OBJECTIVES:To clarify the crucial prediction role of intestinal barrier markers - lipopolysaccharide binding protein (LBP), soluble cluster of differentiation 14 (sCD14), and intestinal fatty acid binding protein (I-FABP) - through combined diagnostics in rheumatoid arthritis (RA) patients. METHODS:A retrospective multi-centre study was conducted involving 139 RA patients from three hospitals, alongside 52 healthy controls (HCs). Serum levels of LBP, sCD14, and I-FABP were quantified by enzyme-linked immunosorbent assay (ELISA). Clinical records were systematically collected, and receiver operating characteristic (ROC) analysis was performed to assess the predictive performance of the biomarkers. RESULTS:Compared to HCs, serum levels of sCD14, LBP and I-FABP were significantly higher in RA patients (p<0.05). Among those, sCD14 levels demonstrated a significant positive correlation with disease activity score for 28 joints based on C-reactive protein (DAS28-CRP) (p=0.002), DAS28 based on erythrocyte sedimentation rate (DAS28-ESR) (p=0.048) and inflammatory index. I-FABP also exhibited a positive association with DAS28-ESR (p=0.027). The triad of biomarkers demonstrated a superior diagnostic capability for distinguishing RA from HCs (area under the curve [AUC]=0.936; p<0.001) and contributed to the reliability of disease activity prediction, yielding an AUC of 0.804. Notably, sCD14 levels emerged as an independent predictor of synovitis (odds ratio: 1.834, 95% confidence interval: [1.160-2.901], p=0.009). CONCLUSIONS:Intestinal barrier-related biomarkers are associated with disease activity in RA. The combined assessment of LBP, sCD14, and I-FABP demonstrates good performance in differentiating RA from HCs and in evaluating disease activity. Furthermore, sCD14 may serve as a potential indicator of active synovitis, highlighting the clinical value of these biomarkers as complementary tools for disease assessment.

OBJECTIVE:This study aimed to evaluate the efficacy and safety of upadacitinib administered over a short-term period in patients with SAPHO syndrome. METHODS:In this 12-week retrospective observational study, eligible SAPHO syndrome patients diagnosed within the past year and treated with upadacitinib were enrolled. Efficacy was assessed using the Ankylosing Spondylitis Disease Activity Score based on C-reactive protein (ASDAS-CRP) and the Palmoplantar Pustulosis Area and Severity Index (PPPASI). Safety was evaluated based on the incidence of adverse events during the treatment period. RESULTS:A total of 35 eligible patients were included. Both ASDAS-CRP and PPPASI scores decreased rapidly by Week 4 (-1.01 and -11.41, respectively; both p < 0.001) and showed further significant improvements at Week 12 (-1.50 and -14.69, respectively; both p < 0.001) compared to baseline. Similar improvements were observed in the Visual Analogue Scale for overall musculoskeletal pain, the Bath Ankylosing Spondylitis Disease Activity Index, and other quality-of-life measures. Upadacitinib was well tolerated, with no serious adverse events reported. The most common adverse event was upper respiratory tract infection (20%). Other mild adverse events included elevated alanine aminotransferase, nausea, mild headache, and sore throat. CONCLUSION:Upadacitinib demonstrated a rapid onset of action, significant efficacy, and a favorable safety profile in the treatment of SAPHO syndrome, supporting its potential as a therapeutic option in clinical practice.

ObjectiveTo compare the risk of chronic obstructive pulmonary disease (COPD) between patients newly diagnosed with RA and individuals without RA. This large-scale study aims to provide novel insights into the association between RA and COPD by evaluating the impact of clinical factors and medications on COPD risk, using robust propensity-score matching.MethodsThis retrospective comparative cohort study utilized data from the TriNetX Research Network, collected on October 9, 2023. Patients newly diagnosed with RA from 2010 to 2021 were compared to non-RA individuals matched on demographics and medical history. Propensity-score matching balanced baseline covariates. The primary outcome was the 5-year risk of newly onset COPD (ICD-10: J41-J44), analyzed using Kaplan-Meier and Cox’s proportional hazards models.ResultsThe study included 136,820 pairs of RA and non-RA patients. The 5-year cumulative probability of COPD was 7.36% in the RA cohort versus 5.97% in the non-RA cohort, with a hazard ratio of 1.228 (95% CI = 1.186-1.272). Subgroup analyses showed higher COPD risk in RA patients across different demographics and clinical factors. Males, older patients, higher rheumatoid factor, and higher erythrocyte sedimentation rate increased COPD risk, while DMARDs and systemic NSAIDs reduced it.ConclusionRA patients have a significantly higher risk of developing COPD compared to non-RA individuals. These findings underscore the importance of targeted COPD prevention and management in RA patients.

