Key clinical point: Interleukin-6 receptor inhibitors (IL-6Ri) effectively increased hemoglobin levels in patients with rheumatoid arthritis (RA) irrespective of their baseline levels, whereas Janus-kinase inhibitors (JAKi) improved hemoglobin levels in patients with RA and anemia and retained or decreased in those without anemia.

Major finding: From baseline to the 12-month follow-up, IL-6Ri increased hemoglobin levels in all patients with RA, irrespective of whether their baseline hemoglobin levels were low, intermediate, or high, and JAKi increased hemoglobin levels in those with RA and anemia, with levels remaining unaltered in those with intermediate hemoglobin levels and decreasing in those without anemia (all P < .001).

Study details: This study evaluated 2093 patients with RA from the ANSWER cohort who received biologic or targeted-synthetic disease-modifying antirheumatic drugs.

Disclosures: The ANSWER cohort study was supported by grants from 10 pharmaceutical companies, including AbbVie G.K., Asahi-Kasei Pharma, AYUMI Pharmaceutical Co., and others, and an information technology services company. Several authors declared receiving speaker fees, consulting fees, honoraria, or research grants from various sources.

Source: Nakayama Y et al. IL-6 inhibitors and JAK inhibitors as favourable treatment options for patients with anaemia and rheumatoid arthritis: ANSWER cohort study. Rheumatology (Oxford). 2023 (Jun 24). Doi: 10.1093/rheumatology/kead299

Key clinical point: Interleukin-6 receptor inhibitors (IL-6Ri) effectively increased hemoglobin levels in patients with rheumatoid arthritis (RA) irrespective of their baseline levels, whereas Janus-kinase inhibitors (JAKi) improved hemoglobin levels in patients with RA and anemia and retained or decreased in those without anemia.

Major finding: From baseline to the 12-month follow-up, IL-6Ri increased hemoglobin levels in all patients with RA, irrespective of whether their baseline hemoglobin levels were low, intermediate, or high, and JAKi increased hemoglobin levels in those with RA and anemia, with levels remaining unaltered in those with intermediate hemoglobin levels and decreasing in those without anemia (all P < .001).

Study details: This study evaluated 2093 patients with RA from the ANSWER cohort who received biologic or targeted-synthetic disease-modifying antirheumatic drugs.

Disclosures: The ANSWER cohort study was supported by grants from 10 pharmaceutical companies, including AbbVie G.K., Asahi-Kasei Pharma, AYUMI Pharmaceutical Co., and others, and an information technology services company. Several authors declared receiving speaker fees, consulting fees, honoraria, or research grants from various sources.

Source: Nakayama Y et al. IL-6 inhibitors and JAK inhibitors as favourable treatment options for patients with anaemia and rheumatoid arthritis: ANSWER cohort study. Rheumatology (Oxford). 2023 (Jun 24). Doi: 10.1093/rheumatology/kead299

Key clinical point: Interleukin-6 receptor inhibitors (IL-6Ri) effectively increased hemoglobin levels in patients with rheumatoid arthritis (RA) irrespective of their baseline levels, whereas Janus-kinase inhibitors (JAKi) improved hemoglobin levels in patients with RA and anemia and retained or decreased in those without anemia.

Major finding: From baseline to the 12-month follow-up, IL-6Ri increased hemoglobin levels in all patients with RA, irrespective of whether their baseline hemoglobin levels were low, intermediate, or high, and JAKi increased hemoglobin levels in those with RA and anemia, with levels remaining unaltered in those with intermediate hemoglobin levels and decreasing in those without anemia (all P < .001).

Study details: This study evaluated 2093 patients with RA from the ANSWER cohort who received biologic or targeted-synthetic disease-modifying antirheumatic drugs.

Disclosures: The ANSWER cohort study was supported by grants from 10 pharmaceutical companies, including AbbVie G.K., Asahi-Kasei Pharma, AYUMI Pharmaceutical Co., and others, and an information technology services company. Several authors declared receiving speaker fees, consulting fees, honoraria, or research grants from various sources.

Source: Nakayama Y et al. IL-6 inhibitors and JAK inhibitors as favourable treatment options for patients with anaemia and rheumatoid arthritis: ANSWER cohort study. Rheumatology (Oxford). 2023 (Jun 24). Doi: 10.1093/rheumatology/kead299

Key clinical point: Higher adherence to the Mediterranean diet may help reduce disease impact, disease activity, and functional disability in patients with rheumatoid arthritis (RA).

Major finding: Patients with high vs low adherence to the Mediterranean diet had significantly lower Disease Activity Score of 28 Joints calculated with C-reactive protein (median 2.29 vs 3.27; P = .038), Health Assessment Questionnaire score (median 0.56 vs 1.00; P = .027), and Rheumatoid Arthritis Impact of Disease questionnaire score (median 3.51 vs 5.65; P = .032).

