P. Mease, D. Gladman, J. Merola, A. Deodhar, A. Ogdie, D. Collier, L. Liu, A. Kavanaugh
Objective In this post hoc analysis, we examined the potential impact of sex and BMI on response in the Study of Etanercept and Methotrexate in Combination or as Monotherapy in Subjects with Psoriatic Arthritis (SEAM-PsA) trial (NCT02376790), a 48-week, phase III, randomized controlled trial that compared outcomes with methotrexate (MTX) monotherapy, etanercept (ETN) monotherapy, and MTX+ETN combination therapy in patients with psoriatic arthritis (PsA) who were naïve to MTX and biologics. Methods We evaluated key outcomes at week 24 stratified by sex (male vs female) and BMI (kg/m2; ≤ 30 vs > 30), including the American College of Rheumatology 20 (ACR20) criteria, minimal disease activity (MDA), very low disease activity (VLDA), and Psoriatic Arthritis Disease Activity Score (PASDAS). We analyzed data using descriptive statistics, normal approximation, logistic model, and analysis of covariance. Results A total of 851 patients completed the SEAM-PsA trial. Higher proportions of men than women who received MTX+ETN combination therapy achieved ACR20 (71.5% vs 58.3%; P = 0.02), MDA (45.8% vs 25.2%; P = 0.0003), and VLDA (19.1% vs 9.5%; P = 0.03), and men achieved better PASDAS (-3.0 vs -2.3; P = 0.0004). Patients with BMI ≤ 30 generally had better outcomes than those with BMI > 30 in some treatment arms for ACR20, MDA, VLDA, and PASDAS; however, there was no consistent pattern regarding the treatment arm in which the difference occurred. Conclusion Improved outcomes were observed more in men than in women for MDA and PASDAS with MTX+ETN combination therapy. Patients with BMI ≤ 30 had better outcomes than those with BMI > 30, with no clear pattern regarding treatment received. These findings suggest that contextual factors such as sex and BMI may affect response to PsA therapy.
在这项事后分析中，我们研究了性别和BMI对银屑病关节炎患者(seama -PsA)研究(NCT02376790)反应的潜在影响，这是一项为期48周的III期随机对照试验，比较了甲氨蝶呤(MTX)单药治疗、依那西普(ETN)单药治疗和MTX+ETN联合治疗银屑病关节炎(PsA)患者(对MTX和生物制剂naïve)的结果。方法按性别(男性vs女性)和BMI (kg/m2;≤30 vs bbb30)，包括美国风湿病学会20 (ACR20)标准、最小疾病活动性(MDA)、极低疾病活动性(VLDA)和银屑病关节炎疾病活动性评分(PASDAS)。我们使用描述性统计、正态近似、逻辑模型和协方差分析来分析数据。结果共有851例患者完成了SEAM-PsA试验。接受MTX+ETN联合治疗的男性达到ACR20的比例高于女性(71.5% vs 58.3%;P = 0.02)， MDA (45.8% vs 25.2%;P = 0.0003)， VLDA (19.1% vs 9.5%;P = 0.03)，男性获得更好的PASDAS (-3.0 vs -2.3;P = 0.0004)。在ACR20、MDA、VLDA和PASDAS的某些治疗组中，BMI≤30的患者通常比BMI≤30的患者预后更好;然而，没有一致的模式关于治疗组的差异发生。结论MTX+ETN联合治疗MDA和PASDAS患者，男性预后明显优于女性。BMI≤30的患者预后优于BMI≤30的患者，治疗方式无明显规律。这些发现表明，性别和体重指数等环境因素可能影响对PsA治疗的反应。
{"title":"Potential Impact of Sex and BMI on Response to Therapy in Psoriatic Arthritis: Post Hoc Analysis of Results From the SEAM-PsA Trial","authors":"P. Mease, D. Gladman, J. Merola, A. Deodhar, A. Ogdie, D. Collier, L. Liu, A. Kavanaugh","doi":"10.3899/jrheum.211037","DOIUrl":"https://doi.org/10.3899/jrheum.211037","url":null,"abstract":"Objective In this post hoc analysis, we examined the potential impact of sex and BMI on response in the Study of Etanercept and Methotrexate in Combination or as Monotherapy in Subjects with Psoriatic Arthritis (SEAM-PsA) trial (NCT02376790), a 