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ACR Convergence 2025: Do Not Miss – Basic and translational research
Claudia Iannone
Claudia is a Rheumatology resident at Milan University, carrying out her research at Gaetano-Pini Hospital in Milan, Italy. Her research interests are focused systemic sclerosis, Interstital lung disease in rheumatic diseases and vasculitis. She is a member of EULAR lung study group and of EUSTAR YIG. Claudia is part of the social media subcommitteePoster 0019 | Sunday, 26.10.2025 10:30 -12:30
Abstract Session: Genetics, Genomics & Proteomics
Presenting author: A Gómez Gómez (Spain)
Title: Single cell characterization of the circulating immune system in Sjögren’s Syndrome
This study assessed circulating immune cells in 32 Sjögren’s syndrome patients versus 10 controls using single-cell transcriptomics of 198,078 cells. SS showed increased CD4+ TH2, CD8+ TEM, and proliferative T cells, but decreased naive T cells, MAIT, pDC, DC3, and memory B cells. A novel CD8+ T cell subpopulation enriched for SS-risk genes was identified. Strong interferon-response signatures and cell-specific aberrant regulatory changes were observed across multiple cell types.
Providing the largest single-cell atlas of circulating immunity in SS to date, this work reveals novel disease-associated cell populations with potential diagnostic value.Oral Presentation 2584 | Tuesday, 28.10.2025 14:15
Abstract Session: Innate Immunity
Presenting author: L Dionet (France)
Title: Spatially Resolved Transcriptomics Reveal Macrophage Heterogeneity in Giant Cell Arteritis
This study assessed macrophage heterogeneity in Giant Cell Arteritis using spatial transcriptomics. TREM-1 signalling emerged as a top upregulated pathway in media-infiltrating macrophages, with inflammatory SPP1+ TREM1+ macrophages in the media and TREM2+ macrophages near myofibroblasts. Serum sTREM-1 levels correlated with CRP and IL-6. TREM-1 inhibitor nangibotide reduced monocyte migration and NFkB activation, positioning TREM-1 as a promising therapeutic target in GCA.
The spatial resolution approach uniquely identifies distinct macrophage subsets with different therapeutic potential, particularly highlighting TREM-1 as a novel druggable target in GCA.Poster 0942 | Monday, 27.10.2025 10:30 -12:30
Abstract Session: Systemic Lupus Erythematosus – Animal Models
Presenting author: J Nicholson (USA)
Title: Sodium-Glucose Co-Transporter 2 Inhibitors Modulate Renal Injury and Autoreactive Plasma Cells in Lupus
This study assessed SGLT2 inhibitor effects in lupus-prone MRL/lpr and NZB/NZW mice. Dapagliflozin reduced autoreactive plasma cells in spleen, bone marrow, and kidneys, inhibited germinal centers and plasmablast generation, and increased regulatory T cells systemically. Periarterial inflammation and interstitial fibrosis were significantly ameliorated. The glucose metabolism shift induced by SGLT2i may drive decreased autoimmunity, positioning these drugs as novel lupus therapeutics.
Revealing unexpected immunomodulatory effects beyond their renal protective mechanisms, SGLT2 inhibitors may offer a repurposing opportunity for lupus treatment.Oral Presentation 2584 | Tuesday, 28.10.2025 14:15
Abstract Session: Innate Immunity
Poster 0914 | Monday, 27.10.2025 10:30 -12:30
Abstract Session: B Cell Biology & Targets in Autoimmune Disease
Presenting author: X Wu (USA)
Title: Preclinical Expansion of Autoreactive Naive B cells Drives RA onset in ACPA+ individuals
This interesting study assessed preclinical immunologic events in ACPA+ individuals who progressed to RA. Single-cell profiling revealed marked expansion of IGHM+ IGHD+ CXCR5+ CD69+ activated naive B cells in converters, exhibiting pro-inflammatory transcriptional profiles and elevated clonal diversity. Recombinant antibodies from these cells demonstrated broad autoreactivity to RA-associated autoantigens. This autoreactive IgM pool may drive early immunologic activation and eventual RA onset, offering predictive biomarkers.
This study is interesting because it identifies a specific pre-clinical B cell signature that predicts RA development in at-risk individuals. The identification of a specific pre-clinical B cell signature predicting RA development in at-risk individuals opens new avenues for preventive interventions.Poster 0953 | Monday, 27.10.2025 10:30 -12:30
Abstract Session: Systemic Lupus Erythematosus – Animal Models
Presenting author: R Weissman-Tsukamoto (USA)
Title: NMDAR Autoantibody-Induced Neuronal Damage in the Amygdala Mediates Mood and Anxiety Disorders in a Model of Neuropsychiatric Lupus
This study assessed chronic effects of anti-NMDAR antibodies in neuropsychiatric lupus. Epinephrine caused selective blood-brain barrier breach in the amygdala, enabling antibody penetration. Significant neuronal loss occurred in basolateral and lateral amygdala nuclei, correlating with anxiety behaviors. Surviving neurons showed abnormal morphology and lipid oxidation suggesting ferroptosis, differing from hippocampal pathology. This reveals distinct neuropathological mechanisms underlying psychiatric symptoms in NPSLE.
This study is interesting because it demonstrates region-specific neuronal damage mechanisms that could explain the varied psychiatric manifestations in lupus patients, which are the most difficult to address and treat at the moment.Oral Presentation 1757 | Tuesday, 28.10.2025 11:15
Abstract Session: Spondyloarthritis – Basic Science
Presenting author: M Raimondo (Germany)
Title: Skin-to-Joint Immune Cell Migration and Synovial Reprogramming in Psoriatic Arthritis Onset
This interesting study assessed skin-joint axis mechanisms in PsA using IL-23 overexpression KAEDE mice with photo-conversion tracking. Skin-derived CD2+MHCII+ myeloid progenitors migrated to synovium, differentiating into pro-inflammatory macrophages in susceptible mice but M2-like cells in resistant mice. CD200+ synovial fibroblasts emerged as key modulators promoting protective responses. Mitochondrial DNA sequencing validated skin origin of synovial myeloid cells in human early PsA patients.
