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Global perspectives on lupus nephritis: a review of clinical trials and therapeutic innovations.

BACKGROUND AND OBJECTIVES: Lupus nephritis (LN) remains a leading cause of morbidity and mortality in systemic lupus erythematosus (SLE). Although recent years have witnessed the approval of several targeted therapies, achieving long-term, drug-free remission remains challenging. This commentary evaluates the global landscape of interventional LN clinical trials from 2001 to 2026 to identify emerging trends and strategic gaps in drug development. METHODS: We analyzed 200 interventional pharmacological trials retrieved from three major global registries: ClinicalTrials.gov, Chinadrugtrials.org

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… Ann Rheum Dis . ( 2023 ) 82 : 351–6 . doi: 10.1136/ard-2022-223035 . PMID: 36241363 PMC9933169 2 Yu C Li P Dang X Zhang X Mao Y Chen X . Lupus nephritis: new progress in diagnosis and treatment . J Autoimmun . ( 2022 ) 132 : 102871 . doi: 10.1016/j.jaut.2022.102871 . … Ann Rheum Dis . ( 2025 ) 84 : 697 – 715 . doi: 10.1016/j.ard.2025.01.024 . PMID: 39934016 54 Dawudi Y Benarroch S Helfer H Smadja DM Mahé I . Janus kinase inhibitor treatment for inflammatory diseases: excess or no excess risk of venous thromboembolism ? …

CAR-T cell therapies in autoimmune rheumatic diseases: a brief report on the clinical trial landscape, current status, and future perspectives.

Autoimmune rheumatic diseases (ARDs) are chronic inflammatory disorders where B cells play a key role. Traditional B-cell-targeted therapies have limitations, whereas CAR-T-cell therapy, which aims for a broader reset of the B-cell compartment by targeting B-cell surface markers such as CD19 or B-cell maturation antigen (BCMA), has unique advantages. Currently, most CAR-T cell trials for ARDs are in the early stages, with 64.29% (36/56 trials) of studies being phase I trials and only 7.14% (4/56 trials) progressing to phase II trials, primarily focusing on conditions, such as systemic lupus er…

Autoantibodies as Biomarker and Therapeutic Target in Systemic Sclerosis.

Systemic sclerosis (SSc) is a rare connective tissue disorder characterized by immune dysregulation evoking the pathophysiological triad of inflammation, fibrosis and vasculopathy. In SSc, several alterations in the B-cell compartment have been described, leading to polyclonal B-cell hyperreactivity, hypergammaglobulinemia and autoantibody production. Autoreactive B cells and autoantibodies promote and maintain pathologic mechanisms. In addition, autoantibodies in SSc are important biomarkers for predicting clinical phenotype and disease progression. Autoreactive B cells and autoantibodies rep

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… Arthritis Rheum. 2018 48 1133 1141 10.1016/j.semarthrit.2018.10.007 30409417 56. Sato S. Fujimoto M. Hasegawa M. Takehara K. … Rheum. Dis. 2013 72 1747 1755 10.1136/annrheumdis-2013-204424 24092682 73. Mierau R. Moinzadeh P. Riemekasten G. Melchers I. Meurer M. Reichenberger F. Buslau M. Worm M. Blank N. Hein R. …

Targeted Small Molecules for Systemic Lupus Erythematosus: Drugs in the Pipeline.

Despite the uncertainty of the pathogenesis of systemic lupus erythematosus, novel small molecules targeting specific intracellular mechanisms of immune cells are being developed to reverse the pathophysiological processes. These targeted molecules have the advantages of convenient administration, lower production costs, and the lack of immunogenicity. The Janus kinases, Bruton's tyrosine kinases, and spleen tyrosine kinases are important enzymes for activating downstream signals from various receptors on immune cells that include cytokines, growth factor, hormones, Fc, CD40, and B-cell recept

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… Ann Rheum Dis. 2018;77:1070–1077. doi: 10.1136/annrheumdis-2017-212794. 44. de la Varga MR, Rodríguez-Bayona B, Añez GA, Medina Varo F, Pérez Venegas JJ, Brieva JA, et al. … Ann Rheum Dis. 2018;77:1516–1523. doi: 10.1136/annrheumdis-2017-212916. 141. Rivellese F, Manou-Stathopoulou S, Mauro D, Goldmann K, Pyne D, Rajakariar R, et al. …

Chronic Pain and Bone-Related Pathologies: A Narrative Review.

