Seminars in arthritis and rheumatism最新文献

{"title":"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”","authors":"Sung Hae Chang , Misti L. Paudel , Eun Young Lee , Jeffrey A. Sparks","doi":"10.1016/j.semarthrit.2026.152912","DOIUrl":"10.1016/j.semarthrit.2026.152912","url":null,"abstract":"","PeriodicalId":21715,"journal":{"name":"Seminars in arthritis and rheumatism","volume":"77 ","pages":"Article 152912"},"PeriodicalIF":4.4,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145917945","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}

{"title":"Reply to letter to the editor","authors":"Yasser El Miedany","doi":"10.1016/j.semarthrit.2026.152918","DOIUrl":"10.1016/j.semarthrit.2026.152918","url":null,"abstract":"","PeriodicalId":21715,"journal":{"name":"Seminars in arthritis and rheumatism","volume":"77 ","pages":"Article 152918"},"PeriodicalIF":4.4,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146019577","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}

{"title":"Fronto-cerebellar features associate with cognitive dysfunction in childhood-onset systemic lupus erythematosus","authors":"Hanne Van der Heijden ,&nbsp;Gabrielle Alonzi ,&nbsp;Amanda Cao ,&nbsp;Raquel van Gool ,&nbsp;Merve Koç Yekedüz ,&nbsp;Lise Vrolix ,&nbsp;Itamar Ronen ,&nbsp;Vanessa Rameh ,&nbsp;Kyle McBrearty ,&nbsp;Aditi Deokar ,&nbsp;Robert P. Sundel ,&nbsp;Eyal Muscal ,&nbsp;Joseph Gonzalez-Heydrich ,&nbsp;Andrea Knight ,&nbsp;Joyce C. Chang ,&nbsp;Jaymin Upadhyay","doi":"10.1016/j.semarthrit.2026.152916","DOIUrl":"10.1016/j.semarthrit.2026.152916","url":null,"abstract":"<div><h3>Objective</h3><div>Cognitive dysfunction (CD) is a prevalent symptom in childhood-onset systemic lupus erythematosus (cSLE). This study aimed to investigate the neurobehavioral basis of CD in cSLE.</div></div><div><h3>Methods</h3><div>Patients with cSLE (N=20) and age- and sex-matched healthy controls (HCs, N=20) completed questionnaires and multiple neurocognitive tests. The Systemic Lupus Erythematosus Disease Activity Index 2000 and laboratory markers were used to monitor patients’ clinical status. Neuroimaging assessments included functional near-infrared spectroscopy (fNIRS), functional magnetic resonance imaging (fMRI), and structural MRI.</div></div><div><h3>Results</h3><div>cSLE patients demonstrated moderate disease activity with high inflammation and immune dysregulation, alongside low medication adherence. Relative to HCs, cSLE patients showed worse cognitive functioning, higher emotional distress and more physical symptoms. fNIRS revealed higher prefrontal cortex activity in cSLE vs. HCs during the color-word Stroop task, suggesting impaired cognitive flexibility. fMRI performed during the N-back working memory task revealed altered frontal cortex and cerebellum activity, while modulations in resting-state fronto-cerebellar connectivity in the cSLE cohort were observed. Patients with cSLE were characterized by reduced gray matter morphological properties in frontal cortex and cerebellar subdivisions (e.g., crus II) alongside altered white matter structural connectivity among these cognitive processing hubs. K-means clustering analysis delineated three subgroups within the cSLE cohort based on neuroimaging profiles, where subgroups varied based on cognitive and emotional health.</div></div><div><h3>Conclusion</h3><div>This study provides evidence of fronto-cerebellar abnormalities and their associations with CD in cSLE. This investigation underscores the need for multidisciplinary research efforts to further elucidate the neurobiological underpinnings of CD in cSLE.</div></div>","PeriodicalId":21715,"journal":{"name":"Seminars in arthritis and rheumatism","volume":"77 ","pages":"Article 152916"},"PeriodicalIF":4.4,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146019532","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}

