ACR open rheumatology最新文献

{"title":"Uncovering Genetic Variation in Systemic Lupus Erythematosus Risk Variants in Indigenous Peruvians.","authors":"Cristina M Lanata, Richard F Oppong, Mary K Horton, Victor Borda, Manuel F Ugarte-Gil, Joanne Nititham, Eduardo Tarazona-Santos, Timothy D O'Connor, Heinner Guio, Lindsey A Criswell","doi":"10.1002/acr2.70053","DOIUrl":"10.1002/acr2.70053","url":null,"abstract":"<p><strong>Objective: </strong>Systemic lupus erythematosus (SLE) results in worse clinical outcomes among individuals of Amerindian descent. The genetic basis for this is uncertain, and there is a significant lack of genetic research focused on Amerindian ancestry populations. This study aims to compare the frequencies of SLE risk variants and polygenic risk scores between Indigenous Peruvians and global populations with diverse ancestral backgrounds.</p><p><strong>Methods: </strong>We studied 670 individuals from the Peruvian Genome Project, 2,068 individuals from the 1000 Genomes Project Phase 3 release, and 47 patients with SLE from Lima, Peru. Ancestry was inferred using admixture and RFMix. Data were imputed with the TOPMed Imputation server and annotated to hg38. We compared the frequencies of 199 SLE-associated risk variants among study participants. We also calculated SLE genetic risk scores and fixation index (FST) statistics.</p><p><strong>Results: </strong>All 199 SLE risk single-nucleotide polymorphisms had highly significant differences in frequencies across Peruvian and other continental populations (P values <0.001). Indigenous Peruvian patients have higher polygenic risk for SLE compared to European, African, South Asian, and East Asian patients. FST analysis of SLE risk variants revealed the largest FST between Peruvian patients and African patients (mean FST 0.12), and the smallest between Peruvian patients and East Asian patients (mean FST 0.09).</p><p><strong>Conclusion: </strong>SLE-associated variants are common among Indigenous Peruvian patients, with varying frequencies across subpopulations. This underscores the need for ongoing genetic studies in Indigenous populations, potentially explaining SLE heterogeneity.</p>","PeriodicalId":93845,"journal":{"name":"ACR open rheumatology","volume":"7 5","pages":"e70053"},"PeriodicalIF":2.8,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12099220/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144129709","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":"Seropositive Rheumatoid Arthritis Following Complete Remission of Antineutrophil Cytoplasmic Antibody-Associated Vasculitis With Renal Involvement: A Case Report.","authors":"Aaron Shulkin, Naushad Abid, Mehmoodur Rasheed","doi":"10.1002/acr2.70050","DOIUrl":"https://doi.org/10.1002/acr2.70050","url":null,"abstract":"<p><p>Seropositive rheumatoid arthritis (RA) and antineutrophil cytoplasmic antibody-associated vasculitis (AAV) are two autoimmune conditions with unique etiologies and clinical presentations. Although few reports have documented rare cases in which a single individual has both conditions at the same time, it is much rarer to see them in sequence of each other. Here, we report a 69-year-old man diagnosed with AAV before achieving remission following six years of treatment. Following two years of remission, he was subsequently diagnosed with seropositive RA. This case invites unique insights to further explore underlying etiologies of autoimmune diseases and the interrelationship between them.</p>","PeriodicalId":93845,"journal":{"name":"ACR open rheumatology","volume":"7 5","pages":"e70050"},"PeriodicalIF":2.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12042695/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144058652","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":"Should Joint Deformity, which is More Common Than Swelling or Tenderness, be Assessed in all Rheumatoid Arthritis Patients and Databases?","authors":"Theodore Pincus, Tengfei Li, Kathryn A Gibson","doi":"10.1002/acr2.70025","DOIUrl":"10.1002/acr2.70025","url":null,"abstract":"<p><strong>Objective: </strong>We analyzed 28 joint counts in 173 contemporary routine care patients with rheumatoid arthritis (RA), who had disease duration of 10 years and were examined in 2021, for swollen joint count (SJC), tender joint count (TJC)/pain on motion, and deformity joint count (DJC)/limited motion. In addition, we computed DJC according to Disease Activity Score in 28 joints (DA28), Clinical Disease Activity Index (CDAI), and Routine Assessment of Patient Index Data 3 (RAPID3) as remission/low or moderate/high activity or severity.