首页 > 最新文献

Seminars in arthritis and rheumatism最新文献

英文 中文
IgG4 related coronary artery involvement: A scoping review of the literature IgG4相关冠状动脉受累:文献综述
IF 4.4 2区 医学 Q1 RHEUMATOLOGY Pub Date : 2026-01-23 DOI: 10.1016/j.semarthrit.2026.152925
Francesco Carubbi , Alessia Alunno , Salvatore Di Bartolomeo , Maria Ester Carugno , Fabiana Di Vincenzo , Marianna Litterio , Claudio Ferri

Objectives

Immunoglobulin (Ig)G4-related disease (IgG4-RD) can affect any organ, but coronary artery involvement (CAI) is a potentially life-threatening manifestation of this disease. In this scoping review, we critically appraised the literature on IgG4-related CAI, aiming to explore clinical, radiological and histopathological characteristics as well as treatment strategies and prognosis.

Methods

A comprehensive search was performed on January 02, 2025 in PubMed® to identify studies describing individuals with IgG4-related CAI, including both coronaritis (true arteritis of the coronary vessel wall) and periarteritis (peri-coronary involvement), and considering case reports, case series, retrospective cohort studies and observational studies. Two reviewers independently conducted the revision of literature under the guidance of the methodologist to identify eligible studies. Data extraction included clinical presentation, imaging findings, histopathology, treatment, and outcomes. Given the heterogeneity of the studies, descriptive statistical analysis was used whenever possible to summarise the data.

Results

Out of 964 screened references, 143 articles met the above-mentioned inclusion criteria. Most CAI cases were included in case reports (90.2 %), 7 % in case series and 2.8 % in retrospective cohort studies or observational studies. CAI predominantly affected males in the sixth decade of life and frequently coexisted with aortic and large vessel involvement. All segments of the coronary arterial tree could be involved, even the smallest branches. Images detected by various methods revealed several types of lesions: stenosis, wall-thickening, aneurysm, ectasia, pseudotumor, pseudoaneurysm, dissection, and soft tissue masses. Increase serum IgG4 levels and increased inflammatory markers were reported. Histopathology was consistent with IgG4-RD in all coronary samples obtained. Glucocorticoid therapy, alone or combined with immunosuppressants and/or surgical interventions, was the most commonly reported treatment. Rituximab seemed to be an effective therapy for IgG4-related CAI even without associated glucocorticoids. Despite treatment, relapse and progression of coronary lesions were noted in some cases.

