Seminars in arthritis and rheumatism最新文献

{"title":"Rheumatologist and patient perspectives on axial spondyloarthritis management and treatment satisfaction in Europe","authors":"Xenofon Baraliakos ,&nbsp;Victoria Navarro-Compán ,&nbsp;Elena Nikiphorou ,&nbsp;Thao Pham ,&nbsp;Francesco Ciccia ,&nbsp;Isabel Truman ,&nbsp;Bruno Kranz ,&nbsp;Giorgio Castellano ,&nbsp;Anna Jus ,&nbsp;Margarita Romero Durán ,&nbsp;Jo Lowe ,&nbsp;Sofia Ramiro","doi":"10.1016/j.semarthrit.2025.152884","DOIUrl":"10.1016/j.semarthrit.2025.152884","url":null,"abstract":"<div><h3>Objective</h3><div>To investigate the characteristics of axial spondyloarthritis (axSpA) and understand rheumatologists’ and patients’ experiences of axSpA management in a large real-world population using data from a cross-sectional survey.</div></div><div><h3>Methods</h3><div>Rheumatologists recruited from France, Germany, Italy, Spain, and the UK completed surveys for their next eight consulting adult patients with axSpA. The same patients were asked to voluntarily complete a survey, allowing rheumatologist- and patient-reported responses to be matched and compared. Surveys covered clinical status, symptoms and treatment decisions, preferences, and satisfaction.</div></div><div><h3>Results</h3><div>Between June 2023 and June 2024, 268 rheumatologists provided data on 2165 patients, 538 of whom completed the survey. At the time of the survey, patients continued to experience symptoms of axSpA (morning stiffness [35 %], inflammatory back, hip, or buttock pain [25 %], and fatigue [25 %]), despite 77 % having received disease-modifying advanced therapy. There was moderate agreement between patients and their rheumatologists on disease severity (86 % weighted agreement at the time of the survey, κ=0.515) and on their satisfaction with current treatment. The most common treatment target for rheumatologists was to achieve low disease activity (76 %), while the most common target for patients was to alleviate pain (61 %). Rheumatologists highlighted lack of efficacy, pain control, and flare control, and residual fatigue as reasons for treatment dissatisfaction.</div></div><div><h3>Conclusion</h3><div>Patients and their rheumatologists were moderately aligned on their perception of disease severity and treatment satisfaction but differed in their expectations regarding treatment target. The study highlights the need for ongoing involvement of patients in discussions and decisions about axSpA management.</div></div>","PeriodicalId":21715,"journal":{"name":"Seminars in arthritis and rheumatism","volume":"76 ","pages":"Article 152884"},"PeriodicalIF":4.4,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145775265","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":"Hand function impairment in Systemic Sclerosis: determinants through investigations of clinical, radiographic and ultrasonographic features","authors":"Giulia Franchi ,&nbsp;Elena Marazzi ,&nbsp;Alain Lescoat ,&nbsp;Sophie Hecquet ,&nbsp;Sandrine Carvès ,&nbsp;Guillaume Coiffier ,&nbsp;Marine Tas ,&nbsp;Veronica Codullo ,&nbsp;Carlomaurizio Montecucco ,&nbsp;Jérôme Avouac ,&nbsp;Yannick Allanore","doi":"10.1016/j.semarthrit.2025.152901","DOIUrl":"10.1016/j.semarthrit.2025.152901","url":null,"abstract":"<div><h3>Objectives</h3><div>to investigate the impact of cutaneous, vascular, and musculoskeletal (MSK) involvements on hand function-related patient-reported outcomes (PROs) by assessing clinical, radiographic, and ultrasonographic (US) features in a real-world cohort of Systemic Sclerosis (SSc) patients.</div></div><div><h3>Methods</h3><div>patients were enrolled in a multicentre cross-sectional study. PROs included Cochin Hand Function Scale (CHFS). Medical history and clinical examination, hands and wrists’ ultrasonography and radiography were collected. Analogue data were obtained from an external validation cohort. Separate and pooled cohorts’ analyses were conducted.