April 2023 to July 2023
Authors: Olivier Fakih and Clementina López-Medina
Arthritis Research & Therapy
Infectious risk in JAK-inhibitors and TNF inhibitors users
Choi et al (doi:10.1186/s13075-023-03111-w) compared infectious risk between 2963 JAK inhibitors (JAKi) initiators versus 5169 patients treated with TNF inhibitors (TNFi) among rheumatoid arthritis (RA) patients in Korea. Propensity-score fine-stratification (PSS) and weighting were applied to adjust for >70 baseline covariates. They found that, during a follow-up of 1.16 years, the most frequent type of infections were herpes zoster (HZ) with an incidence rate of 11.58 and 4.88 person-years in JAKi and TNFi users, respectively. The incidence rate (IR) of serious bacterial infections (SBI) was low (0.11 and 0.49 in JAKi and TNFi users). They concluded that patients treated with JAKi or TNFi in Korea showed an exceptionally high IR of HZ in both treatment groups, with an approximately doubled risk associated with JAKi versus TNFi use. However, the risk of SBI was comparable.
Granulocyte activation and IFN-alpha levels as risk factors for pregnancy complications in SLE
Torell et al (doi:10.1186/s13075-023-03092-w) evaluated whether low-density granulocytes (LDG) and granulocyte activation during pregnancy, INF-alpha protein levels and autoantibody profile were related with SLE pregnancy complications. They collected blood samples in first, second and third trimesters in 60 women with SLE and 27 healthy pregnant women (HC). They found that women with SLE had higher LDG proportions and increased INF-alpha protein levels compared to HC, as well as a higher granulocyte activation status. In addition, higher LDG proportions in third trimester correlated independently with lower gestational age at birth in SLE. They concluded that higher LDG proportion late in pregnancy are related to shorter pregnancy duration but not to INF-alpha blood levels in SLE.
The ability of enthesitis indexes to detect enthesitis in different conditions
Granados et al (doi:10.1186/s13075-023-03080-0) assessed whether the proportion of patients with enthesitis differed according to the index used and the spondyloarthritis (SpA) subtype, as well as the level of agreement between indexes. They used the worldwide ASAS-PerSpA dataset, and they found that the indices that identified most patients with enthesitis were the MEI and MASES in axial SpA (axSpA), and MEI and SPARCC in peripheral SpA (pSpA) and psoriatic arthritis (PsA). MASES vs. MEI showed the strongest agreement in axSpA (kappa 0.86), while SPARCC vs. MEI showed the strongest agreement in pSpA (kappa 0.90) and PsA (kappa 0.83). They conclude that MEI and MASES appeared best for assessing enthesitis in axSpA, while the MEI and SPARCC index appeared best for assessing enthesitis in pSpA and PsA.
The impact of ILD and pulmonary hypertension on the prognosis of scleroderma patients
Fairley et al (doi:10.1186/s13075-023-03059-x) evaluated the clinical phenotype and prognosis of patients with Scleroderma (SSc) with pulmonary arterial hypertension (PAH) with our without interstitial lung disease (ILD). Survival was reduced in patients with PAH only and in patients with concurrent PAH and ILD (PAH-ILD). In addition, they demonstrated the worst prognosis in extensive ILD and PAH (HR: 5.7, 95%CI 3.5 – 9.12, p<0.01) followed by PAH only (HR: 4.2, 95%CI 2.9 – 6.1, p<0.01). Authors concluded that concurrent PAH-ILD showed poorer survival compared to ILD or SSc alone. In addition, the presence of PAH confers a poorer overall prognosis than extensive ILD.
Olivier is a rheumatology resident at the Department of Rheumatology of Besançon University Hospital in France. His research interests include the epidemiology of inflammatory rheumatic diseases, in particular mortality and comorbidities in spondyloarthritis. Olivier is a member of the French Society of Rheumatology and the society’s young rheumatologists section (REF). He is a member of the EMEUNET Social Media sub-committee, in the podcast team.
Clementina López-Medina is a Rheumatologist and postdoctoral researcher at the Spondyloarthritis Unit of the Reina Sofia University Hospital in Cordoba, Spain. Her work focuses on the epidemiology and clinical phenotypes of Spondyloarthritis. Clementina is a member of the Social Media Sub-Committee.