Reumatologia clinica最新文献

{"title":"Cognitive impairment in patients with rheumatoid arthritis in relation to disease activity: A cross-sectional observational study","authors":"Marco Tobar-Marcillo,&nbsp;Diana Camila Fernández Delgado,&nbsp;Nathalia Sofía Eraso Muñoz,&nbsp;Arley Sebastián España Lopez","doi":"10.1016/j.reumae.2026.502167","DOIUrl":"10.1016/j.reumae.2026.502167","url":null,"abstract":"<div><h3>Introduction</h3><div>Rheumatoid arthritis (RA) is an immune-mediated disease that affects multiple organs. Among its extra-articular manifestations is cognitive impairment (CI).</div></div><div><h3>Methodology</h3><div>This was an observational, cross-sectional study with an analytical approach, including 59 patients with RA from three specialized outpatient centers in the city of Pasto, Colombia. Data were collected on disease activity using the DAS28 scale, as well as the degree of CI using the Montreal Cognitive Assessment (MoCA).</div></div><div><h3>Results</h3><div>A total of 44.1% of participants were classified as having suspected CI, with lower performance across all assessed subdomains. The most affected domains were visuospatial abilities and language. In the multivariate model, lower educational level was associated with CI, while age, glucocorticoid use, disease activity, and functional disability did not show an independent association.</div></div><div><h3>Conclusion</h3><div>CI has a higher prevalence in patients with RA compared with the general population, with no relationship found between CI and disease activity.</div></div>","PeriodicalId":94193,"journal":{"name":"Reumatologia clinica","volume":"22 5","pages":"Article 502167"},"PeriodicalIF":0.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148152689","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Quantitative assessment of interstitial lung disease in rheumatoid arthritis","authors":"Chiara Bertolazzi,&nbsp;Mario Silva,&nbsp;Jorge Rojas-Serrano,&nbsp;Espiridión Ramos-Martínez,&nbsp;Aldo Carnevale,&nbsp;Nicolas Sverzellati,&nbsp;Marwin Gutierrez,&nbsp;Alfonso Alfaro-Rodriguez,&nbsp;Alarico Ariani","doi":"10.1016/j.reumae.2026.502159","DOIUrl":"10.1016/j.reumae.2026.502159","url":null,"abstract":"<div><h3>Background</h3><div>Interstitial lung disease (ILD) is the most common pulmonary affection of rheumatoid arthritis (RA). Patients with a severe RA-ILD extent i.e. &gt;20% according to chest Computed Tomography (CT) semiquantitative (SQCT) scores, have poor prognosis. Quantitative CT (QCT) assessment with operator independent methods based on free software represents a reliable solution already tested in other ILD related to rheumatic diseases.</div></div><div><h3>Objectives</h3><div>The main objective of this monocentric study is to verify if in RA-ILD there is a correlation between QCT and SQCT performed by experienced radiologists. Secondary aims are: (a) to explore if there is a difference of QTC indexes (QCTi) in RA-ILD patients with severe vs mild ILD extent; (b) to evaluate the discriminative ability of QCT in identifying severe RA-ILD patients.</div></div><div><h3>Materials and methods</h3><div>The chest CTs of consecutive RA-ILD underwent to a SQCT assessment by two experienced chest radiologists. All CTs were also blindly post-processed by a rheumatologist in order to obtain the QCTi. QCTi correlations, distribution and discriminative ability were, respectively, verified using Spearman rank test, Mann–Whitney test and ROC curves.</div></div><div><h3>Results</h3><div>The majority of QCTi showed a moderate degree (0.40<!--> <!-->&lt;<!--> <em>r</em> <!-->&lt;<!--> <!-->0.59) with SQCT assessment (<em>p</em>-value<!--> <!-->&lt;<!--> <!-->0.01). Patients with severe and mild ILD had dissimilar QCTi values (<em>p</em> <!-->=<!--> <!-->0.001). Almost all of QCTi had a good discriminative ability (AUC from 0.73 to 0.81, <em>p</em>-value<!--> <!-->=<!--> <!-->0.0001).