Medical nutrition therapy significantly impacts cardiovascular risk and overall health, but effects on muscle diseases remain unclear. This systematic review evaluates the safety and efficacy of dietary interventions and supplements on muscle disease outcomes.

To analyze the available scientific evidence on differences in inflammatory biomarker levels between patients with fibromyalgia and healthy controls.

Sjögren'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.

Current guidelines recommend influenza and pneumococcal vaccination in the majority of patients with rheumatic diseases. This study aimed to summarize the coverage of influenza and pneumococcal vaccines among these patients.

This meta-analysis examines factors associated with malignancy in systemic sclerosis (SSc).

Systemic Lupus Erythematosus (SLE) is a severe autoimmune disorder that impacts multiple organ systems, with African American (AA) adults having worse outcomes and poor prognoses compared to other ethnic groups. Ineffective patient-provider communication and inadequate screening for modifiable risk factors contribute to poorer SLE outcomes and ongoing health disparities. This scoping review evaluated the influence of patient-provider communication among adults with SLE, with particular attention to implications for African American populations, to inform the development of strategies to mitigate SLE health disparities.

Rheumatoid arthritis (RA) is a chronic inflammatory disease that impacts patients' quality of life. Evidence regarding the effectiveness of metformin use as an adjunct therapy in RA is limited and fragmented. This systematic review and meta-analysis aimed to evaluate the effectiveness of metformin as an adjunct therapy in RA and to quantitatively synthesize available evidence.

Interstitial lung disease (ILD) is a serious extra-articular complication of rheumatoid arthritis (RA) and a leading cause of mortality. This meta-analysis aims to comprehensively evaluate the diagnostic utility and clinical relevance of tumor-associated biomarkers in patients with Rheumatoid Arthritis-Associated Interstitial Lung Disease (RA-ILD).

The risk of neoplasm is elevated in patients with various autoimmune diseases. Although the overall risk of cancer in systemic lupus erythematosus (SLE) patients is slightly elevated, the standardized incidence ratio of several cancers is above 3.0. The main risk factor for neoplasm in this group is dysfunction of the immune system caused by the disease and by immunosuppressive drugs. The most common cancers in patients with SLE are related to viral latent infections caused by human herpesvirus 8, Epstein-Barr virus, and human papillomavirus. The risk of sarcoma has not been established in large cohort studies, but several case reports have been published. It remains uncertain whether there is a direct relationship between sarcoma and SLE. We performed a systematic review of case reports and case series and analyzed the detailed data of 26 SLE patients with sarcoma. The most common sarcomas were Kaposi's sarcoma and leiomyosarcoma - 2 neoplasms that are potentially related to viral infection.

Biologic DMARDs (bDMARDs) are widely used to treat moderate to severe PsA. TNF inhibitors (TNFi) are the most common initial biologic owing to their long market availability, clinician familiarity and lower cost. However, the optimal strategy following TNFi failure, cycling to another TNFi or swapping to a bDMARD with a different mechanism, remains uncertain. This meta-analysis compared the two strategies in these patients.

To evaluate the impact of continuing versus stopping biologic disease-modifying anti-rheumatic drugs (bDMARDs) during the perioperative period on surgical site infections (SSIs), delayed wound healing, and disease flares in patients with inflammatory arthritis (IA) undergoing elective non-orthopaedic surgery.

Polymyalgia rheumatica (PMR) is an inflammatory rheumatic condition primarily managed with glucocorticoids (GCs), but prolonged GC use carries significant adverse effects. Tocilizumab, an interleukin−6 receptor inhibitor, has emerged as a promising steroid-sparing therapy for patients with relapsing or GC-dependent PMR. We conducted a systematic review and meta-analysis according to PRISMA guidelines to assess the efficacy and safety of tocilizumab in PMR. Four randomized controlled trials (RCTs) involving 317 patients were included in the meta-analysis, and one multicentre observational cohort was narratively synthesized to provide supportive real-world evidence. Relapse outcomes were categorized as short-term (≤ 12 weeks), medium-term (13–26 weeks), and long-term (> 26 weeks). Pooled analysis showed that tocilizumab significantly reduced short-term relapse rates (OR: 0.22, 95% CI: 0.12–0.41; I² = 22.5%) and medium and long-term relapse rates (OR: 0.19, 95% CI: 0.10–0.35; I² = 27.1%) compared to placebo. Tocilizumab also significantly lowered cumulative GC dose (SMD: -0.78, 95% CI: -1.21 to -0.23; I² = 84.5%). Severe relapse showed a non-significant trend favoring tocilizumab, and safety outcomes were comparable between groups (OR: 0.57, 95% CI:0.27–1.18; I² = 30.0%). The included observational study supported these results, demonstrating high rates of successful tapering (77% to ≤ 5 mg at six months; 97% at twelve months) with few adverse events. This updated synthesis supports tocilizumab as an effective steroid-sparing option in PMR and provides practical tapering guidance to assist clinicians in managing relapsing or GC-dependent cases.

