Rheumatology最新文献_第10页

Potential impact of European Medicines Agency measures to minimize risk of serious side effects on JAKi prescribing and utilization in the UK. 欧洲药品管理局降低严重副作用风险的措施对英国 JAKi 处方和使用的潜在影响。

IF 4.7 2区医学

Rheumatology Pub Date : 2025-03-01 DOI: 10.1093/rheumatology/keae279

Zixing Tian, Lianne Kearsley-Fleet, James Galloway, Kath Watson, Mark Lunt, Kimme L Hyrich

{"title":"Potential impact of European Medicines Agency measures to minimize risk of serious side effects on JAKi prescribing and utilization in the UK.","authors":"Zixing Tian, Lianne Kearsley-Fleet, James Galloway, Kath Watson, Mark Lunt, Kimme L Hyrich","doi":"10.1093/rheumatology/keae279","DOIUrl":"10.1093/rheumatology/keae279","url":null,"abstract":"Objective: Janus kinase inhibitors (JAKis) or targeted synthetic (ts) disease-modifying antirheumatic drugs (DMARDs) effectively treat rheumatoid arthritis (RA). However, due to safety concerns, the European Medicines Agency (EMA) published risk-minimization measures limiting JAKi prescription to certain at-risk patients unless no suitable alternative is available. This analysis included patients who had started their first-ever JAKi (before EMA measures were published) in a large national cohort study to investigate the potential impact of these measures on JAKi prescribing and utilization in the UK.Method: RA patients starting first-ever JAKi therapy in BSRBR-RA between 13 February 2017 and 31 May 2022 were included. The percentages of patients meeting the EMA risk criteria were presented. For the at-risk patients, their previous numbers of distinct biologic (b) DMARD classes prescribed were described.Result: A total of 1341 patients were included, and 80% (N = 1075) met ≥1 EMA risk criterion. Of those who met ≥1 risk criterion, 529 patients (49%) had received JAKi as their first or second b/tsDMARD class, whereas 299 (28%) had received ≥3 prior bDMARD classes.Conclusion: Four-fifths of RA patients who had commenced a JAKi before the EMA advisory were considered 'at-risk', with prescribing only advised if there was no suitable alternative. Almost a third of those patients had already received ≥3 bDMARDs classes, and alternative therapies would be very limited for them; however, suitable alternatives might have existed for the remaining proportion, especially for those who received a JAKi as their first or second b/tsDMARD, and re-evaluation of the suitability of their treatment may be needed.","PeriodicalId":21255,"journal":{"name":"Rheumatology","volume":" ","pages":"1453-1458"},"PeriodicalIF":4.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11879295/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140945916","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Long-term clinical outcomes in early rheumatoid arthritis that was treated-to-target in the BeSt and IMPROVED studies. 在 BeSt 和 IMPROVED 研究中接受靶向治疗的早期类风湿关节炎患者的长期临床疗效。

IF 4.7 2区医学

Rheumatology Pub Date : 2025-03-01 DOI: 10.1093/rheumatology/keae212

Sascha Louise Heckert, Johanna M Maassen, Isabell Nevins, Paul Baudoin, Gerda M Steup-Beekman, Tom W J Huizinga, Sytske Anne Bergstra, Cornelia F Allaart

{"title":"Long-term clinical outcomes in early rheumatoid arthritis that was treated-to-target in the BeSt and IMPROVED studies.","authors":"Sascha Louise Heckert, Johanna M Maassen, Isabell Nevins, Paul Baudoin, Gerda M Steup-Beekman, Tom W J Huizinga, Sytske Anne Bergstra, Cornelia F Allaart","doi":"10.1093/rheumatology/keae212","DOIUrl":"10.1093/rheumatology/keae212","url":null,"abstract":"Objectives: To assess disease outcomes after 20 and 12 years of patients with RA or undifferentiated arthritis (UA), treated-to-target in the BeSt and IMPROVED trials.Methods: In BeSt (inclusion 2000-02, duration 10 years), 508 patients with early RA were randomized to: 1. sequential monotherapy, 2. step-up combination therapy, 3. initial csDMARD combination therapy, 4. initial bDMARD/csDMARD combination therapy. The treatment target was low disease activity (DAS ≤ 2.4).In IMPROVED (inclusion 2007-10, duration 5 years), 610 patients with early RA/UA started MTX with prednisone bridging. The treatment target was remission (DAS < 1.6). Patients not in early remission were randomized to 1. csDMARD combination therapy or 2. bDMARD/csDMARD combination therapy.Between 2019 and 22, these patients were invited for long-term follow-up.Results: One-hundred-fifty-three ex-Best and 282 ex-IMPROVED patients participated in the follow-up study after a median of 12 and 20 years since the study started.In ex-BeSt and ex-IMPROVED patients, the rate of low disease activity was 91%, and 68% were in DAS remission. Median SHS was 14.0 in ex-BeSt (IQR 6.0-32.5; progression since end BeSt 6.0, IQR 2.0-12.5) and 8 in ex-IMPROVED participants (IQR 3-16; progression since end IMPROVED 4, IQR 2-9). Mean HAQ was 0.8 ± 0.6 in ex-BeSt (change since end BeSt: 0.3 ± 0.5) and 0.6 ± 0.6 in ex-IMPROVED participants (change since end IMPROVED: 0.06 ± 0.5).Conclusion: At 12/20 years after treatment started, the majority of RA and UA patients who had been treated to target low DAS or DAS remission were in DAS remission and had limited functional disability. Radiographic damage progression was mild although not completely suppressed.","PeriodicalId":21255,"journal":{"name":"Rheumatology","volume":" ","pages":"1052-1059"},"PeriodicalIF":4.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11879312/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140336687","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Imaging findings in polymyalgia rheumatica.

