Herpes zoster events are common in tofacitinib-treated RA patients but are clinically manageable

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Key clinical point: Herpes zoster (HZ) events occur in tofacitinib-treated patients with rheumatoid arthritis (RA), but most of them are nonserious, mild, or moderate with HZ events resolving in most patients.

 

Major finding: Overall, 11.1% and 8.0% of patients with RA experienced at least 1 or recurring HZ events, respectively. Most events were nonserious, mild, or moderate in severity, with the majority of the first (97.6%) and second (96.8%) HZ events resolved in most patients. Tofacitinib treatment remained unchanged in 47.3% of patients with the first HZ event and was temporarily or permanently discontinued in 42.8% and 9.1% of patients, respectively.

 

Study details: The data come from a post hoc analysis of pooled data from 21 RA and 3 psoriatic arthritis (PsA) clinical studies involving 7,061 and 783 tofacitinib-treated patients with RA and PsA, respectively.

 

Disclosures: These studies were sponsored by Pfizer Inc. T Hirose, J L Rivas, and K Kwok reported being employees and shareholders of Pfizer Inc. Other authors reported receiving grant/research support and speaker/consultancy fees from various companies including Pfizer.

 

Source: Winthrop KL et al. Rheumatol Ther. 2021 (Dec 6). Doi: 10.1007/s40744-021-00390-0.

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Key clinical point: Herpes zoster (HZ) events occur in tofacitinib-treated patients with rheumatoid arthritis (RA), but most of them are nonserious, mild, or moderate with HZ events resolving in most patients.

 

Major finding: Overall, 11.1% and 8.0% of patients with RA experienced at least 1 or recurring HZ events, respectively. Most events were nonserious, mild, or moderate in severity, with the majority of the first (97.6%) and second (96.8%) HZ events resolved in most patients. Tofacitinib treatment remained unchanged in 47.3% of patients with the first HZ event and was temporarily or permanently discontinued in 42.8% and 9.1% of patients, respectively.

 

Study details: The data come from a post hoc analysis of pooled data from 21 RA and 3 psoriatic arthritis (PsA) clinical studies involving 7,061 and 783 tofacitinib-treated patients with RA and PsA, respectively.

 

Disclosures: These studies were sponsored by Pfizer Inc. T Hirose, J L Rivas, and K Kwok reported being employees and shareholders of Pfizer Inc. Other authors reported receiving grant/research support and speaker/consultancy fees from various companies including Pfizer.

 

Source: Winthrop KL et al. Rheumatol Ther. 2021 (Dec 6). Doi: 10.1007/s40744-021-00390-0.

Key clinical point: Herpes zoster (HZ) events occur in tofacitinib-treated patients with rheumatoid arthritis (RA), but most of them are nonserious, mild, or moderate with HZ events resolving in most patients.

 

Major finding: Overall, 11.1% and 8.0% of patients with RA experienced at least 1 or recurring HZ events, respectively. Most events were nonserious, mild, or moderate in severity, with the majority of the first (97.6%) and second (96.8%) HZ events resolved in most patients. Tofacitinib treatment remained unchanged in 47.3% of patients with the first HZ event and was temporarily or permanently discontinued in 42.8% and 9.1% of patients, respectively.

 

Study details: The data come from a post hoc analysis of pooled data from 21 RA and 3 psoriatic arthritis (PsA) clinical studies involving 7,061 and 783 tofacitinib-treated patients with RA and PsA, respectively.

 

Disclosures: These studies were sponsored by Pfizer Inc. T Hirose, J L Rivas, and K Kwok reported being employees and shareholders of Pfizer Inc. Other authors reported receiving grant/research support and speaker/consultancy fees from various companies including Pfizer.

 

Source: Winthrop KL et al. Rheumatol Ther. 2021 (Dec 6). Doi: 10.1007/s40744-021-00390-0.

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Flaxseed shows promise as adjuvant therapy in RA

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Key clinical point: Consumption of flaxseed for 12 weeks improved disease activity and reduced pain, morning stiffness, and disease feeling in patients with rheumatoid arthritis (RA).