</div></div><div><h3>Results</h3><div>140 consecutive patients were enrolled from 3 centres. In both univariate and multivariate analyses, CHFS scores showed a significant correlation with modified Rodnan Skin Score (mRSS) (<em>p</em> <em>&lt;</em> <em>0.001</em>) and with US-detected tenosynovitis (<em>p</em> <em>&lt;</em> <em>0.01</em>). A trend was observed for the presence of US-detected tenosynovitis with a sclerosing pattern and for the presence of calcinosis, with statistically significant correlations in univariate analysis (<em>p</em> <em>=</em> <em>0.01 and 0.02, respectively</em>) but not in multivariate analysis <em>(p</em> <em>=</em> <em>0.06 and 0.055, respectively)</em>.</div></div><div><h3>Conclusion</h3><div>our findings support the multifactorial origin of hand function impairment in SSc patients, with mostly contributions from cutaneous and MSK involvement. Skin fibrosis and US-detected tenosynovitis were the most significant variables explaining hand disability as measured by CHFS. Ultrasonography may represent a valuable complementary tool, assessing MSK disease severity and activity.</div></div><div><h3>What was already known</h3><div>cutaneous, vascular and musculoskeletal involvement contribute to hand function impairment in SSc patients</div></div><div><h3>What was learned from this study</h3><div>● Skin fibrosis and US-detected tenosynovitis are the most relevant features. ● Ultrasonography may provide complementary information in the routine care of SSc patients.</div></div>","PeriodicalId":21715,"journal":{"name":"Seminars in arthritis and rheumatism","volume":"76 ","pages":"Article 152901"},"PeriodicalIF":4.4,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145841199","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":"Cardiovascular risk assessment in idiopathic inflammatory myopathies: a multicentre international study by the myositis audit and research collaborative group","authors":"Athena Chin ,&nbsp;Lekshmi Minikumari Rahulan ,&nbsp;Devansh Lalwani ,&nbsp;Ryan Moore ,&nbsp;Jessica A Day ,&nbsp;Samuel Katsuyuki Shinjo ,&nbsp;Tamaraudubamo Agunbiade ,&nbsp;Aman Kumar ,&nbsp;Tsz Ho Luk ,&nbsp;Yan Ki Tang ,&nbsp;Marco Fornaro ,&nbsp;Anamika Anuja ,&nbsp;Ho So ,&nbsp;Vidya Sadanand Limaye ,&nbsp;Vikas Agarwal ,&nbsp;Latika Gupta","doi":"10.1016/j.semarthrit.2025.152898","DOIUrl":"10.1016/j.semarthrit.2025.152898","url":null,"abstract":"<div><h3>Introduction and Aims</h3><div>Cardiovascular disease (CVD) is a leading contributor of morbidity and mortality in patients with idiopathic inflammatory myopathies (IIM). The British Society for Rheumatology (BSR) 2022 guidelines recommend that IIM patients should undergo a regular cardiovascular risk assessment; however, many tools underestimate scores in IIM due to their sole focus on traditional risk factors. Cardiovascular Risk Score (QRISK) incorporates risk factors that are more relevant in IIM, such as corticosteroid use. The National Institute for Health and Care Excellence (NICE) guidelines recommend offering statin therapy for the primary prevention of CVD in patients with an estimated 10-year CVD risk of ≥10 %. This study aimed to undertake an audit of cardiovascular risk assessment in a multinational cohort of patients with IIM, based on BSR and NICE recommendations.