Pub Date : 2026-03-19DOI: 10.1016/j.jbspin.2026.106055
Athan Baillet, Minh Vu Chuong Nguyen, Anaïs Courtier, Lisa Guigue, Marie Bossert, Philippe Gaudin, Hubert Marotte, Anne Tournadre, Daniel Wendling, Denis Mulleman
{"title":"Serum biomarkers fail to predict response to adalimumab in axial spondyloarthritis: results from discovery and validation cohorts.","authors":"Athan Baillet, Minh Vu Chuong Nguyen, Anaïs Courtier, Lisa Guigue, Marie Bossert, Philippe Gaudin, Hubert Marotte, Anne Tournadre, Daniel Wendling, Denis Mulleman","doi":"10.1016/j.jbspin.2026.106055","DOIUrl":"https://doi.org/10.1016/j.jbspin.2026.106055","url":null,"abstract":"","PeriodicalId":54902,"journal":{"name":"Joint Bone Spine","volume":" ","pages":"106055"},"PeriodicalIF":4.3,"publicationDate":"2026-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147493906","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-03-19DOI: 10.1016/j.jbspin.2026.106053
Raymond Anna, Savadogo Binta, Bourguiba Rim, Dellal Azeddine, Buob David, Savey Léa, Grateau Gilles, Assaraf Morgane, JeanJacques Boffa, Cez Alexandre, Michel Pierre Antoine, Sellam Jérémie, Georgin Lavialle Sophie, Fautrel Bruno, Mitrovic Stéphane
Objectives: AA amyloidosis (AAA) is a complication of chronic inflammation whose burden is expected to decrease in the era of biological therapies. We assessed the prevalence, clinical and laboratory manifestations, management and evolution of AAA in patients with inflammatory joint diseases (IJDs).
Methods: We retrospectively assessed adults followed from 2008 to 2025 in 2 French tertiary university hospitals. AAA had to be histologically confirmed and related to one of the following IJDs: rheumatoid arthritis, spondylarthritis, juvenile idiopathic arthritis, undifferentiated arthritis or gout.
Results: The prevalence of rheumatoid arthritis- and spondylarthritis-related AAA was low, estimated at 0.6‰ and 0.5‰, respectively. We identified 15 patients with IJD-related AAA: 5 rheumatoid arthritis, 4 spondylarthritis, 2 juvenile idiopathic arthritis, 3 undifferentiated arthritis and 1 gout. Ten (66.7%) patients were from developing countries. All patients experienced delays in diagnosis and treatment. At AAA diagnosis, most patients (80%) were not receiving any treatment for IJD. AAA clinical manifestations were mainly renal and digestive; the median (interquartile range) C-reactive protein level was 41.5 (16.8-59.5) mg/L, serum amyloid A level 31 (13-44) mg/L and proteinuria/creatinuria ratio 3.5 (1.3-5.2) g/mmol. Biological disease-modifying anti-rheumatic drugs were started in 14 patients (1 patient lost to follow-up) and resulted in clinically inactive disease in 57.2%; normal C-reactive protein and serum amyloid A and proteinuria negativity in 71.4%.
Conclusion: In the last 2 decades, AAA occurred in only patients with IJDs who experienced long diagnostic and therapeutic delays, mainly related to country of origin and difficulties in access to care.
