2f:I[703058,["/_next/static/immutable/chunks/3bhq_5eh1d760.js","/_next/static/immutable/chunks/1855-ogyi8eh4.js","/_next/static/immutable/chunks/2pfsjpn6k6zlg.js","/_next/static/immutable/chunks/26c7v3_3uwnwu.js","/_next/static/immutable/chunks/25a3ozcrvi1ff.js","/_next/static/immutable/chunks/2r4wx50nvjh_4.js","/_next/static/immutable/chunks/23fsw06hsi5b1.js","/_next/static/immutable/chunks/06_yt270h41rg.js","/_next/static/immutable/chunks/3ezsiz-7shkna.js","/_next/static/immutable/chunks/20x2y96ldu5wx.js","/_next/static/immutable/chunks/2lxntcm3pd1_h.js","/_next/static/immutable/chunks/00dgco8irq3jw.js","/_next/static/immutable/chunks/00nwe-kq0rboc.js","/_next/static/immutable/chunks/2051ffx3xzio9.js"],"PaperListPageClient"] 30:Tc22,MRI-detected bone marrow oedema in sacroiliac joints is central to diagnosing axial spondyloarthritis, influencing treatment decisions including anti-inflammatory therapy initiation. However, the prevalence of bone marrow oedema in the general population remains unknown, restricting interpretation of MRI findings and potentially leading to overdiagnosis when imaging findings are considered without clinical context. We aimed to establish the prevalence and determinants of sacroiliac bone marrow oedema in the general adult population. In this national, population-based, cross-sectional study, we analysed adults aged 20-69 years from the German National Cohort who underwent whole-body MRI between May 1, 2014, and Dec 31, 2016. Three masked experts independently assessed randomly selected participants for sacroiliac bone marrow oedema. The remaining participants were evaluated using a validated deep-learning algorithm that automatically segments and quantifies bone marrow oedema volume from fat-suppressed proton density sequences. We examined associations between the presence of bone marrow oedema (primary outcome) and demographic, lifestyle, and reproductive factors using multivariable logistic regression with sex-stratified analyses to identify differential patterns. There was no patient or public involvement in this study. Of 11 163 participants (median age 53·0 years [IQR 45·0-61·0], 5432 [48·7%] women and 5731 [51·3%] men), sacroiliac bone marrow oedema was detected in 288 (28·9% [95% CI 26·2-31·9]) of 998 participants analysed by expert readers and 3131 (30·8% [29·9-31·7]) of 10 165 participants analysed by the deep-learning algorithm, approximately 50 times higher than the 0·6% prevalence of self-reported axial spondyloarthritis diagnosis. Bone marrow oedema prevalence was higher in women (33·9% [95% CI 32·6-35·3]) than in men (27·8% [26·6-29·1]; adjusted odds ratio [OR] 1·33 [95% CI 1·23-1·45]). In women, pregnancy history was associated with bone marrow oedema compared with nulliparous women (OR 1·43 [95% CI 1·21-1·71]). In men, age (OR 1·28 per decade [95% CI 1·21-1·35]) and intensive recreational physical activity (1·24 [1·08-1·42]) showed independent associations, whereas age effects were minimal in women (1·16 per decade [1·11-1·23]). Of modifiable risk factors, BMI of 25 kg/m Sacroiliac bone marrow oedema affects nearly one-third of adults, showing associations with pregnancy, overweight, and occupational physical stress rather than inflammatory disease. This prevalence exceeds self-reported axial spondyloarthritis by 50 times, providing essential population reference data for contextualising MRI findings. These findings show that bone marrow oedema, the key imaging marker for sacroiliitis in Assessment of Spondyloarthritis International Society criteria, commonly occurs from non-inflammatory causes. These population-based data can inform diagnostic interpretation and support development of more specific imaging thresholds to reduce misdiagnosis and inappropriate treatments. Max Kade Foundation and Novartis.31:T72c,This study aims to investigate the impact of non-steroidal anti-inflammatory drug (NSAID) intake on radiographic spinal progression in axial spondyloarthritis (axSpA), considering different NSAID types (COX-2 inhibitors [COX2i] and non-selective NSAIDs [ns-NSAIDs]) and disease subgroups (radiographic (r-axSpA) and non-radiographic (nr-axSpA). Leveraging data from the German Spondyloarthritis Inception Cohort (GESPIC), we conducted analyses on 252 axSpA patients (139 nr- axSpA and 113 r-axSpA), who had minimum 2 sets of spinal radiographs. The outcome was progression in modified Stoke Ankylosing Spondylitis Spine Score (mSASSS) in 2-year intervals. We fitted sequential conditional mean models by utilizing generalized estimating equations and adjusting for longitudinal repeated measures of exposure and time-dependent confounders. We report β-coefficients with 95% confidence intervals (CIs) for outcome reflecting the progression in mSASSS per 10-point increase in NSAID intake score. At baseline, 201 (80.0%) patients were under NSAID treatment, with 46 (18%) taking COX2i and 156 (62%) ns-NSAIDs and mean total NSAID intake score was 38.3±35.5. A 10-point increase in NSAID intake score was associated with retardation of radiographic progression (β=-0.052, 95%CI: -0.097, -0.007), with this effect being most pronounced in r-axSpA patients (β=-0.077, 95%CI: -0.152, -0.003). COX2i showed a slightly lower point estimate (although not statistically significant) in progression compared to ns-NSAIDs among all axSpA patients (β= -0.061 and -0.045, respectively). Our findings suggest a beneficial effect of higher NSAID intake, particularly COX2i, on slowing radiographic progression in axSpA. These findings may help inform therapeutic strategies, particularly in r-axSpA, while further research is needed for nr-axSpA.32:T9ad, Objectives This study aims to investigate the impact of non‐steroidal anti‐inflammatory drug (NSAID) intake on radiographic spinal progression in axial spondyloarthritis (axSpA), considering different NSAID types (COX‐2 inhibitors [COX2i] and non‐selective NSAIDs [ns‐NSAIDs]) and disease subgroups (radiographic (r‐axSpA) and non‐radiographic (nr‐axSpA). Methods Leveraging data from the German Spondyloarthritis Inception Cohort (GESPIC), we conducted analyses on 252 axSpA patients (139 nr‐ axSpA and 113 r‐axSpA), who had minimum 2 sets of spinal radiographs. The outcome was progression in modified Stoke Ankylosing Spondylitis Spine Score (mSASSS) in 2‐year intervals. We fitted sequential conditional mean models by utilizing generalized estimating equations and adjusting for longitudinal repeated measures of exposure and time‐dependent confounders. We report β‐coefficients with 95% confidence intervals (CIs) for outcome reflecting the progression in mSASSS per 10‐point increase in NSAID intake score. Results At baseline, 201 (80.0%) patients were under NSAID treatment, with 46 (18%) taking COX2i and 156 (62%) ns‐NSAIDs and mean total NSAID intake score was 38.3±35.5. A 10‐point increase in NSAID intake score was associated with retardation of radiographic progression (β=‐0.052, 95%CI: ‐0.097, ‐0.007), with this effect being most pronounced in r‐axSpA patients (β=‐0.077, 95%CI: ‐0.152, ‐0.003). COX2i showed a slightly lower point estimate (although not statistically significant) in progression compared to ns‐NSAIDs among all axSpA patients (β= ‐0.061 and ‐0.045, respectively). Conclusions Our findings suggest a beneficial effect of higher NSAID intake, particularly COX2i, on slowing radiographic progression in axSpA. These findings may help inform therapeutic strategies, particularly in r‐axSpA, while further research is needed for nr‐axSpA. 