Maternal RA tied to increased risk for mental disorders in their children

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Key clinical point: Children of mothers, but not fathers, with rheumatoid arthritis (RA) were predisposed to the risk of developing multiple mental disorders.

 

Major finding: Children of mothers with RA had a significantly higher risk for autism spectrum disorders (odds ratio [OR] 1.49; 95% CI 1.01-2.20), bipolar disorder (OR 1.47; 95% CI 1.20-1.81), attention-deficit/hyperactivity disorder (OR 1.37; 95% CI 1.17-1.60), and major depressive disorder (OR 1.20; 95% CI 1.05-1.37), with no risk for these disorders observed in children of fathers with RA.

 

Study details: This was a retrospective cohort study including 23,981 RA-parent-child pairs and age-/sex-matched 239,810 non-RA-parent-child pairs.

 

Disclosures: This study received research grants from Taipei Veterans General Hospital, Yen

Tjing Ling Medical Foundation, and the Ministry of Science and Technology, Taiwan. The authors declared no conflicts of interest.

 

Source: Chiu HJ et al. A nationwide study of the risks of major mental disorders among the offspring of parents with rheumatoid arthritis. Sci Rep. 2022;12:4962 (Mar 23). Doi: 10.1038/s41598-022-08834-5

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Key clinical point: Children of mothers, but not fathers, with rheumatoid arthritis (RA) were predisposed to the risk of developing multiple mental disorders.

 

Major finding: Children of mothers with RA had a significantly higher risk for autism spectrum disorders (odds ratio [OR] 1.49; 95% CI 1.01-2.20), bipolar disorder (OR 1.47; 95% CI 1.20-1.81), attention-deficit/hyperactivity disorder (OR 1.37; 95% CI 1.17-1.60), and major depressive disorder (OR 1.20; 95% CI 1.05-1.37), with no risk for these disorders observed in children of fathers with RA.

 

Study details: This was a retrospective cohort study including 23,981 RA-parent-child pairs and age-/sex-matched 239,810 non-RA-parent-child pairs.

 

Disclosures: This study received research grants from Taipei Veterans General Hospital, Yen

Tjing Ling Medical Foundation, and the Ministry of Science and Technology, Taiwan. The authors declared no conflicts of interest.

 

Source: Chiu HJ et al. A nationwide study of the risks of major mental disorders among the offspring of parents with rheumatoid arthritis. Sci Rep. 2022;12:4962 (Mar 23). Doi: 10.1038/s41598-022-08834-5

Key clinical point: Children of mothers, but not fathers, with rheumatoid arthritis (RA) were predisposed to the risk of developing multiple mental disorders.

 

Major finding: Children of mothers with RA had a significantly higher risk for autism spectrum disorders (odds ratio [OR] 1.49; 95% CI 1.01-2.20), bipolar disorder (OR 1.47; 95% CI 1.20-1.81), attention-deficit/hyperactivity disorder (OR 1.37; 95% CI 1.17-1.60), and major depressive disorder (OR 1.20; 95% CI 1.05-1.37), with no risk for these disorders observed in children of fathers with RA.

 

Study details: This was a retrospective cohort study including 23,981 RA-parent-child pairs and age-/sex-matched 239,810 non-RA-parent-child pairs.

 

Disclosures: This study received research grants from Taipei Veterans General Hospital, Yen

Tjing Ling Medical Foundation, and the Ministry of Science and Technology, Taiwan. The authors declared no conflicts of interest.

 

Source: Chiu HJ et al. A nationwide study of the risks of major mental disorders among the offspring of parents with rheumatoid arthritis. Sci Rep. 2022;12:4962 (Mar 23). Doi: 10.1038/s41598-022-08834-5

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Rheumatoid arthritis tied to increased risk of developing primary open-angle glaucoma

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Key clinical point: Patients with seropositive rheumatoid arthritis (RA) were at a higher risk of developing primary open-angle glaucoma (POAG) compared with matched control participants, with risk being evident within 2 years after RA diagnosis and among patients aged 75 years.

 

Major finding: Compared with matched control participants, patients with incident RA were 1.44 times more likely to develop POAG (hazard ratio [HR] 1.44; 95% CI 1.13-1.84), which was predominantly observed within 2 years of RA diagnosis (HR 1.83; 95% CI 1.28-2.61) and in patients aged ≥75 years (HR 2.12;95% CI 1.34-3.35).

 

Study details: This was a retrospective, nationwide cohort study including 2049 patients with seropositive RA who were propensity score-matched with 8196 control participants without RA.

