Haroon N, Baskurt Z, Chim T
… +6 more, Inman RD, Kumke T, Tham R, Kim M, van der Horst-Bruinsma I, Gensler LS
Int J Rheum Dis
· 2026 Apr · PMID 41919656
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OBJECTIVE: Acute anterior uveitis (AAU) is the most common extra-musculoskeletal manifestation of axial spondyloarthritis (axSpA). This study compared the effect of the tumor necrosis factor inhibitor (TNFi) certolizumab...OBJECTIVE: Acute anterior uveitis (AAU) is the most common extra-musculoskeletal manifestation of axial spondyloarthritis (axSpA). This study compared the effect of the tumor necrosis factor inhibitor (TNFi) certolizumab pegol (CZP) with standard non-biologic care, on AAU flare rate in patients with axSpA and high risk of recurrent uveitis flares. METHODS: C-VIEW (NCT03020992) was an open-label, multicenter study in which patients with radiographic or non-radiographic axSpA and high risk of uveitis flares received CZP for 96 weeks. Here, AAU flare rate was compared between patients in C-VIEW (up to 120 weeks) and high-risk patients with axSpA receiving standard non-biologic treatment from the University of California, San Francisco (UCSF) and University Health Network Toronto Western Hospital (UHN). Overlap weighting (OW) was utilized to adjust for potential confounders, followed by Poisson regression to evaluate the effect of CZP on AAU flare rate. RESULTS: Eighty-seven patients from C-VIEW were compared to 75 axSpA patients with comparative disease activity and not on biologic treatment (UCSF n = 40; UHN n = 35). After OW, there were no significant differences between groups in baseline characteristics included in the model. The AAU flare rate was significantly lower for patients treated with CZP than in the comparator population: after OW, a 70.9% lower AAU flare rate was associated with CZP treatment (risk ratio [95% confidence interval]: 0.29 [0.18, 0.47]; p < 0.001). CONCLUSION: This study supports the findings of C-VIEW and demonstrates the benefit of CZP over standard non-biologic treatment as a promising therapeutic option in reducing AAU flares among high-risk patients with axSpA.
OBJECTIVE: To evaluate the frequency and management of flares in rheumatoid arthritis (RA) patients treated with biologic or targeted synthetic disease-modifying antirheumatic drugs (b/tsDMARDs). METHODS: Data were analy...OBJECTIVE: To evaluate the frequency and management of flares in rheumatoid arthritis (RA) patients treated with biologic or targeted synthetic disease-modifying antirheumatic drugs (b/tsDMARDs). METHODS: Data were analyzed from the KOrean nationwide BIOlogics (KOBIO) registry, which includes RA patients initiating b/tsDMARDs therapy. Flares were defined as an increase in DAS28 (> 1.2, or > 0.6 if DAS28 ≥ 3.2) requiring medication changes. Patients were stratified by flare occurrence, and predictive factors and management strategies were assessed. RESULTS: Of the 2745 RA patients, 386 (14.1%) experienced flares over a median follow-up period of 5.4 years (IQR, 1.7-11.4). Flares were associated with a significantly higher incidence of shoulder swelling compared with non-flare patients (14.2% vs. 13.7%, p = 0.01). Predictive factors for flares included a higher swollen joint count (HR: 1.125, p = 0.003) and shoulder swelling (HR: 2.810, p = 0.002). Eight patients switched to an alternative b/tsDMARD during flare episodes, while 168 added or modified conventional synthetic DMARDs (csDMARDs). The remaining 210 patients made no changes to their csDMARD regimen. The 12 month retention rate of b/tsDMARDs did not significantly differ between patients who adjusted their csDMARDs and those who did not (86.7% vs. 82.1%, p = 0.23). However, the mean steroid dose over 12 months was lower in the group that adjusted csDMARDs. CONCLUSIONS: Flares occurred in approximately 14% of RA patients during b/tsDMARD treatment, with baseline joint involvement, particularly shoulder swelling, being a predictor. While the adjustment of csDMARDs was associated with reduced steroid use during flare management, it did not significantly affect b/tsDMARD retention rates.
