Pub Date : 2024-12-21DOI: 10.1016/j.jbspin.2024.105833
Danielle Bar , Merav Lidar , Sharon Baum , Aviv Barzilai , Felix Pavlotsky , Amit Druyan
Objectives
Early initiation of biologic therapies for psoriasis has been explored to prevent or delay the onset of psoriatic arthritis (PsA). This has renewed interest in the potential role of methotrexate (MTX) in mitigating PsA risk in newly diagnosed psoriasis patients. The aim of this study was to evaluate the impact of early MTX initiation on PsA incidence in individuals with psoriasis.
Methods
A retrospective, longitudinal cohort study of psoriasis patients treated at a tertiary center from 2014 to 2024 was conducted. Patients were categorized into early MTX (MTX initiation within 2 years of psoriasis onset), late MTX (> 2 years after onset), and a control group (non-DMARD treatment). PsA incidence was calculated as events per 100 patient years, and a time-dependent Cox proportional hazard model was used to compare PsA risk across groups. Sensitivity analyses were performed to validate results.
Results
A total of 629 patients were followed for a mean of 13.03 years, accumulating 8498.5 person-years. The overall PsA risk was 3.51 events per 100 patient years. The early MTX group had a significantly lower PsA incidence (1.07 events/100 patient years) compared to both the control (4.45 events/100 patient years, adjusted HR: 0.24, P < 0.001) and late MTX groups (2.66 events/100 patient years, adjusted HR: 0.36, P < 0.01). This effect persisted in patients naïve to biologics and with a minimum follow-up of 10 years.
Conclusions
Early initiation of methotrexate in patients with moderate to severe psoriasis may reduce the risk of developing PsA.
{"title":"Early methotrexate treatment for psoriatic arthritis prevention in psoriasis patients – A retrospective cohort study","authors":"Danielle Bar , Merav Lidar , Sharon Baum , Aviv Barzilai , Felix Pavlotsky , Amit Druyan","doi":"10.1016/j.jbspin.2024.105833","DOIUrl":"10.1016/j.jbspin.2024.105833","url":null,"abstract":"<div><h3>Objectives</h3><div>Early initiation of biologic therapies for psoriasis has been explored to prevent or delay the onset of psoriatic arthritis (PsA). This has renewed interest in the potential role of methotrexate (MTX) in mitigating PsA risk in newly diagnosed psoriasis patients. The aim of this study was to evaluate the impact of early MTX initiation on PsA incidence in individuals with psoriasis.</div></div><div><h3>Methods</h3><div>A retrospective, longitudinal cohort study of psoriasis patients treated at a tertiary center from 2014 to 2024 was conducted. Patients were categorized into early MTX (MTX initiation within 2 years of psoriasis onset), late MTX (> 2 years after onset), and a control group (non-DMARD treatment). PsA incidence was calculated as events per 100 patient years, and a time-dependent Cox proportional hazard model was used to compare PsA risk across groups. Sensitivity analyses were performed to validate results.</div></div><div><h3>Results</h3><div>A total of 629 patients were followed for a mean of 13.03 years, accumulating 8498.5 person-years. The overall PsA risk was 3.51 events per 100 patient years. The early MTX group had a significantly lower PsA incidence (1.07 events/100 patient years) compared to both the control (4.45 events/100 patient years, adjusted HR: 0.24, <em>P</em> <!--><<!--> <!-->0.001) and late MTX groups (2.66 events/100 patient years, adjusted HR: 0.36, <em>P</em> <!--><<!--> <!-->0.01). This effect persisted in patients naïve to biologics and with a minimum follow-up of 10 years.</div></div><div><h3>Conclusions</h3><div>Early initiation of methotrexate in patients with moderate to severe psoriasis may reduce the risk of developing PsA.</div></div>","PeriodicalId":54902,"journal":{"name":"Joint Bone Spine","volume":"92 2","pages":"Article 105833"},"PeriodicalIF":3.8,"publicationDate":"2024-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142883501","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-12-21DOI: 10.1016/j.jbspin.2024.105830
Fulvia Ceccarelli, Claudia Ciancarella, Francesco Natalucci, Alberto Scorda, Giuseppe Tripodi, Cristina Garufi, Silvia Mancuso, Francesca Romana Spinelli, Cristiano Alessandri , Fabrizio Conti
