The Lancet Rheumatology in conversation with

In this month’s episode we discuss childhood-onset Sjögren’s disease-a rare and under-researched rheumatic condition.

 Lack of robust clinical and immunological characterisation of this condition alongside assessment of its impact on quality of life has significantly hampered progress in the delivery of high-quality research and evidence-based recommendations for care.  There are currently no studies following up children and young people with childhood-onset Sjögren's disease as they move into adulthood and there remains a clear knowledge gap surrounding the natural course and long-term outcomes of childhood-onset Sjögren's disease.

Professor Coziana Cuirtin from the Centre for Adolescent Rheumatology at the University College London discusses the long-term outcomes of patients with childhood-onset Sjögren’s disease. We also discuss barriers and facilitators to recruiting these patients, the current management strategies available and what’s next for childhood-onset Sjögren’s disease research.
Click here to read the full article: https://www.thelancet.com/journals/lanrhe/article/PIIS2665-9913(25)00283-8/fulltext
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Medical imaging and theranostics are revolutionising how we diagnose, treat, and understand disease. To meet this moment, The Lancet group is happy to announce the launch of, The Lancet Medical Imaging and Theranostics. 
You can visit https://www.thelancet.com/medical-imaging-theranostics to learn more.
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This months episode covers Hemophagocytic lymphohistiocytosis, or HLH, a rare, life-threatening disorder characterised by dysregulated immune activity resulting in systemic inflammation, tissue damage and multiorgan failure which affects both children and adults.
The annual prevalence of HLH in England is around 2 per million people in the adult population, with an overall 1-year survival rate of around 50% and similar rates have also been reported in other countries across the world. However, as most studies of HLH prevalence primarily focus on single nations and specific subpopulations, epidemiological data on global incidence and mortality rates are scarce.
Dr Fiona Pearce and Dr Rachel Tattersall discuss their recent publication in The Lancet Rheumatology which looked at mortality rates of HLH across Europe, we also discuss what manifestations clinicians should be looking out for and what’s next for HLH research.
Click here to read the full article: https://www.thelancet.com/journals/lanrhe/article/PIIS2665-9913(25)00292-9/fulltext
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During this episode, Dr John Isaacs and Dr Josh Bennett from Newcastle University and the NIHR Newcastle Biomedical Research Centre, discuss sarcopenia - an age-related loss of muscle mass and strength. Sarcopenia is relatively common in rheumatoid arthritis, with a prevalence ranging from 4·5% to 44% of people with rheumatoid arthritis, depending on the definition of sarcopenia used. Rheumatoid sarcopenia increases the risk of fall, fractures, disability, and hospitalisation. Therefore, prevention and management is important, especially in older patients. We discuss the how and why sarcopenia arises and how it can be managed, as well as the recent publication of the RAMUS study, which looked at the skeletal muscle effects of JAK inhibitor tofacitinib in rheumatoid arthritis. The link to the Nature Rheumatology Review mentioned can also be found below.
RAMUS study: https://www.thelancet.com/journals/lanrhe/article/PIIS2665-9913(25)00184-5/fulltext
Nature Rheumatology Review: https://www.nature.com/articles/s41584-023-00921-9
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This month's episode covers Sjögren’s disease—an autoimmune condition that primarily affects areas of the body that produce fluids, such as tears and saliva. The cause of the disease isn’t understood. Currently there are no licensed drugs to treat the disease, but phase 2 clinical trials have reported encouraging results, and phase 3 trials are underway.

Dr Samuel Bitoun, from the University of Paris-Saclay and APHP, discusses how Sjögren’s disease is currently classified, the challenges of using such classification, and how AI and deep learning could potentially contribute to this area, which is the focus of his recent study published in The Lancet Rheumatology, which aimed to train a neural network model to perform focus score classification and identify new histological patterns associated with this disease.
Click here to read the full article: https://www.thelancet.com/journals/lanrhe/article/PIIS2665-9913(25)00181-X/fulltext
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In today's episode, Sophie discusses psoriatic arthritis with Dr Ryan Hum from The University of Manchester.

Psoriatic arthritis affects between 0.1% and 1% of the general population globally, and appears to be more prevalent in certain regions. It affects men and women equally and typically appears between the ages of 30 and 55 years. Psoriatic arthritis tends to be more common in people with psoriasis affecting around 20% of individuals, but estimates can depend on the inclusion criteria studies use.

We touch on the pathogenesis of psoriatic arthritis and how it might manifest in a patient, as well as the contribution of synovial inflammation and how research into this topic contributes to our understanding of the disease. We also discuss the reasons psoriatic arthritis research is in the early stages when compared to rheumatoid arthritis. 
The Review discussed can be found here: https://www.thelancet.com/journals/lanrhe/article/PIIS2665-9913(25)00231-0/fulltext

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