48-week, phase III, randomized controlled trial that compared outcomes with methotrexate (MTX) monotherapy, etanercept (ETN) monotherapy, and MTX+ETN combination therapy in patients with psoriatic arthritis (PsA) who were naïve to MTX and biologics. Methods We evaluated key outcomes at week 24 stratified by sex (male vs female) and BMI (kg/m2; ≤ 30 vs > 30), including the American College of Rheumatology 20 (ACR20) criteria, minimal disease activity (MDA), very low disease activity (VLDA), and Psoriatic Arthritis Disease Activity Score (PASDAS). We analyzed data using descriptive statistics, normal approximation, logistic model, and analysis of covariance. Results A total of 851 patients completed the SEAM-PsA trial. Higher proportions of men than women who received MTX+ETN combination therapy achieved ACR20 (71.5% vs 58.3%; P = 0.02), MDA (45.8% vs 25.2%; P = 0.0003), and VLDA (19.1% vs 9.5%; P = 0.03), and men achieved better PASDAS (-3.0 vs -2.3; P = 0.0004). Patients with BMI ≤ 30 generally had better outcomes than those with BMI > 30 in some treatment arms for ACR20, MDA, VLDA, and PASDAS; however, there was no consistent pattern regarding the treatment arm in which the difference occurred. Conclusion Improved outcomes were observed more in men than in women for MDA and PASDAS with MTX+ETN combination therapy. Patients with BMI ≤ 30 had better outcomes than those with BMI > 30, with no clear pattern regarding treatment received. These findings suggest that contextual factors such as sex and BMI may affect response to PsA therapy.","PeriodicalId":35278,"journal":{"name":"The Journal of rheumatology. Supplement","volume":"54 1","pages":"885 - 893"},"PeriodicalIF":0.0,"publicationDate":"2022-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88414060","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Sino-orbital disease from IgG4-related disease (IgG4-RD) has been described previously,1,2 but nasal bridge collapse due to bone involvement has been rarely reported.3,4 A 34-year-old woman presented with right eye swelling.
{"title":"IgG4-related Disease With Destructive Nasal Bone Involvement Leading to Saddle Nose Deformity","authors":"Giorgos Loizidis, Mindy R. Rabinowitz, M. Tuluc","doi":"10.3899/jrheum.200621","DOIUrl":"https://doi.org/10.3899/jrheum.200621","url":null,"abstract":"Sino-orbital disease from IgG4-related disease (IgG4-RD) has been described previously,1,2 but nasal bridge collapse due to bone involvement has been rarely reported.3,4 A 34-year-old woman presented with right eye swelling.","PeriodicalId":35278,"journal":{"name":"The Journal of rheumatology. Supplement","volume":"3 1","pages":"748 - 749"},"PeriodicalIF":0.0,"publicationDate":"2022-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82677256","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Psoriatic arthritis (PsA) is a systemic inflammatory disease that includes uveitis as one of its extraarticular associations. Studies involving predominantly adult patients report a significant association between the incidence of uveitis and psoriasis, the risk of which is greatest in patients with severe PsA.1,2.