 

Disclosures: This study was partly supported by the publication fee from the Graduate School of Public Health, Yonsei University. No conflicts of interest were declared.

 

Source: Kim SH et al. Development of open-angle glaucoma in adults with seropositive rheumatoid arthritis in Korea. JAMA Netw Open. 2022;5(3):e223345 (Mar 21). Doi:  10.1001/jamanetworkopen.2022.3345

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Key clinical point: Patients with seropositive rheumatoid arthritis (RA) were at a higher risk of developing primary open-angle glaucoma (POAG) compared with matched control participants, with risk being evident within 2 years after RA diagnosis and among patients aged 75 years.

 

Major finding: Compared with matched control participants, patients with incident RA were 1.44 times more likely to develop POAG (hazard ratio [HR] 1.44; 95% CI 1.13-1.84), which was predominantly observed within 2 years of RA diagnosis (HR 1.83; 95% CI 1.28-2.61) and in patients aged ≥75 years (HR 2.12;95% CI 1.34-3.35).

 

Study details: This was a retrospective, nationwide cohort study including 2049 patients with seropositive RA who were propensity score-matched with 8196 control participants without RA.

 

Disclosures: This study was partly supported by the publication fee from the Graduate School of Public Health, Yonsei University. No conflicts of interest were declared.

 

Source: Kim SH et al. Development of open-angle glaucoma in adults with seropositive rheumatoid arthritis in Korea. JAMA Netw Open. 2022;5(3):e223345 (Mar 21). Doi:  10.1001/jamanetworkopen.2022.3345

Key clinical point: Patients with seropositive rheumatoid arthritis (RA) were at a higher risk of developing primary open-angle glaucoma (POAG) compared with matched control participants, with risk being evident within 2 years after RA diagnosis and among patients aged 75 years.

 

Major finding: Compared with matched control participants, patients with incident RA were 1.44 times more likely to develop POAG (hazard ratio [HR] 1.44; 95% CI 1.13-1.84), which was predominantly observed within 2 years of RA diagnosis (HR 1.83; 95% CI 1.28-2.61) and in patients aged ≥75 years (HR 2.12;95% CI 1.34-3.35).

 

Study details: This was a retrospective, nationwide cohort study including 2049 patients with seropositive RA who were propensity score-matched with 8196 control participants without RA.

 

Disclosures: This study was partly supported by the publication fee from the Graduate School of Public Health, Yonsei University. No conflicts of interest were declared.

 

Source: Kim SH et al. Development of open-angle glaucoma in adults with seropositive rheumatoid arthritis in Korea. JAMA Netw Open. 2022;5(3):e223345 (Mar 21). Doi:  10.1001/jamanetworkopen.2022.3345

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Controlling inflammation may not alleviate disability in all patients with RA

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Key clinical point: Some patients with rheumatoid arthritis (RA) had excess disability despite low inflammation level. This persisted over 8-10 years after onset, with age, pain, and depression being significant predictors of disability, independent of inflammation.

 

Major finding: Nearly 30%-45% of patients with RA persistently showed excess disability over 8-10 years of follow-up, independent of their inflammation status. Patients who were older (odds ratio [OR] 1.05; 95% CI 1.02-1.09) or had higher pain (OR 1.48; 95% CI 1.23-1.78) or depression (OR 1.40; 95% CI 1.01-1.94) were more likely to have higher vs. lower disability trajectory, irrespective of their inflammation level.

 

Study details: Findings are from an analysis of three cohort studies including 2500 patients with RA and <24 months symptom duration who were followed-up for 8-10 years.

 

Disclosures: This study was supported by the UK Medical Research Council, Versus Arthritis, UK National Institute for Health Care and Research (NIHR) Manchester Biomedical Research Centre, and NIHR Nottingham Biomedical Research Centre. The authors declared no competing interests directly relevant to this manuscript.

 

Source: Gwinnutt JM et al. Exploring the disparity between inflammation and disability in the 10-year outcomes of people with rheumatoid arthritis. Rheumatology (Oxford). 2022 (Mar 11). Doi: 10.1093/rheumatology/keac137

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Key clinical point: Some patients with rheumatoid arthritis (RA) had excess disability despite low inflammation level. This persisted over 8-10 years after onset, with age, pain, and depression being significant predictors of disability, independent of inflammation.

 

Major finding: Nearly 30%-45% of patients with RA persistently showed excess disability over 8-10 years of follow-up, independent of their inflammation status. Patients who were older (odds ratio [OR] 1.05; 95% CI 1.02-1.09) or had higher pain (OR 1.48; 95% CI 1.23-1.78) or depression (OR 1.40; 95% CI 1.01-1.94) were more likely to have higher vs. lower disability trajectory, irrespective of their inflammation level.

