Key clinical point: Compared with fludarabine, cyclophosphamide, and rituximab, ibrutinib and rituximab provided a significant progression-free survival (PFS) benefit in treatment-naive patients with chronic lymphocytic leukemia (CLL).

Major finding: After a median follow-up of 53 months, the median PFS was not reached in patients receiving ibrutinib and rituximab and was 67 months (95% CI 63-not reached) in those receiving fludarabine, cyclophosphamide, and rituximab (hazard ratio 0.44; P < .0001). A substantial number of sudden cardiac or unexplained deaths occurred, which were more frequent in the ibrutinib and rituximab group.

Study details: This interim analysis of the multicenter phase 3 FLAIR trial included 771 treatment-naive adult patients with CLL or small lymphocytic lymphoma who were randomly assigned to receive ibrutinib and rituximab (n = 386) or fludarabine, cyclophosphamide, and rituximab (n = 385).

Disclosures: This study was funded by Cancer Research UK, Janssen, and others. Some authors declared participating on data safety monitoring or advisory boards and receiving grants, personal consulting or speaker fees, lecture honoraria, or travel support from the study funders and others.

Source: Hillmen P et al. Ibrutinib and rituximab versus fludarabine, cyclophosphamide, and rituximab for patients with previously untreated chronic lymphocytic leukaemia (FLAIR): Interim analysis of a multicentre, open-label, randomised, phase 3 trial. Lancet Oncol. 2023;24(5):535-552 (May). Doi: 10.1016/S1470-2045(23)00144-4

Key clinical point: Compared with fludarabine, cyclophosphamide, and rituximab, ibrutinib and rituximab provided a significant progression-free survival (PFS) benefit in treatment-naive patients with chronic lymphocytic leukemia (CLL).

Major finding: After a median follow-up of 53 months, the median PFS was not reached in patients receiving ibrutinib and rituximab and was 67 months (95% CI 63-not reached) in those receiving fludarabine, cyclophosphamide, and rituximab (hazard ratio 0.44; P < .0001). A substantial number of sudden cardiac or unexplained deaths occurred, which were more frequent in the ibrutinib and rituximab group.

Study details: This interim analysis of the multicenter phase 3 FLAIR trial included 771 treatment-naive adult patients with CLL or small lymphocytic lymphoma who were randomly assigned to receive ibrutinib and rituximab (n = 386) or fludarabine, cyclophosphamide, and rituximab (n = 385).

Disclosures: This study was funded by Cancer Research UK, Janssen, and others. Some authors declared participating on data safety monitoring or advisory boards and receiving grants, personal consulting or speaker fees, lecture honoraria, or travel support from the study funders and others.

Source: Hillmen P et al. Ibrutinib and rituximab versus fludarabine, cyclophosphamide, and rituximab for patients with previously untreated chronic lymphocytic leukaemia (FLAIR): Interim analysis of a multicentre, open-label, randomised, phase 3 trial. Lancet Oncol. 2023;24(5):535-552 (May). Doi: 10.1016/S1470-2045(23)00144-4

Key clinical point: Compared with fludarabine, cyclophosphamide, and rituximab, ibrutinib and rituximab provided a significant progression-free survival (PFS) benefit in treatment-naive patients with chronic lymphocytic leukemia (CLL).

Major finding: After a median follow-up of 53 months, the median PFS was not reached in patients receiving ibrutinib and rituximab and was 67 months (95% CI 63-not reached) in those receiving fludarabine, cyclophosphamide, and rituximab (hazard ratio 0.44; P < .0001). A substantial number of sudden cardiac or unexplained deaths occurred, which were more frequent in the ibrutinib and rituximab group.

Study details: This interim analysis of the multicenter phase 3 FLAIR trial included 771 treatment-naive adult patients with CLL or small lymphocytic lymphoma who were randomly assigned to receive ibrutinib and rituximab (n = 386) or fludarabine, cyclophosphamide, and rituximab (n = 385).

Disclosures: This study was funded by Cancer Research UK, Janssen, and others. Some authors declared participating on data safety monitoring or advisory boards and receiving grants, personal consulting or speaker fees, lecture honoraria, or travel support from the study funders and others.

Source: Hillmen P et al. Ibrutinib and rituximab versus fludarabine, cyclophosphamide, and rituximab for patients with previously untreated chronic lymphocytic leukaemia (FLAIR): Interim analysis of a multicentre, open-label, randomised, phase 3 trial. Lancet Oncol. 2023;24(5):535-552 (May). Doi: 10.1016/S1470-2045(23)00144-4

Key clinical point: Compared with the current standard chemoimmunotherapy, venetoclax-obinutuzumab with or without ibrutinib as first line treatment improved outcomes in fit patients with advanced chronic lymphocytic leukemia (CLL).

