Rheumatoid Arthritis

Key clinical point: Acupuncture relieves pain and improves the health index in patients with rheumatoid arthritis (RA) and can be considered an adjunctive nonpharmacological treatment in rehabilitation programs.

Major finding: Invasive acupuncture vs control interventions significantly reduced pain (mean difference [MD] −1.00; P ­= .04), Health Assessment Questionnaire score (MD −0.20; P < .001), Physician Global Assessment score (MD ­−0.98; P < .001), tender joint count (MD ­−1.24; P ­= .005), C-reactive protein level (MD, −1.81; P =­ .019), and erythrocyte sedimentation rate (MD, −3.03; P =­ .032). Similar benefits were observed with laser acupuncture. No adverse events were reported.

Study details: This was a meta-analysis of 11 randomized controlled trials including 796 patients with RA, of which 402 received acupuncture therapy and 394 received control interventions.

Disclosures: The study was supported by Beijing Jishuitan Hospital Elite Young Scholar Programme, Beijing, China. The authors declared no conflicts of interest.

Source: Li H et al. Clinical efficacy of acupuncture for the treatment of rheumatoid arthritis: Meta-analysis of randomized clinical trials. Evid Based Complementary Altern Med. 2022;5264977 (Apr 30). Doi: 10.1155/2022/5264977

Key clinical point: Acupuncture relieves pain and improves the health index in patients with rheumatoid arthritis (RA) and can be considered an adjunctive nonpharmacological treatment in rehabilitation programs.

Major finding: Invasive acupuncture vs control interventions significantly reduced pain (mean difference [MD] −1.00; P ­= .04), Health Assessment Questionnaire score (MD −0.20; P < .001), Physician Global Assessment score (MD ­−0.98; P < .001), tender joint count (MD ­−1.24; P ­= .005), C-reactive protein level (MD, −1.81; P =­ .019), and erythrocyte sedimentation rate (MD, −3.03; P =­ .032). Similar benefits were observed with laser acupuncture. No adverse events were reported.

Study details: This was a meta-analysis of 11 randomized controlled trials including 796 patients with RA, of which 402 received acupuncture therapy and 394 received control interventions.

Disclosures: The study was supported by Beijing Jishuitan Hospital Elite Young Scholar Programme, Beijing, China. The authors declared no conflicts of interest.

Source: Li H et al. Clinical efficacy of acupuncture for the treatment of rheumatoid arthritis: Meta-analysis of randomized clinical trials. Evid Based Complementary Altern Med. 2022;5264977 (Apr 30). Doi: 10.1155/2022/5264977

Key clinical point: Acupuncture relieves pain and improves the health index in patients with rheumatoid arthritis (RA) and can be considered an adjunctive nonpharmacological treatment in rehabilitation programs.

Major finding: Invasive acupuncture vs control interventions significantly reduced pain (mean difference [MD] −1.00; P ­= .04), Health Assessment Questionnaire score (MD −0.20; P < .001), Physician Global Assessment score (MD ­−0.98; P < .001), tender joint count (MD ­−1.24; P ­= .005), C-reactive protein level (MD, −1.81; P =­ .019), and erythrocyte sedimentation rate (MD, −3.03; P =­ .032). Similar benefits were observed with laser acupuncture. No adverse events were reported.

Study details: This was a meta-analysis of 11 randomized controlled trials including 796 patients with RA, of which 402 received acupuncture therapy and 394 received control interventions.

Disclosures: The study was supported by Beijing Jishuitan Hospital Elite Young Scholar Programme, Beijing, China. The authors declared no conflicts of interest.

Source: Li H et al. Clinical efficacy of acupuncture for the treatment of rheumatoid arthritis: Meta-analysis of randomized clinical trials. Evid Based Complementary Altern Med. 2022;5264977 (Apr 30). Doi: 10.1155/2022/5264977

Key clinical point: The rates of achieving low disease activity (LDA) and clinical remission were almost 20%-40% lower in patients with rheumatoid arthritis (RA) and elevated levels of adipocytokines.

Major finding: Patients in the highest vs lowest quartile of adiponectin (adjusted hazard ratio [aHR] 0.69) and leptin (aHR 0.77; both P < .05) had a significantly lower rate of achieving LDA. The odds of achieving clinical remission were lower in patients in the highest vs lowest quartile of adiponectin (aHR 0.69) and leptin (aHR 0.64; both P < .05).

Study details: This was an observational cohort study including 1274 veterans with RA and a disease activity score in 28 joints of >3.2.

