BMC RheumatologyBMC 风湿病学
BMC Rheumatology(英文缩写 BMC RHEUMATOL),ISSN 2520-1026,eISSN 2520-1026,中文译名:BMC 风湿病学 是一本学术期刊。本页汇总该期刊的最新影响因子、分区信息以及最新收录于 PubMed 的文献,帮助您快速了解期刊全貌。
发文量统计区间：2025-10-01 至 2026-09-30，按本站收录文献的发表日期统计。
期刊介绍
BMC Rheumatology 最新收录文献
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1. Predictors at diagnosis for initiation of biologic or targeted synthetic disease-modifying anti-rheumatic drugs in patients with spondyloarthritis and psoriatic arthritis.
PMID:日期:2026-09-29There is limited data on factors predicting the initiation of biologic and targeted synthetic disease modifying anti-rheumatic drugs (bDMARDs/tsDMARDs) in Spondyloarthritis (SpA) and Psoriatic arthritis (PsA). The relative importance of objective inflammation and other patient factors in this context is unclear. A retrospective cohort study included consecutive patients diagnosed with SpA and PsA in 2012-2016 at a single rheumatology center. Data at diagnosis were obtained from medical records and from linkage to national and regional registers. Baseline predictors of b/tsDMARD initiation were assessed by Cox regression. Among 119 PsA patients (mean age 49 years, 49% male), 41.7% initiated b/tsDMARDs (median 15 months after diagnosis). In patients with PsA, older age was negatively associated with b/tsDMARD initiation (hazard ratio (HR) per standard deviation 0.74; 95% confidence interval (CI) 0.55-1.00), but no other significant predictors were identified. Among 120 SpA patients (mean age 38 years, 64% male), 41.5% initiated bDMARDs (median 7 months after diagnosis). Predictors included elevated CRP levels (HR 2.68; 95% CI 1.44-5.01) and bone marrow edema (BME) on magnetic resonance imaging of sacroiliac joints (SIJ) (HR 1.94; 95% CI 1.02-3.70). There was no significant association with age at SpA diagnosis, or with sex, education, family background, country of birth, or comorbidities. Elevated CRP and SIJ BME at diagnosis were associated with bDMARD initiation in patients with SpA, while older patients with PsA may be less likely to start b/tsDMARDs. Education and ethnicity did not seem to influence b/tsDMARD initiation, suggesting equitable treatment access. Not applicable.
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2. Longitudinal clinical outcomes after the escalation of subcutaneous tocilizumab from every 2 weeks to once weekly in rheumatoid arthritis with inadequate disease control: A 52-week real-world observational study.
PMID:日期:2026-09-25To describe 52-week longitudinal clinical outcomes after escalation of subcutaneous tocilizumab (TCZ-SC) from every 2 weeks (Q2W) to once weekly (Q1W) in rheumatoid arthritis (RA) patients with inadequate clinical control during Q2W dosing, and contextualize findings using a TCZ-SC Q2W continuation cohort. This single-center retrospective observational study included 58 patients with RA who escalated from TCZ-SC Q2W to Q1W. The primary outcome was the overall longitudinal change in the Clinical Disease Activity Index (CDAI) through week 52, assessed using a complete-case Friedman test. Linear mixed-effects models using all available observations were fitted as sensitivity analyses. Secondary analyses included the Disease Activity Score in 28 joints using the erythrocyte sedimentation rate (DAS28-ESR), matrix metalloproteinase-3 (MMP-3), laboratory safety and renal outcomes, re-adjudicated difficult-to-treat (D2T) RA status, follow-up disposition, individual-level concomitant treatment intensification, and a Q2W continuation contextual comparison. The median CDAI decreased from 16.00 at Q1W escalation to 8.20 at week 52 (complete-case Friedman test, n = 42, P < 0.001). In mixed-effects sensitivity analyses, model-estimated week-52 changes were - 5.89 points for CDAI (95% CI, - 8.15 to - 3.63), - 1.29 points for DAS28-ESR (95% CI, - 1.63 to - 0.95), - 45.8% for MMP-3 (95% CI, - 54.9% to - 34.7%), and - 4.79 mL/min/1.73 m for estimated glomerular filtration rate (eGFR) (95% CI, - 7.65 to - 1.92). Five patients (8.6%) fulfilled the stricter D2T RA definition. Fifteen patients lacked week-52 CDAI data because of Q1W discontinuation or interruption (n = 13) or transfer of care (n = 2); the incomplete follow-up group had higher baseline disease activity. Seven patients had documented regular systemic treatment intensification during weeks 0-12; after excluding them, the median 12-week ΔCDAI remained - 3.00 (P < 0.001). In the exploratory 12-week comparison, the median ΔCDAI was - 2.85 in the Q1W escalation cohort and - 3.40 in the Q2W residual-activity subgroup, with no significant between-group difference (P = 0.754). No serious infections or treatment discontinuations due to adverse events were documented. Disease activity decreased after Q1W escalation, with directionally consistent sensitivity analyses. However, the 12-week CDAI changes did not differ significantly between the Q1W escalation cohort and the Q2W residual-activity subgroup. These descriptive findings do not establish an incremental or causal benefit of Q1W escalation.
