August 2024 to November 2024
Author: Claudia Cobilinschi
2023 American College of Rheumatology (ACR)/American College of Chest Physicians (CHEST) Guideline for the Treatment of Interstitial Lung Disease in People with Systemic Autoimmune Rheumatic Diseases
Johnson et al. (10.1002/art.42861) developed the 2023 American College of Rheumatology (ACR)/American College of Chest Physicians (CHEST) Guideline for managing interstitial lung disease (ILD) in systemic autoimmune rheumatic diseases (SARDs). Thirty-five recommendations were issued, including not using glucocorticoids in systemic sclerosis–ILD as a first-line ILD therapy and after ILD progression. Otherwise, glucocorticoids are conditionally recommended for first-line ILD treatment in all other SARDs. The guideline also addresses immunosuppressants and antifibrotic therapies and highlights the importance of early intervention, multidisciplinary collaboration, and regular monitoring to optimize patient outcomes and reduce ILD progression.
Effect of Secukinumab Versus Adalimumab Biosimilar on Radiographic Progression in Patients With Radiographic Axial Spondyloarthritis: Results From a Head-to-Head Randomized Phase IIIb Study
Baraliakos et al. (10.1002/art.42852) conducted a randomized phase IIIb study comparing secukinumab and an adalimumab biosimilar in 859 patients with radiographic axial spondyloarthritis. Over two years, 66.1% of patients on secukinumab 150 mg, 66.9% on secukinumab 300 mg, and 65.6% on adalimumab showed no radiographic progression. Mean changes in mSASSS were 0.54, 0.55, and 0.72, respectively. Safety profiles were consistent with previous reports.
Impact of Glucocorticoid Dose on Complete Response, Serious Infections, and Mortality During the Initial Therapy of Lupus Nephritis: A Systematic Review and Meta-Analysis of the Control Arms of Randomized Controlled Trials
Figueroa-Parra et al. (10.1002/art.42920) conducted a systematic review and meta-analysis (Fifty RCT arms) to assess the impact of glucocorticoid (GC) dosing on outcomes in lupus nephritis (3,231 patients with LN). Higher initial GC doses (prednisone at 60 mg/day) correlated with increased complete response rates but also elevated risks of serious infections (12.1% (95% CI 9.3–14.9)) and mortality (2.7% (95% CI 0.0–5.3)). Adding glucocorticoid pulses increased the rates of CR and death but not serious infections. The study highlights the need for careful consideration of GC dosing to balance therapeutic benefits in LN against potential adverse effects.
Comparison of Gout Flares With the Initiation of Treat-to-Target Allopurinol and Febuxostat: A Post-Hoc Analysis of a Randomized Multicenter Trial
Mikuls et al. (10.1002/art.42927) conducted a post-hoc analysis of a 72-week randomized, double-blind, placebo-controlled, noninferiority trial comparing gout flares during the initiation of treat-to-target allopurinol versus febuxostat (Study participants 940). Gout flares occurred in 33% of patients on allopurinol and 36% on febuxostat during the first three months (P = 0.55). Both drugs demonstrated similar efficacy in achieving serum urate targets at six months, with flare rates decreasing over time. The findings support comparable safety and effectiveness of both treatments when used with prophylaxis.
Development and Initial Validation of the Novel Scleroderma Clinical Trials Consortium Activity Index
Nikpour et al. (10.1002/art.42939) developed and validated the Scleroderma Clinical Trials Consortium Activity Index (SCTC-AI) to assess disease activity in systemic sclerosis. The index demonstrated excellent reliability (Cronbach’s alpha = 0.88) and significant correlation with physician global assessment (r = 0.76, P < 0.001). This tool includes 24-item SSc-specific AI and provides a standardized approach for evaluating systemic sclerosis activity, supporting its utility in both clinical trials and practice.
Claudia Cobilinschi
Claudia is working at Sf Maria Clinical Hospital in Bucharest, where she leads the Rheumatology Department. Her main clinical interests lie in immune-mediated diseases and topics of clinical nutrition. She also works as a teaching assistant, sharing her knowledge with students and trainees. She is a member of the EMEUNET Education Sub-Committee.