PurposePain related to bone may occur as a result of trauma, bone fracture, genetic disease, arthritis, benign or malignant primary bone tumors and bone cancer metastases. We discuss the pathophysiology of chronic bone-related pain, treatment options and therapeutic perspectives.MethodsUsing predefined terms, we searched PubMed, MEDLINE, and Google Scholar for meta-analyses, evidence-based reviews, and clinical practice guidelines. This narrative article reviews pathologies linked to chronic bone pain and discusses the preventive and therapeutic strategies for better bone pain management.Resul

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… Semin Arthritis Rheum . 2018;47(4):457–463. doi: 10.1016/j.semarthrit.2017.08.006 9. Vincent TL. Peripheral pain mechanisms in osteoarthritis. Pain . 2020;161(Suppl 1):S138–S146. PMID: 33090747. doi: 10.1097/j.pain.0000000000001923 10. Motta F, Barone E, Sica A, Selmi C. … Arthritis Rheum . 1987;30(1):36–43. doi: 10.1002/art.1780300105 25. Scholz J, Finnerup NB, Attal N. Attal N et al.The IASP classification of chronic pain for ICD-11: chronic neuropathic pain. Pain . 2019;160(1):53–59. PMID: 30586071. doi: 10.1097/j.pain.0000000000001365 26. …

CAR T cell therapy for refractory pediatric systemic lupus erythematosus: a new era of hope?

Systemic lupus erythematosus (SLE) is a chronic autoimmune condition that can affect multiple organ systems and is heterogenous in its presentation and response to therapy. When diagnosed in childhood, SLE is associated with increased morbidity and mortality compared to adult SLE, often requiring substantial immunosuppression with the risk of significant side effects. There remains a significant unmet need for new therapies that can improve disease control and reduce glucocorticoid and other toxic medication exposure for patients with severe or refractory disease. The pathogenesis of SLE invol

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… Ann Rheum Dis. 2023;82:999–1014. 10.1136/ard-2022-223741 18. Loh JT, Lam K-P. Neutrophils in the pathogenesis of rheumatic diseases. Rheumatol Immunol Res. 2022;3:120–7. 10.2478/rir-2022-0020 19. Sutanto H, Yuliasih Y. … Arthritis Rheum. 2012;64:1215–26. 10.1002/art.34359 44. Merrill J, et al. Assessment of flares in lupus patients enrolled in a phase II/III study of Rituximab (EXPLORER). Lupus. 2011;20:709–16. 10.1177/0961203310395802 45. Navarra SV, et al. …

Stem cell therapy as a potential treatment option for psoriasis.

Psoriasis is a chronic inflammatory dermatological disorder characterized by white scales and clearly demarcated erythematous plaques. The prevalence of psoriasis varies from country to country and can occur at any age, implying that ethnicity, environmental factors, and genetic background all play a role in its onset. According to the World Psoriasis Day Consortium, 125 million people globally and 2%-3% of the overall community have psoriasis. The introduction of biological treatments has revolutionized the treatment of moderate to severe psoriasis. These novel drugs, particularly those targe

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… Arthritis Rheum Off J Am Coll Rheumatol. 2010;62:430–440. doi: 10.1002/art.27203. 8. Campa M., Mansouri B., Warren R., Menter A. A Review of Biologic Therapies Targeting IL-23 and IL-17 for Use in Moderate-to-Severe Plaque Psoriasis. … Ann Rheum Dis. 2006;65:697. doi: 10.1136/ard.2005.039479. 30. Zurita G, Geffner L, Maldonado B, Uraga E, Armijos L. Autologous Stem Cells Implants in Psoriasis. Published online 2017. 31. Li X., Li J., Wang L., Niu X., Hou R., Liu R., et al. …

Secondary renal amyloidosis due to primary Sjogren's syndrome: a case report.

UNLABELLED: Amyloidosis is a rare disorder characterized by the deposition of abnormal proteins in extracellular tissues, resulting in the d … nuclear antibodies, antimitochondrial antibodies, SSA, SSA native, and Ro-52 recombinant as well as rheumatoid factor showed positive results. After establishing the diagnosis of pSS through clinical, physical, and laboratory assessments, a renal biopsy was performed, which revealed the occurrence of secondary amyloidosis. CLINICAL DISCUSSION: The risk …

The Glucocorticoid Receptor: Isoforms, Functions, and Contribution to Glucocorticoid Sensitivity.

