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RA, seropositivity, and risk for Parkinson disease: Is there a link?
Key clinical point: Patients with rheumatoid arthritis (RA) were at an increased risk for Parkinson disease (PD), and patients with seropositive RA had an augmented risk for PD.
Major finding: The risk for PD was 1.74-fold higher in patients with RA vs control individuals without RA (adjusted hazard ratio [aHR] 1.74; 95% CI 1.52-1.99), 1.95-fold higher in patients with seropositive RA vs control individuals without RA (aHR 1.95; 95% CI 1.68-2.26), and 1.61-fold higher in patients with seropositive vs seronegative RA (aHR 1.61; 95% CI 1.20-2.16).
Study details: Findings are from a retrospective cohort study including 54,680 patients with RA (seropositive RA n = 39,010, and seronegative RA n = 15,670) and 273,400 age- and sex-matched control individuals without RA.
Disclosures: This study did not declare the source of funding or any conflicts of interest.
Source: Kang J et al. Rheumatoid arthritis and risk of Parkinson disease in Korea. JAMA Neurol. 2023 (May 1). Doi: 10.1001/jamaneurol.2023.0932
Key clinical point: Patients with rheumatoid arthritis (RA) were at an increased risk for Parkinson disease (PD), and patients with seropositive RA had an augmented risk for PD.
Major finding: The risk for PD was 1.74-fold higher in patients with RA vs control individuals without RA (adjusted hazard ratio [aHR] 1.74; 95% CI 1.52-1.99), 1.95-fold higher in patients with seropositive RA vs control individuals without RA (aHR 1.95; 95% CI 1.68-2.26), and 1.61-fold higher in patients with seropositive vs seronegative RA (aHR 1.61; 95% CI 1.20-2.16).
Study details: Findings are from a retrospective cohort study including 54,680 patients with RA (seropositive RA n = 39,010, and seronegative RA n = 15,670) and 273,400 age- and sex-matched control individuals without RA.
Disclosures: This study did not declare the source of funding or any conflicts of interest.
Source: Kang J et al. Rheumatoid arthritis and risk of Parkinson disease in Korea. JAMA Neurol. 2023 (May 1). Doi: 10.1001/jamaneurol.2023.0932
Key clinical point: Patients with rheumatoid arthritis (RA) were at an increased risk for Parkinson disease (PD), and patients with seropositive RA had an augmented risk for PD.
Major finding: The risk for PD was 1.74-fold higher in patients with RA vs control individuals without RA (adjusted hazard ratio [aHR] 1.74; 95% CI 1.52-1.99), 1.95-fold higher in patients with seropositive RA vs control individuals without RA (aHR 1.95; 95% CI 1.68-2.26), and 1.61-fold higher in patients with seropositive vs seronegative RA (aHR 1.61; 95% CI 1.20-2.16).
Study details: Findings are from a retrospective cohort study including 54,680 patients with RA (seropositive RA n = 39,010, and seronegative RA n = 15,670) and 273,400 age- and sex-matched control individuals without RA.
Disclosures: This study did not declare the source of funding or any conflicts of interest.
Source: Kang J et al. Rheumatoid arthritis and risk of Parkinson disease in Korea. JAMA Neurol. 2023 (May 1). Doi: 10.1001/jamaneurol.2023.0932
Comparable efficacy of TNFi and IL-6Ri in b/tsDMARD-experienced patients with RA
Key clinical point: Monotherapy or combination therapy with tumor necrosis factor inhibitors (TNFi) and interleukin-6 receptor inhibitors (IL-6Ri) led to similar clinical outcomes in biologic/targeted synthetic disease-modifying antirheumatic drug (b/tsDMARD)-experienced patients with rheumatoid arthritis (RA).
Major finding: Over 6 months, TNFi and IL-6Ri monotherapies were associated with comparable odds of achieving Clinical Disease Activity Index-based low disease activity (adjusted odds ratio [aOR] 0.99; 95% CI 0.59-1.67) and ≥0.22-unit improvement in Health Assessment Questionnaire-Disability Index (aOR 1.13; 95% CI 0.72-1.77), with results being similar with combination therapy.
Study details: This retrospective observational study included 2739 b/tsDMARD-experienced patients with RA and moderate or high disease activity who initiated TNFi or IL-6Ri monotherapy or combination therapy.
Disclosures: The registry was sponsored by CorEvitas, LLC, and this analysis was funded by Sanofi and Regeneron. Seven authors declared being current or former employees or owning stocks, stock options, or patents of Sanofi or CorEvitas, LLC. Several authors reported ties with Sanofi, Regeneron, and other sources.
