December 2024 to March 2025
Authors: Slaverio La Bella & Stephanie Ling
Real-world effectiveness of nintedanib in RA-ILD
Atienza-Mateo B, et al. (doi:10.1016/j.semarthrit.2025.152710) assessed the real-world effectiveness and safety of nintedanib in 74 patients with progressive rheumatoid arthritis-associated interstitial lung disease (RA-ILD). Over a median 15-month follow-up, forced vital capacity (FVC) and diffusing capacity (DLCO) remained stable, diverging significantly from predicted declines without treatment. The retention rate was 78.4%, with 16.7% showing further ILD progression. Compared to the INBUILD trial (n = 89, 42 treated with nintedanib), patients were older and more often treated with combined immunosuppressants, yet showed similar baseline lung function and response, supporting nintedanib’s utility in clinical care.
Biologic therapy does not impair fertility in women with RA or PsA
Herzberger H, et al. (doi:10.1016/j.semarthrit.2024.152608) conducted a large retrospective cohort study of 4517 women with rheumatoid arthritis (RA) and 1415 women with psoriatic arthritis (PsA) aged 18–40 to assess the impact of biologic treatments on fertility. Despite a general decline in conception rates post-diagnosis, biologic exposure did not reduce the likelihood of positive pregnancy tests or increase infertility. In RA patients, in vitro fertilization use after treatment initiation decreased significantly (p < 0.01). Beta-hCG testing increased post-biologic initiation, suggesting more pregnancy attempts. These findings support the reproductive safety of biologics, though data on live birth outcomes remain needed.
Rheumatic complications following CAR-T cell therapy
Gómez-Puerta J, et al. (doi:10.1016/j.semarthrit.2024.152610) retrospectively analysed 310 patients treated with CAR-T cell therapy, identifying rheumatologic complications in 1.9%. Manifestations included rheumatoid arthritis-like disease with nodulosis, palindromic rheumatism, myositis, necrotizing fasciitis, and osteonecrosis. Symptoms emerged 2–11 weeks post-therapy, with inflammatory arthritis occurring later. Treatment responses to glucocorticoids and hydroxychloroquine were variable. The study underscores the importance of early recognition and management of immune-mediated musculoskeletal complications after CAR-T and highlights the need for further research into their pathogenesis and optimal treatment strategies.
Refining cancer risk stratification in idiopathic inflammatory myopathies (IIM)
Ceribelli A, et al. (doi:10.1016/j.semarthrit.2024.152619) analysed 95 patients with IIM over a median 6-year follow-up to assess cancer prevalence and evaluate the utility of IMACS cancer risk guidelines. Cancer was diagnosed in 23%, with 14% meeting criteria for cancer-associated myositis (CAM). Anti-TIF1-γ antibodies predicted CAM but not overall cancer risk, particularly in patients with no additional autoantibody specificities. Respiratory comorbidities, anaemia, hypergammaglobulinemia, and dermatomyositis phenotype were more common in patients with malignancy. Findings support IMACS guidelines but underscore the need for detailed antibody profiling to improve cancer surveillance.
Ultrasound-assessed dactylitis predicts psoriatic arthritis development in patients with psoriasis
Olivas-Vergara O, et al. (doi:10.1016/j.semarthrit.2024.152612) conducted a prospective, longitudinal study to assess whether ultrasound-detected dactylitis-related lesions could predict the development of psoriatic arthritis (PsA) in psoriasis (PsO) patients with hand arthralgia. Over 12 months, 15 of 64 patients (23.4%) developed PsA. Baseline ultrasound findings—particularly power Doppler (PD) synovitis and B-mode (BM) enthesitis—were significantly associated with PsA onset. A predictive model combining these two variables achieved 89.1% accuracy, 86.7% sensitivity, and 89.8% specificity. These results suggest that ultrasound evaluation of dactylitis can help identify PsO patients at risk for PsA transition.
Saverio La Bella
Saverio is a pediatric rheumatology resident at the IRCCS Istituto Giannina Gaslini in Genoa, Italy. His research interests include autoinflammatory diseases, the application of artificial intelligence tools, and the use of media platforms as educational tools in pediatric rheumatology. He is a member of the Paediatric Rheumatology European Society (PReS) and its Young Investigators group. Saverio is a member of the social media sub-committee of EMEUNET.
Stephanie Ling
Steph is an NIHR Academic Clinical Lecturer, carrying out her research at the University of Manchester. Her research interests are focused on analysis of multi-omics methods to define predictors of treatment response in patients with rheumatoid arthritis, as well as pharmacological modelling and simulation. She is a member of the British Society for Rheumatology. She is currently an author for the 19th EULAR Online Course on Rheumatic Diseases. Steph is a member of the EMEUNET Newsletter sub-committee.