Background/Aims: Sarcopenia is a common condition in patients with chronic inflammatory diseases, including rheumatoid arthritis (RA). The present study was designed to investigate the factors related to sarcopenia in patients with RA and to evaluate the diagnostic performance of ultrasonography (USG) in sarcopenia. Materials and Methods: Fifty-one patients with RA (aged 18-65 years), diagnosed according to the 2010 American College of Rheumatology/European Alliance of Associations for Rheumatology criteria, and 51 age-and sexmatched healthy controls were included. Participants were assessed for Disease Activity Score 28, muscle strength, muscle mass, anthropometric data, functional status, physical performance, balance, and quality of life (QoL). Sarcopenia was diagnosed by handgrip strength and calculating the skeletal muscle mass index value with dual-energy x-ray absorptiometry. Quadriceps muscle mass was measured by USG. Results: Among RA patients, 41 were female, with a mean age of 45.59 ± 9.85 years. In the control group, 37 were female, with a mean age of 47.41 ± 8.90 years. The mean disease duration was 15.12 ± 9.36 years. Sarcopenia prevalence was significantly higher in the RA group (37.3%) than controls (17.6%, P = .027). Sarcopenia was associated with disease duration, history of falls, reduced function, lower physical performance, anthropometric parameters, and decreased ultrasound muscle mass. Diagnostic cut-off values for quadriceps muscle thickness were 1.72 cm (right) and 1.71 cm (left) on ultrasound. Conclusion: Sarcopenia in RA patients is significantly associated with disease duration, falls, functional status, physical performance, anthropometric measures, muscle mass assessed by ultrasound, and QoL. Ultrasonography may be a useful screening tool for sarcopenia, with defined cut-off values for quadriceps muscle thickness. Cite this article as: Kılıç Z, Yurdakul FG, Güler T, Durmuş EB, Nakipoğlu Yüzer GF, Bodur H. Sarcopenia-related factors and the diagnostic role of ultrasonography in rheumatoid arthritis. ArchRheumatol. Published online August 5, 2026. doi: 10.5152/ArchRheumatol.2026.26339.
Background/Aims: In order to delineate the involvement of oxidative stress in fibromyalgia syndrome (FMS), this investigation analyzed systemic biomarkers - including nuclear factor erythroid 2 (Nrf2), total antioxidant status (TAS), total oxidant status (TOS) and thiol-disulfide equilibrium—in female patients with FMS and a reference group of healthy subjects. It was investigated how the patient group’s clinical characteristics, oxidative stress metrics, and Nrf2 levels related to one another. To date, no published studies have assessed serum Nrf2 levels in patients with FMS. Materials and Methods: The study enrolled 50 healthy female participants and 60 FMS patients. Participants were evaluated using the Visual Analog Scale (VAS), Fibromyalgia Impact Questionnaire (FIQ), Beck Depression Scale (BDS), Beck Anxiety Scale (BAS), Pittsburgh Sleep Quality Index (PSQI), Fatigue Severity Scale (FSS), the DN4 Neuropathic Pain Questionnaire, and the count of tender points (TP). Nrf2 level was measured by Enzyme-linked immunosorbent assay method, TAS, TOS, native thiol (NT), total thiol (TT), and disulfide levels were measured by spectrophotometric method. Results: In comparison with the reference group of healthy subjects, patients with FMS displayed significantly elevated values in TP count, FIQ, BDS, BAS, PSQI, FSS, VAS, DN4, TAS, and TOS (P < .001). Conversely, levels of serum Nrf2 were markedly reduced in the FMS group (P < .001). The DN4 scores were negatively and significantly correlated with Nrf2 concentrations (P = .049). Conclusion: The results point to a possible role for Nrf2 in the pathophysiology of FMS and may help identify and treat the condition, especially in individuals with neuropathic pain complaints. These findings are promising, as they indicate that the use of Nrf2 activators may be considered in patients with low Nrf2 levels. The potential utility of Nrf2-activating agents in such subgroups warrants further investigation. Cite this article as: Aşık M, Gur A, Altindag O, Akaltun MS, Balbal E. Investigation of serum nuclear factor erythroid 2–related factor 2 levels, oxidative stress parameters, and thiol-disulfide homeostasis in patients with fibromyalgia. ArchRheumatol. Published online June 3, 2026. doi: 10.5152/ArchRheumatol.2026.25024.
