Article

Key clinical point: Laparoscopic distal gastrectomy was surgically and oncologically noninferior to open distal gastrectomy in patients with locally advanced gastric cancer throughout the 5-year follow-up period.

Major finding: Patients who underwent laparoscopic vs open distal gastrectomy had a significantly lower late complication rate (6.5% vs 11.0%; P  =  .01), but similar 5-year overall survival (88.9% vs 88.7%; P  =  .30) and relapse-free survival (79.5% vs 81.1%; P  =  .658) rates.

Study details: This study reports the 5-year follow-up results of the KLASS-02 trial that included 974 patients with locally advanced gastric cancer who underwent R0 resection by laparoscopic (n = 492) or open (n = 482) distal gastrectomy.

Disclosures: This study was sponsored by the National R&D Program for Cancer Control (NRDPCC), Ministry of Health and Welfare, Republic of Korea, and Ethicon Endo-Surgery, a Johnson & Johnson Company. Some authors reported receiving grants or personal fees from various sources, including NRDPCC and Ethicon Endo-Surgery.

Source: Son SY et al. Laparoscopic vs open distal gastrectomy for locally advanced gastric cancer: 5-year outcomes of the KLASS-02 randomized clinical trial. JAMA Surg. 2022 (Jul 20). Doi: 10.1001/jamasurg.2022.2749

Key clinical point: Laparoscopic distal gastrectomy was surgically and oncologically noninferior to open distal gastrectomy in patients with locally advanced gastric cancer throughout the 5-year follow-up period.

Major finding: Patients who underwent laparoscopic vs open distal gastrectomy had a significantly lower late complication rate (6.5% vs 11.0%; P  =  .01), but similar 5-year overall survival (88.9% vs 88.7%; P  =  .30) and relapse-free survival (79.5% vs 81.1%; P  =  .658) rates.

Study details: This study reports the 5-year follow-up results of the KLASS-02 trial that included 974 patients with locally advanced gastric cancer who underwent R0 resection by laparoscopic (n = 492) or open (n = 482) distal gastrectomy.

Disclosures: This study was sponsored by the National R&D Program for Cancer Control (NRDPCC), Ministry of Health and Welfare, Republic of Korea, and Ethicon Endo-Surgery, a Johnson & Johnson Company. Some authors reported receiving grants or personal fees from various sources, including NRDPCC and Ethicon Endo-Surgery.

Source: Son SY et al. Laparoscopic vs open distal gastrectomy for locally advanced gastric cancer: 5-year outcomes of the KLASS-02 randomized clinical trial. JAMA Surg. 2022 (Jul 20). Doi: 10.1001/jamasurg.2022.2749

Key clinical point: Laparoscopic distal gastrectomy was surgically and oncologically noninferior to open distal gastrectomy in patients with locally advanced gastric cancer throughout the 5-year follow-up period.

Major finding: Patients who underwent laparoscopic vs open distal gastrectomy had a significantly lower late complication rate (6.5% vs 11.0%; P  =  .01), but similar 5-year overall survival (88.9% vs 88.7%; P  =  .30) and relapse-free survival (79.5% vs 81.1%; P  =  .658) rates.

Study details: This study reports the 5-year follow-up results of the KLASS-02 trial that included 974 patients with locally advanced gastric cancer who underwent R0 resection by laparoscopic (n = 492) or open (n = 482) distal gastrectomy.

Disclosures: This study was sponsored by the National R&D Program for Cancer Control (NRDPCC), Ministry of Health and Welfare, Republic of Korea, and Ethicon Endo-Surgery, a Johnson & Johnson Company. Some authors reported receiving grants or personal fees from various sources, including NRDPCC and Ethicon Endo-Surgery.

Source: Son SY et al. Laparoscopic vs open distal gastrectomy for locally advanced gastric cancer: 5-year outcomes of the KLASS-02 randomized clinical trial. JAMA Surg. 2022 (Jul 20). Doi: 10.1001/jamasurg.2022.2749

Key clinical point: Patients with rheumatoid arthritis (RA) and low or moderate disease activity were at a higher risk for hospitalized infections compared with those in remission.

Major finding: Compared with patients attaining remission, patients attaining low disease activity (adjusted hazard ratio [aHR] 1.60; 95% CI 1.13-2.27) and moderate disease activity (aHR 1.83; 95% CI 1.29-2.61) were at a higher risk for hospitalized infections.

