ACR open rheumatology最新文献

{"title":"Evolving Curricular Needs of Rheumatology Fellowship Programs, Fellows-in-Training, and the American College of Rheumatology's Virtual Rheumatology Program for Fellows-in-Training.","authors":"Laura C Arneson, M Dave Dimachkie, Anisha B Dua, David Leverenz, Janet Mitchell, Juliet Aizer, Lisa Zickuhr","doi":"10.1002/acr2.90097","DOIUrl":"10.1002/acr2.90097","url":null,"abstract":"<p><strong>Objective: </strong>Adult rheumatology fellowships' curricular needs are changing following the COVID-19 pandemic. The American College of Rheumatology's (ACR's) Virtual Program for Fellows-in-Training (FITs), initially developed to maintain didactic instruction while sheltering in place, has suffered decreased attendance in recent years. We describe the evolving curricular needs of adult rheumatology fellowship programs and FITs as well as suggest opportunities for the ACR to address them.</p><p><strong>Methods: </strong>Adult rheumatology fellowship program directors (PDs) in the United States and Canada were invited to describe how they used the ACR Virtual Program for FITs, their perceived challenges with the programming, and curricular needs via online surveys. PDs and FITs shared ideas for future ACR Virtual Programs for FITs via surveys and focus groups. We conducted descriptive statistics of survey data and qualitative analysis of focus group transcripts.</p><p><strong>Results: </strong>Of 123 PDs, 17 (13.8%) completed the survey, and 8 PDs and 6 FITs participated in five focus groups. Of 17 PDs, 7 (41%) reported insufficient resources to create a comprehensive curriculum, and all respondents used the ACR Virtual Program for FITs to supplement clinical expertise and/or time available for teaching. Focus group participants requested that the ACR Virtual Program for FITs expand to advanced rheumatology topics, foster active learning methods while maintaining safety in learning, and make educational materials easily accessible to PDs and FITs.</p><p><strong>Conclusion: </strong>Shared educational resources enhance adult rheumatology fellowships' curricula. The ACR Virtual Program for FITs can meet changing curricular needs by expanding content, incorporating active learning, and sharing resources through easily accessible methods.</p>","PeriodicalId":93845,"journal":{"name":"ACR open rheumatology","volume":"8 7","pages":"e90097"},"PeriodicalIF":2.9,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13309293/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148341423","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":"Cutaneous IgA Vasculitis in Primary Sjögren Disease: Findings From a Medical Record-Based Review.","authors":"Shay Brikman, Mohammad Egbaria, Amir Bieber","doi":"10.1002/acr2.90080","DOIUrl":"10.1002/acr2.90080","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to describe clinical observations of patients presenting with palpable purpura, which is suspected to represent IgA vasculitis (IgAV) based on direct immunofluorescence (DIF), who were ultimately diagnosed with cutaneous vasculitis associated with primary Sjögren disease (SjD).</p><p><strong>Methods: </strong>We retrospectively reviewed biopsy reports from a single center between 2014 and 2022 consistent with IgAV, identifying patients who were concurrently diagnosed with SjD. Data collected included clinical history, serologic findings, and skin biopsy results with DIF. A focused literature review was also performed to assess prior reports and to explore potential underlying mechanisms.</p><p><strong>Results: </strong>We reviewed 103 biopsy reports from a single center between 2014 and 2022 that were consistent with IgAV. Three female patients with SjD who developed palpable purpura, initially suspected to represent IgAV, were identified. This corresponds to a prevalence of 2.91% (95% confidence interval 0.61%-8.28%). All patients were seropositive for antinuclear antibodies and anti-SSA antibodies. In two of the three cases, cutaneous vasculitis was the first manifestation of SjD. In all patients, skin biopsy demonstrated small-vessel leukocytoclastic vasculitis, and DIF revealed perivascular IgA and C3 deposits without IgG deposits. The diagnosis was revised to cutaneous vasculitis associated with SjD following comprehensive clinical evaluation.