Anna Eberhard, Daniela Di Giuseppe, Johan Askling, Stefan Bergman, Hannah Bower, Katerina Chatzidionysiou, Helena Forsblad‐d'Elia, Alf Kastbom, Tor Olofsson, Thomas Frisell, Carl Turesson
ObjectiveTo compare the effectiveness of Janus kinase inhibitors (JAKis) and biologic disease‐modifying anti‐rheumatic drugs (bDMARDs) on pain in patients with rheumatoid arthritis (RA).MethodsIn this retrospective study, we investigated patients with a diagnosis of RA, starting treatment with a JAKi (n=1827), TNF inhibitor (TNFi, n=6422), IL‐6 inhibitor (n=887), abatacept (n=1102) or rituximab (n=1149) in 2017‐2019, using data from several linked Swedish national registers. Differences in change in pain, assessed with a visual analogue scale (VAS; 0‐100 mm), from baseline to 3 months, as well as proportions of patients remaining on initial treatment with low pain (VAS pain <20) at 12 months, were compared between treatments. Comparisons of treatment responses between JAKis and bDMARDs were evaluated using multivariable linear regression, adjusted for patient characteristics, comorbidities, current co‐medication and previous treatment.ResultsJAKi treatment was associated with a greater decrease in pain at 3 months compared with TNFi treatment (adjusted mean additional decrease: 4.0 mm; 95% confidence interval (CI) 1.6, 6.3), with similar trends in comparisons with non‐TNFi bDMARDs. More patients achieved low pain at 12 months on JAKis compared with TNFis, in particular among those previously treated with ≥2 bDMARDs (adjusted change contrast: 5.3 percentage points; 95% CI 1.0, 9.6).ConclusionJAKis had a slightly better effect on pain outcomes at 3 and 12 months compared with TNFis, with significantly greater differences in patients previously treated with ≥2 bDMARDs. The effect of JAKis on pain reduction was at least similar to that of non‐TNFi bDMARDs.
{"title":"Effectiveness of janus kinase inhibitors compared with biologic disease modifying anti‐rheumatic drugs on pain reduction in rheumatoid arthritis","authors":"Anna Eberhard, Daniela Di Giuseppe, Johan Askling, Stefan Bergman, Hannah Bower, Katerina Chatzidionysiou, Helena Forsblad‐d'Elia, Alf Kastbom, Tor Olofsson, Thomas Frisell, Carl Turesson","doi":"10.1002/art.43014","DOIUrl":"https://doi.org/10.1002/art.43014","url":null,"abstract":"ObjectiveTo compare the effectiveness of Janus kinase inhibitors (JAKis) and biologic disease‐modifying anti‐rheumatic drugs (bDMARDs) on pain in patients with rheumatoid arthritis (RA).MethodsIn this retrospective study, we investigated patients with a diagnosis of RA, starting treatment with a JAKi (n=1827), TNF inhibitor (TNFi, n=6422), IL‐6 inhibitor (n=887), abatacept (n=1102) or rituximab (n=1149) in 2017‐2019, using data from several linked Swedish national registers. Differences in change in pain, assessed with a visual analogue scale (VAS; 0‐100 mm), from baseline to 3 months, as well as proportions of patients remaining on initial treatment with low pain (VAS pain <20) at 12 months, were compared between treatments. Comparisons of treatment responses between JAKis and bDMARDs were evaluated using multivariable linear regression, adjusted for patient characteristics, comorbidities, current co‐medication and previous treatment.ResultsJAKi treatment was associated with a greater decrease in pain at 3 months compared with TNFi treatment (adjusted mean additional decrease: 4.0 mm; 95% confidence interval (CI) 1.6, 6.3), with similar trends in comparisons with non‐TNFi bDMARDs. More patients achieved low pain at 12 months on JAKis compared with TNFis, in particular among those previously treated with ≥2 bDMARDs (adjusted change