Rheumatology

Malignancy risk is similar across b/tsDMARD classes in RA

In this Taiwanese nationwide cohort of 8732 biologic-naïve adults with RA, cancer risk was comparable among TNFi, tocilizumab, abatacept, and tsDMARDs. No statistically significant differences in malignancy incidence appeared over 5-year and extended 18-year follow-up across these treatment groups. Male sex, older age at b/tsDMARD initiation, chronic lung disease, and higher-dose corticosteroid use were independently associated with higher malignancy risk. Conventional DMARD co-therapy and more frequent ambulatory follow-up were linked with lower malignancy risk, likely reflecting better disease control. 1

Unfavorable social context shortens life expectancy in RA

More than 15,000 adults with RA from China Kadoorie Biobank and UK Biobank were stratified by composite social determinants of health scores. Unfavorable social determinants were associated with substantially higher mortality, with adjusted hazard ratios around 1.6–1.8 versus favorable profiles. At age 45, RA patients with unfavorable social context lost several years of life expectancy, with sex- and country-specific patterns. Phenome-wide analysis identified 51 incident conditions, including heart failure, obstructive chronic bronchitis, and renal failure, with 1.2–5.2-fold higher risks. 2

Pulmonary involvement is frequent and damaging in AAV

Among 1026 patients with ANCA-associated vasculitis, 81.3% developed pulmonary manifestations during their disease course. Pulmonary involvement was present at onset in 62.7% and recurred in 41.4% of relapse episodes, often with multiple concurrent manifestations. Nodules and cavities, diffuse alveolar hemorrhage, and inflammatory infiltrates were most common; nodules predominated in GPA, hemorrhage in MPA. Overall, 17.4% of those with pulmonary disease accrued permanent pulmonary damage attributed to vasculitis. 3

Epigenomic maps in primary OA tissues identify effector genes

In 314 patients undergoing knee replacement for osteoarthritis, investigators profiled genotype, DNA methylation, and gene expression across multiple primary tissues. They generated genome-wide mQTL maps in cartilage, synovium, infrapatellar fat pad, and blood, plus eQTM maps in cartilage and synovium. Integration with OA GWAS signals revealed widespread variant–methylation and methylation–expression associations relevant to disease biology. Colocalisation analyses highlighted methylation sites with potential causal roles and identified 50 likely effector genes at GWAS loci. 4