Abstract Background To assess a combination of novel color Doppler ultrasound (CDUS), greyscale ultrasound (GSUS), and oscillometric indices of macroangiopathy and (CV) risk in patients with giant cell arteritis (GCA). Additionally, to explore the relationships between these imaging markers and both patient-specific and disease-related characteristics, as well as traditional CV risk factors. Methods CDUS was performed to evaluate arterial compliance markers, specifically the resistance (RI) and pulsatility (PI) indices, in both the common (CCA) and internal carotid artery (ICA) of GCA patients and healthy controls. GSUS examinations were conducted to measure carotid intima-media-thickness (cIMT), identify plaques, and quantify cumulative carotid calcification surface. Oscillometry was utilized to determine aortic stiffness via carotid-femoral pulse-wave velocity (cfPWV). Results Sixty-six GCA patients and 93 healthy subjects were included. Patients showed significantly higher cfPWV (padj <0.001), cIMT (padj =0.037), CCA-PI (padj =0.009), CCA-RI (padj=0.019), and plaque-area (p < 0.001) compared with controls. cfPWV correlated with traditional CV risk factors, like age (rho = 0.330, p < 0.009), mean-arterial-pressure (rho = 0.257, p = 0.044), and cholesterol (rho = 0.318, p = 0.017). CCA-PI and -RI were lower in patients receiving immunosuppressive therapy [1.5 (1.33–2.04) vs. 1.95 (1.72–2.29); 0.74 (0.68–0.82) vs. 0.80 (0.76–0.85), both; p < 0.05], and CCA-RI was predicted by erythrocyte-sedimentation-rate (rho = 0.343, p = 0.044). cIMT correlated with age (r = 0.619, p < 0.001) and plaque area (rho = 0.305, p = 0.047). Conclusion GCA patients demonstrated increased carotid pulsatility, resistance, atherosclerosis, and aortic stiffness compared to controls. Moreover, key predictors of impaired CV and cerebrovascular surrogates were identified. The combined assessment of CDUS and GSUS could provide a more thorough evaluation of the arterial tree, thereby enhancing the overall assessment of macroangiopathy. Trial registration DRKS00031470.

OBJECTIVES:To assess the value of optical spectral transmission (OST) in detecting joint inflammation in patients with psoriatic arthritis (PsA) and to evaluate correlations of OST with musculoskeletal ultrasound (US) and clinical disease activity markers. METHODS:OST and clinical examinations were performed on the finger (metacarpophalangeal, proximal-interphalangeal, distal-interphalangeal) and wrist joints of patients with PsA and healthy controls. A subset of patients was additionally examined via musculoskeletal US. OST differences in the two groups were statistically assessed and the diagnostic performance of OST was evaluated by Receiver-Operating-Characteristics (ROC). Additionally, associations between OST values and clinical, laboratory, as well as US activity markers were examined through correlation analyses and linear regression. RESULTS:A total of 3,000 joints from 100 PsA patients were examined using OST and compared to 3,000 joints from 100 controls. OST was significantly higher in the PsA group compared to the control group (15.76 vs. 10.24; p<0.001). ROC (PsA vs. controls) revealed a very good diagnostic OST performance by an area-under-the-curve of 0.848 (95%-CI 0.795-0.900; p<0.001), with a sensitivity of 0.89 and specificity of 0.71 for an OST cut-off of 12.75. Among patients, OST correlated moderately with Joint-Power-Doppler- (rho=0.412; p=0.015) and Grey-Scale-US (rho=0.419; p=0.014), respectively. Moreover, significant OST correlations with CRP (rho=0.232; p=0.021), ''Disease-Activity-in-Psoriatic-Arthritis (DAPSA)'' (rho=0.215; p=0.032) and "Disease-Activity-Score-28 (DAS28)" (rho=0.23; p=0.021) were found. CONCLUSION:OST associated significantly with clinical, US and laboratory disease activity markers in patients with PsA. Furthermore, OST could reliably differentiate between sonographically inflamed and non-inflamed joints in patients with PsA.