Major finding: The venetoclax-obinutuzumab and venetoclax-obinutuzumab-ibrutinib groups vs the chemoimmunotherapy group had significantly higher undetectable minimal residual disease rates at 15 months (86.5% and 92.2% vs 52.0%, respectively; both P < .001) and 3-year progression-free survival (hazard ratio for disease progression or death 0.42 and 0.32, respectively; both P < .001) and numerically lower fatal adverse event rate (3.9% and 3.9% vs 4.6%, respectively).

Study details: This phase 3 trial, GAIA-CLL13, included 926 fit adult patients with previously untreated, advanced CLL and no del(17p) or TP53 mutations who were randomly assigned to receive standard chemoimmunotherapy (fludarabine-cyclophosphamide-rituximab or bendamustine-rituximab), venetoclax-rituximab, venetoclax-obinutuzumab, or venetoclax-obinutuzumab-ibrutinib.

Disclosures: This study was supported by AbbVie, Janssen, and Roche. Some authors declared serving as consultants, advisory board members, or speakers and receiving research grants, speaker honoraria, or travel support from the study funders and others.

Source: Eichhorst B et al for the GCLLSG, the HOVON and Nordic CLL Study Groups, the SAKK, the Israeli CLL Association, and Cancer Trials Ireland. First-line venetoclax combinations in chronic lymphocytic leukemia. N Engl J Med. 2023;388(19):1739-1754 (May 11). Doi: 10.1056/NEJMoa2213093

Key clinical point: Compared with the current standard chemoimmunotherapy, venetoclax-obinutuzumab with or without ibrutinib as first line treatment improved outcomes in fit patients with advanced chronic lymphocytic leukemia (CLL).

Major finding: The venetoclax-obinutuzumab and venetoclax-obinutuzumab-ibrutinib groups vs the chemoimmunotherapy group had significantly higher undetectable minimal residual disease rates at 15 months (86.5% and 92.2% vs 52.0%, respectively; both P < .001) and 3-year progression-free survival (hazard ratio for disease progression or death 0.42 and 0.32, respectively; both P < .001) and numerically lower fatal adverse event rate (3.9% and 3.9% vs 4.6%, respectively).

Study details: This phase 3 trial, GAIA-CLL13, included 926 fit adult patients with previously untreated, advanced CLL and no del(17p) or TP53 mutations who were randomly assigned to receive standard chemoimmunotherapy (fludarabine-cyclophosphamide-rituximab or bendamustine-rituximab), venetoclax-rituximab, venetoclax-obinutuzumab, or venetoclax-obinutuzumab-ibrutinib.

Disclosures: This study was supported by AbbVie, Janssen, and Roche. Some authors declared serving as consultants, advisory board members, or speakers and receiving research grants, speaker honoraria, or travel support from the study funders and others.

Source: Eichhorst B et al for the GCLLSG, the HOVON and Nordic CLL Study Groups, the SAKK, the Israeli CLL Association, and Cancer Trials Ireland. First-line venetoclax combinations in chronic lymphocytic leukemia. N Engl J Med. 2023;388(19):1739-1754 (May 11). Doi: 10.1056/NEJMoa2213093

Key clinical point: Compared with the current standard chemoimmunotherapy, venetoclax-obinutuzumab with or without ibrutinib as first line treatment improved outcomes in fit patients with advanced chronic lymphocytic leukemia (CLL).

Major finding: The venetoclax-obinutuzumab and venetoclax-obinutuzumab-ibrutinib groups vs the chemoimmunotherapy group had significantly higher undetectable minimal residual disease rates at 15 months (86.5% and 92.2% vs 52.0%, respectively; both P < .001) and 3-year progression-free survival (hazard ratio for disease progression or death 0.42 and 0.32, respectively; both P < .001) and numerically lower fatal adverse event rate (3.9% and 3.9% vs 4.6%, respectively).

Study details: This phase 3 trial, GAIA-CLL13, included 926 fit adult patients with previously untreated, advanced CLL and no del(17p) or TP53 mutations who were randomly assigned to receive standard chemoimmunotherapy (fludarabine-cyclophosphamide-rituximab or bendamustine-rituximab), venetoclax-rituximab, venetoclax-obinutuzumab, or venetoclax-obinutuzumab-ibrutinib.

Disclosures: This study was supported by AbbVie, Janssen, and Roche. Some authors declared serving as consultants, advisory board members, or speakers and receiving research grants, speaker honoraria, or travel support from the study funders and others.

Source: Eichhorst B et al for the GCLLSG, the HOVON and Nordic CLL Study Groups, the SAKK, the Israeli CLL Association, and Cancer Trials Ireland. First-line venetoclax combinations in chronic lymphocytic leukemia. N Engl J Med. 2023;388(19):1739-1754 (May 11). Doi: 10.1056/NEJMoa2213093

Key clinical point: The risk for all-cause mortality is higher among elderly patients with vs without rheumatoid arthritis (RA) who undergo percutaneous coronary intervention (PCI), with the risk being the highest among those with elderly-onset RA (disease presentation after 65 years of age).

