RMD Open最新文献

{"title":"Long-term safety of bimekizumab in adult patients with axial spondyloarthritis or psoriatic arthritis: pooled results from integrated phase IIb/III clinical studies.","authors":"Philip J Mease, Lianne S Gensler, Ana-Maria Orbai, Richard B Warren, Rajan Bajracharya, Barbara Ink, Alexander Marten, Ute Massow, Vishvesh Shende, Myriam Manente, Luke Peterson, Katy White, Robert Landewé, Denis Poddubnyy","doi":"10.1136/rmdopen-2024-005026","DOIUrl":"https://doi.org/10.1136/rmdopen-2024-005026","url":null,"abstract":"<p><strong>Objective: </strong>To assess the long-term safety profile of bimekizumab (BKZ) in patients with axial spondyloarthritis (axSpA) and psoriatic arthritis (PsA).</p><p><strong>Methods: </strong>Safety data pooled from six integrated phase IIb/III studies in axSpA and PsA are reported (to the July 2022 data-cut for phase III) for patients who received ≥1 dose of BKZ 160 mg every 4 weeks. Treatment-emergent adverse events (TEAEs) are reported using exposure-adjusted incidence rate per 100 patient-years (EAIR/100 PY).</p><p><strong>Results: </strong>The axSpA and PsA safety pools included 848 (total BKZ exposure: 2034.4 PY) and 1407 patients (2590.8 PY), respectively. TEAEs occurred at an EAIR/100 PY of 136.9 in axSpA and 139.6 in PsA; study discontinuation due to TEAEs was low (axSpA: 2.7/100 PY; PsA: 3.1/100 PY). The three most frequently reported TEAEs were SARS-CoV-2 (COVID-19) infection (axSpA: 7.8/100 PY; PsA: 8.8/100 PY), nasopharyngitis (axSpA: 8.2/100 PY; PsA: 7.7/100 PY) and upper respiratory tract infection (axSpA: 5.0/100 PY; PsA: 5.6/100 PY). EAIR/100 PY of oral candidiasis was 3.7 in axSpA and 4.2 in PsA; most events were mild/moderate. EAIR of BKZ discontinuation due to oral candidiasis was low (both axSpA and PsA: 0.3/100 PY). No systemic fungal infections or cases of active tuberculosis were reported. EAIRs of adjudicated definite/probable inflammatory bowel disease, uveitis, adjudicated major adverse cardiovascular events and adjudicated suicidal ideation/behaviour were low.</p><p><strong>Conclusion: </strong>Overall, BKZ demonstrated good tolerability, with TEAE EAIRs comparable between axSpA and PsA cohorts, remaining stable over extended treatment periods. No new safety signals were identified.</p><p><strong>Trial registration numbers: </strong>NCT02963506 (BE AGILE); NCT03355573 (BE AGILE 2); NCT03928704 (BE MOBILE 1); NCT03928743 (BE MOBILE 2); NCT04436640 (BE MOVING); NCT02969525 (BE ACTIVE); NCT03347110 (BE ACTIVE 2); NCT03895203 (BE OPTIMAL); NCT03896581 (BE COMPLETE); NCT04009499 (BE VITAL).</p>","PeriodicalId":21396,"journal":{"name":"RMD Open","volume":"11 2","pages":""},"PeriodicalIF":5.1,"publicationDate":"2025-04-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143803965","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}

