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Glucocorticoids spike cardiovascular risk in a dose-dependent manner in RA

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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

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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

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Antidrug antibodies and response to biologics in RA: Is there a link?

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Key clinical point: The presence of antidrug antibodies was associated with a diminished response to biologic disease-modifying antirheumatic drugs (bDMARD) among patients with rheumatoid arthritis (RA), highlighting the importance of monitoring antidrug antibodies, particularly among nonresponders.

 

Major finding: At month 12, the prevalence of antidrug antibodies against rituximab (50.0%), anti-tumor necrosis factor monoclonal antibodies (38.2%), and tocilizumab (20.0%) was relatively high, and an inverse association was observed between antidrug antibody positivity for all bDMARD and the European Alliance of Associations for Rheumatology response (odds ratio 0.19; P < .001).

 

Study details: This cohort study used data from the ABI-RA prospective study to evaluate 230 patients with RA who initiated bDMARD.

 

Disclosures: The ABI-RA study was a part of ABIRISK, which was funded by the European Union and included financial contribution from the European Union’s Seventh Framework Programme and others. Several authors declared receiving personal fees, grants, or non-financial support from various sources.

 

Source: Bitoun S et al for the ABIRISK Consortium. Response to biologic drugs in patients with rheumatoid arthritis and antidrug antibodies. JAMA Netw Open. 2023;6(7):e2323098 (Jul 12). doi: 10.1001/jamanetworkopen.2023.23098

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Key clinical point: The presence of antidrug antibodies was associated with a diminished response to biologic disease-modifying antirheumatic drugs (bDMARD) among patients with rheumatoid arthritis (RA), highlighting the importance of monitoring antidrug antibodies, particularly among nonresponders.

 

Major finding: At month 12, the prevalence of antidrug antibodies against rituximab (50.0%), anti-tumor necrosis factor monoclonal antibodies (38.2%), and tocilizumab (20.0%) was relatively high, and an inverse association was observed between antidrug antibody positivity for all bDMARD and the European Alliance of Associations for Rheumatology response (odds ratio 0.19; P < .001).

 

Study details: This cohort study used data from the ABI-RA prospective study to evaluate 230 patients with RA who initiated bDMARD.

 

Disclosures: The ABI-RA study was a part of ABIRISK, which was funded by the European Union and included financial contribution from the European Union’s Seventh Framework Programme and others. Several authors declared receiving personal fees, grants, or non-financial support from various sources.

 

Source: Bitoun S et al for the ABIRISK Consortium. Response to biologic drugs in patients with rheumatoid arthritis and antidrug antibodies. JAMA Netw Open. 2023;6(7):e2323098 (Jul 12). doi: 10.1001/jamanetworkopen.2023.23098

Key clinical point: The presence of antidrug antibodies was associated with a diminished response to biologic disease-modifying antirheumatic drugs (bDMARD) among patients with rheumatoid arthritis (RA), highlighting the importance of monitoring antidrug antibodies, particularly among nonresponders.

 

Major finding: At month 12, the prevalence of antidrug antibodies against rituximab (50.0%), anti-tumor necrosis factor monoclonal antibodies (38.2%), and tocilizumab (20.0%) was relatively high, and an inverse association was observed between antidrug antibody positivity for all bDMARD and the European Alliance of Associations for Rheumatology response (odds ratio 0.19; P < .001).

 

Study details: This cohort study used data from the ABI-RA prospective study to evaluate 230 patients with RA who initiated bDMARD.

 

Disclosures: The ABI-RA study was a part of ABIRISK, which was funded by the European Union and included financial contribution from the European Union’s Seventh Framework Programme and others. Several authors declared receiving personal fees, grants, or non-financial support from various sources.

 

Source: Bitoun S et al for the ABIRISK Consortium. Response to biologic drugs in patients with rheumatoid arthritis and antidrug antibodies. JAMA Netw Open. 2023;6(7):e2323098 (Jul 12). doi: 10.1001/jamanetworkopen.2023.23098

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Study finds possible link between rheumatoid arthritis and aortic stenosis

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Key clinical point: Patients with rheumatoid arthritis (RA) are at a significantly higher risk for aortic stenosis (AS) and subsequent aortic valve intervention and AS-related death than those without RA.

 

Major finding: Patients with vs without RA were at an increased risk for incident AS (adjusted hazard ratio [aHR] 1.48; 95% CI 1.41-1.55), AS-related death (aHR 1.26; 95% CI 1.04-1.54), and undergoing an AS-related aortic valvular intervention (aHR 1.34; 95% CI 1.22-1.48), including both surgical (aHR 1.30; 95% CI 1.16-1.45) and transcatheter (aHR 1.53; 95% CI 1.26-1.85) aortic valve replacements.

