August 2024 to November 2024
Authors: Milena Bond & Ufuk Ilgen
Cancer Risk Factors in Idiopathic Inflammatory Myopathies
Tang et al. (10.1093/rheumatology/keae504) validated the International Myositis Assessment and Clinical Studies Group (IMACS) cancer risk stratification guideline in 479 patients with idiopathic inflammatory myopathies. Patients were stratified into high (44.7%), intermediate (49.7%), and standard-risk (5.6%) groups. Overall, 12.5% developed cancer within three years. Independent risk factors for cancer development included older age (OR: 1.05, 95% CI: 1.02–1.08), Gottron’s rash (OR: 2.45, 95% CI: 1.12–5.36), absence of interstitial lung disease (OR 2.69, 95% CI: 1.15–6.29), anti-TIF1γ positivity (OR: 4.63, 95% CI: 2.05–10.46) and anti-SAE1 positivity (OR: 5.32, 95% CI: 1.27–22.30).
Impact of glucocorticoids on ultrasound sensitivity in giant cell arteritis diagnosis
A prospective study by Hansen et al. (10.1093/rheumatology/keae551) evaluated ultrasound (US) sensitivity in 48 treatment-naive giant cell arteritis (GCA) patients before and after glucocorticoid (GC) therapy. Overall, pre-treatment US sensitivity was 94%, decreasing to 92% after 3 days and to 83% after 10 days of GC treatment. Temporal artery US sensitivity showed a significant reduction from 73% pre-treatment to 53% by day 10 (p<0.01), while large-vessel (LV) US was less affected (71% vs. 60%, p=0.13), highlighting the importance of including US LV-assessment. The OMERACT GCA Ultrasonography Score (OGUS) and halo counts also decreased significantly over 10 days.
High prevalence of tendon involvement in hand osteoarthritis unveiled by ultrasound
Gessl et al. (10.1093/rheumatology/keae395) cross-sectionally examined tendon involvement in 86 patients with hand osteoarthritis (OA) using ultrasound (US). Involvement of 1 or more tendons was detected in 69.8% of patients with OA compared to 8.7% in the age- and sex-matched control group. In the hand OA group, US detected tendon damage more frequently in flexor tendons than extensor tendons (2.1% vs. 0.9%, p=0.03), while tenosynovitis was more common in extensor tendons than flexor tendons (8% vs. 0.6%, p<0.001). However, tendon involvement did not correlate with self-reported pain or hand function.
From arthralgia to psoriatic arthritis: key predictors of disease progression
Within 1419 prospectively evaluated patients with arthralgia, Garcia-Salinas et al. (10.1093/rheumatology/keae562) focused on 119 patients meeting ARP-PsA criteria (arthralgia with psoriasis and/or a family history of psoriasis). Of these, 29% progressed to PsA within one year. Combination of psoriasis plus a family history (OR: 32; 95% CI: 1.2–1026), power doppler synovitis (OR: 31; 95% CI: 1.1–967), US-confirmed enthesopathy (OR: 75; 95% CI: 13–710), and tender joint count (OR 0.2, 95% CI: 0.05–0.6) were independent predictors of progression to PsA.
JAK inhibitors facilitate efficient glucocorticoid reduction in rheumatoid arthritis
Adami et al. (10.1093/rheumatology/keae455), in their single-centre observational retrospective analysis, evaluated the glucocorticoid (GC)-sparing effect of Janus kinase inhibitors (JAKi) versus biologic DMARDs (bDMARDs) in 716 patients with rheumatoid arthritis, JAKi facilitated a faster GC dose reduction until month 6 (−1.26 in JAKi group vs. −0.71 mg/day) and a 60% higher likelihood of GC discontinuation within 12 months (54% vs. 41%, OR 1.63, 95% CI: 1.02–2.60, p=0.039). They also found that rescue therapy with GCs was more frequent in the bDMARD group (rate ratio 2.66, 95% CI: 1.88–3.74).
Milena Bond
Milena Bond is a consultant in rheumatology at the Hospital of Bruneck (Italy) and a PhD candidate at Paracelsus Medical University of Salzburg (Austria). Her research interests focus on systemic vasculitis, and she is part of several international task forces in the field. Milena is a member of the EMEUNET Visibility & Global Affairs Sub-Committee.
E-mail: milena.bond@sabes.it
Ufuk Ilgen
Ufuk is a rheumatologist from Turkey. Currently, he is doing his MSc in Translational Medical Research Programme at Heidelberg University, Germany. His main clinical and research interests are the immunopathological background of autoimmune diseases, the concept of autoimmunity and autoantibodies, and RNA biology in endothelial cells. He is a member of the Turkish Society for Rheumatology and European Lupus Society. He is a member of the EMEUNET Country Liaisons Sub-Committee.
E-mail: ufukilgen@gmail.com