Major finding: During the 10-year follow-up, all-cause mortality-associated survival rates were significantly lower in patients with vs without RA (53.7% vs 58.3%; log-rank P < .001) and in patients with elderly-onset vs young-onset RA (48.1% vs 73.7%; log-rank P < .001). Trends were similar for cardiovascular disease-associated survival rates (all log-rank P < .001).

Study details: This was a population-based retrospective cohort study including 74,623 patients age ≥ 65 years with (n = 14,074) or without (n = 60,549) RA who were diagnosed with acute coronary syndrome and underwent PCI.

Disclosures: This study was funded by Soonchunhyang University, South Korea, and the Asan Foundation, South Korea. The authors declared no conflicts of interest.

Source: Kim BY et al. Outcomes of percutaneous coronary intervention in elderly patients with rheumatoid arthritis: A nationwide population-based cohort study. Healthcare (Basel). 2023;11(10):1381 (May 10). Doi: 10.3390/healthcare11101381

Key clinical point: The risk for all-cause mortality is higher among elderly patients with vs without rheumatoid arthritis (RA) who undergo percutaneous coronary intervention (PCI), with the risk being the highest among those with elderly-onset RA (disease presentation after 65 years of age).

Major finding: During the 10-year follow-up, all-cause mortality-associated survival rates were significantly lower in patients with vs without RA (53.7% vs 58.3%; log-rank P < .001) and in patients with elderly-onset vs young-onset RA (48.1% vs 73.7%; log-rank P < .001). Trends were similar for cardiovascular disease-associated survival rates (all log-rank P < .001).

Study details: This was a population-based retrospective cohort study including 74,623 patients age ≥ 65 years with (n = 14,074) or without (n = 60,549) RA who were diagnosed with acute coronary syndrome and underwent PCI.

Disclosures: This study was funded by Soonchunhyang University, South Korea, and the Asan Foundation, South Korea. The authors declared no conflicts of interest.

Source: Kim BY et al. Outcomes of percutaneous coronary intervention in elderly patients with rheumatoid arthritis: A nationwide population-based cohort study. Healthcare (Basel). 2023;11(10):1381 (May 10). Doi: 10.3390/healthcare11101381

Key clinical point: The risk for all-cause mortality is higher among elderly patients with vs without rheumatoid arthritis (RA) who undergo percutaneous coronary intervention (PCI), with the risk being the highest among those with elderly-onset RA (disease presentation after 65 years of age).

Major finding: During the 10-year follow-up, all-cause mortality-associated survival rates were significantly lower in patients with vs without RA (53.7% vs 58.3%; log-rank P < .001) and in patients with elderly-onset vs young-onset RA (48.1% vs 73.7%; log-rank P < .001). Trends were similar for cardiovascular disease-associated survival rates (all log-rank P < .001).

Study details: This was a population-based retrospective cohort study including 74,623 patients age ≥ 65 years with (n = 14,074) or without (n = 60,549) RA who were diagnosed with acute coronary syndrome and underwent PCI.

Disclosures: This study was funded by Soonchunhyang University, South Korea, and the Asan Foundation, South Korea. The authors declared no conflicts of interest.

Source: Kim BY et al. Outcomes of percutaneous coronary intervention in elderly patients with rheumatoid arthritis: A nationwide population-based cohort study. Healthcare (Basel). 2023;11(10):1381 (May 10). Doi: 10.3390/healthcare11101381

Key clinical point: Patients with rheumatoid arthritis (RA) were at an increased risk for Parkinson disease (PD), and patients with seropositive RA had an augmented risk for PD.

Major finding: The risk for PD was 1.74-fold higher in patients with RA vs control individuals without RA (adjusted hazard ratio [aHR] 1.74; 95% CI 1.52-1.99), 1.95-fold higher in patients with seropositive RA vs control individuals without RA (aHR 1.95; 95% CI 1.68-2.26), and 1.61-fold higher in patients with seropositive vs seronegative RA (aHR 1.61; 95% CI 1.20-2.16).

Study details: Findings are from a retrospective cohort study including 54,680 patients with RA (seropositive RA n = 39,010, and seronegative RA n = 15,670) and 273,400 age- and sex-matched control individuals without RA.

Disclosures: This study did not declare the source of funding or any conflicts of interest.

Source: Kang J et al. Rheumatoid arthritis and risk of Parkinson disease in Korea. JAMA Neurol. 2023 (May 1). Doi: 10.1001/jamaneurol.2023.0932

Key clinical point: Patients with rheumatoid arthritis (RA) were at an increased risk for Parkinson disease (PD), and patients with seropositive RA had an augmented risk for PD.