BACKGROUND/AIMS:Multiple epidemiological studies in different ethnic groups demonstrate diverse results about the prevalence of chondrocalcinosis (CC), yet no definitive data are available concerning its frequency in most countries. Furthermore, the prevalence of CC in the Turkish population is not known to date. The aim of this study was to investigate the frequency of radiographic CC in the knee, wrist, or both joints in individuals aged ≥50 years from the hospital records of the last 5 years. MATERIALS AND METHODS:In this retrospective study, radiographs of the knee and/or wrist taken at Çukurova University Faculty of Medicine Balcalı Hospital were reviewed by an experienced physiatrist, rheumatologist, and radiologist. RESULTS:A total of 1818 radiographs from 772 individuals were included in the study. A total of 32 individuals exhibited calcification in at least 1 knee or wrist in total. Of these, 9.3% were male and 90.6% were female, with an overall radiographic prevalence of 4.1%. The prevalence of radiographic knee CC was found to be 4.1%, while that of wrist CC was 3.2%. Only 2 female patients exhibited CC in both the knee and wrist joints simultaneously. The frequency of CC in bilateral knee joints have been increased with age and no significant association was found regarding CC coexisting with other comorbidities except hyperparathyroidism. CONCLUSION:The prevalence of radiographically detected knee and wrist CC in the Turkish population has not yet been reported. These findings emphasize the need for clinical research that could increase awareness and advance knowledge of the relationship between CC and possible risk factors in Türkiye. Cite this article as: Kozanoğlu E, Andırın M, Bıçkıcı Ö, Köse S. Prevalence of radiographic knee and wrist chondrocalcinosis in Adana province, Türkiye: A hospital-based retrospective study. Arch Rheumatol. 2026;41(3):193-200.
BACKGROUND/AIMS:This study aimed to evaluate the relationship between the Insall-Salvati ratio (ISR) and femoral cartilage thickness (FCT) in patients with knee osteoarthritis (KOA), and to examine their associations with radiographic disease stage, clinical findings, and functional capacity, including the ability of mean FCT to discriminate late-stage KOA. MATERIALS AND METHODS:This cross-sectional study included 104 patients (52/group) diagnosed with KOA via American College of Rheumatology criteria: early stage (Kellgren-Lawrence [K-L] 1-2) and late stage (K-L 3-4). One index knee per participant was analyzed. The ISR was measured on radiographs, and FCT on ultrasonography. Visual Analog Scale (VAS), Knee Injury and Osteoarthritis Outcome Score (KOOS), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and 100-m walking time were recorded. Data were analyzed using age- and body mass index (BMI)-adjusted ANCOVA. Stage-specific Pearson correlations were adjusted via the Benjamini-Hochberg false discovery rate (FDR) procedure. Multivariable regression and receiver-operating characteristic curve analyses were also conducted. RESULTS:After FDR correction, mean ISR correlated with FCT in late-stage KOA (r = 0.527, q < 0.001) but not in early-stage KOA (r = 0.331, q = 0.058). Age- and BMI-adjusted ANCOVA confirmed between-stage differences in mean FCT, VAS, KOOS, WOMAC, and 100-m walking time (all P < .001); however, mean ISR did not differ by stage (P = .419). In multivariable regression, late-stage KOA (B = -0.411 mm) and mean ISR (B = 0.829 mm per 1-unit increase) were independently associated with mean FCT (R2 = 0.463). Mean FCT discriminated late-stage KOA (area under the curve = 0.845, 95% CI: 0.771-0.919); a cutoff of ≤1.82 mm yielded 63.5% sensitivity and 88.5% specificity. CONCLUSION:Ultrasonographic FCT is strongly associated with radiographic stage, pain, functional scores, and walking performance, showing good discrimination of late-stage KOA. While ISR was not stage discriminative, it was independently associated with FCT. These findings should be viewed as exploratory; causal inferences cannot be drawn from this cross-sectional design. Cite this article as: Yesilmen N, Elbastı MŞ, Korkmaz M. Insall-Salvati ratio and femoral cartilage thickness: Ultrasonographic and clinical evaluation in knee osteoarthritis. ArchRheumatol. Published online April 27, 2026. doi:10.5152/ArchRheumatol.2026.26308.