Conclusions

Early identification and multidisciplinary management og IgG4-related CAI are crucial to reduce morbidity and mortality. Available data on the response to various treatments are limited, as dedicated coronary artery imaging was not consistently obtained soon enough after treatment to assess response. In addition, long-term follow-up was not available for all patients. Further studies are required to understand the real prevalence, natural history, optimal diagnostic strategies, and therapeutic approaches for this serious condition.
目的免疫球蛋白(Ig) g4相关疾病(IgG4-RD)可影响任何器官,但冠状动脉受累(CAI)是该疾病潜在的危及生命的表现。在这篇范围综述中,我们对igg4相关CAI的文献进行了批判性评价,旨在探讨临床、放射学和组织病理学特征以及治疗策略和预后。方法于2025年1月2日在PubMed®中进行全面检索,以确定描述igg4相关CAI个体的研究,包括冠状动脉炎(冠状动脉壁真动脉炎)和动脉周炎(冠状动脉周围受累),并考虑病例报告、病例系列、回顾性队列研究和观察性研究。两名审稿人在方法学家的指导下独立进行文献修订,以确定符合条件的研究。资料提取包括临床表现、影像学表现、组织病理学、治疗和结果。考虑到研究的异质性,尽可能使用描述性统计分析来总结数据。结果964篇文献中,有143篇符合上述纳入标准。大多数CAI病例被纳入病例报告(90.2%),7%被纳入病例系列,2.8%被纳入回顾性队列研究或观察性研究。CAI主要发生在60岁左右的男性,经常与主动脉和大血管并存。冠状动脉树的所有部分都可能受累,甚至是最小的分支。通过各种方法检测的图像显示了几种类型的病变:狭窄、壁增厚、动脉瘤、扩张、假瘤、假动脉瘤、夹层和软组织肿块。血清IgG4水平升高,炎症标志物升高。所有冠状动脉样本的组织病理学结果均与IgG4-RD一致。糖皮质激素治疗,单独或联合免疫抑制剂和/或手术干预,是最常见的治疗方法。即使没有相关的糖皮质激素,利妥昔单抗似乎也是igg4相关CAI的有效治疗方法。尽管治疗,在一些病例中冠状动脉病变复发和进展。结论igg4相关CAI的早期发现和多学科管理对降低发病率和死亡率至关重要。关于各种治疗反应的可用数据是有限的,因为在治疗后不能及时获得专门的冠状动脉成像来评估反应。此外,并非所有患者都有长期随访。需要进一步的研究来了解这种严重疾病的真实患病率、自然病史、最佳诊断策略和治疗方法。
{"title":"IgG4 related coronary artery involvement: A scoping review of the literature","authors":"Francesco Carubbi ,&nbsp;Alessia Alunno ,&nbsp;Salvatore Di Bartolomeo ,&nbsp;Maria Ester Carugno ,&nbsp;Fabiana Di Vincenzo ,&nbsp;Marianna Litterio ,&nbsp;Claudio Ferri","doi":"10.1016/j.semarthrit.2026.152925","DOIUrl":"10.1016/j.semarthrit.2026.152925","url":null,"abstract":"<div><h3>Objectives</h3><div>Immunoglobulin (Ig)G4-related disease (IgG4-RD) can affect any organ, but coronary artery involvement (CAI) is a potentially life-threatening manifestation of this disease. In this scoping review, we critically appraised the literature on IgG4-related CAI, aiming to explore clinical, radiological and histopathological characteristics as well as treatment strategies and prognosis.</div></div><div><h3>Methods</h3><div>A comprehensive search was performed on January 02, 2025 in PubMed® to identify studies describing individuals with IgG4-related CAI, including both coronaritis (true arteritis of the coronary vessel wall) and periarteritis (peri-coronary involvement), and considering case reports, case series, retrospective cohort studies and observational studies. Two reviewers independently conducted the revision of literature under the guidance of the methodologist to identify eligible studies. Data extraction included clinical presentation, imaging findings, histopathology, treatment, and outcomes. Given the heterogeneity of the studies, descriptive statistical analysis was used whenever possible to summarise the data.</div></div><div><h3>Results</h3><div>Out of 964 screened references, 143 articles met the above-mentioned inclusion criteria. Most CAI cases were included in case reports (90.2 %), 7 % in case series and 2.8 % in retrospective cohort studies or observational studies. CAI predominantly affected males in the sixth decade of life and frequently coexisted with aortic and large vessel involvement. All segments of the coronary arterial tree could be involved, even the smallest branches. Images detected by various methods revealed several types of lesions: stenosis, wall-thickening, aneurysm, ectasia, pseudotumor, pseudoaneurysm, dissection, and soft tissue masses. Increase serum IgG4 levels and increased inflammatory markers were reported. Histopathology was consistent with IgG4-RD in all coronary samples obtained. Glucocorticoid therapy, alone or combined with immunosuppressants and/or surgical interventions, was the most commonly reported treatment. Rituximab seemed to be an effective therapy for IgG4-related CAI even without associated glucocorticoids. Despite treatment, relapse and progression of coronary lesions were noted in some cases.</div></div><div><h3>Conclusions</h3><div>Early identification and multidisciplinary management og IgG4-related CAI are crucial to reduce morbidity and mortality. Available data on the response to various treatments are limited, as dedicated coronary artery imaging was not consistently obtained soon enough after treatment to assess response. In addition, long-term follow-up was not available for all patients. Further studies are required to understand the real prevalence, natural history, optimal diagnostic strategies, and therapeutic approaches for this serious condition.</div></div>","PeriodicalId":21715,"journal":{"name":"Seminars in arthritis and rheumatism","volume":"77 ","pages":"Article 152925"},"PeriodicalIF":4.4,"publicationDate":"2026-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146078672","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
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 Pub 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。
{"title":"Adequacy of trial registration and consistency in outcome reporting in rheumatology RCTs: A meta-research study","authors":"Diana Buitrago-Garcia ,&nbsp;Samia Mehouachi ,&nbsp;Thomas Agoritsas ,&nbsp;Michele Iudici ,&nbsp;Denis Mongin","doi":"10.1016/j.semarthrit.2026.152926","DOIUrl":"10.1016/j.semarthrit.2026.152926","url":null,"abstract":"<div><h3>Introduction</h3><div>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.</div></div><div><h3>Objectives</h3><div>To evaluate the adequacy of primary outcome registration and the consistency of outcome reporting between registry entries and publications in rheumatology RCTs.</div></div><div><h3>Methods</h3><div>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.</div></div><div><h3>Results</h3><div>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.</div><div>Registration of adequately described primary outcome improved between 2009 and 2013 before plateauing, while consistency in reporting showed no improvement over time.</div></div><div><h3>Conclusion</h3><div>Despite improvements in trial registration practices, major gaps persist in outcome specification and reporting consistency in rheumatology RCTs.</div></div>","PeriodicalId":21715,"journal":{"name":"Seminars in arthritis and rheumatism","volume":"77 ","pages":"Article 152926"},"PeriodicalIF":4.4,"publicationDate":"2026-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146078674","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
Risk factors for herpes zoster in patients with systemic lupus erythematosus 系统性红斑狼疮患者带状疱疹的危险因素
IF 4.4 2区 医学 Q1 RHEUMATOLOGY Pub Date : 2026-01-22 DOI: 10.1016/j.semarthrit.2026.152934
Arthur Mageau , Valdrin Shala , Clémence David , Tiphaine Goulenok , Thomas Papo , Pascale Nicaise-Roland , Karim Sacre

Introduction

International guidelines state that all immunocompromised adults should be vaccinated with the recombinant varicella zoster virus (VZV) vaccine. We aimed to assess the risk factors for herpes zoster (HZ) in patients with systemic lupus erythematosus (SLE).

Methods

Electronic medical records of all SLE patients registered at our referral centre were analysed at the time of clinical visit between July and December 2024. Demographic, medical history, laboratory and treatment data were extracted using a standardised data collection form. Herpes zoster incidence and associated factors were identified.

Results

A total of 224 SLE patients (female 93.8 %, median age 48 [38;56] years) were included. Of these, 30 (n = 30/224, 13.4 %) had HZ. The incidence was 0.81 for 100 patient-years. Univariable analysis showed that gamma globulin level (OR 0.81, 95 %CI 0.70–0.92), duration of steroid treatment (OR 1.07, 95 % CI 1.03–1.11), immunosuppressive (IS) drugs (OR 2.41, 95 % CI 1.06–6.05), duration of IS treatment (OR 1.05, 95 % CI 1.00–1.09) and biologics (OR 3.50, 95 % CI 1.53–7.93) were significantly associated with HZ. In a multivariable logistic regression analysis, only gamma globulin level (OR 0.86, 95 % CI 0.74–0.98) remained independently associated with HZ. The ROC curve for gamma globulin levels showed significant associations with HZ (AUC = 0.71 (0.59–0.82)), with a threshold of 10.3 g/L providing the best discrimination between SLE patients with and without HZ.