Providing first direct evidence of functional skin-to-joint immune cell migration in humans through innovative tracking methods, this work reveals fibroblast-mediated control mechanisms that determine arthritis susceptibility in psoriasis patients.Poster 0956 | Monday, 27.10.2025 10:30 -12:30
Abstract Session: Systemic Sclerosis – Basic Science
Presenting author: A Matei (Germany)
Title: Mapping Metabolic Changes in Skin Fibrosis in Systemic Sclerosis by Spatial Proteomics
This interesting study assessed metabolic profiles in SSc skin using imaging mass cytometry with 38 metal-labeled antibodies targeting metabolic enzymes. Progressive SSc patients showed distinct metabolic regulomes with upregulated glycolysis and TCA/OXPHOS scores. A metabolically active fibroblast subset expressing high αSMA and FAP was enriched in progressive disease, forming niches with similarly metabolic endothelial cells and macrophages. Metabolic phenotyping may identify patients at progression risk.
The discovery of metabolically-defined fibroblast niches through spatial proteomics offers a novel biomarker approach for identifying patients at risk for progressive skin fibrosis.Poster 0114 | Sunday, 26.10.2025 10:30 – 12:30
Abstract Session: Spondyloarthritis – Basic Science
Presenting author: S Hilliquin (France)
Title: A Rare Variant in the extl3 Gene Is Associated with Altered Wnt Signaling Pathway in a Novel Mouse Model of Axial Spondyloarthritis
This interesting study assessed Wnt signaling in Extl3mut/+ mice developing sacroiliac joint lesions resembling axSpA. Tcf1 immunostaining increased markedly in chondrocyte columns and subchondral bone. RNA-seq revealed downregulation of Wnt inhibitors Dkk-1 and Sclerostin, with overexpression of β-catenin and Tcf7. Notably, Wnt pathway inhibition with Dkk-1 reversed the phenotypes, including delayed osteoblast and accelerated chondrocyte differentiation, highlighting potential therapeutic targets for AS ossification.
Linking a rare EXTL3 variant to disrupted Wnt signaling in a novel mouse model reinforces the pathway’s critical role in AS pathological ossification and validates Wnt modulation as a therapeutic strategy. -
Stats Made Simple: How to read a scientific paper?
Reading a scientific paper is not always easy or appealing. Where to begin, which section to prioritise, how to approach the often-dense methods section? Depending on your career stage, this task may require more or less effort [1]. The large volume of publications also makes it impossible to read everything of interest [2]. It is therefore useful to cultivate two complementary skills: rapid reading to screen articles and careful reading for in-depth appraisal.
The IMRAD structure
Scientific papers generally follow the IMRAD format: Introduction, Methods, Results, and Discussion [3]. Each section serves a distinct purpose:
- Introduction: frames the rationale and the problem.
- Methods: describes how the study was conducted; key for assessing validity.
- Results: presents the data without interpretation.
- Discussion: interprets findings, acknowledges limitations, and situates the work in context.
Understanding these functions is essential for effective reading. A useful rule is to trust the data more than the authors’ interpretations, and to verify that the conclusions logically follow from the results. For instance, no overinterpretation that goes beyond the results.
Where to start?
When carefully reading a paper, most researchers begin with the Abstract. It offers a concise overview and helps determine relevance. A large survey across career stages showed that the abstract is consistently the entry point, but differences emerge in what follows [1]. Junior readers often gravitate towards the Introduction and Discussion, while experienced researchers emphasise the Methods and Results, which are central to critical appraisal.
Reading with purpose
Your reading strategy should reflect your goal. If the aim is a quick overview, focusing on the Abstract, figures, and Discussion may be sufficient. For an analytical review, the Methods and Results are indispensable [4]. Key questions to ask include: Is the study design appropriate? Are the analyses robust? Are the findings relevant to my field? Validated checklists such as CASP, CONSORT, or PRISMA provide structured ways to guide this process and avoid overlooking important details.
Practice makes perfect
Finally, and most importantly: reading scientific papers is a skill that develops with practice, not overnight. To make progress, find dedicated time in your weekly schedule for active reading and stick to it [5]. Stay focused on what is relevant to your field, but remain open to papers outside your specialty; innovation often happens at the boundaries.
Practical Roadmap
How to read a scientific paper: a practical roadmap (inspired by [4–6], realised with draw.io)
Further reading
If you want to learn more about CASP, CONSORT or PRISMA checklists, you can read the following papers:
Checklist Type of articles concerned Main authors/organizations responsible References CASP (Critical Appraisal Skills Programme) Randomised controlled trials (RCTs), including extensions for nonpharmacologic, noninferiority, equivalence, and pragmatic trials CASP UK (Critical Appraisal Skills Programme), developed by an interdisciplinary team of educators and methodologists [7] CONSORT (Consolidated Standards of Reporting Trials) The CONSORT Group (an international collaboration of clinical trialists, statisticians, epidemiologists, and biomedical editors) The CONSORT Group (international collaboration of clinical trialists, statisticians, epidemiologists, and biomedical editors) [8] PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) Systematic reviews and meta-analyses PRISMA Group (international group of authors and methodologists) [9] References
1. Hubbard KE, Dunbar SD. Perceptions of scientific research literature and strategies for reading papers depend on academic career stage. PloS One. 2017;12:e0189753. doi: 10.1371/journal.pone.0189753
2. Erren TC, Cullen P, Erren M. How to surf today’s information tsunami: on the craft of effective reading. Med Hypotheses. 2009;73:278–9. doi: 10.1016/j.mehy.2009.05.002
3. Shiely F, Gallagher K, Millar SR. How, and why, science and health researchers read scientific (IMRAD) papers. PloS One. 2024;19:e0297034. doi: 10.1371/journal.pone.0297034
4. Subramanyam R. Art of reading a journal article: Methodically and effectively. J Oral Maxillofac Pathol JOMFP. 2013;17:65–70. doi: 10.4103/0973-029X.110733
5. Sun T-T. Active versus passive reading: how to read scientific papers? Natl Sci Rev. 2020;7:1422–7. doi: 10.1093/nsr/nwaa130