</p><p><strong>Conclusion: </strong>This case series suggests that IgAV may overlap with SjD. Clinicians should consider underlying SjD in patients presenting with features of IgAV, and histopathologic findings alone should not exclude the possibility of an underlying systemic autoimmune disease.</p>","PeriodicalId":93845,"journal":{"name":"ACR open rheumatology","volume":"8 7","pages":"e90080"},"PeriodicalIF":2.9,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13351931/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148427233","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":"Factors Associated With Intermittent and Constant Pain Patterns in People With Gout: A Cross-Sectional Analysis.","authors":"Sarah Stewart, Mia Clarke, Irene Zeng, Nicola Dalbeth, Tania Ka'ai, Karl Rudolph, Julie Collis, Nicola Kayes, David Rice","doi":"10.1002/acr2.90115","DOIUrl":"10.1002/acr2.90115","url":null,"abstract":"<p><strong>Objective: </strong>Although gout is traditionally conceptualized as an episodic disease characterized by acute flares and symptom-free intercritical periods, some individuals report persistent joint pain that extends beyond flares. This cross-sectional analysis aimed to explore factors associated with self-reported pain patterns (constant vs intermittent) in people with gout.</p><p><strong>Methods: </strong>This cross-sectional analysis was performed on data from 90 participants with physician-diagnosed gout who completed clinical assessments and patient-reported outcome measures. Pain patterns were classified using participant-selected validated graphical representations representing intermittent and constant pain patterns. Multivariable logistic regression was used to identify factors independently associated with constant pain. Model discrimination was assessed using the area under the receiver operating characteristic curve (ROC AUC).</p><p><strong>Results: </strong>One-third of participants (34.4%) reported a constant pain pattern. The final regression model indicated that constant pain was independently associated with younger age of gout onset (adjusted odds ratio [aOR] 0.86, 95% confidence interval [CI] 0.79-0.93), greater activity limitation (aOR 5.75, 95% CI 1.43-23.01), and current co-existing anxiety or depression (aOR 9.21, 95% CI 1.39-60.91). The regression model demonstrated good discrimination between participants with constant and intermittent pain patterns with an ROC AUC of 0.82 (95% CI 0.73-0.91).</p><p><strong>Conclusion: </strong>A substantial proportion of people with gout experience constant pain, which is linked to early disease onset, functional impairment, and mood disturbance. These hypothesis-generating findings suggest that the model of pain-free intercritical gout may not apply to all people with gout and may emphasize the need for tailored management strategies for people with gout.</p>","PeriodicalId":93845,"journal":{"name":"ACR open rheumatology","volume":"8 7","pages":"e90115"},"PeriodicalIF":2.9,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13401753/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148594984","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":"Integrating Behavioral Health Services for Individuals With Rheumatic Diseases: A Quantitative Analysis of a Pilot Study.","authors":"Shannon Teaw, Jessica Link-Malcolm, Michelle Ghebranious, Dorothy Jet Patterson, Jenny Foster, Sofia Bereket, Urooj Wahid, Puneet Bajaj, E Blair Solow, Linda S Hynan, Jennifer L Barton, Una E Makris","doi":"10.1002/acr2.90095","DOIUrl":"10.1002/acr2.90095","url":null,"abstract":"<p><strong>Objective: </strong>Chronic pain, depressive and anxiety symptoms are common comorbidities among persons with rheumatic disease (RD) and contribute to increased symptom burden and reduced quality of life (QoL). Behavioral health (BH) interventions to motivate behavior change and promote self-management can effectively address these conditions. Despite potential benefits, efforts to integrate BH services into rheumatology clinics have been limited. We developed and piloted a BH program integrated within an academic rheumatology clinic to evaluate feasibility and impact on patient-reported outcomes (PROs).