Key clinical point: The patients with seropositive rheumatoid arthritis (RA) are at an increased risk for ischemic stroke, particularly females and those without diabetes and dyslipidemia.

Major finding: The risk for ischemic stroke was significantly higher in the seropositive RA vs. control group (adjusted hazard ratio [aHR], 1.40; 95% confidence interval, 1.07-1.82). The risk for ischemic stroke was higher in females with seropositive RA vs. males (aHR, 1.44 vs. 1.12; P less than .001) and those without vs. with diabetes (aHR, 1.47 vs. 0.98; P less than .001) and dyslipidemia (aHR, 1.43 vs. 0.92; P = .008).

Study details: This was a nationwide, longitudinal 12-year follow-up study involving patients with seropositive RA (n=2,765) who were prescribed any disease-modifying antirheumatic drug and age- and sex-matched with control participants (n=13,825).

Disclosures: This study was funded by the Basic Science Research Program through the National Research Foundation of Korea funded by the Ministry of Science, ICT, and Future Planning. The authors declared no conflicts of interest.

Source: Lee DH et al. PLoS One. 2021 May 17. doi: 10.1371/journal.pone.0251851.

Key clinical point: The patients with seropositive rheumatoid arthritis (RA) are at an increased risk for ischemic stroke, particularly females and those without diabetes and dyslipidemia.

Major finding: The risk for ischemic stroke was significantly higher in the seropositive RA vs. control group (adjusted hazard ratio [aHR], 1.40; 95% confidence interval, 1.07-1.82). The risk for ischemic stroke was higher in females with seropositive RA vs. males (aHR, 1.44 vs. 1.12; P less than .001) and those without vs. with diabetes (aHR, 1.47 vs. 0.98; P less than .001) and dyslipidemia (aHR, 1.43 vs. 0.92; P = .008).

Study details: This was a nationwide, longitudinal 12-year follow-up study involving patients with seropositive RA (n=2,765) who were prescribed any disease-modifying antirheumatic drug and age- and sex-matched with control participants (n=13,825).

Disclosures: This study was funded by the Basic Science Research Program through the National Research Foundation of Korea funded by the Ministry of Science, ICT, and Future Planning. The authors declared no conflicts of interest.

Source: Lee DH et al. PLoS One. 2021 May 17. doi: 10.1371/journal.pone.0251851.

Key clinical point: The patients with seropositive rheumatoid arthritis (RA) are at an increased risk for ischemic stroke, particularly females and those without diabetes and dyslipidemia.

Major finding: The risk for ischemic stroke was significantly higher in the seropositive RA vs. control group (adjusted hazard ratio [aHR], 1.40; 95% confidence interval, 1.07-1.82). The risk for ischemic stroke was higher in females with seropositive RA vs. males (aHR, 1.44 vs. 1.12; P less than .001) and those without vs. with diabetes (aHR, 1.47 vs. 0.98; P less than .001) and dyslipidemia (aHR, 1.43 vs. 0.92; P = .008).

Study details: This was a nationwide, longitudinal 12-year follow-up study involving patients with seropositive RA (n=2,765) who were prescribed any disease-modifying antirheumatic drug and age- and sex-matched with control participants (n=13,825).

Disclosures: This study was funded by the Basic Science Research Program through the National Research Foundation of Korea funded by the Ministry of Science, ICT, and Future Planning. The authors declared no conflicts of interest.

Source: Lee DH et al. PLoS One. 2021 May 17. doi: 10.1371/journal.pone.0251851.

Key clinical point: Long-term treatment with baricitinib was effective for up to 120 weeks and was well tolerated in patients with moderately to severely active rheumatoid arthritis (RA) with an inadequate response to conventional synthetic disease-modifying antirheumatic drugs or tumor necrosis factor inhibitor.

Major finding: In RA-BUILD-BEYOND and RA-BEACON-BEYOND, 85.1% and 86.5% of patients treated with baricitinib achieved Simple Disease Activity Index (SDAI) low-disease activity (LDA); 40.5% and 24.3% were in SDAI remission; 62.2% and 50.0% had Health Assessment Questionnaire Disability Index of 0.5 or less; and 81.1% and 73.7% achieved 0.22 or greater change from baseline at week 120, respectively. Rates of adverse events of special interest were similar as reported previously.