</p><p><strong>Methods: </strong>This report presents a retrospective analyses of a cross-sectional Australian database for medians and prevalences of SJC, TJC, and DJC, including in RA index categories.</p><p><strong>Results: </strong>Median values were 0 for SJC, 2.0 for TJC, and 4.0 for DJC, respectively, including SJC of 0,1 in 123 patients (71%), TJC of 0,1 in 82 patients (47%), SJC+TJC of 0,1 in 73 patients (42%), and DJC of 0,1 in 65 patients (38%). Among 4,498 joints, 1,330 with any abnormality included 286 swollen joints (6%), 590 tender joints (13%), 879 deformed joints (20%), 37 only swollen joints (1%), 289 only tender joints (6%), 659 only deformed joints (15%), 458 joints with two abnormalities (10%), and 80 joints with three abnormalities (2%). The 73 of all 173 with patients with SJC and TJC 0,1 (42%), included 56% to 67% who were classified in remission or low DAS28 ESR erythrocyte sedimentation rate, CDAI, or RAPID3 activity or severity, of whom 47% to 58% had DJC ≥2, whereas 11% to 36% were classified as moderate or high RA index activity or severity, of whom 57% to 58% had DJC ≥2.</p><p><strong>Conclusion: </strong>SJC+TJC of 0,1 was more common than a DJC of 0,1 in contemporary patients with RA. DJC was ≥2 in the majority of patients who met SJC+TJC remission criteria for RA indices, as in patients who were classified as moderate/high although they met SJC+TJC remission criteria. DJC should be included in long-term routine care and RA databases.</p>","PeriodicalId":93845,"journal":{"name":"ACR open rheumatology","volume":"7 5","pages":"e70025"},"PeriodicalIF":2.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12089699/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144103182","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":"Exploring the Association of Sociodemographic Factors and Primary Diagnosis With Transition Readiness in Adolescents With Rheumatic Disease.","authors":"Maryem Al Manaa, Yuhan Ma, Chan-Hee Jo, Una E Makris, Nicole Bitencourt, Tracey Wright, Lorien Nassi","doi":"10.1002/acr2.70055","DOIUrl":"10.1002/acr2.70055","url":null,"abstract":"<p><strong>Objective: </strong>Transitioning from pediatric to adult care is challenging for adolescents with chronic health conditions. The Transition Readiness Assessment Questionnaire (TRAQ) is a validated tool for measuring transition readiness in pediatric patients with chronic diseases. This study examines the association of sociodemographic factors and primary diagnosis with transition readiness in adolescents with rheumatic disease using TRAQ scores.</p><p><strong>Methods: </strong>We conducted a retrospective chart review of 882 adolescents with rheumatic diseases, aged 14 to 19 years, from September 2019 to December 2021. TRAQ scores, primary diagnosis, and demographic characteristics were collected. Bivariate and multiple linear regression analyses were used to identify predictors of transition readiness.</p><p><strong>Results: </strong>We collected 882 TRAQs. Lupus diagnosis was significantly associated with higher TRAQ scores, whereas juvenile dermatomyositis diagnosis negatively influenced transition readiness. Non-Hispanic ethnicity correlated with higher scores in managing medications and tracking health issues, and male gender was significantly linked to lower scores in tracking health issues and managing daily activities. There was no association between TRAQ scores and age, race, primary language of the parent, insurance type, median household income, and suicidality screen. A total of 118 patients completed two TRAQs with a mean interval of 13.5 months. There was no significant change in TRAQ scores over time. However, Hispanic patients, patients with Spanish-speaking parents, and patients with lupus scored higher on the second TRAQ.</p><p><strong>Conclusion: </strong>In our cohort, transition readiness varied by primary diagnosis. Transition plans tailored to the needs of vulnerable adolescents are required to enhance health management skills and facilitate a successful transition.</p>","PeriodicalId":93845,"journal":{"name":"ACR open rheumatology","volume":"7 5","pages":"e70055"},"PeriodicalIF":2.