RMD Open最新文献

{"title":"Transcriptome analysis to decipher the molecular underpinnings of response to treatment in systemic lupus erythematosus.","authors":"Panagiotis Garantziotis, Georgia Savina Moysidou, Noemin Kapsala, Sofia Flouda, Dionysis Nikolopoulos, Katerina Chavatza, George Sentis, Anastasia Filia, Nikos Malissovas, Antigone Pieta, Aggelos Banos, Spyridon Katechis, Antonis Fanouriakis, George Bertsias, Dimitrios T Boumpas","doi":"10.1136/rmdopen-2024-005050","DOIUrl":"10.1136/rmdopen-2024-005050","url":null,"abstract":"<p><strong>Objective: </strong>Systemic lupus erythematosus (SLE) is a multisystem autoimmune disease characterised by variable treatment responses. We investigated the transcriptional landscape associated with treatment response and resistance in SLE.</p><p><strong>Methods: </strong>Blood was collected from 92 active patients with SLE at baseline and after 6 months (n=32 paired samples) of treatment with cyclophosphamide (n=40), rituximab (n=20), belimumab (n=23), mycophenolate mofetil (n=8) or azathioprine (n=1) and was subjected to RNA sequencing. The response was defined by the Lupus Low Disease Activity State. We identified differentially expressed genes and co-expressed transcript modules.</p><p><strong>Results: </strong>Achieving response, irrespective of treatment, was accompanied by downregulation of B cell immunity-related and complement activation-related signatures. Rituximab led to the most profound decrease in the activity of the B cell pathway, while cyclophosphamide uniquely downregulated neutrophil activation pathways. Responders, regardless of medication, showed increased activity in pathways related to neutrophil migration, type I interferon signalling, complement activation and B cell function prior to treatment. A 539-gene signature, enriched in processes related to chemokine signalling, characterised patients with insufficient response to treatment.</p><p><strong>Conclusions: </strong>Baseline B cell immunity transcriptional signatures correlate with favourable treatment outcomes-accounting for better responses in serologically active patients in SLE clinical trials-with effective treatment reversing the B cell immunity signature. Cyclophosphamide uniquely targets a neutrophil gene signature linked to severe SLE. Alterations in chemotaxis may represent a mechanism driving resistance to treatment in SLE.</p>","PeriodicalId":21396,"journal":{"name":"RMD Open","volume":"11 1","pages":""},"PeriodicalIF":5.1,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11931925/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143625824","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":"Associations of sociodemographic, clinical factors and HLA-B alleles with enthesitis and peripheral arthritis in patients with ankylosing spondylitis.","authors":"Benjamin Sornrung Naovarat, Lianne Gensler, Michael Ward, Mark Hwang, Amirali Tahanan, Mohammad Hossein Rahbar, Mariko Ishimori, MinJae Lee, Matthew A Brown, Michael H Weisman, John D Reveille","doi":"10.1136/rmdopen-2024-004589","DOIUrl":"https://doi.org/10.1136/rmdopen-2024-004589","url":null,"abstract":"<p><strong>Objectives: </strong>Factors associated with peripheral arthritis and enthesitis, especially Achilles tendonitis and plantar fasciitis, were examined in a longitudinal cohort of 1075 patients with ankylosing spondylitis (AS) (also known as radiographic axial spondyloarthritis).</p><p><strong>Methods: </strong>Patients were derived from the Prospective Study of Outcomes in Ankylosing Spondylitis cohort. Disease activity and functional indices, as well as physical examination and medications used, were measured at every study visit. Univariable and multivariable analyses of the association of peripheral arthritis and enthesitis with clinical, sociodemographic factors were performed. Human leucocyte antigen (HLA)-B alleles were analysed by single-stranded conformational polymorphism analysis.</p><p><strong>Results: </strong>Those with peripheral arthritis on examination were more likely to have psoriasis (p=0.001, OR=1.68; CI, 1.11, 2.54), greater functional impairment (p<0.001 OR=1.72; CI, 1.31, 2.27), higher erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) levels (p<0.001), greater tumour necrosis factor (TNF) inhibitor (p<0.001, OR=1.50; CI, 1.14, 1.97) and use methotrexate/sulfasalazine (p<0.001, OR=2.25, CI [1.57, 3.23]). Patients with enthesitis were less likely to be male (p<0.001, OR=0.57; CI, 0.43, 0.75) and have peripheral arthritis (p<0.001, OR=2.35; CI, 1.47, 3.75), greater functional impairment (p<0.001, OR=1.91; CI, 1.43, 2.55) and higher ESR/CRP levels (p<0.001). Patients with plantar fasciitis and/or Achilles' tendonitis on examination were less likely to male (p<0.001 OR=0.57; CI, 0.43, 0.75), to have significant functional impairment (p<0.001), to be using TNF inhibitors (p<0.001, OR=1.48; CI 1.13, 1.93) and to be using either sulfasalazine or methotrexate (p<0.001, OR=1.86, CI, 1.30, 2.67). HLA-B*15 (p=0.03, OR=1.84; CI, 1.05, 3.21) and HLA-B*37 (p=0.04, OR=3.00; CI, 1.03, 8.74) were marginally increased in frequency in those with peripheral arthritis on examination compared with those without.