BMC Rheumatology最新文献

{"title":"Management and treatment of early rheumatoid arthritis, process and barriers among rheumatologists in Spain: a Delphi consensus.","authors":"Jose Javier Pérez Venegas, Sagrario Bustabad Reyes, Francisca Sivera Mascaró, Virginia Villaverde García, Inmaculada Ros Vilamajó, Jaime Calvo Alén, Julio Antonio Medina Luezas, Ismael Gómez, Mónica Valderrama, María Montoro Álvarez","doi":"10.1186/s41927-025-00591-y","DOIUrl":"10.1186/s41927-025-00591-y","url":null,"abstract":"","PeriodicalId":9150,"journal":{"name":"BMC Rheumatology","volume":"9 1","pages":"137"},"PeriodicalIF":2.5,"publicationDate":"2025-11-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12625278/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145538256","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":"Autoimmune aplastic anemia- a rare and devastating presentation of Systemic Lupus Erythematosus - a case report.","authors":"Dhriti Sundar Das, Saktipada Singha, Anupama Behera, Rashmi Ranjan Mohanty, Srikant Behera, Somanath Padhi, Suvendu Purkait","doi":"10.1186/s41927-025-00590-z","DOIUrl":"10.1186/s41927-025-00590-z","url":null,"abstract":"","PeriodicalId":9150,"journal":{"name":"BMC Rheumatology","volume":"9 1","pages":"138"},"PeriodicalIF":2.5,"publicationDate":"2025-11-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12625481/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145538268","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":"Extreme thrombocytosis and ANCA-associated vasculitis in an adult patient: a case report.","authors":"Andrés Hormaza-Jaramillo, Maria J Varela, Daniela Peñaloza Gonzalez, Sara Alejandra Benavides-Ibarra, Carlos Jimenez, David Aguirre-Valencia","doi":"10.1186/s41927-025-00562-3","DOIUrl":"10.1186/s41927-025-00562-3","url":null,"abstract":"<p><strong>Introduction: </strong>We describe the case of a 39-year-old woman who presented with extreme reactive thrombocytosis as a prominent and unusual feature in the context of anti-neutrophil cytoplasmic antibody (myeloperoxidase, MPO)-associated vasculitis. To our knowledge, this is the first reported case in an adult patient where marked thrombocytosis was part of the initial presentation of ANCA-associated vasculitis.</p><p><strong>Case presentation: </strong>The patient presented with a two-month history of constitutional symptoms and polyarticular pain. Laboratory evaluation revealed extreme thrombocytosis, impaired renal function, and positive MPO-ANCA. Renal biopsy demonstrated rapidly progressive pauci-immune crescentic glomerulonephritis consistent with MPA. Based on these findings, a diagnosis of ANCA-associated vasculitis was established. Treatment with high-dose corticosteroids and intravenous cyclophosphamide led to clinical improvement, including resolution of thrombocytosis and recovery of renal function.</p><p><strong>Conclusions: </strong>Although the clinical features of ANCA-associated vasculitis were typical, the presence of extreme thrombocytosis may indicate a heightened inflammatory response and deserves careful evaluation. Early recognition and prompt treatment are essential to prevent irreversible organ damage and other complications.</p>","PeriodicalId":9150,"journal":{"name":"BMC Rheumatology","volume":"9 1","pages":"136"},"PeriodicalIF":2.5,"publicationDate":"2025-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12616982/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145511237","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":"CMV infection in active systemic lupus erythematosus: clinical characteristics, prognosis and treatment outcomes.","authors":"Kittiwan Sumethkul, Tassanee Kitumnuaypong, Pannipa Bupparenoo, Sungchai Angthararak","doi":"10.1186/s41927-025-00592-x","DOIUrl":"10.1186/s41927-025-00592-x","url":null,"abstract":"","PeriodicalId":9150,"journal":{"name":"BMC Rheumatology","volume":"9 1","pages":"134"},"PeriodicalIF":2.5,"publicationDate":"2025-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12613559/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145502072","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":"Mapping the future: identifying research priorities in rheumatoid arthritis with the James Lind Alliance approach.","authors":"Kristine Røren Nordén, Anna Fryxelius, Ingrid Fjeldheim Bånerud, Gunnstein Bakland, Tore Voksø, Mona Larsen, Astrid Torgersen Lunestad, Kjersti Storheim, Amy Martinsen, Rikke Munk Killingmo","doi":"10.1186/s41927-025-00588-7","DOIUrl":"10.1186/s41927-025-00588-7","url":null,"abstract":"<p><strong>Background: </strong>Considerable knowledge gaps remain regarding the cause, prevention, and management of rheumatoid arthritis (RA), with limited systematic effort to establish research priorities that truly align with the preferences of those impacted by RA.