Incidence of dementia appears to be declining over time in patients with RA

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Key clinical point: The risk for dementia in patients with rheumatoid arthritis (RA) appears to be decreasing over time even when compared with non-RA referents.

Major finding: The 10-year cumulative incidence of ADRD for incident RA in the 1980s, 1990s and 2000s was 12.7%, 7.2% and 6.2%, respectively. Overall risk for ADRD was higher among patients with RA vs non-RA referents (HR, 1.37; 95% CI, 1.04-1.81), but this gap narrowed over time, with ADRD risk being higher in patients diagnosed with RA vs referents in the 1990s (HR, 1.72; 95% CI, 1.09-2.70) but not in the 2000s (HR, 0.86; 95% CI, 0.51-1.45).

Study details: The data come from a retrospective, population-based cohort study involving 897 patients with RA diagnosed between 1980 and 2009 and matched with 885 non-RA referents.

Disclosures: This study was supported by grants from the National Institutes of Health, National Institute of Arthritis and Musculoskeletal and Skin Disease and National Institute of Aging. No conflicts of interest were reported.

Source: Kronzer VL et al. Semin Arthritis Rheum. 2021 Jun 15. doi: 10.1016/j.semarthrit.2021.06.003.

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Key clinical point: The risk for dementia in patients with rheumatoid arthritis (RA) appears to be decreasing over time even when compared with non-RA referents.

Major finding: The 10-year cumulative incidence of ADRD for incident RA in the 1980s, 1990s and 2000s was 12.7%, 7.2% and 6.2%, respectively. Overall risk for ADRD was higher among patients with RA vs non-RA referents (HR, 1.37; 95% CI, 1.04-1.81), but this gap narrowed over time, with ADRD risk being higher in patients diagnosed with RA vs referents in the 1990s (HR, 1.72; 95% CI, 1.09-2.70) but not in the 2000s (HR, 0.86; 95% CI, 0.51-1.45).

Study details: The data come from a retrospective, population-based cohort study involving 897 patients with RA diagnosed between 1980 and 2009 and matched with 885 non-RA referents.

Disclosures: This study was supported by grants from the National Institutes of Health, National Institute of Arthritis and Musculoskeletal and Skin Disease and National Institute of Aging. No conflicts of interest were reported.

Source: Kronzer VL et al. Semin Arthritis Rheum. 2021 Jun 15. doi: 10.1016/j.semarthrit.2021.06.003.

Key clinical point: The risk for dementia in patients with rheumatoid arthritis (RA) appears to be decreasing over time even when compared with non-RA referents.

Major finding: The 10-year cumulative incidence of ADRD for incident RA in the 1980s, 1990s and 2000s was 12.7%, 7.2% and 6.2%, respectively. Overall risk for ADRD was higher among patients with RA vs non-RA referents (HR, 1.37; 95% CI, 1.04-1.81), but this gap narrowed over time, with ADRD risk being higher in patients diagnosed with RA vs referents in the 1990s (HR, 1.72; 95% CI, 1.09-2.70) but not in the 2000s (HR, 0.86; 95% CI, 0.51-1.45).

Study details: The data come from a retrospective, population-based cohort study involving 897 patients with RA diagnosed between 1980 and 2009 and matched with 885 non-RA referents.

Disclosures: This study was supported by grants from the National Institutes of Health, National Institute of Arthritis and Musculoskeletal and Skin Disease and National Institute of Aging. No conflicts of interest were reported.

Source: Kronzer VL et al. Semin Arthritis Rheum. 2021 Jun 15. doi: 10.1016/j.semarthrit.2021.06.003.

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Risk factors for VTE and ASCVD in patients with RA

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Key clinical point: Among patients with rheumatoid arthritis (RA), traditional risk factors for cardiovascular disease (CVD) mostly predicted atherosclerotic CVD (ASCVD), except for obesity, which was a risk factor for unprovoked venous thromboembolism (VTE).

Major finding: Obesity was associated with increased VTE risk (adjusted hazard ratio [aHR], 1.47; 95% confidence interval [CI], 1.14-1.89) and reduced ASCVD risk (aHR, 0.56; 95% CI, 0.48-0.66). Other traditional CVD risk factors such as diabetes (aHR, 1.39; 95% CI, 1.20-1.62), hypertension (aHR, 1.21; 95% CI, 1.07-1.39), and chronic kidney disease (aHR, 1.31; 95% CI, 1.10-1.66) predicted higher ASCVD risk.

Study details: The data come from an analysis of 31,366 patients with RA from a US-wide longitudinal observational registry, who did not have any prior CVD at baseline and active cancer throughout follow-up.

Disclosures: No sources of funding were reported. K Michaud reported receiving grant support from the Rheumatology Research Foundation. No competing interests were declared.

