Emerging research in intervertebral disc degeneration in 2024 highlights microbial, immune and inflammatory mechanisms that drive chronic low back pain. These insights pave the way for potential transformative therapies that address the root causes of intervertebral disc degeneration and could improve patient outcomes.

Osteoarthritis (OA) is a painful degenerative joint disease and a leading source of years lived with disability globally due to inadequate treatment options. Neuroimmune interactions reportedly contribute to OA pain pathogenesis. Notably, in rodents, macrophages in the DRG are associated with onset of persistent OA pain. Our objective was to determine the effects of acute systemic macrophage depletion

Accumulated evidence supports the tendency of antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis(AAV) to coexist with atherosclerosis (AS). However, the common etiology of these two diseases remains unclear. This study aims to explore the mechanisms underlying the concurrent occurrence of ANCA and AS. Microarray data of AAV and AS were examined in a comprehensive gene expression database

Neutropenia is more common in patients with systemic lupus erythematosus (SLE) and is a major cause of life-threatening infections. The increased apoptosis of neutrophils is likely to be an essential cause of neutropenia in SLE. However, the detailed mechanisms of increased neutrophil apoptosis in SLE remain unknown. This study focused on the role of Krüppel-like factor 2 (KLF2) in the regulation of

This study investigated poor prognostic factors for the relapse of interstitial lung disease (ILD) in patients with microscopic polyangiitis (MPA) after remission induction therapy. We enrolled patients diagnosed with MPA complicated by ILD according to the Chapel Hill Consensus definition from 2001 to 2023 in multiple institutions in the REVEAL cohort. All patients who were treated with immunosuppressive

To investigate the levels of plasma neutrophil extracellular traps (NETs) and free thiols, the latter reflecting systemic oxidative stress (OS), and to explore the relationship between NETs and OS in quiescent systemic lupus erythematosus (SLE) patients with and without renal involvement. Plasma levels of NETs and free thiols were measured cross-sectionally in 100 SLE patients with low disease activity

This study aimed to assess the quantitative uptake of 18F-FDG PET-CT in the lungs of patients with early severe diffuse cutaneous systemic sclerosis (SSc) with and without interstitial lung disease (ILD), compared to controls. In patients with SSc-ILD, 18F-FDG uptake was correlated to high-resolution computed tomography (HRCT) and pulmonary function test (PFT) parameters. A prospective, cross-sectional

Data on treatment switching directly from tumor necrosis factor inhibitors to tofacitinib in psoriatic arthritis (PsA) are limited. This post hoc analysis assessed efficacy and safety outcomes in patients with PsA who directly switched to tofacitinib in a long-term extension (LTE) study after receiving adalimumab (ADA) in a Phase 3 study, compared with those who continued to receive tofacitinib. Patients

Minor salivary gland (MSG) biopsy is a critical but invasive method for the classification of primary Sjögren’s disease (pSjD). Here we aimed to identify salivary proteins as potential biomarkers and to establish a non-invasive prediction model for pSjD. Liquid chromatography-tandem mass spectrometry was conducted on whole saliva samples from patients with pSjD and non-Sjögren control subjects (non-pSjD)

In an age where there is a remarkable upsurge in developing precision medicines, antibody-drug conjugates (ADCs) have emerged as a progressive therapeutic strategy. ADCs typically consist of monoclonal antibodies (mAb) conjugated to the cytotoxic payloads by utilizing a linker, combining the benefits of definitive target specificity of mAbs and potent killing impact of payload to achieve precise and

Limb-girdle muscular dystrophy (LGMD) is usually confused with idiopathic inflammatory myopathy (IIM) in clinical practice. Our study aimed to establish convenient and reliable diagnostic models for distinguishing between LGMD and IIM. A total of 71 IIM patients, 24 LGMDR2 patients and 22 LGMDR1 patients diagnosed at our neuromuscular center were enrolled. Differences in clinical, laboratory and histopathological