Study details: Findings are from the post hoc analysis of 2 24-week phase 3 studies, RA-BUILD and RA-BEACON. Patients who completed either trial entered the ongoing 120-week RA-BEYOND long-term extension study.

Disclosures: This study was supported by Eli Lilly and Company and Incyte Corporation. The authors reported receiving research grant, consulting/speakers fees, and/or honoraria from various sources. Five of the authors reported being employees and stockholders of Eli Lilly and Company.

Source: Wells AF et al. Rheumatol Ther. 2021 May 24. doi: 10.1007/s40744-021-00317-9.

Key clinical point: Long-term treatment with baricitinib was effective for up to 120 weeks and was well tolerated in patients with moderately to severely active rheumatoid arthritis (RA) with an inadequate response to conventional synthetic disease-modifying antirheumatic drugs or tumor necrosis factor inhibitor.

Major finding: In RA-BUILD-BEYOND and RA-BEACON-BEYOND, 85.1% and 86.5% of patients treated with baricitinib achieved Simple Disease Activity Index (SDAI) low-disease activity (LDA); 40.5% and 24.3% were in SDAI remission; 62.2% and 50.0% had Health Assessment Questionnaire Disability Index of 0.5 or less; and 81.1% and 73.7% achieved 0.22 or greater change from baseline at week 120, respectively. Rates of adverse events of special interest were similar as reported previously.

Study details: Findings are from the post hoc analysis of 2 24-week phase 3 studies, RA-BUILD and RA-BEACON. Patients who completed either trial entered the ongoing 120-week RA-BEYOND long-term extension study.

Disclosures: This study was supported by Eli Lilly and Company and Incyte Corporation. The authors reported receiving research grant, consulting/speakers fees, and/or honoraria from various sources. Five of the authors reported being employees and stockholders of Eli Lilly and Company.

Source: Wells AF et al. Rheumatol Ther. 2021 May 24. doi: 10.1007/s40744-021-00317-9.

Key clinical point: Long-term treatment with baricitinib was effective for up to 120 weeks and was well tolerated in patients with moderately to severely active rheumatoid arthritis (RA) with an inadequate response to conventional synthetic disease-modifying antirheumatic drugs or tumor necrosis factor inhibitor.

Major finding: In RA-BUILD-BEYOND and RA-BEACON-BEYOND, 85.1% and 86.5% of patients treated with baricitinib achieved Simple Disease Activity Index (SDAI) low-disease activity (LDA); 40.5% and 24.3% were in SDAI remission; 62.2% and 50.0% had Health Assessment Questionnaire Disability Index of 0.5 or less; and 81.1% and 73.7% achieved 0.22 or greater change from baseline at week 120, respectively. Rates of adverse events of special interest were similar as reported previously.

Study details: Findings are from the post hoc analysis of 2 24-week phase 3 studies, RA-BUILD and RA-BEACON. Patients who completed either trial entered the ongoing 120-week RA-BEYOND long-term extension study.

Disclosures: This study was supported by Eli Lilly and Company and Incyte Corporation. The authors reported receiving research grant, consulting/speakers fees, and/or honoraria from various sources. Five of the authors reported being employees and stockholders of Eli Lilly and Company.

Source: Wells AF et al. Rheumatol Ther. 2021 May 24. doi: 10.1007/s40744-021-00317-9.

Key clinical point: Patients with treatment-naive early rheumatoid arthritis (RA) had higher serum clusterin levels, which decreased significantly after the initiation of conventional therapy. Moreover, baseline clusterin levels predicted the achievement of low disease activity and remission during the first year.

Major finding: Patients with treatment-naive early RA vs. healthy controls (HCs) had significantly higher clusterin levels (P less than .0001), which declined significantly after 3 months of therapy (P less than .0001) and was comparable with that of HCs (P = .865). Lower clusterin levels at baseline predicted achieving remission (P = .018) and low disease activity (P = .025) at 12 months.

Study details: The data come from an analysis of patients with treatment-naive early RA (n=52) who were age-/sex-matched with HCs (n=52).

Disclosures: This study received support from the Ministry of Health of the Czech Republic. No competing interest was reported.

Source: Kropáčková T et al. Sci Rep. 2021 Jun 1. doi: 10.1038/s41598-021-90973-2.

Key clinical point: Patients with treatment-naive early rheumatoid arthritis (RA) had higher serum clusterin levels, which decreased significantly after the initiation of conventional therapy. Moreover, baseline clusterin levels predicted the achievement of low disease activity and remission during the first year.

