ACR open rheumatology最新文献

{"title":"Clinical Images: Multiple blisters on the upper and lower extremities in granulomatosis with polyangiitis.","authors":"Tokio Katakura, Tsuyoshi Shirai, Hiroshi Fujii, Kenta Oka, Yoshihide Asano","doi":"10.1002/acr2.70031","DOIUrl":"10.1002/acr2.70031","url":null,"abstract":"","PeriodicalId":93845,"journal":{"name":"ACR open rheumatology","volume":"7 3","pages":"e70031"},"PeriodicalIF":2.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11929109/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143677456","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":"Development and Pilot Testing of a Patient-Centered Reproductive Decision Aid for Pregnancy-Capable People With Rheumatic Diseases.","authors":"Mehret Birru Talabi, Megan E B Clowse, Kaleab Abebe, Susan J Blalock, Lisa S Callegari, Traci M Kazmerski, Raelynn O'Leary, Ashley Deal, Catherine Wright, Leslie E Pierce, Olivia M Stransky, Goutham Lakkaraju, Swetha Jasti, Sonya Borrero","doi":"10.1002/acr2.11791","DOIUrl":"10.1002/acr2.11791","url":null,"abstract":"<p><strong>Objective: </strong>Although women with rheumatic and musculoskeletal diseases (RMDs) are at an elevated risk for adverse pregnancy and perinatal outcomes, some report that they lack access to resources that support informed reproductive decision-making. We developed MyVoice:Rheum, a web-based decision aid to support women with RMDs in reproductive decision-making. We conducted a pilot trial to assess feasibility and acceptability of MyVoice:Rheum and to assess its preliminary effectiveness compared to a freely available online pamphlet about reproductive and RMDs.</p><p><strong>Methods: </strong>Using a parallel-arm randomized pilot trial design, we assigned women aged 18 to 44 years with RMDs in a 3:1 ratio to receive either MyVoice:Rheum or the control pamphlet immediately before a rheumatology clinical encounter. Quantitative and qualitative measures of feasibility, acceptability, and usability were assessed among MyVoice:Rheum users. We evaluated the preliminary effectiveness of MyVoice:Rheum in prompting family planning discussions as compared to pamphlet users, as well as its effects on users' reproductive knowledge and/or communication self-efficacy with rheumatologists.</p><p><strong>Results: </strong>We enrolled MyVoice:Rheum users (n = 31) and controls (n = 9) in the pilot study. MyVoice:Rheum users scored the tool as feasible, acceptable, and easy to use. Approximately 61% of MyVoice:Rheum users and 44% of controls had family planning discussions with their rheumatologists. MyVoice:Rheum users demonstrated increases in self-efficacy and knowledge scores after the intervention.</p><p><strong>Conclusion: </strong>In pilot testing, MyVoice:Rheum was feasible, acceptable, and usable to women with RMDs. Preliminary findings suggest that MyVoice:Rheum may increase family planning discussions in the rheumatology context and augment patients' reproductive knowledge and self-efficacy; these findings should be confirmed in a future full-scale study.</p>","PeriodicalId":93845,"journal":{"name":"ACR open rheumatology","volume":"7 3","pages":"e11791"},"PeriodicalIF":2.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11865636/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143517625","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":"Mitochondrial-Mediated Platelet Activation in Polymyalgia Rheumatica.","authors":"Despina Michailidou, Linda Johansson, Jorge Armando Gonzalez Chapa, Ting Wang, Junmei Chen, José A López, Solbritt Rantapää-Dahlqvist, Christian Lood","doi":"10.1002/acr2.70021","DOIUrl":"10.1002/acr2.70021","url":null,"abstract":"<p><strong>Objective: </strong>Platelet activation is thought to participate in polymyalgia rheumatica (PMR) pathogenesis. Upon platelet activation, mitochondria are expelled into the extracellular space. However, whether extracellular mitochondria are present in patients with PMR and whether they can induce platelet activation is not known.