Clinical Edge Journal Scan

Key clinical point: Patients with rheumatoid arthritis (RA) have a higher risk for peritonsillar abscess (PTA) and longer hospital stay than those without RA.

Major finding: The RA cohort had a significantly higher PTA incidence (incidence rate ratio, 1.73, P = .017) and cumulative incidence (P = .016) than the non-RA cohort. PTA was also associated with a significantly longer length of hospital stay in the RA cohort vs. the non-RA cohort (6.5 ± 4.5 days vs. 4.6 ± 2.8 days; P = .045).

Study details: The data come from a real-world evidence study of 30,328 patients with RA (RA cohort) matched to 121,312 individuals without RA (non-RA cohort).

Disclosures: The study was financially supported by grants from the Chang Gung Memorial Hospital, Taiwan. The authors declared no conflicts of interest.

Source: Ding M-C et al. Eur Arch Otorhinolaryngol. 2021 Feb 3. doi: 10.1007/s00405-021-06638-3.

Key clinical point: Patients with rheumatoid arthritis (RA) have a higher risk for peritonsillar abscess (PTA) and longer hospital stay than those without RA.

Major finding: The RA cohort had a significantly higher PTA incidence (incidence rate ratio, 1.73, P = .017) and cumulative incidence (P = .016) than the non-RA cohort. PTA was also associated with a significantly longer length of hospital stay in the RA cohort vs. the non-RA cohort (6.5 ± 4.5 days vs. 4.6 ± 2.8 days; P = .045).

Study details: The data come from a real-world evidence study of 30,328 patients with RA (RA cohort) matched to 121,312 individuals without RA (non-RA cohort).

Disclosures: The study was financially supported by grants from the Chang Gung Memorial Hospital, Taiwan. The authors declared no conflicts of interest.

Source: Ding M-C et al. Eur Arch Otorhinolaryngol. 2021 Feb 3. doi: 10.1007/s00405-021-06638-3.

Key clinical point: Patients with rheumatoid arthritis (RA) have a higher risk for peritonsillar abscess (PTA) and longer hospital stay than those without RA.

Major finding: The RA cohort had a significantly higher PTA incidence (incidence rate ratio, 1.73, P = .017) and cumulative incidence (P = .016) than the non-RA cohort. PTA was also associated with a significantly longer length of hospital stay in the RA cohort vs. the non-RA cohort (6.5 ± 4.5 days vs. 4.6 ± 2.8 days; P = .045).

Study details: The data come from a real-world evidence study of 30,328 patients with RA (RA cohort) matched to 121,312 individuals without RA (non-RA cohort).

Disclosures: The study was financially supported by grants from the Chang Gung Memorial Hospital, Taiwan. The authors declared no conflicts of interest.

Source: Ding M-C et al. Eur Arch Otorhinolaryngol. 2021 Feb 3. doi: 10.1007/s00405-021-06638-3.

Key clinical point: Magnetic resonance imaging (MRI)-detected tenosynovitis is highly predictive of rheumatoid arthritis (RA), irrespective of anti-citrullinated protein antibodies (ACPA) status.

Major finding: The sensitivity of imaging-detected tenosynovitis was high for both, ACPA-positive RA (88%) and ACPA-negative RA (82%). The sensitivity of MRI-detected tenosynovitis for RA was significantly higher than that for psoriatic arthritis (65%; P = .001), peripheral spondylarthritis (53%; P less than .001), reactive arthritis (36%; P less than .001), and self-limiting undifferentiated arthritis (42%; P less than .001).

Study details: The data come from a large cross-sectional MRI study of 1,211 consecutive patients with early arthritis who underwent contrast-enhanced 1.5T MRI of hand and foot at diagnosis.

Disclosures: The study received funding from the Dutch Arthritis Foundation and the European Research Council under the European Union’s Horizon 2020 research and innovation programme. The authors declared no conflicts of interest.

Source: Matthijssen XME et al. Ann Rheum Dis. 2021 Feb 5. doi: 10.1136/annrheumdis-2020-219302.

Key clinical point: Magnetic resonance imaging (MRI)-detected tenosynovitis is highly predictive of rheumatoid arthritis (RA), irrespective of anti-citrullinated protein antibodies (ACPA) status.