 

Study details: This retrospective cohort study included 73,070 patients with RA who were matched with 639,268 patients without RA.

 

Disclosures: This study was supported by the Center of Excellence for Suicide Prevention and other sources. TM Johnson declared receiving grants from the Rheumatology Research Foundation. Some authors declared receiving personal or consulting fees, grants, speaking honoraria, or royalties from various sources.

 

Source: Johnson TM et al. Aortic stenosis risk in rheumatoid arthritis. JAMA Intern Med. 2023 (Jul 31). doi: 10.1001/jamainternmed.2023.3087

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Key clinical point: Patients with rheumatoid arthritis (RA) are at a significantly higher risk for aortic stenosis (AS) and subsequent aortic valve intervention and AS-related death than those without RA.

 

Major finding: Patients with vs without RA were at an increased risk for incident AS (adjusted hazard ratio [aHR] 1.48; 95% CI 1.41-1.55), AS-related death (aHR 1.26; 95% CI 1.04-1.54), and undergoing an AS-related aortic valvular intervention (aHR 1.34; 95% CI 1.22-1.48), including both surgical (aHR 1.30; 95% CI 1.16-1.45) and transcatheter (aHR 1.53; 95% CI 1.26-1.85) aortic valve replacements.

 

Study details: This retrospective cohort study included 73,070 patients with RA who were matched with 639,268 patients without RA.

 

Disclosures: This study was supported by the Center of Excellence for Suicide Prevention and other sources. TM Johnson declared receiving grants from the Rheumatology Research Foundation. Some authors declared receiving personal or consulting fees, grants, speaking honoraria, or royalties from various sources.

 

Source: Johnson TM et al. Aortic stenosis risk in rheumatoid arthritis. JAMA Intern Med. 2023 (Jul 31). doi: 10.1001/jamainternmed.2023.3087

Key clinical point: Patients with rheumatoid arthritis (RA) are at a significantly higher risk for aortic stenosis (AS) and subsequent aortic valve intervention and AS-related death than those without RA.

 

Major finding: Patients with vs without RA were at an increased risk for incident AS (adjusted hazard ratio [aHR] 1.48; 95% CI 1.41-1.55), AS-related death (aHR 1.26; 95% CI 1.04-1.54), and undergoing an AS-related aortic valvular intervention (aHR 1.34; 95% CI 1.22-1.48), including both surgical (aHR 1.30; 95% CI 1.16-1.45) and transcatheter (aHR 1.53; 95% CI 1.26-1.85) aortic valve replacements.

 

Study details: This retrospective cohort study included 73,070 patients with RA who were matched with 639,268 patients without RA.

 

Disclosures: This study was supported by the Center of Excellence for Suicide Prevention and other sources. TM Johnson declared receiving grants from the Rheumatology Research Foundation. Some authors declared receiving personal or consulting fees, grants, speaking honoraria, or royalties from various sources.

 

Source: Johnson TM et al. Aortic stenosis risk in rheumatoid arthritis. JAMA Intern Med. 2023 (Jul 31). doi: 10.1001/jamainternmed.2023.3087

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On the trail of a new vaccine for Lyme disease

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French researchers have been working on an innovative vaccine that targets tick microbiota to indirectly reduce the bacterial load within the vector. The results of their study were published in the journal Microbiome.

Ticks are vectors of many harmful pathogens that can cause life-threatening illnesses. Ixodes ricinus (in Europe) and Ixodes scapularis (in Canada and the United States) carry Borrelia, the bacteria that cause Lyme disease. At the moment, there is no vaccine for this disease. But that could all change, thanks to the findings of scientists at the National Research Institute for Agriculture, Food, and Environment (INRAE), in collaboration with the Agency for Food, Environmental, and Occupational Health and Safety and the National Veterinary School of Alfort, France.

“Ticks can transmit a broad variety of pathogens of medical importance, including Borrelia afzelii, the causative agent of Lyme borreliosis in Europe. Tick microbiota is an important factor modulating not only vector physiology, but also the vector competence,” the team reported. They focused their efforts on developing a vaccine that would disturb the tick microbiota and thus reduce Borrelia colonization.

