August to November 2022
Authors: Anastasia Madenidou and Sizheng Steven Zhao
Glucocorticoids (GC) have a plethora of potential adverse events that are particularly relevant to people with GCA who are typically older. Patel et al (10.1002/art.42405) performed a post hoc analysis of the GiACTA (Tocilizumab in GCA) trial to look at changes in a glycemic index, HbA1c, with tocilizumab. Tocilizumab was associated with significantly lower HbA1c values compared to treatment with GCs alone. 42.5% of patients in the tocilizumab/GC group experienced a decline in their HbA1c level, compared with only 12.5% in the GC-only group. The mechanisms through which IL-6 inhibition might reduce HbA1c is unclear, and lower GC exposure did not account for the differences in HbA1c between the tocilizumab/GC and GC-only arms.
Sirotti et al (10.1002/art.42368) investigated the reliability and diagnostic accuracy of new radiographic definitions for calcium pyrophosphate deposition (CPPD) identification. Definition: “linear or punctate opacities 1) in the region of fibro- or hyaline articular cartilage, or 2) synovial membrane or joint capsule, or 3) within tendons or entheses that are distinct from denser, nummular radio-opaque deposits due to BCP deposition.” They showed that radiography is a reliable diagnostic test and offers an overall high specificity.
Alabarse et al (10.1002/art.42351) set out to determine the role of CD38, which can function as an enzyme to degrade nicotinamide adenosine dinucleotide (NAD+), in osteoarthritis development. CD38 expression was upregulated in human knee OA cartilage and in human chondrocytes challenged with pro-inflammatory cytokine IL-1β. CD38 deficiency has OA disease modifying effects in experimental mouse OA. Inhibition of CD38 has a potential to be a novel therapeutic approach for OA treatment.
Sen et al (10.1002/art.42333) evaluated the usefulness of neutrophil-to-lymphocyte ratio (NLR) and the platelet-to-lymphocyte ratio (PLR) as biomarkers in patients with axial SpA using a large prospective registry of US veteran. Their results demonstrate an association between NLR and PLR and sacroiliitis and disease activity, with NLR and PLR showing response after TNFi treatment and adding useful clinical information to established biomarkers.
Seifert et al (10.1002/art.42370) investigated antibodies to Prevotella copri (Pc), a gut commensal, in rheumatoid arthritis. At-risk participants and those with early RA had overall higher levels of IgG anti-Pc-p27 antibodies and those with established RA had significantly increased levels of IgA anti-Pc-p27 antibodies. These findings may lead to the development of therapies targeting immunogenic bacterial commensals and/or pathobionts, which may prevent the development of RA in at-risk individuals.
About the AuthorS
Anastasia is a rheumatology trainee and a Clinical Research Fellow at the Centre of Musculoskeletal Research, University of Manchester. Her research work focuses on omics techniques to cluster lupus patients according to their molecular profile. Anastasia is the Deputy Chair of the British Rheumatology Society Trainee Committee and a member of the Newsletter Sub-Committee.
Sizheng Steven Zhao
Steven is a rheumatologist and epidemiologist at the University of Manchester, UK. His research focuses on inflammatory arthritis and drug safety, for which he uses registry, routine healthcare and genetic data.