Study details: Findings are from a cross-sectional observational study including 120 patients with RA.

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

Source: Charneca S et al. The Mediterranean diet, and not dietary inflammatory index, is associated with rheumatoid arthritis disease activity, the impact of disease and functional disability. Eur J Nutr. 2023 (Jun 24). Doi: 10.1007/s00394-023-03196-8

Key clinical point: Higher adherence to the Mediterranean diet may help reduce disease impact, disease activity, and functional disability in patients with rheumatoid arthritis (RA).

Major finding: Patients with high vs low adherence to the Mediterranean diet had significantly lower Disease Activity Score of 28 Joints calculated with C-reactive protein (median 2.29 vs 3.27; P = .038), Health Assessment Questionnaire score (median 0.56 vs 1.00; P = .027), and Rheumatoid Arthritis Impact of Disease questionnaire score (median 3.51 vs 5.65; P = .032).

Study details: Findings are from a cross-sectional observational study including 120 patients with RA.

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

Source: Charneca S et al. The Mediterranean diet, and not dietary inflammatory index, is associated with rheumatoid arthritis disease activity, the impact of disease and functional disability. Eur J Nutr. 2023 (Jun 24). Doi: 10.1007/s00394-023-03196-8

Key clinical point: Higher adherence to the Mediterranean diet may help reduce disease impact, disease activity, and functional disability in patients with rheumatoid arthritis (RA).

Major finding: Patients with high vs low adherence to the Mediterranean diet had significantly lower Disease Activity Score of 28 Joints calculated with C-reactive protein (median 2.29 vs 3.27; P = .038), Health Assessment Questionnaire score (median 0.56 vs 1.00; P = .027), and Rheumatoid Arthritis Impact of Disease questionnaire score (median 3.51 vs 5.65; P = .032).

Study details: Findings are from a cross-sectional observational study including 120 patients with RA.

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

Source: Charneca S et al. The Mediterranean diet, and not dietary inflammatory index, is associated with rheumatoid arthritis disease activity, the impact of disease and functional disability. Eur J Nutr. 2023 (Jun 24). Doi: 10.1007/s00394-023-03196-8

Key clinical point: Concomitant interstitial lung disease (ILD) is a significant factor associated with failure to achieve clinical remission and an increased risk for unfavorable clinical events in patients with rheumatoid arthritis (RA).

Major finding: The presence of ILD was significantly associated with failure to achieve Disease Activity Score in 28 Joints remission (adjusted hazard ratio [aHR] 0.71; P = .002) and increased risk for death (aHR 3.24; P < .001), hospitalized infections (aHR 2.60; P < .001), major adverse cardiac events (aHR 3.40; P < .001), and lung cancer (aHR 16.0; P < .001).

Study details: This study analyzed the data of 1522 patients with RA (ILD group n = 287; non-ILD group n = 1235) from the observational IORRA cohort.

Disclosures: This study was supported by the Ministry of Health, Labour, and Welfare of Japan and other sources. Some authors declared serving as consultants for or receiving research grants, research funding, or lecture, speaker, or consulting fees from various sources.

Source: Sugano E et al. Impact of interstitial lung disease on clinical remission and unfavourable events of rheumatoid arthritis: Results from the IORRA cohort. Rheumatology (Oxford). 2023 (Jun 28). Doi: 10.1093/rheumatology/kead317

Key clinical point: Concomitant interstitial lung disease (ILD) is a significant factor associated with failure to achieve clinical remission and an increased risk for unfavorable clinical events in patients with rheumatoid arthritis (RA).

Major finding: The presence of ILD was significantly associated with failure to achieve Disease Activity Score in 28 Joints remission (adjusted hazard ratio [aHR] 0.71; P = .002) and increased risk for death (aHR 3.24; P < .001), hospitalized infections (aHR 2.60; P < .001), major adverse cardiac events (aHR 3.40; P < .001), and lung cancer (aHR 16.0; P < .001).

Study details: This study analyzed the data of 1522 patients with RA (ILD group n = 287; non-ILD group n = 1235) from the observational IORRA cohort.

Disclosures: This study was supported by the Ministry of Health, Labour, and Welfare of Japan and other sources. Some authors declared serving as consultants for or receiving research grants, research funding, or lecture, speaker, or consulting fees from various sources.

Source: Sugano E et al. Impact of interstitial lung disease on clinical remission and unfavourable events of rheumatoid arthritis: Results from the IORRA cohort. Rheumatology (Oxford). 2023 (Jun 28). Doi: 10.1093/rheumatology/kead317

Key clinical point: Concomitant interstitial lung disease (ILD) is a significant factor associated with failure to achieve clinical remission and an increased risk for unfavorable clinical events in patients with rheumatoid arthritis (RA).