{"title":"Uveitis in Juvenile Psoriatic Arthritis: Still So Much To Learn","authors":"K. Mireskandari","doi":"10.3899/jrheum.220163","DOIUrl":"https://doi.org/10.3899/jrheum.220163","url":null,"abstract":"Psoriatic arthritis (PsA) is a systemic inflammatory disease that includes uveitis as one of its extraarticular associations. Studies involving predominantly adult patients report a significant association between the incidence of uveitis and psoriasis, the risk of which is greatest in patients with severe PsA.1,2.","PeriodicalId":35278,"journal":{"name":"The Journal of rheumatology. Supplement","volume":"14 1","pages":"661 - 662"},"PeriodicalIF":0.0,"publicationDate":"2022-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74792636","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Monoarthritis warrants a broad differential diagnosis including trauma, infection, malignancy, and hemarthrosis.1 Most children with hemophilia are diagnosed before age 2 years, with hemarthrosis typically occurring 1-2 years after bleeding into the soft tissues, skin, and mucosa.2.
{"title":"Monoarthritis and Microhematomas in a 4-year-old Boy","authors":"Chelsea DeCoste, S. Tse","doi":"10.3899/jrheum.210181","DOIUrl":"https://doi.org/10.3899/jrheum.210181","url":null,"abstract":"Monoarthritis warrants a broad differential diagnosis including trauma, infection, malignancy, and hemarthrosis.1 Most children with hemophilia are diagnosed before age 2 years, with hemarthrosis typically occurring 1-2 years after bleeding into the soft tissues, skin, and mucosa.2.","PeriodicalId":35278,"journal":{"name":"The Journal of rheumatology. Supplement","volume":"56 1","pages":"1068 - 1069"},"PeriodicalIF":0.0,"publicationDate":"2022-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90419342","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
T. Gunderson, E. Myasoedova, John M. Davis, C. Crowson
We thank Drs. Liao, Liao, and Liaw for their interest in our article on multimorbidity burden in patients with rheumatoid arthritis (RA).1 We agree that not all morbidities were included in the assessment of multimorbidity in our article, and further research is warranted to more comprehensively assess multimorbidity in patients with RA.
{"title":"Dr. Gunderson et al reply","authors":"T. Gunderson, E. Myasoedova, John M. Davis, C. Crowson","doi":"10.3899/jrheum.211343","DOIUrl":"https://doi.org/10.3899/jrheum.211343","url":null,"abstract":"We thank Drs. Liao, Liao, and Liaw for their interest in our article on multimorbidity burden in patients with rheumatoid arthritis (RA).1 We agree that not all morbidities were included in the assessment of multimorbidity in our article, and further research is warranted to more comprehensively assess multimorbidity in patients with RA.","PeriodicalId":35278,"journal":{"name":"The Journal of rheumatology. Supplement","volume":"104 1","pages":"964 - 964"},"PeriodicalIF":0.0,"publicationDate":"2022-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74369282","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
P. Mease, A. Kavanaugh, A. Ogdie, A. Wells, Martin Bergman, D. Gladman, S. Richter, L. Teng, S. Jardon, J. Smolen
Objective. The probability of achieving Clinical Disease Activity Index for Psoriatic Arthritis (cDAPSA) treatment targets (remission [REM], low disease activity [LDA]) was evaluated following apremilast monotherapy in disease-modifying antirheumatic drug (DMARD)-naïve patients with psoriatic arthritis (PsA) based on baseline disease activity. Methods. This post hoc probability analysis of PALACE 4, a phase III, multicenter, randomized, placebo-controlled study, evaluated shifting across cDAPSA categories from baseline to week 52 and included DMARD-naïve patients receiving apremilast 30 mg BID with available baseline cDAPSA data. Changes in articular/extraarticular manifestations were evaluated in patients with week 52 cDAPSA components. cDAPSA treatment target achievement was assessed in a subgroup with baseline extraarticular PsA manifestations (skin involvement, enthesitis, dactylitis). Results. Of 175 apremilast-treated patients in the probability analysis, 66.3% were in high disease activity (HDA) and 31.4% in moderate disease activity (ModDA) at baseline. Approximately twice as many patients in ModDA at baseline reached REM/LDA at week 52 vs those in HDA (61.7% vs 28.2%). Achieving cDAPSA treatment targets was associated with reductions in articular (swollen/tender joints) and extraarticular (skin involvement, enthesitis, dactylitis, functional disability) disease activity. Similar treatment target achievement rates were observed in the subgroup with ≥ 1 extraarticular PsA manifestation (n = 126; ModDA: 66.7%, HDA: 32.2%). Conclusion. Apremilast-treated patients with baseline ModDA had higher probability of achieving cDAPSA treatment targets than patients with HDA. Resolution and/or near resolution of articular and/or extraarticular PsA manifestations was achieved by patients in REM/LDA at week 52. Consistent treatment target achievement was observed in patients with 1 or multiple extraarticular manifestations of active PsA.