AIM: Osteoarthritis (OA) is a common degenerative joint disease that is difficult to diagnose in its early stages, which can easily delay treatment. MicroRNAs (miRNAs) are key regulatory factors in the pathogenesis of OA...AIM: Osteoarthritis (OA) is a common degenerative joint disease that is difficult to diagnose in its early stages, which can easily delay treatment. MicroRNAs (miRNAs) are key regulatory factors in the pathogenesis of OA. This study investigated the clinical diagnostic value of miR-744-5p in OA and its regulatory effect on chondrocyte inflammation through modulation of thrombospondin-2 (THBS2). METHODS: This study included 108 OA patients and 62 healthy controls. Serum levels of miR-744-5p were detected using qRT-PCR. The diagnostic value of miR-744-5p was evaluated using the ROC curve and logistic regression. LPS-induced chondrocyte OA models were used to assess the regulatory effect of miR-744-5p on chondrocyte inflammation via CCK-8 and ELISA. Dual-luciferase assay verified the targeting relationship between miR-744-5p and THBS2. RESULTS: The serum level of miR-744-5p in OA patients was markedly reduced (p < 0.001), showing good diagnostic performance (AUC = 0.860). Logistic regression indicated that it could serve as an independent protective factor for OA (OR = 0.089). miR-744-5p mimic significantly restored the viability of chondrocytes induced by LPS (p < 0.001), inhibited the expression of inflammatory factors (p < 0.001), and alleviated oxidative stress damage. Dual-luciferase reporter assay confirmed that miR-744-5p directly targets THBS2. Overexpression of THBS2 reversed the protective effects of miR-744-5p. CONCLUSION: miR-744-5p is significantly downregulated in OA and is a highly promising diagnostic and predictive molecule for OA. It can alleviate inflammation in chondrocytes by targeting THBS2, thereby inhibiting the progression of OA.
Chen Y, Zhou YF, Long ZY
… +7 more, Peng YM, Wu SX, Peng F, Yuan MH, Zhou YZ, Wang L, Yuan H
Int J Rheum Dis
· 2026 Mar · PMID 41860145
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Rheumatoid arthritis (RA) is a chronic autoimmune disease that not only severely impairs joint function but also leads to various systemic complications, significantly reducing patients' quality of life. Furthermore, RA...Rheumatoid arthritis (RA) is a chronic autoimmune disease that not only severely impairs joint function but also leads to various systemic complications, significantly reducing patients' quality of life. Furthermore, RA imposes a substantial economic burden on healthcare systems globally. Current clinical treatments primarily consist of non-steroidal anti-inflammatory drugs, glucocorticoids, and disease-modifying antirheumatic drugs, which effectively control symptoms and delay joint damage. However, achieving a complete cure remains a considerable challenge. Consequently, therapeutic strategies aimed at joint protection and the prevention of systemic complications have become central to research efforts. Spermidine (SPD), a naturally occurring polyamine in the human body, has garnered significant attention due to its multifaceted effects as anti-aging, cardiovascular protection, neuroregulation, and anti-inflammation. Notably, SPD has shown significant therapeutic effects in mouse models of various inflammatory diseases, including inflammatory bowel disease, psoriasis, osteoarthritis and RA. The exploration of the role of SPD in RA may provide new targets and effective therapeutic approaches for the treatment of RA. This review provided a comprehensive overview of the potential mechanisms of SPD in the pathological progression of RA, including the inhibition of inflammatory cytokines expression, reduction of oxidative stress, modulation of immune cell functions, and maintenance of bone metabolism homeostasis. Through these mechanisms, SPD shows potential as a promising novel candidate for RA therapy. However, its precise efficacy and safety must be validated through large-scale clinical trials. This article aimed to provide theoretical insights and future research directions for understanding the pathological mechanisms of RA and developing novel therapeutic agents.