Major finding: Disease Activity Score 28-joints-erythrocyte sedimentation rate improved significantly in patients receiving flaxseed plus regular diet (RF; P = .001), but not in patients receiving flaxseed plus anti-inflammatory diet (AIF; P = .057) and roasted wheat plus regular diet (RW; P = .110). Significant reductions in pain severity (P ≤ .001), morning stiffness (P < .05), and disease feeling (P < .01) were observed in the AIF and RF groups.

Study details: This randomized controlled trial included 120 patients with RA who were randomly assigned to 12-week intervention with AIF, RF, or RW diet groups.

Disclosures: This study was funded by the Shiraz University of Medical Sciences, Shiraz, Iran. No disclosures were reported.

Source: Ghaseminasab-Parizi M et al. Eur J Nutr. 2021 (Nov 27). Doi: 10.1007/s00394-021-02707-9.

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Key clinical point: Consumption of flaxseed for 12 weeks improved disease activity and reduced pain, morning stiffness, and disease feeling in patients with rheumatoid arthritis (RA).

Major finding: Disease Activity Score 28-joints-erythrocyte sedimentation rate improved significantly in patients receiving flaxseed plus regular diet (RF; P = .001), but not in patients receiving flaxseed plus anti-inflammatory diet (AIF; P = .057) and roasted wheat plus regular diet (RW; P = .110). Significant reductions in pain severity (P ≤ .001), morning stiffness (P < .05), and disease feeling (P < .01) were observed in the AIF and RF groups.

Study details: This randomized controlled trial included 120 patients with RA who were randomly assigned to 12-week intervention with AIF, RF, or RW diet groups.

Disclosures: This study was funded by the Shiraz University of Medical Sciences, Shiraz, Iran. No disclosures were reported.

Source: Ghaseminasab-Parizi M et al. Eur J Nutr. 2021 (Nov 27). Doi: 10.1007/s00394-021-02707-9.

Key clinical point: Consumption of flaxseed for 12 weeks improved disease activity and reduced pain, morning stiffness, and disease feeling in patients with rheumatoid arthritis (RA).

Major finding: Disease Activity Score 28-joints-erythrocyte sedimentation rate improved significantly in patients receiving flaxseed plus regular diet (RF; P = .001), but not in patients receiving flaxseed plus anti-inflammatory diet (AIF; P = .057) and roasted wheat plus regular diet (RW; P = .110). Significant reductions in pain severity (P ≤ .001), morning stiffness (P < .05), and disease feeling (P < .01) were observed in the AIF and RF groups.

Study details: This randomized controlled trial included 120 patients with RA who were randomly assigned to 12-week intervention with AIF, RF, or RW diet groups.

Disclosures: This study was funded by the Shiraz University of Medical Sciences, Shiraz, Iran. No disclosures were reported.

Source: Ghaseminasab-Parizi M et al. Eur J Nutr. 2021 (Nov 27). Doi: 10.1007/s00394-021-02707-9.

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No higher risk for surgical site infection following TKA in RA vs. osteoarthritis

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Key clinical point: Patients with rheumatoid arthritis (RA) do not exhibit an elevated risk for acute or 1-year postoperative surgical site infection following total knee arthroplasty (TKA) compared with patients with osteoarthritis.

Major finding: The risk for surgical site infection at 90 days (adjusted odds ratio [aOR] 0.81; P = .598) and 1 year (aOR 0.463; P = .26) post-TKA was not significantly different between patients with RA and osteoarthritis.

Study details: This retrospective cohort study included patients with RA (n = 1,126) and osteoarthritis (n = 63,215) who underwent primary TKA.

Disclosures: No external funding was received for this study. The authors declared no conflict of interests.

Source: Chung HK et al. Sci Rep. 2021;11:22704 (Nov 22). Doi: 10.1038/s41598-021-02153-x.

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Key clinical point: Patients with rheumatoid arthritis (RA) do not exhibit an elevated risk for acute or 1-year postoperative surgical site infection following total knee arthroplasty (TKA) compared with patients with osteoarthritis.