Major finding: The risk for PD was 1.74-fold higher in patients with RA vs control individuals without RA (adjusted hazard ratio [aHR] 1.74; 95% CI 1.52-1.99), 1.95-fold higher in patients with seropositive RA vs control individuals without RA (aHR 1.95; 95% CI 1.68-2.26), and 1.61-fold higher in patients with seropositive vs seronegative RA (aHR 1.61; 95% CI 1.20-2.16).

Study details: Findings are from a retrospective cohort study including 54,680 patients with RA (seropositive RA n = 39,010, and seronegative RA n = 15,670) and 273,400 age- and sex-matched control individuals without RA.

Disclosures: This study did not declare the source of funding or any conflicts of interest.

Source: Kang J et al. Rheumatoid arthritis and risk of Parkinson disease in Korea. JAMA Neurol. 2023 (May 1). Doi: 10.1001/jamaneurol.2023.0932

Key clinical point: Patients with rheumatoid arthritis (RA) were at an increased risk for Parkinson disease (PD), and patients with seropositive RA had an augmented risk for PD.

Major finding: The risk for PD was 1.74-fold higher in patients with RA vs control individuals without RA (adjusted hazard ratio [aHR] 1.74; 95% CI 1.52-1.99), 1.95-fold higher in patients with seropositive RA vs control individuals without RA (aHR 1.95; 95% CI 1.68-2.26), and 1.61-fold higher in patients with seropositive vs seronegative RA (aHR 1.61; 95% CI 1.20-2.16).

Study details: Findings are from a retrospective cohort study including 54,680 patients with RA (seropositive RA n = 39,010, and seronegative RA n = 15,670) and 273,400 age- and sex-matched control individuals without RA.

Disclosures: This study did not declare the source of funding or any conflicts of interest.

Source: Kang J et al. Rheumatoid arthritis and risk of Parkinson disease in Korea. JAMA Neurol. 2023 (May 1). Doi: 10.1001/jamaneurol.2023.0932

Key clinical point: Monotherapy or combination therapy with tumor necrosis factor inhibitors (TNFi) and interleukin-6 receptor inhibitors (IL-6Ri) led to similar clinical outcomes in biologic/targeted synthetic disease-modifying antirheumatic drug (b/tsDMARD)-experienced patients with rheumatoid arthritis (RA).

Major finding: Over 6 months, TNFi and IL-6Ri monotherapies were associated with comparable odds of achieving Clinical Disease Activity Index-based low disease activity (adjusted odds ratio [aOR] 0.99; 95% CI 0.59-1.67) and ≥0.22-unit improvement in Health Assessment Questionnaire-Disability Index (aOR 1.13; 95% CI 0.72-1.77), with results being similar with combination therapy.

Study details: This retrospective observational study included 2739 b/tsDMARD-experienced patients with RA and moderate or high disease activity who initiated TNFi or IL-6Ri monotherapy or combination therapy.

Disclosures: The registry was sponsored by CorEvitas, LLC, and this analysis was funded by Sanofi and Regeneron. Seven authors declared being current or former employees or owning stocks, stock options, or patents of Sanofi or CorEvitas, LLC. Several authors reported ties with Sanofi, Regeneron, and other sources.

Source: Sebba A et al. Comparative effectiveness of TNF inhibitor vs IL-6 receptor inhibitor as monotherapy or combination therapy with methotrexate in biologic-experienced patients with rheumatoid arthritis: An analysis from the CorEvitas RA Registry. Clin Rheumatol. 2023 (Apr 15). Doi: 10.1007/s10067-023-06588-7

Key clinical point: Monotherapy or combination therapy with tumor necrosis factor inhibitors (TNFi) and interleukin-6 receptor inhibitors (IL-6Ri) led to similar clinical outcomes in biologic/targeted synthetic disease-modifying antirheumatic drug (b/tsDMARD)-experienced patients with rheumatoid arthritis (RA).

Major finding: Over 6 months, TNFi and IL-6Ri monotherapies were associated with comparable odds of achieving Clinical Disease Activity Index-based low disease activity (adjusted odds ratio [aOR] 0.99; 95% CI 0.59-1.67) and ≥0.22-unit improvement in Health Assessment Questionnaire-Disability Index (aOR 1.13; 95% CI 0.72-1.77), with results being similar with combination therapy.

Study details: This retrospective observational study included 2739 b/tsDMARD-experienced patients with RA and moderate or high disease activity who initiated TNFi or IL-6Ri monotherapy or combination therapy.

Disclosures: The registry was sponsored by CorEvitas, LLC, and this analysis was funded by Sanofi and Regeneron. Seven authors declared being current or former employees or owning stocks, stock options, or patents of Sanofi or CorEvitas, LLC. Several authors reported ties with Sanofi, Regeneron, and other sources.