Synovial macrophages (SMs) are important effectors of joint health and disease. A novel Cx3CR1 + TREM2 + SM population expressing the tight junction protein claudin-5, was recently discovered in synovial lining. Ablation of these SMs was associated with onset of arthritis. Proteoglycan 4 (PRG4) is a mucinous glycoprotein that fulfills lubricating and homeostatic roles in the joint. The aim of this

To use routine demographic and clinical data to develop an interpretable individual-level machine learning (ML) model to diagnose knee osteoarthritis (KOA) and to identify highly ranked features. In this retrospective, population-based cohort study, anonymized questionnaire data was retrieved from the Wu Chuan KOA Study, Inner Mongolia, China. After feature selections, participants were divided in

Background Therapy non-response (NR) can be seen in 30% of axial spondyloarthritis (axSpA) with some patients requiring multiple therapies. We wanted to assess in our axSpA population those with difficult to treat (D2T) disease as defined in two ways: (ever) failure of any 2 b/ts-DMARDs which we called “standard definition” or (ever) failure ≥2 b/ts-DMARDs with differing mechanisms of action (MoA)

Background and aims The mean average time to diagnosis (TTD) in the UK for axial SpA is currently 8.29 yearsi. However, it should be possible to ensure diagnosis within 12 months of symptom onset to optimise clinical outcomesii. Current evidence suggests significant variability in the patient journey, particularly within primary care, where patients have repeat consultations for axial SpA related symptoms

Background and aims Treatment of axial spondyloarthritis (axSpA) involves the management of flares which can be unpredictable. ASAS developed a data-driven definition of flares/disease worsening as an increase in ASDAS-CRP of at least 0.9 points, for use in axSpA clinical trials (1). With the current pressures on clinic capacity, there is a challenge to see flare patients in a timely manner. Artificial

Background and aims ASAS-EULAR guidance on the management of Axial Spondyloarthropathy (AxSpa) recommends regular collection of Disease Activity Metrics like Bath AxSpa Disease Activity Index (BASDAI) (Ramiro et al., 2022). NICE advocates use of BASDAI in disease management. Mid Yorkshire NHS Rheumatology service also collects BASFI and BASMI measures regularly (6-12 months). This has been historically

Introduction Timely diagnosis of axial spondyloarthritis (axSpA) remains challenging and delays result in harmful consequences. Few studies have evaluated the cost of delayed axSpA diagnosis. This study aims to develop an economic analysis to determine the annual cost of delaying the axSpA diagnosis, adopting both NHS (UK) and societal perspectives. Methods We developed a Markov economic model to estimate

Background and aims Inflammatory spondyloarthropathies (ISpAs) are associated with pain, fatigue, stiffness, and anxiety. The guidance on lifestyle management for ISpAs from the National Institute for Care and Excellence (NICE) and the European Alliance of Associations for Rheumatology (EULAR) is non-specific and vague, mostly drawing from studies on rheumatoid and osteoarthritis(1). This distinction

Imaging has transformed the understanding of inflammatory and degenerative arthritis in both peripheral and axial disease. In axial inflammation, fat suppression magnetic resonance imaging (MRI) has unravelled the role of sub-fibrocartilaginous osteitis in axial spondyloarthritis and the role of peri-entheseal vertebral body osteitis and subsequent spinal new bone formation. Established or late-stage

Background and aims The Act on Axial SpA campaign is dedicated to minimising the lengthy 8.5-year delay in diagnosing axial spondyloarthritis (axial SpA) by implementing a pioneering Gold Standard diagnosis time of just one year. Collaborating with the Belfast Health & Social Care Trust, our initiative aims to streamline the patient journey from symptom onset to diagnosis through a comprehensive, integrated

Objective To propose a new definition for SLEDAI arthritis informed by imaging. Methods We performed a planned secondary analysis of observational data from a multicentre study evaluating SLE patients with inflammatory joint pain (swelling not required) using various clinical instruments, laboratory tests and ultrasound. For SLEDAI arthritis, assessors (blinded to ultrasound) were asked which of the