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12090365/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144113045","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":"Soluble Co-Inhibitory Immune Checkpoint Molecules Are Increased in Patients With Polymyalgia Rheumatica Without Significant Correlations With Clinical Status: A Case-Control Study.","authors":"Elvis Hysa, Dario Camellino, Christian Dejaco, Matteo Bauckneht, Giampaola Pesce, Silvia Morbelli, Marcello Bagnasco, Maurizio Cutolo, Eric L Matteson, Marco A Cimmino, Daniele Saverino","doi":"10.1002/acr2.70045","DOIUrl":"https://doi.org/10.1002/acr2.70045","url":null,"abstract":"<p><strong>Objective: </strong>A dysregulated immune response is involved in the pathogenesis of polymyalgia rheumatica (PMR) and giant cell arteritis (GCA). These diseases have been reported as immune-related adverse events in patients with cancer treated with immune checkpoints inhibitors. In this cross-sectional study, the relationship between soluble immune checkpoint molecules (sICMs) and clinical/imaging features of PMR and GCA was investigated.</p><p><strong>Methods: </strong>Consecutive patients with PMR diagnosed according to the criteria by Bird et al were compared with age- and sex-matched healthy controls. Patients with PMR and overlapping GCA had to also satisfy the 1990 ACR classification criteria for GCA. All patients underwent standardized clinical, laboratory examination, and ¹⁸F-fluorodeoxyglucose positron emission tomography/computed tomography scans. The sICM anticytotoxic T Ly-4, the programmed cell death protein 1 (PD-1), and PD-1 ligands PD-L1 and PD-L2 were measured by enzyme-linked immunosorbent assay.</p><p><strong>Results: </strong>Forty patients (80% women, mean age 76 years, and mean disease duration 88 days) were assessed. Of these, 30 had isolated PMR and 10 had PMR with GCA. Patients showed significantly higher concentrations of all sICMs compared with controls (P < 0.001). Conditional logistic regression revealed the strong discriminative capacity of these molecules between patients and healthy controls, with PD-1 showing complete separation among groups (effect size = 0.78) and PD-L1 (odds ratio [OR] 134.33, P < 0.001) and PD-L2 (OR 63.00, P < 0.001) demonstrating the strongest ability to distinguish patients from controls. Correlations between sICM levels and clinical features were generally weak or absent, with no significant differences based on disease phenotype or glucocorticoid exposure. Results were similar in glucocorticoid-naive patients.</p><p><strong>Conclusion: </strong>sICMs are significantly elevated in PMR and GCA and strongly differentiate patients from healthy controls. Although they do not correlate with clinical or imaging features, their consistent elevation in active disease might suggest a complex interplay between innate and adaptive immunity.</p>","PeriodicalId":93845,"journal":{"name":"ACR open rheumatology","volume":"7 5","pages":"e70045"},"PeriodicalIF":2.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12063068/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144031921","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":"Urinary V-Set Ig Domain-Containing Protein 4 and Immune Complexes for Tracking Lupus Nephritis and Renal Pathology.","authors":"Aygun Teymur, Chenling Tang, Fariz Nazir, Neda Ostadnejad, Qi Cai, Ramesh Saxena, Tianfu Wu","doi":"10.1002/acr2.70044","DOIUrl":"10.1002/acr2.70044","url":null,"abstract":"<p><strong>Objective: </strong>This study aims to investigate whether V-set Ig domain-containing protein 4 (VSIG4; also known as complement receptor of the Ig superfamily [CRIg]) forms immune complexes (ICxs) with IgG and complement component 3 (C3) in the kidneys of patients with lupus nephritis (LN) and to assess the potential of urinary VSIG4 and VSIG4-ICx as noninvasive biomarkers of LN.</p><p><strong>Methods: </strong>Immunofluorescent staining was employed to detect the deposition of VSIG4 (CRIg), IgG, and C3 in kidney tissue. Urine samples from 102 patients with LN, 51 healthy controls (HCs), and 13 patients with chronic kidney disease (CKD) were analyzed via enzyme-linked immunosorbent assay for VSIG4-ICx and free-form VSIG4.</p><p><strong>Results: </strong>Immunofluorescence costaining demonstrated the colocalization of VSIG4, IgG, and C3 in the kidneys of those with LN and elevated VSIG4 protein expression in the glomeruli regions in LN. Compared with HCs and those with CKD, patients with LN exhibited significantly elevated levels of urinary VSIG4 in both free form and ICx. Urinary VSIG4-ICx correlated with clinical parameters, including the Systemic Lupus Erythematosus Disease Activity Index (SLEDAI) (R = 0.55, P < 0.0001), renal SLEDAI (R = 0.52, P < 0.0001), estimated glomerular filtration rate (-0.5, P < 0.001), activity index (R = 0.25, P < 0.05), chronicity index (R = 0.32, P < 0.05), complement C3 (R = -0.33, P < 0.05), and complement C4 (R = -0.31, P < 0.05). The strong association of the urinary VSIG4-ICx with disease activity metrics and histopathologic evidence underscores its potential for clinical utility in diagnosing and monitoring LN.