The findings come from a pragmatic randomised controlled trial conducted in Singapore, published in BMC Complementary Medicine and Therapies. Researchers led by Yu Heng Kwan and Ting Hui Woon of Singapore General Hospital enrolled 139 patients with active axial spondyloarthritis and randomly assigned them to two groups. Seventy patients received a Traditional Chinese Medicine collaborative model of care, which involved ten TCM consultations paired with acupuncture sessions delivered over the first five weeks, layered on top of their usual rheumatologic care. The remaining 69 patients continued with standard rheumatologic care alone. The trial, registered on ClinicalTrials.gov as NCT03420404, was designed to reflect real-world clinical practice rather than the artificial conditions of a highly controlled explanatory study.

The scientific rationale for the intervention rests on long-standing hypotheses about acupuncture’s physiological effects. Acupuncture has been postulated to exert analgesic and anti-inflammatory actions, potentially modulating pain signaling pathways and inflammatory mediators relevant to conditions like axial spondyloarthritis. Whether those mechanisms translate into measurable, durable clinical benefit in patients already receiving modern disease management is precisely the question the Singapore team set out to answer with a design that could capture the therapy as it would actually be delivered in a health system.

Earlier reports from this trial had generated genuine excitement. At week six, the intervention group showed meaningful improvements in spinal pain, disease activity, and disease-specific quality of life compared with patients receiving usual care alone. Those primary and exploratory outcomes suggested that embedding TCM physicians and acupuncturists within a collaborative care framework alongside rheumatologists could offer patients something extra during a critical window of treatment. For a condition where non-steroidal anti-inflammatory drugs and biologic therapies leave many patients with residual symptoms, a safe adjunct that blunts pain would be a significant clinical advance.

The new publication, however, extends the analysis through week 52 and tempers that optimism considerably. The researchers tracked a comprehensive battery of validated outcome measures at weeks 6, 12, 24, and 52. These included spinal pain, the Bath Ankylosing Spondylitis Disease Activity Index known as BASDAI, the Bath Ankylosing Spondylitis Functional Index or BASFI, the Bath Ankylosing Spondylitis Patient Global Score, the Health Assessment Questionnaire, the 36-item Short Form survey capturing both physical and mental health components, and the Ankylosing Spondylitis Quality of Life instrument. Together, these measures span the full spectrum of what matters to patients: pain, stiffness, physical function, global wellbeing, and quality of life.

To analyze the longitudinal data, the team employed linear mixed models, a statistical approach well suited to repeated measures because it accounts for the correlation between observations taken from the same patient over time and can handle missing data more gracefully than simpler methods. The key quantity of interest was the average treatment effect across all four follow-up time points for each outcome. The result was consistent and unambiguous: for spinal pain, BASDAI, BASFI, HAQ, BAS-G, the SF-36 Physical Component Summary, the SF-36 Mental Component Summary, and ASQoL, the average treatment effects were not statistically significant. In other words, when the entire year of follow-up is considered as a whole, the collaborative TCM care did not outperform usual rheumatologic care.

What does this pattern of results actually mean? The data paint a picture of a treatment effect that is real but transient. The benefits observed at week six, immediately after the intensive five-week course of ten TCM consultations and acupuncture sessions, appear to have faded as the follow-up lengthened. By the time the analysis averages effects across the full year, the early gains are diluted to statistical insignificance. This is a familiar trajectory in trials of complementary therapies and, indeed, in trials of many interventions for chronic pain conditions: short-term symptomatic relief does not necessarily translate into sustained disease modification or long-term functional improvement.

Several explanations merit consideration. Axial spondyloarthritis is a progressive inflammatory disease, and the standard care received by both groups, which can include non-steroidal anti-inflammatory drugs, conventional disease-modifying anti-rheumatic drugs, biologic agents, and targeted synthetic therapies, continues to evolve over a year of treatment. Any modest symptomatic benefit from acupuncture may be overwhelmed by the natural fluctuation of the disease and by adjustments in conventional therapy. It is also possible that the intensive early dosing of acupuncture was insufficient to maintain effects, and that ongoing booster sessions might have preserved the benefit, though the trial was not designed to test that hypothesis. Additionally, pragmatic trials trade some internal control for real-world relevance, and factors such as patient expectations, concurrent treatments, and the heterogeneity of disease severity can all influence the detectable treatment effect.