{"title":"Rapid response to anifrolumab in lupus related joint involvement as assessed by ultrasonography: A case series study","authors":"Fulvia Ceccarelli, Claudia Ciancarella, Francesco Natalucci, Alberto Scorda, Giuseppe Tripodi, Cristina Garufi, Silvia Mancuso, Francesca Romana Spinelli, Cristiano Alessandri , Fabrizio Conti","doi":"10.1016/j.jbspin.2024.105830","DOIUrl":"10.1016/j.jbspin.2024.105830","url":null,"abstract":"","PeriodicalId":54902,"journal":{"name":"Joint Bone Spine","volume":"92 2","pages":"Article 105830"},"PeriodicalIF":3.8,"publicationDate":"2024-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142883662","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-12-21DOI: 10.1016/j.jbspin.2024.105831
Çisem Yıldız, Sevcan A. Bakkaloğlu
{"title":"Exploring the complosome: Implications for the regulation of autoimmune and inflammatory disorders","authors":"Çisem Yıldız, Sevcan A. Bakkaloğlu","doi":"10.1016/j.jbspin.2024.105831","DOIUrl":"10.1016/j.jbspin.2024.105831","url":null,"abstract":"","PeriodicalId":54902,"journal":{"name":"Joint Bone Spine","volume":"92 3","pages":"Article 105831"},"PeriodicalIF":3.8,"publicationDate":"2024-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142883656","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Data on the economic consequences of systemic lupus erythematosus (SLE) and lupus nephritis (LN) are scarce in Europe. We aimed to estimate the total direct costs attributable to SLE and LN in France, at the nationwide level.
Methods
Patients with SLE and LN were identified in the French nationwide health insurance database (SNDS). Prevalent SLE patients for the year 2019 were age- and sex-matched (1:1) with non-SLE controls. Direct costs (in 2019 euros) were assigned from a societal and a third-party payer perspective, using official sources.
Results
A total of 29,135 SLE patients, including 4357 (14.5%) with lupus nephritis, were matched to non-SLE controls. The median overall direct cost for SLE was €4795 versus €1910 for controls from a third-party payer perspective (P < 0.0001). From a societal perspective the overall direct cost of SLE patients was higher (€5894) compared to non-SLE matched controls (€2601, P < 0.0001), for hospitalizations (+€1305 versus non-SLE controls), medications (+€872), consultations (+€343) and transportation (+€193). The overall median cost for LN was €9800 versus €3918 for SLE patients without LN, from third-party payer perspective, and €11,279 versus €4950 from a societal perspective (P < 0.0001, for both). At a national level, the extra cost of SLE compared to non-SLE controls was M€104.9 with hospitalizations contributing to 39.6% of this extra cost.
Conclusions
The direct extra costs of SLE and LN are substantial in France, particularly for hospitalizations, outpatient medications, consultations, and transportations. By identifying and addressing major drivers of SLE costs, healthcare providers and policymakers can work towards more cost-effective strategies for managing SLE.
{"title":"Economic burden of systemic lupus erythematosus and lupus nephritis in France: a nationwide population-based study using the French medico-administrative (SNDS) claims database","authors":"Laurent Arnaud , Caroline Fabry-Vendrand , Remus Todea , Blandine Vidal , Juliette Cottin , Isabelle Bureau , Stéphane Bouée , Gabriel Thabut","doi":"10.1016/j.jbspin.2024.105827","DOIUrl":"10.1016/j.jbspin.2024.105827","url":null,"abstract":"<div><h3>Objectives</h3><div>Data on the economic consequences of systemic lupus erythematosus (SLE) and lupus nephritis (LN) are scarce in Europe. We aimed to estimate the total direct costs attributable to SLE and LN in France, at the nationwide level.</div></div><div><h3>Methods</h3><div>Patients with SLE and LN were identified in the French nationwide health insurance database (SNDS). Prevalent SLE patients for the year 2019 were age- and sex-matched (1:1) with non-SLE controls. Direct costs (in 2019 euros) were assigned from a societal and a third-party payer perspective, using official sources.</div></div><div><h3>Results</h3><div>A total of 29,135 SLE patients, including 4357 (14.5%) with lupus nephritis, were matched to non-SLE controls. The median overall direct cost for SLE was €4795 versus €1910 for controls from a third-party payer perspective (<em>P</em> <!--><<!--> <!-->0.0001). From a societal perspective the overall direct cost of SLE patients was higher (€5894) compared to non-SLE matched controls (€2601, <em>P</em> <!--><<!--> <!-->0.0001), for hospitalizations (+€1305 versus non-SLE controls), medications (+€872), consultations (+€343) and transportation (+€193). The overall median cost for LN was €9800 versus €3918 for SLE patients without LN, from third-party payer perspective, and €11,279 versus €4950 from a societal perspective (<em>P</em> <!--><<!--> <!