 

Study details: Findings are from an analysis of three cohort studies including 2500 patients with RA and <24 months symptom duration who were followed-up for 8-10 years.

 

Disclosures: This study was supported by the UK Medical Research Council, Versus Arthritis, UK National Institute for Health Care and Research (NIHR) Manchester Biomedical Research Centre, and NIHR Nottingham Biomedical Research Centre. The authors declared no competing interests directly relevant to this manuscript.

 

Source: Gwinnutt JM et al. Exploring the disparity between inflammation and disability in the 10-year outcomes of people with rheumatoid arthritis. Rheumatology (Oxford). 2022 (Mar 11). Doi: 10.1093/rheumatology/keac137

Key clinical point: Some patients with rheumatoid arthritis (RA) had excess disability despite low inflammation level. This persisted over 8-10 years after onset, with age, pain, and depression being significant predictors of disability, independent of inflammation.

 

Major finding: Nearly 30%-45% of patients with RA persistently showed excess disability over 8-10 years of follow-up, independent of their inflammation status. Patients who were older (odds ratio [OR] 1.05; 95% CI 1.02-1.09) or had higher pain (OR 1.48; 95% CI 1.23-1.78) or depression (OR 1.40; 95% CI 1.01-1.94) were more likely to have higher vs. lower disability trajectory, irrespective of their inflammation level.

 

Study details: Findings are from an analysis of three cohort studies including 2500 patients with RA and <24 months symptom duration who were followed-up for 8-10 years.

 

Disclosures: This study was supported by the UK Medical Research Council, Versus Arthritis, UK National Institute for Health Care and Research (NIHR) Manchester Biomedical Research Centre, and NIHR Nottingham Biomedical Research Centre. The authors declared no competing interests directly relevant to this manuscript.

 

Source: Gwinnutt JM et al. Exploring the disparity between inflammation and disability in the 10-year outcomes of people with rheumatoid arthritis. Rheumatology (Oxford). 2022 (Mar 11). Doi: 10.1093/rheumatology/keac137

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Reasons for b/tsDMARD treatment interruptions in rheumatoid arthritis

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Key clinical point: A majority of patients with rheumatoid arthritis (RA) stopped their first-time biological or targeted synthetic disease-modifying antirheumatic drug (b/tsDMARD) because of nonresponse to the treatment. Patients who stopped because of remission vs. nonresponse had worse disease activity at treatment restart.

 

Major finding: Nonresponse (38%), adverse events (19%), and remission (8%) were the major reasons to stop the first-time b/tsDMARD, with the median time to restart treatment being shortest among patients with nonresponse (30 days) and longest among those with remission (1597 days). Moreover, RA disease activity was worse at b/tsDMARD restart in patients who stopped b/tsDMARD after achieving remission (P < .0001).

 

Study details: This was an explorative descriptive cohort study including 2526 patients with RA who stopped their first b/tsDMARD treatment.

 

Disclosures: The study did not declare any source of funding. No conflicts of interest were declared.

 

Source: Burkard T et al. Interruptions of biological and targeted synthetic disease-modifying antirheumatic drugs in rheumatoid arthritis: a descriptive cohort study assessing trends in patient characteristics in Switzerland. BMJ Open. 2022;12:e056352 (Mar 15). Doi: 10.1136/bmjopen-2021-056352

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Key clinical point: A majority of patients with rheumatoid arthritis (RA) stopped their first-time biological or targeted synthetic disease-modifying antirheumatic drug (b/tsDMARD) because of nonresponse to the treatment. Patients who stopped because of remission vs. nonresponse had worse disease activity at treatment restart.

 

Major finding: Nonresponse (38%), adverse events (19%), and remission (8%) were the major reasons to stop the first-time b/tsDMARD, with the median time to restart treatment being shortest among patients with nonresponse (30 days) and longest among those with remission (1597 days). Moreover, RA disease activity was worse at b/tsDMARD restart in patients who stopped b/tsDMARD after achieving remission (P < .0001).

 

Study details: This was an explorative descriptive cohort study including 2526 patients with RA who stopped their first b/tsDMARD treatment.

 

Disclosures: The study did not declare any source of funding. No conflicts of interest were declared.

