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Early disease remission reduces fatigue risk in RA
Key clinical point: Disease activity is associated with fatigue in early rheumatoid arthritis (RA), and patients who achieve early remission are at lower risk for experiencing fatigue.
Major finding: Patients who achieved remission at 6 months had a lower chance of experiencing fatigue at 24 months (Disease Activity Score 44 remission, odds ratio [OR] 0.31; P < .001). Fewer swollen joints (OR 0.92; P = .006), lower power Doppler ultrasound score (OR 0.95; P = .027), and a higher patient global assessment score (OR 1.03; P < .001) raised the likelihood of clinically relevant fatigue at 24 months.
Study details: The findings come from the analysis of 205 individuals from the ARCTIC trial. Patients were randomly assigned to a treat-to-target approach with and without musculoskeletal ultrasonography during clinical examinations and treatment decisions.
Disclosures: This work was supported by the DAM Foundation. Some of the authors declared receiving personal fees, personal honoraria, consultancy honorariums/fees, and serving on the data safety monitoring board or advisory board of various sources.
Source: Holton K et al. Ann Rheum Dis. 2021 Aug 13. doi: 10.1136/annrheumdis-2021-220750.
Key clinical point: Disease activity is associated with fatigue in early rheumatoid arthritis (RA), and patients who achieve early remission are at lower risk for experiencing fatigue.
Major finding: Patients who achieved remission at 6 months had a lower chance of experiencing fatigue at 24 months (Disease Activity Score 44 remission, odds ratio [OR] 0.31; P < .001). Fewer swollen joints (OR 0.92; P = .006), lower power Doppler ultrasound score (OR 0.95; P = .027), and a higher patient global assessment score (OR 1.03; P < .001) raised the likelihood of clinically relevant fatigue at 24 months.
Study details: The findings come from the analysis of 205 individuals from the ARCTIC trial. Patients were randomly assigned to a treat-to-target approach with and without musculoskeletal ultrasonography during clinical examinations and treatment decisions.
Disclosures: This work was supported by the DAM Foundation. Some of the authors declared receiving personal fees, personal honoraria, consultancy honorariums/fees, and serving on the data safety monitoring board or advisory board of various sources.
Source: Holton K et al. Ann Rheum Dis. 2021 Aug 13. doi: 10.1136/annrheumdis-2021-220750.
Key clinical point: Disease activity is associated with fatigue in early rheumatoid arthritis (RA), and patients who achieve early remission are at lower risk for experiencing fatigue.
Major finding: Patients who achieved remission at 6 months had a lower chance of experiencing fatigue at 24 months (Disease Activity Score 44 remission, odds ratio [OR] 0.31; P < .001). Fewer swollen joints (OR 0.92; P = .006), lower power Doppler ultrasound score (OR 0.95; P = .027), and a higher patient global assessment score (OR 1.03; P < .001) raised the likelihood of clinically relevant fatigue at 24 months.
Study details: The findings come from the analysis of 205 individuals from the ARCTIC trial. Patients were randomly assigned to a treat-to-target approach with and without musculoskeletal ultrasonography during clinical examinations and treatment decisions.
Disclosures: This work was supported by the DAM Foundation. Some of the authors declared receiving personal fees, personal honoraria, consultancy honorariums/fees, and serving on the data safety monitoring board or advisory board of various sources.
Source: Holton K et al. Ann Rheum Dis. 2021 Aug 13. doi: 10.1136/annrheumdis-2021-220750.
No link between recent antibiotic use and RA risk later in life
Key clinical point: Over 6 years of prospective follow-up found no association between recent antibiotic use and subsequent risk for rheumatoid arthritis (RA) later in life.
Major finding: Compared with no antibiotic usage, short-term (adjusted hazard ratio [aHR] 0.88; 95% CI 0.38-1.38) and middle-to-long-term (aHR 1.06; 95% CI 0.42-1.71) antibiotic use was not associated with an increased risk for RA.
Study details: The study included 1,33,125 female participants from Nurses' Health Study (NHS; n=58,757) and NHS II (n=74,368) databases. Based on antibiotic usage, participants were categorized into nonuse, short-term use (1-14 days), and middle-to-long-term use (15 or more days) groups.