Objectives Salivary gland ultrasound (SGUS) has an interest in primary Sjögren’s disease (pSD) for diagnosis, but the evolution of parenchymal lesions over time is unknown. The objective of this study was to assess the severity of ultrasound abnormalities in relation to pSD duration from the time of buccal dryness onset. Methods In this cross-sectional international multicentre study, patients with

Objective Patients with lupus nephritis (LN), including those below age 50, face significantly higher risk of atherosclerotic cardiovascular disease (ASCVD) vs. peers. This highlights the need for identifying specific ASCVD risk factors in LN. Renal arteriosclerosis in kidney biopsies (subclinical arteriosclerosis) may be able to predict future clinical ASCVD events. However, renal arteriosclerosis

Objective The Very Early Diagnosis of Systemic Sclerosis (VEDOSS) EUSTAR study showed that, despite not showing any clinical sign of disease, patients with Raynaud’s and antinuclear antibodies and/or capillaroscopy abnormalities often progress to systemic sclerosis (SSc) within 5 years. We aimed to determine whether VEDOSS biosamples show biological SSc activity pre-clinically. Methods Skin biopsies

Objectives Podocyte bridging may be a key initial event occurring early in crescent formation. This study aims to probe the underlying mechanism of atypical protein kinase C (aPKC)/protease-activated receptor 3(Par3)/Par6 polarity complexes on podocyte motility and crescent formation during the progression of antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV). Methods The effects

Uncontrolled pain remains a major clinical challenge in the management of knee osteoarthritis (OA), the most common disabling joint disease. Worse pain is associated with synovial innate immune cell infiltration (synovitis), but the role of innate immune regulatory cells in pain is unknown. Our objective was to identify synovial innate immune cell subsets and pathophysiologic mechanisms associated

In the murine K/BxN serum transfer rheumatoid arthritis (RA) model, tactile allodynia persists after resolution of inflammation in male and partially in female wild type (WT) mice, which is absent in Toll-like receptor (TLR)4 deficient animals. We assessed the role of TLR4 on allodynia, bone remodeling and afferent sprouting in this model of arthritis. K/BxN sera were injected into male and female

: Objectives This scoping-review sought to summarize the current knowledge on the epidemiology, pathogenesis, clinical presentation, and the investigations that may help characterize faecal incontinence (FI) in patients with systemic sclerosis (SSc). Methods The planned scoping review was based on the methodological framework proposed by Arksey & O’Malley.Two databases were screened: PubMed (Medline)

Background Interstitial lung disease (ILD) develops in 5–10% of patients with rheumatoid arthritis (RA) and contributes significantly to morbidity and mortality, particularly in those with a fibrotic phenotype. Yet, biomarkers to reliably identify RA patients with underlying pulmonary fibrosis are inadequate. Herein, we used sputum to identify lung-based biomarkers that distinguish RA patients with

Objectives To calculate a polygenic risk score (PRS) based on single nucleotide variants (SNVs) previously associated with primary Sjögren’s disease (SjD) with genome-wide significance, and determine the genetic risk for SjD stratified by antibodies, sex and age at diagnosis. Methods Patients with SjD (n = 1065) were genotyped using Illumina OmniExpressExome chip. Control genotype data were available

ObjectivesEndogenous retroelements (EREs) stimulate type 1 interferon (IFN‐I) production but have not been explored as potential interferonogenic triggers in Rheumatoid Arthritis (RA). We investigated ERE expression in early RA (eRA), a period where IFN‐I is increased.MethodsERE expression (LTR5, LINE1, SINE) in disease modifying treatment naïve eRA whole blood and bulk synovial tissue was examined

Objectives The 2023 ACR/EULAR antiphospholipid syndrome (APS) classification criteria distinguish between anticardiolipin (aCL) or anti-β2-glycoprotein I (aβ2GPI) IgG vs IgM isotypes, having isolate IgM positivity a low weight, insufficient for APS classification, and define aCL and aβ2GPI thresholds based on fixed cut-off values. We aimed to assess the performance of the 2023 ACR/EULAR criteria in

