Bernardy C, Dalecky M, Guillaud-Rollin S
… +3 more, Dujardin T, Gastaldi R, Baillet A
Joint Bone Spine
· 2025 Dec · PMID 40441348
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Chronic inflammatory rheumatic diseases include rheumatoid arthritis, spondyloarthritis and psoriatic arthritis. These diseases affect mainly joints but also have systemic involvement. Patients with chronic inflammatory...Chronic inflammatory rheumatic diseases include rheumatoid arthritis, spondyloarthritis and psoriatic arthritis. These diseases affect mainly joints but also have systemic involvement. Patients with chronic inflammatory rheumatic diseases have an increased risk of comorbidities, both due to disease activity and the use of treatments such as corticosteroids. Thus, a higher mortality rate was shown in these patients, particularly in RA, with a risk of premature death increased by half compared to the general population in epidemiological studies from the early 2000s. However, severe forms of rheumatic diseases, particularly at the radiological level, seem to be decreasing. This review reports the evolution of the incidence, prevalence and mortality in rheumatic diseases rheumatism, including in the context of prescription of targeted treatments.
Claudepierre P, Gaujoux-Viala C, Constantin A
… +12 more, Berenbaum F, Combe B, Devauchelle V, Goupille P, Richette P, Wendling D, Mouterde G, Pascart T, Razat B, Audureau E, Jousse-Joulin S, Gossec L
Joint Bone Spine
· 2025 Dec · PMID 40441347
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OBJECTIVES: To describe the design and methodology of APACHE, a cohort of patients with early peripheral psoriatic arthritis (pPsA), and to assess the main baseline clinical characteristics of the first included patients...OBJECTIVES: To describe the design and methodology of APACHE, a cohort of patients with early peripheral psoriatic arthritis (pPsA), and to assess the main baseline clinical characteristics of the first included patients. METHODS: APACHE is an ongoing prospective multicentre national cohort (NCT03768271) with a planned follow-up of 10years. Included patients have recent-onset (<12months) peripheral arthritis, a personal and/or family history of psoriasis, pPsA diagnosed by a rheumatologist, and no history of targeted disease-modifying antirheumatic drug therapy. At inclusion, demographic data, disease activity, comorbidities, and imaging results (not reported here) are collected. A descriptive analysis of these data was performed. RESULTS: The first 186 study patients had a mean age of 44±11years and mean arthritis duration of 6±4months; 84 (45%) were women; 169 (91%) had a history of psoriasis (mean duration, 14years) and 71 (38%) were receiving methotrexate. Disease activity was moderate with a mean DAPSA score of 19±14 and mean swollen and tender joint counts of 2.1±3.2 and 6.0±8.0, respectively. The initially involved joints were mainly the hands (40%) and knees (28%). Entheseal pain (39%) was more prevalent than dactylitis (27%). Comorbidities were common, with obesity in 27% and at least one cardiovascular risk factor or disease in 49% of patients. CONCLUSION: Patients with early peripheral PsA had moderate disease activity, a predominant oligoarticular profile, and a high prevalence of entheseal pain.
