Safety issues related to the risk of cancer associated with immune-mediated inflammatory disease (IMID) treatments have always been a major concern. Skin cancer is the most common type of cancer, especially non-melanoma skin cancer (NMSC), with a steadily increasing incidence. Some guidelines recommend that all patients with IMID should undergo regular skin cancer screening due to a combination of treatment-related and disease-related risk factors. However, systematic skin cancer screening is still controversial because there is no substantial evidence that it reduces skin cancer mortality. Furthermore, dermatologists have insufficient resources to screen all IMID patients and need, therefore, to focus on at-risk patients. Such screening could also lead to overdiagnosis. In this review, we will summarise the data on the risk of skin cancer in patients with non-dermatologic IMID according to treatment. We will also propose an algorithm to help the clinician focus on those patients most needing annual skin screening.
{"title":"Skin cancer risk in patients with non-dermatologic immune-mediated inflammatory diseases","authors":"Jean-Guillaume Letarouilly , Pauline Wils , Delphine Staumont-Sallé , Denis Jullien , Laurent Mortier , Laurent Peyrin-Biroulet , Christophe Richez , Marie Boileau , René-Marc Flipo","doi":"10.1016/j.jbspin.2025.105972","DOIUrl":"10.1016/j.jbspin.2025.105972","url":null,"abstract":"<div><div>Safety issues related to the risk of cancer associated with immune-mediated inflammatory disease (IMID) treatments have always been a major concern. Skin cancer is the most common type of cancer, especially non-melanoma skin cancer (NMSC), with a steadily increasing incidence. Some guidelines recommend that all patients with IMID should undergo regular skin cancer screening due to a combination of treatment-related and disease-related risk factors. However, systematic skin cancer screening is still controversial because there is no substantial evidence that it reduces skin cancer mortality. Furthermore, dermatologists have insufficient resources to screen all IMID patients and need, therefore, to focus on at-risk patients. Such screening could also lead to overdiagnosis. In this review, we will summarise the data on the risk of skin cancer in patients with non-dermatologic IMID according to treatment. We will also propose an algorithm to help the clinician focus on those patients most needing annual skin screening.</div></div>","PeriodicalId":54902,"journal":{"name":"Joint Bone Spine","volume":"93 1","pages":"Article 105972"},"PeriodicalIF":4.3,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145088432","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 : 2025-09-16DOI: 10.1016/j.jbspin.2025.105968
Xingxin Hu, Yao Kong, Bingkui Li
{"title":"Polyostotic fibrous dysplasia of the thoracic cage","authors":"Xingxin Hu, Yao Kong, Bingkui Li","doi":"10.1016/j.jbspin.2025.105968","DOIUrl":"10.1016/j.jbspin.2025.105968","url":null,"abstract":"","PeriodicalId":54902,"journal":{"name":"Joint Bone Spine","volume":"93 1","pages":"Article 105968"},"PeriodicalIF":4.3,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145088464","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 : 2025-09-16DOI: 10.1016/j.jbspin.2025.105969
Yunjung Choi
{"title":"Unilateral forearm lymphoedema as a rare extra-articular manifestation of chronic tophaceous gout","authors":"Yunjung Choi","doi":"10.1016/j.jbspin.2025.105969","DOIUrl":"10.1016/j.jbspin.2025.105969","url":null,"abstract":"","PeriodicalId":54902,"journal":{"name":"Joint Bone Spine","volume":"93 1","pages":"Article 105969"},"PeriodicalIF":4.3,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145088448","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 : 2025-09-16DOI: 10.1016/j.jbspin.2025.105970
Nimetullah Aksoy , Guillaume Grenet , Maëlys Granal , Marine Auffret , François Gueyffier , Audrey Lajoinie , Jean-Christophe Lega , Emmanuel Massy , Arthur Gougeon
Objectives
The association between bisphosphonates (BP) and osteonecrosis of the jaw (ONJ) has been studied since 2006. However, meta-analyses conducted in 2014 and 2024 detected publication bias. Although it is often assumed that such bias diminishes over time, possibly due to the delayed publication of non-significant results, this trend has not been empirically confirmed in medicine. The aim of this study was to assess how publication bias has evolved in this safety context over time.
Methods
A systematic review was conducted on studies assessing the association between BP and ONJ. A cumulative, meta-analysis was performed to estimate the crude odds ratio (OR) year by year. Publication bias was assessed using a visual inspection of funnel plots and Egger's test. When publication bias was detected, the trim-and-fill method was applied to obtain an adjusted OR. The impact of publication bias was quantified using the ratio of odds ratios (ROR) (ORadjusted/ORcrude).
