August to November 2022
Authors: Anastasia Madenidou and Sizheng Steven Zhao
Arriens et al (doi: 10.1002/acr.25007) performed an integrated analysis evaluating the efficacy and safety of voclosporin, a novel calcineurin inhibitor, in combination with mycophenolate mofetil and oral glucocorticoids in lupus nephritis using pooled data from two large phase 2 (AURA-LV) and phase 3 (AURORA 1) clinical trials (n= 534). Significantly more patients achieved a CRR at 1 year in the voclosporin than control group (43.7% vs. 23.3%, OR 2.76; 95% CI 1.88, 4.05 p<0.0001). The incidence of adverse events (AEs) was similar; 91.4% voclosporin and 87.2% control. Most AEs were mild to moderate in severity, with infections and infestations (62.2% voclosporin, 54.9% control) the commonest ones.
Choi et al (doi: 10.1002/acr.25017) investigated whether sleep deprivation was associated with risk of developing systemic lupus erythematosus (SLE) using the Nurses’ Health Study (NHS) (1986-2016) and NHSII (1989-2017) cohorts. The authors included 186,072 women with 187 incident SLE cases during 4,246,094 person-years of follow-up. Chronic low sleep duration (≤5 hours/night vs reference >7-8 hours) was associated with increased SLE risk (adjusted HR 2.47, 95%CI:1.29-4.75). There was also an interaction between low sleep duration and depression with an AP of 68% (95%CI:49%-88%) and an HR for SLE of 2.82 (95%CI:1.64-4.85).
Harris et al (doi: 10.1002/acr.25022) evaluated the cost-effectiveness of telehealth-delivered Exercise and Diet+Exercise programs within 12 months. The study populations was 415 people with knee osteoarthritis aged 45-80 years and body mass index 28-40 kg/m2. The clinical trial demonstrated greater improvements in pain and function compared to information only for individuals with knee osteoarthritis and overweight/obesity. They also showed that we can be 86% confident that augmenting Exercise with the Diet program is cost effective ($21,100 per QALY).
Kneeland et al (doi: 10.1002/acr.25058) performed a systematic review and network meta-analysis of studies that examined clinical response in patients with cutaneous lupus with or without SLE receiving belimumab. Pooled odds of clinical response at 52 weeks in belimumab users with SLE were 44% higher compared to non-users (OR 1.44, 95% CI 1.20-1.74, I2 0%). Clinical response was first noted after 20 weeks of starting belimumab (OR 1.35, 95% CI 1.01-1.81, I2 0%). The findings support that belimumab is an effective therapy for cutaneous lupus.
Yang et al (doi: 10.1002/acr.24998) investigated if intrinsic subset (IS) classification based upon skin gene expression yields additional valuable clinical information in systemic sclerosis (n= 223). Classification by IS identified subgroups of systemic sclerosis (SSc) patients with more radiographic ILD (Fibroproliferative), higher mRSS (Inflammatory) and milder phenotype (Normal-like) and may provide additional clinically useful information to current SSc classification systems.
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.