RheumaCast – Details, episodes & analysis

This episode deals with the development of a consensus-based expert definition for difficult-to-manage (D2M) axial spondyloarthritis (axSpA), including treatment-refractory (TR) disease. The Assessment of SpondyloArthritisInternational Society (ASAS) spearheaded this effort through a literature review and a two-round Delphi process. The resulting D2M definition encompasses treatment failure, suboptimal disease control, and acknowledgement ofproblematic signs/symptoms by physicians or patients. TRaxSpA falls under this D2M umbrella but requires evidence of treatment failure and objective signs of inflammatory activity. Endorsed by ASAS, the definition aims tostandardize the identification of patients with unmet needs and facilitate further research and improved clinical care in this area.

This episode is based on the publication Poddubnyy D, et al. Ann Rheum Dis 2025

and is developed with NotebookLM.

This research investigates the impact of colchicine, a medication used to prevent gout flares, on cardiovascular events in patients initiating urate-lowering therapy. Using a large UK primary care database, the study compared patients prescribed colchicine prophylaxis with those who received no prophylaxis. The findings suggest that colchicine prophylaxis is associated with a reduced risk of myocardial infarction or stroke in gout patients starting urate-lowering therapy.

Based on Cipolletta E, et al. Lancet Rheumatol 2025

and developed with NotebookLM.

This episode of RheumaCast dives into the latest expert guidelines from the Assessment of Spondyloarthritis International Society (ASAS) for imaging referrals in patients with suspected or confirmed axial spondyloarthritis (axSpA). We explore how these recommendations, designed by an international task force, aim to improve communication between rheumatologists and radiologists, ensuring imaging requests are precise, informative, and clinically relevant. By standardizing essential clinical data in referral forms, these guidelines support more accurate diagnoses, enhanced report quality, and ultimately better patient management in axSpA. Join us as we discuss the significance, application, and expected impact of these recommendations in clinical practice.

This podcast is based on the publication Diekhoff T, et al. Ann Rheum Dis 2024 Sep 24:ard-2024-226280

and is developed with NotebookLM.

This study assesses the accuracy and readability of four AI chatbots (ChatGPT 3.5, Bing, Bard, and ChatGPT 4.0) in answering common patient questions about low back pain (LBP). Researchers evaluated responses against established LBP guidelines, finding moderate accuracy overall, but with significant variations across topics (self-management, treatment, and risk factors).

This podcast is based on the publication by Simone P.S. Scaff et al. Ann Rheum Dis 2025;84(1):143-149

and is developed with NotebookLM.

This episode deals with the development of extra-musculoskeletal manifestations (EMMs) in patients with psoriatic arthritis or axial spondyloarthritis treated with a Janus-kinase-1-Inhibitor upadacitinib. The study analyzed data from five clinical trials, comparing upadacitinib to placebo and adalimumab. Results indicate low rates of EMM development overall, with numerically lower uveitis rates observed in upadacitinib-treated patients compared to those receiving placebo, particularly in radiographic axial spondyloarthritis.

This episode is based on the publication Poddubnyy D, et al. Arthritis Rheumatol 2024, doi: 10.1002/art.43069.

and developed with Notebook LM.

This study investigates the link between MRI-detected inflammation and clinical outcomes in axial spondyloarthritis (axSpA) patients treated with a TNF inhibitor etanercept. Using data from the ESTHER trial, the study found a strong association between the resolution of inflammation on MRI and improved clinical outcomes, as measured by the ASDAS score. Specifically, reducing inflammation on sacroiliac joint MRI scans significantly predicted better clinical outcomes six months later.

This podcast is based on the publication Torgutalp M, et al. RMD Open. 2025 Jan 6;11(1):e004921.

and is developed with NotebookLM.

This research article investigates the relationship between osteo-proliferative lesions on finger phalanges, sex, age, and osteoarthritis. Using X-rays of 1153 patients, researchers examined the frequency and location of these lesions, finding that men showed more lesions than women, with age and osteoarthritis positively correlated with lesion extent. A modified Osseographic Scoring System was used to evaluate the findings, showing excellent inter-reader agreement. The study's anatomical dissection of a finger helped clarify the origin of these lesions, emphasizing the importance of differentiating normal aging changes from pathological conditions like psoriatic arthritis.

Based on Hermann S et al. Diagnostics 2022; 12: 618.

Develop with NotebookLM.

This study compares osteitis condensans ilii (OCI) and axial spondyloarthritis (axSpA), focusing on their clinical, laboratory, and MRI characteristics. Researchers found that OCI predominantly affects women and lacks the inflammatory markers typical of axSpA. While both conditions can present with sacroiliac joint osteitis on MRI, OCI shows anterior localization and an absence of erosions, distinguishing it from axSpA. The study highlights the challenges in differentiating these conditions and emphasizes the need for comprehensive clinical and imaging assessment. The findings provide valuable information for the differential diagnosis of these two conditions.

This episode is based on Poddubnyy D, et al. Rheumatology (Oxford) 2020;59(12):3798-3806.

and developed with NotebookLM.

This episode focuses on a randomized, placebo-controlled trial that evaluated the efficacy of infliximab, a tumor necrosis factor (TNF) inhibitor, in alleviating chronic low back pain in patients with Modic type 1 changes (degenerative disc disease with bone marrow edema) identified on magnetic resonance imaging (MRI). The results indicate that TNF blockade is not effective for this condition.

This podcast is based on the publication by Gjefsen E, et al (2024)

and was developed with NotebookLM.

This article presents expert consensus recommendations for diagnosing and treating chronic non-bacterial osteitis (CNO) in adults. A systematic review of existing literature and a multidisciplinary expert panel informed the creation of a standardized disease definition and proposed the term "CNO" to replace previous, less precise terminology. The recommendations cover diagnostic imaging, laboratory testing, and a tiered treatment approach starting with NSAIDs and moving to intravenous bisphosphonates or TNF-α inhibitors as needed. Long-term follow-up and a multidisciplinary care team are emphasized, along with a research agenda to improve understanding and treatment of this rare condition.