International Journal of Rheumatic Diseases最新文献

{"title":"Exploring the Alleviating Effects and Mechanism of Qianggu Kangshu on Rheumatoid Arthritis","authors":"Xia Huang,&nbsp;Jiangyang Tang,&nbsp;Yan Xia,&nbsp;Nianan Yang,&nbsp;Dan Chen,&nbsp;Xingxing Gao,&nbsp;Lin Yuan,&nbsp;Linchong Su,&nbsp;Ling Lei","doi":"10.1111/1756-185x.70571","DOIUrl":"10.1111/1756-185x.70571","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>This study discussed the treatment effects and underlying mechanisms of the Qianggu Kangshu (QGKS) formula in rheumatoid arthritis (RA).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Rat models of collagen-induced arthritis (CIA) were established and divided into six groups: control group, model group, low-dose QGKS group (QGKS-L, 6.3 g/kg/day), middle-dose QGKS group (QGKS-M, 12.6 g/kg/day), high-dose QGKS group (QGKS-H, 25.2 g/kg/day), and methotrexate (MTX, 1 mg/kg/week). The histopathological changes regarding synovial and ankle tissues were evaluated using hematoxylin–eosin staining and safranin-O staining. Serum levels of TNF-α, IL-1β, and IL-6 were measured using ELISA kits. UPLC/MS–MS was used to analyze serum components, and 16S rDNA sequencing was conducted for analyzing the intestinal contents of the treated CIA rats.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Arthritis symptoms were alleviated in QGKS-treated CIA rats, evidenced by decreased paw swelling and lower arthritis scores compared to control groups. QGKS treatment resulted in a marked decrease in proinflammatory cytokines (TNF-α, IL-1β, and IL-6). Histological analyses revealed reduced synovial inflammation and preserved cartilage integrity following QGKS intervention. Metabolomic profiling identified significant alterations in metabolic pathways related to glycerophospholipid metabolism and fatty acid degradation after addition of QGKS in CIA rats. Moreover, QGKS treatment improved gut microbiota composition, along with increased beneficial bacteria <i>Lactobacillus</i> and decreased pathogenic strains.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>QGKS alleviated CIA symptoms by reducing inflammation, correcting metabolic disturbances, and modulating gut microbiota, suggesting its potential as a novel therapeutic option for RA.</p>\u0000 </section>\u0000 </div>","PeriodicalId":14330,"journal":{"name":"International Journal of Rheumatic Diseases","volume":"29 2","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-02-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146149657","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Animal Models of Lupus Nephritis: Current Status and Future Perspectives","authors":"Lihe Sheng,&nbsp;Niqin Xiao,&nbsp;Bingbing Chen,&nbsp;Yang Xiang,&nbsp;Zhaohu Xie,&nbsp;Zhaofu Li","doi":"10.1111/1756-185x.70496","DOIUrl":"10.1111/1756-185x.70496","url":null,"abstract":"<div>\u0000 \u0000 <p>Lupus nephritis (LN) represents one of the most severe complications associated with systemic lupus erythematosus (SLE) characterized by a complex pathogenesis. Animal models play a pivotal role in elucidating the pathogenesis of LN, facilitating drug discovery, and evaluating therapeutic interventions. A diverse array of LN animal models is currently employed in research. Concurrently, the evaluation of these animal models' validity is of paramount importance. This paper provides a comprehensive review of the key characteristics of common spontaneous, inducible, humanized and knockout models, along with an assessment of the effectiveness of LN models. Through a comparative analysis of these models, this study offers valuable references and guidance for LN research.</p>\u0000 </div>","PeriodicalId":14330,"journal":{"name":"International Journal of Rheumatic Diseases","volume":"29 2","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-02-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146149652","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Integrating Musculoskeletal Ultrasound and Serological Markers to Optimize Acute Gouty Arthritis Diagnosis","authors":"Xiao-Jian Zong,&nbsp;Lei Liu,&nbsp;Mao Yang,&nbsp;Jing-Jing Li,&nbsp;Ping Yuan,&nbsp;Jian Cao","doi":"10.1111/1756-185x.70564","DOIUrl":"10.1111/1756-185x.70564","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>This study aimed to evaluate the diagnostic utility of combining musculoskeletal ultrasound (MSUS) with serum levels of hypoxia-inducible factor-1α (HIF-1α) and cyclooxygenase-2 (COX-2) for acute gouty arthritis (AGA).