To explore this indirect approach, they injected a harmless strain of Escherichia coli bacteria into mice, which then produced antibodies. Their reasoning was that when a tick bites one of these mice, the antibodies would pass into the arachnid’s microbiota and disturb it, thereby making the tick less harmful. And indeed, the researchers’ work showed that in the ticks that fed on vaccinated mice, levels of Borrelia levels were much lower than in than ticks that fed on unvaccinated mice (see video for an explanation). So, when given to a mouse, this vaccine “protects” the tick against colonization by Borrelia but does not protect the mouse against the disease.

The study has advanced this area of research in two significant ways: It provides new information on the importance of the microbiota when it comes to ticks that are infected with Borrelia, and it suggests an innovative vaccination strategy. Indeed, the results confirm that tick microbiota is essential for the development of Borrelia in the arachnid. As noted in an INRAE press release, “This is a key piece of data that opens the door to one day having an innovative vaccination strategy aimed at perturbing the microbiota of the vector of the Lyme disease agent.”

Dengue, Zika virus, and malaria are also transmitted by a vector – the mosquito. Innovative antimicrobiota vaccines may be able to control these diseases as well.

This article was translated from the Medscape French Edition. A version of this article appeared on Medscape.com.

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French researchers have been working on an innovative vaccine that targets tick microbiota to indirectly reduce the bacterial load within the vector. The results of their study were published in the journal Microbiome.

Ticks are vectors of many harmful pathogens that can cause life-threatening illnesses. Ixodes ricinus (in Europe) and Ixodes scapularis (in Canada and the United States) carry Borrelia, the bacteria that cause Lyme disease. At the moment, there is no vaccine for this disease. But that could all change, thanks to the findings of scientists at the National Research Institute for Agriculture, Food, and Environment (INRAE), in collaboration with the Agency for Food, Environmental, and Occupational Health and Safety and the National Veterinary School of Alfort, France.

“Ticks can transmit a broad variety of pathogens of medical importance, including Borrelia afzelii, the causative agent of Lyme borreliosis in Europe. Tick microbiota is an important factor modulating not only vector physiology, but also the vector competence,” the team reported. They focused their efforts on developing a vaccine that would disturb the tick microbiota and thus reduce Borrelia colonization.

To explore this indirect approach, they injected a harmless strain of Escherichia coli bacteria into mice, which then produced antibodies. Their reasoning was that when a tick bites one of these mice, the antibodies would pass into the arachnid’s microbiota and disturb it, thereby making the tick less harmful. And indeed, the researchers’ work showed that in the ticks that fed on vaccinated mice, levels of Borrelia levels were much lower than in than ticks that fed on unvaccinated mice (see video for an explanation). So, when given to a mouse, this vaccine “protects” the tick against colonization by Borrelia but does not protect the mouse against the disease.

The study has advanced this area of research in two significant ways: It provides new information on the importance of the microbiota when it comes to ticks that are infected with Borrelia, and it suggests an innovative vaccination strategy. Indeed, the results confirm that tick microbiota is essential for the development of Borrelia in the arachnid. As noted in an INRAE press release, “This is a key piece of data that opens the door to one day having an innovative vaccination strategy aimed at perturbing the microbiota of the vector of the Lyme disease agent.”

Dengue, Zika virus, and malaria are also transmitted by a vector – the mosquito. Innovative antimicrobiota vaccines may be able to control these diseases as well.

This article was translated from the Medscape French Edition. A version of this article appeared on Medscape.com.

French researchers have been working on an innovative vaccine that targets tick microbiota to indirectly reduce the bacterial load within the vector. The results of their study were published in the journal Microbiome.

Ticks are vectors of many harmful pathogens that can cause life-threatening illnesses. Ixodes ricinus (in Europe) and Ixodes scapularis (in Canada and the United States) carry Borrelia, the bacteria that cause Lyme disease. At the moment, there is no vaccine for this disease. But that could all change, thanks to the findings of scientists at the National Research Institute for Agriculture, Food, and Environment (INRAE), in collaboration with the Agency for Food, Environmental, and Occupational Health and Safety and the National Veterinary School of Alfort, France.

“Ticks can transmit a broad variety of pathogens of medical importance, including Borrelia afzelii, the causative agent of Lyme borreliosis in Europe. Tick microbiota is an important factor modulating not only vector physiology, but also the vector competence,” the team reported. They focused their efforts on developing a vaccine that would disturb the tick microbiota and thus reduce Borrelia colonization.

To explore this indirect approach, they injected a harmless strain of Escherichia coli bacteria into mice, which then produced antibodies. Their reasoning was that when a tick bites one of these mice, the antibodies would pass into the arachnid’s microbiota and disturb it, thereby making the tick less harmful. And indeed, the researchers’ work showed that in the ticks that fed on vaccinated mice, levels of Borrelia levels were much lower than in than ticks that fed on unvaccinated mice (see video for an explanation). So, when given to a mouse, this vaccine “protects” the tick against colonization by Borrelia but does not protect the mouse against the disease.

