Background: Chatbots have the potential to enhance health care interaction, satisfaction, and service delivery. However, data regarding their acceptance across diverse patient populations are limited. In-depth studies on the reception of chatbots by patients with chronic autoimmune inflammatory diseases are lacking, although such studies are vital for facilitating the effective integration of chatbots in rheumatology care. Objective: We aim to assess patient perceptions and acceptance of a chatbot designed for autoimmune inflammatory rheumatic diseases (AIIRDs). Methods: We administered a comprehensive survey in an outpatient setting at a top-tier rheumatology referral center. The target cohort included patients who interacted with a chatbot explicitly tailored to facilitate diagnosis and obtain information on AIIRDs. Following the RE-AIM (Reach, Effectiveness, Adoption, Implementation and Maintenance) framework, the survey was designed to gauge the effectiveness, user acceptability, and implementation of the chatbot. Results: Between June and October 2022, we received survey responses from 200 patients, with an equal number of 100 initial consultations and 100 follow-up (FU) visits. The mean scores on a 5-point acceptability scale ranged from 4.01 (SD 0.63) to 4.41 (SD 0.54), indicating consistently high ratings across the different aspects of chatbot performance. Multivariate regression analysis indicated that having a FU visit was significantly associated with a greater willingness to reuse the chatbot for symptom determination (P=.01). Further, patients’ comfort with chatbot diagnosis increased significantly after meeting physicians (P<.001). We observed no significant differences in chatbot acceptance according to sex, education level, or diagnosis category. Conclusions: This study underscores that chatbots tailored to AIIRDs have a favorable reception. The inclination of FU patients to engage with the chatbot signifies the possible influence of past clinical encounters and physician affirmation on its use. Although further exploration is required to refine their integration, the prevalent positive perceptions suggest that chatbots have the potential to strengthen the bridge between patients and health care providers, thus enhancing the delivery of rheumatology care to various cohorts.

Lewis hunting reaction refers to the alternating cold-induced vasoconstriction and dilation in extremities, whose underlying mechanism is complex. While numerous studies reported this intriguing phenomenon by measuring cutaneous temperature fluctuation under cold exposure, few of them tracked peripheral vascular responses in real-time, lacking a non-invasive and quantitative imaging tool. To better monitor hunting reaction and diagnose relevant diseases, we developed a hybrid photoacoustic ultrasound (PAUS) tomography system to monitor finger vessels’ dynamic response to cold, together with simultaneous temperature measurement. We also came out a standard workflow for image analysis with self-defined indices. In the small cohort observational study, vascular changes in the first cycle of hunting reaction were successfully captured by the image series and quantified. Time difference between vasodilation and temperature recovery was noticed and reported for the first time, thanks to the unique capability of the PAUS imaging system in real-time and continuous vascular monitoring. The developed imaging system and indices enabled more objective and quantitative monitoring of peripheral vascular activities, indicating its great potential in numerous clinical applications.

Background/Objectives: Digital health technologies show promise in improving rheumatic disease management and reducing healthcare access disparities globally. This paper examines how electronic health records, telemedicine, apps, and wearable devices are used in rheumatic care across different economic settings. Methods: The study evaluates digital health technology implementation and outcomes in high-income versus low- and middle-income countries (LMICs). Results: Digital health technologies demonstrate improvements in disease monitoring, treatment adherence, and doctor-patient communication, though impact varies by region. Key barriers include poor infrastructure, limited tech literacy, and the digital divide, particularly affecting LMICs. The proposed evidence-based framework recommends strategic investments in digital infrastructure, healthcare system integration, and professional training to address these challenges. Conclusions: Implementation of digital health technologies, guided by targeted interventions and regional adaptations, can effectively reduce global disparities in rheumatic care. Success requires sustained commitment to addressing infrastructure and literacy barriers while ensuring equitable access across all economic settings.

To evaluate the adoption, effectiveness and cost-effectiveness of digital health interventions for rheumatic disease management. Between 25 May 2024 and 2 June 2024, we systematically searched PubMed®, Scopus, ClinicalTrials.gov, the Global Observatory for eHealth and the World Bank Open Knowledge Repository for randomized controlled trials (RCTs) evaluating digital health interventions for rheumatic disease management. We included studies published between 2000 and 2024 that reported on adoption rates and efficacy. Two reviewers independently screened the studies, extracted data and categorized the digital interventions according to the World Health Organization's classification of digital health interventions. Of the 455 unique records identified, 21 RCTs met the inclusion criteria. Most digital health interventions (15 studies) focused on individual-centric interventions, such as targeted communication, personal health tracking, educational tools and wearable devices. Studies in high-income countries implemented advanced, integrated digital interventions combining individual-focused approaches with health worker interventions and data services using telemedicine platforms and decision support systems. In contrast, studies in low- and middle-income countries adapted accessible technologies such as mobile messaging and telephone-based education. Many telehealth, wearable technologies and educational interventions significantly improved disease control, patient adherence, knowledge and self-efficacy. Of the five studies assessing cost-effectiveness, all found digital interventions to be cost-effective. Digital health interventions show promise for managing rheumatic diseases. Tailoring these interventions to local infrastructure and emphasizing patient engagement are crucial for successful adoption. Future research should focus on standardizing evaluation methods, addressing digital divides and enhancing provider support and data services.

Objectives: Current therapeutic paradigms for treatment-refractory rheumatic diseases rely on chronic immunosuppression with variable efficacy and potential for cumulative toxicity. We systematically synthesised evidence on the clinical efficacy, safety and durability of chimeric antigen receptor T-cell (CAR-T) therapy in autoimmune rheumatic diseases. Methods: We conducted a systematic review following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines (PROSPERO: CRD42025641602). Five databases were searched from inception to February 2025 for primary studies investigating CAR-T therapy in autoimmune rheumatic diseases. Two reviewers independently assessed studies using the Joanna Briggs Institute tools and the Risk of Bias in Non-Randomised Studies of Interventions tool. Results: 12 studies encompassed 44 patients with severe treatment-refractory disease across six rheumatic conditions. Patients had extensive prior exposure (median 5 therapies), including conventional and biological agents. Cluster of Differentiation antigen 19 (CD19)-targeted constructs predominated (83% of studies), with emerging dual-target approaches (17%). Universal clinical responses were achieved (100% of studies; individual response rates 92%–100%), with complete responses occurring within 2–16 weeks. Sustained drug-free remissions extended 6–46 months, accompanied by profound autoantibody reductions (80%–99% across disease-specific markers). Safety profiles diverged markedly from oncological experience: cytokine release syndrome (CRS) remained exclusively confined to grades 1–2, while immune effector cell-associated neurotoxicity occurred in 25% of studies, with predominantly grade 1 severity. Conclusions: CAR-T therapy demonstrates substantial efficacy in treatment-refractory rheumatic diseases, achieving sustained remissions through comprehensive B-cell elimination. Importantly, safety profiles were favourable, with CRS limited to grades 1–2 severity, no grade ≥3 events and rare immune effector cell-associated neurotoxicity, representing markedly superior tolerability compared with oncological applications. PROSPERO registration number: CRD42025641602.