Objectives To investigate the association between risk of different co-morbidities and diagnosis of rheumatoid arthritis (RA) using a temporal approach. Methods Retrospective, case-control study. Data were extracted from all healthcare claims for Poland between 2011-2021. Prevalent RA(n = 262 265) patients were examined to evaluate morbidity patterns. Incident RA(n = 15 879) and age-, sex- and region-matched

Objectives Idiopathic retroperitoneal fibrosis (IRF) is a rare autoimmune-mediated condition characterized by fibro-inflammatory tissue development around the abdominal aorta and iliac arteries. Ureteral entrapment and hydronephrosis are the most common manifestations and acute renal failure or chronic renal insufficiency may occur as the consequence. Glucocorticoids and immunosuppressants may be effective

Objectives The clinical manifestations of dermatomyositis (DM) are diverse, nailfold video-capillaroscopy (NVC) can reflect microangiopathy, a process believed to contribute significantly to the clinical manifestations of DM. We aimed to explore the distinctive alterations and implications of nailfold capillary for evaluating disease progression in individuals with DM. Methods We gathered clinical

Idiopathic inflammatory myopathies (myositis, IIMs) are rare, systemic autoimmune disorders that lead to muscle inflammation, weakness, and extra-muscular manifestations, with a strong genetic component influencing disease development and progression. Previous genome-wide association studies identified loci associated with IIMs. In this study, we imputed data from two prior genome-wide myositis studies

ObjectiveAn increased risk of primary biliary cholangitis (PBC) has been reported in patients with systemic sclerosis (SSc). Our study aims to investigate the shared genetic susceptibility between the two disorders and to define candidate causal genes using cross‐phenotype GWAS meta‐analysis.MethodsWe performed cross‐phenotype GWAS meta‐analysis and Bayesian colocalization analysis for SSc and PBC

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ObjectiveIn rheumatoid arthritis (RA) and spondyloarthritis (SpA), managing persistent pain remains challenging. Little is known regarding impaired pain pathways in these patients and the impact of bDMARDs. The objective of the RAPID (Rheumatism Pain Inhibitory Descending pathways) study was to assess pain thresholds and descending pain modulation in patients with active RA or SpA following introduction

ObjectivePeople with axial spondyloarthritis (axSpA) have increased fracture risk relative to the general population, possibly related to chronic inflammation. We assessed the impact of treatment with tumor necrosis factor inhibitors (TNFi) and non‐biologic conventional synthetic disease‐modifying antirheumatic drugs (csDMARDs) on hip and spine fractures in axSpA, relative to nonsteroidal anti‐inflammatory

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Objectives To compare treatment outcomes in patients with late-onset rheumatoid arthritis (LORA) and younger-onset rheumatoid arthritis (YORA). Methods We analyzed patients diagnosed with early rheumatoid arthritis (disease duration < 2 years) between 2000 and 2016 in the IORRA cohort. Patients were categorized into LORA (onset at ≥ 65 years) and YORA (onset at < 65 years). The primary outcomes were

OBJECTIVE Some concerns remain about the safety of nintedanib in patients with interstitial lung disease (ILD) related to rheumatoid arthritis (RA-ILD), such as in presence of comorbidities or in combination with biologic, targeted synthetic and/or conventional synthetic disease modifying antirheumatic drugs (DMARDs). In this multicentre study, we retrospectively evaluated the safety of nintedanib

OBJECTIVE Immune checkpoint inhibitors (ICI) have revolutionized cancer outcomes but are limited by immunerelated adverse events (irAE), including rheumatic irAEs (Rh-irAE). Aging is associated with increased inflammation, referred to as "inflamm-aging". In this study, we explore the impact of age on severity, frequency, and treatment of Rh-irAEs. METHODS Adults with new Rh-irAEs after ICI exposure