Rheumatoid arthritis patients are at higher risk of developing comorbidities. The main objective of this study was to evaluate the prevalence of major comorbidities in Chinese rheumatoid arthritis patients. We also aimed to identify factors associated with these comorbidities. Baseline demographic, clinical characteristics and comorbidity data from RA patients enrolled in the Chinese Registry of rhEumatoiD arthrITis (CREDIT) from Nov 2016 to August 2017 were presented and compared with those from five other registries across the world. Possible factors related to three major comorbidities (cardiovascular disease, fragility fracture and malignancy) were identified using multivariate logistic regression analyses. A total of 13,210 RA patients were included (80.6% female, mean age 52.9 years and median RA duration 4.0 years). Baseline prevalence rates of major comorbidities were calculated: CVD, 2.2% (95% CI 2.0–2.5%); fragility fracture, 1.7% (95% CI 1.5–1.9%); malignancy, 0.6% (95% CI 0.5–0.7%); overall major comorbidities, 4.2% (95% CI 3.9–4.6%). Advanced age was associated with all comorbidities. Male gender and disease duration were positively related to CVD. Female sex and longer disease duration were potential risk factors for fragility fractures. Ever use of methotrexate (MTX) was negatively related to baseline comorbidities. Patients with rheumatoid arthritis in China have similar prevalence of comorbidities with other Asian countries. Advanced age and long disease duration are possible risk factors for comorbidities. On the contrary, MTX may protect RA patients from several major comorbidities, supporting its central role in the management of rheumatoid arthritis.

Sphingosine-1-phosphate (S1P) is a versatile sphingolipid that is generated through the phosphorylation of sphingosine by sphingosine kinase (SPHK). S1P exerts its functional effects by binding to the G protein-coupled S1P receptor (S1PR). This lipid mediator plays a pivotal role in various cellular activities. The S1P/S1PR signaling pathway is implicated in the pathogenesis of immune-mediated diseases, significantly contributing to the functioning of the immune system. It plays a crucial role in diverse physiological and pathophysiological processes, including cell survival, proliferation, migration, immune cell recruitment, synthesis of inflammatory mediators, and the formation of lymphatic and blood vessels. However, the full extent of the involvement of this signaling pathway in the development of autoimmune diseases remains to be fully elucidated. Therefore, this study aims to comprehensively review recent research on the S1P/S1PR axis in diseases related to autoimmunity.

Objective.: To analyze the trend of prevalence and incidence rates for psoriatic arthritis (PsA) and psoriasis in Taiwan, and to determine the changes in medication patterns.Methods.: Data were collected from the Taiwan National Health Insurance Research Database, which covered at least 95% of the population from 2000 to 2013. International Classification of Diseases, 9th edition (ICD-9) was used to identify PsA (ICD-9 696.0) and other psoriasis (ICD-9 696.1). Medications were identified by Anatomical Therapeutic Chemical Classification code. We calculated the annual age standardized prevalence and incidence rate of PsA and psoriasis in individuals aged ≥ 16 years from 2000 to 2013, and used the Poisson regression to test the trends by Wald chi-square statistic.Results.: The prevalence (per 100,000 population) of psoriatic diseases between 2000 and 2013 increased from 11.12 to 37.75 for PsA, and from 179.2 to 281.5 for psoriasis. The incidence (per 100,000 person-yrs) increased from 3.64 to 6.91 in PsA, while there was no significant change in psoriasis. Prevalence and incidence in PsA were more rapidly increased than in psoriasis. Sex ratio (men to women) of PsA decreased from 2.0 to 1.5 in 2000 and 2013, respectively. There was an increase in the use of disease-modifying antirheumatic drugs (DMARD), especially biologics, which is significantly different from topical therapies.Conclusion.: The prevalence and incidence rates of psoriatic disease, especially PsA, were increasing in Taiwan. The medication pattern showed an increase in DMARD and biologics, while use of topical therapies decreased.

Objective: To evaluate the risk of activation of latent tuberculosis infection (LTBI) in Chinese patients with rheumatic diseases who have received glucocorticoid treatment. Methods: We conducted a 2-year study, enrolling 1788 patients with rheumatic diseases who were treated with glucocorticoid for at least 4 weeks at the Department of Immunology and Rheumatology, First Affiliated Hospital of Nanchang University. Interferon-release assays (IGRA) were performed with patient blood samples obtained at baseline. Patient data, including age, gender, body mass index (BMI), duration and dosage of glucocorticoid and disease-modifying antirheumatic drug (immunosuppressant) treatment and comorbidities (malignancies, diabetes, chronic renal failure, silicosis) were collected. Patients were followed for 2 years to detect the emergence of active tuberculosis (TB). Results: 21.8% (349/1600) of the patients tested positive in IGRA, indicating LTBI. 2-year follow-up showed that 18 (5.16%) patients with positive IGRA but only 4 (0.35%) patients with negative IGRA developed active TB (p < .05). SLE patients had the highest activation rate of 2.22 per 100 total recruitment cases/year. Univariate and multivariate analysis showed that low BMI(15 mg daily), and comorbidities that included interstitial lung disease and malignant cancers were significantly associated with LTBI activation. Conclusion: Our results suggest that screening and preventive therapy of LTBI may be advisable for Chinese rheumatic disease and particularly SLE patients undergoing glucocorticoid therapy with dosage above 15 mg prednisone equivalent daily for more than 4 weeks.