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3. Clinical and genetic characteristics of adult patients with familial Mediterranean fever at a German tertiary referral centre.
PMID:日期:2026-08-28To characterise the clinical and genetic profile of adult familial Mediterranean fever (FMF) patients at a German tertiary referral centre and examine genotype-phenotype associations. In this prospective single-centre registry study (October 2019-March 2021), 95 adult FMF patients at University Hospital Tübingen were evaluated using structured questionnaires and medical record review. All patients had a pre-existing clinical diagnosis of FMF based on the Tel Hashomer and/or Eurofever/PRINTO criteria. Demographic data, clinical manifestations, treatment, and MEFV mutations were analysed. Patients were stratified by mutation status (homozygous M694V, heterozygous/compound-heterozygous M694V, other mutations). Statistical analyses included the Fisher-Freeman-Halton exact test and ANOVA. Variants were classified according to the INSAID consensus classification; R202Q was treated as a benign polymorphism. All subgroup comparisons were exploratory and were not corrected for multiple testing. Median age was 36 years, with median symptom onset at 10 years. Most patients were of Turkish origin (74.7%), and 59.6% reported a family history of FMF. Common manifestations included abdominal pain (90.5%), arthralgia/arthritis (75.8%), fever (66.3%), and chest pain (52.6%). Colchicine was used in 96.8% of patients, while 38.3% received biologic therapy, a figure influenced by concurrent participation in a tocilizumab trial at our centre. MEFV analysis had been performed in 91 of the 95 patients (95.8%); among these, at least one MEFV variant was detected in 87 (95.6%), with M694V being the most frequent variant (61.5%). Homozygous M694V patients showed earlier disease onset (nominal p = 0.02) and higher rates of arthralgia/arthritis (nominal p = 0.035). Amyloidosis occurred in one patient with homozygous M694V. This cohort demonstrates typical FMF features with a predominance of the M694V mutation. Homozygosity for M694V is associated with earlier disease onset and increased musculoskeletal involvement. Subgroup findings are exploratory and require confirmation in independent cohorts.
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4. Glucocorticoid tapering and clinical outcomes during belimumab treatment in systemic lupus erythematosus: a retrospective real-world cohort study with exploratory renal analyses.
PMID:日期:2026-08-03To describe real-world clinical outcomes of belimumab (BEL) treatment in patients with systemic lupus erythematosus (SLE), with a particular focus on longitudinal glucocorticoid tapering and exploratory renal analyses. This single-center retrospective observational study included 46 patients with SLE who initiated BEL treatment between 2018 and 2025. Clinical and laboratory data, including prednisolone (PSL) dose, disease activity indices, serological markers, urine protein-to-creatinine ratio (UPCR), and estimated glomerular filtration rate (eGFR), were collected at baseline and during follow-up, when available. Longitudinal changes in concomitant background therapies were summarized descriptively. Exploratory renal analyses were performed in patients with lupus nephritis (LN) using changes in the UPCR and eGFR. Drug retention was evaluated using the Kaplan-Meier method. Renal histopathological analyses were performed in a subset with available biopsy data and were considered exploratory because of the heterogeneous clinical backgrounds and variable biopsy timing. The median PSL dose decreased from 10 mg/day at baseline to 8 mg/day at 24 weeks and 6 mg/day at 52 weeks after BEL initiation, with significant within-patient decreases at both time points (p < 0.001). Overall disease activity remained controlled, while complement levels improved during the follow-up. Among patients with LN (n = 12), UPCR showed a numerical decrease at 24 weeks (p = 0.055) and decreased at 52 weeks (p = 0.016) among patients with paired data, whereas the eGFR showed no significant change at either time point. Exploratory analyses did not identify significant associations between the available renal histopathological indices and changes in proteinuria. BEL treatment was continued in many patients during follow-up, although adverse events, including severe infections and death, were observed. In this real-world cohort, PSL doses decreased during follow-up after the initiation of BEL, while the overall disease activity remained controlled. In the small LN subgroup, the UPCR decreased at 52 weeks, and no statistically significant change in eGFR was detected. Because this study lacked a comparator group and the renal analyses were exploratory and limited by the small sample size, heterogeneous treatment backgrounds, and variable biopsy timing, these findings should be interpreted as within-patient observational data and require validation in future studies.