Conclusion

A reduced level gammaglobulin - with a cut-off of 10.3 g/L - is associated with HZ in SLE and may identify SLE patients who should be prioritized for VZV vaccination.
国际指南指出,所有免疫功能低下的成年人都应接种重组水痘带状疱疹病毒(VZV)疫苗。我们旨在评估系统性红斑狼疮(SLE)患者发生带状疱疹(HZ)的危险因素。方法对2024年7月至12月在我院转诊中心登记的所有SLE患者的电子病历进行分析。使用标准化数据收集表提取人口统计、病史、实验室和治疗数据。确定带状疱疹发病率及相关因素。结果共纳入224例SLE患者,女性占93.8%,中位年龄48[38;56]岁。其中30例(n = 30/224, 13.4%)患有HZ。100例患者年的发病率为0.81。单变量分析显示,γ球蛋白水平(OR 0.81, 95% CI 0.70-0.92)、类固醇治疗持续时间(OR 1.07, 95% CI 1.03-1.11)、免疫抑制(IS)药物(OR 2.41, 95% CI 1.06-6.05)、IS治疗持续时间(OR 1.05, 95% CI 1.00-1.09)和生物制剂(OR 3.50, 95% CI 1.53-7.93)与HZ显著相关。在多变量logistic回归分析中,只有丙种球蛋白水平(OR 0.86, 95% CI 0.74-0.98)仍然与HZ独立相关。γ -球蛋白水平的ROC曲线显示与HZ有显著相关性(AUC = 0.71 (0.59-0.82)), 10.3 g/L的阈值是区分合并和不合并HZ的SLE患者的最佳阈值。结论:降低的丙种球蛋白水平(临界值为10.3 g/L)与SLE患者的HZ相关,可以确定哪些SLE患者应该优先接种VZV疫苗。
{"title":"Risk factors for herpes zoster in patients with systemic lupus erythematosus","authors":"Arthur Mageau ,&nbsp;Valdrin Shala ,&nbsp;Clémence David ,&nbsp;Tiphaine Goulenok ,&nbsp;Thomas Papo ,&nbsp;Pascale Nicaise-Roland ,&nbsp;Karim Sacre","doi":"10.1016/j.semarthrit.2026.152934","DOIUrl":"10.1016/j.semarthrit.2026.152934","url":null,"abstract":"<div><h3>Introduction</h3><div>International guidelines state that all immunocompromised adults should be vaccinated with the recombinant varicella zoster virus (VZV) vaccine. We aimed to assess the risk factors for herpes zoster (HZ) in patients with systemic lupus erythematosus (SLE).</div></div><div><h3>Methods</h3><div>Electronic medical records of all SLE patients registered at our referral centre were analysed at the time of clinical visit between July and December 2024. Demographic, medical history, laboratory and treatment data were extracted using a standardised data collection form. Herpes zoster incidence and associated factors were identified.</div></div><div><h3>Results</h3><div>A total of 224 SLE patients (female 93.8 %, median age 48 [38;56] years) were included. Of these, 30 (<em>n</em> = 30/224, 13.4 %) had HZ. The incidence was 0.81 for 100 patient-years. Univariable analysis showed that gamma globulin level (OR 0.81, 95 %CI 0.70–0.92), duration of steroid treatment (OR 1.07, 95 % CI 1.03–1.11), immunosuppressive (IS) drugs (OR 2.41, 95 % CI 1.06–6.05), duration of IS treatment (OR 1.05, 95 % CI 1.00–1.09) and biologics (OR 3.50, 95 % CI 1.53–7.93) were significantly associated with HZ. In a multivariable logistic regression analysis, only gamma globulin level (OR 0.86, 95 % CI 0.74–0.98) remained independently associated with HZ. The ROC curve for gamma globulin levels showed significant associations with HZ (AUC = 0.71 (0.59–0.82)), with a threshold of 10.3 g/L providing the best discrimination between SLE patients with and without HZ.</div></div><div><h3>Conclusion</h3><div>A reduced level gammaglobulin - with a cut-off of 10.3 g/L - is associated with HZ in SLE and may identify SLE patients who should be prioritized for VZV vaccination.</div></div>","PeriodicalId":21715,"journal":{"name":"Seminars in arthritis and rheumatism","volume":"77 ","pages":"Article 152934"},"PeriodicalIF":4.4,"publicationDate":"2026-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146078669","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
Response to the letter for the editor by Sozeri B. et al 对Sozeri B.等人给编辑的信的回复。
IF 4.4 2区 医学 Q1 RHEUMATOLOGY Pub Date : 2026-01-22 DOI: 10.1016/j.semarthrit.2026.152930
Amir Haddad , Devy Zisman
{"title":"Response to the letter for the editor by Sozeri B. et al","authors":"Amir Haddad ,&nbsp;Devy Zisman","doi":"10.1016/j.semarthrit.2026.152930","DOIUrl":"10.1016/j.semarthrit.2026.152930","url":null,"abstract":"","PeriodicalId":21715,"journal":{"name":"Seminars in arthritis and rheumatism","volume":"77 ","pages":"Article 152930"},"PeriodicalIF":4.4,"publicationDate":"2026-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146113903","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
Reassessing the prevalence of monophasic, polyphasic and persistent disease courses in still’s disease 重新评估斯蒂尔氏病中单相、多相和持续性病程的患病率
IF 4.4 2区 医学 Q1 RHEUMATOLOGY Pub Date : 2026-01-22 DOI: 10.1016/j.semarthrit.2026.152928
Itay Marmor , Rotem Semo-Oz , Amir Hendel , Guy Hazan , Kevin Baszis , Anthony French , Cuoghi Edens , Irit Tirosh , Yonatan Butbul , Liora Harel , Gil Amarilyo

Objective

To classify Still’s disease (known as “systemic JIA”) course into monophasic, polyphasic and chronic-persistent disease, using data collected before and after the introduction of biologic IL-1/6 inhibitors, and identify predictors for a non-monophasic disease.

Methods

A multi-center, retrospective chart review from 3 hospitals in Israel and 2 in the US, involving patients diagnosed with Still’s disease between 1998–2021, with a minimum follow-up of 1 year.

Results

Eighty-two patients met the inclusion criteria, with a median follow up time of 2.8 years (1.1–17). Fifty-two (63.4%) were females; mean age at diagnosis was 6.4 ± 4.4 years. Fifty-nine (72%) were diagnosed in 2012 or later, when IL-1 and IL-6 inhibitors became widely used. The rates of monophasic, polyphasic and persistent disease were 34.1%, 46.3% and 19.5%, respectively, with a higher-than-expected rate of polyphasic disease. The proportion of a non-monophasic (polyphasic or persistent) disease decreased from 78.2% in cases diagnosed before 2012 to 61% in cases diagnosed after 2012 albeit not statistically significant (p = 0.22). In a multivariate logistic regression model, an active disease 3 months from diagnosis was an independent risk factor for a non-monophasic disease course (OR 4.16 [1.33–15.2], p = 0.02).

