Rheumatology and Therapy最新文献

{"title":"Prophylaxis of Gout Flares in Patients with Renal Impairment: Dosing Adjustments with Colchicine Oral Solution Informed by a Pharmacokinetic Model.","authors":"Jaymin Shah, Michael H Pillinger, Elaine K Chan, Dmitri Lissin","doi":"10.1007/s40744-025-00772-8","DOIUrl":"10.1007/s40744-025-00772-8","url":null,"abstract":"<p><strong>Introduction: </strong>Patients receiving the standard prophylaxis dose of colchicine for gout flares are at increased risk for developing toxicity if there are pre-existing renal impairment or drug-drug interactions. Guidelines recommend exercising caution, deferring dose adjustment to the clinician's discretion.</p><p><strong>Methods: </strong>Pharmacokinetic study data for colchicine oral solution in healthy subjects was used to build a pharmacokinetic model. Using the derived pharmacokinetic disposition parameters from the best fit model and the derived parameters of clearance in patients with renal impairment, simulation of colchicine plasma levels to target 0.5-3 ng/mL with colchicine oral solution was undertaken for various dose levels in different degrees of renal impairment.</p><p><strong>Results: </strong>With the standard colchicine 0.6 mg daily dose, plasma levels are expected to be therapeutic in patients with mild renal impairment (estimated glomerular filtration rate [eGFR] 60-89 mL/min/1.73 m²). However, with this same 0.6 mg daily dose, patients with moderate renal impairment (eGFR 30-59 mL/min/1.73 m²) and severe renal impairment (eGFR of 15-29 mL/min/1.73 m²) would have excursions up to 10% and 36%, respectively, above the maximum tolerated level. Administering a lower dose such as 0.3 mg daily by splitting the conventional 0.6 mg tablet or by administering 0.6 mg once every-other-day (QOD) in moderate renal impairment would result in plasma colchicine levels in subtherapeutic range (< 0.5 ng/mL) for 20-70% of the dosing interval.</p><p><strong>Conclusion: </strong>Analysis of pharmacokinetic model data confirms that the majority of patients with renal impairment taking colchicine solid dosage formulations will be above or below therapeutic levels, exposing them to potential side effects. However, more precise dosing with colchicine oral solution of 0.48 mg (4 mL) or 0.5 mg tablet available in certain countries for moderate renal impairment and 0.3 mg (2.5 mL) for severe renal impairment are associated with optimal levels and safer for patients with renal impairment. No dosage adjustment is needed for patients with mild renal impairment.</p>","PeriodicalId":21267,"journal":{"name":"Rheumatology and Therapy","volume":" ","pages":"721-730"},"PeriodicalIF":2.9,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12245748/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144199953","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Safety of Accelerated Rituximab Infusion in Rheumatic Diseases: A Systematic Review.","authors":"Jozélio Freire de Carvalho, Samuel de Oliveira Andrade, Ana Tereza Amoedo Martinez, Thelma Skare, Simone Appenzeller","doi":"10.1007/s40744-025-00773-7","DOIUrl":"10.1007/s40744-025-00773-7","url":null,"abstract":"<p><strong>Objective: </strong>To systematically evaluate the safety and feasibility of rapid rituximab (RTX) infusion protocols in patients with autoimmune rheumatic diseases.</p><p><strong>Methods: </strong>A comprehensive literature review was conducted using PubMed, LILACS, and Scielo databases from 1965 to May 2024 without language restrictions. Studies reporting infusion reactions associated with accelerated RTX protocols (infusion over 90 to 120 min) in rheumatologic conditions were included. Infusion-related adverse events were assessed and graded according to the National Cancer Institute Common Terminology Criteria for Adverse Events (Grades 1-5). Key variables extracted included patient demographics, underlying diseases, RTX dosage, use of premedication, number of infusions, and frequency and severity of infusion reactions.