Source: Sebba A et al. Comparative effectiveness of TNF inhibitor vs IL-6 receptor inhibitor as monotherapy or combination therapy with methotrexate in biologic-experienced patients with rheumatoid arthritis: An analysis from the CorEvitas RA Registry. Clin Rheumatol. 2023 (Apr 15). Doi: 10.1007/s10067-023-06588-7
Key clinical point: Monotherapy or combination therapy with tumor necrosis factor inhibitors (TNFi) and interleukin-6 receptor inhibitors (IL-6Ri) led to similar clinical outcomes in biologic/targeted synthetic disease-modifying antirheumatic drug (b/tsDMARD)-experienced patients with rheumatoid arthritis (RA).
Major finding: Over 6 months, TNFi and IL-6Ri monotherapies were associated with comparable odds of achieving Clinical Disease Activity Index-based low disease activity (adjusted odds ratio [aOR] 0.99; 95% CI 0.59-1.67) and ≥0.22-unit improvement in Health Assessment Questionnaire-Disability Index (aOR 1.13; 95% CI 0.72-1.77), with results being similar with combination therapy.
Study details: This retrospective observational study included 2739 b/tsDMARD-experienced patients with RA and moderate or high disease activity who initiated TNFi or IL-6Ri monotherapy or combination therapy.
Disclosures: The registry was sponsored by CorEvitas, LLC, and this analysis was funded by Sanofi and Regeneron. Seven authors declared being current or former employees or owning stocks, stock options, or patents of Sanofi or CorEvitas, LLC. Several authors reported ties with Sanofi, Regeneron, and other sources.
Source: Sebba A et al. Comparative effectiveness of TNF inhibitor vs IL-6 receptor inhibitor as monotherapy or combination therapy with methotrexate in biologic-experienced patients with rheumatoid arthritis: An analysis from the CorEvitas RA Registry. Clin Rheumatol. 2023 (Apr 15). Doi: 10.1007/s10067-023-06588-7
Key clinical point: Monotherapy or combination therapy with tumor necrosis factor inhibitors (TNFi) and interleukin-6 receptor inhibitors (IL-6Ri) led to similar clinical outcomes in biologic/targeted synthetic disease-modifying antirheumatic drug (b/tsDMARD)-experienced patients with rheumatoid arthritis (RA).
Major finding: Over 6 months, TNFi and IL-6Ri monotherapies were associated with comparable odds of achieving Clinical Disease Activity Index-based low disease activity (adjusted odds ratio [aOR] 0.99; 95% CI 0.59-1.67) and ≥0.22-unit improvement in Health Assessment Questionnaire-Disability Index (aOR 1.13; 95% CI 0.72-1.77), with results being similar with combination therapy.
Study details: This retrospective observational study included 2739 b/tsDMARD-experienced patients with RA and moderate or high disease activity who initiated TNFi or IL-6Ri monotherapy or combination therapy.
Disclosures: The registry was sponsored by CorEvitas, LLC, and this analysis was funded by Sanofi and Regeneron. Seven authors declared being current or former employees or owning stocks, stock options, or patents of Sanofi or CorEvitas, LLC. Several authors reported ties with Sanofi, Regeneron, and other sources.
Source: Sebba A et al. Comparative effectiveness of TNF inhibitor vs IL-6 receptor inhibitor as monotherapy or combination therapy with methotrexate in biologic-experienced patients with rheumatoid arthritis: An analysis from the CorEvitas RA Registry. Clin Rheumatol. 2023 (Apr 15). Doi: 10.1007/s10067-023-06588-7
Mendelian randomization study supports causal association between RA and coronary atherosclerosis
Key clinical point: Patients with rheumatoid arthritis (RA) may be more susceptible to coronary atherosclerosis, and active intervention for RA may reduce the incidence of coronary atherosclerosis.
Major finding: Genetic predisposition to RA increased the risk for coronary atherosclerosis (odds ratio 1.0021; P < .05). However, genetic liability to coronary atherosclerosis did not increase the risk for RA (P = .06).
Study details: Findings are from a two-sample Mendelian randomization study that evaluated genetic variants associated with RA using the data of 14,361 patients and 42,923 control individuals and those associated with coronary atherosclerosis using data of 14,334 patients and 346,860 control individuals.
Disclosures: This study did not declare any specific source of funding. The authors declared no conflicts of interest.
Source: Nie Q et al. Rheumatoid arthritis and coronary atherosclerosis: A two-sample Mendelian randomization study. Front Cardiovasc Med. 2023;10:1033644 (Apr 28). Doi: 10.3389/fcvm.2023.1033644
Key clinical point: Patients with rheumatoid arthritis (RA) may be more susceptible to coronary atherosclerosis, and active intervention for RA may reduce the incidence of coronary atherosclerosis.
Major finding: Genetic predisposition to RA increased the risk for coronary atherosclerosis (odds ratio 1.0021; P < .05). However, genetic liability to coronary atherosclerosis did not increase the risk for RA (P = .06).
Study details: Findings are from a two-sample Mendelian randomization study that evaluated genetic variants associated with RA using the data of 14,361 patients and 42,923 control individuals and those associated with coronary atherosclerosis using data of 14,334 patients and 346,860 control individuals.
