ACR open rheumatology最新文献

{"title":"Insomnia Treatment Preferences and Barriers of Individuals With Arthritis.","authors":"Emilie McGuire, Nicole J Andersen, Diane Lacaille, Josée Savard, Paul R Fortin, Elham Rahme, Deborah Da Costa","doi":"10.1002/acr2.90104","DOIUrl":"10.1002/acr2.90104","url":null,"abstract":"<p><strong>Objective: </strong>Sleep disturbances, including difficulty initiating sleep, maintaining sleep or early morning awakenings, are prevalent in arthritis, contributing to fatigue, pain, and reducing quality of life. Cognitive-behavioral therapy for insomnia (CBTi) is the first-line treatment. Accessibility remains challenging. Internet-delivered CBTi (ICBTi) increases accessibility. To tailor ICBTi to arthritis, a needs assessment survey was conducted.</p><p><strong>Methods: </strong>Individuals with arthritis, recruited through social media and patient organizations, completed an online survey assessing insomnia, help-seeking behaviors or barriers, management strategies, and treatment preferences.</p><p><strong>Results: </strong>Of the 248 participants, 55% discussed sleep with health care providers, and 35% did not in the past year despite perceiving the need. Common barriers to seeking treatment despite the need were having their own ways of coping (54% in inflammatory arthritis [IA] and 46% in osteoarthritis [OA]), and believing sleep problems are normal stress responses (53% in IA and 38% in OA). In IA, 54% and in OA, 43% used relaxation techniques for sleep, and 37% in IA and OA used over-the-counter medication at least once. In IA, 44%, and in OA, 39% rated medication as somewhat or very acceptable, 74% with IA and 66% in OA were willing to see health care providers for insomnia regularly, and 91% with IA and 86% with OA were likely or very likely to try an online arthritis-specific approach.</p><p><strong>Conclusion: </strong>Given the prevalence, chronicity, and consequences of insomnia, better insomnia management is needed for individuals with arthritis. ICBTi is an acceptable approach for this population. These findings will guide the evaluation of an arthritis-specific ICBTi.</p>","PeriodicalId":93845,"journal":{"name":"ACR open rheumatology","volume":"8 8","pages":"e90104"},"PeriodicalIF":2.9,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13490846/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148802928","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":"Tofacitinib for Calcinosis Cutis Associated With Juvenile Dermatomyositis: An Open-Label Single-Arm Study.","authors":"Pragati Jain, Supraja Laguduva Mohan, Shivani Kaushik, Rakesh Deepak, Dibyanshu Mishra, M A Khan, Vishal Gupta, Priyanka Naranje, A V Ramanan, Rakesh Lodha, Manisha Jana, Narendra Kumar Bagri","doi":"10.1002/acr2.90117","DOIUrl":"10.1002/acr2.90117","url":null,"abstract":"<p><strong>Objective: </strong>Calcinosis cutis (CC) is dystrophic calcification affecting 20% to 40% of patients with juvenile dermatomyositis (JDM). Management of CC is often challenging owing to its being refractory to usual therapeutic options. Type I interferon (IFN)-mediated immune dysregulation may be involved in the pathogenic role in CC, suggesting that altering JAK/STAT signaling through JAK inhibitors might offer a therapeutic benefit.</p><p><strong>Methods: </strong>In this open-label, single-arm study, the primary objective was to study the effect of tofacitinib (MSN Pharmaceuticals) on the burden of CC in children (2-18 years) with JDM, as assessed by the Agatston score using a low-dose whole-body computed tomography scan at 24 ± 2 weeks follow-up. Secondary objectives were to evaluate the effect on Cutaneous Dermatomyositis Disease Area and Severity Index, Childhood Myositis and Assessment scales, steroid usage, IFNα and IFNβ levels and adverse events. Children with JDM and clinical or radiologic evidence of CC were enrolled for this study. The study drug tofacitinib was administered orally as per the standard doses based on the participant's weight band. The standard therapy included concomitant steroids, methotrexate and/or mycophenolate mofetil, and/or intravenous immunoglobulin. Those who received cyclophosphamide or rituximab in the preceding six months, were receiving concomitant topical tacrolimus, had active tuberculosis, or had hematologic abnormalities were excluded.</p><p><strong>Results: </strong>Twenty children (11 boys) with a mean age of 10.4 (SD 3.6 years) completed the study. Eighteen children had CC associated with JDM, whereas two had JDM-systemic sclerosis overlap. Median duration of CC in the study population was 31 (interquartile range [IQR] 19.5-54) months. There was a significant reduction in the Agatston score, median at follow-up compared to baseline 6,349 (IQR 3,765-65,255) versus 4,007 (1,616-55,515), P = 0.012, with a moderate effect size (d-robust -0.52). No serious adverse events were noted during the study period.