The identification of responders to methotrexate (MTX) would optimize the therapy of patients with early rheumatoid arthritis (eRA). Our aim was to identify protein biomarkers for the prediction of the response to MTX.

Understanding the impact of intensive treatment on pain in patients with rheumatoid arthritis (RA) and psoriatic arthritis (PsA) is crucial to informing the application of evidence-based arthritis pain care. The impact of intensive treatment on inflammatory arthritis pain has received relatively limited attention. We addressed this through a detailed secondary analysis of three trials evaluating varying intensities of disease-modifying anti-rheumatic drug treatment. We considered a range of pain outcomes of clinical relevance to patients, including the achievement of mild endpoint pain scores and clinically-meaningful pain reductions.

Artificial intelligence (AI) tools, particularly Large Language Models (LLMs), are revolutionizing medical practice, including rheumatology. However, their diagnostic capabilities remain underexplored in the African context. To assess the diagnostic accuracy of ChatGPT-4, Gemini, Copilot, and Claude AI in rheumatology within an African population.

Giant cell arteritis (GCA) is a large vessel vasculitis characterized by granulomatous inflammation classically affecting the carotid artery branches. GCA most often presents with one or more classic clinical features which include headache, jaw claudication, temporal scalp tenderness, and polymyalgia rheumatica. In a minority of cases, GCA can adopt an "occult" presentation (i.e., failure to thrive in the setting of unexplained inflammation) where vascular manifestations affect vascular beds, such as lingual ulceration, not amenable to biopsy. While the diagnosis of GCA is often supported by temporal artery biopsy or imaging studies, such as temporal artery ultrasound or magnetic resonance angiography, these techniques are known to have limited sensitivity. As a result, there is the potential for GCA to be misdiagnosed where it presents both in the absence of classic clinical manifestations and without clear diagnostic evidence by imaging or histopathology.

Data regarding the relationship between socioeconomic status (SES) and incidence of Giant Cell Arteritis (GCA) is conflicting. No previous studies have explored whether SES influences the likelihood of undergoing temporal artery biopsy (TAB). The aim of this study was to determine whether SES influences access to TAB and rate of biopsy positivity in those with suspected GCA.

Osteoarthritis (OA) is a chronic disease primarily affecting older adults, mainly impacting the hip and knee joints. The increasing prevalence of OA contributes to rising healthcare demands and costs. Current OA treatment guidelines emphasize the importance of self-management education and guidance, particularly in promoting physical activity and weight management. In addition, improving sleep is crucial for managing OA. Developing effective self-management interventions necessitates a comprehensive understanding of the factors that facilitate these behaviors. Especially for changing health behaviors, it is important to focus on psychosocial factors. Therefore, this systematic review aimed to identify the psychosocial factors associated with physical activity, weight management, and sleep in adults with hip and/or knee OA.

Dermatomyositis (DM) is an immune-mediated myopathy characterized by proximal muscle weakness, inflammation, and cutaneous manifestations. Up to 25% of DM patients have an associated malignancy. Those with cancer-associated DM often face worse prognoses, poorer treatment responses, and reduced survival rates. Interestingly, anti TIF1γ-positive DM patients are notably at increased risk for malignancy, yet the underlying mechanisms and clinical correlation remain poorly understood. Nailfold video capillaroscopy (NVC) is a safe, non-invasive method for assessing vascular abnormalities, previously explored in various DM subsets but not specifically in anti TIF1γ-positive DM patients with malignancy. This study aims to characterize NVC findings in anti-TIF1γ-positive DM and assess their clinical relevance, particularly in malignancy-associated cases.

CD19-targeting chimeric antigen receptor (CAR) T-cell therapy has advanced treatment strategies for severe autoimmune diseases such as systemic lupus erythematosus (SLE), systemic sclerosis, and idiopathic inflammatory myopathy. Data regarding side-effects are mostly generated from patients with malignancies, but little is known about autoimmune disease-specific adverse events. This study aimed to describe autoimmune disease-specific adverse events that occur with CAR T-cell therapy.

Effective biological markers able to monitor the response of Janus kinase inhibitor (JAKi) are lacking. Exosomal microRNAs (exomiRNAs) can alter their expression during treatment and are ideal biomarkers for therapeutic interventions. In this study, we explored potential biomarkers for monitoring tofacitinib treatment response in patients with RA.

Professionals in health and social care are challenged by the complexity and fragmentation across primary and secondary levels of care. To study coherent rehabilitation pathways, we focused on people with inflammatory arthritis admitted to a specialised rehabilitation stay as these pathways will involve a myriad of different professionals from primary and secondary levels of care. This study aimed to explore how health and social care professionals establish coherent rehabilitation pathways for people with inflammatory arthritis across primary and secondary levels of care and how organisational factors influence on workflow.