Study details: Findings are from a prospective observational cohort study including 3254 patients with moderate RA from the CorEvitas RA registry.

Disclosures: H Yun and JR Curtis declared receiving support from US National Institutes of Health/National Institute of Arthritis and Musculoskeletal and Skin Diseases. Two authors reported being employees and shareholders of CorEvitas LLC. Several authors reported receiving research funding from or serving on speakers bureaus or as consultants for various sources.

Source: Yun H et al. Rheumatoid arthritis disease activity and hospitalized infection in a large U.S. registry. Arthritis Care Res (Hoboken). 2022 (Jul 22). Doi: 10.1002/acr.24984

Key clinical point: Patients with rheumatoid arthritis (RA) and low or moderate disease activity were at a higher risk for hospitalized infections compared with those in remission.

Major finding: Compared with patients attaining remission, patients attaining low disease activity (adjusted hazard ratio [aHR] 1.60; 95% CI 1.13-2.27) and moderate disease activity (aHR 1.83; 95% CI 1.29-2.61) were at a higher risk for hospitalized infections.

Study details: Findings are from a prospective observational cohort study including 3254 patients with moderate RA from the CorEvitas RA registry.

Disclosures: H Yun and JR Curtis declared receiving support from US National Institutes of Health/National Institute of Arthritis and Musculoskeletal and Skin Diseases. Two authors reported being employees and shareholders of CorEvitas LLC. Several authors reported receiving research funding from or serving on speakers bureaus or as consultants for various sources.

Source: Yun H et al. Rheumatoid arthritis disease activity and hospitalized infection in a large U.S. registry. Arthritis Care Res (Hoboken). 2022 (Jul 22). Doi: 10.1002/acr.24984

Key clinical point: Patients with rheumatoid arthritis (RA) and low or moderate disease activity were at a higher risk for hospitalized infections compared with those in remission.

Major finding: Compared with patients attaining remission, patients attaining low disease activity (adjusted hazard ratio [aHR] 1.60; 95% CI 1.13-2.27) and moderate disease activity (aHR 1.83; 95% CI 1.29-2.61) were at a higher risk for hospitalized infections.

Study details: Findings are from a prospective observational cohort study including 3254 patients with moderate RA from the CorEvitas RA registry.

Disclosures: H Yun and JR Curtis declared receiving support from US National Institutes of Health/National Institute of Arthritis and Musculoskeletal and Skin Diseases. Two authors reported being employees and shareholders of CorEvitas LLC. Several authors reported receiving research funding from or serving on speakers bureaus or as consultants for various sources.

Source: Yun H et al. Rheumatoid arthritis disease activity and hospitalized infection in a large U.S. registry. Arthritis Care Res (Hoboken). 2022 (Jul 22). Doi: 10.1002/acr.24984

Key clinical point: The rate of development of rheumatoid arthritis (RA) was lower in patients with diabetes who used vs did not use sulfonylureas or biguanides, with biguanides appearing to have a more rapid and sulfonylureas having a longer effect in lowering RA incidence.

Major finding: Among patients with diabetes, sulfonylureas or biguanides users vs nonusers were at a reduced risk of developing RA (adjusted hazard ratio 0.73; 95% CI 0.60-0.90), with the risk being lower in those prescribed biguanides for >180 days within 1 year (adjusted odds ratio [aOR] 0.72; 95% CI 0.53-0.99) and those prescribed sulfonylureas for >365 days within 3 years (aOR 0.62; 95% CI 0.46-0.84) of the first RA visit.

Study details: Findings are from a cohort study including 94,141 patients with diabetes, of which 494 patients developed RA and were age- and sex-matched with 988 patients who did not develop RA.

Disclosures: This study was supported by Chung Shan Medical University Hospital, Taiwan, Chang Gung Memorial Hospital, and others. The authors declared no conflicts of interest.

Source: Su YJ et al. Sulfonylureas or biguanides is associated with a lower risk of rheumatoid arthritis in patients with diabetes: A nationwide cohort study. Front Med (Lausanne). 2022;9:934184 (Jul 27). Doi: 10.3389/fmed.2022.934184

Key clinical point: The rate of development of rheumatoid arthritis (RA) was lower in patients with diabetes who used vs did not use sulfonylureas or biguanides, with biguanides appearing to have a more rapid and sulfonylureas having a longer effect in lowering RA incidence.