{"title":"Influence of body mass index on cardiovascular risk in rheumatoid arthritis varies across anti-citrullinated protein antibody status and biologic use.","authors":"George Athanasios Karpouzas, Miguel A Gonzalez-Gay, Alfonso Corrales, Elena Myasoedova, Solbritt Rantapää-Dahlqvist, Petros P Sfikakis, Patrick Dessein, Carol Hitchon, Virginia Pascual-Ramos, Irazú Contreras-Yáñez, Iris J Colunga-Pedraza, Dionicio Angel Galarza-Delgado, Jose Ramon Azpiri-Lopez, Anne Grete Semb, Piet Leonardus Cornelis Maria van Riel, Durga Prasanna Misra, Durez Patrick, Brian Bridal Logstrup, Ellen-Margrethe Hauge, George Kitas, Sarah R Ormseth","doi":"10.1136/rmdopen-2025-005464","DOIUrl":"10.1136/rmdopen-2025-005464","url":null,"abstract":"<p><strong>Objectives: </strong>The impact of body mass index (BMI) on cardiovascular risk in rheumatoid arthritis (RA) is unclear. RA characteristics may influence the association between BMI and risk. Disease activity, which predicts cardiovascular risk, is associated with obesity only among anticitrullinated antibody (ACPA)-positive patients. Biologics alter body composition and mitigate cardiovascular risk in RA. We explored the association of BMI with cardiovascular risk and whether this varied across ACPA status and biologic use.</p><p><strong>Methods: </strong>We evaluated 3982 patients from an international observational cohort. Outcomes included (a) first major adverse cardiovascular event (MACE) encompassing myocardial infarction, stroke or cardiovascular death; and (b) all events comprising MACE, angina, revascularisation, transient ischaemic attack, peripheral arterial disease and heart failure. Multivariable Cox models stratified by centre risk evaluated the impact of BMI, ACPA, biologics and their two- and three-way interactions on outcomes.</p><p><strong>Results: </strong>We recorded 192 MACE and 319 total events. No main effects of BMI, ACPA or biologics were observed. A three-way interaction between them on MACE (p-interaction<0.001) and all events (p-interaction=0.028) was noted. Among ACPA negative patients, BMI was inversely associated with MACE (HR 0.38 (95% CI 0.25 to 0.57)) and all events (HR 0.67 (0.49 to 0.92)) in biologic users but not non-users (p-for-interaction <0.001 and 0.012). Among ACPA-positive patients, BMI was associated with MACE (HR 1.04 [1.01-1.07]) and all events (HR 1.03 (1.00 to 1.06)) independently of biologic use.</p><p><strong>Conclusions: </strong>BMI is inversely associated with cardiovascular risk only among ACPA-negative biologic users. In contrast, BMI is associated with cardiovascular risk in ACPA-positive patients independently of biologic use.</p>","PeriodicalId":21396,"journal":{"name":"RMD Open","volume":"11 2","pages":""},"PeriodicalIF":5.1,"publicationDate":"2025-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143788890","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}

{"title":"Venous vessel-wall assessment with superb microvascular imaging in Behçet syndrome.","authors":"Yasemin Kayadibi, Yesim Ozguler, Melike Melikoglu, Sinem Nihal Esatoglu, Ugur Kimyon, Ayse Kalyoncu Ucar, Ibrahim Adaletli, Gulen Hatemi","doi":"10.1136/rmdopen-2024-005382","DOIUrl":"10.1136/rmdopen-2024-005382","url":null,"abstract":"<p><strong>Objectives: </strong>Superb microvascular imaging (SMI) provides a more sensitive assessment of small vessels compared with power and colour Doppler ultrasonography (PDUS and CDUS). We aimed to investigate the potential of SMI for use in research and clinical practice in Behçet syndrome (BS) and to gain a better understanding of erythema nodosum (EN) like and superficial thrombophlebitis (STM) lesions using SMI.</p><p><strong>Methods: </strong>We studied 51 patients with BS and 31 patients with non-BS with red palpable lesions on physical examination. B-mode US, CDUS, PDUS and SMI were performed and recorded by the same radiologist and recorded images were additionally evaluated independently by another radiologist. Vessel-wall signal intensity of STM lesions by SMI was graded in four groups according to the percentages of the affected vessel-wall area (Grade 0: no signal, Grade 1: < 25%, Grade 2: 25%-50%, Grade 3: 50%-75% and Grade 4: >75%).</p><p><strong>Results: </strong>The lesions of 26 patients with BS and 17 patients with non-BS were diagnosed as STM with CDUS. SMI of STM lesions revealed vessel-wall signals in 21/26 patients with BS (81%), in contrast to only 3/17 (18%) patients with non-BS. While 16 of 21 patients with BS (76%) had at least grade 2 signal, only 1 of 3 non-BS had it. Lesions of 25 BS and 11 non-BS were diagnosed as EN by CDUS and SMI showed no vessel-wall signal in these patients.</p><p><strong>Conclusions: </strong>Evaluation of the vessel wall with SMI in BS may be a promising approach for showing inflammation as an inexpensive, non-invasive and reliable imaging method that does not require a contrast agent.</p>","PeriodicalId":21396,"journal":{"name":"RMD Open","volume":"11 2","pages":""},"PeriodicalIF":5.1,"publicationDate":"2025-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143788218","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}