Major finding: The risk for surgical site infection at 90 days (adjusted odds ratio [aOR] 0.81; P = .598) and 1 year (aOR 0.463; P = .26) post-TKA was not significantly different between patients with RA and osteoarthritis.

Study details: This retrospective cohort study included patients with RA (n = 1,126) and osteoarthritis (n = 63,215) who underwent primary TKA.

Disclosures: No external funding was received for this study. The authors declared no conflict of interests.

Source: Chung HK et al. Sci Rep. 2021;11:22704 (Nov 22). Doi: 10.1038/s41598-021-02153-x.

Key clinical point: Patients with rheumatoid arthritis (RA) do not exhibit an elevated risk for acute or 1-year postoperative surgical site infection following total knee arthroplasty (TKA) compared with patients with osteoarthritis.

Major finding: The risk for surgical site infection at 90 days (adjusted odds ratio [aOR] 0.81; P = .598) and 1 year (aOR 0.463; P = .26) post-TKA was not significantly different between patients with RA and osteoarthritis.

Study details: This retrospective cohort study included patients with RA (n = 1,126) and osteoarthritis (n = 63,215) who underwent primary TKA.

Disclosures: No external funding was received for this study. The authors declared no conflict of interests.

Source: Chung HK et al. Sci Rep. 2021;11:22704 (Nov 22). Doi: 10.1038/s41598-021-02153-x.

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Inflammatory cytokines positively correlate with coinhibitory checkpoint molecules in RA

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Key clinical point: Positive correlations between circulating inflammatory cytokines and coinhibitory checkpoint molecules modulated by anticitrullinated peptide antibodies (ACPA) or joint damage stage existed in patients with rheumatoid arthritis (RA).

Major finding: Serum levels of interleukin-6 (IL-6) and tumor necrosis factor-a (TNF-α) were positively associated with RA disease activity and galectin-9, independent of ACPA titers (all P < .05) and with soluble T-cell immunoglobulin and mucin-domain containing-3 in patients with ACPA <200 U/mL (P < .05). Galectin-9 was positively correlated with IL-6 (P = .005) only in patients without advanced joint damage and with TNF-a (P = .001) and IL-6 (P = .02) in patients with advanced joint damage.

Study details: This retrospective analysis included 132 patients with RA.

Disclosures: The work was funded by the Japan Grant-in-Aid for Scientific Research. K Migita received grants from Chugai, Pfizer, and AbbVie. Other authors declared no conflict of interests.

Source: Matsumoto H et al. PLoS One. 2021;16(11):e0260254 (Nov 18). Doi: 10.1371/journal.pone.0260254.

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Key clinical point: Positive correlations between circulating inflammatory cytokines and coinhibitory checkpoint molecules modulated by anticitrullinated peptide antibodies (ACPA) or joint damage stage existed in patients with rheumatoid arthritis (RA).

Major finding: Serum levels of interleukin-6 (IL-6) and tumor necrosis factor-a (TNF-α) were positively associated with RA disease activity and galectin-9, independent of ACPA titers (all P < .05) and with soluble T-cell immunoglobulin and mucin-domain containing-3 in patients with ACPA <200 U/mL (P < .05). Galectin-9 was positively correlated with IL-6 (P = .005) only in patients without advanced joint damage and with TNF-a (P = .001) and IL-6 (P = .02) in patients with advanced joint damage.

Study details: This retrospective analysis included 132 patients with RA.

Disclosures: The work was funded by the Japan Grant-in-Aid for Scientific Research. K Migita received grants from Chugai, Pfizer, and AbbVie. Other authors declared no conflict of interests.

Source: Matsumoto H et al. PLoS One. 2021;16(11):e0260254 (Nov 18). Doi: 10.1371/journal.pone.0260254.

Key clinical point: Positive correlations between circulating inflammatory cytokines and coinhibitory checkpoint molecules modulated by anticitrullinated peptide antibodies (ACPA) or joint damage stage existed in patients with rheumatoid arthritis (RA).