Major finding: The presence of ILD was significantly associated with failure to achieve Disease Activity Score in 28 Joints remission (adjusted hazard ratio [aHR] 0.71; P = .002) and increased risk for death (aHR 3.24; P < .001), hospitalized infections (aHR 2.60; P < .001), major adverse cardiac events (aHR 3.40; P < .001), and lung cancer (aHR 16.0; P < .001).

Study details: This study analyzed the data of 1522 patients with RA (ILD group n = 287; non-ILD group n = 1235) from the observational IORRA cohort.

Disclosures: This study was supported by the Ministry of Health, Labour, and Welfare of Japan and other sources. Some authors declared serving as consultants for or receiving research grants, research funding, or lecture, speaker, or consulting fees from various sources.

Source: Sugano E et al. Impact of interstitial lung disease on clinical remission and unfavourable events of rheumatoid arthritis: Results from the IORRA cohort. Rheumatology (Oxford). 2023 (Jun 28). Doi: 10.1093/rheumatology/kead317

Key clinical point: Exposure to volatile organic compounds (VOC) significantly increased the risk for rheumatoid arthritis (RA), highlighting environmental pollutants as a risk factor for RA.

Major finding: Patients with RA had a significantly higher urine concentration of seven VOC than those without arthritis (all P < .05). The risk for RA was significantly higher among those in the highest vs lowest concentration quantile of AMCC (adjusted odds ratio [aOR] 2.173; 95% CI 1.021-4.627) and 3HPMA (aOR 2.663; 95% CI 1.288-5.508), with the parent compounds being N,N-Dimethylformamide and acrolein, respectively.

Study details: This cross-sectional study included 9536 participants with complete information on 15 urine VOC, of whom 618 participants had RA and 8918 did not have arthritis.

Disclosures: This study was supported by the Fundamental Research Funds for the Central Universities of Central South University, the National Natural Science Foundation of China, and other sources. The authors declared no conflicts of interest.

Source: Lei T et al. The exposure to volatile organic chemicals associates positively with rheumatoid arthritis: A cross-sectional study from the NHANES program. Front Immunol. 2023;14:1098683 (Jun 19). Doi: 10.3389/fimmu.2023.1098683

Key clinical point: Exposure to volatile organic compounds (VOC) significantly increased the risk for rheumatoid arthritis (RA), highlighting environmental pollutants as a risk factor for RA.

Major finding: Patients with RA had a significantly higher urine concentration of seven VOC than those without arthritis (all P < .05). The risk for RA was significantly higher among those in the highest vs lowest concentration quantile of AMCC (adjusted odds ratio [aOR] 2.173; 95% CI 1.021-4.627) and 3HPMA (aOR 2.663; 95% CI 1.288-5.508), with the parent compounds being N,N-Dimethylformamide and acrolein, respectively.

Study details: This cross-sectional study included 9536 participants with complete information on 15 urine VOC, of whom 618 participants had RA and 8918 did not have arthritis.

Disclosures: This study was supported by the Fundamental Research Funds for the Central Universities of Central South University, the National Natural Science Foundation of China, and other sources. The authors declared no conflicts of interest.

Source: Lei T et al. The exposure to volatile organic chemicals associates positively with rheumatoid arthritis: A cross-sectional study from the NHANES program. Front Immunol. 2023;14:1098683 (Jun 19). Doi: 10.3389/fimmu.2023.1098683

Key clinical point: Exposure to volatile organic compounds (VOC) significantly increased the risk for rheumatoid arthritis (RA), highlighting environmental pollutants as a risk factor for RA.

Major finding: Patients with RA had a significantly higher urine concentration of seven VOC than those without arthritis (all P < .05). The risk for RA was significantly higher among those in the highest vs lowest concentration quantile of AMCC (adjusted odds ratio [aOR] 2.173; 95% CI 1.021-4.627) and 3HPMA (aOR 2.663; 95% CI 1.288-5.508), with the parent compounds being N,N-Dimethylformamide and acrolein, respectively.

Study details: This cross-sectional study included 9536 participants with complete information on 15 urine VOC, of whom 618 participants had RA and 8918 did not have arthritis.

Disclosures: This study was supported by the Fundamental Research Funds for the Central Universities of Central South University, the National Natural Science Foundation of China, and other sources. The authors declared no conflicts of interest.