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5. Severe infections in giant cell arteritis - incidence over time and relation to large vessel involvement and comorbidities, a population-based study.
PMID:日期:2026-07-22Patients with giant cell arteritis (GCA) are considered to be at increased risk of infections. The objectives of this study were to investigate the risk of severe infections in different time intervals after the diagnosis of GCA, compared to the general population, and to explore potential predictors for severe infections including large vessel involvement (LVI). Patients with biopsy-proven GCA, diagnosed between 2002 and 2010 in Region Skåne, Sweden, were identified and each case compared with 4 age-, sex- and residence area-matched reference subjects. Aortic involvement and other LVI was identified by case record review. Data on severe infections (requiring hospitalization) were obtained from linkage to the Skåne Healthcare Register through 2011. Prevalent comorbidities at GCA diagnosis were identified using ICD-10 codes. Predictors of severe infection in patients with GCA were evaluated using Cox regression. In 516 patients with GCA (100 with LVI), 22.9% experienced severe infections (mainly pneumonia and urinary tract infections), incidence rate of severe infection episodes 9.65/100 person-years (py). The incidence was particularly high during the first six months after diagnosis (14.8/100 py, rate ratio compared to reference subjects 3.27; 95% CI 2.06; 5.11). Higher age, LVI and several pre-existing comorbidities were associated with severe infections. In multivariable analysis, aortic involvement was a significant predictor of severe infection (multi-adjusted hazard ratio 1.75; 95% CI 1.04; 2.94). Compared to reference subjects from background population, patients with biopsy-positive GCA have increased risk of severe infections, in particular in early disease. Age, comorbidities and aortic involvement may predict severe infections in GCA. Further prospective studies on this subject, including detailed assessment of LVI, are needed.
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6. Inflammatory biomarker alterations in patients with fibromyalgia: a systematic review and meta-analysis.
PMID:日期:2026-07-20To analyze the available scientific evidence on differences in inflammatory biomarker levels between patients with fibromyalgia and healthy controls. A systematic review and meta-analysis were conducted in accordance with PRISMA guidelines. Methodological quality was assessed using the Newcastle-Ottawa Scale. Inflammatory, neuroendocrine, and oxidative stress biomarkers were analyzed, along with their association with clinical symptoms. Eighteen observational studies (case-control and cross-sectional) involving a total of 1,605 participants were included. Of these 18 studies, quantitative data suitable for meta-analysis could be extracted from only 10 studies. The fibromyalgia group showed elevated levels of p =high sensitive C-reactive protein (hsCRP) levels confirmed by meta-analysis too (SMD = 0.34; 95% CI: 0.16 to 0.52; p = 0.0002). In the quantitative synthesis, only hsCRP reached statistical significance, whereas the meta-analyses of hair cortisol, IL-6 and IFN-γ showed no significant between-group differences. In the qualitative synthesis were observed alterations in oxidative stress markers (including MDA and glutathione) and dysregulation of the hypothalamic-pituitary-adrenal axis (cortisol, adrenaline, and serotonin), with lower serotonin levels compared to healthy subjects. These biomarkers were associated with greater severity of clinical symptoms, including pain, fatigue, sleep disturbances, anxiety, and depression. Overall methodological quality was moderate, and heterogeneity between studies was high. Significant differences in hsCRP levels were observed between patients with fibromyalgia and healthy controls, supporting a role of low-grade inflammatory mechanism in the pathophysiology of the disease. However, methodological heterogeneity limits direct clinical applicability. Further well-designed studies with better control of confounding factors are needed to advance the diagnostic and therapeutic use of these biomarkers.