The trial’s methodology strengthens the credibility of its conclusions. The study followed the Consolidated Standards of Reporting Trials and the Standards for Reporting Interventions in Clinical Trials of Acupuncture, used the Pragmatic Explanatory Continuum Indicator Summary Framework-2 to position the design on the pragmatic spectrum, and aligned its outcome selection with the Outcomes Measures in Rheumatology initiative. A Data and Safety Monitoring Board oversaw the trial, reviewing it in December 2019 and recommending continuation without change. The study was approved by the SingHealth Centralised Institutional Review Board and conducted under the principles of the Declaration of Helsinki, with all participants providing informed consent. Funding came from the Singapore Ministry of Health Traditional Chinese Medicine Research Grant and the Reverie Rheumatology Research Fund, with the funders having no role in study design, data analysis, or the decision to publish.

For patients and clinicians, the practical message is nuanced rather than dismissive. The trial does not claim that acupuncture is useless; it demonstrates that a defined, time-limited course of TCM collaborative care produces short-term improvements in spinal pain, disease activity, and disease-specific quality of life that are not sustained through a full year. Patients who find symptomatic relief from acupuncture during flare periods may still have legitimate reasons to pursue it, provided they continue their prescribed rheumatologic treatment. But health systems and policymakers weighing whether to invest in integrated TCM-rheumatology services now have high-quality evidence that such programs, at least in this configuration, deliver a temporary rather than lasting advantage. The challenge for future research is clear: determine whether modified treatment schedules, different patient subgroups, or combined approaches can convert short-term relief into durable, year-long benefit for people living with this demanding disease.

Subject of Research: Long-term effectiveness of Traditional Chinese Medicine collaborative care with acupuncture for axial spondyloarthritis

Article Title: Traditional Chinese medicine collaborative care in the management of patients with axial spondyloarthritis: long-term outcomes of a pragmatic randomised controlled trial through week 52

Article References: Kwan, Y. H., Woon, T. H., Sum, C. W. Y., Tai, B. C., Huang, Y., Bilger, M., Phang, J. K., Tan, H. C., Quek, S.-A., Lee, J. V., Koh, H. L., Leung, Y. Y., Yeo, S. I., Ng, S. C., Wang, C. T. M., Fong, K. Y., Thumboo, J., Østbye, T., & Fong, W. (2026). Traditional Chinese medicine collaborative care in the management of patients with axial spondyloarthritis: long-term outcomes of a pragmatic randomised controlled trial through week 52. BMC Complementary Medicine and Therapies. https://doi.org/10.1186/s12906-026-05562-5

Image Credits: AI Generated

DOI: 10.1186/s12906-026-05562-5

Keywords: axial spondyloarthritis, acupuncture, Traditional Chinese Medicine, randomised controlled trial, rheumatology, BASDAI, spinal pain, quality of life, integrative medicine, chronic inflammatory disease, pragmatic trial, Singapore

Hidradenitis suppurativa, often abbreviated HS, is a chronic, debilitating inflammatory skin disease characterized by painful nodules, abscesses, and draining tunnels known as sinus tracts, typically developing in intertriginous areas where skin rubs against skin. It affects an estimated one percent or more of the population, with women disproportionately affected, and it is far more than a cosmetic nuisance. Patients endure flares that can last decades, scarring that limits movement, and a psychological burden that includes elevated rates of depression and anxiety. The disease is also increasingly recognized as systemic: it is associated with metabolic syndrome, cardiovascular disease, inflammatory arthritis, and other comorbidities that suggest the inflammation driving HS does not respect the boundaries of the skin.