-->0.0001, for both). At a national level, the extra cost of SLE compared to non-SLE controls was M€104.9 with hospitalizations contributing to 39.6% of this extra cost.</div></div><div><h3>Conclusions</h3><div>The direct extra costs of SLE and LN are substantial in France, particularly for hospitalizations, outpatient medications, consultations, and transportations. By identifying and addressing major drivers of SLE costs, healthcare providers and policymakers can work towards more cost-effective strategies for managing SLE.</div></div>","PeriodicalId":54902,"journal":{"name":"Joint Bone Spine","volume":"92 3","pages":"Article 105827"},"PeriodicalIF":3.8,"publicationDate":"2024-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142774815","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-30DOI: 10.1016/j.jbspin.2024.105826
Dan Kaufmann , Nathorn Chaiyakunapruk , Naomi Schlesinger
Gout is the most common inflammatory arthritis, affecting approximately 5.1% of adults in the United States (US) population. Gout is a metabolic and autoinflammatory disease. Elevated uric acid pools lead to the precipitation of monosodium urate (MSU) crystals in and around joints, as well as other tissues, and the subsequent autoinflammatory response. Since elevated serum urate (SU) levels (hyperuricemia) correspond with gout severity, urate-lowering therapies (ULTs) are the cornerstone of gout treatment. ULTs include xanthine oxidoreductase inhibitors, uricosurics, less commonly used in the US but widely used in Europe and Asia, including benzbromarone, dotinurad, and probenecid (the only US Food and Drug Administration (FDA) approved uricosuric in the US), and uricases, including rasburicase and pegloticase (available only in the US). Over 90% of the daily load of uric acid filtered by the kidneys is reabsorbed through renal transporters. These urate transporters include uric acid transporter 1 (URAT1), glucose transporter 9, and organic anion transporters 1, 3, and 4 (OAT1, OAT3, OAT4). They are the target of approved and in-the-pipeline uricosurics. Any drug that increases renal excretion of uric acid, independently of the mechanism through which it exerts its effect, may be considered a uricosuric drug. This review discusses drugs that increase renal excretion of uric acid, either approved or in development, as well as off-label drugs with uricosuric properties.
{"title":"Optimizing gout treatment: A comprehensive review of current and emerging uricosurics","authors":"Dan Kaufmann , Nathorn Chaiyakunapruk , Naomi Schlesinger","doi":"10.1016/j.jbspin.2024.105826","DOIUrl":"10.1016/j.jbspin.2024.105826","url":null,"abstract":"<div><div>Gout is the most common inflammatory arthritis, affecting approximately 5.1% of adults in the United States (US) population. Gout is a metabolic and autoinflammatory disease. Elevated uric acid pools lead to the precipitation of monosodium urate (MSU) crystals in and around joints, as well as other tissues, and the subsequent autoinflammatory response. Since elevated serum urate (SU) levels (hyperuricemia) correspond with gout severity, urate-lowering therapies (ULTs) are the cornerstone of gout treatment. ULTs include xanthine oxidoreductase inhibitors, uricosurics, less commonly used in the US but widely used in Europe and Asia, including benzbromarone, dotinurad, and probenecid (the only US Food and Drug Administration (FDA) approved uricosuric in the US), and uricases, including rasburicase and pegloticase (available only in the US). Over 90% of the daily load of uric acid filtered by the kidneys is reabsorbed through renal transporters. These urate transporters include uric acid transporter 1 (URAT1), glucose transporter 9, and organic anion transporters 1, 3, and 4 (OAT1, OAT3, OAT4). They are the target of approved and in-the-pipeline uricosurics. Any drug that increases renal excretion of uric acid, independently of the mechanism through which it exerts its effect, may be considered a uricosuric drug. This review discusses drugs that increase renal excretion of uric acid, either approved or in development, as well as off-label drugs with uricosuric properties.</div></div>","PeriodicalId":54902,"journal":{"name":"Joint Bone Spine","volume":"92 2","pages":"Article 105826"},"PeriodicalIF":3.8,"publicationDate":"2024-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142774921","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-30DOI: 10.1016/j.jbspin.2024.105828
Ilaria Pagnini , Sarah Abu-Rumeileh , Ilaria Maccora , Maria Vincenza Mastrolia , Valerio Maniscalco , Edoardo Marrani , Anna Rosati , Gabriele Simonini