{"title":"From Aortitis to Sweet’s: The Immune Spectrum of G-CSF Adverse Events","authors":"Jozélio Freire de Carvalho ,&nbsp;Cezar Augusto Muniz Caldas","doi":"10.1016/j.semarthrit.2026.152939","DOIUrl":"10.1016/j.semarthrit.2026.152939","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;div&gt;Granulocyte colony-stimulating factor (G-CSF) and its PEGylated formulation (pegfilgrastim) are indispensable for preventing chemotherapy-induced neutropenia and for stem-cell mobilization. Beyond hematopoiesis, G-CSF modulates innate/adaptive immunity and may precipitate immune-mediated events in susceptible hosts. Clinical signals span large-vessel vasculitis/aortitis and non-vascular neutrophil-dominant phenotypes, yet timing, spectrum, and management remain variably characterized.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Objective&lt;/h3&gt;&lt;div&gt;To identify and synthesize primary clinical reports of autoimmune/rheumatic disease triggered or exacerbated by exogenous G-CSF (filgrastim or pegfilgrastim), describing phenotypes, latency, management, outcomes, and implications for practice.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;We performed a narrative review of primary clinical studies, including observational cohorts and case reports or short case series, identified through targeted searches of PubMed/MEDLINE, Scopus, and Embase, complemented by investigator-curated references. Eligible reports described autoimmune, inflammatory, or rheumatic manifestations occurring after exposure to exogenous G-CSF. Predefined phenotypes included large-vessel vasculitis/aortitis; neutrophilic dermatoses (e.g., Sweet’s syndrome, neutrophilic dermatosis of the dorsal hands); cutaneous small-vessel vasculitis; inflammatory or crystal arthritis (e.g., calcium pyrophosphate deposition disease); pulmonary inflammatory injury (e.g., diffuse alveolar hemorrhage); and clear flares of established autoimmune disease. Narrative or mechanistic reviews and trials of GM-CSF pathway blockade were excluded from qualitative synthesis.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;Twenty-four studies met inclusion criteria: two observational cohorts and twenty-two single-patient reports/short series. Cohorts quantified a low but reproducible burden of pegfilgrastim-associated aortitis, with stereotyped involvement of the aortic arch/proximal branches and typical latency of 7–15 days. Case-level data confirmed marked elevation of acute phase reactants, usually negative autoantibodies, favorable outcomes after G-CSF withdrawal with or without short glucocorticoid courses, and recurrence/migration on re-exposure. Non-vascular events clustered earlier (2–7 days) and included biopsy-proven Sweet’s/NDDH, leukocytoclastic vasculitis, CPPD flares, and rare diffuse alveolar hemorrhage; granulomatous dermatitis and perioperative pyoderma gangrenosum were also observed. &lt;em&gt;Re&lt;/em&gt;-exposure information suggested phenotype-specific risk: recurrent CPPD with pegfilgrastim was mitigated by switching to short-acting filgrastim; selected limited aortitis resolved without steroids; refractory aortitis responded to IL-6 blockade, enabling uninterrupted chemotherapy.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusions&lt;/h3&gt;&lt;div&gt;Exogenous G-CSF can precipitate a coherent spectrum of immune-mediated toxicity with distinct, clini","PeriodicalId":21715,"journal":{"name":"Seminars in arthritis and rheumatism","volume":"77 ","pages":"Article 152939"},"PeriodicalIF":4.4,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146143468","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}

{"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":"2026-04-01","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}

{"title":"Vaccine-associated lupus and related organ involvements: A pharmacovigilance analysis of VAERS database 1990–2025","authors":"Ruiyan Xie ,&nbsp;Lai Yee Cheong ,&nbsp;Danting Zhang ,&nbsp;Kevin C.H. Wu ,&nbsp;Shirley C.W. Chan ,&nbsp;Ivan Au ,&nbsp;Kathy S.M. Leung ,&nbsp;Joseph T.K. Wu ,&nbsp;Tak Mao Chan ,&nbsp;Desmond Y.H. Yap","doi":"10.1016/j.semarthrit.2026.152933","DOIUrl":"10.1016/j.semarthrit.2026.152933","url":null,"abstract":"<div><h3>Objectives</h3><div>The relationships between vaccines and the development of systemic lupus erythematosus (SLE) and related organ involvements remain unclear.</div></div><div><h3>Methods</h3><div>We analyzed data from the Vaccine Adverse Event Reporting System (VAERS) during the period of 1990 to 2025 to determine the incidence of vaccine-associated SLE over time. The relationships between vaccines and the development of SLE and organ involvements were assessed by disproportionality and case-control analyses.</div></div><div><h3>Results</h3><div>1976 (0.017%) cases of vaccine-associated lupus were identified amongst 11,301,263 adverse events (AEs) reported in VAERS (1990-2025). Median time from vaccination to symptom onset was 8 (0-8,070) days. The most common manifestations are musculoskeletal and connective tissue disorders (82.94%) followed by skin and subcutaneous tissue lesions (10.83%), while kidney and nervous system involvements are rare. 702 (40.48%) patients had serious outcomes, and 22 (3.13%) died. Human papilloma virus (HPV) vaccine is associated with lupus AEs, especially musculoskeletal/connective tissue disorders, kidney and nervous system involvements. Hepatitis B virus (HBV) vaccine also shows correlations with lupus AEs, particularly musculoskeletal/connective tissue disorders. COVID-19, influenza and zoster vaccines show no relationship with lupus AEs and specific organ involvements. Recombinant protein vaccines show significant links with lupus AEs.</div></div><div><h3>Conclusion</h3><div>Vaccine-associated lupus is uncommon and manifestations are generally mild. HPV and HBV vaccines show strong associations with lupus AEs with distinct organ involvements.</div></div>","PeriodicalId":21715,"journal":{"name":"Seminars in arthritis and rheumatism","volume":"77 ","pages":"Article 152933"},"PeriodicalIF":4.4,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146078670","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}