contrast: 5.3 percentage points; 95% CI 1.0, 9.6).ConclusionJAKis had a slightly better effect on pain outcomes at 3 and 12 months compared with TNFis, with significantly greater differences in patients previously treated with ≥2 bDMARDs. The effect of JAKis on pain reduction was at least similar to that of non‐TNFi bDMARDs.","PeriodicalId":129,"journal":{"name":"Arthritis & Rheumatology","volume":"5 1","pages":""},"PeriodicalIF":13.3,"publicationDate":"2024-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142276796","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Strength Training Associates with Less Symptom and Structure Outcomes for Knee Osteoarthritis.","authors":"Grace H Lo,Jeffrey B Driban","doi":"10.1002/art.42994","DOIUrl":"https://doi.org/10.1002/art.42994","url":null,"abstract":"","PeriodicalId":129,"journal":{"name":"Arthritis & Rheumatology","volume":"1 1","pages":""},"PeriodicalIF":13.3,"publicationDate":"2024-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142273532","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
OBJECTIVETo assess the efficacy and safety of intravenous (IV) secukinumab for the treatment of adults with active axial spondyloarthritis (axSpA) in INVIGORATE-1.METHODSINVIGORATE-1 (NCT04156620) was a randomized, double-blind, parallel-group, phase III trial in patients with active axSpA (either radiographic or non-radiographic). Patients were randomized 1:1 to receive IV secukinumab (6 mg/kg at baseline followed by 3 mg/kg every 4 weeks) or IV placebo for 16 weeks. After Week 16, patients randomized to placebo were switched to IV secukinumab (3 mg/kg every 4 weeks), while patients randomized to secukinumab continued treatment through Week 52. The primary endpoint was Assessment of SpondyloArthritis international Society (ASAS40) response at Week 16. Safety was evaluated through Week 60.RESULTSAmong patients initially randomized to IV secukinumab (n = 264) or placebo (n = 262), 86.0% and 88.9% completed the entire 60-week study period, respectively. A higher proportion of patients receiving secukinumab vs placebo met the primary endpoint (ASAS40 response) at Week 16 (40.9% vs 22.9%; P<.0001). By Week 24, patients who switched from placebo to secukinumab at Week 16 achieved ASAS40 response rates comparable to those in patients originally randomized to secukinumab. All secondary efficacy endpoints were met at Week 16, and responses were sustained through Week 52. No new or unexpected safety signals were observed with IV secukinumab.CONCLUSIONIV secukinumab was effective for the treatment of adults with active axSpA over 52 weeks. The safety profile was consistent with that in previous reports on subcutaneous secukinumab.
目的评估INVIGORATE-1中静脉注射（IV）secukinumab治疗活动性轴性脊椎关节炎（axSpA）成人患者的疗效和安全性。方法INVIGORATE-1（NCT04156620）是一项随机、双盲、平行分组的III期试验，对象是活动性axSpA（放射性或非放射性）患者。患者按1:1的比例随机接受静脉注射secukinumab（基线剂量为6毫克/千克，之后每4周3毫克/千克）或静脉注射安慰剂，疗程为16周。第16周后，随机接受安慰剂治疗的患者转为静脉注射secukinumab（3毫克/千克，每4周一次），而随机接受secukinumab治疗的患者则继续治疗至第52周。主要终点是第16周时国际脊柱炎协会（ASAS40）的反应评估。结果在最初随机接受静脉注射secukinumab（264人）或安慰剂（262人）治疗的患者中，分别有86.0%和88.9%的患者完成了整个60周的研究。与安慰剂相比，接受secukinumab治疗的患者在第16周达到主要终点（ASAS40反应）的比例更高（40.9% vs 22.9%; P<.0001）。到第24周时，在第16周从安慰剂转用secukinumab的患者的ASAS40应答率与最初随机使用secukinumab的患者相当。所有次要疗效终点均在第16周达到，反应持续到第52周。静脉注射secukinumab没有观察到新的或意外的安全信号。其安全性与之前关于皮下注射secukinumab的报告一致。
