microbiota to be altered with diet, it might be possible to manipulate the progression of RA.</p>","PeriodicalId":9150,"journal":{"name":"BMC Rheumatology","volume":"9 1","pages":"71"},"PeriodicalIF":2.1,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12220324/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144538801","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}