</p><p><strong>Methods: </strong>To investigate this, we measured markers of platelet activation (thrombospondin-1 [TSP-1]), mitochondrial-derived N-formyl methionine peptide (fMET), and autoantibodies directed toward specific mitochondrial antigen mitofusin-1 (MFN1) by enzyme-linked immunosorbent assay in plasma of healthy controls (HCs, n = 30) and patients with PMR without giant cell arteritis (GCA) (n = 45) and patients with PMR with GCA (n = 9) before and after treatment with glucocorticoid therapy. Ultrapure mitochondria were opsonized with plasma from patients with PMR without GCA (n = 45) or HCs (n = 10) and were subsequently incubated with HC platelets. Platelet activation was assessed by P-selectin levels using flow cytometry.</p><p><strong>Results: </strong>Plasma levels of anti-MFN1 IgG were elevated in patients with PMR with and without GCA before glucocorticoid therapy when compared with HCs (P < 0.01 for both groups). Levels of anti-MFN1 IgG significantly reduced after treatment with glucocorticoids in both groups (P < 0.01). Levels of fMET were also significantly higher in patients with PMR with and without GCA before glucocorticoid therapy in comparison with HCs (P < 0.001 and P < 0.01, respectively). However, the levels of fMET only dropped significantly after therapy in patients with PMR without GCA (P < 0.001). Plasma levels of TSP-1 were elevated in patients with PMR with and without GCA before glucocorticoid therapy when compared to HC (P < 0.001 for both groups). After glucocorticoid therapy, plasma levels of TSP-1 decreased significantly only in patients with PMR without GCA (P = 0.023). Mitochondria opsonized with plasma from patients with PMR without GCA induced higher platelet activation regardless of treatment status as compared with plasma from HCs (P < 0.0001 and P < 0.01 for pretreatment and posttreatment).</p><p><strong>Conclusion: </strong>Our results indicate increased platelet activation and the presence of mitochondrial antigens and antibodies in the circulation of patients with PMR. Blocking mitochondrial-mediated platelet activation may reduce inflammation in patients with PMR, with potential therapeutic implications.</p>","PeriodicalId":93845,"journal":{"name":"ACR open rheumatology","volume":"7 3","pages":"e70021"},"PeriodicalIF":2.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11897803/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143607553","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: Erythema on the toes in anti-melanoma differentiation-associated gene 5 antibody-positive dermatomyositis.","authors":"Toshimasa Shimizu, Yushiro Endo, Masataka Umeda, Atsushi Kawakami","doi":"10.1002/acr2.70011","DOIUrl":"10.1002/acr2.70011","url":null,"abstract":"","PeriodicalId":93845,"journal":{"name":"ACR open rheumatology","volume":"7 3","pages":"e70011"},"PeriodicalIF":2.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11887495/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143574880","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":"Patient-Reported Social Risk Factor Screening Among Rheumatology Outpatients.","authors":"Alissa Chandler, Mohammed Hamid, Ziqiao Jiao, Kelsey Hulcher, Isha Sharma, Patrice Odom, Andrew Robinson, Sara Kellahan, Maura Kepper, Colleen Dostal, Senada Fenelon, Seth Eisen, Daphne Lew, Alfred H J Kim","doi":"10.1002/acr2.70018","DOIUrl":"10.1002/acr2.70018","url":null,"abstract":"<p><strong>Objective: </strong>The purpose of this study was to pilot test a patient-reported social risk factor (SRF) screening tool among rheumatology outpatients and to examine the distribution of SRFs in this population.</p><p><strong>Methods: </strong>A SRF screening tool was completed electronically by patients. Patients were screened for four core SRF domains (financial strain, housing instability, food insecurity, and transportation needs) and four supplemental SRF domains (physical inactivity, social isolation, stress, and depression). Data from the electronic health record were extracted for patients with at least one domain screened who were seen by participating rheumatology providers between January 1 and October 31, 2023. Descriptive statistics and multivariable logistic regressions were used to examine trends and associations of SRFs in this population.