Rheumatology

ObjectiveRegular imaging by conventional radiography to assess for joint damage is a cornerstone in the management of rheumatoid arthritis (RA). Scoring systems to quantify such damage, such as the widely used Sharp/van der Heijde (SvdH) score, are limited by the requirement of time and experienced staff as well as intra- and inter-rater variability. To alleviate these problems, autoscoRA, a fully automated scoring system to assign SvdH scores to radiographs of the hands and feet was developed. ...

ObjectiveTo clinically evaluate a digital biomarker, the Finger Fold Index (FFI), derived from the ratio of joint diameter to finger fold surface area in hand photographs, for assessing joint swelling in inflammatory arthritis. MethodsSmartphone hand photographs from two routine care cohorts of patients with rheumatoid (RA) and psoriatic arthritis (PsA) were analyzed using a machine learning pipeline for automated detection and processing of proximal interphalangeal (PIP) joints. The FFI was cl...

ObjectiveQuantitative computed tomography (QCT) can automatically quantify parenchymal abnormalities on chest CT imaging using deep learning. We leveraged QCT to detect pulmonary abnormalities in patients with early rheumatoid arthritis (RA) compared to healthy controls. MethodsWe analyzed high-resolution CT chest imaging from participants with early RA in the prospective, multicenter, SAIL-RA study and healthy non-smoking controls from the COPDGene study. A deep learning classifier quantified ...

BackgroundRheumatoid arthritis (RA) is a chronic inflammatory disease characterized by metabolic dysregulation, including altered lipid metabolism. While polyunsaturated fatty acids have been studied, the plasma levels, endogenous synthesis, and relevance of monounsaturated fatty acids (MUFAs) in RA remain unclear. This study examined plasma MUFA levels in RA and their associations with disease activity, adiposity, and intake. MethodsIn this cross-sectional study, 59 individuals with rheumatoid...

Predictors of Health-Related Quality of Life in Indonesian Women with Systemic Lupus Erythematosus: A Cross-Sectional Within-Cohort Analysis ObjectiveThis study aims to determine the effects of sleep quality along with age, marital status, socioeconomic status, depression, anxiety, disease activity, pain scale, and dose of corticosteroids on quality of life in women with SLE. MethodsVariables were assessed in 75 women with SLE using the Pittsburgh Sleep Quality Index (PSQI), Lupus Quality of L...

Autoimmune inflammatory myopathies (AIM) with prominent B cell aggregates (BCM) on muscle biopsy is an uncommon finding. We aimed to compare the characteristics and clinical course of patients with BCM on muscle biopsy to those without and characterize B cell infiltrates in the muscle of these patients. We performed a retrospective study of subjects with AIM in the Canada Inflammatory Myopathy Study (CIMS) cohort to identify cases with BCM on muscle biopsy, which was defined as [≥]30 CD20+ c...

IntroductionPain is often persistent in patients with inflammatory arthritis (IA). There is limited research on pain mechanisms in early IA. We used detailed assessments to characterise pain types longitudinally. MethodsThis prospective observational study investigated the relative contribution of peripheral versus centrally mediated pain in newly diagnosed IA patients with pain scores [≥]3, followed over two years. Assessments included: disease activity (Disease Activity Score-28, musculosk...

ObjectivesTo assess whether baseline ESR-CRP difference (D score) is associated with discontinuation due to loss of efficacy during Janus kinase inhibitor therapy after biologic failure in rheumatoid arthritis. MethodsSingle-centre retrospective cohort of 24 patients with rheumatoid arthritis who initiated a Janus kinase inhibitor after inadequate response to at least one biologic DMARD. D score was ESR (mm/h) minus CRP (mg/L). The primary outcome was discontinuation due to loss of efficacy; ot...

ObjectiveIdentifying risk factors enables stratification of patients susceptibility to inflammatory arthritis immune-related adverse events (IA-irAE). This retrospective study examines whether preexisting osteoarthritis (OA) increases the likelihood of de novo IA in patients treated with immune checkpoint inhibitors (ICIs). MethodsThe prevalence of OA among ICI-treated patients who developed IA-irAE, those who developed other types of irAEs but not IA (non-IA irAE), and those who did not develo...

BackgroundGout is the among the most prevalent arthritides worldwide and is associated with high morbidity, cardiovascular risk, and substantial healthcare burden. Despite effective urate-lowering therapies (ULT), many patients remain undertreated, particularly those with severe or complex disease. Nurse-led gout management has improved outcomes in primary care, but data in multimorbid tertiary center populations are lacking. ObjectiveTo evaluate the effectiveness of a supervised nurse-led gout...