{"title":"AA amyloidosis in inflammatory joint diseases in the era of biological therapies: prevalence, manifestations, management and evolution.","authors":"Raymond Anna, Savadogo Binta, Bourguiba Rim, Dellal Azeddine, Buob David, Savey Léa, Grateau Gilles, Assaraf Morgane, JeanJacques Boffa, Cez Alexandre, Michel Pierre Antoine, Sellam Jérémie, Georgin Lavialle Sophie, Fautrel Bruno, Mitrovic Stéphane","doi":"10.1016/j.jbspin.2026.106053","DOIUrl":"https://doi.org/10.1016/j.jbspin.2026.106053","url":null,"abstract":"<p><strong>Objectives: </strong>AA amyloidosis (AAA) is a complication of chronic inflammation whose burden is expected to decrease in the era of biological therapies. We assessed the prevalence, clinical and laboratory manifestations, management and evolution of AAA in patients with inflammatory joint diseases (IJDs).</p><p><strong>Methods: </strong>We retrospectively assessed adults followed from 2008 to 2025 in 2 French tertiary university hospitals. AAA had to be histologically confirmed and related to one of the following IJDs: rheumatoid arthritis, spondylarthritis, juvenile idiopathic arthritis, undifferentiated arthritis or gout.</p><p><strong>Results: </strong>The prevalence of rheumatoid arthritis- and spondylarthritis-related AAA was low, estimated at 0.6‰ and 0.5‰, respectively. We identified 15 patients with IJD-related AAA: 5 rheumatoid arthritis, 4 spondylarthritis, 2 juvenile idiopathic arthritis, 3 undifferentiated arthritis and 1 gout. Ten (66.7%) patients were from developing countries. All patients experienced delays in diagnosis and treatment. At AAA diagnosis, most patients (80%) were not receiving any treatment for IJD. AAA clinical manifestations were mainly renal and digestive; the median (interquartile range) C-reactive protein level was 41.5 (16.8-59.5) mg/L, serum amyloid A level 31 (13-44) mg/L and proteinuria/creatinuria ratio 3.5 (1.3-5.2) g/mmol. Biological disease-modifying anti-rheumatic drugs were started in 14 patients (1 patient lost to follow-up) and resulted in clinically inactive disease in 57.2%; normal C-reactive protein and serum amyloid A and proteinuria negativity in 71.4%.</p><p><strong>Conclusion: </strong>In the last 2 decades, AAA occurred in only patients with IJDs who experienced long diagnostic and therapeutic delays, mainly related to country of origin and difficulties in access to care.</p>","PeriodicalId":54902,"journal":{"name":"Joint Bone Spine","volume":" ","pages":"106053"},"PeriodicalIF":4.3,"publicationDate":"2026-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147494719","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-03-11DOI: 10.1016/j.jbspin.2026.106051
Josephine Therkildsen, Rasmus Klose-Jensen, Anne-Birgitte G Blavnsfeldt, Stinne R Greisen, Bente L Langdahl, Jesper S Thomsen, Sarah L Manske, Bent Deleuran, Kresten K Keller, Ellen-Margrethe Hauge
{"title":"High Negative Predictive Value of CXCL13 for One-year Erosive Progression in Long-standing Rheumatoid Arthritis - A Cohort Study using High-Resolution CT and Radiography.","authors":"Josephine Therkildsen, Rasmus Klose-Jensen, Anne-Birgitte G Blavnsfeldt, Stinne R Greisen, Bente L Langdahl, Jesper S Thomsen, Sarah L Manske, Bent Deleuran, Kresten K Keller, Ellen-Margrethe Hauge","doi":"10.1016/j.jbspin.2026.106051","DOIUrl":"https://doi.org/10.1016/j.jbspin.2026.106051","url":null,"abstract":"","PeriodicalId":54902,"journal":{"name":"Joint Bone Spine","volume":" ","pages":"106051"},"PeriodicalIF":4.3,"publicationDate":"2026-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147461219","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-03-11DOI: 10.1016/j.jbspin.2026.106050
Camille Lagarde, Franck Grados, Bruno Bonnaire, Mathilde Warin, Vincent Goëb
{"title":"Condensation of the lower part of the iliac bone.","authors":"Camille Lagarde, Franck Grados, Bruno Bonnaire, Mathilde Warin, Vincent Goëb","doi":"10.1016/j.jbspin.2026.106050","DOIUrl":"https://doi.org/10.1016/j.jbspin.2026.106050","url":null,"abstract":"","PeriodicalId":54902,"journal":{"name":"Joint Bone Spine","volume":" ","pages":"106050"},"PeriodicalIF":4.3,"publicationDate":"2026-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147461182","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-03-09DOI: 10.1016/j.jbspin.2026.106049
Gaetan Noeppel, Raluca Prunel, Yves-Marie Pers
