Seminars in arthritis and rheumatism最新文献

英文中文

Biologic switching challenges in psoriatic arthritis: A pediatric reflection, letter to "biologic switching in psoriatic arthritis: Insights from real-world data and key risk factors" 银屑病关节炎的生物转换挑战：儿科反思，致“银屑病关节炎的生物转换：来自现实世界数据和关键危险因素的见解”的信

IF 4.4 2区医学 Q1 RHEUMATOLOGY

Seminars in arthritis and rheumatism

Pub Date : 2026-04-01 Epub Date: 2026-01-01 DOI: 10.1016/j.semarthrit.2025.152910

Sıla Atamyıldız Uçar, Eray Tunce, Betül Sözeri

引用次数: 0

The efficacy of metformin for pain, function, and quality of life in knee osteoarthritis: A systematic review and meta-analysis 二甲双胍对膝关节骨关节炎患者疼痛、功能和生活质量的疗效：一项系统回顾和荟萃分析

IF 4.4 2区医学 Q1 RHEUMATOLOGY

Seminars in arthritis and rheumatism

Pub Date : 2026-04-01 Epub Date: 2025-12-31 DOI: 10.1016/j.semarthrit.2025.152908

Chi-Lan Kao , Shih-Ming Chen , Chih-Cheng Hsieh , Tzu-Rong Peng , Pei-Yun Tsai , Chia-Yu Lin , Ming-Chia Lee

Background

Knee osteoarthritis (KOA) is a leading cause of disability worldwide; however current therapies offer only symptomatic relief. Metformin, a widely used antidiabetic agent, has been demonstrated to have anti-inflammatory and chondroprotective effects in preclinical models, suggesting its KOA modifying properties.

Methods

We conducted a systematic review and meta-analysis of randomized controlled trials evaluating the effects of metformin in patients with KOA. A comprehensive search of PubMed, Embase, and Cochrane Library was performed up to May 2025. Two reviewers independently screened studies and extracted data. Statistical analyses were conducted using a random-effects model to account for between-study heterogeneity. Subgroup analyses based on formulation, treatment duration, and nonsteroidal anti-inflammatory drugs (NSAIDs) co-administration were also performed.

Results

Five studies (n = 337) were included. Metformin significantly reduced pain scores (standardized mean difference [SMD] = −1.295; 95 % confidence interval [CI]: −2.063 to −0.526) and stiffness (SMD = −0.746; 95 % CI: −1.385 to −0.107), improved physical function (SMD = −2.042; 95 % CI: −3.372 to −0.712), and health-related quality of life (SMD = −1.505; 95 % CI: −2.896 to −0.115). Effects were consistent regardless of oral or topical metformin use, treatment duration, and NSAID use, although the benefits were greater when metformin was combined with NSAIDs.

Conclusion

While metformin demonstrated consistent benefits in pain and functional outcomes, these findings should be interpreted as symptomatic and adjunctive effects rather than definitive disease modification. Future trials incorporating structural endpoints are needed to confirm disease-modifying potential.

膝骨关节炎（KOA）是世界范围内致残的主要原因；然而，目前的治疗只能缓解症状。二甲双胍是一种广泛使用的降糖药，在临床前模型中已被证明具有抗炎和软骨保护作用，表明其具有改变KOA的特性。方法对评价二甲双胍对KOA患者疗效的随机对照试验进行系统回顾和荟萃分析。对PubMed， Embase和Cochrane Library进行了全面的检索，直至2025年5月。两位审稿人独立筛选研究并提取数据。采用随机效应模型进行统计分析，以解释研究间的异质性。基于处方、治疗时间和非甾体抗炎药（NSAIDs）联合使用的亚组分析也进行了。结果纳入5项研究（n = 337）。二甲双胍显著降低了疼痛评分（标准化平均差[SMD] = - 1.295； 95%可信区间[CI]: - 2.063至- 0.526）和僵硬（SMD = - 0.746; 95% CI: - 1.385至- 0.107），改善了身体功能（SMD = - 2.042; 95% CI: - 3.372至- 0.712），以及与健康相关的生活质量（SMD = - 1.505; 95% CI: - 2.896至- 0.115）。无论口服或外用二甲双胍、治疗持续时间和使用非甾体抗炎药，效果都是一致的，尽管二甲双胍与非甾体抗炎药联合使用的效果更大。结论：虽然二甲双胍在疼痛和功能结局方面表现出一致的益处，但这些发现应被解释为症状和辅助作用，而不是确定的疾病改变。未来的试验需要结合结构终点来确认疾病改善的潜力。