Conclusions

Drug-free remissions in chronic, non-monophasic Still’s disease may be more common than previously demonstrated. In the age of IL-1 and IL-6 inhibitors, a monophasic disease course may be more prevalent. This finding provides further evidence that cytokine blockers may potentially alter the natural history of this disease, and that early aggressive treatment may be warranted.
目的利用引入生物IL-1/6抑制剂前后收集的数据,将斯蒂尔氏病(称为“系统性JIA”)病程分为单相、多相和慢性持续性疾病,并确定非单相疾病的预测因素。方法对来自以色列3家医院和美国2家医院的多中心回顾性图表进行回顾,纳入1998-2021年间诊断为斯蒂尔氏病的患者,随访时间至少为1年。结果符合纳入标准的患者有82例,中位随访时间2.8年(1.1 ~ 17年)。女性52例(63.4%);平均诊断年龄为6.4±4.4岁。当IL-1和IL-6抑制剂被广泛使用时,59例(72%)在2012年或之后被诊断出来。单期病、多期病和持续性病的发生率分别为34.1%、46.3%和19.5%,多期病的发生率高于预期。非单相(多相或持续性)疾病的比例从2012年之前诊断的78.2%下降到2012年之后诊断的61%,尽管没有统计学意义(p = 0.22)。在多因素logistic回归模型中,诊断后3个月的活动性疾病是非单相病程的独立危险因素(OR 4.16 [1.33-15.2], p = 0.02)。结论慢性非单相斯蒂尔氏病的无药缓解可能比以前所证明的更为常见。在使用IL-1和IL-6抑制剂的年龄,单相病程可能更为普遍。这一发现进一步证明细胞因子阻滞剂可能潜在地改变这种疾病的自然史,并且早期积极治疗可能是必要的。
{"title":"Reassessing the prevalence of monophasic, polyphasic and persistent disease courses in still’s disease","authors":"Itay Marmor ,&nbsp;Rotem Semo-Oz ,&nbsp;Amir Hendel ,&nbsp;Guy Hazan ,&nbsp;Kevin Baszis ,&nbsp;Anthony French ,&nbsp;Cuoghi Edens ,&nbsp;Irit Tirosh ,&nbsp;Yonatan Butbul ,&nbsp;Liora Harel ,&nbsp;Gil Amarilyo","doi":"10.1016/j.semarthrit.2026.152928","DOIUrl":"10.1016/j.semarthrit.2026.152928","url":null,"abstract":"<div><h3>Objective</h3><div>To classify Still’s disease (known as “systemic JIA”) course into monophasic, polyphasic and chronic-persistent disease, using data collected before and after the introduction of biologic IL-1/6 inhibitors, and identify predictors for a non-monophasic disease.</div></div><div><h3>Methods</h3><div>A multi-center, retrospective chart review from 3 hospitals in Israel and 2 in the US, involving patients diagnosed with Still’s disease between 1998–2021, with a minimum follow-up of 1 year.</div></div><div><h3>Results</h3><div>Eighty-two patients met the inclusion criteria, with a median follow up time of 2.8 years (1.1–17). Fifty-two (63.4%) were females; mean age at diagnosis was 6.4 ± 4.4 years. Fifty-nine (72%) were diagnosed in 2012 or later, when IL-1 and IL-6 inhibitors became widely used. The rates of monophasic, polyphasic and persistent disease were 34.1%, 46.3% and 19.5%, respectively, with a higher-than-expected rate of polyphasic disease. The proportion of a non-monophasic (polyphasic or persistent) disease decreased from 78.2% in cases diagnosed before 2012 to 61% in cases diagnosed after 2012 albeit not statistically significant (<em>p</em> = 0.22). In a multivariate logistic regression model, an active disease 3 months from diagnosis was an independent risk factor for a non-monophasic disease course (OR 4.16 [1.33–15.2], <em>p</em> = 0.02).</div></div><div><h3>Conclusions</h3><div>Drug-free remissions in chronic, non-monophasic Still’s disease may be more common than previously demonstrated. In the age of IL-1 and IL-6 inhibitors, a monophasic disease course may be more prevalent. This finding provides further evidence that cytokine blockers may potentially alter the natural history of this disease, and that early aggressive treatment may be warranted.</div></div>","PeriodicalId":21715,"journal":{"name":"Seminars in arthritis and rheumatism","volume":"77 ","pages":"Article 152928"},"PeriodicalIF":4.4,"publicationDate":"2026-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146078519","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
VEXAS syndrome and cancer: Insights about a possible “Tip of the Iceberg”. Ambidirectional data from the international AIDA network registries VEXAS综合征和癌症:关于可能的“冰山一角”的见解。来自国际AIDA网络注册的双向数据
IF 4.4 2区 医学 Q1 RHEUMATOLOGY Pub Date : 2026-01-22 DOI: 10.1016/j.semarthrit.2026.152932
Francesco Gavioli , Valeria Caggiano , Jessica Sbalchiero , Micol Frassi , Francesca Crisafulli , Ilaria Cavazzana , Andrea Hinojosa-Azaola , Eduardo Martín-Nares , Guillermo Arturo Guaracha-Basañez , Jiram Torres-Ruiz , Ewa Wiesik-Szewczyk , Paolo Sfriso , Samuele Rizzo , Marta Schermi , Sara Bindoli , José Hernández-Rodríguez , Verónica Gómez-Caverzaschi , Olga Araújo , Annachiara Alemanno , Henrique A Mayrink Giardini , Antonio Vitale

Background

VEXAS (Vacuoles, E1 enzyme, X-linked, Autoinflammatory, Somatic) syndrome is an acquired autoinflammatory disorder characterized by severe chronic inflammation and an increased occurrence of hematologic neoplasms. Although chronic inflammation is a well-established risk factor for cancer, the specific contribution of UBA1 gene mutations to tumorigenesis remains unclear. Therefore, this study aimed to evaluate the overall cancer risk in patients with VEXAS syndrome, including both hematologic and non-hematologic neoplasms.

