Key clinical point: Treatment with calcitonin gene-related peptide (CGRP) monoclonal antibodies (mAb) did not increase the risk for SARS-CoV‑2 infection or its severe clinical outcomes in veterans with migraine.

Major finding: Over a 28-month follow-up, 12.5% vs 9.6% of CGRP mAb initiators vs non-initiators tested positive for SARS-CoV-2, respectively, with the incidence of SARS-CoV-2 infection (P  =  .08) and hospitalization (P  =  .45), requirement for supplemental oxygen (P  =  .27) or mechanical ventilation (P  =  .96), and death (P  =  .37) among those testing positive for SARS-CoV-2 not being significantly different between CGRP mAb initiators and non-initiators.

Study details: The data come from a retrospective cohort study including 354,294 veterans (8,178,652 person-trials) with migraine who were at risk for COVID-19, of whom 9382 initiated a CGRP mAb.

Disclosures: This study was supported by the special purpose medical service award from the US Department of Veterans Affairs. Dr. Schindler, Prof. Lipton, and Dr. Seng declared receiving grants, personal fees, or paid royalties from various sources.

Source: Wang K et al. Calcitonin gene-related peptide monoclonal antibodies and risk of SARS-CoV-2 infection and severe COVID-19 outcomes among veterans with migraine disorder. JAMA Netw Open. 2023;6(7):e2326371 (Jul 31). doi: 10.1001/jamanetworkopen.2023.26371

Key clinical point: Treatment with calcitonin gene-related peptide (CGRP) monoclonal antibodies (mAb) did not increase the risk for SARS-CoV‑2 infection or its severe clinical outcomes in veterans with migraine.

Major finding: Over a 28-month follow-up, 12.5% vs 9.6% of CGRP mAb initiators vs non-initiators tested positive for SARS-CoV-2, respectively, with the incidence of SARS-CoV-2 infection (P  =  .08) and hospitalization (P  =  .45), requirement for supplemental oxygen (P  =  .27) or mechanical ventilation (P  =  .96), and death (P  =  .37) among those testing positive for SARS-CoV-2 not being significantly different between CGRP mAb initiators and non-initiators.

Study details: The data come from a retrospective cohort study including 354,294 veterans (8,178,652 person-trials) with migraine who were at risk for COVID-19, of whom 9382 initiated a CGRP mAb.

Disclosures: This study was supported by the special purpose medical service award from the US Department of Veterans Affairs. Dr. Schindler, Prof. Lipton, and Dr. Seng declared receiving grants, personal fees, or paid royalties from various sources.

Source: Wang K et al. Calcitonin gene-related peptide monoclonal antibodies and risk of SARS-CoV-2 infection and severe COVID-19 outcomes among veterans with migraine disorder. JAMA Netw Open. 2023;6(7):e2326371 (Jul 31). doi: 10.1001/jamanetworkopen.2023.26371

Key clinical point: Treatment with calcitonin gene-related peptide (CGRP) monoclonal antibodies (mAb) did not increase the risk for SARS-CoV‑2 infection or its severe clinical outcomes in veterans with migraine.

Major finding: Over a 28-month follow-up, 12.5% vs 9.6% of CGRP mAb initiators vs non-initiators tested positive for SARS-CoV-2, respectively, with the incidence of SARS-CoV-2 infection (P  =  .08) and hospitalization (P  =  .45), requirement for supplemental oxygen (P  =  .27) or mechanical ventilation (P  =  .96), and death (P  =  .37) among those testing positive for SARS-CoV-2 not being significantly different between CGRP mAb initiators and non-initiators.

Study details: The data come from a retrospective cohort study including 354,294 veterans (8,178,652 person-trials) with migraine who were at risk for COVID-19, of whom 9382 initiated a CGRP mAb.

Disclosures: This study was supported by the special purpose medical service award from the US Department of Veterans Affairs. Dr. Schindler, Prof. Lipton, and Dr. Seng declared receiving grants, personal fees, or paid royalties from various sources.

Source: Wang K et al. Calcitonin gene-related peptide monoclonal antibodies and risk of SARS-CoV-2 infection and severe COVID-19 outcomes among veterans with migraine disorder. JAMA Netw Open. 2023;6(7):e2326371 (Jul 31). doi: 10.1001/jamanetworkopen.2023.26371

Key clinical point: Atogepant showed clinically relevant benefits in patients with chronic migraine (CM), making it the first calcitonin gene-related peptide (CGRP)-targeted, efficacious, and safe oral preventive treatment option for CM.

