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":"2025-11-22","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":"Prevalence, incidence and mortality of interstitial lung disease in patients with Sjogren disease: data from the prospective observational “EMERGE” study","authors":"Andreina Manfredi ,&nbsp;Caterina Vacchi ,&nbsp;Stefania Cerri ,&nbsp;Roberta Eufrasia Ledda ,&nbsp;Roberto D'Amico ,&nbsp;Fabrizio Luppi ,&nbsp;Fabrizio Pancaldi ,&nbsp;Giulia Cassone ,&nbsp;Alessandra Rai ,&nbsp;Dario Andrisani ,&nbsp;Filippo Gozzi ,&nbsp;Giovanni Della Casa ,&nbsp;Lucia Dardani ,&nbsp;Fabiola Atzeni ,&nbsp;Athina Patsoura ,&nbsp;Francesca Cozzini ,&nbsp;Marco Sebastiani","doi":"10.1016/j.semarthrit.2025.152886","DOIUrl":"10.1016/j.semarthrit.2025.152886","url":null,"abstract":"<div><h3>Background</h3><div>Interstitial lung disease (ILD) is a severe pulmonary complication of Sjögren disease (SjD), but its prevalence, natural history and survival are not completely understood. Our study aimed to investigate prevalence, incidence, and mortality of SjD-ILD in a cohort of unselected consecutive SjD patients.</div></div><div><h3>Methods</h3><div>all consecutive SjD patients referred to our centre were enrolled in the study. A careful assessment for respiratory symptoms was periodically performed for each patient, and high-resolution computed tomography (HRCT) was requested in case of new-onset dyspnoea, persistent dry cough, or detection of velcro crackles by mean of electronic auscultation (VECTOR).</div></div><div><h3>Findings</h3><div>At enrolment, ILD was detected in 61/257 patients with a prevalence of 23.7 %. During a mean follow-up of 42.6 ± 14.6 months, 3 new cases of ILD were recorded, with an incidence of 0.41 new cases per 100 patients/year. Multivariate analysis showed a direct association between ILD and male sex, age at SjD diagnosis, and erythro‑sedimentation rate &gt;40 mm, and an inverse correlation with sicca syndrome. Nonspecific interstitial pneumonia was the most observed HRCT pattern, followed by usual interstitial pneumonia. During the follow-up, 21 patients (8.2 %) died, with a statistically significant difference between the overall survival of patients with (66.5 %±11.7) and without ILD (88.4 %±5.5) (<em>p</em>&lt;0.001). A fibrotic pattern was associated to a worse survival rate, while no difference was observed according to the radiologic pattern. Anti-SSA antibody was a protective factor for death, while the age at diagnosis of SjD, and the extent of ILD at HRCT were directly associated to an increased mortality.</div></div><div><h3>Interpretation</h3><div>ILD can be identified in a high number of SjD patients, inducing a significant impairment in survival. The ILD extent, but not HRCT pattern of ILD, represents the main predictor of mortality. Therefore, careful monitoring, by a multidisciplinary team, should be ensured to all SjD-ILD patients.</div></div>","PeriodicalId":21715,"journal":{"name":"Seminars in arthritis and rheumatism","volume":"76 ","pages":"Article 152886"},"PeriodicalIF":4.4,"publicationDate":"2025-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145828137","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":"The osteoarticular features of Gitelman Syndrome: Chondrocalcinosis and more","authors":"Ting Zhang ,&nbsp;You Ke ,&nbsp;Zhenxiao Lei ,&nbsp;Xiuliang Zhu ,&nbsp;Lijun Mou","doi":"10.1016/j.semarthrit.2025.152883","DOIUrl":"10.1016/j.semarthrit.2025.152883","url":null,"abstract":"<div><h3>Objective</h3><div>To characterize the clinical and radiographic osteoarticular features of patients with Gitelman Syndrome (GS) in a prospective Chinese cohort.</div></div><div><h3>Methods</h3><div>Patients with clinically and genetically diagnosed GS were prospectively and systematically screened for osteoarticular involvement. Clinical manifestations, laboratory parameters, and radiographic findings were recorded. Patients were categorized as: chondrocalcinosis, or calcium pyrophosphate deposition (CPPD), non-chondrocalcinosis osteoarticular abnormalities, and non-radiographic GS. Group differences were analyzed.</div></div><div><h3>Results</h3><div>A total of 110 patients with GS were enrolled (mean age 39.90±13.70 years, 52.73% females), and 46 (41.82%) reported arthralgia. Radiographically, 46 patients (41.82%) were classified as CPPD, 15 (13.64%) showed non-chondrocalcinosis abnormalities, and 49 (44.54%) had no detectable osteoarticular involvement. CPPD patients were significantly older and had lower serum magnesium and estimated glomerular filtration rate (eGFR) compared with non-radiographic patients. Arthralgia occurred in 78.26% of CPPD cases. Knees were the most frequently involved joints in patients with CPPD, followed by cervical spine, Archilles tendon, hips, hands, shoulders, and wrists. Remarkably, non-chondrocalcinosis findings included dense bone islands and condensing osteitis of the sacroiliac joint.