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https://www.readbyqxmd.com/read/29415145/response-to-baricitinib-based-on-prior-biologic-use-in-patients-with-refractory-rheumatoid-arthritis
#1
Mark C Genovese, Joel M Kremer, Cynthia E Kartman, Douglas E Schlichting, Li Xie, Tara Carmack, Carlos Pantojas, Juan Sanchez Burson, Hans-Peter Tony, William L Macias, Terence P Rooney, Josef S Smolen
Objective: RA patients who have failed biologic DMARDs (bDMARDs) represent an unmet medical need. We evaluated the effects of baseline characteristics, including prior bDMARD exposure, on baricitinib efficacy and safety. Methods: RA-BEACON patients (previously reported) had moderate to severe RA with insufficient response to one or more TNF inhibitor and were randomized 1:1:1 to once-daily placebo or 2 or 4 mg baricitinib. Prior bDMARD use was allowed. The primary endpoint was a 20% improvement in ACR criteria (ACR20) at week 12 for 4 mg vs placebo...
February 3, 2018: Rheumatology
https://www.readbyqxmd.com/read/29391382/identification-of-new-biomarkers-to-promote-personalised-treatment-of-patients-with-inflammatory-rheumatic-disease-protocol-for-an-open-cohort-study
#2
Tina Marie Kringelbach, Bente Glintborg, Estrid V Hogdall, Julia Sidenius Johansen, Merete Lund Hetland
INTRODUCTION: The introduction of biological disease-modifying antirheumatic drugs (bDMARDs) has improved the treatment of inflammatory rheumatic diseases dramatically. However, bDMARD treatment failure occurs in 30%-40% of patients due to lack of effect or adverse events, and the tools to predict treatment outcomes in individual patients are currently limited. The objective of the present study is to identify diagnostic, prognostic and predictive biomarkers, which can be used to (1) diagnose inflammatory rheumatic diseases early in the disease course with high sensitivity and specificity, (2) improve prognostication or (3) predict and monitor treatment effectiveness and tolerability for the individual patient...
February 1, 2018: BMJ Open
https://www.readbyqxmd.com/read/29389829/therapeutic-drug-monitoring-of-biologicals-in-rheumatoid-arthritis-a-disconnect-between-beliefs-and-facts
#3
Alfons A den Broeder, Noortje van Herwaarden, Bart J F van den Bemt
PURPOSE OF REVIEW: To give an overview of recently published articles covering therapeutic drug monitoring (TDM) of biological DMARDs (bDMARDs) in rheumatoid arthritis. RECENT FINDINGS: In the last 18 months, two clinical studies and nine reviews were found after a systematic literature search. Most (narrative) reviews conclude that TDM should be used to improve biological treatment in rheumatoid arthritis patients, whereas most of the clinical studies (including 13 studies identified earlier) whenever scrutinized do not support this conclusion...
January 31, 2018: Current Opinion in Rheumatology
https://www.readbyqxmd.com/read/29378619/chromosome-conformation-signatures-define-predictive-markers-of-inadequate-response-to-methotrexate-in-early-rheumatoid-arthritis
#4
Claudio Carini, Ewan Hunter, Aroul S Ramadass, Jayne Green, Alexandre Akoulitchev, Iain B McInnes, Carl S Goodyear
BACKGROUND: There is a pressing need in rheumatoid arthritis (RA) to identify patients who will not respond to first-line disease-modifying anti-rheumatic drugs (DMARD). We explored whether differences in genomic architecture represented by a chromosome conformation signature (CCS) in blood taken from early RA patients before methotrexate (MTX) treatment could assist in identifying non-response to DMARD and, whether there is an association between such a signature and RA specific expression quantitative trait loci (eQTL)...
January 29, 2018: Journal of Translational Medicine
https://www.readbyqxmd.com/read/29368023/variability-in-the-prescription-of-biological-drugs-in-rheumatoid-arthritis-in-spain-a-multilevel-analysis
#5
Francisco Javier López-Longo, Daniel Seoane-Mato, María A Martín-Martínez, Fernando Sánchez-Alonso
To describe variability in the prescription of biologics (B-DMARDs) for patients with rheumatoid arthritis (RA) in hospitals in Spain, and to explore which characteristics of the patient, the doctor and the hospital are associated with this variability. Cross-sectional multicentric study in 46 rheumatology services of the National Health System. Medical records of 1188 randomly selected patients were reviewed. The association of each variable with B-DMARD prescription was analyzed using simple logistic regressions...