Major finding: Among patients with diabetes, sulfonylureas or biguanides users vs nonusers were at a reduced risk of developing RA (adjusted hazard ratio 0.73; 95% CI 0.60-0.90), with the risk being lower in those prescribed biguanides for >180 days within 1 year (adjusted odds ratio [aOR] 0.72; 95% CI 0.53-0.99) and those prescribed sulfonylureas for >365 days within 3 years (aOR 0.62; 95% CI 0.46-0.84) of the first RA visit.

Study details: Findings are from a cohort study including 94,141 patients with diabetes, of which 494 patients developed RA and were age- and sex-matched with 988 patients who did not develop RA.

Disclosures: This study was supported by Chung Shan Medical University Hospital, Taiwan, Chang Gung Memorial Hospital, and others. The authors declared no conflicts of interest.

Source: Su YJ et al. Sulfonylureas or biguanides is associated with a lower risk of rheumatoid arthritis in patients with diabetes: A nationwide cohort study. Front Med (Lausanne). 2022;9:934184 (Jul 27). Doi: 10.3389/fmed.2022.934184

Key clinical point: The rate of development of rheumatoid arthritis (RA) was lower in patients with diabetes who used vs did not use sulfonylureas or biguanides, with biguanides appearing to have a more rapid and sulfonylureas having a longer effect in lowering RA incidence.

Major finding: Among patients with diabetes, sulfonylureas or biguanides users vs nonusers were at a reduced risk of developing RA (adjusted hazard ratio 0.73; 95% CI 0.60-0.90), with the risk being lower in those prescribed biguanides for >180 days within 1 year (adjusted odds ratio [aOR] 0.72; 95% CI 0.53-0.99) and those prescribed sulfonylureas for >365 days within 3 years (aOR 0.62; 95% CI 0.46-0.84) of the first RA visit.

Study details: Findings are from a cohort study including 94,141 patients with diabetes, of which 494 patients developed RA and were age- and sex-matched with 988 patients who did not develop RA.

Disclosures: This study was supported by Chung Shan Medical University Hospital, Taiwan, Chang Gung Memorial Hospital, and others. The authors declared no conflicts of interest.

Source: Su YJ et al. Sulfonylureas or biguanides is associated with a lower risk of rheumatoid arthritis in patients with diabetes: A nationwide cohort study. Front Med (Lausanne). 2022;9:934184 (Jul 27). Doi: 10.3389/fmed.2022.934184

Key clinical point: A serum lipid profile rich in long chain n-3 and n-6 polyunsaturated fatty acids (PUFA) was independently associated with a lower 6-month disease activity in a cohort of patients with early rheumatoid arthritis (RA).

Major finding: At 6 months, the odds of having a 28-joint Disease Activity Score of ≥5.1 was significantly lower in patients in higher tertiles of n-3 PUFA (odds ratio for tertile 3 vs 1 [ORt] 0.49; 95% CI 0.25-0.97) and n-6 PUFA (ORt 0.51; 95% CI 0.28-0.95), with the association being independent of baseline C-reactive protein levels.

Study details: This was a longitudinal cohort study including 669 patients with early RA.

Disclosures: This study was supported by Sorbonne Paris Nord University. The authors declared no conflicts of interest.

Source: Sigaux J et al. Serum fatty acid profiles are associated with disease activity in early rheumatoid arthritis: Results from the ESPOIR cohort. Nutrients. 2022;14(14):2947 (Jul 19). Doi:  10.3390/nu14142947

Key clinical point: A serum lipid profile rich in long chain n-3 and n-6 polyunsaturated fatty acids (PUFA) was independently associated with a lower 6-month disease activity in a cohort of patients with early rheumatoid arthritis (RA).

Major finding: At 6 months, the odds of having a 28-joint Disease Activity Score of ≥5.1 was significantly lower in patients in higher tertiles of n-3 PUFA (odds ratio for tertile 3 vs 1 [ORt] 0.49; 95% CI 0.25-0.97) and n-6 PUFA (ORt 0.51; 95% CI 0.28-0.95), with the association being independent of baseline C-reactive protein levels.

Study details: This was a longitudinal cohort study including 669 patients with early RA.

Disclosures: This study was supported by Sorbonne Paris Nord University. The authors declared no conflicts of interest.

Source: Sigaux J et al. Serum fatty acid profiles are associated with disease activity in early rheumatoid arthritis: Results from the ESPOIR cohort. Nutrients. 2022;14(14):2947 (Jul 19). Doi:  10.3390/nu14142947

Key clinical point: A serum lipid profile rich in long chain n-3 and n-6 polyunsaturated fatty acids (PUFA) was independently associated with a lower 6-month disease activity in a cohort of patients with early rheumatoid arthritis (RA).