Methods

The relative risk (RR) of cancer was compared between VEXAS patients and a control cohort comprising individuals with Still’s disease, Behçet’s disease, and Schnitzler’s syndrome. Logistic regression analysis was performed to identify variables potentially associated with cancer development. Patient’s data were drawn from the International AutoInflammatory Disease Alliance (AIDA) Network registries for VEXAS syndrome, Still’s disease, Behçet’s disease, and Schnitzler’s syndrome.

Results

Ninety-six VEXAS patients and 2181 controls were enrolled. To minimize selection bias, only subjects aged >60 years were included, yielding 90 and 174 individuals in the exposed and control groups, respectively. The overall RR for cancer in VEXAS patients was 1.93 (95 % Confidence Interval [C.I.] 1.03-3.60, p = 0.036). Logistic regression analysis identified associations between cancer development and relapsing polychondritis (RR = 2.67, 95 %C.I. 1.22-10.64, p = 0.01), the p.Met41Thr mutation (RR = 3.33, 95 %C.I. 1.29-17.33, p = 0.02), elevated serum erythrocyte sedimentation rate (RR = 1.02, 95 %C.I. 1.01-1.05 p = 0.01), and lactate dehydrogenase (RR = 1.02, 95 %C.I. 1.01-1.07 p = 0.04) levels outside of flares.

Conclusions

VEXAS patients exhibit a significantly increased risk of both hematologic and non-hematologic malignancies compared with controls, particularly among those with RP, p.Met41Thr mutation, and persistent systemic inflammation.
dvexas(液泡,E1酶,x -连锁,自体炎症,躯体)综合征是一种获得性自体炎症疾病,其特征是严重的慢性炎症和血液肿瘤的发生率增加。虽然慢性炎症是一个公认的癌症危险因素,但UBA1基因突变在肿瘤发生中的具体作用尚不清楚。因此,本研究旨在评估VEXAS综合征患者的总体癌症风险,包括血液和非血液肿瘤。方法比较VEXAS患者与Still病、behet病和Schnitzler综合征患者的相对危险度(RR)。进行逻辑回归分析以确定可能与癌症发展相关的变量。患者数据来自国际自身炎症疾病联盟(AIDA)网络登记的VEXAS综合征、Still病、behet病和Schnitzler综合征。结果纳入96例VEXAS患者和2181例对照。为了尽量减少选择偏差,只纳入了60岁的受试者,暴露组和对照组分别有90人和174人。VEXAS患者患癌的总RR为1.93(95%可信区间[C.I.[1.03-3.60, p = 0.036]。Logistic回归分析发现癌症发展与复发性多软骨炎之间存在关联(RR = 2.67, 95% C.I.)1.22 ~ 10.64, p = 0.01), p. met41thr突变(RR = 3.33, 95% C.I.1.29-17.33, p = 0.02),血清红细胞沉降升高(RR = 1.02, 95% C.I.1.01 ~ 1.05 p = 0.01),乳酸脱氢酶(RR = 1.02, 95% C.I.1.01-1.07 p = 0.04)。结论:与对照组相比,svexas患者发生血液学和非血液学恶性肿瘤的风险均显著增加,尤其是那些伴有RP、p.Met41Thr突变和持续性全身炎症的患者。
{"title":"VEXAS syndrome and cancer: Insights about a possible “Tip of the Iceberg”. Ambidirectional data from the international AIDA network registries","authors":"Francesco Gavioli ,&nbsp;Valeria Caggiano ,&nbsp;Jessica Sbalchiero ,&nbsp;Micol Frassi ,&nbsp;Francesca Crisafulli ,&nbsp;Ilaria Cavazzana ,&nbsp;Andrea Hinojosa-Azaola ,&nbsp;Eduardo Martín-Nares ,&nbsp;Guillermo Arturo Guaracha-Basañez ,&nbsp;Jiram Torres-Ruiz ,&nbsp;Ewa Wiesik-Szewczyk ,&nbsp;Paolo Sfriso ,&nbsp;Samuele Rizzo ,&nbsp;Marta Schermi ,&nbsp;Sara Bindoli ,&nbsp;José Hernández-Rodríguez ,&nbsp;Verónica Gómez-Caverzaschi ,&nbsp;Olga Araújo ,&nbsp;Annachiara Alemanno ,&nbsp;Henrique A Mayrink Giardini ,&nbsp;Antonio Vitale","doi":"10.1016/j.semarthrit.2026.152932","DOIUrl":"10.1016/j.semarthrit.2026.152932","url":null,"abstract":"<div><h3>Background</h3><div>VEXAS (Vacuoles, E1 enzyme, X-linked, Autoinflammatory, Somatic) syndrome is an acquired autoinflammatory disorder characterized by severe chronic inflammation and an increased occurrence of hematologic neoplasms. Although chronic inflammation is a well-established risk factor for cancer, the specific contribution of <em>UBA1</em> gene mutations to tumorigenesis remains unclear. Therefore, this study aimed to evaluate the overall cancer risk in patients with VEXAS syndrome, including both hematologic and non-hematologic neoplasms.</div></div><div><h3>Methods</h3><div>The relative risk (RR) of cancer was compared between VEXAS patients and a control cohort comprising individuals with Still’s disease, Behçet’s disease, and Schnitzler’s syndrome. Logistic regression analysis was performed to identify variables potentially associated with cancer development. Patient’s data were drawn from the International AutoInflammatory Disease Alliance (AIDA) Network registries for VEXAS syndrome, Still’s disease, Behçet’s disease, and Schnitzler’s syndrome.</div></div><div><h3>Results</h3><div>Ninety-six VEXAS patients and 2181 controls were enrolled. To minimize selection bias, only subjects aged &gt;60 years were included, yielding 90 and 174 individuals in the exposed and control groups, respectively. The overall RR for cancer in VEXAS patients was 1.93 (95 % Confidence Interval [C.I.] 1.03-3.60, <em>p</em> = 0.036). Logistic regression analysis identified associations between cancer development and relapsing polychondritis (RR = 2.67, 95 %C.I. 1.22-10.64, <em>p</em> = 0.01), the p.Met41Thr mutation (RR = 3.33, 95 %C.I. 1.29-17.33, <em>p</em> = 0.02), elevated serum erythrocyte sedimentation rate (RR = 1.02, 95 %C.I. 1.01-1.05 <em>p</em> = 0.01), and lactate dehydrogenase (RR = 1.02, 95 %C.I. 1.01-1.07 <em>p</em> = 0.04) levels outside of flares.</div></div><div><h3>Conclusions</h3><div>VEXAS patients exhibit a significantly increased risk of both hematologic and non-hematologic malignancies compared with controls, particularly among those with RP, p.Met41Thr mutation, and persistent systemic inflammation.</div></div>","PeriodicalId":21715,"journal":{"name":"Seminars in arthritis and rheumatism","volume":"77 ","pages":"Article 152932"},"PeriodicalIF":4.4,"publicationDate":"2026-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146078613","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
Hormone therapy in menopause increases rheumatoid arthritis risk: A systematic review and meta-analysis 绝经期激素治疗增加类风湿关节炎风险:系统回顾和荟萃分析
IF 4.4 2区 医学 Q1 RHEUMATOLOGY Pub Date : 2026-01-22 DOI: 10.1016/j.semarthrit.2026.152935
Camila Guimarães , Eduarda Balbinot , Fernanda Marçal , Sarah Dagostin Ferraz , Maria Laura Rodrigues Uggioni , Ana Cristina Lacerda Macedo , Antonio Jose Grande , Tamy Colonetti , Maria Inês da Rosa