BACKGROUND/AIMS:Maresin-1 (MaR-1), a specialized pro-resolving mediator, modulates inflammation and pain signaling. Serum MaR-1 was compared across rheumatoid arthritis (RA), fibromyalgia (FM), and healthy controls and examined its associations with disease activity and pain measures. MATERIALS AND METHODS:In this cross-sectional study, patients with rheumatoid arthritis (RA) (n = 30), patients with fibromyalgia (FM) (n = 30), and healthy controls (n = 29) were enrolled. Clinical assessments included visual analog scale (VAS) scores for pain and fatigue, DAS28-CRP in the RA group, the PainDETECT questionnaire for neuropathic pain screening in RA patients, the Fibromyalgia Impact Questionnaire (FIQ) in the FM group, and the Beck Depression and Beck Anxiety Inventories (BDI and BAI) to assess emotional status. Serum MaR-1 was quantified by enzyme-linked immunosorbent assay. Group comparisons, correlations, and receiveroperating characteristic analyses were performed. RESULTS:Controls had higher MaR-1 than both patient groups (P < .001). In RA, MaR-1 inversely correlated with VAS pain, DAS28; in FM, MaR-1 inversely correlated with VAS pain (P < .001). Discriminative ability in this cohort (RA): Area under the curve (AUC) 0.941 (95% CI 0.887-0.996), cut-off ≤1.07, sensitivity 86.7%, and specificity 93.1%. Discriminative ability in this cohort (FM): AUC 0.933 (95% CI 0.861-1.000), cut-off ≤1.19, sensitivity 90.0%, specificity 93.1%. CONCLUSION:Serum MaR-1 is reduced in RA and FM and tracks with pain severity and disease activity, supporting its potential as a biomarker of chronic inflammatory pain biology. Larger longitudinal studies are warranted to establish clinical utility. Cite this article as: Tuncer T, Pıhtılı Taş N, Elbastı MŞ, Demirelli Ş. Reduced serum maresin-1 in rheumatoid arthritis and fibromyalgia compared with healthy controls: A cross-sectional study. Arch Rheumatol. 2026;41(3):233-241.
BACKGROUND/AIMS:Rheumatoid arthritis (RA) is associated with increased cardiovascular risk beyond traditional risk factors. Recently, atherogenic lipid ratios and visceral adiposity indices have emerged as potential markers of cardiometabolic risk in chronic inflammatory diseases. This study aimed to examine their associations with estimated cardiovascular risk scores in patients with RA. MATERIALS AND METHODS:This cross-sectional study included 198 patients with RA. Individuals with established cardiovascular disease or majör comorbid conditions were excluded. Atherogenic lipid ratios, including the Atherogenic Index of Plasma (AIP), Atherogenic Coefficient (AC), Castelli Risk Index (CRI)-1, CRI-2, and triglycerides (TG)/high-density lipoprotein cholesterol (HDL-C) ratio, were calculated. Visceral adiposity indices included the Visceral Adiposity Index (VAI), Lipid Accumulation Product (LAP), and Waist-Triglyceride Index. Ten-year cardiovascular risk was estimated using the modified Framingham Risk Score (FRS) and the modified Systematic Coronary Risk Evaluation (SCORE) system. RESULTS:Atherogenic lipid ratios, particularly AC, CRI-1, and CRI-2, demonstrated weak but statistically significant positive correlations with both modified SCORE and modified FRS. In contrast, adiposity-related indices (LAP and VAI) and atherogenic lipid ratios (AIP and the TG/HDL-C ratio) were significantly associated with the modified FRS but not with the modified SCORE. No significant associations were observed between RA disease activity measures and cardiovascular risk scores. CONCLUSION:In RA, cardiovascular risk is linked closely to adiposity and lipid disturbances than current disease activity. Modified FRS may better capture adiposity-related cardiovascular risk than modified SCORE, and incorporation of atherogenic lipid and visceral adiposity indices may improve risk stratification. Cite this article as: Demir UG, Demir AN, Uysal A. Associations of atherogenic lipid ratios and visceral adiposity indices with cardiovascular risk scores in rheumatoid arthritis. ArchRheumatol. 2026;41(3):242-248.
Cite this article as: Kara M. Fibromyalgia as a confounder of disease activity assessment in inflammatory arthritis. ArchRheumatol. 2026;41(3):258-259.