</p><p><strong>Results: </strong>The sample included 483 patients, and 84% of patients screened positive for at least one SRF. Physical inactivity (73%, 311 of 429) and social isolation (58%, 212 of 367) were the most common SRFs. Prevalence of core SRF domains was 35% for financial strain (145 of 412), 22% for housing instability (82 of 370), 23% for food insecurity (96 of 420), and 11% for transportation needs (48 of 427). Sociodemographic groups with higher prevalence of SRFs included patients reporting Medicaid insurance, younger age, Black race, or unmarried status. Multivariate analyses showed that Medicaid insurance increased odds of reporting SRFs in all core domains.</p><p><strong>Conclusion: </strong>Our SRF screening identified a high burden of SRFs among rheumatology outpatients, giving a new level of detail into patients' barriers and possible needs. Future work will uncover associations between SRFs and clinical outcomes and evaluate the impact of interventions to address SRFs.</p>","PeriodicalId":93845,"journal":{"name":"ACR open rheumatology","volume":"7 3","pages":"e70018"},"PeriodicalIF":2.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11876293/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143544929","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: Temporalis muscle and temporal bone metastasis: giant cell arteritis mimicker.","authors":"Georges El Hasbani, Jennifer I Stern, Ugur Sener, Judith Jebastin Thangaiah, Kenneth J Warrington","doi":"10.1002/acr2.70022","DOIUrl":"10.1002/acr2.70022","url":null,"abstract":"","PeriodicalId":93845,"journal":{"name":"ACR open rheumatology","volume":"7 3","pages":"e70022"},"PeriodicalIF":2.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11883280/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143569251","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 Impact of HLA-B27 on Juvenile Idiopathic Arthritis: Eighteen Years of Follow-up in the Population-Based Nordic Juvenile Idiopathic Arthritis Cohort.","authors":"Maria Ekelund, Agnes Szentpetery, Ellen D Arnstad, Kristiina Aalto, Anders Fasth, Mia Glerup, Troels Herlin, Charlotte Myrup, Ellen Nordal, Suvi Peltoniemi, Marite Rygg, Veronika Rypdal, Lillemor Berntson","doi":"10.1002/acr2.70005","DOIUrl":"10.1002/acr2.70005","url":null,"abstract":"<p><strong>Objective: </strong>We have previously shown that HLA-B27 was negatively associated with remission status eight years after the onset of juvenile idiopathic arthritis (JIA). We now aimed to study the associations of HLA-B27 with clinical features and disease outcomes 18 years after the onset of JIA.</p><p><strong>Methods: </strong>We studied 434 patients from the population-based Nordic JIA cohort. Demographic and clinical data, including remission status, were collected consecutively at baseline, eight years after disease onset, and 18 years after disease onset and presented in relation to HLA-B27 status.</p><p><strong>Results: </strong>The HLA-B27 status was available for 416 of the 434 participants (96%) and was positive for 93 participants (22.4%), more often in men (P = 0.01). The sacroiliac, hips, and subtalar joints were more frequently involved in individuals who were HLA-B27 positive than in individuals who were HLA-B27 negative. In almost half of the individuals with HLA-B27 positivity and uveitis, the uveitis was asymptomatic. Uveitis, inflammatory back pain, sacroiliitis, arthritis in hip, tarsal, and subtalar joints, and enthesitis during the disease course were all associated with a lower rate of remission off medication. HLA-B27 positivity was significantly associated with a higher risk of not being in remission off medication after 18 years (odds ratio [OR] 2.6), especially in men (OR 5.6).</p><p><strong>Conclusion: </strong>Clinical features related to spondylarthropathies were more common in patients who were HLA-B27 positive and associated with worse outcomes and nonremission 18 years after disease onset, particularly in men. Our results underline the adverse impact of having HLA-B27 positivity on long-term outcomes in individuals with JIA.</p>","PeriodicalId":93845,"journal":{"name":"ACR open rheumatology","volume":"7 3","pages":"e70005"},"PeriodicalIF":2.