Source: Ozen G et al. RMD Open. 2021 Jun 30. doi: 10.1136/rmdopen-2021-001618.

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Key clinical point: Among patients with rheumatoid arthritis (RA), traditional risk factors for cardiovascular disease (CVD) mostly predicted atherosclerotic CVD (ASCVD), except for obesity, which was a risk factor for unprovoked venous thromboembolism (VTE).

Major finding: Obesity was associated with increased VTE risk (adjusted hazard ratio [aHR], 1.47; 95% confidence interval [CI], 1.14-1.89) and reduced ASCVD risk (aHR, 0.56; 95% CI, 0.48-0.66). Other traditional CVD risk factors such as diabetes (aHR, 1.39; 95% CI, 1.20-1.62), hypertension (aHR, 1.21; 95% CI, 1.07-1.39), and chronic kidney disease (aHR, 1.31; 95% CI, 1.10-1.66) predicted higher ASCVD risk.

Study details: The data come from an analysis of 31,366 patients with RA from a US-wide longitudinal observational registry, who did not have any prior CVD at baseline and active cancer throughout follow-up.

Disclosures: No sources of funding were reported. K Michaud reported receiving grant support from the Rheumatology Research Foundation. No competing interests were declared.

Source: Ozen G et al. RMD Open. 2021 Jun 30. doi: 10.1136/rmdopen-2021-001618.

Key clinical point: Among patients with rheumatoid arthritis (RA), traditional risk factors for cardiovascular disease (CVD) mostly predicted atherosclerotic CVD (ASCVD), except for obesity, which was a risk factor for unprovoked venous thromboembolism (VTE).

Major finding: Obesity was associated with increased VTE risk (adjusted hazard ratio [aHR], 1.47; 95% confidence interval [CI], 1.14-1.89) and reduced ASCVD risk (aHR, 0.56; 95% CI, 0.48-0.66). Other traditional CVD risk factors such as diabetes (aHR, 1.39; 95% CI, 1.20-1.62), hypertension (aHR, 1.21; 95% CI, 1.07-1.39), and chronic kidney disease (aHR, 1.31; 95% CI, 1.10-1.66) predicted higher ASCVD risk.

Study details: The data come from an analysis of 31,366 patients with RA from a US-wide longitudinal observational registry, who did not have any prior CVD at baseline and active cancer throughout follow-up.

Disclosures: No sources of funding were reported. K Michaud reported receiving grant support from the Rheumatology Research Foundation. No competing interests were declared.

Source: Ozen G et al. RMD Open. 2021 Jun 30. doi: 10.1136/rmdopen-2021-001618.

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RA: IL-6i with or without T-cell inhibitors lowers T2DM risk

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Key clinical point: Patients with rheumatoid arthritis (RA) receiving interleukin-6 inhibition (IL-6i) therapy with or without T-cell inhibitors had a significantly lower risk for type 2 diabetes mellitus (T2DM) vs those receiving tumor necrosis factor inhibitors (TNFi) or not receiving any biological disease-modifying antirheumatic drugs (bDMARDs).

Major finding: Compared with patients not receiving bDMARDs, those who received IL-6i and IL-6i+T-cell inhibitors had a significant 37% (hazard ratio [HR], 0.63; P = .021) and 34% (HR, 0.66; P = .019) lower risk for T2DM, respectively, whereas no significant difference was observed among patients receiving TNFi (HR, 0.99; P = .26) and T-cell inhibitors (HR, 0.96; P = .37).

Study details: This was a retrospective cohort study of 283,756 patients with RA categorized as bDMARD recipients (TNFi, n=34,873; IL-6i, n=1,884; T-cell inhibitors, n=5,935; and IL-6i+T-cell inhibitor abatacept, n=1,213) and non-bDMARD recipients (n=125,337).

Disclosures: This study was supported by Roche/Genentech. The principal author reported receiving grants, consultancy, and/or speaker fees from various sources. JH Best, S Gale, and K Sarsour reported being employees of Genentech.

Source: Paul SK et al. BMJ Open. 2021 Jun 16. doi: 10.1136/bmjopen-2020-042246.

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Key clinical point: Patients with rheumatoid arthritis (RA) receiving interleukin-6 inhibition (IL-6i) therapy with or without T-cell inhibitors had a significantly lower risk for type 2 diabetes mellitus (T2DM) vs those receiving tumor necrosis factor inhibitors (TNFi) or not receiving any biological disease-modifying antirheumatic drugs (bDMARDs).