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引用次数: 0

Adequacy of trial registration and consistency in outcome reporting in rheumatology RCTs: A meta-research study 风湿病随机对照试验中试验注册的充分性和结果报告的一致性：一项meta研究

IF 4.4 2区医学 Q1 RHEUMATOLOGY

Seminars in arthritis and rheumatism

Pub Date : 2026-04-01 Epub Date: 2026-01-22 DOI: 10.1016/j.semarthrit.2026.152926

Diana Buitrago-Garcia , Samia Mehouachi , Thomas Agoritsas , Michele Iudici , Denis Mongin

Introduction

Transparent reporting of randomized controlled trials (RCTs) is essential to ensure research integrity. While registration practices of RCTs are improving, concerns remain regarding the adequacy of outcome registration and the consistency of outcome reporting in publications.

Objectives

To evaluate the adequacy of primary outcome registration and the consistency of outcome reporting between registry entries and publications in rheumatology RCTs.

Methods

We conducted a meta-research study including primary reports of RCTs in rheumatology published from 2009 to 2022. We assessed whether primary outcomes were adequately registered (presence of SPIRIT-based criteria: measurement, analysis metric, and time points). For adequately registered outcomes, we evaluated consistency between the registry and the published report. Logistic regression was used to explore factors associated with inadequate registration and inconsistent reporting.

Results

We analyzed 947 RCTs involving 1679 primary outcomes. Only 38% of trials adequately described all their primary outcomes in the registry. Of these adequately registered trials, 67% reported their primary outcomes consistently in the corresponding publication, meaning just 25% of trials met both criteria. The most common gap in outcome description was missing participant-level analysis metric, while the most prevalent inconsistency was related to changes in the timing of outcome assessment.

Registration of adequately described primary outcome improved between 2009 and 2013 before plateauing, while consistency in reporting showed no improvement over time.

Conclusion

Despite improvements in trial registration practices, major gaps persist in outcome specification and reporting consistency in rheumatology RCTs.

透明的随机对照试验（RCTs）报告对于确保研究的完整性至关重要。虽然随机对照试验的注册实践正在改进，但结果注册的充分性和出版物中结果报告的一致性仍然令人担忧。目的评价风湿病随机对照试验中主要结局登记的充分性以及登记条目和出版物之间结局报告的一致性。方法我们进行了一项荟萃研究，包括2009年至2022年风湿病学发表的随机对照试验的主要报告。我们评估了主要结果是否被充分登记（是否存在基于spirits的标准：测量、分析度量和时间点）。为了充分登记的结果，我们评估了登记和发表报告之间的一致性。Logistic回归用于探讨与不充分登记和不一致报告相关的因素。我们分析了947项随机对照试验，涉及1679个主要结局。只有38%的试验在登记中充分描述了所有的主要结果。在这些充分注册的试验中，67%的试验在相应的出版物中一致地报告了其主要结果，这意味着只有25%的试验符合两个标准。结果描述中最常见的差距是缺少参与者水平的分析指标，而最普遍的不一致与结果评估时间的变化有关。2009年至2013年期间，充分描述的主要结局的登记在趋于稳定之前有所改善，而报告的一致性没有随着时间的推移而改善。结论：尽管试验注册实践有所改进，但在风湿病随机对照试验的结果规范和报告一致性方面仍存在主要差距。

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引用次数: 0

Risk and temporal trends of heart failure subtype risk in Rheumatoid Arthritis 类风湿关节炎心衰亚型风险的风险和时间趋势

IF 4.4 2区医学 Q1 RHEUMATOLOGY

Seminars in arthritis and rheumatism

Pub Date : 2026-04-01 Epub Date: 2025-12-30 DOI: 10.1016/j.semarthrit.2025.152905

Tate M. Johnson , Bryant R. England

引用次数: 0

Correspondence to 'Nailfold capillaroscopy as a predictor of major cardiovascular events and mortality in systemic sclerosis' 对应于“甲襞毛细血管镜检查作为系统性硬化症主要心血管事件和死亡率的预测指标”

IF 4.4 2区医学 Q1 RHEUMATOLOGY

Seminars in arthritis and rheumatism

Pub Date : 2026-04-01 Epub Date: 2026-01-10 DOI: 10.1016/j.semarthrit.2026.152915

Yanxia Chen , Jinlin Liu

引用次数: 0

Exploring the association between adiposity, pain intensity, and effusion-synovitis in people with knee osteoarthritis: A cross-sectional study 探讨膝关节骨关节炎患者肥胖、疼痛强度和积液性滑膜炎之间的关系：一项横断面研究

IF 4.4 2区医学 Q1 RHEUMATOLOGY

Seminars in arthritis and rheumatism

Pub Date : 2026-04-01 Epub Date: 2026-01-04 DOI: 10.1016/j.semarthrit.2026.152913

YV Raghava Neelapala , C Thomas Appleton , Luciana Macedo , Steve Hanna , Dylan Kobsar , Trevor B Birmingham , Lisa C. Carlesso

Objectives

To examine (i) the association of adiposity with pain intensity and/or effusion-synovitis in people with knee osteoarthritis (OA), adjusting for body mass index (BMI), and (ii) whether indicators of systemic immune inflammation (i.e., the systemic immune-inflammation index (SII) and the systemic immune response index (SIRI)) moderate the above associations.