{"title":"From Multiple Sclerosis to Spondyloarthritis: A Case of Teriflunomide-Associated Immune-Mediated Disease.","authors":"Gaetan Noeppel, Raluca Prunel, Yves-Marie Pers","doi":"10.1016/j.jbspin.2026.106049","DOIUrl":"https://doi.org/10.1016/j.jbspin.2026.106049","url":null,"abstract":"","PeriodicalId":54902,"journal":{"name":"Joint Bone Spine","volume":" ","pages":"106049"},"PeriodicalIF":4.3,"publicationDate":"2026-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147437740","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-03-03DOI: 10.1016/j.jbspin.2026.106048
Christian Hubert Roux, Jean-François Gonzelez, Jacques Sedat, Mahamadou Sidibe, Yves Chau
Knee osteoarthritis is increasingly recognized as a whole-organ disease in which synovial inflammation and neurovascular alterations contribute substantially to pain and functional impairment. In recent years, genicular artery embolization (GAE) has emerged as a minimally invasive, image-guided intervention targeting pathological synovial hypervascularization in patients with symptomatic knee osteoarthritis refractory to conservative treatment. This narrative review summarizes the pathophysiological rationale underlying GAE, focusing on the role of synovitis, angiogenesis, and neurovascular coupling in osteoarthritic pain. We provide an overview of the anatomical and technical principles of the procedure and critically appraise the available clinical evidence, including observational studies and randomized sham-controlled trials. While early observational studies have consistently reported clinically meaningful pain reduction, randomized evidence remains heterogeneous and highlights a substantial placebo response. Current data suggest that GAE may benefit selected patients with mild-to-moderate disease and inflammatory phenotypes, whereas its role in advanced osteoarthritis remains limited. Finally, we discuss unresolved issues, including patient selection, choice of embolic agents, and long-term safety, and outline future research directions required to define the place of GAE in the therapeutic algorithm of knee osteoarthritis.
{"title":"Genicular artery embolization in knee osteoarthritis: rationale, evidence, and perspectives for rheumatologic practice.","authors":"Christian Hubert Roux, Jean-François Gonzelez, Jacques Sedat, Mahamadou Sidibe, Yves Chau","doi":"10.1016/j.jbspin.2026.106048","DOIUrl":"https://doi.org/10.1016/j.jbspin.2026.106048","url":null,"abstract":"<p><p>Knee osteoarthritis is increasingly recognized as a whole-organ disease in which synovial inflammation and neurovascular alterations contribute substantially to pain and functional impairment. In recent years, genicular artery embolization (GAE) has emerged as a minimally invasive, image-guided intervention targeting pathological synovial hypervascularization in patients with symptomatic knee osteoarthritis refractory to conservative treatment. This narrative review summarizes the pathophysiological rationale underlying GAE, focusing on the role of synovitis, angiogenesis, and neurovascular coupling in osteoarthritic pain. We provide an overview of the anatomical and technical principles of the procedure and critically appraise the available clinical evidence, including observational studies and randomized sham-controlled trials. While early observational studies have consistently reported clinically meaningful pain reduction, randomized evidence remains heterogeneous and highlights a substantial placebo response. Current data suggest that GAE may benefit selected patients with mild-to-moderate disease and inflammatory phenotypes, whereas its role in advanced osteoarthritis remains limited. Finally, we discuss unresolved issues, including patient selection, choice of embolic agents, and long-term safety, and outline future research directions required to define the place of GAE in the therapeutic algorithm of knee osteoarthritis.</p>","PeriodicalId":54902,"journal":{"name":"Joint Bone Spine","volume":" ","pages":"106048"},"PeriodicalIF":4.3,"publicationDate":"2026-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147367260","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-03-01Epub Date: 2025-09-29DOI: 10.1016/j.jbspin.2025.105984
Florian Bailly , Benjamin Granger , Violaine Foltz , Sofiane Kab , Audrey Petit , Florence Tubach , Bruno Fautrel
Objective
Musculoskeletal pain (MP) is a leading cause of disability worldwide, affecting individual well-being and public health. However, in the literature, the prevalence of MP varies considerably because of methodological inconsistencies, selection biases, and differences in case definitions. This study aimed to estimate the population-based prevalence of MP in France and identify key demographic, socioeconomic, and occupational factors associated with MP.