Glucocorticoids exert pleiotropic effects on all tissues to regulate cellular and metabolic homeostasis. Synthetic forms are used therapeutically in a wide range of conditions for their anti-inflammatory benefits, at the cost of dose and duration-dependent side effects. Significant variability occurs between tissues, disease states, and individuals with regard to both the beneficial and deleterious effects. The glucocorticoid receptor (GR) is the site of action for these hormones and a vast body of work has been conducted understanding its function. Traditionally, it was thought that the anti-

Corticosteroid-associated osteonecrosis in paediatric compared with adult patients: are they the same disease?

Osteonecrosis of the femoral head (ONFH) is a debilitating condition with a poorly characterized pathogenesis. Among the reported aetiologies, excessive alcohol consumption and corticosteroid administration are leading causes. Corticosteroids are often administered as a life-saving treatment for primary oncological or autoimmune conditions, but the subsequent development of ONFH can significantly impair the quality of life of both paediatric and adult patients. This review provides a comprehensive summary and critical analysis of recent advances in the understanding of corticosteroid-associate

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… Assouline-Dayan Y Chang C Greenspan A Shoenfeld Y Gershwin ME Pathogenesis and natural history of osteonecrosis Semin Arthritis Rheum 2002 32 2 94 124 12430099 2. … Chen CH Chang JK Lai KA Hou SM Chang CH Wang GJ Alendronate in the prevention of collapse of the femoral head in nontraumatic osteonecrosis: a two-year multicenter, prospective, randomized, double-blind, placebo-controlled study Arthritis Rheum 2012 64 5 1572 1578 10.1002/art.33498 22127729 4. …

A new hope with CAR T-cell therapy for refractory idiopathic inflammatory myopathies: a systematic review.

BACKGROUND: Treatment options for refractory idiopathic inflammatory myopathies (IIMs) remain limited, and sustained remission is frequently not achieved with conventional immunosuppression or biologic agents. Chimeric antigen receptor (CAR) T-cell therapy has been approved for multiple refractory hematologic malignancies and is increasingly being explored as an immune reset strategy for autoimmune diseases. MAIN BODY: This Review synthesizes all available clinical evidence on CAR T-cell therapy in adult and pediatric IIM, with the aim of raising awareness within the rheumatology community re…

Joint manifestations revealing inborn metabolic diseases in adults: a narrative review.

Inborn metabolic diseases (IMD) are rare conditions that can be diagnosed during adulthood. Patients with IMD may have joint symptoms and the challenge is to establish an early diagnosis in order to institute appropriate treatment and prevent irreversible damage. This review describes the joint manifestations of IMD that may be encountered in adults. The clinical settings considered were arthralgia and joint stiffness as well as arthritis. Unspecific arthralgias are often the first symptoms of hereditary hemochromatosis, chronic low back pain may reveal an intervertebral disc calcification in

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… Ann Rheum Dis. 2020;79. 10.1136/annrheumdis-2019-215476 8. Brissot P, Pietrangelo A, Adams PC, et al. Haemochromatosis. Nat Rev Dis Primer. 2018;4. 10.1038/nrdp.2018.16 9. Contributors, Taskforce HI, Adams P, Altes A, et al. … Semin Arthritis Rheum 2004;33. 23. Ladjouze-Rezig A, Rodriguez de Cordoba S, Aquaron R. Ochronotic rheumatism in Algeria: clinical, radiological, biological and molecular studies—a case study of 14 patients in 11 families. Joint Bone Spine. 2006;73. 10.1016/j.jbspin.2005.03.010 24. …

IgA Vasculitis (Henoch-Schönlein Purpura): An Update on Treatment.

Objective: IgA vasculitis (IgAV), previously named as Henoch-Schönlein purpura, is the most frequent systemic vasculitis in children. In adults, IgAV is less common although it is associated with more severe disease. In fact, the frequency of glomerulonephritis (referred to as IgAV nephritis) in adults is higher than in children and tends to present more severely, with around 10-30% of those affected eventually progressing to end-stage renal disease. In this review, we describe the pathophysiology, main clinical features, diagnosis of the disease, and latest clinical data regarding IgAV therap

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… Epidemiology of the vasculitides Rheum. Dis. Clin. N. Am. 2001 27 729 749 10.1016/S0889-857X(05)70232-5 11723761 9. Deshayes S. Moulis G. Pillebout E. Aouba A. Audemard-Verger A. … Arthritis Rheum. 2023 61 152209 10.1016/j.semarthrit.2023.152209 37126983 54. Floege J. Rauen T. Tang S.C.W. Current treatment of IgA nephropathy Semin. Immunopathol. 2021 43 717 728 10.1007/s00281-021-00888-3 34495361 PMC8551131 55. …

Postmenopausal women with osteoporosis and osteoarthritis show different microstructural characteristics of trabecular bone in proximal tibia using high-resolution magnetic resonance imaging at 3 tesla.