Methods

Individuals with knee OA were sampled from the Western Ontario Registry for Early Osteoarthritis Knee Study. Total body and visceral fat percentages were measured using bioimpedance analysis, and effusion-synovitis was graded using knee ultrasonography. Multiple regression models with interaction terms were used to examine the association between fat percentages and pain intensity (linear)/effusion-synovitis (logistic), and the interaction effect of fat and SII/SIRI on pain intensity/effusion-synovitis. The analyses were adjusted for confounders (age, sex, BMI, radiographic severity of the opposite knee, and anxio-depressive symptoms).

Results

Data from 225 participants (mean age: 61.1 (10.9), 68% female, mean BMI: 31.7 (7.7)) were analyzed. The associations for adjusted fat and pain intensity models were as follows: total body fat: β): - 0.03 (-0.54 to 0.46) and visceral fat: β (: -0.25 (-1.03 to 0.51)., The odds ratios for adjusted fat and effusion-synovitis models were total body fat: OR): 0.98 (0.92 to 1.05) and visceral fat: OR (): 1.01 (0.91 to 1.11)). Neither the main nor the interaction effects were significant.

Conclusion

Our preliminary results do not support an association of adiposity and its interaction with generalized inflammation with pain/effusion-synovitis adjusted for BMI. Further studies are needed.

目的研究(i)肥胖与膝关节骨性关节炎（OA）患者疼痛强度和/或积液性滑膜炎的相关性，调整体重指数（BMI），以及（ii）系统性免疫炎症指标（即系统性免疫炎症指数（SII）和系统性免疫反应指数（SIRI））是否调节上述相关性。方法从安大略省西部早期骨关节炎膝关节研究登记处抽取患有膝关节炎的个体。使用生物阻抗分析测量全身和内脏脂肪百分比，并使用膝关节超声检查对积液-滑膜炎进行分级。采用带交互项的多元回归模型检验脂肪百分比与疼痛强度（线性）/积液-滑膜炎（logistic）之间的关系，以及脂肪和SII/SIRI对疼痛强度/积液-滑膜炎的交互作用。根据混杂因素（年龄、性别、BMI、对侧膝关节的放射学严重程度和焦虑抑郁症状）对分析进行了调整。结果225名参与者(平均年龄：61.1（10.9)，68%为女性，平均BMI: 31.7(7.7)）的数据被分析。调整后的脂肪和疼痛强度模型的相关性如下：全身脂肪：β): - 0.03(-0.54 ~ 0.46)，内脏脂肪：β(: -0.25（-1.03 ~ 0.51）。调整脂肪和积液-滑膜炎模型的比值比为：全身脂肪：OR: 0.98(0.92 ~ 1.05)，内脏脂肪：OR(): 1.01（0.91 ~ 1.11）。主效应和交互效应均不显著。结论：我们的初步结果不支持肥胖及其与全身炎症（疼痛/积液-滑膜炎）的相互作用的关联。需要进一步的研究。

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引用次数: 0

Response to Wang regarding correspondence to “Development of a prediction model for progression of rheumatoid arthritis-associated interstitial lung disease using serologic and clinical factors: The prospective KORAIL cohort” 对Wang对《基于血清学和临床因素的类风湿关节炎相关间质性肺病进展预测模型的建立：KORAIL前瞻性队列》的回应

IF 4.4 2区医学 Q1 RHEUMATOLOGY

Seminars in arthritis and rheumatism

Pub Date : 2026-04-01 Epub Date: 2026-01-23 DOI: 10.1016/j.semarthrit.2026.152931

Sung Hae Chang , Misti L. Paudel , Eun Young Lee , Jeffrey A. Sparks

引用次数: 0

Re: comment on: Miedany et al. response letter: Beyond the symptoms: personalizing giant cell arteritis care through multidimensional patient reported outcome measure. Volume 75, December 2025, 152844 回复：评论：Miedany等人的回应信：超越症状：通过多维患者报告的结果测量个性化巨细胞动脉炎护理。第75卷，2025年12月，152844。

