ACR open rheumatology最新文献

{"title":"Scleroderma-Specific Autoantibodies and Disease Trajectories in Early Systemic Sclerosis: Insights From a Single-Center Prospective Registry.","authors":"Marzieh Jamali, Amisha Kaur, Suiyuan Huang, Carleigh Zahn, Erica Mulcaire-Jones, John Varga, Dinesh Khanna","doi":"10.1002/acr2.90142","DOIUrl":"10.1002/acr2.90142","url":null,"abstract":"<p><strong>Objective: </strong>Early diffuse cutaneous systemic sclerosis (dcSSc) is associated with substantial disease-specific mortality.  Scleroderma-specific autoantibodies (SSc-Ab) may influence disease course, but their prognostic value in very early dcSSc remains unclear. We examined associations between autoantibody profiles and disease trajectories for clinical events in a prospective single-center cohort.</p><p><strong>Methods: </strong>We retrospectively analyzed prospectively collected data from a subset of patients enrolled in an early SSc registry between October 2012 and July 2021, including those with early dcSSc or individuals at risk for dcSSc less than two years of their first non-Raynaud phenomenon (RP) symptom. Participants were classified as anti-RNA polymerase III antibody positive (RNAP3+), anti-topoisomerase I antibody positive (Scl70+), or triple-negative (negative for RNAP3, Scl70, and anticentromere antibody [ACA]).</p><p><strong>Results: </strong>Among 115 patients with available SSc-Ab data (median follow-up, 5.5 years [interquartile range 2.1-7.2]), 42 were RNAP3+, 29 Scl70+, 6 ACA+, and 38 triple-negative. ACA+ patients were excluded from subgroup analyses because of the small sample size. Of the remaining 109 patients, 17 with prior clinical events at baseline were excluded from time-to-event analyses. Among the 92 included patients, 50 (54.3%) experienced one or more new clinical events during follow-up, including 59.4% of RNAP3+, 57.1% of Scl70+, and 46.9% of triple-negative patients. Among first new clinical events, RNAP3+ patients had higher frequencies of scleroderma renal crisis (6.3% vs 3.6% in Scl70+ and 0% in triple-negative), malignancy (35.7% vs 24.1% and 15.8%, respectively), mortality (9.4% vs 3.6% and 0%, respectively), and forced vital capacity decline (15.6% vs 10.7% and 12.5%, respectively), whereas modified Rodnan skin score worsening was most frequent in triple-negative patients (15.6% vs 10.7% in Scl70+ and 9.4% in RNAP3+).</p><p><strong>Conclusion: </strong>Scleroderma-specific autoantibodies in early SSc were associated with distinct baseline clinical phenotypes and showed numerical differences in longitudinal clinical outcomes in this single-center cohort.</p>","PeriodicalId":93845,"journal":{"name":"ACR open rheumatology","volume":"8 9","pages":"e90142"},"PeriodicalIF":2.9,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13578917/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148979001","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":"Correction to \"HLA-B Associates With Distinct Disease Expression in Juvenile Spondyloarthritis: A Retrospective Cohort Study\".","authors":"","doi":"10.1002/acr2.90158","DOIUrl":"10.1002/acr2.90158","url":null,"abstract":"","PeriodicalId":93845,"journal":{"name":"ACR open rheumatology","volume":"8 9","pages":"e90158"},"PeriodicalIF":2.9,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13575856/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148972619","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of Disease Activity and Socioeconomic Factors With Physical Activity in Patients With Systemic Lupus Erythematosus.","authors":"Heather T Gold, Isabella Giunta, Jiyu Kim, Yi Li, Jill P Buyon, Peter M Izmirly, Mala Masson, Amit Saxena, H Michael Belmont, Chung-E Tseng, Rebecca Anthopolos","doi":"10.1002/acr2.90150","DOIUrl":"10.1002/acr2.90150","url":null,"abstract":"<p><strong>Objective: </strong>Physical activity can reduce cardiovascular disease and depression risk and improve quality of life in patients with systemic lupus erythematosus (SLE). To facilitate physical activity and achieve health benefits in patients with SLE, it is critical to understand potential barriers to physical activity, including socioeconomic, social, demographic, quality-of-life, or clinical factors.