Major finding: Patients with treatment-naive early RA vs. healthy controls (HCs) had significantly higher clusterin levels (P less than .0001), which declined significantly after 3 months of therapy (P less than .0001) and was comparable with that of HCs (P = .865). Lower clusterin levels at baseline predicted achieving remission (P = .018) and low disease activity (P = .025) at 12 months.

Study details: The data come from an analysis of patients with treatment-naive early RA (n=52) who were age-/sex-matched with HCs (n=52).

Disclosures: This study received support from the Ministry of Health of the Czech Republic. No competing interest was reported.

Source: Kropáčková T et al. Sci Rep. 2021 Jun 1. doi: 10.1038/s41598-021-90973-2.

Key clinical point: Patients with treatment-naive early rheumatoid arthritis (RA) had higher serum clusterin levels, which decreased significantly after the initiation of conventional therapy. Moreover, baseline clusterin levels predicted the achievement of low disease activity and remission during the first year.

Major finding: Patients with treatment-naive early RA vs. healthy controls (HCs) had significantly higher clusterin levels (P less than .0001), which declined significantly after 3 months of therapy (P less than .0001) and was comparable with that of HCs (P = .865). Lower clusterin levels at baseline predicted achieving remission (P = .018) and low disease activity (P = .025) at 12 months.

Study details: The data come from an analysis of patients with treatment-naive early RA (n=52) who were age-/sex-matched with HCs (n=52).

Disclosures: This study received support from the Ministry of Health of the Czech Republic. No competing interest was reported.

Source: Kropáčková T et al. Sci Rep. 2021 Jun 1. doi: 10.1038/s41598-021-90973-2.

Key clinical point: High-resolution peripheral quantitative computed tomography (HR-pQCT) of 2 metacarpophalangeal joints and conventional radiography (CR) of 44 joints had comparable diagnostic accuracy for classifying patients with established rheumatoid arthritis (RA) as having erosive disease.

Major finding: Using CR as reference, the sensitivity and specificity of HR-pQCT for classifying patients having erosive RA was 89% (95% confidence interval [CI], 84%-92%) and 30% (95% Cl, 20%-43%), respectively. In contrast, the sensitivity and specificity of CR of 44 joints was 85% (95% Cl, 80%-89%) and 38% (95% Cl, 25%-52%), respectively, when HR-pQCT was used as reference. There was no significant difference between the sensitivities of patients classified as having erosive RA by HR-pQCT or CR (2.14; P = .177).

Study details: Data come from a single-center cross-sectional study of 353 patients with established RA.

Disclosures: The study received support from the Aarhus University Research Foundation, Danish Rheumatism Association, Novo Nordic Foundation, and A.P. Møller Fonden. E M Hauge and B Langdahl reported receiving grants and personal fees from various sources. All the other authors reported no conflicts of interest.

Source: Klose-Jensen R et al. Rheumatology (Oxford). 2021 May 20. doi: 10.1093/rheumatology/keab446.

Key clinical point: High-resolution peripheral quantitative computed tomography (HR-pQCT) of 2 metacarpophalangeal joints and conventional radiography (CR) of 44 joints had comparable diagnostic accuracy for classifying patients with established rheumatoid arthritis (RA) as having erosive disease.

Major finding: Using CR as reference, the sensitivity and specificity of HR-pQCT for classifying patients having erosive RA was 89% (95% confidence interval [CI], 84%-92%) and 30% (95% Cl, 20%-43%), respectively. In contrast, the sensitivity and specificity of CR of 44 joints was 85% (95% Cl, 80%-89%) and 38% (95% Cl, 25%-52%), respectively, when HR-pQCT was used as reference. There was no significant difference between the sensitivities of patients classified as having erosive RA by HR-pQCT or CR (2.14; P = .177).

Study details: Data come from a single-center cross-sectional study of 353 patients with established RA.

Disclosures: The study received support from the Aarhus University Research Foundation, Danish Rheumatism Association, Novo Nordic Foundation, and A.P. Møller Fonden. E M Hauge and B Langdahl reported receiving grants and personal fees from various sources. All the other authors reported no conflicts of interest.

Source: Klose-Jensen R et al. Rheumatology (Oxford). 2021 May 20. doi: 10.1093/rheumatology/keab446.