Disclosures: This study did not declare any specific funding. JF Baker, BR England, and TR Mikuls reported receiving funding, grants, research support, or consulting fees from various sources.

Source: Baker JF et al. Adipocytokines and achievement of low disease activity in rheumatoid arthritis. Semin Arthritis Rheum. 2022;55:152003 (Apr 12). Doi: 10.1016/j.semarthrit.2022.152003

Key clinical point: The rates of achieving low disease activity (LDA) and clinical remission were almost 20%-40% lower in patients with rheumatoid arthritis (RA) and elevated levels of adipocytokines.

Major finding: Patients in the highest vs lowest quartile of adiponectin (adjusted hazard ratio [aHR] 0.69) and leptin (aHR 0.77; both P < .05) had a significantly lower rate of achieving LDA. The odds of achieving clinical remission were lower in patients in the highest vs lowest quartile of adiponectin (aHR 0.69) and leptin (aHR 0.64; both P < .05).

Study details: This was an observational cohort study including 1274 veterans with RA and a disease activity score in 28 joints of >3.2.

Disclosures: This study did not declare any specific funding. JF Baker, BR England, and TR Mikuls reported receiving funding, grants, research support, or consulting fees from various sources.

Source: Baker JF et al. Adipocytokines and achievement of low disease activity in rheumatoid arthritis. Semin Arthritis Rheum. 2022;55:152003 (Apr 12). Doi: 10.1016/j.semarthrit.2022.152003

Key clinical point: The rates of achieving low disease activity (LDA) and clinical remission were almost 20%-40% lower in patients with rheumatoid arthritis (RA) and elevated levels of adipocytokines.

Major finding: Patients in the highest vs lowest quartile of adiponectin (adjusted hazard ratio [aHR] 0.69) and leptin (aHR 0.77; both P < .05) had a significantly lower rate of achieving LDA. The odds of achieving clinical remission were lower in patients in the highest vs lowest quartile of adiponectin (aHR 0.69) and leptin (aHR 0.64; both P < .05).

Study details: This was an observational cohort study including 1274 veterans with RA and a disease activity score in 28 joints of >3.2.

Disclosures: This study did not declare any specific funding. JF Baker, BR England, and TR Mikuls reported receiving funding, grants, research support, or consulting fees from various sources.

Source: Baker JF et al. Adipocytokines and achievement of low disease activity in rheumatoid arthritis. Semin Arthritis Rheum. 2022;55:152003 (Apr 12). Doi: 10.1016/j.semarthrit.2022.152003

Key clinical point: The risks for any serious bacterial, opportunistic, or herpes zoster infections were similar with add-on leflunomide or tacrolimus and tumor necrosis factor inhibitors (TNFi) in patients with seropositive rheumatoid arthritis (RA) receiving methotrexate.

Major finding: The risk for any serious infection was not significantly different with leflunomide (propensity score fine stratification-weighted hazard ratio [pHR, 1.03; 95% CI 0.89-1.22) or tacrolimus (pHR 0.91; 95% CI 0.77-1.08) compared to TNFi.

Study details: This was a population-based cohort study including 72,516 patients with seropositive RA who were taking methotrexate, of which 20,262 patients initiated leflunomide, tacrolimus, or TNFi therapy.

Disclosures: This study was supported by an investigator-sponsored grant from Hanlim pharmaceutical company. The authors declared no conflicts of interest.

Source: Shin A et al. Semin Arthritis Rheum. 2022 Apr 28. doi: 10.1016/j.semarthrit.2022.152019.

Key clinical point: The risks for any serious bacterial, opportunistic, or herpes zoster infections were similar with add-on leflunomide or tacrolimus and tumor necrosis factor inhibitors (TNFi) in patients with seropositive rheumatoid arthritis (RA) receiving methotrexate.

Major finding: The risk for any serious infection was not significantly different with leflunomide (propensity score fine stratification-weighted hazard ratio [pHR, 1.03; 95% CI 0.89-1.22) or tacrolimus (pHR 0.91; 95% CI 0.77-1.08) compared to TNFi.

Study details: This was a population-based cohort study including 72,516 patients with seropositive RA who were taking methotrexate, of which 20,262 patients initiated leflunomide, tacrolimus, or TNFi therapy.

Disclosures: This study was supported by an investigator-sponsored grant from Hanlim pharmaceutical company. The authors declared no conflicts of interest.

Source: Shin A et al. Semin Arthritis Rheum. 2022 Apr 28. doi: 10.1016/j.semarthrit.2022.152019.