Results
Forty-four studies published between 2006 and 2025 were included. Publication bias was detected from 2008 to 2025. The ROR increased from 0.42 in 2008 to 0.66 in 2025, indicating overestimation of 58% and 34%, respectively. The greatest impact was observed between 2013 and 2020. Subgroup analyses showed stronger residual bias in non-cancer indications.
Conclusions
Although publication bias decreased over time, its impact persisted for 17 years. Consequently, risk perception may remain distorted for an extended period. This observation mirrors the dynamics of pharmacovigilance alerts, which often rely on initial publications. When publication bias is identified in previous meta-analyses, future updates should carefully reassess its presence, even many years later.
{"title":"Temporal evolution of publication bias in drug safety assessment: A case study on association between osteonecrosis of the jaw and bisphosphonates","authors":"Nimetullah Aksoy , Guillaume Grenet , Maëlys Granal , Marine Auffret , François Gueyffier , Audrey Lajoinie , Jean-Christophe Lega , Emmanuel Massy , Arthur Gougeon","doi":"10.1016/j.jbspin.2025.105970","DOIUrl":"10.1016/j.jbspin.2025.105970","url":null,"abstract":"<div><h3>Objectives</h3><div>The association between bisphosphonates (BP) and osteonecrosis of the jaw (ONJ) has been studied since 2006. However, meta-analyses conducted in 2014 and 2024 detected publication bias. Although it is often assumed that such bias diminishes over time, possibly due to the delayed publication of non-significant results, this trend has not been empirically confirmed in medicine. The aim of this study was to assess how publication bias has evolved in this safety context over time.</div></div><div><h3>Methods</h3><div>A systematic review was conducted on studies assessing the association between BP and ONJ. A cumulative, meta-analysis was performed to estimate the crude odds ratio (OR) year by year. Publication bias was assessed using a visual inspection of funnel plots and Egger's test. When publication bias was detected, the trim-and-fill method was applied to obtain an adjusted OR. The impact of publication bias was quantified using the ratio of odds ratios (ROR) (OR<sub>adjusted</sub>/OR<sub>crude</sub>).</div></div><div><h3>Results</h3><div>Forty-four studies published between 2006 and 2025 were included. Publication bias was detected from 2008 to 2025. The ROR increased from 0.42 in 2008 to 0.66 in 2025, indicating overestimation of 58% and 34%, respectively. The greatest impact was observed between 2013 and 2020. Subgroup analyses showed stronger residual bias in non-cancer indications.</div></div><div><h3>Conclusions</h3><div>Although publication bias decreased over time, its impact persisted for 17<!--> <!-->years. Consequently, risk perception may remain distorted for an extended period. This observation mirrors the dynamics of pharmacovigilance alerts, which often rely on initial publications. When publication bias is identified in previous meta-analyses, future updates should carefully reassess its presence, even many years later.</div></div>","PeriodicalId":54902,"journal":{"name":"Joint Bone Spine","volume":"93 2","pages":"Article 105970"},"PeriodicalIF":4.3,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145088446","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 : 2025-09-12DOI: 10.1016/j.jbspin.2025.105967
Nicolas Rosine , Corinne Miceli-Richard
{"title":"The failure of IL-23 targeted therapies in axial spondyloarthritis: an unexpected observation","authors":"Nicolas Rosine , Corinne Miceli-Richard","doi":"10.1016/j.jbspin.2025.105967","DOIUrl":"10.1016/j.jbspin.2025.105967","url":null,"abstract":"","PeriodicalId":54902,"journal":{"name":"Joint Bone Spine","volume":"93 2","pages":"Article 105967"},"PeriodicalIF":4.3,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145066208","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 : 2025-09-09DOI: 10.1016/j.jbspin.2025.105960
Cunhao Shan , Fanzhang Meng , Aijie Yuan , Zhimin Lin , Fan Bu , Litao Zhang , Chen Li
{"title":"A case of SAPHO syndrome with wrist involvement as the first presentation and response to tofacitinib therapy","authors":"Cunhao Shan , Fanzhang Meng , Aijie Yuan , Zhimin Lin , Fan Bu , Litao Zhang , Chen Li","doi":"10.1016/j.jbspin.2025.105960","DOIUrl":"10.1016/j.jbspin.2025.105960","url":null,"abstract":"","PeriodicalId":54902,"journal":{"name":"Joint Bone Spine","volume":"92 6","pages":"Article 105960"},"PeriodicalIF":4.3,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145042363","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 : 2025-09-09DOI: 10.1016/j.jbspin.2025.105966
Maria Giovanna Lommano , Sonia Farah , Benedetta Bianchi , Anna Maria Risa , Piercarlo Sarzi-Puttini , Fausto Salaffi , Marco Di Carlo
Introduction
Fibromyalgia is a complex chronic pain disorder frequently associated with autonomic dysregulation, central sensitization, and cognitive-emotional disturbances. Transcutaneous vagus nerve stimulation (tVNS) has recently emerged as a non-invasive neuromodulatory approach with potential to modulate autonomic function, pain perception, and affective processing. We aim to evaluate the short-term effects of a 28-day tVNS protocol on autonomic function, symptom severity, central sensitization, neuropathic-like pain features, and pain catastrophizing in patients with fibromyalgia.