Major finding: Compared with placebo, the reduction in mean monthly migraine days at week 12 was significantly higher in patients who received 30 mg atogepant twice daily (adjusted least squares mean difference from placebo [LSMD] −2.4; P < .0001) and 60 mg once daily (adjusted LSMD −1.8; P  =  .0009). Constipation and nausea were the most common adverse events in both atogepant groups.

Study details: This phase 3 PROGRESS trial included 755 patients with CM who were randomly assigned to receive atogepant (30 mg twice daily or 60 mg once daily) or placebo.

Disclosures: This study was funded by Allergan (now AbbVie). Some authors declared receiving research support and personal and institutional fees from various sources, including AbbVie. Eleven authors declared being current or former employees or stockholders of AbbVie.

Source: Pozo-Rosich P et al. Atogepant for the preventive treatment of chronic migraine (PROGRESS): A randomised, double-blind, placebo-controlled, phase 3 trial. Lancet. 2023 (Jul 26). doi: 10.1016/S0140-6736(23)01049-8

Key clinical point: Atogepant showed clinically relevant benefits in patients with chronic migraine (CM), making it the first calcitonin gene-related peptide (CGRP)-targeted, efficacious, and safe oral preventive treatment option for CM.

Major finding: Compared with placebo, the reduction in mean monthly migraine days at week 12 was significantly higher in patients who received 30 mg atogepant twice daily (adjusted least squares mean difference from placebo [LSMD] −2.4; P < .0001) and 60 mg once daily (adjusted LSMD −1.8; P  =  .0009). Constipation and nausea were the most common adverse events in both atogepant groups.

Study details: This phase 3 PROGRESS trial included 755 patients with CM who were randomly assigned to receive atogepant (30 mg twice daily or 60 mg once daily) or placebo.

Disclosures: This study was funded by Allergan (now AbbVie). Some authors declared receiving research support and personal and institutional fees from various sources, including AbbVie. Eleven authors declared being current or former employees or stockholders of AbbVie.

Source: Pozo-Rosich P et al. Atogepant for the preventive treatment of chronic migraine (PROGRESS): A randomised, double-blind, placebo-controlled, phase 3 trial. Lancet. 2023 (Jul 26). doi: 10.1016/S0140-6736(23)01049-8

Key clinical point: Atogepant showed clinically relevant benefits in patients with chronic migraine (CM), making it the first calcitonin gene-related peptide (CGRP)-targeted, efficacious, and safe oral preventive treatment option for CM.

Major finding: Compared with placebo, the reduction in mean monthly migraine days at week 12 was significantly higher in patients who received 30 mg atogepant twice daily (adjusted least squares mean difference from placebo [LSMD] −2.4; P < .0001) and 60 mg once daily (adjusted LSMD −1.8; P  =  .0009). Constipation and nausea were the most common adverse events in both atogepant groups.

Study details: This phase 3 PROGRESS trial included 755 patients with CM who were randomly assigned to receive atogepant (30 mg twice daily or 60 mg once daily) or placebo.

Disclosures: This study was funded by Allergan (now AbbVie). Some authors declared receiving research support and personal and institutional fees from various sources, including AbbVie. Eleven authors declared being current or former employees or stockholders of AbbVie.

Source: Pozo-Rosich P et al. Atogepant for the preventive treatment of chronic migraine (PROGRESS): A randomised, double-blind, placebo-controlled, phase 3 trial. Lancet. 2023 (Jul 26). doi: 10.1016/S0140-6736(23)01049-8

Key clinical point: Despite improvements in COVID-19 clinical outcomes in the SARS-CoV-2 Omicron era, patients with rheumatoid arthritis (RA) remain at higher risk for COVID-19-associated adverse outcomes compared with the general population, suggesting continued need to follow all prophylactic measures, including receiving vaccinations and antivirals against SARS-CoV-2.

Major finding: Patients with RA vs general population who contracted COVID-19 continue to be at a higher risk for COVID-19-associated hospitalization (adjusted odds ratio [aOR] 2.02; 95% CI 1.79-2.27) and death (aOR 1.73; 95% CI 1.36-2.20) despite better vaccination coverage (88.89% vs 84.07%) and more frequent use of SARS-CoV-2-directed oral antivirals (0.67% vs 0.23%) and monoclonal antibodies (0.10% vs 0.02%).

Study details: This retrospective, population-based study included 34,182 patients with RA matched with 170,910 comparators from the general population.

Disclosures: This study did not receive any specific funding. The authors declared no conflicts of interest.

