August 2025 to November 2025
Author: Giovanni Fulvio
‘Fast Ossifier’ in diffuse idiopathic skeletal hyperostosis: a sex-modulated, heterogeneous phenotype with accelerated ossification and early trabecular decline
Pariente-Rodrigo et al. (10.1136/rmdopen-2025-006024) found that FO subjects had higher Triglyceride-Glucose Index (TyG) (8.65±0.9 vs 8.39±0.4; p=0.002), FO-females showed higher visceral adiposity (VAI 2.30±2 vs 1.44±0.1; p=0.024), and both sexes presented elevated iPTH. In multivariable models, FO was associated with high TyG (adjusted OR=9.31; 95% CI: 1.04 to 36; p=0.046), low Trabecular Bone Score (adjusted OR=0.002; 95% CI: 0.001 to 0.61) and higher alkaline phosphatase levels (79 vs 69 (U/L); p=0.043).
Distribution of nailfold videocapillaroscopy parameters in systemic lupus erythematosus and their association with disease activity: an international blinded case–control analysis on behalf of the EULAR study group on microcirculation in rheumatic diseases
Ingegnoli et al. (10.1136/rmdopen-2025-005772) evaluated nailfold videocapillaroscopy (NVC) findings in patients with systemic lupus erythematosus (SLE). A normal NVC pattern was observed in most patients with SLE (86.6%) and, a significantly higher frequency of NVC abnormalities (p<0.001) were found in the remaining patients. The most severe NVC pattern (cluster 2) had significantly higher disease activity compared with cluster 1 for both Systemic Lupus Erythematosus Disease Activity Index cut-off points ≥3 and ≥4 (p=0.016 and p=0.028, respectively). SLE with ‘more severe’ NVC pattern (cluster 2) have a significantly higher frequency of arthritis, renal involvement and ongoing glucocorticoid therapy, whereas serositis was significantly associated with ‘less severe’ NVC pattern (cluster 1).
METHOFRACT, a methotrexate osteopathy multicentre cohort study
Robin et al. (10.1136/rmdopen-2025-005941) investigated Methotrexate-induced osteopathy (MTX-IO), a rare condition typically involving the lower limbs, especially tibia or foot fractures. Patients were predominantly postmenopausal women. A history of major fractures was noted for 22% of the patients, and 56% presented osteoporosis at diagnosis. Fractures were most common in the tibial metaphysis (distal and proximal) (88%) and the foot bones (49%), with multiple fractures often present at diagnosis (76). Management involved methotrexate discontinuation in 79% of the cases. Fracture healing and pain relief were achieved in 77% of the cases, with a significant difference in outcomes between those who discontinued methotrexate (91%) versus those who continued (29%) (p<0.001).
Targeted proteomics identifies differentially expressed proteins in Sjögren’s disease with incident lymphoma
Imgenberg-Kreuz et al. (10.1136/rmdopen-2025-00589) investigated serum protein biomarkers for lymphoma in patients with primary Sjögren’s disease (SjD). Among the top upregulated proteins were TNFSF14, FGF2, IL8, CD40 and CXCL13, where CXCL13 was the only protein with decreased levels at follow-up. We also observed upregulated expression of CD40 in the SjD pre-lymphoma group compared with SjD without lymphoma and healthy controls. All SjD patient groups presented elevated pIFN scores compared with healthy controls, where SjD sampled pre-lymphoma showed the most distinct IFN activation.
Efficacy and safety of avacopan for treatment of patients with ANCA-associated vasculitis receiving cyclophosphamide
Geetha et al. (10.1136/rmdopen-2025-005743) evaluated the efficacy and safety of avacopan versus a prednisone taper in the subgroup of patients with antineutrophil cytoplasmic antibody-associated vasculitis. Remission at week 26 and sustained remission at week 52 were achieved by 37/59 (62.7%) and 33/59 (55.9%) patients in the avacopan group and 34/57 (59.6%) and 30/57 (52.6%) in the prednisone taper group, respectively. Over 52 weeks, relapses were observed in 13.0% in the avacopan group and 22.6% in the prednisone taper group. Serious adverse events occurred in 55.9% and 56.1% of patients in the avacopan and prednisone taper groups, respectively.
Giovanni Fulvio
Giovanni is currently a PhD student at the University of Pisa. His research is focused on salivary gland ultrasonography and the role of multi-modal imaging techniques in rheumatology, particularly in the diagnosis and management of Sjögren’s syndrome. He completed his fellowship at the Rheumatology Unit, University of Pisa, where he also is a tutor in salivary gland ultrasonography. Giovanni is actively involved in professional societies, being a member of the Società Italiana di Reumatologia, European Reference Network on Connective Tissue and Musculoskeletal Diseases (ERN ReCONNET) and of the EMEUNET Newsletter Sub-Committee.