{"title":"Infliximab in the treatment of childhood primary angiitis of the CNS: A report of 4 cases","authors":"Ilaria Pagnini , Sarah Abu-Rumeileh , Ilaria Maccora , Maria Vincenza Mastrolia , Valerio Maniscalco , Edoardo Marrani , Anna Rosati , Gabriele Simonini","doi":"10.1016/j.jbspin.2024.105828","DOIUrl":"10.1016/j.jbspin.2024.105828","url":null,"abstract":"","PeriodicalId":54902,"journal":{"name":"Joint Bone Spine","volume":"92 2","pages":"Article 105828"},"PeriodicalIF":3.8,"publicationDate":"2024-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142774920","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Minor salivary gland biopsy (MSGB) is a minimally invasive test used in suspected autoimmune diseases. Our study goal was to evaluate diagnostic performance of MSGB in children suspected of Sjögren's syndrome (SS).
Methods
We did a retrospective monocentric study on patients under 18 years old who had a MSGB between October 2011 and December 2021 at Bicêtre University Hospital. Biopsy was considered positive if focus score was positive or Chisholm-Mason score was superior to 2.
Results
Sixty-six MSGB were analysed in SS indication, 23/66 (35%) were positive and 13/23 (57%) were associated with a confirmed final diagnosis. MSGB was sensitive and specific (Se = 81%, Sp = 80), but with low positive and negative predictive value (57% and 7%). Twenty of 64 MSGB also had positive anti-SSA antibodies. Anti-SSA antibodies improved MSGB specificity (98%).
Conclusion
MSGB demonstrates good sensitivity and specificity, but the predictive values and likelihood ratios make it a poor screening test. However, when combined with other criteria such as the presence of anti-SSA antibodies, the specificity of MSGB is improved. A larger prospective study should be carried out to support our results and clarify the good indications for MSGB.
{"title":"Diagnostic value of minor salivary gland biopsy for Sjögren's syndrome in children: A monocentric retrospective study over 10 years","authors":"Fanny Adeline , Ambre Hittinger , Lois Bolko , Catherine Guettier , Isabelle Kone-Paut , Adrien Schvartz","doi":"10.1016/j.jbspin.2024.105825","DOIUrl":"10.1016/j.jbspin.2024.105825","url":null,"abstract":"<div><h3>Objectives</h3><div>Minor salivary gland biopsy (MSGB) is a minimally invasive test used in suspected autoimmune diseases. Our study goal was to evaluate diagnostic performance of MSGB in children suspected of Sjögren's syndrome (SS).</div></div><div><h3>Methods</h3><div>We did a retrospective monocentric study on patients under 18<!--> <!-->years old who had a MSGB between October 2011 and December 2021 at Bicêtre University Hospital. Biopsy was considered positive if focus score was positive or Chisholm-Mason score was superior to 2.</div></div><div><h3>Results</h3><div>Sixty-six MSGB were analysed in SS indication, 23/66 (35%) were positive and 13/23 (57%) were associated with a confirmed final diagnosis. MSGB was sensitive and specific (Se<!--> <!-->=<!--> <!-->81%, Sp<!--> <!-->=<!--> <!-->80), but with low positive and negative predictive value (57% and 7%). Twenty of 64 MSGB also had positive anti-SSA antibodies. Anti-SSA antibodies improved MSGB specificity (98%).</div></div><div><h3>Conclusion</h3><div>MSGB demonstrates good sensitivity and specificity, but the predictive values and likelihood ratios make it a poor screening test. However, when combined with other criteria such as the presence of anti-SSA antibodies, the specificity of MSGB is improved. A larger prospective study should be carried out to support our results and clarify the good indications for MSGB.</div></div>","PeriodicalId":54902,"journal":{"name":"Joint Bone Spine","volume":"92 3","pages":"Article 105825"},"PeriodicalIF":3.8,"publicationDate":"2024-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142752416","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-26DOI: 10.1016/j.jbspin.2024.105824
Marion Pons , Stylianos Georgiadis , Mikkel Østergaard , Zohra Faizy Ahmadzay , Bente Glintborg , Jette Heberg , Sara Nysom Christensen , Simon Rasmussen , Anne Gitte Loft , Isabel Castrejón , Fernando Sánchez-Alonso , Florenzo Iannone , Dan Nordström , Anna-Mari Hokkanen , Adrian Ciurea , Michael J. Nissen , Jakub Závada , Karel Pavelka , Ziga Rotar , Katja Perdan Pirkmajer , Lykke Midtbøll Ørnbjerg
Objectives
In axial spondyloarthritis (axSpA) and psoriatic arthritis (PsA) patients initiating secukinumab, we aimed to assess retention rates and proportions of patients achieving remission and low disease activity (LDA), according to disease activity measures and patient-reported outcomes at 24 and 48 months.