Disclosures: This study did not declare any specific source of funding. The authors declared no conflicts of interest.
Source: Nie Q et al. Rheumatoid arthritis and coronary atherosclerosis: A two-sample Mendelian randomization study. Front Cardiovasc Med. 2023;10:1033644 (Apr 28). Doi: 10.3389/fcvm.2023.1033644
Key clinical point: Patients with rheumatoid arthritis (RA) may be more susceptible to coronary atherosclerosis, and active intervention for RA may reduce the incidence of coronary atherosclerosis.
Major finding: Genetic predisposition to RA increased the risk for coronary atherosclerosis (odds ratio 1.0021; P < .05). However, genetic liability to coronary atherosclerosis did not increase the risk for RA (P = .06).
Study details: Findings are from a two-sample Mendelian randomization study that evaluated genetic variants associated with RA using the data of 14,361 patients and 42,923 control individuals and those associated with coronary atherosclerosis using data of 14,334 patients and 346,860 control individuals.
Disclosures: This study did not declare any specific source of funding. The authors declared no conflicts of interest.
Source: Nie Q et al. Rheumatoid arthritis and coronary atherosclerosis: A two-sample Mendelian randomization study. Front Cardiovasc Med. 2023;10:1033644 (Apr 28). Doi: 10.3389/fcvm.2023.1033644
No evidence to indicate significantly higher risk for cancer with JAKi vs bDMARD in RA
Key clinical point: Risk for first primary cancer was not significantly different among patients with rheumatoid arthritis (RA) receiving Janus kinase inhibitors (JAKi) vs biologic disease-modifying antirheumatic drugs (bDMARD). However, excess risk cannot be ruled out among those receiving JAKi.
Major finding: Patients with RA treated with JAKi had a numerically higher but not statistically significantly higher risk for first primary cancer (hazard ratio 1.41; 95% CI 0.76-2.37) compared with those treated with bDMARD.
Study details: Findings are from an observational cohort study including patients with RA without prior cancer diagnosis who initiated JAKi (n = 875) or bDMARD (n = 4247).
Disclosures: This study received financial support from the Danish Rheumatism Association and Danish Cancer Society. Several authors declared being employees of, receiving research grants and honoraria from, participating in advisory boards of, or serving on steering committees for various sources.
Source: Westermann R et al. Cancer risk in patients with rheumatoid arthritis treated with Janus kinase inhibitors: A nationwide Danish register-based cohort study. Rheumatology (Oxford). 2023 (Apr 13). Doi: 10.1093/rheumatology/kead163
Key clinical point: Risk for first primary cancer was not significantly different among patients with rheumatoid arthritis (RA) receiving Janus kinase inhibitors (JAKi) vs biologic disease-modifying antirheumatic drugs (bDMARD). However, excess risk cannot be ruled out among those receiving JAKi.
Major finding: Patients with RA treated with JAKi had a numerically higher but not statistically significantly higher risk for first primary cancer (hazard ratio 1.41; 95% CI 0.76-2.37) compared with those treated with bDMARD.
Study details: Findings are from an observational cohort study including patients with RA without prior cancer diagnosis who initiated JAKi (n = 875) or bDMARD (n = 4247).
Disclosures: This study received financial support from the Danish Rheumatism Association and Danish Cancer Society. Several authors declared being employees of, receiving research grants and honoraria from, participating in advisory boards of, or serving on steering committees for various sources.
Source: Westermann R et al. Cancer risk in patients with rheumatoid arthritis treated with Janus kinase inhibitors: A nationwide Danish register-based cohort study. Rheumatology (Oxford). 2023 (Apr 13). Doi: 10.1093/rheumatology/kead163
Key clinical point: Risk for first primary cancer was not significantly different among patients with rheumatoid arthritis (RA) receiving Janus kinase inhibitors (JAKi) vs biologic disease-modifying antirheumatic drugs (bDMARD). However, excess risk cannot be ruled out among those receiving JAKi.
Major finding: Patients with RA treated with JAKi had a numerically higher but not statistically significantly higher risk for first primary cancer (hazard ratio 1.41; 95% CI 0.76-2.37) compared with those treated with bDMARD.
Study details: Findings are from an observational cohort study including patients with RA without prior cancer diagnosis who initiated JAKi (n = 875) or bDMARD (n = 4247).
Disclosures: This study received financial support from the Danish Rheumatism Association and Danish Cancer Society. Several authors declared being employees of, receiving research grants and honoraria from, participating in advisory boards of, or serving on steering committees for various sources.
Source: Westermann R et al. Cancer risk in patients with rheumatoid arthritis treated with Janus kinase inhibitors: A nationwide Danish register-based cohort study. Rheumatology (Oxford). 2023 (Apr 13). Doi: 10.1093/rheumatology/kead163
HPV infection, HPV immunization, and RA prevalence: What is the link?
