Pub Date : 2025-10-30DOI: 10.1038/s41584-025-01324-8
Sarah Onuora
In a phase III placebo-controlled trial, the addition of telitacicept to standard therapy led to increased clinical response rates for people with systemic lupus erythematosus.
在一项III期安慰剂对照试验中，在标准治疗中加入泰利他塞普可提高系统性红斑狼疮患者的临床反应率。
{"title":"Phase III trial of telitacicept in SLE","authors":"Sarah Onuora","doi":"10.1038/s41584-025-01324-8","DOIUrl":"10.1038/s41584-025-01324-8","url":null,"abstract":"In a phase III placebo-controlled trial, the addition of telitacicept to standard therapy led to increased clinical response rates for people with systemic lupus erythematosus.","PeriodicalId":18810,"journal":{"name":"Nature Reviews Rheumatology","volume":"21 12","pages":"698-698"},"PeriodicalIF":32.7,"publicationDate":"2025-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145396941","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-10-23DOI: 10.1038/s41584-025-01311-z
Progress has been astonishing, but the need for personalized care can only be addressed through a universal focus on diversity and equity in rheumatology research.
取得了惊人的进展，但只有通过普遍关注风湿病研究的多样性和公平性才能满足个性化护理的需求。
{"title":"The next breakthrough in rheumatology will require prioritizing diversity","authors":"","doi":"10.1038/s41584-025-01311-z","DOIUrl":"10.1038/s41584-025-01311-z","url":null,"abstract":"Progress has been astonishing, but the need for personalized care can only be addressed through a universal focus on diversity and equity in rheumatology research.","PeriodicalId":18810,"journal":{"name":"Nature Reviews Rheumatology","volume":"21 11","pages":"641-641"},"PeriodicalIF":32.7,"publicationDate":"2025-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.nature.comhttps://www.nature.com/articles/s41584-025-01311-z.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145351839","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-10-16DOI: 10.1038/s41584-025-01306-w
Marta Casal Moura, Peter A. Merkel, David Jayne, Maria C. Cid, Neil Basu, Bernhard Hellmich, Benjamin Terrier, Abraham Rutgers, Jennifer Gordon, Peter Verhoeven, Joyce Kullman, Carol A. Langford, Ingeborg M. Bajema, Duvuru Geetha, Fernando C. Fervenza, A. Richard Kitching, John H. Stone, Ulrich Specks, Andreas Kronbichler
Anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) encompasses three rare yet interrelated diseases: granulomatosis with polyangiitis (GPA), microscopic polyangiitis (MPA) and eosinophilic granulomatosis with polyangiitis (EGPA). Despite increasing recognition, the diagnosis of AAV remains challenging, even in specialized medical centres, owing to its clinical heterogeneity, overlap with mimicking conditions, and the variable performance of ANCA testing. The assessment of a patient suspected of AAV requires a timely synthesis of symptoms, physical examination, laboratory tests, histopathology and imaging data to substantiate the diagnosis, exclude alternative diagnoses, assess disease activity and extent, and enable rapid initiation of appropriate therapies. Classification is similarly complex, and evolving classification systems are based on clinical phenotype, ANCA specificity or a combination of both, each with implications for disease monitoring, therapeutic decisions and trial design. Assessing disease severity and predicting prognosis are fundamental but complicated by the diverse patterns of organ involvement, relapsing–remitting course and co-morbidities. Although validated tools exist for measuring disease activity, organ damage and prognosis, many limitations remain, particularly in identifying smouldering disease, irreversible damage and risk of relapse. Emerging therapies have improved outcomes, with recovery of kidney function, better overall survival and improved glucocorticoid-related toxicity, but patients with AAV continue to experience high risks of chronic morbidity and early mortality. This Review explores current challenges and opportunities in the diagnosis, classification and prognostic assessment of AAV, and outlines a structured framework to support personalized and outcome-focused care. ANCA-associated vasculitis (AAV) includes three disease subtypes with partly overlapping clinical manifestations: granulomatosis with polyangiitis (GPA), microscopic polyangiitis (MPA) and eosinophilic granulomatosis with polyangiitis (EGPA). This Review article provides an update on the diagnosis and classification of AAV, discussing parameters for assessing disease activity and predicting outcomes towards a personalized medicine approach.