{"title":"Long-term evolution of postpartum sacroiliac bone marrow oedema: a 5-year longitudinal follow-up study.","authors":"Gaëlle Varkas, Liesbet De Meester, Manouk de Hooge, Ann-Sophie De Craemer, Nele Herregods, Lennart Jans, Philippe Carron, Dirk Elewaut, Filip Van den Bosch","doi":"10.1136/rmdopen-2024-005309","DOIUrl":"10.1136/rmdopen-2024-005309","url":null,"abstract":"<p><strong>Introduction: </strong>Bone marrow oedema (BME) on MRI of the sacroiliac joints (SIJ) commonly occurs after pregnancy. Our goal was to assess the evolution of BME over a period of 5 years and the potential development of structural lesions.</p><p><strong>Methods: </strong>MRI-SIJ was performed after an uncomplicated vaginal delivery, with a follow-up 5 years later, evaluating both inflammatory and structural lesions.</p><p><strong>Results: </strong>19 women were assessed. Mean age was 35.3 years, with median body mass index of 20.8. Six subjects reported back pain, of which only one reported inflammatory back pain (IBP). No association was found between IBP and Spondyloarthritis Research Consortium of Canada (SPARCC) score (p=0.24), nor with a positive MRI according to the Assessment of SpondyloArthritis international Society (ASAS) definition at baseline (p=0.64). Thirty-two percent (6/19) presented with BME after 5 years, 3 of whom met the ASAS definition of a positive MRI-SIJ, irrespective of subsequent pregnancies. A new delivery during follow-up was linked to the total number of structural lesions at year 5, whereas mean weight gain across all pregnancies correlated with sclerosis. Sclerosis and erosions were more frequently detected by synthetic CT compared with T1-weighted MRI.</p><p><strong>Conclusions: </strong>In postpartum women, no significant development of structural MRI lesions was observed 5 years after a single delivery, despite the presence of BME in a significant number of individuals postpartum and at follow-up. These results support the hypothesis that, unlike BME in SpA, childbirth-related mechanical stress-induced BME does not lead to structural lesions. However, subsequent pregnancies may contribute to their development.</p>","PeriodicalId":21396,"journal":{"name":"RMD Open","volume":"11 2","pages":""},"PeriodicalIF":5.1,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143788201","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}

{"title":"Patient-reported outcomes as early warning signs of flare following drug cessation in rheumatoid arthritis.","authors":"Leher Gumber, Fiona Rayner, Theophile Bigirumurame, Bernard Dyke, Andrew Melville, Sean Kerrigan, Andrew McGucken, Najib Naamane, Jonathan Prichard, Christopher D Buckley, Andrew Filer, Iain B McInnes, Karim Raza, Stefan Siebert, James Ms Wason, Wan-Fai Ng, Amy E Anderson, John D Isaacs, Kenneth F Baker, Arthur G Pratt","doi":"10.1136/rmdopen-2025-005442","DOIUrl":"10.1136/rmdopen-2025-005442","url":null,"abstract":"<p><strong>Objectives: </strong>Drug withdrawal in rheumatoid arthritis (RA) in remission can reduce toxicity, but with the risk of flare which requires close monitoring. We explored the potential of patient-reported outcomes (PROs) for flare detection among RA patients in sustained remission after conventional synthetic disease-modifying antirheumatic drug (csDMARD) cessation.</p><p><strong>Methods: </strong>Four PROs (Factors that Limit sustAined Remission in rhEumatoid arthritis (FLARE-RA), EuroQol-5 Dimensions (EQ5D), Routine Assessment of Patient Index Data-3 (RAPID-3) and RA Flare Questionnaire (RA-FQ)) were captured at baseline and at sequential visits until time-of-flare or end of 6-month follow-up as part of the BIO-FLARE prospective cohort study. Flare was defined as any of (i) Disease Activity Score 28 (DAS28)-C reactive protein (CRP) ≥3.2 at any visit, (ii) DAS28-CRP≥2.4 on two visits within 2 weeks or (iii) resuming DMARD and/or steroid therapy despite DAS28-CRP<2.4. Cox regression models with time-varying covariates were fitted to evaluate associations between PRO changes and likelihood of flare. Receiver-operating characteristic (ROC) curves enabled discriminatory changes in each PRO to be compared as a means of identifying flare.</p><p><strong>Results: </strong>58/121 (47.9%) participants (70.1% females, mean age 64.8 years) experienced a flare. A 1-point change in each PRO score was strongly associated with flare development in the multivariate Cox regression model (p<0.001 in each case). ROC curve analysis confirmed that monitoring adverse changes in PROs from baseline offered robust discriminatory utility for identifying flare occurrence. This was most evident for RA-FQ and FLARE-RA (both areas under the curves 0.90, 95% CI 0.84 to 0.96; p=0.001); for example, an RA-FQ increment of ≥5.5 from baseline identified objective flare with positive and negative predictive values of 80% and 91%, respectively.</p><p><strong>Conclusions: </strong>Our data support the potential value of remote PRO monitoring of RA patients in drug-free remission to identify flare occurrence.</p>","PeriodicalId":21396,"journal":{"name":"RMD Open","volume":"11 2","pages":""},"PeriodicalIF":5.1,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11962807/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143764948","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}