Zhang Y, Jin Z, Yao J
… +3 more, Wang D, Yu Y, Zhang W
Joint Bone Spine
· 2025 Dec · PMID 40436105
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OBJECTIVES: To evaluate the trends and cross-country inequalities of gout burden in people aged 15-39 years from 1990 to 2021, with projections to 2035. METHODS: The study employed estimates from Global Burden of Disease...OBJECTIVES: To evaluate the trends and cross-country inequalities of gout burden in people aged 15-39 years from 1990 to 2021, with projections to 2035. METHODS: The study employed estimates from Global Burden of Diseases (GBD) 2021 to assess prevalence, incidence, and years lived with disability (YLDs) of gout across global, demographic, GBD regional, national, sociodemographic index (SDI) regional, and risk factor levels. Temporal trends in the age-standardized rates (ASRs) of prevalence, incidence and YLDs were assessed by Joinpoint regression, while associations between SDI and ASRs were examined through Spearman correlation. Health inequalities were measured using the slope index of inequality and the concentration index. Future trends were forecast by a Bayesian age-period-cohort model. RESULTS: The burden of gout increased in global, demographic, GBD regional, and SDI level from 1990 to 2021. Males, the 35-39 years subgroup, and High-SDI regions experienced the highest burden. High-income North America owned the highest ASRs while East Asia reported the largest numbers. A moderate positive correlation was observed between gout burden and SDI for nations. Both absolute and relative inequalities increased. Males had higher YLDs due to high body mass index (BMI), females due to kidney dysfunction. Although ASRs were predicted to decrease from 2020 to 2035, numbers were predicted to rise. CONCLUSIONS: The gout burden gout in people aged 15-39 years increased with notable inequalities. Despite projected ASRs decreases, overall numbers were likely to increase, highlighting the urgent need for targeted interventions and public health strategies.
Joint Bone Spine
· 2025 Dec · PMID 40436104
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OBJECTIVES: This study seeks to assess how the Naples Prognostic Score (NPS) correlates with mortality in individuals with RA. METHODS: This study assessed the National Health and Nutrition Examination Survey (NHANES) da...OBJECTIVES: This study seeks to assess how the Naples Prognostic Score (NPS) correlates with mortality in individuals with RA. METHODS: This study assessed the National Health and Nutrition Examination Survey (NHANES) database spanning from 2001 to 2018. NPS was computed utilizing serum albumin (SA), total cholesterol (TC), neutrophil to lymphocyte ratio (NLR), and lymphocyte to monocyte ratio (LMR). A self-administered questionnaire was utilized to gather data from individuals with RA, and the national death index was adopted to determine death rates. Weighted multivariate Cox regression evaluation and Kaplan-Meier survival curve assessment were carried out to explore the correlation of NPS with RA mortality risk, and subgroup analysis and sensitivity analysis were performed to investigate the robustness of the correlation. RESULTS: Altogether 1683 individuals with RA were enrolled in this research. In the Kaplan-Meier analysis, notable survival discrepancies were observed among various groups in all-cause and cardiovascular (CV) mortality events (P<0.001). Following adjustment for all confounders, Group 3 (NPS=3-4) exhibited a markedly heightened likelihood of all-cause mortality by 2.04 times (hazard ratio [HR]=2.04, 95% confidence interval [CI]: 1.21-3.05, P<0.01) and CV mortality by 3.59 times (HR=3.59, 95%CI: 1.24-10.4, P<0.05) in comparison to Group 1 (NPS=0). Subgroup analysis and sensitivity analysis indicated that the results were robust. CONCLUSION: In the US population, NPS shows a significantly positive correlation with the likelihood of all-cause and CV mortality in individuals with RA. The integration of the NPS into clinical decision-making can offer a more dependable evaluation of the prognosis of individuals with RA.
Joint Bone Spine
· 2025 Oct · PMID 40414524
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BACKGROUND: The advent of advanced therapies in the recent years have improved outcomes for inflammatory bowel disease patients, but a significant subset of patients remains refractory to monotherapy. Advanced combinatio...BACKGROUND: The advent of advanced therapies in the recent years have improved outcomes for inflammatory bowel disease patients, but a significant subset of patients remains refractory to monotherapy. Advanced combination therapy, involving two biologic agents or a biologic combined with a small molecule drug, is emerging as a potential strategy to improve clinical remission and address extra-intestinal manifestations. METHODS: This narrative review summarizes current evidence on advanced combination therapy for inflammatory bowel disease, including mechanisms of action, clinical efficacy, safety considerations, and future perspectives. Key clinical trials and real-world studies were analyzed to assess advanced combination therapy outcomes. RESULTS: Preliminary data indicate that advanced combination therapy enhances response rates in patients who fail monotherapy and appears to be a new therapeutic option in patients with refractory disease or extra-intestinal manifestations. However, long-term safety concerns remain, and few clinicals trials have investigated advanced combination therapy, and standardized guidelines regarding its use in clinical practice are lacking. CONCLUSIONS: Advanced combination therapy represents a promising yet evolving approach in inflammatory bowel disease management. Future research should focus on optimizing combination strategies, identifying patient subgroups most likely to benefit, and establishing safety profiles through large-scale controlled trials. The integration of precision medicine approaches, including biomarker-driven treatment selection, will be crucial in maximizing the efficacy of advanced combination therapy in clinical practice.