Major finding: Serum levels of interleukin-6 (IL-6) and tumor necrosis factor-a (TNF-α) were positively associated with RA disease activity and galectin-9, independent of ACPA titers (all P < .05) and with soluble T-cell immunoglobulin and mucin-domain containing-3 in patients with ACPA <200 U/mL (P < .05). Galectin-9 was positively correlated with IL-6 (P = .005) only in patients without advanced joint damage and with TNF-a (P = .001) and IL-6 (P = .02) in patients with advanced joint damage.

Study details: This retrospective analysis included 132 patients with RA.

Disclosures: The work was funded by the Japan Grant-in-Aid for Scientific Research. K Migita received grants from Chugai, Pfizer, and AbbVie. Other authors declared no conflict of interests.

Source: Matsumoto H et al. PLoS One. 2021;16(11):e0260254 (Nov 18). Doi: 10.1371/journal.pone.0260254.

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Doctor-patient relation can help improve treatment adherence in RA

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Key clinical point: Complete treatment adherence has still not been achieved in rheumatoid arthritis (RA), and factors like having patient-physician agreement on the treatment and the type of treatment prescribed are significant predictors of adherence.

Major finding: The 6-month prevalence of adherence was 59.1% (95% CI 48.1%-71.8%), with treatment agreement between patient and physician (odds ratio [OR] 4.29; P = .01) and information adaptation (OR 1.54; P = .015) being significant predictors of adherence. Treatment adherence was higher with second-line conventional synthetic disease-modifying rheumatic drug (csDMARD; OR 4.72; P = .005) and biological DMARDs/targeted synthetic DMARDs (OR 3.50; P = .029) vs. first-line csDMARDs.

Study details: This was a 6-month observational longitudinal prospective cohort study involving 180 patients with RA.

 

Disclosures: The ADHIERA trial was supported by a grant from Roche España to the Spanish Foundation of Rheumatology. A Balsa reported receiving speaker fees from various sources including Roche. Two other authors did not receive fees or personal grants from any laboratory, although their institute works by contract for laboratories for various sources.

 

Source: Balsa A et al. Ann Rheum Dis. 2021 (Nov 29). Doi: 10.1136/annrheumdis-2021-221163.

 

 

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Key clinical point: Complete treatment adherence has still not been achieved in rheumatoid arthritis (RA), and factors like having patient-physician agreement on the treatment and the type of treatment prescribed are significant predictors of adherence.

Major finding: The 6-month prevalence of adherence was 59.1% (95% CI 48.1%-71.8%), with treatment agreement between patient and physician (odds ratio [OR] 4.29; P = .01) and information adaptation (OR 1.54; P = .015) being significant predictors of adherence. Treatment adherence was higher with second-line conventional synthetic disease-modifying rheumatic drug (csDMARD; OR 4.72; P = .005) and biological DMARDs/targeted synthetic DMARDs (OR 3.50; P = .029) vs. first-line csDMARDs.

Study details: This was a 6-month observational longitudinal prospective cohort study involving 180 patients with RA.

 

Disclosures: The ADHIERA trial was supported by a grant from Roche España to the Spanish Foundation of Rheumatology. A Balsa reported receiving speaker fees from various sources including Roche. Two other authors did not receive fees or personal grants from any laboratory, although their institute works by contract for laboratories for various sources.

 

Source: Balsa A et al. Ann Rheum Dis. 2021 (Nov 29). Doi: 10.1136/annrheumdis-2021-221163.

 

 

Key clinical point: Complete treatment adherence has still not been achieved in rheumatoid arthritis (RA), and factors like having patient-physician agreement on the treatment and the type of treatment prescribed are significant predictors of adherence.

Major finding: The 6-month prevalence of adherence was 59.1% (95% CI 48.1%-71.8%), with treatment agreement between patient and physician (odds ratio [OR] 4.29; P = .01) and information adaptation (OR 1.54; P = .015) being significant predictors of adherence. Treatment adherence was higher with second-line conventional synthetic disease-modifying rheumatic drug (csDMARD; OR 4.72; P = .005) and biological DMARDs/targeted synthetic DMARDs (OR 3.50; P = .029) vs. first-line csDMARDs.

Study details: This was a 6-month observational longitudinal prospective cohort study involving 180 patients with RA.

