{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T05:57:15Z","timestamp":1790575035037,"version":"4.1.0"},"reference-count":36,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T00:00:00Z","timestamp":1790553600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Pharmacol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Targeted synthetic disease-modifying antirheumatic drugs (tsDMARDs) show promise for rheumatoid arthritis (RA), but multi-dimensional efficacy evaluation needs further study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This study aimed to comprehensively assess tsDMARDs\u2019 efficacy in RA and explore factors linked to treatment response.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>123 consecutive active RA patients treated with tsDMARDs for \u22656 months at Suzhou Ninth People\u2019s Hospital (January 2023\u2013December 2024) were retrospectively analyzed; 120 were included after exclusions. Clinical efficacy was appraised using the Disease Activity Score in 28 joints based on C-reactive protein (DAS28-CRP), Clinical Disease Activity Index (CDAI), American College of Rheumatology 20\/50\/70 (ACR20\/50\/70), and the overall effective rate. Immunological parameters included erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), rheumatoid factor (RF), and anti-citrullinated protein antibody (ACPA). Musculoskeletal ultrasound parameters consisted of synovial hypertrophy score assessed by gray-scale ultrasound (GSUS) and synovial vascularity grade assessed by power Doppler ultrasound (PDUS). Correlations between parameters were analyzed, and multivariate logistic regression pinpointed independent risk factors of favorable therapeutic response.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among 120 patients, patients were stratified into effective (n = 78) and non-effective (n = 42) groups, with comparable baseline characteristics (all\n                      <jats:italic>P<\/jats:italic>\n                      &amp;gt; 0.05). After 6 months, the effective group showed significantly greater improvements in DAS28-CRP, CDAI, ESR, CRP, RF, ACPA, GSUS, and PDUS (all\n                      <jats:italic>P<\/jats:italic>\n                      &amp;lt; 0.001). Positive correlations were present between immunological\/ultrasound parameters and disease activity scores. Multivariate logistic regression identified reduced PDUS signal, lower CRP, and improved DAS28-CRP as independent predictors of favorable response.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>tsDMARDs effectively improve joint symptoms, reduce disease activity, and enhance articular function in RA patients, potentially supporting personalized therapeutic strategies.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fphar.2026.1819771","type":"journal-article","created":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T05:44:44Z","timestamp":1790574284000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Efficacy, mechanisms, and influence factors of small molecule targeted therapy in treating rheumatoid arthritis: a multi-dimensional clinical, immunological, and ultrasonographic study"],"prefix":"10.3389","volume":"17","author":[{"given":"Zhe","family":"Zhou","sequence":"first","affiliation":[{"name":"Department of Rheumatology and Immunology, Suzhou Ninth People\u2019s Hospital","place":["Suzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yiwen","family":"Zhu","sequence":"additional","affiliation":[{"name":"Department of Rheumatology and Immunology, Suzhou Ninth People\u2019s Hospital","place":["Suzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rui","family":"Jing","sequence":"additional","affiliation":[{"name":"Department of Rheumatology and Immunology, Affiliated Hospital of Nantong University","place":["Nantong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,9,28]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"42","DOI":"10.1186\/s13063-022-06000-w","article-title":"Outcome selection for tissue-agnostic drug trials for immune-mediated inflammatory diseases: a systematic review of core outcome sets and regulatory guidance","volume":"23","author":"Aiyegbusi","year":"2022","journal-title":"Trials"},{"key":"B2","doi-asserted-by":"publisher","first-page":"e002777","DOI":"10.1136\/rmdopen-2022-002777","article-title":"Interstitial lung disease in rheumatoid arthritis: incidence, prevalence and related drug prescriptions between 2007 and 2020","volume":"9","author":"Albrecht","year":"2023","journal-title":"RMD Open"},{"key":"B3","doi-asserted-by":"publisher","first-page":"3","DOI":"10.1007\/s11926-024-01173-6","article-title":"Immune checkpoint inhibitor associated rheumatoid arthritis","volume":"27","author":"Bernabela","year":"2024","journal-title":"Curr. 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