Major finding: Compared with patients not receiving bDMARDs, those who received IL-6i and IL-6i+T-cell inhibitors had a significant 37% (hazard ratio [HR], 0.63; P = .021) and 34% (HR, 0.66; P = .019) lower risk for T2DM, respectively, whereas no significant difference was observed among patients receiving TNFi (HR, 0.99; P = .26) and T-cell inhibitors (HR, 0.96; P = .37).

Study details: This was a retrospective cohort study of 283,756 patients with RA categorized as bDMARD recipients (TNFi, n=34,873; IL-6i, n=1,884; T-cell inhibitors, n=5,935; and IL-6i+T-cell inhibitor abatacept, n=1,213) and non-bDMARD recipients (n=125,337).

Disclosures: This study was supported by Roche/Genentech. The principal author reported receiving grants, consultancy, and/or speaker fees from various sources. JH Best, S Gale, and K Sarsour reported being employees of Genentech.

Source: Paul SK et al. BMJ Open. 2021 Jun 16. doi: 10.1136/bmjopen-2020-042246.

Key clinical point: Patients with rheumatoid arthritis (RA) receiving interleukin-6 inhibition (IL-6i) therapy with or without T-cell inhibitors had a significantly lower risk for type 2 diabetes mellitus (T2DM) vs those receiving tumor necrosis factor inhibitors (TNFi) or not receiving any biological disease-modifying antirheumatic drugs (bDMARDs).

Major finding: Compared with patients not receiving bDMARDs, those who received IL-6i and IL-6i+T-cell inhibitors had a significant 37% (hazard ratio [HR], 0.63; P = .021) and 34% (HR, 0.66; P = .019) lower risk for T2DM, respectively, whereas no significant difference was observed among patients receiving TNFi (HR, 0.99; P = .26) and T-cell inhibitors (HR, 0.96; P = .37).

Study details: This was a retrospective cohort study of 283,756 patients with RA categorized as bDMARD recipients (TNFi, n=34,873; IL-6i, n=1,884; T-cell inhibitors, n=5,935; and IL-6i+T-cell inhibitor abatacept, n=1,213) and non-bDMARD recipients (n=125,337).

Disclosures: This study was supported by Roche/Genentech. The principal author reported receiving grants, consultancy, and/or speaker fees from various sources. JH Best, S Gale, and K Sarsour reported being employees of Genentech.

Source: Paul SK et al. BMJ Open. 2021 Jun 16. doi: 10.1136/bmjopen-2020-042246.

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Radiological progression persists despite limited radiological damage in RA patients treated to target of remission

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Key clinical point: Despite limited radiological damage, rapid radiological progression (RRP) still occurred in about 1 of 5 patients in a real-world cohort of patients with rheumatoid arthritis (RA) treated to the target of remission. RRP was most strongly predicted by baseline erosive disease.

Major finding: Most radiological damage occurred in the first year of treatment vs subsequent 5 years of follow-up (median Sharp/van der Heijde score, 2.0 vs 3.0). Despite achieving low disease activity, almost 18.8% of the patients developed RRP within 6 months, and the number of patients with erosive disease increased from 16% at baseline to 58% at 6 years. The erosive disease was the strongest predictor of RRP (odds ratio, 8.8; P less than .001).

Study details: Findings are from the observational DREAM remission induction cohort involving 219 patients diagnosed with RA who had at least 1 radiograph of hands and feet at baseline and at least 1 additional pair of radiographs during 6 years of follow-up and were treated to the target of remission.

Disclosures: No external funding and/or potential conflicts of interest were reported.

Source: Versteeg GA et al. Scand J Rheumatol. 2021 Jun 21. doi: 10.1080/03009742.2021.1917161.

 

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Key clinical point: Despite limited radiological damage, rapid radiological progression (RRP) still occurred in about 1 of 5 patients in a real-world cohort of patients with rheumatoid arthritis (RA) treated to the target of remission. RRP was most strongly predicted by baseline erosive disease.

Major finding: Most radiological damage occurred in the first year of treatment vs subsequent 5 years of follow-up (median Sharp/van der Heijde score, 2.0 vs 3.0). Despite achieving low disease activity, almost 18.8% of the patients developed RRP within 6 months, and the number of patients with erosive disease increased from 16% at baseline to 58% at 6 years. The erosive disease was the strongest predictor of RRP (odds ratio, 8.8; P less than .001).

Study details: Findings are from the observational DREAM remission induction cohort involving 219 patients diagnosed with RA who had at least 1 radiograph of hands and feet at baseline and at least 1 additional pair of radiographs during 6 years of follow-up and were treated to the target of remission.

Disclosures: No external funding and/or potential conflicts of interest were reported.

Source: Versteeg GA et al. Scand J Rheumatol. 2021 Jun 21. doi: 10.1080/03009742.2021.1917161.