Major finding: At 6 months, the odds of having a 28-joint Disease Activity Score of ≥5.1 was significantly lower in patients in higher tertiles of n-3 PUFA (odds ratio for tertile 3 vs 1 [ORt] 0.49; 95% CI 0.25-0.97) and n-6 PUFA (ORt 0.51; 95% CI 0.28-0.95), with the association being independent of baseline C-reactive protein levels.

Study details: This was a longitudinal cohort study including 669 patients with early RA.

Disclosures: This study was supported by Sorbonne Paris Nord University. The authors declared no conflicts of interest.

Source: Sigaux J et al. Serum fatty acid profiles are associated with disease activity in early rheumatoid arthritis: Results from the ESPOIR cohort. Nutrients. 2022;14(14):2947 (Jul 19). Doi:  10.3390/nu14142947

Key clinical point: Patients with rheumatoid arthritis (RA) who were positive for anti-Sjögren's-syndrome-related antigen A (SSA) antibody were less responsive to initial methotrexate treatment compared with patients negative for anti-SSA antibody.

Major finding: At 6 months, a significantly lower proportion of patients in the anti-SSA antibody positive vs negative group achieved low disease activity based on the 28-joint Disease Activity Score-C-reactive protein (56.2% vs 75.8%; P  =  .03). Patients positive for anti-SSA antibody had a higher patient visual analogue score (median score 22 vs 19; P  =  .038) and use of nonsteroidal anti-inflammatory drugs (37.5% vs 18.0%; P  =  .018).

Study details: This was a retrospective cohort study including 210 methotrexate- or biologic disease-modifying antirheumatic drug-naive patients with RA who initiated methotrexate, of which 32 patients tested positive for anti-SSA antibody.

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

Source: Waki D et al. Effects of anti-SSA antibodies on the response to methotrexate in rheumatoid arthritis: A retrospective multicenter observational study. PLoS One. 2022;17(7):e0271921 (Jul 22). Doi: 10.1371/journal.pone.0271921

Key clinical point: Patients with rheumatoid arthritis (RA) who were positive for anti-Sjögren's-syndrome-related antigen A (SSA) antibody were less responsive to initial methotrexate treatment compared with patients negative for anti-SSA antibody.

Major finding: At 6 months, a significantly lower proportion of patients in the anti-SSA antibody positive vs negative group achieved low disease activity based on the 28-joint Disease Activity Score-C-reactive protein (56.2% vs 75.8%; P  =  .03). Patients positive for anti-SSA antibody had a higher patient visual analogue score (median score 22 vs 19; P  =  .038) and use of nonsteroidal anti-inflammatory drugs (37.5% vs 18.0%; P  =  .018).

Study details: This was a retrospective cohort study including 210 methotrexate- or biologic disease-modifying antirheumatic drug-naive patients with RA who initiated methotrexate, of which 32 patients tested positive for anti-SSA antibody.

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

Source: Waki D et al. Effects of anti-SSA antibodies on the response to methotrexate in rheumatoid arthritis: A retrospective multicenter observational study. PLoS One. 2022;17(7):e0271921 (Jul 22). Doi: 10.1371/journal.pone.0271921

Key clinical point: Patients with rheumatoid arthritis (RA) who were positive for anti-Sjögren's-syndrome-related antigen A (SSA) antibody were less responsive to initial methotrexate treatment compared with patients negative for anti-SSA antibody.

Major finding: At 6 months, a significantly lower proportion of patients in the anti-SSA antibody positive vs negative group achieved low disease activity based on the 28-joint Disease Activity Score-C-reactive protein (56.2% vs 75.8%; P  =  .03). Patients positive for anti-SSA antibody had a higher patient visual analogue score (median score 22 vs 19; P  =  .038) and use of nonsteroidal anti-inflammatory drugs (37.5% vs 18.0%; P  =  .018).

Study details: This was a retrospective cohort study including 210 methotrexate- or biologic disease-modifying antirheumatic drug-naive patients with RA who initiated methotrexate, of which 32 patients tested positive for anti-SSA antibody.