BACKGROUND: Osteoporosis (OP) and osteoarthritis (OA) are two common musculoskeletal disorders that affect the quality of life in aged people. An inverse relationship between OP and OA was proposed four decades ago. However, the difference in microstructure of the trabecular bone of these two disorders by high-resolution MRI (HR-MRI) has not been compared. The primary objective of the study is to explain the actual relationship between OA and OP based on differences between bone microstructure of these two diseases. The secondary objectives are to find out the significance of Euler number and

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… Ann Rheum Dis. 1972;31(4):259–264. doi: 10.1136/ard.31.4.259. Dequeker J. Inverse relationship osteoarthritis-osteoporosis: what is the evidence? What are the consequences? Br J Rheumatol. 1996;35(9):813–818. doi: 10.1093/rheumatology/35.9.813. Dequeker J. … Ann Rheum Dis. 2000;59(8):641–646. doi: 10.1136/ard.59.8.641. Watson PJ. Degenerative joint disease in the guinea pig. Use of magnetic resonance imaging to monitor progression of bone pathology. Arthritis Rheum. 1996;39(8):1327–1337. doi: 10.1002/art.1780390810. Feldkamp LA. …

Challenges and strategies in clinical applications of CAR-T therapy for autoimmune diseases.

Chimeric antigen receptor (CAR) T-cell therapy has demonstrated substantial efficacy against various hematological malignancies. The remarkable success of CAR-T cell therapy in targeting B-cell malignancies has generated significant interest in its potential application for treating autoimmune diseases (ADs). By engineering T cells to express CARs that specifically recognize B-cell antigens, researchers aim to selectively eliminate or modulate the dysregulated autoimmune responses underlying disease pathology. Early clinical trials targeting the B-cell marker CD19 have shown promising results,

Chimeric antigen receptor T-cell therapy in systemic lupus erythematosus: From B cell depletion to immune reprogramming.

Systemic lupus erythematosus (SLE) is a complex autoimmune disease in which current immunosuppressive and biologic therapies often fail to achieve durable remission in refractory patients. The emergence of chimeric antigen receptor T-cell (CAR-T) therapy has introduced a fundamentally new therapeutic concept, shifting therapeutic strategies from transient immune suppression toward the possibility of durable immune reprogramming. Recent studies suggest that the benefit of CAR-T therapy extends beyond depletion of autoreactive B cells. By depleting disease-associated immune cell populations and

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… Rheum. Dis. 2025 Oct;84(10):1675–1683. doi: 10.1016/j.ard.2025.06.2128. PMID: 40681435. 42. Feng J., et al. Co-infusion of CD19-targeting and BCMA-targeting CAR-T cells for treatment-refractory systemic lupus erythematosus: a phase 1 trial. … Rheum. Dis. 2025 Nov;84(11):1811–1821. doi: 10.1016/j.ard.2025.07.028. PMID: 40858468. 54. Gao J., et al. Efficacy and safety of allogeneic CD19 CAR NK-cell therapy in systemic lupus erythematosus: a case series in China. …

Amyloidosis in Childhood: A Review of Clinical Features and Comparison with Adult Forms.

