To investigate the progression of radiographic damage in hands and feet of patients with early rheumatoid arthritis monitored prospectively for 15 years, and to search for predictors.

The development and implementation of genetic testing has revolutionized the diagnostic landscape of autoinflammatory diseases, leading to an exponential increase in the identification of disease-associated genetic variants. Yet a substantial proportion of these are considered variants of uncertain significance (VUS), complicating both diagnosis and therapeutic decision-making. This challenge is relevant not only for monogenic systemic autoinflammatory diseases, but also in the context of genetically complex disorders that can involve multiple low-penetrance variants. Advances in protein structure prediction tools, machine learning and artificial intelligence provide powerful computational frameworks for the classification of variants; however, their predictive accuracy must be benchmarked against functional assays, particularly with respect to gain-of-function variants. Functional screening approaches benefit from both technological progress and expanding knowledge of the innate immune pathways underlying systemic autoinflammatory diseases. Large-scale analyses of variants including multiplexed functional assays and deep mutational scanning experiments have enabled the assessment of hundreds of variants, notably in NLRP3, MEFV and ADA2, generating datasets that improve variant interpretation and genetic diagnosis. Altogether, these advances increase the potential of accurately predicting in the near future the effects of missense VUS, although numerous challenges remain to be addressed, especially those concerning our understanding of the influence of non-coding VUS in systemic autoinflammatory diseases.

To determine the incidence, predictors and impact of pneumonia among hospitalized patients with ANCA-associated vasculitis (AAV).

International guidelines recommend early combination of standard therapy with innovative agents in lupus nephritis (LN) to prevent kidney damage. Whether this accelerates renal response is unclear. We aimed to compare renal response trajectories, predictors and glucocorticoid (GC) burden in LN patients receiving early belimumab plus standard-of-care (SoC) vs SoC alone.

Older patients with anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) are underrepresented in clinical trials, and long-term outcome data in this group are limited. We evaluated treatment approaches and outcomes among hospitalised older patients with AAV.

Idiopathic retroperitoneal fibrosis (RPF) is considered a "silent disease" due to the lack of distinct disease biomarker. Our purpose was to study characteristic changes in circulating lymphocytes in RPF patients and explore their roles in etiopathogenesis.

To develop and externally validate a pragmatic prognostic model for identifying children at risk of refractory systemic JIA (rSJIA) by combining baseline disease activity with early treatment-response information.

To investigate the effect of belimumab combined with conventional therapy on natural killer (NK) cells counts and its correlation with clinical response in childhood systemic lupus erythematosus (cSLE).

The VACIMRA trial demonstrated that delaying MTX initiation in RA by 1 month after the 13-valent pneumococcal conjugate vaccine (PCV13) improves humoral responses at 1 and 12 months. Whether this delay impacts disease activity and radiographic progression over 1 year remains uncertain.

Telangiectasia are common in SSc. We explored the relationship between the site and quantity of telangiectasia with disease characteristics in SSc, and the agreement between patient- and physician-reported quantification of telangiectasia.

The objective of this study was to characterise the agreement of the CE-certified automated robotic ultrasound system ARTHUR v.2.0, combined with the AI model DIANA v.2.0, for grading osteophytes in hand osteoarthritis (OA), using expert rheumatologist assessment as the reference standard.

Behçet syndrome is a complex systemic immune-mediated form of vasculitis characterized by diverse clinical manifestations and a variable disease course. The treat-to-target (T2T) concept has emerged as a pivotal approach in managing various systemic autoimmune rheumatic diseases; however, its application in Behçet syndrome requires further work. Despite the limited literature on this subject, advancements from clinical trials have underscored the necessity for a T2T approach in Behçet syndrome. This article proposes an evidence-based perspective on the T2T strategy in Behçet syndrome, featuring a multidisciplinary and comprehensive collaboration of international experts, including rheumatologists, immunologists, ophthalmologists, gastroenterologists and neurologists. By adopting an organ-based approach to tackling crucial challenges, we aim to define treatment goals for organ involvement, discuss outcome measures that can be used as targets and definitions of remission and relapse, and also propose monitoring strategies (including treatment targets). The goal of this Perspective is to pave the way for future research and clinical practice, enhance the management of this complex condition and ultimately improve patient outcomes.

Giant cell arteritis (GCA) and polymyalgia rheumatica (PMR) are closely related chronic inflammatory conditions. Glucocorticoids remain the cornerstone of treatment for both conditions, as they rapidly control inflammation and also reduce the risk of ischaemic complications in GCA. However, glucocorticoid therapy is often prolonged and associated with substantial treatment-related morbidity. In addition, many patients experience relapses during glucocorticoid maintenance therapy and can accrue vascular damage. Advances in understanding the immunopathology of GCA and PMR have led to the development of targeted therapies, particularly agents inhibiting the IL-6 pathway and, more recently, Janus kinase (JAK) signalling. IL-6 receptor inhibitors reduce the risk of disease relapse and allow for reduction in glucocorticoid use in both GCA and PMR, and JAK inhibition enables glucocorticoid sparing and lowers the risk of relapse in GCA. Optimal management of GCA and PMR requires close monitoring, careful assessment of disease activity and treatment-related toxicity, as well as individualized therapeutic strategies. Ongoing research continues to refine treatment algorithms and could help to define therapeutic targets across GCA and PMR. Emerging therapeutic options and evolving treatment algorithms reflect the dynamic and patient-centred nature of advancements in GCA and PMR management.

Sjögren's disease is a systemic autoimmune disease characterised by secretory gland dysfunction that lacks effective systemic treatment. We aimed to replicate the findings of the RepurpSS-I trial and determine the efficacy and safety of leflunomide and hydroxychloroquine combination therapy as a first conventional treatment for Sjögren's disease.