Mauro D, Cai B, Ciancio A
… +5 more, Forte G, Gandolfo S, Thomas R, Bergot AS, Ciccia F
Joint Bone Spine
· 2025 Dec · PMID 40404007
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Spondyloarthritis (SpA) encompasses chronic inflammatory diseases affecting both axial and peripheral joints. Emerging evidence highlights a pivotal role for the gut-joint axis in SpA pathogenesis, where intestinal dysbi...Spondyloarthritis (SpA) encompasses chronic inflammatory diseases affecting both axial and peripheral joints. Emerging evidence highlights a pivotal role for the gut-joint axis in SpA pathogenesis, where intestinal dysbiosis and barrier dysfunction facilitate microbial translocation and trigger systemic immune activation. Clinical observations of subclinical gut inflammation, alongside findings from HLA-B27 transgenic rats and SKG mice, underscore the gut's role in initiating joint pathology. Genetic predispositions, particularly HLA-B27, further exacerbate these processes through mechanisms such as endoplasmic reticulum stress and IL-23-mediated T-cell activation. This review integrates epidemiological, mechanistic, and experimental insights to elucidate the complex interplay between the gut microbiota and immune responses in SpA, outlining potential avenues for targeted intervention.
Kun L, Gessl I, Filippou G
… +3 more, Ferrito M, Giacomelli R, Mandl P
Joint Bone Spine
· 2025 Dec · PMID 40324716
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In last two decades, the use of ultrasound has assumed an increasingly important role in the assessment of almost all rheumatic and musculoskeletal diseases. Over the years, much advancement has been made in the sonograp...In last two decades, the use of ultrasound has assumed an increasingly important role in the assessment of almost all rheumatic and musculoskeletal diseases. Over the years, much advancement has been made in the sonographic evaluation of articular and periarticular structures, validating definitions of normal sonographic appearance of various types of tissues and structures as well as elementary sonographic lesions and scoring systems to apply in the detection and monitoring of inflammatory and structural lesions. Since extra-articular involvement is very common in rheumatic and musculoskeletal diseases, there is growing interest and evidence on how ultrasound can be applied to the examination of different tissues and organs beyond synovial joints. In this narrative review, we will provide an overview of the available data on the use of ultrasound in the musculoskeletal system (joint, tendon, enthesis, muscle) and extra-articular organs (cardiovascular system, salivary and lacrimal gland, lung, skin and nails), including elementary lesions, scoring systems and their relevance to diagnosis, monitoring, prediction and assessing treatment efficacy in rheumatic and musculoskeletal diseases.