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The study included 122 patients hospitalized for gouty arthritis between February 2021 and February 2022. Of these, 60 patients presented with AGA, while 62 had non-acute gouty arthritis (NAGA). Semi-quantitative musculoskeletal ultrasound (MSUS) scores and serum levels of hypoxia-inducible factor-1α (HIF-1α) and cyclooxygenase-2 (COX-2) were compared between the two groups. A Disease Activity Score-28 (DAS28) was used to further classify the AGA group into low-activity and high-activity subgroups.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>MSUS scores, DAS28, and serum levels of HIF-1α and COX-2 were significantly elevated in the AGA group compared to the NAGA group (<i>p</i> &lt; 0.05). Furthermore, within the AGA group, the high-activity subgroup exhibited higher MSUS semi-quantitative scores, DAS28 scores, and serum levels of HIF-1α and COX-2 compared to the low-activity subgroup (<i>p</i> &lt; 0.05). Pearson correlation analysis revealed a positive correlation between the MSUS semi-quantitative score and serum levels of HIF-1α, COX-2, as well as the DAS28 score in patients diagnosed with AGA (<i>p</i> &lt; 0.05). The combined application of MSUS semi-quantitative scoring and serological markers provided significantly enhanced diagnostic accuracy for AGA and better assessment of disease activity compared to any individual marker.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>MSUS and serum HIF-1α and COX-2 represent valuable tools for assessing the acute phase and disease activity of AGA. The combined diagnostic approach demonstrates superior effectiveness and holds potential for broader clinical application.</p>\u0000 </section>\u0000 </div>","PeriodicalId":14330,"journal":{"name":"International Journal of Rheumatic Diseases","volume":"29 2","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-02-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146142354","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk Factors for Major Adverse Cardiovascular Events, Malignancies, and Serious Infections With Tofacitinib in Rheumatoid Arthritis: Post Hoc Analysis of a 3-Year J-Post-Marketing Surveillance","authors":"Kunihiro Yamaoka,&nbsp;Masato Hoshi,&nbsp;Yutaka Endo,&nbsp;Toshitaka Hirano","doi":"10.1111/1756-185x.70572","DOIUrl":"10.1111/1756-185x.70572","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>This post hoc analysis of all-case post-marketing surveillance in Japanese patients with rheumatoid arthritis assessed risk factors for major adverse cardiovascular events (MACE), malignancies, and serious infections (SI).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Data of patients who received tofacitinib (≥ 1 dose) were stratified by each combination of age (&lt; 50 years and ≥ 50 years) and the number of cardiovascular (CV) risk factors (0 or ≥ 1). Incidence rates (IRs) of each adverse event (AE)-MACE, malignancies, and SI, stratified by age, CV risk factors, and patient background factors were calculated.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Overall, 7021 patients were stratified by each combination of age (&lt; 50 and ≥ 50 years) and the number of CV risk factors (0 or ≥ 1). The IRs for malignancies and SI were higher in patients aged ≥ 50 vs. &lt; 50 years. The IRs for all AEs were higher in patients with ≥ 1 CV risk factors than 0 CV risk factors. Older age was strongly correlated with all AEs. MACE and SI were more likely to be affected by any CV risk factors, while the other AE was influenced by some of them.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Older age was a risk factor for all AEs (MACE, malignancies, and SI). MACE risk was also increased in patients with ≥ 1 CV risk factors versus those without. SI risk might also be increased in patients with ≥ 1 CV risk factors.</p>\u0000 </section>\u0000 </div>","PeriodicalId":14330,"journal":{"name":"International Journal of Rheumatic Diseases","volume":"29 2","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-02-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12886613/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146149668","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Recommendations of the Qazaq College of Rheumatology for the Diagnosis and Treatment of Rheumatoid Arthritis: 2025 National Initiative","authors":"Galymzhan Togizbayev,&nbsp;Aigul Turtayeva,&nbsp;Gulzhan Gabdullina,&nbsp;Zharkynay Akhmetova,&nbsp;Bibikhan Eraliyeva","doi":"10.1111/1756-185x.70566","DOIUrl":"10.1111/1756-185x.70566","url":null,"abstract":"&lt;p&gt;Rheumatoid arthritis (RA) remains a major cause of disability and reduced quality of life worldwide [&lt;span&gt;1&lt;/span&gt;], with notable differences in disease management across regions. In Kazakhstan, the increasing burden of RA [&lt;span&gt;2&lt;/span&gt;] and the need for harmonized care have led to the development of the country's first comprehensive national clinical recommendations for the diagnosis and treatment of RA under the leadership of the Qazaq College of Rheumatology (QCR) in 2025.