{"title":"Challenges in the diagnosis, classification and prognosis of ANCA-associated vasculitis","authors":"Marta Casal Moura, Peter A. Merkel, David Jayne, Maria C. Cid, Neil Basu, Bernhard Hellmich, Benjamin Terrier, Abraham Rutgers, Jennifer Gordon, Peter Verhoeven, Joyce Kullman, Carol A. Langford, Ingeborg M. Bajema, Duvuru Geetha, Fernando C. Fervenza, A. Richard Kitching, John H. Stone, Ulrich Specks, Andreas Kronbichler","doi":"10.1038/s41584-025-01306-w","DOIUrl":"10.1038/s41584-025-01306-w","url":null,"abstract":"Anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) encompasses three rare yet interrelated diseases: granulomatosis with polyangiitis (GPA), microscopic polyangiitis (MPA) and eosinophilic granulomatosis with polyangiitis (EGPA). Despite increasing recognition, the diagnosis of AAV remains challenging, even in specialized medical centres, owing to its clinical heterogeneity, overlap with mimicking conditions, and the variable performance of ANCA testing. The assessment of a patient suspected of AAV requires a timely synthesis of symptoms, physical examination, laboratory tests, histopathology and imaging data to substantiate the diagnosis, exclude alternative diagnoses, assess disease activity and extent, and enable rapid initiation of appropriate therapies. Classification is similarly complex, and evolving classification systems are based on clinical phenotype, ANCA specificity or a combination of both, each with implications for disease monitoring, therapeutic decisions and trial design. Assessing disease severity and predicting prognosis are fundamental but complicated by the diverse patterns of organ involvement, relapsing–remitting course and co-morbidities. Although validated tools exist for measuring disease activity, organ damage and prognosis, many limitations remain, particularly in identifying smouldering disease, irreversible damage and risk of relapse. Emerging therapies have improved outcomes, with recovery of kidney function, better overall survival and improved glucocorticoid-related toxicity, but patients with AAV continue to experience high risks of chronic morbidity and early mortality. This Review explores current challenges and opportunities in the diagnosis, classification and prognostic assessment of AAV, and outlines a structured framework to support personalized and outcome-focused care. ANCA-associated vasculitis (AAV) includes three disease subtypes with partly overlapping clinical manifestations: granulomatosis with polyangiitis (GPA), microscopic polyangiitis (MPA) and eosinophilic granulomatosis with polyangiitis (EGPA). This Review article provides an update on the diagnosis and classification of AAV, discussing parameters for assessing disease activity and predicting outcomes towards a personalized medicine approach.","PeriodicalId":18810,"journal":{"name":"Nature Reviews Rheumatology","volume":"21 12","pages":"719-736"},"PeriodicalIF":32.7,"publicationDate":"2025-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145305455","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-10-16DOI: 10.1038/s41584-025-01317-7
Filippo Fagni, Giacomo Bagni, Federica Bello, Catherine L. Hill, Aladdin J. Mohammad, Sergey Moiseev, Iacopo Olivotto, Emire Seyahi, Giacomo Emmi
{"title":"Reply to ‘Potential benefit of anticoagulation in Behçet syndrome’","authors":"Filippo Fagni, Giacomo Bagni, Federica Bello, Catherine L. Hill, Aladdin J. Mohammad, Sergey Moiseev, Iacopo Olivotto, Emire Seyahi, Giacomo Emmi","doi":"10.1038/s41584-025-01317-7","DOIUrl":"10.1038/s41584-025-01317-7","url":null,"abstract":"","PeriodicalId":18810,"journal":{"name":"Nature Reviews Rheumatology","volume":"21 12","pages":"755-755"},"PeriodicalIF":32.7,"publicationDate":"2025-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145305457","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-10-13DOI: 10.1038/s41584-025-01310-0
Arjun Mahajan, David W. Bates, Katherine P. Liao, Jeffrey A. Sparks
Generative artificial intelligence promises to reshape clinical care in rheumatology by supporting diagnostic reasoning, treatment planning and patient communication. Yet its potential rests on careful validation, transparent integration and thoughtful collaboration that strengthens, rather than substitutes, the human expertise central to patient care.