</p><p><strong>Results: </strong>Seven studies encompassing 538 patients aged 14-78 years were included. The patient cohort covered a spectrum of autoimmune rheumatic conditions, including systemic lupus erythematosus, rheumatoid arthritis, systemic vasculitis, Sjögren's syndrome, systemic sclerosis, IgG4-related disease, and anti-synthetase syndrome. All studies implemented rapid RTX infusion protocols exclusively for the second and subsequent doses. Premedication with acetaminophen, diphenhydramine, and corticosteroids was routine in most studies. RTX dosage varied between 375 mg/m² and 1000 mg, administered in two infusions spaced two weeks apart. The incidence of infusion reactions ranged from 3 to 15%, predominantly of mild severity (Grades 1 and 2), with only six cases classified as Grade 3. No Grade 4 or 5 reactions were reported. Rapid infusion protocols consistently reduced the total time patients spent in infusion clinics.</p><p><strong>Conclusion: </strong>Rapid infusion of RTX in patients with autoimmune rheumatic diseases appears to be a safe and efficient alternative to standard infusion protocols. The frequency and severity of infusion reactions were comparable to traditional infusion rates, with the added benefit of reduced clinic time. These findings support the broader implementation of rapid infusion protocols in rheumatology. However, larger prospective studies with standardized reporting of adverse events are necessary to validate these results and explore the feasibility of even shorter infusion durations, as seen in oncology.</p>","PeriodicalId":21267,"journal":{"name":"Rheumatology and Therapy","volume":" ","pages":"601-607"},"PeriodicalIF":2.9,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12246283/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144302794","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Outcomes of Patients with SLE Treated with Belimumab, Without Versus With Prior Immunosuppressant Use: a US Claims Database Study.","authors":"Karen H Costenbader, Maral DerSarkissian, Yan Chen, Brendan Rabideau, Karen Worley, Theo Man, Bernard Rubin, S Sam Lim","doi":"10.1007/s40744-025-00774-6","DOIUrl":"10.1007/s40744-025-00774-6","url":null,"abstract":"<p><strong>Introduction: </strong>This study examined the benefit of belimumab as standard treatment in patients with systemic lupus erythematosus (SLE) treated without versus with immunosuppressants (IS) prior to belimumab initiation.</p><p><strong>Methods: </strong>This retrospective cohort study (GSK Study 217537) used healthcare claims from the US Komodo Health Database from January 2015 to October 2023. Eligible adults had ≥ 1 inpatient or ≥ 2 outpatient SLE diagnosis codes, ≥ 1 belimumab claim (January 2017-October 2023; index date) and 24 months continuous data pre-index. Two cohorts were defined: those with ≥ 1 claim for non-IS SLE treatment (antimalarials, oral glucocorticoids [OGC] or biologics; non-IS cohort) or ≥ 1 claim for incident IS (IS cohort) within 12 months pre-index. Cohort comparability was assessed across the 12 months before non-IS/IS treatment, applying inverse probability of treatment weighting (IPTW) to adjust for confounding. Outcomes included OGC use, SLE flare rates and healthcare resource utilisation, compared using Cox, Poisson regression and logit models, respectively.</p><p><strong>Results: </strong>Overall, 2190 and 2533 patients were included in IPTW-adjusted non-IS and IS cohorts, respectively. The non-IS cohort had a median (95% confidence interval [CI]) time to OGC discontinuation of 9.8 (8.2, 12.2) months versus 11.7 (10.5, 13.4) for the IS cohort, and a 30% higher likelihood of OGC discontinuation (hazard ratio [95% CI] 1.30 [1.11, 1.52]). The likelihood of OGC dose reduction and discontinuation or dose reduction alone was similar between cohorts. The non-IS versus IS cohort had a lower incidence rate ratio (IRR [95% CI]) of total (0.94 [0.92, 0.96]) and moderate (0.77 [0.74, 0.80]) SLE flares, with similar odds of SLE-related inpatient stays (odds ratio [95% CI] 1.12 [0.94, 1.34]) and emergency visits (1.02 [0.82, 1.27]).</p><p><strong>Conclusion: </strong>In this large, retrospective, real-word study using IPTW adjustment, initiating belimumab without prior IS use was associated with OGC-sparing benefits and reduced incidence and severity of SLE flares.