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7. A machine-learning-derived online prediction model for risk during the activity period in SLE patients: a retrospective historical cross-sectional study.
7. 机器学习衍生的SLE患者活动期风险在线预测模型：一项回顾性历史横断面研究PMID:日期:2026-07-08Given the challenges in predicting systemic lupus erythematosus (SLE) disease activity and the limitations of existing assessment tools, this study aimed to integrate multidimensional clinical and laboratory indicators to develop and validate a machine learning-based predictive model for SLE disease activity. It further sought to explore the association and potential mechanisms linking N-acetylglucosamine-1-phosphotransferase (NAG1) to SLE disease activity, thereby offering clinical risk assessment tools and identifying novel therapeutic targets. Clinical data from 201 SLE patients were retrospectively collected. Patients were stratified according to Systemic Lupus Erythematosus Disease Activity Index (SLEDAI) scores. Core predictive variables were selected using multivariate logistic regression, LASSO regression, and the Boruta algorithm. Seven machine learning algorithms were employed to construct predictive models, with SHapley Additive exPlanations (SHAP) and Local Interpretable Model-agnostic Explanations (LIME) used for model interpretation. The role of NAG1 and the mediating effect of fibrinogen (FIB) were analyzed using multivariate logistic regression, restricted cubic splines, and a quasi-Bayesian approach. Finally, a nomogram and an interactive dynamic risk calculator were developed based on the optimal model. Joint involvement, renal involvement, fibrinogen (FIB), immunoglobulin G (IgG), complement 3 (C3), and NAG1 were identified as core predictive indicators for SLE disease activity. The support vector machine (SVM) model demonstrated balanced predictive performance, while the logistic regression model was selected for nomogram construction due to its high predictive accuracy and interpretability. NAG1 was the most critical predictive factor; elevated NAG1 levels were significantly associated with an increased risk of SLE disease activity, with a more pronounced correlation in high-risk subgroups, such as patients positive for anti-double-stranded DNA (anti-dsDNA) or with low C3 levels. FIB mediated 9.3% of the pro-flare effect of NAG1. The constructed model and supporting tools showed favorable clinical applicability. Study limitations include its retrospective design and limited sample size. A predictive model for SLE disease activity, based on six core indicators, was successfully developed and validated. The logistic regression model demonstrated excellent performance. The nomogram and dynamic risk calculator enable non-invasive, personalized risk assessment for SLE disease activity. As a key predictive factor, NAG1 may act as a pathogenic mediator in SLE, and its mediating relationship with FIB suggests novel crosstalk between metabolic dysregulation and the coagulation-inflammation pathway. This model can facilitate early risk stratification and individualized management of SLE patients. NAG1 represents a promising biomarker for evaluating therapeutic response and predicting relapse in SLE, and may serve as a potential therapeutic target. Future multicenter prospective studies are warranted to validate the model and further investigate the biological functions of NAG1.
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8. Real-world exercise and disease activity in axial spondyloarthritis: does the association vary by age, BMI, or socioeconomic status?
8. 轴型脊椎关节炎的真实运动和疾病活动：这种关联是否因年龄、BMI或社会经济地位而异？PMID:日期:2026-07-07Exercise is recommended in axial spondyloarthritis (axSpA), yet evidence on habitual exercise in routine care and whether its association with disease activity varies by age, body mass index (BMI), or socioeconomic position remains limited. We assessed the association between self-reported regular exercise during the previous year and disease activity (ASDAS) at the study visit. We performed a cross-sectional analysis from two multicentre registries (REGISPONSER and RESPONDIA), including 1233 patients with axSpA. The exposure was self-reported regular exercise in the preceding year. Missing data were handled using multiple imputation. We estimated the association between exercise and ASDAS using stabilised inverse probability of treatment weighting (IPTW) based on a propensity score model including age, sex, BMI, HLA-B27 status, and country (Spain vs. Latin America). Doubly robust augmented IPTW (AIPW) and sensitivity analyses using a clinically expanded confounder specification and sex-stratified models were also performed. We then explored whether the exercise-ASDAS association varied across age, BMI, and socioeconomic position (Graffar scale) by fitting weighted interaction models, using spline terms for age and BMI, and deriving marginal effects across the observed ranges and by Graffar levels. Regular exercise was associated with lower disease activity. In IPTW analyses, exercise was associated with a reduction in ASDAS of - 0.153 points (95% CI - 0.276 to - 0.031; p = 0.014). Results were consistent in doubly robust AIPW analyses (- 0.155, 95% CI - 0.277 to - 0.034; p = 0.012) and in a clinically expanded sensitivity analysis (IPTW: -0.157, 95% CI - 0.279 to - 0.035; AIPW: -0.158, 95% CI - 0.280 to - 0.036). Exploratory analyses suggested possible variation in the association across age, BMI, socioeconomic position, and sex, but global interaction tests were not statistically significant, and sex-stratified estimates in women were imprecise. Self-reported regular exercise during the previous year was associated with modestly lower ASDAS at the clinical visit, consistently across IPTW and doubly robust estimators. These findings are consistent with current recommendations supporting regular physical activity as a core component of axial spondyloarthritis management; however, the cross-sectional design, retrospective self-report of exercise, and the potential for residual confounding and reverse causation preclude causal inference. Not applicable.