Key clinical point: The risks for any serious bacterial, opportunistic, or herpes zoster infections were similar with add-on leflunomide or tacrolimus and tumor necrosis factor inhibitors (TNFi) in patients with seropositive rheumatoid arthritis (RA) receiving methotrexate.

Major finding: The risk for any serious infection was not significantly different with leflunomide (propensity score fine stratification-weighted hazard ratio [pHR, 1.03; 95% CI 0.89-1.22) or tacrolimus (pHR 0.91; 95% CI 0.77-1.08) compared to TNFi.

Study details: This was a population-based cohort study including 72,516 patients with seropositive RA who were taking methotrexate, of which 20,262 patients initiated leflunomide, tacrolimus, or TNFi therapy.

Disclosures: This study was supported by an investigator-sponsored grant from Hanlim pharmaceutical company. The authors declared no conflicts of interest.

Source: Shin A et al. Semin Arthritis Rheum. 2022 Apr 28. doi: 10.1016/j.semarthrit.2022.152019.

Key clinical point: Regular vitamin E supplementation in patients with rheumatoid arthritis (RA) may help reduce joint discomfort, edema, and stiffness, thus enhancing the overall quality of life.

Major finding: Patients with RA who received regular vitamin E supplementation showed improvements in uncomfortable joints (mean difference [MD] −0.62; 95% CI −12.59 to 11.36) and tender joints (MD −1.66; 95% CI −6.32 to 2.99) compared with those who received placebo, fish oil, or other medications, without any significant safety concerns.

Study details: This was a systematic review and meta-analysis of nine studies including 39,845 individuals with RA who received vitamin E (experimental group) or placebo, fish oil, or other medications (control group).

Disclosures: This study was supported by funding from the Natural Science Foundation of Shaanxi Province, China. The authors declared no competing interests.

Source: Kou H et al. Effect of vitamin E supplementation in rheumatoid arthritis: A systematic review and meta-analysis. Eur J Clin Nutr. 2022 (Apr 25). Doi: 10.1038/s41430-022-01148-9

Key clinical point: Regular vitamin E supplementation in patients with rheumatoid arthritis (RA) may help reduce joint discomfort, edema, and stiffness, thus enhancing the overall quality of life.

Major finding: Patients with RA who received regular vitamin E supplementation showed improvements in uncomfortable joints (mean difference [MD] −0.62; 95% CI −12.59 to 11.36) and tender joints (MD −1.66; 95% CI −6.32 to 2.99) compared with those who received placebo, fish oil, or other medications, without any significant safety concerns.

Study details: This was a systematic review and meta-analysis of nine studies including 39,845 individuals with RA who received vitamin E (experimental group) or placebo, fish oil, or other medications (control group).

Disclosures: This study was supported by funding from the Natural Science Foundation of Shaanxi Province, China. The authors declared no competing interests.

Source: Kou H et al. Effect of vitamin E supplementation in rheumatoid arthritis: A systematic review and meta-analysis. Eur J Clin Nutr. 2022 (Apr 25). Doi: 10.1038/s41430-022-01148-9

Key clinical point: Regular vitamin E supplementation in patients with rheumatoid arthritis (RA) may help reduce joint discomfort, edema, and stiffness, thus enhancing the overall quality of life.

Major finding: Patients with RA who received regular vitamin E supplementation showed improvements in uncomfortable joints (mean difference [MD] −0.62; 95% CI −12.59 to 11.36) and tender joints (MD −1.66; 95% CI −6.32 to 2.99) compared with those who received placebo, fish oil, or other medications, without any significant safety concerns.

Study details: This was a systematic review and meta-analysis of nine studies including 39,845 individuals with RA who received vitamin E (experimental group) or placebo, fish oil, or other medications (control group).

Disclosures: This study was supported by funding from the Natural Science Foundation of Shaanxi Province, China. The authors declared no competing interests.

Source: Kou H et al. Effect of vitamin E supplementation in rheumatoid arthritis: A systematic review and meta-analysis. Eur J Clin Nutr. 2022 (Apr 25). Doi: 10.1038/s41430-022-01148-9

Key clinical point: Regular vitamin E supplementation in patients with rheumatoid arthritis (RA) may help reduce joint discomfort, edema, and stiffness, thus enhancing the overall quality of life.

Major finding: Patients with RA who received regular vitamin E supplementation showed improvements in uncomfortable joints (mean difference [MD] −0.62; 95% CI −12.59 to 11.36) and tender joints (MD −1.66; 95% CI −6.32 to 2.99) compared with those who received placebo, fish oil, or other medications, without any significant safety concerns.