{"title":"Trends and influences in women authorship in randomised controlled trials in rheumatology: a comprehensive analysis of all published RCTs from 2009 to 2023.","authors":"Kim Lauper, Diana Buitrago-Garcia, Delphine S Courvoisier, Michele Iudici, Denis Mongin","doi":"10.1136/rmdopen-2024-005341","DOIUrl":"https://doi.org/10.1136/rmdopen-2024-005341","url":null,"abstract":"<p><strong>Objectives: </strong>We examined the evolution and influencing factors of women's authorship in randomised controlled trials (RCTs) published in rheumatology.</p><p><strong>Methods: </strong>We analysed all RCTs published in rheumatology from 2009 to 2023 determining authors' gender using the Gender API service. The percentage of women as authors in published RCTs and its association with potential factors was assessed using generalised estimating equations. We considered women's gender as the primary outcome and included the continent of the RCT, the status of international collaboration, industrial funding, intervention type, sample size, the journal's adherence to International Committee of Medical Journal Editors recommendations, impact factor, publication year, authors' non-academic affiliations and author positions as exposures of interest.</p><p><strong>Results: </strong>We included 1092 RCTs with 10 794 authors; in the overall non-adjusted estimated analysis, we found that women accounted for 39.8% (95% CI 38.4% to 41.2%) of all authors. Women authorship was higher in African-based RCTs, among pharmaceutical-affiliated authors, and when the last author was a woman (OR 2.34 (95% CI 1.02 to 5.38), +19.46 pp). It was lower in Asian and European RCTs and industry-funded RCTs (OR 0.79 (95% CI 0.66 to 0.93), -5.85 pp). Women were less often last (OR 0.63 (95% CI 0.54 to 0.74), -10.2 pp) or second-to-last authors (OR 0.73 (95% CI 0.62 to 0.85), -10.19 pp), with no differences by international status or publication year.</p><p><strong>Conclusion: </strong>The persistent under-representation of women in RCTs and their lower chances of being senior authors highlight the need for better strategies to close the gender gap. RCTs with a woman last author were more likely to have a woman first author, suggesting a potential role model effect.</p>","PeriodicalId":21396,"journal":{"name":"RMD Open","volume":"11 1","pages":""},"PeriodicalIF":5.1,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143743369","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}

{"title":"Social media in advancing equity and collaboration in rheumatology: the CORDIALITY review.","authors":"Ihsane Hmamouchi, Nelly Ziade, Adewale Adebajo, Latika Gupta, Puja Mehta, Angela Migowa, Elena Nikiphorou, Noelle A Rolle, Didem Saygin, Namrata Singh, Lisa S Traboco, Manuel Francisco Ugarte-Gil, Jean Liew","doi":"10.1136/rmdopen-2025-005490","DOIUrl":"10.1136/rmdopen-2025-005490","url":null,"abstract":"<p><p>Social media has transformed communication in academia and medicine, offering stakeholders innovative avenues for knowledge exchange and collaboration. The CORDIALITY review (soCial media fOR aDvancing equIty And coLlaboration In rheumaTologY) examines the impact of social media on education and information dissemination, patient education and empowerment, networking and mentorship, and research collaboration within rheumatology, when effectively used. In this narrative review, we consider the opportunities as well as the challenges related to each of these facets of social media use. With a focus on inequities faced globally, we give particular consideration to disparities by gender as they relate to the rheumatology workforce, and issues pertaining to lower-income and middle-income countries such as limitations of digital access and digital literacy. To maximise the potential of social media in rheumatology, we propose a strategic framework that encourages innovation, responsible practices and support from rheumatology organisations.</p>","PeriodicalId":21396,"journal":{"name":"RMD Open","volume":"11 1","pages":""},"PeriodicalIF":5.1,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11956376/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143743187","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}

{"title":"Correction: experimental myositis: an optimised version of C-protein-induced myositis.","authors":"","doi":"10.1136/rmdopen-2024-004558corr1","DOIUrl":"https://doi.org/10.1136/rmdopen-2024-004558corr1","url":null,"abstract":"","PeriodicalId":21396,"journal":{"name":"RMD Open","volume":"11 1","pages":""},"PeriodicalIF":5.1,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143731440","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}