Methods
This cross-sectional study used baseline data for the CONSTANCES cohort study, a large, population-based epidemiological study with participants representative of the French adult population (18–69 years old). Inverse probability weighting was used to correct for selection bias and to improve the generalizability of prevalence estimates. MP was assessed with the Nordic Musculoskeletal Questionnaire, with significant pain defined as lasting > 30 days in the past 12 months. Multivariate logistic regression models were used to identify factors associated with low back pain, estimating odds ratios (ORs) and 95% confidence intervals (CIs).
Results
Among 193,436 participants, 46.2% reported pain in at least one anatomical site. The most affected areas were the low back (26.6% adjusted prevalence), shoulder (21.4%), neck (19.0%), and knee (19.1%). Odds of low back pain was associated with female sex (OR: 1.39 [95% CI: 1.32–1.47]), older age, obesity, depression (1.71 [1.62–1.80]), and comorbidity burden (1.20 [1.15–1.25]). Odds of low back pain was associated with moderate or high occupational physical activity (OR: 1.33 [1.20–1.50] and 1.69 [1.48–1.93]) but was inversely associated with very active leisure-time physical activity (0.82 [0.70–0.96]). Education level but not household income was a significant socioeconomic factor associated with MP.
Conclusion
MP imposes a substantial burden on the French population, particularly among individuals with physically demanding jobs and low education levels. These findings highlight the paradox of physical activity associated with MP.
目的：肌肉骨骼疼痛（MP）是世界范围内致残的主要原因，影响个人福祉和公共卫生。然而，在文献中，由于方法不一致、选择偏差和病例定义的差异，MP的患病率差异很大。本研究旨在估计法国以人群为基础的MP患病率，并确定与MP相关的关键人口统计学、社会经济和职业因素。方法：本横断面研究使用constance队列研究的基线数据，constance队列研究是一项大型、基于人群的流行病学研究，参与者为具有代表性的法国成年人（18-69岁）。使用逆概率加权来纠正选择偏差并提高患病率估计的泛化性。MP采用北欧肌肉骨骼问卷进行评估，在过去的12个月里，明显的疼痛被定义为持续50 - 30天。使用多变量logistic回归模型确定与腰痛相关的因素，估计优势比（ORs）和95%置信区间（ci）。结果：在193,436名参与者中，46.2%的人报告至少一个解剖部位疼痛。受影响最大的部位是腰背部（26.6%）、肩部（21.4%）、颈部（19.0%）和膝关节（19.1%）。腰痛的发生率与女性（OR 1.39 [95% CI 1.32-1.47]）、年龄较大、肥胖、抑郁（1.71[1.62-1.80]）和合并症负担（1.20[1.15-1.25]）相关。腰痛的发生率与中度或高度职业体力活动相关（or分别为1.33[1.20-1.50]和1.69[1.48-1.93]），但与非常积极的休闲体力活动呈负相关（or为0.82[0.70-0.96]）。教育水平是影响MP的重要社会经济因素，而家庭收入不是。结论：MP给法国人带来了巨大的负担，特别是那些体力要求高的工作和低教育水平的人。这些发现强调了与MP相关的体育活动的悖论。
{"title":"Social and occupational factors are associated with musculoskeletal pain prevalence in the general population: A population-based cohort study","authors":"Florian Bailly , Benjamin Granger , Violaine Foltz , Sofiane Kab , Audrey Petit , Florence Tubach , Bruno Fautrel","doi":"10.1016/j.jbspin.2025.105984","DOIUrl":"10.1016/j.jbspin.2025.105984","url":null,"abstract":"<div><h3>Objective</h3><div>Musculoskeletal pain (MP) is a leading cause of disability worldwide, affecting individual well-being and public health. However, in the literature, the prevalence of MP varies considerably because of methodological inconsistencies, selection biases, and differences in case definitions. This study aimed to estimate the population-based prevalence of MP in France and identify key demographic, socioeconomic, and occupational factors associated with MP.</div></div><div><h3>Methods</h3><div>This cross-sectional study used baseline data for the CONSTANCES cohort study, a large, population-based epidemiological study with participants representative of the French adult population (18–69<!--> <!-->years old). Inverse probability weighting was used to correct for selection bias and to improve the generalizability of prevalence estimates. MP was assessed with the Nordic Musculoskeletal Questionnaire, with significant pain defined as lasting<!--> <!-->><!--> <!-->30<!