IF 4.4 2区医学 Q1 RHEUMATOLOGY

Seminars in arthritis and rheumatism

Pub Date : 2026-04-01 Epub Date: 2026-01-11 DOI: 10.1016/j.semarthrit.2026.152919

JC Robson , J Dawson , SL Mackie , M Ndosi

引用次数: 0

Disease activity and hyperuricemia predict the development of cardiovascular events in patients with Psoriatic Arthritis: results of the 10-year prospective evaluation in the CARMA cohort 疾病活动性和高尿酸血症预测银屑病关节炎患者心血管事件的发展：CARMA队列10年前瞻性评估结果

IF 4.4 2区医学 Q1 RHEUMATOLOGY

Seminars in arthritis and rheumatism

Pub Date : 2026-04-01 Epub Date: 2026-01-11 DOI: 10.1016/j.semarthrit.2026.152923

Javier Llorca , Iván Ferraz-Amaro , María José Moreno-Martínez , Zulema Plaza , Fernando Sánchez-Alonso , Manuel José Moreno-Ramos , Carmen García-Gómez , Santos Castañeda , Carlos González-Juanatey , Miguel Ángel González-Gay

Objective

To identify predictors of cardiovascular (CV) events in psoriatic arthritis (PsA) patients from the CARdiovascular in RheuMAtology (CARMA) project during 10 years of prospective follow-up.

Methods

Between July 2010 and January 2012, 725 PsA patients were enrolled from 67 Spanish hospitals. Analyses focused on 682 patients without prior CV events at baseline. At 10-year follow-up, CV event occurrence, patient-years, and linearized event rates were evaluated. Cox regression analyses were performed, both crude and adjusted for the PREVENT-CVD score.

Results

Over 6397 patient-years, 85 patients (12.46%) experienced CV events, yielding a rate of 1.33 per 100 patient-years. Patients with CV events were older (67.1 ± 11.1 vs. 56.7 ± 11.8 years, p < 0.001), more often male (68.2% vs. 51.9%, p = 0.005), and had higher frequencies of hypertension (60.0% vs. 21.8%, p < 0.001), diabetes (18.8% vs. 6.0%, p = 0.001), and dyslipidemia (56.5% vs. 29.8%, p < 0.001). They also showed greater abdominal perimeter and body mass index (p < 0.05 for both). After adjusting for PREVENT-CVD, the highest tertile of DAS28-ESR remained a significant predictor of CV events (HR 1.79; 95%CI: 1.03–3.14; p = 0.04). Urate in the highest tertile was also independently associated in the crude model (HR 1.88; 95%CI: 1.11–3.20; p = 0.02). When stratified (<6.5, 6.5–8.9, and ≥9.0 mg/dl), urate≥9.0 mg/dl was also associated with increased risk of CV events in the adjusted model (HR 3.50; 95%CI: 1.10–11.2; p = 0.02). While HAQ score in the third tertile was associated with increased CV risk in the crude analysis (HR 1.70; p = 0.04), this association did not persist after adjustment.

Conclusions

Disease activity and elevated urate levels independently predict CV events in PsA, highlighting their value as markers of CV risk beyond traditional factors captured by the PREVENT-CVD score.

目的从风湿病心血管（CARMA）项目中确定10年前瞻性随访期间银屑病关节炎（PsA）患者心血管（CV）事件的预测因素。方法2010年7月至2012年1月，来自西班牙67家医院的725例PsA患者入组。分析集中在682例基线时无CV事件的患者。在10年随访中，评估CV事件发生率、患者年数和线性化事件发生率。对prevention - cvd评分进行原始和校正Cox回归分析。结果在6397患者-年的研究中，85例患者（12.46%）经历了CV事件，发生率为1.33 / 100患者-年。发生CV事件的患者年龄较大（67.1±11.1比56.7±11.8岁，p < 0.001），男性较多（68.2%比51.9%,p = 0.005），高血压（60.0%比21.8%,p < 0.001）、糖尿病（18.8%比6.0%,p = 0.001）和血脂异常（56.5%比29.8%,p < 0.001）的发生率较高。他们也表现出更大的腹围和体重指数（p < 0.05）。在调整了prevention - cvd后，DAS28-ESR的最高分位数仍然是CV事件的重要预测因子（HR 1.79; 95%CI: 1.03-3.14; p = 0.04）。在粗模型中，最高类别的尿酸盐也独立相关（HR 1.88; 95%CI: 1.11-3.20; p = 0.02）。当分层（<6.5, 6.5 - 8.9和≥9.0 mg/dl）时，在调整模型中，尿酸≥9.0 mg/dl也与CV事件风险增加相关（HR 3.50; 95%CI: 1.10-11.2; p = 0.02）。在粗分析中，第三分位数的HAQ评分与CV风险增加相关（HR 1.70; p = 0.04），但调整后这种关联不存在。结论：疾病活动性和尿酸水平升高独立预测PsA中CV事件，突出了它们作为CV风险标志物的价值，超越了prevention - cvd评分所捕获的传统因素。