33:T418,The mean age across the 3 indications was 45.9 years; most patients in the PsO and axSpA cohorts were male (4696/6892 [68.1%] and 650/932 [69.7%], respectively), whereas the proportion of male to female patients in the PsA cohort was largely balanced (679/1401 [48.5%] vs 722/1401 [51.5%], respectively). The study included 6892 patients with PsO, 1401 patients with PsA, and 932 patients with axSpA, representing a cumulative exposure to IXE of 22 371.1 patient-years (PY) (18 025.7 PY for PsO, 2247.7 PY for PsA, and 2097.7 PY for axSpA). Malignant neoplasms were reported among 141 patients with PsO (2.0%; incidence rate [IR], 0.8 per 100 PY [95% CI, 0.7-0.9]), 15 patients with PsA (1.1%; IR, 0.7 per 100 PY [95% CI, 0.4-1.1]), and 9 patients with axSpA (1.0%; IR, 0.4 per 100 PY [95% CI, 0.2-0.8]). IRs of malignant neoplasms at 1-year intervals remained low (≤1.2 per 100 PY) and constant over time. SIRs with 95% CIs were below or near 1 (PsO, 0.89 [95% CI, 0.71-1.08]; PsA, 0.49 [95% CI, 0.13-0.85]; axSpA, 1.07 [95% CI, 0.37-1.77]).34:T9a0,Assessing malignant neoplasm risk among patients with long-term biologic exposure is of interest. This study provides insight into the risk of malignant neoplasm among patients with psoriasis (PsO), psoriatic arthritis (PsA), or axial spondyloarthritis (axSpA) who received ixekizumab (IXE) over time. To determine the incidence of malignant neoplasms among patients with PsO, PsA, or axSpA who received long-term (up to 6 years) IXE treatment, and to compare the recorded incidences (excluding nonmelanoma skin cancer) with those observed in the US general population. This multicenter, global pooled analysis examined patient data from 25 randomized clinical trials (RCTs) in patients with PsO, PsA, or axSpA receiving at least 1 dose of IXE over 5 years (PsO) or 3 years (PsA and axSpA). Eligibility criteria varied across the 25 RCTs, but most of the patients were naive to biologic treatments. The primary analysis was performed in March 2021 (PsA) and March 2022 (PsO and axSpA). Long-term treatment with IXE. Incidence rates of malignant neoplasms and standardized incidence ratios (SIRs). The mean age across the 3 indications was 45.9 years; most patients in the PsO and axSpA cohorts were male (4696/6892 [68.1%] and 650/932 [69.7%], respectively), whereas the proportion of male to female patients in the PsA cohort was largely balanced (679/1401 [48.5%] vs 722/1401 [51.5%], respectively). The study included 6892 patients with PsO, 1401 patients with PsA, and 932 patients with axSpA, representing a cumulative exposure to IXE of 22 371.1 patient-years (PY) (18 025.7 PY for PsO, 2247.7 PY for PsA, and 2097.7 PY for axSpA). Malignant neoplasms were reported among 141 patients with PsO (2.0%; incidence rate [IR], 0.8 per 100 PY [95% CI, 0.7-0.9]), 15 patients with PsA (1.1%; IR, 0.7 per 100 PY [95% CI, 0.4-1.1]), and 9 patients with axSpA (1.0%; IR, 0.4 per 100 PY [95% CI, 0.2-0.8]). IRs of malignant neoplasms at 1-year intervals remained low (≤1.2 per 100 PY) and constant over time. SIRs with 95% CIs were below or near 1 (PsO, 0.89 [95% CI, 0.71-1.08]; PsA, 0.49 [95% CI, 0.13-0.85]; axSpA, 1.07 [95% CI, 0.37-1.77]). This pooled analysis of 25 RCTs demonstrated that the safety profile of IXE supports long-term use in patients with PsO, PsA, or axSpA. This is evidenced by incidences of malignant neoplasms consistent with previous reports, and with SIRs of malignant neoplasms across indications similar to the US general population.35:Tc5a,ImportanceAssessing malignant neoplasm risk among patients with long-term biologic exposure is of interest. This study provides insight into the risk of malignant neoplasm among patients with psoriasis (PsO), psoriatic arthritis (PsA), or axial spondyloarthritis (axSpA) who received ixekizumab (IXE) over time.ObjectiveTo determine the incidence of malignant neoplasms among patients with PsO, PsA, or axSpA who received long-term (up to 6 years) IXE treatment, and to compare the recorded incidences (excluding nonmelanoma skin cancer) with those observed in the US general population.Design, Setting, and ParticipantsThis multicenter, global pooled analysis examined patient data from 25 randomized clinical trials (RCTs) in patients with PsO, PsA, or axSpA receiving at least 1 dose of IXE over 5 years (PsO) or 3 years (PsA and axSpA). Eligibility criteria varied across the 25 RCTs, but most of the patients were naive to biologic treatments. The primary analysis was performed in March 2021 (PsA) and March 2022 (PsO and axSpA).InterventionLong-term treatment with IXE.Main Outcomes and MeasuresIncidence rates of malignant neoplasms and standardized incidence ratios (SIRs).ResultsThe mean age across the 3 indications was 45.9 years; most patients in the PsO and axSpA cohorts were male (4696/6892 [68.1%] and 650/932 [69.7%], respectively), whereas the proportion of male to female patients in the PsA cohort was largely balanced (679/1401 [48.5%] vs 722/1401 [51.5%], respectively). The study included 6892 patients with PsO, 1401 patients with PsA, and 932 patients with axSpA, representing a cumulative exposure to IXE of 22 371.1 patient-years (PY) (18 025.7 PY for PsO, 2247.7 PY for PsA, and 2097.7 PY for axSpA). Malignant neoplasms were reported among 141 patients with PsO (2.0%; incidence rate [IR], 0.8 per 100 PY [95% CI, 0.7-0.9]), 15 patients with PsA (1.1%; IR, 0.7 per 100 PY [95% CI, 0.4-1.1]), and 9 patients with axSpA (1.0%; IR, 0.4 per 100 PY [95% CI, 0.2-0.8]). IRs of malignant neoplasms at 1-year intervals remained low (≤1.2 per 100 PY) and constant over time. SIRs with 95% CIs were below or near 1 (PsO, 0.89 [95% CI, 0.71-1.08]; PsA, 0.49 [95% CI, 0.13-0.85]; axSpA, 1.07 [95% CI, 0.37-1.77]).Conclusions and RelevanceThis pooled analysis of 25 RCTs demonstrated that the safety profile of IXE supports long-term use in patients with PsO, PsA, or axSpA. This is evidenced by incidences of malignant neoplasms consistent with previous reports, and with SIRs of malignant neoplasms across indications similar to the US general population.25:[[["$","script","0",{"type":"application/ld+json","dangerouslySetInnerHTML":{"__html":"{\"@context\":\"https://schema.org\",\"@type\":\"CollectionPage\",\"name\":\"Axial Spondyloarthritis: condition Research & Clinical Takeaways\",\"description\":\"Explore peer-reviewed papers on Axial Spondyloarthritis (condition). Clinician-written summaries and actionable practice insights. 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Some may classify it differently depending on the evidence hierarchy used.","value_numeric":null},{"paper_doi":"10.1016/j.ard.2026.08.003","tag_type":"warning","value":"Total sample size of n=1,101 is derived by summing all three trial cohorts (MEASURE 1: 132; PREVENT: 555; SURPASS: 414); the paper does not report a single combined N explicitly.","value_numeric":null}],"summaries":{"what_studied":"A fully automated deep learning (DL) pipeline was developed to detect 5 MRI lesion types in sacroiliac joints (SIJs) in axial spondyloarthritis (axSpA) — bone marrow oedema (BMO), erosions, fat lesions, sclerosis, and ankylosis — trained on the MEASURE 1 trial (n=132) and validated on two independent phase III datasets (PREVENT, n=555; SURPASS, n=414) using paired T1-weighted and STIR sequences scored by the Berlin SIJ method.","key_result":"The DL model matched expert interreader agreement across all datasets; ankylosis detection was strongest (MEASURE 1 AUC 0.97, SURPASS AUC 0.99; balanced accuracy 0.95–0.97), while BMO showed high AUCs (0.85–0.93) but lower balanced accuracy (0.72–0.74). Performance generalised to independent datasets without additional retraining.","limitations":"BMO balanced accuracy was modest (0.72–0.74), suggesting reduced reliability for active lesion detection compared to structural lesions. The model was trained and validated exclusively on phase III clinical trial populations, which may limit generalisability to routine clinical or early axSpA cohorts. Consensus-based labels used for training may not fully reflect real-world single-reader variability.","practice_takeaway":"This automated DL tool reliably detects structural SIJ lesions in axSpA and generalises across trial datasets without retraining, supporting its use to improve consistency and scalability of MRI scoring in clinical trials. Clinicians should note that active lesion (BMO) detection is less precise and may still require expert review."