Disclosures: This work was supported by the Natural Science Foundation of China, the Guangdong Provincial Key Laboratory of Digestive Cancer Research, the Startup Fund for the 100 Top Talents Program, the Sun Yat-sen University, and the National Institutes of Health. All the authors reported no conflict of interests.
Source: Liu Y et al. Expert Opin Drug Saf. 2021 Aug 25. doi: 10.1080/14740338.2021.1970134.
Key clinical point: Over 6 years of prospective follow-up found no association between recent antibiotic use and subsequent risk for rheumatoid arthritis (RA) later in life.
Major finding: Compared with no antibiotic usage, short-term (adjusted hazard ratio [aHR] 0.88; 95% CI 0.38-1.38) and middle-to-long-term (aHR 1.06; 95% CI 0.42-1.71) antibiotic use was not associated with an increased risk for RA.
Study details: The study included 1,33,125 female participants from Nurses' Health Study (NHS; n=58,757) and NHS II (n=74,368) databases. Based on antibiotic usage, participants were categorized into nonuse, short-term use (1-14 days), and middle-to-long-term use (15 or more days) groups.
Disclosures: This work was supported by the Natural Science Foundation of China, the Guangdong Provincial Key Laboratory of Digestive Cancer Research, the Startup Fund for the 100 Top Talents Program, the Sun Yat-sen University, and the National Institutes of Health. All the authors reported no conflict of interests.
Source: Liu Y et al. Expert Opin Drug Saf. 2021 Aug 25. doi: 10.1080/14740338.2021.1970134.
Key clinical point: Over 6 years of prospective follow-up found no association between recent antibiotic use and subsequent risk for rheumatoid arthritis (RA) later in life.
Major finding: Compared with no antibiotic usage, short-term (adjusted hazard ratio [aHR] 0.88; 95% CI 0.38-1.38) and middle-to-long-term (aHR 1.06; 95% CI 0.42-1.71) antibiotic use was not associated with an increased risk for RA.
Study details: The study included 1,33,125 female participants from Nurses' Health Study (NHS; n=58,757) and NHS II (n=74,368) databases. Based on antibiotic usage, participants were categorized into nonuse, short-term use (1-14 days), and middle-to-long-term use (15 or more days) groups.
Disclosures: This work was supported by the Natural Science Foundation of China, the Guangdong Provincial Key Laboratory of Digestive Cancer Research, the Startup Fund for the 100 Top Talents Program, the Sun Yat-sen University, and the National Institutes of Health. All the authors reported no conflict of interests.
Source: Liu Y et al. Expert Opin Drug Saf. 2021 Aug 25. doi: 10.1080/14740338.2021.1970134.
Impaired long-term outcomes in RA patients treated with CABG
Key clinical point: Patients with rheumatoid arthritis (RA) had worse prognosis after coronary artery bypass grafting surgery (CABG) than matched controls.
Major finding: The risk for mortality at 14.3 years’ follow-up after CABG was significantly higher in patients diagnosed with RA than those without (hazard ratio [HR] 1.50; P < .0001). Moreover, patients with RA were at a higher risk for myocardial infarction during the follow-up period (HR 1.61; P < .0001).
Study details: This was a retrospective analysis of patients with RA (n=378) matched with those without RA (n=7,560), all treated with CABG.
Disclosures: The Finnish Cultural Foundation, the Paulon Säätiö Foundation, the Finnish Governmental VTR-funding, and Suomen Kulttuurirahasto funded this study. The authors disclosed receipt of travel grants, consulting/speaker fees, honoraria, and congress sponsorship from and serving on advisory boards for various sources.
Source: Malmberg M et al. Ann Med. 2021 Aug 31. doi: 10.1080/07853890.2021.1969591.
Key clinical point: Patients with rheumatoid arthritis (RA) had worse prognosis after coronary artery bypass grafting surgery (CABG) than matched controls.
Major finding: The risk for mortality at 14.3 years’ follow-up after CABG was significantly higher in patients diagnosed with RA than those without (hazard ratio [HR] 1.50; P < .0001). Moreover, patients with RA were at a higher risk for myocardial infarction during the follow-up period (HR 1.61; P < .0001).
Study details: This was a retrospective analysis of patients with RA (n=378) matched with those without RA (n=7,560), all treated with CABG.
