ACR open rheumatology最新文献

{"title":"Control of Inflammation and Sustained Improvements in Patient-Reported Outcomes in Patients With Psoriatic Arthritis: Bimekizumab Two-Year Results From Two Phase 3 Studies.","authors":"Laure Gossec, William Tillett, Laura C Coates, Philip J Mease, Maarten de Wit, Dafna D Gladman, Ana-Maria Orbai, Fabian Proft, Barbara Ink, Rajan Bajracharya, Jérémy Lambert, Patrick Healy, M Elaine Husni","doi":"10.1002/acr2.90053","DOIUrl":"10.1002/acr2.90053","url":null,"abstract":"<p><strong>Objective: </strong>To assess two-year impact of bimekizumab on patient-reported outcomes (PROs), and their association with objective measures of inflammation, in patients with psoriatic arthritis (PsA) who were biologic disease-modifying antirheumatic drug (bDMARD)-naïve or had tumor necrosis factor inhibitor inadequate response or intolerance (TNFi-IR).</p><p><strong>Methods: </strong>BE OPTIMAL (NCT03895203; bDMARD-naïve) and BE COMPLETE (NCT03896581; TNFi-IR) were phase 3 studies that assessed subcutaneous bimekizumab 160 mg every four weeks. Both were double-blind, placebo-controlled to week16, then placebo patients switched to bimekizumab. BE OPTIMAL week52 or BE COMPLETE week16 completers could enter BE VITAL (NCT04009499; open-label extension), where all patients received bimekizumab. PROs, disease impact (Psoriatic Arthritis Impact of Disease-12 questionnaire [PsAID-12]), and their association with inflammation (assessed using swollen joint count [SJC]) are reported to year 2.</p><p><strong>Results: </strong>Among 712 bDMARD-naïve and 400 TNFi-IR patients, bimekizumab resulted in long-term sustained improvements in PROs for pain, fatigue, and function (Health Assessment Questionnaire-Disability Index) to year 2. Mean change from baseline (year 2) in bimekizumab-randomized patients for pain and disease impact (PsAID-12) was -33.9 to -29.2 and -2.5 to -2.2, respectively. An achievement of SJC = 0 was associated with the greatest reduction in pain. Decreased SJC was associated with improved pain, fatigue, function, and reduced disease impact to year 2. By year 2, 44.4% to 54.3% of patients originally randomized to placebo or bimekizumab reported no or low disease impact (PsAID-12 ≤1.95), and 88.0% to 92.0% of bimekizumab-randomized patients achieved a patient acceptable symptom state for disease impact (PsAID-12 ≤4), associated with concurrent improvement in SJC and skin involvement.</p><p><strong>Conclusion: </strong>Bimekizumab treatment resulted in sustained clinically meaningful improvements in PROs and reduced disease impact to two years in bDMARD-naïve and TNFi-IR patients with PsA. Stringent inflammation control was associated with symptom relief and reduced disease impact.</p>","PeriodicalId":93845,"journal":{"name":"ACR open rheumatology","volume":"8 5","pages":"e90053"},"PeriodicalIF":2.9,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13184177/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147977765","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":"A Novel Use of Anifrolumab for a Novel Disease.","authors":"Zachary Holtz, Adam Schulz, Alexa Meara","doi":"10.1002/acr2.90063","DOIUrl":"10.1002/acr2.90063","url":null,"abstract":"<p><strong>Objective: </strong>To explore the potential role of type-I interferon (IFN-I) signaling in autoimmune cytopenias outside the context of systemic lupus erythematosus (SLE), and to evaluate the clinical response to off-label anifrolumab in two patients with fatigue and immune-mediated cytopenias who did not meet established criteria for SLE.</p><p><strong>Methods: </strong>We describe two older White male patients with fatigue and autoimmune cytopenias who did not meet established SLE criteria and were refractory to standard immunosuppressants. Both received off-label anifrolumab.</p><p><strong>Results: </strong>Both patients experienced rapid and sustained improvement in fatigue and resolution of cytopenias following treatment, with continued benefit and no significant adverse effects.</p><p><strong>Conclusion: </strong>These cases suggest IFN-I signaling may underlie autoimmune cytopenias outside classic SLE. The positive response to anifrolumab raises the possibility of an atypical or distinct IFN-mediated autoimmune condition and supports broader investigation of IFN blockade in hematologic autoimmunity.