Major finding: The sensitivity of imaging-detected tenosynovitis was high for both, ACPA-positive RA (88%) and ACPA-negative RA (82%). The sensitivity of MRI-detected tenosynovitis for RA was significantly higher than that for psoriatic arthritis (65%; P = .001), peripheral spondylarthritis (53%; P less than .001), reactive arthritis (36%; P less than .001), and self-limiting undifferentiated arthritis (42%; P less than .001).

Study details: The data come from a large cross-sectional MRI study of 1,211 consecutive patients with early arthritis who underwent contrast-enhanced 1.5T MRI of hand and foot at diagnosis.

Disclosures: The study received funding from the Dutch Arthritis Foundation and the European Research Council under the European Union’s Horizon 2020 research and innovation programme. The authors declared no conflicts of interest.

Source: Matthijssen XME et al. Ann Rheum Dis. 2021 Feb 5. doi: 10.1136/annrheumdis-2020-219302.

Key clinical point: Magnetic resonance imaging (MRI)-detected tenosynovitis is highly predictive of rheumatoid arthritis (RA), irrespective of anti-citrullinated protein antibodies (ACPA) status.

Major finding: The sensitivity of imaging-detected tenosynovitis was high for both, ACPA-positive RA (88%) and ACPA-negative RA (82%). The sensitivity of MRI-detected tenosynovitis for RA was significantly higher than that for psoriatic arthritis (65%; P = .001), peripheral spondylarthritis (53%; P less than .001), reactive arthritis (36%; P less than .001), and self-limiting undifferentiated arthritis (42%; P less than .001).

Study details: The data come from a large cross-sectional MRI study of 1,211 consecutive patients with early arthritis who underwent contrast-enhanced 1.5T MRI of hand and foot at diagnosis.

Disclosures: The study received funding from the Dutch Arthritis Foundation and the European Research Council under the European Union’s Horizon 2020 research and innovation programme. The authors declared no conflicts of interest.

Source: Matthijssen XME et al. Ann Rheum Dis. 2021 Feb 5. doi: 10.1136/annrheumdis-2020-219302.

Key clinical point: Nonsurgical periodontal treatment (NSPT) was associated with a significant reduction in disease activity score (DAS28), tender joint counts (TJC), swollen joint counts (SJC), visual analogical scale (VAS), and C-reactive protein (CRP) in patients with rheumatoid arthritis (RA) and periodontitis.

Major finding: NSPT significantly reduced DAS28 (P less than .001), TJC (P less than .001), SJC (P = .008), VAS (P = .02), and CRP (P = .01) in patients with RA and periodontitis.

Study details: Data come from a meta-analysis of 9 studies that compared RA-related indicator changes between NSPT and no treatment groups.

Disclosures: The work was supported by the Natural Science Foundation of Tianjin, China, and the Science and Technology Foundation of Tianjin Health Commission, China. The authors declared no conflicts of interest.

Source: Sun J et al. Clin Oral Investig. 2021 Jan 29. doi: 10.1007/s00784-021-03807-w.

Key clinical point: Nonsurgical periodontal treatment (NSPT) was associated with a significant reduction in disease activity score (DAS28), tender joint counts (TJC), swollen joint counts (SJC), visual analogical scale (VAS), and C-reactive protein (CRP) in patients with rheumatoid arthritis (RA) and periodontitis.

Major finding: NSPT significantly reduced DAS28 (P less than .001), TJC (P less than .001), SJC (P = .008), VAS (P = .02), and CRP (P = .01) in patients with RA and periodontitis.

Study details: Data come from a meta-analysis of 9 studies that compared RA-related indicator changes between NSPT and no treatment groups.

Disclosures: The work was supported by the Natural Science Foundation of Tianjin, China, and the Science and Technology Foundation of Tianjin Health Commission, China. The authors declared no conflicts of interest.

Source: Sun J et al. Clin Oral Investig. 2021 Jan 29. doi: 10.1007/s00784-021-03807-w.

Key clinical point: Nonsurgical periodontal treatment (NSPT) was associated with a significant reduction in disease activity score (DAS28), tender joint counts (TJC), swollen joint counts (SJC), visual analogical scale (VAS), and C-reactive protein (CRP) in patients with rheumatoid arthritis (RA) and periodontitis.

Major finding: NSPT significantly reduced DAS28 (P less than .001), TJC (P less than .001), SJC (P = .008), VAS (P = .02), and CRP (P = .01) in patients with RA and periodontitis.