</div></div><div><h3>Conclusion</h3><div>CPPD presents in 41.82% of patients with GS. Low serum magnesium and decreased eGFR are risk factors for CPPD. In addition to chondrocalcinosis, GS may be associated with other osteoarticular manifestations, including dense bone islands and condensing osteitis.</div></div>","PeriodicalId":21715,"journal":{"name":"Seminars in arthritis and rheumatism","volume":"75 ","pages":"Article 152883"},"PeriodicalIF":4.4,"publicationDate":"2025-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145575990","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":"Distinct predictors of peripheral neuropathy in antineutrophil cytoplasmic antibody-associated vasculitis: KEIO-vasculitis cohort","authors":"Yuki Imai ,&nbsp;Sho Ishigaki ,&nbsp;Mitsuhiro Akiyama,&nbsp;Yuko Kaneko","doi":"10.1016/j.semarthrit.2025.152882","DOIUrl":"10.1016/j.semarthrit.2025.152882","url":null,"abstract":"<div><h3>Objectives</h3><div>Peripheral neuropathy affects quality of life in patients with anti-neutrophil cytoplasmic autoantibody (ANCA)-associated vasculitis. Early recognition and treatment initiation are essential to prevent irreversible nerve damage. The aim of this study was to identify baseline factors associated with peripheral neuropathy in ANCA-associated vasculitis.</div></div><div><h3>Methods</h3><div>A total of 111 consecutive patients with newly diagnosed, treatment-naïve, active ANCA-associated vasculitis were enrolled. Baseline characteristics were compared among the three groups: patients without peripheral neuropathy, with sensory neuropathy, and with sensorimotor neuropathy. Analysis was further stratified by disease subtypes (eosinophilic granulomatosis with polyangiitis, EGPA; granulomatosis with polyangiitis, GPA; microscopic polyangiitis, MPA).</div></div><div><h3>Results</h3><div>Patients with EGPA (84.6 %) were most prone to having peripheral neuropathy compared with GPA (20.0 %) and MPA (28.9 %) (<em>P</em> &lt; 0.001). Among patients with EGPA, baseline eosinophil counts showed a stepwise increase with peripheral neuropathy severity: 2340/μL in patients without peripheral neuropathy, 4276/μL with sensory neuropathy, and 11,859/μL with sensorimotor neuropathy (<em>P</em> = 0.004). The most useful cutoff values of baseline eosinophil counts to predict peripheral neuropathy and sensorimotor neuropathy were 2468/μL (sensitivity 90 % and specificity 75 %) and 6724/μL (sensitivity 80 % and specificity 71 %), respectively. In patients with GPA and MPA, the neutrophil-to-lymphocyte ratio tended to rise with increasing peripheral neuropathy severity, although the difference was not statistically significant.</div></div><div><h3>Conclusion</h3><div>Baseline eosinophil counts may be useful predictors for both the presence and motor involvement of peripheral neuropathy in patients with EGPA, highlighting their clinical utility and early risk stratification. In GPA and MPA, neutrophil-driven inflammation may contribute to peripheral neuropathy development.</div></div>","PeriodicalId":21715,"journal":{"name":"Seminars in arthritis and rheumatism","volume":"75 ","pages":"Article 152882"},"PeriodicalIF":4.4,"publicationDate":"2025-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145576041","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":"Identifying domains for CNO and SAPHO: A scoping review to create domains from existing outcomes by the OMERACT CNO and SAPHO working group","authors":"Melissa Oliver ,&nbsp;Farzana Nuruzzaman ,&nbsp;Aleksander Lenert ,&nbsp;Arundathi Jayatilleke ,&nbsp;Alexander Theos ,&nbsp;Natalia Palmou-Fontana ,&nbsp;Alissa Skinner ,&nbsp;Marinka Twilt ,&nbsp;Eveline Y. Wu ,&nbsp;Cassyanne Aguiar ,&nbsp;Samir Shah ,&nbsp;Micol Romano ,&nbsp;Suzanne Li ,&nbsp;Sivia Lapidus ,&nbsp;Jenna King ,&nbsp;Sierra Gerber ,&nbsp;Bethany Welc ,&nbsp;Lindsey Bergstrom ,&nbsp;Emily Fox ,&nbsp;Matthew Hollander ,&nbsp;Yongdong Zhao","doi":"10.1016/j.semarthrit.2025.152862","DOIUrl":"10.1016/j.semarthrit.2025.152862","url":null,"abstract":"<div><h3>Introduction</h3><div>Chronic nonbacterial osteomyelitis (CNO) and synovitis, acne, pustulosis, hyperostosis, and osteitis (SAPHO) syndrome are autoinflammatory bone diseases of unknown etiology that present with bone pain and varying degrees of extraosseous manifestations such as skin, intestinal and joint involvement. Currently, there are no validated outcome measurement sets that represent the input from all collaborating groups.