</p><p><strong>Methods: </strong>We conducted cross-sectional analyses of data from a large, diverse cohort of patients with SLE. All completed the International Physical Activity Questionnaire, recalling the past seven days of vigorous physical activity, moderate activity, or walking. Data included financial insecurity, Everyday Discrimination Scale, education, demographics, lupus-specific disease activity, immunosuppressive medication, Census Block Area Deprivation Index, and patient-reported pain, fatigue, and cognitive function. Multivariable models included logistic regression for dichotomous outcome of \"any\" moderate/vigorous physical activity and quasi-Poisson model for total combined days of moderate and vigorous activity.</p><p><strong>Results: </strong>Of the 271 participants, 170 (63%) reported any moderate or vigorous activity in the past 7 days (mean = 2.6 days of moderate/vigorous activity). Only 4% reported zero days of physical activity. Logistic regression analysis indicated that active disease was associated with 47% lower odds of engaging in any moderate/vigorous physical activity (P = 0.04) and with a 35% reduction in the mean number of days of moderate to vigorous physical activity (P = 0.04). In contrast, individual- and area-level socioeconomic factors and patient-reported outcomes were not associated with physical activity.</p><p><strong>Conclusion: </strong>Moderate/vigorous physical activity was negatively associated only with disease activity. The current study reinforces the need primarily to control SLE disease activity to promote patients' ability to be physically active, which may improve symptoms.</p>","PeriodicalId":93845,"journal":{"name":"ACR open rheumatology","volume":"8 9","pages":"e90150"},"PeriodicalIF":2.9,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13545506/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148893118","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":"Variations in the Management of Uncontrolled Gout Between Rheumatologists and Nephrologists: A Retrospective Medical Record Review.","authors":"Kenneth Saag, Nana Kragh, Amod Athavale, Bhavisha Desai, Amal Gulaid, Abiola Oladapo, Brittany Smith, Hyon Choi","doi":"10.1002/acr2.90140","DOIUrl":"10.1002/acr2.90140","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the management practices of rheumatologists and nephrologists in treating patients with uncontrolled gout.</p><p><strong>Methods: </strong>US board-certified rheumatologists and nephrologists treating patients with uncontrolled gout participated in a web-based, retrospective medical record audit study, sharing their perceptions of uncontrolled gout management and treatment. Two-sample t-tests and chi-square tests were used to test the differences between specialties and the P values reported reflected statistically significant differences.</p><p><strong>Results: </strong>A total of 75 nephrologists and 150 rheumatologists extracted medical records of 611 patients with uncontrolled gout. Common comorbidities included chronic kidney disease (CKD) (85%), hypertension (47%), obesity (36%), and diabetes (35%). Rheumatologists frequently prescribed higher doses of allopurinol (29% vs 17%; P = 0.002) and monitored serum urate (SU) levels at every visit (90% vs 75%; P < 0.001) compared with nephrologists. Patients managed by nephrologists had higher rates of emergency department visits (24% vs 13%; P = 0.001) and hospitalization for gout-related issues (6% vs 1%; P = 0.011) than patients managed by rheumatologists. Both specialties acknowledged a significant burden of current gout treatments among their patients and the need for improved treatment options for uncontrolled gout.</p><p><strong>Conclusion: </strong>Rheumatologists prescribed higher gout medication doses and monitored SU levels more frequently, whereas patients with uncontrolled gout managed by nephrologists had higher incidence of CKD and greater health care resource utilization. Both groups agreed on the need for improved gout treatments.</p>","PeriodicalId":93845,"journal":{"name":"ACR open rheumatology","volume":"8 9","pages":"e90140"},"PeriodicalIF":2.9,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13522722/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148842393","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 Perspectives and Expectations on the Use of Artificial Intelligence to Guide Treatment Decision-Making in Juvenile Idiopathic Arthritis: A Qualitative Study.","authors":"Mei-Sing Ong, Laura E Schanberg, Melanie Kohlheim, Jenny Leal, Ashley Luo, Marc D Natter, Yukiko Kimura","doi":"10.1002/acr2.90105","DOIUrl":"10.1002/acr2.90105","url":null,"abstract":"<p><strong>Objective: </strong>Artificial intelligence (AI) is rapidly transforming clinical decision-making. However, patient perspectives on these technologies remain understudied in pediatric care. We investigated patient and parent perspectives on AI use in juvenile idiopathic arthritis (JIA) care among a highly engaged cohort.