 

Source: Burkard T et al. Interruptions of biological and targeted synthetic disease-modifying antirheumatic drugs in rheumatoid arthritis: a descriptive cohort study assessing trends in patient characteristics in Switzerland. BMJ Open. 2022;12:e056352 (Mar 15). Doi: 10.1136/bmjopen-2021-056352

Key clinical point: A majority of patients with rheumatoid arthritis (RA) stopped their first-time biological or targeted synthetic disease-modifying antirheumatic drug (b/tsDMARD) because of nonresponse to the treatment. Patients who stopped because of remission vs. nonresponse had worse disease activity at treatment restart.

 

Major finding: Nonresponse (38%), adverse events (19%), and remission (8%) were the major reasons to stop the first-time b/tsDMARD, with the median time to restart treatment being shortest among patients with nonresponse (30 days) and longest among those with remission (1597 days). Moreover, RA disease activity was worse at b/tsDMARD restart in patients who stopped b/tsDMARD after achieving remission (P < .0001).

 

Study details: This was an explorative descriptive cohort study including 2526 patients with RA who stopped their first b/tsDMARD treatment.

 

Disclosures: The study did not declare any source of funding. No conflicts of interest were declared.

 

Source: Burkard T et al. Interruptions of biological and targeted synthetic disease-modifying antirheumatic drugs in rheumatoid arthritis: a descriptive cohort study assessing trends in patient characteristics in Switzerland. BMJ Open. 2022;12:e056352 (Mar 15). Doi: 10.1136/bmjopen-2021-056352

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Elevated adipokine levels predict early death in RA

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Key clinical point: Higher levels of circulating adiponectin and leptin were associated with an increased risk for all-cause and cardiovascular mortality in patients with rheumatoid arthritis (RA).

 

Major finding: Patients in the highest vs. lowest quartile of adiponectin were at a 46% higher risk for all-cause mortality (hazard ratio [HR] 1.46; P = .009) and an 85% higher risk for cardiovascular mortality (HR 1.85; P = .003). Patients in the highest vs. lowest quartile of both adiponectin and leptin were at a 73% higher risk for all-cause mortality (HR 1.73; P = .002).

 

Study details: This was a longitudinal study including 2583 patients with RA.

 

Disclosures: This study did not declare any source of funding. JF Baker and TR MIkuls reported receiving consulting fees and research support from various sources.

 

Source: Baker JF et al. Elevations in adipocytokines and mortality in rheumatoid arthritis. Rheumatology (Oxford). 2022 Mar 23. Doi: 10.1093/rheumatology/keac191

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Key clinical point: Higher levels of circulating adiponectin and leptin were associated with an increased risk for all-cause and cardiovascular mortality in patients with rheumatoid arthritis (RA).

 

Major finding: Patients in the highest vs. lowest quartile of adiponectin were at a 46% higher risk for all-cause mortality (hazard ratio [HR] 1.46; P = .009) and an 85% higher risk for cardiovascular mortality (HR 1.85; P = .003). Patients in the highest vs. lowest quartile of both adiponectin and leptin were at a 73% higher risk for all-cause mortality (HR 1.73; P = .002).

 

Study details: This was a longitudinal study including 2583 patients with RA.

 

Disclosures: This study did not declare any source of funding. JF Baker and TR MIkuls reported receiving consulting fees and research support from various sources.

 

Source: Baker JF et al. Elevations in adipocytokines and mortality in rheumatoid arthritis. Rheumatology (Oxford). 2022 Mar 23. Doi: 10.1093/rheumatology/keac191

Key clinical point: Higher levels of circulating adiponectin and leptin were associated with an increased risk for all-cause and cardiovascular mortality in patients with rheumatoid arthritis (RA).

 

Major finding: Patients in the highest vs. lowest quartile of adiponectin were at a 46% higher risk for all-cause mortality (hazard ratio [HR] 1.46; P = .009) and an 85% higher risk for cardiovascular mortality (HR 1.85; P = .003). Patients in the highest vs. lowest quartile of both adiponectin and leptin were at a 73% higher risk for all-cause mortality (HR 1.73; P = .002).

 

Study details: This was a longitudinal study including 2583 patients with RA.

 

Disclosures: This study did not declare any source of funding. JF Baker and TR MIkuls reported receiving consulting fees and research support from various sources.

 

Source: Baker JF et al. Elevations in adipocytokines and mortality in rheumatoid arthritis. Rheumatology (Oxford). 2022 Mar 23. Doi: 10.1093/rheumatology/keac191

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Frailty is dynamic and responsive to treatment in early RA

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Key clinical point: Frailty may be partially reversible with treatment in early rheumatoid arthritis (RA) and is associated with a greater risk for hospitalization and all-cause mortality in early and established RA.