Study details: Data come from a meta-analysis of 9 studies that compared RA-related indicator changes between NSPT and no treatment groups.

Disclosures: The work was supported by the Natural Science Foundation of Tianjin, China, and the Science and Technology Foundation of Tianjin Health Commission, China. The authors declared no conflicts of interest.

Source: Sun J et al. Clin Oral Investig. 2021 Jan 29. doi: 10.1007/s00784-021-03807-w.

Key clinical point: Tocilizumab is more effective than rituximab for reducing disease activity in patients with rheumatoid arthritis (RA) who had an inadequate response to tumor necrosis factor (TNF) inhibitors stratified for synovial B-cell status.

Major finding: At 16 weeks, the rituximab group vs. the tocilizumab group showed no significant difference in the rate of Clinical Disease Activity Index (CDAI50%; 45% vs. 56%; P = .31). However, the tocilizumab group had a significantly higher response rate compared with the rituximab group for both CDAI50% (63% vs. 36%; P = .035) and CDAI­major treatment response (50% vs. 12%, P = .0012).

Study details: The data come from a 48-week, biopsy-driven, multicenter, open-label, phase 4 trial involving 164 patients randomly assigned to receive either 2 1 gm rituximab infusions at an interval of 2 weeks (n=83) or 8 mg/kg tocilizumab infusions at 4-week intervals (n=81).

Disclosures: The study received funding from the UK National Institute for Health Research. MH Buch, A Nerviani, VC Romão, P Verschueren, B Dasgupta, A Cauli, PC Taylor, CJ Edwards, J Isaacs, E Choy, C Pitzalism, P Sasieni, MJ Lewis, and F Humby reported relationships with various pharmaceutical companies and/or research organizations. C Pitzalis reported a patent relevant to the work. The remaining authors declared no conflicts of interest.

Source: Humby F et al. Lancet. 2021 Jan 23. doi: 10.1016/S0140-6736(20)32341-2.

Key clinical point: Tocilizumab is more effective than rituximab for reducing disease activity in patients with rheumatoid arthritis (RA) who had an inadequate response to tumor necrosis factor (TNF) inhibitors stratified for synovial B-cell status.

Major finding: At 16 weeks, the rituximab group vs. the tocilizumab group showed no significant difference in the rate of Clinical Disease Activity Index (CDAI50%; 45% vs. 56%; P = .31). However, the tocilizumab group had a significantly higher response rate compared with the rituximab group for both CDAI50% (63% vs. 36%; P = .035) and CDAI­major treatment response (50% vs. 12%, P = .0012).

Study details: The data come from a 48-week, biopsy-driven, multicenter, open-label, phase 4 trial involving 164 patients randomly assigned to receive either 2 1 gm rituximab infusions at an interval of 2 weeks (n=83) or 8 mg/kg tocilizumab infusions at 4-week intervals (n=81).

Disclosures: The study received funding from the UK National Institute for Health Research. MH Buch, A Nerviani, VC Romão, P Verschueren, B Dasgupta, A Cauli, PC Taylor, CJ Edwards, J Isaacs, E Choy, C Pitzalism, P Sasieni, MJ Lewis, and F Humby reported relationships with various pharmaceutical companies and/or research organizations. C Pitzalis reported a patent relevant to the work. The remaining authors declared no conflicts of interest.

Source: Humby F et al. Lancet. 2021 Jan 23. doi: 10.1016/S0140-6736(20)32341-2.

Key clinical point: Tocilizumab is more effective than rituximab for reducing disease activity in patients with rheumatoid arthritis (RA) who had an inadequate response to tumor necrosis factor (TNF) inhibitors stratified for synovial B-cell status.

Major finding: At 16 weeks, the rituximab group vs. the tocilizumab group showed no significant difference in the rate of Clinical Disease Activity Index (CDAI50%; 45% vs. 56%; P = .31). However, the tocilizumab group had a significantly higher response rate compared with the rituximab group for both CDAI50% (63% vs. 36%; P = .035) and CDAI­major treatment response (50% vs. 12%, P = .0012).

Study details: The data come from a 48-week, biopsy-driven, multicenter, open-label, phase 4 trial involving 164 patients randomly assigned to receive either 2 1 gm rituximab infusions at an interval of 2 weeks (n=83) or 8 mg/kg tocilizumab infusions at 4-week intervals (n=81).