Source: Lei T et al. The exposure to volatile organic chemicals associates positively with rheumatoid arthritis: A cross-sectional study from the NHANES program. Front Immunol. 2023;14:1098683 (Jun 19). Doi: 10.3389/fimmu.2023.1098683

Key clinical point: In patients with established rheumatoid arthritis (RA) age ≥ 65 years, an add-on low-dose prednisolone administration for 2 years led to a marginal weight gain, which appeared mostly as a beneficial increase in lean mass.

Major finding: At 2 years, the body weight increased slightly with 5 mg/day prednisolone (mean change +0.9 kg; 95% CI 0.3-1.6 kg), whereas there was a non-significant decrease with placebo (between-treatment difference 1.3 kg; P < .01). The change in body weight with prednisolone was mostly due to increased lean mass rather than fat mass and was not significantly related to disease activity.

Study details: This substudy of the phase 4 GLORIA trial included 449 patients aged ≥65 years with active RA who were randomly assigned to receive placebo (n = 225) or 5 mg/day prednisolone (n = 224) along with standard care for 2 years.

Disclosures: The GLORIA study was funded by the European Union’s Horizon 2020 research and innovation program. M Boers and MR Kok declared ties with various sources. The other authors declared no competing interests.

Source: Güler-Yüksel M et al. Changes in body weight and body composition in patients with active rheumatoid arthritis aged 65+ treated with 2-year low-dose add-on prednisolone in the randomised double-blind placebo-controlled GLORIA trial. RMD Open. 2023;9:e002905 (Jun 22). Doi: 10.1136/rmdopen-2022-002905

Key clinical point: In patients with established rheumatoid arthritis (RA) age ≥ 65 years, an add-on low-dose prednisolone administration for 2 years led to a marginal weight gain, which appeared mostly as a beneficial increase in lean mass.

Major finding: At 2 years, the body weight increased slightly with 5 mg/day prednisolone (mean change +0.9 kg; 95% CI 0.3-1.6 kg), whereas there was a non-significant decrease with placebo (between-treatment difference 1.3 kg; P < .01). The change in body weight with prednisolone was mostly due to increased lean mass rather than fat mass and was not significantly related to disease activity.

Study details: This substudy of the phase 4 GLORIA trial included 449 patients aged ≥65 years with active RA who were randomly assigned to receive placebo (n = 225) or 5 mg/day prednisolone (n = 224) along with standard care for 2 years.

Disclosures: The GLORIA study was funded by the European Union’s Horizon 2020 research and innovation program. M Boers and MR Kok declared ties with various sources. The other authors declared no competing interests.

Source: Güler-Yüksel M et al. Changes in body weight and body composition in patients with active rheumatoid arthritis aged 65+ treated with 2-year low-dose add-on prednisolone in the randomised double-blind placebo-controlled GLORIA trial. RMD Open. 2023;9:e002905 (Jun 22). Doi: 10.1136/rmdopen-2022-002905

Key clinical point: In patients with established rheumatoid arthritis (RA) age ≥ 65 years, an add-on low-dose prednisolone administration for 2 years led to a marginal weight gain, which appeared mostly as a beneficial increase in lean mass.

Major finding: At 2 years, the body weight increased slightly with 5 mg/day prednisolone (mean change +0.9 kg; 95% CI 0.3-1.6 kg), whereas there was a non-significant decrease with placebo (between-treatment difference 1.3 kg; P < .01). The change in body weight with prednisolone was mostly due to increased lean mass rather than fat mass and was not significantly related to disease activity.

Study details: This substudy of the phase 4 GLORIA trial included 449 patients aged ≥65 years with active RA who were randomly assigned to receive placebo (n = 225) or 5 mg/day prednisolone (n = 224) along with standard care for 2 years.

Disclosures: The GLORIA study was funded by the European Union’s Horizon 2020 research and innovation program. M Boers and MR Kok declared ties with various sources. The other authors declared no competing interests.

Source: Güler-Yüksel M et al. Changes in body weight and body composition in patients with active rheumatoid arthritis aged 65+ treated with 2-year low-dose add-on prednisolone in the randomised double-blind placebo-controlled GLORIA trial. RMD Open. 2023;9:e002905 (Jun 22). Doi: 10.1136/rmdopen-2022-002905

Key clinical point: A substantial proportion of patients with early rheumatoid arthritis (RA) had unacceptably high levels of pain with or without low inflammation at 2 years after diagnosis, with joint tenderness at the 3-month follow-up predicting long-term pain despite low inflammation.

Major finding: Nearly one third of patients with early RA had unacceptable pain levels after 2 years of follow-up, with almost 80% of them also having low inflammation. At the 3-month follow-up, the difference between tender and swollen joint counts predicted the 2-year risk for unacceptable pain (odds ratio [OR] 2.00; P < .05) and unacceptable pain with low inflammation (OR 2.02; P < .05).