}},{"doi":"10.1002/art.70297","pmid":"42605840","title":"Risk of Cancer according to Duration of Targeted Therapy Exposure in Spondyloarthritis: A Nationwide Cohort Study from the French Health Insurance Database","journal_title":"Arthritis & Rheumatology","journal_issn":"2326-5191","published_at":"2026-08-17T00:00:00.000Z","url":"https://doi.org/10.1002/art.70297","source_score":3,"is_retracted":false,"is_open_access":false,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-08-22T06:53:21.288Z","updated_at":"2026-08-22T06:53:21.288Z","tags":[{"paper_doi":"10.1002/art.70297","tag_type":"age_group","value":"adult","value_numeric":null},{"paper_doi":"10.1002/art.70297","tag_type":"category","value":"Rheumatology","value_numeric":null},{"paper_doi":"10.1002/art.70297","tag_type":"condition","value":"Axial Spondyloarthritis","value_numeric":null},{"paper_doi":"10.1002/art.70297","tag_type":"condition","value":"Cancer","value_numeric":null},{"paper_doi":"10.1002/art.70297","tag_type":"condition","value":"Psoriatic Arthritis","value_numeric":null},{"paper_doi":"10.1002/art.70297","tag_type":"condition","value":"Spondyloarthritis","value_numeric":null},{"paper_doi":"10.1002/art.70297","tag_type":"impact_flag","value":"confirms_prior","value_numeric":null},{"paper_doi":"10.1002/art.70297","tag_type":"level_of_evidence","value":"3","value_numeric":null},{"paper_doi":"10.1002/art.70297","tag_type":"modality","value":"IL-12/23 Inhibitor","value_numeric":null},{"paper_doi":"10.1002/art.70297","tag_type":"modality","value":"IL-17 Inhibitor","value_numeric":null},{"paper_doi":"10.1002/art.70297","tag_type":"modality","value":"IL-23 Inhibitor","value_numeric":null},{"paper_doi":"10.1002/art.70297","tag_type":"modality","value":"JAK Inhibitor","value_numeric":null},{"paper_doi":"10.1002/art.70297","tag_type":"modality","value":"TNF Inhibitor","value_numeric":null},{"paper_doi":"10.1002/art.70297","tag_type":"sample_size","value":"n=56591","value_numeric":56591},{"paper_doi":"10.1002/art.70297","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1002/art.70297","tag_type":"study_design","value":"Nationwide Cohort Study","value_numeric":null},{"paper_doi":"10.1002/art.70297","tag_type":"warning","value":"Causal inference relies on inverse probability weighting from claims data; unmeasured confounders (e.g., disease severity, concomitant medications) may not be fully accounted for.","value_numeric":null},{"paper_doi":"10.1002/art.70297","tag_type":"warning","value":"The protective signal for hematological malignancies (wHR 0.65) is based on only 116 events, so this estimate should be interpreted cautiously — wide confidence intervals reflect limited precision.","value_numeric":null},{"paper_doi":"10.1002/art.70297","tag_type":"warning","value":"The study pools multiple SpA subtypes and multiple drug classes (TNFi, IL-17i, IL-12/23i, IL-23i, JAKi) into a single exposure variable; drug-class-specific or subtype-specific cancer risks may differ and are not fully delineated in the abstract.","value_numeric":null}],"summaries":{"what_studied":"This nationwide French cohort study examined whether duration of targeted therapy exposure (TNFi, IL-17i, IL-12/23i, IL-23i, JAKi) affects cancer risk in 56,591 adults with spondyloarthritis (including psoriatic arthritis and axial SpA), followed for a median of 5.0 years (2014–2024).","key_result":"Exposure >6 months/year vs. ≤6 months/year was associated with a **lower** overall cancer risk (wHR 0.86, 95% CI 0.75–0.99), driven primarily by hematological malignancies (wHR 0.65, 95% CI 0.42–0.99); no significant reduction was seen for solid cancers (wHR 0.92, 95% CI 0.79–1.07). Of 1,224 total cancers, 1,029 were solid and 116 hematological. Cumulative multi-year exposure was not associated with cancer risk.","limitations":"- **Observational design**: residual confounding cannot be excluded despite inverse probability weighting.\n- **Database-based exposure**: therapy adherence is inferred from insurance claims, not directly measured.\n- **Heterogeneous SpA subtypes**: pooling psoriatic arthritis, axial SpA, and other subtypes may obscure subgroup-specific risks.","practice_takeaway":"Clinicians can reassure patients with SpA that prolonged targeted therapy use is not associated with increased cancer risk — and may even lower hematological malignancy risk. Cumulative years of exposure should not, on its own, prompt treatment discontinuation over cancer concerns."}},{"doi":"10.1016/j.ard.2026.06.021","pmid":"42443018","title":"Influence of national socioeconomic status on treatment retention and disease activity in psoriatic arthritis and axial spondyloarthritis: evidence over 2 years in 13 European countries","journal_title":"Annals of the Rheumatic Diseases","journal_issn":"0003-4967","published_at":"2026-07-13T00:00:00.000Z","url":"https://doi.org/10.1016/j.ard.2026.06.021","source_score":26,"is_retracted":false,"is_open_access":false,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-08-12T13:26:20.276Z","updated_at":"2026-08-12T13:26:20.276Z","tags":[{"paper_doi":"10.1016/j.ard.2026.06.021","tag_type":"age_group","value":"adult","value_numeric":null},{"paper_doi":"10.1016/j.ard.2026.06.021","tag_type":"category","value":"Rheumatology","value_numeric":null},{"paper_doi":"10.1016/j.ard.2026.06.021","tag_type":"condition","value":"Axial Spondyloarthritis","value_numeric":null},{"paper_doi":"10.1016/j.ard.2026.06.021","tag_type":"condition","value":"Psoriatic Arthritis","value_numeric":null},{"paper_doi":"10.1016/j.ard.2026.06.021","tag_type":"impact_flag","value":"practice_changing","value_numeric":null},{"paper_doi":"10.1016/j.ard.2026.06.021","tag_type":"level_of_evidence","value":"3","value_numeric":null},{"paper_doi":"10.1016/j.ard.2026.06.021","tag_type":"modality","value":"Biologic Disease-Modifying Antirheumatic Drug","value_numeric":null},{"paper_doi":"10.1016/j.ard.2026.06.021","tag_type":"modality","value":"Targeted Synthetic Disease-Modifying Antirheumatic Drug","value_numeric":null},{"paper_doi":"10.1016/j.ard.2026.06.021","tag_type":"sample_size","value":"n=38911","value_numeric":38911},{"paper_doi":"10.1016/j.ard.2026.06.021","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1016/j.ard.2026.06.021","tag_type":"study_design","value":"Longitudinal Cohort Study","value_numeric":null},{"paper_doi":"10.1016/j.ard.2026.06.021","tag_type":"warning","value":"Age distribution of the cohort is not specified in the abstract; 'adult' age group is assumed based on typical spondyloarthritis registry populations.","value_numeric":null},{"paper_doi":"10.1016/j.ard.2026.06.021","tag_type":"warning","value":"No specific biologic or targeted synthetic agents are named in the abstract; brand and generic drug tags could not be assigned.","value_numeric":null},{"paper_doi":"10.1016/j.ard.2026.06.021","tag_type":"warning","value":"The 'practice_changing' impact flag is applied with caution — while findings are novel and policy-relevant, the ecological study design limits direct clinical translation at the individual patient level.","value_numeric":null}],"summaries":{"what_studied":"This study examined how national socioeconomic indicators (GDP per capita, HDI, gross national income, health expenditure, out-of-pocket expenditure) relate to b/tsDMARD treatment retention at 6, 12, and 24 months and disease activity at treatment initiation in 38,911 patients with PsA (n=17,296) or axSpA (n=21,615) across 13 European countries from 2015–2021.","key_result":"Higher national wealth was paradoxically associated with **earlier** b/tsDMARD discontinuation — retention was significantly lower in high-GDP countries vs. medium/low-GDP countries at 6, 12, and 24 months (log-rank P<.001 for all). Conversely, patients in lower-GDP countries started treatment with **worse disease activity**, especially in PsA. The strongest socioeconomic effects on retention were seen with GDP per capita and HDI, and were most pronounced in women with axSpA.","limitations":"- Country-level (ecological) socioeconomic indicators were used rather than individual patient-level socioeconomic data, limiting causal inference.\n- Registry data may reflect variation in prescribing practices, access policies, and drug availability across countries rather than purely socioeconomic effects.\n- The 2015–2021 timeframe may not reflect more recent changes in drug access or health policy across Europe.","practice_takeaway":"In lower-income European countries, patients with PsA and axSpA tend to start biologics with higher disease burden and stay on them longer — possibly due to restricted switching options rather than better drug performance. Clinicians and health policy makers in these settings should actively monitor disease activity at treatment initiation and ensure timely access to treatment optimization."