</p><p><strong>Objectives: </strong>To identify and prioritize unanswered questions about RA, capturing insights from people living with RA and healthcare professionals involved it its management.</p><p><strong>Methods: </strong>A James Lind Alliance (JLA) Priority Setting Partnership was established and followed six steps: (1) form a steering group, (2) define scope, (3) collect evidence uncertainties using focus groups, (4) collate evidence uncertainties and verify by checking existing research, (5) shortlist evidence uncertainties in an online survey, and (6) identify the top 10 research priorities through a priority-setting workshop.</p><p><strong>Results: </strong>A total of 212 questions were generated from three focus group interviews and distilled into 36 questions for a survey distributed to people with RA and healthcare professionals. Among 554 responses (mean age 58 [SD 13] years; 481 [87%] women), 449 (81%) identified as people with RA, and 105 (19%) as healthcare professionals, with some reporting dual roles. The ranking process resulted in a shortlist of 26 questions, which were further narrowed down to the top 10 research priorities. The top 10 research priorities addressed strategies for RA prevention, rapid diagnosis, identifying effective treatments, reducing treatment side effects, and holistic management approaches.</p><p><strong>Conclusion: </strong>Adopting the JLA method, this study mapped out core research priorities in RA, offering valuable insights that can help researchers, policymakers, and funders align future RA research with patient and clinical needs.</p><p><strong>Clinical trial number: </strong>Not applicable.</p>","PeriodicalId":9150,"journal":{"name":"BMC Rheumatology","volume":"9 1","pages":"133"},"PeriodicalIF":2.5,"publicationDate":"2025-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12613741/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145502049","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":"TNF-α inhibitor etanercept improves cerebrovascular function in elderly RA patients: findings from a randomized controlled trial.","authors":"Qiao-Qiao Ren, Pei Chen, Lin Qiao, Yong-Ku Du, Rui-Song Wang, Xiao-Qiang Huang, Hua Guo, Jun Yan","doi":"10.1186/s41927-025-00589-6","DOIUrl":"10.1186/s41927-025-00589-6","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Rheumatoid arthritis (RA) is a systemic autoimmune inflammatory disease that can affect the cardiovascular and cerebrovascular systems. Elderly RA patients face a significantly elevated risk of cerebrovascular events, the core mechanism of which may be related to chronic inflammation-mediated vascular endothelial dysfunction and impaired cerebral blood flow regulation. Tumor necrosis factor-alpha (TNF-α) is a key pro-inflammatory cytokine in RA, yet whether its inhibitor can improve cerebral hemodynamics remains unclear. This study aims to investigate the effects and underlying mechanisms of TNF-α inhibitor etanercept on cerebral blood flow in elderly RA patients.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;This study aimed to evaluate the effects of the TNF-α inhibitor Etanercept on cerebral hemodynamics in elderly RA patients and to explore the relationships between changes in inflammatory markers, endothelial function, and cerebral hemodynamics.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A single-center, prospective, randomized controlled trial was conducted. A total of 159 elderly RA patients in mild disease activity, recruited from the Department of Rheumatology and Immunology at Xi'an No.5 Hospital between November 2023 and November 2024, were enrolled. Baseline data were collected, and patients were randomly assigned to either the experimental group (TNF-α inhibitor + Methotrexate + Celecoxib) or the control group (Methotrexate + Celecoxib). Before treatment and after 6 months of treatment, transcranial Doppler (TCD) was used to assess the mean flow velocity (Vm), pulsatility index (PI), and resistance index (RI) of the middle cerebral artery (MCA). Cerebrovascular reactivity (CVR) was evaluated using the breath-holding index (BHI). Serum inflammatory markers and vascular endothelial function were also assessed at both time points. Adverse drug reactions during the treatment period were recorded.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Compared to the control group, the experimental group showed a significant increase in MCA Vm, significant decreases in PI and RI, and a marked improvement in BHI after treatment. Serum levels of erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), rheumatoid factor (RF), anti-cyclic citrullinated peptide antibody (anti-CCP), interleukin-1β (IL-1β), interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α), soluble vascular cell adhesion molecule-1 (sVCAM-1), and endothelin-1 (ET-1) were all significantly reduced. Correlation analysis revealed that the improvement in BHI was significantly associated with reductions in TNF-α, sVCAM-1, and ET-1. The incidence of adverse events was 11.96% (11/92) in the experimental group and 10.87% (10/92) in the control group, with no statistically significant difference.