Study details: Findings are from a retrospective study including 275 patients with early RA.

Disclosures: This study was supported by The Swedish Research Council, The Swedish Rheumatism Association, and Lund University. Some authors declared working as a medical solution lead in rheumatology or receiving consulting fees, speaking fees, and unrestricted grant from various sources. Three authors declared no conflicts of interest.

Source: Eberhard A et al. Joint tenderness at 3 months follow-up better predicts long-term pain than baseline characteristics in early rheumatoid arthritis patients. Rheumatology (Oxford). 2023 (Jun 14). Doi: 10.1093/rheumatology/kead278

Key clinical point: A substantial proportion of patients with early rheumatoid arthritis (RA) had unacceptably high levels of pain with or without low inflammation at 2 years after diagnosis, with joint tenderness at the 3-month follow-up predicting long-term pain despite low inflammation.

Major finding: Nearly one third of patients with early RA had unacceptable pain levels after 2 years of follow-up, with almost 80% of them also having low inflammation. At the 3-month follow-up, the difference between tender and swollen joint counts predicted the 2-year risk for unacceptable pain (odds ratio [OR] 2.00; P < .05) and unacceptable pain with low inflammation (OR 2.02; P < .05).

Study details: Findings are from a retrospective study including 275 patients with early RA.

Disclosures: This study was supported by The Swedish Research Council, The Swedish Rheumatism Association, and Lund University. Some authors declared working as a medical solution lead in rheumatology or receiving consulting fees, speaking fees, and unrestricted grant from various sources. Three authors declared no conflicts of interest.

Source: Eberhard A et al. Joint tenderness at 3 months follow-up better predicts long-term pain than baseline characteristics in early rheumatoid arthritis patients. Rheumatology (Oxford). 2023 (Jun 14). Doi: 10.1093/rheumatology/kead278

Key clinical point: A substantial proportion of patients with early rheumatoid arthritis (RA) had unacceptably high levels of pain with or without low inflammation at 2 years after diagnosis, with joint tenderness at the 3-month follow-up predicting long-term pain despite low inflammation.

Major finding: Nearly one third of patients with early RA had unacceptable pain levels after 2 years of follow-up, with almost 80% of them also having low inflammation. At the 3-month follow-up, the difference between tender and swollen joint counts predicted the 2-year risk for unacceptable pain (odds ratio [OR] 2.00; P < .05) and unacceptable pain with low inflammation (OR 2.02; P < .05).

Study details: Findings are from a retrospective study including 275 patients with early RA.

Disclosures: This study was supported by The Swedish Research Council, The Swedish Rheumatism Association, and Lund University. Some authors declared working as a medical solution lead in rheumatology or receiving consulting fees, speaking fees, and unrestricted grant from various sources. Three authors declared no conflicts of interest.

Source: Eberhard A et al. Joint tenderness at 3 months follow-up better predicts long-term pain than baseline characteristics in early rheumatoid arthritis patients. Rheumatology (Oxford). 2023 (Jun 14). Doi: 10.1093/rheumatology/kead278

Key clinical point: Functional disabilities involving the hands started earlier and were more frequent and severe than those involving feet in patients with clinically suspect arthralgia (CSA) who progressed toward rheumatoid arthritis (RA) or clinical inflammatory arthritis (IA).

Major finding: In patients with RA development, hand disabilities occurred earlier and were more frequent and severe (mean difference over time 0.41 units; P < .001) than foot disabilities. The evaluation of tender joints and subclinical joint inflammation showed similar findings for hand and foot involvement.

Study details: This study longitudinally assessed 600 patients with CSA who developed clinical IA or had at least 1 year of follow-up.

Disclosures: This study was supported by the European Research Council and the Dutch Arthritis Society. AHM van der Helm-van Mil declared being an Editorial Board Member for RMD Open. The other authors did not report any conflicts of interest.

Source: Khidir SJH et al. Joint involvement in RA starts predominantly in the hands: Functional, clinical and imaging studies in clinically suspect arthralgia and during progression to RA. RMD Open. 2023;9:e003107 (Jun 16). Doi: 10.1136/rmdopen-2023-003107

Key clinical point: Functional disabilities involving the hands started earlier and were more frequent and severe than those involving feet in patients with clinically suspect arthralgia (CSA) who progressed toward rheumatoid arthritis (RA) or clinical inflammatory arthritis (IA).

Major finding: In patients with RA development, hand disabilities occurred earlier and were more frequent and severe (mean difference over time 0.41 units; P < .001) than foot disabilities. The evaluation of tender joints and subclinical joint inflammation showed similar findings for hand and foot involvement.

Study details: This study longitudinally assessed 600 patients with CSA who developed clinical IA or had at least 1 year of follow-up.