ObjectivesResearch of refractory disease in juvenile idiopathic arthritis (JIA) is limited, and a potential genetic contribution has yet to be investigated. This study aimed to explore the presence of rare monogenic disease gene coding variants in a refractory JIA population. MethodsCases were included with a record of inefficacy for methotrexate and [≥]1 biologic drug or exposure to methotrexate and [≥]2 biologic drugs for any reason. Whole exome sequencing data were analysed using VarSe...

Background and AimFibromyalgia is an idiopathic chronic widespread pain syndrome affecting 2-4% of the general population globally. Besides widespread fibromyalgia pain, morning stiffness, associated neurologic as well as sleep problems are also reported. Disease is more prevalent in females of middle-age group with low socioeconomic status, thus deteriorating overall productivity and psychosocial health. There is no permanent cure of the disease. This study aimed to explore, validate and assess...

ObjectivesEosinophilic granulomatosis with polyangiitis (EGPA) is classified as a subtype of anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV). A recent genome-wide association study (GWAS) of EGPA in populations of European ancestry reported several susceptibility loci. In view of population differences in genetic factors of AAV, we made an attempt to examine the contribution of these loci to EGPA in a Japanese population. MethodsThe EGPA associated variants in LPP, TSLP,...

ObjectivesWhether febuxostat is associated with an increased cardiovascular risk compared to allopurinol in patients with gout remains controversial, with major randomized trials reporting conflicting results. This study aims to perform a comprehensive meta-analysis using reconstructed individual participant data (IPD) to evaluate the time-varying cardiovascular and mortality risk of febuxostat versus allopurinol in gout. MethodsWe conducted a one-stage individual participant data meta-analysis...

OBJECTIVESOsteoarthritis is a heterogeneous disease, with diverse structural patterns likely reflecting distinct genetic drivers. Robust, data-driven methods to identify and characterise such phenotypes are lacking. This study leveraged the UK Biobank to define machine learning-derived structural osteoarthritis phenotypes and evaluate their clinical and genetic profiles. METHODSMachine learning models were applied to knee and hip DXA scans to derive osteophyte area, minimum joint space width, a...

ObjectiveTo apply large language models (LLMs) to Reddit posts referencing systemic lupus erythematosus (SLE) to identify patient-expressed unmet medical needs, symptom experiences, and healthcare challenges, demonstrating how AI-enabled social media listening complements traditional patient-experience research. MethodsWe extracted 4,633 posts from ten SLE-related or health-focused Reddit communities using the public Reddit API (October-November 2025). After removing duplicates, promotional con...

Autoimmune demyelinating central nervous system (CNS) disorders encompass a wide array of clinical entities ranging from the organ specific Multiple Sclerosis (MS) to systemic autoimmune diseases (SADs) such as Systemic Lupus Erythematosus (SLE) and Sjogrens syndrome (SS). Despite international research efforts, distinction of these entities at clinical, imaging and laboratory level remains challenging, with almost 20% of patients being misdiag-nosed with MS, out of which more than 50% carry the...

ObjectivesRheumatoid arthritis (RA) exhibits clinical and biological heterogeneity, with synovial tissue stratified into histological pathotypes: lympho-myeloid, diffuse-myeloid, and pauci-immune fibroid. Although GWAS have uncovered RA risk loci, how genetic risk relates to synovial immunopathology remains unclear. To better understand how genetic predisposition may shape divergent early disease mechanisms, we characterised the expression patterns of GWAS-identified RA susceptibility genes and ...

ObjectivesMosaic chromosomal alterations (mCAs) increase with age and are associated with many diseases, including autoimmune diseases. The associations between mCAs and systemic sclerosis (SSc) and its clinical subtypes have not been explored. MethodsWe recruited study subjects from two independent datasets (Set 1: 635 SSc, 4,401 controls; Set 2: 347 SSc, 2,170 controls) and detected mCAs (Loss, LOH, Gain, and mLOX) from their peripheral blood samples. Logistic regression analyses were conduct...

ObjectivesTo investigate genetic architecture and identify novel risk loci shared between juvenile idiopathic arthritis (JIA) and other human leukocyte antigen (HLA)-associated autoimmune diseases (AIDs) by leveraging genome-wide association studies (GWAS) data. MethodsWe analyzed GWAS summary statistics from over two million participants (123,997 cases and 1,843,249 controls) of European ancestry across multiple AIDs including JIA, autoimmune thyroid disease (AITD), celiac disease, inflammator...