}},{"doi":"10.1002/art.70265","pmid":"42386693","title":"Same Family, Different Stories: Distinct Peripheral Immune Signatures in Axial Spondyloarthritis and Psoriatic Arthritis","journal_title":"Arthritis & Rheumatology","journal_issn":"2326-5191","published_at":"2026-07-10T00:00:00.000Z","url":"https://doi.org/10.1002/art.70265","source_score":7,"is_retracted":false,"is_open_access":false,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-08-10T13:22:02.667Z","updated_at":"2026-08-10T13:22:02.667Z","tags":[{"paper_doi":"10.1002/art.70265","tag_type":"age_group","value":"adult","value_numeric":null},{"paper_doi":"10.1002/art.70265","tag_type":"category","value":"Rheumatology","value_numeric":null},{"paper_doi":"10.1002/art.70265","tag_type":"condition","value":"Axial Spondyloarthritis","value_numeric":null},{"paper_doi":"10.1002/art.70265","tag_type":"condition","value":"Psoriatic Arthritis","value_numeric":null},{"paper_doi":"10.1002/art.70265","tag_type":"impact_flag","value":"practice_changing","value_numeric":null},{"paper_doi":"10.1002/art.70265","tag_type":"level_of_evidence","value":"4","value_numeric":null},{"paper_doi":"10.1002/art.70265","tag_type":"study_design","value":"Cross-Sectional Study","value_numeric":null},{"paper_doi":"10.1002/art.70265","tag_type":"warning","value":"Full paper text was not provided — summary, key result, sample size, sex distribution, and specific numeric outcomes are based on the title, abstract context, and journal metadata only. Clinicians should verify quantitative findings in the full publication.","value_numeric":null},{"paper_doi":"10.1002/art.70265","tag_type":"warning","value":"Impact flag 'practice_changing' is tentative — the framing of distinct immune signatures across two commonly conflated conditions is clinically significant, but full data are needed to confirm.","value_numeric":null},{"paper_doi":"10.1002/art.70265","tag_type":"warning","value":"Level of evidence assigned as 4 (cross-sectional/observational) pending confirmation of study design.","value_numeric":null},{"paper_doi":"10.1002/art.70265","tag_type":"warning","value":"Study design inferred as cross-sectional based on the nature of peripheral immune profiling studies; this should be confirmed against the full methods section.","value_numeric":null}],"summaries":{"what_studied":"This study compared peripheral immune cell signatures between patients with axial spondyloarthritis (axSpA) and psoriatic arthritis (PsA), two related but distinct spondyloarthritis subtypes, to identify immunological differences at the cellular level.","key_result":"Despite belonging to the same disease family, axSpA and PsA showed distinct peripheral immune signatures, suggesting divergent underlying immunopathology between the two conditions.","limitations":"Specific sample size, control comparators, and granular quantitative outcomes are not available from the provided metadata alone; the cross-sectional nature of peripheral blood studies may not fully reflect tissue-level immune activity.","practice_takeaway":"AxSpA and PsA should not be treated as immunologically interchangeable — their distinct peripheral immune profiles may have implications for treatment selection and biomarker development."}},{"doi":"10.1002/art.70269","pmid":"42405423","title":"Deep Immunophenotyping Reveals Distinct Immune Signatures in Axial Spondyloarthritis and Psoriatic Arthritis","journal_title":"Arthritis & Rheumatology","journal_issn":"2326-5191","published_at":"2026-07-06T00:00:00.000Z","url":"https://doi.org/10.1002/art.70269","source_score":6,"is_retracted":false,"is_open_access":true,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-07-10T13:25:26.719Z","updated_at":"2026-07-10T13:25:26.719Z","tags":[{"paper_doi":"10.1002/art.70269","tag_type":"age_group","value":"adult","value_numeric":null},{"paper_doi":"10.1002/art.70269","tag_type":"category","value":"Rheumatology","value_numeric":null},{"paper_doi":"10.1002/art.70269","tag_type":"condition","value":"Axial Spondyloarthritis","value_numeric":null},{"paper_doi":"10.1002/art.70269","tag_type":"condition","value":"Psoriatic Arthritis","value_numeric":null},{"paper_doi":"10.1002/art.70269","tag_type":"impact_flag","value":"practice_changing","value_numeric":null},{"paper_doi":"10.1002/art.70269","tag_type":"level_of_evidence","value":"3","value_numeric":null},{"paper_doi":"10.1002/art.70269","tag_type":"modality","value":"Immunophenotyping / Biomarker","value_numeric":null},{"paper_doi":"10.1002/art.70269","tag_type":"modality","value":"Spectral Flow Cytometry","value_numeric":null},{"paper_doi":"10.1002/art.70269","tag_type":"sample_size","value":"n=228","value_numeric":228},{"paper_doi":"10.1002/art.70269","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1002/art.70269","tag_type":"study_design","value":"Cross-Sectional Study","value_numeric":null},{"paper_doi":"10.1002/art.70269","tag_type":"warning","value":"Impact flag 'practice_changing' is aspirational based on findings — clinical validation of the biomarker signature in prospective cohorts has not yet been reported.","value_numeric":null},{"paper_doi":"10.1002/art.70269","tag_type":"warning","value":"Study design is cross-sectional; causality and treatment influence on immune profiles cannot be determined from the abstract alone.","value_numeric":null},{"paper_doi":"10.1002/art.70269","tag_type":"warning","value":"The 49 healthy donors serve as a reference group but the abstract does not describe matching criteria (age, sex, comorbidities), which may affect comparisons.","value_numeric":null}],"summaries":{"what_studied":"Peripheral blood immune cell subsets, cytokine profiles, and inflammatory mediators were compared between 88 axSpA patients, 91 PsA patients, and 49 healthy donors using high-dimensional spectral flow cytometry (230 million acquired events) to identify disease-specific immunophenotypic signatures.","key_result":"AxSpA and PsA had clearly distinct immune profiles: axSpA showed innate-like activation (expanded γδ T cells, plasmablasts, Th17 skewing, elevated inflammasome cytokines), while PsA featured adaptive/memory responses (more dendritic cells, central memory CD4+ T cells, elevated IL-17A, sIL2R, sTNFR1). A regularized regression model distinguished the two with a cross-validated AUC of 0.94.","limitations":"Cross-sectional design limits causal inference; peripheral blood may not fully reflect tissue-level immunopathology; the impact of concurrent treatments on immunophenotyping is not detailed in the abstract.","practice_takeaway":"AxSpA and PsA have biologically distinct immune signatures despite clinical overlap — axSpA leans innate/activated while PsA leans adaptive/memory. These findings support the future development of biomarker-guided treatment stratification rather than treating them as interchangeable SpA subtypes."}},{"doi":"10.1016/s2665-9913(26)00142-6","pmid":"42379213","title":"Trends in autoimmune rheumatic disease diagnoses before and after the COVID-19 pandemic in England: a population-based cohort study using OpenSAFELY","journal_title":"The Lancet Rheumatology","journal_issn":"2665-9913","published_at":"2026-06-30T00:00:00.000Z","url":"https://doi.org/10.1016/s2665-9913(26)00142-6","source_score":5,"is_retracted":false,"is_open_access":true,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-07-05T13:38:35.585Z","updated_at":"2026-07-05T13:38:35.585Z","tags":[{"paper_doi":"10.1016/s2665-9913(26)00142-6","tag_type":"age_group","value":"adult","value_numeric":null},{"paper_doi":"10.1016/s2665-9913(26)00142-6","tag_type":"category","value":"Rheumatology","value_numeric":null},{"paper_doi":"10.1016/s2665-9913(26)00142-6","tag_type":"condition","value":"Autoimmune Rheumatic Disease","value_numeric":null},{"paper_doi":"10.1016/s2665-9913(26)00142-6","tag_type":"condition","value":"Axial Spondyloarthritis","value_numeric":null},{"paper_doi":"10.1016/s2665-9913(26)00142-6","tag_type":"condition","value":"Connective Tissue Disease","value_numeric":null},{"paper_doi":"10.1016/s2665-9913(26)00142-6","tag_type":"condition","value":"Giant Cell Arteritis","value_numeric":null},{"paper_doi":"10.1016/s2665-9913(26)00142-6","tag_type":"condition","value":"Psoriatic Arthritis","value_numeric":null},{"paper_doi":"10.1016/s2665-9913(26)00142-6","tag_type":"condition","value":"Rheumatoid Arthritis","value_numeric":null},{"paper_doi":"10.1016/s2665-9913(26)00142-6","tag_type":"condition","value":"Small Vessel Vasculitis","value_numeric":null},{"paper_doi":"10.1016/s2665-9913(26)00142-6","tag_type":"impact_flag","value":"practice_changing","value_numeric":null},{"paper_doi":"10.1016/s2665-9913(26)00142-6","tag_type":"level_of_evidence","value":"3","value_numeric":null},{"paper_doi":"10.1016/s2665-9913(26)00142-6","tag_type":"sample_size","value":"n=23353040","value_numeric":23353040},{"paper_doi":"10.1016/s2665-9913(26)00142-6","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1016/s2665-9913(26)00142-6","tag_type":"study_design","value":"Population-Based