</p>","PeriodicalId":21267,"journal":{"name":"Rheumatology and Therapy","volume":" ","pages":"679-694"},"PeriodicalIF":2.9,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12246324/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144317840","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Lupus Check 5 Tool: A Practical Approach to Initiating Treatment Reviews in Systemic Lupus Erythematosus.","authors":"Anca Askanase, Antonis Fanouriakis, Lyra Agustin, Maria Dall'Era, Marta Mosca, Yoshiya Tanaka","doi":"10.1007/s40744-025-00770-w","DOIUrl":"10.1007/s40744-025-00770-w","url":null,"abstract":"<p><p>Although the treatment landscape for systemic lupus erythematosus (SLE) has evolved in recent years, there is still a significant unmet need and many patients do not achieve key treatment goals, such as remission and low disease activity. Failure to reach these goals increases the risk of flare, organ damage accrual, and mortality in patients with SLE, and can have a significant impact on patient quality of life (QOL). While the importance of monitoring patients with SLE is highlighted across treatment recommendations, there is no clinical guidance on how to identify patients at risk of disease exacerbation and when to effectively initiate treatment reviews to improve their clinical outcomes. To address this, a panel of lupus experts have developed a clinical decision aid named the Lupus Check 5 Tool, which aims to identify patients in need of a treatment review through a simple five-question checklist. These questions cover a range of topics, including persistent glucocorticoid use, ongoing disease activity despite therapy, monitoring changes in laboratory values, flare frequency and severity, and the incorporation of the patient perspective and shared decision-making into clinical practice. Herein, we provide a detailed overview of the tool questions and the clinical evidence supporting their use to identify patients at risk of disease worsening. Use of the Lupus Check 5 Tool during each patient visit could facilitate timely alteration of therapy to help reduce disease activity, improve QOL, and work toward the long-term goals of remission and low disease activity.</p>","PeriodicalId":21267,"journal":{"name":"Rheumatology and Therapy","volume":" ","pages":"731-740"},"PeriodicalIF":2.9,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12246300/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144187809","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Oral Urate-Lowering Therapy Use and Efficacy Following Pegloticase Treatment: Findings from a Rheumatology Network Database.","authors":"Lissa Padnick-Silver, Andrew Concoff, Hong-Ye Gao, Qianhong Fu, Brian LaMoreaux, N Lawrence Edwards","doi":"10.1007/s40744-025-00767-5","DOIUrl":"10.1007/s40744-025-00767-5","url":null,"abstract":"<p><strong>Introduction: </strong>Pegloticase rapidly reduces serum urate (SU) in uncontrolled gout. This preliminary retrospective analysis of a large US rheumatology database examined post-pegloticase use and SU-lowering efficacy of oral urate-lowering therapy (ULT; allopurinol, febuxostat, probenecid).</p><p><strong>Methods: </strong>Patients in the United Rheumatology (UR)-NICE data repository with first pegloticase code (J2507) in 2012-2022 and data for ≥ 60 days following last infusion were included. Post-pegloticase oral ULT efficacy was defined as SU < 6 mg/dL after oral ULT initiation and examined by shorter (< 12 infusions) and longer (≥ 12 infusions) pegloticase course and by time to post-pegloticase oral ULT start.</p><p><strong>Results: </strong>A total of 211 patients (77.3% male; 62.7 ± 12.8 years, body mass index 32.9 ± 7.2 kg/m², estimated glomerular filtration rate 66.0 ± 24.7 ml/min/1.73 m²) with gout [74.4% tophaceous, SU 7.9 ± 2.5 mg/dL (n = 148)] were included; 66.8% received pre-pegloticase oral ULT (48.8% allopurinol, 32.2% febuxostat, and/or 12.3% probenecid). Patients received 12.3 ± 12.6 pegloticase infusions [median 9; 88 (42%) ≥ 12 infusions; 2.3 ± 2.0 weeks between infusions], with 115 patients (54.5%) beginning oral ULT after pegloticase discontinuation (67.0% allopurinol, 43.5% febuxostat, and/or 16.5% probenecid) most-often (66.1%) ≤ 30 days of last infusion. More patients who received ≥ 12 infusions than < 12 infusions had SU < 6 mg/dL with post-pegloticase oral ULT use [first post-ULT SU < 6 mg/dL, 78.4% vs. 36.2%; SU 4.7 ± 3.0 (n = 37) vs. 7.4 ± 2.9 (n = 47) mg/dL].