{"title":"Advancing rheumatic disease care through generative artificial intelligence","authors":"Arjun Mahajan, David W. Bates, Katherine P. Liao, Jeffrey A. Sparks","doi":"10.1038/s41584-025-01310-0","DOIUrl":"10.1038/s41584-025-01310-0","url":null,"abstract":"Generative artificial intelligence promises to reshape clinical care in rheumatology by supporting diagnostic reasoning, treatment planning and patient communication. Yet its potential rests on careful validation, transparent integration and thoughtful collaboration that strengthens, rather than substitutes, the human expertise central to patient care.","PeriodicalId":18810,"journal":{"name":"Nature Reviews Rheumatology","volume":"22 1","pages":"1-2"},"PeriodicalIF":32.7,"publicationDate":"2025-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145283528","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-10-03DOI: 10.1038/s41584-025-01305-x
Nicholas R. Fuggle, Roland Chapurlat, Andrea Laslop, Nasser Al-Daghri, Majed Alokail, Jotheeswaran Amuthavalli Thiyagarajan, Ewa Balkowiec-Iskra, Francis Berenbaum, Angie Botto-van Bemden, John-Joseph Borg, Olivier Bruyère, Nansa Burlet, Etienne Cavalier, Mario M. Rosa, Philip G. Conaghan, Cyrus Cooper, Elaine M. Dennison, Martin Englund, Gun-il Im, Ida K. Haugen, Mickaël Hiligsmann, Andreas Kurth, Nancy Lane, Rik Lories, Stefan Marlovits, Radmila Matijevic, Ali Mobasheri, Sif Ormarsdóttir, Maria C. Prieto Yerro, Régis P. Radermecker, François Rannou, Bruno Sepodes, Stuart Silverman, Carla Torre, Nicola Veronese, René Rizzoli, Jean-Yves Reginster, Nicholas C. Harvey
Knee osteoarthritis is a highly prevalent whole-joint disease that is associated with substantial morbidity. If step changes are to be made in the management of knee osteoarthritis, novel patient stratification approaches are needed to identify the most effective treatment for individual patients. Numerous methods for stratifying patients with knee osteoarthritis can be employed; clinical presentation, including co-morbidity and pain phenotype, can influence treatment decisions, and there is a rich history of imaging biomarker use, both from conventional radiographs and, since its development, via MRI, in identifying patients at risk of disease progression, and the latter facilitates the detection of synovitis. The development of novel biochemical biomarkers and the rapid growth of ‘-omics’ technologies provide fresh opportunities to deploy these advances in the stratification of patients with knee osteoarthritis. The health economic landscape in this area is developing, and scoping work has highlighted the need for further studies. This Perspective article discusses the stratification of patients with knee osteoarthritis (OA) in the context of current guidelines, biomarkers and emerging and future developments of targeted treatment. The authors aim to highlight how these novel developments can enhance the stratification of patients with knee OA to improve patient outcomes.