 

Key clinical point: Despite limited radiological damage, rapid radiological progression (RRP) still occurred in about 1 of 5 patients in a real-world cohort of patients with rheumatoid arthritis (RA) treated to the target of remission. RRP was most strongly predicted by baseline erosive disease.

Major finding: Most radiological damage occurred in the first year of treatment vs subsequent 5 years of follow-up (median Sharp/van der Heijde score, 2.0 vs 3.0). Despite achieving low disease activity, almost 18.8% of the patients developed RRP within 6 months, and the number of patients with erosive disease increased from 16% at baseline to 58% at 6 years. The erosive disease was the strongest predictor of RRP (odds ratio, 8.8; P less than .001).

Study details: Findings are from the observational DREAM remission induction cohort involving 219 patients diagnosed with RA who had at least 1 radiograph of hands and feet at baseline and at least 1 additional pair of radiographs during 6 years of follow-up and were treated to the target of remission.

Disclosures: No external funding and/or potential conflicts of interest were reported.

Source: Versteeg GA et al. Scand J Rheumatol. 2021 Jun 21. doi: 10.1080/03009742.2021.1917161.

 

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Screening for sarcopenia warranted in middle-aged and older adults with RA

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Key clinical point: Sarcopenia and low muscle mass are common comorbidities among middle-aged and elderly patients with rheumatoid arthritis (RA). Corticosteroid therapy was positively and conventional synthetic disease-modifying antirheumatic drugs (csDMARDs) were inversely associated with sarcopenia.

Major finding: Overall, the prevalence of low muscle mass and sarcopenia was 30.2% (95% confidence interval [CI], 24.2%-36.2%). The use of csDMARDs was inversely (odds ratio [OR], 0.70; P = .019) and corticosteroid was positively (OR, 1.46; 95% CI, 0.94-2.29) associated with sarcopenia. No association was observed between biological/targeted DMARDs and sarcopenia (OR, 0.83; P = .420).

Study details: Findings are from a meta-analysis of 16 observational studies involving 2,240 middle-aged and older adults with RA.

Disclosures: No specific funding was received for this study. All the authors declared no conflicts of interest.

Source: Dao T et al. Calcif Tissue Int. 2021 Jun 16. doi: 10.1007/s00223-021-00873-w.

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Key clinical point: Sarcopenia and low muscle mass are common comorbidities among middle-aged and elderly patients with rheumatoid arthritis (RA). Corticosteroid therapy was positively and conventional synthetic disease-modifying antirheumatic drugs (csDMARDs) were inversely associated with sarcopenia.

Major finding: Overall, the prevalence of low muscle mass and sarcopenia was 30.2% (95% confidence interval [CI], 24.2%-36.2%). The use of csDMARDs was inversely (odds ratio [OR], 0.70; P = .019) and corticosteroid was positively (OR, 1.46; 95% CI, 0.94-2.29) associated with sarcopenia. No association was observed between biological/targeted DMARDs and sarcopenia (OR, 0.83; P = .420).

Study details: Findings are from a meta-analysis of 16 observational studies involving 2,240 middle-aged and older adults with RA.

Disclosures: No specific funding was received for this study. All the authors declared no conflicts of interest.

Source: Dao T et al. Calcif Tissue Int. 2021 Jun 16. doi: 10.1007/s00223-021-00873-w.

Key clinical point: Sarcopenia and low muscle mass are common comorbidities among middle-aged and elderly patients with rheumatoid arthritis (RA). Corticosteroid therapy was positively and conventional synthetic disease-modifying antirheumatic drugs (csDMARDs) were inversely associated with sarcopenia.

Major finding: Overall, the prevalence of low muscle mass and sarcopenia was 30.2% (95% confidence interval [CI], 24.2%-36.2%). The use of csDMARDs was inversely (odds ratio [OR], 0.70; P = .019) and corticosteroid was positively (OR, 1.46; 95% CI, 0.94-2.29) associated with sarcopenia. No association was observed between biological/targeted DMARDs and sarcopenia (OR, 0.83; P = .420).

Study details: Findings are from a meta-analysis of 16 observational studies involving 2,240 middle-aged and older adults with RA.

Disclosures: No specific funding was received for this study. All the authors declared no conflicts of interest.

Source: Dao T et al. Calcif Tissue Int. 2021 Jun 16. doi: 10.1007/s00223-021-00873-w.

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RA: Lower swollen joint count at 5 years is a predictor of unacceptable pain

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Key clinical point: Almost one-third of patients with new-onset rheumatoid arthritis (RA) had long-lasting unacceptable pain. Patients with a less inflammatory disease at baseline, in the form of lower swollen joint count (SJC), were at an increased risk for unacceptable pain at 5 years.