Disclosures: The Finnish Cultural Foundation, the Paulon Säätiö Foundation, the Finnish Governmental VTR-funding, and Suomen Kulttuurirahasto funded this study. The authors disclosed receipt of travel grants, consulting/speaker fees, honoraria, and congress sponsorship from and serving on advisory boards for various sources.
Source: Malmberg M et al. Ann Med. 2021 Aug 31. doi: 10.1080/07853890.2021.1969591.
Key clinical point: Patients with rheumatoid arthritis (RA) had worse prognosis after coronary artery bypass grafting surgery (CABG) than matched controls.
Major finding: The risk for mortality at 14.3 years’ follow-up after CABG was significantly higher in patients diagnosed with RA than those without (hazard ratio [HR] 1.50; P < .0001). Moreover, patients with RA were at a higher risk for myocardial infarction during the follow-up period (HR 1.61; P < .0001).
Study details: This was a retrospective analysis of patients with RA (n=378) matched with those without RA (n=7,560), all treated with CABG.
Disclosures: The Finnish Cultural Foundation, the Paulon Säätiö Foundation, the Finnish Governmental VTR-funding, and Suomen Kulttuurirahasto funded this study. The authors disclosed receipt of travel grants, consulting/speaker fees, honoraria, and congress sponsorship from and serving on advisory boards for various sources.
Source: Malmberg M et al. Ann Med. 2021 Aug 31. doi: 10.1080/07853890.2021.1969591.
Joint inflammation tends to recur in the same joints during RA disease course
Key clinical point: Joint swelling associated with rheumatoid arthritis (RA) tends to recur in the same joints swollen at RA onset, even in patients who are intensively treated.
Major finding: Overall, 46% of joints swollen at baseline showed swelling recurrence at least once during follow-up. Baseline joint swelling was predictive for swelling during follow-up (odds ratio [OR] 2.37; P < .001) and recurrent, persistent swelling in joints swollen (OR 1.52) and not swollen (OR 1.73) at the previous visit (both P < .001).
Study details: This is a subanalysis of the BeSt (Behandel-Strategieën) study, a treat-to-target trial involving 508 patients with newly diagnosed active RA followed up for a median of 10 years.
Disclosures: The original BeSt study was funded by a research grant from the Dutch College of Health Insurances with additional funding from Schering-Plough BV and Centocor Inc.
Source: Heckert SL et al. Ann Rheum Dis. 2021 Aug 30. doi: 10.1136/annrheumdis-2021-220882.
Key clinical point: Joint swelling associated with rheumatoid arthritis (RA) tends to recur in the same joints swollen at RA onset, even in patients who are intensively treated.
Major finding: Overall, 46% of joints swollen at baseline showed swelling recurrence at least once during follow-up. Baseline joint swelling was predictive for swelling during follow-up (odds ratio [OR] 2.37; P < .001) and recurrent, persistent swelling in joints swollen (OR 1.52) and not swollen (OR 1.73) at the previous visit (both P < .001).
Study details: This is a subanalysis of the BeSt (Behandel-Strategieën) study, a treat-to-target trial involving 508 patients with newly diagnosed active RA followed up for a median of 10 years.
Disclosures: The original BeSt study was funded by a research grant from the Dutch College of Health Insurances with additional funding from Schering-Plough BV and Centocor Inc.
Source: Heckert SL et al. Ann Rheum Dis. 2021 Aug 30. doi: 10.1136/annrheumdis-2021-220882.
Key clinical point: Joint swelling associated with rheumatoid arthritis (RA) tends to recur in the same joints swollen at RA onset, even in patients who are intensively treated.
Major finding: Overall, 46% of joints swollen at baseline showed swelling recurrence at least once during follow-up. Baseline joint swelling was predictive for swelling during follow-up (odds ratio [OR] 2.37; P < .001) and recurrent, persistent swelling in joints swollen (OR 1.52) and not swollen (OR 1.73) at the previous visit (both P < .001).
Study details: This is a subanalysis of the BeSt (Behandel-Strategieën) study, a treat-to-target trial involving 508 patients with newly diagnosed active RA followed up for a median of 10 years.
Disclosures: The original BeSt study was funded by a research grant from the Dutch College of Health Insurances with additional funding from Schering-Plough BV and Centocor Inc.