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

Source: Waki D et al. Effects of anti-SSA antibodies on the response to methotrexate in rheumatoid arthritis: A retrospective multicenter observational study. PLoS One. 2022;17(7):e0271921 (Jul 22). Doi: 10.1371/journal.pone.0271921

Key clinical point: Patients with rheumatoid arthritis (RA) who had symptoms of clinically active RA and cardiovascular disease were at an increased risk for dementia.

Major finding: Apart from the universally recognized risk factors for dementia, such as older age at RA incidence, hypertension, depression, and anxiety, RA disease characteristics, such as the presence of rheumatoid nodules (adjusted hazard ratio [aHR] 1.76; 95% CI 1.05-2.95), large joint swellings (aHR 2.11; 95% CI 1.33-3.34), and any cardiovascular disease at anytime after RA incidence (aHR 2.25; 95% CI 1.38-3.66) were significantly associated with an increased risk for dementia.

Study details: This was a retrospective cohort study including 886 patients with incident RA and without prior dementia, of which 103 patients developed dementia during a median follow-up of 8.5 years.

Disclosures: This study was supported by the US National Institutes of Health, National Institute of Aging, and National Institute of Arthritis and Musculoskeletal and Skin Diseases. M Vassilaki reported receiving research funding and owning equity in various companies. MM Mielke reported receiving research grants or funding from and serving as a consultant for various sources.

Source: Kodishala C et al. Risk factors for dementia in patients with incident rheumatoid arthritis: A population-based cohort study. J Rheumatol. 2022 (Jul 15). Doi: 10.3899/jrheum.220200

Key clinical point: Patients with rheumatoid arthritis (RA) who had symptoms of clinically active RA and cardiovascular disease were at an increased risk for dementia.

Major finding: Apart from the universally recognized risk factors for dementia, such as older age at RA incidence, hypertension, depression, and anxiety, RA disease characteristics, such as the presence of rheumatoid nodules (adjusted hazard ratio [aHR] 1.76; 95% CI 1.05-2.95), large joint swellings (aHR 2.11; 95% CI 1.33-3.34), and any cardiovascular disease at anytime after RA incidence (aHR 2.25; 95% CI 1.38-3.66) were significantly associated with an increased risk for dementia.

Study details: This was a retrospective cohort study including 886 patients with incident RA and without prior dementia, of which 103 patients developed dementia during a median follow-up of 8.5 years.

Disclosures: This study was supported by the US National Institutes of Health, National Institute of Aging, and National Institute of Arthritis and Musculoskeletal and Skin Diseases. M Vassilaki reported receiving research funding and owning equity in various companies. MM Mielke reported receiving research grants or funding from and serving as a consultant for various sources.

Source: Kodishala C et al. Risk factors for dementia in patients with incident rheumatoid arthritis: A population-based cohort study. J Rheumatol. 2022 (Jul 15). Doi: 10.3899/jrheum.220200

Key clinical point: Patients with rheumatoid arthritis (RA) who had symptoms of clinically active RA and cardiovascular disease were at an increased risk for dementia.

Major finding: Apart from the universally recognized risk factors for dementia, such as older age at RA incidence, hypertension, depression, and anxiety, RA disease characteristics, such as the presence of rheumatoid nodules (adjusted hazard ratio [aHR] 1.76; 95% CI 1.05-2.95), large joint swellings (aHR 2.11; 95% CI 1.33-3.34), and any cardiovascular disease at anytime after RA incidence (aHR 2.25; 95% CI 1.38-3.66) were significantly associated with an increased risk for dementia.

Study details: This was a retrospective cohort study including 886 patients with incident RA and without prior dementia, of which 103 patients developed dementia during a median follow-up of 8.5 years.

Disclosures: This study was supported by the US National Institutes of Health, National Institute of Aging, and National Institute of Arthritis and Musculoskeletal and Skin Diseases. M Vassilaki reported receiving research funding and owning equity in various companies. MM Mielke reported receiving research grants or funding from and serving as a consultant for various sources.

Source: Kodishala C et al. Risk factors for dementia in patients with incident rheumatoid arthritis: A population-based cohort study. J Rheumatol. 2022 (Jul 15). Doi: 10.3899/jrheum.220200

Key clinical point: Janus kinase inhibitors (JAKi) ameliorated the signs and symptoms of rheumatoid arthritis (RA) and improved the health-related quality of life more effectively than placebo; however, safety concerns should be addressed.

Major finding: JAKi vs placebo significantly improved the American College of Rheumatology ≥20% improvement response rate (risk ratio [RR] 2.03; P < .001) and Health Assessment Questionnaire-Disability Index (mean difference −0.31; P < .001), but were associated with a higher risk for ≥1 adverse events (RR 1.10; P < .001) and infections (RR 1.29; P < .001).