The study has advanced this area of research in two significant ways: It provides new information on the importance of the microbiota when it comes to ticks that are infected with Borrelia, and it suggests an innovative vaccination strategy. Indeed, the results confirm that tick microbiota is essential for the development of Borrelia in the arachnid. As noted in an INRAE press release, “This is a key piece of data that opens the door to one day having an innovative vaccination strategy aimed at perturbing the microbiota of the vector of the Lyme disease agent.”

Dengue, Zika virus, and malaria are also transmitted by a vector – the mosquito. Innovative antimicrobiota vaccines may be able to control these diseases as well.

This article was translated from the Medscape French Edition. A version of this article appeared on Medscape.com.

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Cardiometabolic multimorbidity positively impacts secukinumab treatment persistence in PsA

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Key clinical point: The presence of cardiometabolic multimorbidity may be associated with an improved treatment persistence with secukinumab in patients with psoriatic arthritis (PsA).

Major finding: The cumulative 60-month drug retention rate for secukinumab was 57.0% in patients with cardiometabolic multimorbidity (P  =  .042). Those with type 2 diabetes had a significantly better drug retention rate than those without (P  =  .044).

Study details: Findings are from a retrospective study of prospectively followed-up patients with PsA (n = 207) who received secukinumab for at least 3 months.

Disclosures: The study did not disclose the source of funding. The authors declared no conflicts of interest.

Source: Ruscitti P et al. The assessment of the drug retention rate of secukinumab in patients with psoriatic arthritis in a real-life multicentre cohort. Clin Exp Rheumatol. 2023 (Jul 24). doi: 10.55563/clinexprheumatol/tpp63h

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Key clinical point: The presence of cardiometabolic multimorbidity may be associated with an improved treatment persistence with secukinumab in patients with psoriatic arthritis (PsA).

Major finding: The cumulative 60-month drug retention rate for secukinumab was 57.0% in patients with cardiometabolic multimorbidity (P  =  .042). Those with type 2 diabetes had a significantly better drug retention rate than those without (P  =  .044).

Study details: Findings are from a retrospective study of prospectively followed-up patients with PsA (n = 207) who received secukinumab for at least 3 months.

Disclosures: The study did not disclose the source of funding. The authors declared no conflicts of interest.

Source: Ruscitti P et al. The assessment of the drug retention rate of secukinumab in patients with psoriatic arthritis in a real-life multicentre cohort. Clin Exp Rheumatol. 2023 (Jul 24). doi: 10.55563/clinexprheumatol/tpp63h

Key clinical point: The presence of cardiometabolic multimorbidity may be associated with an improved treatment persistence with secukinumab in patients with psoriatic arthritis (PsA).

Major finding: The cumulative 60-month drug retention rate for secukinumab was 57.0% in patients with cardiometabolic multimorbidity (P  =  .042). Those with type 2 diabetes had a significantly better drug retention rate than those without (P  =  .044).

Study details: Findings are from a retrospective study of prospectively followed-up patients with PsA (n = 207) who received secukinumab for at least 3 months.

Disclosures: The study did not disclose the source of funding. The authors declared no conflicts of interest.

Source: Ruscitti P et al. The assessment of the drug retention rate of secukinumab in patients with psoriatic arthritis in a real-life multicentre cohort. Clin Exp Rheumatol. 2023 (Jul 24). doi: 10.55563/clinexprheumatol/tpp63h

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Real-world study confirms efficacy and longer treatment persistence with ixekizumab

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Key clinical point: In the real-world setting, ixekizumab showed improvements in disease activity and treatment persistence in patients with psoriatic arthritis (PsA) with long-standing disease.

Major finding: The mean time of ixekizumab persistence was 86.9 weeks with the persistence rates at 24, 48, and 104 weeks being 95.5%, 84.3%, and 68.5%, respectively. The Disease Activity in Psoriatic Arthritis score reduced significantly from 23.7 at baseline to 14.8 (P  =  .005) and 14.3 (P  =  .004) at 12 and 24 weeks, respectively, of ixekizumab treatment.

Study details: Findings are from an observational, retrospective longitudinal study including 89 adult patients with PsA who initiated ixekizumab.

Disclosures: This study was funded by Eli Lilly & Co. Three authors declared being employees of Lilly and two authors reported employment with a consulting company funded by Lilly. Five authors reported ties with various sources, including Lilly. Other authors declared no conflicts of interest.