</p><p><strong>Conclusions: </strong>In this uncontrolled gout population, approximately two-thirds of patients began oral ULT within 30 days after their last pegloticase infusion. Those with longer pegloticase course more often had oral ULT efficacy, perhaps because of greater urate burden depletion, suggesting oral ULTs may be effective after successful pegloticase therapy. Further studies to understand any influence of urate burden on oral ULT efficacy are warranted.</p>","PeriodicalId":21267,"journal":{"name":"Rheumatology and Therapy","volume":" ","pages":"709-719"},"PeriodicalIF":2.9,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12246296/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144111286","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Response to: Letter to the Editor Regarding Impact of Race on the Efficacy and Safety of Tofacitinib in Rheumatoid Arthritis: Post Hoc Analysis of Pooled Clinical Trials.","authors":"Grace C Wright, Eduardo Mysler, Arne Yndestad, Cassandra D Kinch, Alexis Ogdie","doi":"10.1007/s40744-025-00751-z","DOIUrl":"10.1007/s40744-025-00751-z","url":null,"abstract":"","PeriodicalId":21267,"journal":{"name":"Rheumatology and Therapy","volume":" ","pages":"595-596"},"PeriodicalIF":2.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12084185/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143650105","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Filgotinib Radiographic and Clinical Efficacy Versus Other JAK Inhibitors and Adalimumab in Patients With Rheumatoid Arthritis and Inadequate Response to Methotrexate: A Systematic Review and Network Meta-Analysis.","authors":"Yoshiya Tanaka, Rene Westhovens, Hong Sun, Carole Van der Donckt, Yan Zhong, Toshihiko Kaise","doi":"10.1007/s40744-025-00757-7","DOIUrl":"10.1007/s40744-025-00757-7","url":null,"abstract":"<p><p>A Bayesian network meta-analysis was conducted to examine the radiographic and clinical efficacy of the Janus kinase (JAK) inhibitors tofacitinib, baricitinib, upadacitinib, and filgotinib and the biologic disease-modifying antirheumatic drug (bDMARD) adalimumab (all given with methotrexate [MTX]) in patients with rheumatoid arthritis (RA) and an inadequate response to MTX (MTX-IR). The PubMed database was systematically searched to identify relevant randomized controlled trials. Efficacy outcomes included the modified total Sharp score (mTSS), erosion, joint space narrowing, 70% improvement in American College of Rheumatology criteria (ACR70), Boolean remission, Clinical Disease Activity Index (CDAI) score ≤ 2.8, and Simplified Disease Activity Index (SDAI) score ≤ 3.3. Five studies were identified using the inclusion criteria, and two additional publications presented further results from one of the five studies, with the total meta-analysis population comprising 6933 patients. Among all JAK inhibitors analyzed and the bDMARD adalimumab, filgotinib 200 mg had the highest probability of being the treatment with the greatest improvement in mTSS versus placebo at 48/52 weeks, followed by filgotinib 100 mg, adalimumab 40 mg, baricitinib 4 mg, and upadacitinib 15 mg. Filgotinib 200 mg also had the highest probability of being the treatment with the greatest improvement in erosion and joint space narrowing at 48/52 weeks versus the same comparators. At 12 weeks, filgotinib 200 mg had the highest probability versus other JAK inhibitors and adalimumab of achieving clinical remission (CDAI ≤ 2.8 and SDAI ≤ 3.3). Varying treatments had the highest probability of achieving other efficacy outcomes of interest at 12, 24/26, and 48/52 weeks. In the absence of head-to-head comparisons, this analysis provides valuable evidence for the role of filgotinib in the treatment of patients with MTX-IR RA.