</p><p><strong>Conclusion: </strong>VSIG4-ICx shows promise as a novel urine biomarker for LN, with potential utility for diagnosis and disease monitoring.</p>","PeriodicalId":93845,"journal":{"name":"ACR open rheumatology","volume":"7 5","pages":"e70044"},"PeriodicalIF":2.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12056603/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144032990","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: Acrometastasis: A rare mimicker of synovitis.","authors":"Jessica Qi, Terry Kwong","doi":"10.1002/acr2.70047","DOIUrl":"10.1002/acr2.70047","url":null,"abstract":"","PeriodicalId":93845,"journal":{"name":"ACR open rheumatology","volume":"7 5","pages":"e70047"},"PeriodicalIF":2.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12053042/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144053599","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":"Gut Expansion of a Human Lupus Pathobiont is Associated With Autoantibody Production and T Cell Dysregulation.","authors":"Longhuan Ma, Yong Ge, Natalie Six, Seung-Chul Choi, Josephine Brown, Abigail Castellanos Garcia, Mansour Mohamadzadeh, Gregg J Silverman, Laurence Morel","doi":"10.1002/acr2.70033","DOIUrl":"https://doi.org/10.1002/acr2.70033","url":null,"abstract":"<p><strong>Objective: </strong>The mechanisms by which the gut microbiome contributes to lupus pathogenesis remain poorly understood. The anaerobe Ruminococcus gnavus (RG) expands in patients with lupus in association with flares. The goal of this study was to determine the mechanisms by which candidate pathobiont lipoglycan-producing RG2 may contribute to autoimmunity and to identify factors promoting its expansion.</p><p><strong>Methods: </strong>The consequences of RG colonization or depletion were evaluated in the B6.Sle1.Sle2.Sle3 triple congenic (TC) lupus model by flow cytometry and enzyme-linked immunosorbent assay. RG lysates were tested on Treg cells in vitro. Fecal microbiota transfers evaluated the contribution of the microbiome origin from lupus or control donors and dietary tryptophan. RG1 and RG2 growth and metabolome were evaluated in response to tryptophan in vitro.</p><p><strong>Results: </strong>Only RG2 stably colonized TC mice, in which it induced autoantibody production and T cell activation. Depletion of anaerobes had the opposite effect, with an increased Treg frequency. RG2 induced Treg apoptosis in cocultures with dendritic cells. RG is present in TC microbiota, from which it is amplified by tryptophan. The combination of TC microbiota and high dietary tryptophan induced autoimmune activation and intestinal inflammation in healthy control mice. Finally, tryptophan enhanced RG2 growth and production of immunomodulatory metabolites.</p><p><strong>Conclusion: </strong>RG2 contributes to autoimmune activation, at least by inducing Treg apoptosis. The expansion of this pathobiont is promoted by host genetic factors and tryptophan metabolism. Thus, targeted RG2 depletion may improve disease outcomes in patients with lupus.</p>","PeriodicalId":93845,"journal":{"name":"ACR open rheumatology","volume":"7 5","pages":"e70033"},"PeriodicalIF":2.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12052470/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144014211","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 Manifestations and Treatment in Patients With Relapsing Polychondritis: A Multicenter Observational Cohort Study.","authors":"Roger Yang, Rennie L Rhee, Kaitlin A Quinn, Naomi A Amudala, Carol A McAlear, Peter C Grayson, Peter A Merkel, Marcela Ferrada, Shubhasree Banerjee","doi":"10.1002/acr2.70027","DOIUrl":"10.1002/acr2.70027","url":null,"abstract":"<p><strong>Objective: </strong>Relapsing polychondritis (RP) is a rare, heterogeneous, multisystem disease lacking standard treatment guidelines. This study describes clinical manifestations in association with approaches to treatment.</p><p><strong>Methods: </strong>Adults with physician-diagnosed RP were recruited into a multicenter observational cohort study. Clinical manifestations, organ damage, and medication history were recorded at the baseline study visit. Treatments received for RP at any time point before the initial visit were categorized into three groups: group 1 was treated with glucocorticoids (GCs) or no drugs, group 2 was treated with nonbiologic immunosuppressive (IS) drugs excluding JAK inhibitors (JAKis) with or without GCs, and group 3 was treated with JAKis or biologic IS drugs with or without nonbiologic IS drugs or GCs.