Source: Sebba A et al. Comparative effectiveness of TNF inhibitor vs IL-6 receptor inhibitor as monotherapy or combination therapy with methotrexate in biologic-experienced patients with rheumatoid arthritis: An analysis from the CorEvitas RA Registry. Clin Rheumatol. 2023 (Apr 15). Doi: 10.1007/s10067-023-06588-7

Key clinical point: Monotherapy or combination therapy with tumor necrosis factor inhibitors (TNFi) and interleukin-6 receptor inhibitors (IL-6Ri) led to similar clinical outcomes in biologic/targeted synthetic disease-modifying antirheumatic drug (b/tsDMARD)-experienced patients with rheumatoid arthritis (RA).

Major finding: Over 6 months, TNFi and IL-6Ri monotherapies were associated with comparable odds of achieving Clinical Disease Activity Index-based low disease activity (adjusted odds ratio [aOR] 0.99; 95% CI 0.59-1.67) and ≥0.22-unit improvement in Health Assessment Questionnaire-Disability Index (aOR 1.13; 95% CI 0.72-1.77), with results being similar with combination therapy.

Study details: This retrospective observational study included 2739 b/tsDMARD-experienced patients with RA and moderate or high disease activity who initiated TNFi or IL-6Ri monotherapy or combination therapy.

Disclosures: The registry was sponsored by CorEvitas, LLC, and this analysis was funded by Sanofi and Regeneron. Seven authors declared being current or former employees or owning stocks, stock options, or patents of Sanofi or CorEvitas, LLC. Several authors reported ties with Sanofi, Regeneron, and other sources.

Source: Sebba A et al. Comparative effectiveness of TNF inhibitor vs IL-6 receptor inhibitor as monotherapy or combination therapy with methotrexate in biologic-experienced patients with rheumatoid arthritis: An analysis from the CorEvitas RA Registry. Clin Rheumatol. 2023 (Apr 15). Doi: 10.1007/s10067-023-06588-7

Key clinical point: Patients with rheumatoid arthritis (RA) may be more susceptible to coronary atherosclerosis, and active intervention for RA may reduce the incidence of coronary atherosclerosis.

Major finding: Genetic predisposition to RA increased the risk for coronary atherosclerosis (odds ratio 1.0021; P < .05). However, genetic liability to coronary atherosclerosis did not increase the risk for RA (P  =  .06).

Study details: Findings are from a two-sample Mendelian randomization study that evaluated genetic variants associated with RA using the data of 14,361 patients and 42,923 control individuals and those associated with coronary atherosclerosis using data of 14,334 patients and 346,860 control individuals.

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

Source: Nie Q et al. Rheumatoid arthritis and coronary atherosclerosis: A two-sample Mendelian randomization study. Front Cardiovasc Med. 2023;10:1033644 (Apr 28). Doi: 10.3389/fcvm.2023.1033644

Key clinical point: Patients with rheumatoid arthritis (RA) may be more susceptible to coronary atherosclerosis, and active intervention for RA may reduce the incidence of coronary atherosclerosis.

Major finding: Genetic predisposition to RA increased the risk for coronary atherosclerosis (odds ratio 1.0021; P < .05). However, genetic liability to coronary atherosclerosis did not increase the risk for RA (P  =  .06).

Study details: Findings are from a two-sample Mendelian randomization study that evaluated genetic variants associated with RA using the data of 14,361 patients and 42,923 control individuals and those associated with coronary atherosclerosis using data of 14,334 patients and 346,860 control individuals.

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

Source: Nie Q et al. Rheumatoid arthritis and coronary atherosclerosis: A two-sample Mendelian randomization study. Front Cardiovasc Med. 2023;10:1033644 (Apr 28). Doi: 10.3389/fcvm.2023.1033644

Key clinical point: Patients with rheumatoid arthritis (RA) may be more susceptible to coronary atherosclerosis, and active intervention for RA may reduce the incidence of coronary atherosclerosis.

Major finding: Genetic predisposition to RA increased the risk for coronary atherosclerosis (odds ratio 1.0021; P < .05). However, genetic liability to coronary atherosclerosis did not increase the risk for RA (P  =  .06).

Study details: Findings are from a two-sample Mendelian randomization study that evaluated genetic variants associated with RA using the data of 14,361 patients and 42,923 control individuals and those associated with coronary atherosclerosis using data of 14,334 patients and 346,860 control individuals.