Kwok TSH, Bajaj S, Papneja T
… +3 more, Ahluwalia V, Choy G, Joshi R
Joint Bone Spine
· 2025 Dec · PMID 40324715
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OBJECTIVES: To evaluate diagnostic accuracy and trajectories of gout referrals to rheumatology including factors associated with an accurate diagnosis. METHODS: We performed a retrospective cohort study of referrals at 4...OBJECTIVES: To evaluate diagnostic accuracy and trajectories of gout referrals to rheumatology including factors associated with an accurate diagnosis. METHODS: We performed a retrospective cohort study of referrals at 4 rheumatology clinics in Brampton, Canada from December 2019 to January 2023. We assessed gout diagnostic accuracy referenced to the rheumatologist's "gold standard" diagnosis, describing alternative final diagnoses. Using multivariable logistic regression, we identified factors associated with an accurate gout diagnosis. RESULTS: Among 4315 patients, 216 were diagnosed with gout. Of 191 gout referrals (mean (SD) age 58.4 (15.4) years; 77.0% male), the diagnosis was unchanged in 159 (83.2%) patients with alternative diagnoses comprising osteoarthritis, autoimmune inflammatory arthritis and calcium pyrophosphate deposition disease. Referring physicians had moderate-to-high sensitivity (73.6%, 95% CI: 67.2-79.4), specificity (99.2%, 95% CI: 98.9-99.5), positive predictive value (83.2%, 95% CI: 77.2-88.2), negative predictive value (98.6%, 95% CI: 98.2-99.0) and inter-rater reliability (Cohen's kappa: 0.77, 95% CI: 0.72-0.82). Accuracy was highest amongst internists and emergency room physicians. Male sex (OR 14.32, 95% CI: 4.44-46.17), serum urate ≥500μmol/L (OR 9.10, 95% CI: 2.19-37.78), lower extremity monoarthritis (OR 5.08, 95% CI: 1.59-16.27) and symptom duration ≤2weeks (OR 3.87, 95% CI 1.23-12.21) were predictive of a final gout diagnosis. CONCLUSIONS: Referring providers had reasonably high accuracy in diagnosing gout. Traditional risk factors were associated with concordance with the consultant rheumatologist. Suboptimal gout care likely does not stem at point-of-diagnosis and quality improvement efforts should be focused on mitigating treatment-associated care gaps.
Joint Bone Spine
· 2025 Oct · PMID 40316202
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OBJECTIVES: Over 450,000 primary total hip arthroplasties (THA) are performed each year in the US, with osteoarthritis (OA) as the major indication for primary THA. We examined the association of patient, payer, hospital...OBJECTIVES: Over 450,000 primary total hip arthroplasties (THA) are performed each year in the US, with osteoarthritis (OA) as the major indication for primary THA. We examined the association of patient, payer, hospital, and geographic factors with extended lengths of stay (eLOS) and increased hospital costs in primary THA. METHODS: We utilized the National Inpatient Sample (NIS) to identify patients with OA who underwent primary THA in 2019. Diagnoses and procedures were identified using the International Classification of Disease (ICD-10) codes. We stratified healthcare/resource utilization by the occurrence of an extended length of hospital stay (eLOS) at 90th percentile or higher, i.e.,>3days. We used univariate and multivariable-adjusted logistic regression analyses to assess whether patient, payer, hospital, and geographic factors associated with an eLOS. Predictive probabilities from multivariable analyses were used in area under the curve (AUC) analysis. RESULTS: There were 1,525,730 primary THAs performed for patients with OA during 2016-2019. Patient race and ethnicity, Medicaid or Medicare payer status, income, age/sex and nearly all regional, and hospital, characteristics were independently associated with eLOS (>3days; ROC C-statistic=0.78). CONCLUSION: Patient race and ethnicity and insurance payer status are important patient-level determinants of longer LOS for primary THA hospitalizations in the US. Well-known geographical and hospital-level factors are negatively associated with the hospitalization stay duration outcomes of primary THA in patients with OA. Policy and other interventions targeting these factors may help reduce inpatient healthcare utilization for primary THA.