{"title":"Baseline Disease Activity Predicts Achievement of cDAPSA Treatment Targets With Apremilast: Phase III Results in DMARD-naïve Patients With Psoriatic Arthritis","authors":"P. Mease, A. Kavanaugh, A. Ogdie, A. Wells, Martin Bergman, D. Gladman, S. Richter, L. Teng, S. Jardon, J. Smolen","doi":"10.3899/jrheum.210906","DOIUrl":"https://doi.org/10.3899/jrheum.210906","url":null,"abstract":"Objective. The probability of achieving Clinical Disease Activity Index for Psoriatic Arthritis (cDAPSA) treatment targets (remission [REM], low disease activity [LDA]) was evaluated following apremilast monotherapy in disease-modifying antirheumatic drug (DMARD)-naïve patients with psoriatic arthritis (PsA) based on baseline disease activity. Methods. This post hoc probability analysis of PALACE 4, a phase III, multicenter, randomized, placebo-controlled study, evaluated shifting across cDAPSA categories from baseline to week 52 and included DMARD-naïve patients receiving apremilast 30 mg BID with available baseline cDAPSA data. Changes in articular/extraarticular manifestations were evaluated in patients with week 52 cDAPSA components. cDAPSA treatment target achievement was assessed in a subgroup with baseline extraarticular PsA manifestations (skin involvement, enthesitis, dactylitis). Results. Of 175 apremilast-treated patients in the probability analysis, 66.3% were in high disease activity (HDA) and 31.4% in moderate disease activity (ModDA) at baseline. Approximately twice as many patients in ModDA at baseline reached REM/LDA at week 52 vs those in HDA (61.7% vs 28.2%). Achieving cDAPSA treatment targets was associated with reductions in articular (swollen/tender joints) and extraarticular (skin involvement, enthesitis, dactylitis, functional disability) disease activity. Similar treatment target achievement rates were observed in the subgroup with ≥ 1 extraarticular PsA manifestation (n = 126; ModDA: 66.7%, HDA: 32.2%). Conclusion. Apremilast-treated patients with baseline ModDA had higher probability of achieving cDAPSA treatment targets than patients with HDA. Resolution and/or near resolution of articular and/or extraarticular PsA manifestations was achieved by patients in REM/LDA at week 52. Consistent treatment target achievement was observed in patients with 1 or multiple extraarticular manifestations of active PsA.","PeriodicalId":35278,"journal":{"name":"The Journal of rheumatology. Supplement","volume":"67 1","pages":"694 - 699"},"PeriodicalIF":0.0,"publicationDate":"2022-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81186982","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Geodes are subarticular cystic lesions caused by inflammatory changes in the synovial lining of the articular cavity and can destroy cartilage and bone. This lesion occurs with rheumatoid arthritis (RA), but a single giant geode is rare.1.