Disclosures: The study received funding from the UK National Institute for Health Research. MH Buch, A Nerviani, VC Romão, P Verschueren, B Dasgupta, A Cauli, PC Taylor, CJ Edwards, J Isaacs, E Choy, C Pitzalism, P Sasieni, MJ Lewis, and F Humby reported relationships with various pharmaceutical companies and/or research organizations. C Pitzalis reported a patent relevant to the work. The remaining authors declared no conflicts of interest.

Source: Humby F et al. Lancet. 2021 Jan 23. doi: 10.1016/S0140-6736(20)32341-2.

Key clinical point: This study found an increased risk of first fracture before age 50 years in people with rheumatoid arthritis (RA) diagnosed before this age.

Major finding: Overall, the rate of first fractures occurring before age 50 was significantly higher in patients diagnosed with RA before age 50 (incidence rate ratio [IRR], 1.24; 95% confidence interval [CI], 1.10-1.40). The IRR of first fracture before age 50 was significantly higher in women (1.29; 95% CI, 1.12-1.49) and not in men diagnosed with RA before age 50 (1.15; 95% CI, 0.92-1.43). IRR of subsequent fractures below age 50 was also higher in both men and women but not significantly so.

Study details: A retrospective observational study of RA cases (n = 36,858) and matched controls (n=110,574) from the U.K. Clinical Practice Research Datalink.

Disclosures: The study was funded by a grant through the Pfizer competitive I-CRP funding program. The authors declared no conflicts of interest.

Source: Erwin J et al. Osteoporos Int. 2021 Feb 11. doi: 10.1007/s00198-021-05862-1.

Key clinical point: This study found an increased risk of first fracture before age 50 years in people with rheumatoid arthritis (RA) diagnosed before this age.

Major finding: Overall, the rate of first fractures occurring before age 50 was significantly higher in patients diagnosed with RA before age 50 (incidence rate ratio [IRR], 1.24; 95% confidence interval [CI], 1.10-1.40). The IRR of first fracture before age 50 was significantly higher in women (1.29; 95% CI, 1.12-1.49) and not in men diagnosed with RA before age 50 (1.15; 95% CI, 0.92-1.43). IRR of subsequent fractures below age 50 was also higher in both men and women but not significantly so.

Study details: A retrospective observational study of RA cases (n = 36,858) and matched controls (n=110,574) from the U.K. Clinical Practice Research Datalink.

Disclosures: The study was funded by a grant through the Pfizer competitive I-CRP funding program. The authors declared no conflicts of interest.

Source: Erwin J et al. Osteoporos Int. 2021 Feb 11. doi: 10.1007/s00198-021-05862-1.

Key clinical point: This study found an increased risk of first fracture before age 50 years in people with rheumatoid arthritis (RA) diagnosed before this age.

Major finding: Overall, the rate of first fractures occurring before age 50 was significantly higher in patients diagnosed with RA before age 50 (incidence rate ratio [IRR], 1.24; 95% confidence interval [CI], 1.10-1.40). The IRR of first fracture before age 50 was significantly higher in women (1.29; 95% CI, 1.12-1.49) and not in men diagnosed with RA before age 50 (1.15; 95% CI, 0.92-1.43). IRR of subsequent fractures below age 50 was also higher in both men and women but not significantly so.

Study details: A retrospective observational study of RA cases (n = 36,858) and matched controls (n=110,574) from the U.K. Clinical Practice Research Datalink.

Disclosures: The study was funded by a grant through the Pfizer competitive I-CRP funding program. The authors declared no conflicts of interest.

Source: Erwin J et al. Osteoporos Int. 2021 Feb 11. doi: 10.1007/s00198-021-05862-1.

Key clinical point: Early age at first pregnancy (less than 22 years) and early menopause (45 years and earlier) were associated with a higher risk of rheumatoid arthritis (RA), whereas long-term progestogen use (more than 24 months) before menopause was associated with a reduced risk.

Major finding: The risk of RA was a significantly increased with early age at first pregnancy (less than 22 vs. 27 or more years; hazard ratio [HR], 1.34; P_trend = .028) and menopause (45 or less vs. 53 or more years; HR, 1.40; P_trend = .039). Risk of RA was inversely related to exposure to progestogen only in perimenopause (more than 24 vs. 0 months; multi-adjusted HR, 0.77; P_trend = .004).