</p>","PeriodicalId":93845,"journal":{"name":"ACR open rheumatology","volume":"8 5","pages":"e90063"},"PeriodicalIF":2.9,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13240433/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147977759","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":"Clinical Images: Bisphosphonate-associated atypical femoral fracture with contralateral cortical beaking.","authors":"Andreina Martinez Paulino, Valentin Marian","doi":"10.1002/acr2.90067","DOIUrl":"10.1002/acr2.90067","url":null,"abstract":"","PeriodicalId":93845,"journal":{"name":"ACR open rheumatology","volume":"8 5","pages":"e90067"},"PeriodicalIF":2.9,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13184541/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147977752","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":"Clinical Images: Chronic nonbacterial osteomyelitis associated with inflammatory bowel disease.","authors":"Cheng Xu, Yue Shi, Wenjuan Zhang, Yongmei Han","doi":"10.1002/acr2.90076","DOIUrl":"10.1002/acr2.90076","url":null,"abstract":"","PeriodicalId":93845,"journal":{"name":"ACR open rheumatology","volume":"8 5","pages":"e90076"},"PeriodicalIF":2.9,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13240272/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147990383","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":"The ERβ Agonist, OSU-ERβ-012, Mitigates Inflammation in a Chimeric Model of Systemic Lupus Erythematosus.","authors":"Braden Zeno, Shane Bruckner, Hongyu Yuan, Morgan Stahl, Timothy Alexandrov, Kyle Jablonski, Judith Lin, Nicholas A Young, Wael N Jarjour","doi":"10.1002/acr2.90031","DOIUrl":"10.1002/acr2.90031","url":null,"abstract":"<p><strong>Objective: </strong>Systemic lupus erythematosus (SLE) is an autoimmune disease characterized by multiple organ damage, affecting women between the ages of 15 and 45 years at a 9:1 rate as compared to men. The etiology of SLE is complex and elusive; however, the susceptibility of women during the years in which estrogen levels are at their highest suggests a significant contribution to the development of SLE. Previously, our group and others have shown that estrogen receptor α (ERα) carrying immune cells are mediators of the proinflammatory effects of estrogen as compared to cells that lack this receptor. ERβ, the other estrogen responsive transcription factor, has been postulated to have an antagonistic effect to ERα, which mediates the anti-inflammatory effects of estrogen.</p><p><strong>Methods: </strong>In the pursuit of a drug that is tailored to have a favorable selective estrogenic effect, The Ohio State University Drug Development Institute discovered a novel carborane-based selective ER modulator, OSU-ERβ-012. This ERβ agonist exhibits potent binding of human ERβ (Ki = 2.0 nM) and functional selectivity for ERβ over ERα of at least 200-fold. We tested the effectiveness of OSU-ERβ-012 in treating lupus-humanized NSG mice by examining serum for the presence of inflammatory cytokines and histopathology of hearts and kidneys.</p><p><strong>Results: </strong>The humanized mice exhibited increased expression of inflammatory cytokines, pericarditis, and increased glomerular size, which were all mitigated by the treatment with OSU-ERβ-012.</p><p><strong>Conclusion: </strong>OSU-ERβ-012 is an effective therapeutic in this NSG mouse model with humanized SLE because it inhibits the proinflammatory renal and cardiac phenotype.</p>","PeriodicalId":93845,"journal":{"name":"ACR open rheumatology","volume":"8 5","pages":"e90031"},"PeriodicalIF":2.9,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13129409/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147791753","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":"Lupus, a Leading Cause of Years of Potential Life Lost in Young Women: Implications for Public Health Priorities and Research Funding.","authors":"Eric Y Yen, Elizabeth J Park, Ram Raj Singh","doi":"10.1002/acr2.90051","DOIUrl":"10.1002/acr2.90051","url":null,"abstract":"<p><strong>Objective: </strong>Premature mortality burden is an important component of disease burden and can help guide health care and research priorities. However, relying solely on mortality rates may underestimate lupus mortality burden because a substantial proportion of deaths occur at younger ages. Years of potential life lost (YPLL) captures premature mortality by applying a predefined age threshold. We estimated the YPLL from lupus in US women relative to leading causes of death and other autoimmune diseases.</p><p><strong>Methods: </strong>Using the US population-based national Multiple Cause-of-Death database, we obtained death counts for 28 diseases, including lupus, the Centers for Disease Control and Prevention's 15 leading causes of death, and 12 additional autoimmune diseases. We calculated YPLL before age 75 years by summing 75 minus age at death for deaths occurring before age 75. Official cause-of-death rankings were obtained from the Web-based Injury Statistics Query and Reporting System (WISQARS). Sensitivity analyses were repeated in female decedents during 2018 to 2024.