</div></div><div><h3>Conclusions</h3><div>These preliminary findings suggest that RA-ILD extent is related to QCTi. Moreover, QCTi can discriminate very well patients with a severe ILD. So, QCTi may become simple tools quickly estimate RA-ILD prognosis.</div></div>","PeriodicalId":94193,"journal":{"name":"Reumatologia clinica","volume":"22 5","pages":"Article 502159"},"PeriodicalIF":0.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148267545","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Protective effect of methotrexate against severe forms of COVID-19 in rheumatoid arthritis: A retrospective cohort study","authors":"Freddy Liñán-Ponce ,&nbsp;Juan Leiva-Goicochea ,&nbsp;Fernando Gross-Melo","doi":"10.1016/j.reumae.2026.502160","DOIUrl":"10.1016/j.reumae.2026.502160","url":null,"abstract":"<div><h3>Introduction</h3><div>The COVID-19 pandemic posed a unique challenge for patients with rheumatoid arthritis (RA) receiving immunomodulatory therapy. Methotrexate (MTX), a first-line agent for RA, has pleiotropic effects that may modulate both viral replication and the inflammatory response. This study aimed to determine whether MTX use is associated with a lower incidence of severe or critical COVID-19.</div></div><div><h3>Materials and methods</h3><div>A retrospective cohort study was conducted among patients with a confirmed diagnosis of RA and a documented episode of COVID-19 between 2020 and 2023 at Hospital Víctor Lazarte Echegaray (Trujillo, Peru). Patients with additional autoimmune diseases, neoplasia, pregnancy, significant organ damage, or use of biologic therapy were excluded. Two groups were compared: 207 patients treated with MTX and 155 treated with other conventional disease-modifying antirheumatic drugs (DMARDs). Primary outcomes were severe/critical COVID-19 and 28-day mortality; secondary outcomes included oxygen supplementation, ICU admission, mechanical ventilation, and length of hospitalization.</div></div><div><h3>Results</h3><div>MTX use was associated with a lower frequency of severe/critical COVID-19 (10.6% vs. 22.6%; RR 0.47; 95% CI 0.29–0.77; <em>p</em> = 0.003) and reduced 28-day mortality (1.4% vs. 5.2%; RR 0.27; 95% CI 0.07–0.98; <em>p</em> = 0.041). MTX-treated patients required less supplemental oxygen (16.9% vs. 35.5%; <em>p</em> = 0.001), fewer ICU admissions (4.8% vs. 12.9%) and mechanical ventilation (1.9% vs. 5.8%), and had a shorter median hospital stay (7 vs. 9 days; <em>p</em> = 0.002).</div></div><div><h3>Conclusions</h3><div>Methotrexate use was associated with reduced disease severity, mortality, and hospitalization duration in RA patients with COVID-19. These findings support a potential protective effect of MTX and highlight the need for multicenter prospective studies to confirm its clinical benefit.</div></div>","PeriodicalId":94193,"journal":{"name":"Reumatologia clinica","volume":"22 5","pages":"Article 502160"},"PeriodicalIF":0.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148159719","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Guide from the Colegio Mexicano de Reumatología for the Pharmacological Treatment of Systemic Sclerosis Part 1: Cutaneous Involvement, Interstitial Lung Disease, and Pulmonary Arterial Hypertension","authors":"Karla Chacón-Abril ,&nbsp;Margarita Portela-Hernández ,&nbsp;Luis Daniel Fajardo-Hermosillo ,&nbsp;Leonardo Limón-Camacho ,&nbsp;Natllely Itzel Ruiz-Gómez ,&nbsp;César Pacheco-Tena ,&nbsp;Aarón Alejandro Barrera-Rodríguez ,&nbsp;Olga Vera-Lastra ,&nbsp;Mayra Mejía ,&nbsp;Ivette Buedía-Roldán ,&nbsp;Karen Martínez-Espinosa ,&nbsp;Heidegger Mateos ,&nbsp;Silvia Méndez Flores ,&nbsp;Tomás Pulido-Zamudio ,&nbsp;Nayeli Zayas-Hernández ,&nbsp;José Antonio García-Cuellar ,&nbsp;Dulce Navarro-Vergara ,&nbsp;Jorge Rojas-Serrano ,&nbsp;Gabriel Medrano-Ramírez ,&nbsp;Tatiana S. Rodríguez-Reyna","doi":"10.1016/j.reumae.2026.502164","DOIUrl":"10.1016/j.reumae.2026.502164","url":null,"abstract":"<div><div>Systemic sclerosis (SSc) is a severe autoimmune disease characterized by fibrosis, inflammation, and vasculopathy, with high morbidity and mortality. Cutaneous involvement is an important marker of disease severity, while interstitial lung disease and pulmonary arterial hypertension represent the leading causes of death.