Rheumatoid Arthritis

Key clinical point: Multimorbidity was more prevalent in women vs men with rheumatoid arthritis (RA), with psychological and musculoskeletal conditions being more prevalent in women and cardiovascular-related conditions being more prevalent in men, thus highlighting the need for individualized treatment plans.

Major finding: Among patients with RA age 18-50 years, women vs men were at higher risk for ≥ 2 morbidities (difference in adjusted absolute risk [Δ] 7.5 percentage points; P < .001) and ≥ 5 morbidities (Δ 4.4 percentage points; P < .001). Moreover, the prevalence of psychological and musculoskeletal conditions was higher in women vs men with RA, whereas the prevalence of cardiovascular-related conditions was higher in men vs women with RA (all P < .05).

Study details: This cross-sectional analysis of national administrative claims data from the OptumLabs Data Warehouse included 154,391 patients with RA who were matched with 154,391 comparator individuals without RA.

Disclosures: This study was supported by grants from the US National Institutes of Health and other sources. The authors declared no conflicts of interest. Two authors declared receiving unrelated funding support from various sources.

Source: Stevens MA et al. Disparities in multimorbidity and comorbidities in rheumatoid arthritis by sex acrossthe lifespan. Rheumatology (Oxford). 2023 (Aug 31). doi: 10.1093/rheumatology/kead454

Key clinical point: Multimorbidity was more prevalent in women vs men with rheumatoid arthritis (RA), with psychological and musculoskeletal conditions being more prevalent in women and cardiovascular-related conditions being more prevalent in men, thus highlighting the need for individualized treatment plans.

Major finding: Among patients with RA age 18-50 years, women vs men were at higher risk for ≥ 2 morbidities (difference in adjusted absolute risk [Δ] 7.5 percentage points; P < .001) and ≥ 5 morbidities (Δ 4.4 percentage points; P < .001). Moreover, the prevalence of psychological and musculoskeletal conditions was higher in women vs men with RA, whereas the prevalence of cardiovascular-related conditions was higher in men vs women with RA (all P < .05).

Study details: This cross-sectional analysis of national administrative claims data from the OptumLabs Data Warehouse included 154,391 patients with RA who were matched with 154,391 comparator individuals without RA.

Disclosures: This study was supported by grants from the US National Institutes of Health and other sources. The authors declared no conflicts of interest. Two authors declared receiving unrelated funding support from various sources.

Source: Stevens MA et al. Disparities in multimorbidity and comorbidities in rheumatoid arthritis by sex acrossthe lifespan. Rheumatology (Oxford). 2023 (Aug 31). doi: 10.1093/rheumatology/kead454

Key clinical point: Multimorbidity was more prevalent in women vs men with rheumatoid arthritis (RA), with psychological and musculoskeletal conditions being more prevalent in women and cardiovascular-related conditions being more prevalent in men, thus highlighting the need for individualized treatment plans.

Major finding: Among patients with RA age 18-50 years, women vs men were at higher risk for ≥ 2 morbidities (difference in adjusted absolute risk [Δ] 7.5 percentage points; P < .001) and ≥ 5 morbidities (Δ 4.4 percentage points; P < .001). Moreover, the prevalence of psychological and musculoskeletal conditions was higher in women vs men with RA, whereas the prevalence of cardiovascular-related conditions was higher in men vs women with RA (all P < .05).

Study details: This cross-sectional analysis of national administrative claims data from the OptumLabs Data Warehouse included 154,391 patients with RA who were matched with 154,391 comparator individuals without RA.

Disclosures: This study was supported by grants from the US National Institutes of Health and other sources. The authors declared no conflicts of interest. Two authors declared receiving unrelated funding support from various sources.

Source: Stevens MA et al. Disparities in multimorbidity and comorbidities in rheumatoid arthritis by sex acrossthe lifespan. Rheumatology (Oxford). 2023 (Aug 31). doi: 10.1093/rheumatology/kead454

Key clinical point: Janus kinase inhibitors (JAKi) were more potent in inhibiting bone mineral density (BMD) loss compared with other targeted therapies in patients with rheumatoid arthritis (RA), specifically in those with anti-cyclic citrullinated peptide antibody (ACPA)-positive RA.

Major finding: JAKi therapy led to greater gains in bilateral femoral BMD than conventional synthetic disease-modifying antirheumatic drugs (csDMARD; P < .05), tumor necrosis factor inhibitors (TNFi), and non-TNFi biologics, with the improvements in femoral BMD being significant in patients with ACPA-positive RA (P < .01) but not in those with ACPA-negative RA. Similar trends were observed for BMD values at the lumbar spine.