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;The TNF-α inhibitor Etanercept significantly improves cerebral hemodynamics and cerebrovascular reserve function in elderly RA patients, potentially by suppressin","PeriodicalId":9150,"journal":{"name":"BMC Rheumatology","volume":"9 1","pages":"135"},"PeriodicalIF":2.5,"publicationDate":"2025-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12613686/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145501567","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":"Machine learning for predicting treatment response to biologic and targeted synthetic disease-modifying antirheumatic drugs in rheumatoid arthritis: a scoping review.","authors":"Ehiremen Bennard Eriakha, Yu Han, Mai Li, Jieni Li, Yinan Huang","doi":"10.1186/s41927-025-00584-x","DOIUrl":"10.1186/s41927-025-00584-x","url":null,"abstract":"<p><strong>Background: </strong>Biologic and targeted synthetic disease-modifying antirheumatic drugs (b/tsDMARDs) have improved outcomes in rheumatoid arthritis (RA). However, heterogeneity in treatment response remains a significant challenge. Machine learning (ML) may enable improved prediction, but the comprehensive review of ML applications in RA is fragmented and limited. This scoping review synthesizes the literature on ML methods for predicting treatment response to b/tsDMARDs in RA.</p><p><strong>Methods: </strong>Following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Extension for Scoping Reviews (PRISMA-ScR) guidelines, we systematically searched PubMed, MEDLINE, and Embase (from databases' inception through March 2024). Using the Covidence online platform, two reviewers independently screened titles, abstracts, and full texts for eligibility. Studies were included if they applied ML methods in predicting treatment response to b/tsDMARD in RA. We provided a qualitative synthesis of databases used, study design, population, outcomes, predictors, and model validation. Risk of bias was assessed using Quality in Prognosis Studies (QUIPS), and reporting quality was evaluated using TRIPOD guidelines.</p><p><strong>Results: </strong>Of 294 citations reviewed, 24 studies met the inclusion criteria. Most used real-world data from registries (N = 12, 50%), followed by electronic health records (N = 4, 17%). Study sample sizes ranged from 39 to 7,300 (Median = 494). ML models-especially boosted trees, random forests, support vector machines, and regularized regression-were most frequently applied. Study outcomes included remission, low disease activity, and treatment non-response. Common baseline predictors were disease activity, biomarkers, functional status, and patient-reported measures. AUCs ranged from 0.54 to 0.92 (Mean = 0.71), with boosted trees and neural networks often performing best. External validation was rare (N = 7, 17.5%), and most studies showed a low-to-moderate risk of bias (N = 32, 80%).</p><p><strong>Conclusion: </strong>ML methods are increasingly used to predict RA treatment response, but vary widely in methodology and performance. Standardization, external validation, and transparent reporting are critical for advancing clinical application.</p><p><strong>Clinical trial number: </strong>Not Applicable (NA).</p>","PeriodicalId":9150,"journal":{"name":"BMC Rheumatology","volume":"9 1","pages":"132"},"PeriodicalIF":2.5,"publicationDate":"2025-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12607112/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145494504","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":"Financial burden of systemic lupus erythematosus in India: prevalence and predictors of catastrophic health expenditure in a multicentre cross-sectional study.","authors":"Vineeta Shobha, Kriti Kishor, Chanchal Gera, V Nayana, Smruti Ramteke, Sunitha Kayidhi, Anuj Shukla, Namisha Patel, Ramaswamy Subramanian, Mamadapur Mahabaleshwar, Avinash Jain, Aradhana Singh, Anshul Goel, Subramanian Nallasivan, Sahana Baliga, Sourabh Malviya, Sumithra Selvam, Amita Aggarwal","doi":"10.1186/s41927-025-00583-y","DOIUrl":"10.1186/s41927-025-00583-y","url":null,"abstract":"<p><strong>Background: </strong>We estimated the frequency of catastrophic healthcare expenditure(CHE), and their determinants in Indian patients with systemic lupus erythematosus(SLE).</p><p><strong>Methods: </strong>This was a cross-sectional, questionnaire-based survey conducted by the Lupus Special Interest Group of the Indian Rheumatology Association across 14 centers. Patients with SLE diagnosed as per SLICC-2012 on follow-up for at least 1-year were interviewed regarding annual disease-related expenditures including direct (medical and non-medical) and indirect costs. CHE was defined as > 20% of the annual income. Results are presented in Indian currency (INR), wherein 100 INR = 1.19 USD = 1.1 EURO.