Study details: This was a systematic review and meta-analysis of nine studies including 39,845 individuals with RA who received vitamin E (experimental group) or placebo, fish oil, or other medications (control group).

Disclosures: This study was supported by funding from the Natural Science Foundation of Shaanxi Province, China. The authors declared no competing interests.

Source: Kou H et al. Effect of vitamin E supplementation in rheumatoid arthritis: A systematic review and meta-analysis. Eur J Clin Nutr. 2022 (Apr 25). Doi: 10.1038/s41430-022-01148-9

Key clinical point: Regular vitamin E supplementation in patients with rheumatoid arthritis (RA) may help reduce joint discomfort, edema, and stiffness, thus enhancing the overall quality of life.

Major finding: Patients with RA who received regular vitamin E supplementation showed improvements in uncomfortable joints (mean difference [MD] −0.62; 95% CI −12.59 to 11.36) and tender joints (MD −1.66; 95% CI −6.32 to 2.99) compared with those who received placebo, fish oil, or other medications, without any significant safety concerns.

Study details: This was a systematic review and meta-analysis of nine studies including 39,845 individuals with RA who received vitamin E (experimental group) or placebo, fish oil, or other medications (control group).

Disclosures: This study was supported by funding from the Natural Science Foundation of Shaanxi Province, China. The authors declared no competing interests.

Source: Kou H et al. Effect of vitamin E supplementation in rheumatoid arthritis: A systematic review and meta-analysis. Eur J Clin Nutr. 2022 (Apr 25). Doi: 10.1038/s41430-022-01148-9

Key clinical point: Regular vitamin E supplementation in patients with rheumatoid arthritis (RA) may help reduce joint discomfort, edema, and stiffness, thus enhancing the overall quality of life.

Major finding: Patients with RA who received regular vitamin E supplementation showed improvements in uncomfortable joints (mean difference [MD] −0.62; 95% CI −12.59 to 11.36) and tender joints (MD −1.66; 95% CI −6.32 to 2.99) compared with those who received placebo, fish oil, or other medications, without any significant safety concerns.

Study details: This was a systematic review and meta-analysis of nine studies including 39,845 individuals with RA who received vitamin E (experimental group) or placebo, fish oil, or other medications (control group).

Disclosures: This study was supported by funding from the Natural Science Foundation of Shaanxi Province, China. The authors declared no competing interests.

Source: Kou H et al. Effect of vitamin E supplementation in rheumatoid arthritis: A systematic review and meta-analysis. Eur J Clin Nutr. 2022 (Apr 25). Doi: 10.1038/s41430-022-01148-9

Key clinical point: Treatment with tofacitinib, tocilizumab, or tumor necrosis factor inhibitors (TNFi) vs. abatacept did not reduce the risk of developing Alzheimer disease and related dementia (ADRD) in patients with rheumatoid arthritis (RA).

Major finding: The risk for ADRD associated with tofacitinib (adjusted hazard ratio [aHR] 0.90; 95% CI 0.55-1.51), tocilizumab (aHR 0.82; 95% CI 0.55-1.21), and TNFi (aHR 0.93; 95% CI 0.72-1.20) was similar to that with abatacept.

Study details: This was an observational study including 22,569 patients aged ≥65 years with RA from the DREAM study who were treated with tofacitinib, tocilizumab, or TNFi and were propensity score-matched with an equal number of patients treated with abatacept.

Disclosures: The DREAM study is funded by the National Institute on Aging. Several authors reported receiving grants, personal fees, or salary support from or owning stocks in various sources outside the submitted work.

Source: Desai RJ et al. Comparative risk of Alzheimer disease and related dementia among Medicare beneficiaries with rheumatoid arthritis treated with targeted disease-modifying antirheumatic agents. JAMA Netw Open. 2022;5(4):e226567 (Apr 8). Doi: 10.1001/jamanetworkopen.2022.6567

Key clinical point: Treatment with tofacitinib, tocilizumab, or tumor necrosis factor inhibitors (TNFi) vs. abatacept did not reduce the risk of developing Alzheimer disease and related dementia (ADRD) in patients with rheumatoid arthritis (RA).

Major finding: The risk for ADRD associated with tofacitinib (adjusted hazard ratio [aHR] 0.90; 95% CI 0.55-1.51), tocilizumab (aHR 0.82; 95% CI 0.55-1.21), and TNFi (aHR 0.93; 95% CI 0.72-1.20) was similar to that with abatacept.