</p>","PeriodicalId":21267,"journal":{"name":"Rheumatology and Therapy","volume":" ","pages":"453-468"},"PeriodicalIF":2.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12084188/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144044720","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Relationship Between Metabolic Syndrome and Pain Catastrophizing in Psoriatic Arthritis.","authors":"Damiano Currado, Onorina Berardicurti, Francesca Saracino, Francesca Trunfio, Lyubomyra Kun, Annalisa Marino, Erika Corberi, Ludovica Lamberti, Piero Ruscitti, Vasiliki Liakouli, Marta Vadacca, Amelia Rigon, Luisa Arcarese, Manuela Pietramale, Francesco De Vincenzo, Marta Vomero, Francesco Ciccia, Roberto Giacomelli, Luca Navarini","doi":"10.1007/s40744-025-00758-6","DOIUrl":"10.1007/s40744-025-00758-6","url":null,"abstract":"<p><strong>Introduction: </strong>Psoriatic arthritis (PsA) is a complex inflammatory disease often associated with metabolic syndrome (MetS). It has been demonstrated that pain catastrophizing (PC), characterized by an exaggerated negative cognitive and emotional response to actual or anticipated pain, impacts the achievement of remission and therapy discontinuation in patients with PsA. In this study, we evaluate the potential role of MetS, the most prevalent comorbidity in PsA, in influencing PC in patients with PsA.</p><p><strong>Methods: </strong>We conducted a cross-sectional, observational study on 170 patients with PsA who met the Classification Criteria for PsA and MetS criteria. Data on disease activity, PC, and comorbidities were collected and analyzed using univariable and multivariable regressions.</p><p><strong>Results: </strong>Our results indicate a significant association between MetS and elevated PC levels in patients with PsA. Univariable analysis identified female gender, fibromyalgia, and higher Disease Activity for Psoriatic Arthritis (DAPSA) scores as factors associated with increased PC. Multivariable analysis, adjusted for age, sex, fibromyalgia, and DAPSA, confirmed that MetS independently correlates with higher PC levels (b = 8.84, 95% CI 4.66-13.02, p < 0.0001) and its domains (helplessness, rumination, magnification).</p><p><strong>Conclusions: </strong>These findings suggest that MetS significantly impacts PC in PsA, underscoring the need for a multidisciplinary approach to patient management. This study highlights the importance of addressing MetS to reduce pain catastrophizing and enhance disease management in PsA.</p>","PeriodicalId":21267,"journal":{"name":"Rheumatology and Therapy","volume":" ","pages":"581-592"},"PeriodicalIF":2.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12084470/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143731469","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Secukinumab Persistence in Patients with Psoriatic Arthritis: An Adalimumab-Matched Retrospective Cohort Database Study (FLYWAY).","authors":"Hideto Kameda, Kentaro Ishii, Junna Kiriyama, Toshiaki Mikami, Hideya Uratsuji, Akimichi Morita","doi":"10.1007/s40744-025-00749-7","DOIUrl":"10.1007/s40744-025-00749-7","url":null,"abstract":"<p><strong>Introduction: </strong>Long-term treatment of psoriatic arthritis (PsA) is required to prevent progression. However, persistence with current treatments is challenging due to tolerability and acceptability issues. The objective of this study was to estimate 1-year persistence with secukinumab in patients with PsA treated with secukinumab, to compare persistence rates between secukinumab and adalimumab, to estimate usefulness rates, and to document adverse events.</p><p><strong>Methods: </strong>This retrospective study used data from the Japanese Medical Data Vision database. A total of 182 patients with PsA initiating secukinumab were identified between February 1, 2015 and September 30, 2020. Of these, 171 could be matched to 171 patients initiating adalimumab over the same period using a propensity score. Patients were followed until death, treatment discontinuation, or until the end of the study period. Persistence rates were analyzed using Kaplan-Meier survival analysis. Usefulness was evaluated using a published algorithm. Selected adverse events were documented.