Study details: This study included 78,452 women, with 698 incident cases of RA using data from the French E3N-EPIC cohort study.

Disclosures: The study was funded by a research grant from FOREUM Foundation for Research in Rheumatology. The authors declared no conflicts of interest.

Source: Salliot C et al. Rheumatology (Oxford). 2021 Feb 6. doi: 10.1093/rheumatology/keab101.

Key clinical point: Early age at first pregnancy (less than 22 years) and early menopause (45 years and earlier) were associated with a higher risk of rheumatoid arthritis (RA), whereas long-term progestogen use (more than 24 months) before menopause was associated with a reduced risk.

Major finding: The risk of RA was a significantly increased with early age at first pregnancy (less than 22 vs. 27 or more years; hazard ratio [HR], 1.34; P_trend = .028) and menopause (45 or less vs. 53 or more years; HR, 1.40; P_trend = .039). Risk of RA was inversely related to exposure to progestogen only in perimenopause (more than 24 vs. 0 months; multi-adjusted HR, 0.77; P_trend = .004).

Study details: This study included 78,452 women, with 698 incident cases of RA using data from the French E3N-EPIC cohort study.

Disclosures: The study was funded by a research grant from FOREUM Foundation for Research in Rheumatology. The authors declared no conflicts of interest.

Source: Salliot C et al. Rheumatology (Oxford). 2021 Feb 6. doi: 10.1093/rheumatology/keab101.

Key clinical point: Early age at first pregnancy (less than 22 years) and early menopause (45 years and earlier) were associated with a higher risk of rheumatoid arthritis (RA), whereas long-term progestogen use (more than 24 months) before menopause was associated with a reduced risk.

Major finding: The risk of RA was a significantly increased with early age at first pregnancy (less than 22 vs. 27 or more years; hazard ratio [HR], 1.34; P_trend = .028) and menopause (45 or less vs. 53 or more years; HR, 1.40; P_trend = .039). Risk of RA was inversely related to exposure to progestogen only in perimenopause (more than 24 vs. 0 months; multi-adjusted HR, 0.77; P_trend = .004).

Study details: This study included 78,452 women, with 698 incident cases of RA using data from the French E3N-EPIC cohort study.

Disclosures: The study was funded by a research grant from FOREUM Foundation for Research in Rheumatology. The authors declared no conflicts of interest.

Source: Salliot C et al. Rheumatology (Oxford). 2021 Feb 6. doi: 10.1093/rheumatology/keab101.

Key clinical point: A modern treat-to-target (T2T) approach with the use of tumor necrosis factor inhibitors (TNFi) resulted in low disease activity (LDA) and remission in 90% of pregnant patients with rheumatoid arthritis (RA).

Major finding: Among patients treated with T2T, 90.4% and 76.1% of patients were in LDA or remission, respectively, in the third trimester. Mean disease activity over time was lower in patients treated with the T2T approach vs. reference cohort (P less than .001).

Study details: Findings are from an analysis of 309 patients with RA from the PreCARA cohort who wished to conceive or were pregnant. Patients were treated with a T2T approach with the use of TNFi and/or a combination of disease-modifying antirheumatic drugs along with obvious pregnancy restrictions. The reference cohort consisted of pregnant patients with RA treated according to the 2002-2010 standards from the PARA study.

Disclosures: This investigator-initiated study was supported by UCB and Dutch Arthritis Foundation (ReumaNederland). The investigators did not report any competing interests.

Source: Smeele HTW et al. Ann Rheum Dis. 2021 Feb 10. doi: 10.1136/annrheumdis-2020-219547.

Key clinical point: A modern treat-to-target (T2T) approach with the use of tumor necrosis factor inhibitors (TNFi) resulted in low disease activity (LDA) and remission in 90% of pregnant patients with rheumatoid arthritis (RA).

Major finding: Among patients treated with T2T, 90.4% and 76.1% of patients were in LDA or remission, respectively, in the third trimester. Mean disease activity over time was lower in patients treated with the T2T approach vs. reference cohort (P less than .001).

Study details: Findings are from an analysis of 309 patients with RA from the PreCARA cohort who wished to conceive or were pregnant. Patients were treated with a T2T approach with the use of TNFi and/or a combination of disease-modifying antirheumatic drugs along with obvious pregnancy restrictions. The reference cohort consisted of pregnant patients with RA treated according to the 2002-2010 standards from the PARA study.