Source: Bournia VK et al. Outcomes of COVID-19 Omicron variant in patients with rheumatoid arthritis: A nationwide Greek cohort study. Rheumatology (Oxford). 2023 (Jul 19). doi: 10.1093/rheumatology/kead354

Key clinical point: Despite improvements in COVID-19 clinical outcomes in the SARS-CoV-2 Omicron era, patients with rheumatoid arthritis (RA) remain at higher risk for COVID-19-associated adverse outcomes compared with the general population, suggesting continued need to follow all prophylactic measures, including receiving vaccinations and antivirals against SARS-CoV-2.

Major finding: Patients with RA vs general population who contracted COVID-19 continue to be at a higher risk for COVID-19-associated hospitalization (adjusted odds ratio [aOR] 2.02; 95% CI 1.79-2.27) and death (aOR 1.73; 95% CI 1.36-2.20) despite better vaccination coverage (88.89% vs 84.07%) and more frequent use of SARS-CoV-2-directed oral antivirals (0.67% vs 0.23%) and monoclonal antibodies (0.10% vs 0.02%).

Study details: This retrospective, population-based study included 34,182 patients with RA matched with 170,910 comparators from the general population.

Disclosures: This study did not receive any specific funding. The authors declared no conflicts of interest.

Source: Bournia VK et al. Outcomes of COVID-19 Omicron variant in patients with rheumatoid arthritis: A nationwide Greek cohort study. Rheumatology (Oxford). 2023 (Jul 19). doi: 10.1093/rheumatology/kead354

Key clinical point: Despite improvements in COVID-19 clinical outcomes in the SARS-CoV-2 Omicron era, patients with rheumatoid arthritis (RA) remain at higher risk for COVID-19-associated adverse outcomes compared with the general population, suggesting continued need to follow all prophylactic measures, including receiving vaccinations and antivirals against SARS-CoV-2.

Major finding: Patients with RA vs general population who contracted COVID-19 continue to be at a higher risk for COVID-19-associated hospitalization (adjusted odds ratio [aOR] 2.02; 95% CI 1.79-2.27) and death (aOR 1.73; 95% CI 1.36-2.20) despite better vaccination coverage (88.89% vs 84.07%) and more frequent use of SARS-CoV-2-directed oral antivirals (0.67% vs 0.23%) and monoclonal antibodies (0.10% vs 0.02%).

Study details: This retrospective, population-based study included 34,182 patients with RA matched with 170,910 comparators from the general population.

Disclosures: This study did not receive any specific funding. The authors declared no conflicts of interest.

Source: Bournia VK et al. Outcomes of COVID-19 Omicron variant in patients with rheumatoid arthritis: A nationwide Greek cohort study. Rheumatology (Oxford). 2023 (Jul 19). doi: 10.1093/rheumatology/kead354

Key clinical point: Standardized 3-dimensional computed tomography (3D-CT) showed significant loss of lung volume (LV) at acute exacerbation of rheumatoid arthritis-associated interstitial lung disease (RA-ILD), which was associated with a significant increase in the risk for mortality.

Major finding: Patients with lower vs higher 3D-CT LV had shorter survival (median 2.8 vs 41.7 months; P < .001), with standardized 3D-CT LV being significantly associated with mortality at acute exacerbation of RA-ILD (hazard ratio 0.958; P < .001). Loss of LV was predominantly in the lower lobes at diagnosis and extended to the upper and lower lobes at acute exacerbation (P < .001).

Study details: The data come from a retrospective, observational study including 54 patients with a diagnosis of RA-ILD, 53 patients admitted with an acute exacerbation of RA-ILD, and 35 control individuals.

Disclosures: This study was supported by the Japan Society for the Promotion of Science. The authors declared no conflicts of interest.

Source: Tanaka Y et al. Standardised 3D-CT lung volumes for patients with acute exacerbation of rheumatoid arthritis-associated interstitial lung disease. Rheumatology (Oxford). 2023 (Jul 17). doi: 10.1093/rheumatology/kead363

Key clinical point: Standardized 3-dimensional computed tomography (3D-CT) showed significant loss of lung volume (LV) at acute exacerbation of rheumatoid arthritis-associated interstitial lung disease (RA-ILD), which was associated with a significant increase in the risk for mortality.

Major finding: Patients with lower vs higher 3D-CT LV had shorter survival (median 2.8 vs 41.7 months; P < .001), with standardized 3D-CT LV being significantly associated with mortality at acute exacerbation of RA-ILD (hazard ratio 0.958; P < .001). Loss of LV was predominantly in the lower lobes at diagnosis and extended to the upper and lower lobes at acute exacerbation (P < .001).