Major finding: Almost 49.1% of patients had unacceptable pain at inclusion, which decreased to 30.1% during the first year and remained unchanged thereafter. At 5 years, lower SJC (adjusted odds ratio [aOR] per standard deviation, 0.61; P = .01) was a significant predictor of unacceptable pain.

Study details: The data come from an inception cohort of 232 patients with early RA with symptom duration of at least 12 months.

Disclosures: This work was supported by the Swedish Research Council, the Swedish Rheumatism Association, and Lund University. Some of the authors declared receiving grants, personal fees, and lecture/consulting fees from and/or being an employee of or working as a medical advisor for various sources.

Source: Eberhard A et al. Arthritis Res Ther. 2021 Jun 14. doi: 10.1186/s13075-021-02550-7.

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Key clinical point: Almost one-third of patients with new-onset rheumatoid arthritis (RA) had long-lasting unacceptable pain. Patients with a less inflammatory disease at baseline, in the form of lower swollen joint count (SJC), were at an increased risk for unacceptable pain at 5 years.

Major finding: Almost 49.1% of patients had unacceptable pain at inclusion, which decreased to 30.1% during the first year and remained unchanged thereafter. At 5 years, lower SJC (adjusted odds ratio [aOR] per standard deviation, 0.61; P = .01) was a significant predictor of unacceptable pain.

Study details: The data come from an inception cohort of 232 patients with early RA with symptom duration of at least 12 months.

Disclosures: This work was supported by the Swedish Research Council, the Swedish Rheumatism Association, and Lund University. Some of the authors declared receiving grants, personal fees, and lecture/consulting fees from and/or being an employee of or working as a medical advisor for various sources.

Source: Eberhard A et al. Arthritis Res Ther. 2021 Jun 14. doi: 10.1186/s13075-021-02550-7.

Key clinical point: Almost one-third of patients with new-onset rheumatoid arthritis (RA) had long-lasting unacceptable pain. Patients with a less inflammatory disease at baseline, in the form of lower swollen joint count (SJC), were at an increased risk for unacceptable pain at 5 years.

Major finding: Almost 49.1% of patients had unacceptable pain at inclusion, which decreased to 30.1% during the first year and remained unchanged thereafter. At 5 years, lower SJC (adjusted odds ratio [aOR] per standard deviation, 0.61; P = .01) was a significant predictor of unacceptable pain.

Study details: The data come from an inception cohort of 232 patients with early RA with symptom duration of at least 12 months.

Disclosures: This work was supported by the Swedish Research Council, the Swedish Rheumatism Association, and Lund University. Some of the authors declared receiving grants, personal fees, and lecture/consulting fees from and/or being an employee of or working as a medical advisor for various sources.

Source: Eberhard A et al. Arthritis Res Ther. 2021 Jun 14. doi: 10.1186/s13075-021-02550-7.

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Sarilumab shows long-term promise in RA refractory to TNF inhibitors

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Key clinical point: The long-term safety profile of sarilumab was consistent with prior clinical studies and postmarketing reports in patients with rheumatoid arthritis (RA) refractory to tumor necrosis factor inhibitors (TNFi).

Major finding: Incidence rates of adverse events (AEs) and serious AEs were 160.4 and 10.2 per 100 patient-years (PY), respectively, with 132 discontinuations (8.1/100 PY). The rate of serious infections was 3.9 per 100 PY. Grade 3/4 neutropenia was observed in 14% of patients and normalized on treatment in 65% of patients. Clinical efficacy was sustained throughout the 5-year follow-up.

Study details: Findings are from the open-label extension (OLE), EXTEND study, which included 454 patients with TNFi-refractory RA who completed the phase 3 TARGET study. In the OLE, patients received sarilumab 200 mg twice per week plus conventional synthetic disease-modifying antirheumatic drugs.

Disclosures: This work was supported by Sanofi (Cambridge, MA, USA) and Regeneron Pharmaceuticals, Inc. (Tarrytown, NY, USA). Some of the authors reported receiving research grants and/or consulting fees from various sources. Some authors declared being an employee of and/or holding stocks/stock options at Sanofi or Regeneron Pharmaceuticals, Inc.

Source: Fleischmann R et al. Rheumatology (Oxford). 2021 Jun 24. doi: 10.1093/rheumatology/keab355.

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Key clinical point: The long-term safety profile of sarilumab was consistent with prior clinical studies and postmarketing reports in patients with rheumatoid arthritis (RA) refractory to tumor necrosis factor inhibitors (TNFi).

Major finding: Incidence rates of adverse events (AEs) and serious AEs were 160.4 and 10.2 per 100 patient-years (PY), respectively, with 132 discontinuations (8.1/100 PY). The rate of serious infections was 3.9 per 100 PY. Grade 3/4 neutropenia was observed in 14% of patients and normalized on treatment in 65% of patients. Clinical efficacy was sustained throughout the 5-year follow-up.