Disclosures: This study was supported by the European Research Council and the Dutch Arthritis Society. AHM van der Helm-van Mil declared being an Editorial Board Member for RMD Open. The other authors did not report any conflicts of interest.

Source: Khidir SJH et al. Joint involvement in RA starts predominantly in the hands: Functional, clinical and imaging studies in clinically suspect arthralgia and during progression to RA. RMD Open. 2023;9:e003107 (Jun 16). Doi: 10.1136/rmdopen-2023-003107

Key clinical point: Functional disabilities involving the hands started earlier and were more frequent and severe than those involving feet in patients with clinically suspect arthralgia (CSA) who progressed toward rheumatoid arthritis (RA) or clinical inflammatory arthritis (IA).

Major finding: In patients with RA development, hand disabilities occurred earlier and were more frequent and severe (mean difference over time 0.41 units; P < .001) than foot disabilities. The evaluation of tender joints and subclinical joint inflammation showed similar findings for hand and foot involvement.

Study details: This study longitudinally assessed 600 patients with CSA who developed clinical IA or had at least 1 year of follow-up.

Disclosures: This study was supported by the European Research Council and the Dutch Arthritis Society. AHM van der Helm-van Mil declared being an Editorial Board Member for RMD Open. The other authors did not report any conflicts of interest.

Source: Khidir SJH et al. Joint involvement in RA starts predominantly in the hands: Functional, clinical and imaging studies in clinically suspect arthralgia and during progression to RA. RMD Open. 2023;9:e003107 (Jun 16). Doi: 10.1136/rmdopen-2023-003107

Key clinical point: First-line therapy with biologics, including abatacept and certolizumab pegol but not tocilizumab, all in combination with methotrexate, was clinically superior to conventional therapy with bridging glucocorticoids in patients with moderate-to-severe early rheumatoid arthritis (RA).

Major finding: Compared with active conventional therapy, the Clinical Disease Activity Index-based remission rates at week 48 were significantly higher with abatacept (adjusted difference +20.1%; P < .001) and certolizumab pegol (adjusted difference +13.1%; P = .021) but not with tocilizumab, whereas the radiographic progression was low and lacked between-group differences.

Study details: Findings are from the NORD-STAR trial including 812 treatment-naive patients with moderate-to-severe early RA who were randomly assigned to receive methotrexate combined with active conventional therapy, certolizumab pegol, abatacept, or tocilizumab.

Disclosures: This study was funded by the Academy of Finland, Finska Läkaresällskapet, and other sources. Several authors declared chairing the committees of or receiving travel support, research grants, or fees for lectures, speaking, consultancy, advisory roles, or other services from various sources.

Source: Østergaard M et al, on behalf of the NORD-STAR study group. Certolizumab pegol, abatacept, tocilizumab or active conventional treatment in early rheumatoid arthritis: 48-week clinical and radiographic results of the investigator-initiated randomised controlled NORD-STAR trial. Ann Rheum Dis. 2023 (Jul 9). Doi: 10.1136/ard-2023-224116

Key clinical point: First-line therapy with biologics, including abatacept and certolizumab pegol but not tocilizumab, all in combination with methotrexate, was clinically superior to conventional therapy with bridging glucocorticoids in patients with moderate-to-severe early rheumatoid arthritis (RA).

Major finding: Compared with active conventional therapy, the Clinical Disease Activity Index-based remission rates at week 48 were significantly higher with abatacept (adjusted difference +20.1%; P < .001) and certolizumab pegol (adjusted difference +13.1%; P = .021) but not with tocilizumab, whereas the radiographic progression was low and lacked between-group differences.

Study details: Findings are from the NORD-STAR trial including 812 treatment-naive patients with moderate-to-severe early RA who were randomly assigned to receive methotrexate combined with active conventional therapy, certolizumab pegol, abatacept, or tocilizumab.

Disclosures: This study was funded by the Academy of Finland, Finska Läkaresällskapet, and other sources. Several authors declared chairing the committees of or receiving travel support, research grants, or fees for lectures, speaking, consultancy, advisory roles, or other services from various sources.

Source: Østergaard M et al, on behalf of the NORD-STAR study group. Certolizumab pegol, abatacept, tocilizumab or active conventional treatment in early rheumatoid arthritis: 48-week clinical and radiographic results of the investigator-initiated randomised controlled NORD-STAR trial. Ann Rheum Dis. 2023 (Jul 9). Doi: 10.1136/ard-2023-224116

Key clinical point: First-line therapy with biologics, including abatacept and certolizumab pegol but not tocilizumab, all in combination with methotrexate, was clinically superior to conventional therapy with bridging glucocorticoids in patients with moderate-to-severe early rheumatoid arthritis (RA).