6. Durbin CG. How to read a scientific research paper. Respir Care. 2009;54:1366–71.
7. Rosati P, Porzsolt F. A practical educational tool for teaching child-care hospital professionals attending evidence-based practice courses for continuing medical education to appraise internal validity in systematic reviews. J Eval Clin Pract. 2013;19:648–52. doi: 10.1111/j.1365-2753.2012.01889.x
8. Schulz KF, Altman DG, Moher D, et al. CONSORT 2010 statement: updated guidelines for reporting parallel group randomised trials. BMJ. 2010;340:c332. doi: 10.1136/bmj.c332
9. Liberati A, Altman DG, Tetzlaff J, et al. The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions: explanation and elaboration. J Clin Epidemiol. 2009;62:e1-34. doi: 10.1016/j.jclinepi.2009.06.006
Cécile Philippoteaux
on behalf of the EMEUNET Newsletter SC -
Autumn 2025 Press Review – Annals of Rheumatic Diseases
April 2025 to July 2025
Author: Omar Dhrif
Increasing the number of minor salivary glands from patients with Sjögren’s disease improves the diagnostic and measurement precision of the histological focus score
Tryposkiadis et al. (10.1002/art.42860) examined how the number of minor salivary glands (MSGs) affects Sjögren’s disease diagnosis and research outcomes. Monte Carlo simulations (2–7 MSGs) showed that reproducibility improved with more glands, as the median absolute difference between two focus score (FS) measurements decreased from 1.05 with 2 glands to 0.52 with 7. The probability of FS ≥1 rose from 0.67 with 2 glands to 0.77 with ≥5. Clinical trial sample size needs were reduced, requiring 62 patients per group with 2 glands versus 25 with 7.
Mitochondrial transplantation as a novel therapeutic approach in idiopathic inflammatory myopathy
Kim et al. (10.1016/j.ard.2024.11.005) evaluated mitochondrial transplantation (PN-101, derived from umbilical cord mesenchymal stem cells) as therapy for idiopathic inflammatory myopathy (IIM). In vitro, PN-101 improved mitochondrial function, adenosine triphosphate content, viability, and myogenesis in patient-derived and C2C12 myoblasts. In vivo, PN-101 reduced inflammation and metabolic shifts in a mouse model of myositis. In a phase 1/2a trial with 9 patients with refractory polymyositis/dermatomyositis, PN-101 showed no severe adverse reactions and led to at least minimal improvement in disease activity scores.
Post hoc comparison of the effectiveness of tocilizumab, rituximab, mycophenolate mofetil, and cyclophosphamide in patients with SSc-ILD from the EUSTAR database
Yan et al. (10.1016/j.ard.2025.01.014) in this post hoc study compared the effectiveness of tocilizumab (TCZ), rituximab (RTX), mycophenolate mofetil (MMF), and cyclophosphamide (CYC) in systemic sclerosis–associated interstitial lung disease (SSc-ILD) using the EUSTAR database. Among 955 patients (997 treatment observations, median follow-up 11 months), inverse probability of treatment weighting showed no significant difference in change of forced vital capacity (FVC) percent predicted across groups (P = 0.101). Paired and subgroup analyses confirmed no differences, although CYC was associated with stable FVC in logistic regression.
The giant cell arteritis (GCA) ultrasound score (OGUS) at diagnosis and after initial treatment predicts future relapses in GCA patients: results of a multicentre prospective study
Monti et al. (10.1016/j.ard.2025.01.018) in this prospective multicentre study assessed the prognostic value of ultrasonography in giant cell arteritis (GCA). Ninety-seven patients underwent serial ultrasound with the OMERACT GCA ultrasonography score (OGUS). Over 849 visits, 35 patients (36%) had 66 relapses. Higher OGUS at diagnosis increased relapse risk (IRR per 1-point increase: 1.85; 95% CI 1.05–3.32). OGUS normalisation within 3 weeks reduced relapse risk (IRR 0.44; 95% CI 0.22–0.88), while OGUS reduction over 12 weeks was inversely associated with disease-modifying antirheumatic drug (DMARD) initiation.
Novel IgG and IgA autoantibodies validated in two independent cohorts are associated with disease activity and determine organ manifestations in systemic lupus erythematosus: implications for anti-LIN28A, anti-HMGN5, anti-IRF5, and anti-TGIF1
Lindblow et al. (10.1016/j.ard.2025.04.008) identified and validated novel autoantibodies linked to systemic lupus erythematosus (SLE) activity. Plasma from discovery (n = 196) and validation (n = 30) SLE cohorts versus controls revealed 89 IgG and 66 IgA differentially abundant autoantibodies (daAAbs). IgG anti-LIN28A, IgG anti-HMGN5, and IgG/IgA anti-IRF5 and anti-TGIF1 correlated with high disease activity (SLEDAI-2K ≥ 10) and were prevalent across organ manifestations. IgG anti-LIN28A was positive in 53% with CNS involvement (vs 20% for anti-dsDNA) and 47% with renal activity. IgA anti-FOSL2 is uniquely associated with musculoskeletal activity.
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 focus 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.
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Autumn 2025 Press Review – Arthritis Care and Research
April 2025 to July 2025
Author: Antony Psarras
Risk of Incident Heart Failure and Heart Failure Subtypes in Patients With Rheumatoid Arthritis
Kawano et al. (10.1002/acr.25481) identified incident HF and categorized HF subtypes based on EF closest to the HF incident date in 1,445 patients with RA and 4,335 matched non-RA comparators. HFpEF was the most common HF subtype in both groups (65% in RA vs 59% in non-RA). Patients with RA had an HR of 1.79 (95% confidence interval [CI] 1.38–2.32) for incident HF compared with those without RA after adjusting for CVD risk factors. Patients with RA had a higher rate of HFpEF (HR 1.99, 95% CI 1.43–2.77), but there was no statistical difference in the HFrEF rate (HR 1.45, 95% CI 0.81–2.60). Conclusion: RA was associated with a higher rate of HF overall compared with non-RA, even after adjustment for established CVD risk factors. The elevated risk was driven by HFpEF, supporting a role for inflammation in HFpEF and highlighting potential opportunities to address this excess risk in RA.