{"title":"Response to letter to the editor regarding \"Nailfold Capillaroscopy as a predictor of cardiovascular events and mortality in systemic sclerosis\"","authors":"Carlos Valera-Ribera,&nbsp;Juan José Alegre-Sancho,&nbsp;Joaquín Lacasa-Molina,&nbsp;Montserrat Robustillo-Villarino,&nbsp;Javier Narváez","doi":"10.1016/j.semarthrit.2025.152909","DOIUrl":"10.1016/j.semarthrit.2025.152909","url":null,"abstract":"","PeriodicalId":21715,"journal":{"name":"Seminars in arthritis and rheumatism","volume":"77 ","pages":"Article 152909"},"PeriodicalIF":4.4,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145928551","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}

{"title":"Almost half of the patients with axial spondyloarthritis reporting an acceptable symptom state have high disease activity; data from two standard-of-care cohorts","authors":"Marlies Carbo ,&nbsp;Anne Kampman ,&nbsp;Davy Paap ,&nbsp;Freke Wink ,&nbsp;Casper Webers ,&nbsp;Harald Vonkeman ,&nbsp;Astrid van Tubergen ,&nbsp;Suzanne Arends ,&nbsp;Anneke Spoorenberg","doi":"10.1016/j.semarthrit.2025.152903","DOIUrl":"10.1016/j.semarthrit.2025.152903","url":null,"abstract":"<div><h3>Objectives</h3><div>To assess the proportion of axial spondylarthritis (axSpA) patients reporting PASS, explore variables associated with PASS and determine the relation with axSpA Disease Activity Score (ASDAS) to predict PASS in two Dutch standard-of-care cohorts.</div></div><div><h3>Methods</h3><div>Patients from the GLAS cohort were included in this cross-sectional analysis. External validation was performed in the SpA-Net cohort. Univariable and multivariable logistic regression were performed to identify determinants of PASS. The predictive accuracy and threshold of the ASDAS for predicting PASS were determined using AUC and highest Youden’s index.</div></div><div><h3>Results</h3><div>Of 673 included GLAS patients, 63 % were male, mean age was 48 (±14) years, and mean ASDAS 2.3 (±0.9). In total, 77 % perceived their symptom state as acceptable. Of these patients, 44 % had an ASDAS ≥2.1. In multivariable regression, lower ASDAS, absence of tender entheses and older age were independently associated with reported PASS (R² = 0.39). The ASDAS showed good accuracy in predicting PASS, with AUC of 0.84 (95 % CI 0.80–0.85) and optimal cut-off value of 2.6 (sensitivity 78 %, specificity 77 %). Similar results were found in the 159 patients from SpA-Net.</div></div><div><h3>Conclusion</h3><div>In daily clinical practice, 3 out of 4 axSpA patients report an acceptable symptom state, although almost half of them have high disease activity. In line, the ASDAS threshold for predicting PASS is 2.6. Our results show that the PASS question provides additional information to disease activity, which can contribute to better shared decision making.</div></div>","PeriodicalId":21715,"journal":{"name":"Seminars in arthritis and rheumatism","volume":"77 ","pages":"Article 152903"},"PeriodicalIF":4.4,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145886337","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}