Early detection of arthritis in autoimmune rheumatic diseases (ARDs) is critical to prevent irreversible damage. Joint ultrasound (US) offers high sensitivity and availability in a routine clinical practice. However, US is limited by examiner dependency and resource requirements. Infrared thermography (IRT) is a non-invasive, radiation-free method to examine surface temperature alterations linked to arthritis. Although promising, its diagnostic performance relative to joint US remains incompletely defined. The aim of this review was to examine the literature on IRT and its relationship to joint US. We conducted a systematic review of PubMed, Web of Science, Directory of Open Access Journals (DOAJ) and Cochrane Central Register of Controlled Trials (CENTRAL) for studies published between January 2000 and December 2025. Studies were included if they assessed arthritic conditions using both IRT and US. Data on patient cohorts, assessment methods, findings, and diagnostic accuracy were extracted. Of 945 records, 19 studies met the inclusion criteria, primarily in rheumatoid arthritis (n = 13) and mixed populations (n = 4). IRT consistently differentiated inflamed from healthy joints. Sensitivity detecting arthritis ranged from 79 to 100

Abstract Objectives To assess, for the first time, macrovascular, medium-calibre vessel, and microvascular damage in Sjögren’s disease (SjD) using carotid greyscale ultrasound (GSUS), retrobulbar colour Doppler ophthalmic artery (OA) ultrasound (RCDUS), and static retinal vessel analysis (SRVA). Additionally, to evaluate associations of these markers with cardiovascular (CV) risk factors, patient- and disease-related characteristics. Methods GSUS of the common carotid arteries was performed to measure carotid intima-media thickness (cIMT) and evaluate plaque burden. RCDUS assessed OA flow velocity integral (FVI), resistive, and pulsatility indices (RI, PI). SRVA quantified retinal microvasculature using central retinal arteriolar, venular equivalents (CRAE, CRVE), and the arteriovenous ratio (AVR). Imaging findings were compared between patients with SjD and healthy controls and analysed in relation to clinical parameters. Results 130 SjD patients and 100 controls were included. SjD patients showed significantly higher cIMT (padj=0.003), OA-RI (padj=0.003) and -PI (padj<0.001), as well as lower OA-FVI (padj=0.012) and CRAE (padj=0.013) compared with controls. Higher OA-RI and -PI correlated with higher disease activity (ESSDAI: both; rho=0.324, p = 0.006), and impaired renal function (rho=-0.461, p < 0.001 and rho=-0.370, p = 0.002, respectively). OA-RI associated positively with age (rho=0.435, p < 0.001) and inversely with lung carbon monoxide diffusion (r=-0.342, p = 0.019). Lower CRAE correlated with higher mean arterial pressure (r =-0.378, p < 0.001), CRP (rho= -0.215, p = 0.046), ANA titre (rho=-0.268, p = 0.016), and disease activity (ESSDAI: rho=-0.273, p = 0.011). Conclusions In this first comprehensive study of CV surrogate markers in SjD, patients exhibited vascular alterations across multiple vascular beds, indicating systemic vascular involvement and a possible link to increased cardiovascular and cerebrovascular risk.

BACKGROUND:Connective tissue diseases such as systemic lupus erythematosus (SLE) and systemic sclerosis (SSc) require interdisciplinary management due to their multisystem involvement. Pulmonary manifestations (CTD-ILD) are of particular prognostic relevance. However, real-world data on current healthcare provision remain limited. METHODS:A cross-sectional survey (14 modules) was conducted between September 2024 and March 2025, targeting 2173 practices across various specialties in Rhineland-Palatinate and Saarland. Data on healthcare structures, patient numbers, pulmonary involvement, and pharmacological treatment were collected. Analysis was performed descriptively at the provider level. RESULTS:A total of 67 institutions reported on 1569 patients (SLE: n = 859; SSc: n = 421), of whom 286 (≈18%) had pulmonary involvement. Care was predominantly delivered in specialized centers, but with substantial contribution from office-based physicians. Marked differences in treatment strategies were observed: office-based settings more frequently relied on higher-dose glucocorticoids (up to ≈28% > 10 mg/day), whereas specialized centers achieved significant glucocorticoid reduction (≈1.5% > 10 mg/day) through increased use of biologics and disease-modifying therapies, particularly mycophenolate mofetil (MMF). MMF was notably more frequently used in rheumatology-based care compared to other specialties. CONCLUSION:The findings reveal relevant deficiencies in care, particularly an overreliance on glucocorticoids and underutilization of evidence-based disease-modifying antirheumatic drugs (DMARDs) such as MMF in nonspecialized settings. Contributing factors likely include limited rheumatology expertise and insufficient interdisciplinary coordination. Improving care requires expansion of rheumatologic capacity, earlier specialist referral, and broader implementation of guideline-based, steroid-sparing treatment strategies.