 

Major finding: Patients with early RA improved from moderate/severe frailty to mild (33%) and robust (13%) states in the first 6 months of treatment with disease-modifying antirheumatic drugs. In early and established RA, the moderate/severe vs. robust frailty level was associated with unscheduled hospitalization (incidence rate ratio [IRR] 2.88; 95% CI 1.97-4.20, and IRR 2.74; 95% CI 2.29-3.29, respectively) and all-cause mortality (hazard ratio [HR] 4.41; 95% CI 1.85-10.49 and HR 1.68; 95% CI 1.26-2.13, respectively).

 

Study details: This was a longitudinal analysis of two cohorts including 899 and 3605 patients with early and established RA, respectively.

 

Disclosures: No information on funding was reported. No conflicts of interest were declared.

 

Source: Hanlon P et al. Frailty in rheumatoid arthritis and its relationship with disease activity, hospitalisation and mortality: a longitudinal analysis of the Scottish Early Rheumatoid Arthritis cohort and UK Biobank. RMD Open. 2022;8:e002111 (Mar 15). Doi: 10.1136/rmdopen-2021-002111

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Key clinical point: Frailty may be partially reversible with treatment in early rheumatoid arthritis (RA) and is associated with a greater risk for hospitalization and all-cause mortality in early and established RA.

 

Major finding: Patients with early RA improved from moderate/severe frailty to mild (33%) and robust (13%) states in the first 6 months of treatment with disease-modifying antirheumatic drugs. In early and established RA, the moderate/severe vs. robust frailty level was associated with unscheduled hospitalization (incidence rate ratio [IRR] 2.88; 95% CI 1.97-4.20, and IRR 2.74; 95% CI 2.29-3.29, respectively) and all-cause mortality (hazard ratio [HR] 4.41; 95% CI 1.85-10.49 and HR 1.68; 95% CI 1.26-2.13, respectively).

 

Study details: This was a longitudinal analysis of two cohorts including 899 and 3605 patients with early and established RA, respectively.

 

Disclosures: No information on funding was reported. No conflicts of interest were declared.

 

Source: Hanlon P et al. Frailty in rheumatoid arthritis and its relationship with disease activity, hospitalisation and mortality: a longitudinal analysis of the Scottish Early Rheumatoid Arthritis cohort and UK Biobank. RMD Open. 2022;8:e002111 (Mar 15). Doi: 10.1136/rmdopen-2021-002111

Key clinical point: Frailty may be partially reversible with treatment in early rheumatoid arthritis (RA) and is associated with a greater risk for hospitalization and all-cause mortality in early and established RA.

 

Major finding: Patients with early RA improved from moderate/severe frailty to mild (33%) and robust (13%) states in the first 6 months of treatment with disease-modifying antirheumatic drugs. In early and established RA, the moderate/severe vs. robust frailty level was associated with unscheduled hospitalization (incidence rate ratio [IRR] 2.88; 95% CI 1.97-4.20, and IRR 2.74; 95% CI 2.29-3.29, respectively) and all-cause mortality (hazard ratio [HR] 4.41; 95% CI 1.85-10.49 and HR 1.68; 95% CI 1.26-2.13, respectively).

 

Study details: This was a longitudinal analysis of two cohorts including 899 and 3605 patients with early and established RA, respectively.

 

Disclosures: No information on funding was reported. No conflicts of interest were declared.

 

Source: Hanlon P et al. Frailty in rheumatoid arthritis and its relationship with disease activity, hospitalisation and mortality: a longitudinal analysis of the Scottish Early Rheumatoid Arthritis cohort and UK Biobank. RMD Open. 2022;8:e002111 (Mar 15). Doi: 10.1136/rmdopen-2021-002111

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RA: Dosage and timing of rituximab infusion influence response to COVID-19 vaccine

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Key clinical point: An ultralow dose (200 mg) of rituximab infusion and an increased time interval between COVID-19 vaccination and rituximab infusion significantly improved humoral response to COVID-19 vaccine in patients with rheumatoid arthritis (RA).

 

Major finding: Positive vaccination response was more frequently observed in the 200 mg vs. 1000 mg rituximab infusion group (odds ratio [OR] 3.07; P = .03) and improved with greater time interval between rituximab infusion and COVID-19 vaccination (per month OR 1.67; P < .0001).

 

Study details: This was a prospective cohort study, RTX-COVAC, including 196 patients with RA who received at least one dose of rituximab (200, 500, or 1000 mg) in the year prior to their first dose of COVID-19 vaccination.

 

Disclosures: This study did not receive any specific funding. AA den Broeder reported receiving personal fees, congress invitations, and grants outside the submitted work from various sources. Other authors declared no conflicts of interest.