{"title":"Immunoglobulins G from Patients with Systemic Sclerosis Modify the Molecular Signatures of Endothelial Cells.","authors":"Aurélien Chepy, Solange Vivier, Fabrice Bray, Clément Chauvet, Alain Lescoat, Abderrahmane Elhannani, Martin Figeac, Lucile Guilbert, Frédéric Leprêtre, Louisa Bourel, Eric Hachulla, Christian Rolando, Valérie Lecureur, Sylvain Dubucquoi, David Launay, Vincent Sobanski","doi":"10.1136/rmdopen-2024-004290","DOIUrl":"10.1136/rmdopen-2024-004290","url":null,"abstract":"<p><strong>Objective: </strong>Antinuclear antibodies (ANA) are powerful biomarkers in systemic sclerosis (SSc). Functional antibodies (FA) might be implicated in vasculopathy, in which endothelial cells (EC) are key players. We aimed to explore the effect of purified IgG from patients with SSc on omics signatures of EC and examine the influence of ANA serotypes and FA.</p><p><strong>Methods: </strong>EC were cultured in the presence of purified IgG from patients with SSc, patients with systemic lupus erythematosus (SLE) or healthy controls (HC). EC omics profiles were analysed by liquid chromatography with tandem mass spectrometry (LC-MS/MS) and RNA sequencing. EC proteome induced by IgG from patients with SSc was confirmed with an external validation cohort.</p><p><strong>Results: </strong>In the derivation cohort, principal component analysis (PCA) using proteomics data showed three distinct groups of subjects: a first one including mostly anti-topoisomerase-I positive patients (ATA+), a second one including mostly anti-centromere positive patients and a third group comprising anti-RNA polymerase-III positive patients, SLE and HC. In transcriptomics, PCA distinguished one group composed of ATA+patients only from a second group mixing ATA+patients with other individuals. The validation cohort confirmed the existence of two groups of distinct EC proteome profiles and clinical severity in ATA+patients. In both SSc cohorts, no association between FA presence and proteomic profiles was observed. Quantitative proteomics measured the most discriminant proteins in EC exposed to purified IgG.</p><p><strong>Conclusion: </strong>Purified IgG from patients with SSc can modify EC proteome and transcriptome. The observed changes closely associate with ANA serotype.</p>","PeriodicalId":21396,"journal":{"name":"RMD Open","volume":"11 1","pages":""},"PeriodicalIF":5.1,"publicationDate":"2025-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11931898/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143692896","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}

{"title":"Infliximab use and cervical spine deformity in patients with rheumatoid arthritis.","authors":"Anna Baukje Lebouille-Veldman, Tom W J Huizinga, Rania A Mekary, Carmen L A Vleggeert-Lankamp","doi":"10.1136/rmdopen-2024-005237","DOIUrl":"10.1136/rmdopen-2024-005237","url":null,"abstract":"<p><strong>Objective: </strong>Over the past decades, the incidence of surgery for rheumatoid arthritis (RA)-associated cervical spine deformity decreased. Infliximab has been observed as a protective treatment for joint damage in hands and feet; yet, the protective association between infliximab and the cervical spine has been uncertain.</p><p><strong>Methods: </strong>Duration of infliximab use during 10 years of follow-up was evaluated in patients with new-onset RA (case control study using data from the BeSt Trial). Missing values on the exposure were imputed using last observation carried forward. Lateral X-rays at 5-year and 10-year follow-ups were assessed for atlantoaxial subluxation (AAS) and subaxial subluxation (SAS). Multiple logistic regression models adjusted for age, gender, baseline Disease Activity Score (DAS44), ACPA-positivity and rheumatoid factor-positivity were used to estimate ORs and their 95% CIs. Mediation analysis was performed to evaluate whether a potential association was mediated via mean DAS44.</p><p><strong>Results: </strong>Cervical deformity (AAS and/or SAS>2 mm) was observed in 108 (40%) of 272 patients. There was an 11% reduction in odds for cervical spine deformity (OR: 0.89, 95% CI: 0.81 to 0.98; p=0.02) for every 1-year increase in duration of infliximab use. Mediation analysis could not reveal an influence of DAS44 on the association between infliximab use and cervical spine outcomes.</p><p><strong>Conclusions: </strong>There was evidence of a beneficial association between longer duration of use of infliximab and cervical spine deformity after 10 years follow-up. Thus, it is important to balance the favourable effects of infliximab use for the joints and possibly the cervical spine with the potential adverse events of this medication when used continuously.</p><p><strong>Trial registration number: </strong>Netherlands Trial Register Number: NTR262.</p>","PeriodicalId":21396,"journal":{"name":"RMD Open","volume":"11 1","pages":""},"PeriodicalIF":5.1,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11934621/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143658547","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}