Tseng CF, Wu MC, Wang YH
… +5 more, Huang JY, Lin HC, Tseng TC, Yeh CJ, Wei JC
Int J Rheum Dis
· 2026 Mar · PMID 41858144
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INTRODUCTION: Inflammatory bowel disease (IBD) has been associated with several allergic diseases, including atopic dermatitis, allergic rhinitis, and asthma. However, the correlations between these conditions vary-some...INTRODUCTION: Inflammatory bowel disease (IBD) has been associated with several allergic diseases, including atopic dermatitis, allergic rhinitis, and asthma. However, the correlations between these conditions vary-some are positively correlated, and some are negatively correlated. To address these discrepancies, this study explored the risk of IBD in patients with allergic diseases. METHODS: Data were collected from the Taiwan National Health Insurance Research Database, which contains data on approximately 99% of Taiwan's population. Patients with new-onset IBD and matched controls were enrolled. Data on comorbidities, demographics, and corticosteroid use were collected. Statistical analysis included conditional logistic regression analysis. RESULTS: In total, 300 patients with IBD and 2400 patients without IBD were enrolled. Atopic dermatitis (OR: 5.73, 95% CI: 1.69-19.48), allergic rhinitis (OR: 1.72, 95% CI: 1.06-2.79), chronic kidney disease (OR: 3.04, 95% CI: 1.15-8.04), and ischemic heart disease (OR: 1.97, 95% CI: 1.20-3.26) were associated with an increased risk of IBD. Among patients with atopic dermatitis or allergic rhinitis, the risk of IBD was higher for those aged < 65 years, men, or those not using corticosteroids. CONCLUSION: This study highlights an associated risk of IBD in patients with atopic dermatitis and allergic rhinitis.
Tuzcu TU, Karaduman İ, Kardaş RC
… +4 more, Erden A, Küçük H, Öztürk MA, Göker B
Int J Rheum Dis
· 2026 Mar · PMID 41841201
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OBJECTIVES: Familial clustering and HLA haplotype association studies suggest that genetic factors disrupting the regulation of the immune system may predispose to risk of both neoplasms and autoimmune diseases, potentia...OBJECTIVES: Familial clustering and HLA haplotype association studies suggest that genetic factors disrupting the regulation of the immune system may predispose to risk of both neoplasms and autoimmune diseases, potentially leading to an increased frequency of cancer development in patients with primary Sjögren's disease (SjD), as well as their relatives. In this study, we aimed to assess the risk of cancer in patients with primary SjD and their close relatives. METHODS: Primary SjD patients who were actively followed-up in the rheumatology outpatient clinic at Gazi University Hospital and who met the 2016 ACR-EULAR classification criteria for primary SjD were included in the study. Data on cancer history in patients and their relatives were collected through direct face-to-face interviews and telephone surveys with the patients. The risk of developing cancer was calculated by comparing it with the general population of Turkey obtained from the Global Cancer Observatory of the World Health Organization International Agency for Research on Cancer (GLOBOCAN). RESULTS: A total of 323 primary SjD patients (F/M: 313/10, mean age: 56 ± 11) and their 1750 close relatives (parents, siblings, and children) were studied. Among SjD patients, 29 (9%) had a history of malignancy. Of these, 19 (5.9%) were solid organ and 10 (3.1%) were hematological malignancies. Breast cancer was the most common solid tumor. The median follow-up was 3.6 years, and the calculated standardized incidence ratio (SIR) for all cancers was 3.3 (95% CI: 2.2-4.7, p < 0.001). Leukemia or lymphoma cases had an SIR of 22.5 (95% CI: 10.8-41.4, p < 0.001). Among 313 women, seven cases of breast cancer had an SIR of 3.8 (95% CI: 1.5-7.9, p < 0.001). Risk of malignancy in patients with SjD did not differ based on age, gender, smoking history, Schirmer test result, laboratory parameters including anti-SSA, anti-SSB, ANA, complement levels, ESSDAI status, or Focus score, but it was higher in the presence of a cancer among close relatives. A total of 128 (43.3%) patients with SjD had at least one close relative with cancer (176 cancer cases in total), giving an SIR of 3.5 (95% CI: 3.0-4.1, p < 0.001). The average age of close relatives with cancer was 58 ± 10 years; 56% were male, and 7.4% were active smokers. CONCLUSION: Our results suggest that not only patients with primary SjD but also their close relatives have an increased risk of developing cancer compared with the general population.