Objective

To assess the association between menopausal hormone therapy use and Rheumatoid Arthritis (RA) incidence among postmenopausal women.

Methods

A systematic review and meta-analysis were conducted following PRISMA guidelines. MEDLINE, Embase, and the Cochrane Library were searched up to October 2025 for observational studies evaluating menopausal hormone therapy use and RA risk. Pooled risk ratios (RR) with 95% confidence intervals (CIs) were calculated using random-effects models. Subgroup analyses explored current versus former use and therapy duration.

Results

Five studies comprising 22,291,843 person-years of follow-up were included. Overall, menopausal hormone therapy use was associated with a modestly increased RA risk (Rate Ratio 1.15, 95% CI 1.10–1.21, p < 0.001; I² = 0%). Current users had higher risk (Rate Ratio 1.18, 95% CI 1.00–1.37, p = 0.04) compared with former users (Rate Ratio 1.11, 95% CI 0.94–1.32, p = 0.20). Long-term use (≥4 years) conferred greater risk (Rate Ratio 1.19, 95% CI 1.07–1.33, p = 0.002).

Conclusions

Current menopausal hormone therapy use is associated with a modestly higher incidence of rheumatoid arthritis. Although the absolute increase is small, the widespread use highlights the need for individualized risk–benefit assessment, especially in women with autoimmune susceptibility.
目的探讨绝经后妇女激素治疗与类风湿关节炎(RA)发病率的关系。方法按照PRISMA指南进行系统评价和荟萃分析。MEDLINE、Embase和Cochrane图书馆检索了截至2025年10月评估绝经期激素治疗使用和RA风险的观察性研究。采用随机效应模型计算合并风险比(RR)和95%置信区间(ci)。亚组分析探讨了目前与以前的使用和治疗持续时间。结果纳入5项研究,随访22291843人年。总体而言,绝经期激素治疗与RA风险适度增加相关(比率比1.15,95% CI 1.10-1.21, p < 0.001; I²= 0%)。与以前的使用者相比,现在的使用者有更高的风险(比率比1.18,95% CI 1.00-1.37, p = 0.04)(比率比1.11,95% CI 0.94-1.32, p = 0.20)。长期使用(≥4年)风险更大(比率比1.19,95% CI 1.07-1.33, p = 0.002)。结论:目前绝经期激素治疗的使用与类风湿关节炎的适度高发病率相关。虽然绝对增加很小,但广泛使用强调了个体化风险-收益评估的必要性,特别是对自身免疫易感性的妇女。
{"title":"Hormone therapy in menopause increases rheumatoid arthritis risk: A systematic review and meta-analysis","authors":"Camila Guimarães ,&nbsp;Eduarda Balbinot ,&nbsp;Fernanda Marçal ,&nbsp;Sarah Dagostin Ferraz ,&nbsp;Maria Laura Rodrigues Uggioni ,&nbsp;Ana Cristina Lacerda Macedo ,&nbsp;Antonio Jose Grande ,&nbsp;Tamy Colonetti ,&nbsp;Maria Inês da Rosa","doi":"10.1016/j.semarthrit.2026.152935","DOIUrl":"10.1016/j.semarthrit.2026.152935","url":null,"abstract":"<div><h3>Objective</h3><div>To assess the association between menopausal hormone therapy use and Rheumatoid Arthritis (RA) incidence among postmenopausal women.</div></div><div><h3>Methods</h3><div>A systematic review and meta-analysis were conducted following PRISMA guidelines. MEDLINE, Embase, and the Cochrane Library were searched up to October 2025 for observational studies evaluating menopausal hormone therapy use and RA risk. Pooled risk ratios (RR) with 95% confidence intervals (CIs) were calculated using random-effects models. Subgroup analyses explored current versus former use and therapy duration.</div></div><div><h3>Results</h3><div>Five studies comprising 22,291,843 person-years of follow-up were included. Overall, menopausal hormone therapy use was associated with a modestly increased RA risk (Rate Ratio 1.15, 95% CI 1.10–1.21, <em>p</em> &lt; 0.001; I² = 0%). Current users had higher risk (Rate Ratio 1.18, 95% CI 1.00–1.37, <em>p</em> = 0.04) compared with former users (Rate Ratio 1.11, 95% CI 0.94–1.32, <em>p = 0.20).</em> Long-term use (≥4 years) conferred greater risk (Rate Ratio 1.19, 95% CI 1.07–1.33, <em>p</em> = 0.002).</div></div><div><h3>Conclusions</h3><div>Current menopausal hormone therapy use is associated with a modestly higher incidence of rheumatoid arthritis. Although the absolute increase is small, the widespread use highlights the need for individualized risk–benefit assessment, especially in women with autoimmune susceptibility.</div></div>","PeriodicalId":21715,"journal":{"name":"Seminars in arthritis and rheumatism","volume":"77 ","pages":"Article 152935"},"PeriodicalIF":4.4,"publicationDate":"2026-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146078668","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
Patients’ perspectives of living with Sjögren disease: A systematic review of qualitative studies from the OMERACT Sjögren disease working group 患者对Sjögren疾病生活的看法:对OMERACT Sjögren疾病工作组定性研究的系统回顾
IF 4.4 2区 医学 Q1 RHEUMATOLOGY Pub Date : 2026-01-22 DOI: 10.1016/j.semarthrit.2026.152929
Adrian Y.S. Lee , Hanna Zembrzuska , Kyle B. Franke , Rachael Gordon , Elisabeth F. Franke , Lindsay Kumble , Brianna Boderman , Cristina Pelkas , Mary E. Hitchcock , Divi Cornec , Maureen Rischmueller , Simon J. Bowman , Raphaèle Seror , Sara S. McCoy , Dana DiRenzo

