Antiphospholipid syndrome (APS) is a complex disease that affects daily life. Previous studies have shown that poor information levels are correlated with lower health-related quality of life among individuals with APS. We conducted a scoping review on the available literature up to November 2025 to assess by what means health information-seeking behavior (HISB) among patients with APS has been evaluated. Furthermore, we conducted a cross-sectional survey in June 2021 to assess HISB among French-speaking patients with APS and to analyze HISB among internet posts related to APS between 2001 and 2021 using text analytics and cluster analysis. Five studies were retrieved and described according to the scoping review methodology. With respect to surveys among French patients with APS, the main source of information identified is rheumatologists/Lupus/APS specialists (more than 85
People with rheumatoid arthritis (RA) experience premature aging and RA is associated with poor health outcomes. Frailty tools offer a holistic view of an individual’s health status that may inform treatment strategies in RA. This review provides an overview of frailty in RA including methods of measurement, associations with clinical outcomes, and potential paths for frailty intervention. Frailty is common in RA, affecting approximately one-third of patients, with prevalence estimates varying according to the measurement instrument used. The causes of frailty are not well studied but likely include a combination of chronic systemic inflammation, immunosenescence, deconditioning and medication effects. Frailty is consistently associated with higher disease activity, poorer physical function, depression, pain, reduced quality of life, and greater comorbidity burden. Longitudinal studies show that frailty predicts hospitalization, serious infections, osteoporotic fractures, functional decline, readmission, and mortality, independent of traditional clinical risk factors and comorbidity indices. Emerging evidence also supports a bidirectional relationship between frailty and RA disease activity, suggesting that some aspects of frailty may be modifiable through improved disease control. Frailty-specific interventions have not yet been studied in RA, however, RA disease control, medication optimization and promotion of physical activity are likely to improve frailty in this high-risk population. Frailty is an important predictor of poor health outcomes in RA and may be amenable to interventions. Incorporation of frailty assessment into clinical care and clinical trials will be essential to move the field forward.
Chronic musculoskeletal pain (CMP), including osteoarthritis (OA), rheumatoid arthritis (RA), fibromyalgia, and chronic low back pain (cLBP), contributes substantially to disability and reduced quality of life. Contemporary pain science supports biopsychosocial, multimodal management addressing nociceptive, neuropathic, and nociplastic mechanisms. Tai Chi is a multicomponent mind–body exercise integrating gentle movement, breathing, relaxation, balance, and attentional focus. This narrative review summarizes approximately 20 years of research on Tai Chi for CMP and considers its evolving evidence in contemporary rheumatology and pain management. Findings are strongest for knee and hip OA, with randomized trials and systematic reviews demonstrating improvements in pain, mobility, physical function, and stiffness compared with non-exercise controls. For cLBP, studies suggest potential improvements in pain and physical function, although heterogeneity and limitations in the certainty of evidence warrant cautious interpretation. In fibromyalgia, Tai Chi may improve pain and selected symptoms, but findings remain variable and the certainty of evidence is limited. In RA, research is sparse and inconsistent, with insufficient data to establish clinically meaningful effects on disease activity, pain, or physical function. Across conditions, Tai Chi has a generally favorable safety profile, although variations in interventions and outcome measures limit direct comparisons. Over two decades, research on Tai Chi for chronic musculoskeletal pain has expanded from relatively small efficacy trials to larger randomized studies, as well as mechanistic and pragmatic investigations. Findings are most supportive for knee and hip OA, whereas evidence for cLBP and fibromyalgia remains promising but heterogeneous, with limitations in the certainty of evidence. Evidence for RA remains insufficient to draw firm conclusions. Overall, Tai Chi appears to be a feasible and generally safe nonpharmacological intervention that may complement multimodal management of musculoskeletal pain. Further high-quality studies are needed to establish the magnitude and clinical relevance of its benefits, determine comparative effectiveness and optimal dose and delivery, and evaluate longer-term outcomes.
Immune-mediated necrotizing myopathy (IMNM) is a rare and heterogeneous subgroup of idiopathic inflammatory myopathies. IMNM is broadly classified into seropositive disease, encompassing anti-3-hydroxy-3-methylglutaryl-coenzyme A reductase (anti-HMGCR) and anti-signal recognition particle (anti-SRP) antibody-associated forms, and seronegative IMNM. Although seronegative IMNM has traditionally been considered largely analogous to seropositive disease, emerging evidence suggests that it may represent, at least in part, a distinct clinical entity. This review synthesizes the current evidence regarding the clinical management of seronegative IMNM. Seronegative IMNM typically presents with symmetric proximal muscle weakness, predominantly affecting the lower extremities. Recent data suggest that myalgia at disease onset may occur more frequently in seronegative patients, while evidence also indicates potential associations with prior statin exposure, malignancy, and connective tissue diseases; however, these relationships remain incompletely defined. Furthermore, extramuscular manifestations, particularly cardiac involvement, may be more clinically relevant than traditionally recognized. Muscle biopsy remains central to diagnosis, demonstrating prominent myofiber necrosis and regeneration with minimal inflammatory infiltrates, whereas research suggests that sarcolemmal membrane attack complex deposition may be less frequent than in seropositive IMNM. Immunosuppressive therapy constitutes the cornerstone of treatment, with glucocorticoids as first-line therapy and methotrexate commonly employed as the preferred steroid-sparing agent. Rituximab may be considered in refractory or relapsing disease. Seronegative IMNM is an uncommon and frequently underrecognized disorder. Significant gaps persist regarding its pathogenesis, associated comorbidities, and long-term outcomes. This narrative review provides a practical, evidence-based framework for the clinical evaluation and management of patients with seronegative IMNM. Seronegative IMNM accounts for approximately 10
Axial spondyloarthritis (axSpA) encompasses a broad disease spectrum, and the management landscape has expanded considerably over the past two decades. This review synthesizes the current evidence on pharmacological and non-pharmacological interventions in axSpA, addressing both symptom control and radiographic outcomes across drug classes and patient contexts. NSAIDs remain the cornerstone of first-line therapy, with emerging long-term cohort data suggesting a dose-response relationship between NSAID exposure and reduced radiographic spinal progression in radiographic disease. TNF inhibitors retain the most mature evidence base regarding radiographic progression, with longitudinal data associating TNFi exposure with slower mSASSS progression and suggesting that this effect may be partially uncoupled from inflammation as measured by ASDAS, particularly with earlier treatment initiation. IL-17 inhibitors demonstrate robust symptomatic efficacy, while two-year structural data show low radiographic progression, although a treatment-specific structural effect has not been established. JAK inhibitors provide effective symptom control, and longer-term radiographic data are now available, but controlled evidence demonstrating inhibition of structural progression remains lacking. Exercise therapy, supported by a recent systematic review and meta-analysis, improves disease activity, function, mobility, pain, and fatigue, with subgroup analyses showing significant BASFI improvement only for sessions lasting ≤60 minutes. Obesity is associated with greater disease activity and poorer response to TNF inhibitors. Symptom control is achievable across all major drug classes in axSpA. Evidence regarding radiographic progression is most mature for TNF inhibitors, more limited for IL-17 inhibitors, context-dependent for NSAIDs, and currently insufficient to establish structural modification with JAK inhibitors. Effective management requires integrating pharmacological and non-pharmacological strategies, including structured exercise as an evidence-based intervention, while recognizing obesity as a clinically relevant prognostic factor.