Key clinical point: High-resolution peripheral quantitative computed tomography (HR-pQCT) of 2 metacarpophalangeal joints and conventional radiography (CR) of 44 joints had comparable diagnostic accuracy for classifying patients with established rheumatoid arthritis (RA) as having erosive disease.

Major finding: Using CR as reference, the sensitivity and specificity of HR-pQCT for classifying patients having erosive RA was 89% (95% confidence interval [CI], 84%-92%) and 30% (95% Cl, 20%-43%), respectively. In contrast, the sensitivity and specificity of CR of 44 joints was 85% (95% Cl, 80%-89%) and 38% (95% Cl, 25%-52%), respectively, when HR-pQCT was used as reference. There was no significant difference between the sensitivities of patients classified as having erosive RA by HR-pQCT or CR (2.14; P = .177).

Study details: Data come from a single-center cross-sectional study of 353 patients with established RA.

Disclosures: The study received support from the Aarhus University Research Foundation, Danish Rheumatism Association, Novo Nordic Foundation, and A.P. Møller Fonden. E M Hauge and B Langdahl reported receiving grants and personal fees from various sources. All the other authors reported no conflicts of interest.

Source: Klose-Jensen R et al. Rheumatology (Oxford). 2021 May 20. doi: 10.1093/rheumatology/keab446.

Key clinical point: Initial treatment with methotrexate (MTX) and glucocorticoids (GC) bridging reduced chronic use of the nonsteroidal anti-inflammatory drug (NSAID) and analgesics compared with MTX treatment alone in patients with early rheumatoid arthritis (eRA) considered to have a favorable prognosis.

Major finding: The number of patients with a daily chronic intake of NSAIDs was significantly lower in MTX monotherapy along with step-down GC vs. MTX monotherapy without oral GC group (14% vs. 40%; P less than .01). Even after correcting for previous chronic analgesic use and baseline pain, patients treated with MTX and step-down GCs had an 83% lower hazard of chronic use of NSAID or analgesic (P less than .001).

Study details: Findings are from a post hoc analysis of the CareRA trial of 90 patients with eRA and favorable risk profile. Patients were randomly allocated to either MTX monotherapy without oral GC (n=47) or MTX monotherapy along with step-down GC (n=43).

Disclosures: The CareRA trial was funded by a Flemish governmental grant. All the authors declared no conflicts of interest.

Source: Pazmino S et al. RMD Open. 2021 May 24. doi: 10.1136/rmdopen-2021-001615.

Key clinical point: Initial treatment with methotrexate (MTX) and glucocorticoids (GC) bridging reduced chronic use of the nonsteroidal anti-inflammatory drug (NSAID) and analgesics compared with MTX treatment alone in patients with early rheumatoid arthritis (eRA) considered to have a favorable prognosis.

Major finding: The number of patients with a daily chronic intake of NSAIDs was significantly lower in MTX monotherapy along with step-down GC vs. MTX monotherapy without oral GC group (14% vs. 40%; P less than .01). Even after correcting for previous chronic analgesic use and baseline pain, patients treated with MTX and step-down GCs had an 83% lower hazard of chronic use of NSAID or analgesic (P less than .001).

Study details: Findings are from a post hoc analysis of the CareRA trial of 90 patients with eRA and favorable risk profile. Patients were randomly allocated to either MTX monotherapy without oral GC (n=47) or MTX monotherapy along with step-down GC (n=43).

Disclosures: The CareRA trial was funded by a Flemish governmental grant. All the authors declared no conflicts of interest.

Source: Pazmino S et al. RMD Open. 2021 May 24. doi: 10.1136/rmdopen-2021-001615.

Key clinical point: Initial treatment with methotrexate (MTX) and glucocorticoids (GC) bridging reduced chronic use of the nonsteroidal anti-inflammatory drug (NSAID) and analgesics compared with MTX treatment alone in patients with early rheumatoid arthritis (eRA) considered to have a favorable prognosis.

Major finding: The number of patients with a daily chronic intake of NSAIDs was significantly lower in MTX monotherapy along with step-down GC vs. MTX monotherapy without oral GC group (14% vs. 40%; P less than .01). Even after correcting for previous chronic analgesic use and baseline pain, patients treated with MTX and step-down GCs had an 83% lower hazard of chronic use of NSAID or analgesic (P less than .001).

