ACR open rheumatology最新文献

{"title":"In Vitro Fertilization is Essential Healthcare for Patients With Rheumatic Disease.","authors":"Amanda Moyer, Catherine A Sims, Rosalind Ramsey-Goldman, Solmaz Chamanara, Cuoghi Edens","doi":"10.1002/acr2.90090","DOIUrl":"10.1002/acr2.90090","url":null,"abstract":"<p><p>Infertility presents a profound physical, emotional, and financial burden, particularly for rheumatology patients who often face substantial barriers to family building. The 2024 Alabama Supreme Court ruling in LePage v. Center for Reproductive Medicine equating embryo destruction with wrongful death introduced new legal uncertainties, sparking concerns about access to in vitro fertilization (IVF) and reproductive health services across the United States. Although Alabama's subsequent legislative action granted temporary protections for fertility providers, the broader implications of embryo personhood laws remain unresolved. For patients with rheumatic diseases, timely access to assisted reproductive technology (ART) is essential. However, barriers such as limited ART awareness, concerns about safety and success, social and religious stigma, and financial and legal restrictions disproportionately impact this population. The consequences of restrictive policies extend beyond females, affecting men and same-sex couples who rely on IVF to expand their families. Infertility is a recognized medical condition, and restricting ART access is medically and ethically indefensible. As physicians, researchers, and advocates, we must actively oppose legal decisions and policies that limit ART availability, including insurance restrictions, discriminatory practices, and embryo personhood legislation. Protecting and expanding ART access is critical-not only for rheumatology patients but for the one in eight couples and one in four physicians affected by infertility. Ensuring equitable, evidence-based reproductive care is imperative to safeguarding the right to family building for all.</p>","PeriodicalId":93845,"journal":{"name":"ACR open rheumatology","volume":"8 7","pages":"e90090"},"PeriodicalIF":2.9,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13307328/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148341449","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":"Reproducible Molecular Subtypes in Systemic Lupus Erythematosus Are Associated With Disease Activity, Serology, and Distinct Trajectories Over Time.","authors":"Loqmane Seridi, Eugene Myshkin, Erika Noss, Sheng Gao, Julio Molineros, Carolyn Cuff, Dawn Waterworth, Matthew J Loza","doi":"10.1002/acr2.90083","DOIUrl":"10.1002/acr2.90083","url":null,"abstract":"<p><strong>Objective: </strong>Systemic lupus erythematosus (SLE) is biologically heterogeneous, motivating development of reproducible molecular subtypes that can track change over time. The aim of this study was to establish a reproducible molecular stratification of SLE across cohorts and platforms and connect the resulting subtypes to clinical activity, serology, and serum proteomics.</p><p><strong>Methods: </strong>We computed Gene Set Variation Analysis scores for eight immune gene modules from baseline transcriptomes (ILLUMINATE whole-blood microarray [N = 1,756], LOTUS whole-blood RNA sequencing [RNA-seq; N = 585], and Genuity peripheral blood mononuclear cell (PBMC) RNA-seq [N = 812]). We clustered ILLUMINATE patients (K = 2-8) and selected K = 6, then used a random forest classifier to assign subtypes in LOTUS and Genuity. We analyzed serum proteomics (SomaScan in LOTUS; Olink in Genuity), assessed glucocorticoid associations with neutrophil modules, and quantified baseline to week 24 stability in LOTUS.</p><p><strong>Results: </strong>Six molecular subtypes replicated across cohorts and corresponded to different levels of disease activity and serology (P < 0.001). Proteomic patterns converged with transcriptomics, with concordant differential proteins across Olink and SomaScan among shared targets. Neutrophils were a key axis: one neutrophil module tracked glucocorticoid use, whereas a second was glucocorticoid independent. In LOTUS, subtype assignments were mostly stable to week 24; when patients moved, transitions were nonrandom, occurred between adjacent subtypes, and were similar in the placebo group.</p><p><strong>Conclusion: </strong>We demonstrated reproducible SLE molecular subtypes (interferon, plasmablast/B cell, neutrophil) supported by independent proteomics. In LOTUS, subtypes were largely stable through week 24. When patients changed subtypes, transitions followed preferential trajectories, supporting longitudinal tracking and trial design utility.