The C-reactive protein (CRP)-albumin-lymphocyte (CALLY) index is a novel biomarker reflecting inflammation, nutrition, and immune status, and its potential clinical significance and prognostic role in patients with rheumatoid arthritis (RA) has not been reported.

Immune-mediated necrotizing myopathy (IMNM) and dermatomyositis (DM) are characterized by weakness, hyperCKemia, associated autoantibodies, and varying extramuscular manifestations. Muscle MRI, currently subordinate to histopathology and serology in idiopathic inflammatory myopathy (IIM) classification, has an evolving role. Our study aims to define thigh muscle MRI involvement in IMNM and DM by direct comparison.

Early initiation of effective treatment is associated with positive long-term prognosis for patients with rheumatoid arthritis (RA). Currently, there are no biomarkers in clinical use to predict treatment response. A predictor of treatment response may be the B-cell compartment, as this is altered in RA patients, making it a potential candidate for predicting treatment response. In this study, we sought to identify B-cell subset(s) at diagnosis that might be associated with Clinical Disease Activity Index (CDAI) remission at 24-week follow-up.

Fatigue is a prominent symptom in patients with psoriatic arthritis (PsA). There was a wide variety of statistics previously reported on fatigue prevalence in patients. This systematic review examined the current literature to derive the overall prevalence of fatigue and risk factors in PsA patients.

This study examines the influence of pharmacological treatments on foot functionality in patients with rheumatoid arthritis over a five-year period. A longitudinal analysis categorized patients into different treatment groups, assessing their foot function using the Foot Function Index (FFI) at the start and end of the study. The groups are based on their pharmacological treatment. Pharmacological treatment groups were categorized into: I methotrexate (MTX), II MTX plus biological treatments (including all variables), III biological treatment alone, and IV a miscellaneous group comprising patients with diverse treatments, including patients for whom various drugs had failed or who had not achieved remission with pharmacological treatment. The study included 206 RA patients with an average age of 58.32 years and a disease evolution of 15.28 years. The analysis of the FFI in total and across its domains of pain, disability, and activity revealed significant differences only in the pain domain (p = 0.011), with a trend toward worsening over time observed in the other domains. Notably, MTX treatment showed improvement in the pain domain (decreasing from 45.76 in 2018 to 40.43 in 2023). Findings suggest that while pharmacological treatments are essential in managing rheumatoid arthritis, their impact on foot function is limited, with MTX demonstrating the most significant benefit in terms of pain reduction.

IgA vasculitis is a predominantly pediatric autoimmune disease characterized by IgA deposit in small vessels. Chronic myelomonocytic leukemia (CMML) is a rare hematological malignancy classified within myelodysplastic syndromes. Here, we present a previously unrecognized case of CMML associated with IgA vasculitis. A 62-year-old woman presented with necrotic and infiltrated purpura and mild arthralgia, primarily affecting the knees and wrists, without gastrointestinal or kidney involvement. A comprehensive screening for other etiologies was unremarkable. Blood tests showed an increase of monocyte count and circulating monocyte phenotyping was consistent with CMML. Bone marrow analysis showed no blast cells or karyotypic abnormalities. Genetic testing identified an NRAS mutation. Autoantibody screening and viral serologies were negative. A skin biopsy revealed small-vessel vasculitis with IgA immune deposits. CMML can be associated with autoimmune diseases, such as polyarteritis nodosa and cutaneous leukocytoclastic vasculitis. However, this is the first report of IgA vasculitis occurring in the context of low risk CMML.

The role of preceding infections in the development of reactive arthritis (ReA) is well known but is less studied in association with other inflammatory arthritides. Therefore, in 1979-80 we screened for infections in patients with early musculoskeletal symptoms who were referred for rheumatological consultation and assessed the role of infections and other clinical factors in the development of chronic disease in following 14 years.

Idiopathic inflammatory myopathies (IIM) are a group of rare systemic autoimmune diseases characterized by muscle weakness, histopathological signs of inflammation in muscle tissues, elevated serum levels of muscle-associated enzymes, inflammatory mononuclear cells infiltrating muscle tissue and progressive symmetrical proximal muscle weakness. The current view is that they begin by immune activation in response to environmental factors in genetically predisposed people, but despite the number of investigations into the genetic background, the detailed etiopathogenesis remains unknown. The aim of this study was to examine the relationship between select polymorphisms located in the human major histocompatibility complex (MHC) and IIM. These genetic markers may take part in the onset of the autoimmune process, and their identification could aid in the diagnosis and classification of IIM subtypes.

Henoch-Schönlein purpura (HSP), also known as IgA vasculitis (IgAV), is the most prevalent systemic vasculitis. Renal involvement occurs in approximately one third of children with IgAV, while biopsy-proven nephritis could be diagnosed in only 6% of patients with prolonged proteinuria or nephritic syndrome. The renal resistive index (RRI) provides insights into intrarenal arterial resistance. The aim of this study was to assess the potential utility of RRI measurements in patients with IgA vasculitis (IgAV).