{"title":"Giant Geode at the Humeral Head in the Rheumatoid Shoulder Treated With Allograft Bone Grafting and Shoulder Arthroplasty","authors":"A. Urita, Takeshi Endo, N. Iwasaki, H. Taneichi","doi":"10.3899/jrheum.211082","DOIUrl":"https://doi.org/10.3899/jrheum.211082","url":null,"abstract":"Geodes are subarticular cystic lesions caused by inflammatory changes in the synovial lining of the articular cavity and can destroy cartilage and bone. This lesion occurs with rheumatoid arthritis (RA), but a single giant geode is rare.1.","PeriodicalId":35278,"journal":{"name":"The Journal of rheumatology. Supplement","volume":"13 1","pages":"1174 - 1175"},"PeriodicalIF":0.0,"publicationDate":"2022-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85272995","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
We read with great interest the article by Gunderson et al, which reported the multimorbidity burden in rheumatoid arthritis (RA).1 We appreciate that the authors estimated comorbidities in RA with a novel perspective, thus giving us a chance to further clarify the RA patient complexity. We would like, however, to discuss some key points.
{"title":"Extraarticular Manifestations and Comorbidities in Patients With Rheumatoid Arthritis","authors":"Pei-Yu Liao, Shin-Liang Liao, Y. Liaw","doi":"10.3899/jrheum.211278","DOIUrl":"https://doi.org/10.3899/jrheum.211278","url":null,"abstract":"We read with great interest the article by Gunderson et al, which reported the multimorbidity burden in rheumatoid arthritis (RA).1 We appreciate that the authors estimated comorbidities in RA with a novel perspective, thus giving us a chance to further clarify the RA patient complexity. We would like, however, to discuss some key points.","PeriodicalId":35278,"journal":{"name":"The Journal of rheumatology. Supplement","volume":"24 1","pages":"963 - 963"},"PeriodicalIF":0.0,"publicationDate":"2022-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81159465","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
P. Mease, T. Blachley, Blessing Dube, R. McLean, N. Kim, P. Hur, A. Ogdie
Objective. To evaluate clinical and patient-reported outcomes (PROs) at 6 months after secukinumab initiation in US patients with psoriatic arthritis (PsA). Methods. Patients with PsA in the CorEvitas Psoriatic Arthritis/Spondyloarthritis Registry who initiated secukinumab between April 1, 2017, and December 2, 2019, and maintained secukinumab at their 6-month follow-up visit were included. Achievement of minimal disease activity (MDA) among patients not in MDA at initiation; resolution (ie, no evidence) of tender and swollen joint counts, enthesitis, and dactylitis among patients with ≥ 1 of these at initiation; and change in disease activity and PROs were evaluated at 6 months in all patients and in patients who received secukinumab as a first-line biologic. Results. Of the 100 eligible patients included, most (83.0%) were biologic experienced and 17.0% initiated secukinumab as a first-line biologic. At initiation, 75/90 patients (83.3%) with available data were not in MDA; 26/71 (36.6%) with follow-up data achieved MDA at 6 months. Further, 28/68 patients (41.2%) with ≥ 1 tender joint, 24/54 (44.4%) with ≥ 1 swollen joint, 17/28 (60.7%) with enthesitis, and 9/12 (75.0%) with dactylitis at initiation achieved resolution at 6 months. Improvements in clinical manifestations, PRO measures, and work productivity and activity were observed after 6 months among patients with PsA who initiated and maintained secukinumab. Conclusion. In this real-world population, patients with PsA who received and maintained secukinumab for 6 months achieved MDA in proportions consistent with clinical trials and demonstrated improvements in clinical manifestations and PROs.