Source: Joven B et al. Persistence and use of Ixekizumab in patients with psoriatic arthritis in real-world practice in Spain. The PRO-STIP Study. Rheumatol Ther. 2023 (Jul 23). doi: 10.1007/s40744-023-00584-8

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Key clinical point: In the real-world setting, ixekizumab showed improvements in disease activity and treatment persistence in patients with psoriatic arthritis (PsA) with long-standing disease.

Major finding: The mean time of ixekizumab persistence was 86.9 weeks with the persistence rates at 24, 48, and 104 weeks being 95.5%, 84.3%, and 68.5%, respectively. The Disease Activity in Psoriatic Arthritis score reduced significantly from 23.7 at baseline to 14.8 (P  =  .005) and 14.3 (P  =  .004) at 12 and 24 weeks, respectively, of ixekizumab treatment.

Study details: Findings are from an observational, retrospective longitudinal study including 89 adult patients with PsA who initiated ixekizumab.

Disclosures: This study was funded by Eli Lilly & Co. Three authors declared being employees of Lilly and two authors reported employment with a consulting company funded by Lilly. Five authors reported ties with various sources, including Lilly. Other authors declared no conflicts of interest.

Source: Joven B et al. Persistence and use of Ixekizumab in patients with psoriatic arthritis in real-world practice in Spain. The PRO-STIP Study. Rheumatol Ther. 2023 (Jul 23). doi: 10.1007/s40744-023-00584-8

Key clinical point: In the real-world setting, ixekizumab showed improvements in disease activity and treatment persistence in patients with psoriatic arthritis (PsA) with long-standing disease.

Major finding: The mean time of ixekizumab persistence was 86.9 weeks with the persistence rates at 24, 48, and 104 weeks being 95.5%, 84.3%, and 68.5%, respectively. The Disease Activity in Psoriatic Arthritis score reduced significantly from 23.7 at baseline to 14.8 (P  =  .005) and 14.3 (P  =  .004) at 12 and 24 weeks, respectively, of ixekizumab treatment.

Study details: Findings are from an observational, retrospective longitudinal study including 89 adult patients with PsA who initiated ixekizumab.

Disclosures: This study was funded by Eli Lilly & Co. Three authors declared being employees of Lilly and two authors reported employment with a consulting company funded by Lilly. Five authors reported ties with various sources, including Lilly. Other authors declared no conflicts of interest.

Source: Joven B et al. Persistence and use of Ixekizumab in patients with psoriatic arthritis in real-world practice in Spain. The PRO-STIP Study. Rheumatol Ther. 2023 (Jul 23). doi: 10.1007/s40744-023-00584-8

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Differential synovial and serum B-cell signatures between autoantibody-negative and autoantibody-positive RA

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Key clinical point: Synovial and serum B-lymphocyte involvement differ between autoantibody-positive and autoantibody-negative rheumatoid arthritis (RA), with autoantibody-negative RA closely resembling that in polyarticular psoriatic arthritis (PsA).

Major finding: The CD20+ B-cell aggregational score was significantly lower in autoantibody-negative RA than in autoantibody-positive RA (mean 1.8 vs 2.4; P  =  .03) but comparable to that of polyarticular PsA (P  =  .78). The frequency of lympho-myeloid synovitis was lower in autoantibody-negative RA than in autoantibody-positive RA (38.2% vs 62.9%; P  =  .07) but comparable to that of polyarticular PsA (P  =  .8).

Study details: This study included 131 patients who underwent synovial biopsy and were categorized into those having autoantibody-positive RA (n = 43), autoantibody-negative RA (n = 35), symmetric polyarticular PsA (n = 25), and asymmetric oligoarticular PsA (n = 28).

Disclosures: This study was supported by IRCCS Policlinico San Matteo Foundation, Pavia, Italy. C Montecucco and S Bugatti reported receiving grants or research support and personal fees from various sources. The remaining authors declared no conflicts of interest.

Source: De Stefano L et al. Synovial and serum B-cell signature of autoantibody-negative rheumatoid arthritis versus autoantibody-positive rheumatoid arthritis and psoriatic arthritis. Rheumatology (Oxford). 2023 (Jul 22). doi: 10.1093/rheumatology/kead378

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Key clinical point: Synovial and serum B-lymphocyte involvement differ between autoantibody-positive and autoantibody-negative rheumatoid arthritis (RA), with autoantibody-negative RA closely resembling that in polyarticular psoriatic arthritis (PsA).

