Rheumatoid arthritis (RA) is a chronic autoimmune disorder that increases the risk of systemic complications, particularly metabolic syndrome (MetS). MetS, defined by central obesity, hypertension, hyperglycemia, and dyslipidemia, not only raises cardiovascular risk but also worsens the prognosis of RA. This meta-analysis aimed to estimate the global prevalence of MetS in RA patients and identify clinical factors contributing to its occurrence. A comprehensive literature search was conducted in PubMed, Scopus, and Web of Science. Studies included in the analysis diagnosed RA and defined MetS using standardized guidelines. Pooled estimates were calculated using a random-effects model. Heterogeneity was assessed using the I² statistic. All statistical analyses were conducted using Stata. The study is registered with PROSPERO (CRD420251007337). The overall pooled prevalence of MetS among RA patients was 30.3
Background Atopic dermatitis (AD) is a chronic, relapsing inflammatory skin disorder with a significant impact on psychosocial health and quality of life. Despite growing prevalence in India, particularly among adults, a comprehensive, India-specific guideline incorporating recent advances is lacking. Objective To develop a standardised, evidence-based consensus on the diagnosis and management of paediatric and adult AD in India through a modified Delphi methodology. Methods A total of 14 dermatology experts across India, with over 15 years of clinical and academic experience, formed the Special Interest Group of Paediatric Dermatology under IADVL. A systematic literature review was conducted using databases such as PubMed, Embase, and Cochrane, focusing on Indian and global literature up to December 2024. Based on this, 29 draft statements were generated covering domains of diagnosis, severity assessment, non-pharmacological measures, and topical and systemic therapies. A two-round, web-based, modified Delphi process was conducted anonymously to reach consensus. Statements with ≥75% agreement were retained. Results Consensus was achieved on all 29 statements. Thirteen statements were finalised after the first round, and 16 were refined and approved in the second round. Key recommendations included the use of modified Hanifin and Rajka criteria for diagnosis, SCORAD and IGA for severity assessment, therapeutic patient education, and individualised use of moisturisers, topical corticosteroids, and topical calcineurin inhibitors. For systemic therapy, cyclosporine remains first-line for moderate-to-severe AD, with conditional recommendations for methotrexate, mycophenolate, and JAK inhibitors such as abrocitinib. Emerging therapies like topical tofacitinib and crisaborole were discussed with caution due to limited Indian data. Limitation Although several new therapies—such as abrocitinib and dupilumab—have been approved for pediatric atopic dermatitis, consensus among Delphi panelists remains limited. There is lack of sufficient clinical experience and pediatric-specific data on these agents, highlighting the urgent need for more robust studies to inform expert alignment and clinical practice. Conclusion This updated Indian consensus guideline provides comprehensive, evidence-based, and context-sensitive recommendations for diagnosing and managing AD across age groups. It addresses previously unmet needs in adult AD. This consensus is expected to enhance clinical outcomes and standardise AD management nationally.