{"title":"Efficacy and Safety of Intravenous Secukinumab in Patients With Active Axial Spondyloarthritis: Results From the Randomized, Placebo-Controlled, Phase III INVIGORATE-1 Study.","authors":"Atul Deodhar,Jerzy Supronik,Alan Kivitz,Guillermo Valenzuela,Karen Kapur,Susanne Rohrer,Eva Dokoupilova,Hanno B Richards,Karel Pavelka","doi":"10.1002/art.42993","DOIUrl":"https://doi.org/10.1002/art.42993","url":null,"abstract":"OBJECTIVETo assess the efficacy and safety of intravenous (IV) secukinumab for the treatment of adults with active axial spondyloarthritis (axSpA) in INVIGORATE-1.METHODSINVIGORATE-1 (NCT04156620) was a randomized, double-blind, parallel-group, phase III trial in patients with active axSpA (either radiographic or non-radiographic). Patients were randomized 1:1 to receive IV secukinumab (6 mg/kg at baseline followed by 3 mg/kg every 4 weeks) or IV placebo for 16 weeks. After Week 16, patients randomized to placebo were switched to IV secukinumab (3 mg/kg every 4 weeks), while patients randomized to secukinumab continued treatment through Week 52. The primary endpoint was Assessment of SpondyloArthritis international Society (ASAS40) response at Week 16. Safety was evaluated through Week 60.RESULTSAmong patients initially randomized to IV secukinumab (n = 264) or placebo (n = 262), 86.0% and 88.9% completed the entire 60-week study period, respectively. A higher proportion of patients receiving secukinumab vs placebo met the primary endpoint (ASAS40 response) at Week 16 (40.9% vs 22.9%; P<.0001). By Week 24, patients who switched from placebo to secukinumab at Week 16 achieved ASAS40 response rates comparable to those in patients originally randomized to secukinumab. All secondary efficacy endpoints were met at Week 16, and responses were sustained through Week 52. No new or unexpected safety signals were observed with IV secukinumab.CONCLUSIONIV secukinumab was effective for the treatment of adults with active axSpA over 52 weeks. The safety profile was consistent with that in previous reports on subcutaneous secukinumab.","PeriodicalId":129,"journal":{"name":"Arthritis & Rheumatology","volume":"45 1","pages":""},"PeriodicalIF":13.3,"publicationDate":"2024-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142273538","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
OBJECTIVETo evaluate the efficacy and safety of intravenous (IV) secukinumab in patients with active psoriatic arthritis (PsA).METHODSINVIGORATE-2 (NCT04209205) is a randomized, placebo-controlled, phase III trial. Patients with active PsA were randomized 1:1 to receive IV secukinumab (6 mg/kg at baseline followed by 3 mg/kg every 4 weeks [q4w]) or placebo. At Week 16, patients randomized to placebo were switched to IV secukinumab (3 mg/kg q4w), and patients receiving IV secukinumab continued treatment through Week 52. The primary efficacy endpoint was achievement of American College of Rheumatology (ACR) 50 response at Week 16. Efficacy and safety were evaluated through Weeks 52 and 60, respectively.RESULTSAmong 191 patients randomized to IV secukinumab and 190 to placebo/IV secukinumab, 177 (92.7%) and 170 (89.5%) completed the entire study period, respectively. A significantly higher proportion of patients receiving IV secukinumab vs placebo achieved ACR50 at Week 16 (31.4% vs 6.3%; adjusted P<.0001). All secondary efficacy endpoints were met at Week 16 (all adjusted P<.05 using the predefined hypothesis-testing hierarchy). Patients who switched from placebo to secukinumab at Week 16 showed rapid improvements in ACR50 response rates; by Week 52, both treatment arms experienced similar improvements in efficacy outcomes. No new or unexpected safety signals were observed with IV secukinumab. One death was reported in the placebo group prior to Week 16.CONCLUSIONIV secukinumab led to rapid and sustained improvements in clinical measures of PsA, and the safety profile was consistent with that of secukinumab administered subcutaneously.