BACKGROUND/AIMS:Fibromyalgia is diagnosed without a definitive biomarker, so classification and diagnostic criteria carry unusual clinical and epidemiologic weight. This Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020-guided systematic review examined why fibromyalgia criteria keep changing and how those changes influence overdiagnosis, misdiagnosis, missed diagnosis, chronic widespread pain boundaries, comorbid rheumatic disease, sex ratios, vitamin D deficiency, and prevalence estimates. MATERIALS AND METHODS:MEDLINE/PubMed, Scopus, and Web of Science Core Collection were searched from January 1, 1990 to March 4, 2026. Backward and forward citation tracking was added. Eligible records included criteria papers, validation and concordance studies, prevalence studies, health-system analyses, comorbidity studies, and digital or bodymap measurement studies. Fifty-eight records were included in the qualitative synthesis. Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2) and Risk of Bias In Non-Randomized Studies of Interventions (ROBINS-I)-informed domains guided appraisal where appropriate. RESULTS:Across criteria eras, revisions redistributed rather than eliminated diagnostic error. The 1990 criteria standardized research cohorts but depended on tender-point examination. The 2010/2011 criteria improved feasibility and symptom capture, yet increased vulnerability to regionalpain and high-distress misclassification. The 2016 revision introduced a generalized pain requirement and clarified that fibromyalgia can coexist with other disorders, improving boundary control but not resolving clinician- criteria discordance, sex-sensitive under-recognition, or comorbidityrelated diagnostic delay. Prevalence estimates vary partly because criteria architecture, sampling frame, pain-map methods, and case-finding purpose differ across studies. CONCLUSION:The 2016 criteria remain useful, but they are not a complete clinical diagnostic system. Future work should not merely add another threshold; it should combine generalized pain verification, dimensional severity reporting, comorbidity-aware interpretation, sex-sensitive screening, and explicit separation of chronic widespread pain from fibromyalgia. Cite this article as: Gür A. Why fibromyalgia criteria keep changing: A systematic review of misclassification, measurement, and diagnostic spillover. Arch Rheumatol. 2026;41(3):155-167.
BACKGROUND/AIMS:Celiac disease (CD) is a chronic autoimmune systemic disease characterized by extraintestinal involvement. The existing pathogenic mechanisms of CD may lead to the development of spondyloarthropathies. The aim was to determine the frequency of spondyloarthropathy in CD. MATERIALS AND METHODS:Celiac patients followed up in the gastroenterology clinic were evaluated clinically and radiologically by rheumatologists. Patients with spondyloarthropathy were recorded. RESULTS:A total of 82 patients (20 male, 62 female) were included. The mean duration of CD was 4.85 (SD ± 6.28) years. Inflammatory low back pain was found in 43.9% of patients. Of the 36 patients who underwent sacroiliac magnetic resonance imaging (MRI), 12 (33.3%) had sacroiliitis. Among these, 4 patients (33.3% of those with sacroiliitis, 4.9% of the total cohort) had active sacroiliitis, and 8 (66.7% of those with sacroiliitis, 9.8% of the total cohort) had chronic sacroiliitis. Human Leukocyte Antigen B27 (HLA-B27) positivity was not significantly associated with MRI findings or clinical activity in the cohort. Two patients had knee monoarthritis. CONCLUSION:The frequency of spondyloarthropathy may be associated with factors such as persistent antigenic stimulation of the intestinal mucosa, disruption of the mucosal barrier, T lymphocyte activation, and intestinal dysbiosis in CD. A notable frequency was observed in inflammatory low back pain and sacroiliitis in patients with CD was found. Cite this article as: Koç E, Albayrak F, Taşdemir Ü, et al. Frequency of spondyloarthropathy in patients with celiac disease. ArchRheumatol. 2026;41(3):188-192.
BACKGROUND/AIMS:Neck pain and limited neck mobility are common symptoms in patients with ankylosing spondylitis (AS). This study aimed to quantify neck muscle thickness in individuals with AS using ultrasonography and to compare these findings with measurements obtained from healthy volunteers. MATERIALS AND METHODS:A total of 30 individuals diagnosed with AS and 30 healthy participants were enrolled in this case-control study. The anteroposterior dimension, lateral dimension, cross-sectional area (CSA) of the longus colli (LC), cervical multifidus (CM), and anteroposterior dimension of the sternocleidomastoid were measured via ultrasound. Individuals diagnosed with AS were asked to complete the Neck Disability Index (NDI), the Ankylosing Spondylitis Quality of Life questionnaire (ASQoL), the Bath Ankylosing Spondylitis Activity Index (BASDAI), the Bath Ankylosing Spondylitis Functional Index (BASFI), and the Bath Ankylosing Spondylitis Metrology Index (BASMI). RESULTS:In the AS group, the anteroposterior thickness (P = .025) and CSA (P = .021) of the right LC were markedly reduced compared with the control group. Similarly, the left LC exhibited significantly smaller anteroposterior measurements (P = .023) and CSA values (P = .012) in patients with AS. Additionally, the lateral dimension of the CM was significantly decreased on both the right (P = .001) and left (P = .002) sides relative to healthy controls. In patients with AS, LC thickness correlated negatively with NDI, ASQoL, BASDAI, BASFI, and BASMI, and positively with cervical extension and lateral flexion. In multivariate regression analyses adjusted for age and body mass index, LC thickness was independently associated with disability, functional impairment, and spinal mobility limitation. CONCLUSION:Neck muscle thickness is reduced in AS patients, and atrophy of the LC shows significant correlations with greater disability, poorer quality of life, higher disease activity, impaired functional status, and limited spinal mobility. Cite this article as: Karacif D, Karacif O, Cagliyan Turk A. Comparison of neck muscle thickness via ultrasound in patients with ankylosing spondylitis and healthy controls. ArchRheumatol. 2026;41(3):212-222.