Source: Heckert SL et al. Ann Rheum Dis. 2021 Aug 30. doi: 10.1136/annrheumdis-2021-220882.
Impact of childhood passive smoking exposure on adult-onset seropositive RA
Key clinical point: Passive smoking exposure in childhood is associated with adult-onset seropositive rheumatoid arthritis (RA), suggesting that early life exposures influence RA risk.
Major finding: After adjusting for confounders, maternal smoking during pregnancy was associated with all-incident RA (adjusted hazard ratio [aHR] 1.25; 95% CI 1.03-1.52) and seropositive RA (aHR 1.34; 95% CI 1.06-1.70), whereas childhood parental smoking was associated with seropositive RA (aHR 1.41; 95% CI 1.08-1.83).
Study details: This was an analysis of prospectively collected data from the Nurses’ Health Study II, involving 90,923 women.
Disclosures: This work was supported by the National Institute of Arthritis and Musculoskeletal and Skin Diseases, Rheumatology Research Foundation, and National Institutes of Health. K Yoshida and J Sparks reported receiving research support and consultancy fees from various sources.
Source: Yoshida K et al. Arthritis Rheumatol. 2021 Aug 18. doi: 10.1002/art.41939.
Key clinical point: Passive smoking exposure in childhood is associated with adult-onset seropositive rheumatoid arthritis (RA), suggesting that early life exposures influence RA risk.
Major finding: After adjusting for confounders, maternal smoking during pregnancy was associated with all-incident RA (adjusted hazard ratio [aHR] 1.25; 95% CI 1.03-1.52) and seropositive RA (aHR 1.34; 95% CI 1.06-1.70), whereas childhood parental smoking was associated with seropositive RA (aHR 1.41; 95% CI 1.08-1.83).
Study details: This was an analysis of prospectively collected data from the Nurses’ Health Study II, involving 90,923 women.
Disclosures: This work was supported by the National Institute of Arthritis and Musculoskeletal and Skin Diseases, Rheumatology Research Foundation, and National Institutes of Health. K Yoshida and J Sparks reported receiving research support and consultancy fees from various sources.
Source: Yoshida K et al. Arthritis Rheumatol. 2021 Aug 18. doi: 10.1002/art.41939.
Key clinical point: Passive smoking exposure in childhood is associated with adult-onset seropositive rheumatoid arthritis (RA), suggesting that early life exposures influence RA risk.
Major finding: After adjusting for confounders, maternal smoking during pregnancy was associated with all-incident RA (adjusted hazard ratio [aHR] 1.25; 95% CI 1.03-1.52) and seropositive RA (aHR 1.34; 95% CI 1.06-1.70), whereas childhood parental smoking was associated with seropositive RA (aHR 1.41; 95% CI 1.08-1.83).
Study details: This was an analysis of prospectively collected data from the Nurses’ Health Study II, involving 90,923 women.
Disclosures: This work was supported by the National Institute of Arthritis and Musculoskeletal and Skin Diseases, Rheumatology Research Foundation, and National Institutes of Health. K Yoshida and J Sparks reported receiving research support and consultancy fees from various sources.
Source: Yoshida K et al. Arthritis Rheumatol. 2021 Aug 18. doi: 10.1002/art.41939.
Better outcomes with combination therapies vs. tofacitinib alone in RA patients with lesser response
Key clinical point: Combination therapy of methotrexate with tofacitinib or adalimumab improved outcomes in patients with rheumatoid arthritis (RA) who did not respond well to tofacitinib alone.
Major finding: Overall, greater response was achieved by 28.8%, 37.2%, and 39.1% of patients receiving tofacitinib monotherapy, tofacitinib + metotrexate, and adalimumab + methotrexate, respectively. Patients with greater response showed similar 12-month cumulative probability plots for a mean percentage change in Clinical Disease Activity Index across treatment. However, patients with lower responses receiving tofacitinib monotherapy did not respond as well as those receiving combination therapies.
Study details: The data come from a post hoc analysis of the ORAL Strategy trial, which included 1,146 patients with active RA despite methotrexate treatment who were randomly assigned to receive 5 mg tofacitinib twice daily, 5 mg tofacitinib twice daily + methotrexate, or 40 mg adalimumab every other week + methotrexate.