</p><p><strong>Methods: </strong>Participants were adults with RD who chose one of three primary BH goals: increase physical activity, improve mood and/or anxiety, or manage pain. The BH specialist met via telephone with participants for up to eight sessions, which included psychoeducation, motivational interviewing, and mindfulness meditation, combined with supplemental apps and videos. Feasibility data included recruitment, retention, and intervention process data. PROs evaluated change from baseline to end assessment for pain interference, depression and anxiety, pain catastrophizing, QoL, and PRO Measurement Information System measures of fatigue, sleep disturbance, social satisfaction, and physical function. Sign-rank tests or paired Student's t-test were used to compare baseline and postintervention scores.</p><p><strong>Results: </strong>Twenty-eight participants completed the program. Most (n = 15, 54%) chose the goal of improving mood and anxiety. Participants completed a mean of 6.86 (SD 1.56) sessions. Mean change scores demonstrated statistically significant improvements from baseline to end assessment across all PROs (P < 0.05), except social satisfaction and physical function (P > 0.05).</p><p><strong>Conclusion: </strong>Integrating BH services within a rheumatology clinic was feasible and demonstrated promising trends in improvement of PROs, warranting future research to evaluate effectiveness and sustainability.</p>","PeriodicalId":93845,"journal":{"name":"ACR open rheumatology","volume":"8 7","pages":"e90095"},"PeriodicalIF":2.9,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13392204/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148564122","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":"Anifrolumab Plus Standard of Care Reduces Long-Term Cardiovascular Damage in Adults With Systemic Lupus Erythematosus: Findings From a Real-World External Control Study.","authors":"Zahi Touma, Ian N Bruce, Richard A Furie, Eric F Morand, Raj Tummala, Shelly Chandran, Gabriel Abreu, Jacob Knagenhjelm, Cathy Emmas, Lyra Agustin, Catrina Richards, Tarana Mehdikhanova, Zheyuan Yang, Miina Waratani","doi":"10.1002/acr2.90071","DOIUrl":"10.1002/acr2.90071","url":null,"abstract":"<p><strong>Objective: </strong>Despite improvements in overall survival, cardiovascular (CV) events remain a leading cause of death in patients with systemic lupus erythematosus (SLE). Anifrolumab controls disease activity while reducing glucocorticoid use and has been associated with reduced organ-damage accrual; however, its long-term efficacy for reducing CV damage is unknown. This study evaluates the effect of anifrolumab plus standard of care (SoC) on long-term CV damage in SLE compared with real-world external controls.</p><p><strong>Methods: </strong>We included 354 patients who initiated anifrolumab 300 mg in the Treatment of Uncontrolled Lupus via the Interferon Pathway (TULIP) trials in the cohort of patients who received anifrolumab. The real-world SoC cohort comprised 561 patients from the University of Toronto Lupus Clinic registry, selected using matched eligibility criteria. Baseline characteristics were balanced using propensity score weighting. Mean changes in CV-related Systemic Lupus International Collaborating Clinics/American College of Rheumatology Damage Index (SDI) from baseline to year 4 were estimated using weighted linear-regression models. Time to first CV event up to four years was assessed using Kaplan-Meier estimators and a Cox regression model.</p><p><strong>Results: </strong>Patients receiving anifrolumab accrued, on average, 0.046 fewer CV-SDI points at four years (95% confidence interval [CI] -0.074 to -0.018; P = 0.008) compared with patients with real-world SoC. The hazard ratio for CV events over four years was 0.257 (95% CI 0.0687 to 0.961; P = 0.0583) for patients treated with anifrolumab versus controls with real-world SoC.</p><p><strong>Conclusion: </strong>These findings suggest that anifrolumab may reduce long-term CV damage in patients with SLE.