In this Viewpoint article, six patients and patient advocates discuss the role of the patient in rheumatology, the current unmet needs of patients and promising advances. By reflecting on their own lived experiences, the authors emphasize the integral role of patients for progress in the field.

Obesity affects nearly one in six adults worldwide. Excess adiposity is a pro-inflammatory state associated with increased risk of several types of arthritis, increased arthritis disease activity and/or severity, and poorer response to certain treatments. Obesity is a major risk factor for cardiovascular disease, the leading cause of death in people with common arthritides such as osteoarthritis (OA), gout, rheumatoid arthritis, psoriatic arthritis and axial spondyloarthritis. Glucagon-like peptide-1 receptor agonists (GLP-1RAs) are a promising therapeutic option for people with arthritis and obesity or type 2 diabetes mellitus owing to their pleiotropic effects, including weight loss, improved survival and reduced risk of major cardiovascular and renal events. In vitro and preclinical in vivo experiments in arthritis have uncovered weight-loss-independent anti-inflammatory and chondroprotective properties of GLP-1RAs. In knee OA, clinical data suggest that GLP-1RAs improve pain and function and reduce the risk of surgical intervention; however, their effects on OA incidence remain incompletely understood. Evidence suggests that GLP-1RAs do not directly prevent gout attacks, but are effective in managing cardiometabolic conditions commonly associated with gout and other arthritides. More research is needed to clarify the effects of GLP-1RAs on incidence, disease activity, and progression of rheumatoid arthritis, psoriatic arthritis and axial spondyloarthritis.

Lyme disease is a tick-borne illness that can result in a spectrum of musculoskeletal complications, ranging from infection-related arthritis to post-infectious, immune-mediated conditions. Although prior reports have linked Lyme disease to systemic autoimmune diseases, such as rheumatoid arthritis and psoriatic arthritis, non-radiographic axial spondyloarthritis (nr-axSpA) has not previously been described following Lyme disease.

Recent attempts to understand the pathophysiology and characteristics of osteoarthritis (OA) have led to the stratification of samples and data. An important part of this process is the use of specific terminology, although the lack of clear definitions for these terms can lead to misinterpretation across different disciplines. In this study, we aimed to assess the frequency of use and chronological appearance of key scientific terminology of four prevalent terms in the field of OA research: PHENOTYPE, SUBTYPE, SUBGROUP and ENDOTYPE. These terms were analysed in conjunction with tissues and fluids associated with OA research, specifically plasma/serum, synovial fluid, synovial membrane, cartilage, meniscus and bone. The method for screening the published literature focused on publications from January 2010 to September 2024, with priority given to studies that reported results from unmanipulated human tissues and applying unbiased analytical methods. Excluded from the analysis were reviews, clinical trials, animal studies, in vitro data, and analyses of pre-existing datasets. The data revealed that the most frequently used term was PHENOTYPE, followed by SUBGROUP and SUBTYPE, with ENDOTYPE being the most recently introduced term in 2019. These terms were rarely defined and often used interchangeably within a single paper, particularly in studies involving cartilage and serum. Notably, the use of these terms has tripled in total over the last 14 years, with an increase in the past decade, reflecting a growing interest in OA stratification, as well as the utility of advanced unbiased analytical methods including microarray and RNA sequencing. The term PHENOTYPE was broadly used and often when describing clinical features, whilst the term ENDOTYPE is used when describing molecular mechanisms related to OA pathogenesis. To improve communication of findings associated with OA stratification, we propose a harmonised application in the use of these stratification terms to prevent misinterpretation and support better communication of OA-related research findings. Building on published terminology, PHENOTYPE could be used to describe clinical features, while ENDOTYPE could be used to describe molecular mechanisms.

To gather all relevant literature surrounding the use of Bayesian methods in clinical trials for rheumatoid arthritis and systemic sclerosis; and to assess the use of these methods within said trials.

To investigate the long-term trajectory of radiographic progression in difficult-to-treat rheumatoid arthritis (D2T RA) and poly-refractory RA (pr-RA) patients and to evaluate the impact of ultrasound-based persistent inflammatory refractory RA (PIRRA) and non-inflammatory refractory RA (NIRRA) classification on predicting rapid radiographic progression (RRP, ≥5 mSvdH units/year).

To validate the revised patient global assessment (PtGA) threshold of 2 cm in the Boolean 2.0 remission definition by assessing its agreement with index-based remission criteria and its predictive validity for quality of life (QoL) outcomes, compared with Boolean 1.0, in Korean patients with rheumatoid arthritis (RA) receiving targeted therapy.

To investigate cutaneous manifestations in Still's disease patients, evaluating any correlation with ethnic origin, age at disease onset, disease patterns, occurrence of macrophage activation syndrome (MAS) and systemic activity scores.

We applied latent class and trajectory modelling to examine whether subgroups of axial spondylarthritis (axSpA) patients report discordant scores for disease activity and mental health symptoms at baseline and after treatment change.

To investigate the relative contribution of cartilage and synovial turnover to predict progression in patients with knee or hip osteoarthritis (OA).

Pharmacological management in the axial spondyloarthritis (axSpA) field has advanced in recent years. Accumulating evidence on long-term efficacy and safety of biological agents targeting TNFa and IL-17, as well as data on JAK inhibitors is now available. Rheumatologists have currently more options for treatment as compared with 20 years ago, but choosing the best therapeutical approach for a single patient remains a challenge. Despite generalized treatment recommendations provided by international societies, patients present with a heterogeneity of symptoms and treatment responses. In the context of personalized medicine, understanding the disease phenotype in combination with extra-musculoskeletal manifestations is a core step for treatment decision making. Beyond disease-related aspects, comorbidities could also be particularly relevant in the selection of the most appropriate drug, given their different efficacy and safety profiles. AxSpA patient's fertility and pregnancy outcomes with regard to therapy also form a consideration, since symptom onset usually falls into the child-bearing age. This article will discuss the selective effect of the approved treatment modalities on the different axSpA manifestations and co-existing conditions.

Diagnostic delay (DD) is well-documented in SpA, particularly in axial disease. This ancillary analysis from the ASAS-PerSpA study estimated DD across SpA entities, considering the presenting disease manifestation, and evaluated factors associated with DD.

Rheumatoid arthritis is a chronic and progressive disease, the most important and common symptom of which is pain. Considering the physical and psychological effects of pain on health and well-being, it seems that finding new methods such as conceptual mapping to teach self-care to patients is important for controlling and reducing pain. This study was conducted to determine the effect of self-care education based on conceptual mapping on the pain severity of patients with rheumatoid arthritis.

We assessed the validity of Patient-Reported Outcome Measurement Information System (PROMIS) for juvenile and adult-onset idiopathic inflammatory myopathies (JIIM/IIM) and determined associations with disease characteristics and assessments.