Study details: The data come from a retrospective, observational study including 54 patients with a diagnosis of RA-ILD, 53 patients admitted with an acute exacerbation of RA-ILD, and 35 control individuals.

Disclosures: This study was supported by the Japan Society for the Promotion of Science. The authors declared no conflicts of interest.

Source: Tanaka Y et al. Standardised 3D-CT lung volumes for patients with acute exacerbation of rheumatoid arthritis-associated interstitial lung disease. Rheumatology (Oxford). 2023 (Jul 17). doi: 10.1093/rheumatology/kead363

Key clinical point: Standardized 3-dimensional computed tomography (3D-CT) showed significant loss of lung volume (LV) at acute exacerbation of rheumatoid arthritis-associated interstitial lung disease (RA-ILD), which was associated with a significant increase in the risk for mortality.

Major finding: Patients with lower vs higher 3D-CT LV had shorter survival (median 2.8 vs 41.7 months; P < .001), with standardized 3D-CT LV being significantly associated with mortality at acute exacerbation of RA-ILD (hazard ratio 0.958; P < .001). Loss of LV was predominantly in the lower lobes at diagnosis and extended to the upper and lower lobes at acute exacerbation (P < .001).

Study details: The data come from a retrospective, observational study including 54 patients with a diagnosis of RA-ILD, 53 patients admitted with an acute exacerbation of RA-ILD, and 35 control individuals.

Disclosures: This study was supported by the Japan Society for the Promotion of Science. The authors declared no conflicts of interest.

Source: Tanaka Y et al. Standardised 3D-CT lung volumes for patients with acute exacerbation of rheumatoid arthritis-associated interstitial lung disease. Rheumatology (Oxford). 2023 (Jul 17). doi: 10.1093/rheumatology/kead363

Key clinical point: Opioids not only increase the risk for all-cause mortality among patients with rheumatoid arthritis (RA) but also carry a similar risk for major adverse cardiovascular events (MACE) as nonsteroidal anti-inflammatory drugs (NSAID).

Major finding: The risk for MACE was similar among patients initiating opioids and those initiating NSAID (adjusted hazard ratio [aHR] 1.02; 95% CI 0.85-1.22); however, opioid initiators had a 33% higher risk for all-cause mortality compared with NSAID initiators (aHR 1.33; 95% CI 1.06-1.67).

Study details: This new user active comparator cohort study included patients with RA within the FORWARD databank and propensity-score matched patients initiating opioids (n = 6866) to those initiating NSAID (n = 13,689).

Disclosures: This study was supported by the Rheumatology Research Foundation Resident Preceptor Award. The authors declared no conflicts of interest.

Source: Ozen G et al. Major adverse cardiovascular events and mortality with opioids versus NSAIDs initiation in patients with rheumatoid arthritis. Ann Rheum Dis. 2023 (Jul 17). doi: 10.1136/ard-2023-224339

Key clinical point: Opioids not only increase the risk for all-cause mortality among patients with rheumatoid arthritis (RA) but also carry a similar risk for major adverse cardiovascular events (MACE) as nonsteroidal anti-inflammatory drugs (NSAID).

Major finding: The risk for MACE was similar among patients initiating opioids and those initiating NSAID (adjusted hazard ratio [aHR] 1.02; 95% CI 0.85-1.22); however, opioid initiators had a 33% higher risk for all-cause mortality compared with NSAID initiators (aHR 1.33; 95% CI 1.06-1.67).

Study details: This new user active comparator cohort study included patients with RA within the FORWARD databank and propensity-score matched patients initiating opioids (n = 6866) to those initiating NSAID (n = 13,689).

Disclosures: This study was supported by the Rheumatology Research Foundation Resident Preceptor Award. The authors declared no conflicts of interest.

Source: Ozen G et al. Major adverse cardiovascular events and mortality with opioids versus NSAIDs initiation in patients with rheumatoid arthritis. Ann Rheum Dis. 2023 (Jul 17). doi: 10.1136/ard-2023-224339

Key clinical point: Opioids not only increase the risk for all-cause mortality among patients with rheumatoid arthritis (RA) but also carry a similar risk for major adverse cardiovascular events (MACE) as nonsteroidal anti-inflammatory drugs (NSAID).

Major finding: The risk for MACE was similar among patients initiating opioids and those initiating NSAID (adjusted hazard ratio [aHR] 1.02; 95% CI 0.85-1.22); however, opioid initiators had a 33% higher risk for all-cause mortality compared with NSAID initiators (aHR 1.33; 95% CI 1.06-1.67).

