December 2022 to March 2023
Authors: Serena Fasano and Jean-Guillaume Letarouilly
Jie Wei et al (doi: 10.1002/art.42504) investigated if lowering serum urate levels with urate-lowering therapy to a target level reduced the risk of fracture among patients with gout. Among 28,554 people with gout from the UK primary care database, the 5-year risk of hip fracture was 0.5% for the “achieving the target level” arm and 0.8% for “not achieving the target level” arm, with a risk difference of -0.3. This study show that lowering the serum urate levels to the guideline-based target level is associated with a lower risk of incident fracture in people with gout with a hazard ratio of 0.66 (95% CI: 0.46 to 0.93).
Tian et al (doi: 10.1002/art.42496) compared the efficacy of secukinumab, an IL-17A monoclonal antibody, to treatment with TNF inhibitors in Takayasu’s arteritis. Nineteen patients in the secukinumab group and 34 patients in the TNF inhibitors group who failed to respond to oral glucocorticoids and conventional immunosuppressive agents, were enrolled. Similar response rates at 3 and 6 months were registered, suggesting that both secukinumab and TNF inhibitors are effective in Takayasu’s arteritis.
An international study led by Yu Zuo (doi: 10.1002/art.42489) described a new class of autoantibodies in antiphospholipid Syndrome (APS) patients called anti-neutrophil extracellular traps (NETs) antibodies, that may potentially activate the complement cascade. The team analyzed serum from over 300 APS patients collected by the APS Alliance for Clinical Trials and International Networking international consortium and found elevated levels of the anti-NET in 45% of APS patients. High anti-NET antibody levels were associated with brain white matter lesions and complement consumption.
Khanna et al (doi: 110.1002/art.42477) explored the efficacy and safety of ziritaxestat, a selective autotaxin inhibitor, in patients with early diffuse systemic sclerosis. Patients were randomized to receive either ziritaxestat (n = 21) or placebo (n = 12). Reduction in modified Rodnan skin score at Week 24 was significantly greater in the ziritaxestat versus placebo group (–8.9 vs. –6.0 units; p = 0.041). Ziritaxestat was well tolerated.
Fiorentino et al (doi: 110.1002/art.42474) identified new antibodies against the cell division cycle and apoptosis regulator 1 (anti-CCAR1) in patients with dermatomyositis. Anti-CCAR1 antibodies were present in approximately one-third of the patients with anti–TIF1-γ antibody–positive dermatomyositis and were uncommon in patients with anti–TIF1-γ antibody–negative dermatomyositis, in other rheumatic diseases, and healthy controls. Among patients positive for anti–TIF1-γ antibodies but not anti-CCAR1, the incidence of malignancy was five to six times higher than that in controls, whereas patients positive for anti–TIF1-γ antibodies who were additionally positive for anti-CCAR1 did not experience significant increases in the risk of cancer.
Serena is a consultant rheumatologist at Hospital San Giovanni Bosco in Naples, Italy. Her research interests include Connective tissue diseases, especially Systemic Lupus Erythematosus and Systemic Sclerosis. Serena is a member of the Social Media Sub-Committee.
Jean-Guillaume is a fellow in rheumatology at Lille University Hospital in Lille, France. His main research focus on spondyloarthritis and its crosstalk with inflammatory bowel diseases and psoriasis. Jean-Guillaume is a member of the Social Media Sub-Committee.