</p><p><strong>Conclusion: </strong>There was a higher prevalence of peripheral musculoskeletal manifestations in women with AS, with significant impact on physical function and greater use of methotrexate or sulfasalazine and TNF inhibitors and enrichment for certain non-HLA-B27 HLA-B alleles.</p>","PeriodicalId":21396,"journal":{"name":"RMD Open","volume":"11 1","pages":""},"PeriodicalIF":5.1,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143625788","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":"Cardiovascular events in patients with myositis: results from a French retrospective cohort.","authors":"Camille Kasser, Alexis F Guédon, Yves Allenbach, Olivier Fain, Ariel Cohen, Arsène Mekinian","doi":"10.1136/rmdopen-2024-005276","DOIUrl":"10.1136/rmdopen-2024-005276","url":null,"abstract":"<p><strong>Introduction: </strong>Idiopathic inflammatory myositis (IIM) are systemic diseases, including dermatomyositis (DM), inclusion body myositis (IBM), immune-mediated necrotising myopathy (IMNM), antisynthetase syndrome (ASSD) and overlap myositis (OM). Patients with IIM have an increased risk of premature death, largely due to cardiovascular events (CVE). The aim of this study was to describe specific and non-specific cardiac involvement in patients with IIM, and to assess the occurrence of CVE.</p><p><strong>Methods: </strong>We conducted a retrospective observational cohort study of patients with IIM from Saint Antoine University Hospital, Paris, between 1997 and 2020. Cardiac involvement was defined as abnormalities at baseline on ECG, Holter ECG, transthoracic echocardiography, cardiac MRI or elevated cardiac biomarkers. CVE were defined as heart failure due to ischaemia, arrhythmia or conductive block, inflammatory myocarditis or resuscitation department admission.</p><p><strong>Results: </strong>78 patients were included (median age 49 years; 67% female); 33 (42%) had DM, 18 (23%) ASSD, 12 (15%) OM, 11 (14%) IMNM and 4 (5%) IBM. Cardiac involvement at diagnosis was present in 12 (15%) patients; 15 (19%) had a CVE during follow-up. Patients with versus without cardiac involvement at diagnosis were more likely to present a CVE (6 (50%) vs 9 (14%); p=0.01). Median (IQR) time to CVE was shorter in patients with cardiac involvement (9 (0-34) vs 84 (26-156) months; p<0.01).</p><p><strong>Conclusion: </strong>Patients with cardiac involvement at myositis diagnosis are at increased risk of CVE and experience them earlier than patients without and should be carefully followed up, particularly during the first months after diagnosis.</p>","PeriodicalId":21396,"journal":{"name":"RMD Open","volume":"11 1","pages":""},"PeriodicalIF":5.1,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11907079/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143625789","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":"Holistic approaches in systemic lupus erythematosus: do physicians avoid addressing difficult-to-treat but highly relevant symptoms?","authors":"Ioannis Parodis, Chris Wincup, Zahi Touma, Jeanette Andersen, Vibeke Strand, Christopher Sjöwall","doi":"10.1136/rmdopen-2024-005400","DOIUrl":"10.1136/rmdopen-2024-005400","url":null,"abstract":"<p><p>Despite advancements in the management of systemic lupus erythematosus (SLE), patients experience poor health-related quality of life (hrQoL) and premature death due to disease severity and treatment side effects. Achieving remission offers substantial benefits, including improved hrQoL and reduced mortality, yet the complexity of SLE, with its diverse underlying immune mechanisms and clinical manifestations, hampers progress. Involvement of the central nervous system with symptoms like fatigue, pain and brain fog often goes unaddressed due to limited evidence-based guidance and measurement tools. This neglect reflects gaps in training, discomfort in addressing untreatable symptoms and an overemphasis on evidence-based medicine, compromising holistic care. Recognising patient-reported outcomes has shifted SLE care towards a more patient-centred model, addressing hrQoL and aligning treatment goals. Embracing this approach and prioritising symptom management, even when a definitive cure is lacking, ensures compassionate, comprehensive care that improves adherence, satisfaction and the overall lived experience of patients with SLE.