Against that backdrop, the Henry Ford team, led by Albert T. Young and including colleagues Alexandra Turfe, Meyer Gershater, Umer Nadir, Mulin Xiong, Li Zhou, and Qing-Sheng Mi, asked a deceptively simple question: do patients with hidradenitis suppurativa adhere to breast cancer screening guidelines at the same rate as comparable women without the disease? Breast cancer remains one of the most common cancers among women in the United States, and organizations such as the American Cancer Society have long issued screening recommendations, generally centered on regular mammography beginning in middle age, because early detection dramatically improves survival. Screening adherence is therefore one of the most closely watched metrics in preventive care, and gaps in adherence are a well-documented driver of cancer disparities.

The study design was a retrospective cohort analysis, a method that mines years of real-world clinical data rather than following patients forward in time. The researchers drew on the medical records of a large, diverse health care system in Detroit, an institution whose patient population includes substantial numbers of Black patients, a group that bears a disproportionate burden of both hidradenitis suppurativa and aggressive breast cancer. By identifying age-eligible women with a documented HS diagnosis and comparing their screening behavior against appropriate comparison groups, the team could ask whether the disease itself, or the circumstances surrounding it, correlates with missed mammograms. Retrospective designs of this kind cannot prove causation, but they are powerful for detecting patterns that would take years and enormous budgets to capture prospectively.

There are several plausible reasons to suspect that women with HS might fall behind on screening. The disease’s physical symptoms can make mammography genuinely uncomfortable or painful, since the procedure involves compressing the breast tissue, and HS lesions frequently occur in the inframammary fold and axillae. Flares of abscesses and draining tunnels may make patients reluctant to schedule any procedure involving the chest wall. Beyond the mechanical barriers, HS patients face well-documented delays in diagnosis, stigma in clinical settings, and a fragmented care experience in which dermatology, primary care, and specialty services operate in separate silos. A patient whose medical visits are consumed by managing painful flares may have little bandwidth for preventive care that addresses a risk that feels distant.

The broader literature on screening adherence reinforces why this question matters. Large national surveys, including analyses of the National Health Interview Survey, have shown that even among age-eligible women in the general population, adherence to breast cancer screening guidelines falls well short of universal, with substantial variation by race, income, insurance status, and access to a usual source of care. Any chronic disease that adds friction to the health care experience, whether through pain, stigma, or logistical burden, has the potential to widen those gaps further. Conversely, identifying a specific population at elevated risk of under-screening creates a concrete target for intervention, from reminder systems to coordinated care pathways that bundle preventive services into dermatology visits.

The Detroit study is notable not only for its question but for its setting. Henry Ford Health maintains one of the country’s most extensive longitudinal databases on hidradenitis suppurativa, and the same group previously published a retrospective cross-sectional analysis of more than 13,000 HS patients drawn from health system records spanning nearly three decades, from 1995 to 2022. That earlier work helped establish the demographic and comorbidity profile of a diverse HS cohort in the United States, and it provided the methodological scaffolding for the current investigation. The new study was supported by grants from the National Institute of Arthritis and Musculoskeletal and Skin Diseases, part of the National Institutes of Health, reflecting a sustained federal investment in a disease that was, until relatively recently, chronically underfunded and understudied.

The research also fits into a wider effort to map the full systemic footprint of hidradenitis suppurativa in women’s health. The same Detroit group and collaborators have previously examined pregnancy outcomes in HS patients and surveyed patients about breastfeeding decisions, work that revealed how the disease and its treatments intersect with reproductive choices in ways that clinicians rarely discuss. Breast cancer screening is a natural extension of that agenda: it concerns the same anatomical region, the same patient population, and the same underlying question of whether a stigmatized, painful, chronic disease quietly reshapes the preventive care a woman receives. If screening rates among HS patients lag behind guidelines, the finding would add a new dimension to the growing list of health disparities associated with the condition.

For clinicians, the practical implications of this line of research are straightforward even before the results are translated into practice. Dermatologists, who often serve as the primary point of contact for HS patients, are well positioned to ask about mammography during routine visits and to coordinate referrals, particularly because many patients with moderate to severe HS see their dermatologist more frequently than their primary care physician. Health systems can embed screening reminders into dermatology workflows, and radiology departments can offer accommodations, such as scheduling flexibility around flares or additional pain management, that make mammography more feasible for patients whose disease makes compression especially uncomfortable. None of these interventions requires new technology; they require only the recognition that a skin disease can create barriers to cancer detection.