Study details: This new user active comparator cohort study included patients with RA within the FORWARD databank and propensity-score matched patients initiating opioids (n = 6866) to those initiating NSAID (n = 13,689).

Disclosures: This study was supported by the Rheumatology Research Foundation Resident Preceptor Award. The authors declared no conflicts of interest.

Source: Ozen G et al. Major adverse cardiovascular events and mortality with opioids versus NSAIDs initiation in patients with rheumatoid arthritis. Ann Rheum Dis. 2023 (Jul 17). doi: 10.1136/ard-2023-224339

Key clinical point: The use of combination therapy or biologics was associated with a lower risk for diabetes than methotrexate monotherapy in patients with rheumatoid arthritis (RA), with hydroxychloroquine having a significant protective effect on the development of diabetes.

Major finding: The risk for diabetes was significantly lower in the biologic disease-modifying antirheumatic drug (DMARD) periods (adjusted hazard ratio [aHR] 0.51; 95% CI 0.32-0.83), methotrexate combination periods (aHR 0.50; 95% CI 0.32-0.78), and other conventional DMARD periods (aHR 0.56; 95% CI 0.37-0.84) than in the methotrexate monotherapy periods. Hydroxychloroquine (aHR 0.52; P < .001) and sulfasalazine (aHR 0.69; P  =  .002) had a significant protective effect on diabetes development.

Study details: The data come from a retrospective cohort study that included 5530 adults with RA without diabetes.

Disclosures: This study did not declare any specific funding or conflicts of interest.

Source: Su YJ et al. Disease-modifying anti-rheumatic drugs associated with different diabetes risks in patients with rheumatoid arthritis. RMD Open. 2023;9:e003045 (Jul 17). doi: 10.1136/rmdopen-2023-003045

Key clinical point: The use of combination therapy or biologics was associated with a lower risk for diabetes than methotrexate monotherapy in patients with rheumatoid arthritis (RA), with hydroxychloroquine having a significant protective effect on the development of diabetes.

Major finding: The risk for diabetes was significantly lower in the biologic disease-modifying antirheumatic drug (DMARD) periods (adjusted hazard ratio [aHR] 0.51; 95% CI 0.32-0.83), methotrexate combination periods (aHR 0.50; 95% CI 0.32-0.78), and other conventional DMARD periods (aHR 0.56; 95% CI 0.37-0.84) than in the methotrexate monotherapy periods. Hydroxychloroquine (aHR 0.52; P < .001) and sulfasalazine (aHR 0.69; P  =  .002) had a significant protective effect on diabetes development.

Study details: The data come from a retrospective cohort study that included 5530 adults with RA without diabetes.

Disclosures: This study did not declare any specific funding or conflicts of interest.

Source: Su YJ et al. Disease-modifying anti-rheumatic drugs associated with different diabetes risks in patients with rheumatoid arthritis. RMD Open. 2023;9:e003045 (Jul 17). doi: 10.1136/rmdopen-2023-003045

Key clinical point: The use of combination therapy or biologics was associated with a lower risk for diabetes than methotrexate monotherapy in patients with rheumatoid arthritis (RA), with hydroxychloroquine having a significant protective effect on the development of diabetes.

Major finding: The risk for diabetes was significantly lower in the biologic disease-modifying antirheumatic drug (DMARD) periods (adjusted hazard ratio [aHR] 0.51; 95% CI 0.32-0.83), methotrexate combination periods (aHR 0.50; 95% CI 0.32-0.78), and other conventional DMARD periods (aHR 0.56; 95% CI 0.37-0.84) than in the methotrexate monotherapy periods. Hydroxychloroquine (aHR 0.52; P < .001) and sulfasalazine (aHR 0.69; P  =  .002) had a significant protective effect on diabetes development.

Study details: The data come from a retrospective cohort study that included 5530 adults with RA without diabetes.

Disclosures: This study did not declare any specific funding or conflicts of interest.

Source: Su YJ et al. Disease-modifying anti-rheumatic drugs associated with different diabetes risks in patients with rheumatoid arthritis. RMD Open. 2023;9:e003045 (Jul 17). doi: 10.1136/rmdopen-2023-003045

Key clinical point: Cleaning activities and dusty clothes laundry are underestimated yet potential sources of lifetime silicon dioxide (SiO₂) exposure in women with rheumatoid arthritis (RA); high SiO₂ exposure increases the risk for mediastinal lymphadenopathy.

Major finding: Cleaning activities were the major source of SiO₂ exposure in women with RA and control individuals, with the exposure scores for occupational and non-occupational cleaning activities and occupational dusty work clothes laundry (all P < .05) being higher in women with RA vs control individuals and high SiO₂ exposure was associated with a greater risk for mediastinal lymphadenopathy (adjusted odds ratio 6.3; 95% CI 1.4-27.7).