 

Disclosures: The ADHIERA trial was supported by a grant from Roche España to the Spanish Foundation of Rheumatology. A Balsa reported receiving speaker fees from various sources including Roche. Two other authors did not receive fees or personal grants from any laboratory, although their institute works by contract for laboratories for various sources.

 

Source: Balsa A et al. Ann Rheum Dis. 2021 (Nov 29). Doi: 10.1136/annrheumdis-2021-221163.

 

 

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Patients with RA at increased risk for COVID-19

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Key clinical point: Compared with the general population, the risk for COVID-19 was significantly higher in patients with rheumatoid arthritis (RA) but not in those with osteoarthritis, supporting recommendations for booster vaccines and priority access to anti-SARS-CoV-2 monoclonal antibody treatment for patients with RA.

Major finding: Compared with the general population, the risk for suspected/confirmed COVID-19 was significantly higher in patients with RA (hazard ratio [HR] 1.19; 95% CI 1.04-1.36) but not in patients with osteoarthritis (HR 1.00; 95% CI 0.93-1.07).

Study details: This was a cohort analysis that compared the risk for COVID-19 among 17,268 patients with RA and 1,616,600 participants from the general population.

Disclosures: This work was supported by the National Natural Science Foundation of China, the Project Program of National Clinical Research Center for Geriatric Disorders (Xiangya Hospital), and others. No conflict of interests was reported.

Source: Wang Y et al. Arthritis Care Res (Hoboken). 2021 (Dec 7). Doi: 10.1002/acr.24831.

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Key clinical point: Compared with the general population, the risk for COVID-19 was significantly higher in patients with rheumatoid arthritis (RA) but not in those with osteoarthritis, supporting recommendations for booster vaccines and priority access to anti-SARS-CoV-2 monoclonal antibody treatment for patients with RA.

Major finding: Compared with the general population, the risk for suspected/confirmed COVID-19 was significantly higher in patients with RA (hazard ratio [HR] 1.19; 95% CI 1.04-1.36) but not in patients with osteoarthritis (HR 1.00; 95% CI 0.93-1.07).

Study details: This was a cohort analysis that compared the risk for COVID-19 among 17,268 patients with RA and 1,616,600 participants from the general population.

Disclosures: This work was supported by the National Natural Science Foundation of China, the Project Program of National Clinical Research Center for Geriatric Disorders (Xiangya Hospital), and others. No conflict of interests was reported.

Source: Wang Y et al. Arthritis Care Res (Hoboken). 2021 (Dec 7). Doi: 10.1002/acr.24831.

Key clinical point: Compared with the general population, the risk for COVID-19 was significantly higher in patients with rheumatoid arthritis (RA) but not in those with osteoarthritis, supporting recommendations for booster vaccines and priority access to anti-SARS-CoV-2 monoclonal antibody treatment for patients with RA.

Major finding: Compared with the general population, the risk for suspected/confirmed COVID-19 was significantly higher in patients with RA (hazard ratio [HR] 1.19; 95% CI 1.04-1.36) but not in patients with osteoarthritis (HR 1.00; 95% CI 0.93-1.07).

Study details: This was a cohort analysis that compared the risk for COVID-19 among 17,268 patients with RA and 1,616,600 participants from the general population.

Disclosures: This work was supported by the National Natural Science Foundation of China, the Project Program of National Clinical Research Center for Geriatric Disorders (Xiangya Hospital), and others. No conflict of interests was reported.

Source: Wang Y et al. Arthritis Care Res (Hoboken). 2021 (Dec 7). Doi: 10.1002/acr.24831.

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High disease activity during pregnancy tied to adverse pregnancy outcomes in RA

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Key clinical point: The risk for preterm birth (PTB) and small for gestational age (SGA) is almost 2-fold higher in pregnant women with vs. without rheumatoid arthritis (RA), with high maternal RA disease activity during pregnancy being a significant risk factor.