Major finding: The CD20+ B-cell aggregational score was significantly lower in autoantibody-negative RA than in autoantibody-positive RA (mean 1.8 vs 2.4; P  =  .03) but comparable to that of polyarticular PsA (P  =  .78). The frequency of lympho-myeloid synovitis was lower in autoantibody-negative RA than in autoantibody-positive RA (38.2% vs 62.9%; P  =  .07) but comparable to that of polyarticular PsA (P  =  .8).

Study details: This study included 131 patients who underwent synovial biopsy and were categorized into those having autoantibody-positive RA (n = 43), autoantibody-negative RA (n = 35), symmetric polyarticular PsA (n = 25), and asymmetric oligoarticular PsA (n = 28).

Disclosures: This study was supported by IRCCS Policlinico San Matteo Foundation, Pavia, Italy. C Montecucco and S Bugatti reported receiving grants or research support and personal fees from various sources. The remaining authors declared no conflicts of interest.

Source: De Stefano L et al. Synovial and serum B-cell signature of autoantibody-negative rheumatoid arthritis versus autoantibody-positive rheumatoid arthritis and psoriatic arthritis. Rheumatology (Oxford). 2023 (Jul 22). doi: 10.1093/rheumatology/kead378

Key clinical point: Synovial and serum B-lymphocyte involvement differ between autoantibody-positive and autoantibody-negative rheumatoid arthritis (RA), with autoantibody-negative RA closely resembling that in polyarticular psoriatic arthritis (PsA).

Major finding: The CD20+ B-cell aggregational score was significantly lower in autoantibody-negative RA than in autoantibody-positive RA (mean 1.8 vs 2.4; P  =  .03) but comparable to that of polyarticular PsA (P  =  .78). The frequency of lympho-myeloid synovitis was lower in autoantibody-negative RA than in autoantibody-positive RA (38.2% vs 62.9%; P  =  .07) but comparable to that of polyarticular PsA (P  =  .8).

Study details: This study included 131 patients who underwent synovial biopsy and were categorized into those having autoantibody-positive RA (n = 43), autoantibody-negative RA (n = 35), symmetric polyarticular PsA (n = 25), and asymmetric oligoarticular PsA (n = 28).

Disclosures: This study was supported by IRCCS Policlinico San Matteo Foundation, Pavia, Italy. C Montecucco and S Bugatti reported receiving grants or research support and personal fees from various sources. The remaining authors declared no conflicts of interest.

Source: De Stefano L et al. Synovial and serum B-cell signature of autoantibody-negative rheumatoid arthritis versus autoantibody-positive rheumatoid arthritis and psoriatic arthritis. Rheumatology (Oxford). 2023 (Jul 22). doi: 10.1093/rheumatology/kead378

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Anti-IL-23 treatment may increase the risk for ischemic cerebral stroke in PsA

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Key clinical point: Patients with psoriasis or psoriatic arthritis (PsA) treated with anti-interleukin-23 (anti-IL-23) antibodies are at a significantly higher risk for ischemic cerebral stroke (ICS) compared with individuals from the general population.

Major finding: The risk for ICS was significantly higher among patients receiving anti-IL-23 treatment compared with individuals from the general population (hazard ratio 1.770; P  =  .03).

Study details: This comparative observational study included patients with psoriasis or PsA who received anti-IL-23 (n = 7051), anti-IL-17 (n = 12,215), anti-IL-12/23 (n = 2819), anti-tumor necrosis factor-α (n = 2133), or apremilast (n = 13,139) therapy, whereas individuals with at least 1 healthcare consumption in a month formed the control group (n = 33,428,380).

Disclosures: This study did not receive any funding. T Passeron declared receiving grants or honoraria from various sources. The other authors declared no conflicts of interest.

Source: Bulsei J et al. Ischemic cerebral stroke risk under psoriasis and psoriatic arthritis treatment: A real-world observational study from the French national healthcare system database. J Eur Acad Dermatol Venereol. 2023 (Jul 17). doi: 10.1111/jdv.19356

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Key clinical point: Patients with psoriasis or psoriatic arthritis (PsA) treated with anti-interleukin-23 (anti-IL-23) antibodies are at a significantly higher risk for ischemic cerebral stroke (ICS) compared with individuals from the general population.

Major finding: The risk for ICS was significantly higher among patients receiving anti-IL-23 treatment compared with individuals from the general population (hazard ratio 1.770; P  =  .03).

Study details: This comparative observational study included patients with psoriasis or PsA who received anti-IL-23 (n = 7051), anti-IL-17 (n = 12,215), anti-IL-12/23 (n = 2819), anti-tumor necrosis factor-α (n = 2133), or apremilast (n = 13,139) therapy, whereas individuals with at least 1 healthcare consumption in a month formed the control group (n = 33,428,380).

