Author: Daliya Pencheva
Aymon et al. (OP0092) assessed the incidence of infections in rheumatoid arthritis (RA) patients from 14 RA registries in the JAK-POT study. Data from 54,905 treatment initiations, with a mean follow-up of 2.8 years, showed no significant difference in the incidence of any infections (adjusted incidence rate ratio [aIRR] = 1.13, 95% CI: 0.91–1.40) or serious infections (aIRR = 0.99, 95% CI: 0.71–1.39) between JAK inhibitors (JAKi) and TNF inhibitors (TNFi). However, a significantly higher incidence of herpes zoster (HZ) was observed with JAKi (aIRR = 2.27, 95% CI: 1.71–3.02).
Atiqi et al. (POS0017) assessed a therapeutic drug monitoring (TDM)-based strategy, targeting a drug level of 2 mg/L as non-inferior to 5 mg/L regarding disease activity and flares in 62 RA pts on ongoing adalimumab therapy in the ADDORA-low study. They found this approach significantly reduced medication usage, thereby decreasing the burden of self-injections and potential adverse events.
In the AMPLIFIED trial, Emery et al. (OP0007) evaluated whether autoantibody and shared epitope (SE) positivity in early RA predict a superior response to abatacept compared to adalimumab, finding no significant difference in the primary endpoint (ACR50) between abatacept and adalimumab in the SE+ subset, or the overall population.
Paudel et al. (OP0156) validated EULAR’s difficult-to-treat rheumatoid arthritis (D2T-RA) definition and estimated its prevalence, reporting rates of 14.4 per 100 persons (95% CI: 12.8–16.3) among 1,581 RA patients exposed to bDMARDs, and 22.3 per 100 persons (95% CI: 19.9–25.0) among 1,021 RA patients with exposure to tsDMARDs.
Tanaka et al. (POS0408) demonstrated that RA patients achieving low disease activity (LDA) on bDMARDs had significantly lower rates of newly-developed or progressive interstitial lung disease (ILD) compared to those with non-LDA (5.7% vs. 28.0%, p = 0.006), emphasising the importance of controlling disease activity to prevent ILD in RA.
In a substudy of the SELECT-COMPARE trial, Winthrop et al. (OP0020) evaluated the long-term immunogenicity of recombinant zoster vaccine (RZV) in RA patients receiving upadacitinib 15 mg QDS with background methotrexate, finding satisfactory humoral and cell-mediated responses at weeks 4, 16, and 60, with no serious adverse events reported.
In the COVAD2 study, Ziade et al. (POS0069) analysed global disparities in novel DMARD use among RA patients, observing the highest utilisation in Europe (44%), and emphasising the importance of equitable access to advanced RA therapies worldwide.
ABOUT THE AUTHOR
Daliya Pencheva
Daliya received her PhD focused on systemic lupus erythematosus management from the Medical University of Sofia, Bulgaria. Her major interests are patient-reported outcome measures, quality of life and treat-to-target strategies.
Daliya is a member of the Country Liaison Sub-committee.