Key clinical point: Human papillomavirus (HPV) infection was associated with an increased prevalence of rheumatoid arthritis (RA), whereas HPV immunization lowered RA prevalence in adults aged 18-59 years.
Major finding: A significant association was observed between HPV infection and increased prevalence of RA (adjusted odds ratio [aOR] 1.074; 95% CI 1.071-1.076), whereas HPV immunization was associated with a significantly reduced RA prevalence (aOR 0.477; 95% CI 0.472-0.481).
Study details: Findings are from a population-based cohort study including adults age 18-59 years with complete data on HPV infection and history of RA (n = 15,677) and those with complete data on HPV vaccination and history of RA (n = 8944).
Disclosures: This study was supported by the Nanjing Medical University Science, China, and Technology Development Fund and other sources. The authors declared no conflicts of interest.
Source: Yang G et al. Association between human papillomavirus infection or immunization and risk for rheumatoid arthritis. Front Immunol. 2023;14:1130217 (Apr 14). Doi: 10.3389/fimmu.2023.1130217
Key clinical point: Human papillomavirus (HPV) infection was associated with an increased prevalence of rheumatoid arthritis (RA), whereas HPV immunization lowered RA prevalence in adults aged 18-59 years.
Major finding: A significant association was observed between HPV infection and increased prevalence of RA (adjusted odds ratio [aOR] 1.074; 95% CI 1.071-1.076), whereas HPV immunization was associated with a significantly reduced RA prevalence (aOR 0.477; 95% CI 0.472-0.481).
Study details: Findings are from a population-based cohort study including adults age 18-59 years with complete data on HPV infection and history of RA (n = 15,677) and those with complete data on HPV vaccination and history of RA (n = 8944).
Disclosures: This study was supported by the Nanjing Medical University Science, China, and Technology Development Fund and other sources. The authors declared no conflicts of interest.
Source: Yang G et al. Association between human papillomavirus infection or immunization and risk for rheumatoid arthritis. Front Immunol. 2023;14:1130217 (Apr 14). Doi: 10.3389/fimmu.2023.1130217
Key clinical point: Human papillomavirus (HPV) infection was associated with an increased prevalence of rheumatoid arthritis (RA), whereas HPV immunization lowered RA prevalence in adults aged 18-59 years.
Major finding: A significant association was observed between HPV infection and increased prevalence of RA (adjusted odds ratio [aOR] 1.074; 95% CI 1.071-1.076), whereas HPV immunization was associated with a significantly reduced RA prevalence (aOR 0.477; 95% CI 0.472-0.481).
Study details: Findings are from a population-based cohort study including adults age 18-59 years with complete data on HPV infection and history of RA (n = 15,677) and those with complete data on HPV vaccination and history of RA (n = 8944).
Disclosures: This study was supported by the Nanjing Medical University Science, China, and Technology Development Fund and other sources. The authors declared no conflicts of interest.
Source: Yang G et al. Association between human papillomavirus infection or immunization and risk for rheumatoid arthritis. Front Immunol. 2023;14:1130217 (Apr 14). Doi: 10.3389/fimmu.2023.1130217
Factors guiding sustained remission after withdrawal of combination therapy in RA
Key clinical point: Patients with rheumatoid arthritis (RA) with better overall disease activity and longer etanercept treatment duration are more likely to remain in remission after transition from methotrexate+etanercept combination therapy to methotrexate or etanercept monotherapy.
Major finding: At week 48, the likelihood of patients remaining in Simple Disease Activity Index-based remission or maintaining low disease activity was 1.12 times higher with long-term etanercept monotherapy (P = .044) but was 0.93 times lower with each 1-point increase in Patient Global Assessment of Disease Activity (P = .012) and C-reactive protein (P = .033).
Study details: Findings are from the phase 3, SEAM-RA trial including 253 patients with RA who achieved remission with 24 weeks of methotrexate+etanercept combination therapy and were randomly assigned to continue combination therapy or transition to methotrexate+placebo or etanercept+placebo.
Disclosures: A wholly owned subsidiary of Amgen Inc., Immunex, funded this study. Three authors declared being employees and stockholders of Amgen Inc., and four authors declared ties with various sources, including Amgen.
Source: Curtis JR R et al. Factors associated with maintenance of remission following change from combination therapy to monotherapy in patients with rheumatoid arthritis. J Rheumatol. 2023 (Apr 15). Doi: 10.3899/jrheum.2022-1008.
Key clinical point: Patients with rheumatoid arthritis (RA) with better overall disease activity and longer etanercept treatment duration are more likely to remain in remission after transition from methotrexate+etanercept combination therapy to methotrexate or etanercept monotherapy.