Cohort Study","value_numeric":null},{"paper_doi":"10.1016/s2665-9913(26)00142-6","tag_type":"warning","value":"Level of evidence assigned as 3 (large observational cohort); no randomization or intervention was performed. Causal claims about the pandemic driving diagnostic changes cannot be confirmed from this design alone.","value_numeric":null},{"paper_doi":"10.1016/s2665-9913(26)00142-6","tag_type":"warning","value":"Socioeconomic and ethnicity subgroup findings are described in the abstract but specific numerical results are not reported; clinical interpretation of these subanalyses should be cautious.","value_numeric":null},{"paper_doi":"10.1016/s2665-9913(26)00142-6","tag_type":"warning","value":"The study covers adults in England registered with TPP-software GP practices only — approximately 40% of England's population — which may introduce selection bias.","value_numeric":null}],"summaries":{"what_studied":"This population-based cohort study used OpenSAFELY to evaluate incident diagnosis rates for 10 autoimmune rheumatic diseases in England (April 2016–March 2025), comparing observed post-pandemic rates to Prophet time-series–modelled expected rates across age, sex, ethnicity, and socioeconomic status.","key_result":"Five years after pandemic onset, cumulative diagnosis deficits persist for psoriatic arthritis (−12,320 diagnoses; −24.9%), rheumatoid arthritis (−11,690; −9.8%), and giant cell arteritis (−5,660; −15.2%); axial spondyloarthritis bucked the trend with a net increase (+2,040 diagnoses; +8.9%), driven notably by women surpassing men in diagnosis rates from 2023 onward.","limitations":"Observational design limits causal inference; data restricted to practices using TPP software, which may not be fully representative of all England; ethnicity and socioeconomic subgroup analyses may be underpowered for rarer conditions.","practice_takeaway":"Clinicians should actively screen for undiagnosed psoriatic arthritis, rheumatoid arthritis, and giant cell arteritis, as cumulative diagnostic backlogs from COVID-19 disruption remain substantial 5 years on. The unexpected rise in axial spondyloarthritis diagnoses in women warrants heightened clinical suspicion in this group."}},{"doi":"10.1007/s10067-026-08238-0","pmid":"42348128","title":"Uveitis in spondyloarthritis: clinical patterns and differences between axial and peripheral forms","journal_title":"Clinical Rheumatology","journal_issn":"0770-3198","published_at":"2026-06-25T00:00:00.000Z","url":"https://doi.org/10.1007/s10067-026-08238-0","source_score":2,"is_retracted":false,"is_open_access":false,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-07-03T13:38:42.087Z","updated_at":"2026-07-03T13:38:42.087Z","tags":[{"paper_doi":"10.1007/s10067-026-08238-0","tag_type":"age_group","value":"adult","value_numeric":null},{"paper_doi":"10.1007/s10067-026-08238-0","tag_type":"category","value":"Rheumatology","value_numeric":null},{"paper_doi":"10.1007/s10067-026-08238-0","tag_type":"condition","value":"Axial Spondyloarthritis","value_numeric":null},{"paper_doi":"10.1007/s10067-026-08238-0","tag_type":"condition","value":"Inflammatory Bowel Disease-Associated Spondyloarthritis","value_numeric":null},{"paper_doi":"10.1007/s10067-026-08238-0","tag_type":"condition","value":"Psoriatic Arthritis","value_numeric":null},{"paper_doi":"10.1007/s10067-026-08238-0","tag_type":"condition","value":"Spondyloarthritis","value_numeric":null},{"paper_doi":"10.1007/s10067-026-08238-0","tag_type":"condition","value":"Uveitis","value_numeric":null},{"paper_doi":"10.1007/s10067-026-08238-0","tag_type":"generic","value":"methotrexate","value_numeric":null},{"paper_doi":"10.1007/s10067-026-08238-0","tag_type":"generic","value":"sulfasalazine","value_numeric":null},{"paper_doi":"10.1007/s10067-026-08238-0","tag_type":"impact_flag","value":"confirms_prior","value_numeric":null},{"paper_doi":"10.1007/s10067-026-08238-0","tag_type":"level_of_evidence","value":"4","value_numeric":null},{"paper_doi":"10.1007/s10067-026-08238-0","tag_type":"modality","value":"Biologic DMARD","value_numeric":null},{"paper_doi":"10.1007/s10067-026-08238-0","tag_type":"modality","value":"Conventional Synthetic DMARD","value_numeric":null},{"paper_doi":"10.1007/s10067-026-08238-0","tag_type":"sample_size","value":"n=163","value_numeric":163},{"paper_doi":"10.1007/s10067-026-08238-0","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1007/s10067-026-08238-0","tag_type":"study_design","value":"Retrospective Observational Study","value_numeric":null},{"paper_doi":"10.1007/s10067-026-08238-0","tag_type":"warning","value":"Age group tagged as 'adult' — the paper does not explicitly state an age range or restrict enrollment to adults, but the SpA context and multidisciplinary uveitis clinic setting make a predominantly adult population highly likely.","value_numeric":null},{"paper_doi":"10.1007/s10067-026-08238-0","tag_type":"warning","value":"Biologic drug names (e.g., adalimumab) are referenced in the literature review but not reported as distinct treatment arms in the results; they were not tagged as individual brands/generics to avoid misrepresentation.","value_numeric":null},{"paper_doi":"10.1007/s10067-026-08238-0","tag_type":"warning","value":"The impact flag 'confirms_prior' was applied because the study largely validates known clinical patterns; no single practice-changing finding was identified.","value_numeric":null}],"summaries":{"what_studied":"Retrospective observational study of 163 patients with non-infectious uveitis and spondyloarthritis (SpA) from a multidisciplinary uveitis clinic, comparing uveitis clinical patterns across SpA subtypes (radiographic axSpA, non-radiographic axSpA, IBD-SpA, psoriatic arthritis, peripheral SpA) and between axial vs. peripheral forms.","key_result":"Anterior uveitis (97%), acute relapsing course (79%), and alternating laterality (47.4%) dominated overall. Peripheral SpA forms showed exclusively non-anterior locations (intermediate, posterior, panuveitis), more chronic courses (p<0.001), more bilateralism (p<0.05), and greater systemic therapy use (p=0.05). Among all patients, 28.2% needed immunomodulatory therapy and 17.8% needed biologics.","limitations":"- Retrospective single-center design limits generalizability.\n- Peripheral SpA subgroups (pSpA 4%, PsA 12%, IBD-SpA 13%) were small, reducing statistical power for subgroup comparisons.\n- Biologic discontinuation difference in peripheral forms did not reach significance (p=0.059).","practice_takeaway":"Patients with peripheral SpA (including PsA and IBD-SpA) are at higher risk for non-anterior, chronic, and bilateral uveitis and need closer ophthalmologic monitoring and earlier consideration of systemic immunomodulatory therapy. Predictors of greater systemic therapy need include chronic course, bilateralism, frequent episodes, younger onset age, peripheral joint involvement, and vitritis."}},{"doi":"10.1002/art.70221","pmid":"42112876","title":"T cells, the Next Big Target in Axial Spondyloarthritis?","journal_title":"Arthritis & Rheumatology","journal_issn":"2326-5191","published_at":"2026-05-25T00:00:00.000Z","url":"https://doi.org/10.1002/art.70221","source_score":4,"is_retracted":false,"is_open_access":true,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-06-16T13:54:25.645Z","updated_at":"2026-06-16T13:54:25.645Z","tags":[{"paper_doi":"10.1002/art.70221","tag_type":"age_group","value":"adult","value_numeric":null},{"paper_doi":"10.1002/art.70221","tag_type":"category","value":"Rheumatology","value_numeric":null},{"paper_doi":"10.1002/art.70221","tag_type":"condition","value":"Axial Spondyloarthritis","value_numeric":null},{"paper_doi":"10.1002/art.70221","tag_type":"impact_flag","value":"limited_evidence","value_numeric":null},{"paper_doi":"10.1002/art.70221","tag_type":"level_of_evidence","value":"5","value_numeric":null},{"paper_doi":"10.1002/art.70221","tag_type":"modality","value":"Anti-TRBV9 Antibody","value_numeric":null},{"paper_doi":"10.1002/art.70221","tag_type":"modality","value":"IL-17 Inhibitor","value_numeric":null},{"paper_doi":"10.1002/art.70221","tag_type":"modality","value":"IL-23 Inhibitor","value_numeric":null},{"paper_doi":"10.1002/art.70221","tag_type":"modality","value":"JAK Inhibitor","value_numeric":null},{"paper_doi":"10.1002/art.70221","tag_type":"modality","value":"TNF Inhibitor","value_numeric":null},{"paper_doi":"10.1002/art.70221","tag_type":"study_design","value":"Narrative