</p>","PeriodicalId":21396,"journal":{"name":"RMD Open","volume":"11 1","pages":""},"PeriodicalIF":5.1,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11891533/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143586603","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":"The metabolic score for insulin resistance predicts the risk of cardiovascular disease in patients with psoriatic arthritis: results from the 10-year prospective CARMA cohort.","authors":"Miguel A Gonzalez-Gay, Ivan Ferraz-Amaro, Santos Castañeda, Jose A Pinto Tasende, Miren Uriarte-Ecenarro, Zulema Plaza, Fernando Sánchez-Alonso, Carmen García Gómez, Carlos González-Juanatey, Javier Llorca","doi":"10.1136/rmdopen-2024-005352","DOIUrl":"10.1136/rmdopen-2024-005352","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the predictive value of the metabolic score for insulin resistance (METS-IR) in identifying patients with psoriatic arthritis (PsA) at high risk of cardiovascular (CV) events.</p><p><strong>Methods: </strong>Assessment of patients with PsA enrolled in the Spanish prospective CARdiovascular in ReuMAtology (CARMA) project. Baseline data from 500 PsA patients without a history of CV events, chronic kidney disease, diabetes mellitus or statin use at the baseline visit were analysed. Patients were prospectively followed for 10 years in rheumatology outpatient clinics at tertiary centres. The performance of the METS-IR in predicting CV events was evaluated. METS-IR was categorised into three groups: <2.25, 2.25-2.48 and >2.48.</p><p><strong>Results: </strong>Over 4788 patient-years of follow-up, 27 individuals experienced at least one CV event. The annualised incidence rate was 5.6 events per 1000 patient-years (95% CI: 3.7 to 8.2). PsA patients with CV events had significantly higher METS-IR scores than those without CV events (2.37±0.24 vs 2.26±0.19; p=0.01). In this regard, patients who had CV events were more commonly included in the METS-IR 2.25-2.48 and >2.48 categories than those without CV events (p=0.008). Adjusted regression models indicated that PsA patients with a METS-IR >2.48 at baseline had an increased risk of experiencing a CV event during the follow-up period.</p><p><strong>Conclusions: </strong>In PsA patients under close observation in rheumatology units included in the prospective CARMA project, METS-IR serves as a reliable prognostic predictor of CV.</p>","PeriodicalId":21396,"journal":{"name":"RMD Open","volume":"11 1","pages":""},"PeriodicalIF":5.1,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11891542/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143586604","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":"Decreased concentrations of C5a complement receptor antibodies are associated with relapse in eosinophilic granulomatosis with polyangiitis (EGPA).","authors":"Sebastian Klapa, Antje Müller, Sabrina Arnold, Andreas Koch, Anja Staehle, Wataru Kaehler, Harald Heidecke, Gabriela Riemekasten, Christian M Karsten, Peter Lamprecht","doi":"10.1136/rmdopen-2024-005323","DOIUrl":"10.1136/rmdopen-2024-005323","url":null,"abstract":"","PeriodicalId":21396,"journal":{"name":"RMD Open","volume":"11 1","pages":""},"PeriodicalIF":5.1,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11887279/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143573929","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":"Experimental myositis: an optimised version of C-protein-induced myositis.","authors":"Margherita Giannini, Daniela Rovito, Mustapha Oulad-Abdelghani, Nadia Messaddeq, Léa Debrut, Giulia Quiring, Pascal Kessler, Anne-Laure Charles, Bernard Geny, Daniel Metzger, Gilles Laverny, Alain Meyer","doi":"10.1136/rmdopen-2024-004558","DOIUrl":"10.1136/rmdopen-2024-004558","url":null,"abstract":"<p><strong>Introduction: </strong>Inflammatory myopathies (IM) are a group of severe autoimmune diseases, sharing some similarities, whose cause is unknown and treatment is empirical.While C-protein-induced myositis (CIM), the most currently used mouse model of IM, has removed some roadblocks to understand and improve the treatment of IM, it has only been partially characterised and its generation limited by poor reproducibility. This study aimed at optimising the generation and the characterisation of CIM.</p><p><strong>Methods: </strong>In silico analysis was run to identify the top three specific and immunogenic regions of C-protein. The cognate polypeptides were synthesised and used to immunise C57BL/6N mice. Grip strength, walking ability, serum creatine kinase levels and muscle pathology (histological and electron microscopic features) were assessed. Immune cell proportions and interferon signature in muscles were also determined.