&lt;/p&gt;&lt;p&gt;The QCR 2025 recommendations were developed by a national expert panel integrating international evidence with local epidemiological data and clinical experience from rheumatology centers across the country. The recommendations are aligned with the 2022 EULAR and 2021 ACR guidelines while addressing clinical priorities specific to Kazakhstan.&lt;/p&gt;&lt;p&gt;Consistent with EULAR and ACR principles, the QCR recommendations emphasize treat-to-target strategies, regular monitoring of disease activity (DAS28), and shared decision-making between clinicians and patients. At the same time, the initiative highlights issues of particular relevance to Kazakhstan and other countries in Central Asia.&lt;/p&gt;&lt;p&gt;For example, the management of latent tuberculosis infection (LTBI) remains critical in a country with an intermediate TB burden. The new recommendations outline clear screening and prophylactic treatment pathways developed in collaboration with infectious disease specialists. Likewise, viral hepatitis B and C, prevalent in the region, are addressed with guidance on safe use of csDMARDs, bDMARDs, and tsDMARDs in affected patients.&lt;/p&gt;&lt;p&gt;In pregnant patients, the recommendations adapt EULAR guidance to local practice, supporting the use of sulfasalazine, glucocorticoids, and selected TNF inhibitors during pregnancy and lactation, while strictly avoiding teratogenic agents such as methotrexate and leflunomide.&lt;/p&gt;&lt;p&gt;The QCR guidelines also encourage integration of RA management into Kazakhstan's national digital health strategy, including expansion of national RA registries to collect real-world data and improve health system planning [&lt;span&gt;7&lt;/span&gt;]. This experience of adapting international recommendations to local conditions may provide a useful model for other countries in Central Asia, Eastern Europe, and low- and middle-income regions.&lt;/p&gt;&lt;p&gt;The development of national clinical recommendations represents an important milestone in improving the quality of RA care in Kazakhstan and contributes to global efforts to ensure equitable access to evidence-based rheumatologic treatment for all patients.&lt;/p&gt;&lt;p&gt;G.T.: conceptualization, writing – project administration, original draft preparation, review and editing. A.T.: methodology, literature search, writing. G.G.: data curation, formal analysis. Z.A.: visualization, validation, clinical expertise. B.E.: evidence verification and pharmacological expertise.&lt;/p&gt;&lt;p&gt;The authors have nothing to report.&lt;/p&gt;&lt;p&gt;The authors declare no conflict","PeriodicalId":14330,"journal":{"name":"International Journal of Rheumatic Diseases","volume":"29 2","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1756-185x.70566","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146131833","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Case With Concurrent Monoclonal Gammopathy, Thrombocytopenia, and Antiphospholipid Antibodies","authors":"Zhan Su,&nbsp;Jie Xu,&nbsp;Hui Yan","doi":"10.1111/1756-185x.70567","DOIUrl":"10.1111/1756-185x.70567","url":null,"abstract":"","PeriodicalId":14330,"journal":{"name":"International Journal of Rheumatic Diseases","volume":"29 2","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146131838","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Large Language Models in Rheumatology: Prospects and Challenges for the Clinician","authors":"Po-Cheng Shih,&nbsp;James Cheng Chung Wei","doi":"10.1111/1756-185x.70565","DOIUrl":"10.1111/1756-185x.70565","url":null,"abstract":"<p>Artificial intelligence (AI) is rapidly evolving and reshaping everyday life for everyone, including healthcare. The general-purpose models, such as the GPT series, Claude, Gemini, Grok, and others, have demonstrated remarkable capabilities in the solution of medical problems and presenting opportunities and challenges for medical research and clinical practice [<span>1</span>]. Rheumatology, characterized by complex chronic diseases, benefits a lot from rapid advances in LLMs, but must also carefully manage the associated risks.