Evidence map›Paper›PMID 41980709›Full record

ArticleACR open rheumatology2026

Romosozumab-Associated Recurrent Erythema Nodosum in Mixed Connective Tissue Disease.

Jose Luis Diaz Macip, Izabela Turcu, Jyothsna Goranti, Sreeja Sivaguru, Sai Priyanka Kodam, Zeeshan Afzal

Abstract read
In one paragraph

Article in ACR open rheumatology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
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1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Jose Luis Diaz MacipDepartment of Internal Medicine, Texas Tech University Health Sciences Center El Paso.ORCID https://orcid.org/0000-0002-8504-8454
Izabela TurcuDepartment of Internal Medicine, Texas Tech University Health Sciences Center El Paso.
Jyothsna GorantiDepartment of Internal Medicine, Texas Tech University Health Sciences Center El Paso.
Sreeja SivaguruDepartment of Internal Medicine, Texas Tech University Health Sciences Center El Paso.
Sai Priyanka KodamDivision of Rheumatology, University of Nevada, Las Vegas.
Zeeshan AfzalDivision of Rheumatology, Texas Tech University Health Sciences Center El Paso.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveThe aim of this study was to describe recurrent erythema nodosum (EN) temporally associated with romosozumab in a patient with mixed connective tissue disease and to examine the biologic plausibility of this association in the context of Wnt/β-catenin-mediated immune regulation.

methodsWe evaluated a patient with mixed connective tissue disease and osteoporosis who developed EN following romosozumab exposure. Clinical assessment included detailed medication reconciliation, infectious evaluation, markers of inflammation, response to glucocorticoids, and recurrence upon re-exposure. A focused literature review was conducted to assess prior reports and mechanistic relevance.

resultsA 71-year-old woman developed EN approximately one month after her first dose of romosozumab, with complete remission following prednisone therapy. Within days of the second dose, she experienced a more extensive recurrence involving the hands, thighs, and right calf, which resolved after a glucocorticoid taper. Infectious evaluation was negative, markers of inflammation were normal, and medication reconciliation did not identify alternative pharmacologic triggers. Romosozumab was discontinued, and no recurrence occurred during follow-up before transition to denosumab.

conclusionThis case supports a probable association between romosozumab and recurrent EN. Rechallenge, exclusion of alternative etiologies, and emerging evidence on Wnt-mediated immune regulation suggest a mechanistic link between sclerostin inhibition and panniculitic hypersensitivity reactions.

Identifiers

PMID41980709
PMCPMC13078908

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