Seminars in arthritis and rheumatism最新文献

Predictors of achieving clinical remission in ACPA-positive RA-patients treated with abatacept and methotrexate and methotrexate monotherapy: a post-hoc analysis of the AVERT and AVERT-II trials 阿巴接受联合甲氨蝶呤和甲氨蝶呤单药治疗的acpa阳性ra患者实现临床缓解的预测因素：对AVERT和AVERT- ii试验的事后分析

IF 4.4 2区医学 Q1 RHEUMATOLOGY

Seminars in arthritis and rheumatism

Pub Date : 2026-01-12 DOI: 10.1016/j.semarthrit.2026.152917

S.A. Bergstra, M. Verstappen, E. Niemantsverdriet, T.W.J. Huizinga, A.H.M. van der Helm-van Mil

Objective

To predict which early RA-patients achieve clinical remission on initial treatment with methotrexate monotherapy or with abatacept+methotrexate.

Methods

This study is a subanalysis of the AVERT and AVERT-2 randomized controlled trials, which were performed in ACPA-positive early RA-patients who received methotrexate monotherapy or abatacept + methotrexate. External model validation of patients on methotrexate monotherapy was performed in the observational Leiden Early Arthritis Clinic (EAC) cohort. Primary outcome was DAS28-CRP remission at 6 and 12 months follow-up. Prediction models were developed using logistic regression analysis. First, a model including clinical baseline variables only was estimated. Subsequently, it was assessed whether adding serological or imaging data, shared epitope or early DAS28 response improved model performance.

Results

In the methotrexate-monotherapy group (n=388), 27% and 39% of patients achieved DAS28-remission after 6 and 12-months. In the abatacept + methotrexate group (n=743) this was 43% and 53%. Baseline DAS28-CRP was predictive for clinical remission in all models. Optimism-adjusted model performance (AUROC) for DAS28-remission at 6 and 12-months was 0.66/0.65 in the methotrexate-group and 0.68/0.59 in the abatacept + methotrexate group. Adding baseline MRI-detected joint-inflammation, baseline serology or HLA-shared epitope alleles did not significantly improve model performance. Early DAS28-response did improve model performance. In the external validation cohort model performance was very similar.

Conclusion

Determining which patients achieve clinical remission upon methotrexate or abatacept+methotrexate treatment remains challenging. Disease activity at disease presentation and early DAS response were the only consistent predictors for achieving clinical remission. Genetic, imaging and serology parameters did not improve model performance.

目的预测早期ra患者在初始接受甲氨蝶呤单药治疗或阿巴接受+甲氨蝶呤治疗后获得临床缓解的情况。方法本研究是AVERT和AVERT-2随机对照试验的亚分析，这些试验是在acpa阳性的早期ra患者中进行的，他们接受甲氨蝶呤单药治疗或阿巴接受+甲氨蝶呤治疗。在Leiden早期关节炎诊所（EAC）观察队列中进行甲氨蝶呤单药治疗患者的外部模型验证。主要结局是随访6个月和12个月时DAS28-CRP缓解。采用logistic回归分析建立预测模型。首先，估计一个只包括临床基线变量的模型。随后，评估添加血清学或影像学数据、共享表位或早期DAS28反应是否改善了模型性能。结果甲氨蝶呤单药治疗组（388例）患者在6个月和12个月后das28缓解率分别为27%和39%。在阿巴接受+甲氨蝶呤组（n=743），这一比例分别为43%和53%。在所有模型中，基线DAS28-CRP可预测临床缓解。6个月和12个月时，甲氨蝶呤组das28缓解的乐观调整模型性能（AUROC）为0.66/0.65，阿巴接受特+甲氨蝶呤组为0.68/0.59。添加基线mri检测到的关节炎症、基线血清学或hla共享表位等位基因并没有显著改善模型的性能。早期das28反应确实改善了模型性能。在外部验证队列模型中，表现非常相似。结论确定哪些患者在甲氨蝶呤或阿巴接受+甲氨蝶呤治疗后获得临床缓解仍然具有挑战性。疾病出现时的疾病活动性和早期DAS反应是实现临床缓解的唯一一致预测因素。遗传、影像学和血清学参数对模型性能没有改善作用。

