{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T07:59:56Z","timestamp":1790236796704,"version":"4.1.0"},"reference-count":5,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T00:00:00Z","timestamp":1789603200000},"content-version":"vor","delay-in-days":16,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T00:00:00Z","timestamp":1788220800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["acrjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["ACR Open Rheumatology"],"published-print":{"date-parts":[[2026,9]]},"abstract":"\n Background<\/jats:title>\n \n Altered NAD\n +<\/jats:sup>\n metabolism has been described in rheumatoid arthritis (RA), but intravenous NAD\n +<\/jats:sup>\n has not been clinically evaluated for inflammatory arthritis.\n <\/jats:p>\n <\/jats:sec>\n \n Case presentation<\/jats:title>\n \n A 49\u2010year\u2010old woman with a rheumatologist\u2010documented diagnosis of RA had progressive polyarthralgia, intermittent swelling, marked morning stiffness, and baseline hand and wrist ultrasonography showing active synovitis. After approximately 4 months of inconsistently taken methotrexate, discontinued because of adverse effects, she received four intravenous NAD\n +<\/jats:sup>\n infusions for aesthetic and antiaging purposes: 250 mg in 500 mL of 0.9% sodium chloride over approximately 1 hour every 2 weeks. She reported rapid pain relief after individual infusions and subsequent improvement in swelling, morning mobility, function, and analgesic use. No infusion\u2010related adverse events were reported. Nine months later, follow\u2010up ultrasonography showed no synovitis or Doppler hyperemia. Psychologic support, exercise, and improvement in personal circumstances occurred concurrently.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n \n The symptomatic and ultrasonographic changes were temporally associated with intravenous NAD\n +<\/jats:sup>\n , but incomplete diagnostic documentation, previous methotrexate exposure, concurrent psychosocial changes, and the uncontrolled retrospective design preclude causal inference. This case is hypothesis\u2010generating and supports prospective controlled investigation.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1002\/acr2.90151","type":"journal-article","created":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T09:23:27Z","timestamp":1789637007000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Symptomatic and Ultrasonographic Improvement in Rheumatoid Arthritis Temporally Associated with Intravenous\n NAD<\/scp>\n +<\/sup>\n Therapy: A Case Report"],"prefix":"10.1002","volume":"8","author":[{"given":"Mohamad Rabih","family":"Itani","sequence":"first","affiliation":[{"name":"Faculty of Medicine Beirut Arab University Beirut Lebanon"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arije","family":"Farhat","sequence":"additional","affiliation":[{"name":"Faculty of Medicine Beirut Arab University Beirut Lebanon"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nour","family":"Abou Yehya","sequence":"additional","affiliation":[{"name":"Medistic Medical Center Beirut Lebanon"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lana","family":"Ghraizi","sequence":"additional","affiliation":[{"name":"Faculty of Medicine Beirut Arab University Beirut Lebanon"},{"name":"Department of Radiology Al\u2010Jabal Hospital Qurnayil Lebanon"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-3953-3238","authenticated-orcid":false,"given":"Bahaa","family":"Bou Dargham","sequence":"additional","affiliation":[{"name":"Faculty of Medicine Beirut Arab University Beirut Lebanon"},{"name":"Department of Anesthesiology Hammoud Hospital University Medical Center Saida Lebanon"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,17]]},"reference":[{"key":"e_1_2_4_2_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2018.13103"},{"key":"e_1_2_4_3_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41580-020-00313-x"},{"key":"e_1_2_4_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.42528"},{"key":"e_1_2_4_5_1","doi-asserted-by":"publisher","DOI":"10.3389\/fnagi.2019.00257"},{"key":"e_1_2_4_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.27584"}],"container-title":["ACR Open Rheumatology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/acrjournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/acr2.90151","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/acrjournals.onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/acr2.90151","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/acrjournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/acr2.90151","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T07:21:09Z","timestamp":1790234469000},"score":1,"resource":{"primary":{"URL":"https:\/\/acrjournals.onlinelibrary.wiley.com\/doi\/10.1002\/acr2.90151"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9]]},"references-count":5,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2026,9]]}},"alternative-id":["10.1002\/acr2.90151"],"URL":"https:\/\/doi.org\/10.1002\/acr2.90151","archive":["Portico"],"relation":{},"ISSN":["2578-5745","2578-5745"],"issn-type":[{"value":"2578-5745","type":"print"},{"value":"2578-5745","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9]]},"assertion":[{"value":"2026-08-05","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-08-19","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-09-17","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e90151"}}