Study details: Findings are from a post hoc analysis of the CareRA trial of 90 patients with eRA and favorable risk profile. Patients were randomly allocated to either MTX monotherapy without oral GC (n=47) or MTX monotherapy along with step-down GC (n=43).

Disclosures: The CareRA trial was funded by a Flemish governmental grant. All the authors declared no conflicts of interest.

Source: Pazmino S et al. RMD Open. 2021 May 24. doi: 10.1136/rmdopen-2021-001615.

Key clinical point: Early rheumatoid arthritis (RA) strategies have different risk profiles. Moreover, the use of early steroid-based regimens did not emerge as more harmful.

Major finding: The risk for serious adverse events was higher with biologic monotherapy vs. methotrexate (MTX)+steroid therapy (rate ratio [RR], 3.22; 95% confidence interval [CI], 1.47-7.07) and with biological monotherapy vs. MTX monotherapy (RR, 1.39; 95% CI, 1.12-1.73) and MTX+biologic disease-modifying antirheumatic drugs (DMARD; RR, 1.26; 95% CI, 1.02-1.54).

Study details: Findings are from a network meta-analysis of 20 double-blind randomized clinical trials involving 9,202 adult patients with RA who were initiated on DMARD therapy.

Disclosures: This study received no external funding. The authors received speaker’s fees and honoraria from various pharmaceutical companies including AbbVie. None of the authors reported any conflict of interest.

Source: Adas MA et al. Rheumatology (Oxford). 2021 May 18. doi: 10.1093/rheumatology/keab429.

Key clinical point: Early rheumatoid arthritis (RA) strategies have different risk profiles. Moreover, the use of early steroid-based regimens did not emerge as more harmful.

Major finding: The risk for serious adverse events was higher with biologic monotherapy vs. methotrexate (MTX)+steroid therapy (rate ratio [RR], 3.22; 95% confidence interval [CI], 1.47-7.07) and with biological monotherapy vs. MTX monotherapy (RR, 1.39; 95% CI, 1.12-1.73) and MTX+biologic disease-modifying antirheumatic drugs (DMARD; RR, 1.26; 95% CI, 1.02-1.54).

Study details: Findings are from a network meta-analysis of 20 double-blind randomized clinical trials involving 9,202 adult patients with RA who were initiated on DMARD therapy.

Disclosures: This study received no external funding. The authors received speaker’s fees and honoraria from various pharmaceutical companies including AbbVie. None of the authors reported any conflict of interest.

Source: Adas MA et al. Rheumatology (Oxford). 2021 May 18. doi: 10.1093/rheumatology/keab429.

Key clinical point: Early rheumatoid arthritis (RA) strategies have different risk profiles. Moreover, the use of early steroid-based regimens did not emerge as more harmful.

Major finding: The risk for serious adverse events was higher with biologic monotherapy vs. methotrexate (MTX)+steroid therapy (rate ratio [RR], 3.22; 95% confidence interval [CI], 1.47-7.07) and with biological monotherapy vs. MTX monotherapy (RR, 1.39; 95% CI, 1.12-1.73) and MTX+biologic disease-modifying antirheumatic drugs (DMARD; RR, 1.26; 95% CI, 1.02-1.54).

Study details: Findings are from a network meta-analysis of 20 double-blind randomized clinical trials involving 9,202 adult patients with RA who were initiated on DMARD therapy.

Disclosures: This study received no external funding. The authors received speaker’s fees and honoraria from various pharmaceutical companies including AbbVie. None of the authors reported any conflict of interest.

Source: Adas MA et al. Rheumatology (Oxford). 2021 May 18. doi: 10.1093/rheumatology/keab429.

Key clinical point: Tocilizumab (TCZ) was associated with an increased risk for diverticulitis and gastrointestinal (GI) perforation related to diverticulitis compared with rituximab (RTX) and abatacept (ABA) in patients with rheumatoid arthritis (RA).

Major finding: TCZ vs. RTX or ABA was associated with an increased risk for diverticulitis (hazard ratio [HR], 3.1; P = .002) and GI perforation because of diverticulitis (HR, 2.9; P = .03).

Study details: Data come from an analysis of a real-life cohort of 4,501 patients with RA from 3 observational registries of the French Society of Rheumatology who received RTX (n=1,986), ABA (n=1,019), or TCZ (n=1,496).