</p><p><strong>Conclusion: </strong>Tofacitinib, when added to standard therapy, reduced the Agatston score in children with CC associated with JDM. No major safety signals were observed during the study period. Clinical Trials Registry - India: CTRI/2024/02/062740.</p>","PeriodicalId":93845,"journal":{"name":"ACR open rheumatology","volume":"8 8","pages":"e90117"},"PeriodicalIF":2.9,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13476698/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148763360","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":"Signaling Pathway-Biomarker Coupling for Precision Therapy in Rheumatoid Arthritis: Mechanistic Insights, Translational Bottlenecks, and Emerging Strategies.","authors":"Shijie Meng, Feng Xing, Yuyang Luo, Jianxin Li, Yingchen Ni, Fengyuan Zhang, Hua Xu, Youhua Wang, Weidong Zhang","doi":"10.1002/acr2.90136","DOIUrl":"10.1002/acr2.90136","url":null,"abstract":"<p><p>Rheumatoid arthritis (RA) is a heterogeneous autoimmune disease. Despite advances in targeted therapies, significant interindividual variability in treatment response and a lack of precise predictive tools limit the achievement of treat-to-target goals. This review aims to establish a signaling pathway-biomarker-targeted therapy coupling paradigm to address unmet clinical needs in precision rheumatology. We systematically reviewed the literature on core pathogenic cascades (JAK/STAT, MAPK, phosphoinositide 4-kinase-AKT/mechanistic target of rapamycin, spleen tyrosine kinase, Wnt, and Notch) and their crosstalk in RA. We analyzed the direct coupling between pathway dysregulation and specific biomarkers and evaluated emerging therapeutic strategies. We identified a direct mapping between aberrant pathways and biomarkers (eg, interleukin-6 or C-reactive protein for JAK/STAT, matrix metalloproteinase 3 for MAPK). Critically, we argue that the failure of most biomarker-driven trials stems not from the biomarkers themselves but from treating RA as a single entity rather than a spectrum of pathway-dominant endotypes. Current clinical translation is hindered by heterogeneity and a disconnect between bench research and bedside application. Emerging strategies, including highly selective kinase inhibitors, proteolysis-targeting chimeras, and nanoparticle-mediated delivery systems, show promise in overcoming these bottlenecks. Bridging the gap between dysregulated signaling pathways and validated biomarkers is essential for advancing precision medicine in RA. A roadmap for pathway-guided individualized treatment is proposed.</p>","PeriodicalId":93845,"journal":{"name":"ACR open rheumatology","volume":"8 8","pages":"e90136"},"PeriodicalIF":2.9,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13501258/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148809601","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":"Exploratory Analysis of the Inhibitory Effects of Propranolol on NLRP3 and Pyrin Inflammasomes.","authors":"Renske J de Jong, Christopher T Neullens, Aljoscha Swoboda, Melanie Saers, Philipp Berger, Sudheendra Hebbar Subramanyam, Anastasia Wiener, Kim Ohl, Ralf Weiskirchen, Heidi Noels, Tilmann Kallinich, Julia Guthrie, Christoph Kessel, Klaus Tenbrock","doi":"10.1002/acr2.90133","DOIUrl":"10.1002/acr2.90133","url":null,"abstract":"<p><strong>Objective: </strong>Propranolol, a nonselective beta receptor blocking agents, impacts cAMP levels and is commonly used to treat hypertension and hemangioma in children and adults. Although there are reports indicating its anti-inflammatory properties, the exact mechanism is not fully understood.</p><p><strong>Methods: </strong>Murine and human monocytes and macrophages were exposed to ATP and lipopolysaccharide (LPS), as well as Clostridioides difficile toxin A (TcdA) and LPS in the presence or absence of propranolol. Levels of interleukin-1β (IL-1β), tumor necrosis factor α, and IL-6 were then measured. This same process was repeated with monocytes obtained from six different patients with familial Mediterranean fever (FMF). In a murine atherosclerosis model, a model known to be highly impacted by inflammasome activation, propranolol was administered through drinking water, and the size of aortic plaques was measured.</p><p><strong>Results: </strong>Propranolol was found to decrease the production and secretion of IL-1β in both murine and human monocytes and macrophages following activation of the NLRP3 inflammasome, accompanied by reduced caspase-1 levels in human cells. Propranolol treatment effectively prevented IL-1β production in monocytes from healthy donors and patients with FMF after stimulation with the NLRP3 inflammasome activators LPS and ATP, as well as the pyrin inflammasome activator TcdA. In mice, propranolol treatment also resulted in reduced aortic plaque formation.