Despite advances in the treatment of psoriatic arthritis (PsA), a substantial proportion of patients continue to report persistent symptoms and impaired quality of life. However, terminology remains inconsistent for patients who fail to achieve disease control despite treatment, which limits research comparability and contributes to therapeutic inertia. To address this gap, a Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA) task force developed consensus definitions for two distinct states: complex-to-manage PsA (C2M-PsA) and treatment-refractory PsA (TR-PsA). C2M-PsA is defined as a state of persistent symptoms despite treatment with at least one biologic or targeted synthetic DMARD (b/tsDMARD), extending beyond biological non-response to include factors such as comorbidities, overlapping conditions, psychosocial burden and treatment-related challenges (for example, non-adherence). TR-PsA, a more specific subset of C2M-PsA, is characterized by failure of at least three therapies with distinct mechanisms of action (including at least two biologic/targeted synthetic DMARDs), persistent symptoms considered problematic by both patient and clinician, and objective evidence of ongoing inflammation - after ruling out alternative explanations for treatment refractoriness. These consensus-derived GRAPPA definitions provide a shared framework to standardize terminology, support individualized care, and improve patient stratification in research and practice. Prospective validation across diverse settings and phenotypes is needed to confirm their reliability, responsiveness and clinical utility.

Rheumatoid arthritis (RA) is a systemic autoimmune disease with articular and extra-articular manifestations. Chronic inflammation may contribute to sarcopenia independently of age. While cross-sectional studies report sarcopenia in 24-30% of RA patients, longitudinal data remain limited. This study aimed to assess long-term changes in sarcopenia and body composition in RA patients and explore their associations with clinical features and health outcomes.

Hip morphology has emerged as an important factor in the development of hip osteoarthritis (OA). Cam morphology is one of the most common hip morphologies, characterized by a bony prominence around the femoral head-neck junction of the hip that alters the normal shape of the femoral head. Cam morphology can contribute to intra-articular joint damage by generating abnormal contact stresses at this junction, initiating femoroacetabular impingement (FAI) syndrome and eventually leading to hip OA. Cam morphology is a causal risk factor for hip OA, but not everybody with this morphology will develop FAI syndrome or OA. The pathogenesis of hip disease is probably driven by the interplay between cam morphology, other coexisting hip morphologies (such as pincer morphology), femoral version, spinopelvic parameters and biomechanical and environmental factors. Early identification of FAI syndrome could enable timely, multidisciplinary intervention and offers the potential to modify the trajectory of disease. Cam morphology can develop during skeletal maturation, particularly in adolescents participating in high-joint-load physical activity, raising important questions about preventative approaches. Management of FAI syndrome includes both surgical and non-surgical approaches. Emerging insights into the pathogenesis and detection of cam morphology are paving the way for more targeted interventions and a deeper understanding of its role in FAI syndrome and hip OA development.

Ankylosing spondylitis (AS) often affects individuals during their most productive working years. However, few studies have investigated factors influencing employment in Japanese AS patients. This study investigates the employment status and related factors in Japanese patients with ankylosing spondylitis.

The objective of this study was to validate the achievement of treat-to-target (T2T) in childhood-onset SLE (cSLE) at Wuhan Children's Hospital.

VEXAS syndrome is a severe systemic haemato-inflammatory disease with heterogeneous clinical presentations. Most patients experience recurrent inflammatory flares despite anti-inflammatory therapy. The lack of accepted definitions of flare in these patients is preventing development of disease activity tools that are essential for conducting clinical trials. We aimed to develop a consensus definition of a VEXAS flare for use in clinical trials.

The increase in biological disease-modifying antirheumatic drugs for psoriatic arthritis (PsA) made it possible to consider different mechanisms of action (MoA) after the failure of the first advanced-line therapy. However, there is still a lack of real-world evidence comparing the cycling (re-administration of a similar MoA) and the swap strategy. This retrospective observational study aims to evaluate the retention rate, as a proxy for effectiveness, of second-line therapeutic options after the failure of a TNF inhibitor (TNFi) by comparing cycling versus swap strategies.

Obesity constitutes a substantial burden in psoriatic disease that affects approximately half of patients. Importantly, increased adiposity and psoriatic disease are strongly linked, with obesity functioning as both a possible trigger and a disease modifier. Obesity predisposes individuals to develop psoriasis and is likely to drive, at least partially, the progression from psoriasis to psoriatic arthritis. For people with psoriasis or psoriatic arthritis, obesity is associated with lower rates of remission and poorer responses to treatment. Several mechanisms probably underlie this relationship, including systemic and local pro-inflammatory properties of adipose tissue, increased biomechanical stress on joints and entheses, gut dysbiosis and synergistic effects of osteoarthritis. Notably, weight loss can improve both psoriatic disease course and response to therapy; however, current approaches (such as dietary interventions or bariatric surgery) are difficult to implement. Glucagon-like peptide-1-based therapies are an effective strategy for weight loss in psoriatic disease and might even have additive disease-modifying effects to conventional immunomodulators. Although often overlooked, weight loss intervention and obesity management should be included as an integral part of psoriatic disease treatment algorithms.

Sternoclavicular joint (SCJ) involvement in PsA is poorly characterized. We aimed to assess its prevalence and clinical associations in a longitudinal PsA cohort.

Treat-to-target strategies have previously been shown to improve outcomes in psoriatic arthritis. We aimed to evaluate whether a treat-to-target strategy using early intensive treatment with the IL-17A inhibitor secukinumab improves outcomes compared with a standard step-up treat-to-target approach in patients with psoriatic arthritis.

Childhood-onset Sjögren's disease is a rare and under-investigated rheumatic condition. The natural course of childhood-onset Sjögren's disease in adulthood in not known. This study aimed to evaluate long-term disease trajectories and complications of childhood-onset Sjögren's disease and explore management strategies.

The European Alliance of Associations for Rheumatology recommendations for cardiovascular risk management highlighted the importance of traditional cardiovascular risk factor control in antiphospholipid syndrome (APS). However, cardiovascular risk factor target attainment in APS and differences between primary APS and systemic lupus erythematosus (SLE)-related APS remain uncertain.