Disclosures: The French Society of Rheumatology received unrestricted grants from Bristol Myers Squibb, Roche, and Roche-Chugai. Some of the authors including the lead author declared receiving grants and consulting/speaker/personal fees from various sources including Bristol Myers Squibb. C Rempenault, A Herrero, and I Pane declared no conflicts of interest.

Source: Rempenault C et al. Rheumatology (Oxford). 2021 May 16. doi: 10.1093/rheumatology/keab438.

Key clinical point: Tocilizumab (TCZ) was associated with an increased risk for diverticulitis and gastrointestinal (GI) perforation related to diverticulitis compared with rituximab (RTX) and abatacept (ABA) in patients with rheumatoid arthritis (RA).

Major finding: TCZ vs. RTX or ABA was associated with an increased risk for diverticulitis (hazard ratio [HR], 3.1; P = .002) and GI perforation because of diverticulitis (HR, 2.9; P = .03).

Study details: Data come from an analysis of a real-life cohort of 4,501 patients with RA from 3 observational registries of the French Society of Rheumatology who received RTX (n=1,986), ABA (n=1,019), or TCZ (n=1,496).

Disclosures: The French Society of Rheumatology received unrestricted grants from Bristol Myers Squibb, Roche, and Roche-Chugai. Some of the authors including the lead author declared receiving grants and consulting/speaker/personal fees from various sources including Bristol Myers Squibb. C Rempenault, A Herrero, and I Pane declared no conflicts of interest.

Source: Rempenault C et al. Rheumatology (Oxford). 2021 May 16. doi: 10.1093/rheumatology/keab438.

Key clinical point: Tocilizumab (TCZ) was associated with an increased risk for diverticulitis and gastrointestinal (GI) perforation related to diverticulitis compared with rituximab (RTX) and abatacept (ABA) in patients with rheumatoid arthritis (RA).

Major finding: TCZ vs. RTX or ABA was associated with an increased risk for diverticulitis (hazard ratio [HR], 3.1; P = .002) and GI perforation because of diverticulitis (HR, 2.9; P = .03).

Study details: Data come from an analysis of a real-life cohort of 4,501 patients with RA from 3 observational registries of the French Society of Rheumatology who received RTX (n=1,986), ABA (n=1,019), or TCZ (n=1,496).

Disclosures: The French Society of Rheumatology received unrestricted grants from Bristol Myers Squibb, Roche, and Roche-Chugai. Some of the authors including the lead author declared receiving grants and consulting/speaker/personal fees from various sources including Bristol Myers Squibb. C Rempenault, A Herrero, and I Pane declared no conflicts of interest.

Source: Rempenault C et al. Rheumatology (Oxford). 2021 May 16. doi: 10.1093/rheumatology/keab438.

Key clinical point: Use of methotrexate significantly reduced the risk for cardiovascular disease (CVD) events, particularly heart failure (HF)-related hospitalizations in patients with rheumatoid arthritis (RA).

Major finding: Use of methotrexate was associated with a significant 24% reduced risk for composite CVD events (hazard ratio [HR], 0.76; P = .04), including a 57% lower risk for HF hospitalizations (HR, 0.43; P = .005).

Study details: The data come from a prospective cohort study of 2,044 US veterans with RA.

Disclosures: The work was supported by Centre of Excellence for Suicide Prevention and Joint Department of Veterans Affairs and Department of Defense Mortality Data Repository—National Death Index. MD George reported receiving grant support from Bristol Myers Squibb for unrelated work.

Source: Johnson TM et al. Ann Rheum Dis. 2021 May 28. doi: 10.1136/annrheumdis-2021-220125.

Key clinical point: Use of methotrexate significantly reduced the risk for cardiovascular disease (CVD) events, particularly heart failure (HF)-related hospitalizations in patients with rheumatoid arthritis (RA).

Major finding: Use of methotrexate was associated with a significant 24% reduced risk for composite CVD events (hazard ratio [HR], 0.76; P = .04), including a 57% lower risk for HF hospitalizations (HR, 0.43; P = .005).

Study details: The data come from a prospective cohort study of 2,044 US veterans with RA.

Disclosures: The work was supported by Centre of Excellence for Suicide Prevention and Joint Department of Veterans Affairs and Department of Defense Mortality Data Repository—National Death Index. MD George reported receiving grant support from Bristol Myers Squibb for unrelated work.