Study details: This retrospective, case-control study obtained lifetime SiO₂ exposure data from the Dust Exposure Life-Course Questionnaire administered to 97 patients with RA, including 76 women who were matched with 308 control individuals from the general population.

Disclosures: The SILICOSIS Project was sponsored by the European Research Council. The authors declared no conflicts of interest.

Source: Sigaux J et al. Are cleaning activities a source of exposure to crystalline silica in women with rheumatoid arthritis? A case-control study. RMD Open. 2023;9:e003205 (Aug 2). doi: 10.1136/rmdopen-2023-003205

Key clinical point: Cleaning activities and dusty clothes laundry are underestimated yet potential sources of lifetime silicon dioxide (SiO₂) exposure in women with rheumatoid arthritis (RA); high SiO₂ exposure increases the risk for mediastinal lymphadenopathy.

Major finding: Cleaning activities were the major source of SiO₂ exposure in women with RA and control individuals, with the exposure scores for occupational and non-occupational cleaning activities and occupational dusty work clothes laundry (all P < .05) being higher in women with RA vs control individuals and high SiO₂ exposure was associated with a greater risk for mediastinal lymphadenopathy (adjusted odds ratio 6.3; 95% CI 1.4-27.7).

Study details: This retrospective, case-control study obtained lifetime SiO₂ exposure data from the Dust Exposure Life-Course Questionnaire administered to 97 patients with RA, including 76 women who were matched with 308 control individuals from the general population.

Disclosures: The SILICOSIS Project was sponsored by the European Research Council. The authors declared no conflicts of interest.

Source: Sigaux J et al. Are cleaning activities a source of exposure to crystalline silica in women with rheumatoid arthritis? A case-control study. RMD Open. 2023;9:e003205 (Aug 2). doi: 10.1136/rmdopen-2023-003205

Key clinical point: Cleaning activities and dusty clothes laundry are underestimated yet potential sources of lifetime silicon dioxide (SiO₂) exposure in women with rheumatoid arthritis (RA); high SiO₂ exposure increases the risk for mediastinal lymphadenopathy.

Major finding: Cleaning activities were the major source of SiO₂ exposure in women with RA and control individuals, with the exposure scores for occupational and non-occupational cleaning activities and occupational dusty work clothes laundry (all P < .05) being higher in women with RA vs control individuals and high SiO₂ exposure was associated with a greater risk for mediastinal lymphadenopathy (adjusted odds ratio 6.3; 95% CI 1.4-27.7).

Study details: This retrospective, case-control study obtained lifetime SiO₂ exposure data from the Dust Exposure Life-Course Questionnaire administered to 97 patients with RA, including 76 women who were matched with 308 control individuals from the general population.

Disclosures: The SILICOSIS Project was sponsored by the European Research Council. The authors declared no conflicts of interest.

Source: Sigaux J et al. Are cleaning activities a source of exposure to crystalline silica in women with rheumatoid arthritis? A case-control study. RMD Open. 2023;9:e003205 (Aug 2). doi: 10.1136/rmdopen-2023-003205

Key clinical point: Abatacept showed similar efficacy and safety in patients with rheumatoid arthritis (RA) with vs without previous malignancies and did not increase the risk for malignancy or relapse.

Major finding: Patients with RA with and without previous malignancies had no significant differences in the disease activity scores for 28 Joints based on C-reactive protein (up to 60 months after initiating abatacept; P  =  .36), 10-year abatacept continuation rates (P  =  .70), and the incidence rates of malignancies after initiating abatacept (adjusted hazard ratio 0.99; P  =  1.00).

Study details: This retrospective study included 312 patients with RA who received abatacept, of whom 23.4% patients had previous malignancies when initiating abatacept.

Disclosures: This study was partly supported by JSPS KAKENHI and the Japan Rheumatism Foundation. Y Kunishita declared receiving personal fees from Bristol-Myers K.K. and Eisai, which are unrelated to this study. The other authors did not report any conflicts of interest.

Source: Kunishita Y et al. Efficacy and safety of abatacept in patients with rheumatoid arthritis with previous malignancy. Ther Adv Musculoskelet Dis. 2023;15 (Aug 1). doi: 10.1177/1759720X231186874

Key clinical point: Abatacept showed similar efficacy and safety in patients with rheumatoid arthritis (RA) with vs without previous malignancies and did not increase the risk for malignancy or relapse.