</p><p><strong>Results: </strong>Twelve-month persistence with secukinumab was 68.3%. The median persistence duration was significantly higher (p = 0.002) for secukinumab (27.8 months) than for adalimumab (12.5 months). After 12 months, the treatment was found to be useful in 47.0% of the secukinumab cohort and 22.2% of the adalimumab cohort (p < 0.001). Fourteen patients (7.7%) in the unmatched secukinumab cohort and 32 (9.1%) in the unmatched adalimumab cohort presented an adverse event of interest.</p><p><strong>Conclusions: </strong>Patients with PsA showed higher persistence with secukinumab than with adalimumab. Since PsA is a chronic disease that requires long-term treatment, long-term persistence and usefulness should be considered for the treatment choice. Infographic available for this article. INFOGRAPHIC.</p>","PeriodicalId":21267,"journal":{"name":"Rheumatology and Therapy","volume":" ","pages":"493-511"},"PeriodicalIF":2.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12084206/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143617083","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Burden of Glucocorticoid Use and Risk of Toxicities Among Patients with Immunoglobulin-G4-Related Disease: A Retrospective US-Based Claims Study.","authors":"Zachary S Wallace, Jenny Y Park, Elizabeth Serra, Patrick Gagnon-Sanschagrin, Annie Guérin, Kristina Patterson, Haridarshan Patel, Vikesh K Singh","doi":"10.1007/s40744-025-00763-9","DOIUrl":"10.1007/s40744-025-00763-9","url":null,"abstract":"<p><strong>Introduction: </strong>Glucocorticoids are commonly used to treat immunoglobulin G4-related disease (IgG4-RD), but there is limited real-world evidence describing glucocorticoid-related toxicities in this population. This study assessed glucocorticoid use and toxicities during the first year after diagnosis among patients with IgG4-RD.</p><p><strong>Methods: </strong>The IQVIA PharMetrics® Plus database was used to identify adults with IgG4-RD using a validated algorithm. Patients were stratified according to glucocorticoid use during the 12-month study period following the first observed IgG4-RD-related diagnosis (index date): low glucocorticoid use (prednisone equivalent daily dose [PEDD] < 5 mg/day) or high glucocorticoid use (PEDD ≥ 5 mg/day). Incident glucocorticoid-related toxicities were assessed during the study period and incidence was compared between groups using Chi-square tests.</p><p><strong>Results: </strong>Among 295 patients with IgG4-RD, 150 (50.8%) had low glucocorticoid use, and 145 (49.2%) had high glucocorticoid use during the study period. In each glucocorticoid group, mean PEDD was highest in the 3 months post-index and subsequently decreased. At 12 months post-index, 24.7% of the low glucocorticoid use group and 60.7% of the high glucocorticoid use group were receiving glucocorticoids. The high glucocorticoid use group had a significantly higher mean (± standard deviation) number of incident glucocorticoid-related toxicities (1.8 ± 1.7 vs. 1.2 ± 1.3) and more frequently had ≥ 3 glucocorticoid-related toxicities (29.0% vs. 13.3%; both p < 0.01) compared to the low glucocorticoid use group. Specifically, cardiovascular- (29.0% vs. 18.7%), gastrointestinal- (29.7% vs. 16.0%), and infection-related (31.0% vs. 17.3%) toxicities were significantly more common in the high glucocorticoid use group than the low glucocorticoid use group (all p < 0.05).</p><p><strong>Conclusions: </strong>In this retrospective, claims-based analysis, high glucocorticoid use was seen in half of patients with IgG4-RD during the first year following diagnosis. Patients with high glucocorticoid use experienced significantly more incident glucocorticoid-related toxicities than those with low use during this first year.</p>","PeriodicalId":21267,"journal":{"name":"Rheumatology and Therapy","volume":" ","pages":"547-560"},"PeriodicalIF":2.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12084433/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143812218","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}