Rheumatology

In a new study, investigators set out to discover whether the Janus kinase-1 inhibitor filgotinib is efficacious, either in combination with MTX or as monotherapy, in patients with RA who have had limited or no MTX exposure.

Investigators determined, “Treatment with TNF inhibitors is not associated with increased risks of solid cancer overall, or eight common cancer types. There were no indications of different crude incidence of solid cancers overall by TNF inhibitor agent.”

A recent study published in The Journal of Rheumatology found no association between hydroxychloroquine therapy and heart failure in patients with rheumatoid arthritis (RA) and other rheumatic diseases, such as systemic lupus erythematous (SLE).

Increasing dosage of mometasone is associated with elevated risk of osteoporosis and major osteoporotic fractures.

The treatment is the first approved medication for this patient population.

Despite the limitations of the study, non-adherence rates were significantly reduced in patients observed throughout the 3 years, indicating that the methods developed and deployed were successful.

Voclosporin (LUPKYNIS), in combination with an existing immunosuppressive therapy regimen, works to safely and effectively treat adult patients with lupus nephritis.

Alyssa Johnsen, MD, PhD, shares her insight on the importance of understanding key pathways that drive immune-mediated diseases, which can help rheumatologists develop more potent and specific therapies for patients with rheumatic disease.

“Based on 16,235 pairs of zoledronic acid and denosumab initiators (for osteoporosis), we found a greater risk (HR 1.25, 95% CI 1.04-1.50) of atrial fibrillation with zoledronic acid vs denosumab: an absolute risk difference of 3.69 events per 1000 person-years,” said Seoyoung Kim, MD, ScD.

Investigators aimed to improve the quality of care by creating effective management plans using the goals of both the patient and physician. During the course of the Elderly Multimorbidity Clinic (EMC) program, 75% of patients accomplished at least 1 of their goals. Unfortunately, no sustained benefits were observed because of low follow-up.

Improvement in ASAS20 (Assessment of SpondyloArthritis international Society) was seen in 63% of participants assigned to secukinumab 300 mg and 66% of those assigned to secukinumab 150 mg, versus 31% of the placebo group.

Investigators found "improved outcomes for patients with rheumatic and musculoskeletal diseases after COVID-19 diagnosis in more recent months of the pandemic compared with earlier months, including lower risks of death, respiratory failure, and renal failure."

The VELYS Robotic-Assisted solution will be used in conjunction with the VELYS Digital Surgery Platform.

Dr Joan Lo, MD, a research scientist with the Kaiser Permanente Northern California Division of Research, said: “We found that hip fracture risk in women did not differ if women stopped bisphosphonate use after five years or stayed on the medication for 10 years. Whether there is a benefit to staying on the drug for seven years needs to be further studied in randomized trials.”

A range of biologic therapies are available as options for treating patients with rheumatoid arthritis who do not respond to first-line conventional DMARDs, but which to choose and why? Test your knowledge of biologics with this quiz.

“The most important take home message for rheumatologists is that we can predict lack of response to methotrexate by analyzing the fecal microbiome of patients before the initiation of the treatment,” said Jose Scher, MD, rheumatologist from the Department of Medicine, Mount Sinai School of Medicine, New York.

Although the stakes couldn’t be higher and the promotion of healthy behavior is paramount, the emphasis on BMI and weight is likely to yield little benefit. The Association for Size Diversity and Health (ASDAH) developed Health at Every Size (HAES) to take the focus off of weight change and place it more squarely on health, thus supporting people of all sizes to take care of themselves and improve health outcomes.

Investigators compared a self-directed, stepped exercise program to improve symptoms of knee osteoarthritis in randomized trial to an education-based approach.

Previously proven to be an effective and well-tolerated treatment for patients with RA, baricitinib can also help patients reduce joint damage progression and erosion.

The outcomes with COVID-19 infection in patients with rheumatic or musculoskeletal disease are better in those infected later in the pandemic.

Coupled with the fact that there were no new safety concerns identified, these findings further solidify the safety and effectiveness of abatacept for RA patients.

The study is the first randomized trial to examine the comparative benefits and safety of biological drugs with different modes of action versus active conventional treatment.

The reviewers find persistent disease activity and flares despite progress to date. In addition, they point to the persistence of glucocorticoid treatment dependency, comorbidity burden, reduced health-related quality of life, and inconsistent access to high-quality care.

“Bone mineral density screening rates remain low, as do calcium/vitamin D supplementation and primary prophylaxis with anti-osteoporotic therapy," lead author Eileen Rife, MD, said.

The results of a study presented at ACR 2020 demonstrate that a greater proportion of patients were initiated on denosumab compared with bisphosphonates for the first time—18.5% compared with 16.9%— in 2018.

The US and the world must appreciate the role of the pharmaceutical industry—the investigators, physicians and business leaders—who are rescuing the world from COVID-19. It’s the medical breakthrough of our lifetime.

In part 1 of this article series, Dr. Concoff dusts off the crystal ball to envision the future of the practice of rheumatology, in particular the role of telemedicine during the COVID-19 pandemic and beyond.

Catch up on the biggest studies and expert interviews from ACR 2020.

Some studies have suggested an increase in the incidence of neuropsychiatric disorders in rheumatic patients may be due to the immunological mechanisms of the disease itself.

Long-term outcomes in systemic lupus erythematosus have improved over time, but unmet needs include glucorticoid dependency and comorbidity burden.