Study details: This was an observational study including 22,569 patients aged ≥65 years with RA from the DREAM study who were treated with tofacitinib, tocilizumab, or TNFi and were propensity score-matched with an equal number of patients treated with abatacept.

Disclosures: The DREAM study is funded by the National Institute on Aging. Several authors reported receiving grants, personal fees, or salary support from or owning stocks in various sources outside the submitted work.

Source: Desai RJ et al. Comparative risk of Alzheimer disease and related dementia among Medicare beneficiaries with rheumatoid arthritis treated with targeted disease-modifying antirheumatic agents. JAMA Netw Open. 2022;5(4):e226567 (Apr 8). Doi: 10.1001/jamanetworkopen.2022.6567

Key clinical point: Treatment with tofacitinib, tocilizumab, or tumor necrosis factor inhibitors (TNFi) vs. abatacept did not reduce the risk of developing Alzheimer disease and related dementia (ADRD) in patients with rheumatoid arthritis (RA).

Major finding: The risk for ADRD associated with tofacitinib (adjusted hazard ratio [aHR] 0.90; 95% CI 0.55-1.51), tocilizumab (aHR 0.82; 95% CI 0.55-1.21), and TNFi (aHR 0.93; 95% CI 0.72-1.20) was similar to that with abatacept.

Study details: This was an observational study including 22,569 patients aged ≥65 years with RA from the DREAM study who were treated with tofacitinib, tocilizumab, or TNFi and were propensity score-matched with an equal number of patients treated with abatacept.

Disclosures: The DREAM study is funded by the National Institute on Aging. Several authors reported receiving grants, personal fees, or salary support from or owning stocks in various sources outside the submitted work.

Source: Desai RJ et al. Comparative risk of Alzheimer disease and related dementia among Medicare beneficiaries with rheumatoid arthritis treated with targeted disease-modifying antirheumatic agents. JAMA Netw Open. 2022;5(4):e226567 (Apr 8). Doi: 10.1001/jamanetworkopen.2022.6567

Key clinical point: Identification of swelling in specific large, medium, and small joints in early rheumatoid arthritis (RA) is correlated with severe disease activity and may indicate the need for more intensive therapy.

Major finding: At baseline, 91.9% and 89.1% of patients had swelling in the wrist and meta-carpophalangeal-2 joint, respectively, and swelling in the knee, temporomandibular joint, wrist, and elbow was associated with severe disease activity (P < .001). Patients treated with abatacept+methotrexate vs. methotrexate alone showed higher swelling resolution and Boolean remission rates (all P < .01).

Study details: This was a post hoc analysis of the phase 3 study, AGREE, including 509 methotrexate-naive patients with early erosive, seropositive RA and factors associated with poor prognosis who were randomly assigned to receive abatacept+methotrexate or methotrexate alone for 12 months.

Disclosures: This study was funded by Bristol-Myers Squibb (BMS). P Durez reported receiving speaker fees from BMS and other sources. Four authors reported being employees or shareholders of BMS or companies contracting with BMS.

Source: Durez P et al. Identification of poor prognostic joint locations in an early rheumatoid arthritis cohort at risk of rapidly progressing disease: a post-hoc analysis of the Phase III AGREE study. BMC Rheumatol. 2022;6:24 (Apr 14). Doi: 10.1186/s41927-022-00252-4

Key clinical point: Identification of swelling in specific large, medium, and small joints in early rheumatoid arthritis (RA) is correlated with severe disease activity and may indicate the need for more intensive therapy.

Major finding: At baseline, 91.9% and 89.1% of patients had swelling in the wrist and meta-carpophalangeal-2 joint, respectively, and swelling in the knee, temporomandibular joint, wrist, and elbow was associated with severe disease activity (P < .001). Patients treated with abatacept+methotrexate vs. methotrexate alone showed higher swelling resolution and Boolean remission rates (all P < .01).

Study details: This was a post hoc analysis of the phase 3 study, AGREE, including 509 methotrexate-naive patients with early erosive, seropositive RA and factors associated with poor prognosis who were randomly assigned to receive abatacept+methotrexate or methotrexate alone for 12 months.

Disclosures: This study was funded by Bristol-Myers Squibb (BMS). P Durez reported receiving speaker fees from BMS and other sources. Four authors reported being employees or shareholders of BMS or companies contracting with BMS.

