april 2024 to july 2024
Author: Olivier Fakih & Roba Ghossan
Arthritis Research & Therapy
Long-term Efficacy and Safety of Upadacitinib vs Methotrexate in Early Rheumatoid Arthritis: 5-Year Findings of the SELECT-EARLY trial
Vollenhoven et al. (10.1186/s13075-024-03358-x) aimed to evaluate the efficacy and safety of upadacitinib monotherapy versus methotrexate monotherapy over 5 years among MTX-naïve patients with moderately to severely active rheumatoid arthritis. The study demonstrates that upadacitinib, particularly the 15 mg dose, offers sustained improvements in disease activity and patient outcomes with a favorable long-term benefit-risk profile. However, the 30 mg dose was associated with higher rates of adverse events compared to methotrexate. Overall, the 15 mg dose of upadacitinib showed better long-term efficacy and a more balanced safety profile compared to methotrexate.
Impact of Gastroesophageal Reflux Disease and Its Treatment on Interstitial Lung Disease Outcomes in Systemic Sclerosis
Quinlivan et al. (10.1186/s13075-024-03355-0) examine the effect of gastroesophageal reflux disease (GERD) and its treatment on interstitial lung disease (ILD) in systemic sclerosis (SSc). The study finds that managing GERD significantly improves ILD symptoms and survival. Anti-reflux medication for GERD in SSc-related ILD is linked to better pulmonary function and fewer exacerbations. Combination therapy with a proton pump inhibitor (PPI) and a histamine-2 receptor antagonist (H2RA) showed a greater survival benefit compared to PPI alone (HR 0.3 vs 0.5, p < 0.050), emphasizing the need for comprehensive GERD management.
Effectiveness of Janus Kinase Inhibitors in Relapsing Giant Cell Arteritis: Clinical Insights and Literature Review
Loricera et al. (10.1186/s13075-024-03314-9) assess Janus kinase (JAK) inhibitors for relapsing giant cell arteritis (GCA) in a real-world setting. Data from 13 centers in Spain and one in the U.S. (01/2017-12/2022) show that 57% of patients achieved clinical remission and 46% achieved complete remission after a median follow-up of 11 months on JAKi therapy. JAK inhibitors, including baricitinib, tofacitinib, and upadacitinib, proved effective for patients unresponsive to conventional therapies like tocilizumab and methotrexate. Despite some adverse events and relapses, they are a promising alternative for relapsing GCA.
White Matter Changes in SLE Patients Without Neuropsychiatric Symptoms: A Multi-Shell Diffusion Imaging Study
Hu et al. (10.1186/s13075-024-03344-3) investigate white matter microstructural changes in systemic lupus erythematosus (SLE) patients without neuropsychiatric symptoms using multi-shell diffusion imaging. The study reveals subtle alterations in white matter integrity, indicating that SLE affects brain structure even in the absence of clinical symptoms. These findings underscore the need for early imaging and monitoring in SLE patients to detect and address potential subclinical brain involvement.
Plasma mtDNA: A Contributor to Inflammation and Potential Biomarker in Rheumatoid Arthritis
Lehmann et al. (10.1186/s13075-024-03329-2) explore the role of plasma mitochondrial DNA (mtDNA) in rheumatoid arthritis (RA), assessing its contribution to and potential as a biomarker for inflammation. The study finds elevated levels of plasma mtDNA in RA patients, correlating with disease activity and inflammation markers. These results suggest that plasma mtDNA may serve as both a mediator of inflammation and a useful biomarker for monitoring disease progression and response to treatment in RA.
Olivier Fakih
Olivier is a rheumatology fellow 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 Education Sub-Committee.
Roba Ghossan
Roba is a rheumatologist at the Department of Rheumatology of Cochin Hospital APHP in Paris, France. Her main clinical and research interests include Inflammatory Rheumatic Diseases, MSK Ultrasound and Epidemiology. Roba is a member of the French Society of Rheumatology and the society’s young rheumatologists section (REF). She is a member of the EMEUNET Social Media Sub-Committee.