A newsletter destaca que a infecção por SARS-CoV-2 aumenta a positividade de anticorpos antifosfolípides em gestantes com SAF, especialmente no terceiro trimestre, embora o manejo padrão pareça mitigar desfechos adversos graves. Paralelamente, apresenta dados robustos de fase 3 que posicionam o obinutuzumabe como uma terapia eficaz para o LES sistêmico, alcançando altas taxas de resposta clínica e redução sustentada do uso de corticoides. O informativo também revisa casos de hipermobilidade articular e novas diretrizes internacionais para o manejo de doenças reumáticas.
To investigate the age-associated prevalence patterns of sacroiliac joint (SIJ) variations, evaluate their association with structural damage in axial spondyloarthritis (axSpA) patients, and compare their prevalence and morphological spectrum with European data. This retrospective study analyzed high-resolution CT scans from 806 adults. Six predefined SIJ morphotypes were evaluated. Age-associated prevalence was modeled using generalized additive models (GAM) and Bayesian additive regression trees (BART) to capture non-linear dependencies. The association between SIJ variations and structural damage severity (Innsbruck CT grade) in axSpA patients was assessed with multivariable cumulative-link mixed models. European data were derived from a random-effects meta-analysis. SIJ variation prevalence showed a strong, monotonic increase with age (OR = 1.26/year, 95% CI 1.15–1.38), accelerating after 60 years and being more common in women (73.5% vs. 25.2%, P < 0.001). Critically, the presence of any SIJ variant was significantly associated with higher odds of severe structural damage in axSpA patients (OR = 2.23, 95% CI: 1.56–3.19, P < 0.001). BART modeling provided superior net benefit for risk prediction versus GAM, facilitating exploratory risk stratification. While overall prevalence was similar to European data (44.4% vs. 41.0%, P = 0.236), morphological distributions differed significantly: semicircular defects (11.2% vs. 4.8%) and crescent-shaped plates (12.4% vs. 3.6%) were more prevalent in our cohort. SIJ variations are strongly associated with age, suggesting a degenerative component, and constitute a relevant risk marker for severe structural damage in axSpA. The BART model effectively supports exploratory risk assessment. Our cohort shares a similar prevalence but demonstrates a distinct morphological spectrum compared to European populations.
Assessing quality of life in patients with axial spondyloarthritis (axSpA) is essential for capturing the full burden of the disease beyond clinical and imaging findings. Quality of life measures support clinicians in identifying unmet patient needs and informing treatment decisions. The aim of this study was to develop and validate the first Bulgarian version of the Ankylosing Spondylitis Quality of Life (ASQoL) questionnaire. The development of the Bulgarian version of the ASQoL followed a three-stage process: translation, field testing, and psychometric evaluation. Following translation and field testing of the ASQoL, the psychometric evaluation involved administering the ASQoL to a random sample of axSpA patients on two occasions, 10–20 days apart, to assess its reliability and validity. Reliability was examined using internal consistency (Cronbach’s alpha) and test–retest reliability (Spearman’s rank correlation). Convergent validity was evaluated using the Short Form Health Survey Version 2 (SF-36v2) and the Ankylosing Spondylitis Disease Activity Score with C-reactive protein (ASDAS-CRP). Known-groups validity was assessed based on self-perceived general health and self-perceived disease activity. The Bulgarian version of the ASQoL demonstrated high internal consistency, with Cronbach’s alpha coefficients of 0.884 at time 1 and 0.882 at time 2. Test-retest reliability was excellent (Spearman’s ρ = 0.98, p < 0.001), indicating strong temporal stability. Convergent validity was supported by moderate correlations between ASQoL scores and relevant SF-36 domains, with the strongest associations observed for Physical Functioning, General Health, and Role Limitations. ASQoL scores showed a strong positive correlation with ASDAS-CRP (Spearman’s ρ = 0.70, p < 0.001), indicating close alignment between patient-reported quality of life and clinical disease activity. Known-groups validity was demonstrated by the ASQoL’s ability to distinguish between patient subgroups based on self-perceived general health and
Objective To characterize systemic transcriptomic alterations across psoriatic arthritis (PsA) disease states, including distinctions from psoriasis-only (PsO), signatures of disease activity, and treatment-responsive changes in peripheral blood mononuclear cells. Methods RNA sequencing was performed in patients with PsA, psoriasis without arthritis (PSO) and healthy controls (HC). Four analytical comparisons were examined: PsA versus healthy controls, PsA versus PsO, active versus remission PsA, and paired pre- versus post-treatment PsA. Differential gene expression(DEGs), functional enrichment, and protein-protein interaction analyses were integrated to delineate immune and metabolic programs across conditions. Results PsA showed extensive transcriptional alterations relative to healthy individuals, characterized by activation of adaptive immune pathways, cytokine signaling, and coordinated metabolic adjustments. Compared with PsO, PsA exhibited pronounced dysregulation of extracellular matrix components, platelet activation, coagulation, and complement pathways, indicating systemic involvement not observed in skin-limited disease. Disease activity was associated with enhanced angiogenesis, cell adhesion, cell adhesion and migration, and extracellular matrix remodeling, alongside enrichment of PI3K-Akt, MAPK, IL-17, and complement/coagulation signaling. Paired longitudinal profiling demonstrated substantial transcriptomic reversibility after treatment, including attenuation of immune, stromal, and vascular signatures. Across analyses, recurrent patterns emerged: pervasive peripheral immune activation, distinct vascular and hemostatic alterations differentiating PsA from PsO, and consistent metabolic remodeling with partial normalization following therapy. Conclusion This multi-dimensional transcriptomic study delineates immune, vascular, and metabolic perturbations across PsA disease states and highlights their dynamic modulation with disease activity and treatment. These findings provide an integrated framework for understanding systemic inflammatory patterns in PsA and support future mechanistic and translational investigation.
A newsletter discute o papel do ultrassom de alta frequência como complemento ao escore de Rodnan na esclerose sistêmica e apresenta o telitacicept como uma nova opção promissora para o controle do lúpus eritematoso sistêmico. Adicionalmente, traz atualizações sobre o manejo seguro da gestação em pacientes com DII e benefícios metabólicos musculares do uso de inibidores de JAK na artrite reumatoide.