</p><p><strong>Methods: </strong>We conducted four focus groups with patients with JIA and parents of children with JIA to explore: (1) perceived utility of AI, (2) anticipated benefits and risks of its implementation, (3) information needs for fostering understanding and trust in AI tools, and (4) preferences for model calibration, including acceptable performance thresholds and trade-offs between sensitivity and specificity. Transcripts were analyzed using reflexive thematic analysis.</p><p><strong>Results: </strong>Participants included 8 patients with JIA (3 children and 5 adults) and 10 parents (n = 18 total). Participants expressed enthusiasm for AI's potential to support personalized treatment, but acceptance was universally contingent on AI serving as decision support rather than replacing physician judgment. Primary concerns were physician over-reliance undermining clinical reasoning, privacy vulnerability for pediatric populations, and potential algorithmic bias. Participants emphasized that successful implementation must preserve the patient-provider relationship and accommodate individual circumstances, including disease severity, patient preferences, and lifestyle factors. Acceptable sensitivity-specificity trade-offs varied widely, shaped by each participant's disease experience. Some participants emphasized that trust required disclosing AI use, training data sources, model performance, model provenance and conflicts of interest, and cohort characteristics.</p><p><strong>Conclusion: </strong>Patients expect AI technologies to augment rather than replace clinical judgment, operate transparently, and accommodate individual circumstances. These priorities should guide AI implementation to ensure trust and meaningful adoption.</p>","PeriodicalId":93845,"journal":{"name":"ACR open rheumatology","volume":"8 9","pages":"e90105"},"PeriodicalIF":2.9,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13575497/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148972644","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":"Correction to \"Exploring the Association Between Systemic Lupus Erythematosus and High-Density Lipoproteins: A Systematic Review and Meta-Analysis\".","authors":"","doi":"10.1002/acr2.90138","DOIUrl":"10.1002/acr2.90138","url":null,"abstract":"","PeriodicalId":93845,"journal":{"name":"ACR open rheumatology","volume":"8 9","pages":"e90138"},"PeriodicalIF":2.9,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13535332/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148877050","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":"Stakeholders' Perspectives on the Development of the Early Pain Intervention After Knee Replacement Model of Care: A Qualitative Study.","authors":"Navneet Chadha, Joshua R Zadro, Sam Adie, Ian A Harris, Ilana N Ackerman, Deanne E Jenkin, Blake F Dear, Christopher G Maher, Rachelle Buchbinder, Laurent Billot, Ian D Cameron, Bernadette Brady, Alexandra Ortega, Haiwad Rashtia, Tracey Gregson, Brenda Luck, Giovanni E Ferreira","doi":"10.1002/acr2.90139","DOIUrl":"10.1002/acr2.90139","url":null,"abstract":"<p><strong>Objective: </strong>Persistent pain affects around 20% of Australians after total knee replacement (TKR), yet no dedicated Australian model of care exists to address this unmet need. The Early Pain Intervention after Knee replacement (EPIK) model is being developed, informed by the effective and cost-effective UK Support and Treatment After Replacement care pathway and extensive multistakeholder engagement. Before evaluating the EPIK model of care in a randomized controlled trial, it must be adapted for the Australian context. This qualitative study aimed to explore stakeholders' perspectives to inform this adaptation.</p><p><strong>Methods: </strong>This qualitative descriptive study, guided by a subtle realist ontologic stance and a pragmatic epistemology, used semistructured interviews with key stakeholders across Australia. A preinterview screening questionnaire captured demographic, clinical, and professional characteristics which informed purposive sampling to ensure diverse views. Interviews were audio-recorded, transcribed verbatim, and analyzed using inductive analysis.