Disclosures: This investigator-initiated study was supported by UCB and Dutch Arthritis Foundation (ReumaNederland). The investigators did not report any competing interests.

Source: Smeele HTW et al. Ann Rheum Dis. 2021 Feb 10. doi: 10.1136/annrheumdis-2020-219547.

Key clinical point: A modern treat-to-target (T2T) approach with the use of tumor necrosis factor inhibitors (TNFi) resulted in low disease activity (LDA) and remission in 90% of pregnant patients with rheumatoid arthritis (RA).

Major finding: Among patients treated with T2T, 90.4% and 76.1% of patients were in LDA or remission, respectively, in the third trimester. Mean disease activity over time was lower in patients treated with the T2T approach vs. reference cohort (P less than .001).

Study details: Findings are from an analysis of 309 patients with RA from the PreCARA cohort who wished to conceive or were pregnant. Patients were treated with a T2T approach with the use of TNFi and/or a combination of disease-modifying antirheumatic drugs along with obvious pregnancy restrictions. The reference cohort consisted of pregnant patients with RA treated according to the 2002-2010 standards from the PARA study.

Disclosures: This investigator-initiated study was supported by UCB and Dutch Arthritis Foundation (ReumaNederland). The investigators did not report any competing interests.

Source: Smeele HTW et al. Ann Rheum Dis. 2021 Feb 10. doi: 10.1136/annrheumdis-2020-219547.

Key clinical point: Citrate-free adalimumab biosimilar (CT-P17) and European Union-approved adalimumab (EU-adalimumab) demonstrated equivalent efficacy and comparable safety in patients with rheumatoid arthritis (RA).

Major finding: At week 24, CT-P17 and EU-adalimumab groups showed similar 20% improvement by the American College of Rheumatology criteria response rate (82.7%). The 95% confidence interval (CI; −5.94 to 5.94) and 90% CI (−4.98 to 4.98) for estimated treatment difference were within predefined equivalence margin, demonstrating therapeutic equivalence. Overall, safety was similar between both treatment groups.

Study details: This was a randomized, double-blind phase 3 study of 648 patients with RA who were randomly allocated to receive 40 mg of either CT-P17 (n=324) or EU-adalimumab (n=324), every 2 weeks until week 48.

Disclosures: This study was funded by Celltrion, Inc. (Incheon, Republic of Korea). The authors reported receiving support, investigator fees, speaking fees, and/or consulting for various pharmaceutical companies including Celltrion, Inc. SJ Lee, YJ Bae, GE Yang, and JK Yoo reported being employees of Celltrion, Inc.

Source: Kay J et al. Arthritis Res Ther. 2021 Feb 5. doi: 10.1186/s13075-020-02394-7.

Key clinical point: Citrate-free adalimumab biosimilar (CT-P17) and European Union-approved adalimumab (EU-adalimumab) demonstrated equivalent efficacy and comparable safety in patients with rheumatoid arthritis (RA).

Major finding: At week 24, CT-P17 and EU-adalimumab groups showed similar 20% improvement by the American College of Rheumatology criteria response rate (82.7%). The 95% confidence interval (CI; −5.94 to 5.94) and 90% CI (−4.98 to 4.98) for estimated treatment difference were within predefined equivalence margin, demonstrating therapeutic equivalence. Overall, safety was similar between both treatment groups.

Study details: This was a randomized, double-blind phase 3 study of 648 patients with RA who were randomly allocated to receive 40 mg of either CT-P17 (n=324) or EU-adalimumab (n=324), every 2 weeks until week 48.

Disclosures: This study was funded by Celltrion, Inc. (Incheon, Republic of Korea). The authors reported receiving support, investigator fees, speaking fees, and/or consulting for various pharmaceutical companies including Celltrion, Inc. SJ Lee, YJ Bae, GE Yang, and JK Yoo reported being employees of Celltrion, Inc.

Source: Kay J et al. Arthritis Res Ther. 2021 Feb 5. doi: 10.1186/s13075-020-02394-7.

Key clinical point: Citrate-free adalimumab biosimilar (CT-P17) and European Union-approved adalimumab (EU-adalimumab) demonstrated equivalent efficacy and comparable safety in patients with rheumatoid arthritis (RA).