Major finding: At week 48, the likelihood of patients remaining in Simple Disease Activity Index-based remission or maintaining low disease activity was 1.12 times higher with long-term etanercept monotherapy (P = .044) but was 0.93 times lower with each 1-point increase in Patient Global Assessment of Disease Activity (P = .012) and C-reactive protein (P = .033).
Study details: Findings are from the phase 3, SEAM-RA trial including 253 patients with RA who achieved remission with 24 weeks of methotrexate+etanercept combination therapy and were randomly assigned to continue combination therapy or transition to methotrexate+placebo or etanercept+placebo.
Disclosures: A wholly owned subsidiary of Amgen Inc., Immunex, funded this study. Three authors declared being employees and stockholders of Amgen Inc., and four authors declared ties with various sources, including Amgen.
Source: Curtis JR R et al. Factors associated with maintenance of remission following change from combination therapy to monotherapy in patients with rheumatoid arthritis. J Rheumatol. 2023 (Apr 15). Doi: 10.3899/jrheum.2022-1008.
Key clinical point: Patients with rheumatoid arthritis (RA) with better overall disease activity and longer etanercept treatment duration are more likely to remain in remission after transition from methotrexate+etanercept combination therapy to methotrexate or etanercept monotherapy.
Major finding: At week 48, the likelihood of patients remaining in Simple Disease Activity Index-based remission or maintaining low disease activity was 1.12 times higher with long-term etanercept monotherapy (P = .044) but was 0.93 times lower with each 1-point increase in Patient Global Assessment of Disease Activity (P = .012) and C-reactive protein (P = .033).
Study details: Findings are from the phase 3, SEAM-RA trial including 253 patients with RA who achieved remission with 24 weeks of methotrexate+etanercept combination therapy and were randomly assigned to continue combination therapy or transition to methotrexate+placebo or etanercept+placebo.
Disclosures: A wholly owned subsidiary of Amgen Inc., Immunex, funded this study. Three authors declared being employees and stockholders of Amgen Inc., and four authors declared ties with various sources, including Amgen.
Source: Curtis JR R et al. Factors associated with maintenance of remission following change from combination therapy to monotherapy in patients with rheumatoid arthritis. J Rheumatol. 2023 (Apr 15). Doi: 10.3899/jrheum.2022-1008.
Tofacitinib withdrawal not a universal option for all patients with RA in remission
Key clinical point: Blanket withdrawal of tofacitinib may not be suitable for all patients with rheumatoid arthritis (RA) who have achieved clinical remission as more than half relapsed after tofacitinib discontinuation. However, the majority regained remission after tofacitinib resumption.
Major finding: At week 104, the tofacitinib vs methotrexate discontinuation group had a numerically lower Clinical Disease Activity Index-based sustained remission rate (29.2% vs 50.0%) and higher relapse rate (58.3% vs 35.0%). However, 71.4% vs 28.6% of patients regained remission on tofacitinib vs methotrexate resumption.
Study details: This prospective randomized controlled trial included 113 patients with RA and an inadequate response to methotrexate with or without biologic disease-modifying antirheumatic drugs who received 52 weeks of tofacitinib plus methotrexate treatment and thereafter, were randomly assigned to discontinue tofacitinib or methotrexate if experiencing clinical remission.
Disclosures: This study was supported by the Japan Society for the Promotion of Science, KAKENHI. Several authors declared receiving consulting fees, speaking fees, research grants, or honoraria from various sources.
Source: Kubo S et al. Sustained remission following the discontinuation of tofacitinib in patients with rheumatoid arthritis (XANADU study): An open-label randomised study. RMD Open. 2023;9(2):e003029 (Apr 25). Doi: 10.1136/rmdopen-2023-003029
Key clinical point: Blanket withdrawal of tofacitinib may not be suitable for all patients with rheumatoid arthritis (RA) who have achieved clinical remission as more than half relapsed after tofacitinib discontinuation. However, the majority regained remission after tofacitinib resumption.
Major finding: At week 104, the tofacitinib vs methotrexate discontinuation group had a numerically lower Clinical Disease Activity Index-based sustained remission rate (29.2% vs 50.0%) and higher relapse rate (58.3% vs 35.0%). However, 71.4% vs 28.6% of patients regained remission on tofacitinib vs methotrexate resumption.
Study details: This prospective randomized controlled trial included 113 patients with RA and an inadequate response to methotrexate with or without biologic disease-modifying antirheumatic drugs who received 52 weeks of tofacitinib plus methotrexate treatment and thereafter, were randomly assigned to discontinue tofacitinib or methotrexate if experiencing clinical remission.
Disclosures: This study was supported by the Japan Society for the Promotion of Science, KAKENHI. Several authors declared receiving consulting fees, speaking fees, research grants, or honoraria from various sources.