</div><div>This manuscript presents the first national pharmacologic treatment guideline, developed using the GRADE methodology and structured around a flexible, stepwise therapeutic algorithm. Unlike international guidelines, this proposal prioritizes clinical applicability and context-specific decision-making, given the heterogeneity of resources and access to treatments within our healthcare system.</div><div>The guideline was developed by a multidisciplinary panel including rheumatologists, dermatologists, pulmonologists, cardiopulmonologists, and methodologists. Authors formulated ten PICO questions, and a systematic search was conducted in PubMed, Cochrane Library, EMBASE, and LILACS (2006–February 2024), including key earlier literature. Of 594 records identified, 114 studies were ultimately included after evaluation using the GRADE methodology. Steroids, immunosuppressants, immunomodulators, hematopoietic stem cell transplantation, and vasodilators were assessed. A total of 26 recommendations were issued and subjected to Delphi consensus, with agreement defined as ≥80% acceptance.</div></div>","PeriodicalId":94193,"journal":{"name":"Reumatologia clinica","volume":"22 5","pages":"Article 502164"},"PeriodicalIF":0.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148221493","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gender bias in guidelines and recommendations on rheumatology in Argentina: A bibliometric analysis","authors":"Belén Navarro,&nbsp;Gabriel Sequeira,&nbsp;Eduardo Kerzberg","doi":"10.1016/j.reumae.2026.502156","DOIUrl":"10.1016/j.reumae.2026.502156","url":null,"abstract":"<div><h3>Introduction</h3><div>Women constitute the majority in Argentine rheumatology research, but their participation in rheumatology guidelines and recommendations (RGRs) has not been evaluated.</div></div><div><h3>Objective</h3><div>To analyze women's representation in RGRs published between 2010 and 2024 that included at least one Argentine rheumatologist.</div></div><div><h3>Methods</h3><div>Cross-sectional bibliometric study of rheumatology guidelines and recommendations published between January 1, 2010, and December 31, 2024, including at least one rheumatologist affiliated with an Argentine center. Publications were identified through searches in PubMed, the Revista Argentina de Reumatología, and Google Scholar using predefined affiliation-based keywords. The main study variables were author gender, first and corresponding authorship, guideline classification national (NAC) or international (INT), and declared conflicts of interest with the pharmaceutical industry. Descriptive analyses were performed, and group comparisons were conducted using the Mann–Whitney <em>U</em> test and chi-square test.</div></div><div><h3>Results</h3><div>Eighty-seven RGRs were analyzed (79% INT), with a median publication year of 2021. Of 526 authors, 274 (52%) were women. In NAC RGRs, 57% of authors were women versus 43% in INT (<em>p</em> <!-->=<!--> <!-->0.003). Among 25 first authors based in Argentina, 11 (44%) were women; among 12 corresponding authors, 5 (42%) were women. COIs were reported in 24 RGRs, totaling 59 declarations, 37 (63%) from men.</div></div><div><h3>Conclusions</h3><div>Although women are the majority among Argentine rheumatology researchers, their representation decreases in international publications and leadership roles. Conflicts of interest show a gender bias favoring men.</div></div>","PeriodicalId":94193,"journal":{"name":"Reumatologia clinica","volume":"22 5","pages":"Article 502156"},"PeriodicalIF":0.