</div></div><div><h3>Methods</h3><div>A multi-centre, international retrospective chart review was conducted in IIM cohorts from centres in India, Hong Kong, Brazil, Italy, Australia, and the United Kingdom, of patients who attended clinics between 2020 and 2023. Data were collected from medical records to evaluate CVD risk using both WHO cardiovascular risk charts and QRISK3 score. Based on their risk of cardiovascular events in the next 10 years, patients were defined as high-risk (&gt;20 %), moderate-risk (10–20 %), or low-risk (&lt;10 %). Adherence to the BSR and NICE guidelines was evaluated.</div></div><div><h3>Results</h3><div>A total of 336 patients were included. All centres, except one, did not routinely assess CVD risk. More than a third of patients were deemed moderate-high risk for CVD as per QRISK3, although only 34 % in this group were prescribed a statin as per NICE guidelines. Disease subtype immune-mediated necrotizing myopathy was strongly associated with moderate-high risk scores (OR = 4.64; 95 %CI = 1.88–11.45, <em>p</em> &lt; 0.001), as was active steroid use [OR = 1.76 (95 % CI = 1.06–2.92), <em>p</em> = 0.03] and dyslipidaemia [OR = 1.22 (95 % CI = 1.03–1.45), <em>p</em> = 0.02]. There was a moderate level of agreement between WHO and QRISK3 scores.</div></div><div><h3>Conclusion</h3><div>Over a third of patients with IIM are at moderate-high-risk of cardiovascular events in 10 years. Steroid use and dyslipidaemia were modifiable risk factors that were statistically significant predictors of risk. Despite this, there is a lack of adherence to current guidelines advising regular CVD risk assessment and use of statins for primary prevention in this moderate-high risk group.</div></div>","PeriodicalId":21715,"journal":{"name":"Seminars in arthritis and rheumatism","volume":"76 ","pages":"Article 152898"},"PeriodicalIF":4.4,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145865392","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":"Benefits of nintedanib continuation in systemic autoimmune rheumatic disease-related progressive pulmonary fibrosis: KEIO-SARD-ILD-cohort","authors":"Koji Suzuki,&nbsp;Mitsuhiro Akiyama,&nbsp;Kanako Shimanuki,&nbsp;Hiroyuki Fukui,&nbsp;Yuko Kaneko","doi":"10.1016/j.semarthrit.2025.152891","DOIUrl":"10.1016/j.semarthrit.2025.152891","url":null,"abstract":"<div><h3>Objective</h3><div>To clarify the real-world effectiveness of nintedanib continuation beyond 12 months on pulmonary function in progressive pulmonary fibrosis (PPF) associated with systemic autoimmune rheumatic disease-related interstitial lung disease (SARD-ILD).</div></div><div><h3>Methods</h3><div>We conducted a review of all consecutive SARD-ILD patients from the KEIO-SARD-ILD cohort who received nintedanib for PPF between 2015 and 2025. The primary outcome was the 12-month change in percent predicted forced vital capacity (%FVC) between patients who continued nintedanib for 12 months and those who discontinued treatment earlier. Secondary outcomes included 12-month changes in Krebs von den Lungen-6 (KL-6) levels and mortality between the two groups.</div></div><div><h3>Results</h3><div>Among the 65 patients, systemic sclerosis was the most common underlying condition (<em>n</em> = 16), followed by idiopathic inflammatory myopathies (<em>n</em> = 15), and rheumatoid arthritis (<em>n</em> = 13). The overall 12-month retention rate of nintedanib was 69.2 %. Both the continuation and discontinuation groups exhibited a comparable decline in %FVC in 12 months prior to nintedanib initiation (-3.6 % vs. -3.8 %, <em>p</em> = 0.58), but after 12 months of treatment, the continuation group demonstrated a significantly greater improvement in %FVC (1.8 % vs. -3.5 %, <em>p</em> = 0.01) and KL-6 (-175 vs 71 U/mL, <em>p</em> = 0.04) compared to the discontinuation group. The ILD-related survival rates were better in the continuation group compared to the discontinuation group (<em>p</em> = 0.02).