Seminars in arthritis and rheumatism最新文献

{"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":"2026-01-23","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":"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}

{"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}

{"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}

{"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}

{"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}

{"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}

{"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}

{"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}

{"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}