Study details: This retrospective observational study included 362 patients with RA who were treated with JAKi, csDMARD, TNFi, and non-TNFi biologics.

Disclosures: This study was supported by the National Science and Technology Council, Taiwan, and other sources. The authors declared no conflicts of interest.

Source: Chen YW et al. Potential alleviation of bone mineral density loss with Janus kinase inhibitors in rheumatoid arthritis. Clin Rheumatol. 2023 (Sep 2). doi: 10.1007/s10067-023-06735-0

Key clinical point: Janus kinase inhibitors (JAKi) were more potent in inhibiting bone mineral density (BMD) loss compared with other targeted therapies in patients with rheumatoid arthritis (RA), specifically in those with anti-cyclic citrullinated peptide antibody (ACPA)-positive RA.

Major finding: JAKi therapy led to greater gains in bilateral femoral BMD than conventional synthetic disease-modifying antirheumatic drugs (csDMARD; P < .05), tumor necrosis factor inhibitors (TNFi), and non-TNFi biologics, with the improvements in femoral BMD being significant in patients with ACPA-positive RA (P < .01) but not in those with ACPA-negative RA. Similar trends were observed for BMD values at the lumbar spine.

Study details: This retrospective observational study included 362 patients with RA who were treated with JAKi, csDMARD, TNFi, and non-TNFi biologics.

Disclosures: This study was supported by the National Science and Technology Council, Taiwan, and other sources. The authors declared no conflicts of interest.

Source: Chen YW et al. Potential alleviation of bone mineral density loss with Janus kinase inhibitors in rheumatoid arthritis. Clin Rheumatol. 2023 (Sep 2). doi: 10.1007/s10067-023-06735-0

Key clinical point: Janus kinase inhibitors (JAKi) were more potent in inhibiting bone mineral density (BMD) loss compared with other targeted therapies in patients with rheumatoid arthritis (RA), specifically in those with anti-cyclic citrullinated peptide antibody (ACPA)-positive RA.

Major finding: JAKi therapy led to greater gains in bilateral femoral BMD than conventional synthetic disease-modifying antirheumatic drugs (csDMARD; P < .05), tumor necrosis factor inhibitors (TNFi), and non-TNFi biologics, with the improvements in femoral BMD being significant in patients with ACPA-positive RA (P < .01) but not in those with ACPA-negative RA. Similar trends were observed for BMD values at the lumbar spine.

Study details: This retrospective observational study included 362 patients with RA who were treated with JAKi, csDMARD, TNFi, and non-TNFi biologics.

Disclosures: This study was supported by the National Science and Technology Council, Taiwan, and other sources. The authors declared no conflicts of interest.

Source: Chen YW et al. Potential alleviation of bone mineral density loss with Janus kinase inhibitors in rheumatoid arthritis. Clin Rheumatol. 2023 (Sep 2). doi: 10.1007/s10067-023-06735-0

Key clinical point: Circulating semaphorin 4A (SEMA4A) serum levels predicted treatment failure and showed an association with response to therapy in patients with rheumatoid arthritis (RA).

Major finding: Baseline serum levels of SEMA4A > 94 ng/mL predicted the risk for treatment failure defined by the occurrence of flares and treatment escalation (adjusted hazard ratio [aHR] 2.73; 95% CI 1.24-5.96). The baseline SEMA4A serum levels were significantly higher in patients who experienced no or moderate response than in those with a good response (P = .035).

Study details: The data come from a prospective observational routine care study that included two cohorts; the first cohort comprised 101 patients with established RA and the second comprised 40 patients with RA who initiated new therapy due to insufficient disease control.

Disclosures: E Vandebeuque declared receiving grants from the Société Française de Rhumatologie, Paris, and other sources. The authors declared no conflicts of interest.

Source: Avouac J et al. Relevance of circulating Semaphorin 4A for rheumatoid arthritis response to treatment. Sci Rep. 2023;13:14626 (Sep 5). doi: 10.1038/s41598-023-41943-3

Key clinical point: Circulating semaphorin 4A (SEMA4A) serum levels predicted treatment failure and showed an association with response to therapy in patients with rheumatoid arthritis (RA).

Major finding: Baseline serum levels of SEMA4A > 94 ng/mL predicted the risk for treatment failure defined by the occurrence of flares and treatment escalation (adjusted hazard ratio [aHR] 2.73; 95% CI 1.24-5.96). The baseline SEMA4A serum levels were significantly higher in patients who experienced no or moderate response than in those with a good response (P = .035).

Study details: The data come from a prospective observational routine care study that included two cohorts; the first cohort comprised 101 patients with established RA and the second comprised 40 patients with RA who initiated new therapy due to insufficient disease control.