Source: Kubo S et al. Sustained remission following the discontinuation of tofacitinib in patients with rheumatoid arthritis (XANADU study): An open-label randomised study. RMD Open. 2023;9(2):e003029 (Apr 25). Doi: 10.1136/rmdopen-2023-003029
Key clinical point: Blanket withdrawal of tofacitinib may not be suitable for all patients with rheumatoid arthritis (RA) who have achieved clinical remission as more than half relapsed after tofacitinib discontinuation. However, the majority regained remission after tofacitinib resumption.
Major finding: At week 104, the tofacitinib vs methotrexate discontinuation group had a numerically lower Clinical Disease Activity Index-based sustained remission rate (29.2% vs 50.0%) and higher relapse rate (58.3% vs 35.0%). However, 71.4% vs 28.6% of patients regained remission on tofacitinib vs methotrexate resumption.
Study details: This prospective randomized controlled trial included 113 patients with RA and an inadequate response to methotrexate with or without biologic disease-modifying antirheumatic drugs who received 52 weeks of tofacitinib plus methotrexate treatment and thereafter, were randomly assigned to discontinue tofacitinib or methotrexate if experiencing clinical remission.
Disclosures: This study was supported by the Japan Society for the Promotion of Science, KAKENHI. Several authors declared receiving consulting fees, speaking fees, research grants, or honoraria from various sources.
Source: Kubo S et al. Sustained remission following the discontinuation of tofacitinib in patients with rheumatoid arthritis (XANADU study): An open-label randomised study. RMD Open. 2023;9(2):e003029 (Apr 25). Doi: 10.1136/rmdopen-2023-003029
Joint damage repair: A rare phenomenon in early RA
Key clinical point: Repair of joint space narrowing occurred but was rare in patients with early rheumatoid arthritis (RA) who underwent 8 years of treatment to a target disease activity score (DAS) ≤ 2.4. Therefore, suppression of damage progression should be the focus of clinical care.
Major finding: Only 5.3% of patients showed repair of joint space narrowing and bone erosions after 8 years of treatment to a target of DAS ≤ 2.4. No significant association was observed between achieving repair and suppression of disease activity, duration of previous remission, or other predictors of repair.
Study details: Findings are from a subanalysis of BeSt study including 508 patients with severe early RA who were treated to a target of DAS ≤ 2.4 and followed for 8 years.
Disclosures: The BeSt study was supported by grants from the Dutch College of Health Insurances, Schering-Plough B.V., and Janssen B.V. The authors did not declare any conflicts of interest.
Source: van der Pol JA et al. Repair of joint damage in patients with rheumatoid arthritis does not relate to previous suppression of inflammation: A subanalysis after 8 years treat-to-target in the BeSt-trial. RMD Open. 2023;9(2):e002995 (Apr 25). Doi: 10.1136/rmdopen-2023-002995
Key clinical point: Repair of joint space narrowing occurred but was rare in patients with early rheumatoid arthritis (RA) who underwent 8 years of treatment to a target disease activity score (DAS) ≤ 2.4. Therefore, suppression of damage progression should be the focus of clinical care.
Major finding: Only 5.3% of patients showed repair of joint space narrowing and bone erosions after 8 years of treatment to a target of DAS ≤ 2.4. No significant association was observed between achieving repair and suppression of disease activity, duration of previous remission, or other predictors of repair.
Study details: Findings are from a subanalysis of BeSt study including 508 patients with severe early RA who were treated to a target of DAS ≤ 2.4 and followed for 8 years.
Disclosures: The BeSt study was supported by grants from the Dutch College of Health Insurances, Schering-Plough B.V., and Janssen B.V. The authors did not declare any conflicts of interest.
Source: van der Pol JA et al. Repair of joint damage in patients with rheumatoid arthritis does not relate to previous suppression of inflammation: A subanalysis after 8 years treat-to-target in the BeSt-trial. RMD Open. 2023;9(2):e002995 (Apr 25). Doi: 10.1136/rmdopen-2023-002995
Key clinical point: Repair of joint space narrowing occurred but was rare in patients with early rheumatoid arthritis (RA) who underwent 8 years of treatment to a target disease activity score (DAS) ≤ 2.4. Therefore, suppression of damage progression should be the focus of clinical care.
Major finding: Only 5.3% of patients showed repair of joint space narrowing and bone erosions after 8 years of treatment to a target of DAS ≤ 2.4. No significant association was observed between achieving repair and suppression of disease activity, duration of previous remission, or other predictors of repair.
Study details: Findings are from a subanalysis of BeSt study including 508 patients with severe early RA who were treated to a target of DAS ≤ 2.4 and followed for 8 years.
Disclosures: The BeSt study was supported by grants from the Dutch College of Health Insurances, Schering-Plough B.V., and Janssen B.V. The authors did not declare any conflicts of interest.
