APRIL 2024 to JULY 2024
Author: Barbara Russo & Omar Dhrif
Arthritis Care and Research
Ultraprocessed Food Consumption and Increased Risk of Systemic Lupus Erythematosus in Women: Insights from the Nurses’ Health Study Cohorts
Rossati et al. (10.1002/acr.25395) investigated the association between ultra-processed food (UPF) intake and systemic lupus erythematosus (SLE) risk, utilizing data from over 230,000 women in the Nurses’ Health Study (NHS) and NHS-II. It revealed that higher UPF consumption correlated with a 56% increased risk of SLE and more than doubled the risk of anti-dsDNA–positive SLE. Specifically, sugar-sweetened and artificially sweetened beverages were strongly linked to elevated SLE risk. The study highlights a dose-response relationship between UPF and lupus development, with strengths including the large sample size and long follow-up period, though SLE rarity in the cohort limited statistical power for smaller effect sizes and subgroup analyses.
Opioid Prescribing Patterns for Systemic Autoimmune/Inflammatory Diseases: Insights from 2006–2019 U.S. National Data
Huang al. (10.1002/acr.25378) analyzed U.S. national data (2006–2019) and found that patients with systemic autoimmune/inflammatory rheumatic diseases (SARDs) were significantly more likely to be prescribed opioids compared to those without SARDs (OR 2.65; 95% CI 1.68-4.18). Key risk factors included older age (OR 1.95; 95% CI 1.05-3.65) and glucocorticoid use (OR 1.75; 95% CI 1.20-2.54). Patients with private insurance were 50% less likely to receive opioids than those with Medicare (OR 0.50; 95% CI 0.31-0.82). Utilizing large-scale national data, the study provides a comprehensive overview of opioid prescribing practices, highlights significant risk factors, and underscores the need for careful monitoring and management to prevent potential opioid-related harms in SARD patients, despite limitations in causal inference due to its cross-sectional design.
Impact of Protocol Violations on Treatment Outcomes in the TICOSPA Trial for Axial Spondyloarthritis
Lopez Medina et al. (10.1002/acr.25387) investigated protocol violations in the Tight Control in Spondyloarthritis (TICOSPA) trial, a cluster-randomized, controlled 48-week trial targeting biologic-naive patients with axSpA. Eighteen expert centers were allocated to either a treat-to-target (TtT) strategy with four-week visits or usual care (UC) with 12-week visits. Protocol violations were assessed, with 51.2% of TtT patients violating the protocol, predominantly due to treatment changes. Despite these violations, both TtT and UC arms showed similar improvements in the ASAS Health Index (ASAS-HI) and comparable adherence to ASAS/EULAR recommendations (63.9% vs. 61.8%). The study underscores that real-world protocol violations have minimal impact on treatment outcomes, though it is limited by its single-trial and observational design.
Benefits of Early vs Late Initiation of IVIG in Anti-HMGCR Immune-Mediated Necrotizing Myopathy
Sharf et al. (10.1002/acr.25406) compared early versus late IVIG treatment in anti-HMGCR immune-mediated necrotizingmyopathy among 31 patients. Early treatment (within 30 days of symptom onset) led to better muscle strength (12 month mean ±SD MMT8: 149 ±3 vs. 132 ±18, P < 0.001), improved TIS at 3, 6, and 12 months (P = 0.002, 0.019, 0.001), reduced wheelchair use (0 vs. 7 individuals, P < 0.0009), and lower prednisone doses (mean ±SD mg/day at 12 months: 3 ±5 vs. 8 ±7, P = 0.03). Despite the small sample size, retrospective design, and nonstandardized treatment regimens, the findings support early IVIG initiation. Further research is needed to confirm these results.
Risk of Neuroinflammatory Diseases Among New Recipients of Biologic and Targeted Synthetic Disease-Modifying Antirheumatic Drugs
Maximilian Casey et al. (10.1002/acr.25340) assessed the risk of neuroinflammatory disease among new users of tumor necrosis factor inhibitors (TNFi) versus other biologic or targeted synthetic disease-modifying antirheumatic drugs (b/tsDMARDs). Using a US-based cohort of 132,015 patients with various autoimmune conditions, the unadjusted incidence of neuroinflammatory events was lower among TNFi users (1.34 per 1,000 patient-years) compared to non-TNF users (1.69 per 1,000 patient-years). No significant difference in neuroinflammatory risk was found between TNF inhibitors and b/tsDMARDs (HR: 1.01, 95%CI 0.75–1.36).
Barbara Russo
Barbara Russo is a research assistant in the Department of Medicine at Hôpitaux Universitaires de Genève. Her research is focused on the pathogenesis of systemic sclerosis (SSc), with a particular emphasis on fibrosis and mechanotransduction. She is also dedicated to investigating current treatment practices to identify effective strategies for improving the quality of life for patients with SSc.
Barbara actively contributes to the Eustar Young Investigator Group and serves on the EMEUNET Education Sub-Committee.
Omar Dhrif
Omar is an Internal Medicine Specialist, from University Tunis El Manar currently residing in Dijon, France. His main clinical and research interests are focused on Vasculitis, Global access to health care and educational therapy. Omar is the past-Treasurer of the Tunisian Association of Young Internists, Co-Founder of the Francophonic Young Internists Group, member of the Research Committee of the Tunisian Society of Internal Medicine and American College of Rheumatology Social Media Ambassador. Omar is a member of the EMEUNET Social Media sub-committee.