</div></div><div><h3>Conclusions</h3><div>Continuation of nintedanib beyond 12 months, compared with discontinuation within 12 months, is associated with significant improvements in pulmonary function, biomarkers, and survival in patients with SARD-ILD-related PPF, suggesting that long-term nintedanib therapy plays a critical role in stabilizing disease progression.</div></div>","PeriodicalId":21715,"journal":{"name":"Seminars in arthritis and rheumatism","volume":"76 ","pages":"Article 152891"},"PeriodicalIF":4.4,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145750220","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":"Exploring factors contributing to frailty in Chinese patients with rheumatoid arthritis: Validation of a tailored assessment tool","authors":"Bingxin Ma ,&nbsp;Yan Kan ,&nbsp;Jie Lv ,&nbsp;Jianyu Sun ,&nbsp;Juan Kang ,&nbsp;Xinyi Dong ,&nbsp;Junwei Ma ,&nbsp;Shixiang Chen ,&nbsp;Jin Yang ,&nbsp;Yue Zhao ,&nbsp;Qi Lu","doi":"10.1016/j.semarthrit.2025.152896","DOIUrl":"10.1016/j.semarthrit.2025.152896","url":null,"abstract":"<div><h3>Aims</h3><div>To identify the factors associated with frailty in Chinese participants with rheumatoid arthritis (RA), guided by the health ecology theory, and to provide a culturally adapted and psychometrically validated Chinese version of the Comprehensive Rheumatologic Assessment of Frailty (CRAF) to support context-specific assessments in clinical practice.</div></div><div><h3>Methods</h3><div>This cross-sectional study involved the translation and cultural adaptation of the CRAF using a modified Brislin method. Psychometric properties were evaluated, and factors associated with frailty were identified through multivariate ordered logistic regression, guided by the health ecology theory.</div></div><div><h3>Results</h3><div>A total of 1288 RA participants were recruited. The Cronbach’s alpha for the Chinese CRAF was 0.75, and the intraclass correlation coefficient was 0.92. The Item-content validity index (CVI) ranged from 0.80 to 1.00, with an average CVI of 0.92. A significant positive correlation between the CRAF and the FRAIL Scale was found (<em>P</em> &lt; 0.001), with the CRAF demonstrating better discriminatory power than the FRAIL scale (<em>P</em> = 0.041). Factors significantly associated with frailty included disease duration, pain intensity, limitations in physical function, the use of methotrexate, non-steroidal anti-inflammatory drugs, glucocorticoids, and biologic disease-modifying antirheumatic drugs, as well as comorbidities such as hypertension, diabetes, cardiovascular disease, stroke/transient ischemic attack, pulmonary disease, diminished grip strength, smoking, depression, and lack of social participation.</div></div><div><h3>Conclusion</h3><div>The Chinese version of the CRAF is a reliable and valid tool for assessing frailty in RA participants. Targeted interventions addressing the identified risk factors may help prevent or delay frailty progression, ultimately improving prognosis and quality of life.</div></div>","PeriodicalId":21715,"journal":{"name":"Seminars in arthritis and rheumatism","volume":"76 ","pages":"Article 152896"},"PeriodicalIF":4.4,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145799065","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":"Incidence and management of first metatarsophalangeal joint osteoarthritis in Dutch general practice estimates from the Rijnmond Primary Care Database","authors":"S.E. (Sabine) Kloprogge,&nbsp;J.J. (Jacoline) van den Driest,&nbsp;L. (Laura) Struik,&nbsp;S.M.A. (Sita) Bierma-Zeinstra,&nbsp;M. (Marienke) van Middelkoop","doi":"10.1016/j.semarthrit.2025.152894","DOIUrl":"10.1016/j.semarthrit.2025.152894","url":null,"abstract":"<div><h3>Objective</h3><div>Osteoarthritis (OA) of the first metatarsophalangeal (MTP) joint is accompanied by pain and stiffness and associated with reduced health-related quality of life. Although prevalence of radiographic 1st MTP joint OA is high, the incidence of clinical 1st MTP joint OA is unknown. Therefore, we aimed to determine the incidence and management of general practice (GP) consultations for symptomatic 1st MTP joint OA.