--> <!-->days in the past 12<!--> <!-->months. Multivariate logistic regression models were used to identify factors associated with low back pain, estimating odds ratios (ORs) and 95% confidence intervals (CIs).</div></div><div><h3>Results</h3><div>Among 193,436 participants, 46.2% reported pain in at least one anatomical site. The most affected areas were the low back (26.6% adjusted prevalence), shoulder (21.4%), neck (19.0%), and knee (19.1%). Odds of low back pain was associated with female sex (OR: 1.39 [95% CI: 1.32–1.47]), older age, obesity, depression (1.71 [1.62–1.80]), and comorbidity burden (1.20 [1.15–1.25]). Odds of low back pain was associated with moderate or high occupational physical activity (OR: 1.33 [1.20–1.50] and 1.69 [1.48–1.93]) but was inversely associated with very active leisure-time physical activity (0.82 [0.70–0.96]). Education level but not household income was a significant socioeconomic factor associated with MP.</div></div><div><h3>Conclusion</h3><div>MP imposes a substantial burden on the French population, particularly among individuals with physically demanding jobs and low education levels. These findings highlight the paradox of physical activity associated with MP.</div></div>","PeriodicalId":54902,"journal":{"name":"Joint Bone Spine","volume":"93 2","pages":"Article 105984"},"PeriodicalIF":4.3,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145208181","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-03-01Epub Date: 2025-09-06DOI: 10.1016/j.jbspin.2025.105965
Lene Terslev , Hilde Berner Hammer
{"title":"Monitoring gout with ultrasound: Is it useful in daily practice?","authors":"Lene Terslev , Hilde Berner Hammer","doi":"10.1016/j.jbspin.2025.105965","DOIUrl":"10.1016/j.jbspin.2025.105965","url":null,"abstract":"","PeriodicalId":54902,"journal":{"name":"Joint Bone Spine","volume":"93 2","pages":"Article 105965"},"PeriodicalIF":4.3,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145024809","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-03-01Epub Date: 2025-09-26DOI: 10.1016/j.jbspin.2025.105978
Ai Li Yeo , Kevin L. Winthrop
Purpose
Vaccine preventable diseases, especially respiratory infections, occur at higher frequency in patients with rheumatic diseases who are immunosuppressed. The focus of this review is to highlight vaccinations that patients with rheumatic diseases should optimally receive, with a focus on efficacy and safety of vaccines.
Main findings
In general, vaccines are effective in reducing the burden of infection. However, due to underlying immunosuppression, their efficacy is most likely reduced compared to the general population. This is even true of the novel vaccines, mRNA and subunit vaccines. Emerging evidence, particularly for withholding methotrexate for 1–2 weeks post vaccination can improve immunogenicity without significantly increasing the risk of disease flare. Administration of live vaccines continue to provide clinicians a challenge especially in the setting of recent measles outbreaks. Assessing underlying degree of immunosuppression and following national guidelines can help clinicians vaccinate these patients safely. If this is not possible, then measles immunoglobulin can be administered.
Principle conclusions
Vaccination is an important part of infection reduction strategies for the rheumatologist to consider during a consultation as the number of vaccines available for infective conditions increases. High dose prednisolone, B cell depleting therapies, and methotrexate have the most evidence for reduced vaccine responses and where feasible, attempts should be made to vaccinate when immunosuppression is thought to be lower.