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

Source: Nie Q et al. Rheumatoid arthritis and coronary atherosclerosis: A two-sample Mendelian randomization study. Front Cardiovasc Med. 2023;10:1033644 (Apr 28). Doi: 10.3389/fcvm.2023.1033644

Key clinical point: Risk for first primary cancer was not significantly different among patients with rheumatoid arthritis (RA) receiving Janus kinase inhibitors (JAKi) vs biologic disease-modifying antirheumatic drugs (bDMARD). However, excess risk cannot be ruled out among those receiving JAKi.

Major finding: Patients with RA treated with JAKi had a numerically higher but not statistically significantly higher risk for first primary cancer (hazard ratio 1.41; 95% CI 0.76-2.37) compared with those treated with bDMARD.

Study details: Findings are from an observational cohort study including patients with RA without prior cancer diagnosis who initiated JAKi (n = 875) or bDMARD (n = 4247).

Disclosures: This study received financial support from the Danish Rheumatism Association and Danish Cancer Society. Several authors declared being employees of, receiving research grants and honoraria from, participating in advisory boards of, or serving on steering committees for various sources.

Source: Westermann R et al. Cancer risk in patients with rheumatoid arthritis treated with Janus kinase inhibitors: A nationwide Danish register-based cohort study. Rheumatology (Oxford). 2023 (Apr 13). Doi: 10.1093/rheumatology/kead163

Key clinical point: Risk for first primary cancer was not significantly different among patients with rheumatoid arthritis (RA) receiving Janus kinase inhibitors (JAKi) vs biologic disease-modifying antirheumatic drugs (bDMARD). However, excess risk cannot be ruled out among those receiving JAKi.

Major finding: Patients with RA treated with JAKi had a numerically higher but not statistically significantly higher risk for first primary cancer (hazard ratio 1.41; 95% CI 0.76-2.37) compared with those treated with bDMARD.

Study details: Findings are from an observational cohort study including patients with RA without prior cancer diagnosis who initiated JAKi (n = 875) or bDMARD (n = 4247).

Disclosures: This study received financial support from the Danish Rheumatism Association and Danish Cancer Society. Several authors declared being employees of, receiving research grants and honoraria from, participating in advisory boards of, or serving on steering committees for various sources.

Source: Westermann R et al. Cancer risk in patients with rheumatoid arthritis treated with Janus kinase inhibitors: A nationwide Danish register-based cohort study. Rheumatology (Oxford). 2023 (Apr 13). Doi: 10.1093/rheumatology/kead163

Key clinical point: Risk for first primary cancer was not significantly different among patients with rheumatoid arthritis (RA) receiving Janus kinase inhibitors (JAKi) vs biologic disease-modifying antirheumatic drugs (bDMARD). However, excess risk cannot be ruled out among those receiving JAKi.

Major finding: Patients with RA treated with JAKi had a numerically higher but not statistically significantly higher risk for first primary cancer (hazard ratio 1.41; 95% CI 0.76-2.37) compared with those treated with bDMARD.

Study details: Findings are from an observational cohort study including patients with RA without prior cancer diagnosis who initiated JAKi (n = 875) or bDMARD (n = 4247).

Disclosures: This study received financial support from the Danish Rheumatism Association and Danish Cancer Society. Several authors declared being employees of, receiving research grants and honoraria from, participating in advisory boards of, or serving on steering committees for various sources.

Source: Westermann R et al. Cancer risk in patients with rheumatoid arthritis treated with Janus kinase inhibitors: A nationwide Danish register-based cohort study. Rheumatology (Oxford). 2023 (Apr 13). Doi: 10.1093/rheumatology/kead163

Key clinical point: Human papillomavirus (HPV) infection was associated with an increased prevalence of rheumatoid arthritis (RA), whereas HPV immunization lowered RA prevalence in adults aged 18-59 years.

Major finding: A significant association was observed between HPV infection and increased prevalence of RA (adjusted odds ratio [aOR] 1.074; 95% CI 1.071-1.076), whereas HPV immunization was associated with a significantly reduced RA prevalence (aOR 0.477; 95% CI 0.472-0.481).

Study details: Findings are from a population-based cohort study including adults age 18-59 years with complete data on HPV infection and history of RA (n = 15,677) and those with complete data on HPV vaccination and history of RA (n = 8944).

Disclosures: This study was supported by the Nanjing Medical University Science, China, and Technology Development Fund and other sources. The authors declared no conflicts of interest.

Source: Yang G et al. Association between human papillomavirus infection or immunization and risk for rheumatoid arthritis. Front Immunol. 2023;14:1130217 (Apr 14). Doi: 10.3389/fimmu.2023.1130217

Key clinical point: Human papillomavirus (HPV) infection was associated with an increased prevalence of rheumatoid arthritis (RA), whereas HPV immunization lowered RA prevalence in adults aged 18-59 years.

Major finding: A significant association was observed between HPV infection and increased prevalence of RA (adjusted odds ratio [aOR] 1.074; 95% CI 1.071-1.076), whereas HPV immunization was associated with a significantly reduced RA prevalence (aOR 0.477; 95% CI 0.472-0.481).