</p>","PeriodicalId":93845,"journal":{"name":"ACR open rheumatology","volume":"8 7","pages":"e90083"},"PeriodicalIF":2.9,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13332139/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148383355","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":"Synovial Fluid Cell Profiling Identifies Distinct Inflammatory Phenotypes in Late-Onset Rheumatoid Arthritis and Polymyalgia Rheumatica.","authors":"Shigeru Tanaka, Takahiro Sugiyama, Shuhei Kameda, Tatsuro Takahashi, Masahiro Yasui, Yuki Hayashi, Tomoaki Ida, Yuhi Yoshida, Soichiro Kubota, Takashi Ito, Takahiro Kageyama, Daiki Nakagomi, Kei Ikeda, Shin-Ichiro Kagami, Hiroshi Nakajima","doi":"10.1002/acr2.90086","DOIUrl":"10.1002/acr2.90086","url":null,"abstract":"<p><strong>Objective: </strong>Late-onset rheumatoid arthritis (LORA) and polymyalgia rheumatica (PMR) can be difficult to distinguish, particularly in anti-citrullinated protein antibody (ACPA)-negative patients. We aimed to characterize synovial fluid immune cell profiles in ACPA-positive LORA, ACPA-negative LORA, and PMR, and to explore biologically informed patient stratification using an unbiased approach.</p><p><strong>Methods: </strong>Synovial fluid was aspirated from inflamed periarticular synovial structures of the shoulder, including the subacromial and subdeltoid bursae and the tendon sheath of the long head of the biceps, in 21 patients with ACPA-positive LORA (n = 5), ACPA-negative LORA (n = 8), or PMR (n = 8). Immune cell composition was analyzed by mass cytometry. Principal component analysis and hierarchical clustering were performed to stratify patients.</p><p><strong>Results: </strong>ACPA-positive LORA demonstrated neutrophil predominance compared with PMR. In contrast, PMR demonstrated a neutrophil-poor profile characterized by higher proportions of T cells and natural killer cells. ACPA-negative LORA showed substantial heterogeneity, with individual patients displaying either neutrophil-rich or neutrophil-poor patterns. Unsupervised clustering of mass cytometry data segregated ACPA-positive LORA and PMR into distinct clusters, whereas ACPA-negative LORA cases were distributed across both clusters.</p><p><strong>Conclusion: </strong>This exploratory study suggests that late-onset inflammatory arthritis comprises at least two distinct synovial inflammatory phenotypes that may not fully correspond to current clinical diagnoses. ACPA-negative LORA appears to represent a heterogeneous condition encompassing these distinct states of inflammation. Synovial fluid immunophenotyping may complement conventional classification and support biologically informed therapeutic stratification.</p>","PeriodicalId":93845,"journal":{"name":"ACR open rheumatology","volume":"8 7","pages":"e90086"},"PeriodicalIF":2.9,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13309291/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148341444","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":"Local Circadian Clocks Are Desynchronized From the Central Circadian Pacemaker in a Mouse Model of Inflammatory Arthritis.","authors":"Lance A Riley, Luke E Springer, Sandra Paola Cárdenas-García, Tatiana Simon, Farshid Guilak, Christine T N Pham, Erik D Herzog","doi":"10.1002/acr2.90112","DOIUrl":"10.1002/acr2.90112","url":null,"abstract":"<p><strong>Objective: </strong>Rheumatoid arthritis (RA) is a chronic autoimmune disease affecting joints marked by daily and intermittent surges in inflammatory cytokine levels that result in \"flares\" of disease activity. Because circadian proteins regulate inflammatory responses in arthritis, continuous behavioral- and tissue-level monitoring may clarify therapeutic dynamics. Using the K/BxN serum transfer arthritis (STA) mouse model, we tested whether locomotor activity and circadian clock gene expression track RA progression from onset through symptom resolution.</p><p><strong>Methods: </strong>C57BL/6NJ and PER2::luciferase mice (8-10 weeks) received 180 μL K/BxN serum via retroorbital injection. Uninjected littermates served as controls. We measured daily ankle thickness and continuously monitored open-field locomotion from singly housed mice, a subset of which received dexamethasone (DEX) at dusk daily for 6 days. PER2::luciferase bioluminescence from paw, suprachiasmatic nuclei (SCNs), and femoral heads explants from mice treated with or without DEX were compared during STA.</p><p><strong>Results: </strong>Total daily locomotion decreased alongside ankle swelling approximately 2 days following K/BxN STA. STA altered the timing of daily PER2 peak expression in arthritic paws but not in the SCN or nonarthritic joints. By day 22, total daily locomotion, ankle thickness, and paw circadian phase had resolved. In vivo DEX reduced circadian phase disruption in arthritic paws, accelerated the resolution of ankle swelling, and increased total daily locomotion without altering locomotor timing.