Source: Durez P et al. Identification of poor prognostic joint locations in an early rheumatoid arthritis cohort at risk of rapidly progressing disease: a post-hoc analysis of the Phase III AGREE study. BMC Rheumatol. 2022;6:24 (Apr 14). Doi: 10.1186/s41927-022-00252-4

Key clinical point: Identification of swelling in specific large, medium, and small joints in early rheumatoid arthritis (RA) is correlated with severe disease activity and may indicate the need for more intensive therapy.

Major finding: At baseline, 91.9% and 89.1% of patients had swelling in the wrist and meta-carpophalangeal-2 joint, respectively, and swelling in the knee, temporomandibular joint, wrist, and elbow was associated with severe disease activity (P < .001). Patients treated with abatacept+methotrexate vs. methotrexate alone showed higher swelling resolution and Boolean remission rates (all P < .01).

Study details: This was a post hoc analysis of the phase 3 study, AGREE, including 509 methotrexate-naive patients with early erosive, seropositive RA and factors associated with poor prognosis who were randomly assigned to receive abatacept+methotrexate or methotrexate alone for 12 months.

Disclosures: This study was funded by Bristol-Myers Squibb (BMS). P Durez reported receiving speaker fees from BMS and other sources. Four authors reported being employees or shareholders of BMS or companies contracting with BMS.

Source: Durez P et al. Identification of poor prognostic joint locations in an early rheumatoid arthritis cohort at risk of rapidly progressing disease: a post-hoc analysis of the Phase III AGREE study. BMC Rheumatol. 2022;6:24 (Apr 14). Doi: 10.1186/s41927-022-00252-4

Key clinical point: Management of patients with rheumatoid arthritis-associated interstitial lung disease (RA-ILD) should include regular assessment of disease activity and pulmonary function because both independently predicted the mortality risk in U.S. veterans with RA-ILD.

Major finding: Uncontrolled RA disease activity (adjusted hazard ratio [aHR], 3.00; 95% CI, 1.13-7.97) and forced vital capacity (FVC) impairment (aHR, 3.07; 95% CI, 1.03-9.19) were independently associated with higher mortality among US veterans with RA-ILD, with survival being the poorest among veterans with impaired disease activity and FVC impairment (aHR 4.43; 95% CI 1.70-11.55).

Study details: This was a prospective cohort study including 227 US veterans with RA-ILD.

Disclosures: This study was supported by the US Department of Veterans Affairs, the Rheumatology Research Foundation, and others. Several authors reported consulting with or receiving research funding from various sources.

Source: Brooks R et al. The impact of disease severity measures on survival in U.S. Veterans with rheumatoid arthritis-associated interstitial lung disease. Rheumatology (Oxford). 2022 (Apr 4). Doi: 10.1093/rheumatology/keac208

Key clinical point: Management of patients with rheumatoid arthritis-associated interstitial lung disease (RA-ILD) should include regular assessment of disease activity and pulmonary function because both independently predicted the mortality risk in U.S. veterans with RA-ILD.

Major finding: Uncontrolled RA disease activity (adjusted hazard ratio [aHR], 3.00; 95% CI, 1.13-7.97) and forced vital capacity (FVC) impairment (aHR, 3.07; 95% CI, 1.03-9.19) were independently associated with higher mortality among US veterans with RA-ILD, with survival being the poorest among veterans with impaired disease activity and FVC impairment (aHR 4.43; 95% CI 1.70-11.55).

Study details: This was a prospective cohort study including 227 US veterans with RA-ILD.

Disclosures: This study was supported by the US Department of Veterans Affairs, the Rheumatology Research Foundation, and others. Several authors reported consulting with or receiving research funding from various sources.

Source: Brooks R et al. The impact of disease severity measures on survival in U.S. Veterans with rheumatoid arthritis-associated interstitial lung disease. Rheumatology (Oxford). 2022 (Apr 4). Doi: 10.1093/rheumatology/keac208

Key clinical point: Management of patients with rheumatoid arthritis-associated interstitial lung disease (RA-ILD) should include regular assessment of disease activity and pulmonary function because both independently predicted the mortality risk in U.S. veterans with RA-ILD.

Major finding: Uncontrolled RA disease activity (adjusted hazard ratio [aHR], 3.00; 95% CI, 1.13-7.97) and forced vital capacity (FVC) impairment (aHR, 3.07; 95% CI, 1.03-9.19) were independently associated with higher mortality among US veterans with RA-ILD, with survival being the poorest among veterans with impaired disease activity and FVC impairment (aHR 4.43; 95% CI 1.70-11.55).