Objectives

Sjögren disease (SjD) is a common systemic autoimmune disease and patients experience a wide range of symptoms with unique emotional, social and physical impacts. Understanding the individual experience of SjD is crucial to providing comprehensive and sensitive care in the clinics. Therefore, the aim of this systematic review was to analyze primary literature that examined the lived experiences of patients with SjD.

Methods

Primary literature qualitatively exploring the lived experiences of SjD patients through interviews and/or focus groups were identified. Papers were included if they were written in English, participants were ≥ 18 years old and they fulfilled a diagnosis of SjD as per the 2002 American-European Consensus or 2016 American College of Rheumatology/European Alliance of Associations for Rheumatology criteria. Thematic analyses were performed using the Thomas and Harden approach.

Results

Nine of 1990 screened manuscripts (0.5 %) fulfilled our selection criteria. These comprised a total of 162 participants (154, 95 % female) across 10 countries. Thematic analysis revealed several key themes: the burden of the physical symptoms (such as sicca), social isolation, negative impact on function, unpredictability of the disease, diverse coping strategies, and the challenges of navigating the healthcare system. Few studies addressed any bias in the recruitment of patients or analyses of data.

Conclusion

SjD patients encounter a large variety of individual experiences in their illness that have important repercussions on quality of life. Understanding these experiences will help create a harmonized set of patient-centered outcomes to inform the generation of Outcome Measurement in Rheumatology (OMERACT) target domains in SjD.
ObjectivesSjögren疾病(SjD)是一种常见的系统性自身免疫性疾病,患者会经历广泛的症状,并具有独特的情绪,社会和身体影响。了解SjD的个人经历对于在诊所提供全面和敏感的护理至关重要。因此,本系统综述的目的是分析研究SjD患者生活经历的主要文献。方法通过访谈和/或焦点小组对SjD患者的生活经历进行定性研究。如果论文用英文撰写,受试者年龄≥18岁,并且符合2002年欧美共识或2016年美国风湿病学会/欧洲风湿病协会联盟标准的SjD诊断,则纳入研究。采用Thomas和Harden方法进行主题分析。结果90篇筛选稿中有9篇(0.5%)符合筛选标准。这些研究包括来自10个国家的162名参与者(154名,其中95%为女性)。专题分析揭示了几个关键主题:身体症状的负担(如sicca),社会隔离,对功能的负面影响,疾病的不可预测性,多样化的应对策略以及导航医疗保健系统的挑战。很少有研究指出在患者招募或数据分析中存在任何偏倚。结论sjd患者在疾病中会遇到各种各样的个体经历,这些经历对生活质量有重要的影响。了解这些经验将有助于创建一套统一的以患者为中心的结果,为SjD中风湿病学结果测量(OMERACT)目标域的生成提供信息。
{"title":"Patients’ perspectives of living with Sjögren disease: A systematic review of qualitative studies from the OMERACT Sjögren disease working group","authors":"Adrian Y.S. Lee ,&nbsp;Hanna Zembrzuska ,&nbsp;Kyle B. Franke ,&nbsp;Rachael Gordon ,&nbsp;Elisabeth F. Franke ,&nbsp;Lindsay Kumble ,&nbsp;Brianna Boderman ,&nbsp;Cristina Pelkas ,&nbsp;Mary E. Hitchcock ,&nbsp;Divi Cornec ,&nbsp;Maureen Rischmueller ,&nbsp;Simon J. Bowman ,&nbsp;Raphaèle Seror ,&nbsp;Sara S. McCoy ,&nbsp;Dana DiRenzo","doi":"10.1016/j.semarthrit.2026.152929","DOIUrl":"10.1016/j.semarthrit.2026.152929","url":null,"abstract":"<div><h3>Objectives</h3><div>Sjögren disease (SjD) is a common systemic autoimmune disease and patients experience a wide range of symptoms with unique emotional, social and physical impacts. Understanding the individual experience of SjD is crucial to providing comprehensive and sensitive care in the clinics. Therefore, the aim of this systematic review was to analyze primary literature that examined the lived experiences of patients with SjD.</div></div><div><h3>Methods</h3><div>Primary literature qualitatively exploring the lived experiences of SjD patients through interviews and/or focus groups were identified. Papers were included if they were written in English, participants were ≥ 18 years old and they fulfilled a diagnosis of SjD as per the 2002 American-European Consensus or 2016 American College of Rheumatology/European Alliance of Associations for Rheumatology criteria. Thematic analyses were performed using the Thomas and Harden approach.</div></div><div><h3>Results</h3><div>Nine of 1990 screened manuscripts (0.5 %) fulfilled our selection criteria. These comprised a total of 162 participants (154, 95 % female) across 10 countries. Thematic analysis revealed several key themes: the burden of the physical symptoms (such as sicca), social isolation, negative impact on function, unpredictability of the disease, diverse coping strategies, and the challenges of navigating the healthcare system. Few studies addressed any bias in the recruitment of patients or analyses of data.</div></div><div><h3>Conclusion</h3><div>SjD patients encounter a large variety of individual experiences in their illness that have important repercussions on quality of life. Understanding these experiences will help create a harmonized set of patient-centered outcomes to inform the generation of Outcome Measurement in Rheumatology (OMERACT) target domains in SjD.</div></div>","PeriodicalId":21715,"journal":{"name":"Seminars in arthritis and rheumatism","volume":"77 ","pages":"Article 152929"},"PeriodicalIF":4.4,"publicationDate":"2026-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146078673","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