BACKGROUND/AIMS:Primary nonresponse to biological therapy in patients with spondyloarthropathy (SpA) is a considerable challenge. This study sought to identify the factors associated with primary nonresponse to biological therapy in a cohort of patients diagnosed with SpA. MATERIALS AND METHODS:A retrospective analysis was performed on 261 patients with SpA who underwent at least 1 biological therapy. The incidence of primary nonresponse to any biological treatment was evaluated, and various clinical and demographic factors were analyzed for their potential associations with treatment outcomes. RESULTS:The study found that the frequency of primary nonresponse to any biological disease-modifying antirheumatic drugs (bDMARDs) was 15.3% in the study population. In the logistic regression analysis of baseline parameters, presentation with arthritis at diagnosis was identified as a significant predictor of primary nonresponse (odds ratio: 2.113, 95% CI: 1.069-4.175, P = .031). Beyond this baseline predictor, primary non-responders significantly differed from responders by having higher frequencies of concomitant fibromyalgia (FMS) treatment (P = .047) and higher terminal C-reactive protein (CRP) levels (P = .030), as well as variations in acute-phase reactants, presence of psoriasis or enthesitis at diagnosis, and treatment-related factors such as bDMARDs duration. CONCLUSION:This study identifies baseline arthritis as a significant predictor of primary nonresponse to bDMARDs in SpA patients. Additionally, the presence of FMS and elevated CRP levels during follow-up are key clinical characteristics associated with the non-responder phenotype. These findings highlight the need for more objective assessment tools to distinguish true biological treatment failure from comorbid pain syndromes and the influence of disease phenotypes. Cite this article as: Oğuz Kökoğlu E, Kaplan H, Kızıltepe M, Kahraman Denizhan T, Cengiz CB, Şenel AS. An evaluation of factors contributing to primary nonresponse to biological therapy in patients with spondyloarthropathy: A retrospective cohort study. Arch Rheumatol. 2026;41(3):201-211.
BACKGROUND/AIMS:Growing evidence indicates that gut microbiota dysregulation plays a crucial role in the pathogenesis of systemic lupus erythematosus (SLE); yet, a quantitative overview of research activity in this field is lacking. This study aimed to provide a bibliometric analysis of global research trends and thematic evolution concerning gut microbiota and SLE between 2014 and 2025. MATERIALS AND METHODS:Relevant publications were retrieved from the Web of Science Core Collection and Scopus databases, and only original research articles and review articles published in English between January 1, 2014, and December 31, 2025, were included. Bibliometric analyses were performed using the bibliometrix package in R and CiteSpace to evaluate publication trends, country and institutional contributions, collaboration networks, keyword co-occurrence, and citation burst patterns. RESULTS:A total of 525 publications were included, comprising 248 original articles and 277 reviews. Annual publication output increased steadily, with accelerated growth after 2019 (annual growth rate of 121.20%), and 91 papers were published in 2025. China and the United States were the main contributors, accounting for more than half of the total publications, with field-normalized contributions of 1.0927 and 1.2268. The Medical University of South Carolina and Zhejiang Chinese Medical University were the most productive institutions (10 articles). Citation burst analysis showed that "Intestinal dysbiosis associated with systemic lupus erythematosus" laid the foundation for research in this field. Keyword analysis indicated a gradual shift from descriptive microbial characterization toward themes related to immune regulation and dysbiosis. In addition, increasing research attention has been directed toward microbiota-based therapeutic approaches in SLE. CONCLUSION:Research on gut microbiota in SLE has expanded substantially over the past decade, with an observable shift from association-based studies toward more mechanistic and translational research themes. Distinct regional research emphases were noted, highlighting the potential value of enhanced international and interdisciplinary collaboration in advancing research in this field. Cite this article as: Yang J, Wang J. Research trends and emerging themes in gut microbiota-systemic lupus erythematosus research: A bibliometric analysis (2014-2025). ArchRheumatol. 2026;41(3):249-257.
Cite this article as: Çiftci İnceoğlu S. Comment to the article “association of sarcopenia with pain and disability in hand osteoarthritis: A retrospective, cross-sectional, single-center study.” ArchRheumatol. Published online June 3, 2026. doi: 10.5152/ArchRheumatol.2026.26335.