</p><p>Include applications in Table 1.</p><p>Despite rapid and extensive resource investment in AI research, significant limitations persist. First, a primary concern for general use remains the validation of AI accuracy. AI hallucination has yet to be fully resolved within current training paradigms, although numerous approaches to solve this issue have already been proposed. Second, the various training datasets lead to data bias, potentially exacerbating health inequities. Third, cloud-based deployment raises significant concerns regarding patient privacy and data security. Conversely, running AI locally is often constrained by limited computing power on personal devices, thereby further restricting its practical application. Fourth, even with current reasoning models, the internal cognitive mechanisms remain inadequately understood. Therefore, these concerns must be carefully considered when applying AI to clinical scenarios.</p><p>LLMs offer significant promise as tools for rheumatology, with potential improvement of clinical practice, medical research, and personal life, but several challenges remain. To effectively utilize these technologies, their differences in ability, accuracy, adherence to the highest ethical standards, and flexibility to continuous learning need to be carefully evaluated.</p><p>Po-Cheng Shih wrote the manuscript. James Cheng Chung Wei supervise and edit the manuscript. All authors are responsible for the final version of the manuscript.</p><p>The views expressed in this article represent those of the authors and do not necessarily reflect the official position of the institutions with which they are affiliated.</p><p>Dr. James Wei is the Editor-in-Chief of IJRD and a co-author of this article. They were excluded from editorial decision-making related to the acceptance and publication of this article. Editorial decision-making was handled independently by other editors to minimize bias. The other authors declare no conflicts of interest.</p><p>The data that support the findings of this study are available from the corresponding author upon reasonable request.</p>","PeriodicalId":14330,"journal":{"name":"International Journal of Rheumatic Diseases","volume":"29 2","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1756-185x.70565","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146131877","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Perspectives on a Large Language Models-Generated Referral Summary for Rheumatology Co-Management","authors":"Shiuan-Tzuen Su,&nbsp;Wei-Chih Shen,&nbsp;Shih-Chun Kuo,&nbsp;Hung-Ke Lin","doi":"10.1111/1756-185x.70568","DOIUrl":"10.1111/1756-185x.70568","url":null,"abstract":"&lt;p&gt;Rheumatologic diagnosis is complex, requiring detailed history, examination findings, serologic markers, and advanced imaging, such as magnetic resonance imaging (MRI). In chronic inflammatory rheumatic diseases, such as axial spondyloarthritis (axSpA) and rheumatoid arthritis (RA), early diagnosis within the so-called “window of opportunity” was crucial to optimizing long-term functional outcomes, underscoring the necessity for high-quality referral documentation to support efficient care pathways [&lt;span&gt;1&lt;/span&gt;].&lt;/p&gt;&lt;p&gt;Large language models (LLMs) could analyze unstructured clinical text alongside structured data for early rheumatic disease detection, enabling faster referrals. By identifying patterns in general practitioner (GP) records, they could support timely recognition and greater efficiency. Evidence from other specialties showed artificial intelligence (AI)-assisted documentation could reduce preparation time while maintaining accuracy and improving clinician satisfaction. Veen et al. reported that LLMs might surpass experts in summarization, might reduce documentation burden and clinician workload, and improve care, warranting further prospective validation [&lt;span&gt;2&lt;/span&gt;]. Table 1 summarizes current applications of large language models in clinical note generation.