Ramírez J, Torrente-Segarra V, Cuervo A
… +19 more, Moreno M, Azuaga AB, Mateo L, Frade-Sosa B, Zacarías A, Busquets-Pérez N, Holgado S, Estrada P, Camacho O, De Agustín JJ, Moragues C, Bonet M, Farietta S, Corzo P, Ponce A, Ruiz-Esquide V, Alascio L, Cañete JD, ECOCAT Group
Joint Bone Spine
· 2025 Dec · PMID 40316201
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Publisher ↗
OBJECTIVES: To define ultrasound (US) characteristics in patients with Rheumatoid Arthritis (RA) and Psoriatic Arthritis (PsA) exhibiting active hand inflammation. METHODS: This cross-sectional, multicenter study collect...OBJECTIVES: To define ultrasound (US) characteristics in patients with Rheumatoid Arthritis (RA) and Psoriatic Arthritis (PsA) exhibiting active hand inflammation. METHODS: This cross-sectional, multicenter study collected epidemiological and clinical data from RA and PsA patients with active hand inflammation. US examinations of wrists and metacarpophalangeal joints were performed, focusing on extensor and flexor tendons. RESULTS: A total of 292 patients were included: 192 (61.7%) were women, with a mean age of 56.1 years and mean disease duration of 105.4 months. Ninety-one patients (31.1%) had seropositive RA, 79 (27%) had seronegative RA, and 122 (41.7%) had PsA. Overall, 125 patients (42.8%) exhibited erosive disease, with 103 (35.2%) receiving targeted therapies. All patients had active disease (mean SDAI: 29.5; mean DAPSA: 22.3). Among the cohort, 144 patients (49.3%) showed synovial hypertrophy (SH)≥2+Power Doppler (PD). This was more common in seropositive (72.5%) than in seronegative RA (43%) or PsA (36%) (P≤0.001). Erosive disease (OR 8.4 [3.9-18], P≤0.001) and US global score (OR 1.1 [1-1.1], P≤0.001) were associated with SH≥2+PD. Extensor paratenonitis was more frequent in PsA (27%) compared to seropositive (9.8%) and seronegative RA (18.9%) (P≤0.01). The number of swollen joints (OR 1.1 [1-1.2], P≤0.001) and joint ankylosis (OR 4.3 [1.1-16.9], P≤0.05) were positively associated with paratenonitis. CONCLUSIONS: Synovial pannus was characteristic of RA, while paratenonitis was more common in PsA. SH≥2+PD correlated with erosive disease, highlighting the need for prospective studies to validate US as a decision-making tool in arthritis.
The Publisher regrets that this article is an accidental duplication of an article that has already been published, https://doi.org/10.1016/j.jbspin.2025.105904. The duplicate article has therefore been withdrawn. The fu...The Publisher regrets that this article is an accidental duplication of an article that has already been published, https://doi.org/10.1016/j.jbspin.2025.105904. The duplicate article has therefore been withdrawn. The full Elsevier Policy on Article Withdrawal can be found at https://www.elsevier.com/about/policies-and-standards/article-withdrawal.
Auroux M, Pialat JB, Mercier-Guery A
… +10 more, Piot A, Grapinet J, Himpens PH, Merle B, Fontanges E, Duvert F, Proriol M, Szulc P, Lespessailles E, Chapurlat R
Joint Bone Spine
· 2025 Oct · PMID 40316199
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Publisher ↗
OBJECTIVES: Hip osteoarthritis (OA) is a major public health concern. The determinants of hip OA, however, are not as well understood as those of other OA sites, such as the knee. In recent years, the role of subchondral...OBJECTIVES: Hip osteoarthritis (OA) is a major public health concern. The determinants of hip OA, however, are not as well understood as those of other OA sites, such as the knee. In recent years, the role of subchondral bone in the pathogenesis of OA has been emphasized but data are lacking for hip OA. Therefore, we aimed to determine which bone characteristics were associated to hip OA. METHODS: We made a cross-sectional analysis of 1537 postmenopausal women included in the QUALYOR prospective cohort. At baseline, we measured areal BMD by DXA at the lumbar spine and the hip, volumetric BMD and geometry by hip quantitative computerized tomography (QCT) using the Bone Investigational Toolkit (BIT) software, as well as microarchitecture at the distal radius and