Study details: Findings are from the open-label extension (OLE), EXTEND study, which included 454 patients with TNFi-refractory RA who completed the phase 3 TARGET study. In the OLE, patients received sarilumab 200 mg twice per week plus conventional synthetic disease-modifying antirheumatic drugs.

Disclosures: This work was supported by Sanofi (Cambridge, MA, USA) and Regeneron Pharmaceuticals, Inc. (Tarrytown, NY, USA). Some of the authors reported receiving research grants and/or consulting fees from various sources. Some authors declared being an employee of and/or holding stocks/stock options at Sanofi or Regeneron Pharmaceuticals, Inc.

Source: Fleischmann R et al. Rheumatology (Oxford). 2021 Jun 24. doi: 10.1093/rheumatology/keab355.

Key clinical point: The long-term safety profile of sarilumab was consistent with prior clinical studies and postmarketing reports in patients with rheumatoid arthritis (RA) refractory to tumor necrosis factor inhibitors (TNFi).

Major finding: Incidence rates of adverse events (AEs) and serious AEs were 160.4 and 10.2 per 100 patient-years (PY), respectively, with 132 discontinuations (8.1/100 PY). The rate of serious infections was 3.9 per 100 PY. Grade 3/4 neutropenia was observed in 14% of patients and normalized on treatment in 65% of patients. Clinical efficacy was sustained throughout the 5-year follow-up.

Study details: Findings are from the open-label extension (OLE), EXTEND study, which included 454 patients with TNFi-refractory RA who completed the phase 3 TARGET study. In the OLE, patients received sarilumab 200 mg twice per week plus conventional synthetic disease-modifying antirheumatic drugs.

Disclosures: This work was supported by Sanofi (Cambridge, MA, USA) and Regeneron Pharmaceuticals, Inc. (Tarrytown, NY, USA). Some of the authors reported receiving research grants and/or consulting fees from various sources. Some authors declared being an employee of and/or holding stocks/stock options at Sanofi or Regeneron Pharmaceuticals, Inc.

Source: Fleischmann R et al. Rheumatology (Oxford). 2021 Jun 24. doi: 10.1093/rheumatology/keab355.

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RA: Systemic glucocorticoids most beneficial for pain reduction shortly after initiation

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Key clinical point: Systemic glucocorticoids (GCs) were effective at reducing pain in patients with active rheumatoid arthritis (RA), with the effect being greatest within 3 months of initiation, whereas it appeared to be less effective beyond 6 months.

Major finding: Treatment with systemic GCs significantly decreased spontaneous pain (standardized mean differences [MD], −0.67; 95% confidence interval [CI], −0.84 to −0.50), with the effect being greatest at 3 months or lesser (MD, −14.55 mm; 95% CI, −20.40 to −8.69) and appeared to be less effective at more than 3 to 6 months (MD, −7.82 mm; 95% CI, −12.27 to -3.38) and beyond 6 months (MD, −6.52 mm; 95% CI, −13.28 to 0.24).

Study details: Findings are from a systematic review and meta-analysis of 33 randomized controlled trials including 2,658 patients with RA.

Disclosures: The study received no specific funding. D McWilliams, DA Walsh, and NG Shanker reported receiving grant support and consultancy fees from various sources like Pfizer Ltd., Eli Lilly, UCB, AbbVie, GSK, and Cambridge Nutraceuticals.

Source: McWilliams DF et al. Rheumatology (Oxford). 2021 Jul 2. doi: 10.1093/rheumatology/keab503.

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Key clinical point: Systemic glucocorticoids (GCs) were effective at reducing pain in patients with active rheumatoid arthritis (RA), with the effect being greatest within 3 months of initiation, whereas it appeared to be less effective beyond 6 months.

Major finding: Treatment with systemic GCs significantly decreased spontaneous pain (standardized mean differences [MD], −0.67; 95% confidence interval [CI], −0.84 to −0.50), with the effect being greatest at 3 months or lesser (MD, −14.55 mm; 95% CI, −20.40 to −8.69) and appeared to be less effective at more than 3 to 6 months (MD, −7.82 mm; 95% CI, −12.27 to -3.38) and beyond 6 months (MD, −6.52 mm; 95% CI, −13.28 to 0.24).

Study details: Findings are from a systematic review and meta-analysis of 33 randomized controlled trials including 2,658 patients with RA.

Disclosures: The study received no specific funding. D McWilliams, DA Walsh, and NG Shanker reported receiving grant support and consultancy fees from various sources like Pfizer Ltd., Eli Lilly, UCB, AbbVie, GSK, and Cambridge Nutraceuticals.