</p>","PeriodicalId":93845,"journal":{"name":"ACR open rheumatology","volume":"8 7","pages":"e90071"},"PeriodicalIF":2.9,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13402008/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148594939","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 Combined Transcriptomics and Proteomics Approach to Identify Immune Signatures in ANCA-Associated Glomerulonephritis.","authors":"Ivana Stojkic, John P Shapiro, Arnon Arazi, Huijuan Song, Pearlly Yan, Estela Puchulu-Campanella, Hubao Wang, William E Smoyer, Lynn A Fussner, Anjali Satoskar, Xin Wang, Samir V Parikh, Stacy P Ardoin, Dan Koboldt, Brad H Rovin, Salem Almaani","doi":"10.1002/acr2.90114","DOIUrl":"10.1002/acr2.90114","url":null,"abstract":"<p><strong>Objective: </strong>Antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis often leads to severe kidney damage. To better understand ANCA-associated glomerulonephritis (AAGN) and identify potential new therapeutic targets, we performed comprehensive transcriptomic and compartmental proteomic analysis of kidney biopsies from 23 patients in the transcriptomic cohort, 10 in the proteomic cohort, and 5 healthy controls for each comparison.</p><p><strong>Methods: </strong>Bulk RNA sequencing was performed on formalin-fixed paraffin-embedded kidney biopsies. Differentially expressed genes and pathways were identified using DESeq2, Ingenuity Pathway Analysis, and gene set enrichment analysis (GSEA). Correlations between gene expression and histologic features were assessed. Proteomic analysis was conducted via mass spectrometry of laser-microdissected glomerular and tubulointerstitial compartments to identify differentially abundant proteins and enriched pathways.</p><p><strong>Results: </strong>In AAGN, 347 genes were up-regulated and 134 down-regulated compared to controls, including IL17D, CXCR2, IL7R, and CD163. Notably, several tripartite motif (TRIM) family genes were up-regulated. GSEA revealed broad immune cell enrichment and activation of proinflammatory interleukin (IL)-12, IL-17, and IL-18 signaling. Additionally, specific pathways correlated with histologic features (r ≥ 0.6), including enrichment of the complement cascade in histologically normal glomeruli, suggesting complement activation precedes visible structural damage. Conversely, STAT3/TRIM25 signaling correlated with glomerulosclerosis, IL-23 with necrotizing glomeruli, and FAT10 (UBD) signaling with interstitial fibrosis and tubular atrophy. Proteomics identified 63 differentially abundant proteins in the tubulointerstitium and 271 in glomeruli, with key network activators overlapping across data sets.</p><p><strong>Conclusion: </strong>This study uncovered a complex intrarenal immune landscape in AAGN, featuring diverse immune cell involvement and pathways associated with progressive damage. Our findings highlight potential therapeutic targets for further investigation, including IL-17, IL-8, and IL-23.</p>","PeriodicalId":93845,"journal":{"name":"ACR open rheumatology","volume":"8 7","pages":"e90114"},"PeriodicalIF":2.9,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13393067/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148564069","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":"Comparison of Rule-Based Algorithms to Identify Patients With Idiopathic Inflammatory Myopathies in Electronic Health Records.","authors":"Ana Lucia Valle, Amy Vo, Rochelle L Castillo, Yumeko Kawano, Leah M Santacroce, Daniel H Solomon, Katherine P Liao, Candace H Feldman","doi":"10.1002/acr2.90102","DOIUrl":"10.1002/acr2.90102","url":null,"abstract":"<p><strong>Objective: </strong>Studying rare diseases requires assembling robust, correctly classified cohorts. We compared the performance of seven published International Classification of Diseases, Ninth Revision (ICD-9) and International Statistical Classification of Diseases and Related Health Problems, Tenth Revision (ICD-10) code rule-based algorithms in the electronic health record (EHR) to identify cases of idiopathic inflammatory myopathies (IIM).</p><p><strong>Methods: </strong>We identified patients seen at a multihospital academic medical center with one or more ICD-9 or ICD-10 codes for IIM (2000-2024). From this cohort, a random sample of 250 cases was selected for chart review for IIM based on the 2017 EULAR/American College of Rheumatology IIM classification criteria. Review was performed by two reviewers and adjudicated by a third. The performance of the algorithms was compared against (1) definite and (2) definite and probable cases of IIM. Positive predictive value (PPV), specificity, sensitivity, and negative predictive value were calculated.