 

Major finding: The risk for PTB (adjusted odds ratio [aOR] 1.92; 95% CI 1.56-2.35) and SGA (aOR 1.93; 95% CI 1.45-2.57) was significantly higher in RA pregnancies vs. control pregnancies, with the risk even higher with maternal Disease Activity Score in 28 joints-C-reactive protein of >4.1 vs. <3.2 during pregnancy (PTB: aOR 3.38; 95% CI 1.52-7.55; SGA: aOR 3.90; 95% CI 1.46-10.4).

 

Study details: This was a prospective cohort study of 1,739 RA-pregnancies matched with 17,390 control-pregnancies.

 

Disclosures: This study was supported by NordForsk and others. Some of the authors declared receiving consultancy fees, research grants, and serving on the steering committee for various sources.

 

Source: Hellgren K et al. Rheumatology (Oxford). 2021;keab894 (Dec 3). Doi:  10.1093/rheumatology/keab894.

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Key clinical point: The risk for preterm birth (PTB) and small for gestational age (SGA) is almost 2-fold higher in pregnant women with vs. without rheumatoid arthritis (RA), with high maternal RA disease activity during pregnancy being a significant risk factor.

 

Major finding: The risk for PTB (adjusted odds ratio [aOR] 1.92; 95% CI 1.56-2.35) and SGA (aOR 1.93; 95% CI 1.45-2.57) was significantly higher in RA pregnancies vs. control pregnancies, with the risk even higher with maternal Disease Activity Score in 28 joints-C-reactive protein of >4.1 vs. <3.2 during pregnancy (PTB: aOR 3.38; 95% CI 1.52-7.55; SGA: aOR 3.90; 95% CI 1.46-10.4).

 

Study details: This was a prospective cohort study of 1,739 RA-pregnancies matched with 17,390 control-pregnancies.

 

Disclosures: This study was supported by NordForsk and others. Some of the authors declared receiving consultancy fees, research grants, and serving on the steering committee for various sources.

 

Source: Hellgren K et al. Rheumatology (Oxford). 2021;keab894 (Dec 3). Doi:  10.1093/rheumatology/keab894.

Key clinical point: The risk for preterm birth (PTB) and small for gestational age (SGA) is almost 2-fold higher in pregnant women with vs. without rheumatoid arthritis (RA), with high maternal RA disease activity during pregnancy being a significant risk factor.

 

Major finding: The risk for PTB (adjusted odds ratio [aOR] 1.92; 95% CI 1.56-2.35) and SGA (aOR 1.93; 95% CI 1.45-2.57) was significantly higher in RA pregnancies vs. control pregnancies, with the risk even higher with maternal Disease Activity Score in 28 joints-C-reactive protein of >4.1 vs. <3.2 during pregnancy (PTB: aOR 3.38; 95% CI 1.52-7.55; SGA: aOR 3.90; 95% CI 1.46-10.4).

 

Study details: This was a prospective cohort study of 1,739 RA-pregnancies matched with 17,390 control-pregnancies.

 

Disclosures: This study was supported by NordForsk and others. Some of the authors declared receiving consultancy fees, research grants, and serving on the steering committee for various sources.

 

Source: Hellgren K et al. Rheumatology (Oxford). 2021;keab894 (Dec 3). Doi:  10.1093/rheumatology/keab894.

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Factors predicting response to TNF inhibitors in RA

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Key clinical point: Patients with rheumatoid arthritis (RA) who are not obese, those who have high initial disease activity, and those with long disease duration are more responsive to tumor necrosis factor (TNF) inhibitors.

Major finding: The risk for European League Against Rheumatism nonresponse was significantly higher in patients with obesity vs. those with a body mass index of <30 kg/m2 (odds ratio 0.52 vs. 0.36; P = .01). Among patients treated with TNF inhibitors, the final Disease Activity Score on 28 joints-C-reactive protein (DAS28-CRP) decreased by 0.02 each year of disease duration (P < .001), with a reduction of 0.21 in patients with a baseline DAS28-CRP of >5.1 (P = .05).

Study details: This was a pooled analysis of individual patient data of 11,617 patients with RA from 29 randomized controlled trials.

Disclosures: This work was partly supported by the French Higher Education and Research Ministry. P Goupille and D Mulleman declared serving as a consultant or speaker, participating in international congresses or clinical trials, and receiving grants from various sources.