{"title":"Vaccinating patients with autoimmune diseases","authors":"Ai Li Yeo , Kevin L. Winthrop","doi":"10.1016/j.jbspin.2025.105978","DOIUrl":"10.1016/j.jbspin.2025.105978","url":null,"abstract":"<div><h3>Purpose</h3><div>Vaccine preventable diseases, especially respiratory infections, occur at higher frequency in patients with rheumatic diseases who are immunosuppressed. The focus of this review is to highlight vaccinations that patients with rheumatic diseases should optimally receive, with a focus on efficacy and safety of vaccines.</div></div><div><h3>Main findings</h3><div>In general, vaccines are effective in reducing the burden of infection. However, due to underlying immunosuppression, their efficacy is most likely reduced compared to the general population. This is even true of the novel vaccines, mRNA and subunit vaccines. Emerging evidence, particularly for withholding methotrexate for 1–2 weeks post vaccination can improve immunogenicity without significantly increasing the risk of disease flare. Administration of live vaccines continue to provide clinicians a challenge especially in the setting of recent measles outbreaks. Assessing underlying degree of immunosuppression and following national guidelines can help clinicians vaccinate these patients safely. If this is not possible, then measles immunoglobulin can be administered.</div></div><div><h3>Principle conclusions</h3><div>Vaccination is an important part of infection reduction strategies for the rheumatologist to consider during a consultation as the number of vaccines available for infective conditions increases. High dose prednisolone, B cell depleting therapies, and methotrexate have the most evidence for reduced vaccine responses and where feasible, attempts should be made to vaccinate when immunosuppression is thought to be lower.</div></div>","PeriodicalId":54902,"journal":{"name":"Joint Bone Spine","volume":"93 2","pages":"Article 105978"},"PeriodicalIF":4.3,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145187424","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-03-01Epub Date: 2025-08-28DOI: 10.1016/j.jbspin.2025.105954
Yannick Degboé , Guillaume Couture
Discontinuation of denosumab in postmenopausal osteoporosis causes a rebound phenomenon with a rapid increase in bone turnover markers and accelerated bone loss, often within 6–12 months. Without an appropriate relay therapy, up-to 10% of the patients experience multiple vertebral fractures. This phenomenon is linked to a multifactorial dysregulation of bone remodelling. In 2021, the European Calcified Tissue Society (ECTS) proposed guidelines for discontinuing denosumab in patients with postmenopausal osteoporosis. Our review covers the latest research on risk stratification for rebound phenomenon, the various relay treatment options based on risk levels, and the recommended follow-up for these patients. Post-denosumab treatment is important. Bisphosphonates therapy and regular monitoring of serum CTX (crosslaps) represent the cornerstone of the management of rebound phenomenon following denosumab discontinuation in postmenopausal osteoporosis.
{"title":"Strategies for denosumab discontinuation in postmenopausal osteoporosis","authors":"Yannick Degboé , Guillaume Couture","doi":"10.1016/j.jbspin.2025.105954","DOIUrl":"10.1016/j.jbspin.2025.105954","url":null,"abstract":"<div><div>Discontinuation of denosumab in postmenopausal osteoporosis causes a rebound phenomenon with a rapid increase in bone turnover markers and accelerated bone loss, often within 6–12 months. Without an appropriate relay therapy, up-to 10% of the patients experience multiple vertebral fractures. This phenomenon is linked to a multifactorial dysregulation of bone remodelling. In 2021, the European Calcified Tissue Society (ECTS) proposed guidelines for discontinuing denosumab in patients with postmenopausal osteoporosis. Our review covers the latest research on risk stratification for rebound phenomenon, the various relay treatment options based on risk levels, and the recommended follow-up for these patients. Post-denosumab treatment is important. Bisphosphonates therapy and regular monitoring of serum CTX (crosslaps) represent the cornerstone of the management of rebound phenomenon following denosumab discontinuation in postmenopausal osteoporosis.</div></div>","PeriodicalId":54902,"journal":{"name":"Joint Bone Spine","volume":"93 2","pages":"Article 105954"},"PeriodicalIF":4.3,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144979563","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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