</div></div><div><h3>Methods</h3><div>A retrospective cohort study was conducted using electronic health records of GPs. An algorithm was defined to identify 1st MTP joint OA patients based on free text and codified data between 2013 and 2022. First MTP joint OA incidence rate, comorbidities and management strategies were assessed.</div></div><div><h3>Results</h3><div>The overall 1st MTP joint OA incidence was 0.74/1000 person-years in patients ≥35 years. The most initiated management by GPs was explanation/reassurance (360/672 (53.6 %)), followed by referral to podiatry (171/672 (25.4 %)) and orthopedic surgeon consultation (162/672 (24.1 %)). Of the 823 patients consulting their GP with foot/toe problems in the year before diagnosis, 491 (47.1 %) were referred to radiology, and 271 (26 %) for orthopedic surgeon consultation.</div></div><div><h3>Conclusion</h3><div>The incidence of 1st MTP joint OA has been estimated for the first time in general practice. Most patients are diagnosed after referral to radiology or orthopedic surgeon consultation. From diagnosis, half of 1st MTP joint OA patients are referred, mostly for orthopedic surgeon consultation and podiatry. As evidence for these diagnostic and management strategies is lacking, research into their effectiveness for 1st MTP joint OA in general practice is needed.</div></div>","PeriodicalId":21715,"journal":{"name":"Seminars in arthritis and rheumatism","volume":"76 ","pages":"Article 152894"},"PeriodicalIF":4.4,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145782587","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":"Self-administered screening questionnaires for spondyloarthritis in inflammatory bowel disease: A systematic review","authors":"Romain Schotkosky ,&nbsp;Tiphaine Dujardin ,&nbsp;Marianne Hupé ,&nbsp;Athan Baillet ,&nbsp;Xavier Romand","doi":"10.1016/j.semarthrit.2025.152890","DOIUrl":"10.1016/j.semarthrit.2025.152890","url":null,"abstract":"<div><h3>Objective</h3><div>Although musculoskeletal symptoms are common in patients with inflammatory bowel disease (IBD), spondyloarthritis (SpA) remains underdiagnosed. This systematic review aimed at identifying and comparing self-administered screening questionnaires for SpA in IBD patients.</div></div><div><h3>Methods</h3><div>We conducted a systematic review according to PRISMA guidelines using PubMed, Cochrane, and ACR/EULAR congress databases, with the last search on April 21, 2024. Studies focusing on self-administered screening questionnaires for SpA in IBD patients were included. We extracted questionnaire characteristics and their psychometric data. The content validity of each questionnaire was assessed using the COSMIN method.</div></div><div><h3>Results</h3><div>A total of 1491 articles were screened. Eight were included and six screening questionnaires were identified. Two questionnaires assessed axial, one peripheral and three both axial and peripheral symptoms of SpA. The IBIS-Q questionnaire showed the highest sensitivity (92.7 %), while the Queiro’s axial questionnaire had the highest specificity (89.8 %). The DETAIL questionnaire gave the highest post-test probability to have a SpA with a positive likelihood ratio of at least 14, using a threshold of three affirmative responses. None of these questionnaires met all criteria of the COSMIN methodology to evaluate their quality. The content validity of the questionnaires was judged to be sufficient or inconsistent by reviewers with moderate qualities of evidence at best.