</p><p><strong>Results: </strong>Included in the study were 195 patients with RP who were predominantly female (167, 86%) and White (174, 89%), with a mean age of 49 ± 13years. All patients had ear, nose, or airway involvement, and 163 (83%) had musculoskeletal manifestations of RP. All patients had at least three clinical manifestations with median of 11 (range 3-19). GC treatment was given to 186 (95%) patients. Organ damage was seen in 80 (41%) patients. Treatment groups 1, 2, and 3 had 37 (19%), 55 (28%), and 103 (53%) patients, respectively. Patients in group 3 were more likely to have organ damage, arthritis, and subglottic stenosis.</p><p><strong>Conclusion: </strong>Patients with RP have a high burden of clinical manifestations with resultant damage. Physicians typically treat RP with GCs, and the use of other immunosuppressive medications is variable. Absence of a consensus approach to treatment underscores the need for clinical trials and treatment guidelines for RP.</p>","PeriodicalId":93845,"journal":{"name":"ACR open rheumatology","volume":"7 5","pages":"e70027"},"PeriodicalIF":2.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12090363/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144113041","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Catalog of \"Knee Friendly\" Aerobic Exercises Developed for Patients With Knee Osteoarthritis: An International Patient Survey.","authors":"Mathilde Espe Pedersen, Tanja Schjødt Jørgensen, Thomas Bandholm, Mathias Ried-Larsen, Cecilie Bartholdy, Jos Runhaar, Dieuwke Schiphof, Kim L Bennell, Daniel White, Lauren K King, Marius Henriksen","doi":"10.1002/acr2.70052","DOIUrl":"10.1002/acr2.70052","url":null,"abstract":"<p><strong>Objective: </strong>Aerobic exercise is recommended for the management of knee osteoarthritis (OA), but knee pain is often a barrier for participation. Some types of aerobic exercise may be less painful to undertake than others, though little is known about which are the most \"knee friendly,\" that is, unlikely to exacerbate knee pain to an unacceptable level. This study aimed to identify aerobic exercise activities that (1) are knee friendly and (2) meet requirements for targeting cardiovascular health.</p><p><strong>Methods: </strong>We conducted a three-phase international survey. In phase 1, persons living with knee OA provided descriptions of knee friendly exercise types, defined as activities that would cause shortness of breath and difficulty talking without worsening symptoms to an unacceptable level (cause severe symptoms and/or lasting more than 24 hours). In phase 2, exercise physiologists identified exercise activities meeting requirements for increasing aerobic fitness, which were grouped into broader aerobic exercise activities. In phase 3, participants nominated each aerobic exercise activity for \"knee friendliness.\"</p><p><strong>Results: </strong>In phase 1, 487 respondents (Denmark: 259; the Netherlands: 144; Australia: 57; and North America: 15) provided a total of 1,590 exercise descriptions. In phase 2, 154 exercise activities were identified and grouped into a list of 30 broader aerobic exercise activities. In phase 3, 349 participants (Denmark: 195; the Netherlands: 114; Australia: 32; and North America: 8) nominated indoor biking and water exercise as most knee friendly (82% and 70%, respectively). Participants were predominantly women (60.7%), the mean ± SD age was 68.4 ± 8.81 years, the mean ± SD body mass index was 27.5 ± 5.8, the mean ± SD self-efficacy score was 7.3 ± 3.0 (0-10 scale), the mean ± SD symptom duration was 11.7 ± 9.05 years, and the mean ± SD current knee pain was 4.5 ± 2.2 (0-10 scale).</p><p><strong>Conclusion: </strong>A catalog of 30 knee friendly aerobic exercise activities was generated for individuals living with knee OA. The catalog aims to empower individuals living with knee OA, offering suitable aerobic exercise options without exacerbating knee pain.</p>","PeriodicalId":93845,"journal":{"name":"ACR open rheumatology","volume":"7 5","pages":"e70052"},"PeriodicalIF":2.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12094883/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144121686","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}