</p><p><strong>Results: </strong>Among the three C-protein polypeptides with the highest immunogenic score, immunisation with the amino acids 965-991 induced the most severe phenotype (experimental myositis (EM)) characterised by 37% decrease in strength, 36% increase in hind base width, 45% increase in serum creatine-kinase level and 80% increase in histological inflammatory score. Optical and electron microscopy revealed mononuclear cell infiltrate, myofibre necrosis, atrophy, major histocompatibility complex-I expression as well as sarcolemmal, sarcomeric and mitochondrial abnormalities. Autoantibodies targeting C-protein, proinflammatory T-lymphocytes, macrophages, and type I and II interferon-stimulated transcripts were detected within the muscle of EM mice.</p><p><strong>Conclusion: </strong>EM recapitulates the common hallmarks of IM. This costless, high throughput, reproducible and robust model, generated in the most commonly used background for genetically engineered mice, may foster preclinical research in IM.</p>","PeriodicalId":21396,"journal":{"name":"RMD Open","volume":"11 1","pages":""},"PeriodicalIF":5.1,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11883622/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143568080","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":"Patients with systemic autoimmune rheumatic diseases remain at risk for hospitalisation for COVID-19 infection in the Omicron era (2022-2024): a retrospective cohort study.","authors":"Naomi J Patel, Shruthi Srivatsan, Emily N Kowalski, Andrew King, Xiaosong Wang, Kathleen Mm Vanni, Grace Qian, Jennifer S Hanberg, Katarina J Bade, Alene A Saavedra, Kevin T Mueller, Buuthien Hang, Zachary K Williams, Colebrooke Johnson, Madison Negron, Jeffrey A Sparks, Zachary S Wallace","doi":"10.1136/rmdopen-2024-005114","DOIUrl":"10.1136/rmdopen-2024-005114","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the risk factors for severe acute COVID-19 outcomes in the Omicron era among individuals with systemic autoimmune rheumatic diseases (SARDs).</p><p><strong>Methods: </strong>We identified patients with confirmed SARDs and COVID-19 (positive PCR and/or antigen test) from 1 September 2022 to 15 March 2024 in the Mass General Brigham healthcare system. We estimated the associations of baseline characteristics with the odds of hospitalisation due to COVID-19 infection, verified by medical record review, using multivariable logistic regression.</p><p><strong>Results: </strong>Of 2061 patients with SARDs and COVID-19 during the Omicron era (75% female, mean age 62.2 years), 134 (6.5%) were hospitalised due to COVID-19, mostly due to respiratory symptoms (84, 63%). Of those hospitalised, 11 (8%) required mechanical ventilation and 20 (15%) died. Older age (adjusted OR (aOR) 1.05 per year), Black race (vs White race, aOR 4.15), ever smoking (vs never, aOR 1.76), CD20 inhibitor use (vs antimalarial monotherapy, aOR 2.22) and glucocorticoid use (vs non-use, aOR 2.07) were significantly associated with higher odds of hospitalisation. Female sex (vs male, aOR 0.63), booster SARS-CoV-2 vaccination (vs initial series, aOR 0.49) and vaccination within either 3 months or 3-6 months prior to infection (aOR 0.41 and aOR 0.38, respectively, vs none within 12 months) were significantly associated with lower odds of hospitalisation.</p><p><strong>Conclusions: </strong>Some patients with SARDs remain at higher risk of severe COVID-19 in the Omicron era. Patients who are older, Black, have more comorbidities, use CD20 inhibitors and/or glucocorticoids, or have not been vaccinated recently may benefit from risk-mitigating strategies, including booster vaccines and pre-exposure prophylaxis.</p>","PeriodicalId":21396,"journal":{"name":"RMD Open","volume":"11 1","pages":""},"PeriodicalIF":5.1,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11883534/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143568081","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":"Major adverse cardiovascular, thromboembolic and malignancy events in the filgotinib rheumatoid arthritis and ulcerative colitis clinical development programmes.","authors":"Xavier Mariette, Sven Borchmann, Sandrine Aspeslagh, Zoltan Szekanecz, Christina Charles-Schoeman, Stefan Schreiber, Ernest Hs Choy, Laurent Peyrin-Biroulet, Marc Schmalzing, Yoshiya Tanaka, Hugo Ten Cate, René Westhovens, C Janneke van der Woude, Edmund V Ekoka Omoruyi, Margaux Faes, Tomasz Masior, Paul Van Hoek, Chris Watson, Christine Rudolph, Andreas Stallmach","doi":"10.1136/rmdopen-2024-005033","DOIUrl":"10.1136/rmdopen-2024-005033","url":null,"abstract":"<p><strong>Objectives: </strong>Long-term safety is fundamental for treatment decision-making. This integrated analysis of filgotinib clinical trials in rheumatoid arthritis (RA) and ulcerative colitis (UC) assessed adverse events of interest (AEI): major adverse cardiovascular events (MACE), venous thromboembolism (VTE) and malignancies.