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11925805/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143671998","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":"Comparative Efficacy of Immunosuppressive Therapies in the Treatment of Diffuse Cutaneous Systemic Sclerosis.","authors":"Barbara White, Daniel E Furst, Tracy M Frech, Masataka Kuwana, Laura Hummers, Wendy Stevens, Suzanne Kafaja, Eun Bong Lee, Oliver Distler, Dinesh Khanna, Christopher P Denton, Robert Spiera","doi":"10.1002/acr2.70004","DOIUrl":"10.1002/acr2.70004","url":null,"abstract":"<p><strong>Objectives: </strong>The RESOLVE-1 trial of lenabasum in diffuse cutaneous systemic sclerosis (dcSSc) allowed background immunosuppressive therapy (IST) at the discretion of individual investigators, and no significant differences were observed between treatment arms. This provides a powerful opportunity to compare the relative efficacy of different ISTs in a well-defined large cohort of patients with dcSSc.</p><p><strong>Methods: </strong>Prespecified IST categories, efficacy end points, baseline disease characteristics likely to influence efficacy outcomes, the definition of interstitial lung disease, definitions of IST use, and categories of IST use by which efficacy outcomes were evaluated were. Descriptive statistics are used to present results.</p><p><strong>Results: </strong>For skin, change in modified Rodnan skin score (mRSS) was numerically greatest with mycophenolate mofetil (MMF) treatment in patients with the earliest disease, reaching -10.8 points in the MMF group versus -4.8 points in the no IST group in patients with a disease duration ≤2 years. Other ISTs had improvements intermediate between that seen in the MMF and no IST groups. Forced vital capacity (mL) was stable over 52 weeks in patients in the MMF group compared to an around 160-mL decline over 52 weeks in no IST group. Differences in outcome were observed between antinuclear antibody subgroups, with greater difference in favor of MMF for skin and lungs being observed in anti-topoisomerase 1 autoantibody-positive patients. In contrast, anti-RNA polymerase III autoantibody-positive patients in both the no IST and MMF groups improved rapidly, with a decrease in mRSS.</p><p><strong>Conclusion: </strong>Taken together, our findings robustly support routine use of MMF in dcSSc and show benefit especially in early-stage disease. Those patients with high-risk antibodies for lung fibrosis might be especially suitable for MMF treatment.</p>","PeriodicalId":93845,"journal":{"name":"ACR open rheumatology","volume":"7 3","pages":"e70004"},"PeriodicalIF":2.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11893482/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143598406","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":"Frequency and Determinants of Flare and Persistently Active Disease in a Large Multinational Prospective Lupus Cohort.","authors":"Yanjie Hao, Dylan Hansen, Worawit Louthrenoo, Yi-Hsing Chen, Jiacai Cho, Aisha Lateef, Laniyati Hamijoyo, Shue Fen Luo, Yeong-Jian Wu, Sandra Navarra, Leonid Zamora, Zhanguo Li, Sargunan Sockalingam, Yasuhiro Katsumata, Masayoshi Harigai, Lanlan Ji, Zhuoli Zhang, Madelynn Chan, Jun Kikuchi, Tsutomu Takeuchi, Sang-Cheol Bae, Fiona Goldblatt, Sean O'Neill, Kristine Pek Ling Ng, B M D B Basnayake, Nicola Tugnet, Naoaki Ohkubo, Yoshiya Tanaka, Cherica Tee, Michael Tee, C S Lau, Ning Li, Vera Golder, Alberta Hoi, Rangi Kandane-Rathnayake, Eric Morand, Shereen Oon, Mandana Nikpour","doi":"10.1002/acr2.70007","DOIUrl":"10.1002/acr2.70007","url":null,"abstract":"<p><strong>Objective: </strong>In contrast to relapsing-remitting patterns, persistently active disease (PAD) is a disease activity pattern in patients with systemic lupus erythematosus (SLE) that is inadequately studied. We sought to identify the frequency and determinants of flare and PAD in SLE.</p><p><strong>Methods: </strong>Flare was defined using the Safety of Estrogens in Lupus Erythematosus National Assessment version of the Systemic Lupus Erythematosus Disease Activity Index (SELENA-SLEDAI flare index), and PAD was defined as an SLEDAI-2K score of ≥4, excluding serology only, on two or more consecutive visits with a maximum six-month interval. Multivariable logistic regression was used to develop predictive models for flare and PAD, which were tested in an independent validation subset.