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148267607","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Knowledge, intentions, and practices of breastfeeding among women with systemic lupus erythematosus: A cross-sectional survey","authors":"María Pía Izaguirre Germain,&nbsp;Susana Villamizar Pérez,&nbsp;Nicole Josianne Paris,&nbsp;Melissa Brenda Serna Góngora,&nbsp;Ariel Brener,&nbsp;Jerson Claros,&nbsp;Emel Gonzalez,&nbsp;Bárbara Cristina Pérez Cepas,&nbsp;Marina Laura Micelli,&nbsp;Gabriel Sequeira,&nbsp;Eduardo Mario Kerzberg","doi":"10.1016/j.reumae.2026.502103","DOIUrl":"10.1016/j.reumae.2026.502103","url":null,"abstract":"<div><h3>Introduction</h3><div>Breastfeeding in systemic lupus erythematosus (SLE) is often influenced by concerns about medication safety, with limited data on patients’ perceptions and decision-making.</div></div><div><h3>Objectives</h3><div>To assess breastfeeding knowledge, intentions, and practices among women with SLE, focusing on disease activity and medication-related perceptions, particularly regarding hydroxychloroquine and prednisone.</div></div><div><h3>Methods</h3><div>A cross-sectional survey was conducted with women diagnosed with SLE. Participants answered questions on demographics, previous pregnancy and breastfeeding experiences, knowledge of breastfeeding with SLE, and perceptions of breastfeeding safety with hydroxychloroquine and prednisone. The survey also assessed their intention to breastfeed in future pregnancies, especially during active disease.</div></div><div><h3>Results</h3><div>The survey was completed by 85 patients, with a mean age of 35 years (SD 9). Of these, 56% reported at least one pregnancy, 53% had breastfed, and 32.9% had a child after being diagnosed with SLE (SLE&amp;Child group). When considering future pregnancies, 88% intended to breastfeed, but 62% prioritized treatment over breastfeeding if SLE was active (<em>p</em> <!-->&lt;<!--> <!-->0.001). After reading patient information leaflets (PILs), 64% considered breastfeeding on prednisone, while only 26% thought it safe with hydroxychloroquine. Breastfeeding knowledge was higher in the SLE&amp;Child group. Initiation rates were 79.3% in the SLE&amp;Child group and 93.2% in controls (<em>p</em> <!-->=<!--> <!-->0.08). The average breastfeeding duration was 14 months in the SLE&amp;Child group and 17 months in controls (log-rank test<!--> <!-->=<!--> <!-->0.5).</div></div><div><h3>Conclusions</h3><div>Most patients with SLE intended to breastfeed, but this intention decreased during active disease. Hydroxychloroquine PILs appeared to discourage breastfeeding despite the drug's safety.</div></div>","PeriodicalId":94193,"journal":{"name":"Reumatologia clinica","volume":"22 4","pages":"Article 502103"},"PeriodicalIF":0.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147827224","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence of latent tuberculosis in patients with rheumatological diseases exposed to biologic drugs and small molecules: A study based on the BIOBADAMEX national registry","authors":"Luis Francisco Valdés Corona ,&nbsp;Ana González Andrade ,&nbsp;Aylin Luna Salazar ,&nbsp;David Vega-Morales ,&nbsp;Jiram Torres-Ruiz ,&nbsp;Iris Jazmín Colunga-Pedraza ,&nbsp;Sandra Sicsik ,&nbsp;Ángel Castillo Ortiz ,&nbsp;Miguel A. Saavedra Salinas ,&nbsp;Guillermo Guaracha-Basáñez ,&nbsp;Dafhne Guadalupe Miranda Hernández ,&nbsp;Fedra Irazoque-Palazuelos ,&nbsp;Sandra Carrillo Vazquez ,&nbsp;Julio Cesar Casasola Vargas ,&nbsp;Omar Eloy Muñoz-Monroy ,&nbsp;Javier Merayo-Chalico ,&nbsp;Estefanía Torres Valdez ,&nbsp;Sergio Duran Barragán ,&nbsp;Erick Adrián Zamora-Theozol ,&nbsp;Daniel Xavier Xibille Friedmann ,&nbsp;Vijaya Rivera Terán","doi":"10.1016/j.reumae.2026.502097","DOIUrl":"10.1016/j.reumae.2026.502097","url":null,"abstract":"<div><h3>Introduction</h3><div>Latent tuberculosis infection (LTBI) represents a challenge in patients with rheumatic diseases treated with immunological drugs, including TNF-α inhibitors, due to the increased risk of progression to active tuberculosis. Identifying the prevalence of LTBI and its associated factors is key to improving screening and prevention of this condition in this vulnerable population.