</div></div><div><h3>Conclusions</h3><div>Six self-administered questionnaires have been developed to screen for SpA in IBD patients. Limited methodological transparency hinders direct comparison. Although none of the available questionnaires fully meets validation standards, the DETAIL questionnaire appears to offer the greatest clinical potential, despite only moderate-quality evidence.</div></div>","PeriodicalId":21715,"journal":{"name":"Seminars in arthritis and rheumatism","volume":"76 ","pages":"Article 152890"},"PeriodicalIF":4.4,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145799056","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":"Erratum to “Magnetic resonance imaging for adult idiopathic inflammatory myopathies: a scoping review of protocols, grading systems and applications”[Seminars in Arthritis and Rheumatism Volume 75, (2025) 152865]","authors":"Jessica A. Day ,&nbsp;Daniel Brito de Araújo ,&nbsp;Mickael Essouma ,&nbsp;Edoardo Conticini ,&nbsp;Lisa G. Rider ,&nbsp;Daren Gibson ,&nbsp;Adriana Maluf Elias ,&nbsp;Claudia Saad Magalhães ,&nbsp;Simone Appenzeller ,&nbsp;Adam Schiffenbauer ,&nbsp;Anneke J van der Koi ,&nbsp;Siamak Moghadam-Kia ,&nbsp;Vitor Tavares Paula ,&nbsp;Julio Brandão Guimarães ,&nbsp;Edoardo Marrani ,&nbsp;Andrea Schwarz Doria ,&nbsp;Samuel Katsuyuki Shinjo","doi":"10.1016/j.semarthrit.2025.152899","DOIUrl":"10.1016/j.semarthrit.2025.152899","url":null,"abstract":"","PeriodicalId":21715,"journal":{"name":"Seminars in arthritis and rheumatism","volume":"76 ","pages":"Article 152899"},"PeriodicalIF":4.4,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145884780","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":"Metabolomics in systemic lupus erythematosus: A systematic review and meta-analysis","authors":"Susana Barrera-Hernández ,&nbsp;Claudia Mendoza-Pinto ,&nbsp;Pamela Munguía-Realpozo ,&nbsp;Ivet Etchegaray-Morales ,&nbsp;Blanca Guadalupe Baez-Duarte ,&nbsp;Irma Zamora-Ginez ,&nbsp;Edith Ramírez-Lara ,&nbsp;Álvaro José Montiel-Jarquin ,&nbsp;Máximo Alejandro García-Flores ,&nbsp;Socorro Méndez-Martínez","doi":"10.1016/j.semarthrit.2025.152893","DOIUrl":"10.1016/j.semarthrit.2025.152893","url":null,"abstract":"<div><h3>Background</h3><div>Systemic lupus erythematosus (SLE) still lacks highly specific biomarkers; high-throughput metabolomics offers a route to elucidate disease-defining metabolic perturbations.</div></div><div><h3>Objective</h3><div>This systematic review aims to identify common metabolite changes related to SLE.</div></div><div><h3>Methods</h3><div>PubMed, Web of Science, Scopus, and the Cochrane Library were searched through November 2024 for human observational studies comparing the metabolomic profiles of adult SLE patients with those of healthy controls. Random-effects meta-analyses used the ratio of means (RoM); heterogeneity was assessed using the I² statistic.</div></div><div><h3>Results</h3><div>Forty-six studies comprising 2,238 SLE patients and 1,761 healthy controls (total n = 3,999) were included. Ten metabolites, each reported in ≥2 of the five eligible studies, were quantitatively synthesized. Compared with controls, isoleucine (RoM = 0.73, 95 % CI = 0.72–0.74, I² = 0 %), leucine (RoM = 0.81, 95 % CI = 0.80–0.81, I² = 0 %), and tryptophan (RoM = 0.73, 95 % CI = 0.64–0.84, I² = 75 %) were significantly lower in SLE, whereas methionine was significantly higher (RoM = 1.54, 95 % CI = 1.26–1.88, I² = 88 %). Lipid remodeling included elevated oleic acid (RoM = 1.42, 95 % CI = 1.19–1.69, I² = 0 %) and reduced capric acid (RoM = 0.80, 95 % CI = 0.67–0.95, I² = 31 %). Qualitative synthesis revealed consistent reduction of tricarboxylic acid intermediates, accumulation of acylcarnitines, and an oxidized-lipid signature (e.g., 9-hydroxyoctadecadienoic acid, leukotriene B4), implying mitochondrial stress and redox imbalance.