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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 : 2026-01-11 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

Alleviation of depression rather than pain predicts disease improvement in fibromyalgia patients with prominent psychological symptoms–a prospective observational study 缓解抑郁而不是疼痛预示着纤维肌痛患者有明显心理症状的疾病改善——一项前瞻性观察研究

IF 4.4 2区医学 Q1 RHEUMATOLOGY

Seminars in arthritis and rheumatism

Pub Date : 2026-01-11 DOI: 10.1016/j.semarthrit.2026.152920

Kuo-Wei Lee , Yi-On Fong , Yen-Ju Lin , Fu-Wen Liang , Meng-Ni Wu , Chiou-Lian Lai , Chih-Hsien Hung

Background

How depression and anxiety symptoms affect fibromyalgia (FM) phenotypes and initial treatment outcomes remains unclear. This study prospectively investigated the impact of psychological symptoms on disease manifestations and therapeutic responses in individuals with newly diagnosed FM.

Methods

FM patients and healthy controls were prospectively recruited and assessed with questionnaires measuring emotional symptoms and disease conditions. The effects of anxiety and depression symptoms on FM manifestations and therapeutic responses (using pregabalin with/without imipramine; no placebo control) were investigated using cluster, correlation, regression, and mediation analyses through a 4-week follow-up.

Results

One hundred twelve newly diagnosed FM cases were included. Based on their psychological symptoms, patients were classified into two subgroups exhibiting different phenotypes; patients with prominent anxiety and depression symptoms (FM-AD) had more intense pain, worse disease severity, and poorer therapeutic responses than those without (FM-nAD; all p < 0.001). Correlation analyses showed that, along with pain, both depression and anxiety symptoms crucially modulated disease severity (all p < 0.001). Although pain relief conduced clinical improvement overall, linear mixed-effect regression analysis denoted that depression remission (p = 0.039), but not pain reduction (p = 0.062), determined clinical improvement for FM-AD cases. Notably, depression remission exerted a direct impact (p = 0.003) on disease improvement in FM-AD cases, independent of pain reduction (indirect effect: p = 0.101).

Conclusion

Psychological symptoms, as much as pain, vitally determined disease severity in FM. For FM-AD individuals, alleviation of depression, rather than pain relief alone, pivotally predicted disease improvement. Early detecting and addressing depression in FM management could help with discriminating phenotypes, thereby improving FM care strategy.

背景：抑郁和焦虑症状如何影响纤维肌痛（FM）的表型和初始治疗结果尚不清楚。本研究前瞻性地探讨了心理症状对新诊断的FM患者的疾病表现和治疗反应的影响。方法前瞻性招募fm患者和健康对照者，采用情绪症状和疾病状况问卷进行评估。焦虑和抑郁症状对FM表现和治疗反应的影响（使用普瑞巴林加/不加丙咪嗪，无安慰剂对照）通过4周的随访，采用聚类、相关、回归和中介分析进行研究。结果共纳入112例新诊断的FM病例。根据患者的心理症状，将患者分为两个亚组，表现出不同的表型；有明显焦虑和抑郁症状（FM-AD）的患者比没有FM-AD的患者有更强烈的疼痛、更严重的疾病严重程度和更差的治疗反应（FM-nAD；均p <； 0.001）。相关分析显示，与疼痛一起，抑郁和焦虑症状对疾病严重程度起着至关重要的调节作用（均p <； 0.001）。虽然疼痛缓解总体上促进了临床改善，但线性混合效应回归分析表明，抑郁缓解（p = 0.039）而非疼痛减轻（p = 0.062）决定了FM-AD病例的临床改善。值得注意的是，抑郁缓解对FM-AD病例的疾病改善有直接影响（p = 0.003），独立于疼痛减轻（间接影响：p = 0.101）。结论FM患者的心理症状与疼痛一样，是决定病情严重程度的重要因素。对于FM-AD个体，抑郁的缓解，而不是疼痛的缓解，是预测疾病改善的关键。在FM管理中早期发现和处理抑郁症有助于区分表型，从而改善FM护理策略。