Disclosures: E Vandebeuque declared receiving grants from the Société Française de Rhumatologie, Paris, and other sources. The authors declared no conflicts of interest.

Source: Avouac J et al. Relevance of circulating Semaphorin 4A for rheumatoid arthritis response to treatment. Sci Rep. 2023;13:14626 (Sep 5). doi: 10.1038/s41598-023-41943-3

Key clinical point: Circulating semaphorin 4A (SEMA4A) serum levels predicted treatment failure and showed an association with response to therapy in patients with rheumatoid arthritis (RA).

Major finding: Baseline serum levels of SEMA4A > 94 ng/mL predicted the risk for treatment failure defined by the occurrence of flares and treatment escalation (adjusted hazard ratio [aHR] 2.73; 95% CI 1.24-5.96). The baseline SEMA4A serum levels were significantly higher in patients who experienced no or moderate response than in those with a good response (P = .035).

Study details: The data come from a prospective observational routine care study that included two cohorts; the first cohort comprised 101 patients with established RA and the second comprised 40 patients with RA who initiated new therapy due to insufficient disease control.

Disclosures: E Vandebeuque declared receiving grants from the Société Française de Rhumatologie, Paris, and other sources. The authors declared no conflicts of interest.

Source: Avouac J et al. Relevance of circulating Semaphorin 4A for rheumatoid arthritis response to treatment. Sci Rep. 2023;13:14626 (Sep 5). doi: 10.1038/s41598-023-41943-3

Key clinical point: Tofacitinib combined with iguratimod relieves clinical symptoms and results in a higher response rate compared with conventional synthetic disease-modifying antirheumatic drugs (csDMARD) in patients with rheumatoid arthritis with usual interstitial pneumonia (RA-UIP).

Major finding: After 6 months, treatment with tofacitinib + iguratimod vs csDMARD significantly improved forced vital capacity percentage (P = .031) and high-resolution computed tomography fibrosis score (P = .015) and resulted in a higher overall response rate (66.7% vs 35.7%; P = .027), with no patients discontinuing tofacitinib or iguratimod due to side effects or poor efficacy.

Study details:This prospective observational cohort study included 78 patients with RA-UIP who received tofacitinib + iguratimod, csDMARD + iguratimod, or csDMARD.

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

Source: Wang S et al. A prospective observational cohort study of the efficacy of tofacitinib plus iguratimod on rheumatoid arthritis with usual interstitial pneumonia. Front Immunol. 2023;14:1215450 (Aug 23). doi: 10.3389/fimmu.2023.1215450

Key clinical point: Tofacitinib combined with iguratimod relieves clinical symptoms and results in a higher response rate compared with conventional synthetic disease-modifying antirheumatic drugs (csDMARD) in patients with rheumatoid arthritis with usual interstitial pneumonia (RA-UIP).

Major finding: After 6 months, treatment with tofacitinib + iguratimod vs csDMARD significantly improved forced vital capacity percentage (P = .031) and high-resolution computed tomography fibrosis score (P = .015) and resulted in a higher overall response rate (66.7% vs 35.7%; P = .027), with no patients discontinuing tofacitinib or iguratimod due to side effects or poor efficacy.

Study details:This prospective observational cohort study included 78 patients with RA-UIP who received tofacitinib + iguratimod, csDMARD + iguratimod, or csDMARD.

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

Source: Wang S et al. A prospective observational cohort study of the efficacy of tofacitinib plus iguratimod on rheumatoid arthritis with usual interstitial pneumonia. Front Immunol. 2023;14:1215450 (Aug 23). doi: 10.3389/fimmu.2023.1215450

Key clinical point: Tofacitinib combined with iguratimod relieves clinical symptoms and results in a higher response rate compared with conventional synthetic disease-modifying antirheumatic drugs (csDMARD) in patients with rheumatoid arthritis with usual interstitial pneumonia (RA-UIP).

Major finding: After 6 months, treatment with tofacitinib + iguratimod vs csDMARD significantly improved forced vital capacity percentage (P = .031) and high-resolution computed tomography fibrosis score (P = .015) and resulted in a higher overall response rate (66.7% vs 35.7%; P = .027), with no patients discontinuing tofacitinib or iguratimod due to side effects or poor efficacy.

Study details:This prospective observational cohort study included 78 patients with RA-UIP who received tofacitinib + iguratimod, csDMARD + iguratimod, or csDMARD.