Source: McWilliams DF et al. Rheumatology (Oxford). 2021 Jul 2. doi: 10.1093/rheumatology/keab503.

Key clinical point: Systemic glucocorticoids (GCs) were effective at reducing pain in patients with active rheumatoid arthritis (RA), with the effect being greatest within 3 months of initiation, whereas it appeared to be less effective beyond 6 months.

Major finding: Treatment with systemic GCs significantly decreased spontaneous pain (standardized mean differences [MD], −0.67; 95% confidence interval [CI], −0.84 to −0.50), with the effect being greatest at 3 months or lesser (MD, −14.55 mm; 95% CI, −20.40 to −8.69) and appeared to be less effective at more than 3 to 6 months (MD, −7.82 mm; 95% CI, −12.27 to -3.38) and beyond 6 months (MD, −6.52 mm; 95% CI, −13.28 to 0.24).

Study details: Findings are from a systematic review and meta-analysis of 33 randomized controlled trials including 2,658 patients with RA.

Disclosures: The study received no specific funding. D McWilliams, DA Walsh, and NG Shanker reported receiving grant support and consultancy fees from various sources like Pfizer Ltd., Eli Lilly, UCB, AbbVie, GSK, and Cambridge Nutraceuticals.

Source: McWilliams DF et al. Rheumatology (Oxford). 2021 Jul 2. doi: 10.1093/rheumatology/keab503.

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Bazedoxifene effectively prevents glucocorticoid-induced bone loss in RA

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Key clinical point: Treatment with bazedoxifene for 48 weeks significantly increased bone mineral density (BMD) of L-spine and decreased bone turnover markers in postmenopausal women with rheumatoid arthritis (RA) receiving low-dose glucocorticoids.

Major finding: Treatment with bazedoxifene significantly increased L-spine BMD (0.015 g/cm2; P = .007), whereas the change in the control group was not significant (0.002 g/cm2; P = .694). At 24 weeks, all bone turnover biomarkers decreased significantly with bazedoxifene, which persisted to 48 weeks (all P less than .01), whereas recovery observed in the control group was not significant.

Study details: The data come from an open-label study involving 114 postmenopausal women with osteopenia who had been receiving low-dose glucocorticoids for RA and were randomly assigned to either daily bazedoxifene (20 mg/day) with calcium and vitamin D or only calcium and vitamin D (control group).

Disclosures: The study was supported by a research grant from Pfizer Pharmaceuticals Korea Ltd. YK Sung reported receiving research grants from Bristol-Myers Squibb, Eisai, Pfizer, and JW Pharmaceutical.

Source: Cho SK et al. Arthritis Res Ther. 2021 Jul 2. doi: 10.1186/s13075-021-02564-1.

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Key clinical point: Treatment with bazedoxifene for 48 weeks significantly increased bone mineral density (BMD) of L-spine and decreased bone turnover markers in postmenopausal women with rheumatoid arthritis (RA) receiving low-dose glucocorticoids.

Major finding: Treatment with bazedoxifene significantly increased L-spine BMD (0.015 g/cm2; P = .007), whereas the change in the control group was not significant (0.002 g/cm2; P = .694). At 24 weeks, all bone turnover biomarkers decreased significantly with bazedoxifene, which persisted to 48 weeks (all P less than .01), whereas recovery observed in the control group was not significant.

Study details: The data come from an open-label study involving 114 postmenopausal women with osteopenia who had been receiving low-dose glucocorticoids for RA and were randomly assigned to either daily bazedoxifene (20 mg/day) with calcium and vitamin D or only calcium and vitamin D (control group).

Disclosures: The study was supported by a research grant from Pfizer Pharmaceuticals Korea Ltd. YK Sung reported receiving research grants from Bristol-Myers Squibb, Eisai, Pfizer, and JW Pharmaceutical.

Source: Cho SK et al. Arthritis Res Ther. 2021 Jul 2. doi: 10.1186/s13075-021-02564-1.

Key clinical point: Treatment with bazedoxifene for 48 weeks significantly increased bone mineral density (BMD) of L-spine and decreased bone turnover markers in postmenopausal women with rheumatoid arthritis (RA) receiving low-dose glucocorticoids.

Major finding: Treatment with bazedoxifene significantly increased L-spine BMD (0.015 g/cm2; P = .007), whereas the change in the control group was not significant (0.002 g/cm2; P = .694). At 24 weeks, all bone turnover biomarkers decreased significantly with bazedoxifene, which persisted to 48 weeks (all P less than .01), whereas recovery observed in the control group was not significant.

Study details: The data come from an open-label study involving 114 postmenopausal women with osteopenia who had been receiving low-dose glucocorticoids for RA and were randomly assigned to either daily bazedoxifene (20 mg/day) with calcium and vitamin D or only calcium and vitamin D (control group).