Disclosures: This study did not receive any funding. T Passeron declared receiving grants or honoraria from various sources. The other authors declared no conflicts of interest.

Source: Bulsei J et al. Ischemic cerebral stroke risk under psoriasis and psoriatic arthritis treatment: A real-world observational study from the French national healthcare system database. J Eur Acad Dermatol Venereol. 2023 (Jul 17). doi: 10.1111/jdv.19356

Key clinical point: Patients with psoriasis or psoriatic arthritis (PsA) treated with anti-interleukin-23 (anti-IL-23) antibodies are at a significantly higher risk for ischemic cerebral stroke (ICS) compared with individuals from the general population.

Major finding: The risk for ICS was significantly higher among patients receiving anti-IL-23 treatment compared with individuals from the general population (hazard ratio 1.770; P  =  .03).

Study details: This comparative observational study included patients with psoriasis or PsA who received anti-IL-23 (n = 7051), anti-IL-17 (n = 12,215), anti-IL-12/23 (n = 2819), anti-tumor necrosis factor-α (n = 2133), or apremilast (n = 13,139) therapy, whereas individuals with at least 1 healthcare consumption in a month formed the control group (n = 33,428,380).

Disclosures: This study did not receive any funding. T Passeron declared receiving grants or honoraria from various sources. The other authors declared no conflicts of interest.

Source: Bulsei J et al. Ischemic cerebral stroke risk under psoriasis and psoriatic arthritis treatment: A real-world observational study from the French national healthcare system database. J Eur Acad Dermatol Venereol. 2023 (Jul 17). doi: 10.1111/jdv.19356

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Ultrasound can be a useful tool in detecting subclinical juvenile psoriatic arthritis

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Key clinical point: Musculoskeletal ultrasound along with physical examination can help identify juvenile psoriatic arthritis in pediatric patients with skin psoriasis showing musculoskeletal symptoms.

Major finding: Ultrasound evaluation showed higher number of joint and enthesitis abnormalities in pediatric patients with psoriasis who were symptomatic vs asymptomatic for musculoskeletal pain or swelling (all P .01). The concordance for detecting synovitis and enthesitis between physical and ultrasound examination was 82%.

Study details: Findings are from a cross-sectional study including 57 pediatric patients with psoriasis and no previous diagnosis of juvenile idiopathic arthritis or any systemic disease-causing articular manifestations who underwent ultrasound evaluation and clinical examination.

Disclosures: This study was supported by the PARTNER Fellowship program created with an unrestricted grant by Celgene-AMGEN, with L Coronel as a PARTNER fellow. Two authors declared ties with various sources, including Amgen. Two authors declared no conflicts of interest.

Source: Coronel L et al. Prevalence of ultrasound and clinical findings suggestive of inflammatory arthritis in children with skin psoriasis. Rheumatology (Oxford). 2023 (Aug 4). doi: 10.1093/rheumatology/kead398

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Key clinical point: Musculoskeletal ultrasound along with physical examination can help identify juvenile psoriatic arthritis in pediatric patients with skin psoriasis showing musculoskeletal symptoms.

Major finding: Ultrasound evaluation showed higher number of joint and enthesitis abnormalities in pediatric patients with psoriasis who were symptomatic vs asymptomatic for musculoskeletal pain or swelling (all P .01). The concordance for detecting synovitis and enthesitis between physical and ultrasound examination was 82%.

Study details: Findings are from a cross-sectional study including 57 pediatric patients with psoriasis and no previous diagnosis of juvenile idiopathic arthritis or any systemic disease-causing articular manifestations who underwent ultrasound evaluation and clinical examination.

Disclosures: This study was supported by the PARTNER Fellowship program created with an unrestricted grant by Celgene-AMGEN, with L Coronel as a PARTNER fellow. Two authors declared ties with various sources, including Amgen. Two authors declared no conflicts of interest.

Source: Coronel L et al. Prevalence of ultrasound and clinical findings suggestive of inflammatory arthritis in children with skin psoriasis. Rheumatology (Oxford). 2023 (Aug 4). doi: 10.1093/rheumatology/kead398

Key clinical point: Musculoskeletal ultrasound along with physical examination can help identify juvenile psoriatic arthritis in pediatric patients with skin psoriasis showing musculoskeletal symptoms.

Major finding: Ultrasound evaluation showed higher number of joint and enthesitis abnormalities in pediatric patients with psoriasis who were symptomatic vs asymptomatic for musculoskeletal pain or swelling (all P .01). The concordance for detecting synovitis and enthesitis between physical and ultrasound examination was 82%.