目的评估活动性银屑病关节炎（PsA）患者静脉注射（IV）secukinumab的疗效和安全性。方法INVIGORATE-2（NCT04209205）是一项随机、安慰剂对照的III期试验。活动性PsA患者按1:1比例随机接受静脉注射secukinumab（基线剂量为6毫克/千克，之后每4周[q4w]剂量为3毫克/千克）或安慰剂。在第16周，随机接受安慰剂治疗的患者转为静脉注射secukinumab（3 mg/kg q4w），接受静脉注射secukinumab的患者继续治疗至第52周。主要疗效终点是在第16周时达到美国风湿病学会（ACR）50的应答水平。结果在191名随机接受静脉注射secukinumab治疗的患者和190名随机接受安慰剂/静脉注射secukinumab治疗的患者中，分别有177人（92.7%）和170人（89.5%）完成了整个研究。与安慰剂相比，接受IV secukinumab治疗的患者在第16周达到ACR50的比例明显更高（31.4% vs 6.3%；调整后P<.0001）。所有次要疗效终点均在第16周达到（采用预定义的假设检验层次，调整后P<.05）。在第16周从安慰剂转用secukinumab的患者的ACR50反应率迅速改善；到第52周时，两种治疗方案的疗效改善情况相似。静脉注射secukinumab未发现新的或意外的安全信号。结论静脉注射secukinumab能快速、持续地改善PsA的临床症状，其安全性与皮下注射secukinumab一致。
{"title":"Efficacy and Safety of Intravenous Secukinumab for the Treatment of Active Psoriatic Arthritis: Results From the Randomized, Placebo-Controlled Phase III INVIGORATE-2 Study.","authors":"Alan Kivitz,Liliana Sedova,Melvin Churchill,Roshan Kotha,Atul Singhal,Alexander Torres,Guillermo Valenzuela,Sarah Whelan,Thomas Dumortier,Xuan Zhu,Ruvie Martin,Luminita Pricop","doi":"10.1002/art.42997","DOIUrl":"https://doi.org/10.1002/art.42997","url":null,"abstract":"OBJECTIVETo evaluate the efficacy and safety of intravenous (IV) secukinumab in patients with active psoriatic arthritis (PsA).METHODSINVIGORATE-2 (NCT04209205) is a randomized, placebo-controlled, phase III trial. Patients with active PsA were randomized 1:1 to receive IV secukinumab (6 mg/kg at baseline followed by 3 mg/kg every 4 weeks [q4w]) or placebo. At Week 16, patients randomized to placebo were switched to IV secukinumab (3 mg/kg q4w), and patients receiving IV secukinumab continued treatment through Week 52. The primary efficacy endpoint was achievement of American College of Rheumatology (ACR) 50 response at Week 16. Efficacy and safety were evaluated through Weeks 52 and 60, respectively.RESULTSAmong 191 patients randomized to IV secukinumab and 190 to placebo/IV secukinumab, 177 (92.7%) and 170 (89.5%) completed the entire study period, respectively. A significantly higher proportion of patients receiving IV secukinumab vs placebo achieved ACR50 at Week 16 (31.4% vs 6.3%; adjusted P<.0001). All secondary efficacy endpoints were met at Week 16 (all adjusted P<.05 using the predefined hypothesis-testing hierarchy). Patients who switched from placebo to secukinumab at Week 16 showed rapid improvements in ACR50 response rates; by Week 52, both treatment arms experienced similar improvements in efficacy outcomes. No new or unexpected safety signals were observed with IV secukinumab. One death was reported in the placebo group prior to Week 16.CONCLUSIONIV secukinumab led to rapid and sustained improvements in clinical measures of PsA, and the safety profile was consistent with that of secukinumab administered subcutaneously.","PeriodicalId":129,"journal":{"name":"Arthritis & Rheumatology","volume":"63 1","pages":""},"PeriodicalIF":13.3,"publicationDate":"2024-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142273533","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Strength Training Is Associated With Less Knee Osteoarthritis: Data From the Osteoarthritis Initiative: comment on the article by Lo et al.","authors":"Yuncheng Bai,Yang Wu,Ge Wang","doi":"10.1002/art.42995","DOIUrl":"https://doi.org/10.1002/art.42995","url":null,"abstract":"","PeriodicalId":129,"journal":{"name":"Arthritis & Rheumatology","volume":"72 1","pages":""},"PeriodicalIF":13.3,"publicationDate":"2024-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142273535","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jie Wei,Yilun Wang,Nicola Dalbeth,Junqing Xie,Jing Wu,Chao Zeng,Guanghua Lei,Yuqing Zhang