January 24, 2018: Rheumatology International
https://www.readbyqxmd.com/read/29365183/drug-immunogenicity-in-patients-with-inflammatory-arthritis-and-secondary-failure-to-tumour-necrosis-factor-inhibitor-therapies-the-reason-study
#6
Alejandro Balsa, Raimon Sanmarti, José Rosas, Victor Martin, Ana Cabez, Susana Gómez, María Montoro
Objectives: The aims were to evaluate the prevalence of anti-drug antibodies (ADA) in patients with RA or SpA experiencing secondary failure to anti-TNF therapy and to correlate ADA presence with anti-TNF concentration and clinical response. Methods: This was a cross-sectional, observational study of patients with active RA or SpA experiencing secondary failure to etanercept (ETN), infliximab (INF) or adalimumab (ADL). Concomitant non-biologic DMARDs were permitted...
January 19, 2018: Rheumatology
https://www.readbyqxmd.com/read/29361199/mavrilimumab-a-fully-human-granulocyte-macrophage-colony-stimulating-factor-receptor-%C3%AE-monoclonal-antibody-long-term-safety-and-efficacy-in-patients-with-rheumatoid-arthritis
#7
Gerd R Burmester, Iain B McInnes, Joel M Kremer, Pedro Miranda, Jiří Vencovský, Alex Godwood, Marius Albulescu, M Alex Michaels, Xiang Guo, David Close, Michael Weinblatt
OBJECTIVE: Mavrilimumab, a human monoclonal antibody, targets granulocyte-macrophage colony-stimulating factor receptor alpha. We report mavrilimumab long-term safety and efficacy in rheumatoid arthritis patients in two phase IIb studies (1071, 1107) and open-label extension (OLE; NCT01712399). METHODS: In 1071, patients with disease-modifying antirheumatic drug (DMARD)-inadequate responses received mavrilimumab 30, 100, 150 mg, or placebo every other week (eow), plus methotrexate...
January 23, 2018: Arthritis & Rheumatology
https://www.readbyqxmd.com/read/29352841/predict-rheumatoid-arthritis-conversion-from-undifferentiated-arthritis-with-dynamic-contrast-enhanced-mri-and-laboratory-indexes
#8
Xinwei Lei, Huixia Li, Ying Zhan, Jin Qu
OBJECTIVES: To investigate the clinical value of dynamic contrast-enhanced MRI (DCE-MRI) and laboratory indexes in predicting conversion from undifferentiated arthritis (UA) to rheumatoid arthritis (RA). METHODS: A total 81 DMARD-naive UA patients were studied. 37 cases were ultimately diagnosed as RA, 32 cases were diagnosed as other types of arthritis, and the remaining cases were still UA during the 1-year follow-up. The DCE-MRI and laboratory measures were fed into a logistic regression analysis...
January 15, 2018: Clinical and Experimental Rheumatology
https://www.readbyqxmd.com/read/29350637/clinical-utility-of-eco-color-power-doppler-ultrasonography-and-contrast-enhanced-magnetic-resonance-imaging-for-interpretation-and-quantification-of-joint-synovitis-a-review
#9
Marina Carotti, Vittoria Galeazzi, Francesca Catucci, Marcello Zappia, Francesco Arrigoni, Antonio Barile, Andrea Giovagnoni
With the introduction of new biologics such as anti-TNF-alpha antibodies and other therapies in the treatment of inflammatory arthritis, capable of halting joint destruction and functional disability, there are new pressures on diagnostic and prognostic imaging. Early demonstration of pre-erosive inflammatory features and monitoring of the long-term effects of treatment are becoming increasingly important. Early detection of synovitis offers advantages in terms of allowing early instigation of therapy and may allow the identification of those patients displaying more aggressive disease who might benefit from early intervention with expensive DMARD therapy...
January 19, 2018: Acta Bio-medica: Atenei Parmensis
https://www.readbyqxmd.com/read/29346649/endothelial-function-in-rheumatoid-arthritis
#10
Mohammad Adawi, Abdulla Watad, Nicola Luigi Bragazzi, Howard Amital, Saaida Golan, Sirchan Rizak, Blum Arnon
Background: Rheumatoid arthritis (RA) patients are at higher risk of accelerated atherosclerosis. We sought to assess endothelial dysfunction in RA to find a possible mechanistic pathway that will explain this clinical phenomenon. Methods: A prospective study recruited 44 RA patients with an active long standing (>12 months) disease. All underwent a detailed assessment of disease activity. To estimate the endothelial function the Brachial Artery Method was performed, measuring flow mediated diameter percent change (FMD%)...
