L. Gupta, K. Ansa Ashari, and G. Harifi, “APLAR Young Rheumatology's Vision for Holistic Professional Development in Rheumatology,” International Journal of Rheumatic Diseases 28, no. 11 (2025): e70454. https://doi.org/10.1111/1756-185x.70454.
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Sjögren's syndrome (SS) is a chronic autoimmune disorder characterized by heterogeneous manifestations and often delayed diagnosis due to its nonspecific symptoms and reliance on invasive tests. This review highlights the transformative role of artificial intelligence (AI), particularly machine learning (ML), and deep learning (DL), in enhancing SS diagnostic accuracy across diverse clinical settings. Artificial intelligence–driven models have demonstrated remarkable performance in histopathological analysis, automating the evaluation of salivary gland biopsies and minimizing observer variability. Imaging diagnostics, such as salivary gland ultrasonography and computed tomography (CT), have benefited from DL models that outperform inexperienced radiologists in detecting glandular abnormalities. When paired with ML classifiers, noninvasive approaches using Raman spectroscopy and tongue imaging offer promising alternatives to traditional diagnostics. Moreover, AI applications in genomic and metabolomic profiling have unveiled novel biomarkers and molecular signatures for SS. In primary-care, ML models trained on electronic health records (EHRs) show potential in early case identification and reducing referral delays. These innovations collectively illustrate AI's capability to unify disparate data sources from visual and molecular to clinical and support timely, personalized diagnostics. The inference drawn from this review is that AI integration across multiple diagnostic modalities can bridge existing gaps in SS detection, making diagnosis faster, more objective, and accessible even in resource-limited settings.
Patients with rheumatoid arthritis (RA) are at an increased risk of developing osteoporosis and fractures, particularly when treated with glucocorticoids. Trabecular bone score (TBS) is a valuable complementary tool for evaluating bone microarchitecture, enhancing the prediction of fracture risk beyond bone mineral density (BMD).
To determine factors associated with osteoporosis and degraded TBS in RA patients.
A cross-sectional study was conducted on 131 RA patients treated at Nguyen Tri Phuong Hospital. BMD and TBS were evaluated according to Asian reference standards; osteoporosis was defined according to WHO criteria and TBS was categorized using two cut-off points of < 1.23 (degraded) and 1.32 (normal). General risk factors and RA-specific factors were analyzed using univariate analysis, followed by multivariate logistic regression to identify factors associated with osteoporosis (T-score ≤ −2.5) and degraded TBS (< 1.23).
Osteoporosis was identified in 22.1% of patients, while more patients (26%) exhibited degraded TBS. Combining BMD with TBS identified 32.8% of patients as high risk. Factors associated with osteoporosis included advanced age (OR = 1.05, p = 0.05), lower body weight (OR = 0.94, p = 0.02), and sarcopenia (OR = 2.99, p = 0.08). Degraded TBS was significantly associated with older age (OR = 1.13, p < 0.005) and structural RA-associated bone damage (OR = 2.50, p = 0.09).
The study highlights that advanced age, low body weight, and sarcopenia are key factors associated with osteoporosis in RA patients. Similarly, older age and RA-associated structural damage, are associated with degraded TBS. The combination of BMD and TBS is recommended for bone health assessment in rheumatoid arthritis patients.
We aim to review the current state of evidence about tapering or withdrawal of biological (b-) or targeted synthetic (ts-) disease-modifying anti-rheumatic drugs (DMARDs) in psoriatic arthritis (PsA).
We search the literature for published articles in withdrawal or tapering of b-/ts-DMARDs in PsA. We summarized data according to remission criteria prior to therapy tapering, relapse criteria, relapse rate and re-treatment effects. We collected data on the effect of tapering on safety, quality of life, costs, and predictors for successful tapering.
A total of 11 observational studies and 4 randomized controlled trials (RCT) in tapering or withdrawal of b-DMARDs were included. Most data were derived from observational studies; high quality of evidence from RCTs remained sparse. b-DMARDs withdrawal generally led to high rates of flare, whilst gradual tapering of therapy while maintaining a low disease activity state may be feasible, and safe. There were high rates of response with re-treatment with b-DMARDs regimens during flares. Heterogeneity in remission criteria prior to therapy tapering regimens and relapse criteria was noted. Lower disease activity prior to tapering seems to predict success more consistently; other predictive variables were inconsistent. Predictive biomarkers for successful therapy tapering were lacking.
Tapering of biologic therapy in PsA patients may be effective and safe in low disease activity states. Lack of standardization of tapering strategies warrants further studies. The knowledge gap lies in the lack of data from high-quality RCTs and biomarkers that predict success in tapering therapy for patients with PsA.
Assess whether drinking freshly squeezed lemons in water (lemon water) influences serum urate (SU) levels, glomerular filtration rate (GFR), and urine pH levels in gout patients and individuals with hyperuricemia.
In this cohort study, we retrospectively analyzed the medical records of patients who presented to two outpatient Polish rheumatology clinics. Patients who consumed the juice of two squeezed lemons mixed with 2 L of water each day, according to a general recommendation made by clinic providers, were included in this analysis. We collected all relevant medical and medication histories from each patient. SU levels, GFR, and urine pH were extracted from the medical record.
The study included 90 patients who reported consumption of lemon juice. The mean age was 49.2 years, and 69% were men. The patients were categorized into three groups: Group A consisted of gout patients, Group B included individuals with hyperuricemia but without gout, and Group C served as a control group with diagnoses other than gout. After six weeks, SU levels decreased from baseline in Group A compared to Group B (p = 0.03) and in Group B compared to Group C (p = 0.003), and there was an increase in GFR when comparing Group A to Group B (p = 0.03) and Group A to Group C (p = 0.0007).
After 6 weeks of drinking lemon water, a statistically significant reduction in SU level and improved GFR was observed. Lemon water may serve as a beneficial adjunct therapy for individuals with gout and hyperuricemia.
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