Disclosures: This study was funded by Pfizer Inc. Some of the authors reported receiving grants/research support and consultancy fees from various sources including Pfizer Inc. J Paulissen reported being an employee of Syneos Health. N Iikuni, H Shi, K Soma, and T Hirose reported being employees and shareholders of Pfizer Inc.
Source: Takeuchi T et al. Arthritis Res Ther. 2021 Aug 24. doi: 10.1186/s13075-021-02591-y.
Key clinical point: Combination therapy of methotrexate with tofacitinib or adalimumab improved outcomes in patients with rheumatoid arthritis (RA) who did not respond well to tofacitinib alone.
Major finding: Overall, greater response was achieved by 28.8%, 37.2%, and 39.1% of patients receiving tofacitinib monotherapy, tofacitinib + metotrexate, and adalimumab + methotrexate, respectively. Patients with greater response showed similar 12-month cumulative probability plots for a mean percentage change in Clinical Disease Activity Index across treatment. However, patients with lower responses receiving tofacitinib monotherapy did not respond as well as those receiving combination therapies.
Study details: The data come from a post hoc analysis of the ORAL Strategy trial, which included 1,146 patients with active RA despite methotrexate treatment who were randomly assigned to receive 5 mg tofacitinib twice daily, 5 mg tofacitinib twice daily + methotrexate, or 40 mg adalimumab every other week + methotrexate.
Disclosures: This study was funded by Pfizer Inc. Some of the authors reported receiving grants/research support and consultancy fees from various sources including Pfizer Inc. J Paulissen reported being an employee of Syneos Health. N Iikuni, H Shi, K Soma, and T Hirose reported being employees and shareholders of Pfizer Inc.
Source: Takeuchi T et al. Arthritis Res Ther. 2021 Aug 24. doi: 10.1186/s13075-021-02591-y.
Key clinical point: Combination therapy of methotrexate with tofacitinib or adalimumab improved outcomes in patients with rheumatoid arthritis (RA) who did not respond well to tofacitinib alone.
Major finding: Overall, greater response was achieved by 28.8%, 37.2%, and 39.1% of patients receiving tofacitinib monotherapy, tofacitinib + metotrexate, and adalimumab + methotrexate, respectively. Patients with greater response showed similar 12-month cumulative probability plots for a mean percentage change in Clinical Disease Activity Index across treatment. However, patients with lower responses receiving tofacitinib monotherapy did not respond as well as those receiving combination therapies.
Study details: The data come from a post hoc analysis of the ORAL Strategy trial, which included 1,146 patients with active RA despite methotrexate treatment who were randomly assigned to receive 5 mg tofacitinib twice daily, 5 mg tofacitinib twice daily + methotrexate, or 40 mg adalimumab every other week + methotrexate.
Disclosures: This study was funded by Pfizer Inc. Some of the authors reported receiving grants/research support and consultancy fees from various sources including Pfizer Inc. J Paulissen reported being an employee of Syneos Health. N Iikuni, H Shi, K Soma, and T Hirose reported being employees and shareholders of Pfizer Inc.
Source: Takeuchi T et al. Arthritis Res Ther. 2021 Aug 24. doi: 10.1186/s13075-021-02591-y.
Incremental benefits with filgotinib 200 mg+methotraxate in RA patients with poor prognostic factors
Key clinical point: The combination of filgotinib 200 mg and methotrexate showed an incremental benefit vs. methotrexate monotherapy in methotrexate-naive patients with rheumatoid arthritis (RA) and poor prognostic factors (PPF) with no new safety signals.
Major finding: Among patients with 4 PPFs, methotrexate + 200 mg filgotinib vs. methotrexate monotherapy was associated with higher rates of American College of Rheumatology (ACR) core criteria 20 (85.5% vs. 74.7%), ACR50 (70.3% vs. 48.2%), and ACR70 (54.1% vs. 28.3%) responses at week 24 and weeks 12 and 52 (nominal P < .05 for all).
Study details: This was a post hoc analysis of the phase 3 FINCH 3 study involving 1,249 methotrexate-naive adult patients with moderate-to-severe active RA with multiple PPFs. Patients were randomly assigned to once-weekly methotrexate with once-daily oral filgotinib (200 mg or 100 mg), 200 mg filgotinib monotherapy, or oral methotrexate monotherapy for up to 52 weeks.
