April 2026 to July 2026
Author: Iulia–Simona Chirică
Chronic histologic damage predicts kidney function loss despite proteinuria responses in lupus nephritis
Zhang et al. (doi: 10.1002/acr.80070) studied predictors of kidney function loss in 172 patients with lupus nephritis followed for a median 4.6 years. Kidney function loss occurred in 33%; histologic chronicity, but not activity or histologic class, predicted risk. A urine protein-to-creatinine ratio below 0.7 g/g at 12 months was associated with better outcomes but did not eliminate future kidney risk, highlighting limitations of proteinuria-based response targets.
Low muscle mass and cardiometabolic comorbidity identify obesity subtypes with persistently poorer function
Godziuk et al. (doi: 10.1002/acr.80066) examined seven-year functional trajectories in 1,211 adults with obesity and established or increased risk of knee osteoarthritis. Compared with uncomplicated obesity, low muscle mass and cardiometabolic comorbidities were associated with the poorest functional trajectory (adjusted odds ratios 1.9 and 2.6; 95% confidence intervals 1.1–3.1 and 1.4–5.0, respectively). These findings support assessing body composition and comorbidities beyond body mass index, without demonstrating the effectiveness of subtype-specific interventions.
Higher rheumatoid arthritis disease activity associates with greater frailty over five years
Loecker et al. (doi: 10.1002/acr.80056) evaluated five-year associations between disease activity and frailty in 2,800 veterans with rheumatoid arthritis (89% men). Higher Disease Activity Score in 28 joints was associated with higher frailty index scores (adjusted coefficient for index ×100: 0.53; 95% confidence interval 0.26–0.80; P<0.001). At baseline, 28% were frail; the predominantly male cohort and observational design limit generalisability and causal interpretation.
Structured workflows improve documentation of contraception and pregnancy interest in rheumatology clinics
Clowse et al. (doi: 10.1002/acr.80113) assessed a five-clinic quality-improvement initiative addressing contraception and pregnancy-interest documentation in rheumatology. Among 1,982 women at three community sites, contraception and pregnancy interest were documented in 48.6% and 50.1%, respectively. Flagged data fields and medical assistant-led collection produced the most consistent documentation improvements, supporting practical workflow changes but not demonstrating better pregnancy outcomes.
Patient-reported symptoms and wearable data complement clinical monitoring after rheumatoid arthritis treatment initiation
Nowell et al. (doi: 10.1002/acr.80124) followed 150 patients with rheumatoid arthritis starting upadacitinib or adalimumab for at least 12 weeks; 95 also provided wearable data. Mean Clinical Disease Activity Index fell by 13 points, and changes in patient-reported outcomes explained 52% of variability in its change. Remote assessments covered pain, fatigue and sleep; substantial missing data and the observational design preclude comparative treatment claims.
Iulia–Simona Chirică
Simona is a Rheumatology resident at the Rheumatology Department of Dr. Ion Cantacuzino Clinical Hospital and a PhD fellow at Carol Davila University of Medicine and Pharmacy in Bucharest.
Her clinical and research interests focus on inflammatory rheumatic diseases, particularly rheumatoid arthritis, psoriatic arthritis and spondyloarthritis. Her research primarily explores neuropathic-like and nociplastic pain in inflammatory arthritis, including their prevalence, longitudinal evolution and clinical predictors. As part of a EULAR Long-Term Scientific Training Grant at KU Leuven, she contributed to the NEUPIA study, a longitudinal research project investigating different pain phenotypes in patients with inflammatory arthritis. She is a member of the EMEUNET Newsletter Sub-Committee.