Immunosuppressive Drugs in Early Systemic Sclerosis and Prevention of Damage Accrual
Baron et al. (10.1002/acr.25467) investigated whether receiving immunosuppresants (ISs) may reduce global organ damage accrual in patients with early SSc. This was a retrospective study of patients with two or fewer years of disease duration in Canadian and Australian cohorts with SSc. Patients with either limited cutaneous SSc (lcSSc) or diffuse cutaneous SSc (dcSSc) were observed separately and divided into groups who were either ever or never exposed to ISs. The SCTC-DI was the outcome, and inverse probability of treatment weighting (IPTW) was used to balance the study groups and to fit a marginal structural generalised estimating equation model. In the cohort with lcSSc, there were 210 patients, of whom 34% were exposed to ISs at some time. Exposure to ISs was associated with lower damage scores. In the cohort with dcSSc, there were 192 patients, of whom 76% were exposed to ISs at some time. Exposure to ISs was not associated with damage scores. Conclusion: protective effect of receiving ISs on damage accrual in patients with lcSSc. But unable to determine such an effect in patients with dcSSc.
Gout Flares After Stopping Anti-Inflammatory Prophylaxis: A Rapid Literature Review and Meta-Analysis
Stamp et al. (doi.org/10.1002/acr.25486) performed a rapid literature review and meta-analysis. PubMed was searched from inception to February 2024. Eligibility criteria included any clinical trial of people with gout with at least one arm starting or intensifying urate-lowering therapy (ULT) with coprescription of anti-inflammatory prophylaxis and that had the percentage of participants experiencing one or more gout flares reported during and after the period of prophylaxis. Gout flares were found to be common after stopping anti-inflammatory prophylaxis, but returned to levels seen during prophylaxis. Patients should be cautioned about the risk of gout flares and have a plan for effective gout flare management in the three months after stopping anti-inflammatory prophylaxis.
Predictors of Mortality in Antiphospholipid Antibody–Positive Patients: Prospective Results From Antiphospholipid Syndrome Alliance for Clinical Trials and International Networking Clinical Database and Repository
Ahmadzadeh et al. (10.1002/acr.25503) investigated the mortality rate as well as the causes and predictors of death in antiphospholipid antibody (aPL)–positive patients with and without antiphospholipid syndrome (APS) classification. Of 967 patients, 43 (5%) were deceased after a median follow-up of 5.3 years. Based on the univariate analysis, deceased patients, compared to living patients, were more likely to be older and have a history of arterial thrombosis, catastrophic APS, concomitant systemic autoimmune diseases (SAIDs), and baseline cardiovascular disease (CVD) risk factors. Based on the Cox proportional hazards model adjusted for age and for each of the strongest predictors of death, arterial thrombosis (hazard ratio [HR] 2.94, 95% confidence interval [CI] 1.50–5.76), concomitant SAIDs (HR 2.97, 95% 1.56–5.63), and baseline any CVD risk factor (HR 2.43, 95% CI 1.05–5.71) were significantly associated with mortality. Conclusion: In this cohort of persistently aPL-positive patients, the mortality rate was 5% after a median follow-up of five years and was highest for patients ≥60 years old at registry entry. History of arterial thrombosis, concomitant SAIDs, and baseline any CVD risk factor independently predicted future death.
Comparing Rituximab and Cyclophosphamide in Induction Therapy for Childhood-Onset Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis: An ARChiVe Registry Cohort Study
Gagne et al. (10.1002/acr.25455) identified patients with GPA and MPA from a registry of Childhood Vasculitis, who received induction with RTX or CYC. Pediatric Vasculitis Activity Score (PVAS) and Pediatric Vasculitis Damage Index (pVDI) score evaluated disease activity and damage. Descriptive statistics summarized patient characteristics. RTX and CYC comparisons used logistic regression for primary outcomes of postinduction remission (PVAS = 0) or low disease activity (PVAS ≤ 2). Among 104 patients, 43% received RTX, 46% CYC, 11% both. Treatment groups did not significantly differ for diagnosis PVAS and onset age. There was no difference in remission among the groups (63% overall; odds ratio [OR] 1.07, 95% confidence interval [CI] 0.45–2.52). Hospitalizations occurred in 22% of patients receiving RTX versus 10% patients receiving CYC (OR 2.27, 95% CI 0.73–7.05). The median 12-month pVDI score was 1 in both groups (OR 0.98, 95% CI 0.43–2.22). Conclusion: This was the first study comparing CYC and RTX for induction in pediatric GPA and MPA. No significant differences were shown in rates of remission, severe adverse events, or organ damage. Limitations included lack of standardized treatment regimens, retrospectivity, and lack of longitudinal adverse drug-related event data.
Antony Psarras
Antony is an NIHR Academic Clinical Lecturer in Rheumatology at the University of Oxford and Oxford University Hospitals. His research interest lies in immune regulation of autoimmune rheumatic diseases, particularly systemic lupus erythematosus (SLE). He is currently focusing on high dimensional single cell multi –omic approaches to investigate the immunometabolic reprogramming in preclinical autoimmunity and SLE. Antony is a member of the EMEUNET Newsletter Sub-committee.