</div></div><div><h3>Conclusions</h3><div>Metabolomic profiling identifies a reproducible SLE signature: relative to controls, branched-chain (isoleucine, leucine) and aromatic (tryptophan) amino acids are lower, methionine is higher, and lipid profiles show higher oleic and lower capric acids, patterns consistent with impaired mitochondrial energetics and altered one-carbon flux.</div></div>","PeriodicalId":21715,"journal":{"name":"Seminars in arthritis and rheumatism","volume":"76 ","pages":"Article 152893"},"PeriodicalIF":4.4,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145820675","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":"Juvenile-onset mixed connective tissue disease: A multicenter retrospective cohort study","authors":"Kevin Chevalier ,&nbsp;Brigitte Bader-Meunier ,&nbsp;Isabelle Kone-Paut ,&nbsp;Benjamin Thoreau ,&nbsp;Marc Michel ,&nbsp;Bertrand Godeau ,&nbsp;Christian Agard ,&nbsp;Thomas Papo ,&nbsp;Karim Sacre ,&nbsp;Raphaèle Seror ,&nbsp;Xavier Mariette ,&nbsp;Patrice Cacoub ,&nbsp;Ygal Benhamou ,&nbsp;Mathilde Leclercq ,&nbsp;Cécile Goujard ,&nbsp;Olivier Lambotte ,&nbsp;Bernard Bonnotte ,&nbsp;Maxime Samson ,&nbsp;Félix Ackermann ,&nbsp;Jean Schmidt ,&nbsp;Benjamin Chaigne","doi":"10.1016/j.semarthrit.2025.152889","DOIUrl":"10.1016/j.semarthrit.2025.152889","url":null,"abstract":"<div><h3>Objectives</h3><div>Juvenile-onset mixed connective tissue disease (jMCTD) accounts for 7–23 % of MCTD cases but remains poorly described. We aimed to characterize clinical features, treatments, and outcomes of patients with jMCTD, and compare them to adult-onset MCTD (aMCTD) patients.</div></div><div><h3>Methods</h3><div>We conducted a multicenter, retrospective, case-control study within the French MCTD cohort. Each jMCTD patient was compared to 3 matched aMCTD patients.</div></div><div><h3>Results</h3><div>Forty-seven jMCTD patients (93.6 % girls; median age at onset 14 [11–16] years) were included. Forty-four (93.6 %) jMCTD patients fulfilled either Sharp or Kasukawa diagnostic criteria. None of them met other diagnostic criteria without fulfilling Sharp or Kasukawa criteria. At diagnosis, jMCTD patients’ main manifestations were Raynaud’s phenomenon, arthralgia, and myalgia. jMCTD patients had less frequently puffy fingers than aMCTD (<em>p</em> &lt; 0.0001). Cumulatively, jMCTD patients mainly received glucocorticoids (80.9 %), hydroxychloroquine (95.7 %) and immunosuppressants (93.6 %). They received a higher initial dose of glucocorticoids (30 [20–60] mg/day <em>vs.</em> 15 [10–35] mg/day, <em>p</em> = 0.02), and significantly more frequently methotrexate (Methotrexate) and rituximab (<em>p</em> = 0.01) over time compared to aMCTD. After a median follow-up of 9.8 [6.6–16.2] years, 29 (61.7 %) jMCTD patients were in remission (<em>vs.</em> 62 (44.0 %) aMCTD; <em>p</em> &lt; 0.05), 36 % had progressed to another CTD (<em>vs</em>. 30.5 % aMCTD; <em>p</em> = 0.5), mainly systemic lupus erythematosus, 11 (23.4 %) had developed interstitial lung disease, 2 (4.3 %) pulmonary arterial hypertension, and 1 (2.1 %) died.</div></div><div><h3>Conclusions</h3><div>jMCTD share the same clinical characteristics as aMCTD patients, but less frequently have puffy fingers. Outcomes appear more favorable in jMCTD than aMCTD, with higher remission rates, albeit at the cost of more intensive treatment.</div></div>","PeriodicalId":21715,"journal":{"name":"Seminars in arthritis and rheumatism","volume":"76 ","pages":"Article 152889"},"PeriodicalIF":4.4,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145782627","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}