Disclosures: The study was funded by Gilead Sciences, Inc. The authors, including the lead author, reported receiving grants, speaker’s fees, and consultancy fees from various sources. Three authors reported being employees and shareholders of Gilead Sciences, Inc.
Source: Aletaha D et al. RMD Open. 2021 Aug 12. doi: 10.1136/rmdopen-2021-001621.
Key clinical point: The combination of filgotinib 200 mg and methotrexate showed an incremental benefit vs. methotrexate monotherapy in methotrexate-naive patients with rheumatoid arthritis (RA) and poor prognostic factors (PPF) with no new safety signals.
Major finding: Among patients with 4 PPFs, methotrexate + 200 mg filgotinib vs. methotrexate monotherapy was associated with higher rates of American College of Rheumatology (ACR) core criteria 20 (85.5% vs. 74.7%), ACR50 (70.3% vs. 48.2%), and ACR70 (54.1% vs. 28.3%) responses at week 24 and weeks 12 and 52 (nominal P < .05 for all).
Study details: This was a post hoc analysis of the phase 3 FINCH 3 study involving 1,249 methotrexate-naive adult patients with moderate-to-severe active RA with multiple PPFs. Patients were randomly assigned to once-weekly methotrexate with once-daily oral filgotinib (200 mg or 100 mg), 200 mg filgotinib monotherapy, or oral methotrexate monotherapy for up to 52 weeks.
Disclosures: The study was funded by Gilead Sciences, Inc. The authors, including the lead author, reported receiving grants, speaker’s fees, and consultancy fees from various sources. Three authors reported being employees and shareholders of Gilead Sciences, Inc.
Source: Aletaha D et al. RMD Open. 2021 Aug 12. doi: 10.1136/rmdopen-2021-001621.
Key clinical point: The combination of filgotinib 200 mg and methotrexate showed an incremental benefit vs. methotrexate monotherapy in methotrexate-naive patients with rheumatoid arthritis (RA) and poor prognostic factors (PPF) with no new safety signals.
Major finding: Among patients with 4 PPFs, methotrexate + 200 mg filgotinib vs. methotrexate monotherapy was associated with higher rates of American College of Rheumatology (ACR) core criteria 20 (85.5% vs. 74.7%), ACR50 (70.3% vs. 48.2%), and ACR70 (54.1% vs. 28.3%) responses at week 24 and weeks 12 and 52 (nominal P < .05 for all).
Study details: This was a post hoc analysis of the phase 3 FINCH 3 study involving 1,249 methotrexate-naive adult patients with moderate-to-severe active RA with multiple PPFs. Patients were randomly assigned to once-weekly methotrexate with once-daily oral filgotinib (200 mg or 100 mg), 200 mg filgotinib monotherapy, or oral methotrexate monotherapy for up to 52 weeks.
Disclosures: The study was funded by Gilead Sciences, Inc. The authors, including the lead author, reported receiving grants, speaker’s fees, and consultancy fees from various sources. Three authors reported being employees and shareholders of Gilead Sciences, Inc.
Source: Aletaha D et al. RMD Open. 2021 Aug 12. doi: 10.1136/rmdopen-2021-001621.
Fasting C-peptide levels tied to EPI in patients with T2DM
Key clinical point: Fasting C-peptide (FCP) was positively associated with fecal elastase (FE)-1 levels with an independent predictive value for exocrine pancreatic insufficiency (EPI) in patients with type 2 diabetes mellitus (T2DM).
Major finding: Overall, the prevalence of EPI (FE-1 < 200 mg/g) was 18.8%. FE-1 levels were positively associated with FCP levels (correlation coefficient 0.451; P < .001). FCP level was an independent factor (odds ratio 0.204; P = .024) with a good predictive value (area under the receiver operating curve 0.793; sensitivity 0.710; specificity 0.812; P < .001) for EPI.
Study details: Findings are from a cross-sectional analysis of 85 adult inpatients with T2DM without known exocrine pancreatic disorders or digestive system diseases.
Disclosures: This study was supported by the National Natural Science Foundation of China, the Key Research & Development Program of Jiangsu Province, and the Joint Key Project funded by the Southeast University and Nanjing Medical University. The authors declared no conflict of interests.