{"title":"Effectiveness of 6-month Use of Secukinumab in Patients With Psoriatic Arthritis in the CorEvitas Psoriatic Arthritis/Spondyloarthritis Registry","authors":"P. Mease, T. Blachley, Blessing Dube, R. McLean, N. Kim, P. Hur, A. Ogdie","doi":"10.3899/jrheum.211033","DOIUrl":"https://doi.org/10.3899/jrheum.211033","url":null,"abstract":"Objective. To evaluate clinical and patient-reported outcomes (PROs) at 6 months after secukinumab initiation in US patients with psoriatic arthritis (PsA). Methods. Patients with PsA in the CorEvitas Psoriatic Arthritis/Spondyloarthritis Registry who initiated secukinumab between April 1, 2017, and December 2, 2019, and maintained secukinumab at their 6-month follow-up visit were included. Achievement of minimal disease activity (MDA) among patients not in MDA at initiation; resolution (ie, no evidence) of tender and swollen joint counts, enthesitis, and dactylitis among patients with ≥ 1 of these at initiation; and change in disease activity and PROs were evaluated at 6 months in all patients and in patients who received secukinumab as a first-line biologic. Results. Of the 100 eligible patients included, most (83.0%) were biologic experienced and 17.0% initiated secukinumab as a first-line biologic. At initiation, 75/90 patients (83.3%) with available data were not in MDA; 26/71 (36.6%) with follow-up data achieved MDA at 6 months. Further, 28/68 patients (41.2%) with ≥ 1 tender joint, 24/54 (44.4%) with ≥ 1 swollen joint, 17/28 (60.7%) with enthesitis, and 9/12 (75.0%) with dactylitis at initiation achieved resolution at 6 months. Improvements in clinical manifestations, PRO measures, and work productivity and activity were observed after 6 months among patients with PsA who initiated and maintained secukinumab. Conclusion. In this real-world population, patients with PsA who received and maintained secukinumab for 6 months achieved MDA in proportions consistent with clinical trials and demonstrated improvements in clinical manifestations and PROs.","PeriodicalId":35278,"journal":{"name":"The Journal of rheumatology. Supplement","volume":"37 1","pages":"700 - 706"},"PeriodicalIF":0.0,"publicationDate":"2022-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76298542","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Katelyn Baggett, T. Brandon, R. Xiao, Zachary Valenzuela, Lisa H. Buckley, P. Weiss
Objective To estimate the differential effect of tumor necrosis factor inhibitor (TNFi) therapies and presence or absence of conventional synthetic disease-modifying antirheumatic drugs (DMARDs) on the incidence of psoriasis (PsO) in children with inflammatory bowel disease (IBD), juvenile idiopathic arthritis (JIA), and chronic nonbacterial osteomyelitis (CNO). Methods This was a retrospective cohort study from 2008 to 2020. TNFi and DMARD exposures were dichotomized as ever/never. The primary outcome was incident PsO. Incidence rates (IRs) of PsO were stratified by underlying diagnosis, TNFi agent, and DMARD use. Poisson regression was used to assess the IR ratios (IRRs) between exposure groups. Results There were 5088 children who met the inclusion criteria: 3794 (75%) had IBD, 1189 (23%) had JIA, and 105 (2%) had CNO. Of the 2023 children with TNFi exposure, 613 (30%) and 1410 (70%) were with or without a DMARD, respectively. When controlling for DMARD, sex, and family history of PsO, the IRR of developing PsO in patients exposed to adalimumab (ADA) was 2.70 times higher (95% CI 1.53-4.75; P < 0.001) than those who did not receive any TNFi treatment. IRR was lower, but not significantly different, for patients exposed to infliximab (IFX; IRR 2.34, 95% CI 1.56-3.51; P < 0.001) and etanercept (ETN; IRR 2.21; 95% CI 1.17-4.21; P = 0.006) compared to TNFi-unexposed patients. IRR of TNFi exposure was lower by 0.25 (P < 0.001) in DMARD-exposed patients compared to non–DMARD-exposed patients. Conclusion IRR of TNFi-induced PsO was not significantly different among ADA, IFX, and ETN. However, for patients with exposure to any of the TNFi evaluated, the IRR was significantly lower in those also exposed to a DMARD.