Patients and methods
Data on patients with axSpA and PsA who initiated secukinumab treatment were pooled from 13 European registries. Analyses were performed overall and stratified according to the number of previous biologic/targeted synthetic Disease-Modifying Antirheumatic Drugs (b/tsDMARDs, 0/1/≥ 2). Kaplan-Meier plots and Cox regression analyses were performed to assess and compare secukinumab retention rates. Comparisons of remission and LDA rates were performed by logistic regression analyses.
Results
The overall 24-/48-month secukinumab retention rates were 61%/51% in 767 axSpA patients, and 64%/49% in 975 PsA patients, respectively. Compared to b/tsDMARD naïve patients, a higher risk of withdrawal from secukinumab was found for those with ≥ 2 prior b/tsDMARDs in axSpA and PsA, and 1 prior b/tsDMARD in axSpA. Generally, remission and LDA rates were numerically higher in b/tsDMARD naïve patients. After adjustment for confounders, statistically significantly higher remission and LDA rates were found for b/tsDMARD naïve patients compared to patients with ≥ 2 prior b/tsDMARDs at 24 months in axSpA and PsA.
Conclusion
This large European real-world study demonstrates that 4-year secukinumab retention rates were approximately 50% in both axSpA and PsA. b/tsDMARD naïve patients had higher retention, remission and LDA rates than patients with prior b/tsDMARD exposure.
{"title":"Four-year secukinumab treatment outcomes in European real-world patients with axial spondyloarthritis and psoriatic arthritis","authors":"Marion Pons , Stylianos Georgiadis , Mikkel Østergaard , Zohra Faizy Ahmadzay , Bente Glintborg , Jette Heberg , Sara Nysom Christensen , Simon Rasmussen , Anne Gitte Loft , Isabel Castrejón , Fernando Sánchez-Alonso , Florenzo Iannone , Dan Nordström , Anna-Mari Hokkanen , Adrian Ciurea , Michael J. Nissen , Jakub Závada , Karel Pavelka , Ziga Rotar , Katja Perdan Pirkmajer , Lykke Midtbøll Ørnbjerg","doi":"10.1016/j.jbspin.2024.105824","DOIUrl":"10.1016/j.jbspin.2024.105824","url":null,"abstract":"<div><h3>Objectives</h3><div>In axial spondyloarthritis (axSpA) and psoriatic arthritis (PsA) patients initiating secukinumab, we aimed to assess retention rates and proportions of patients achieving remission and low disease activity (LDA), according to disease activity measures and patient-reported outcomes at 24 and 48 months.</div></div><div><h3>Patients and methods</h3><div>Data on patients with axSpA and PsA who initiated secukinumab treatment were pooled from 13 European registries. Analyses were performed overall and stratified according to the number of previous biologic/targeted synthetic Disease-Modifying Antirheumatic Drugs (b/tsDMARDs, 0/1/≥<!--> <!-->2). Kaplan-Meier plots and Cox regression analyses were performed to assess and compare secukinumab retention rates. Comparisons of remission and LDA rates were performed by logistic regression analyses.</div></div><div><h3>Results</h3><div>The overall 24-/48-month secukinumab retention rates were 61%/51% in 767 axSpA patients, and 64%/49% in 975 PsA patients, respectively. Compared to b/tsDMARD naïve patients, a higher risk of withdrawal from secukinumab was found for those with<!--> <!-->≥<!--> <!-->2 prior b/tsDMARDs in axSpA and PsA, and 1 prior b/tsDMARD in axSpA. Generally, remission and LDA rates were numerically higher in b/tsDMARD naïve patients. After adjustment for confounders, statistically significantly higher remission and LDA rates were found for b/tsDMARD naïve patients compared to patients with<!--> <!-->≥ <!--> <!-->2 prior b/tsDMARDs at 24 months in axSpA and PsA.</div></div><div><h3>Conclusion</h3><div>This large European real-world study demonstrates that 4-year secukinumab retention rates were approximately 50% in both axSpA and PsA. b/tsDMARD naïve patients had higher retention, remission and LDA rates than patients with prior b/tsDMARD exposure.</div></div>","PeriodicalId":54902,"journal":{"name":"Joint Bone Spine","volume":"92 3","pages":"Article 105824"},"PeriodicalIF":3.8,"publicationDate":"2024-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142751098","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-20DOI: 10.1016/j.jbspin.2024.105823