</p><p><strong>Results: </strong>We included 655 patients with SLE [92.7% women], with a mean age of 32.9 ± 11.6 years. The median direct annual expenditure was INR 52400(30810,96300), largest component being cost of medications [INR 24000(12000,40000) and hospitalizations [INR 35000(14400,90000)] One-third of patients(n = 237,36.2%) suffered CHE; they were older [AOR1.01(0.99,1.03)], had lower level of education [AOR1.95(1.01,3.81)], belonged to lower socio-economic-strata[AOR 9.63(5.66,16.4)], had renal and/or neuropsychiatric lupus [AOR1.42(0.99,2.06)] and higher damage(SDI) [AOR1.84(1.22,2.77)]. The median annual indirect cost was INR16416(5016,52896). Three-fourths(73.7%) of the participants incurred out-of-pocket expenses for their healthcare. The employed population was low(n = 187;28.3%), and the absenteeism rate was 24%.</p><p><strong>Conclusion: </strong>Hospitalization and medication costs are major factors driving exponentially high out-of-pocket expenses, resulting in CHE in one-third of patients with SLE in India.</p><p><strong>Clinical trial number: </strong>Not applicable.</p>","PeriodicalId":9150,"journal":{"name":"BMC Rheumatology","volume":"9 1","pages":"131"},"PeriodicalIF":2.5,"publicationDate":"2025-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12590734/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145457214","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 phenotype and management of axial psoriatic arthritis in Japan compared with other regions, particularly other Asian countries: results of the ASAS-PerSpA study.","authors":"Haruki Sawada, Mitsumasa Kishimoto, Kurisu Tada, Gautam A Deshpande, Daiki Kobayashi, Masato Okada, Diego Benavent, Chamaida Plasencia-Rodriguez, Victoria Navarro-Compán, Clementina López-Medina, Anna Molto, Maxime Dougados, Naoto Tamura","doi":"10.1186/s41927-025-00580-1","DOIUrl":"10.1186/s41927-025-00580-1","url":null,"abstract":"<p><strong>Background: </strong>This study evaluated the disease phenotype and treatment of axial psoriatic arthritis among patients from Japan compared with those from different geographic regions.</p><p><strong>Methods: </strong>Data from the ASAS-PerSpA study were analyzed. Patients with psoriatic arthritis (PsA) with axial involvement, according to a rheumatologist´s judgment, were included. Patients were further categorized by four geographic regions: Europe/North America, Latin America, Middle East/North Africa, and Asia, split into Japan and other Asian countries. Disease and patient characteristics, disease activity, function, and treatment were compared by region.</p><p><strong>Results: </strong>Of the 4,465 patients with SpA, 1,033 (23%) were diagnosed with PsA by their rheumatologist. Among those with PsA, 367 (35.5%) had axial involvement (axPsA). Disease activity and function ranges were 4.1-5.4 for BASDAI, 2.5-3.2 for ASDAS, and 3.0-4.7 for BASFI, by regions. In Japan, disease activity and function were relatively lower, indicated by a mean BASDAI of 3.5 (SD 2.4), ASDAS of 2.2 (SD 1.0), and BASFI of 1.6 (SD 2.3). These indexes were also significantly lower than those in other Asian countries, with scores of 4.8 (SD 3.0), 2.2 (SD 2.4), and 3.2 (SD 1.5) respectively. All regions showed variations in the use of csDMARDs and bDMARDs, the utilization rate of csDMARDs was significantly lower in Japan than in other Asian countries (51.4% vs. 78.1%, p = 0.02).</p><p><strong>Conclusion: </strong>Patients with axPsA in Japan showed relatively lower disease activity and function than those from different geographic regions, especially in other Asian countries with less frequent csDMARD use.</p>","PeriodicalId":9150,"journal":{"name":"BMC Rheumatology","volume":"9 1","pages":"130"},"PeriodicalIF":2.5,"publicationDate":"2025-11-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12581506/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145437184","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":"Impact of HLA-DRB1 SE, anti-citrullinated protein antibodies and smoking on radiographic outcome in Greek patients with Rheumatoid Arthritis.","authors":"Evangelia N Mole, Katerina Tarassi, Alexandra Tsirogianni, Theophilos Athanassiades, Vasiliki Kitsiou, Diamanto Kouniaki, Sousana Gazi, Panagiotis Vlachoyiannopoulos","doi":"10.1186/s41927-025-00579-8","DOIUrl":"10.1186/s41927-025-00579-8","url":null,"abstract":"","PeriodicalId":9150,"journal":{"name":"BMC Rheumatology","volume":"9 1","pages":"128"},"PeriodicalIF":2.5,"publicationDate":"2025-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12577239/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145421302","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}