</p><p><strong>Results: </strong>Of 250 charts, 87 definite and 28 probable IIM cases were identified. The algorithm with the highest PPV (84%) relied on ICD 9/10 codes obtained during hospitalizations but excluded ≥80% of cases with a sensitivity of 14%. Use of two or more ICD codes ≤60 days apart obtained the second highest PPV (79%) and identified 82 cases. Use of two or more ICD codes between 30 and 365 days apart obtained the third highest PPV (78%). These top-performing algorithms included definite and probable cases of IIM.</p><p><strong>Conclusion: </strong>Several rule-based ICD code algorithms had PPVs ranging from 77% to 84% but had lower sensitivity (14%-63%). Limitations of this study include modifications to some of the original algorithms. Future algorithms may benefit from incorporating additional EHR data and natural language processing methods.</p>","PeriodicalId":93845,"journal":{"name":"ACR open rheumatology","volume":"8 7","pages":"e90102"},"PeriodicalIF":2.9,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13341964/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148407293","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 Review and Future Perspective on Renal Outcome Definitions in Lupus Nephritis.","authors":"Ioannis Parodis, Tina Kochar, Frank Cortazar, Yoshiya Tanaka, Nehad Soloman","doi":"10.1002/acr2.90099","DOIUrl":"10.1002/acr2.90099","url":null,"abstract":"<p><p>Lupus nephritis (LN) remains a leading cause of morbidity and mortality in systemic lupus erythematosus, yet the lack of standardized definitions for renal outcomes hinders effective diagnosis, prognosis, treatment personalization, comparisons across trials, and interpretable trial endpoints. Despite significant advances in biomarker discovery, treatment strategies, and histopathological classification, substantial challenges and controversies persist in defining and assessing renal response to therapy. Following a January 2025 roundtable discussion on the subject of LN outcome definitions, a workgroup was established to address these issues and provide an expert perspective on the future of outcome definitions based on current literature. Here, we examine the current limitations of renal outcome definitions and advocate for change toward improved interpretation and comparison of clinical study data. Key areas, such as limitations of traditional kidney function markers and the need for reliable endpoints reflecting improvements in renal inflammation in trials, are addressed. As an international workgroup of rheumatologists and nephrologists with experience in managing LN, we advocate for a unified approach considering standard per-protocol repeat biopsies for histologic response evaluation, estimated glomerular filtration rate slope, glucocorticoid minimization/withdrawal, and extended follow-up for the evaluation of sustained long-term outcomes. The importance of harmonizing clinical and histologic definitions and the potential of novel biomarkers are highlighted. Herein, we provide a perspective toward uniform definitions of response in LN trials, renal flare/relapse, and refractory disease with improved applicability, especially in the context of advanced immunosuppressives. Thereby, we aim to facilitate meaningful study and advanced treatment of LN, ultimately enhancing patient outcomes and future research.</p>","PeriodicalId":93845,"journal":{"name":"ACR open rheumatology","volume":"8 7","pages":"e90099"},"PeriodicalIF":2.9,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13370096/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148450885","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":"Perceptions of Glucagon-like Peptide 1 Receptor Agonists Among Individuals With Knee Osteoarthritis and Excess Weight: A Qualitative Study.","authors":"Kelly Frier, Madison Dietl, Sasha Aronson, Jon Dhani, Khara James, Daniel Betensky, Faith Selzer, Elena Losina, Jeffrey N Katz, Jason S Kim, Nomi S Weiss-Laxer","doi":"10.1002/acr2.90070","DOIUrl":"10.1002/acr2.90070","url":null,"abstract":"<p><strong>Objective: </strong>Glucagon-like peptide 1 receptor agonists (GLP-1RAs) facilitate weight loss and reduce pain among individuals with knee osteoarthritis (OA). We investigated attitudes and barriers influencing GLP-1RA use among individuals with knee OA and excess weight to draw distinctions in perspectives between patients with and without GLP-1RA experience.