Source: Johnson TM et al. Ann Rheum Dis. 2021 May 28. doi: 10.1136/annrheumdis-2021-220125.

Key clinical point: Use of methotrexate significantly reduced the risk for cardiovascular disease (CVD) events, particularly heart failure (HF)-related hospitalizations in patients with rheumatoid arthritis (RA).

Major finding: Use of methotrexate was associated with a significant 24% reduced risk for composite CVD events (hazard ratio [HR], 0.76; P = .04), including a 57% lower risk for HF hospitalizations (HR, 0.43; P = .005).

Study details: The data come from a prospective cohort study of 2,044 US veterans with RA.

Disclosures: The work was supported by Centre of Excellence for Suicide Prevention and Joint Department of Veterans Affairs and Department of Defense Mortality Data Repository—National Death Index. MD George reported receiving grant support from Bristol Myers Squibb for unrelated work.

Source: Johnson TM et al. Ann Rheum Dis. 2021 May 28. doi: 10.1136/annrheumdis-2021-220125.

Key clinical point: Patients with rheumatoid arthritis (RA) treated with rituximab or Janus kinase inhibitors (JAKi) at onset of COVID-19 were more likely to have poor COVID-19 outcomes compared with those treated with tumor necrosis factor inhibitors (TNFi).

Major finding: Odds of worse COVID-19 severity were 4.15 and 2.06 greater in patients on rituximab (odds ratio [OR], 4.15) and JAKi (OR, 2.06; both P less than .01) vs. those on TNFi. Patients on rituximab and JAKi therapy vs. TNFi were more susceptible to hospitalization (OR, 4.53 and 2.40, respectively; P less than .01) and death (OR, 4.57 and 2.04, respectively; P less than .01).

Study details: The data come from the analysis of 2,869 patients with RA and COVID-19 who were on abatacept (n=237), rituximab (n=364), interleukin 6 inhibitors (n=317), Janus kinase inhibitors (n=563), or TNFi (n=1,388) at the time of clinical COVID-19 onset.

Disclosures: The study received support from the American College of Rheumatology and the European Alliance of Associations for Rheumatology. The authors reported receiving research support, grants, and speaker’s/consultancy/personal fees from various sources.

Source: Sparks JA et al. Ann Rheum Dis. 2021 May 28. doi: 10.1136/annrheumdis-2021-220418.

Key clinical point: Patients with rheumatoid arthritis (RA) treated with rituximab or Janus kinase inhibitors (JAKi) at onset of COVID-19 were more likely to have poor COVID-19 outcomes compared with those treated with tumor necrosis factor inhibitors (TNFi).

Major finding: Odds of worse COVID-19 severity were 4.15 and 2.06 greater in patients on rituximab (odds ratio [OR], 4.15) and JAKi (OR, 2.06; both P less than .01) vs. those on TNFi. Patients on rituximab and JAKi therapy vs. TNFi were more susceptible to hospitalization (OR, 4.53 and 2.40, respectively; P less than .01) and death (OR, 4.57 and 2.04, respectively; P less than .01).

Study details: The data come from the analysis of 2,869 patients with RA and COVID-19 who were on abatacept (n=237), rituximab (n=364), interleukin 6 inhibitors (n=317), Janus kinase inhibitors (n=563), or TNFi (n=1,388) at the time of clinical COVID-19 onset.

Disclosures: The study received support from the American College of Rheumatology and the European Alliance of Associations for Rheumatology. The authors reported receiving research support, grants, and speaker’s/consultancy/personal fees from various sources.

Source: Sparks JA et al. Ann Rheum Dis. 2021 May 28. doi: 10.1136/annrheumdis-2021-220418.

Key clinical point: Patients with rheumatoid arthritis (RA) treated with rituximab or Janus kinase inhibitors (JAKi) at onset of COVID-19 were more likely to have poor COVID-19 outcomes compared with those treated with tumor necrosis factor inhibitors (TNFi).

Major finding: Odds of worse COVID-19 severity were 4.15 and 2.06 greater in patients on rituximab (odds ratio [OR], 4.15) and JAKi (OR, 2.06; both P less than .01) vs. those on TNFi. Patients on rituximab and JAKi therapy vs. TNFi were more susceptible to hospitalization (OR, 4.53 and 2.40, respectively; P less than .01) and death (OR, 4.57 and 2.04, respectively; P less than .01).