</div></div><div><h3>Objective</h3><div>Primary: To determine the prevalence of LTBI in Mexican patients with rheumatic diseases treated with biologic DMARDs or small molecules.</div><div>Secondary: To identify factors associated with LTBI, considering sociodemographic, clinical, and geographic characteristics.</div></div><div><h3>Materials and Methods</h3><div>This retrospective, descriptive, cross-sectional study was based on 1464 patients included in the BIOBADAMEX database (June 2016–October 2024). All patients with a confirmed diagnosis of rheumatological diseases who had initiated treatment with biologic therapy or small molecules were included, regardless of age or diagnosis. Diagnostic tests included in the registry (tuberculin skin test, tuberculin booster, and quantiferon for tuberculosis) were analyzed to detect latent thrombolytic disease (LTBD). Sociodemographic, clinical, and laboratory variables were analyzed using descriptive statistics and logistic regression models, considering a significance level of 0.05.</div></div><div><h3>Results</h3><div>The prevalence of LTBI was 10.1% among the patients evaluated. A positive association was identified with male sex (OR: 2.64; 95% CI: 1.77, 3.95) and residence in Northern Mexico (OR: 4.74; 95% CI: 1.46, 15.32). BCG vaccination showed a negative association (OR: 0.61; 95% CI: 0.38, 0.98). No significant associations were identified with the type of drug used or relevant comorbidities, except for a negative association with hypercholesterolemia (OR: 0.25; 95% CI: 0.08, 0.81).</div></div><div><h3>Conclusion</h3><div>The study found that the prevalence of latent tuberculosis infection (LTBI) in Mexican patients with rheumatic diseases who are about to begin biologic therapy is consistent with the prevalence of LTBI in the Mexican population. Screening these patients for tuberculosis before initiating biologic therapy allows for the identification of patients with LTBI and enables appropriate management so they can begin biologic therapy of any mechanism of action. This screening should be expanded and applied to 100% of patients starting biologic therapy, paying particular attention to patients with associated risk factors.</div></div>","PeriodicalId":94193,"journal":{"name":"Reumatologia clinica","volume":"22 4","pages":"Article 502097"},"PeriodicalIF":0.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147679926","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Experience with nintedanib in interstitial lung disease associated with systemic autoimmune diseases","authors":"Minerva Berrocal Acedo ,&nbsp;Rosalía Martínez Pérez ,&nbsp;Zulema Palacios Hidalgo ,&nbsp;María Luisa Velloso Feijoo","doi":"10.1016/j.reumae.2026.502099","DOIUrl":"10.1016/j.reumae.2026.502099","url":null,"abstract":"","PeriodicalId":94193,"journal":{"name":"Reumatologia clinica","volume":"22 4","pages":"Article 502099"},"PeriodicalIF":0.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147679881","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lepromatous reaction mimicking a primary systemic vasculitis: Case report and literature review","authors":"Julia Scafati,&nbsp;Claudia Pena,&nbsp;Camila Ramallo,&nbsp;Damián E. Moavro,&nbsp;Mercedes A. García","doi":"10.1016/j.reumae.2026.502106","DOIUrl":"10.1016/j.reumae.2026.502106","url":null,"abstract":"<div><div>Lucio’s phenomenon is a rare necrotizing skin reaction, almost exclusive to diffuse lepromatous leprosy, that can mimic systemic vasculitis and lead to diagnostic and therapeutic errors. We report the case of a 32-year-old woman from Paraguay with prolonged fever, hepatomegaly, and violaceous, painless necrotic skin lesions on her limbs. She was initially treated with corticosteroids for presumed vasculitis without clinical improvement. Physical examination revealed madarosis, lepromas, and altered thermal-pain sensitivity. Skin biopsy showed a perivascular histiocytic infiltrate with acid-fast bacilli, confirming multibacillary lepromatous leprosy. Treatment with rifampicin, dapsone, and clofazimine was initiated, resulting in good clinical evolution. Lucio’s phenomenon is an immune-mediated vasculopathy that may produce false-positive serologies and mimic autoimmune diseases. Histopathological confirmation is essential to avoid unnecessary immunosuppressive therapy. It should be considered in the differential diagnosis of necrotic skin ulcers, especially in patients from endemic regions. Early recognition and specific treatment help prevent severe complications.