Half your patients are reading things in a group you have never seen

The edition in brief

A mixed-methods study surveyed 1,316 rheumatology patients and 317 clinicians, with interviews of 22 and 14 respectively, about online peer support groups. Patients described validation and belonging, particularly those with rare or invisible disease who felt disbelieved elsewhere; 85% reported finding helpful information, and 48% reported misinformation circulating in the same groups. Seventy-one per cent of clinicians thought the groups helpful, while worrying about negativity and erosion of trust in health services. Members described both toxic positivity and toxic negativity, and younger, male and racially minoritised patients were more likely to report feeling unwelcome. An expert perspective in Arthritis and Rheumatology argues for a treat-to-target framework in adult idiopathic inflammatory myopathies, and is candid that the pieces are missing: there are no validated definitions of remission or low disease activity in myositis, existing activity measures have known limitations, and separating active inflammation from irreversible damage remains hard. The proposal is a domain-based framework covering muscle, skin, lung and patient-reported outcomes with targets adapted to phenotype and accumulated damage. In systemic sclerosis, granulocytic myeloid-derived suppressor cells were enriched in blood and skin and correlated with severity across 37 patients and 27 controls, and single-cell and spatial transcriptomics identified an interaction with type 2 innate lymphoid cells driving fibrosis through IL-13, TGF-beta, arginase 1 and CCL24. The FDA has recorded a supplement against the adalimumab-aqvh biosimilar Yusimry.