{"title":"Characteristics and long-term outcomes of patients with rheumatoid arthritis and concurrent calcium pyrophosphate deposition disease","authors":"Natalie Schanzer ,&nbsp;Bryant R. England ,&nbsp;Katherine D. Wysham ,&nbsp;Thomas R. Riley IV ,&nbsp;Brian Sauer ,&nbsp;Grant W. Cannon ,&nbsp;Ted R. Mikuls ,&nbsp;Joshua F. Baker","doi":"10.1016/j.semarthrit.2025.152902","DOIUrl":"10.1016/j.semarthrit.2025.152902","url":null,"abstract":"<div><h3>Purpose</h3><div>To compare the characteristics, treatment patterns, and long-term outcomes of patients with concurrent calcium pyrophosphate deposition disease (CPPD) and rheumatoid arthritis (RA) to patients with RA without CPPD.</div></div><div><h3>Methods</h3><div>We studied patients with RA from the Veteran’s Affairs RA (VARA) registry and identified patients with CPPD using administrative codes. We compared characteristics of patients with concurrent CPPD and RA to those with RA alone at enrollment. We used parsimonious multivariable logistic regression to study the probability of achieving a low disease activity as well as receiving prednisone and new biologic or targeted synthetic disease modifying antirheumatic drugs (b/tsDMARDs) over follow-up, adjusting for pre-hypothesized confounders and stratifying by autoantibody status.</div></div><div><h3>Results</h3><div>Among 2771 U.S. veterans with RA, we identified 64 (2.3 %) patients with CPPD at enrollment. Patients with CPPD were older [68.5 (9.0) v. 64.2 (11.0), <em>p</em> &lt; 0.001], had higher rates of comorbidities, including osteoarthritis (93.8 % v. 80.1 %, <em>p</em> = 0.007), spine disease, and diabetes, and were less likely to have ACPA (63.5 % v. 77.8 %, <em>p</em> = 0.01). While those with CPPD were numerically less likely to achieve low disease activity over time, this was not statistically significant. Among seronegative patients, CPPD patients exhibited more prednisone use (OR 2.44 [95 % CI 1.15–5.22]) and more frequent initiation of b/tsDMARDs (OR 2.79 [95 % CI 1.46–5.32]) as well as higher rates of joint replacement and death during follow-up.</div></div><div><h3>Conclusions</h3><div>Seronegative RA patients with CPPD changed therapies more frequently, used more prednisone, and had worse long-term outcomes. These findings suggest some seronegative RA may represent CPPD and require alternative diagnostic and treatment approaches.</div></div>","PeriodicalId":21715,"journal":{"name":"Seminars in arthritis and rheumatism","volume":"77 ","pages":"Article 152902"},"PeriodicalIF":4.4,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145886336","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}

{"title":"Gastric disease in systemic sclerosis: Spectrum, challenges, and insights from a systematic literature review","authors":"Robert Mack Anderton ,&nbsp;Austin Zhu ,&nbsp;Ali Ayla ,&nbsp;Montserrat Chavez ,&nbsp;Amanda Mayer ,&nbsp;Kelsey Koym ,&nbsp;Alfredo Guillen-del-Castillo ,&nbsp;Luis G Alcala-Gonzalez ,&nbsp;Michael Hughes ,&nbsp;Zsuzsanna H. McMahan","doi":"10.1016/j.semarthrit.2026.152944","DOIUrl":"10.1016/j.semarthrit.2026.152944","url":null,"abstract":"<div><h3>Objective</h3><div>Gastric complications in systemic sclerosis (SSc) are common, clinically diverse, and often overlooked, despite their profound impact on patient quality of life. This review synthesizes current evidence on prevalence, clinical relevance, and diagnostic strategies, while identifying key gaps and proposing priorities to advance care and research.</div></div><div><h3>Methods</h3><div>A systematic review was conducted per PRISMA guidelines and registered with PROSPERO. MEDLINE, EMBASE, and Web of Science were systematically searched (September 2024). Included studies addressed gastric manifestations in SSc, such as dysmotility, gastric antral vascular ectasia (GAVE), mucosal abnormalities, and/or <em>Helicobacter pylori</em>, and reported on prevalence, clinical impact, or diagnostic approaches.</div></div><div><h3>Results</h3><div>Of 123 full-text articles, 37 met our specified inclusion criteria. Gastric dysmotility was frequent, with delayed emptying in 18–64 % and bradygastria in 12–70 %. GAVE prevalence ranged from 0 to 22.3 % and was negatively associated with anti-topoisomerase-I and variably associated with anti-RNA polymerase III antibodies. Mucosal abnormalities (e.g., gastritis, ulcers, cancer) were common but inconsistently defined. <em>Helicobacter pylori</em> prevalence varied widely (10–78 %), with lower detection via biopsy or breath testing than serology. Associations between objective findings and patient-reported outcomes (PROs) were inconsistent and underexplored; data on gastric-specific mortality were limited.</div></div><div><h3>Conclusion</h3><div>Gastric disease in SSc is underrecognized, yet clinically significant. Progress necessitates standardized diagnostics (scintigraphy, breath tests, electrogastrography), validated patient-reported outcomes (PROs), and longitudinal studies to better define disease burden, optimize screening, and guide targeted therapies that improve outcomes and quality of life in SSc.</div></div>","PeriodicalId":21715,"journal":{"name":"Seminars in arthritis and rheumatism","volume":"77 ","pages":"Article 152944"},"PeriodicalIF":4.4,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146189014","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}