Major finding: At week 24, CT-P17 and EU-adalimumab groups showed similar 20% improvement by the American College of Rheumatology criteria response rate (82.7%). The 95% confidence interval (CI; −5.94 to 5.94) and 90% CI (−4.98 to 4.98) for estimated treatment difference were within predefined equivalence margin, demonstrating therapeutic equivalence. Overall, safety was similar between both treatment groups.

Study details: This was a randomized, double-blind phase 3 study of 648 patients with RA who were randomly allocated to receive 40 mg of either CT-P17 (n=324) or EU-adalimumab (n=324), every 2 weeks until week 48.

Disclosures: This study was funded by Celltrion, Inc. (Incheon, Republic of Korea). The authors reported receiving support, investigator fees, speaking fees, and/or consulting for various pharmaceutical companies including Celltrion, Inc. SJ Lee, YJ Bae, GE Yang, and JK Yoo reported being employees of Celltrion, Inc.

Source: Kay J et al. Arthritis Res Ther. 2021 Feb 5. doi: 10.1186/s13075-020-02394-7.

Key clinical point: Positivity for antipeptidyl-arginine deiminase type-3 (anti-PAD3) antibodies was associated with higher disease activity and joint damage scores in patients with rheumatoid arthritis (RA).

Major finding: Patients positive vs. negative for anti-PAD3 had significantly higher 28-swollen joint count (7.1 vs. 4.3; P less than .0001), 28-joint disease activity score-erythrocyte sedimentation rate (4.2 vs. 3.7; P = .005), and radiographic damage (14.9 vs. 8.8; P = .02).

Study details: Findings are from the assessment of biomarkers in 851 patients with RA and 516 disease controls (axial spondyloarthritis, n=320; psoriatic arthritis, n=196) from the Swiss Clinical Quality Management registry.

Disclosures: This work was supported by the De Reuter Foundation. M Mahler, C Bentow, and L Martinez-Prat declared being current or former employees at Inova Diagnostics. All the other authors declared no conflicts of interest.

Source: Lamacchia C et al. Rheumatology (Oxford). 2021 Jan 27. doi: 10.1093/rheumatology/keab050.

Key clinical point: Positivity for antipeptidyl-arginine deiminase type-3 (anti-PAD3) antibodies was associated with higher disease activity and joint damage scores in patients with rheumatoid arthritis (RA).

Major finding: Patients positive vs. negative for anti-PAD3 had significantly higher 28-swollen joint count (7.1 vs. 4.3; P less than .0001), 28-joint disease activity score-erythrocyte sedimentation rate (4.2 vs. 3.7; P = .005), and radiographic damage (14.9 vs. 8.8; P = .02).

Study details: Findings are from the assessment of biomarkers in 851 patients with RA and 516 disease controls (axial spondyloarthritis, n=320; psoriatic arthritis, n=196) from the Swiss Clinical Quality Management registry.

Disclosures: This work was supported by the De Reuter Foundation. M Mahler, C Bentow, and L Martinez-Prat declared being current or former employees at Inova Diagnostics. All the other authors declared no conflicts of interest.

Source: Lamacchia C et al. Rheumatology (Oxford). 2021 Jan 27. doi: 10.1093/rheumatology/keab050.

Key clinical point: Positivity for antipeptidyl-arginine deiminase type-3 (anti-PAD3) antibodies was associated with higher disease activity and joint damage scores in patients with rheumatoid arthritis (RA).

Major finding: Patients positive vs. negative for anti-PAD3 had significantly higher 28-swollen joint count (7.1 vs. 4.3; P less than .0001), 28-joint disease activity score-erythrocyte sedimentation rate (4.2 vs. 3.7; P = .005), and radiographic damage (14.9 vs. 8.8; P = .02).

Study details: Findings are from the assessment of biomarkers in 851 patients with RA and 516 disease controls (axial spondyloarthritis, n=320; psoriatic arthritis, n=196) from the Swiss Clinical Quality Management registry.

Disclosures: This work was supported by the De Reuter Foundation. M Mahler, C Bentow, and L Martinez-Prat declared being current or former employees at Inova Diagnostics. All the other authors declared no conflicts of interest.

Source: Lamacchia C et al. Rheumatology (Oxford). 2021 Jan 27. doi: 10.1093/rheumatology/keab050.