INTRODUCTION:This study evaluated the effects of belimumab versus placebo on biomarker responses and identified predictive biomarkers for kidney response to belimumab in patients with lupus nephritis (LN) receiving different standard therapies. METHODS:BLISS-LN was a Phase 3 study (NCT01639339) of adults with active LN randomized to intravenous belimumab 10 mg/kg or placebo plus standard therapy (cyclophosphamide [CYC] or mycophenolate mofetil [MMF] as initial therapy followed by azathioprine or MMF). Absolute and percentage changes from baseline in immunoglobulins, anti-dsDNA and anti-C1q antibodies, C3 and C4, CD19+ B cells and subsets were assessed through Week 104. Post hoc logistic regression models assessed the association of baseline biomarker levels, and of early changes in biomarkers, with kidney response to belimumab in the overall population at Week 104. RESULTS:Of 446 patients (belimumab: 59 received CYC, 164 received MMF; placebo: 59 received CYC, 164 received MMF), approximately 50-60% had data on treatment at Week 104. At Week 104, numerically greater percentage reductions in IgA, IgM and anti-dsDNA antibodies and plasmablasts, and greater increases in C3 and C4 levels, were observed with belimumab versus placebo. Overall, belimumab reduced total CD19+ B cells and naïve B cells versus placebo. These results were generally consistent in the overall population and within each induction group. Predictors of kidney response observed in belimumab-treated patients included high baseline levels of IgA, anti-C1q antibodies and naïve B cells, low baseline plasmablasts and early decreases from baseline in levels of IgA, IgM and urinary protein to creatinine ratio. CONCLUSIONS:Similar effects of belimumab on biomarker outcomes were observed within the induction groups. Baseline biomarkers and early changes in biomarkers associated with kidney response to belimumab in LN were identified.

This study aimed to evaluate the diagnostic performance of optical spectral transmission (OST) in patients with hand osteoarthritis (OA) and to assess its associations with clinical findings, joint ultrasound (US) markers of active OA, and patient- and disease-related characteristics. In this exploratory pilot study, consecutive patients with OA and healthy controls underwent OST measurements using the HandScan® device. Clinical examinations and inflammatory markers (C-reactive protein, erythrocyte sedimentation rate) were obtained. A subset of patients underwent standardized joint US [greyscale (GSUS)/power Doppler (PDUS)]. Correlations between OST and clinical, anthropometric and US parameters were examined, and receiver operating characteristics (ROC) assessed discriminative ability. Linear regression was used to evaluate confounding effects. A total of 2910 joints of 97 patients with OA were examined via OST and compared to 3300 joints of 100 control subjects. OST values were significantly higher in patients with OA than in controls (10.39 ± 1.82 vs. 7.51 ± 3.80; p < 0.001), and this difference remained significant after adjustment for potential confounders (β = 1.698; 95

Objectives To evaluate the prognostic value of carotid-femoral pulse wave velocity (cfPWV), a marker of aortic stiffness, for cardiovascular events (CVEs) in patients with autoimmune rheumatic diseases (ARDs) and to compare its performance with the Systematic Coronary Risk Evaluation 2 (SCORE2).Methods This retrospective cohort study included patients with rheumatoid arthritis, systemic sclerosis and spondyloarthritis who underwent clinically indicated baseline non-invasive cfPWV assessment between 2012 and 2017 because of at least one additional cardiovascular risk factor. CV risk was estimated using SCORE2 and SCORE2-OP in eligible patients. Incident CVEs were ascertained through structured interviews over a median 7-year follow-up. Associations were evaluated using Cox proportional hazards models and predictive performance using receiver operating characteristic analysis.Results Among 143 patients, 20 CVEs occurred. Baseline cfPWV was higher in patients who developed CVEs versus those who did not (10.06±2.16 m/s vs 8.8±2.3 m/s; p=0.024). SCORE2 did not differ between groups (6.55±3.90% vs 5.61±4.39%, p=0.35). cfPWV demonstrated strong discriminatory capacity for CVEs (area under the curve (AUC) 0.84; 95% CI (0.73 to 0.93), sensitivity 0.87, specificity 0.73), outperforming SCORE2 (AUC 0.56; 95% CI (0.41 to 0.72), sensitivity 0.60, specificity 0.69). In age-adjusted Cox regression, cfPWV remained a significant predictor of CVEs (HR 1.19, 95% CI (1.00 to 1.39); p=0.047). cfPWV correlated with baseline age (p<0.001), mean arterial pressure (p=0.013) and C reactive protein (p=0.011).Discussion cfPWV is an independent predictor of future CVEs in patients with ARDs and outperforms SCORE2 in long-term risk prediction. Given its non-invasive nature, cfPWV may provide incremental value for CV risk stratification in this high-risk population.