OBJECTIVESWeight loss is conditionally recommended for gout management; however, its impact on incident gout and recurrent gout flares among overweight and obese individuals remains unknown. We aimed to investigate the relationship between weight loss rate following the initiation of anti-obesity medications and the risk of incident gout and recurrent gout flares among overweight/obese individuals.METHODSUsing data from The Health Improvement Network, we selected individuals aged 18 and older who were overweight or obese and started anti-obesity medication. We emulated a target trial to examine the association of different weight loss rates, slow (2-5%), moderate (5-10%), or fast (≥10%), within the first year of treatment with incident gout and recurrent gout flares during a 5-year follow-up period.RESULTSAmong 131,000 participants without gout starting orlistat, the 5-year risk of incident gout was 1.6% for those with weight gain/stable, compared with 1.5%, 1.3%, and 1.2% for those with slow, moderate, and fast weight loss, respectively. Compared with the weight gain/stable arm, the hazard ratios were 0.91 (95% confidence interval [CI]: 0.81 to 1.01), 0.82 (95%CI: 0.72 to 0.92), and 0.73 (95%CI: 0.62 to 0.86) for slow, moderate and fast rate of weight loss arms, respectively. Similar results were observed for the recurrent gout flares among 3,847 overweight or obese individuals with gout starting orlistat.CONCLUSIONSA higher rate of weight loss after initiating orlistat within 1-year was associated with lower risks of incident gout and lower rates of recurrent gout flares among overweight or obese people.
{"title":"Weight loss after initiating anti-obesity medications and gout among overweight and obesity individuals: a population-based cohort study.","authors":"Jie Wei,Yilun Wang,Nicola Dalbeth,Junqing Xie,Jing Wu,Chao Zeng,Guanghua Lei,Yuqing Zhang","doi":"10.1002/art.42996","DOIUrl":"https://doi.org/10.1002/art.42996","url":null,"abstract":"OBJECTIVESWeight loss is conditionally recommended for gout management; however, its impact on incident gout and recurrent gout flares among overweight and obese individuals remains unknown. We aimed to investigate the relationship between weight loss rate following the initiation of anti-obesity medications and the risk of incident gout and recurrent gout flares among overweight/obese individuals.METHODSUsing data from The Health Improvement Network, we selected individuals aged 18 and older who were overweight or obese and started anti-obesity medication. We emulated a target trial to examine the association of different weight loss rates, slow (2-5%), moderate (5-10%), or fast (≥10%), within the first year of treatment with incident gout and recurrent gout flares during a 5-year follow-up period.RESULTSAmong 131,000 participants without gout starting orlistat, the 5-year risk of incident gout was 1.6% for those with weight gain/stable, compared with 1.5%, 1.3%, and 1.2% for those with slow, moderate, and fast weight loss, respectively. Compared with the weight gain/stable arm, the hazard ratios were 0.91 (95% confidence interval [CI]: 0.81 to 1.01), 0.82 (95%CI: 0.72 to 0.92), and 0.73 (95%CI: 0.62 to 0.86) for slow, moderate and fast rate of weight loss arms, respectively. Similar results were observed for the recurrent gout flares among 3,847 overweight or obese individuals with gout starting orlistat.CONCLUSIONSA higher rate of weight loss after initiating orlistat within 1-year was associated with lower risks of incident gout and lower rates of recurrent gout flares among overweight or obese people.","PeriodicalId":129,"journal":{"name":"Arthritis & Rheumatology","volume":"10 1","pages":""},"PeriodicalIF":13.3,"publicationDate":"2024-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142273534","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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