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

Source: Wang S et al. A prospective observational cohort study of the efficacy of tofacitinib plus iguratimod on rheumatoid arthritis with usual interstitial pneumonia. Front Immunol. 2023;14:1215450 (Aug 23). doi: 10.3389/fimmu.2023.1215450

Key clinical point: First-line biologic treatment with tocilizumab significantly reduced disease activity scores and demonstrated a good safety profile in a real-world cohort of patients with rheumatoid arthritis (RA) who had had an inadequate response to disease-modifying antirheumatic drugs (DMARD-IR).

Major finding: At 12 months, tocilizumab treatment led to significant reductions in disease activity scores (all P < .001), with 85.5% of patients receiving tocilizumab achieving remission or low disease activity according to the Disease Activity Score of 28 Joints; however, 22.0% of patients switched to other biologic DMARD either due to inefficacy or side effects.

Study details: Findings are from an analysis of 258 patients with RA from the TReasure Registry who were DMARD-IR and received first-line biologic therapy with tocilizumab as monotherapy (n = 80) or in combination with conventional synthetic DMARD (n = 178).

Disclosures: This study was sponsored by Roche Pharmaceuticals, Turkey, and funded by Hacettepe Rheumatology Society, Ankara. Some authors, including the lead author, declared receiving research support, consulting fees, or honoraria from and having other ties with Roche and other sources.

Source: Karadag O et al. Tocilizumab as a first line biologic agent in rheumatoid arthritis patients with inadequate response to disease-modifying anti-rheumatic drugs: Real life experience from the TReasure Registry. Clin Exp Rheumatol. 2023 (Aug 29). doi: 10.55563/clinexprheumatol/2h6ma1

Key clinical point: First-line biologic treatment with tocilizumab significantly reduced disease activity scores and demonstrated a good safety profile in a real-world cohort of patients with rheumatoid arthritis (RA) who had had an inadequate response to disease-modifying antirheumatic drugs (DMARD-IR).

Major finding: At 12 months, tocilizumab treatment led to significant reductions in disease activity scores (all P < .001), with 85.5% of patients receiving tocilizumab achieving remission or low disease activity according to the Disease Activity Score of 28 Joints; however, 22.0% of patients switched to other biologic DMARD either due to inefficacy or side effects.

Study details: Findings are from an analysis of 258 patients with RA from the TReasure Registry who were DMARD-IR and received first-line biologic therapy with tocilizumab as monotherapy (n = 80) or in combination with conventional synthetic DMARD (n = 178).

Disclosures: This study was sponsored by Roche Pharmaceuticals, Turkey, and funded by Hacettepe Rheumatology Society, Ankara. Some authors, including the lead author, declared receiving research support, consulting fees, or honoraria from and having other ties with Roche and other sources.

Source: Karadag O et al. Tocilizumab as a first line biologic agent in rheumatoid arthritis patients with inadequate response to disease-modifying anti-rheumatic drugs: Real life experience from the TReasure Registry. Clin Exp Rheumatol. 2023 (Aug 29). doi: 10.55563/clinexprheumatol/2h6ma1

Key clinical point: First-line biologic treatment with tocilizumab significantly reduced disease activity scores and demonstrated a good safety profile in a real-world cohort of patients with rheumatoid arthritis (RA) who had had an inadequate response to disease-modifying antirheumatic drugs (DMARD-IR).

Major finding: At 12 months, tocilizumab treatment led to significant reductions in disease activity scores (all P < .001), with 85.5% of patients receiving tocilizumab achieving remission or low disease activity according to the Disease Activity Score of 28 Joints; however, 22.0% of patients switched to other biologic DMARD either due to inefficacy or side effects.

Study details: Findings are from an analysis of 258 patients with RA from the TReasure Registry who were DMARD-IR and received first-line biologic therapy with tocilizumab as monotherapy (n = 80) or in combination with conventional synthetic DMARD (n = 178).

Disclosures: This study was sponsored by Roche Pharmaceuticals, Turkey, and funded by Hacettepe Rheumatology Society, Ankara. Some authors, including the lead author, declared receiving research support, consulting fees, or honoraria from and having other ties with Roche and other sources.

Source: Karadag O et al. Tocilizumab as a first line biologic agent in rheumatoid arthritis patients with inadequate response to disease-modifying anti-rheumatic drugs: Real life experience from the TReasure Registry. Clin Exp Rheumatol. 2023 (Aug 29). doi: 10.55563/clinexprheumatol/2h6ma1

Key clinical point: Patients with early rheumatoid arthritis (RA) presenting with mono- or oligo-arthritis and high perceived disease impact as assessed by Patient Global Assessment (PGA) scores have severe persistent fatigue over time and may benefit from early nonpharmacologic interventions for fatigue.