Sjӧgren’s disease (SjD) is a complex and heterogeneous disease with female predominance. However, gender-related differences in the clinical and immunological profiles of SjD patients have not been fully explored, especially after adjusting for confounding factors such as age and disease duration. This study aims to investigate these gender-specific differences in a Chinese cohort. To explore the gender-related clinical and immunological differences in patients with SjD by conducting a propensity score-matched (PSM) study, controlling for age and disease duration. We retrospectively evaluated the medical records of patients with SjD who visited Peking University Peoples Hospital between January 2018 and December 2023. Using propensity scores, we matched females and males 1:1 based on age and disease duration. We then collected various clinical aspects from the medical records and compared them by gender. Male patients exhibited distinct clinical and immunological profiles compared to females. Clinically, males had a significantly higher prevalence of smoking (P < 0.001), along with lower frequencies of leukopenia (P < 0.001) and peripheral nervous system involvement (P = 0.039). Immunologically, males showed higher white blood cell counts (P = 0.002), lymphocyte counts (P = 0.033), and neutrophils levels (P=0.037), whereas females had elevated antinuclear antibody levels (P = 0.040) and erythrocyte sedimentation rates (P = 0.008). Furthermore, male patients displayed distinct lymphocyte profiles, characterized by reduced proportions of CD8+ T cells (P = 0.016), but increased natural killer cell counts. This study highlights significant gender-related differences in the clinical and immunological features of primary Sjögren’s syndrome in a Chinese cohort. Despite sharing similar sicca symptoms with females, male patients exhibited distinct immunological and hematological profiles. These findings underscore the importance of considering gender when assessing and managing SjD patients in clinical practice.

To investigate the practices of doctors in the diagnosis and treatment of adult SAPHO syndrome. A cross-sectional study was conducted by distributing online questionnaires to physicians across five hospitals, specifically targeting departments involved in the diagnosis and treatment of adult SAPHO syndrome, including rheumatology, dermatology, and orthopedics. A total of 103 clinical physicians participated in the survey.The three most commonly observed clinical features of adult SAPHO syndrome were elevated ESR and CRP (82/84), focal swelling and fever (73/84), and new lesions found on imaging (70/84). The primary diagnostic tools utilized were Whole body bone imaging (76.2

Introduction:Palmoplantar pustulosis (PPP) is a common chronic recurrent skin disease characterized by sterile pustules on the palms and soles of the feet. Most patients with PPP have a rash that improves during pregnancy due to the influence of estrogen and progesterone, but relatively few have an exacerbation of the rash during pregnancy. Case Introduction:Here, we show a female patient diagnosed with PPP, whose rash worsened during pregnancy and gestation. Her lesions were painful and cracked, interfering with normal walking and sleep, and was poorly treated with hormonal ointments and ultraviolet light. She gave birth to a healthy baby boy at 39 weeks plus 4 days of gestation after regular monitoring and stopped breastfeeding at 6 months of age and then presented to the outpatient clinic. For sterile pustules, we choose tofacitinib at a dosage of 5 mg b.i.d. Three months after taking the medication, the pustules on her hands and feet had mostly disappeared. Follow-up showed that the condition remained stable without recurrence. Conclusion:Aggravation of PPP during pregnancy is relatively rare. Tofacitinib, as an oral JAK inhibitor, is effective in the treatment of PPP exacerbated during pregnancy, but the risk to mother and child is unknown, and the relationship between tofacitinib and pregnancy outcome should be further investigated.