Major finding: Compared with active conventional therapy, the Clinical Disease Activity Index-based remission rates at week 48 were significantly higher with abatacept (adjusted difference +20.1%; P < .001) and certolizumab pegol (adjusted difference +13.1%; P = .021) but not with tocilizumab, whereas the radiographic progression was low and lacked between-group differences.

Study details: Findings are from the NORD-STAR trial including 812 treatment-naive patients with moderate-to-severe early RA who were randomly assigned to receive methotrexate combined with active conventional therapy, certolizumab pegol, abatacept, or tocilizumab.

Disclosures: This study was funded by the Academy of Finland, Finska Läkaresällskapet, and other sources. Several authors declared chairing the committees of or receiving travel support, research grants, or fees for lectures, speaking, consultancy, advisory roles, or other services from various sources.

Source: Østergaard M et al, on behalf of the NORD-STAR study group. Certolizumab pegol, abatacept, tocilizumab or active conventional treatment in early rheumatoid arthritis: 48-week clinical and radiographic results of the investigator-initiated randomised controlled NORD-STAR trial. Ann Rheum Dis. 2023 (Jul 9). Doi: 10.1136/ard-2023-224116

Key clinical point: In patients with rheumatoid arthritis (RA), tofacitinib led to a modest yet statistically significant reduction in disease activity at 3 months compared with adalimumab; however, the reduction in disease activity was not significantly different between the treatment groups at 9 months.

Major finding: The difference in the mean Disease Activity Score in 28 Joints using C-reactive protein between patients treated with tofacitinib vs adalimumab was modest yet statistically significant at 3 months (average treatment effect [ATE] −0.2; P = .02), whereas there was no significant difference at 9 months (ATE −0.03; P = .60).

Study details: This observational study emulated a randomized controlled trial using the data of 842 biologic or targeted synthetic disease-modifying antirheumatic drug-naïve patients with RA from the OPAL dataset who initiated adalimumab (n = 569) or tofacitinib (n = 273).

Disclosures: This study did not declare any specific funding source. Four authors declared being a director of, serving on advisory boards or speakers’ bureaus for, or receiving personal fees for consultancy from various sources.

Source: Deakin CT et al, for the OPAL Rheumatology Network. Comparative effectiveness of adalimumab vs tofacitinib in patients with rheumatoid arthritis in Australia. JAMA Netw Open. 2023;6(6):e2320851 (Jun 29). Doi: 10.1001/jamanetworkopen.2023.20851

Key clinical point: In patients with rheumatoid arthritis (RA), tofacitinib led to a modest yet statistically significant reduction in disease activity at 3 months compared with adalimumab; however, the reduction in disease activity was not significantly different between the treatment groups at 9 months.

Major finding: The difference in the mean Disease Activity Score in 28 Joints using C-reactive protein between patients treated with tofacitinib vs adalimumab was modest yet statistically significant at 3 months (average treatment effect [ATE] −0.2; P = .02), whereas there was no significant difference at 9 months (ATE −0.03; P = .60).

Study details: This observational study emulated a randomized controlled trial using the data of 842 biologic or targeted synthetic disease-modifying antirheumatic drug-naïve patients with RA from the OPAL dataset who initiated adalimumab (n = 569) or tofacitinib (n = 273).

Disclosures: This study did not declare any specific funding source. Four authors declared being a director of, serving on advisory boards or speakers’ bureaus for, or receiving personal fees for consultancy from various sources.

Source: Deakin CT et al, for the OPAL Rheumatology Network. Comparative effectiveness of adalimumab vs tofacitinib in patients with rheumatoid arthritis in Australia. JAMA Netw Open. 2023;6(6):e2320851 (Jun 29). Doi: 10.1001/jamanetworkopen.2023.20851

Key clinical point: In patients with rheumatoid arthritis (RA), tofacitinib led to a modest yet statistically significant reduction in disease activity at 3 months compared with adalimumab; however, the reduction in disease activity was not significantly different between the treatment groups at 9 months.

Major finding: The difference in the mean Disease Activity Score in 28 Joints using C-reactive protein between patients treated with tofacitinib vs adalimumab was modest yet statistically significant at 3 months (average treatment effect [ATE] −0.2; P = .02), whereas there was no significant difference at 9 months (ATE −0.03; P = .60).

Study details: This observational study emulated a randomized controlled trial using the data of 842 biologic or targeted synthetic disease-modifying antirheumatic drug-naïve patients with RA from the OPAL dataset who initiated adalimumab (n = 569) or tofacitinib (n = 273).

Disclosures: This study did not declare any specific funding source. Four authors declared being a director of, serving on advisory boards or speakers’ bureaus for, or receiving personal fees for consultancy from various sources.