</div></div><div><h3>Methods</h3><div>The OMERACT CNO &amp; SAPHO working group performed a scoping review to identify domains previously used in CNO and SAPHO clinical studies. The list of potential domains was narrowed through a process of binning and winnowing.</div></div><div><h3>Results</h3><div>A scoping review included 260 observational studies published from 1978 -2020 and 220 domains were initially identified. Domains were reduced to 25 through a binning and winnowing process. Domains cover each of the OMERACT core with most domains mapped to life impact and pathophysiological manifestations.</div></div><div><h3>Conclusion</h3><div>We identified 25 potential domains covering health concepts of function, disease manifestations, pain, and impact on mental health and societal participation to be included in the final core domain set. The next step will be to reach a consensus on the final CNO &amp; SAPHO core domain set and begin instrument selection.</div></div>","PeriodicalId":21715,"journal":{"name":"Seminars in arthritis and rheumatism","volume":"75 ","pages":"Article 152862"},"PeriodicalIF":4.4,"publicationDate":"2025-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145574333","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":"Distinct changes in nailfold capillaries are associated with the clinical and serological features of patients with systemic lupus erythematosus","authors":"Line Kjær Winberg ,&nbsp;Mojgan Sarafrazi ,&nbsp;Malte Lund Adamsen ,&nbsp;Amanda Hempel Zinglersen ,&nbsp;Henrik Christian Bidstrup Leffers ,&nbsp;Louise Pyndt Diederichsen ,&nbsp;Søren Jacobsen","doi":"10.1016/j.semarthrit.2025.152871","DOIUrl":"10.1016/j.semarthrit.2025.152871","url":null,"abstract":"<div><h3>Background</h3><div>The role of nailfold videocapillaroscopy (NVC) in systemic lupus erythematosus (SLE) remains undefined. Prognostic tools are needed for SLE as the phenotypes differ in prognosis and treatment. Recent studies have reported a high prevalence of capillary abnormalities in SLE. This study investigated whether distinct NVC patterns are associated with distinct SLE phenotypes.</div></div><div><h3>Methods</h3><div>We did NVC and comprehensive clinical characterisation in 56 patients with SLE. Correlations within NVC findings were tested using Spearman's rho. Subsets of patients with similar NVC changes were identified through hierarchical cluster analysis of principal components based on Z-normalised scores, and associations with clinical phenotypes were analysed using multinomial logistic regression.</div></div><div><h3>Results</h3><div>The cohort included 56 patients with SLE who had a median SLEDAI score of 6 (interquartile range: 3–10). The capillaroscopic alterations observed were ramifications (66%), disorganisation (89%), tortuous appearance (75%), low density (86%), meandering appearance (52%), dilatations (23%), and microhaemorrhages (29%). Cluster analysis identified three clusters: one dominated by ramifications (<em>n</em> = 16), one dominated by dilations (<em>n</em> = 10), and an unspecific reference cluster. The cluster dominated by ramifications correlated with chronic cutaneous lupus and Raynaud's phenomenon, while the cluster dominated by dilatations correlated with antiphospholipid syndrome and the presence of ≥2 antiphospholipid antibodies.</div></div><div><h3>Conclusions</h3><div>Capillaroscopic alterations are common in patients with SLE, and capillary ramifications and dilations are linked to distinct SLE phenotypes. The potential of NVC as a prognostic tool for specific organ involvement in patients with SLE should be further explored, hopefully paving the way for early prevention of severe manifestations and damage.