</p><p><strong>Conclusion: </strong>Locomotor activity is a real-time, noninvasive supplement for measuring RA onset and resolution. Altered PER2 expression indicates that local circadian synchrony in arthritic joints is impaired. DEX may aid recovery by resynchronizing circadian rhythms in arthritic tissues.</p>","PeriodicalId":93845,"journal":{"name":"ACR open rheumatology","volume":"8 7","pages":"e90112"},"PeriodicalIF":2.9,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13384909/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148537839","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":"Tendon and Ligament Involvement in Gout With Associated Tendon Rupture.","authors":"Thipsukhon Sathapanasiri, Apisan Chinanuvathana, Sungchai Angthararak, Dan Kaufmann, Naomi Schlesinger","doi":"10.1002/acr2.90109","DOIUrl":"10.1002/acr2.90109","url":null,"abstract":"","PeriodicalId":93845,"journal":{"name":"ACR open rheumatology","volume":"8 7","pages":"e90109"},"PeriodicalIF":2.9,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13375072/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148474667","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 Between Rheumatoid Arthritis and Survival After Cancer: A Systematic Literature Review and Meta-analysis.","authors":"Joshua J Hsieh, Hemant Khandelia, Avneet Kaur, Teresa Jewell, Aman Dev Singh, Lauren Barkley, Ishan Bansal, Simmi Oberoi, Namrata Singh","doi":"10.1002/acr2.90107","DOIUrl":"10.1002/acr2.90107","url":null,"abstract":"<p><strong>Objective: </strong>Evidence on cancer outcomes in patients with rheumatoid arthritis (RA) is limited and conflicting. We conducted a systematic review to evaluate the association between RA and overall survival among patients with cancer.</p><p><strong>Methods: </strong>A comprehensive literature search from inception through November 2024 identified observational studies evaluating mortality after cancer diagnosis in patients with RA. Study quality was assessed using the Newcastle-Ottawa Scale, and mortality estimates (RA with cancer vs cancer alone) were pooled using inverse variance weighting and random effects models in RevMan.</p><p><strong>Results: </strong>Twenty studies met our eligibility criteria. A total of 59,299 patients with both RA and any type of cancer were included, whereas 1,761,008 patients with cancer only were included. Compared with patients with cancer alone, those with RA and cancer did not have a significant difference in mortality (pooled hazard ratio [HR] 1.13; 95% confidence interval [CI] 0.90-1.42). There was significantly worse survival in patients with RA and lung cancer (HR 1.22; 95% CI 1.01-1.46), RA and hematologic malignancies (HR 1.20; 95% CI 1.04-1.37), and RA and breast cancer (pooled HR 1.41; 95% CI 1.22-1.63). Results for other cancer types were inconclusive across studies. All studies were of generally good quality, and no major publication bias was identified.</p><p><strong>Conclusion: </strong>Patients with both RA and cancer overall do not experience poorer survival compared to patients with cancer alone. However, survival significantly worsens for patients with RA with lung, hematologic, or breast malignancies. Future prospective studies are warranted to elucidate underlying mechanisms and optimize cancer management strategies in RA.</p>","PeriodicalId":93845,"journal":{"name":"ACR open rheumatology","volume":"8 7","pages":"e90107"},"PeriodicalIF":2.9,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13394375/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148564043","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Autoimmune Disease Risk With GLP-1RA, DPP-4i, and SGLT2i Treatment in Patients With Diabetes.","authors":"Arjun Mahajan, David W Bates, Alessandro Doria, Dinah Foer, Avery H LaChance, Jeffrey A Sparks","doi":"10.1002/acr2.90046","DOIUrl":"10.1002/acr2.90046","url":null,"abstract":"<p><strong>Objective: </strong>Dipeptidyl peptidase-4 inhibitors (DPP-4i), glucagon-like peptide-1 receptor agonists (GLP-1RA), and sodium-glucose cotransporter-2 inhibitors (SGLT2i) are widely used for type 2 diabetes, yet their comparative immunologic safety is uncertain. To address this gap, we evaluated autoimmune disease incidence among patients treated with these agents.</p><p><strong>Methods: </strong>We conducted emulated target trials using electronic health record data from 152 health care organizations in the TriNetX network (2016-2023). Adults with type 2 diabetes initiating DPP-4i, GLP-1RA, or SGLT2i monotherapy and no prior autoimmune disease were included. Propensity score matching balanced demographics, comorbidities, laboratory data, and medications. Cohorts comprised 118,419 matched DPP-4i versus GLP-1RA pairs, 102,810 DPP-4i versus SGLT2i pairs, and 105,869 GLP-1RA versus SGLT2i pairs. Primary outcomes included three-year risks of incident autoimmune diseases such as psoriasis, rheumatoid arthritis, systemic sclerosis, dermatomyositis, and multiple sclerosis.