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Autumn 2025 Press Review – Arthritis & Rheumatology
April 2025 to July 2025
Author: Antony Psarras
Neutrophil Activation Markers and Rheumatoid Arthritis Treatment Response to the JAK1/2 Inhibitor Baricitinib
Kuley et al. (10.1002/art.43042) analysed markers of neutrophil activation, calprotectin, and neutrophil extracellular traps (NETs) using ELISA in plasma from patients with RA (n = 271) and healthy controls (n = 39). For patients with RA, neutrophil activation markers were measured at baseline, 12 weeks, and 24 weeks after receiving placebo and 2 mg and 4 mg baricitinib. Whole-blood RNA analyses from multiple randomised baricitinib RA trials were performed to study neutrophil-related transcripts (n = 1,651). Baseline levels of plasma neutrophil markers were elevated in patients with RA compared to healthy controls (P < 0.001). Receiving baricitinib reduced levels of soluble calprotectin at 12 and 24 weeks, especially in patients with RA responding to treatment. Whole-blood RNA analysis revealed similar changes in the predominant neutrophil markers calprotectin and Fcα receptor I upon reception of baricitinib in three randomised clinical trials involving patients at various stages of disease-modifying therapy.
Efficacy and Safety of Sodium–Glucose Cotransporter 2 Inhibitors for the Primary Prevention of Cardiovascular, Renal Events, and Safety Outcomes in Patients With Systemic Lupus Erythematosus and Comorbid Type 2 Diabetes: A Population-Based Target Trial Emulation
Sheng Kai Ma et al. (10.1002/art.43037) performed an emulated clinical trial in an insurance-based cohort in the United States, evaluating SGLT2i versus DPP4i for primary prevention of cardiovascular, renal, and other clinical outcomes among patients with both SLE and comorbid T2DM. SGLT2i recipients had significantly lower risks of incident acute kidney injury, chronic kidney disease, end-stage renal disease, heart failure, emergency department visits, and severe sepsis. Risks of all-cause mortality, lupus nephritis, myocardial, stroke, and hospitalisations did not differ. Genital infection risk was increased, but urinary tract infection risk did not differ. No significant difference was observed for diabetic ketoacidosis risk and fractures. In this emulated clinical trial, treatment with SGLT2i, compared to DPP4i therapy, was associated with significantly reduced risks of several cardiorenal complications among patients with both SLE and T2DM.
Development of Extramusculoskeletal Manifestations in Upadacitinib-Treated Patients With Psoriatic Arthritis or Axial Spondyloarthritis
Poddubnyy et al. (10.1002/art.43069) the development of extramusculoskeletal manifestations (EMMs) among patients with psoriatic arthritis (PsA) or axial spondyloarthritis (axSpA) treated with upadacitinib 15 mg. Most patients (87.1%–99.3%) did not have a history of EMMs at baseline. In PsA, development of uveitis and IBD were low regardless of treatment or prior EMM history; rates were similar with upadacitinib 15 mg and adalimumab. In r-axSpA, development of uveitis was numerically lower (E/100 PY) in patients treated with upadacitinib 15 mg (2.8) versus placebo (7.5) and in patients with no history of uveitis (upadacitinib 15 mg 0.6; placebo 1.2) versus a history of uveitis (upadacitinib 15 mg 2.1; placebo 6.2); occurrence of IBD and psoriasis were low regardless of treatment or history. In nr-axSpA, development of uveitis was low regardless of history but was numerically lower in patients treated with upadacitinib 15 mg (0.9) versus placebo (2.1); occurrence of IBD and psoriasis were low or absent. In patients with spondyloarthritis, development of EMMs was generally low with upadacitinib 15 mg. Uveitis was numerically lower in patients treated with upadacitinib 15 mg versus placebo, and particularly in r-axSpA. Regardless of treatment in r-axSpA, having a history of uveitis appeared to predispose patients for future uveitis events.
Safety and Efficacy of Ianalumab in Patients With Sjögren’s Disease: 52-Week Results From a Randomized, Placebo-Controlled, Phase 2b Dose-Ranging Study
Dörner et al. (10.1002/art.43059) studied the 52-week safety and efficacy of ianalumab from phase 2b dose-finding study in patients with Sjögren’s disease (SjD). Patients randomly received (1:1:1:1) ianalumab (5, 50, or 300 mg) or placebo subcutaneously every 4 weeks until week 24 (treatment period (TP1). At week 24, patients on 300 mg were rerandomized to continue 300 mg or receive placebo until week 52 (TP2), patients on placebo were switched to ianalumab 150 mg, and patients on 5 and 50 mg directly entered posttreatment safety follow-up. During TP1, 190 patients were randomized (placebo = 49, 5 mg = 47, 50 mg = 47, 300 mg = 47). Of these 190 patients, 90 (47.4 %; 43 continued 300 mg and 47 received placebo) entered TP2, and 81 of 90 (90.0%) completed the study treatment. By week 52, efficacy was sustained in patients who continued 300 mg in TP2 (EULAR Sjögren’s Syndrome Disease Activity Index, EULAR Sjögren’s Syndrome Patient Reported Index, patient global assessment, and physician global assessment change from week 24: −1.45, −0.46, −4.69, and −6.86, respectively). Stimulated salivary flow rates and autoantibody levels numerically improved in the 300 mg group. Conclusion: In patients with SjD, ianalumab 300 mg demonstrated sustained efficacy through week 52 and a favourable safety profile up to two years of follow-up.
Outcome of Patients With Lupus Nephritis Treated With an Anti-CD40 Monoclonal Antibody According to Kidney Biopsy Features
Uzzo et al. (10.1002/art.43076) investigated whether the treatment effect of the anti-CD40 monoclonal antibody BI 655064 on kidney outcomes may be modified by the presence of glomerular monocytes, a target for this drug with a well-known role in lupus nephritis (LN) pathogenesis. One hundred one renal biopsies of patients with LN enrolled in the BI 655064 trial were scored centrally. A higher BI 655064 dose (180 or 240 mg) was associated with better outcomes of UP/UC and CRR when glomerular monocytes were present in kidney biopsy samples (odds ratio [OR] 3.66 [95% confidence interval (CI) 1.09–12.3], P = 0.04; OR 4.58 [95% CI 1.24–16.9], P = 0.02). A trend toward improved eGFR was also observed in these patients (at 52 weeks, P = 0.08). Conclusion: In LN kidney biopsy samples with glomerular monocytes, high-dose BI 655064 treatment improved proteinuria at 52 weeks and resulted in a higher CRR compared to biopsy samples without glomerular monocytes. Histologic features may guide the choice of treatment for individual patients with LN.