&lt;/p&gt;&lt;p&gt;Cross-institutional referrals required exchanging sensitive electronic medical record (EMR) data across heterogeneous systems, and integrating generative AI amplifies privacy and security risks, including unauthorized access, re-identification, and model-driven data leakage. Encrypted transfer, strict access control, auditability, and institutional governance were essential to ensure compliant AI-enabled workflows. At the same time, current evidence showed that LLMs could enhance diagnostic pathways by accurately interpreting patient narratives, accelerating recognition of inflammatory diseases, improving documentation, and supporting task shifting. Embedded within hybrid care models, LLMs enabled scalable education and multimodal data processing, helping reduce diagnostic delays and strengthen patient-centered rheumatology care when properly validated and regulated [&lt;span&gt;7&lt;/span&gt;]. Effective prompt engineering was also essential for generating accurate LLMs summaries. Suboptimal prompts often lead to superficial or incorrect outputs, whereas precise phrasing and clear context enable models to produce focused, reliable results [&lt;span&gt;8&lt;/span&gt;].&lt;/p&gt;&lt;p&gt;Although LLMs could automate rheumatology referral summaries, hallucinated or inaccurate content remains a major risk, often masked by confident language [&lt;span&gt;9&lt;/span&gt;]. Such errors might misrepresent disease activity and delay care, making expert oversight essential for alignment with clinical guidelines.&lt;/p&gt;&lt;p&gt;If an LLMs mistakenly “hallucinated” a positive antinuclear antibody (ANA) result or an elevated rheumatoid factor (RF) value in a referral document, the triage pathway may be distorted. Patients without ","PeriodicalId":14330,"journal":{"name":"International Journal of Rheumatic Diseases","volume":"29 2","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1756-185x.70568","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146119117","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of Hydroxychloroquine on Mortality and Cardiovascular Outcomes in Systemic Sclerosis: A Retrospective Cohort Study","authors":"Bal K. Subedi,&nbsp;Naveen Gautam,&nbsp;Rafal Ali,&nbsp;Irene J. Tan","doi":"10.1111/1756-185x.70515","DOIUrl":"10.1111/1756-185x.70515","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Systemic sclerosis (SSc) is a rare autoimmune disease with high mortality, often due to cardiopulmonary complications. Hydroxychloroquine (HCQ), commonly used in other rheumatic diseases, has immunomodulatory and potentially cardioprotective effects, but its role in SSc remains unclear. This study aimed to evaluate the association between HCQ use and the risk of mortality, ischemic heart disease (IHD), and pulmonary hypertension (PH) in a large real-world SSc cohort.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This retrospective cohort study utilized de-identified electronic medical records from the TriNetX Research network. Adults with an SSc diagnosis (ICD-10-CM: M34) were divided into HCQ users and non-users. After 1:1 propensity score matching for demographics, comorbidities and medications, outcomes including mortality, PH, acute myocardial infarction (MI), cerebral infarction, conduction heart disease, and myocarditis were assessed over 5 years. Risk ratios (RR) and Kaplan–Meier hazard ratios were calculated.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Out of 17 395 HCQ users and 58 576 non-users, 15 485 propensity score matched pairs were analyzed. Over 5 years, HCQ users showed higher PH (RR 1.124, 95% CI, 1.052–1.200, <i>p</i> &lt; 0.001) but lower mortality (RR 0.719, 95% CI, 0.674–0.767, <i>p</i> &lt; 0.001), indicating potential survival benefits. No significant differences were observed for IHD, MI, cerebral infarction, conduction disorders, or myocarditis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Our research indicated that although patients on HCQ had a higher prevalence of PH, they exhibited lower mortality rates, suggesting a possible survival benefit. Further prospective studies are needed to explore these findings and clarify HCQ's role in SSC management.</p>\u0000 </section>\u0000 </div>","PeriodicalId":14330,"journal":{"name":"International Journal of Rheumatic Diseases","volume":"29 2","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146119135","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Letter to the Editor: Short-Term Effectiveness of Sulfasalazine and Tofacitinib in NSAID-Refractory Reactive Arthritis","authors":"Garzeen Ghaffar,&nbsp;Ahmad Furqan Anjum","doi":"10.1111/1756-185x.70569","DOIUrl":"10.1111/1756-185x.70569","url":null,"abstract":"","PeriodicalId":14330,"journal":{"name":"International Journal of Rheumatic Diseases","volume":"29 2","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146119052","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}