Source: Law-Wan J et al. RMD Open. 2021;7(3):e001882 (Nov 17). Doi: 10.1136/rmdopen-2021-001882.

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Key clinical point: Patients with rheumatoid arthritis (RA) who are not obese, those who have high initial disease activity, and those with long disease duration are more responsive to tumor necrosis factor (TNF) inhibitors.

Major finding: The risk for European League Against Rheumatism nonresponse was significantly higher in patients with obesity vs. those with a body mass index of <30 kg/m2 (odds ratio 0.52 vs. 0.36; P = .01). Among patients treated with TNF inhibitors, the final Disease Activity Score on 28 joints-C-reactive protein (DAS28-CRP) decreased by 0.02 each year of disease duration (P < .001), with a reduction of 0.21 in patients with a baseline DAS28-CRP of >5.1 (P = .05).

Study details: This was a pooled analysis of individual patient data of 11,617 patients with RA from 29 randomized controlled trials.

Disclosures: This work was partly supported by the French Higher Education and Research Ministry. P Goupille and D Mulleman declared serving as a consultant or speaker, participating in international congresses or clinical trials, and receiving grants from various sources.

Source: Law-Wan J et al. RMD Open. 2021;7(3):e001882 (Nov 17). Doi: 10.1136/rmdopen-2021-001882.

Key clinical point: Patients with rheumatoid arthritis (RA) who are not obese, those who have high initial disease activity, and those with long disease duration are more responsive to tumor necrosis factor (TNF) inhibitors.

Major finding: The risk for European League Against Rheumatism nonresponse was significantly higher in patients with obesity vs. those with a body mass index of <30 kg/m2 (odds ratio 0.52 vs. 0.36; P = .01). Among patients treated with TNF inhibitors, the final Disease Activity Score on 28 joints-C-reactive protein (DAS28-CRP) decreased by 0.02 each year of disease duration (P < .001), with a reduction of 0.21 in patients with a baseline DAS28-CRP of >5.1 (P = .05).

Study details: This was a pooled analysis of individual patient data of 11,617 patients with RA from 29 randomized controlled trials.

Disclosures: This work was partly supported by the French Higher Education and Research Ministry. P Goupille and D Mulleman declared serving as a consultant or speaker, participating in international congresses or clinical trials, and receiving grants from various sources.

Source: Law-Wan J et al. RMD Open. 2021;7(3):e001882 (Nov 17). Doi: 10.1136/rmdopen-2021-001882.

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RA patients treated with JAK inhibitors may need additional BNT162b2 COVID-19 vaccine boosts

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Thu, 03/17/2022 - 17:23

Key clinical point: Patients with rheumatoid arthritis (RA) who were treated with Janus kinase (JAK) inhibitor showed reduced humoral response following 2 doses of BNT162b2 COVID-19 vaccine compared with healthy individuals.

Major finding: Patients with RA treated with JAK inhibitors had significantly lower levels of anti-spike immunoglobulin G antibodies (P = .024) than healthy individuals.

Study details: This study involved 12 adult patients with RA treated with JAK inhibitors and 26 healthy individuals who received 2 doses of the BNT162b2 COVID-19 vaccine.

Disclosures: This work was funded by the ISF Corona grant. The authors declared no conflict of interests.

Source: Iancovici L et al. Rheumatology (Oxford). 2021:keab879 (Nov 25). Doi:  10.1093/rheumatology/keab879.

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Key clinical point: Patients with rheumatoid arthritis (RA) who were treated with Janus kinase (JAK) inhibitor showed reduced humoral response following 2 doses of BNT162b2 COVID-19 vaccine compared with healthy individuals.

Major finding: Patients with RA treated with JAK inhibitors had significantly lower levels of anti-spike immunoglobulin G antibodies (P = .024) than healthy individuals.

Study details: This study involved 12 adult patients with RA treated with JAK inhibitors and 26 healthy individuals who received 2 doses of the BNT162b2 COVID-19 vaccine.

Disclosures: This work was funded by the ISF Corona grant. The authors declared no conflict of interests.