{"title":"Novel approaches to the stratified management of knee osteoarthritis","authors":"Nicholas R. Fuggle, Roland Chapurlat, Andrea Laslop, Nasser Al-Daghri, Majed Alokail, Jotheeswaran Amuthavalli Thiyagarajan, Ewa Balkowiec-Iskra, Francis Berenbaum, Angie Botto-van Bemden, John-Joseph Borg, Olivier Bruyère, Nansa Burlet, Etienne Cavalier, Mario M. Rosa, Philip G. Conaghan, Cyrus Cooper, Elaine M. Dennison, Martin Englund, Gun-il Im, Ida K. Haugen, Mickaël Hiligsmann, Andreas Kurth, Nancy Lane, Rik Lories, Stefan Marlovits, Radmila Matijevic, Ali Mobasheri, Sif Ormarsdóttir, Maria C. Prieto Yerro, Régis P. Radermecker, François Rannou, Bruno Sepodes, Stuart Silverman, Carla Torre, Nicola Veronese, René Rizzoli, Jean-Yves Reginster, Nicholas C. Harvey","doi":"10.1038/s41584-025-01305-x","DOIUrl":"10.1038/s41584-025-01305-x","url":null,"abstract":"Knee osteoarthritis is a highly prevalent whole-joint disease that is associated with substantial morbidity. If step changes are to be made in the management of knee osteoarthritis, novel patient stratification approaches are needed to identify the most effective treatment for individual patients. Numerous methods for stratifying patients with knee osteoarthritis can be employed; clinical presentation, including co-morbidity and pain phenotype, can influence treatment decisions, and there is a rich history of imaging biomarker use, both from conventional radiographs and, since its development, via MRI, in identifying patients at risk of disease progression, and the latter facilitates the detection of synovitis. The development of novel biochemical biomarkers and the rapid growth of ‘-omics’ technologies provide fresh opportunities to deploy these advances in the stratification of patients with knee osteoarthritis. The health economic landscape in this area is developing, and scoping work has highlighted the need for further studies. This Perspective article discusses the stratification of patients with knee osteoarthritis (OA) in the context of current guidelines, biomarkers and emerging and future developments of targeted treatment. The authors aim to highlight how these novel developments can enhance the stratification of patients with knee OA to improve patient outcomes.","PeriodicalId":18810,"journal":{"name":"Nature Reviews Rheumatology","volume":"21 11","pages":"684-695"},"PeriodicalIF":32.7,"publicationDate":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145215564","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-10-02DOI: 10.1038/s41584-025-01315-9
Sarah Onuora
Findings demonstrate that STING mediates necroptosis in the context of autoinflammatory disease, and suggest a potential therapeutic approach.
研究结果表明，STING介导自身炎症性疾病的坏死性上睑下垂，并提出了一种潜在的治疗方法。
{"title":"STING-driven necroptosis linked to autoinflammatory disease","authors":"Sarah Onuora","doi":"10.1038/s41584-025-01315-9","DOIUrl":"10.1038/s41584-025-01315-9","url":null,"abstract":"Findings demonstrate that STING mediates necroptosis in the context of autoinflammatory disease, and suggest a potential therapeutic approach.","PeriodicalId":18810,"journal":{"name":"Nature Reviews Rheumatology","volume":"21 11","pages":"650-650"},"PeriodicalIF":32.7,"publicationDate":"2025-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145209190","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-10-01DOI: 10.1038/s41584-025-01302-0
Derin Karacabeyli, Diane Lacaille
Obesity affects nearly one in six adults worldwide. Excess adiposity is a pro-inflammatory state associated with increased risk of several types of arthritis, increased arthritis disease activity and/or severity, and poorer response to certain treatments. Obesity is a major risk factor for cardiovascular disease, the leading cause of death in people with common arthritides such as osteoarthritis (OA), gout, rheumatoid arthritis, psoriatic arthritis and axial spondyloarthritis. Glucagon-like peptide-1 receptor agonists (GLP-1RAs) are a promising therapeutic option for people with arthritis and obesity or type 2 diabetes mellitus owing to their pleiotropic effects, including weight loss, improved survival and reduced risk of major cardiovascular and renal events. In vitro and preclinical in vivo experiments in arthritis have uncovered weight-loss-independent anti-inflammatory and chondroprotective properties of GLP-1RAs. In knee OA, clinical data suggest that GLP-1RAs improve pain and function and reduce the risk of surgical intervention; however, their effects on OA incidence remain incompletely understood. Evidence suggests that GLP-1RAs do not directly prevent gout attacks, but are effective in managing cardiometabolic conditions commonly associated with gout and other arthritides. More research is needed to clarify the effects of GLP-1RAs on incidence, disease activity, and progression of rheumatoid arthritis, psoriatic arthritis and axial spondyloarthritis. Evidence is emerging that glucagon-like peptide-1 (GLP-1) receptor agonists have anti-inflammatory and chondroprotective properties independent of their effects on weight loss. In this Review, the authors discuss the potential effects of GLP-1 receptor agonists on the incidence, disease activity and progression of various forms of arthritis, as well as practical considerations for their use in this context.