Study details: The data come from the analysis of 2,869 patients with RA and COVID-19 who were on abatacept (n=237), rituximab (n=364), interleukin 6 inhibitors (n=317), Janus kinase inhibitors (n=563), or TNFi (n=1,388) at the time of clinical COVID-19 onset.

Disclosures: The study received support from the American College of Rheumatology and the European Alliance of Associations for Rheumatology. The authors reported receiving research support, grants, and speaker’s/consultancy/personal fees from various sources.

Source: Sparks JA et al. Ann Rheum Dis. 2021 May 28. doi: 10.1136/annrheumdis-2021-220418.

Key clinical point: ORAL Shift demonstrates safety and efficacy of tofacitinib modified-release 11 mg once daily (OD) plus methotrexate in a global population of patients with rheumatoid arthritis (RA).

Major finding: All efficacy outcomes improved from baseline to week 12 including Disease Activity Score in 28 joints, erythrocyte sedimentation rate (mean change [MC], −2.0), Clinical Disease Activity Index (CDAI; MC, −19.6), Simplified Disease Activity Index (MC, −20.3), and other patient-reported outcomes, which continued to improve through week 24. At week 24, 84.5% of patients achieved CDAI-defined low disease activity. Most adverse events were mild or moderate in severity and no deaths were reported.

Study details: ORAL Shift, a 48-week phase 3b/4 withdrawal study included patients with moderate to severe RA and an inadequate response to methotrexate who received open-label tofacitinib modified-release 11 mg OD and methotrexate.

Disclosures: This study was sponsored by Pfizer Inc. Some of the authors declared receiving research support and honoraria and serving as consultant or on speaker’s bureau for various sources including Pfizer. Seven of the authors declared being employees and shareholders at Pfizer Inc.

Source: Cohen SB et al. RMD Open. 2021 Jun 7. doi: 10.1136/rmdopen-2021-001673.

Key clinical point: ORAL Shift demonstrates safety and efficacy of tofacitinib modified-release 11 mg once daily (OD) plus methotrexate in a global population of patients with rheumatoid arthritis (RA).

Major finding: All efficacy outcomes improved from baseline to week 12 including Disease Activity Score in 28 joints, erythrocyte sedimentation rate (mean change [MC], −2.0), Clinical Disease Activity Index (CDAI; MC, −19.6), Simplified Disease Activity Index (MC, −20.3), and other patient-reported outcomes, which continued to improve through week 24. At week 24, 84.5% of patients achieved CDAI-defined low disease activity. Most adverse events were mild or moderate in severity and no deaths were reported.

Study details: ORAL Shift, a 48-week phase 3b/4 withdrawal study included patients with moderate to severe RA and an inadequate response to methotrexate who received open-label tofacitinib modified-release 11 mg OD and methotrexate.

Disclosures: This study was sponsored by Pfizer Inc. Some of the authors declared receiving research support and honoraria and serving as consultant or on speaker’s bureau for various sources including Pfizer. Seven of the authors declared being employees and shareholders at Pfizer Inc.

Source: Cohen SB et al. RMD Open. 2021 Jun 7. doi: 10.1136/rmdopen-2021-001673.

Key clinical point: ORAL Shift demonstrates safety and efficacy of tofacitinib modified-release 11 mg once daily (OD) plus methotrexate in a global population of patients with rheumatoid arthritis (RA).

Major finding: All efficacy outcomes improved from baseline to week 12 including Disease Activity Score in 28 joints, erythrocyte sedimentation rate (mean change [MC], −2.0), Clinical Disease Activity Index (CDAI; MC, −19.6), Simplified Disease Activity Index (MC, −20.3), and other patient-reported outcomes, which continued to improve through week 24. At week 24, 84.5% of patients achieved CDAI-defined low disease activity. Most adverse events were mild or moderate in severity and no deaths were reported.

Study details: ORAL Shift, a 48-week phase 3b/4 withdrawal study included patients with moderate to severe RA and an inadequate response to methotrexate who received open-label tofacitinib modified-release 11 mg OD and methotrexate.

Disclosures: This study was sponsored by Pfizer Inc. Some of the authors declared receiving research support and honoraria and serving as consultant or on speaker’s bureau for various sources including Pfizer. Seven of the authors declared being employees and shareholders at Pfizer Inc.

Source: Cohen SB et al. RMD Open. 2021 Jun 7. doi: 10.1136/rmdopen-2021-001673.