</p><p><strong>Results: </strong>Sixty-one participants were interviewed (9 patients, 20 physiotherapists, 15 orthopedic surgeons, 14 general practitioners, 1 nurse, and 2 health fund managers) across all six states and the Australian Capital Territory, with 75% residing in metropolitan areas. We identified four key themes: (1) living with pain after TKR, (2) acceptability and value of EPIK, (3) defining the scope of the EPIK care coordinator, and (4) infrastructure and system-level challenges.</p><p><strong>Conclusion: </strong>The EPIK model was well accepted by stakeholders as the first approach designed to improve care coordination for Australians with persistent pain after TKR, with potential to support a more efficient and patient-centered health care system. These insights will inform the EPIK model, which will be tested in a registry-nested randomized controlled trial.</p>","PeriodicalId":93845,"journal":{"name":"ACR open rheumatology","volume":"8 9","pages":"e90139"},"PeriodicalIF":2.9,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13530273/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148868336","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":"Dysregulation of Peripheral Blood B Cells and Natural Killer Cells Is Associated With Myocarditis in Idiopathic Inflammatory Myopathies.","authors":"Carolina Duque, Sylvie T Rousseau, Zuzana Bologna, Monica R Mugnier, Luigi Adamo, Julie J Paik","doi":"10.1002/acr2.90147","DOIUrl":"10.1002/acr2.90147","url":null,"abstract":"<p><strong>Objective: </strong>Idiopathic inflammatory myopathies (IIMs), or myositis, are a group of systemic autoimmune diseases leading to proximal muscle weakness. Myocarditis is a major cause of adverse outcomes. Yet, we know very little about the underlying immunologic processes that are driving myocarditis in the context of IIMs.</p><p><strong>Methods: </strong>We performed single-cell RNA sequencing of peripheral blood mononuclear cells from 12 individuals: myositis without myocarditis (n = 4), myositis with myocarditis (n = 4), and healthy controls (n = 4), to better understand the immunologic alterations characterizing this manifestation of the disease.</p><p><strong>Results: </strong>We found the most notable changes in B cells and natural killer (NK) cells of individuals with myositis with myocarditis compared to myocarditis alone. B cells showed 42 enriched pathways suggestive of increased DNA replication and repair, somatic hypermutation, and lymphocyte activation but a smaller proportion of memory B cells (β = -1.04, false discovery rate = 0.02), suggesting a greater activation of naive B cells in the periphery. NK cells, on the other hand, showed 223 enriched pathways suggestive of reduced proliferation but increased effector functions such as leukocyte degranulation, myeloid cell activation, and tumor necrosis factor secretion, suggesting that NK cells in patients with myositis with myocarditis are more activated but less proliferative than in myositis without myocarditis.</p><p><strong>Conclusion: </strong>Together, these data suggest that B cells and NK cells may be playing important roles in mediating myocarditis pathogenesis in the context of IIMs.</p>","PeriodicalId":93845,"journal":{"name":"ACR open rheumatology","volume":"8 9","pages":"e90147"},"PeriodicalIF":2.9,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13586550/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148993045","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":"Increased Risk of Environmental and Endemic Infectious Diseases in Sjögren's Disease: A Retrospective Analysis (2015-2023).","authors":"Swetha K Shankar, Taylor C Boone, Eliza C Diggins, Melodie L Weller","doi":"10.1002/acr2.90047","DOIUrl":"10.1002/acr2.90047","url":null,"abstract":"<p><strong>Objective: </strong>Sjögren's disease (SjD) is a chronic autoimmune disease with a complex etiology, where pathogens may influence disease development or progression. Although SjD is not communicable, environmental and endemic pathogen exposures may influence its onset or progression. This study assessed the prevalence and patterns of infectious diseases (IDs) in SjD compared to sicca symptom and autoimmune disease controls.