Review","value_numeric":null},{"paper_doi":"10.1002/art.70221","tag_type":"warning","value":"No sample size tag applied — this is a review article with no primary patient cohort.","value_numeric":null},{"paper_doi":"10.1002/art.70221","tag_type":"warning","value":"Study design is a narrative (not systematic) review; conclusions on therapeutic targeting are expert synthesis, not meta-analytic findings.","value_numeric":null},{"paper_doi":"10.1002/art.70221","tag_type":"warning","value":"The anti-TRBV9 antibody therapy mentioned is described as 'emerging' with no clinical trial results reported in this paper; its efficacy and safety profile in axSpA are not yet established.","value_numeric":null}],"summaries":{"what_studied":"This narrative review synthesizes current knowledge on diverse T cell subsets in axial spondyloarthritis (axSpA) — including CD8+ T cells, CD4+ Th17, Tregs, tissue-resident memory T cells, γδ T cells, MAITs, and iNKT cells — their pathogenic mechanisms, and emerging therapeutic strategies targeting these cells.","key_result":"Multiple T cell subsets drive axSpA inflammation primarily through IL-17 production via IL-23 signaling; direct targeting strategies (e.g., anti-TRBV9 antibody therapy, JAK inhibition) and indirect approaches (IL-17 and TNF inhibition) are discussed as potential avenues, with T cell complexity offering explanations for why some cytokine inhibitors fail.","limitations":"This is a narrative review without systematic search criteria or meta-analytic data, so conclusions on therapeutic efficacy are not based on pooled quantitative evidence. No original clinical trial data are presented.","practice_takeaway":"For patients with axSpA who respond poorly to current cytokine inhibitors, the evidence reviewed here suggests that T cell subset heterogeneity — particularly innate-like T cells and tissue-resident memory T cells — may explain treatment gaps, supporting interest in JAK inhibitors and emerging anti-TRBV9 approaches. Clinicians should watch for trials targeting these pathways as next-generation options."}},{"doi":"10.1016/s2665-9913(26)00071-8","pmid":"42105782","title":"Prevalence and determinants of sacroiliac joint bone marrow oedema in the general population in Germany: a population-based cross-sectional study","journal_title":"The Lancet Rheumatology","journal_issn":"2665-9913","published_at":"2026-05-10T00:00:00.000Z","url":"https://doi.org/10.1016/s2665-9913(26)00071-8","source_score":15,"is_retracted":false,"is_open_access":true,"raw_metadata":{"ooir":{"day":"2026-05-11","doi":"10.1016/s2665-9913(26)00071-8","days":"7","issn":"2665-9913","rank":"4","field":"Clinical Medicine","score":"15","category":"Rheumatology","categories":["Rheumatology"],"_categories":["Rheumatology"]},"pubmed":{"doi":"10.1016/S2665-9913(26)00071-8","title":"Prevalence and determinants of sacroiliac joint bone marrow oedema in the general population in Germany: a population-based cross-sectional study.","journal":"The Lancet. 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Study","value_numeric":null},{"paper_doi":"10.1016/s2665-9913(26)00071-8","tag_type":"warning","value":"Axial spondyloarthritis prevalence is based on self-report, likely underestimating true disease burden and widening the apparent gap with BMO prevalence.","value_numeric":null},{"paper_doi":"10.1016/s2665-9913(26)00071-8","tag_type":"warning","value":"The deep-learning algorithm assessed the majority of participants (n=10,165); its agreement with expert readers is validated but not perfectly concordant, which may introduce classification variability.","value_numeric":null},{"paper_doi":"10.1016/s2665-9913(26)00071-8","tag_type":"warning","value":"The study population is restricted to Germany (ages 20–69); ethnic and geographic generalizability is uncertain.","value_numeric":null}],"summaries":{"what_studied":"This population-based cross-sectional study examined the prevalence and determinants of MRI-detected sacroiliac joint bone marrow oedema (BMO) in 11,163 German adults aged 20–69 years from the German National Cohort, assessed between May 2014 and December 2016 using expert readers (n=998) and a validated deep-learning algorithm (n=10,165).","key_result":"BMO was detected in ~30% of the general adult population (28.9% by experts, 30.8% by AI) — roughly 50× the 0.6% self-reported axial spondyloarthritis prevalence. Key associations included female sex (OR 1.33), BMI ≥25 kg/m² (OR 1.62), pregnancy history in women (OR 1.43), intensive recreational physical activity in men (OR 1.24), and physically demanding occupational work overall (OR 1.25).","limitations":"- Cross-sectional design limits causal inference.\n- Self-reported axial spondyloarthritis diagnosis used for comparison, which may underestimate true disease prevalence.\n- No patient or public involvement; study population is exclusively German adults, limiting generalizability.","practice_takeaway":"Sacroiliac BMO on MRI is common in healthy adults (~1 in 3), driven largely by pregnancy, obesity, and physical loading — not inflammation. Clinicians should interpret sacroiliac MRI findings strictly within clinical context to avoid overdiagnosis and unwarranted initiation of anti-inflammatory therapy."}},{"doi":"10.1002/art.70202","pmid":"42045797","title":"Determinants of Difficult‐to‐Manage and Treatment‐Refractory Axial Spondyloarthritis: A Cross‐Sectional Analysis Within a Longitudinal Cohort","journal_title":"Arthritis & Rheumatology","journal_issn":"2326-5191","published_at":"2026-05-10T00:00:00.000Z","url":"https://doi.org/10.1002/art.70202","source_score":18,"is_retracted":false,"is_open_access":false,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-06-10T14:23:52.929Z","updated_at":"2026-06-10T14:23:52.929Z","tags":[{"paper_doi":"10.1002/art.70202","tag_type":"age_group","value":"adult","value_numeric":null},{"paper_doi":"10.1002/art.70202","tag_type":"category","value":"Rheumatology","value_numeric":null},{"paper_doi":"10.1002/art.70202","tag_type":"condition","value":"Axial Spondyloarthritis","value_numeric":null},{"paper_doi":"10.1002/art.70202","tag_type":"condition","value":"Fibromyalgia","value_numeric":null},{"paper_doi":"10.1002/art.70202","tag_type":"impact_flag","value":"practice_changing","value_numeric":null},{"paper_doi":"10.1002/art.70202","tag_type":"level_of_evidence","value":"3","value_numeric":null},{"paper_doi":"10.1002/art.70202","tag_type":"sample_size","value":"n=536","value_numeric":536},{"paper_doi":"10.1002/art.70202","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1002/art.70202","tag_type":"study_design","value":"Cross-Sectional Study","value_numeric":null},{"paper_doi":"10.1002/art.70202","tag_type":"warning","value":"No drug-specific modality or brand tags were applied, as the study does not focus on a specific therapeutic intervention.","value_numeric":null},{"paper_doi":"10.1002/art.70202","tag_type":"warning","value":"The cross-sectional design means the 'longitudinal cohort' framing reflects the source registry, not a longitudinal analysis of outcomes over time — causal relationships cannot be inferred.","value_numeric":null},{"paper_doi":"10.1002/art.70202","tag_type":"warning","value":"The TR subgroup (n=12) is very small; estimates for that group should be interpreted with caution.","value_numeric":null}],"summaries":{"what_studied":"Cross-sectional analysis of 536 axSpA patients in a longitudinal cohort to estimate the prevalence of ASAS-defined difficult-to-manage (D2M) and treatment-refractory (TR) disease, and to identify associated factors using multivariable logistic regression.","key_result":"9.1% (49/536) met D2M criteria and 2.2% (12/536) were classified as TR. Higher spinal pain scores (OR 1.48, 95% CI 1.29–1.70) and fibromyalgia (OR 3.09, 95% CI 1.33–7.15) were independently associated with D2M. TR patients had greater inflammatory disease burden and were more often male and HLA-B27-positive, with fewer noninflammatory pain contributors.","limitations":"Single-cohort cross-sectional design limits generalizability and causal inference. The relatively small number of TR patients (n=12) reduces statistical power for that subgroup. Study population is from a single academic spondylitis program, which may introduce referral bias.","practice_takeaway":"Screen axSpA patients with persistent high spinal pain and fibromyalgia for D2M status, as these are the strongest independent drivers — not just active inflammation. TR and D2M patients need distinct management strategies: address noninflammatory pain contributors (e.g., fibromyalgia) in D2M, and optimize anti-inflammatory therapy in TR."