 

Source: van der Togt CJT et al. Humoral response to Coronavirus Disease-19 vaccines is dependent on dosage and timing of rituximab in patients with rheumatoid arthritis. Rheumatology (Oxford). 2022 (Apr 4). Doi: 10.1093/rheumatology/keac206

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Key clinical point: An ultralow dose (200 mg) of rituximab infusion and an increased time interval between COVID-19 vaccination and rituximab infusion significantly improved humoral response to COVID-19 vaccine in patients with rheumatoid arthritis (RA).

 

Major finding: Positive vaccination response was more frequently observed in the 200 mg vs. 1000 mg rituximab infusion group (odds ratio [OR] 3.07; P = .03) and improved with greater time interval between rituximab infusion and COVID-19 vaccination (per month OR 1.67; P < .0001).

 

Study details: This was a prospective cohort study, RTX-COVAC, including 196 patients with RA who received at least one dose of rituximab (200, 500, or 1000 mg) in the year prior to their first dose of COVID-19 vaccination.

 

Disclosures: This study did not receive any specific funding. AA den Broeder reported receiving personal fees, congress invitations, and grants outside the submitted work from various sources. Other authors declared no conflicts of interest.

 

Source: van der Togt CJT et al. Humoral response to Coronavirus Disease-19 vaccines is dependent on dosage and timing of rituximab in patients with rheumatoid arthritis. Rheumatology (Oxford). 2022 (Apr 4). Doi: 10.1093/rheumatology/keac206

Key clinical point: An ultralow dose (200 mg) of rituximab infusion and an increased time interval between COVID-19 vaccination and rituximab infusion significantly improved humoral response to COVID-19 vaccine in patients with rheumatoid arthritis (RA).

 

Major finding: Positive vaccination response was more frequently observed in the 200 mg vs. 1000 mg rituximab infusion group (odds ratio [OR] 3.07; P = .03) and improved with greater time interval between rituximab infusion and COVID-19 vaccination (per month OR 1.67; P < .0001).

 

Study details: This was a prospective cohort study, RTX-COVAC, including 196 patients with RA who received at least one dose of rituximab (200, 500, or 1000 mg) in the year prior to their first dose of COVID-19 vaccination.

 

Disclosures: This study did not receive any specific funding. AA den Broeder reported receiving personal fees, congress invitations, and grants outside the submitted work from various sources. Other authors declared no conflicts of interest.

 

Source: van der Togt CJT et al. Humoral response to Coronavirus Disease-19 vaccines is dependent on dosage and timing of rituximab in patients with rheumatoid arthritis. Rheumatology (Oxford). 2022 (Apr 4). Doi: 10.1093/rheumatology/keac206

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Meta-analysis backs the clinically significant effects of transcutaneous nerve stimulation in migraine

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Key clinical point: Patients with chronic migraine (CM) or episodic migraine (EM) show a clinically significant improvement in headache characteristics after prophylactic transcutaneous nerve stimulation.

Major finding: Transcutaneous nerve stimulation reduced the headache frequency (mean monthly headache days) by 2.81 (95% CI 2.18-3.43) days in EM and by 2.97 (95% CI 1.66-4.28) days in CM and the pain severity by 2.23 (95% CI 1.64-2.81) pain scale points in EM.

Study details: The data come from a meta-analysis of 14 studies that included 995 patients with EM or CM treated with transcutaneous stimulation of a single nerve.

Disclosures: The study received no financial support. The authors declared no conflicts of interest.

Source: Evans AG et al. Outcomes of transcutaneous nerve stimulation for migraine headaches: a systematic review and meta-analysis. J Neurol. 2022 (Mar 16). Doi: 10.1007/s00415-022-11059-1

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Key clinical point: Patients with chronic migraine (CM) or episodic migraine (EM) show a clinically significant improvement in headache characteristics after prophylactic transcutaneous nerve stimulation.

Major finding: Transcutaneous nerve stimulation reduced the headache frequency (mean monthly headache days) by 2.81 (95% CI 2.18-3.43) days in EM and by 2.97 (95% CI 1.66-4.28) days in CM and the pain severity by 2.23 (95% CI 1.64-2.81) pain scale points in EM.

Study details: The data come from a meta-analysis of 14 studies that included 995 patients with EM or CM treated with transcutaneous stimulation of a single nerve.

Disclosures: The study received no financial support. The authors declared no conflicts of interest.

