August 2025 to November 2025
Author: Maxime Melchior
Patient Perspectives on Glucocorticoid Toxicity in ANCA-Associated Vasculitis
Scherbacher et al. (10.1016/j.ero.2025.10.006) examined the subjective burden of glucocorticoid therapy in patients with ANCA-associated vasculitis. While 91.3% of participants acknowledged positive effects like rapid pain relief, 79.7% reported negative side effects, most commonly moon face, weight gain, and skin alterations. One-third of patients felt these adverse effects significantly impaired their daily life, leading to a strong consensus in support of developing steroid-sparing treatment strategies.
Distinct Phenotypes of Subclinical Giant Cell Arteritis in Polymyalgia Rheumatica
Cowley et al. (10.1016/j.ero.2025.07.003) found that 20.5% of patients referred with polymyalgia rheumatica (PMR) actually had subclinical giant cell arteritis (sGCA) confirmed by ultrasound. This sGCA cohort exhibited a distinct phenotype, featuring more extracranial involvement and lower initial vessel wall inflammation compared to overt GCA. However, sGCA patients suffered earlier relapses and showed increasing inflammation scores after six months of treatment, suggesting they are inadequately managed under standard PMR steroid protocols.
Racial and Ethnic Underrepresentation in Systemic Sclerosis Clinical Trials
Nguyen et al. (10.1016/j.ero.2025.11.002) conducted a 25-year analysis of systemic sclerosis (SSc) trials, revealing significant demographic reporting gaps and disparities. Nearly 43% of trials reported neither race nor ethnicity. The available data showed that Black and Hispanic/Latino participants are markedly underrepresented compared to US population benchmarks, despite often facing more severe SSc phenotypes. Conversely, White and Asian participants were overrepresented, highlighting a need for equity-focused recruitment to ensure findings are generalisable.
Initial Symptoms as Predictors of Clinical Course in Adult-Onset Still’s Disease
Tamai et al. (10.1016/j.ero.2025.09.010) explored how initial symptoms correlate with the diagnosis and management of adult-onset Still’s disease (AOSD). Patients presenting first with a skin rash experienced significantly delayed clinic visits and blood tests. Conversely, an initial sore throat was associated with significantly higher ferritin levels and a greater risk of developing macrophage activation syndrome. While initial symptoms influenced early management, they did not appear to impact long-term outcomes or recurrence rates.
Altered Somatosensory Profile and Allodynia in Chronic Rheumatologic Pain
Petzinna et al. (10.1016/j.ero.2025.07.001) used quantitative sensory testing to identify altered somatosensory profiles in RA, PsA, axSpA, and SSc. Patients across all four conditions demonstrated increased mechanical detection and decreased vibration detection thresholds, suggesting Aβ-fibre dysfunction. Pathological allodynia was more prevalent and occurred independently of localised inflammation or disease activity. These findings add evidence that central and peripheral sensitisation, rather than just active inflammation, drive persistent chronic pain.
Maxime Melchior
Maxime is a Rheumatologist and PhD fellow at the Université Libre de Bruxelles Center for Research in Immunology (U-CRI) where he conducts fundamental and translational research on spondyloarthritis and associated diseases. His research aims to decipher the role of genetic risk factors in shaping T cell dysfunction in these conditions. Maxime is a member of the Belgian Society of Rheumatology’s Young Rheumatologists Working Group (NextGen Academy – SRBR/KBVR) and a member of the EMEUNET Newsletter Sub-Committee.