Source: Deakin CT et al, for the OPAL Rheumatology Network. Comparative effectiveness of adalimumab vs tofacitinib in patients with rheumatoid arthritis in Australia. JAMA Netw Open. 2023;6(6):e2320851 (Jun 29). Doi: 10.1001/jamanetworkopen.2023.20851

Key clinical point: Compared with Bruton tyrosine kinase inhibitors (BTKi) alone, BTKi + anti-CD20 monoclonal antibodies (mAb) demonstrated better efficacy in patients with untreated, relapsed, or refractory chronic lymphocytic leukemia (CLL) without causing safety concerns.

Major finding: The BTKi + anti-CD20 mAb therapy vs BTKi monotherapy group had significantly improved progression-free survival (hazard ratio 0.70; 95% CI 0.51-0.97), complete response rate (relative risk [RR] 2.03; 95% CI 1.01-4.06), and undetectable minimal residual disease rate (RR 6.43; 95% CI 3.54-11.67) and a similar risk for grade ≥3 adverse events (RR 1.08; 95% CI 0.80-1.45).

Study details: Findings are from a meta-analysis of 4 randomized controlled trials including 1056 patients who received a BTKi + anti-CD20 mAb or BTKi monotherapy for untreated, relapsed, or refractory CLL.

Disclosures: This study was supported by grants from the National Science and Technology Council in Taiwan and the industry-academia cooperation program. The authors declared no conflicts of interest.

Source: Nguyen TT et al. Efficacy and safety of add-on anti-CD20 monoclonal antibody to Bruton tyrosine kinase inhibitor treatment for chronic lymphocytic leukemia: A meta-analysis. Sci Rep. 2023;13:9775 (Jun 16). Doi: 10.1038/s41598-023-36279-x

Key clinical point: Compared with Bruton tyrosine kinase inhibitors (BTKi) alone, BTKi + anti-CD20 monoclonal antibodies (mAb) demonstrated better efficacy in patients with untreated, relapsed, or refractory chronic lymphocytic leukemia (CLL) without causing safety concerns.

Major finding: The BTKi + anti-CD20 mAb therapy vs BTKi monotherapy group had significantly improved progression-free survival (hazard ratio 0.70; 95% CI 0.51-0.97), complete response rate (relative risk [RR] 2.03; 95% CI 1.01-4.06), and undetectable minimal residual disease rate (RR 6.43; 95% CI 3.54-11.67) and a similar risk for grade ≥3 adverse events (RR 1.08; 95% CI 0.80-1.45).

Study details: Findings are from a meta-analysis of 4 randomized controlled trials including 1056 patients who received a BTKi + anti-CD20 mAb or BTKi monotherapy for untreated, relapsed, or refractory CLL.

Disclosures: This study was supported by grants from the National Science and Technology Council in Taiwan and the industry-academia cooperation program. The authors declared no conflicts of interest.

Source: Nguyen TT et al. Efficacy and safety of add-on anti-CD20 monoclonal antibody to Bruton tyrosine kinase inhibitor treatment for chronic lymphocytic leukemia: A meta-analysis. Sci Rep. 2023;13:9775 (Jun 16). Doi: 10.1038/s41598-023-36279-x

Key clinical point: Compared with Bruton tyrosine kinase inhibitors (BTKi) alone, BTKi + anti-CD20 monoclonal antibodies (mAb) demonstrated better efficacy in patients with untreated, relapsed, or refractory chronic lymphocytic leukemia (CLL) without causing safety concerns.

Major finding: The BTKi + anti-CD20 mAb therapy vs BTKi monotherapy group had significantly improved progression-free survival (hazard ratio 0.70; 95% CI 0.51-0.97), complete response rate (relative risk [RR] 2.03; 95% CI 1.01-4.06), and undetectable minimal residual disease rate (RR 6.43; 95% CI 3.54-11.67) and a similar risk for grade ≥3 adverse events (RR 1.08; 95% CI 0.80-1.45).

Study details: Findings are from a meta-analysis of 4 randomized controlled trials including 1056 patients who received a BTKi + anti-CD20 mAb or BTKi monotherapy for untreated, relapsed, or refractory CLL.

Disclosures: This study was supported by grants from the National Science and Technology Council in Taiwan and the industry-academia cooperation program. The authors declared no conflicts of interest.

Source: Nguyen TT et al. Efficacy and safety of add-on anti-CD20 monoclonal antibody to Bruton tyrosine kinase inhibitor treatment for chronic lymphocytic leukemia: A meta-analysis. Sci Rep. 2023;13:9775 (Jun 16). Doi: 10.1038/s41598-023-36279-x