Source: Evans AG et al. Outcomes of transcutaneous nerve stimulation for migraine headaches: a systematic review and meta-analysis. J Neurol. 2022 (Mar 16). Doi: 10.1007/s00415-022-11059-1

Key clinical point: Patients with chronic migraine (CM) or episodic migraine (EM) show a clinically significant improvement in headache characteristics after prophylactic transcutaneous nerve stimulation.

Major finding: Transcutaneous nerve stimulation reduced the headache frequency (mean monthly headache days) by 2.81 (95% CI 2.18-3.43) days in EM and by 2.97 (95% CI 1.66-4.28) days in CM and the pain severity by 2.23 (95% CI 1.64-2.81) pain scale points in EM.

Study details: The data come from a meta-analysis of 14 studies that included 995 patients with EM or CM treated with transcutaneous stimulation of a single nerve.

Disclosures: The study received no financial support. The authors declared no conflicts of interest.

Source: Evans AG et al. Outcomes of transcutaneous nerve stimulation for migraine headaches: a systematic review and meta-analysis. J Neurol. 2022 (Mar 16). Doi: 10.1007/s00415-022-11059-1

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Fremanezumab effective and safe for high-frequency episodic and chronic migraine in real world

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Key clinical point: Fremanezumab is effective and well-tolerated in real-life patients with difficult-to-treat high-frequency episodic migraine (HFEM) or chronic migraine (CM).

Major finding: At week 12, fremanezumab significantly decreased monthly migraine days (−4.6 days; P < .05) in patients with HFEM and monthly headache days (−9.4 days; P < .001) in patients with CM. The rate of treatment-emergent adverse events, graded mild and transient, was only 5.7%.

Study details: This was a multicenter, prospective, real-life study including 53 patients with HFEM (8-14 days/month) or CM who had multiple therapeutic failures and received subcutaneous fremanezumab (225 mg monthly or 675 mg quarterly) for 12 weeks.

Disclosures: The study was partially sponsored by the Italian Ministry of Health (Ricerca Corrente). Some authors declared receiving travel grants or honoraria for advisory boards, speaker panels, consultation, or clinical investigation studies from various sources. M Filippi is the Editor-in-Chief of the Journal of Neurology.

Source: Barbanti P et al. Fremanezumab in the prevention of high-frequency episodic and chronic migraine: a 12-week, multicenter, real-life, cohort study (the FRIEND study). J Headache Pain. 2022;23:46 (Apr 9). Doi: 10.1186/s10194-022-01396-x

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Key clinical point: Fremanezumab is effective and well-tolerated in real-life patients with difficult-to-treat high-frequency episodic migraine (HFEM) or chronic migraine (CM).

Major finding: At week 12, fremanezumab significantly decreased monthly migraine days (−4.6 days; P < .05) in patients with HFEM and monthly headache days (−9.4 days; P < .001) in patients with CM. The rate of treatment-emergent adverse events, graded mild and transient, was only 5.7%.

Study details: This was a multicenter, prospective, real-life study including 53 patients with HFEM (8-14 days/month) or CM who had multiple therapeutic failures and received subcutaneous fremanezumab (225 mg monthly or 675 mg quarterly) for 12 weeks.

Disclosures: The study was partially sponsored by the Italian Ministry of Health (Ricerca Corrente). Some authors declared receiving travel grants or honoraria for advisory boards, speaker panels, consultation, or clinical investigation studies from various sources. M Filippi is the Editor-in-Chief of the Journal of Neurology.

Source: Barbanti P et al. Fremanezumab in the prevention of high-frequency episodic and chronic migraine: a 12-week, multicenter, real-life, cohort study (the FRIEND study). J Headache Pain. 2022;23:46 (Apr 9). Doi: 10.1186/s10194-022-01396-x

Key clinical point: Fremanezumab is effective and well-tolerated in real-life patients with difficult-to-treat high-frequency episodic migraine (HFEM) or chronic migraine (CM).

Major finding: At week 12, fremanezumab significantly decreased monthly migraine days (−4.6 days; P < .05) in patients with HFEM and monthly headache days (−9.4 days; P < .001) in patients with CM. The rate of treatment-emergent adverse events, graded mild and transient, was only 5.7%.

Study details: This was a multicenter, prospective, real-life study including 53 patients with HFEM (8-14 days/month) or CM who had multiple therapeutic failures and received subcutaneous fremanezumab (225 mg monthly or 675 mg quarterly) for 12 weeks.

Disclosures: The study was partially sponsored by the Italian Ministry of Health (Ricerca Corrente). Some authors declared receiving travel grants or honoraria for advisory boards, speaker panels, consultation, or clinical investigation studies from various sources. M Filippi is the Editor-in-Chief of the Journal of Neurology.