</div></div>","PeriodicalId":21715,"journal":{"name":"Seminars in arthritis and rheumatism","volume":"75 ","pages":"Article 152871"},"PeriodicalIF":4.4,"publicationDate":"2025-11-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145534612","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":"Corrigendum to “Autonomic dysfunction symptoms in Sjögren's Disease: A missed dimension linked to disease burden and work disability” [Seminars in Arthritis and Rheumatology 75 (2025) 152832]","authors":"Helena Achten ,&nbsp;Deroo Liselotte ,&nbsp;Vanhoof Sophie ,&nbsp;De Boeck Kristel ,&nbsp;Deprez Joke ,&nbsp;Dumas Emilie ,&nbsp;Genbrugge Eva ,&nbsp;Bauters Wouter ,&nbsp;Roels Dimitri ,&nbsp;Dochy Frederick ,&nbsp;Creytens David ,&nbsp;Elewaut Dirk ,&nbsp;Isabelle Peene","doi":"10.1016/j.semarthrit.2025.152860","DOIUrl":"10.1016/j.semarthrit.2025.152860","url":null,"abstract":"","PeriodicalId":21715,"journal":{"name":"Seminars in arthritis and rheumatism","volume":"75 ","pages":"Article 152860"},"PeriodicalIF":4.4,"publicationDate":"2025-11-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145496623","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":"Commentary on: “Prevalence of frailty and prefrailty in systemic lupus erythematosus: A systematic review and meta-analysis”","authors":"Digvijay Singh Rajawat ,&nbsp;Saketh Sainag Mandiga ,&nbsp;Venkata Dileep Kumar Veldi","doi":"10.1016/j.semarthrit.2025.152876","DOIUrl":"10.1016/j.semarthrit.2025.152876","url":null,"abstract":"","PeriodicalId":21715,"journal":{"name":"Seminars in arthritis and rheumatism","volume":"75 ","pages":"Article 152876"},"PeriodicalIF":4.4,"publicationDate":"2025-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145575989","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":"Considerations for integrating SGLT2 inhibitors into systemic lupus erythematosus management: Opportunities and challenges","authors":"Yanhao Chen ,&nbsp;Xiang Li ,&nbsp;Jiao Zhang ,&nbsp;Xingyu Yang ,&nbsp;Jie Bao ,&nbsp;Yongsheng Fan ,&nbsp;Shuo Huang","doi":"10.1016/j.semarthrit.2025.152867","DOIUrl":"10.1016/j.semarthrit.2025.152867","url":null,"abstract":"","PeriodicalId":21715,"journal":{"name":"Seminars in arthritis and rheumatism","volume":"75 ","pages":"Article 152867"},"PeriodicalIF":4.4,"publicationDate":"2025-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145524341","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":"Recurrent thrombosis and hemorrhagic events in a large single-center primary antiphospholipid syndrome cohort: Results from APS-Rio cohort after nearly 1,000 patient-years of follow-up","authors":"Flavio Signorelli ,&nbsp;Gustavo Guimarães Moreira Balbi ,&nbsp;Vinícius Pereira Bastos ,&nbsp;Thaiana Reis-Carvalho ,&nbsp;Evandro Mendes Klumb ,&nbsp;Roger Abramino Levy","doi":"10.1016/j.semarthrit.2025.152873","DOIUrl":"10.1016/j.semarthrit.2025.152873","url":null,"abstract":"<div><h3>Objective</h3><div>Estimating the incidence of new thrombotic and hemorrhagic events in a single-center prospective cohort of Primary Antiphospholipid Syndrome (PAPS) patients over approximately 7.5 years and identifying risk factors associated with a first recurrent thrombotic and hemorrhagic event.</div></div><div><h3>Methods</h3><div>Incidence rates of thrombosis and hemorrhage were calculated considering that patients remained at continuous risk and could experience multiple events. For time-to-event analysis of the first thrombotic episode, patients were followed until their first thrombotic event or last outpatient visit, and baseline clinical and laboratory data were compared. Statistical analysis included Kaplan-Meier curves, log-rank test and Cox proportional hazards modeling.</div></div><div><h3>Results</h3><div>A total of 155 PAPS patients were included, 83.2 % were female. Hypertension was present in 43.9 %, and diabetes in 9 %. Lupus anticoagulant was the most common antibody (93.4 %). During 942 patient-years of follow-up, 32 thrombotic events (18 arterial, 12 venous, and 2 thrombotic microangiopathies) occurred in 26 patients, yielding an incidence rate of 3.4 per 100 patient-years. The INR was within the therapeutic target in 50 % of the 22 events. The incidence of a first thrombotic event was 3.2 per 100 patient-years, occurring at a mean of 3.2 ± 2.0 years. Diabetes was independently associated with increased thrombotic risk (HR 4.10, 95 % CI 1.72–9.78, <em>p</em> = 0.001). Eight first major hemorrhages were recorded (0.9 per 100 patient-years), with baseline microvascular involvement as associated risk factor (HR 9.04, 95 % CI 2.15–37.92, <em>p</em> = 0.003).</div></div><div><h3>Conclusion</h3><div>Thrombotic events were frequent in PAPS, even with therapeutic INR. Diabetes increased 4-fold the risk of a first thrombotic event.</div></div>","PeriodicalId":21715,"journal":{"name":"Seminars in arthritis and rheumatism","volume":"75 ","pages":"Article 152873"},"PeriodicalIF":4.4,"publicationDate":"2025-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145557945","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}