Rheumatology (Bulgaria)

🚀 Rheumatology (Bulgaria) is entering a new era. New platform, renewed Editorial Board, higher standards. We welcome high-quality rheumatology research. 📩Submit now. #Rheumatology #OpenScience rheumatologybg.org/journal/rbj/in…

What is the real-world retention rate of Upadacitinib in Rheumatoid Arthritis? A multicenter study found a 74.7% retention rate at 12 months. Persistence was significantly higher in seropositive (RF+/ACPA+) patients. Full text: rheumatologybg.org/journal/rbj/ar… #Rheumatology #JAKinhibitors

Not all endothelial markers behave the same in spondyloarthritis. In our study, VCAM-1 tracked inflammatory activity and treatment status, especially in ankylosing spondylitis, while ICAM-1 did not. #Rheumatology #Spondyloarthritis link.springer.com/article/10.118…

AS and PsA show broadly similar carotid vascular biomechanics, while higher augmentation index in PsA suggests altered wave reflection rather than true stiffness. Fulltext👉 doi.org/10.35465/jdzt6…

Historically considered mutually exclusive, the overlap of Rheumatoid Arthritis and Axial Spondyloarthritis presents rare diagnostic hurdles. This case report examines the clinical intersection and management of this condition. 🔍 Full text: doi.org/10.35465/2e1wq…

Is osteoarthritis more than "wear and tear"? 🦴⚙️ New research reframes OA as a failure of biological adaptation. This review explores "inflammaging" and exercise as disease-modifying biological signals. Full text: doi.org/10.35465/s1zje… #Rheumatology #Osteoarthritis

How has the history of cytokines shaped the trajectory of modern precision medicine in rheumatic diseases? This comprehensive review traces the evolution from early "pyrogens" to the revolution of targeted biologics and oral JAK inhibitors. Full text: doi.org/10.35465/0cm8p…

How did I almost miss the new EULAR recommendations for Behçet’s syndrome? A major 2025 update, from colchicine/apremilast to TNF inhibitors in severe organ disease and, tellingly, TNF is mentioned 79 times! doi.org/10.1016/j.ard.…

Analysis of YouTube videos on rheumatic diseases and pregnancy: a cross-sectional study @GencTRASD @EMEUNET @OlenaZimba @DDoskaliuk @BurhanFatihKoy1 link.springer.com/article/10.100…

Is proteinuria reduction a key marker for therapeutic response in Immune-Mediated Glomerular Diseases? 🧪📉 A new study evaluates protein dynamics in 57 patients, highlighting early reduction as a vital predictor of renal prognosis. Full text: doi.org/10.35465/gb6ef…

Can Transcatheter Arterial Embolization transform the management of knee osteoarthritis? 🦴💉 A new study in our latest issue evaluates TAE of popliteal artery branches for patients with grade 1-2 knee OA resistant to conservative treatment.  Full text: doi.org/10.35465/jfqs1…

Have new work in rheumatology? Rheumatology (Bulgaria) invites original research, reviews, and clinically relevant papers across the spectrum of rheumatic diseases. Open access, Scopus-indexed, and growing internationally. Submit here: rheumatologybg.org/journal

𝗘𝗺𝗲𝗿𝗴𝗶𝗻𝗴 #𝗔𝘂𝘁𝗼𝗮𝗻𝘁𝗶𝗯𝗼𝗱𝗶𝗲𝘀 𝗶𝗻 #𝗦𝗷𝗼𝗴𝗿𝗲𝗻’𝘀 𝗗𝗶𝘀𝗲𝗮𝘀𝗲 (𝗦𝗷𝗗) Classical markers remain anti-Ro/SSA and anti-La/SSB, but several novel autoantibodies show promising diagnostic, prognostic, and predictive value: Systemic Biomarkers ◦ Anti-Ro52: Present in 55–70% of primary SjD (pSjD). Predicts interstitial lung disease (ILD, especially NSIP; 41.9% vs 16.2%), QTc prolongation, severe glandular disease, cryoglobulinemia (isolated), malignancies. Polymeric IgA1-Ro52 links to inflammation/focus score. ◦ Anti-a-enolase (citrullinated): Up to 92%. Biomarker for pSjD and MALT lymphoma risk (good sensitivity/specificity, better in panel). ◦ Anti-a-fodrin: Low sensitivity (39%); limited utility. Glandular Biomarkers ◦ Anti-aquaporins (mainly AQP5 and AQP1): Promising diagnostic (AQP5 sensitivity up to 95%); linked to xerophthalmia/glandular dysfunction. ◦ Anti-M3R (muscarinic 3 receptor): High specificity (95%), variable sensitivity; correlates with dryness, hypofunction, leukopenia. ◦ Tissue-specific autoantibodies (TSAs: anti-SP-1, anti-PSP, anti-CA6): Early markers in seronegative sicca (45-76%); predict severe dry eye/reduced tear secretion. Panels improve early diagnosis (sensitivity ~91%). Renal Biomarkers ◦ Anti-CA II (carbonic anhydrase II): Predicts renal tubular acidosis & tubular damage. Neurological Biomarkers ◦ Anti-NR2 (NMDA receptor subunit): Linked to cognitive impairment, depression, fatigue, hippocampal damage. ◦ Anti-AQP4: Strong marker for neuromyelitis optica spectrum disorder (NMOSD)/CNS involvement in SjD (>80% in acute cases). These emerging autoantibodies may improve early detection (especial y in seronegative or early-stage disease), risk stratification (ILD, lymphoma, renal, neurological complications), and monitoring. Many require further validation, standardized assays, and longitudinal studies before routine clinical use. *From: Okoń A, Makowska J, Brzezińska O. Beyond anti-SSA and anti-SSB. The clinical significance of new antibodies in the diagnosis of Sjögren disease. Rheumatol Int. 2026;46:62. 🔗doi.org/10.1007/s00296…