Source: Iancovici L et al. Rheumatology (Oxford). 2021:keab879 (Nov 25). Doi:  10.1093/rheumatology/keab879.

Key clinical point: Patients with rheumatoid arthritis (RA) who were treated with Janus kinase (JAK) inhibitor showed reduced humoral response following 2 doses of BNT162b2 COVID-19 vaccine compared with healthy individuals.

Major finding: Patients with RA treated with JAK inhibitors had significantly lower levels of anti-spike immunoglobulin G antibodies (P = .024) than healthy individuals.

Study details: This study involved 12 adult patients with RA treated with JAK inhibitors and 26 healthy individuals who received 2 doses of the BNT162b2 COVID-19 vaccine.

Disclosures: This work was funded by the ISF Corona grant. The authors declared no conflict of interests.

Source: Iancovici L et al. Rheumatology (Oxford). 2021:keab879 (Nov 25). Doi:  10.1093/rheumatology/keab879.

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Not all patients with community-acquired pneumonia respond to adjunctive dexamethasone

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Key clinical point: Neutrophil count, white blood cell (WBC) count, or neutrophil-lymphocyte ratio (NLR) may help in ascertaining which patients hospitalized for community-acquired pneumonia (CAP) would benefit from adjunctive oral dexamethasone therapy.

Main finding: Among patients with a high neutrophil count, WBC count, or NLR who did not die in hospital, those who received dexamethasone had a shorter median length of stay (LOS) than those who received placebo (4 days vs. 6 days), whereas patients with low values for these parameters showed no difference in LOS between those receiving placebo and dexamethasone (P < .05).

Study details: Findings are from a post hoc analysis on 354 out of the 401 non-ICU patients with CAP included in the randomized placebo-controlled Santeon-CAP trial who were randomly assigned to receive either placebo or oral dexamethasone.

Disclosures: The study was sponsored by St. Antonius research fund. The authors declared no conflicts of interests.

Source: Wittermans E et al. Eur J Intern Med. 2021 (Nov 12). Doi: 10.1016/j.ejim.2021.10.030.

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Key clinical point: Neutrophil count, white blood cell (WBC) count, or neutrophil-lymphocyte ratio (NLR) may help in ascertaining which patients hospitalized for community-acquired pneumonia (CAP) would benefit from adjunctive oral dexamethasone therapy.

Main finding: Among patients with a high neutrophil count, WBC count, or NLR who did not die in hospital, those who received dexamethasone had a shorter median length of stay (LOS) than those who received placebo (4 days vs. 6 days), whereas patients with low values for these parameters showed no difference in LOS between those receiving placebo and dexamethasone (P < .05).

Study details: Findings are from a post hoc analysis on 354 out of the 401 non-ICU patients with CAP included in the randomized placebo-controlled Santeon-CAP trial who were randomly assigned to receive either placebo or oral dexamethasone.

Disclosures: The study was sponsored by St. Antonius research fund. The authors declared no conflicts of interests.

Source: Wittermans E et al. Eur J Intern Med. 2021 (Nov 12). Doi: 10.1016/j.ejim.2021.10.030.

Key clinical point: Neutrophil count, white blood cell (WBC) count, or neutrophil-lymphocyte ratio (NLR) may help in ascertaining which patients hospitalized for community-acquired pneumonia (CAP) would benefit from adjunctive oral dexamethasone therapy.

Main finding: Among patients with a high neutrophil count, WBC count, or NLR who did not die in hospital, those who received dexamethasone had a shorter median length of stay (LOS) than those who received placebo (4 days vs. 6 days), whereas patients with low values for these parameters showed no difference in LOS between those receiving placebo and dexamethasone (P < .05).

Study details: Findings are from a post hoc analysis on 354 out of the 401 non-ICU patients with CAP included in the randomized placebo-controlled Santeon-CAP trial who were randomly assigned to receive either placebo or oral dexamethasone.

Disclosures: The study was sponsored by St. Antonius research fund. The authors declared no conflicts of interests.

Source: Wittermans E et al. Eur J Intern Med. 2021 (Nov 12). Doi: 10.1016/j.ejim.2021.10.030.

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