April 2025 to July 2025
Author: Omar Dhrif
Long-term maintenance of remission with spacing of rituximab infusions based on the individualised patient risk profile in ANCA-associated vasculitis: a pilot study
Bartoletti et al. (10.1136/rmdopen-2025-005504) in this prospective pilot study evaluated risk-stratified rituximab (RTX) maintenance beyond 18 months in granulomatosis with polyangiitis (GPA) and microscopic polyangiitis (MPA). Nineteen patients were stratified as high-risk of relapse (RTX every 6 months, n=7), intermediate-risk (RTX every 12 months, n=9), or low-risk (switched to another immunosuppressant, n=3). Over 24 months, no severe relapses, deaths, or end-stage renal disease occurred. One minor relapse was observed in the RTX12m group. Severe infections occurred in 28.6% of RTX6m patients, with higher hypogammaglobulinaemia rates (57.1%). Yearly RTX maintained disease control with fewer complications, supporting tailored regimens.
Serum immunoreactivity to neurofilament-medium shows high sensitivity and specificity in patients with Behçet disease
Akbaba et al. (10.1136/rmdopen-2024-005100) assessed the diagnostic value of neurofilament medium protein (NF-M) immunoreactivity in Behçet disease (BD). Serum from 76 patients (33 BD, 16 MS, 15 SLE, 9 PsA, 3 NBU) and 22 healthy donors was tested on mouse brain tissue. NF-M staining was detected in 97% of BD sera (32/33) but not in controls or other diseases, which showed distinct alternative patterns (e.g., nuclear in SLE, oligodendrocytic in MS). NF-M immunoreactivity appears highly specific and sensitive for BD, suggesting potential diagnostic utility.
Combination therapy of rituximab and mycophenolate in patients with systemic sclerosis and primary cardiac involvement refractory to cyclophosphamide: a retrospective exploratory analysis of 10 cases
Adjailia et al. (10.1136/rmdopen-2025-005493) evaluated rituximab (RTX) plus mycophenolate mofetil (MMF) in 10 systemic sclerosis (SSc) patients with refractory primary cardiac involvement after cyclophosphamide. Over 6–12 months, all patients showed troponin T reduction (p=0.002), left ventricular ejection fraction improved by 3–23% in 5/6 with dysfunction, ventricular extrasystoles declined (p=0.0313), and NT-proBNP decreased in 6/9. Modified Rodnan skin score also improved (p=0.002). Therapy was generally well tolerated, though 7 serious adverse events (5 infections, 2 deaths) occurred during long-term follow-up. RTX/MMF may represent an effective option.
Automated ultrasound system ARTHUR V.2.0 with AI analysis DIANA V.2.0 matches expert rheumatologist in hand joint assessment of rheumatoid arthritis patients
Frederiksen et al. (10.1136/rmdopen-2025-005805) assessed the performance of the robotic ultrasound system ARTHUR V.2.0 with AI model DIANA V.2.0 in rheumatoid arthritis. Thirty patients underwent two automated scans and expert rheumatologist evaluation of 22 hand joints. ARTHUR achieved an 85.5% scanning success rate. Intra-robot repeatability was high (binary agreement 90.5% for synovial hypertrophy, 88.1% for Doppler). Agreement with the rheumatologist was encouraging (binary 87.3% for hypertrophy, 91.2% for Doppler), with kappa values 0.38–0.44. The system showed reliable repeatability and promising concordance with human assessment.
Predictive factors for therapeutic response and cluster analysis in syndrome of undifferentiated recurrent fever (SURF)
Palmeri et al. (10.1136/rmdopen-2025-005874) analysed 101 patients with syndrome of undifferentiated recurrent fever (SURF) from the Eurofever Registry to identify colchicine resistance predictors and assess interleukin-1 (IL-1) inhibitor efficacy. Common symptoms included fever, arthralgia, abdominal pain, and myalgia; PFAPA-like features were sporadic. Colchicine achieved complete response in 61% of 77 patients. Aphthous stomatitis independently predicted resistance (p=0.014). Tonsillectomy was ineffective, whereas IL-1 inhibitors were effective in refractory cases. Cluster analysis identified three subgroups, highlighting SURF heterogeneity and supporting personalised management.
Omar Dhrif
Omar is a Clinical Immunology and Internal Medicine MD, from University Tunis El Manar currently working in University Hospital Dijon Bourgogne, France.
His main clinical and research interests are focused on Vasculitis, Global access to health care and educational therapy. Omar is the past-Treasurer of the Tunisian Association of Young Internists, Co-Founder of the Francophonic Young Internists Group, member of the Research Committee of the Tunisian Society of Internal Medicine and American College of Rheumatology Social Media Ambassador. Omar is a member of the EMEUNET Social Media Sub-committee.