Major finding: During the 5-year follow-up, the average fatigue score was significantly higher in patients presenting with mono-arthritis (mean difference in fatigue score [β] +4.3 mm; P = .038) and oligo-arthritis (β +4.8 mm; P = .001) vs poly-arthritis at diagnosis, whereas it was significantly lower in patients presenting with poly-arthritis and low PGA scores vs mono- or oligo-arthritis and high PGA scores (β −20 mm; P < .001).

Study details: This study evaluated 1560 and 415 patients with early RA from the Leiden Early Arthritis Cohort and the Treatment in the Rotterdam Early Arthritis Cohort, respectively.

Disclosures: This study was supported by the European Research Council and the Dutch Arthritis Society. The authors declared no conflicts of interest.

Source: Boeren AMP et al. Rheumatoid arthritis presenting with mono- or oligo-arthritis and high VAS remains most fatigued during 5-years follow-up. Rheumatology (Oxford). 2023 (Aug 26). doi: 10.1093/rheumatology/kead429

Key clinical point: Patients with early rheumatoid arthritis (RA) presenting with mono- or oligo-arthritis and high perceived disease impact as assessed by Patient Global Assessment (PGA) scores have severe persistent fatigue over time and may benefit from early nonpharmacologic interventions for fatigue.

Major finding: During the 5-year follow-up, the average fatigue score was significantly higher in patients presenting with mono-arthritis (mean difference in fatigue score [β] +4.3 mm; P = .038) and oligo-arthritis (β +4.8 mm; P = .001) vs poly-arthritis at diagnosis, whereas it was significantly lower in patients presenting with poly-arthritis and low PGA scores vs mono- or oligo-arthritis and high PGA scores (β −20 mm; P < .001).

Study details: This study evaluated 1560 and 415 patients with early RA from the Leiden Early Arthritis Cohort and the Treatment in the Rotterdam Early Arthritis Cohort, respectively.

Disclosures: This study was supported by the European Research Council and the Dutch Arthritis Society. The authors declared no conflicts of interest.

Source: Boeren AMP et al. Rheumatoid arthritis presenting with mono- or oligo-arthritis and high VAS remains most fatigued during 5-years follow-up. Rheumatology (Oxford). 2023 (Aug 26). doi: 10.1093/rheumatology/kead429

Key clinical point: Patients with early rheumatoid arthritis (RA) presenting with mono- or oligo-arthritis and high perceived disease impact as assessed by Patient Global Assessment (PGA) scores have severe persistent fatigue over time and may benefit from early nonpharmacologic interventions for fatigue.

Major finding: During the 5-year follow-up, the average fatigue score was significantly higher in patients presenting with mono-arthritis (mean difference in fatigue score [β] +4.3 mm; P = .038) and oligo-arthritis (β +4.8 mm; P = .001) vs poly-arthritis at diagnosis, whereas it was significantly lower in patients presenting with poly-arthritis and low PGA scores vs mono- or oligo-arthritis and high PGA scores (β −20 mm; P < .001).

Study details: This study evaluated 1560 and 415 patients with early RA from the Leiden Early Arthritis Cohort and the Treatment in the Rotterdam Early Arthritis Cohort, respectively.

Disclosures: This study was supported by the European Research Council and the Dutch Arthritis Society. The authors declared no conflicts of interest.

Source: Boeren AMP et al. Rheumatoid arthritis presenting with mono- or oligo-arthritis and high VAS remains most fatigued during 5-years follow-up. Rheumatology (Oxford). 2023 (Aug 26). doi: 10.1093/rheumatology/kead429

Key clinical point: In patients with newly diagnosed rheumatoid arthritis (RA), initial glucocorticoid bridging (GB) led to more rapid clinical improvements than non-bridging, without any apparent risk for increased glucocorticoid use after the intended bridging period.

Major finding: The risk of using glucocorticoids at 12 months was higher in the GB vs non-bridging group, but this risk reduced over time and was not significantly different at 18 and 24 months. The cumulative doses did not differ significantly between groups after the planned bridging schedule. Patients in the GB group showed more rapid improvements in the mean Disease Activity Score of 28 Joints during the first 6 months (P < .001).

Study details: This individual patient data meta-analysis combined data from three randomized clinical trials and included 625 patients with newly diagnosed RA who received conventional synthetic disease-modifying antirheumatic drugs with (n = 252) or without (n = 373) initial GB.

Disclosures: This study did not declare any specific funding source. Some authors declared receiving consultancy or speaker honoraria, fees, or grants from or providing expert advice or testimony for or serving as chair for various sources.

