December 2024 to March 2025
Author: Victoria Konzett & Mustafa Ekici
Switching to biological DMARDs versus cycling among JAK inhibitors in patients with rheumatoid arthritis and with inadequate response to JAK inhibitors: from FIRST registry
Miyazaki Y, et al. (doi:10.1136/rmdopen-2024-004987) evaluated the efficacy and safety of cycling JAK inhibitors (JAKis) versus switching to biological DMARDs (DMARDs) in rheumatoid arthritis (RA) patients with inadequate JAKi response (JAKiIR). Among 138 JAKi-IR patients, cycling to another JAKi resulted in higher remission (38.7% vs. 2.2%) and low disease activity rates (64.5% vs. 28.9%) at 26weeks compared to switching to bDMARDs. Cycling JAKis showed faster CDAI improvement with similar safety. The study suggests cycling JAKis as a superior strategy for JAKi-IR RA patients.
Routine radiographs of hands and feet do not have diagnostic or prognostic value in patients with clinically suspect arthralgia
Dumoulin QA, et al. (doi:10.1136/rmdopen-2024-004966) investigated the diagnostic and prognostic value of routine radiographs in patients with clinically suspect arthralgia (CSA). Among 749 patients, baseline radiographic erosive disease was rare (1.7%-2.5%) and showed no significant progression or association with inflammatory arthritis (IA) development over two years. The study concluded that routine radiographs of hands and feet lack clinical utility in CSA and can be omitted in practice, as they neither predict IA nor provide meaningful diagnostic insights.
Combination of clinical factors predicts successful glucocorticoid withdrawal in systemic lupus erythematosus (SLE): results from a multicentre, retrospective cohort study
Katechis S, et al. (doi:10.1136/rmdopen-2024-005118) identified predictors for successful glucocorticoid (GC) withdrawal in systemic lupus erythematosus (SLE). Among 324 patients, GC discontinuation increased flare risk by 50%, but achieving remission (DORIS) or low disease activity (LLDAS), slow tapering (>6 months), and hydroxychloroquine use significantly reduced flares and organ damage. Patients meeting these criteria had a 25- to 50-fold lower flare risk. The study highlights the importance of combining clinical factors to safely achieve GC withdrawal in SLE management.
Lung ultrasound outperforms symptom-based screening to detect interstitial lung disease associated with rheumatoid arthritis
Vermant M, et al. (doi:10.1136/ rmdopen-2024-005283) compared screening for ILD with lung ultrasound vs conventional symptom-based screening (clinical assessment followed by lung function test and HRCT if deemed necessary). In 116 newly diagnosed RA patients, the authors found a 11.8% prevalence of ILD, with an additional 5% showing subclinical radiographic changes. Lung ultrasound (esp. B-Lines) showed high correlations with clinical and radiographic HRCT scorings, while symptom-based measured only weakly predicted ILD.
The metabolic score for insulin resistance predicts the risk of cardiovascular disease in patients with psoriatic arthritis: results from the 10-year prospective CARMA cohort
Gonzalez-Gay, et al. (doi:10.1136/rmdopen-2024-005352) tested the risk for future cardiovascular (CV) events in a 10-year prospective PsA cohort. 500 PsA patients without prior CV events, diabetes, chronic kidney disease, or statin use were stratified into three risk groups by baseline metabolic risk (assessed with a combined METS-IR-Score; Bello-Cavolla 2018). The annual incidence rate for CV events was 0.56 per 100 PY of exposure, with the METS-IR being a significant and independent predictor for future CV event manifestation. This could support CV risk assessments and disease prevention in PsA patients.
Trends and influences in women authorship in randomised controlled trials in rheumatology: a comprehensive analysis of all published RCTs from 2009 to 2023
Lauper, K et al. (doi:10.1136/rmdopen-2024-005341) analyzed trends and factors that influence female authorships in 1,092 RCTs in rheumatology, with 10,794 authors identified via MEDLINE-PubMed. 36.8% of first authors and 26.1% of last authors were women, indicating an underrepresentation of women especially in senior roles. Proportion of women were highest in African-based, and lowest in Europe- and Asian-based trials. RCTs with a woman as last author were more likely to have a woman as first author, suggesting a positive influence or mentorship effect. No significant trend was observed over a 15-year observation period.
Victoria Konzett
Victoria is an internal medicine resident and PhD fellow at the Division of Rheumatology at the Medical University of Vienna, Austria. Her major research interests are clinical and translational research projects in rheumatoid and psoriatic arthritis, focusing mainly on trial data, at risk stages and outcomes research in both diseases. Victoria is a member of the Newsletter Sub-Committee and the Young Division of the Austrian Society of Rheumatology.
Mustafa Ekici
Mustafa is a researcher and clinician who completed his Internal Medicine and Rheumatology training at Hacettepe University. His primary research focus areas encompass rheumatoid arthritis, interstitial lung disease, and inflammatory myopathies. Mustafa is an active member of the Turkish Society for Rheumatology, the Turkish Society of Young Rheumatologists, and GRAPPA. Mustafa is a member of the EMEUNET Social Media sub-committee.