Time to pregnancy is prolonged in women with rheumatoid arthritis. Rheumatoid arthritis-related factors that influence time to pregnancy include high disease activity, high daily prednisone intake (exceeding 7·5 mg), and non-steroidal anti-inflammatory drug (NSAID) use. The aim of this study was to investigate whether a treat-to-target approach aimed at remission, while avoiding NSAIDs and high doses of prednisone, was associated with a reduced time to pregnancy in women with rheumatoid arthritis who wanted to conceive.

Large language models have generated intense interest in clinical artificial intelligence (AI), yet their evolution from passive chatbots into agentic systems capable of autonomous planning, tool use, and multistep execution represents a distinct technological paradigm. Unlike conversational AI, which makes suggestions and awaits review, agentic systems act independently and can chain clinical decisions across electronic health records, laboratory data, and patient communications. Rheumatology, with its decades-long disease trajectories, multimodal data streams, and iterative treatment adjustments, is a field well suited to such automation, but also particularly vulnerable to its failures. Errors in autonomous chains compound silently, verification demands exceed those of any previous clinical decision support tool, and the foundational tasks most suited to automation are precisely those through which trainees develop clinical expertise. This Viewpoint critically appraises the agentic AI landscape, analyses its applications and risks within rheumatology, and proposes a tiered governance framework to ensure meaningful human oversight.

Patients with psoriatic arthritis (PsA) are at increased risk of cardiovascular (CV) disease, which is not fully captured by traditional risk calculators. SCORE2 is widely recommended in Europe for CV risk stratification, but it may underestimate the burden of subclinical atherosclerosis in PsA. Carotid intima-media thickness (cIMT) is a validated surrogate marker of early atherosclerosis and may provide incremental value. We aimed to determine whether cIMT improves the performance of SCORE2 in detecting subclinical atherosclerosis in patients with PsA.

The use of heterogeneous empirical definitions to assess disease activity in adult-onset Still's disease limits evidence on the efficacy of immunosuppressive agents. Thus, we aimed to specifically develop and validate definitions of clinical criteria for the assessment of disease activity in adult-onset Still's disease.

Immunoglobulin G4-related disease (IgG4-RD) is a chronic fibroinflammatory disorder with heterogeneous clinical behavior. Although glucocorticoids remain the mainstay of treatment, relapse and fibrosis are common. This study investigated predictors of relapse and mortality, integrating disease subtype and cumulative drug exposure using the defined daily dose (DDD) framework.

Coping strategies have been shown to influence health outcomes of persons with axSpA. This study explores which stable and variable factors are associated with coping and whether coping strategies change over time.

Pain, fatigue, and impaired health-related quality of life are common manifestations of rheumatoid arthritis. The aim of this study was to compare the effects of active conventional treatment with three different biological disease-modifying antirheumatic drugs (DMARDs) on patient-reported outcomes after 48 weeks, in patients with early rheumatoid arthritis using data from the NORD-STAR trial.

Patient-initiated follow-up (PIFU) is designed to give patients more control over their follow-up care in rheumatology and relies on patients coming forward to schedule appointments and understand how and when to contact their rheumatology team. Additionally, rheumatology teams need to establish suitable criteria and have systems in place to support PIFU. Resources to inform patients with rheumatic disease about PIFU or to support its implementation in rheumatology clinics is scarce. The aim of this study was to co-design resources with patients and clinicians to support the implementation of PIFU across the UK.