OBJECTIVES:To evaluate for the first time a combination of novel colour Doppler ultrasound (CDUS), greyscale (GSUS) and oscillometric indices of angiopathy in patients with autoinflammatory syndromes (AIS). Further, to explore the associations between these markers and patient- and disease-related characteristics, as well as traditional cardiovascular (CV) risk factors. METHODS:CDUS was used to assess arterial compliance markers, such as resistance index, pulsatility index (PI) and flow-velocity integral (FVI) in the common carotid artery (CCA) of AIS patients and healthy controls. Additionally, GSUS was employed to measure carotid intima-media thickness (cIMT), detect plaques and quantify total calcification surface. Oscillometry was utilized to evaluate aortic stiffness by carotid-femoral pulse wave velocity (cfPWV). RESULTS:Thirty-one patients with AIS and 62-matched (1:2) healthy controls were recruited. AIS patients exhibited higher CCA-PI [1.89 (0.46) vs 1.59 (0.32), P = 0.024] and peak systolic velocity (80.15 vs 64.95 cm/s, P = 0.003), compared with controls. Moreover, AIS patients not receiving biologic therapy demonstrated significantly higher cfPWV [6.99 (1.71) vs 5.86 (0.81) m/s, P = 0.001]. cfPWV and cIMT were predicted by age (cfPWV: rho = 0.573, P < 0.001; cIMT: rho = 0.675, P = 0.002), systolic arterial pressure (SAP) (cfPWV: r = 0.464, P = 0.009; cIMT: rho = 0.514, P = 0.029) and lymphadenopathy (cfPWV: eta = 0.373, P = 0.039). PI associated with nicotine (rho = 0.691, P = 0.008) and FVI (inversely) with SAP (rho = -0.522, v0.026). CONCLUSION:In the first CV surrogate marker study in AIS combining oscillometry and arterial US, patients exhibited increased carotid pulsatility and altered flow dynamics vs controls. Aortic stiffness was lower in patients receiving biologics and mainly predicted by traditional CV factors and lymphadenopathy. Angiopathy markers may reveal significant vascular abnormalities in AIS patients, improving CV screening and risk classification.

Kollagenosen wie systemischer Lupus erythematodes (SLE) und systemische Sklerose (SSc) erfordern aufgrund multisystemischer Manifestationen eine interdisziplinäre Versorgung. Insbesondere die pulmonale Beteiligung (CTD-ILD) ist prognostisch relevant. Daten zur realen Versorgungssituation sind jedoch limitiert, wodurch strukturelle Defizite schwer identifizierbar bleiben. Mit einem selbstentwickelten 14-moduligen Fragebogen wurden zwischen 09/2024 und 03/2025 insgesamt 2173 Praxen verschiedener Fachrichtungen in Rheinland-Pfalz und dem Saarland kontaktiert. Erfasst wurden Versorgungsstrukturen, Patientenzahlen, pulmonale Manifestationen sowie pharmakologische Therapien. Die Auswertung erfolgte deskriptiv auf Behandler-Ebene. Insgesamt 67 Einrichtungen berichteten über 1569 Patienten (SLE: n = 859; SSc: n = 421), von denen 286 (≈18

