Lancet Rheumatology最新文献

Psoriatic arthritis develops in up to one-third of individuals with psoriasis, typically following a prolonged subclinical phase. Diagnostic delays are common, often exceeding 2 years, and can result in irreversible joint damage. The growing recognition of this latent period has fuelled interest in earlier identification and interception. However, efforts are hampered by inconsistent definitions of early or subclinical psoriatic arthritis, insufficient prognostic tools, and an absence of consensus on the outcome for interception studies. This Review synthesises a rapidly evolving field, offering a framework organised around four crucial questions: first, what defines progression from psoriasis to psoriatic arthritis? Second, who is most at risk of transition? Third, how can progression be reliably measured using imaging, molecular biomarkers, or digital health technologies? Fourth, when should preventive intervention be considered? We critically examine new conceptual models, the limitations of existing classification criteria, advances in imaging and biomarker research, and the promise of digital phenotyping. Addressing the current challenges in definitions, risk stratification, measurement, and trial design is essential for the development of biologically grounded, ethically robust interception strategies.

Engaging people with lived experience in research improves research quality, relevance, and translation. Yet, people with lived experience are infrequently engaged in rheumatology research even though they can make important contributions to research planning, implementation, interpretation, and dissemination. Engagement levels might include consulting (by providing perspectives on a single topic or problem), advising (via two-way interactions with researchers to make recommendations on one or more aspects of a study), or partnering (by engaging with researchers to make decisions together). Evidence on strategies for engaging people with lived experience, including the research stages during which engagement might be most meaningful, levels of engagement, and how to align specific purposes and activities, is limited. We review principles (defined roles and responsibilities, alignment of engagement purpose and activities, collaborative relationships between researchers and people with lived experience, and recognition of the contributions of people with lived experience) and considerations for specific approaches to engagement to guide researchers on how to meaningfully and effectively engage people with lived experience in rheumatology research.

In rare and complex connective tissue diseases, patient partnership is essential to address diagnostic delays, fragmented care, unmet needs, and the research agenda. European Reference Network (ERN) ReCONNET, the network dedicated to rare and complex connective tissue diseases, has implemented a structured and transferable model of patient partnership. Patients contribute to every phase of research and care development: from identifying unmet needs to co-authoring scientific publications. Patient input also shapes educational initiatives and strategic planning. By institutionalising partnership through governance structures and shared decision-making processes, ERN ReCONNET shows that involving patients as equal stakeholders enhances the relevance, quality, and effect of activities. This Personal View was co-written with the direct partnership of authors with lived experience of rare and complex connective tissue diseases and reports a model that can be adapted to other rare diseases and rheumatological settings, promoting a culture of patient-centred innovation in health-care systems.