April 2023 to July 2023
Authors: Anastasia Madenidou and Juan Camilo Sarmiento
Seminars in Arthritis and Rheumatism
Malignancy outcomes in patients with rheumatoid arthritis
Simon et al. (doi:10.1016/j.semarthrit.2023.152240) assessed the risk of malignancy in RA patients treated with abatacept, csDMARDs, and other b/tsDMARDsin clinical practice. The study analyzed data from international sources (ARTIS, RABBIT, FORWARD, and BC) and calculated incidence rates per 1000 patient-years. Overall, the study did not find a statistically significant increase in the risk of overall malignancies for patients treated with abatacept compared tocsDMARDs or other b/tsDMARDs. The pooled RRs (95% CIs) for overall malignancy with abatacept were 1.1 (0.8-1.5) versus csDMARDs and 1.0 (0.8-1.3) versus b/tsDMARDs.
Treat-to-target in real-life psoriatic arthritis patients
Ortolan et al. (doi:10.1016/j.semarthrit.2023.152237) aimed to assess minimal disease activity (MDA) in PsA patients and identify predictors of MDA and LDA in those with axial involvement (axPsA). Among PsA patients on stable treatments, 52-61% achieved MDA, and 17-24% achieved LDA. Sustained MDA was less common in axPsA patients and those with fibromyalgia, osteoarthritis, or a BMI≥35. MDA is achievable in real-life PsA patients, with axPsA presenting more significant challenges, and achieving MDA depends on both disease and patient characteristics.
The use of methotrexate in patients with Still’s disease
Ruscitti et al. (doi:10.1016/j.semarthrit.2023.152244) examined the use of MTX in 171 patients with Still’s disease. MTX was commonly used alongside GC. The study found that MTX effectively reduced disease activity, lowered inflammatory markers, and allowed for reduced GC use, with 38.6% of patients achieving clinical remission, especially when combined with a bDMARD. Male patients were more likely to discontinue GC. However, 12.3% discontinued MTX due toadverse effects, and another 12.3% due to lack of efficacy. Overall, MTX demonstrated clinical benefits in managing Still’s disease with joint symptoms and fever but limited multiorgan involvement.
Enhancing the identification of RA-ILD l through text mining of chest computerized tomography reports
Luedders et al. (doi:10.1016/j.semarthrit.2023.152204) hypothesized that including ILD-related terms found in chest computed tomography (CT) reports through text mining would improve the positive predictive value (PPV) of these algorithms. In a derivation cohort of RA-ILD cases, adding ILD-related terms from CT reports increased PPV by 3.6% to 11.7%. This improvement extended to an external validation cohort of RA patients, with the highest PPV reaching 94.6%. Overall, incorporating CT report terms could enhance the utility of RA-ILD algorithms for epidemiological and comparative effectiveness research.
Understanding the role and adoption of artificial intelligence techniques in rheumatology research
Madrid-García et al. (doi: 10.1016/j.semarthrit.2023.152213) examined the use of artificial intelligence (AI) in rheumatic and musculoskeletal disease researchfrom 2017 to 2022. AI techniques were applied in disease identification, classification, patient stratification, and treatment response prediction. The findingshighlighted the increasing use of AI in diverse diseases, including rare conditions. However, variability in data and sample sizes was noted, and further AI advancements are expected. In summary, this review underscores the expanding role of AI in rheumatic and musculoskeletal disease research.
Anastasia is a Clinical Research Fellow at the Centre of Musculoskeletal Research, University of Manchester, UK. Her research work focuses on omics techniques in lupus-spectrum disorders. Anastasia is the Deputy Chair of the British Rheumatology Society Trainee Committee and a member of the EMEUNET Newsletter Sub-Committee.
Juan Camilo Sarmiento
Juan C is a Rheumatologist and Clinical Research Fellow at the Hospital Clinic of Barcelona. His main research interests include the validation of biomarkers in RA-ILD and the utility of ultrasonography in systemic autoimmune diseases. Juan C is a member of the EMEUNET Newsletter Sub-Committee.