BACKGROUND/AIMS:Previous studies examining the association between vitamin D receptor (VDR) polymorphisms (ApaI, BsmI, TaqI, FokI) and rheumatoid arthritis (RA) have reported inconsistent findings. This metaanalysis aimed to evaluate whether clinical and population-level factors moderate this association. MATERIALS AND METHODS:A systematic review of PubMed, Web of Science, Scopus, Cochrane Library, ClinicalTrials.gov, and Google Scholar was conducted up to July 19, 2024. Observational studies comparing VDR polymorphisms between RA patients and healthy controls were included. Studies without a control group, with fewer than 20 cases, or lacking relevant outcome data were excluded. Methodological quality was assessed using the Newcastle-Ottawa Scale. Random-effects meta-analyses, subgroup analyses, and meta-regression were performed. RESULTS:Twenty-five case-control studies (3711 RA patients and 3884 controls) were included. No significant overall association was observed between VDR polymorphisms and RA across genetic models. However, subgroup analyses demonstrated ethnic variability, with reduced RA likelihood observed among South Asians for the ApaI dominant model (OR = 0.26, 95% CI: 0.14-0.49) and BsmI polymorphism, while African populations showed increased likelihood for BsmI under the recessive model (OR = 1.77, 95% CI: 1.13-2.78). Meta-regression identified ethnicity, classification criteria, and bone erosion as significant moderators; bone erosion was associated with increased RA likelihood for the FokI dominant model (OR = 2.21, 95% CI: 1.24-3.97). CONCLUSION:Although no consistent overall association was identified, the relationship between VDR polymorphisms and RA appears to be modified by ethnicity, classification criteria, and disease severity. These findings underscore the importance of accounting for clinical and population heterogeneity in genetic association studies of RA. Cite this article as: Liu W, Xi S. Vitamin D receptor polymorphisms and rheumatoid arthritis risk: A systematic review and meta-analysis evaluating the moderating effects of ethnicity, bone erosion, and classification criteria. Arch Rheumatol. 2026;41(3):168-187.
Background/Aims: Luteolin (LUT), a flavone abundant in Reseda luteola, possesses well-documented anticancer, antioxidant, and anti-inflammatory properties. This study aimed to investigate whether LUT attenuates osteoarthritis (OA) progression by suppressing interleukin (IL)-18 expression in a monosodium iodoacetate (MIA)-induced OA rat model. Materials and Methods: Osteoarthritis was induced by intra-articular injection of MIA. Luteolin and celecoxib (CLX) were administered orally once daily for 2 weeks, beginning 2 weeks after MIA injection (n = 6 per group). Pain-related behaviors were evaluated using weight-bearing and von Frey tests. Structural pathology was assessed using hematoxylin and eosin (H&E), Safranin O, and Toluidine Blue staining, followed by modified Mankin scoring. Interleukin-18 expression was quantified in serum and articular cartilage using immunohistochemistry and quantitative realtime polymerase chain reaction (qRT-PCR). Results: Luteolin significantly increased the weight-bearing ratio and mechanical withdrawal threshold. Luteolin also showed a trend toward attenuating cartilage damage and reducing modified Mankin scores, although these effects were not statistically significant. In addition, LUT significantly reduced the number of IL-18-positive chondrocytes in cartilage and showed a tendency to decrease IL-18 mRNA expression and serum IL-18 concentrations. These effects were comparable to those observed with CLX treatment. Conclusion: This study provides preclinical evidence that LUT may exert anti-inflammatory and chondroprotective effects in MIA-induced OA, potentially through modulation of IL-18. These findings support further investigation of LUT as a potential therapeutic candidate for OA. Cite this article as: Kim JH, Lee SH, Lee YJ, Song JY, Gil HH, Lee J. Effects of luteolin on an MIA-induced osteoarthritis rat model via reducing IL-18. ArchRheumatol. Published online July 03, 2026. doi: 10.5152/ArchRheumatol.2026.25143.