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 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。
{"title":"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","authors":"S.A. Bergstra,&nbsp;M. Verstappen,&nbsp;E. Niemantsverdriet,&nbsp;T.W.J. Huizinga,&nbsp;A.H.M. van der Helm-van Mil","doi":"10.1016/j.semarthrit.2026.152917","DOIUrl":"10.1016/j.semarthrit.2026.152917","url":null,"abstract":"<div><h3>Objective</h3><div>To predict which early RA-patients achieve clinical remission on initial treatment with methotrexate monotherapy or with abatacept+methotrexate.</div></div><div><h3>Methods</h3><div>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.</div></div><div><h3>Results</h3><div>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.</div></div><div><h3>Conclusion</h3><div>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.</div></div>","PeriodicalId":21715,"journal":{"name":"Seminars in arthritis and rheumatism","volume":"77 ","pages":"Article 152917"},"PeriodicalIF":4.4,"publicationDate":"2026-01-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145978980","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
Response to: Self-administered screening questionnaires for spondyloarthritis in inflammatory bowel disease: Methodological and conceptual gaps 回复:炎症性肠病中脊椎关节炎的自我管理筛查问卷:方法学和概念上的差距
IF 4.4 2区 医学 Q1 RHEUMATOLOGY Pub Date : 2026-01-12 DOI: 10.1016/j.semarthrit.2026.152922
Xavier Romand , Romain Schotkosky , Tiphaine Dujardin , Marianne Hupé , Athan Baillet
{"title":"Response to: Self-administered screening questionnaires for spondyloarthritis in inflammatory bowel disease: Methodological and conceptual gaps","authors":"Xavier Romand ,&nbsp;Romain Schotkosky ,&nbsp;Tiphaine Dujardin ,&nbsp;Marianne Hupé ,&nbsp;Athan Baillet","doi":"10.1016/j.semarthrit.2026.152922","DOIUrl":"10.1016/j.semarthrit.2026.152922","url":null,"abstract":"","PeriodicalId":21715,"journal":{"name":"Seminars in arthritis and rheumatism","volume":"77 ","pages":"Article 152922"},"PeriodicalIF":4.4,"publicationDate":"2026-01-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146038269","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
期刊
Seminars in arthritis and rheumatism
全部 Acc. Chem. Res. ACS Applied Bio Materials ACS Appl. Electron. Mater. ACS Appl. Energy Mater. ACS Appl. Mater. Interfaces ACS Appl. Nano Mater. ACS Appl. Polym. Mater. ACS BIOMATER-SCI ENG ACS Catal. ACS Cent. Sci. ACS Chem. Biol. ACS Chemical Health & Safety ACS Chem. Neurosci. ACS Comb. Sci. ACS Earth Space Chem. ACS Energy Lett. ACS Infect. Dis. ACS Macro Lett. ACS Mater. Lett. ACS Med. Chem. Lett. ACS Nano ACS Omega ACS Photonics ACS Sens. ACS Sustainable Chem. Eng. ACS Synth. Biol. Anal. Chem. BIOCHEMISTRY-US Bioconjugate Chem. BIOMACROMOLECULES Chem. Res. Toxicol. Chem. Rev. Chem. Mater. CRYST GROWTH DES ENERG FUEL Environ. Sci. Technol. Environ. Sci. Technol. Lett. Eur. J. Inorg. Chem. IND ENG CHEM RES Inorg. Chem. J. Agric. Food. Chem. J. Chem. Eng. Data J. Chem. Educ. J. Chem. Inf. Model. J. Chem. Theory Comput. J. Med. Chem. J. Nat. Prod. J PROTEOME RES J. Am. Chem. Soc. LANGMUIR MACROMOLECULES Mol. Pharmaceutics Nano Lett. Org. Lett. ORG PROCESS RES DEV ORGANOMETALLICS J. Org. Chem. J. Phys. Chem. J. Phys. Chem. A J. Phys. Chem. B J. Phys. Chem. C J. Phys. Chem. Lett. Analyst Anal. Methods Biomater. Sci. Catal. Sci. Technol. Chem. Commun. Chem. Soc. Rev. CHEM EDUC RES PRACT CRYSTENGCOMM Dalton Trans. Energy Environ. Sci. ENVIRON SCI-NANO ENVIRON SCI-PROC IMP ENVIRON SCI-WAT RES Faraday Discuss. Food Funct. Green Chem. Inorg. Chem. Front. Integr. Biol. J. Anal. At. Spectrom. J. Mater. Chem. A J. Mater. Chem. B J. Mater. Chem. C Lab Chip Mater. Chem. Front. Mater. Horiz. MEDCHEMCOMM Metallomics Mol. Biosyst. Mol. Syst. Des. Eng. Nanoscale Nanoscale Horiz. Nat. Prod. Rep. New J. Chem. Org. Biomol. Chem. Org. Chem. Front. PHOTOCH PHOTOBIO SCI PCCP Polym. Chem.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
0
微信
客服QQ
Book学术公众号 扫码关注我们
反馈
×
意见反馈
请填写您的意见或建议
请填写您的手机或邮箱
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
现在去查看 取消
×
提示
确定
Book学术官方微信
Book学术文献互助
Book学术文献互助群
群 号:604180095
Book学术
文献互助 智能选刊 最新文献 互助须知 联系我们:info@booksci.cn
Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。
Copyright © 2023 Book学术 All rights reserved.
ghs 京公网安备 11010802042870号 京ICP备2023020795号-1