}},{"doi":"10.1038/s41584-026-01376-4","pmid":"42086965","title":"Sex and gender differences in rheumatology: clinical impact and future directions","journal_title":"Nature Reviews Rheumatology","journal_issn":"1759-4790","published_at":"2026-05-05T00:00:00.000Z","url":"https://doi.org/10.1038/s41584-026-01376-4","source_score":6,"is_retracted":false,"is_open_access":false,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-05-11T13:20:58.519Z","updated_at":"2026-05-11T13:20:58.519Z","tags":[{"paper_doi":"10.1038/s41584-026-01376-4","tag_type":"age_group","value":"mixed","value_numeric":null},{"paper_doi":"10.1038/s41584-026-01376-4","tag_type":"category","value":"Rheumatology","value_numeric":null},{"paper_doi":"10.1038/s41584-026-01376-4","tag_type":"condition","value":"Axial Spondyloarthritis","value_numeric":null},{"paper_doi":"10.1038/s41584-026-01376-4","tag_type":"condition","value":"Gout","value_numeric":null},{"paper_doi":"10.1038/s41584-026-01376-4","tag_type":"condition","value":"Psoriatic Arthritis","value_numeric":null},{"paper_doi":"10.1038/s41584-026-01376-4","tag_type":"condition","value":"Rheumatoid Arthritis","value_numeric":null},{"paper_doi":"10.1038/s41584-026-01376-4","tag_type":"condition","value":"Sjögren's Syndrome","value_numeric":null},{"paper_doi":"10.1038/s41584-026-01376-4","tag_type":"condition","value":"Systemic Lupus Erythematosus","value_numeric":null},{"paper_doi":"10.1038/s41584-026-01376-4","tag_type":"impact_flag","value":"practice_changing","value_numeric":null},{"paper_doi":"10.1038/s41584-026-01376-4","tag_type":"level_of_evidence","value":"5","value_numeric":null},{"paper_doi":"10.1038/s41584-026-01376-4","tag_type":"modality","value":"Biologic DMARD","value_numeric":null},{"paper_doi":"10.1038/s41584-026-01376-4","tag_type":"modality","value":"Conventional Synthetic DMARD","value_numeric":null},{"paper_doi":"10.1038/s41584-026-01376-4","tag_type":"modality","value":"TNF Inhibitor","value_numeric":null},{"paper_doi":"10.1038/s41584-026-01376-4","tag_type":"modality","value":"Urate-Lowering Therapy","value_numeric":null},{"paper_doi":"10.1038/s41584-026-01376-4","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1038/s41584-026-01376-4","tag_type":"study_design","value":"Narrative Review","value_numeric":null},{"paper_doi":"10.1038/s41584-026-01376-4","tag_type":"warning","value":"Full article text was not accessible; structured extraction is based on the abstract, key points, author affiliations, and reference list. Specific numeric findings cited in the summary were inferred from referenced studies, not verified from the full review body.","value_numeric":null},{"paper_doi":"10.1038/s41584-026-01376-4","tag_type":"warning","value":"Study design classified as 'Narrative Review' rather than systematic review or meta-analysis; level of evidence set to 5. No sample size tag applied as this is a review article with no primary patient cohort.","value_numeric":null},{"paper_doi":"10.1038/s41584-026-01376-4","tag_type":"warning","value":"The 'practice_changing' impact flag reflects the review's explicit call to embed sex/gender-aware approaches into guidelines and clinical pathways — not a single trial result. Clinicians should weigh this accordingly.","value_numeric":null}],"summaries":{"what_studied":"This narrative review examines how biological sex and sociocultural gender shape disease presentation, diagnostic accuracy, treatment response, and outcomes across major rheumatic diseases (RA, SLE, axial SpA, Sjögren's, gout), with particular attention to under-represented groups including men with female-predominant diseases and transgender/gender-diverse/intersex individuals.","key_result":"Sex and gender systematically affect every stage of rheumatic disease — from delayed diagnosis in women with axSpA and men with RA, to lower remission rates and higher drug discontinuation in women on TNF inhibitors, to accelerated damage accrual in men with SLE. Current guidelines rarely incorporate sex-sensitive or gender-sensitive recommendations.","limitations":"- Full text was not available; summary is based on abstract, key points, and reference list only, limiting granular data extraction.\n- As a narrative review, it does not pool quantitative data or provide effect sizes; findings reflect the authors' synthesis of heterogeneous studies.\n- Evidence for transgender, gender-diverse, and intersex individuals is acknowledged as very sparse, limiting generalizability to these populations.","practice_takeaway":"Clinicians should actively account for sex-related differences when interpreting disease activity scores, imaging, and biomarkers — women may be under-treated due to higher subjective pain scores inflating composite indices, while men with SLE or Sjögren's may be under-recognized and at higher risk for organ damage. Integrating sex-aware reasoning into diagnostic and therapeutic decisions is a concrete step toward more equitable rheumatological care."}},{"doi":"10.1002/art.43447","pmid":"41310944","title":"The impact of non‐steroidal anti‐inflammatory drugs on radiographic spinal progression in patients with axial spondyloarthritis: 10‐year results from an inception cohort","journal_title":"Arthritis & Rheumatology","journal_issn":"2326-5191","published_at":"2025-11-28T00:00:00.000Z","url":"https://doi.org/10.1002/art.43447","source_score":7,"is_retracted":false,"is_open_access":true,"raw_metadata":{"ooir":{"day":"2025-12-03","doi":"10.1002/art.43447","days":"7","issn":"2326-5191","rank":"8","field":"Clinical Medicine","score":"7","category":"Rheumatology","categories":["Rheumatology"],"_categories":["Rheumatology"]},"pubmed":{"doi":"10.1002/art.43447","title":"The impact of non-steroidal anti-inflammatory drugs on radiographic spinal progression in patients with axial spondyloarthritis: 10-year results from an inception cohort.","journal":"Arthritis & rheumatology (Hoboken, N.J.)","methods":"","results":"At baseline, 201 (80.0%) patients were under NSAID treatment, with 46 (18%) taking COX2i and 156 (62%) ns-NSAIDs and mean total NSAID intake score was 38.3±35.5. A 10-point increase in NSAID intake score was associated with retardation of radiographic progression (β=-0.052, 95%CI: -0.097, -0.007), with this effect being most pronounced in r-axSpA patients (β=-0.077, 95%CI: -0.152, -0.003). COX2i showed a slightly lower point estimate (although not statistically significant) in progression compared to ns-NSAIDs among all axSpA patients (β= -0.061 and -0.045, respectively).","abstract":"$31","keywords":[],"pubmed_id":"41310944","conclusions":"","publication_date":"2025-11-28T00:00:00"},"crossref":{"DOI":"10.1002/art.43447","URL":"https://doi.org/10.1002/art.43447","ISSN":["2326-5191","2326-5205"],"link":[{"URL":"https://acrjournals.onlinelibrary.wiley.com/doi/pdf/10.1002/art.43447","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"page":null,"type":"journal-article","issue":null,"score":1,"title":["The impact of non‐steroidal anti‐inflammatory drugs on radiographic spinal progression in patients with axial spondyloarthritis: 10‐year results from an inception cohort"],"author":[{"given":"Murat","family":"Torgutalp","sequence":"first","affiliation":[{"name":"Department of Gastroenterology, Infectiology and Rheumatology (including Nutrition Medicine), Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt‐Universität zu Berlin Berlin Germany"},{"name":"Department of Rheumatology and Clinical Immunology, Charité ‐ Universitätsmedizin Berlin Corporate Member of Freie Universität Berlin and Humboldt‐Universität zu Berlin Berlin Germany"},{"name":"Fraunhofer Institute for Translational Medicine and Pharmacology ITMP Berlin Germany"},{"name":"Institute of Public Health Charité ‐ Universitätsmedizin Berlin Berlin Germany"}]},{"given":"Valeria","family":"Rios Rodriguez","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Infectiology and Rheumatology (including Nutrition Medicine), Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt‐Universität zu Berlin Berlin Germany"}]},{"given":"Fabian","family":"Proft","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Infectiology and Rheumatology (including Nutrition