Factors associated with the risk of difficult-to-treat rheumatoid arthritis remain incompletely understood. We aimed to quantify the associations between key lifestyle factors, comorbidities, and difficult-to-treat rheumatoid arthritis risk.

Dry mouth symptoms in patients with primary SS (pSS) may be associated with oral microbiome dysbiosis, which plays a critical role in the pathogenesis of pSS and potentially contributes to disease progression. This study systematically reviews and meta-analyses the latest research on the relationship between the oral microbiome and pSS to identify potential diagnostic biomarkers.

The objective of this review was to assess the clinical efficacy, safety, and immunological effects of biologic therapies in patients with primary APS (pAPS) and catastrophic APS (CAPS). A systematic literature review was performed using PubMed and Embase (January 2005-January 2025), including studies involving adult patients diagnosed with pAPS or CAPS treated with rituximab, eculizumab, belimumab, or daratumumab. Data on clinical features, therapeutic indications, treatment responses, serological changes, and adverse events were extracted and synthesized. Fifty publications, encompassing over 100 patients, were included. Rituximab was the most frequently used biologic therapy and showed substantial efficacy in haematologic and cutaneous manifestations, notably thrombocytopenia and livedoid vasculopathy, though with limited impact on aPL levels. Eculizumab was effective in complement-mediated presentations such as thrombotic microangiopathy (TMA), thrombocytopenia, and renal involvement, with minimal serological changes. Belimumab led to both clinical and serologic improvement in select high-risk individuals. Daratumumab, reported in a single refractory case, temporarily reduced aPL titres, suggesting potential benefit from plasma cell-targeted approaches. Biologic therapies may represent valuable adjunctive options for specific APS phenotypes, especially refractory or complement-driven cases. However, the data remain limited by the heterogeneity in patient populations, the absence of standardized disease activity metrics, and unclear definitions of treatment response. Future studies should prioritize multicentre prospective designs, standardized outcome measures, and biomarker-driven stratification to guide personalized use of biologics in APS.

Fibromyalgia syndrome (FMS) is a condition characterized by widespread musculoskeletal pain, often involving a neuropathic component. While pathophysiology remains vague, increasing evidence suggests that small fiber pathology (SFP) may be present in a significant subset of patients, indicating a peripheral nervous system contribution. This systematic review aims to evaluate the utility of skin biopsy as a diagnostic tool for patients with FMS, with special focus on SFP. A comprehensive database search was conducted to identify studies assessing intraepidermal nerve fiber density (IENFD) via skin biopsy in individuals diagnosed with FMS. The included studies demonstrated a reduction in IENFD in a substantial proportion of FMS patients, with reported prevalence ranging widely from 30% to over 85%. Small fiber pathology occurs in a significant proportion of individuals with FMS. Skin biopsy emerges as a valuable diagnostic tool. Further research is needed to better understand the underlying mechanism of SFP in FMS.

To systematically review the spectrum of urological manifestations and fertility outcomes reported in FMF patients, excluding renal amyloidosis-related involvement.

BACKGROUND: Early and accurate detection of inflammatory activity is essential in inflammatory arthropathies, as timely treatment can prevent irreversible joint damage. Optical spectral transmission (OST), implemented in the HandScan device, is a novel, non-invasive imaging method that uses red and near-infrared light to detect perfusion changes associated with angiogenesis and hypervascularity in inflamed joints. This review summarizes current evidence on OST, assessing its diagnostic performance and clinical utility relative to musculoskeletal ultrasound, magnetic resonance imaging, and conventional clinical activity indices. METHODS: This review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Relevant studies were identified through systematic searches of the Web of Science and PubMed databases, with the last search conducted on October 7, 2025, according to predefined inclusion criteria. Publications from 2012 to 2025 were considered eligible. Studies enrolling patients with rheumatic diseases were included, and data were extracted on study population characteristics, methodologies, and main findings. RESULTS: Out of 77 studies screened, 22 met the inclusion criteria. Cross-sectional studies showed significant correlations between OST and ultrasound findings, with areas under the curve (AUC) reaching as high as 0.85. This correlation was particularly strong in the metacarpophalangeal and proximal interphalangeal joints. Additionally, OST correlated with MRI-detected synovitis and tenosynovitis but not with bone marrow edema. Moderate associations were observed between OST and clinical indicators such as DAS28, swollen joint counts, and C-reactive protein levels. Longitudinal analyses revealed significant associations between changes in OST values and changes in clinical activity indices, specifically ΔDAS28, and ΔSJC. However, it was found that absolute OST scores alone were inadequate for distinguishing between different levels of disease activity. Factors such as sex, body mass index, and structural joint damage were identified as confounding variables that influenced the measurements. CONCLUSION: OST is a promising, rapid, and operator-independent technique for quantifying joint inflammation in rheumatoid arthritis. Although further evaluation of its stand-alone diagnostic accuracy is needed, its integration with clinical assessment and imaging may enhance the objectivity and efficiency of disease monitoring. Standardized measurement protocols and patient-adjusted thresholds will be essential for broader clinical implementation.