Source: Lv Y et al. Clin Chim Acta. 2021 Sep 14. doi: 10.1016/j.cca.2021.09.008.
Key clinical point: Fasting C-peptide (FCP) was positively associated with fecal elastase (FE)-1 levels with an independent predictive value for exocrine pancreatic insufficiency (EPI) in patients with type 2 diabetes mellitus (T2DM).
Major finding: Overall, the prevalence of EPI (FE-1 < 200 mg/g) was 18.8%. FE-1 levels were positively associated with FCP levels (correlation coefficient 0.451; P < .001). FCP level was an independent factor (odds ratio 0.204; P = .024) with a good predictive value (area under the receiver operating curve 0.793; sensitivity 0.710; specificity 0.812; P < .001) for EPI.
Study details: Findings are from a cross-sectional analysis of 85 adult inpatients with T2DM without known exocrine pancreatic disorders or digestive system diseases.
Disclosures: This study was supported by the National Natural Science Foundation of China, the Key Research & Development Program of Jiangsu Province, and the Joint Key Project funded by the Southeast University and Nanjing Medical University. The authors declared no conflict of interests.
Source: Lv Y et al. Clin Chim Acta. 2021 Sep 14. doi: 10.1016/j.cca.2021.09.008.
Key clinical point: Fasting C-peptide (FCP) was positively associated with fecal elastase (FE)-1 levels with an independent predictive value for exocrine pancreatic insufficiency (EPI) in patients with type 2 diabetes mellitus (T2DM).
Major finding: Overall, the prevalence of EPI (FE-1 < 200 mg/g) was 18.8%. FE-1 levels were positively associated with FCP levels (correlation coefficient 0.451; P < .001). FCP level was an independent factor (odds ratio 0.204; P = .024) with a good predictive value (area under the receiver operating curve 0.793; sensitivity 0.710; specificity 0.812; P < .001) for EPI.
Study details: Findings are from a cross-sectional analysis of 85 adult inpatients with T2DM without known exocrine pancreatic disorders or digestive system diseases.
Disclosures: This study was supported by the National Natural Science Foundation of China, the Key Research & Development Program of Jiangsu Province, and the Joint Key Project funded by the Southeast University and Nanjing Medical University. The authors declared no conflict of interests.
Source: Lv Y et al. Clin Chim Acta. 2021 Sep 14. doi: 10.1016/j.cca.2021.09.008.
Higher prevalence of EPI in patients with pancreatic enzyme abnormalities with or without functional dyspepsia
Key clinical point: The prevalence of exocrine pancreatic insufficiency (EPI) was higher in patients with functional dyspepsia (FD) with pancreatic enzyme abnormalities (PEA) compared to asymptomatic patients (AP) with PEA and was associated with physical function but not with the state of anxiety.
Major finding: The prevalence of EPI was higher in patients with FD-PEA vs. AP-PEA (N-benzoyl-L-tyrosyl-p-aminobenzoic acid test scores, 61.67% ± 5.55% vs. 95.38% ± 2.36%; P = .01). Physical component scale was significantly lower in FD-PEA vs. AP-PEA group (44.60 ± 2.40 vs. 53.56 ± 1.31; P = .002). No difference was observed in State-Trait Anxiety Inventory (STAI)-state (P = .089) and STAI-trait (P = .483) scores between groups.
Study details: This study included 49 patients with PEA with (n=20) or without (n=29) symptoms of FD.
Disclosures: This study was funded by the Ministry of Education, Culture, and Science and the Ministry of Health, Japan. The authors declared no conflict of interests.
Source: Agawa S et al. J Clin Biochem Nutr. 2021 Sep 3. doi: 10.3164/jcbn.21-67.
Key clinical point: The prevalence of exocrine pancreatic insufficiency (EPI) was higher in patients with functional dyspepsia (FD) with pancreatic enzyme abnormalities (PEA) compared to asymptomatic patients (AP) with PEA and was associated with physical function but not with the state of anxiety.
Major finding: The prevalence of EPI was higher in patients with FD-PEA vs. AP-PEA (N-benzoyl-L-tyrosyl-p-aminobenzoic acid test scores, 61.67% ± 5.55% vs. 95.38% ± 2.36%; P = .01). Physical component scale was significantly lower in FD-PEA vs. AP-PEA group (44.60 ± 2.40 vs. 53.56 ± 1.31; P = .002). No difference was observed in State-Trait Anxiety Inventory (STAI)-state (P = .089) and STAI-trait (P = .483) scores between groups.
