August 2024 to November 2024
Authors: Milena Bond & Ufuk Ilgen
Smoking-related bias of standardized mortality ratios in rheumatoid arthritis: A modeling study
Smoking is related to an increased mortality and known to be more common in rheumatoid arthritis (RA) compared to normal population. Standardized mortality ratios (SMRs) have usually been adjusted for age and sex but not for smoking in mortality studies in RA. In this modelling study based on United States National Health Interview Surveys 1999 – 2004, Ward (10.1016/j.semarthrit.2024.152599) revealed that 10- and 15-year SMRs might be inflated up to 1.23- and 1.17-fold in rheumatoid arthritis (RA) when smoking was not taken into consideration.
The impact of cardiovascular and cerebrovascular disease on the risk of dementia in rheumatoid arthritis: A mediation analysis
Lovering et al. (10.1016/j.semarthrit.2024.152570) found no statistically significant increase in Alzheimer’s disease and related dementias (ADRD) in rheumatoid arthritis (RA) in this retrospective cohort of 877 individuals with RA and 877 controls. Cardiovascular disease (CVD) itself was neither found to increase the risk of ADRD in RA and controls significantly. However, the presence of both RA and CVD acted synergistically on the risk of ADRD (HR=1.75 [95% CI: 1.19-2.58]). In conclusion, there was no mediation but an interaction effect of CVD for ADRD risk in RA.
Clinical and imaging outcomes of different phenotypes of axial spondyloarthritis: 5-year analysis of the DESIR cohort
Sepriano et al. (10.1016/j.semarthrit.2024.152424) compared the long-term outcomes of three phenotypes of axial spondyloarthritis (axSpA), ‘Axial’, ‘Inflammatory back pain (IBP)+Peripheral’ and ‘At risk’, among 576 patients in the DESIR cohort. Over five years, ‘At risk’ patients experienced worse disability (∆BASFI: −0.4 vs. -1.3 to −0.9) and less improvement in quality of life (∆SF36 physical domain: +2 vs. +4 to +6 and mental domain +3 vs. +2 to +7) compared to ‘Axial’ and ‘IBP+Peripheral’ patients, with a significant impact noted in those on bDMARDs. Imaging outcomes were worse in the ‘Axial’ phenotype. These findings suggest that treatment strategies might need to be tailored based on axSpA phenotype.
Disease-modifying antirheumatic drugs and risk of incident interstitial lung disease among patients with rheumatoid arthritis: A systematic review and meta-analysis
In this systematic literature review encompassing 486,465 rheumatoid arthritis (RA) patients and 3,928 incident interstitial lung disease (ILD) cases, Zhang et al.(10.1016/j.semarthrit.2024.152561) found no significant difference in the odds of ILD development for any conventional, biologic, or targeted synthetic DMARD in 24 randomized controlled trials. In observational studies, the use of methotrexate suggested even a protective role against incident ILD compared to non-use (pooled OR: 0.49 [95% CI: 0.32-0.76]). In a single observational study, tofacitinib users had lower ILD compared to TNF-inhibitor users (OR: 0.36 [95% CI: 0.15-0.87]). Due to several potential biases, further well-designed prospective studies are warranted for definitive conclusions.
Neuropathic pain in spondyloarthritis: Decoding its prevalence, risk factors, and impact on disease activity
In this cross-sectional study of 177 participants with spondyloarthritis, Lopalco et al. (10.1016/j.semarthrit.2024.152557) assessed neuropathic pain with two specialized questionnaires, PainDETECT and Neuropathic Pain Symptom Inventory. 22.2% of the study population had neuropathic pain, which was found to be associated with a high disease activity, female gender, and obesity. This study highlights the importance of integrating neuropathic pain evaluation into the clinical assessment of spondyloarthritis to tailor treatment approaches effectively and improve patient outcomes.
Metabolic syndrome, radiographic osteoarthritis progression and chronic pain of the knee among men and women from the general population: The Rotterdam study
Szilagyi et al. (10.1016/j.semarthrit.2024.152544) evaluated the relationship between osteoarthritis and metabolic syndrome (and its components) in a large cohort of 6,138 individulas over a median period of 5.7 years. They revealed that the presence of metabolic syndrome is associated with radiographic progression of knee osteoarthritis (OR: 1.35 [95% CI: 1.05-1.73] and 1.26 [95% CI: 1.06-1.5] in males and females, respectively). This effect was found to be primarily mediated by an increased body mass index (BMI). However, metabolic syndrome and high triglycerides were still associated with incident chronic knee pain in males after BMI adjustment.
Milena Bond, MD, PhDc
Country: Italy, Austria
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, MD
Country: Turkey, Germany
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