April 2023 to July 2023
Authors: Rositsa Dacheva
Miscellanous – Rheumatological and non-rheumatological journals
A Phase 2 Trial of Peresolimab for Adults with Rheumatoid Arthritis
Jay Tuttle et al (doi:10.1056/NEJMoa2209856) conducted a phase 2a, double blind, randomized, placebo-controlled trial, assessing the efficacy of peresolimab, a humanized IgG1 monoclonal antibody stimulating the endogenous programmed cell death protein 1 (PD-1) inhibitory pathway, in patients with moderate-to-severe rheumatoid arthritis (RA) who had had a poor or loss of response or side effects to conventional synthetic disease-modifying antirheumaticdrugs (DMARDs) or to biologic or targeted synthetic DMARDs. Patients were assigned in a 2:1:1 ratio to receive 700mg of peresolimab, 300 mg of peresolimab, or placebo intravenously once every 4 weeks. The primary outcome was the change in Disease Activity Score for 28 joints based on the CRP level (DAS28-CRP) at week 12. Results reveal the change in DAS28-CRP was significantly greater in the 700-mg peresolimab group than in the placebo group. Adverse events were similar in both groups.
Response to Biologic Drugs in Patients With Rheumatoid Arthritis and Antidrug Antibodies
Samuel Bitoun et al (doi:10.1001/jamanetworkopen.2023.23098) evaluated the association of antidrug antibodies (ADA) with EULAR response to biologic disease-modifying antirheumatic drugs (bDMARDs) in rheumatoid arthritis (RA) at month 12. Of the 254 patients recruited from 27 centres, 230 were included in the analysis. Antidrug positivity at month 12 was 38.2 % in patients treated with anti-TNF mAbs, 6.1% with etanercept, 50.0% with rituximab, and 20.0% with tocilizumab. An inverse association was found between ADA positivity (OR 0.19, 95% CI, 0.09-0.38; p<.001) directed against all biologic drugs. In the multivariable analysis, ADA were independently inversely associated with response to treatment. Methotrexate co-therapy at baseline was inversely associated with ADA. In this study the presence of ADA was associated with decreased response to bDMARDs.
Opioid analgesia for acute low back pain and neck pain (the OPAL trial): a randomised placebo-controlled trial
Caitlin M P Jones et al (doi:10.1016/S0140-6736(23)00404) assessed the efficacy and safety of opioid analgesics used for acute low back pain and neck pain in the OPAL trial, a triple-blinded, placebo-controlled randomized trial, including patients with 12 weeks or less of low back or neck pain. 356 participants were recruited in the study and were assigned randomly (1:1) to receive guideline-recommended care plus either up to 20 mg oxycodone per day orally or placebo for up to 6 weeks The primary outcome was pain severity at 6 weeks. No significant difference in pain severity was observed between the active and placebo group. However, more participants in the opioid group reported opioid-related adverse events (7.5% in the opioid group to 3.5% in the placebo group).
Mesenchymal stem cells modulate IL-17 and IL-9 production induced by Th17-inducing cytokine conditions in autoimmune arthritis: an explorative analysis
Maximilian Riekert et al (doi:10.1186/s42358-023-00317-z) aim to investigate the influence of mesenchymal stem cells (MSCs) on the cytokine profile and functions of naïve and non-naïve CD4+ T-cells from healthy donors (HD) and patients with autoimmune arthritis. CD4+ T-cells were stimulated under Th17-cytokine polarizing conditions, followed by 6 days of incubation period and determination of the T-cells subpopulations. Quantitative immunofluorescence intensity was used to measure IL-9, IL-17 and IFN- γ production in each subpopulation. Results reveal immunomodulatory properties of MSCs, showing decreased proportion of IL-9 and IL-17 producing effector T-cells. Moreover, MSCs reduced IFN-γ production in the naïve and memory phenotype from HD.
Rositsa is a consultant rheumatologist. She graduated from the Medical University of Sofia, Bulgaria in 2013. In 2020 she completed her rheumatology residency in the Department of Rheumatology in UMHAT “St. Ivan Rilski” in Sofia. Her main interests include inflammatory arthritis, interstitial lung disease, systemic sclerosis and musculoskeletal ultrasound. Rositsa is the Country Liaison for Bulgaria and a member of the Newsletter Sub-Committee.