Study details: Findings are from a cross-sectional study including 57 pediatric patients with psoriasis and no previous diagnosis of juvenile idiopathic arthritis or any systemic disease-causing articular manifestations who underwent ultrasound evaluation and clinical examination.

Disclosures: This study was supported by the PARTNER Fellowship program created with an unrestricted grant by Celgene-AMGEN, with L Coronel as a PARTNER fellow. Two authors declared ties with various sources, including Amgen. Two authors declared no conflicts of interest.

Source: Coronel L et al. Prevalence of ultrasound and clinical findings suggestive of inflammatory arthritis in children with skin psoriasis. Rheumatology (Oxford). 2023 (Aug 4). doi: 10.1093/rheumatology/kead398

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Factors associated with depressive symptoms in PsA

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Key clinical point: Depression is prevalent in patients with psoriatic arthritis (PsA), with patients not engaging in sports activities, experiencing fatigue, and having functional impairment being more likely to suffer from depression.

Major finding: Overall, 8.2% and 20.9% of patients with PsA had severe and moderate depressive symptoms, respectively. The odds of having depressive symptoms were higher in patients with functional impairment (odds ratio [OR] 1.08; P < .0001) and those experiencing fatigue (OR 1.56; P < .0001), whereas those engaging in sports for at least 1 hour/week were less likely to be depressed (OR 0.61; P  =  .0017).

Study details: This study included 1225 patients with PsA and 1245 patients with axial spondyloarthritis from the RABBIT-SpA cohort.

Disclosures: This study received open access funding from Projekt Deal, and RABBIT-SpA is supported by a joint, unconditional grant from AbbVie, Amgen, Biogen, and various other sources. The authors declared no conflicts of interest.

Source: Reich A et al. Depressive symptoms are associated with fatigue, poorer functional status and less engagement in sports in axSpA and PsA: An analysis from the RABBIT-SpA cohort. Arthritis Res Ther. 2023;25:136 (Aug 2). doi: 10.1186/s13075-023-03127-2.

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Key clinical point: Depression is prevalent in patients with psoriatic arthritis (PsA), with patients not engaging in sports activities, experiencing fatigue, and having functional impairment being more likely to suffer from depression.

Major finding: Overall, 8.2% and 20.9% of patients with PsA had severe and moderate depressive symptoms, respectively. The odds of having depressive symptoms were higher in patients with functional impairment (odds ratio [OR] 1.08; P < .0001) and those experiencing fatigue (OR 1.56; P < .0001), whereas those engaging in sports for at least 1 hour/week were less likely to be depressed (OR 0.61; P  =  .0017).

Study details: This study included 1225 patients with PsA and 1245 patients with axial spondyloarthritis from the RABBIT-SpA cohort.

Disclosures: This study received open access funding from Projekt Deal, and RABBIT-SpA is supported by a joint, unconditional grant from AbbVie, Amgen, Biogen, and various other sources. The authors declared no conflicts of interest.

Source: Reich A et al. Depressive symptoms are associated with fatigue, poorer functional status and less engagement in sports in axSpA and PsA: An analysis from the RABBIT-SpA cohort. Arthritis Res Ther. 2023;25:136 (Aug 2). doi: 10.1186/s13075-023-03127-2.

Key clinical point: Depression is prevalent in patients with psoriatic arthritis (PsA), with patients not engaging in sports activities, experiencing fatigue, and having functional impairment being more likely to suffer from depression.

Major finding: Overall, 8.2% and 20.9% of patients with PsA had severe and moderate depressive symptoms, respectively. The odds of having depressive symptoms were higher in patients with functional impairment (odds ratio [OR] 1.08; P < .0001) and those experiencing fatigue (OR 1.56; P < .0001), whereas those engaging in sports for at least 1 hour/week were less likely to be depressed (OR 0.61; P  =  .0017).

Study details: This study included 1225 patients with PsA and 1245 patients with axial spondyloarthritis from the RABBIT-SpA cohort.

Disclosures: This study received open access funding from Projekt Deal, and RABBIT-SpA is supported by a joint, unconditional grant from AbbVie, Amgen, Biogen, and various other sources. The authors declared no conflicts of interest.

Source: Reich A et al. Depressive symptoms are associated with fatigue, poorer functional status and less engagement in sports in axSpA and PsA: An analysis from the RABBIT-SpA cohort. Arthritis Res Ther. 2023;25:136 (Aug 2). doi: 10.1186/s13075-023-03127-2.

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