PurposeAsymptomatic hyperuricemia(AH) is characterized by elevated blood uric acid levels without symptoms,posing risks like gout, kidney stones, and cardiovascular diseases. This study aims to investigate the role of the gut microbiota in uric acid metabolism in AH.MethodsClinical data from 30 AH patients and 30 healthy controls were collected. Fecal microbiota genomic DNA was extracted, PCR amplified, library constructed, and sequenced. Bioinformatics and statistical analyses were conducted to study the gut microbiota of the two groups.ResultsThe AH group exhibited significantly elevated levels of body mass index (BMI), Triglycerides (TG), Total Cholesterol (TC), as along with a history of smoking, hypertension, and fatty liver disease compared to the healthy group (P < 0.05). The overall richness and ecological diversity of gut microbiota in the AH group decreased, with differences in the distribution at the phylum and genus levels compared to the healthy group. Uric acid demonstrated significant correlations with various gut microbiota (e.g., Granulicatella), suggesting their potential as biomarkers for AH. Despite limitations such as a small sample size and lack of long-term follow-up, our findings provide new insights for the early diagnosis and personalized treatment of AH. Looking ahead, these discoveries may advance the clinical management of AH and the exploration of associated biomarkers.

OBJECTIVE:To detect the potential association between the dietary index for gut microbiota (DI-GM) and hyperuricemia. METHOD:Utilizing cross-sectional analysis of National Health and Nutrition Examination Survey (NHANES) data, a multivariable logistic regression model was employed to reveal the impact of DI-GM on uric acid levels. The results indicate that participants with hyperuricemia had significantly lower DI-GM levels compared to those without hyperuricemia (OR = 0.93, 95% CI: 0.91-0.95, p < 0.001). Furthermore, even after adjusting for covariates, the association between DI-GM and hyperuricemia remained significant (OR = 0.97, 95% CI: 0.95-0.99, p = 0.012), suggesting a risk factor association between high DI-GM and low uric acid levels. The study also revealed a gradual decrease in the risk of hyperuricemia with increasing DI-GM, indicating the potential of DI-GM as a prognostic assessment marker (p for overall < 0.001). Additionally, a weak negative correlation between DI-GM and chronic kidney disease (CKD) was observed among patients with hyperuricemia (Adjusted OR = 0.90, 95% CI: 0.82-0.99, p = 0.027). CONCLUSION:These findings support the utility of DI-GM as a potential biomarker with important implications for the prevention and treatment of hyperuricemia. This discovery provides a crucial basis for the development of future dietary interventions and strategies related to gut microbiota, warranting further in-depth research to validate its applicability and effectiveness in diverse populations.

To evaluate the dynamic changes of glucocorticoid (GC) dose and the feasibility of GC discontinuation in rheumatoid arthritis (RA) patients under the background of Chinese medicine (CM). This multicenter retrospective cohort study included 1,196 RA patients enrolled in the China Rheumatoid Arthritis Registry of Patients with Chinese Medicine (CERTAIN) from September 1, 2019 to December 4, 2023, who initiated GC therapy. Participants were divided into the Western medicine (WM) and integrative medicine (IM, combination of CM and WM) groups based on medication regimen. Follow-up was performed at least every 3 months to assess dynamic changes in GC dose. Changes in GC dose were analyzed by generalized estimator equation, the probability of GC discontinuation was assessed using Kaplan-Meier curve, and predictors of GC discontinuation were analyzed by Cox regression. Patients with <12 months of follow-up were excluded for the sensitivity analysis. Among 1,196 patients (85.4