The study, published as a research letter in the Archives of Dermatological Research with the Henry Ford Health institutional review board’s approval, is a reminder of how much remains unknown about the everyday health care experiences of people with chronic inflammatory skin disease. Hidradenitis suppurativa affects millions of people worldwide, yet its influence on routine preventive care has only begun to be quantified. As the evidence base grows, the hope is that screening gaps, wherever they exist, can be closed with targeted, practical measures, and that patients with HS will no longer have to choose between managing the disease they can see and preventing the one they cannot. The findings arrive at a moment when the dermatology community is increasingly committed to treating HS not as an isolated skin complaint but as a systemic condition with consequences that reach into every corner of a patient’s medical life, including the quiet, life-saving work of cancer screening.

Subject of Research: Breast cancer screening adherence among patients with hidradenitis suppurativa

Article Title: Adherence to breast cancer screening guidelines among patients with hidradenitis suppurativa: a retrospective cohort study

Article References: Young, A. T., Turfe, A., Gershater, M., Nadir, U., Xiong, M., Zhou, L., & Mi, Q.-S. (2026). Adherence to breast cancer screening guidelines among patients with hidradenitis suppurativa: a retrospective cohort study. Archives of Dermatological Research, 318(1), Article 484. https://doi.org/10.1007/s00403-026-04930-y

Image Credits: AI Generated

DOI: 10.1007/s00403-026-04930-y

Keywords: hidradenitis suppurativa, breast cancer screening, mammography, retrospective cohort study, dermatology, preventive care, health disparities, chronic inflammatory disease, women's health, cancer screening guidelines, Henry Ford Health, comorbidities

Periodontitis, a chronic inflammatory disease affecting the tissues surrounding teeth, is known for its insidious progression resulting in tooth loss, systemic inflammation, and links to various cardiovascular and metabolic conditions. The research team employed robust epidemiological models, integrating decades of health data to map the incidence, prevalence, and projected trends of severe periodontitis. Their findings illuminate a troubling pattern of persistent and, in some cases, escalating disease prevalence, especially in nations characterized by swift demographic transitions and shifting socioeconomic landscapes.

Focusing on the BRICS-Plus grouping—comprising Brazil, Russia, India, China, South Africa, and additional emerging economies—the study underscores the interplay between economic development and health outcomes. While these nations have experienced considerable advancements in healthcare infrastructure and lifestyle changes, they also face unique challenges such as urbanization-related health disparities, unequal access to dental care, and evolving dietary behaviors that may exacerbate oral disease prevalence. The research meticulously charts these dynamics, illuminating how regional variations in healthcare policy, oral hygiene practices, and socioeconomic factors influence periodontitis burden over five decades.

Technically speaking, the study utilizes age-standardized rates and Disability-Adjusted Life Years (DALYs) to quantify disease burden, providing a comparative framework that neutralizes demographic age structure differences. The researchers applied sophisticated forecasting algorithms, including Bayesian hierarchical models, enabling nuanced predictions that factor in historical trends and emerging risk determinants. This methodological rigor enriches the reliability of the projections, positioning them as indispensable tools for strategic public health planning.

One of the pivotal revelations of the study is the projected increase in severe periodontitis cases in specific BRICS-Plus nations, despite general improvements in healthcare systems. For instance, India and South Africa demonstrate notable surges in disease prevalence, fueled by persistent socioeconomic inequalities and gaps in preventive dental care access. Conversely, China displays a more complex trend, where divisions between urban and rural oral health profiles create a patchwork pattern of disease burden that challenges uniform policy responses.

Understanding the etiological underpinnings, the researchers underscore the role of chronic systemic inflammation driven by bacterial pathogens inhabiting the periodontal pockets. The microbial dysbiosis characteristic of severe periodontitis initiates a cascade of host immune responses culminating in connective tissue degradation and alveolar bone resorption. These pathological mechanisms, although well-established in clinical periodontology, assume heightened significance in populations burdened by comorbid conditions such as diabetes and tobacco use—both prevalent in several BRICS-Plus countries.