Source: van Ouwerkerk L et al. Initial glucocorticoid bridging in rheumatoid arthritis: Does it affect glucocorticoid use over time? Ann Rheum Dis. 2023 (Aug 22). doi: 10.1136/ard-2023-224270

Key clinical point: In patients with newly diagnosed rheumatoid arthritis (RA), initial glucocorticoid bridging (GB) led to more rapid clinical improvements than non-bridging, without any apparent risk for increased glucocorticoid use after the intended bridging period.

Major finding: The risk of using glucocorticoids at 12 months was higher in the GB vs non-bridging group, but this risk reduced over time and was not significantly different at 18 and 24 months. The cumulative doses did not differ significantly between groups after the planned bridging schedule. Patients in the GB group showed more rapid improvements in the mean Disease Activity Score of 28 Joints during the first 6 months (P < .001).

Study details: This individual patient data meta-analysis combined data from three randomized clinical trials and included 625 patients with newly diagnosed RA who received conventional synthetic disease-modifying antirheumatic drugs with (n = 252) or without (n = 373) initial GB.

Disclosures: This study did not declare any specific funding source. Some authors declared receiving consultancy or speaker honoraria, fees, or grants from or providing expert advice or testimony for or serving as chair for various sources.

Source: van Ouwerkerk L et al. Initial glucocorticoid bridging in rheumatoid arthritis: Does it affect glucocorticoid use over time? Ann Rheum Dis. 2023 (Aug 22). doi: 10.1136/ard-2023-224270

Key clinical point: In patients with newly diagnosed rheumatoid arthritis (RA), initial glucocorticoid bridging (GB) led to more rapid clinical improvements than non-bridging, without any apparent risk for increased glucocorticoid use after the intended bridging period.

Major finding: The risk of using glucocorticoids at 12 months was higher in the GB vs non-bridging group, but this risk reduced over time and was not significantly different at 18 and 24 months. The cumulative doses did not differ significantly between groups after the planned bridging schedule. Patients in the GB group showed more rapid improvements in the mean Disease Activity Score of 28 Joints during the first 6 months (P < .001).

Study details: This individual patient data meta-analysis combined data from three randomized clinical trials and included 625 patients with newly diagnosed RA who received conventional synthetic disease-modifying antirheumatic drugs with (n = 252) or without (n = 373) initial GB.

Disclosures: This study did not declare any specific funding source. Some authors declared receiving consultancy or speaker honoraria, fees, or grants from or providing expert advice or testimony for or serving as chair for various sources.

Source: van Ouwerkerk L et al. Initial glucocorticoid bridging in rheumatoid arthritis: Does it affect glucocorticoid use over time? Ann Rheum Dis. 2023 (Aug 22). doi: 10.1136/ard-2023-224270

Key clinical point: In patients with newly diagnosed rheumatoid arthritis (RA), initial glucocorticoid bridging (GB) led to more rapid clinical improvements than non-bridging, without any apparent risk for increased glucocorticoid use after the intended bridging period.

Major finding: The risk of using glucocorticoids at 12 months was higher in the GB vs non-bridging group, but this risk reduced over time and was not significantly different at 18 and 24 months. The cumulative doses did not differ significantly between groups after the planned bridging schedule. Patients in the GB group showed more rapid improvements in the mean Disease Activity Score of 28 Joints during the first 6 months (P < .001).

Study details: This individual patient data meta-analysis combined data from three randomized clinical trials and included 625 patients with newly diagnosed RA who received conventional synthetic disease-modifying antirheumatic drugs with (n = 252) or without (n = 373) initial GB.

Disclosures: This study did not declare any specific funding source. Some authors declared receiving consultancy or speaker honoraria, fees, or grants from or providing expert advice or testimony for or serving as chair for various sources.

Source: van Ouwerkerk L et al. Initial glucocorticoid bridging in rheumatoid arthritis: Does it affect glucocorticoid use over time? Ann Rheum Dis. 2023 (Aug 22). doi: 10.1136/ard-2023-224270

Key clinical point: In patients with newly diagnosed rheumatoid arthritis (RA), initial glucocorticoid bridging (GB) led to more rapid clinical improvements than non-bridging, without any apparent risk for increased glucocorticoid use after the intended bridging period.

Major finding: The risk of using glucocorticoids at 12 months was higher in the GB vs non-bridging group, but this risk reduced over time and was not significantly different at 18 and 24 months. The cumulative doses did not differ significantly between groups after the planned bridging schedule. Patients in the GB group showed more rapid improvements in the mean Disease Activity Score of 28 Joints during the first 6 months (P < .001).