Methods
Twenty-five female patients with fibromyalgia (mean age 48.6 ± 7.3 years; mean disease duration 68 ± 24 months) underwent twice-daily 30-minute tVNS sessions using the Nurosym™ device for 28 consecutive days. Outcome measures included: Composite Autonimic Symptom Score 31 (COMPASS-31), Revised Fibromyalgia Impact Questionnaire (FIQR), PainDETECT Questionnaire (PDQ), Central Sensitization Inventory (CSI-9), and Pain Catastrophizing Scale (PCS). Pre- and post-treatment scores were compared using paired statistical analyses.
Results
Significant improvements were observed in total COMPASS-31 scores (P < 0.05), particularly within the orthostatic (P < 0.05), vasomotor (P < 0.05), and pupillomotor (P < 0.05) subdomains. FIQR scores decreased from 69.12 ± 17.58 to 62.24 ± 19.19 (P < 0.01), indicating a moderate reduction in overall symptom burden. PDQ and CSI-9 scores also improved significantly (P < 0.01 and P < 0.05, respectively), suggesting a reduction in neuropathic-like symptoms and central sensitization. Although PCS scores showed a downward trend, the change was not statistically significant (P = 0.070).
Conclusions
This pilot study suggests that tVNS may be a safe, well-tolerated, and effective intervention for modulating autonomic and central mechanisms in fibromyalgia. The results support further controlled trials to define optimal protocols and assess long-term outcomes.
{"title":"Non-invasive auricular vagus nerve stimulation in fibromyalgia: Impacts on autonomic function, central sensitization and pain catastrophizing","authors":"Maria Giovanna Lommano , Sonia Farah , Benedetta Bianchi , Anna Maria Risa , Piercarlo Sarzi-Puttini , Fausto Salaffi , Marco Di Carlo","doi":"10.1016/j.jbspin.2025.105966","DOIUrl":"10.1016/j.jbspin.2025.105966","url":null,"abstract":"<div><h3>Introduction</h3><div>Fibromyalgia is a complex chronic pain disorder frequently associated with autonomic dysregulation, central sensitization, and cognitive-emotional disturbances. Transcutaneous vagus nerve stimulation (tVNS) has recently emerged as a non-invasive neuromodulatory approach with potential to modulate autonomic function, pain perception, and affective processing. We aim to evaluate the short-term effects of a 28-day tVNS protocol on autonomic function, symptom severity, central sensitization, neuropathic-like pain features, and pain catastrophizing in patients with fibromyalgia.</div></div><div><h3>Methods</h3><div>Twenty-five female patients with fibromyalgia (mean age 48.6<!--> <!-->±<!--> <!-->7.3<!--> <!-->years; mean disease duration 68<!--> <!-->±<!--> <!-->24 months) underwent twice-daily 30-minute tVNS sessions using the Nurosym™ device for 28 consecutive days. Outcome measures included: Composite Autonimic Symptom Score 31 (COMPASS-31), Revised Fibromyalgia Impact Questionnaire (FIQR), PainDETECT Questionnaire (PDQ), Central Sensitization Inventory (CSI-9), and Pain Catastrophizing Scale (PCS). Pre- and post-treatment scores were compared using paired statistical analyses.</div></div><div><h3>Results</h3><div>Significant improvements were observed in total COMPASS-31 scores (<em>P</em> <!--><<!--> <!-->0.05), particularly within the orthostatic (<em>P</em> <!--><<!--> <!-->0.05), vasomotor (<em>P</em> <!--><<!--> <!-->0.05), and pupillomotor (<em>P</em> <!--><<!--> <!-->0.05) subdomains. FIQR scores decreased from 69.12<!--> <!-->±<!--> <!-->17.58 to 62.24<!--> <!-->±<!--> <!-->19.19 (<em>P</em> <!--><<!--> <!-->0.01), indicating a moderate reduction in overall symptom burden. PDQ and CSI-9 scores also improved significantly (<em>P</em> <!--><<!--> <!-->0.01 and <em>P</em> <!--><<!--> <!-->0.05, respectively), suggesting a reduction in neuropathic-like symptoms and central sensitization. Although PCS scores showed a downward trend, the change was not statistically significant (<em>P</em> <!-->=<!--> <!-->0.070).</div></div><div><h3>Conclusions</h3><div>This pilot study suggests that tVNS may be a safe, well-tolerated, and effective intervention for modulating autonomic and central mechanisms in fibromyalgia. The results support further controlled trials to define optimal protocols and assess long-term outcomes.</div></div>","PeriodicalId":54902,"journal":{"name":"Joint Bone Spine","volume":"93 1","pages":"Article 105966"},"PeriodicalIF":4.3,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145042421","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 : 2025-09-09DOI: 10.1016/j.jbspin.2025.105963