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9. Systematic review of the efficacy of rituximab in the management of central nervous system involvement among adults with Sjögren's disease.
PMID:日期:2026-07-04Sjögren's disease is an autoimmune condition that may have neurological involvement. Rituximab is a monoclonal antibody against CD20 that has shown potential in the management of central and peripheral neuropathy in lymphomas and some autoimmune disease. There is limited data on the efficacy of rituximab on central nervous system (CNS) involvement in Sjögren's disease. The aim of this systematic review was to assess the effects of rituximab on CNS involvement among adults with Sjögren's disease. The PubMed, Scopus, and Web of Science medical databases were searched and the related articles were included in the review based on the inclusion and exclusion criteria. All articles published in English language that reported the effect of rituximab in the management of CNS involvement in Sjögren's disease were included and reviewed. Of the primary retrieved 173 articles, three (N = 62) were included in the review. All the studies were cohort studies and reported the effects of rituximab on CNS involvement as secondary analysis. Rituximab was administered in combination of other medications. Data synthesis revealed that rituximab, especially in combination with other medications, might have beneficial effects in severe and refractory CNS involvement in Sjögren's disease. Rituximab administration should be limited to severe and refractory CNS involvements in Sjögren's disease. However, due to the scarcity of articles and low level of confidence, further studies should be conducted to reach a definite conclusion.
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10. Cerebellar volume alterations are associated with cognitive dysfunction and fatigue in patients with systemic lupus erythematosus.
PMID:日期:2026-07-02Systemic lupus erythematosus (SLE) is a systemic autoimmune disease targeting multiple organ systems, including the nervous system. The cerebellum may be involved in prevalent neuropsychiatric manifestations, such as depression and cognitive dysfunction, alongside other prevalent SLE manifestations such as pain and fatigue. We aim to compare cerebellar volumes in SLE patients and healthy individuals (HI) and assess the correlation between cerebellar volumes and cognitive impairment, fatigue, pain, and depression in SLE. 72 female SLE patients and 25 age- and sex-matched HI underwent 3 tesla magnetic resonance imaging (MRI), clinical evaluations, and cognitive testing. T1-weighted MRI scans were segmented using CEREbellum Segmentation (CERES) volBrain automatic segmentation. Extracted cerebellar lobule volumes (normalized to total cerebellar volume) were compared between SLE and HI using analyses of covariance (ANCOVA). In regions showing significant volume changes between SLE and HI, the relationship between volume and clinical scores for cognitive impairment, fatigue, pain, and depression was analyzed using either ANCOVAs or partial correlation analyses. Lobular analysis of the cerebellum revealed significant (p < 0.05) region-specific volume alterations in SLE compared with HI. Bilateral and left lobule IV volumes were larger, while bilateral, right, and left lobule VIIB volumes were smaller in SLE compared to HI. Smaller white matter volumes in right lobule VIIIA, and right lobule X and larger white matter volumes in lobule crus I were observed in SLE compared to HI. In SLE, smaller VIIB volumes were significantly correlated with poorer cognitive performance (both complex attention and cognitive flexibility), and with higher fatigue scores. The findings suggest that the cerebellum, and particularly lobule VIIB, is involved in SLE and may contribute to both cognitive dysfunction and fatigue in patients with systemic lupus erythematosus. Not applicable.