Antony Psarras
Antony is an NIHR Academic Clinical Lecturer in Rheumatology at the University of Oxford and Oxford University Hospitals. His research interest lies in immune regulation of autoimmune rheumatic diseases, particularly systemic lupus erythematosus (SLE). He is currently focusing on high dimensional single cell multi –omic approaches to investigate the immunometabolic reprogramming in preclinical autoimmunity and SLE. Antony is a member of the EMEUNET Newsletter Sub-committee.
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Autumn 2025 Press Review – Arthritis Research & Therapy
April 2025 to July 2025
Author: Clementina López-Medina
Real-world data on the use of the Shingrix vaccine among patients with inflammatory arthritis and risk of cardiovascular events following herpes zoster
Curtis JR, et al. (10.1186/s13075-025-03565-0) aimed to evaluate Shingrix effectiveness and cardiovascular risk after herpes zoster in inflammatory arthritis. Using a retrospective cohort of 132,672 patients (mean age 60 years, 72% female), 22% received ≥1 vaccine dose, but adherence to the second dose was suboptimal. Herpes zoster incidence was halved with vaccination (7.4 vs 14.8 per 1,000 person-years; effectiveness 50%). 360 post-vaccination herpes zoster cases occurred, showing incomplete protection. Risk of venous thromboembolic events was elevated 60–90 days post-herpes zoster, while other cardiovascular risks were not increased. These findings support strong recommendations for Shingrix vaccination in immunosuppressed patients with inflammatory arthritis.
Artificial intelligence-based Raynaud’s quantification index (ARTIX): an objective mobile-based tool for patient-centred assessment of Raynaud’s phenomenon
Di Battista M, et al. (10.1186/s13075-025-03569-w) aimed to develop and validate ARTIX, an AI-based tool for quantifying Raynaud’s phenomenon (RP) from mobile phone photos. ARTIX was built through image segmentation, decomposition, and filtering, and validated against thermography during a cold challenge. The study included 45 RP patients (75.5% secondary RP, mean age 52 years) and 22 healthy controls. RP patients had significantly lower ARTIX scores than controls at baseline and across all cold challenge timepoints (p < 0.01). Scores were higher in men and vasoactive drug users, but lower in patients with severe disease features. ARTIX effectively discriminated RP from healthy responses, showing promise as a patient-centred, objective tool for RP monitoring.
Decoding the impact of exercise and αCGRP signalling on murine post-traumatic osteoarthritis progression
Pann P, et al. (10.1186/s13075-025-03589-6) aimed to investigate the role of αCGRP deficiency and exercise intensity on osteoarthritis (OA) progression in a murine post-traumatic model. OA was induced by destabilisation of the medial meniscus in wild-type and αCGRP knockout mice, followed by moderate or intense treadmill running. Cartilage degradation occurred after surgery, but was unaffected by αCGRP deficiency or exercise intensity. αCGRP deficiency prevented cartilage extracellular matrix stiffening after OA and intense exercise. Subchondral bone sclerosis was aggravated by αCGRP deficiency and OA but improved with intense exercise. In αCGRP-deficient mice, intense exercise caused trabecular bone loss and elevated inflammatory markers. Findings identify αCGRP as a regulator of bone remodelling, ECM stiffness, and inflammatory responses, highlighting its role in joint adaptation to mechanical stress during OA.
Entheseal Doppler signals in ultrasound are associated with vasodilator drugs and age in patients with radiographic axial spondyloarthritis
Hallström M, et al. (10.1186/s13075-025-03614-8) aimed to assess the prevalence and significance of Doppler ultrasound signals in peripheral entheses of patients with long-standing radiographic axial spondyloarthritis. A total of 141 patients underwent ultrasound of 1692 entheses. Active ultrasound enthesitis was detected in 21.3% of patients, but only 4.3% were clinically tender. Isolated Doppler signals were common (89–97% of patients), most frequent at the triceps entheses and least at the Achilles tendons. Multivariable regression showed that older age, NSAID use, and vasodilator therapy were associated with higher Doppler scores, while disease activity was not. Thus, asymptomatic entheseal Doppler findings are frequent in long-standing r-axSpA, but not related to disease activity.
Mortality in polymyalgia rheumatica: a 38-year prospective population-based cohort study from Southern Norway
Tengesdal S, et al. (10.1186/s13075-025-03613-9) aimed to evaluate long-term mortality in polymyalgia rheumatica (PMR) using a 38-year, population-based cohort from Norway. A total of 274 isolated PMR and 63 GCA patients were included, matched with population comparators. Mean age at diagnosis was ~72 years, and 96% were deceased by study end. Mean follow-up was 13.7 years. The standardised mortality ratio (SMR) in PMR was 0.97, showing no excess mortality compared with the general population. Men had slightly reduced mortality risk (SMR 0.77), while women had a marginally higher risk (SMR 1.11). For GCA, SMR was 1.10, with no gender differences. Thus, isolated PMR is not associated with increased mortality, supporting its relatively benign long-term prognosis.
Clementina López-Medina
Clementina is a Rheumatologist and Associate Professor at Reina Sofía University Hospital and the University of Córdoba, Spain. Her main research interest is clinical and translational research in Spondyloarthritis and Psoriatic Arthritis. She also leads the Spondyloarthritis Unit at her hospital. Clementina is a member of the Spanish Society of Rheumatology (SER), the Spanish Group of Interest in Spondyloarthritis (GRESSER), the Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA), and a full member of the Assessment of Spondyloarthritis International Society (ASAS). She is also a member of the EMEUNET Social Media Sub-committee.