</p><p><strong>Results: </strong>From 2000 to 2015, 304.2 thousand years were lost to lupus in US women aged 15 to 44 years. Lupus-associated YPLL ranked 14th in women aged 15 to 44 years and 9th in women aged 15 to 24, exceeding diabetes mellitus, HIV disease, septicemia, chronic lower respiratory disease, anemias, nephritis, and cerebrovascular disease. Among autoimmune diseases, lupus YPLL ranked first in women aged 15 to 24 years and second in women aged 15 to 44 years.</p><p><strong>Conclusion: </strong>Lupus is a major contributor to premature mortality in young women. Quantifying premature mortality burden through YPLL provides a complementary public health perspective and may inform prioritization of research and public health initiatives.</p>","PeriodicalId":93845,"journal":{"name":"ACR open rheumatology","volume":"8 5","pages":"e90051"},"PeriodicalIF":2.9,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13150475/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147846951","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":"Immunosuppressive Medications and Nonserious Infections in People With Rheumatoid Arthritis: A Prospective Cohort Study.","authors":"Michael D George, Kelly Gavigan, Shilpa Venkatachalam, David Curtis, Laura Stradford, W Benjamin Nowell, Joshua F Baker, Fenglong Xie, Jeffrey R Curtis","doi":"10.1002/acr2.90050","DOIUrl":"10.1002/acr2.90050","url":null,"abstract":"<p><strong>Objective: </strong>People with rheumatoid arthritis (RA) are at increased risk of serious infection, but less is known about nonserious infections. Our prospective cohort study evaluated associations between medications for RA and the risk of nonserious infections.</p><p><strong>Methods: </strong>We remotely recruited adults with RA in a community rheumatology practice-based research network. Participants joined the ArthritisPower Registry (now PatientSpot) and completed a baseline and up to six monthly follow-up surveys. Using data from consecutive monthly surveys, we assessed associations between medication use at the prior survey and infection report at the subsequent survey, adjusting for confounders.</p><p><strong>Results: </strong>We recruited 351 people with RA (mean age 60, 84% female) who reported 439 infections (330 infections per 100 patient-years). Associations between medication use and infection were assessed among 1,075 qualifying observations with 289 (27%) total infections and 146 (14%) infections with health care encounters or antibiotic use. Compared to those receiving conventional synthetic disease-modifying antirheumatic drugs who were biologic or JAK inhibitor (JAKi) naïve, current biologic or JAKi use was not associated with either infection outcome. Infections were numerically more common with glucocorticoids ≥10 mg/day (odds ratio 1.94, 95% confidence interval 0.89-4.24). Season, previous infection, poorer function, and rural residence were significantly associated with one or both infection outcomes.</p><p><strong>Conclusion: </strong>Biologics and JAKi were not associated with greater risk for nonserious infections compared to conventional therapies. Given that nonserious infection risk may be due more to exposures and general health status, future studies should assess whether the common practice of interrupting medications in people with infection improves or worsens outcomes.</p>","PeriodicalId":93845,"journal":{"name":"ACR open rheumatology","volume":"8 5","pages":"e90050"},"PeriodicalIF":2.9,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13144764/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147847006","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":"Clinical Images: Delayed presentation of skeletal fluorosis: an uncommon case of increased bone density.","authors":"Guillaume Larid, Pier Olivier Duboe, Aurélie Carcasses","doi":"10.1002/acr2.90075","DOIUrl":"10.1002/acr2.90075","url":null,"abstract":"","PeriodicalId":93845,"journal":{"name":"ACR open rheumatology","volume":"8 5","pages":"e90075"},"PeriodicalIF":2.9,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13179511/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147950421","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":"Use of Semaglutide and Tirzepatide in Rheumatic and Musculoskeletal Diseases: Insights on Initiation Patterns and Weight Loss From the Rheumatology Informatics System for Effectiveness Registry.","authors":"Nicholas P McCormick, Cristiano S Moura, Jingyi Zhang, Emily E Holladay, Fenglong Xie, Tapan Mehta, Joshua F Baker, Jeffrey R Curtis","doi":"10.1002/acr2.90068","DOIUrl":"10.1002/acr2.90068","url":null,"abstract":"<p><strong>Objective: </strong>Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) such as semaglutide (SEM) and tirzepatide (TZP) were initially approved for type 2 diabetes management but are increasingly used for weight loss. Limited data exist on real-world use among patients with rheumatic and musculoskeletal diseases (RMDs). This study aimed to describe characteristics and trends in SEM and TZP initiation among individuals with RMDs and to identify factors associated with weight loss.