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引用次数: 0

Risk of ILD and safety outcomes across DMARD classes in rheumatoid arthritis and RA-ILD 类风湿性关节炎和RA-ILD的DMARD分级间ILD风险和安全性结局

IF 4.4 2区医学 Q1 RHEUMATOLOGY

Seminars in arthritis and rheumatism

Pub Date : 2026-01-11 DOI: 10.1016/j.semarthrit.2026.152921

Kyung-Ann Lee , Bora Lee , Hyun-Sook Kim

Objectives

To evaluate the risk of interstitial lung disease (ILD) and safety outcomes of disease-modifying antirheumatic drug (DMARD) classes in rheumatoid arthritis (RA), focusing on patients with RA-associated ILD (RA-ILD).

Methods

We conducted a nationwide cohort study using Korean National Health Insurance Service data (2011–2020). Adults with newly diagnosed RA prescribed at least one csDMARD were included and followed until 2022. Four treatment groups were evaluated: TNFi, non-TNFi biologics (abatacept, rituximab, tocilizumab), JAKi, and csDMARDs. RA-ILD was defined as ≥2 ILD claims plus chest computed tomography confirmation. Outcomes included ILD incidence, hospitalisation, infection, MACE, and all-cause mortality. Time-varying Cox models with inverse probability of treatment weighting were applied for first-event analyses.

Results

We analysed 26,120 patients with RA (209,852 treatment episodes), including 641 RA-ILD patients (1688 episodes). Adjusted ILD incidence was similar across DMARD classes. In RA and RA-ILD, non-TNFi biologics were associated with higher risks of hospitalisation (RA aHR 1.30, 95% CI 1.21–1.40; RA-ILD 1.35, 1.02–1.80), infection (RA 1.16, 1.05–1.28; RA-ILD 1.51, 1.06–2.15), and mortality (RA 4.09, 3.04–5.50; RA-ILD 4.31, 2.21–8.41) compared with csDMARDs. ILD-related admissions were similar, but pneumonia-related hospitalisations and recurrences were higher with non-TNFi biologics. TNFi and JAKi showed no significant associations with hospitalisation or infection. MACE risk did not differ across groups.

Conclusions

DMARD class was not associated with ILD incidence or ILD-related hospitalisation. Non-TNFi biologics were consistently linked to increased pneumonia-related hospitalisation, recurrence, and mortality, highlighting the need for close infection monitoring in patients receiving these agents.

目的评估类风湿关节炎（RA）患者间质性肺疾病（ILD）的风险和改善疾病的抗风湿药物（DMARD）类别的安全性结果，重点关注RA相关ILD （RA-ILD）患者。方法：我们使用韩国国民健康保险服务数据（2011-2020）进行了一项全国性队列研究。新诊断的RA患者至少服用一种csDMARD，随访至2022年。评估四个治疗组：TNFi、非TNFi生物制剂（阿巴接受、利妥昔单抗、托珠单抗）、JAKi和csDMARDs。RA-ILD定义为≥2例ILD声明加上胸部计算机断层扫描证实。结果包括ILD发生率、住院率、感染、MACE和全因死亡率。采用逆概率处理加权的时变Cox模型进行首次事件分析。结果我们分析了26,120例RA患者（209,852次治疗），其中641例RA- ild患者（1688次）。调整后的ILD发病率在不同的DMARD类别中相似。在RA和RA- ild中，与csDMARDs相比，非tnfi生物制剂与更高的住院风险（RA aHR 1.30, 95% CI 1.21-1.40; RA- ild 1.35, 1.02-1.80）、感染（RA 1.16, 1.05-1.28; RA- ild 1.51, 1.06-2.15）和死亡率（RA 4.09, 3.04-5.50; RA- ild 4.31, 2.21-8.41）相关。与ild相关的入院率相似，但与肺炎相关的住院率和非tnfi生物制剂的复发率更高。TNFi和JAKi与住院或感染无显著相关性。MACE风险在各组间没有差异。结论sdmard分级与ILD发病率或ILD相关住院无关。非tnfi生物制剂一直与肺炎相关住院、复发和死亡率增加有关，强调了对接受这些药物的患者进行密切感染监测的必要性。