In order to implement the requirements of the document Opinions of the Central Committee of the Communist Party of China and the State Council on Promoting the Inheritance and Innovation of Traditional Chinese Medicine,accelerate the promotion of the construction of a healthy China,adhere to the equal importance of Chinese and Western medicines,promote the mutual complementarity of traditional Chinese medicine and Western medicine and coordinated development,strengthen the academic exchanges and cooperation of Chinese and Western medicine in the field of preventing and controlling gout,and cultivate the high-caliber young clinical talents,the China Association of Chinese Medicine(CACM)organized the 48th Salon on Clinical Advantageous Diseases in Beijing on 21 March 2025,focusing on the combined Chinese and Western medicine diagnosis and treatment strategy of gout,bringing together experts in Chinese and Western medicine and interdisciplinary fields,and reaching specific recommendations and consensus on the combined Chinese and Western medicine diagnosis and treatment of gout through in-depth discussion.On this basis,under the leadership of the CACM,gout diagnosis and treatment problems were analyzed from the perspective of gout occurrence and development law,focusing on the advantages and characteristics of Chinese medicine and combined Chinese and Western medicine in gout diagnosis and treatment,and proposing scientific research and technological layout of gout in the following aspects:(1)Improvement of gout staging and identification system,(2)optimization of Chinese medicine to prevent and treat gout and drug research and development,(3)improvement of indicators for post-treatment assessment of gout,(4)research on early warning system of Chinese and Western medicine,(5)construction of gout co-morbidities spectrum and Chinese medicine theoretical system,(6)research on co-morbidities mechanism of gout,(7)chronic disease grassroots health management,and at the same time,it also puts forward the proposed layout and direction of the research,the expected goal and value and the priority of the proposed funding.Therefore,this article is based on the gout Chinese medicine advantageous disease series salon,proposed gout scientific and technological research paradigm,in order to help the high-quality development of traditional Chinese medicine.

Tofacitinib, an oral Janus kinase inhibitor, has demonstrated teratogenic effects in animal models. However, there is a lack of data on its effects during human pregnancy, especially in the context of synovitis, acne, pustulosis, hyperostosis, osteitis (SAPHO) syndrome, a rare disease. We report a case of a 31-year-old female patient with SAPHO syndrome who became pregnant unexpectedly after 5 weeks of continuous tofacitinib treatment during the first trimester. Tofacitinib was immediately discontinued upon discovering the pregnancy. The patient successfully delivered a healthy full-term male infant under vigilant monitoring, and her SAPHO syndrome symptoms ameliorated during gestation but exacerbated 40 days postpartum. Given the limited clinical data available, further monitoring of pregnancy outcomes in patients treated with tofacitinib is still warranted.

Journal Article Corrected proof Clavicle fracture in SAPHO syndrome Get access Yajing Xi, Yajing Xi Department of Rheumatology, Dongfang Hospital, Beijing University of Chinese Medicine, Beijing, China Search for other works by this author on: Oxford Academic PubMed Google Scholar Zhimin Lin, Zhimin Lin Third Affiliated Hospital, Beijing University of Chinese Medicine, Beijing, China https://orcid.org/0009-0002-6034-1942 Search for other works by this author on: Oxford Academic PubMed Google Scholar Naigang Chen, Naigang Chen Department of Medical Imaging, Fangshan Hospital, Beijing University of Chinese Medicine, Beijing, China Search for other works by this author on: Oxford Academic PubMed Google Scholar Xiujuan Hou, Xiujuan Hou Department of Rheumatology, Dongfang Hospital, Beijing University of Chinese Medicine, Beijing, China Search for other works by this author on: Oxford Academic PubMed Google Scholar Yuelan Zhu, Yuelan Zhu Department of Rheumatology, Dongfang Hospital, Beijing University of Chinese Medicine, Beijing, China Search for other works by this author on: Oxford Academic PubMed Google Scholar Chen Li Chen Li Department of Rheumatology, Fangshan Hospital, Beijing University of Chinese Medicine, Beijing, China Correspondence to: Chen Li, Department of Rheumatology, Fangshan Hospital, Beijing University of Chinese Medicine, No.4, Baojian Road, Fangshan District, Beijing 102401, China. E-mail: casio1981@163.com https://orcid.org/0000-0002-8527-1680 Search for other works by this author on: Oxford Academic PubMed Google Scholar Rheumatology, kead640, https://doi.org/10.1093/rheumatology/kead640 Published: 04 December 2023 Article history Published: 04 December 2023 Corrected and typeset: 09 December 2023