Disclosures: The study was supported by a research grant from Pfizer Pharmaceuticals Korea Ltd. YK Sung reported receiving research grants from Bristol-Myers Squibb, Eisai, Pfizer, and JW Pharmaceutical.

Source: Cho SK et al. Arthritis Res Ther. 2021 Jul 2. doi: 10.1186/s13075-021-02564-1.

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RA: No significant change in efficacy and safety after adalimumab to CT-P17 switch

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Key clinical point: In patients with active rheumatoid arthritis (RA), adalimumab biosimilar CT-P17 and reference adalimumab showed comparable efficacy and safety during 1 year of treatment even after switching to CT-P17 from reference adalimumab.

Major finding: At 52 weeks, the proportion of patients achieving a 20%/50%/70% improvement by American College of Rheumatology criteria was comparable among those who continued CT-P17 (80.5%/66.3%/44.6%), continued reference adalimumab (77.8%/62.1%/49.0%), or switched to CT-P17 (82.2%/66.4%/47.4%), respectively. Similar proportions of patients in each treatment group experienced 1 or more treatment-emergent adverse events.

Study details: This was a 52-week, randomized, phase 3 study of 607 patients with active RA who received either 40 mg (100 mg/mL) CT-P17 or reference adalimumab subcutaneously every 2 weeks until week 24. Later, patients receiving CT-P17 continued to receive the same, whereas those receiving reference adalimumab either continued the same or switched to CT-P17.

Disclosures: This work was supported by Celltrion, Inc. Some of the authors reported receiving research grants, consulting, speaker fees, and/or honoraria from various sources. SJ Lee, SH Kim, YJ Bae, GE Yang, and JK Yoo declared being employees of Celltrion, Inc.

Source: Furst DE et al. Rheumatology (Oxford). 2021 Jun 17. doi: 10.1093/rheumatology/keab460.

 

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Key clinical point: In patients with active rheumatoid arthritis (RA), adalimumab biosimilar CT-P17 and reference adalimumab showed comparable efficacy and safety during 1 year of treatment even after switching to CT-P17 from reference adalimumab.

Major finding: At 52 weeks, the proportion of patients achieving a 20%/50%/70% improvement by American College of Rheumatology criteria was comparable among those who continued CT-P17 (80.5%/66.3%/44.6%), continued reference adalimumab (77.8%/62.1%/49.0%), or switched to CT-P17 (82.2%/66.4%/47.4%), respectively. Similar proportions of patients in each treatment group experienced 1 or more treatment-emergent adverse events.

Study details: This was a 52-week, randomized, phase 3 study of 607 patients with active RA who received either 40 mg (100 mg/mL) CT-P17 or reference adalimumab subcutaneously every 2 weeks until week 24. Later, patients receiving CT-P17 continued to receive the same, whereas those receiving reference adalimumab either continued the same or switched to CT-P17.

Disclosures: This work was supported by Celltrion, Inc. Some of the authors reported receiving research grants, consulting, speaker fees, and/or honoraria from various sources. SJ Lee, SH Kim, YJ Bae, GE Yang, and JK Yoo declared being employees of Celltrion, Inc.

Source: Furst DE et al. Rheumatology (Oxford). 2021 Jun 17. doi: 10.1093/rheumatology/keab460.

 

Key clinical point: In patients with active rheumatoid arthritis (RA), adalimumab biosimilar CT-P17 and reference adalimumab showed comparable efficacy and safety during 1 year of treatment even after switching to CT-P17 from reference adalimumab.

Major finding: At 52 weeks, the proportion of patients achieving a 20%/50%/70% improvement by American College of Rheumatology criteria was comparable among those who continued CT-P17 (80.5%/66.3%/44.6%), continued reference adalimumab (77.8%/62.1%/49.0%), or switched to CT-P17 (82.2%/66.4%/47.4%), respectively. Similar proportions of patients in each treatment group experienced 1 or more treatment-emergent adverse events.

Study details: This was a 52-week, randomized, phase 3 study of 607 patients with active RA who received either 40 mg (100 mg/mL) CT-P17 or reference adalimumab subcutaneously every 2 weeks until week 24. Later, patients receiving CT-P17 continued to receive the same, whereas those receiving reference adalimumab either continued the same or switched to CT-P17.

Disclosures: This work was supported by Celltrion, Inc. Some of the authors reported receiving research grants, consulting, speaker fees, and/or honoraria from various sources. SJ Lee, SH Kim, YJ Bae, GE Yang, and JK Yoo declared being employees of Celltrion, Inc.

Source: Furst DE et al. Rheumatology (Oxford). 2021 Jun 17. doi: 10.1093/rheumatology/keab460.

 

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