Study details: Findings are from a systematic review and meta-analysis of pooled data from 37 randomized controlled trials that evaluated JAKi for RA and included a total of 15,174 participants.

Disclosures: This study was supported by the National Natural Science Foundation of China, West China Hospital, and others. The authors declared no conflicts of interest.

Source: Wang F et al. Efficacy and safety of JAK inhibitors for rheumatoid arthritis: A meta-analysis. J Clin Med. 2022;11(15):4459 (Jul 30). Doi: 10.3390/jcm11154459

Key clinical point: Janus kinase inhibitors (JAKi) ameliorated the signs and symptoms of rheumatoid arthritis (RA) and improved the health-related quality of life more effectively than placebo; however, safety concerns should be addressed.

Major finding: JAKi vs placebo significantly improved the American College of Rheumatology ≥20% improvement response rate (risk ratio [RR] 2.03; P < .001) and Health Assessment Questionnaire-Disability Index (mean difference −0.31; P < .001), but were associated with a higher risk for ≥1 adverse events (RR 1.10; P < .001) and infections (RR 1.29; P < .001).

Study details: Findings are from a systematic review and meta-analysis of pooled data from 37 randomized controlled trials that evaluated JAKi for RA and included a total of 15,174 participants.

Disclosures: This study was supported by the National Natural Science Foundation of China, West China Hospital, and others. The authors declared no conflicts of interest.

Source: Wang F et al. Efficacy and safety of JAK inhibitors for rheumatoid arthritis: A meta-analysis. J Clin Med. 2022;11(15):4459 (Jul 30). Doi: 10.3390/jcm11154459

Key clinical point: Janus kinase inhibitors (JAKi) ameliorated the signs and symptoms of rheumatoid arthritis (RA) and improved the health-related quality of life more effectively than placebo; however, safety concerns should be addressed.

Major finding: JAKi vs placebo significantly improved the American College of Rheumatology ≥20% improvement response rate (risk ratio [RR] 2.03; P < .001) and Health Assessment Questionnaire-Disability Index (mean difference −0.31; P < .001), but were associated with a higher risk for ≥1 adverse events (RR 1.10; P < .001) and infections (RR 1.29; P < .001).

Study details: Findings are from a systematic review and meta-analysis of pooled data from 37 randomized controlled trials that evaluated JAKi for RA and included a total of 15,174 participants.

Disclosures: This study was supported by the National Natural Science Foundation of China, West China Hospital, and others. The authors declared no conflicts of interest.

Source: Wang F et al. Efficacy and safety of JAK inhibitors for rheumatoid arthritis: A meta-analysis. J Clin Med. 2022;11(15):4459 (Jul 30). Doi: 10.3390/jcm11154459

Key clinical point: Discontinuation of biologic disease-modifying antirheumatic drugs (bDMARD) upon testing positive for pregnancy is associated with and a major risk factor for disease flare during pregnancy in a large proportion of women with rheumatoid arthritis (RA) and good disease control prior to conception.

Major finding: Overall, flare was reported by 37% of patients during pregnancy and was associated with discontinuing bDMARD upon testing positive for pregnancy (odds ratio [OR] 2.857; P  =  .034) and previous use of >1 bDMARD (OR 4.1; P  =  .019). Patients with vs without disease flare during pregnancy were more likely to report preterm delivery (27% vs 7%; OR 4.625; P  =  .034).

Study details: This study analyzed the retrospectively collected data of 73 pregnancies in 63 women with RA and good disease control during conception who were prospectively followed through their pregnancies.

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

Source: Gerardi MC et al. Stopping bDMARDs at the beginning of pregnancy is associated with disease flares and preterm delivery in women with rheumatoid arthritis. Front Pharmacol. 2022 (Aug 3). Doi: 10.3389/fphar.2022.887462

Key clinical point: Discontinuation of biologic disease-modifying antirheumatic drugs (bDMARD) upon testing positive for pregnancy is associated with and a major risk factor for disease flare during pregnancy in a large proportion of women with rheumatoid arthritis (RA) and good disease control prior to conception.

Major finding: Overall, flare was reported by 37% of patients during pregnancy and was associated with discontinuing bDMARD upon testing positive for pregnancy (odds ratio [OR] 2.857; P  =  .034) and previous use of >1 bDMARD (OR 4.1; P  =  .019). Patients with vs without disease flare during pregnancy were more likely to report preterm delivery (27% vs 7%; OR 4.625; P  =  .034).