The early and accurate detection and diagnosis of diseases play a crucial role in impeding disease progression and guiding appropriate treatment selection. Complex diseases such as autoimmune diseases (ADs), often present nonspecific symptoms that can overlap also with other conditions, leading to misdiagnosis. Medical software, known as clinical decision support systems (CDSS), is used by clinicians to categorize patients based on specific criteria. However, existing CDSS implementations, generally developed within individual hospitals, are often limited to specific data types, and reflect questionnaires that do not take advantage of machine learning (ML) methods for detection and prediction of complex patterns. To address this gap, we developed Personalis as a proof-of-concept medical software. Personalis integrates various modalities of medical datasets and applies ML models to target hospital datasets and disease-target specific prediction tasks within a unified software environment. The platform has been run with real-world data to investigate the potential of this proof-of-concept medical software in providing early clinical support for the personalized prediction of specific autoimmune diseases in individual patients. These intermediate results have been implemented to redesign the front-end to enhance user-experience, and serve the conveyed clinical needs and expectations. Personalis is a proof-of-concept medical software that demonstrated the feasibility of integrating various data modalities and machine learning methods to support clinicians in the diagnosis, treatment or management of individual patients with autoimmune diseases. By leveraging ML methods, Personalis provided prediction with a certain accuracy of a specific autoimmune disease for an individual patient, highlighting factors that contributed to the prediction results. Explainable machine learning made the models’ decisions understandable to humans, and the resulting factors were further used to provide additional clinical insights beyond the disease prediction accuracy metric. The platform was designed considering user-experience and human factors to enable actionable clinical practical adoption. Its results may provide hints on the prognosis assessment by selecting a specific patient record. Personalis provides a proof-of-concept medical software for integrating heterogeneous clinical data with configurable ML-based prediction and interpretation workflows for autoimmune diseases. It offers a mechanistic overview of the parameters that mostly influence the prediction of the machine learning models, therefore providing interpretable results and mechanistic insights essential to model transparency. The potential of the medical software Personalis is be extended to several diseases, and support in cases of challenging differential diagnoses.

BackgroundAxial spondyloarthritis (axSpA) is a chronic inflammatory rheumatic disease characterized by pain and stiffness of the axial skeleton, peripheral manifestations like arthritis, dactylitis and enthesitis, extra-musculoskeletal manifestations, and reduced health-related quality of life (HRQoL). Depressive symptoms and fatigue are common, yet few studies have assessed these outcomes at diagnosis and during early treatment.ObjectiveTo evaluate mental health, fatigue, HRQoL, and their association with disease activity and functional status in patients with axSpA at diagnosis and after 1 year of rheumatologic care.MethodsRheuma-VOR is a multicenter, proof- of concept study in Germany implementing structured preselection and early referral for suspected axSpA. We included 238 patients with confirmed axSpA, of whom 76 completed a 12-month follow-up. Disease activity (BASDAI, ASDAS), functional status (BASFI, BASMI, FFbH), mental health (PHQ-9, WHO-5), fatigue (FACIT-F), and HRQoL (EQ-5D) were assessed at baseline and follow-up. Associations between disease activity, function, and patient-reported outcomes (PROs) were analyzed using correlation and multivariable regression.ResultsAt diagnosis, patients exhibited high disease activity (BASDAI 4.6 ± 2.0, ASDAS 2.6 ± 0.9) and substantial prevalence of depressive symptoms (PHQ-9 ≥ 10 in 36.5%) and fatigue (FACIT-F < 39 in 69.5%). One-year follow-up showed significant improvements in disease activity, functional impairment, HRQoL, mental well-being, and fatigue (all p < 0.05). Higher patient-reported disease activity (BASDAI) consistently predicted depressive symptoms and fatigue, whereas functional capacity (FFbH) was the strongest predictor of HRQoL. Physician-assessed disease activity (ASDAS) and functional impairment (BASFI) had smaller or time-limited effects.ConclusionIn axSpA, patient-reported disease activity and functional capacity are key determinants of mental health, HRQoL, and fatigue. Early diagnosis and initiation of guideline-concordant therapy are associated with improvements across physical and psychological domains, supporting systematic screening and interdisciplinary management strategies.

Abstract 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.

Systemic sclerosis (SSc) is a connective tissue disease of multifactorial origin in which autoimmune inflammatory reactions lead to fibrosis of multiple tissues. In the past, renal crisis was a common complication with a very high mortality. Due to the recommendation for a more cautious use of corticosteroids and the use of ACE inhibitors as an acute treatment reduced the incidence of a renal crisis and improved overall survival since the 1980s. However, lung involvement including pulmonary arterial hypertension, interstitial lung disease and lung fibrosis is now the most common cause of death in SSc. An early detection, including the use of HR-CT screening, and adequate treatment of interstitial lung disease are therefore of the utmost importance. Mycophenolate mofetil (MMF) has proven to be an effective therapeutic agent for the pulmonary manifestation. Nintedanib is the only drug approved in Germany for SSc-associated progressive lung fibrosis. Studies have shown the best prognostic improvements with early combination therapy of MMF in combination with Nintedanib.