{"title":"Glucagon-like peptide-1 receptor agonists in arthritis: current insights and future directions","authors":"Derin Karacabeyli, Diane Lacaille","doi":"10.1038/s41584-025-01302-0","DOIUrl":"10.1038/s41584-025-01302-0","url":null,"abstract":"Obesity affects nearly one in six adults worldwide. Excess adiposity is a pro-inflammatory state associated with increased risk of several types of arthritis, increased arthritis disease activity and/or severity, and poorer response to certain treatments. Obesity is a major risk factor for cardiovascular disease, the leading cause of death in people with common arthritides such as osteoarthritis (OA), gout, rheumatoid arthritis, psoriatic arthritis and axial spondyloarthritis. Glucagon-like peptide-1 receptor agonists (GLP-1RAs) are a promising therapeutic option for people with arthritis and obesity or type 2 diabetes mellitus owing to their pleiotropic effects, including weight loss, improved survival and reduced risk of major cardiovascular and renal events. In vitro and preclinical in vivo experiments in arthritis have uncovered weight-loss-independent anti-inflammatory and chondroprotective properties of GLP-1RAs. In knee OA, clinical data suggest that GLP-1RAs improve pain and function and reduce the risk of surgical intervention; however, their effects on OA incidence remain incompletely understood. Evidence suggests that GLP-1RAs do not directly prevent gout attacks, but are effective in managing cardiometabolic conditions commonly associated with gout and other arthritides. More research is needed to clarify the effects of GLP-1RAs on incidence, disease activity, and progression of rheumatoid arthritis, psoriatic arthritis and axial spondyloarthritis. Evidence is emerging that glucagon-like peptide-1 (GLP-1) receptor agonists have anti-inflammatory and chondroprotective properties independent of their effects on weight loss. In this Review, the authors discuss the potential effects of GLP-1 receptor agonists on the incidence, disease activity and progression of various forms of arthritis, as well as practical considerations for their use in this context.","PeriodicalId":18810,"journal":{"name":"Nature Reviews Rheumatology","volume":"21 11","pages":"671-683"},"PeriodicalIF":32.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145203712","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-10-01DOI: 10.1038/s41584-025-01313-x
Maria Papatriantafyllou
Infused lipid nanoparticles were successfully used to generate CAR-T cells in patients with refractory systemic lupus erythematosus, achieving B cell depletion.
输注脂质纳米颗粒成功用于难治性系统性红斑狼疮患者产生CAR-T细胞，实现B细胞耗竭。
{"title":"In vivo CAR-T cell engineering in refractory SLE","authors":"Maria Papatriantafyllou","doi":"10.1038/s41584-025-01313-x","DOIUrl":"10.1038/s41584-025-01313-x","url":null,"abstract":"Infused lipid nanoparticles were successfully used to generate CAR-T cells in patients with refractory systemic lupus erythematosus, achieving B cell depletion.","PeriodicalId":18810,"journal":{"name":"Nature Reviews Rheumatology","volume":"21 12","pages":"697-697"},"PeriodicalIF":32.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145203878","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
京公网安备 11010802042870号
京ICP备2023020795号-1
扫码关注我们
求助内容：
应助结果提醒方式：