Study details: This study analyzed the retrospectively collected data of 73 pregnancies in 63 women with RA and good disease control during conception who were prospectively followed through their pregnancies.

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

Source: Gerardi MC et al. Stopping bDMARDs at the beginning of pregnancy is associated with disease flares and preterm delivery in women with rheumatoid arthritis. Front Pharmacol. 2022 (Aug 3). Doi: 10.3389/fphar.2022.887462

Key clinical point: Discontinuation of biologic disease-modifying antirheumatic drugs (bDMARD) upon testing positive for pregnancy is associated with and a major risk factor for disease flare during pregnancy in a large proportion of women with rheumatoid arthritis (RA) and good disease control prior to conception.

Major finding: Overall, flare was reported by 37% of patients during pregnancy and was associated with discontinuing bDMARD upon testing positive for pregnancy (odds ratio [OR] 2.857; P  =  .034) and previous use of >1 bDMARD (OR 4.1; P  =  .019). Patients with vs without disease flare during pregnancy were more likely to report preterm delivery (27% vs 7%; OR 4.625; P  =  .034).

Study details: This study analyzed the retrospectively collected data of 73 pregnancies in 63 women with RA and good disease control during conception who were prospectively followed through their pregnancies.

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

Source: Gerardi MC et al. Stopping bDMARDs at the beginning of pregnancy is associated with disease flares and preterm delivery in women with rheumatoid arthritis. Front Pharmacol. 2022 (Aug 3). Doi: 10.3389/fphar.2022.887462

Key clinical point: Patients with seropositive rheumatoid arthritis (RA) treated with first-line biologic or targeted synthetic disease-modifying antirheumatic drugs (b/tsDMARD), particularly tofacitinib, were at an increased risk for herpes zoster (HZ).

Major finding: Overall, the risk for HZ was significantly higher in patients receiving tofacitinib (adjusted hazard ratio [aHR] 2.46; P < .001), infliximab (aHR 1.36; P  =  .017), or adalimumab (aHR 1.29; P  =  .032) vs abatacept, with tofacitinib also increasing the risk for incident (aHR 1.99; P  =  .011) and recurrent (aHR 3.69; P < .001) HZ in patients without prior history of HZ.

Study details: This was a cohort study including 11,720 patients with seropositive RA who received first-line bDMARD or tsDMARD.

Disclosures: This study was supported by the Ministry of Health Welfare, Republic of Korea. The authors declared no conflicts of interest.

Source: Jeong S et al. Incident and recurrent herpes zoster for first-line bDMARD and tsDMARD users in seropositive rheumatoid arthritis patients: a nationwide cohort study. Arthritis Res Ther. 2022;24:180 (Jul 28). Doi: 10.1186/s13075-022-02871-1

Key clinical point: Patients with seropositive rheumatoid arthritis (RA) treated with first-line biologic or targeted synthetic disease-modifying antirheumatic drugs (b/tsDMARD), particularly tofacitinib, were at an increased risk for herpes zoster (HZ).

Major finding: Overall, the risk for HZ was significantly higher in patients receiving tofacitinib (adjusted hazard ratio [aHR] 2.46; P < .001), infliximab (aHR 1.36; P  =  .017), or adalimumab (aHR 1.29; P  =  .032) vs abatacept, with tofacitinib also increasing the risk for incident (aHR 1.99; P  =  .011) and recurrent (aHR 3.69; P < .001) HZ in patients without prior history of HZ.

Study details: This was a cohort study including 11,720 patients with seropositive RA who received first-line bDMARD or tsDMARD.

Disclosures: This study was supported by the Ministry of Health Welfare, Republic of Korea. The authors declared no conflicts of interest.

Source: Jeong S et al. Incident and recurrent herpes zoster for first-line bDMARD and tsDMARD users in seropositive rheumatoid arthritis patients: a nationwide cohort study. Arthritis Res Ther. 2022;24:180 (Jul 28). Doi: 10.1186/s13075-022-02871-1

Key clinical point: Patients with seropositive rheumatoid arthritis (RA) treated with first-line biologic or targeted synthetic disease-modifying antirheumatic drugs (b/tsDMARD), particularly tofacitinib, were at an increased risk for herpes zoster (HZ).