Study details: This individual patient data meta-analysis combined data from three randomized clinical trials and included 625 patients with newly diagnosed RA who received conventional synthetic disease-modifying antirheumatic drugs with (n = 252) or without (n = 373) initial GB.

Disclosures: This study did not declare any specific funding source. Some authors declared receiving consultancy or speaker honoraria, fees, or grants from or providing expert advice or testimony for or serving as chair for various sources.

Source: van Ouwerkerk L et al. Initial glucocorticoid bridging in rheumatoid arthritis: Does it affect glucocorticoid use over time? Ann Rheum Dis. 2023 (Aug 22). doi: 10.1136/ard-2023-224270

Key clinical point: In patients with newly diagnosed rheumatoid arthritis (RA), initial glucocorticoid bridging (GB) led to more rapid clinical improvements than non-bridging, without any apparent risk for increased glucocorticoid use after the intended bridging period.

Major finding: The risk of using glucocorticoids at 12 months was higher in the GB vs non-bridging group, but this risk reduced over time and was not significantly different at 18 and 24 months. The cumulative doses did not differ significantly between groups after the planned bridging schedule. Patients in the GB group showed more rapid improvements in the mean Disease Activity Score of 28 Joints during the first 6 months (P < .001).

Study details: This individual patient data meta-analysis combined data from three randomized clinical trials and included 625 patients with newly diagnosed RA who received conventional synthetic disease-modifying antirheumatic drugs with (n = 252) or without (n = 373) initial GB.

Disclosures: This study did not declare any specific funding source. Some authors declared receiving consultancy or speaker honoraria, fees, or grants from or providing expert advice or testimony for or serving as chair for various sources.

Source: van Ouwerkerk L et al. Initial glucocorticoid bridging in rheumatoid arthritis: Does it affect glucocorticoid use over time? Ann Rheum Dis. 2023 (Aug 22). doi: 10.1136/ard-2023-224270

Key clinical point: Patients with rheumatoid arthritis (RA) in long-standing remission had a significant risk of experiencing a disease flare if the tumor necrosis factor inhibitor (TNFi) dose is tapered to discontinuation, but most patients regained remission after the original TNFi dose was reinstated.

Major finding: The frequency of disease activity flares during the 12-month follow-up was significantly higher among patients who tapered TNFi to discontinuation vs those who continued with the stable dose (risk difference 58%; P < .0001). However, reinstatement of the initial TNFi dose led to comparable remission rates in both treatment groups.

Study details: Findings are from the phase 4 ARCTIC REWIND trial including 92 patients with RA in sustained remission for ≥ 1 year on stable TNFi therapy and without swollen joints at inclusion, who were randomly assigned to either tapering of their TNFi dose to discontinuation or to a continued stable TNFi dose.

Disclosures: This study was funded by the Research Council of Norway and South-Eastern Norway Regional Health Authority. Some authors declared receiving personal fees or grants from various sources, including the study funders.

Source: Lillegraven S et al. Effect of tapered versus stable treatment with tumour necrosis factor inhibitors on disease flares in patients with rheumatoid arthritis in remission: A randomised, open label, non-inferiority trial. Ann Rheum Dis. 2023 (Aug 22). doi: 10.1136/ard-2023-224476

Key clinical point: Patients with rheumatoid arthritis (RA) in long-standing remission had a significant risk of experiencing a disease flare if the tumor necrosis factor inhibitor (TNFi) dose is tapered to discontinuation, but most patients regained remission after the original TNFi dose was reinstated.

Major finding: The frequency of disease activity flares during the 12-month follow-up was significantly higher among patients who tapered TNFi to discontinuation vs those who continued with the stable dose (risk difference 58%; P < .0001). However, reinstatement of the initial TNFi dose led to comparable remission rates in both treatment groups.

Study details: Findings are from the phase 4 ARCTIC REWIND trial including 92 patients with RA in sustained remission for ≥ 1 year on stable TNFi therapy and without swollen joints at inclusion, who were randomly assigned to either tapering of their TNFi dose to discontinuation or to a continued stable TNFi dose.

Disclosures: This study was funded by the Research Council of Norway and South-Eastern Norway Regional Health Authority. Some authors declared receiving personal fees or grants from various sources, including the study funders.

Source: Lillegraven S et al. Effect of tapered versus stable treatment with tumour necrosis factor inhibitors on disease flares in patients with rheumatoid arthritis in remission: A randomised, open label, non-inferiority trial. Ann Rheum Dis. 2023 (Aug 22). doi: 10.1136/ard-2023-224476

Key clinical point: Patients with rheumatoid arthritis (RA) in long-standing remission had a significant risk of experiencing a disease flare if the tumor necrosis factor inhibitor (TNFi) dose is tapered to discontinuation, but most patients regained remission after the original TNFi dose was reinstated.