Ana Bento da Silva , Désirée van der Heijde , Floris van Gaalen , Sofia Ramiro
Structural damage of the sacroiliac joints and spine is a feared consequence of axial spondyloarthritis (axSpA), leading to impairments in spinal mobility and physical function, thus contributing to the high disease burden and compromising patients’ quality of life. Inhibiting the progression of structural damage is a major treatment goal. Contrasting with the proven clinical efficacy of available therapies (tumour necrosis factor-alpha inhibitors [TNFi], interleukin-17 inhibitors [IL-17i], and Janus kinase inhibitors [JAKi]), their efficacy in slowing damage progression is not clearly demonstrated. For various reasons, including methodological challenges, such an effect could not be demonstrated in randomised clinical trials (RCT). Instruments for assessing structural damage have several limitations, notably their low sensitivity to change, and RCTs with a placebo control group over a long period are not viable for ethical reasons. Based on observational studies, TNFi seem to exert an inhibitory effect compared to conventional treatment, particularly in patients with risk factors for disease progression, mainly pre-existing syndesmophytes, and with longer treatment duration (> 2 years). Although evidence relating to IL-17i is scarcer, one head-to-head RCT showed no differences between secukinumab (IL-17Ai) and adalimumab (TNFi) in slowing structural damage progression. For JAKi, comparative evidence is lacking. The potential disease-modifying effect appears to be equally promising for TNFi and IL-17Ai, and structural damage inhibition currently does not seem to be a distinguishing feature between drug classes for the treatment of axSpA. The development of more sensitive instruments to capture structural damage appears crucial for conducting comparative studies on the efficacy of current therapies.
{"title":"Transforming myth into reality: a narrative review on the effect of therapies in slowing structural damage progression in axial spondyloarthritis","authors":"Ana Bento da Silva , Désirée van der Heijde , Floris van Gaalen , Sofia Ramiro","doi":"10.1016/j.jbspin.2025.105963","DOIUrl":"10.1016/j.jbspin.2025.105963","url":null,"abstract":"<div><div>Structural damage of the sacroiliac joints and spine is a feared consequence of axial spondyloarthritis (axSpA), leading to impairments in spinal mobility and physical function, thus contributing to the high disease burden and compromising patients’ quality of life. Inhibiting the progression of structural damage is a major treatment goal. Contrasting with the proven clinical efficacy of available therapies (tumour necrosis factor-alpha inhibitors [TNFi], interleukin-17 inhibitors [IL-17i], and Janus kinase inhibitors [JAKi]), their efficacy in slowing damage progression is not clearly demonstrated. For various reasons, including methodological challenges, such an effect could not be demonstrated in randomised clinical trials (RCT). Instruments for assessing structural damage have several limitations, notably their low sensitivity to change, and RCTs with a placebo control group over a long period are not viable for ethical reasons. Based on observational studies, TNFi seem to exert an inhibitory effect compared to conventional treatment, particularly in patients with risk factors for disease progression, mainly pre-existing syndesmophytes, and with longer treatment duration (><!--> <!-->2 years). Although evidence relating to IL-17i is scarcer, one head-to-head RCT showed no differences between secukinumab (IL-17Ai) and adalimumab (TNFi) in slowing structural damage progression. For JAKi, comparative evidence is lacking. The potential disease-modifying effect appears to be equally promising for TNFi and IL-17Ai, and structural damage inhibition currently does not seem to be a distinguishing feature between drug classes for the treatment of axSpA. The development of more sensitive instruments to capture structural damage appears crucial for conducting comparative studies on the efficacy of current therapies.</div></div>","PeriodicalId":54902,"journal":{"name":"Joint Bone Spine","volume":"93 2","pages":"Article 105963"},"PeriodicalIF":4.3,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145042466","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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