Background/Aims: The primary objective of this investigation is to systematically assess the resemblances and distinctions between enthesitisrelated arthritis (ERA), which serves as a pediatric analog to ankylosing spondylitis (AS), and AS. Materials and Methods: A cross-sectional analysis was conducted within a pediatric rheumatology facility and an adult rheumatology institution. Demographic and clinical attributes were juxtaposed between individuals diagnosed with AS and those with ERA. Results: A cumulative total of 200 subjects (101 minors, 99 adults) were scrutinized. The prevalence of peripheral arthritis was significantly elevated in ERA (54.5%) compared to AS (21.2%, P < .001), whereas sacroiliitis, axial involvement, and morning stiffness were more prevalent in AS. Nonsteroidal anti-inflammatory drugs constituted the predominant initial therapeutic approach (99% vs. 91.9%, P = .01). Patients with ERA exhibited a higher utilization of corticosteroids (35.6% vs. 11.1%, P < .001) and diseasemodifying antirheumatic drugs (DMARDs) (87.1% vs. 60.6%, P < .001), with no notable variance in the application of biological agents. At the final follow-up assessment, 24.8% of ERA patients were free from medication, whereas no AS patients achieved a medication-free status. Conclusion: An increased volume of scientific evidence is requisite concerning the attributes of ERA, which is presently regarded predominantly within the framework of juvenile spondyloarthritis, distinguishing it from its adult counterpart; this study serves as an observational cohort investigation that underscores this imperative. Despite the observable differences and similarities between ERA and AS, further extensive studies incorporating inflammatory biomarkers are essential to ascertain whether these conditions represent discrete diseases or exist within a broader disease continuum. Cite this article as: Unan MK, Özaslan Z, Dilek G, Şahin N, Sönmez HE, Nas K. Juvenile vs. adult-onset spondyloarthritis: Uncovering similarities and differences. Arch Rheumatol. 2026;41(2):90-99.
Objectives: Although numerous risk factors associated with cervical spine involvement (CSI) have been reported in the literature, the relationship between the severity of peripheral joint erosions and CSI has not yet been investigated. In this study, we aimed to investigate this relationship. Materials and Methods: Adult rheumatoid arthritis (RA) patients with a disease duration of more than 5 years were enrolled from 2 tertiary rheumatology clinics. Medical records were retrospectively reviewed. Neutral, open-mouth anteroposterior, full flexion, and full extension cervical spine radiographs, along with hand radiographs, were assessed independently by 2 blinded rheumatologists. “RA-type joint involvement (RJI)” was defined as presence of any erosion or joint space narrowing (JSN) as per the Modified Sharp Score (MSS). “Severe joint involvement (SJI)” was defined as presence of any erosion with a score of ≥ 3 points or JSN with a score of ≥ 4 points as per the MSS. Results: We enrolled 238 patients, 84.5% of whom were female, and the mean age was 58.1 Å} 12.1 years. The frequency of CSI was 19.7% (n = 47), including anterior atlantoaxial subluxation (AAS) (42.3%), posterior AAS (7%), lateral AAS (22.5%), vertical subluxation (11.5%), and subaxial subluxation (12.7%). The CSI-positive group had longer lag time to diagnosis (P = .028), longer disease duration (P = .002), higher rates of RJI (P = .047), SJI (P < .001), and peripheral joint ankylosis (PJA) (P < .001) than CSI-negative group. In multivariate analysis, only PJA remained an independent predictor of CSI (P < .001). In addition, there was no significant difference in the frequency of interstitial lung disease and chronic knee/elbow arthritis between the CSI-positive and CSI-negative groups. Conclusion: To our knowledge, this is the first study to identify PJA as an independent risk factor for CSI. Therefore, RA patients having PJA should be carefully screened for CSI.
Background/Aims: Paraffin bath therapy is used as a topical treatment for inflammatory and non-inflammatory diseases of the hands. The effects of adding paraffin bath therapy to the exercise programme on pain, hand movements, and hand function in patients with systemic sclerosis (SSc) and hand involvement were investigated. Materials and Methods: The study included 40 patients (a total of 245 patients were screened for eligibility) with hand dysfunction (Cochin Hand Functional Scale (COCHIN) ≥ 10). The patients were randomized into a control group (exercise only) (n = 20) and a paraffin bath group (exercise and paraffin bath) (n = 20). Patients were assessed with COCHIN, Modified Hand Mobility in Scleroderma (HAMIS), Delta Finger-To-Palm (DFTP), Hand Grip Strength (HGS), and Numerical Rating Scale (NRS) at baseline, 6 and 12 weeks after treatment. Results: Thirty-five patients (control group (n = 18), paraffin bath group (n = 17)) who had completed the study period were evaluated. There was a significant difference in the change values of the parameters COCHIN, HAMIS-Right Hand, HAMIS-Left Hand, HGS-Right Hand, and HGS-Left Hand at both the 6-week and 12-week follow-up examinations of the control and paraffin groups compared to the baseline values (P < .05 for all). In addition, there was a significant difference in the change values of the NRS and DFTP-Right Hand parameters in the paraffin bath group at both the 6-week and 12-week follow-ups, in addition to the existing parameters (P < .05 for both). When the 2 groups were compared with each other, there was a statistical difference in the NRS parameter in favor of the paraffin bath group (P = .007 in the 6th week, P < .001 in the 12th week). There was no difference between the groups for the other parameters (P > .05). Conclusion: Therapeutic hand exercises are effective for SSc patients with impaired hand function, and the addition of paraffin baths in the exercise program reduces pain.