Medicine), Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt‐Universität zu Berlin Berlin Germany"}]},{"given":"Mikhail","family":"Protopopov","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Infectiology and Rheumatology (including Nutrition Medicine), Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt‐Universität zu Berlin Berlin Germany"}]},{"given":"Judith","family":"Rademacher","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Infectiology and Rheumatology (including Nutrition Medicine), Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt‐Universität zu Berlin Berlin Germany"},{"name":"Berlin Institute of Health at Charité Universitätsmedizin Berlin Berlin Germany"}]},{"given":"Hildrun","family":"Haibel","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Infectiology and Rheumatology (including Nutrition Medicine), Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt‐Universität zu Berlin Berlin Germany"}]},{"given":"Joachim","family":"Sieper","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Infectiology and Rheumatology (including Nutrition Medicine), Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt‐Universität zu Berlin Berlin Germany"}]},{"given":"Martin","family":"Rudwaleit","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine and Rheumatology, Klinikum Bielefeld Rosenhöhe Bielefeld Germany"}]},{"given":"Denis","family":"Poddubnyy","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Infectiology and Rheumatology (including Nutrition Medicine), Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt‐Universität zu Berlin Berlin Germany"},{"name":"Division of Rheumatology, University of Toronto and Schroeder Arthritis Institute University Health Network Toronto Ontario Canada"}]}],"issued":{"date-parts":[[2025,11,27]]},"member":"311","prefix":"10.1002","source":"Crossref","volume":null,"archive":["Portico"],"created":{"date-time":"2025-11-28T05:29:22Z","timestamp":1764307762000,"date-parts":[[2025,11,28]]},"indexed":{"date-time":"2025-11-28T05:32:07Z","timestamp":1764307927013,"date-parts":[[2025,11,28]]},"license":[{"URL":"http://creativecommons.org/licenses/by/4.0/","start":{"date-time":"2025-11-27T00:00:00Z","timestamp":1764201600000,"date-parts":[[2025,11,27]]},"delay-in-days":0,"content-version":"vor"}],"subject":[],"abstract":"$32","language":"en","relation":{},"resource":{"primary":{"URL":"https://acrjournals.onlinelibrary.wiley.com/doi/10.1002/art.43447"}},"subtitle":[],"assertion":[{"name":"received","group":{"name":"publication_history","label":"Publication History"},"label":"Received","order":0,"value":"2025-05-29"},{"name":"accepted","group":{"name":"publication_history","label":"Publication 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Rheumatology"],"is-referenced-by-count":0},"unpaywall":{"doi":"10.1002/art.43447","is_oa":true,"title":"The impact of non‐steroidal anti‐inflammatory drugs on radiographic spinal progression in patients with axial spondyloarthritis: 10‐year results from an inception cohort","updated":"2025-11-29T00:16:09+00:00","published_date":"2025-11-27","best_oa_location":{"url":"https://onlinelibrary.wiley.com/doi/pdfdirect/10.1002/art.43447","pmh_id":null,"url_for_pdf":"https://onlinelibrary.wiley.com/doi/pdfdirect/10.1002/art.43447","url_for_landing_page":"https://doi.org/10.1002/art.43447"}}},"created_at":"2025-12-08T12:24:58.509Z","updated_at":"2025-12-08T12:24:58.509Z","tags":[{"paper_doi":"10.1002/art.43447","tag_type":"category","value":"Rheumatology","value_numeric":null},{"paper_doi":"10.1002/art.43447","tag_type":"condition","value":"Axial Spondyloarthritis","value_numeric":null},{"paper_doi":"10.1002/art.43447","tag_type":"level_of_evidence","value":"3","value_numeric":null},{"paper_doi":"10.1002/art.43447","tag_type":"modality","value":"COX-2 Inhibitor","value_numeric":null},{"paper_doi":"10.1002/art.43447","tag_type":"modality","value":"NSAID","value_numeric":null},{"paper_doi":"10.1002/art.43447","tag_type":"sample_size","value":"n=252","value_numeric":252},{"paper_doi":"10.1002/art.43447","tag_type":"study_design","value":"Cohort","value_numeric":null},{"paper_doi":"10.1002/art.43447","tag_type":"warning","value":"Effect sizes are reported per 10-point increase in an NSAID intake score; the scale’s clinical meaning is not described here.","value_numeric":null},{"paper_doi":"10.1002/art.43447","tag_type":"warning","value":"The COX-2 vs non-selective NSAID difference was not statistically significant; subtype comparisons should be interpreted cautiously.","value_numeric":null}],"summaries":{"what_studied":"A 10‑year analysis from the GESPIC inception cohort evaluated whether NSAID intake (COX‑2 inhibitors vs non‑selective NSAIDs) affects radiographic spinal progression in axial spondyloarthritis, using mSASSS scored every 2 years in 252 patients (139 nr‑axSpA; 113 r‑axSpA).","key_result":"Each 10‑point increase in NSAID intake score was associated with less mSASSS progression (β = −0.052; 95% CI −0.097 to −0.007), with a larger effect in r‑axSpA (β = −0.077; 95% CI −0.152 to −0.003). COX‑2 inhibitors had a slightly lower (not statistically significant) point estimate vs non‑selective NSAIDs (β −0.061 vs −0.045); at baseline, 201/252 (80%) used NSAIDs (46 COX2i; 156 ns‑NSAIDs).","limitations":"Inception cohort (non‑randomized). The COX‑2 vs non‑selective NSAID comparison was not statistically significant.","practice_takeaway":"Higher NSAID intake was associated with slower radiographic spinal progression, especially in radiographic axSpA; this may inform discussions about sustained NSAID use for structural outcomes. Evidence does not support preferring COX‑2 inhibitors over non‑selective NSAIDs for this purpose."}},{"doi":"10.1001/jamadermatol.2025.2056","pmid":"40632525","title":"Ixekizumab and Malignant Neoplasms","journal_title":"JAMA Dermatology","journal_issn":"2168-6068","published_at":"2025-07-09T00:00:00.000Z","url":"https://www.ncbi.nlm.nih.gov/pmc/articles/12242818","source_score":21,"is_retracted":false,"is_open_access":true,"raw_metadata":{"ooir":{"day":"2025-10-19","doi":"10.1001/jamadermatol.2025.2056","days":"7","issn":"2168-6068","rank":"9","field":"Clinical Medicine","score":"21","category":"Dermatology","categories":["Dermatology"],"_categories":["Dermatology"]},"pubmed":{"doi":"10.1001/jamadermatol.2025.2056","title":"Ixekizumab and Malignant Neoplasms: A Pooled Analysis of Data From 25 Randomized Clinical Trials.","journal":"JAMA 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Street Medical Associates, Scarsdale, New York"}]},{"given":"Mark","family":"Lebwohl","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, New York"}]}],"issued":{"date-parts":[[2025,10,1]]},"member":"10","prefix":"10.1001","source":"Crossref","volume":"161","created":{"date-time":"2025-07-09T15:00:49Z","timestamp":1752073249000,"date-parts":[[2025,7,9]]},"indexed":{"date-time":"2025-10-15T15:40:25Z","timestamp":1760542825823,"date-parts":[[2025,10,15]]},"subject":[],"abstract":"$35","language":"en","relation":{},"resource":{"primary":{"URL":"https://jamanetwork.com/journals/jamadermatology/fullarticle/2836177"}},"subtitle":["A Pooled Analysis of Data From 25 Randomized Clinical Trials"],"deposited":{"date-time":"2025-10-15T15:03:07Z","timestamp":1760540587000,"date-parts":[[2025,10,15]]},"issn-type":[{"type":"print","value":"2168-6068"}],"published":{"date-parts":[[2025,10,1]]},"publisher":"American Medical 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SIRs were 0.89 (95% CI, 0.71-1.08) for psoriasis, 0.49 (0.13-0.85) for PsA, and 1.07 (0.37-1.77).","limitations":"Eligibility criteria varied across the 25 trials, and most participants were biologic‑naive. SIR comparisons excluded nonmelanoma skin cancer.","practice_takeaway":"Long‑term ixekizumab exposure showed low, stable malignancy rates across psoriasis, PsA, and axSpA, with SIRs at or near US background levels. These data do not show an increased overall malignancy signal during 3–5 years of treatment."}}],"initialOffset":13,"fetchConfig":{"kind":"tags","tags":[{"tag_type":"condition","value":"Axial Spondyloarthritis"}]},"breadcrumbItems":[{"name":"Home","href":"/"},{"name":"Research Hub","href":"/hub"},{"name":"Conditions","href":"/hub/tag/condition"},{"name":"Axial Spondyloarthritis"}],"hrefConfig":{"basePath":"/hub/papers","webViewQueryParams":{"hub_ctx":"tag","hub_tag_type":"condition","hub_tag_value":"Axial Spondyloarthritis"}}}]]

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