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引用次数: 0

Determining the best discriminatory physical functioning outcome measurement instrument for psoriatic arthritis trials: A meta-epidemiological study 确定银屑病关节炎试验中最佳歧视性身体功能结果测量工具：一项荟萃流行病学研究。

IF 4.4 2区医学 Q1 RHEUMATOLOGY

Seminars in arthritis and rheumatism

Pub Date : 2026-04-01 Epub Date: 2025-12-29 DOI: 10.1016/j.semarthrit.2025.152907

Ying-Ying Leung , Tobias Haugegaard , Tommy Kok Annfeldt , Richard Holland , Vibeke Strand , Philip Mease , Peter Tugwell , George A. Wells , Beverley J. Shea , Ashish J. Mathew , Niti Goel , Christine Lindsay , Alexis Ogdie , Ana-Maria Orbai , Laura C. Coates , Dafna D. Gladman , William Tillett , Jeffrey Chau , Robin Christensen

Objectives

To empirically compare the discriminant capacities of three outcome measurement instruments for assessment of physical functioning for psoriatic arthritis (PsA): HAQ-DI, SF36-PF and SF36-PCS.

Methods

We applied a network meta-analysis technique in a sample of randomized trials (RCTs) for PsA. For randomized comparison, we calculated net effect size estimates for each outcome measurement instrument using standardized mean differences (SMDs); positive values indicated a beneficial effect of the intervention compared to the control groups. We analyzed the differences between outcome measurement instruments at the trial level by applying a multiple-treatment meta-analysis to compare the SMDs within and across randomized comparisons for each outcome measurement instrument.

Results

From 42 articles (31 RCTs), 57, 18, and 18 randomized comparisons enabled a direct comparison between HAQ-DI and SF36-PCS (difference in SMDs: 0.057, 95 % confidence interval, CI: 0.003 to 0.110), SF36-PF and SF36-PCS (difference in SMDs: 0.101, 95 % CI: 0.018 to 0.184); and HAQ-DI and SF36-PF (difference in SMDs:0.059, 95 % CI:0.142 to 0.024), respectively. The network meta-analysis technique confirmed that both HAQ-DI and SF36-PF were more responsive to change than SF36-PCS, with differences between SMDs of 0.057 (95 % CI: 0.003 to 0.110) and 0.109 (95 % CI: 0.032 to 0.185), respectively. No difference in discriminatory capacity between HAQ-DI and SF36-PF was noted.

Conclusions

HAQ-DI and SF-36-PF were equally responsive to change and superior to SF36-PCS in PsA RCTs. We illustrated a new method for quantitative comparison of the performance of different outcome measurement instruments for a particular domain.

目的：实证比较HAQ-DI、SF36-PF和SF36-PCS三种结果测量工具评估银屑病关节炎（PsA）身体功能的判别能力。方法：我们在PsA随机试验（rct）样本中应用网络荟萃分析技术。对于随机比较，我们使用标准化平均差异（SMDs）计算每个结果测量工具的净效应大小估计值；与对照组相比，正值表明干预的有益效果。我们在试验水平上分析了结果测量工具之间的差异，采用多治疗荟萃分析来比较每种结果测量工具的随机比较内部和之间的smd。结果：在42篇文章（31项随机对照试验）中，57、18和18项随机比较可以直接比较HAQ-DI和SF36-PCS （SMDs差异0.057,95%可信区间CI: 0.003至0.110）、SF36-PF和SF36-PCS (SMDs差异0.101,95%可信区间CI: 0.018至0.184)；HAQ-DI和SF36-PF （smd差异为0.059,95% CI为0.142 ~ 0.024）。网络荟萃分析技术证实，HAQ-DI和SF36-PF对变化的反应比SF36-PCS更敏感，smd之间的差异分别为0.057 （95% CI: 0.003至0.110）和0.109 （95% CI: 0.032至0.185）。HAQ-DI和SF36-PF之间的区分能力没有差异。结论：在PsA随机对照试验中，HAQ-DI和SF-36-PF对变化的反应相同，且优于SF36-PCS。我们说明了一种新的方法来定量比较不同的结果测量仪器的性能为特定领域。

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