BACKGROUND/AIMS:The hemoglobin, albumin, lymphocyte, and platelet (HALP) score is a novel biomarker reflecting systemic inflammation and nutritional status. While it has been studied in oncology and some inflammatory diseases, its clinical role in rheumatoid arthritis (RA) remains unclear. This study aimed to investigate the relationship between HALP, disease activity, and inflammatory burden in RA. MATERIALS AND METHODS:This retrospective cross-sectional study included 106 patients with RA diagnosed according to the 2010 ACR/EULAR criteria and 110 age-, sex-, and BMI-matched healthy controls. Clinical and laboratory data were recorded, and HALP scores were calculated. Disease activity was assessed using the disease activity score-28-C-reactive protein (DAS28-CRP). Group comparisons, Spearman correlation analysis, receiveroperating characteristic (ROC) curve analysis, and multivariable logistic regression were performed. RESULTS:The HALP scores were significantly lower in patients with RA compared with healthy controls (P < .0001). Among patients with RA, those with active disease exhibited significantly lower HALP scores than those in remission (P < .05), with a decreasing trend across DAS28-CRP disease activity categories. The HALP scores showed negative correlations with CRP (r = -0.329), Visual Analog Scale (VAS)-pain (r = -0.399), and DAS28-CRP (r = -0.348) (all P ≤ .001). The ROC analysis demonstrated moderate discriminative ability for distinguishing active disease from remission (AUC = 0.708, 95% CI: 0.63-0.81). In multivariable logistic regression analysis, lower HALP scores and older age were independently associated with active RA. CONCLUSION:The study demonstrates that lower HALP scores are associated with higher disease activity in rheumatoid arthritis. As a simple and routinely available laboratory-based index, the HALP score may serve as a supportive marker of inflammatory burden. Prospective multicenter studies are required to validate these findings and to clarify the longitudinal utility of the HALP score. Cite this article as: Çelik G, Çilingiroğlu Ç, Uğur S, Kızıl ŞD. Clinical relevance of the HALP score in rheumatoid arthritis: Association with disease activity and inflammatory burden. Arch Rheumatol. 2026;41(2):134-143.
BACKGROUND/AIMS:Familial Mediterranean fever (FMF) is an autosomal recessive inflammasomopathy caused by mutations in the MEditerranean FeVer (MEFV) gene and is characterized by recurrent inflammatory attacks largely associated with pyrin inflammasome activity. Although FMF is a monogenic disease, clinical heterogeneity suggests the contribution of additional regulatory mechanisms, including epigenetic factors such as microRNAs (miRNAs). Previous studies identified miR-197-3p as a regulator of inflammatory signaling by targeting IL1R1. The objective of this study was to investigate the functional role of miR-197-3p in pyrin inflammasome activation and priming mechanisms in macrophages derived from an FMF knock-in mouse model. MATERIALS AND METHODS:Bone marrow-derived macrophages (BMDMs) from MefvV726A/V726A mice were transfected with pre-miR-197-3p or a mimic control. Following transfection, inflammasome priming and activation were induced using specific inflammasome activators and Toll-like receptor (TLR) agonists targeting pyrin, AIM2, and NOD-like receptor protein 3 pathways. Interleukin-1β (IL-1β) secretion and pro-IL-1β expression were subsequently assessed. RESULTS:Overexpression of miR-197-3p significantly reduced IL-1β secretion following just pyrin inflammasome activation, while responses mediated by other inflammasome pathways were largely preserved. In addition, miR- 197-3p overexpression was associated with decreased pro-IL-1β expression in response to TLR2 stimulation. CONCLUSION:These findings suggest that miR-197-3p may preferentially influence pyrin inflammasome-related inflammatory responses in FMF macrophages. While the present data do not establish a direct mechanistic interaction, they support a potential regulatory role for miR-197-3p in FMF-associated inflammation and provide a basis for future mechanistic and in vivo studies. Cite this article as: Ulum YZA, Sen B, Akbaba TH, Peynircioglu BB. Modulation of inflammasome activity by miR-197-3p in familial Mediterranean fever mouse macrophages. Arch Rheumatol. 2026;41(2):144-152.