Introduction:Medical approval of biosimilars requires comparable quality, biological activity, safety as well as efficacy of the reference biologic drug. Aim:The aim of this study is to examine whether biosimilars for adalimumab and etanercept can be prescribed as substitutes for the originator drugs in a real-world patient collective. Material and methods:For the analysis, 259 outpatients with psoriasis (94%) or hidradenitis suppurativa (6%) were retrospectively examined regarding disease burden, side effects and symptoms during and following the transition from a biologic to a biosimilar and, if applicable, after switching back to the originator drug. Results:Of the analysed cohort, 76.4% of patients had previously received the adalimumab originator, Humira®, and 23.6% the etanercept originator, Enbrel®. 79.5% of those patients were switched to a biosimilar. In that group, 94.2% of patients returned for a follow-up visit (after 3 to 9 months), with 78.9% of them continuing the biosimilar therapy until the end of the observation period. 21.1% of all patients were switched back to the original treatment or another medication due to various reasons, such as deterioration of efficacy (68.3%), progression of arthritis (68.3%) and increased skin symptoms (56.1%). Conclusions:This real-world data shows that biosimilar therapy is successful in around 80% of the population observed. In the event of exacerbation of symptoms or occurrence of side effects, switching back to the biologic might be necessary and was proved to be problem-free.

To assess for the first time a combination of oscillometric, greyscale- and novel color-Doppler ultrasound (US) indices of carotid and aortic damage in patients with primary Sjögren's syndrome (pSS). Moreover, to examine associations of these markers with patient and disease-characteristics, as well as with a traditional cardiovascular (CV) risk score (SCORE) and its EULAR-modified version (mSCORE). Greyscale and color-Doppler indices [resistance (RI)- and pulsatility (PI)-index], as well as markers of atherosclerosis [Intima-Media-Thickness (cIMT), plaques, and cumulative calcification surface], were examined in the common- (CCA) and internal- (ICA) carotid arteries of pSS patients and healthy controls. The gold standard oscillometric marker of aortic stiffness (carotid-femoral pulse wave velocity; cfPWV) and the traditional SCORE/mSCORE, were also assessed. We recruited 119 pSS-patients and 97 controls. Patients exhibited significantly higher cfPWV (padj = 0.025), cIMT (padj < 0.001), and calcification area (p = 0.013), compared to controls. According to mSCORE, 5.7% of the patients had high CV risk. However, cfPWV and carotid-sonography revealed increased aortic stiffness in 45.4% and carotid atherosclerosis in 69.2%, respectively. Among pSS-patients, cfPWV correlated with C-reactive-protein (rho = 0.325, p < 0.001), erythrocyte-sedimentation-rate (rho = 0.271, p = 0.003), and traditional CV-risk factors (age, cholesterol, systolic blood pressure: all; p < 0.01). ICA-RI and ICA-PI were higher in patients with further (non-rheumatological) autoimmune diseases (both; p < 0.05). In the largest cfPWV/US-cohort examined to date, pSS-patients had significantly higher aortic stiffness and atherosclerosis than controls. Aortic stiffness was predicted by systemic inflammation, alongside traditional CV risk factors. cfPWV and carotid-US may help identify subclinical end-organ disease and atherosclerosis and thus assist CV/CVB-screening in pSS. DRKS00031470. .

Abstract Background Optical spectral transmission (OST) is a modern diagnostic method capable of quantifying inflammation in the finger and wrist joints of arthritis patients by assessing the blood-specific absorption of light transmitted through a tissue. The diagnostic performance of this modality has not been adequately examined and data regarding OST associations with magnetic resonance imaging (MRI) are limited. Aim of this study was therefore to investigate the performance of OST in assessing joint inflammation as compared to MRI in patients with inflammatory arthritis (IA). Methods Data from patients who underwent MRI and OST for suspected IA were analyzed. For comparison, a historical healthy control (HC) group with OST was also accounted. MRI findings were quantified using the Rheumatoid Arthritis MRI Score (RAMRIS). Diagnostic accuracy of OST was evaluated using Receiver Operating Characteristics (ROC), while correlation analyses were conducted to explore relationships between OST and MRI, as well as disease activity markers. Results Overall, 71 patients with known rheumatic diseases (n = 1,542 wrist and finger joints) and 114 HC (n = 2,508 joints) subjects were included. 51 patients showed inflammatory signs on MRI (MRI+). These also showed significantly higher OST scores (16.41 ± 5.53) than subjects without MRI inflammation (MRI-) (11.52 ± 5.03) or HC (10.78 ± 4.19) (all; p < 0.001). OST showed significant correlations with RAMRIS-synovitis and tenosynovitis scores in the MRI + group (rho = 0.541, p < 0.001; rho = 0.341, p = 0.01, respectively). Significant correlations were observed between OST and clinical parameters for disease activity. Using MRI as a reference, the best diagnostic value of OST was observed at the wrist level in the MRI + group, by an AUC of 0.833 (95%CI 0.700-0.966). Conclusion OST showed an excellent performance compared to MRI and correlated significantly with RAMRIS scores and clinical parameters in IA patients, also differentiating IA from HC.