</p><p><strong>Results: </strong>Compared with GLP-1RA, DPP-4i was associated with lower risk of psoriasis (hazard ratio [HR] 0.79, 95% confidence interval [CI] 0.70-0.85), psoriatic arthritis (HR 0.65, 95% CI 0.53-0.79), and autoimmune thyroiditis (HR 0.68, 95% CI 0.59-0.76), but higher risk of dermatomyositis (HR 2.18, 95% CI 1.24-3.53) and bullous pemphigoid (HR 1.78, 95% CI 1.24-2.46).</p><p><strong>Conclusion: </strong>Compared with GLP-1RA, DPP-4i use decreased psoriasis and thyroiditis risk but increased dermatomyositis, bullous pemphigoid, and giant cell arteritis risk. No significant differences were observed between GLP-1RA and SGLT2i treatments. These findings provide novel safety signals and may inform antidiabetic drug selection while guiding future mechanistic and prospective research.</p>","PeriodicalId":93845,"journal":{"name":"ACR open rheumatology","volume":"8 7","pages":"e90046"},"PeriodicalIF":2.9,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13341954/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148407361","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 Image: Extensive subcutaneous calcification in SLE/SSc overlap syndrome.","authors":"Jianmei Cao, Jinchao Jia","doi":"10.1002/acr2.90103","DOIUrl":"10.1002/acr2.90103","url":null,"abstract":"","PeriodicalId":93845,"journal":{"name":"ACR open rheumatology","volume":"8 7","pages":"e90103"},"PeriodicalIF":2.9,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13376835/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148474670","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":"Accelerometry-Derived Activity and Sleep Patterns in the NIH All of Us Cohort: Insights and Predictive Potential for Inflammatory Arthritis.","authors":"Souptik Barua, Adeep Kulkarni, Dhairya Upadhyay, Samika Hariharan, Imani Ashman, Kyra Chen, Aristotelis Tsirigos, Jose U Scher, Rebecca H Haberman","doi":"10.1002/acr2.90089","DOIUrl":"10.1002/acr2.90089","url":null,"abstract":"<p><strong>Objective: </strong>The relationship between physical activity and sleep with inflammatory arthritis (IA) is understudied, and existing research has relied largely on self-report or short-term assessments. The NIH All of Us database provides long-term accelerometry data, enabling more precise estimation of the association between lifestyle behaviors and IA.</p><p><strong>Methods: </strong>Participants from the All of Us database who shared electronic health record and Fitbit data were included. Daily activity and sleep metrics were compared between individuals with and without IA using multiple linear regression. Cox proportional hazards regression was used to examine the association of activity and sleep patterns with incident IA in a 10-year follow-up period.</p><p><strong>Results: </strong>A total of 23,855 participants were included, 200 of whom had IA. Participants with IA took fewer daily steps (P < 0.001) and had greater sleep variability (P < 0.001) compared to those without IA. 122 individuals had incident IA. Every 1,000 extra daily steps were associated with a 7% lower risk of IA (hazard ratio [HR] 0.93 [95% confidence interval (CI) 0.87-0.99], P = 0.02). Compared to those who walked <5,000 steps daily, those who walked 5,000 to 10,000 steps and 10,000+ steps had a 41% (HR 0.59 [95% CI 0.39-0.91], P = 0.02) and 50% (HR 0.50 [95% CI 0.29-0.86], P = 0.01) reduction in risk of IA.</p><p><strong>Conclusion: </strong>Individuals with IA had reduced step counts and more sleep variability compared to those without IA, highlighting how physical activity and sleep contribute to IA. Additionally, increased daily step count was associated with decreased risk of incident IA, suggesting a possible research intervention for those at high risk of IA.</p>","PeriodicalId":93845,"journal":{"name":"ACR open rheumatology","volume":"8 7","pages":"e90089"},"PeriodicalIF":2.9,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13401751/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148595018","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: Skin manifestations and radiographic findings of anti-SAE1 positive dermatomyositis.","authors":"Amara Seng, George Matcuk, Wonwoo Shon, Lindsy Forbess, Mariko L Ishimori","doi":"10.1002/acr2.90100","DOIUrl":"10.1002/acr2.90100","url":null,"abstract":"","PeriodicalId":93845,"journal":{"name":"ACR open rheumatology","volume":"8 7","pages":"e90100"},"PeriodicalIF":2.9,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13320627/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148363991","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}