Study details: This study included 49 patients with PEA with (n=20) or without (n=29) symptoms of FD.
Disclosures: This study was funded by the Ministry of Education, Culture, and Science and the Ministry of Health, Japan. The authors declared no conflict of interests.
Source: Agawa S et al. J Clin Biochem Nutr. 2021 Sep 3. doi: 10.3164/jcbn.21-67.
Key clinical point: The prevalence of exocrine pancreatic insufficiency (EPI) was higher in patients with functional dyspepsia (FD) with pancreatic enzyme abnormalities (PEA) compared to asymptomatic patients (AP) with PEA and was associated with physical function but not with the state of anxiety.
Major finding: The prevalence of EPI was higher in patients with FD-PEA vs. AP-PEA (N-benzoyl-L-tyrosyl-p-aminobenzoic acid test scores, 61.67% ± 5.55% vs. 95.38% ± 2.36%; P = .01). Physical component scale was significantly lower in FD-PEA vs. AP-PEA group (44.60 ± 2.40 vs. 53.56 ± 1.31; P = .002). No difference was observed in State-Trait Anxiety Inventory (STAI)-state (P = .089) and STAI-trait (P = .483) scores between groups.
Study details: This study included 49 patients with PEA with (n=20) or without (n=29) symptoms of FD.
Disclosures: This study was funded by the Ministry of Education, Culture, and Science and the Ministry of Health, Japan. The authors declared no conflict of interests.
Source: Agawa S et al. J Clin Biochem Nutr. 2021 Sep 3. doi: 10.3164/jcbn.21-67.
EPI in diabetes is associated with autonomic dysfunction
Key clinical point: Patients with diabetes and exocrine pancreatic insufficiency (EPI) had reduced autonomic function compared with those with diabetes without EPI.
Major finding: Overall, the prevalence of EPI (fecal elastase [FE] < 200 mg/g) was 20%. Patients with or without EPI had reduced baroreflex sensitivity (all P < .05) and heart rate variability (P < .05), but not increased frequency of orthostatic hypotension (P = .92).
Study details: This study included 59 patients with type 1 or type 2 diabetes. Patients with diabetes were stratified into EPI (n=8) and control (n=13) groups based on FE levels.
Disclosures: This study was funded by Haukeland University Hospital. The authors declared no conflict of interests.
Source: Sangnes DA et al. Scand J Gastroenterol. 2021 Sep 7. doi: 10.1080/00365521.2021.1957496.
Key clinical point: Patients with diabetes and exocrine pancreatic insufficiency (EPI) had reduced autonomic function compared with those with diabetes without EPI.
Major finding: Overall, the prevalence of EPI (fecal elastase [FE] < 200 mg/g) was 20%. Patients with or without EPI had reduced baroreflex sensitivity (all P < .05) and heart rate variability (P < .05), but not increased frequency of orthostatic hypotension (P = .92).
Study details: This study included 59 patients with type 1 or type 2 diabetes. Patients with diabetes were stratified into EPI (n=8) and control (n=13) groups based on FE levels.
Disclosures: This study was funded by Haukeland University Hospital. The authors declared no conflict of interests.
Source: Sangnes DA et al. Scand J Gastroenterol. 2021 Sep 7. doi: 10.1080/00365521.2021.1957496.
Key clinical point: Patients with diabetes and exocrine pancreatic insufficiency (EPI) had reduced autonomic function compared with those with diabetes without EPI.
Major finding: Overall, the prevalence of EPI (fecal elastase [FE] < 200 mg/g) was 20%. Patients with or without EPI had reduced baroreflex sensitivity (all P < .05) and heart rate variability (P < .05), but not increased frequency of orthostatic hypotension (P = .92).
Study details: This study included 59 patients with type 1 or type 2 diabetes. Patients with diabetes were stratified into EPI (n=8) and control (n=13) groups based on FE levels.
Disclosures: This study was funded by Haukeland University Hospital. The authors declared no conflict of interests.
Source: Sangnes DA et al. Scand J Gastroenterol. 2021 Sep 7. doi: 10.1080/00365521.2021.1957496.