Study details: This was a prospective cohort study including 227 US veterans with RA-ILD.

Disclosures: This study was supported by the US Department of Veterans Affairs, the Rheumatology Research Foundation, and others. Several authors reported consulting with or receiving research funding from various sources.

Source: Brooks R et al. The impact of disease severity measures on survival in U.S. Veterans with rheumatoid arthritis-associated interstitial lung disease. Rheumatology (Oxford). 2022 (Apr 4). Doi: 10.1093/rheumatology/keac208

Key clinical point: The risk for COVID-19 hospitalization reduced markedly after vaccination in patients with rheumatoid arthritis (RA) and matched individuals from the general population; however, patients with RA remained at a higher risk for hospitalization even after complete vaccination.

Major finding: The absolute risk for hospitalization was 0.20% vs 0.08% among unvaccinated patients with RA vs matched patients at 60 days of follow-up and remained below 0.05% in both fully vaccinated groups after 180 days of follow-up. However, patients with RA remained at a higher risk for COVID-19 hospitalization vs matched patients, even after complete vaccination (adjusted hazard ratio 1.94; 95% CI 1.03-3.66).

Study details: This was an observational study of 28,447 unvaccinated patients with RA receiving conventional synthetic or biological disease-modifying antirheumatic drugs who were matched with 568,940 individuals from the general population with no history of inflammatory rheumatic disease; eventually, all individuals received one or two doses of COVID-19 vaccine.

Disclosures: This study was funded by Aalborg University Hospital. Some authors reported receiving grants and being on speaker’s bureau for various sources.

Source: Cordtz R et al. COVID-19 infection and hospitalization risk according to vaccination status and DMARD treatment in patients with rheumatoid arthritis. Rheumatology (Oxford). 2022 (Apr 13). Doi: 10.1093/rheumatology/keac241

Key clinical point: The risk for COVID-19 hospitalization reduced markedly after vaccination in patients with rheumatoid arthritis (RA) and matched individuals from the general population; however, patients with RA remained at a higher risk for hospitalization even after complete vaccination.

Major finding: The absolute risk for hospitalization was 0.20% vs 0.08% among unvaccinated patients with RA vs matched patients at 60 days of follow-up and remained below 0.05% in both fully vaccinated groups after 180 days of follow-up. However, patients with RA remained at a higher risk for COVID-19 hospitalization vs matched patients, even after complete vaccination (adjusted hazard ratio 1.94; 95% CI 1.03-3.66).

Study details: This was an observational study of 28,447 unvaccinated patients with RA receiving conventional synthetic or biological disease-modifying antirheumatic drugs who were matched with 568,940 individuals from the general population with no history of inflammatory rheumatic disease; eventually, all individuals received one or two doses of COVID-19 vaccine.

Disclosures: This study was funded by Aalborg University Hospital. Some authors reported receiving grants and being on speaker’s bureau for various sources.

Source: Cordtz R et al. COVID-19 infection and hospitalization risk according to vaccination status and DMARD treatment in patients with rheumatoid arthritis. Rheumatology (Oxford). 2022 (Apr 13). Doi: 10.1093/rheumatology/keac241

Key clinical point: The risk for COVID-19 hospitalization reduced markedly after vaccination in patients with rheumatoid arthritis (RA) and matched individuals from the general population; however, patients with RA remained at a higher risk for hospitalization even after complete vaccination.

Major finding: The absolute risk for hospitalization was 0.20% vs 0.08% among unvaccinated patients with RA vs matched patients at 60 days of follow-up and remained below 0.05% in both fully vaccinated groups after 180 days of follow-up. However, patients with RA remained at a higher risk for COVID-19 hospitalization vs matched patients, even after complete vaccination (adjusted hazard ratio 1.94; 95% CI 1.03-3.66).

Study details: This was an observational study of 28,447 unvaccinated patients with RA receiving conventional synthetic or biological disease-modifying antirheumatic drugs who were matched with 568,940 individuals from the general population with no history of inflammatory rheumatic disease; eventually, all individuals received one or two doses of COVID-19 vaccine.

Disclosures: This study was funded by Aalborg University Hospital. Some authors reported receiving grants and being on speaker’s bureau for various sources.