Source: van der Pol JA et al. Repair of joint damage in patients with rheumatoid arthritis does not relate to previous suppression of inflammation: A subanalysis after 8 years treat-to-target in the BeSt-trial. RMD Open. 2023;9(2):e002995 (Apr 25). Doi: 10.1136/rmdopen-2023-002995
Strong link between polycyclic aromatic hydrocarbons and raised rheumatoid arthritis risk
Key clinical point: Exposure to environmental polycyclic aromatic hydrocarbons (PAH) was significantly associated with an increased prevalence of rheumatoid arthritis (RA) in the US population, and PAH mediated the majority of the effects of smoking in RA.
Major finding: Risk of developing RA was significantly higher in participants in the highest vs lowest quartile of 1-hydroxynaphthalene level (adjusted odds ratio [aOR] 1.8; P = .020) and PAH body burden scores (aOR 2.2; P = .028). PAH body burden accounted for ~90% of the total effect of smoking on RA.
Study details: Findings are from a cross-sectional study including adult participants with (n = 1418) or without (n = 20,569) RA who underwent assessments for PAH, phthalate and plasticizer metabolite, and volatile organic compound body burden.
Disclosures: This study did not declare any specific funding source. The lead author declared receiving personal fees from Cleveland HeartLab, unrelated to this study, and holding a patent.
Source: Beidelschies M et al. Polycyclic aromatic hydrocarbons and risk of rheumatoid arthritis: A cross-sectional analysis of the National Health and Nutrition Examination Survey, 2007–2016. BMJ Open. 2023;13(5):e071514 (May 9). Doi: 10.1136/bmjopen-2022-071514
Key clinical point: Exposure to environmental polycyclic aromatic hydrocarbons (PAH) was significantly associated with an increased prevalence of rheumatoid arthritis (RA) in the US population, and PAH mediated the majority of the effects of smoking in RA.
Major finding: Risk of developing RA was significantly higher in participants in the highest vs lowest quartile of 1-hydroxynaphthalene level (adjusted odds ratio [aOR] 1.8; P = .020) and PAH body burden scores (aOR 2.2; P = .028). PAH body burden accounted for ~90% of the total effect of smoking on RA.
Study details: Findings are from a cross-sectional study including adult participants with (n = 1418) or without (n = 20,569) RA who underwent assessments for PAH, phthalate and plasticizer metabolite, and volatile organic compound body burden.
Disclosures: This study did not declare any specific funding source. The lead author declared receiving personal fees from Cleveland HeartLab, unrelated to this study, and holding a patent.
Source: Beidelschies M et al. Polycyclic aromatic hydrocarbons and risk of rheumatoid arthritis: A cross-sectional analysis of the National Health and Nutrition Examination Survey, 2007–2016. BMJ Open. 2023;13(5):e071514 (May 9). Doi: 10.1136/bmjopen-2022-071514
Key clinical point: Exposure to environmental polycyclic aromatic hydrocarbons (PAH) was significantly associated with an increased prevalence of rheumatoid arthritis (RA) in the US population, and PAH mediated the majority of the effects of smoking in RA.
Major finding: Risk of developing RA was significantly higher in participants in the highest vs lowest quartile of 1-hydroxynaphthalene level (adjusted odds ratio [aOR] 1.8; P = .020) and PAH body burden scores (aOR 2.2; P = .028). PAH body burden accounted for ~90% of the total effect of smoking on RA.
Study details: Findings are from a cross-sectional study including adult participants with (n = 1418) or without (n = 20,569) RA who underwent assessments for PAH, phthalate and plasticizer metabolite, and volatile organic compound body burden.
Disclosures: This study did not declare any specific funding source. The lead author declared receiving personal fees from Cleveland HeartLab, unrelated to this study, and holding a patent.
Source: Beidelschies M et al. Polycyclic aromatic hydrocarbons and risk of rheumatoid arthritis: A cross-sectional analysis of the National Health and Nutrition Examination Survey, 2007–2016. BMJ Open. 2023;13(5):e071514 (May 9). Doi: 10.1136/bmjopen-2022-071514
Investigational drug peresolimab shows efficacy in patients with RA
(RA), according to results from a phase 2 clinical trial.
After 12 weeks, patients receiving peresolimab 700 mg saw a greater improvement in the primary endpoint of change in Disease Activity Score for 28 joints based on C-reactive protein (DAS28-CRP), compared with placebo.
“These results provide evidence that stimulation of the PD-1 receptor has potential efficacy in the treatment of rheumatoid arthritis,” said the authors, led by Jay Tuttle, PhD, of Eli Lilly and Company. The study was published in the New England Journal of Medicine.
A total of 98 patients with treatment-resistant, moderate to severe RA were enrolled in the double-blind, placebo-controlled trial. All patients had previously experienced treatment failure with biologic, targeted synthetic, or conventional synthetic disease-modifying antirheumatic drugs. Patients were randomized to receive 700 mg of peresolimab (49 patients), 300 mg of peresolimab (25 patients), or placebo (24 patients) intravenously once every 4 weeks.