Major finding: Patients with RA with and without previous malignancies had no significant differences in the disease activity scores for 28 Joints based on C-reactive protein (up to 60 months after initiating abatacept; P  =  .36), 10-year abatacept continuation rates (P  =  .70), and the incidence rates of malignancies after initiating abatacept (adjusted hazard ratio 0.99; P  =  1.00).

Study details: This retrospective study included 312 patients with RA who received abatacept, of whom 23.4% patients had previous malignancies when initiating abatacept.

Disclosures: This study was partly supported by JSPS KAKENHI and the Japan Rheumatism Foundation. Y Kunishita declared receiving personal fees from Bristol-Myers K.K. and Eisai, which are unrelated to this study. The other authors did not report any conflicts of interest.

Source: Kunishita Y et al. Efficacy and safety of abatacept in patients with rheumatoid arthritis with previous malignancy. Ther Adv Musculoskelet Dis. 2023;15 (Aug 1). doi: 10.1177/1759720X231186874

Key clinical point: Abatacept showed similar efficacy and safety in patients with rheumatoid arthritis (RA) with vs without previous malignancies and did not increase the risk for malignancy or relapse.

Major finding: Patients with RA with and without previous malignancies had no significant differences in the disease activity scores for 28 Joints based on C-reactive protein (up to 60 months after initiating abatacept; P  =  .36), 10-year abatacept continuation rates (P  =  .70), and the incidence rates of malignancies after initiating abatacept (adjusted hazard ratio 0.99; P  =  1.00).

Study details: This retrospective study included 312 patients with RA who received abatacept, of whom 23.4% patients had previous malignancies when initiating abatacept.

Disclosures: This study was partly supported by JSPS KAKENHI and the Japan Rheumatism Foundation. Y Kunishita declared receiving personal fees from Bristol-Myers K.K. and Eisai, which are unrelated to this study. The other authors did not report any conflicts of interest.

Source: Kunishita Y et al. Efficacy and safety of abatacept in patients with rheumatoid arthritis with previous malignancy. Ther Adv Musculoskelet Dis. 2023;15 (Aug 1). doi: 10.1177/1759720X231186874

Key clinical point: The tapering of low-dose prednisolone over a 3-month schedule led to a moderate increase in disease activity to the levels of the placebo group, suggesting the feasibility of withdrawal of low-dose prednisolone in elderly patients with rheumatoid arthritis (RA) after successful completion of 2 years of therapy.

Major finding: After 3 months of tapering, increase in the Disease Activity Score for 28 Joints was moderate and not significantly different for the prednisolone and placebo groups (between-group difference 0.16; P  =  .12), with flares being only numerically higher in the prednisolone vs placebo group (45% vs 33%; P  =  .12).

Study details: This observational controlled cohort study included 191 patients with RA age ≥ 65 years from the GLORIA trial who underwent linear tapering of 5 mg/day prednisolone or placebo after 2 years of administration, to zero over a period of 3 months.

Disclosures: This study was funded by the European Union’s Horizon 2020 research and innovation program. Several authors declared ties with various sources.

Source: Almayali AAH et al. Three-month tapering and discontinuation of long-term, low-dose glucocorticoids in senior patients with rheumatoid arthritis is feasible and safe: Placebo-controlled double blind tapering after the GLORIA trial. Ann Rheum Dis. 2023 (Aug 4). doi: 10.1136/ard-2023-223977

Key clinical point: The tapering of low-dose prednisolone over a 3-month schedule led to a moderate increase in disease activity to the levels of the placebo group, suggesting the feasibility of withdrawal of low-dose prednisolone in elderly patients with rheumatoid arthritis (RA) after successful completion of 2 years of therapy.

Major finding: After 3 months of tapering, increase in the Disease Activity Score for 28 Joints was moderate and not significantly different for the prednisolone and placebo groups (between-group difference 0.16; P  =  .12), with flares being only numerically higher in the prednisolone vs placebo group (45% vs 33%; P  =  .12).

Study details: This observational controlled cohort study included 191 patients with RA age ≥ 65 years from the GLORIA trial who underwent linear tapering of 5 mg/day prednisolone or placebo after 2 years of administration, to zero over a period of 3 months.

Disclosures: This study was funded by the European Union’s Horizon 2020 research and innovation program. Several authors declared ties with various sources.

Source: Almayali AAH et al. Three-month tapering and discontinuation of long-term, low-dose glucocorticoids in senior patients with rheumatoid arthritis is feasible and safe: Placebo-controlled double blind tapering after the GLORIA trial. Ann Rheum Dis. 2023 (Aug 4). doi: 10.1136/ard-2023-223977

Key clinical point: The tapering of low-dose prednisolone over a 3-month schedule led to a moderate increase in disease activity to the levels of the placebo group, suggesting the feasibility of withdrawal of low-dose prednisolone in elderly patients with rheumatoid arthritis (RA) after successful completion of 2 years of therapy.