Study details: Findings are from a population-based cohort study including adults age 18-59 years with complete data on HPV infection and history of RA (n = 15,677) and those with complete data on HPV vaccination and history of RA (n = 8944).

Disclosures: This study was supported by the Nanjing Medical University Science, China, and Technology Development Fund and other sources. The authors declared no conflicts of interest.

Source: Yang G et al. Association between human papillomavirus infection or immunization and risk for rheumatoid arthritis. Front Immunol. 2023;14:1130217 (Apr 14). Doi: 10.3389/fimmu.2023.1130217

Key clinical point: Human papillomavirus (HPV) infection was associated with an increased prevalence of rheumatoid arthritis (RA), whereas HPV immunization lowered RA prevalence in adults aged 18-59 years.

Major finding: A significant association was observed between HPV infection and increased prevalence of RA (adjusted odds ratio [aOR] 1.074; 95% CI 1.071-1.076), whereas HPV immunization was associated with a significantly reduced RA prevalence (aOR 0.477; 95% CI 0.472-0.481).

Study details: Findings are from a population-based cohort study including adults age 18-59 years with complete data on HPV infection and history of RA (n = 15,677) and those with complete data on HPV vaccination and history of RA (n = 8944).

Disclosures: This study was supported by the Nanjing Medical University Science, China, and Technology Development Fund and other sources. The authors declared no conflicts of interest.

Source: Yang G et al. Association between human papillomavirus infection or immunization and risk for rheumatoid arthritis. Front Immunol. 2023;14:1130217 (Apr 14). Doi: 10.3389/fimmu.2023.1130217

Key clinical point: Patients with rheumatoid arthritis (RA) with better overall disease activity and longer etanercept treatment duration are more likely to remain in remission after transition from methotrexate+etanercept combination therapy to methotrexate or etanercept monotherapy.

Major finding: At week 48, the likelihood of patients remaining in Simple Disease Activity Index-based remission or maintaining low disease activity was 1.12 times higher with long-term etanercept monotherapy (P  =  .044) but was 0.93 times lower with each 1-point increase in Patient Global Assessment of Disease Activity (P  =  .012) and C-reactive protein (P  =  .033).

Study details: Findings are from the phase 3, SEAM-RA trial including 253 patients with RA who achieved remission with 24 weeks of methotrexate+etanercept combination therapy and were randomly assigned to continue combination therapy or transition to methotrexate+placebo or etanercept+placebo.

Disclosures: A wholly owned subsidiary of Amgen Inc., Immunex, funded this study. Three authors declared being employees and stockholders of Amgen Inc., and four authors declared ties with various sources, including Amgen.

Source: Curtis JR R et al. Factors associated with maintenance of remission following change from combination therapy to monotherapy in patients with rheumatoid arthritis. J Rheumatol. 2023 (Apr 15). Doi: 10.3899/jrheum.2022-1008.

Key clinical point: Patients with rheumatoid arthritis (RA) with better overall disease activity and longer etanercept treatment duration are more likely to remain in remission after transition from methotrexate+etanercept combination therapy to methotrexate or etanercept monotherapy.

Major finding: At week 48, the likelihood of patients remaining in Simple Disease Activity Index-based remission or maintaining low disease activity was 1.12 times higher with long-term etanercept monotherapy (P  =  .044) but was 0.93 times lower with each 1-point increase in Patient Global Assessment of Disease Activity (P  =  .012) and C-reactive protein (P  =  .033).

Study details: Findings are from the phase 3, SEAM-RA trial including 253 patients with RA who achieved remission with 24 weeks of methotrexate+etanercept combination therapy and were randomly assigned to continue combination therapy or transition to methotrexate+placebo or etanercept+placebo.

Disclosures: A wholly owned subsidiary of Amgen Inc., Immunex, funded this study. Three authors declared being employees and stockholders of Amgen Inc., and four authors declared ties with various sources, including Amgen.

Source: Curtis JR R et al. Factors associated with maintenance of remission following change from combination therapy to monotherapy in patients with rheumatoid arthritis. J Rheumatol. 2023 (Apr 15). Doi: 10.3899/jrheum.2022-1008.

Key clinical point: Patients with rheumatoid arthritis (RA) with better overall disease activity and longer etanercept treatment duration are more likely to remain in remission after transition from methotrexate+etanercept combination therapy to methotrexate or etanercept monotherapy.

Major finding: At week 48, the likelihood of patients remaining in Simple Disease Activity Index-based remission or maintaining low disease activity was 1.12 times higher with long-term etanercept monotherapy (P  =  .044) but was 0.93 times lower with each 1-point increase in Patient Global Assessment of Disease Activity (P  =  .012) and C-reactive protein (P  =  .033).