目的评价肿瘤坏死因子抑制剂(TNFi)治疗和常规合成疾病缓解抗风湿药物(DMARDs)的存在或不存在对炎症性肠病(IBD)、青少年特发性关节炎(JIA)和慢性非细菌性骨髓炎(CNO)患儿银屑病(PsO)发病率的差异影响。方法2008 - 2020年回顾性队列研究。TNFi和DMARD暴露分为曾经/从未。主要结局为PsO事件。PsO的发病率(IRs)根据基础诊断、TNFi药物和DMARD的使用进行分层。使用泊松回归评估暴露组之间的红外比(IRRs)。结果5088例患儿符合纳入标准，其中IBD 3794例(75%)，JIA 1189例(23%)，CNO 105例(2%)。在2023名暴露于TNFi的儿童中，分别有613名(30%)和1410名(70%)患有或不患有DMARD。当控制DMARD、性别和PsO家族史时，暴露于阿达单抗(ADA)的患者发生PsO的IRR高出2.70倍(95% CI 1.53-4.75;P < 0.001)，高于未接受任何TNFi治疗的患者。暴露于英夫利昔单抗(IFX;Irr 2.34, 95% ci 1.56-3.51;P < 0.001)和依那西普(ETN;IRR 2.21;95% ci 1.17-4.21;P = 0.006)。与非dmard暴露患者相比，dmard暴露患者TNFi暴露的IRR低0.25 (P < 0.001)。结论ADA、IFX和ETN对tnfi诱导的PsO的IRR无显著性差异。然而，对于暴露于任何评估的TNFi的患者，暴露于DMARD的IRR明显较低。
{"title":"Incidence Rates of Psoriasis in Children With Inflammatory Bowel Disease and Juvenile Arthritis Treated With Tumor Necrosis Factor Inhibitors and Disease-Modifying Antirheumatic Drugs","authors":"Katelyn Baggett, T. Brandon, R. Xiao, Zachary Valenzuela, Lisa H. Buckley, P. Weiss","doi":"10.3899/jrheum.211359","DOIUrl":"https://doi.org/10.3899/jrheum.211359","url":null,"abstract":"Objective To estimate the differential effect of tumor necrosis factor inhibitor (TNFi) therapies and presence or absence of conventional synthetic disease-modifying antirheumatic drugs (DMARDs) on the incidence of psoriasis (PsO) in children with inflammatory bowel disease (IBD), juvenile idiopathic arthritis (JIA), and chronic nonbacterial osteomyelitis (CNO). Methods This was a retrospective cohort study from 2008 to 2020. TNFi and DMARD exposures were dichotomized as ever/never. The primary outcome was incident PsO. Incidence rates (IRs) of PsO were stratified by underlying diagnosis, TNFi agent, and DMARD use. Poisson regression was used to assess the IR ratios (IRRs) between exposure groups. Results There were 5088 children who met the inclusion criteria: 3794 (75%) had IBD, 1189 (23%) had JIA, and 105 (2%) had CNO. Of the 2023 children with TNFi exposure, 613 (30%) and 1410 (70%) were with or without a DMARD, respectively. When controlling for DMARD, sex, and family history of PsO, the IRR of developing PsO in patients exposed to adalimumab (ADA) was 2.70 times higher (95% CI 1.53-4.75; P < 0.001) than those who did not receive any TNFi treatment. IRR was lower, but not significantly different, for patients exposed to infliximab (IFX; IRR 2.34, 95% CI 1.56-3.51; P < 0.001) and etanercept (ETN; IRR 2.21; 95% CI 1.17-4.21; P = 0.006) compared to TNFi-unexposed patients. IRR of TNFi exposure was lower by 0.25 (P < 0.001) in DMARD-exposed patients compared to non–DMARD-exposed patients. Conclusion IRR of TNFi-induced PsO was not significantly different among ADA, IFX, and ETN. However, for patients with exposure to any of the TNFi evaluated, the IRR was significantly lower in those also exposed to a DMARD.","PeriodicalId":35278,"journal":{"name":"The Journal of rheumatology. Supplement","volume":"6 1","pages":"935 - 941"},"PeriodicalIF":0.0,"publicationDate":"2022-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75455554","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
京公网安备 11010802042870号
京ICP备2023020795号-1
扫码关注我们
求助内容：
应助结果提醒方式：