Major finding: After 3 months of tapering, increase in the Disease Activity Score for 28 Joints was moderate and not significantly different for the prednisolone and placebo groups (between-group difference 0.16; P  =  .12), with flares being only numerically higher in the prednisolone vs placebo group (45% vs 33%; P  =  .12).

Study details: This observational controlled cohort study included 191 patients with RA age ≥ 65 years from the GLORIA trial who underwent linear tapering of 5 mg/day prednisolone or placebo after 2 years of administration, to zero over a period of 3 months.

Disclosures: This study was funded by the European Union’s Horizon 2020 research and innovation program. Several authors declared ties with various sources.

Source: Almayali AAH et al. Three-month tapering and discontinuation of long-term, low-dose glucocorticoids in senior patients with rheumatoid arthritis is feasible and safe: Placebo-controlled double blind tapering after the GLORIA trial. Ann Rheum Dis. 2023 (Aug 4). doi: 10.1136/ard-2023-223977

Key clinical point: The daily administration of prednisolone at a dose of 5 mg or higher increased the risk for major adverse cardiovascular events (MACE) in patients with rheumatoid arthritis (RA), with doses below 5 mg not appearing to increase the cardiovascular risk.

Major finding: Compared with no use of glucocorticoids, the administration of ≥5 mg prednisolone daily led to a nearly twofold increase in the risk for incident MACE (adjusted hazard ratio [aHR] 2.02; P < .001), with the risk increasing by 7% per month (P < .001) over a long-term follow-up. No association was observed between daily use of prednisolone < 5 mg and the risk for MACE (aHR 0.83; 95% CI 0.60-1.14).

Study details: This population-based retrospective cohort study included 12,233 patients with RA and without MACE at baseline.

Disclosures: This study did not receive any specific funding. The authors declared no conflicts of interest.

Source: So H et al. Time and dose-dependent effect of systemic glucocorticoids on major adverse cardiovascular event in patients with rheumatoid arthritis: A population-based study. Ann Rheum Dis. 2023 (Jul 24). doi: 10.1136/ard-2023-224185

Key clinical point: The daily administration of prednisolone at a dose of 5 mg or higher increased the risk for major adverse cardiovascular events (MACE) in patients with rheumatoid arthritis (RA), with doses below 5 mg not appearing to increase the cardiovascular risk.

Major finding: Compared with no use of glucocorticoids, the administration of ≥5 mg prednisolone daily led to a nearly twofold increase in the risk for incident MACE (adjusted hazard ratio [aHR] 2.02; P < .001), with the risk increasing by 7% per month (P < .001) over a long-term follow-up. No association was observed between daily use of prednisolone < 5 mg and the risk for MACE (aHR 0.83; 95% CI 0.60-1.14).

Study details: This population-based retrospective cohort study included 12,233 patients with RA and without MACE at baseline.

Disclosures: This study did not receive any specific funding. The authors declared no conflicts of interest.

Source: So H et al. Time and dose-dependent effect of systemic glucocorticoids on major adverse cardiovascular event in patients with rheumatoid arthritis: A population-based study. Ann Rheum Dis. 2023 (Jul 24). doi: 10.1136/ard-2023-224185

Key clinical point: The daily administration of prednisolone at a dose of 5 mg or higher increased the risk for major adverse cardiovascular events (MACE) in patients with rheumatoid arthritis (RA), with doses below 5 mg not appearing to increase the cardiovascular risk.

Major finding: Compared with no use of glucocorticoids, the administration of ≥5 mg prednisolone daily led to a nearly twofold increase in the risk for incident MACE (adjusted hazard ratio [aHR] 2.02; P < .001), with the risk increasing by 7% per month (P < .001) over a long-term follow-up. No association was observed between daily use of prednisolone < 5 mg and the risk for MACE (aHR 0.83; 95% CI 0.60-1.14).

Study details: This population-based retrospective cohort study included 12,233 patients with RA and without MACE at baseline.

Disclosures: This study did not receive any specific funding. The authors declared no conflicts of interest.

Source: So H et al. Time and dose-dependent effect of systemic glucocorticoids on major adverse cardiovascular event in patients with rheumatoid arthritis: A population-based study. Ann Rheum Dis. 2023 (Jul 24). doi: 10.1136/ard-2023-224185