</p><p><strong>Methods: </strong>Data were integrated from all phase II and III trials that have investigated filgotinib 100 mg or 200 mg once daily in RA and UC to date.</p><p><strong>Results: </strong>Analyses represent >12 500 (RA) and >2800 (UC) patient-years of exposure (PYE) to filgotinib. Incidences of AEI in the integrated analysis population were low. Modest numerical increases in incidence rates occurred in patients aged ≥65 years, including MACE (patients with RA), and malignancies (excluding non-melanoma skin cancer (NMSC)) and NMSC (patients with RA or UC). VTE was rare; in patients with RA aged ≥65 years receiving filgotinib 200 mg, exposure-adjusted incidence rate (95% CI) for VTE was 0.3 (0.1, 0.8)/100 PYE; no VTE events occurred in patients with UC aged ≥65 years. In patients with RA aged ≥65 years, MACE incidence rates were identical between filgotinib 100 mg and 200 mg; rates of malignancies and NMSC were numerically higher with 200 mg compared with 100 mg.</p><p><strong>Conclusions: </strong>Data are consistent with previous overall safety analyses demonstrating low rates of AEI in the overall study population. Numerically increased rates of AEI occurred in patients aged ≥65 years; further data are needed to assess the effect of CV risk factors. Overall, in this analysis, there was no consistent filgotinib dose effect on AEI.</p>","PeriodicalId":21396,"journal":{"name":"RMD Open","volume":"11 1","pages":""},"PeriodicalIF":5.1,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11881192/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143557881","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":"Efficacy of upadacitinib in subgroups of patients with axial spondyloarthritis with early versus established disease.","authors":"Victoria Navarro-Compán, Filip Van den Bosch, Percival Degrava Sampaio-Barros, Andrew J K Östör, Bhumik Parikh, Koji Kato, Tianming Gao, Jayne Stigler, Sofia Ramiro","doi":"10.1136/rmdopen-2024-005110","DOIUrl":"10.1136/rmdopen-2024-005110","url":null,"abstract":"<p><strong>Objectives: </strong>Early disease activity control with targeted therapies may improve long-term outcomes in axial spondyloarthritis (axSpA). Here, we evaluated the efficacy of upadacitinib in patients with axSpA with shorter versus longer symptom durations.</p><p><strong>Methods: </strong>SELECT-AXIS 1 and 2 studies enrolled patients with radiographic axSpA (r-axSpA) and non-radiographic axSpA (nr-axSpA) naïve to biologic disease-modifying antirheumatic drugs (bDMARD-naïve) and with an intolerance or inadequate response to bDMARD therapy. Patients were stratified by symptom duration (nr-axSpA: early vs established (≤2 vs >2 years=Assessment of SpondyloArthritis international Society (ASAS) definition) and shorter vs longer (≤5 vs >5 years); r-axSpA: ≤5 vs >5 years). Efficacy endpoints assessed through week 14 included the proportion of patients achieving Axial Spondyloarthritis Disease Activity Score and ASAS40 responses, among others. Across all endpoints, the efficacy of upadacitinib versus placebo was assessed by relative risk (RR), and the placebo-adjusted effect of upadacitinib between shorter versus longer symptom duration was assessed by the RR ratio.</p><p><strong>Results: </strong>At week 14, better responses were observed in patients treated with upadacitinib in all endpoints assessed compared with placebo, regardless of symptom duration. When comparing patients with early/shorter versus established/longer symptom durations, for all measures assessed, no statistically significant differences were observed except for the change from baseline in high-sensitivity C-reactive protein in the nr-axSpA group, with a better response in early disease (difference -8.2, 95% CI -14.9 to -1.6).</p><p><strong>Conclusion: </strong>Regarding short-term outcomes, both subgroups of patients (shorter axSpA symptom duration (≤2 years) and longer symptom duration (>2 years)) achieved comparable results when treated with upadacitinib.</p><p><strong>Trial registration number: </strong>NCT03178487 (SELECT-AXIS 1) and NCT04169373 (SELECT-AXIS 2).</p>","PeriodicalId":21396,"journal":{"name":"RMD Open","volume":"11 1","pages":""},"PeriodicalIF":5.1,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12083263/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143557880","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}