The study’s longitudinal design enables a critical evaluation of past public health interventions targeting oral disease mitigation. Data indicates that countries adopting integrative dental health programs emphasizing prevention, widespread oral hygiene education, and accessible treatment modalities achieved more favorable disease trajectories. This evidence advocates for scaling such strategies regionwide, tailored to the sociocultural and economic realities inherent to these diverse nations.

Furthermore, the investigation highlights disparities in health literacy and infrastructural capabilities as prominent obstacles impeding effective periodontitis control. Many rural and underserved urban sectors within BRICS-Plus exhibit stark deficiencies in dental workforce density and preventive service coverage, amplifying disease severity and complicating early intervention efforts. Addressing these systemic gaps emerges as a crucial component in reversing the projected upward trend of severe periodontitis.

The systemic implications of untreated periodontitis extend beyond oral health, implicating broader public health domains. Chronic inflammation originating in periodontal tissues has been correlated with exacerbations of cardiovascular disease, adverse pregnancy outcomes, and impaired glycemic control in diabetics. The forecasting model incorporates these associations to emphasize the multifaceted burden severe periodontitis imposes on healthcare systems, particularly in economies already grappling with resource constraints.

Critically, the study proposes innovative policy frameworks prioritizing multisectoral collaboration encompassing oral health promotion, chronic disease management, and socioeconomic development. By fostering cross-disciplinary synergies, these frameworks aim to mitigate the compounded impact of periodontitis within high-burden populations, optimizing resource allocation and enhancing equity in health outcomes.

Technological advancements also feature prominently in the study’s strategic recommendations. The emergence of tele-dentistry and AI-assisted diagnostic tools could revolutionize access to care in remote and underserved areas across BRICS-Plus nations. Integrating these digital solutions with conventional public health initiatives may dramatically improve early detection, patient monitoring, and personalized treatment planning, providing a critical lever to stem the tide of severe periodontal disease.

The authors emphasize the urgency of embedding robust surveillance systems capable of real-time epidemiological tracking. Dynamic data collection platforms would enable health authorities to respond proactively to emerging oral health threats, assess intervention effectiveness, and recalibrate strategies continuously. Such surveillance mechanisms are currently underdeveloped in many BRICS-Plus countries, representing a significant vulnerability in controlling disease spread and impact.

Education remains a cornerstone in the fight against severe periodontitis, and the study commends initiatives that integrate oral health literacy into broader health education curricula. Empowering individuals with knowledge regarding plaque control, smoking cessation, nutritional optimization, and regular dental checkups can drive behavioral changes essential for disease prevention. Culturally sensitive and linguistically appropriate messaging tailored to diverse populations within these countries will be vital for maximizing program efficacy.

Population aging trends observed across BRICS-Plus nations compound the projected periodontitis burden. Older adults are disproportionately affected due to cumulative exposure to risk factors and diminished regenerative capacity of periodontal tissues. Therefore, the study calls for geriatric-focused oral health policies encompassing preventive, restorative, and rehabilitative care to sustain quality of life among aging cohorts.

In conclusion, this comprehensive analysis by Luo et al. integrates historical data with advanced predictive modeling to reveal a sobering forecast for severe periodontitis in the BRICS-Plus context up to 2040. It stresses that without coordinated, equity-driven public health responses incorporating technological innovation, enhanced access, education, and surveillance, the oral health of millions may deteriorate, with cascading effects on systemic health and economic productivity. This study is a clarion call, urging policymakers, researchers, and clinicians to transform oral healthcare paradigms to better serve burgeoning populations at risk.

Subject of Research: Severe periodontitis burden and forecast trends in BRICS-Plus nations from 1990 to 2040

Article Title: Burden and forecast of severe periodontitis in BRICS-Plus nations: trends from 1990 to 2040

Article References:
Luo, LS., Huang, J., Luan, HH. et al. Burden and forecast of severe periodontitis in BRICS-Plus nations: trends from 1990 to 2040. Int J Equity Health 24, 299 (2025). https://doi.org/10.1186/s12939-025-02660-7

Image Credits: AI Generated