</p><p><strong>Conclusion: </strong>This exploratory study suggests that propranolol inhibits both the NLRP3 and pyrin inflammasomes in murine and human monocytes and macrophages. Given its established safety profile and approval for pediatric use, propranolol warrants further investigation as a potential treatment for refractory FMF, particularly in regions with limited access to IL-1β blockade.</p>","PeriodicalId":93845,"journal":{"name":"ACR open rheumatology","volume":"8 8","pages":"e90133"},"PeriodicalIF":2.9,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13500453/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148809569","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":"HLA-B Associates With Distinct Disease Expression in Juvenile Spondyloarthritis: A Retrospective Cohort Study.","authors":"Dimitrios V Bikas, Timothy G Brandon, Brittney N Newby, Pamela F Weiss","doi":"10.1002/acr2.90122","DOIUrl":"10.1002/acr2.90122","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to investigate for possible association between HLA-B genotype and disease phenotype in children with juvenile spondyloarthritis (JSpA).</p><p><strong>Methods: </strong>This was a cross-sectional retrospective study of children evaluated at a large tertiary care rheumatology clinic. Inclusion criteria were (1) fulfillment of criteria for juvenile idiopathic arthritis (JIA) subtypes: enthesitis-related arthritis (ERA), psoriatic arthritis (PsA), or undifferentiated JIA (ERA criteria plus a first-degree relative with psoriasis); or (2) a diagnosis of inflammatory bowel disease-associated arthritis (IBD-AA); or (3) magnetic resonance imaging-confirmed inflammatory sacroiliitis in patients who did not meet JIA subtype criteria. All children underwent complete HLA-B testing. Comparisons of HLA-B allele frequencies between JSpA and a published national cohort were conducted through two-sample tests of proportions and controlled for multiple testing using the Benjamini-Hochberg procedure.</p><p><strong>Results: </strong>There were 150 children who met the inclusion criteria, and 28% (42 of 150) were HLA-B*27-positive. Overall, participants exhibited pronounced heterogeneity in phenotypic and allelic composition, with HLA-B variants associated with distinct patterns of disease expression. Overall, HLA-B*35:02 was significantly enriched in children with IBD-AA (P = 0.007) and in the overall occurrence of IBD (P = 0.005), whereas HLA-B*57:01 was significantly enriched in children with PsA (P = 0.006).</p><p><strong>Conclusion: </strong>These patterns suggest a key role for HLA-B variants in disease pathogenesis, possibly driving diverse JSpA expression through distinct immunogenetic dysregulation. Our findings underscore the need to further elucidate the biologic connection between HLA-B and JSpA, with potential insights that may inform clinical care and guide future investigation.</p>","PeriodicalId":93845,"journal":{"name":"ACR open rheumatology","volume":"8 8","pages":"e90122"},"PeriodicalIF":2.9,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13482771/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148802910","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":"Large-Scale Autoantibody Reactome Analysis Reveals Shared and Specific Signatures Across Different Immune-Mediated Inflammatory Diseases.","authors":"Zhou Bai, Bomiao Yu, Zimo Wei, Pancheng Xiao, Minghua Zhan, Mansheng Li, Fang Wang, Yongjing Cheng, Minshu Zhao, Chao Zhang, Xuan Zhang, Xiaobo Yu, Yudong Liu","doi":"10.1002/acr2.90131","DOIUrl":"10.1002/acr2.90131","url":null,"abstract":"<p><strong>Objective: </strong>The shared and disease-specific mechanisms across the immune-mediated inflammatory diseases (IMIDs) spectrum remains incompletely characterized, despite the recognized role of autoantibodies as important indicators of immune tolerance breakdown and immune dysregulation.</p><p><strong>Methods: </strong>Autoantibody reactome profiling of IgG and IgA autoantibodies was performed across eight IMIDs to delineate both shared and disease-specific autoantibodies using autoantigen microarray.</p><p><strong>Results: </strong>Widespread autoantibody signatures were observed, and 384 and 69 IgG and IgA autoantibodies were identified in IMID, predominantly targeting proteins involved in cytokine signaling and T cell-related pathways. Notably, most IMIDs have the common pathways of cell apoptosis and proliferation, and each IMID has its unique pathways. The identified autoantibody signatures achieved area under the curve values of 0.6 to 1.0 for individual IMIDs and 0.996 for all IMIDs compared with healthy controls. The autoantibodies against SULF1 and HDAC3 were further validated in an independent rheumatoid arthritis cohort, and the overexpression of these two autoantigens was detected at the transcriptomic and protein levels.