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Autumn 2025 Press Review – The Lancet Rheumatology
April 2025 to July 2025
Author: Clementina López-Medina
Baricitinib in early polymyalgia rheumatic (BACHELOR): a randomised, double-blind, placebo-controlled, parallel group trial
Saraux A, et al. (10.1016/S2665-9913(24)00270-4) aimed to test whether baricitinib could control polymyalgia rheumatica without glucocorticoids. In a French multicentre randomised, placebo-controlled trial, 34 recent-onset, glucocorticoid-naive patients were enrolled. At week 12, 78% of patients on baricitinib versus 13% on placebo achieved low disease activity without oral glucocorticoids. Adverse events were more common with baricitinib, mostly musculoskeletal disorders, but no deaths or major cardiovascular events occurred. Baricitinib showed significant efficacy in reducing glucocorticoid need with an acceptable safety profile in polymyalgia rheumatica.
Faecal microbiota transplantation in patients with systemic sclerosis and lower gastrointestinal tract symptoms in Norway (ReSScue): a phase 2, randomised, double-blind, placebo-controlled trial
Fretheim H, et al. (10.1016/S2665-9913(24)00334-5) aimed to assess faecal microbiota transplantation (ACHIM) for gastrointestinal symptoms in systemic sclerosis. In a phase 2 randomised, placebo-controlled trial across four Norwegian centres, 67 patients received either ACHIM (n=33) or placebo (n=34). The primary endpoint—change in worst GI symptom (bloating or diarrhoea) at 12 weeks—showed no significant difference between ACHIM and placebo. Adverse events were mostly mild GI symptoms, reported at similar rates in both groups, with one serious duodenal perforation during gastroscopy. Overall, ACHIM was safe but did not improve lower GI symptoms compared with placebo in systemic sclerosis.
First-line biological versus conventional synthetic disease-modifying antirheumatic drug therapy in adult-onset Still’s disease: a multicentre, retrospective, propensity weighted cohort study
Kernder A, et al. (10.1016/S2665-9913(25)00023-2) compared first-line biological versus conventional synthetic DMARDs in adult-onset Still’s disease (AOSD). In a multicentre German cohort of 86 patients, 44 received biological DMARDs (anakinra, canakinumab, tocilizumab) and 42 received conventional DMARDs (methotrexate or glucocorticoids). Biological DMARDs were strongly associated with sustained, event-free remission (OR 7·20), achieved in 50% versus 12% at week 72. Glucocorticoid-related complications and deaths occurred only in the conventional DMARD group. The study concludes that first-line biologics significantly improve remission rates and reduce complications in AOSD compared with conventional therapy.
Local immune effector cell-associated toxicity syndrome in CAR T-cell treated patients with autoimmune disease: an observational study
Hagen M, et al. (10.1016/S2665-9913(25)00091-8) aimed to characterise autoimmune disease–specific adverse events from CD19 CAR T-cell therapy. In an observational study of 39 patients with SLE, systemic sclerosis, or idiopathic inflammatory myopathy, 77% developed local immune effector cell-associated toxicity syndrome (LICATS). LICATS occurred only in organs previously affected by autoimmune disease, most often skin and kidneys, with onset around day 10 and lasting about 11 days. Most cases were mild (grade 1–2), only three reached grade 3, and all resolved without sequelae. The authors conclude that LICATS is a novel, self-limited, organ-specific, and generally mild toxicity in autoimmune disease patients receiving CAR T-cell therapy.
Trends in the prevalence of autoimmune diseases during pregnancy in the UK, 2000-21: a retrospective cohort study
Singh M, et al. (10.1016/S2665-9913(25)00039-6) aimed to estimate the burden of autoimmune disease in pregnancy using UK data (2000–2021). Among 5.2 million pregnancies, 185,208 had a diagnosis of autoimmune disease, with prevalence rising from 3.5% to 4.7%. Psoriasis was most common, while Hashimoto’s thyroiditis, coeliac disease, Graves’ disease, and type 1 diabetes showed the steepest increases. Higher odds were seen in women from less deprived areas, ex-smokers, those with ≥5 pregnancies, and with metabolic or mental health comorbidities. The authors conclude that the growing prevalence highlights the need for specialised, evidence-based care in pregnancy.
Clementina López-Medina
Clementina is a Rheumatologist and Associate Professor at Reina Sofía University Hospital and the University of Córdoba, Spain. Her main research interest is clinical and translational research in Spondyloarthritis and Psoriatic Arthritis. She also leads the Spondyloarthritis Unit at her hospital. Clementina is a member of the Spanish Society of Rheumatology (SER), the Spanish Group of Interest in Spondyloarthritis (GRESSER), the Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA), and a full member of the Assessment of Spondyloarthritis International Society (ASAS). She is also a member of the EMEUNET Social Media Sub-committee.
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Autumn 2025 Press Review – Miscellanous
April 2025 to July 2025
Author: Victoria Konzett
Upadacitinib FDA and EMA-approved for treatment of giant cell arteritis after positive results from the SELECT-GCA study
Blockmans et al. (10.1056/NEJMoa2413449) compared Upadacitinib 15mg daily and 7.5mg daily combined with a 26-week glucocorticoid taper with placebo combined with a 52-week glucocorticoid taper in 428 patients above 50 years of age, with new-onset or relapsing giant cell arteritis, in the double-blind, randomized, phase 3 SELECT-GCA trial. Upadacitinib 15 mg, but not 7.5mg, combined with a 26-week glucocorticoid taper significantly improved sustained remission rates through weeks 12 to 52 and reduced disease flares and steroid exposure in this study. Safety was comparable between groups. Serious infections were numerically higher in the placebo arms, while Upadacitinib showed increased rates of herpes zoster infections, non-melanoma skin cancers and non-pathologic Creatine kinase elevations. No major cardiovascular events were observed in the upadacitinib arms.