Major finding: Overall, the risk for HZ was significantly higher in patients receiving tofacitinib (adjusted hazard ratio [aHR] 2.46; P < .001), infliximab (aHR 1.36; P  =  .017), or adalimumab (aHR 1.29; P  =  .032) vs abatacept, with tofacitinib also increasing the risk for incident (aHR 1.99; P  =  .011) and recurrent (aHR 3.69; P < .001) HZ in patients without prior history of HZ.

Study details: This was a cohort study including 11,720 patients with seropositive RA who received first-line bDMARD or tsDMARD.

Disclosures: This study was supported by the Ministry of Health Welfare, Republic of Korea. The authors declared no conflicts of interest.

Source: Jeong S et al. Incident and recurrent herpes zoster for first-line bDMARD and tsDMARD users in seropositive rheumatoid arthritis patients: a nationwide cohort study. Arthritis Res Ther. 2022;24:180 (Jul 28). Doi: 10.1186/s13075-022-02871-1

Key clinical point: In women with well-controlled rheumatoid arthritis (RA), the use of a tumor necrosis factor inhibitor (TNFi) during pregnancy was associated with increased birth weight of the offspring and the birth of fewer small-for-gestational age (SGA) children without an increase in adverse pregnancy outcomes.

Major finding: Compared with non-use of TNFi, the use of TNFi during pregnancy significantly increased the mean birth weight of the offspring (absolute difference 173 g; P  =  .03) and led to fewer SGA children being born (9.8% vs 20.0%; P  =  .05) without increasing the risk for large-for-gestational age and adverse pregnancy outcomes, such as prematurity, low birth weight of offspring, cesarean section, and hypertensive disorders.

Study details: Findings are from a prospective cohort study including 188 women with RA, of which 92 used TNFi during pregnancy.

Disclosures: This study was supported by the Dutch Arthritis Foundation and UCB. No competing interests were declared.

Source: Smeele HTW et al. Tumour necrosis factor inhibitor use during pregnancy is associated with increased birth weight of rheumatoid arthritis patients’ offspring. Ann Rheum Dis. 2022 (Jul 11). Doi: 10.1136/ard-2022-222679

Key clinical point: In women with well-controlled rheumatoid arthritis (RA), the use of a tumor necrosis factor inhibitor (TNFi) during pregnancy was associated with increased birth weight of the offspring and the birth of fewer small-for-gestational age (SGA) children without an increase in adverse pregnancy outcomes.

Major finding: Compared with non-use of TNFi, the use of TNFi during pregnancy significantly increased the mean birth weight of the offspring (absolute difference 173 g; P  =  .03) and led to fewer SGA children being born (9.8% vs 20.0%; P  =  .05) without increasing the risk for large-for-gestational age and adverse pregnancy outcomes, such as prematurity, low birth weight of offspring, cesarean section, and hypertensive disorders.

Study details: Findings are from a prospective cohort study including 188 women with RA, of which 92 used TNFi during pregnancy.

Disclosures: This study was supported by the Dutch Arthritis Foundation and UCB. No competing interests were declared.

Source: Smeele HTW et al. Tumour necrosis factor inhibitor use during pregnancy is associated with increased birth weight of rheumatoid arthritis patients’ offspring. Ann Rheum Dis. 2022 (Jul 11). Doi: 10.1136/ard-2022-222679

Key clinical point: In women with well-controlled rheumatoid arthritis (RA), the use of a tumor necrosis factor inhibitor (TNFi) during pregnancy was associated with increased birth weight of the offspring and the birth of fewer small-for-gestational age (SGA) children without an increase in adverse pregnancy outcomes.

Major finding: Compared with non-use of TNFi, the use of TNFi during pregnancy significantly increased the mean birth weight of the offspring (absolute difference 173 g; P  =  .03) and led to fewer SGA children being born (9.8% vs 20.0%; P  =  .05) without increasing the risk for large-for-gestational age and adverse pregnancy outcomes, such as prematurity, low birth weight of offspring, cesarean section, and hypertensive disorders.

Study details: Findings are from a prospective cohort study including 188 women with RA, of which 92 used TNFi during pregnancy.

Disclosures: This study was supported by the Dutch Arthritis Foundation and UCB. No competing interests were declared.

Source: Smeele HTW et al. Tumour necrosis factor inhibitor use during pregnancy is associated with increased birth weight of rheumatoid arthritis patients’ offspring. Ann Rheum Dis. 2022 (Jul 11). Doi: 10.1136/ard-2022-222679