🔥 New Issue Just Dropped Rheumatology (Bulgaria) 2025;33(4) is LIVE From IL-17i in PsA to carotid biomechanics in SpA and complex SLE cases, this issue delivers real-world, clinically relevant science you can use tomorrow FT👉 rheumatologybg.org/journal/rbj/is… #Rheumatology #MedTwitter

The GRAPPA 2025 consensus introduces new definitions for PsA: complex-to-manage and treatment-refractory PsA, aiming to standardize how we define and study D2T disease. #PsoriaticArthritis #RheumTwitter #GRAPPA2025. Do these categories fit ur needs? doi.org/10.1038/s41584…

AI-based capillaroscopy + biomarkers predict disease activity in myositis with high accuracy—promising step toward precision rheumatology! 🔬🤖 #ACR25 #AI #Myositis acrabstracts.org/abstract/artif…

🔥 #ACR2025 Lupus Guidelines 🧬 1️⃣ Hydroxychloroquine (HCQ) → 💊 All SLE unless contraindicated  • Dose: ≤5 mg/kg/day (actual BW)  • Continue lifelong; ↓ flares, CV risk, and damage. 2️⃣ Glucocorticoids (GC) → 🎯 Use minimum, shortest duration  • Induction: Pred ≤0.5 mg/kg/day (severe ≤1 mg/kg/day)  • Pulse: Methylpred 250–1000 mg IV x1–3 days for severe organ/life-threatening disease  • Goal: <5 mg/day (pred-equivalent) maintenance 3️⃣ Steroid-sparing baseline:  • MMF: 1–3 g/day  • AZA: 2 mg/kg/day  • CYC: 500 mg q2wk (Euro-Lupus) or 0.5–1 g/m² q4wk (NIH regimen) 4️⃣ Biologics:  • Belimumab: 10 mg/kg IV q4wk / 200 mg SC weekly  • Anifrolumab: 300 mg IV q4wk (non-renal SLE)  • Rituximab (off-label): 1 g IV x2 (2 wks apart) 5️⃣ Lupus Nephritis (LN):  • Class III/IV ± V: MMF 2–3 g/day or CYC + GC  • Add Belimumab/Obinutuzumab if refractory  • Maintenance: MMF 1–2 g/day ≥36 mo 6️⃣ Neuro / Cardiac / Vasculitic lupus:  • Pulse GC + CYC/MMF ± RTX  • Add IVIG or PLEX if refractory 7️⃣ Antiphospholipid / Libman-Sacks:  • Lifelong anticoagulation (INR 2–3) + HCQ 8️⃣ Monitoring:  • Activity: SLEDAI / PGA q3–6mo  • Damage: SLICC-DI annually  • HCQ retinal screen: baseline + annually after 5 yrs 9️⃣ Comorbid focus:  ☀️ Photoprotection | 💉 Vaccinate | 🩺 Screen CVD | 🚭 Stop smoking 🔟 Target: Remission or LLDAS (Treat-to-target 🧭) 📄 ACR 2025 Guideline for SLE — Arthritis Care Res (2025), DOI:10.1002/acr.25690 #Lupus #ACR25 #RheumTwitter #MedTwitter #Immunology

🆕 Clinical Year in Review at #ACR25 By Dr. Bryant England @UNMC_Rheum 🔶 Review the most impactful studies in #Rheumatology from the past year! ❓ Any studies you would add to the list? #RheumX #RheumTwitter #ACR2025