Only patients taking peresolimab 700 mg had a significantly greater change in DAS28-CRP scores after 12 weeks, compared with placebo. In secondary outcomes, 71% of the 700-mg group experienced an improvement of at least 20% in American College of Rheumatology response criteria (ACR20), as compared with 42% in the placebo group. There was no difference between the placebo and peresolimab groups in ACR50 or ACR70 responses.
The safety profiles were similar across all three groups, although the 700-mg peresolimab group had numerically more adverse events (n = 14) than the 300-mg peresolimab group (n = 8) and the placebo group (n = 9). There were no severe adverse events reported during the study period. The authors noted that larger and longer studies are necessary to understand the safety of peresolimab.
“Careful evaluation of the effect of peresolimab on the risk of cancer will be important given the efficacy of PD-1 inhibitors in oncologic disease,” the authors wrote.
Eli Lilly funded the research. Researchers disclosed financial relationships with AbbVie, Eli Lilly, Janssen, Novartis, Pfizer, and several other pharmaceutical companies.
(RA), according to results from a phase 2 clinical trial.
After 12 weeks, patients receiving peresolimab 700 mg saw a greater improvement in the primary endpoint of change in Disease Activity Score for 28 joints based on C-reactive protein (DAS28-CRP), compared with placebo.
“These results provide evidence that stimulation of the PD-1 receptor has potential efficacy in the treatment of rheumatoid arthritis,” said the authors, led by Jay Tuttle, PhD, of Eli Lilly and Company. The study was published in the New England Journal of Medicine.
A total of 98 patients with treatment-resistant, moderate to severe RA were enrolled in the double-blind, placebo-controlled trial. All patients had previously experienced treatment failure with biologic, targeted synthetic, or conventional synthetic disease-modifying antirheumatic drugs. Patients were randomized to receive 700 mg of peresolimab (49 patients), 300 mg of peresolimab (25 patients), or placebo (24 patients) intravenously once every 4 weeks.
Only patients taking peresolimab 700 mg had a significantly greater change in DAS28-CRP scores after 12 weeks, compared with placebo. In secondary outcomes, 71% of the 700-mg group experienced an improvement of at least 20% in American College of Rheumatology response criteria (ACR20), as compared with 42% in the placebo group. There was no difference between the placebo and peresolimab groups in ACR50 or ACR70 responses.
The safety profiles were similar across all three groups, although the 700-mg peresolimab group had numerically more adverse events (n = 14) than the 300-mg peresolimab group (n = 8) and the placebo group (n = 9). There were no severe adverse events reported during the study period. The authors noted that larger and longer studies are necessary to understand the safety of peresolimab.
“Careful evaluation of the effect of peresolimab on the risk of cancer will be important given the efficacy of PD-1 inhibitors in oncologic disease,” the authors wrote.
Eli Lilly funded the research. Researchers disclosed financial relationships with AbbVie, Eli Lilly, Janssen, Novartis, Pfizer, and several other pharmaceutical companies.
(RA), according to results from a phase 2 clinical trial.
After 12 weeks, patients receiving peresolimab 700 mg saw a greater improvement in the primary endpoint of change in Disease Activity Score for 28 joints based on C-reactive protein (DAS28-CRP), compared with placebo.
“These results provide evidence that stimulation of the PD-1 receptor has potential efficacy in the treatment of rheumatoid arthritis,” said the authors, led by Jay Tuttle, PhD, of Eli Lilly and Company. The study was published in the New England Journal of Medicine.
A total of 98 patients with treatment-resistant, moderate to severe RA were enrolled in the double-blind, placebo-controlled trial. All patients had previously experienced treatment failure with biologic, targeted synthetic, or conventional synthetic disease-modifying antirheumatic drugs. Patients were randomized to receive 700 mg of peresolimab (49 patients), 300 mg of peresolimab (25 patients), or placebo (24 patients) intravenously once every 4 weeks.
Only patients taking peresolimab 700 mg had a significantly greater change in DAS28-CRP scores after 12 weeks, compared with placebo. In secondary outcomes, 71% of the 700-mg group experienced an improvement of at least 20% in American College of Rheumatology response criteria (ACR20), as compared with 42% in the placebo group. There was no difference between the placebo and peresolimab groups in ACR50 or ACR70 responses.
The safety profiles were similar across all three groups, although the 700-mg peresolimab group had numerically more adverse events (n = 14) than the 300-mg peresolimab group (n = 8) and the placebo group (n = 9). There were no severe adverse events reported during the study period. The authors noted that larger and longer studies are necessary to understand the safety of peresolimab.
“Careful evaluation of the effect of peresolimab on the risk of cancer will be important given the efficacy of PD-1 inhibitors in oncologic disease,” the authors wrote.
Eli Lilly funded the research. Researchers disclosed financial relationships with AbbVie, Eli Lilly, Janssen, Novartis, Pfizer, and several other pharmaceutical companies.
FROM THE NEW ENGLAND JOURNAL OF MEDICINE