Study details: Findings are from the phase 3, SEAM-RA trial including 253 patients with RA who achieved remission with 24 weeks of methotrexate+etanercept combination therapy and were randomly assigned to continue combination therapy or transition to methotrexate+placebo or etanercept+placebo.

Disclosures: A wholly owned subsidiary of Amgen Inc., Immunex, funded this study. Three authors declared being employees and stockholders of Amgen Inc., and four authors declared ties with various sources, including Amgen.

Source: Curtis JR R et al. Factors associated with maintenance of remission following change from combination therapy to monotherapy in patients with rheumatoid arthritis. J Rheumatol. 2023 (Apr 15). Doi: 10.3899/jrheum.2022-1008.

Key clinical point: Blanket withdrawal of tofacitinib may not be suitable for all patients with rheumatoid arthritis (RA) who have achieved clinical remission as more than half relapsed after tofacitinib discontinuation. However, the majority regained remission after tofacitinib resumption.

Major finding: At week 104, the tofacitinib vs methotrexate discontinuation group had a numerically lower Clinical Disease Activity Index-based sustained remission rate (29.2% vs 50.0%) and higher relapse rate (58.3% vs 35.0%). However, 71.4% vs 28.6% of patients regained remission on tofacitinib vs methotrexate resumption.

Study details: This prospective randomized controlled trial included 113 patients with RA and an inadequate response to methotrexate with or without biologic disease-modifying antirheumatic drugs who received 52 weeks of tofacitinib plus methotrexate treatment and thereafter, were randomly assigned to discontinue tofacitinib or methotrexate if experiencing clinical remission.

Disclosures: This study was supported by the Japan Society for the Promotion of Science, KAKENHI. Several authors declared receiving consulting fees, speaking fees, research grants, or honoraria from various sources.

Source: Kubo S et al. Sustained remission following the discontinuation of tofacitinib in patients with rheumatoid arthritis (XANADU study): An open-label randomised study. RMD Open. 2023;9(2):e003029 (Apr 25). Doi: 10.1136/rmdopen-2023-003029

Key clinical point: Blanket withdrawal of tofacitinib may not be suitable for all patients with rheumatoid arthritis (RA) who have achieved clinical remission as more than half relapsed after tofacitinib discontinuation. However, the majority regained remission after tofacitinib resumption.

Major finding: At week 104, the tofacitinib vs methotrexate discontinuation group had a numerically lower Clinical Disease Activity Index-based sustained remission rate (29.2% vs 50.0%) and higher relapse rate (58.3% vs 35.0%). However, 71.4% vs 28.6% of patients regained remission on tofacitinib vs methotrexate resumption.

Study details: This prospective randomized controlled trial included 113 patients with RA and an inadequate response to methotrexate with or without biologic disease-modifying antirheumatic drugs who received 52 weeks of tofacitinib plus methotrexate treatment and thereafter, were randomly assigned to discontinue tofacitinib or methotrexate if experiencing clinical remission.

Disclosures: This study was supported by the Japan Society for the Promotion of Science, KAKENHI. Several authors declared receiving consulting fees, speaking fees, research grants, or honoraria from various sources.

Source: Kubo S et al. Sustained remission following the discontinuation of tofacitinib in patients with rheumatoid arthritis (XANADU study): An open-label randomised study. RMD Open. 2023;9(2):e003029 (Apr 25). Doi: 10.1136/rmdopen-2023-003029

Key clinical point: Blanket withdrawal of tofacitinib may not be suitable for all patients with rheumatoid arthritis (RA) who have achieved clinical remission as more than half relapsed after tofacitinib discontinuation. However, the majority regained remission after tofacitinib resumption.

Major finding: At week 104, the tofacitinib vs methotrexate discontinuation group had a numerically lower Clinical Disease Activity Index-based sustained remission rate (29.2% vs 50.0%) and higher relapse rate (58.3% vs 35.0%). However, 71.4% vs 28.6% of patients regained remission on tofacitinib vs methotrexate resumption.

Study details: This prospective randomized controlled trial included 113 patients with RA and an inadequate response to methotrexate with or without biologic disease-modifying antirheumatic drugs who received 52 weeks of tofacitinib plus methotrexate treatment and thereafter, were randomly assigned to discontinue tofacitinib or methotrexate if experiencing clinical remission.

Disclosures: This study was supported by the Japan Society for the Promotion of Science, KAKENHI. Several authors declared receiving consulting fees, speaking fees, research grants, or honoraria from various sources.

Source: Kubo S et al. Sustained remission following the discontinuation of tofacitinib in patients with rheumatoid arthritis (XANADU study): An open-label randomised study. RMD Open. 2023;9(2):e003029 (Apr 25). Doi: 10.1136/rmdopen-2023-003029