tibia by high-resolution peripheral quantitative tomography (HR-pQCT). We built a hip OA score (CT OA score) with images from the hip QCT, based on the depiction of the four major signs of osteoarthritis: subchondral bone sclerosis, joint space narrowing, osteophytes and subchondral cysts. The severity of each of these four signs was graded as absent, mild, moderate or severe (semi-quantitative score ranging from 0 to 3 for each sign). The absence of hip OA was defined as CT score equal to 0, mild hip OA as CT score between 1 and 4 and moderate to severe hip OA as CT score>4. Women with and without hip OA were compared using t tests and multivariable modeling. RESULTS: The mean age was 65.9 (±6.7) years and the mean body mass index was 24.6 (±3.6) kg/m. Among these 1537 women, 601 had an OA score of 0, 756 between 1 and 4 (mild OA) and 180 greater than 4 (severe OA). Women with hip osteoarthritis had lower trabecular total hip vBMD (125 vs. 129mg/cm, P<0.01). Cortical hip vBMD did not differ between women with and without hip OA (966.5 vs. 963.5mg/cm, P n.s). Patients with hip OA also had larger femoral neck volume (11.55 vs. 11.27mm, P<0.001). The BIT analysis showed greater bone resistance to bending (cross-sectional moment of inertia [CSMI] min with 6.03 vs. 5.6cm and section modulus [Z] polar with 7.98 vs. 7.59cm, P<0.05) at the femoral neck in patients with mild hip OA and even greater in women with severe hip OA. Patients with hip OA had significantly higher trabecular area measured at the radius by HR-pQCT (205.11 vs. 192.61mm, between group difference 12.50 95% CI [8.15-16.86] P<0.01), lower trabecular number at the tibia (1.57/μm vs. 1.63/μm, between group difference -0.06 95% CI [-0.09 to -0.03] P<0.001) and higher trabecular spacing at the tibia (0.58 vs. 0.56μm, between group difference 0.02 95% CI [0.011-0.038] P<0.005). Cortical parameters were not different in patients with hip OA compared to controls. CONCLUSION: Women with hip OA have larger femoral neck and lower trabecular bone parameters, suggesting a sizeable role of hip bone geometry and remodeling in the pathophysiology of hip OA.
Carmiel-Haggai M, Daood R, Fassan F
… +6 more, Jeries H, Dror-Zur D, Omar M, Watad A, Patalon T, Naffaa ME
Joint Bone Spine
· 2025 Dec · PMID 40316198
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OBJECTIVE: The association between FMF and incident liver cirrhosis is not widely studied. In this study, we aimed to examine the association between FMF and incident liver cirrhosis in a population-based cohort. METHODS...OBJECTIVE: The association between FMF and incident liver cirrhosis is not widely studied. In this study, we aimed to examine the association between FMF and incident liver cirrhosis in a population-based cohort. METHODS: Patients with FMF aged≥18 in the Maccabi Healthcare Services (MHS) database were identified according to ICD-9 code 277.31 between January 1st, 2000 and December 31st, 2022. A control group was 1:1 age and gender-matched. Patients with chronic liver disease or cirrhosis were excluded, as well as patients who were treated with methotrexate, amiodarone or tamoxifen and patients with less than 12 months of follow-up. Incident cirrhosis was defined as a new diagnosis of cirrhosis according to ICD-9 code (571.5), newly diagnosed major cirrhotic complications or liver transplantation. The Cox proportional hazards models were used to examine the association between FMF and incident cirrhosis and the Kaplan-Meier curves to study the event-free survival. RESULTS: Incident cirrhosis was detected among 2.1% and 0.4% in the study and control groups, respectively, P<0.01. Being in the FMF group was associated with a significantly increased risk of incident cirrhosis (HR=2.60, 95% CI: 1.54-4.38, P<0.01). At 7 years, the cirrhosis-free survival rate was 98.2% in the study group and 99.6% in the control group (P<0.01). CONCLUSION: FMF was associated with incident cirrhosis, irrespective of the traditional risk factors for metabolic syndrome, suggesting the contribution of the inflammatory state to the development of cirrhosis.