January 15, 2018: QJM: Monthly Journal of the Association of Physicians
https://www.readbyqxmd.com/read/29336618/rheumatoid-arthritis-a-single-center-egyptian-experience
#11
B R Sakr, M M Elfishawi, M H ElArousy, A K Hatw, A N AbdulKarim, A B Tammam, A N Kotp, M E Hamed, I E Genedy, E D El Desouky, Z O Nawito
OBJECTIVE: Demonstration of rheumatoid arthritis (RA) characteristics in a large cohort of Egyptian patients. METHODS: Retrospective analysis of data of 3219 RA patients attending the Rheumatology outpatient clinic, Kasr Alainy Hospital, Cairo University; from January 1995 till December 2015. RESULTS: Mean age at disease onset was 36.1 ±13.4 years; 2774 (84%) were females and mean disease duration was 12.9 ±7.9 years. Regarding number of joint affected at disease onset; polyarticular pattern was found in 77...
January 16, 2018: Immunological Investigations
https://www.readbyqxmd.com/read/29335350/epidemiology-and-medication-pattern-change-of-psoriatic-diseases-in-taiwan-from-2000-to-2013-a-nationwide-population-based-cohort-study
#12
James Cheng-Chung Wei, Lin-Hong Shi, Jing-Yang Huang, Xue-Fen Wu, Rui Wu, Jeng-Yuan Chiou
OBJECTIVE: To analyze the trend of prevalence and incidence rates for psoriatic arthritis (PsA) and psoriasis in Taiwan, and to determine the changes in medication patterns. METHODS: Data were collected from the Taiwan National Health Insurance Research Database, which covered at least 95% of the population from 2000 to 2013. International Classification of Diseases, 9th edition (ICD-9) was used to identify PsA (ICD-9 696.0) and other psoriasis (ICD-9 696.1). Medications were identified by Anatomical Therapeutic Chemical Classification code...
January 15, 2018: Journal of Rheumatology
https://www.readbyqxmd.com/read/29334721/efficacy-and-safety-of-tocilizumab-in-korean-patients-with-active-rheumatoid-arthritis
#13
Han Joo Baek, Mie Jin Lim, Won Park, Sung Hwan Park, Seung-Cheol Shim, Dae-Hyun Yoo, Hyun Ah Kim, Soo Kon Lee, Yun Jong Lee, Young Eun Park, Hoon-Suk Cha, Yeong-Wook Song
Background/Aims: To investigate the efficacy and safety of tocilizumab (TCZ) humanized anti-interleukin-6 receptor monoclonal antibody, in Korean patients with active rheumatoid arthritis (RA) refractory to conventional disease modifying anti-rheumatic drugs (DMARDs) including methotrexate (MTX). Methods: The main study was a 24-week, randomized, double-blind, controlled trial that was followed by a 48-week, open-labeled, extension phase. TCZ (8 mg/kg) or placebo was intravenously administered every 4 weeks...
January 17, 2018: Korean Journal of Internal Medicine
https://www.readbyqxmd.com/read/29330755/-lymphoma-in-rheumatic-diseases
#14
REVIEW
A Rubbert-Roth, J T Bittenbring, G Assmann
Various systemic inflammatory diseases, such as rheumatoid arthritis (RA), Sjögren's syndrome and systemic lupus erythematosus (SLE) are associated with an increased risk for the development of lymphomas. Studies on patients with RA and Sjögren's syndrome have shown that there is a clear association of the incidence of lymphoma with the severity and activity of the disease and lymphomas in particular are diseases which preferentially occur in immunosuppressed patients; therefore, knowledge of the different lymphoma subtypes, their prognosis and treatment options are important for rheumatologists...
October 2017: Zeitschrift Für Rheumatologie
https://www.readbyqxmd.com/read/29325724/rheumatoid-arthritis-disease-modifying-agents-and-periprosthetic-joint-infection-what-does-a-joint-surgeon-need-to-know
#15
REVIEW
Mehrnoush H Yeganeh, Michael M Kheir, Alisina Shahi, Javad Parvizi
The incidence of periprosthetic joint infection (PJI) among patients with rheumatoid arthritis (RA) is 1.6× greater than in patients undergoing the same procedure for osteoarthritis. This higher risk "may" be due to the immunosuppressive therapies for RA patients including corticosteroids, such as prednisone, and disease-modifying antirheumatic drugs (DMARDs), such as methotrexate. There is a debate about the role of DMARDs in increasing the incidence of subsequent PJI. Studies show conflicting results, with some demonstrating no significant increase in the rates of PJI and some finding otherwise...