Key clinical point: Treatment with filgotinib and methotrexate (MTX) reduced signs and symptoms of rheumatoid arthritis (RA) in patients with moderate-to-severe active RA and inadequate response to MTX.

Major finding: Proportion of patients achieving 20% improvement in American College of Rheumatology criteria at week 12 was significantly higher with filgotinib 200 mg (76.6%) and 100 mg (69.8%) vs. placebo (49.9%; P for all less than .001). Overall, both filgotinib doses were well tolerated.

Study details: Findings are from FINCH I phase 3 study including 1,755 patients with moderate-to-severe active RA and inadequate response to MTX. Patients were randomly assigned to once-daily oral filgotinib 200 mg or filgotinib 100 mg, subcutaneous adalimumab 40 mg biweekly, or placebo, all with stable background MTX.

Disclosures: The study was funded by Gilead Sciences. Study investigators including the lead author reported ties with various pharmaceutical companies, including Gilead Sciences. MC Genovese, F Matzkies, B Bartok, L Ye, and Y Guo declared being employees and shareholders of Gilead Sciences. JS Sundy, A Jahreis, and N Mozaffarian declared being former employees of Gilead Sciences and may hold shares. C Tasset declared being an employee and shareholder of Galapagos NV. JA Simon, U Kumar U, and S-C Bae report no disclosures.

Source: Combe B et al. Ann Rheum Dis. 2021 Jan 27. doi: 10.1136/annrheumdis-2020-219214.

Key clinical point: Treatment with filgotinib and methotrexate (MTX) reduced signs and symptoms of rheumatoid arthritis (RA) in patients with moderate-to-severe active RA and inadequate response to MTX.

Major finding: Proportion of patients achieving 20% improvement in American College of Rheumatology criteria at week 12 was significantly higher with filgotinib 200 mg (76.6%) and 100 mg (69.8%) vs. placebo (49.9%; P for all less than .001). Overall, both filgotinib doses were well tolerated.

Study details: Findings are from FINCH I phase 3 study including 1,755 patients with moderate-to-severe active RA and inadequate response to MTX. Patients were randomly assigned to once-daily oral filgotinib 200 mg or filgotinib 100 mg, subcutaneous adalimumab 40 mg biweekly, or placebo, all with stable background MTX.

Disclosures: The study was funded by Gilead Sciences. Study investigators including the lead author reported ties with various pharmaceutical companies, including Gilead Sciences. MC Genovese, F Matzkies, B Bartok, L Ye, and Y Guo declared being employees and shareholders of Gilead Sciences. JS Sundy, A Jahreis, and N Mozaffarian declared being former employees of Gilead Sciences and may hold shares. C Tasset declared being an employee and shareholder of Galapagos NV. JA Simon, U Kumar U, and S-C Bae report no disclosures.

Source: Combe B et al. Ann Rheum Dis. 2021 Jan 27. doi: 10.1136/annrheumdis-2020-219214.

Key clinical point: Treatment with filgotinib and methotrexate (MTX) reduced signs and symptoms of rheumatoid arthritis (RA) in patients with moderate-to-severe active RA and inadequate response to MTX.

Major finding: Proportion of patients achieving 20% improvement in American College of Rheumatology criteria at week 12 was significantly higher with filgotinib 200 mg (76.6%) and 100 mg (69.8%) vs. placebo (49.9%; P for all less than .001). Overall, both filgotinib doses were well tolerated.

Study details: Findings are from FINCH I phase 3 study including 1,755 patients with moderate-to-severe active RA and inadequate response to MTX. Patients were randomly assigned to once-daily oral filgotinib 200 mg or filgotinib 100 mg, subcutaneous adalimumab 40 mg biweekly, or placebo, all with stable background MTX.

Disclosures: The study was funded by Gilead Sciences. Study investigators including the lead author reported ties with various pharmaceutical companies, including Gilead Sciences. MC Genovese, F Matzkies, B Bartok, L Ye, and Y Guo declared being employees and shareholders of Gilead Sciences. JS Sundy, A Jahreis, and N Mozaffarian declared being former employees of Gilead Sciences and may hold shares. C Tasset declared being an employee and shareholder of Galapagos NV. JA Simon, U Kumar U, and S-C Bae report no disclosures.

Source: Combe B et al. Ann Rheum Dis. 2021 Jan 27. doi: 10.1136/annrheumdis-2020-219214.