Winter Press Review 2024 – Rheumatology (Oxford)

August 2023 to November 2023

Authors: Dalifer Freites Nuñez and Alejandro Gómez Gómez

Rheumatology (Oxford)

Anifrolumab and SLE

Yusuke Miyazaki et al. (doi.org/10.1093/rheumatology/kead568) determined the safety and efficacy of anifrolumab in patients with systemic lupus erythematosus classified based on the Lupus Low Disease Activity State (LLDAS) in real-world clinical practice. The retention rate of anifrolumab was 89.7% at week 26. The LLDAS achievement rates at week 12 were 42.9% and 66.7% in the non-LLDAS achievement and minor flare groups, respectively. In both groups, GC doses and SELENA–SLEDAI score significantly decreased. 

Skin psoriasis in children and ultrasound

Coronel et al. (doi.org/10.1093/rheumatology/kead398) evaluated the prevalence of clinical and ultrasound (US) abnormalities in joints, periarticular structures and nails of children affected by skin psoriasis (PsO). 57 children with a mean age of 9 years (SD=4) were divided into two groups, asymptomatic (Asy, 42 children) and symptomatic (Sy, 15 children), according to musculoskeletal pain. US evaluation showed differences between the Asy and Sy groups for the presence of US abnormalities [16/42 (38%) vs 12/15 (80%)], synovitis [1/42 (2%) vs 4/15 (25%)] and enthesitis [4/42 (9.5%) vs 5/15 (33%)]. Three children in the Sy group were classified with juvenile PsA (JPsA). Asy patients were more frequently under systemic treatment. 

Biological DMARDs in RA

Onishi et al. (doi.org/10.1093/rheumatology/kead620) investigated the effectiveness and drug tolerability of biological DMARD (bDMARD) and Janus kinase inhibitor (JAKi) monotherapy in patients with RA in a multicentre cohort study. A total of 849 treatment courses were included, involving 635 patients. The change in DAS28-ESR at week 24 as the primary outcome was –0.93 (95% CI: –1.20 to –0.66) lower in the IL-6Ri group than in the TNFi group, while those of the CTLA4Ig and JAKi groups were similar to that of the TNFi group [–0.20 (–0.48 to 0.08), –0.25 (–0.67 to 0.16), respectively]. 

Treatment intensification in axial SpA

Webers et al. (doi.org/10.1093/rheumatology/kead634) investigated which factors are associated with treatment intensification (TI) in axial SpApatients with high disease activity (HDA). 121 patients with HDA from the Dutch SpA-Net registry were included. TI was conducted in a minority (41/121, 33.9%), and mainly involved a switch or addition of a drug. In multivariable regression analyses a higher ASDAS was associated with TI in the patient-centred model (OR ASDAS:1.94, 95%CI: 1.00 to 3.74). However, in the physician-centred model, this association attenuated, and PhGAor PASS-physician were the primary factors associated with TI (OR PhGA:1.71, 95% CI:1.24 to 2.34); OR PASS-physician: 94.95]. Interestingly, patient-centred factors (ASAS HI/PASS-patient/education level) did not contribute to TI. 

Monogenic Behçet’s-like diseases

Burleigh et al. (doi.org/10.1093/rheumatology/kead628) developed a genetic analysis workflow to identify rare monogenic Behçet’s disease BD-like diseases and establish the contribution of HLA haplotype in a cohort of patients from the UK. 31 patients were recruited: Nine/31 (29%) patients had monogenic disease mimicking BD: 5 cases of Haploinsufficiency of A20 with novel TNFAIP3. Of the remaining 22 patients, eight (36%) were HLA-B*51 positive.

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