</p><p><strong>Methods: </strong>This retrospective, cross-sectional study utilized 2015 to 2023 data from the University of Utah UHealth, analyzing 3,826 patients with SjD and age- and sex-matched controls. ID diagnoses were classified using International Classification of Diseases, Tenth Revision (ICD-10) codes, and odds ratios (ORs) were calculated to identify significant differences in ID prevalence between cases and control cohorts. Unique infections, reinfections, and temporal analyses were performed. Hierarchical cluster analysis identified common and unique patterns of ID diagnoses across different patient groups.</p><p><strong>Results: </strong>Patients with SjD had an average of 5.30 ± 8.00 unique ID diagnoses compared to 4.86 ± 6.15 in controls (P < 0.001). Infections and reinfections were more frequent in SjD, particularly bacterial and fungal. Younger age at SjD diagnosis was associated with increased infections and reinfections. Anti-SSA/Ro positivity correlated with higher infection and reinfection rates. One hundred thirty-four ICD-10 codes showed significant differences in prevalence (based on ORs), with increased bacterial (eg, Mycobacterium, Streptococcus spp.), viral (eg, herpesviruses, molluscum contagiosum), fungal (eg, Candida, Aspergillus), and parasitic (onchocerciasis) infections in SjD. ID profiles in SjD strongly aligned with systemic lupus erythematosus.</p><p><strong>Conclusion: </strong>These findings suggest increased prevalence and recurrence of infections in SjD a potential role in disease onset and progression. Further studies are needed to clarify infection-related mechanisms and identify therapeutic targets.</p>","PeriodicalId":93845,"journal":{"name":"ACR open rheumatology","volume":"8 8","pages":"e90047"},"PeriodicalIF":2.9,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13425599/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148633074","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":"Beyond Glucocorticoids: The Current Landscape and Prospects for Treating Immune Checkpoint Inhibitor-Induced Autoimmunity.","authors":"Xizi Hu, Ji Eun Ryoo, Brian S Henick, Adam Mor","doi":"10.1002/acr2.90092","DOIUrl":"10.1002/acr2.90092","url":null,"abstract":"<p><p>The rapid integration of immune checkpoint inhibitors (ICIs) into standard oncology protocols has birthed a new frontier in clinical rheumatology: immune-related adverse events (irAEs). By disrupting the programmed cell death-1 (PD-1)/PD-L1 and cytotoxic T-lymphocyte-associated protein 4 (CTLA-4) axes to restore antitumor T cell activity, these therapies inadvertently breach peripheral tolerance. This results in a spectrum of de novo autoimmune and inflammatory syndromes that frequently mimic established rheumatic diseases, including inflammatory arthritis and myositis. Although ICIs have revolutionized survival outcomes, the resultant irAEs pose a significant clinical challenge, affecting nearly 50% of patients and often necessitating the expertise of rheumatologists for management. This manuscript explores the unique rheumatologic phenotype of ICI-induced toxicities, emphasizing the urgent need for a shift from broad-spectrum glucocorticoid use toward targeted, mechanism-driven therapies that do not compromise the abscopal antitumor effect. We review the current landscape of clinical trials investigating the repurposing of traditional disease-modifying antirheumatic drugs and advanced biologics. Specifically, we discuss the efficacy and safety of tumor necrosis factor-alpha inhibitors, interleukin-6 receptor antagonists, and JAK inhibitors in the context of steroid-refractory irAEs. We further analyze the molecular commonalities between idiopathic autoimmune diseases and ICI-induced inflammation. As the patient population receiving ICIs grows, the rheumatologist's role as a co-manager is increasingly essential. This review highlights the need for standardized grading and treatment algorithms for rheumatologic irAEs and advocates collaborative research to separate immunotherapy toxicities from its oncological benefits.</p>","PeriodicalId":93845,"journal":{"name":"ACR open rheumatology","volume":"8 8","pages":"e90092"},"PeriodicalIF":2.9,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13438176/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148674769","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}