{"title":"Risk of ILD and safety outcomes across DMARD classes in rheumatoid arthritis and RA-ILD","authors":"Kyung-Ann Lee , Bora Lee , Hyun-Sook Kim","doi":"10.1016/j.semarthrit.2026.152921","DOIUrl":"10.1016/j.semarthrit.2026.152921","url":null,"abstract":"<div><h3>Objectives</h3><div>To evaluate the risk of interstitial lung disease (ILD) and safety outcomes of disease-modifying antirheumatic drug (DMARD) classes in rheumatoid arthritis (RA), focusing on patients with RA-associated ILD (RA-ILD).</div></div><div><h3>Methods</h3><div>We conducted a nationwide cohort study using Korean National Health Insurance Service data (2011–2020). Adults with newly diagnosed RA prescribed at least one csDMARD were included and followed until 2022. Four treatment groups were evaluated: TNFi, non-TNFi biologics (abatacept, rituximab, tocilizumab), JAKi, and csDMARDs. RA-ILD was defined as ≥2 ILD claims plus chest computed tomography confirmation. Outcomes included ILD incidence, hospitalisation, infection, MACE, and all-cause mortality. Time-varying Cox models with inverse probability of treatment weighting were applied for first-event analyses.</div></div><div><h3>Results</h3><div>We analysed 26,120 patients with RA (209,852 treatment episodes), including 641 RA-ILD patients (1688 episodes). Adjusted ILD incidence was similar across DMARD classes. In RA and RA-ILD, non-TNFi biologics were associated with higher risks of hospitalisation (RA aHR 1.30, 95% CI 1.21–1.40; RA-ILD 1.35, 1.02–1.80), infection (RA 1.16, 1.05–1.28; RA-ILD 1.51, 1.06–2.15), and mortality (RA 4.09, 3.04–5.50; RA-ILD 4.31, 2.21–8.41) compared with csDMARDs. ILD-related admissions were similar, but pneumonia-related hospitalisations and recurrences were higher with non-TNFi biologics. TNFi and JAKi showed no significant associations with hospitalisation or infection. MACE risk did not differ across groups.</div></div><div><h3>Conclusions</h3><div>DMARD class was not associated with ILD incidence or ILD-related hospitalisation. Non-TNFi biologics were consistently linked to increased pneumonia-related hospitalisation, recurrence, and mortality, highlighting the need for close infection monitoring in patients receiving these agents.</div></div>","PeriodicalId":21715,"journal":{"name":"Seminars in arthritis and rheumatism","volume":"77 ","pages":"Article 152921"},"PeriodicalIF":4.4,"publicationDate":"2026-01-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145978981","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

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 : 2026-01-10 DOI: 10.1016/j.semarthrit.2026.152915

Yanxia Chen , Jinlin Liu

引用次数: 0

Correspondence to ‘Development of a prediction model for progression of rheumatoid arthritis-associated interstitial lung disease using serologic and clinical factors’ 对应于“利用血清学和临床因素开发类风湿关节炎相关间质性肺病进展的预测模型”。

IF 4.4 2区医学 Q1 RHEUMATOLOGY

Seminars in arthritis and rheumatism

Pub Date : 2026-01-07 DOI: 10.1016/j.semarthrit.2026.152914

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 : 2026-01-04 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 Chen and Liu 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Chen和Liu关于“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：前瞻性KORAIL队列”的回应。

IF 4.4 2区医学 Q1 RHEUMATOLOGY

Seminars in arthritis and rheumatism

Pub Date : 2026-01-03 DOI: 10.1016/j.semarthrit.2026.152912

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

引用次数: 0

COVID-19 vaccination and systemic autoimmune rheumatic diseases: No evidence of disproportionately increased reporting in VAERS COVID-19疫苗接种和系统性自身免疫性风湿病：无证据表明VAERS报告比例增加。