IF 4.7 2区医学

Rheumatology Pub Date : 2025-03-01 DOI: 10.1093/rheumatology/keae473

Claire E Owen, Octavia Nakos

引用次数: 0

Highlights from the breakout session: other forms of vasculitis.

IF 4.7 2区医学

Rheumatology Pub Date : 2025-03-01 DOI: 10.1093/rheumatology/keae386

Tanaz A Kermani, Kenneth J Warrington

引用次数: 0

Highlights from the breakout session: vasculitis in paediatric rheumatology.

IF 4.7 2区医学

Rheumatology Pub Date : 2025-03-01 DOI: 10.1093/rheumatology/keae406

Yagmur Bayindir, Marija Jelusic, Seza Ozen

{"title":"Highlights from the breakout session: vasculitis in paediatric rheumatology.","authors":"Yagmur Bayindir, Marija Jelusic, Seza Ozen","doi":"10.1093/rheumatology/keae406","DOIUrl":"https://doi.org/10.1093/rheumatology/keae406","url":null,"abstract":"The 21st International Vasculitis Workshop, held in Barcelona, Spain, from April 7 to 10, 2024, highlighted advances in pediatric vasculitis, focusing on a holistic, multidisciplinary approach. Common childhood vasculitides, including IgA Vasculitis (IgAV) and Kawasaki Disease (KD), were discussed. The Ankara 2008 criteria for IgAV, endorsed by EULAR and PReS, were evaluated for their performance in adults, showing high sensitivity but necessitating further refinement for improved specificity. Studies on genetic associations, such as Human Leukocyte Antigen (HLA) polymorphisms in IgAV, and biomarkers like S100A8/A9, HMGB1, and RAGE, were presented. Kawasaki disease research included novel anti-apolipoprotein A-2 antibodies, showing promise in reducing coronary arteritis. Monogenic vasculitides, such as deficiency of ADA2, were addressed with new consensus-driven recommendations. The workshop underscored the importance of continued research and tailored therapeutic strategies to improve outcomes in pediatric vasculitis, paving the way for advancements in diagnosis, management, and understanding of these complex diseases.","PeriodicalId":21255,"journal":{"name":"Rheumatology","volume":"64 Supplement_1","pages":"i131-i133"},"PeriodicalIF":4.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143606333","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Comment on: Hepatitis B reactivation in PsA patients: an SLR and meta-analysis for IL-17, IL-23 and JAK inhibitors. PsA患者的乙肝再激活：IL-17、IL-23和JAK抑制剂的SLR和荟萃分析

IF 4.7 2区医学

Rheumatology Pub Date : 2025-03-01 DOI: 10.1093/rheumatology/keae645

Rachana Mehta, Ashok Kumar Balaraman, Sanjit Sah, Ganesh Bushi

引用次数: 0

Severe cardiovascular manifestation of ASIA syndrome triggered by silicone breast implants. 硅胶乳房植入物引发 ASIA 综合征的严重心血管表现。

IF 4.7 2区医学

Rheumatology Pub Date : 2025-03-01 DOI: 10.1093/rheumatology/keae564

Ágnes Szappanos, Ágota Hajas, István Hartyánszky, Krisztina Kádár, Luca Kuthi, István Hartyánszky, Béla Merkely, Anikó Ilona Nagy

引用次数: 0

Cyclin dependent kinase inhibitor: a long-awaited, late-coming, novel class agent in rheumatoid arthritis. 细胞周期蛋白依赖性激酶抑制剂：类风湿关节炎患者期待已久、姗姗来迟的新型类药物

IF 4.7 2区医学

Rheumatology Pub Date : 2025-03-01 DOI: 10.1093/rheumatology/keae594

Tadashi Hosoya, Tetsuya Saito, Shinsuke Yasuda

引用次数: 0

Cancer risk with tocilizumab/sarilumab, abatacept and rituximab treatment in patients with rheumatoid arthritis: a Danish cohort study. 类风湿性关节炎患者接受托西珠单抗/沙利单抗、阿帕赛普和利妥昔单抗治疗的癌症风险：一项丹麦队列研究。

IF 4.7 2区医学

Rheumatology Pub Date : 2025-03-01 DOI: 10.1093/rheumatology/keae140

Rasmus Westermann, René Lindholm Cordtz, Kirsten Duch, Lene Mellemkjaer, Merete Lund Hetland, Bergur Magnussen, Lene Dreyer