Methotrexate as a viable alternative to glucocorticoids as first-line treatment in pulmonary sarcoidosis
Kahlmann et al. (10.1056/NEJMoa2501443) compared methotrexate with prednisone – the currently recommended first-line treatment for pulmonary sarcoidosis – in the multicenter, open-label, randomized, non-inferiority PREDMETH trial. In 138 patients with previously untreated pulmonary sarcoidosis methotrexate (15 mg per week increased by 5 mg every 4 weeks to a maximum dose of 25 mg per week if tolerated) was noninferior to prednisone for improving lung function over 24 weeks. Unadjusted mean change from baseline to week 24 in the percentage of the predicted forced vital capacity was 6.75 percentage points (95% CI 4.50 to 8.99) in the prednisone group and 6.11 percentage points (95% CI 3.72 to 8.50) in the methotrexate group (∆ −1.17 percentage points, 95% CI −4.27 to 1.93). Adverse event rates were comparable, but profiles differed: prednisone caused more weight gain, insomnia and increased appetite, while methotrexate led to more nausea, fatigue, and abnormal liver function tests.
Passive maternal immunity in children born to women with systemic autoimmune rheumatic diseases compared to healthy women
Mazzucato-Puchner et al. (10.1016/j.jaut.2025.103439) compared antibody titers in venous blood samples and umbilical cord blood in a case-control study of 25 pregnant women with systemic autoimmune rheumatic diseases (SARD) and 30 healthy controls. An effective transplacental transfer of existing antibodies against varicella-zoster and rubella, as well as newly generated antibodies against SARS-CoV-2 after vaccination during pregnancy could be observed both in the SARDs and the control group. This suggests a robust passive immunity in newborns to women with SARDs, including those receiving immunosuppressive therapy (hydroxychloroquine, azathioprine, TNF inhibitors, salazopyrine) during pregnancy.
Low-dose methotrexate failed to show relevant benefits on signs and symptoms of inflammatory knee osteoarthritis in a placebo-controlled trial
Zhu et al. (10.1001/jamainternmed.2025.1359) investigated the use of low-dose methotrexate for treatment of inflammatory knee osteoarthritis, in a multicenter, randomised, placebo-controlled trial of 215 patients with effusion synovitis due to osteoarthritis on MRI from China. Patients started methotrexate at 5mg weekly for two weeks and increased to up to 15mg weekly throughout to trial if tolerated. This strategy did not significantly improve knee pain or reduce effusion-synovitis over 52 weeks compared to placebo, and no meaningful effect was seen on secondary outcomes either. Adverse event rates were similar between groups. Methotrexate can not therefore not be supported for symptom relief or disease modification in inflammatory knee osteoarthritis.
Allogeneic CD19-targeting T cells induced clinical remission in four of five patients with refractory systemic lupus erythematosus (SLE) and lupus nephritis
Wang et al. (10.1038/s41591-025-03899-x) investigated YTS109, a hypo-immune allogeneic CD-19 targeting T cell product engineered using CRISPR–Cas9 to knock out TRAC, PD1, HLA-A, HLA-B and CIITA, in a phase 1 study in five patients with severe, refractory SLE and complicating lupus nephritis. The compound was well-tolerated, with only mild cytokine release symptoms on no graft-versus-host reactions observed. All five patients achieved SLE responder index 4 response at M3, and four of five patients showed a rapid and sustained reduction in SLE disease activity score (mean 31.30–5.35 by M6), while one patient flared at M6. Resolution of inflammation and tissue restoration was seen in renal biopsies.
Victoria Konzett
Victoria is a resident and PhD fellow at the Division of Rheumatology at the Medical University of Vienna, Austria. Her major research interests are clinical and translational research projects in rheumatoid and psoriatic arthritis, with a focus on strategic advancements and outcomes research in both diseases. Victoria is a member of the Newsletter Sub-Committee and the Young Division of the Austrian Society of Rheumatology.
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Autumn 2025 Press Review – Rheumatology (Oxford)
April 2025 to July 2025
Author: Jacob J.E. Koopman
‘Am I doing this right?’ Physician perceptions of the global assessment in clinical trials of systemic sclerosis
Sabanovic and colleagues (10.1093/rheumatology/keaf377) interviewed experts in the clinical assessment and research of systemic sclerosis on how they define, perform and interpret a physician’s global assessment. According to 18 rheumatologists and 1 patient, major themes were: i) physician uncertainty; ii) variation in the assessment; iii) physician efforts to improve its consistency; iv) its utility. Most thought that it should assess changeable aspects of disease, commonly conceived of as disease activity. The optimal method was uncertain. Participants were also uncertain about their own methods of assessment and their variability.
Changes to physical function and body composition during the first 2 years of polymyalgia rheumatica
Leung and colleagues (10.1093/rheumatology/keaf375) prospectively followed 36 patients with polymyalgia rheumatica and 32 age- and sex-matched controls 3 months after glucocorticoid initiation and 18 months later. Patients had greater disability scores than controls at both times. Female patients performed more poorly in the chair stand test, physical performance battery and gait speed than controls. Body composition was not different.
Clinical features in VEXAS syndrome: a systematic review
Al-Hakim and colleagues (10.1093/rheumatology/keaf293) studied publications about the clinical features of VEXAS syndrome. Analyzing 720 patients from 33 case reports and 21 case series across 32 countries, the following were counted: cutaneous involvement (82%), constitutional symptoms (69%), respiratory disease (61%), joint involvement (47%), ocular disease (44%), venous thromboembolism (42%), myelodysplastic syndrome (36%), cardiac involvement (8%), renal disease (7%) and central nervous system manifestations (8%).
Jacob Koopman
Jacob is a medical specialist in internal medicine and clinical immunology, working in the Netherlands. In his clinical work and research, he focuses on systemic lupus erythematosus, particularly its prediction before it becomes overt. He cares for patients with various other systemic immunological diseases. He is a member of the Dutch Society of Allergy and Clinical Immunology and of EULAR. He is an editor for the Dutch Journal of Asthma, Allergy and Clinical Immunology. He is a member of the EMEUNET Newsletter Sub-committee.
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Autumn 2025 Press Review – RMD Open
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.