Major finding: The frequency of disease activity flares during the 12-month follow-up was significantly higher among patients who tapered TNFi to discontinuation vs those who continued with the stable dose (risk difference 58%; P < .0001). However, reinstatement of the initial TNFi dose led to comparable remission rates in both treatment groups.

Study details: Findings are from the phase 4 ARCTIC REWIND trial including 92 patients with RA in sustained remission for ≥ 1 year on stable TNFi therapy and without swollen joints at inclusion, who were randomly assigned to either tapering of their TNFi dose to discontinuation or to a continued stable TNFi dose.

Disclosures: This study was funded by the Research Council of Norway and South-Eastern Norway Regional Health Authority. Some authors declared receiving personal fees or grants from various sources, including the study funders.

Source: Lillegraven S et al. Effect of tapered versus stable treatment with tumour necrosis factor inhibitors on disease flares in patients with rheumatoid arthritis in remission: A randomised, open label, non-inferiority trial. Ann Rheum Dis. 2023 (Aug 22). doi: 10.1136/ard-2023-224476

Key clinical point: The administration of low-dose glucocorticoids over 2 years resulted in a modest weight gain of ~1 kg but had no effect on blood pressure (BP) in patients with early and established rheumatoid arthritis (RA).

Major finding: After 2 years, participants in both the low-dose glucocorticoid and control groups gained weight, but the low-dose glucocorticoid group gained an additional 1.1 kg of body weight (P < .001), with no significant between-group differences in the mean arterial pressure (P = .187).

Study details: Findings are from a pooled analysis of five randomized controlled trials including 1112 patients with early and established RA who received low-dose glucocorticoids (≤7.5 mg/day of prednisone equivalent; n = 548) or control treatment (n = 564) over at least 2 years.

Disclosures: This study did not receive any specific funding. Some authors declared receiving investigator fees, grants or contracts, consulting fees, payments or honoraria, or support for attending meetings or travel from or owning stocks or options in various sources.

Source: Palmowski A et al. The effect of low-dose glucocorticoids over two years on weight and blood pressure in rheumatoid arthritis: Individual patient data from five randomized trials. Ann Intern Med. 2023 (Aug 15). doi: 10.7326/M23-0192

Key clinical point: The administration of low-dose glucocorticoids over 2 years resulted in a modest weight gain of ~1 kg but had no effect on blood pressure (BP) in patients with early and established rheumatoid arthritis (RA).

Major finding: After 2 years, participants in both the low-dose glucocorticoid and control groups gained weight, but the low-dose glucocorticoid group gained an additional 1.1 kg of body weight (P < .001), with no significant between-group differences in the mean arterial pressure (P = .187).

Study details: Findings are from a pooled analysis of five randomized controlled trials including 1112 patients with early and established RA who received low-dose glucocorticoids (≤7.5 mg/day of prednisone equivalent; n = 548) or control treatment (n = 564) over at least 2 years.

Disclosures: This study did not receive any specific funding. Some authors declared receiving investigator fees, grants or contracts, consulting fees, payments or honoraria, or support for attending meetings or travel from or owning stocks or options in various sources.

Source: Palmowski A et al. The effect of low-dose glucocorticoids over two years on weight and blood pressure in rheumatoid arthritis: Individual patient data from five randomized trials. Ann Intern Med. 2023 (Aug 15). doi: 10.7326/M23-0192

Key clinical point: The administration of low-dose glucocorticoids over 2 years resulted in a modest weight gain of ~1 kg but had no effect on blood pressure (BP) in patients with early and established rheumatoid arthritis (RA).

Major finding: After 2 years, participants in both the low-dose glucocorticoid and control groups gained weight, but the low-dose glucocorticoid group gained an additional 1.1 kg of body weight (P < .001), with no significant between-group differences in the mean arterial pressure (P = .187).

Study details: Findings are from a pooled analysis of five randomized controlled trials including 1112 patients with early and established RA who received low-dose glucocorticoids (≤7.5 mg/day of prednisone equivalent; n = 548) or control treatment (n = 564) over at least 2 years.

Disclosures: This study did not receive any specific funding. Some authors declared receiving investigator fees, grants or contracts, consulting fees, payments or honoraria, or support for attending meetings or travel from or owning stocks or options in various sources.

Source: Palmowski A et al. The effect of low-dose glucocorticoids over two years on weight and blood pressure in rheumatoid arthritis: Individual patient data from five randomized trials. Ann Intern Med. 2023 (Aug 15). doi: 10.7326/M23-0192