IF 4.4 2区医学 Q1 RHEUMATOLOGY

Seminars in arthritis and rheumatism

Pub Date : 2026-01-02 DOI: 10.1016/j.semarthrit.2025.152911

Jacopo Ciaffi , Ginevra Torrigiani , Piero Ruscitti , Antonella Zambon , Francesco Ursini

Objectives

To investigate whether systemic autoimmune rheumatic diseases (SARDs) were disproportionately reported as adverse events following COVID-19 vaccination compared with other vaccines, using data from the Vaccine Adverse Event Reporting System (VAERS).

Methods

We conducted a retrospective disproportionality analysis of VAERS reports collected between December 2020 and December 2024. Reports were identified using a structured query based on MedDRA terms for specific SARDs, including polymyalgia rheumatica, giant cell arteritis, systemic lupus erythematosus, systemic sclerosis, Sjögren’s syndrome, myositis, and other vasculitides. For each disease, the proportional reporting ratio (PRR), reporting odds ratio (ROR), and Bayesian information component (IC) were calculated, comparing COVID-19 vaccines (BNT162b2, mRNA-1273, Ad26.COV2.S) with all other vaccines in VAERS. Analyses were further stratified by sex to explore consistency.

Results

Among approximately 680,000 valid adverse event reports, encompassing both COVID-19 and non–COVID-19 vaccines, no significant disproportionality signal was identified for any SARD. Polymyalgia rheumatica, giant cell arteritis, systemic lupus erythematosus, systemic sclerosis, Sjögren’s syndrome, and myositis showed no evidence of disproportionate reporting following COVID-19 vaccination. The category “other vasculitides” displayed a lower reporting frequency following COVID-19 vaccination compared with other vaccines. Stratified analyses yielded consistent findings across sex subgroups.

Conclusion

In a large national pharmacovigilance dataset, COVID-19 vaccines were not associated with a disproportionate increase in reports of any SARD. These results support the favorable safety profile of COVID-19 vaccines with respect to autoimmune rheumatic events, while highlighting the value of ongoing post-marketing surveillance for rare immune-mediated reactions.

目的：利用疫苗不良事件报告系统（VAERS）的数据，调查与其他疫苗相比，系统性自身免疫性风湿病（SARDs）作为COVID-19疫苗接种后不良事件的报告是否不成比例。方法：对2020年12月至2024年12月收集的VAERS报告进行回顾性歧化分析。使用基于MedDRA术语的结构化查询来识别特定SARDs的报告，包括风湿性多肌痛、巨细胞动脉炎、系统性红斑狼疮、系统性硬化症、Sjögren综合征、肌炎和其他血管疾病。对每种疾病计算比例报告比（PRR）、报告优势比（ROR）和贝叶斯信息分量（IC），比较COVID-19疫苗（BNT162b2、mRNA-1273、Ad26.COV2）。S)与所有其他VAERS疫苗。进一步按性别分层分析以探讨一致性。结果：在约68万份有效不良事件报告中，包括COVID-19和非COVID-19疫苗，未发现任何SARD的显著歧化信号。风湿病多肌痛、巨细胞动脉炎、系统性红斑狼疮、系统性硬化症、Sjögren综合征和肌炎在COVID-19疫苗接种后没有不成比例的报告证据。与其他疫苗相比，COVID-19疫苗接种后“其他血管”类别的报告频率较低。分层分析得出了跨性别亚组的一致结果。结论：在一个大型的国家药物警戒数据集中，COVID-19疫苗与任何SARD报告的不成比例的增加无关。这些结果支持了COVID-19疫苗在自身免疫性风湿病事件方面的良好安全性，同时强调了对罕见免疫介导反应进行持续上市后监测的价值。

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引用次数: 0

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 : 2026-01-01 DOI: 10.1016/j.semarthrit.2025.152910

Sıla Atamyıldız Uçar, Eray Tunce, Betül Sözeri

引用次数: 0