November 23, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29325173/immunogenicity-and-safety-of-pneumococcal-vaccination-in-patients-with-systemic-sclerosis
#16
Roger Hesselstrand, Johanna Nagel, Tore Saxne, Pierra Geborek, Lillemor Skattum, Meliha C Kapetanovic
Objective: To study the impact of disease and treatment with DMARDs on antibody response elicited by either pneumococcal conjugate vaccine (PCV13) or pneumococcal polysaccharide vaccine (PPV23) in patients with SSc. Methods: Forty-four SSc patients and 49 controls received a dose of either PCV13 or PPV23. Twelve patients were treated with DMARDs. Antibody levels to pneumococcal polysaccharides 6B and 23 F were measured before and 4-6 weeks after vaccination using ELISA...
January 8, 2018: Rheumatology
https://www.readbyqxmd.com/read/29323343/targeting-lymphatic-function-as-a-novel-therapeutic-intervention-for-rheumatoid-arthritis
#17
REVIEW
Echoe M Bouta, Richard D Bell, Homaira Rahimi, Lianping Xing, Ronald W Wood, Clifton O Bingham, Christopher T Ritchlin, Edward M Schwarz
Although clinical outcomes for patients with rheumatoid arthritis (RA) have greatly improved with the use of biologic and conventional DMARDs, approximately 40% of patients do not achieve primary clinical outcomes in randomized trials, and only a small proportion achieve lasting remission. Over the past decade, studies in murine models point to the critical role of the lymphatic system in the pathogenesis and therapy of inflammatory-erosive arthritis, presumably by the removal of catabolic factors, cytokines and inflammatory cells from the inflamed synovium...
January 11, 2018: Nature Reviews. Rheumatology
https://www.readbyqxmd.com/read/29318514/the-impact-of-biologics-and-tofacitinib-on-cardiovascular-risk-factors-and-outcomes-in-patients-with-rheumatic-disease-a-systematic-literature-review
#18
REVIEW
Michael Nurmohamed, Ernest Choy, Sadiq Lula, Blerina Kola, Ryan DeMasi, Paola Accossato
INTRODUCTION: Rheumatic diseases are autoimmune, inflammatory diseases often associated with cardiovascular (CV) disease, a major cause of mortality in these patients. In recent years, treatment with biologic and targeted synthetic disease-modifying anti-rheumatic drugs (DMARDs), either as monotherapy or in combination with other drugs, have become the standard of treatment. In this systematic literature review, we evaluated the effect of treatment with biologic or tofacitinib on the CV risk and outcomes in these patients...
January 9, 2018: Drug Safety: An International Journal of Medical Toxicology and Drug Experience
https://www.readbyqxmd.com/read/29314645/tofacitinib-with-conventional-synthetic-disease-modifying-antirheumatic-drugs-in-chinese-patients-with-rheumatoid-arthritis-patient-reported-outcomes-from-a-phase-3-randomized-controlled-trial
#19
Zhanguo Li, Yuan An, Houheng Su, Xiangpei Li, Jianhua Xu, Yi Zheng, Guiye Li, Kenneth Kwok, Lisy Wang, Qizhe Wu
AIM: Tofacitinib is an oral Janus kinase inhibitor for the treatment of rheumatoid arthritis (RA). We assess the effect of tofacitinib + conventional synthetic disease-modifying anti rheumatic drugs (csDMARDs) on patient-reported outcomes in Chinese patients with RA and inadequate response to DMARDs. METHODS: This analysis of data from the Phase 3 study ORAL Sync included Chinese patients randomized 4 : 4 : 1 : 1 to receive tofacitinib 5 mg twice daily, tofacitinib 10 mg twice daily, placebo→tofacitinib 5 mg twice daily, or placebo→tofacitinib 10 mg twice daily, with csDMARDs...
January 4, 2018: International Journal of Rheumatic Diseases
https://www.readbyqxmd.com/read/29313271/mri-assessment-of-erosion-repair-in-patients-with-long-standing-rheumatoid-arthritis-receiving-double-filtration-plasmapheresis-in-addition-to-leflunomide-and-methotrexate-a-randomized-controlled-trial
#20
Xiaoxia Yu, Lei Zhang, Lixin Wang, Weiwei Lu, Fengyan Sun, Ping Xu, Guobin Lan
The objective of this study is to investigate whether the addition of double-filtration plasmapheresis (DFPP) to leflunomide and methotrexate repairs MRI bone erosion in patients with long-standing rheumatoid arthritis (RA). Seventy-two patients with highly active RA of > 3 years' duration were randomized to receive DFPP in addition to DMARDs (leflunomide and methotrexate) or DMARDs. Contrast-enhanced MRI of the right wrist was performed at months 0, 6, and 12. MRI bone erosion, synovitis, and bone edema were scored with validated methods...
January 8, 2018: Clinical Rheumatology
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