</p><p><strong>Conclusion: </strong>These findings provide an exploratory autoantibody-based resource for IMID and identify candidate signatures that may inform future studies of disease stratification, diagnostic refinement, and mechanistic investigation. Nevertheless, owing to the relatively small sample sizes for each disease subgroup, the observed predictive performances should be regarded as preliminary, necessitating further verification in larger independent patient cohorts.</p>","PeriodicalId":93845,"journal":{"name":"ACR open rheumatology","volume":"8 8","pages":"e90131"},"PeriodicalIF":2.9,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13481158/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148802852","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":"Dual Targeted Therapy as a Treatment Strategy for Refractory Psoriatic Arthritis: Real-World Effectiveness and Safety From a Prospective Cohort.","authors":"André Lucas Ribeiro, Zahra Al-Zahir, Virginia Carrizo Abarza, Khalad Maliyar, Siddhartha Sood, Ahmed Bagit, Muskaan Sachdeva, Sahil Koppikar, Dafna D Gladman, Jensen Yeung, Vinod Chandran, Lihi Eder","doi":"10.1002/acr2.90084","DOIUrl":"10.1002/acr2.90084","url":null,"abstract":"<p><strong>Objective: </strong>To describe patient profiles, treatment patterns, clinical outcomes, and safety of intentional dual biologic or targeted synthetic disease-modifying antirheumatic drug (b/tsDMARD) therapy in psoriatic arthritis (PsA). A subset of patients with PsA continue to experience persistent inflammation despite b/tsDMARD monotherapy. Dual b/tsDMARD therapy has emerged as a potential strategy in refractory cases, but evidence in PsA remains limited.</p><p><strong>Methods: </strong>We conducted a nested study within the International Psoriasis and Arthritis Research Team prospective cohort. Adults satisfying Classification Criteria for Psoriatic Arthritis who received two concurrent b/tsDMARDs (TNFi, IL-17i, IL-23i, JAKi, TYK2i, with or without apremilast) for ≥60 days were included. Baseline features, previous therapies, indications for dual therapy, and disease activity measures (tender joint count in 68 joints, swollen joint count in 66 joints, Disease Activity Index for Psoriatic Arthritis [DAPSA], Psoriasis Area and Severity Index [PASI], body surface area, patient visual analog scale) were collected. Clinical outcomes were reassessed at three- to six-month intervals, with effectiveness assessed only for dual bDMARD + JAK/TYK2i combinations. Safety was evaluated through all-cause adverse events.</p><p><strong>Results: </strong>Thirty-nine patients initiated dual therapy: 24 patients received bDMARD + JAK/TYK2i and 15 patients with bDMARD + apremilast. Patients were highly treatment-experienced (median two conventional synthetic DMARDs and five b/tsDMARDs). Indications included refractory peripheral arthritis, concurrent joint and skin activity, palmoplantar or nail psoriasis, and persistent enthesitis. Among bDMARD + JAK/TYK2i combinations, improvements were observed in joint counts, DAPSA, PASI, and patient-reported outcomes. Adverse events were infrequent and mild.</p><p><strong>Conclusions: </strong>In this real-world cohort, dual b/tsDMARD therapy was feasible, well-tolerated, and associated with clinical improvement in patients with refractory PsA. These findings support its individualized use and highlight the need for controlled studies to define long-term safety and optimal combination strategies.</p>","PeriodicalId":93845,"journal":{"name":"ACR open rheumatology","volume":"8 8","pages":"e90084"},"PeriodicalIF":2.9,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13458030/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148708861","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":"Pain Sensitivity Profiles Are Associated With Muscle Biomechanics and Clinical Pain in Persons With Symptomatic Knee Osteoarthritis.","authors":"Alisa J Johnson, Bryce C Murillo, Yenisel Cruz-Almeida","doi":"10.1002/acr2.90118","DOIUrl":"10.1002/acr2.90118","url":null,"abstract":"<p><strong>Objective: </strong>There is growing evidence that knee osteoarthritis (OA), a significant source of chronic pain, is only partly explained by joint pathophysiology, varies significantly between individuals and may be partly driven by changes in periarticular tissues. The objective of this pilot study was to further characterize soft tissue properties that may be important to knee OA pain, and their associations with indicators of pain sensitization.