Amyloidosis is a rare multisystem disorder characterized by extracellular accumulation of insoluble fibrils in various organs and tissues. The most common subtype in the pediatric population is systemic reactive amyloidosis, typically developing secondary to chronic inflammatory conditions and resulting in deposition of serum amyloid A protein in association with apolipoprotein HDL3. Clinical presentation is highly variable and is mostly influenced by specific organs involved, precursor protein type, and extent of amyloid deposition, often closely reflecting clinical features of the underlying

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… A Clinical Overview Rheum. Dis. Clin. N. Am. 2013 39 323 345 10.1016/j.rdc.2013.02.012 23597967 3. Sözeri B. Dincel N. Mir S. An Overview of the Amyloidosis in Children with Rheumatic Disease Amyloidosis—An Insight to Disease of Systems and Novel Therapies Guvenc I.A. … Diagnostic Accuracy of Subcutaneous Abdominal Fat Tissue Aspiration for Detecting Systemic Amyloidosis and Its Utility in Clinical Practice Arthritis Rheum. 2006 54 2015 2021 10.1002/art.21902 16732553 83. Garcia Y. Collins A.B. Stone J.R. …

Воздействие физических упражнений на мышечную силу и характеристики ревматических заболеваний и саркопсии: Протокол исследования по вопросам ухода за мышечными мышцами (C4M).

ЦЕЛЬ: слабость мышечных мышц характерна для ревматоидного артрита (RA), остеоартрита (OA) и саркопсии (SARC). Упражнения на выносливость могут улучшить митохондриальную функцию и окислительную способность, в то время как считается, что упражнения на прочность стимулируют синтез белка миофибрилла. Цель этого исследования заключается в сопоставлении последствий упражнений на прочность и выносливость и в изучении связи между мышечными характеристиками и результатами упражнений у пациентов с RA, OA и SARC. Мы предполагаем, что реакция на выносливость и сильные упражнения у пациентов с мышечной сла

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OBJECTIVE: Muscle weakness is prevalent in rheumatoid arthritis (RA), osteoarthritis (OA) and sarcopenia (SARC). Endurance exercises may improve mitochondrial function and oxidative capacity, while strength exercises are thought to stimulate myofibrillar protein synthesis. This study aims to compare the effects of strength and endurance exercise and explore …

CAR-T cell therapy in nephrology.

In recent years, chimeric antigen receptor T-cell (CAR-T) therapy has emerged as a promising immunotherapeutic strategy beyond oncology, offering new treatment opportunities for immune-mediated kidney diseases. These conditions including systemic lupus erythematosus, ANCA-associated vasculitis, membranous nephropathy, and monoclonal gammopathy-related nephropathies are characterized by dysregulated B cell and plasma cell activity that often proves refractory to standard immunosuppression. CAR-T cells, engineered to target antigens such as CD19 or BCMA, enable potent and durable depletion of pa

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… Ann Rheum Dis . 2021 ; 80 ( 1 ): 14 – 25 . doi: 10.1136/annrheumdis-2020-218272 . 33051219 39 Almaani S , Meara A , Rovin BH. Update on lupus nephritis . … Ann Rheum Dis . 2024 ; 83 ( 4 ): 499 – 507 . doi: 10.1136/ard-2023-224875 . 38182404 PMC10958264 48 Schultze-Florey CR , Gödecke V , Knoll L , et al. …

Параллельные клинические испытания селинксора у пациентов с продвинутой тимомой и тимической карциномой.

ВВЕДЕНИЕ: ТИМИЧЕСКИЕ эпителиальные опухоли (ТЕТ) редки и включают тимомы (Т) и тимические карциномы (ТК). Для пациентов с прогрессивными заболеваниями после платиновой химиотерапии необходимы эффективные варианты лечения. Доклинические исследования показали антитумбурную активность селинксора, ингибитора ядерного рецептора exportin-1 (XPO1/CRM1), поддержка клинического развития XPO1-targeted - лечение ТЭТ. Для дальнейшей оценки безопасности и эффективности селинксора в ТЭЦ мы провели two - скоординированные параллельные клинические испытания второго этапа.МЕТОДЫ: В настоящий доклад включена ин

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… carcinoma 15 (48.4%) Median previous number of previous therapies 2 (range 1–9) Previous thymectomy No 10 (32.3%) Yes 21 (67.7%) Previous chest radiation No 7 (22.6%) Yes 24 (77.4%) History of autoimmune disease No 19 (61.2%) Yes 10 (32.3%) Myasthenia gravis 6 Crohn’s disease 1 Glomerulonephritis 2 Rheum … previous number of previous therapies | 2 (range 1–9) Previous thymectomy | No | 10 (32.3%) Yes | 21 (67.7%) Previous chest radiation | No | 7 (22.6%) Yes | 24 (77.4%) History of autoimmune disease | No | 19 (61.2%) Yes | 10 (32.3%) Myasthenia gravis | 6 Crohn’s disease | 1 Glomerulonephritis | 2 Rheum …