{"title":"Cancer risk with tocilizumab/sarilumab, abatacept and rituximab treatment in patients with rheumatoid arthritis: a Danish cohort study.","authors":"Rasmus Westermann, René Lindholm Cordtz, Kirsten Duch, Lene Mellemkjaer, Merete Lund Hetland, Bergur Magnussen, Lene Dreyer","doi":"10.1093/rheumatology/keae140","DOIUrl":"10.1093/rheumatology/keae140","url":null,"abstract":"Objectives: To investigate cancer risk in RA patients treated with tocilizumab/sarilumab, abatacept or rituximab compared with those who received TNF inhibitors (TNFi) and compared with biological DMARDs (bDMARD)-naïve RA patients.Methods: Nationwide registry-based cohort study of RA patients who initiated bDMARD treatment with tocilizumab/sarilumab, abatacept, rituximab, and TNFi, as well as bDMARD-naive patients who initiated their second type of conventional synthetic DMARD. Patients were identified in the Danish Rheumatology Quality Register (DANBIO) and followed for cancer from 2006 to 2020. Patients could contribute multiple treatments, with person years, deaths and cancers allocated to each treatment group in a 'latest type of treatment' manner. Inverse probability of treatment weighting and weighted cause-specific Cox models were used to calculate hazard ratios (HRs) for cancer in each tocilizumab/sarilumab, abatacept and rituximab group compared with TNFi-treated and bDMARD-naïve groups, respectively.Results: In total, 21 982 treatment initiations, 96 475 person years and 1423 cancers were identified. There were no statistically significant increased HRs for overall cancer in tocilizumab/sarilumab, abatacept or rituximab treatment groups (HRs ranged from 0.7 to 1.1). More than 5 years of abatacept exposure showed a non-significantly increased HR compared with TNFi (HR 1.41, 95% CI 0.74-2.71). For haematological cancers, rituximab treatment showed non-significantly reduced HRs: vs TNFi-treated (HR 0.09; 95% CI 0.00-2.06) and bDMARD-naïve (HR 0.13; 95% CI 0.00-1.89).Conclusion: Treatment with tocilizumab/sarilumab, abatacept or rituximab in RA patients was not associated with increased risks of cancer compared with TNFi-treated and with bDMARD-naïve RA patients in a real-world setting.","PeriodicalId":21255,"journal":{"name":"Rheumatology","volume":" ","pages":"1019-1028"},"PeriodicalIF":4.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140060395","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Flare prediction after tapering the dose of tumour necrosis factor inhibitors in patients with axial spondyloarthritis: a nationwide cohort study. 轴性脊柱关节炎患者减量服用肿瘤坏死因子抑制剂后病情复发的预测：全国性队列研究。

IF 4.7 2区医学

Rheumatology Pub Date : 2025-03-01 DOI: 10.1093/rheumatology/keae138

Jina Yeo, Ju Yeon Kim, Jin Kyun Park, Kichul Shin, Eun Young Lee, Tae-Hwan Kim, Jun Won Park

{"title":"Flare prediction after tapering the dose of tumour necrosis factor inhibitors in patients with axial spondyloarthritis: a nationwide cohort study.","authors":"Jina Yeo, Ju Yeon Kim, Jin Kyun Park, Kichul Shin, Eun Young Lee, Tae-Hwan Kim, Jun Won Park","doi":"10.1093/rheumatology/keae138","DOIUrl":"10.1093/rheumatology/keae138","url":null,"abstract":"Objectives: To develop a model for predicting flares after tapering the dose of tumour necrosis factor inhibitors (TNFi) in patients with axial spondyloarthritis (axSpA).Methods: Data were obtained from the Korean College of Rheumatology Biologics and Targeted Therapy Registry. In total, 526 patients who received the standard-dose TNFi for at least 1 year and tapered their dose were included in the derivation cohort. The main outcome was a flare occurrence defined as an Ankylosing Spondylitis Disease Activity Score with C-reactive protein (ASDAS-CRP) score of ≥2.1 after 1 year of TNFi tapering. The final prediction model was validated using an independent cohort.Results: Among 526 patients, 127 (24.1%) experienced flares. The final prediction model included negative human leucocyte antigen B27 (β = 1.088), inflammatory back pain (β = 1.072), psoriasis (β = 1.567), family history of SpA (β = 0.623), diabetes mellitus (β = 1.092), TNFi tapering by ≥50% of the standard-dose (β = 0.435), ASDAS-CRP at tapering (β = 1.029), and Bath Ankylosing Spondylitis Functional Index score at tapering (β = 0.194) as covariates. It showed an excellent discrimination performance (AUC = 0.828). According to the predictive risk, patients were classified into three groups (low-, intermediate- and high-risk). The probabilities of flares in these groups were 4.5%, 18.1% and 61.8%, respectively. The performance of the model in the validation cohort was also comparable.Conclusion: The established prediction model accurately predicted the risk of flares after TNFi dose tapering in patients with axSpA using eight simple clinical parameters, which could be helpful to select appropriate patients for tapering their TNFi without flare in daily clinical practice.","PeriodicalId":21255,"journal":{"name":"Rheumatology","volume":" ","pages":"1155-1161"},"PeriodicalIF":4.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140120456","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0