OBJECTIVE:To examine the longitudinal associations of optical spectral transmission (OST) with clinical inflammatory arthritis activity markers in order to investigate its potential in monitoring disease activity. METHODS:OST measurements were performed in 1312 wrist and finger joints of 60 patients with clinical suspicion of inflammatory activity, within the context of known rheumatic inflammatory diseases at two separate time intervals. In each time point, patients underwent additional clinical and laboratory examinations. The change of OST values was statistically compared with changes in clinical activity parameters like DAS28 and swollen joint counts (SJC). Additionally, the diagnostic performance of OST was assessed in comparison to a historic control group (2508 joints of 114 healthy subjects) using receiver operating characteristics (ROC). The relationships between OST values, clinical and laboratory parameters, as well as patient characteristics, were evaluated through correlation analyses. RESULTS:Mean OST scores were significantly higher in the inflammatory arthritis group compared with the control group (P < 0.001). OST correlated significantly with clinical activity markers like DAS28, SJC and TJC in both time points (all; P < 0.05). Longitudinal changes of OST values (ΔOST) were significantly associated with changes in DAS28 (ΔDAS28) (r = 0.377; P = 0.004) and ΔSJC (r = 0.488; P < 0.001) over the same time period. The area under the curve of the baseline receiver operating characteristic curve was 0.781 (95%CI 0.82-0.94). CONCLUSION:OST was able to reliably assess disease activity and correlated longitudinally with arthritis activity markers, showing promising potential during monitoring of inflammatory arthritis.

Körperliche Aktivität und gezieltes Training weisen wissenschaftlich belegte gesundheitsfördernde Wirkungen auf und werden zunehmend in der Behandlung entzündlich-rheumatischer Erkrankungen eingesetzt. Studien und Leitlinien zeigen, dass Bewegung sicher und effektiv ist, das subjektive Wohlbefinden verbessert und objektive klinische Parameter positiv beeinflusst. Die Literaturlage wurde systematisch verortet, um die Evidenz für den Einsatz von Sport- und Bewegungstherapie bei rheumatischen Erkrankungen zu verstehen. Dabei wurden Empfehlungen internationaler Fachgesellschaften und aktuelle Studien berücksichtigt. Die Sport- und Bewegungstherapie spielt eine wichtige Rolle bei der Prävention und Therapie verschiedener chronischer Erkrankungen, darunter entzündlich-rheumatische Krankheiten wie rheumatoide Arthritis, Spondyloarthritis, Psoriasisarthritis und Kollagenosen. Nicht für alle rheumatischen Erkrankungen existieren jedoch allgemeingültige Bewegungsempfehlungen (z. B. bei Vaskulitiden). Es stehen unterschiedliche Trainingsformen zur Verfügung (Ausdauer, Kraft, Beweglichkeit, Koordination), die je nach individuellen Bedürfnissen und Möglichkeiten kombiniert werden können. Die Gestaltung des Trainings (Art, Intensität, Frequenz und Dauer) sollte an die jeweiligen Voraussetzungen angepasst werden, beispielsweise im Hinblick auf Begleiterkrankungen, medikamentöse Therapien und das allgemeine Fitnesslevel. Die Sport- und Bewegungstherapie ist kein One-size-fits-all-Ansatz, sondern ein personalisiertes, evidenzbasiertes Behandlungsinstrument. Die Therapie muss die jeweiligen Krankheitsbilder, deren Schweregrad, Begleiterkrankungen sowie den allgemeinen Gesundheitszustand berücksichtigen. Zusammengefasst sind körperliche Aktivität und Sport sichere „Breitbandmedikamente“, die Funktionsfähigkeit, Lebensqualität und Begleiterkrankungen positiv beeinflussen, ohne die Krankheitsaktivität zu erhöhen oder Schübe auszulösen.