</p><p><strong>Methods: </strong>We conducted a retrospective analysis using the American College of Rheumatology's Rheumatology Informatics System for Effectiveness registry. Adults with RMD prescribed SEM or TZP between 2018 and 2024 were included. Patients with an evaluation and management visit before first GLP-1 RA prescription were classified as new users. The primary outcome was percent change in body weight from baseline to 12 months. Multivariable linear regression assessed factors associated with percent weight change, and logistic models identified predictors of ≥5%, ≥10%, and ≥15% weight loss.</p><p><strong>Results: </strong>Among 60,198 patients with RMD treated with GLP-1 RAs (72% SEM), 80.5% were female, and 54.9% had diabetes; the mean age was 57.0 years, and body mass index was 36.4. GLP-1 RA use increased from 0.1% in 2018 to 6.8% in 2024. At 12 months, SEM and TZP users lost 5.8% and 8.2% of body weight, respectively. TZP users lost 2.2% (95% confidence interval [CI] 1.9-2.5) more weight than SEM users, and those without diabetes lost 1.8% (95% CI 1.5-2.1) more than those with diabetes.</p><p><strong>Conclusion: </strong>GLP-1 RA use is increasing among patients with RMD and is associated with clinically meaningful weight loss, particularly with TZP and in individuals without diabetes.</p>","PeriodicalId":93845,"journal":{"name":"ACR open rheumatology","volume":"8 5","pages":"e90068"},"PeriodicalIF":2.9,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13155138/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147847146","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":"Quantification of Vascular Burden on Cranial Vessel Wall Magnetic Resonance Imaging and Ophthalmic Complications in Giant Cell Arteritis.","authors":"David L Yang, Quy Cao, Fang Liu, Tara McWilliams, Ryan Rebello, Madhura A Tamhankar, Shubhasree Banerjee, Rui Liang, Robert M Kurtz, Joshua F Baker, Naomi Amudala, Zhaoyang Fan, Jae W Song, Peter A Merkel, Jeffrey Morris, Rennie L Rhee","doi":"10.1002/acr2.90066","DOIUrl":"10.1002/acr2.90066","url":null,"abstract":"<p><strong>Objective: </strong>There is a need for measures of disease severity for giant cell arteritis (GCA), which may enable identification of high-risk subgroups (eg, ophthalmic complications) and individualized approaches to therapy. We derived a continuous score using data from cranial vessel wall magnetic resonance imaging (VW-MRI) to quantify vascular burden in GCA and assessed the score's association with ophthalmic manifestations.</p><p><strong>Methods: </strong>Patients with suspected new or relapsing GCA underwent cranial VW-MRI plus dedicated orbital MRI. A radiologist assessed VW-MRI enhancement of seven cranial structures bilaterally. Using a generalized linear mixed-effects model, a continuous MRI-derived patient-level score (range 1-10) of disease extent was developed: the Cranial Artery MRI Score for GCA (CAMRIS-GCA). CAMRIS-GCA was compared between clinical diagnosis (ocular GCA, nonocular GCA, or non-GCA) and patients with versus without ocular inflammation on MRI (defined as ophthalmic artery or optic nerve sheath enhancement).</p><p><strong>Results: </strong>Seventy-four patients (17 ocular GCA, 16 nonocular GCA, and 41 non-GCA) were included. CAMRIS-GCA increased linearly across clinically defined groups of non-GCA, nonocular GCA, and ocular GCA (CAMRIS-GCA median 0.6 [interquartile range (IQR) 0-1.7] vs median 2.5 [IQR 0.5-6.6] vs median 4.8 [IQR 2.1-8.5]; P < 0.01). Patients with orbital inflammation on MRI (with or without visual symptoms) had a higher median CAMRIS-GCA compared to patients with negative orbital MRI (median 6.7 [IQR 5.6-8.5] vs median 0.4 [IQR 0-1.6]; P < 0.01).</p><p><strong>Conclusion: </strong>This proof-of-concept study introduces a quantitative MRI-derived vascular burden score in GCA and demonstrates its association with ophthalmic involvement. These early findings suggest that cranial VW-MRI may offer a prognostic value in identifying patients at risk for vision-threatening disease.</p>","PeriodicalId":93845,"journal":{"name":"ACR open rheumatology","volume":"8 5","pages":"e90066"},"PeriodicalIF":2.9,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13147153/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147847085","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}