Source: Barbanti P et al. Fremanezumab in the prevention of high-frequency episodic and chronic migraine: a 12-week, multicenter, real-life, cohort study (the FRIEND study). J Headache Pain. 2022;23:46 (Apr 9). Doi: 10.1186/s10194-022-01396-x

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CGRP mAb vs. standard treatments offer better adherence and persistence in migraine

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Key clinical point: Patients with migraine show higher treatment adherence and persistence to calcitonin gene-related peptide (CGRP) monoclonal antibodies (mAb), specifically to galcanezumab, over standard-of-care (SOC) migraine preventive treatments.

Major finding: At 12 months of follow-up, CGRP mAb vs. SOC initiators had significantly higher mean adherence (proportion of days covered: 55.1% vs. 35.2%; P < .001) and persistence (212.5 vs. 131.9 days; P < .001). Similarly, galcanezumab vs. SOC initiators showed significantly higher adherence (63.7% vs. 33.7%; P < .001) and persistence (252.3 vs. 127.3 days; P < .001).

Study details: This retrospective, observational, claims database study created two separate 1:1 propensity-score-matched cohorts of adult patients with migraine initiating SOC or a CGRP mAb (n = 3082 pairs) and SOC or galcanezumab (n = 421 pairs).

Disclosures: The study was funded by Eli Lilly and Company. All authors declared being current/former employees or minor shareholders of Eli Lilly or a company contracted by Eli Lilly.

Source: Varnado OJ et al. Treatment patterns for calcitonin gene-related peptide monoclonal antibodies including galcanezumab versus conventional preventive treatments for migraine: A retrospective us claims study, Patient Prefer Adherence. 2022;16:821-839 (Mar 29). Doi: 10.2147/PPA.S346660

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Key clinical point: Patients with migraine show higher treatment adherence and persistence to calcitonin gene-related peptide (CGRP) monoclonal antibodies (mAb), specifically to galcanezumab, over standard-of-care (SOC) migraine preventive treatments.

Major finding: At 12 months of follow-up, CGRP mAb vs. SOC initiators had significantly higher mean adherence (proportion of days covered: 55.1% vs. 35.2%; P < .001) and persistence (212.5 vs. 131.9 days; P < .001). Similarly, galcanezumab vs. SOC initiators showed significantly higher adherence (63.7% vs. 33.7%; P < .001) and persistence (252.3 vs. 127.3 days; P < .001).

Study details: This retrospective, observational, claims database study created two separate 1:1 propensity-score-matched cohorts of adult patients with migraine initiating SOC or a CGRP mAb (n = 3082 pairs) and SOC or galcanezumab (n = 421 pairs).

Disclosures: The study was funded by Eli Lilly and Company. All authors declared being current/former employees or minor shareholders of Eli Lilly or a company contracted by Eli Lilly.

Source: Varnado OJ et al. Treatment patterns for calcitonin gene-related peptide monoclonal antibodies including galcanezumab versus conventional preventive treatments for migraine: A retrospective us claims study, Patient Prefer Adherence. 2022;16:821-839 (Mar 29). Doi: 10.2147/PPA.S346660

Key clinical point: Patients with migraine show higher treatment adherence and persistence to calcitonin gene-related peptide (CGRP) monoclonal antibodies (mAb), specifically to galcanezumab, over standard-of-care (SOC) migraine preventive treatments.

Major finding: At 12 months of follow-up, CGRP mAb vs. SOC initiators had significantly higher mean adherence (proportion of days covered: 55.1% vs. 35.2%; P < .001) and persistence (212.5 vs. 131.9 days; P < .001). Similarly, galcanezumab vs. SOC initiators showed significantly higher adherence (63.7% vs. 33.7%; P < .001) and persistence (252.3 vs. 127.3 days; P < .001).

Study details: This retrospective, observational, claims database study created two separate 1:1 propensity-score-matched cohorts of adult patients with migraine initiating SOC or a CGRP mAb (n = 3082 pairs) and SOC or galcanezumab (n = 421 pairs).

Disclosures: The study was funded by Eli Lilly and Company. All authors declared being current/former employees or minor shareholders of Eli Lilly or a company contracted by Eli Lilly.

Source: Varnado OJ et al. Treatment patterns for calcitonin gene-related peptide monoclonal antibodies including galcanezumab versus conventional preventive treatments for migraine: A retrospective us claims study, Patient Prefer Adherence. 2022;16:821-839 (Mar 29). Doi: 10.2147/PPA.S346660

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