Baptiste Chevet, Divi Cornec
Rheumatoid arthritis (RA) is an autoimmune disease characterized by joint inflammation and potential extra-articular manifestations. This review compares the presentation and treatment response between anti-citrullinated protein antibodies (ACPA)-positive and ACPA-negative RA patients. The incidence of seronegative RA (rheumatoid factor [RF]-negative and ACPA-negative) has increased in recent decades, emphasizing the need for new diagnostic biomarkers. Diagnostically, ACPA is highly specific for RA, yet many patients remain ACPA-negative. The absence of RF and ACPA in RA should trigger further analysis to test alternative diagnosis, in particular when new symptoms arise. Emerging biomarkers like anti-PAD4 and anti-CarP antibodies provide additional diagnostic value, identifying some ACPA-negative patients. Clinically, ACPA-negative patients often exhibit higher disease activity at diagnosis, with more swollen joints and elevated CRP levels. They also tend to have fewer pulmonary and ocular manifestations compared to ACPA-positive patients. Radiographically, ACPA-positive patients are at a higher risk for joint erosions over time. Response to treatment also differs according to ACPA status. Abatacept and rituximab have demonstrated greater efficacy in ACPA-positive patients, showing better disease activity control and higher treatment retention rates. Continuous re-evaluation is crucial for ACPA-negative patients, especially when first-line treatments like methotrexate are ineffective, to rule out RA mimickers and adjust the treatment approach accordingly. These findings underscore the importance of personalized treatment strategies in RA management.
{"title":"Clinical presentation and treatment response in ACPA-negative rheumatoid arthritis","authors":"Baptiste Chevet, Divi Cornec","doi":"10.1016/j.jbspin.2024.105823","DOIUrl":"10.1016/j.jbspin.2024.105823","url":null,"abstract":"<div><div>Rheumatoid arthritis (RA) is an autoimmune disease characterized by joint inflammation and potential extra-articular manifestations. This review compares the presentation and treatment response between anti-citrullinated protein antibodies (ACPA)-positive and ACPA-negative RA patients. The incidence of seronegative RA (rheumatoid factor [RF]-negative and ACPA-negative) has increased in recent decades, emphasizing the need for new diagnostic biomarkers. Diagnostically, ACPA is highly specific for RA, yet many patients remain ACPA-negative. The absence of RF and ACPA in RA should trigger further analysis to test alternative diagnosis, in particular when new symptoms arise. Emerging biomarkers like anti-PAD4 and anti-CarP antibodies provide additional diagnostic value, identifying some ACPA-negative patients. Clinically, ACPA-negative patients often exhibit higher disease activity at diagnosis, with more swollen joints and elevated CRP levels. They also tend to have fewer pulmonary and ocular manifestations compared to ACPA-positive patients. Radiographically, ACPA-positive patients are at a higher risk for joint erosions over time. Response to treatment also differs according to ACPA status. Abatacept and rituximab have demonstrated greater efficacy in ACPA-positive patients, showing better disease activity control and higher treatment retention rates. Continuous re-evaluation is crucial for ACPA-negative patients, especially when first-line treatments like methotrexate are ineffective, to rule out RA mimickers and adjust the treatment approach accordingly. These findings underscore the importance of personalized treatment strategies in RA management.</div></div>","PeriodicalId":54902,"journal":{"name":"Joint Bone Spine","volume":"92 2","pages":"Article 105823"},"PeriodicalIF":3.8,"publicationDate":"2024-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142693572","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"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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