</div></div>","PeriodicalId":94193,"journal":{"name":"Reumatologia clinica","volume":"22 4","pages":"Article 502106"},"PeriodicalIF":0.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147793552","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Systematic review and network meta-analysis of interventions for articular involvement in patients with systemic lupus erythematosus","authors":"Pedro Arbey Quevedo Mayorga ,&nbsp;Diana Isabel Muñoz ,&nbsp;Sebastián Giraldo ,&nbsp;Cristhian Camilo Guzmán ,&nbsp;Javier Mauricio Mora ,&nbsp;Jhon Jairo Tipasoca ,&nbsp;Sergio Daniel Montalvo","doi":"10.1016/j.reumae.2026.502105","DOIUrl":"10.1016/j.reumae.2026.502105","url":null,"abstract":"<div><div>Several immunosuppressive therapies beyond corticosteroids have demonstrated efficacy in controlling symptoms and reducing inflammation in lupus-related arthritis. The current standard of care (SOC) remains the combination of antimalarials and low-dose steroids, with the addition of other immunosuppressants in refractory cases. This study aimed to compare the efficacy of available biological and non-biological immunosuppressive therapies in controlling articular activity in patients with systemic lupus erythematosus (SLE). A systematic review and network meta-analysis were conducted following the PRISMA-NMA checklist (PROSPERO registration: CRD42024562392). Randomized controlled trials up to December 2023 evaluating biological and non-biological immunosuppressive treatments in lupus with articular involvement were included. Searches were performed in MEDLINE, EMBASE, LILACS, and SCIELO, including gray literature. Two reviewers independently selected studies, extracted data, and assessed risk of bias (RoB2). A fixed-effects frequentist model was applied using <em>netmeta</em>, estimating relative risks (RR), heterogeneity (I², τ²), and efficacy <em>ranking</em> using <em>P-scores</em>. A total of 1635 records were identified, and five randomized controlled trials met inclusion criteria, comprising 1476 patients, 93.3% of whom were women, with a mean age of 40 years. Evaluated interventions included methotrexate, anifrolumab, and baricitinib, all compared to placebo. Three studies showed low risk of bias, while two presented some concerns in specific domains. The network meta-analysis revealed no significant heterogeneity (Q = 2.44; <em>P</em> = .29) or inconsistency between designs, though global inconsistency was detected by netsplitting analysis. No statistically significant differences in efficacy were observed among the evaluated treatments. In the exploratory <em>ranking</em> analysis, <em>P-scores</em> indicated that methotrexate (<em>P-score</em> = 1.0), baricitinib (<em>P-score</em> = .62), and anifrolumab (<em>P-score</em> = .37) were numerically positioned at the top of the <em>ranking</em>. Nevertheless, these estimates represent probabilistic rather than inferential measures and should therefore be interpreted with caution. Meta-regression did not identify a significant influence of risk of bias on the results (<em>P</em> = .42), although substantial residual heterogeneity was observed (I² = 98.8%), which limits the comparative interpretation of treatment efficacy.</div></div>","PeriodicalId":94193,"journal":{"name":"Reumatologia clinica","volume":"22 4","pages":"Article 502105"},"PeriodicalIF":0.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147793486","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}