</p><p><strong>Methods: </strong>In this cross-sectional qualitative study guided by the Framework Analysis method, we conducted structured interviews with persons with knee OA and excess weight. The moderator's guide included questions about health, weight loss history, and thoughts and experiences related to GLP-1RAs. Of the 286 patients prescreened, 30 completed an interview, after which saturation was reached. Interview transcripts were coded by research assistants using Dedoose software, and themes were identified using inductive analysis, charting, and memo writing.</p><p><strong>Results: </strong>The 30 individuals interviewed were majority female and most self-identified as White. Fifteen participants had current or prior GL-P1RA use, and fifteen had never taken GLP-1RAs. We identified four major themes: (1) health care providers were the primary GLP-1RA information source; (2) most participants recognized that weight loss could contribute to knee pain relief; (3) \"ever users\" reported overall positive experiences and found GLPA-1RAs helped facilitate healthy lifestyle changes, whereas \"never users\" more often described medications as a last resort after lifestyle changes fail; and (4) cost was the most significant barrier to GLP-1RA use.</p><p><strong>Conclusion: </strong>We found that perceptions both differed and overlapped among participants with and without prior GLP-1RA use. Clinicians should address potential concerns regarding GLP-1RAs when discussing treatment options with patients with excess weight and knee OA.</p>","PeriodicalId":93845,"journal":{"name":"ACR open rheumatology","volume":"8 6","pages":"e90070"},"PeriodicalIF":2.9,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13275997/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148274362","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":"An Exploratory Analysis of Antibody Dynamics in Isolated Organ Involvement of Antisynthetase Syndrome: A Single-Center Experience.","authors":"Takeshi Suzuki, Misa Yamaji, Hiroaki Harada, Kimito Kawahata","doi":"10.1002/acr2.90079","DOIUrl":"10.1002/acr2.90079","url":null,"abstract":"<p><strong>Objective: </strong>To characterize longitudinal anti-aminoacyl-tRNA synthetase (anti-ARS) antibody kinetics in antisynthetase syndrome (ASyS) with isolated organ involvement (IOI) and examine associations with clinical trajectories versus multiple organ involvement (MOI).</p><p><strong>Methods: </strong>We retrospectively analyzed 23 patients with ASyS with serial anti-ARS antibody measurements (IOI, n = 12; MOI, n = 11). IOI was defined as involvement of a single organ domain, whereas MOI involved ≥2 domains. Anti-ARS antibody titers were measured using a five-antibody enzyme-linked immunosorbent assay panel. Cumulative antibody burden was quantified as area under the curve (AUC) normalized by observation time. Longitudinal trajectories were evaluated using a linear mixed-effects model.</p><p><strong>Results: </strong>Baseline anti-ARS antibody titers were lower in IOI than MOI (median 84.1 [interquartile range (IQR) 57.6-117.5] vs median 163.0 [IQR 132.0-175.5]; P = 0.007). Among treated patients with longitudinal data (IOI, n = 7; MOI, n = 10), IOI exhibited a more consistent decline and lower cumulative exposure (normalized AUC: median 33.7 [IQR 32.5-61.7] vs median 103.0 [IQR 94.1-144.0]; P < 0.001). Population-level trajectories showed a steeper decline in IOI, with a significant group-time interaction (P = 0.026). In IOI, antibody reductions were concordant with KL-6 improvement and radiologic findings, and prednisolone tapering or discontinuation was achieved without relapse.</p><p><strong>Conclusion: </strong>IOI was associated with lower baseline anti-ARS antibody titers and a more pronounced decline versus MOI. These findings support a stage-based framework in which IOI represents a phase with limited organ involvement. The integrated kinetic pattern-lower baseline titers, steeper decline, and lower cumulative exposure-may be associated with a more favorable treatment-associated clinical course.</p>","PeriodicalId":93845,"journal":{"name":"ACR open rheumatology","volume":"8 6","pages":"e90079"},"PeriodicalIF":2.9,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13239070/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148151396","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}