</p><p><strong>Methods: </strong>Forty-two older adults (aged 50-85 years) with knee OA pain completed quantitative sensory testing (QST), myotonometry (ie, MyotonPRO) in the rectus femoris and biceps femoris, and clinical measures. Using data reduction techniques and unsupervised machine learning, we identified pain sensitivity profiles. Univariate and multivariate analyses of covariance examined associations between pain sensitivity profiles, muscle properties (stiffness, tone, decrement, relaxation time, and creep) and clinical pain, adjusted for age, sex, and body mass index. Pearson correlations assessed bivariate correlations between QST measures and muscle properties.</p><p><strong>Results: </strong>Two profiles were identified: (1) high pain sensitivity or inefficient conditioned pain modulation (CPM) and (2) low pain sensitivity or efficient CPM and were significantly associated with muscle properties and clinical pain (P < 0.05), such that those with low pain sensitivity demonstrated greater tone and stiffness, and lower relaxation time and creep.</p><p><strong>Conclusion: </strong>Using a brief QST battery, we identified two distinct pain sensitivity profiles that were differentially associated with periarticular tissue properties. Our results align with recent findings demonstrating distinct pain phenotypes in knee OA and that periarticular tissues may be important to understanding pain variability in knee OA.</p>","PeriodicalId":93845,"journal":{"name":"ACR open rheumatology","volume":"8 8","pages":"e90118"},"PeriodicalIF":2.9,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13446148/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148681495","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: Features of IgG4-related disease in a patient with granulomatosis with polyangiitis.","authors":"Florian Kollert, David R Bisharat, Velina Widmer, Bernhard Hausenberger, Simona Negoias, Ingmar Heijnen, Alexandar Tzankov, Kirsten Mertz, Diego Kyburz, Thomas Daikeler","doi":"10.1002/acr2.90113","DOIUrl":"10.1002/acr2.90113","url":null,"abstract":"","PeriodicalId":93845,"journal":{"name":"ACR open rheumatology","volume":"8 8","pages":"e90113"},"PeriodicalIF":2.9,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13448140/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148686907","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":"Passive Transfer of Hepatitis B Core Antibody Following Intravenous Ig Administration: Clinical Implications and Considerations.","authors":"Mark McPherson, Alexandra Jianu, Winn Chatham","doi":"10.1002/acr2.90123","DOIUrl":"10.1002/acr2.90123","url":null,"abstract":"<p><strong>Background: </strong>Intravenous Ig (IVIG) is used in the management of a wide array of medical conditions. Passive transfer of hepatitis B core antibody (anti-HBc) following IVIG administration is a well-recognized, but often underappreciated phenomenon that can complicate the interpretation of hepatitis B serologies. Failure to recognize passive anti-HBc transfer may lead to unnecessary diagnostic evaluation and interventions, as well as delays in needed immunosuppressive therapy.</p><p><strong>Cases: </strong>This report presents a case series describing three patients, from our institution, who developed positive anti-HBc after IVIG administration. This passive antibody transfer created diagnostic uncertainty regarding prior hepatitis B virus (HBV) exposure. These cases demonstrate the challenges physicians face when distinguishing passive transfer of anti-HBc from true previous HBV infection and highlight the potential consequences of misinterpretation of positive anti-HBc testing in this clinical setting.</p><p><strong>Conclusion: </strong>Recognition of passive anti-HBc transfer after IVIG administration is important to avoid unnecessary diagnostic testing, antiviral therapy, and delays in starting immunosuppressive treatment. Physicians should consider the timing of IVIG administration when interpreting hepatitis B serologies. We propose obtaining baseline hepatitis B serologies before IVIG administration and we suggest building a best practice advisory into the electronic medical record that would serve as a reminder to providers ordering IVIG to obtain this baseline testing. Increased awareness of this phenomenon should improve accurate interpretation of positive anti-HBc test results following IVIG and limit unnecessary interventions, delays in needed immunosuppressive therapies, and cost to both the patient and health care system.</p>","PeriodicalId":93845,"journal":{"name":"ACR open rheumatology","volume":"8 8","pages":"e90123"},"PeriodicalIF":2.9,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13498856/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148802847","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}