</p><p><strong>Results: </strong>Among 3,811 patients over 2.8 (interquartile range 1.0-5.3) years of follow-up, 2,142 (56.2%) experienced flare and 1,786 (46.9%) had PAD, with 368 (9.7%) experiencing PAD but not flare. The most common flare features were nephritis and arthritis, whereas PAD was most commonly characterized by renal or mucocutaneous activity. After adjusting for prednisone dose and use of antimalarials and immunosuppressants, low gross domestic product in country of residence, smoking, arthritis, nephritis, and low complement levels were predictive for flare, whereas being in a low disease activity state for ≥50% of follow-up time (LLDAS50) was a protective factor. Renal activity and higher time-adjusted mean SLEDAI-2K were predictive of PAD, whereas LLDAS50 was protective. The models developed gave 72.1% and 83.8% correct classification of flare and PAD, respectively, in the validation cohort.</p><p><strong>Conclusion: </strong>Both flare and PAD are common disease activity patterns in SLE; both predict organ damage accrual but differ in disease features and predictive factors. Because 9.7% of patients experience PAD but not flare, flare measures alone do not adequately capture all patients in whom disease control is suboptimal.</p>","PeriodicalId":93845,"journal":{"name":"ACR open rheumatology","volume":"7 3","pages":"e70007"},"PeriodicalIF":2.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11865638/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143517626","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":"Repeated Cranial and Large-Vessel Positron Emission Tomography/Computed Tomography Scans and the Association With Structural Aortic Disease in Giant Cell Arteritis: A Five-Year Observational Study.","authors":"Anthony M Sammel, Ivan Ho Shon, Daniel A Moses, Stacey Fredericks, Gita Mathur, Claudia M Hillenbrand, Edward Hsiao, Geoffrey Schembri, Rodger Laurent, Eva A Wegner","doi":"10.1002/acr2.70006","DOIUrl":"10.1002/acr2.70006","url":null,"abstract":"<p><strong>Objective: </strong>Giant cell arteritis (GCA) is characterized by cranial ischemia at diagnosis and late aortic structural disease. Repeated combined cranial and large-vessel fluoro-2-deoxyglucose (FDG) positron emission tomography (PET)/computed tomography (CT) scans were performed to assess the distribution of vasculitis activity over time and the relationship with clinical outcomes.</p><p><strong>Methods: </strong>Patients were eligible if they were enrolled in a 64-patient inception suspected GCA cohort in 2016 to 2017 and had a positive temporal artery biopsy and/or PET/CT scan at diagnosis. At five years, patients underwent a PET/CT scan, magnetic resonance aortogram, and clinical assessment. Scans were reported for overall metabolic disease activity and a visual FDG avidity grade at each vascular territory.</p><p><strong>Results: </strong>Sixteen patients met inclusion criteria, and 11 attended the five-year visit. Median age was 75 years, 73% were women, and all were in remission. At five years, 4 (36%) patients had aortic dilatation (range 40-43 mm), and five (45%) had globally active scans. Cranial artery activity resolved in all patients between diagnosis and five years, but aortitis developed in four patients who previously had PET-inactive aortas. Disease-modifying rheumatic drug (DMARD) use at five years was associated with scan inactivity (P = 0.02). There was a trend toward a higher mean aortic diameter in those with aortitis at five years (40.2 mm vs 36.0 mm, P = 0.06) but not those with aortitis at diagnosis.</p><p><strong>Conclusion: </strong>Vasculitis activity changed from cranial and large vessel to exclusively large vessel by five years. This may explain the preponderance of early cranial and late aortic complications in GCA. The potential role of long-term DMARDs to mitigate smoldering vasculitis warrants further study.</p>","PeriodicalId":93845,"journal":{"name":"ACR open rheumatology","volume":"7 3","pages":"e70006"},"PeriodicalIF":2.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11865633/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143517627","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}