Source: Cordtz R et al. COVID-19 infection and hospitalization risk according to vaccination status and DMARD treatment in patients with rheumatoid arthritis. Rheumatology (Oxford). 2022 (Apr 13). Doi: 10.1093/rheumatology/keac241

Key clinical point: The disease activity metrics of rheumatoid arthritis (RA) improved significantly with upadacitinib plus elsubrutinib (ABBV-599) vs placebo in patients with inadequate response or intolerance to biologics, with effects likely driven by upadacitinib and not elsubrutinib.

Major finding: At week 12, compared with placebo, the change in Disease Activity Score of 28 joints with C-reactive protein was significantly higher with ABBV-599 (least squares mean difference [LSMD] −1.44) and upadacitinib (LSMD −1.75; both P < .0001) but not with elsubrutinib. The incidence of treatment-emergent adverse events was similar for ABBV-599 and placebo.

Study details: This was a phase 2 trial including 242 patients with RA and inadequate response/intolerance to biologics who were randomly assigned to receive ABBV-599, elsubrutinib (60, 20, or 5 mg), upadacitinib, or placebo for 12 weeks.

Disclosures: This study was funded by AbbVie. R Fleischmann and several authors reported receiving grant support or honorarium for consultancy from various sources, including AbbVie. Six authors declared being full-time current or former employees or holding stocks or stock options at AbbVie.

Source: Fleischmann R et al. Safety and efficacy of elsubrutinib or upadacitinib alone or in combination (ABBV-599) in patients with rheumatoid arthritis and inadequate response or intolerance to biological therapies: A multicentre, double-blind, randomised, controlled, phase 2 trial. Lancet Rheumatol. 2022 (Apr 27). Doi: 10.1016/S2665-9913(22)00092-3

Key clinical point: The disease activity metrics of rheumatoid arthritis (RA) improved significantly with upadacitinib plus elsubrutinib (ABBV-599) vs placebo in patients with inadequate response or intolerance to biologics, with effects likely driven by upadacitinib and not elsubrutinib.

Major finding: At week 12, compared with placebo, the change in Disease Activity Score of 28 joints with C-reactive protein was significantly higher with ABBV-599 (least squares mean difference [LSMD] −1.44) and upadacitinib (LSMD −1.75; both P < .0001) but not with elsubrutinib. The incidence of treatment-emergent adverse events was similar for ABBV-599 and placebo.

Study details: This was a phase 2 trial including 242 patients with RA and inadequate response/intolerance to biologics who were randomly assigned to receive ABBV-599, elsubrutinib (60, 20, or 5 mg), upadacitinib, or placebo for 12 weeks.

Disclosures: This study was funded by AbbVie. R Fleischmann and several authors reported receiving grant support or honorarium for consultancy from various sources, including AbbVie. Six authors declared being full-time current or former employees or holding stocks or stock options at AbbVie.

Source: Fleischmann R et al. Safety and efficacy of elsubrutinib or upadacitinib alone or in combination (ABBV-599) in patients with rheumatoid arthritis and inadequate response or intolerance to biological therapies: A multicentre, double-blind, randomised, controlled, phase 2 trial. Lancet Rheumatol. 2022 (Apr 27). Doi: 10.1016/S2665-9913(22)00092-3

Key clinical point: The disease activity metrics of rheumatoid arthritis (RA) improved significantly with upadacitinib plus elsubrutinib (ABBV-599) vs placebo in patients with inadequate response or intolerance to biologics, with effects likely driven by upadacitinib and not elsubrutinib.

Major finding: At week 12, compared with placebo, the change in Disease Activity Score of 28 joints with C-reactive protein was significantly higher with ABBV-599 (least squares mean difference [LSMD] −1.44) and upadacitinib (LSMD −1.75; both P < .0001) but not with elsubrutinib. The incidence of treatment-emergent adverse events was similar for ABBV-599 and placebo.

Study details: This was a phase 2 trial including 242 patients with RA and inadequate response/intolerance to biologics who were randomly assigned to receive ABBV-599, elsubrutinib (60, 20, or 5 mg), upadacitinib, or placebo for 12 weeks.

Disclosures: This study was funded by AbbVie. R Fleischmann and several authors reported receiving grant support or honorarium for consultancy from various sources, including AbbVie. Six authors declared being full-time current or former employees or holding stocks or stock options at AbbVie.

Source: Fleischmann R et al. Safety and efficacy of elsubrutinib or upadacitinib alone or in combination (ABBV-599) in patients with rheumatoid arthritis and inadequate response or intolerance to biological therapies: A multicentre, double-blind, randomised, controlled, phase 2 trial. Lancet Rheumatol. 2022 (Apr 27). Doi: 10.1016/S2665-9913(22)00092-3