The objective of the study was to explore left atrial (LA) strain, a quantitative index of left ventricular (LV) diastolic function, in risk stratifying patients with SSc-related pulmonary hypertension (SSc-PH).

To investigate the long-term safety and efficacy of tocilizumab, an IL-6 receptor inhibitor, in patients with adult-onset Still's disease.

EULAR recently updated its recommendation for managing SLE by redefining the lupus low disease activity state (LLDAS) with a reduced allowable glucocorticoid dose of ≤5 mg. No studies have validated this revised definition. Thus, we aimed to evaluate its association with clinical outcomes, including organ damage, disease flares and quality of life.

Prevalence of muscle involvement in systemic sclerosis (SSc) ranges from 6% to 96%. If inflammatory myopathy (IM) is present, early diagnosis enables timely treatment; however, there is no standardized approach to detection. We evaluated a screening algorithm for SSc-related muscle involvement.

Cutaneous lupus erythematosus (CLE) is an autoimmune skin condition associated with a considerable treatment burden and diminished quality of life. The absence of a consensus outcome measure to evaluate therapeutic response has posed a challenge to CLE drug development. The Cutaneous Lupus Erythematosus Disease Area and Severity Index (CLASI) was developed in response to this need, incorporating morphological components including erythema, scale, dyspigmentation and scarring, to reflect disease activity and damage. Numerous studies have demonstrated the utility of CLASI in capturing relevant aspects of disease from clinician- and patient-based perspectives; however, no regulatory precedent for use of clinical trial data employing CLASI to evaluate treatment response in CLE exists. Thus, the Lupus Accelerating Breakthroughs Consortium commissioned a working group of members from industry, academia, the US Food and Drug Administration (FDA) and CLE patient advocates to address the potential knowledge gaps with CLASI through evidence-based research. Upon reviewing and submitting these data to the FDA, the working group reached alignment that CLASI is a suitable outcome measure for CLE clinical trials, enabling a clearer regulatory path for clinical drug development. The group recognizes the need for additional information to assess what degree of change in CLASI captures clinically meaningful improvement.

Systemic sclerosis (SSc) is a prototypical systemic immune-mediated fibrosing disease that affects the skin, the lungs, the heart, the kidneys and the intestinal tract. Similar to many other fibrotic diseases, SSc is associated with high morbidity and mortality and therapeutic options are limited. Fibrosis arises from a complex interplay of vascular damage, inflammation and prolonged, misdirected repair responses. The progressive accumulation of extracellular matrix perturbs the physiological tissue architecture and commonly leads to failure of the affected organs. Understanding the mechanisms of fibrotic tissue remodelling can lead to the identification of preclinical targets. Novel fibrosis-promoting cell subpopulations, the interplay of fibroblasts with B cells and macrophages, the nerve-fibroblast axis, matrikines and matricryptins, senescence, profibrotic transcription factors, developmental pathways and epigenetic tissue memory are all important drivers of fibrotic tissue remodelling that might offer potential for novel therapies to improve outcomes for patients with SSc and possibly other fibrotic conditions.

Psoriatic arthritis develops in up to one-third of individuals with psoriasis, typically following a prolonged subclinical phase. Diagnostic delays are common, often exceeding 2 years, and can result in irreversible joint damage. The growing recognition of this latent period has fuelled interest in earlier identification and interception. However, efforts are hampered by inconsistent definitions of early or subclinical psoriatic arthritis, insufficient prognostic tools, and an absence of consensus on the outcome for interception studies. This Review synthesises a rapidly evolving field, offering a framework organised around four crucial questions: first, what defines progression from psoriasis to psoriatic arthritis? Second, who is most at risk of transition? Third, how can progression be reliably measured using imaging, molecular biomarkers, or digital health technologies? Fourth, when should preventive intervention be considered? We critically examine new conceptual models, the limitations of existing classification criteria, advances in imaging and biomarker research, and the promise of digital phenotyping. Addressing the current challenges in definitions, risk stratification, measurement, and trial design is essential for the development of biologically grounded, ethically robust interception strategies.