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Mark C Genovese, Roy Fleischmann, Bernard Combe, Stephen Hall, Andrea Rubbert-Roth, Ying Zhang, Yijie Zhou, Mohamed-Eslam F Mohamed, Sebastian Meerwein, Aileen L Pangan
BACKGROUND: Phase 2 studies with upadacitinib, a selective Janus kinase 1 (JAK1) inhibitor, have shown safety and efficacy in the treatment of patients with active rheumatoid arthritis. We did this study to further assess the safety and efficacy of upadacitinib in patients with an inadequate response to biologic disease-modifying anti-rheumatic drugs (bDMARDs). METHODS: We did this double-blind, randomised controlled phase 3 trial at 153 sites in 26 countries. Patients were aged 18 years or older, had active rheumatoid arthritis and previous inadequate response or intolerance to bDMARDs, and were receiving concomitant background conventional synthetic DMARDS (csDMARDs)...
June 12, 2018: Lancet
May Y Choi, Cheryl Barnabe, Claire E Barber, Vivian Bykerk, Janet E Pope, Glen S Hazlewood
OBJECTIVE: Randomized controlled trials (RCTs) exist along a spectrum, from explanatory, designed to evaluate interventions under ideal conditions, to pragmatic, designed to reflect usual care. This study assessed the pragmaticism of RCTs of advanced therapeutics in rheumatoid arthritis (RA). METHODS: A systematic review was conducted to identify RA RCTs comparing biologic or targeted synthetic therapy in combination with methotrexate, to placebo or any other DMARD(s)...
June 15, 2018: Arthritis Care & Research
Claire E H Barber, J Carter Thorne, Vandana Ahluwalia, Jennifer Burt, Diane Lacaille, Deborah A Marshall, Glen S Hazlewood, Dianne Mosher, Lisa Denning, Ildiko Szamjo, Ricky Chin, Sean Hamilton, Susanne Benseler, Marinka Twilt, Natalie J Shiff, Vivian Bykerk, Joanne Homik, Cheryl Barnabe
OBJECTIVE: To test the feasibility of reporting on 4 national performance measures for patients with rheumatoid arthritis (RA) in 5 different models of care. METHODS: The following performance measures were evaluated in 5 models of care: waiting time (WT) to rheumatologist consultation, percentage of patients seen in yearly followup (FU), percentage taking disease-modifying antirheumatic drugs (DMARD), and time to starting DMARD. All models aimed to improve early access and care for patients with RA...
June 15, 2018: Journal of Rheumatology
Sytske Anne Bergstra, Cornelia F Allaart, Sofia Ramiro, Arvind Chopra, Nimmisha Govind, Cândida Silva, Elizabeth A Murphy, Robert B M Landewé
OBJECTIVE: To assess differences in initial treatment and treatment response in male and female patients with rheumatoid arthritis (RA) in daily clinical practice. METHODS: The proportion of patients with RA starting different antirheumatic treatments (disease-modifying antirheumatic drugs; DMARD) and the response to treatment were compared in the international, observational METEOR register. All visits from start of the first DMARD until the first DMARD switch or the end of followup were selected...
June 15, 2018: Journal of Rheumatology
Georgina Nakafero, Matthew J Grainge, Puja R Myles, Christian D Mallen, Weiya Zhang, Michael Doherty, Jonathan S Nguyen-Van-Tam, Abhishek Abhishek
Objectives: To examine temporal trend in uptake of seasonal influenza vaccine (SIV) in the UK and explore disease and demographic factors associated with vaccination. Methods: From the Clinical Practice Research Datalink, 32 751 people with auto-immune rheumatic diseases prescribed DMARDs between 2006 and 2016 were identified. The proportion vaccinated between 1 September of one year and 31 March of the next year was calculated and stratified by age, other indications for vaccination, auto-immune rheumatic diseases type and number of DMARDs prescribed...
June 12, 2018: Rheumatology
Alyssa Wohlfahrt, Clifton O Bingham, Wendy Marder, Kristine Phillips, Marcy B Bolster, Larry W Moreland, Zhi Zhang, Tuhina Neogi, Yvonne C Lee
OBJECTIVE: The Patient Reported Outcomes Measurement Information System (PROMIS) is a calibrated item bank used to assess patient reported outcomes across multiple domains. The purpose of this study was to describe the performance of selected PROMIS measures in rheumatoid arthritis (RA) patients with active disease, initiating a disease-modifying antirheumatic drug (DMARD). METHODS: Participants in an ongoing prospective observational study completed eight PROMIS measures before and after DMARD initiation...
June 8, 2018: Arthritis Care & Research
Sang-Cheol Bae, Soo-Kyung Cho, Soyoung Won, Hye-Soon Lee, Sang-Heon Lee, Young Mo Kang, Sang-Hoon Lee, Yeon-Ah Lee, Jung-Yoon Choe, Won-Tae Chung, Chang-Hee Suh, Seung-Cheol Shim, Jisoo Lee, Bo Young Yoon, Dong-Wook Kim, Shin-Seok Lee, Wan-Hee Yoo, Jin-Seok Kim, Young-Ok Jung, Seong-Su Nah, Choong-Ki Lee, Gwan-Gyu Song, Sung Jae Choi, Chung-Il Joung, Hyein Koh, Young-Joo Kim
AIM: To determine characteristics of rheumatoid arthritis (RA) patients in Korea using disease-modifying anti-rheumatic drugs (DMARDs) for at least 6 months, and to identify factors associated with poor health-related outcomes. METHOD: A total of 2000 RA patients aged > 20 years, treated with DMARDs for at least 6 months, and signed informed consent, were enrolled in this non-interventional, multicenter, cross-sectional observational study from December 2012 to June 2013...
May 2018: International Journal of Rheumatic Diseases
Brigitte Michelsen, Till Uhlig, Joseph Sexton, Désirée van der Heijde, Hilde Berner Hammer, Eirik Klami Kristianslund, Ada Wierød, Gunnstein Bakland, Erik Rødevand, Frode Krøll, Jon Håvard Loge, Glenn Haugeberg, Tore K Kvien
OBJECTIVES: To compare (1) Short Form-36 (SF-36) Physical Component Summary (PCS) and Mental Component Summary (MCS), scale scores and Short Form-6 dimensions (SF-6D) between patients with rheumatoid arthritis (RA) and patients with psoriatic arthritis (PsA) and Norwegian general population controls and (2) improvements in these measures between patients with RA and PsA. METHODS: Analyses of covariance were performed to compare SF-36 measures between first-time enrolled patients with RA (n=3898) and PsA (n=1515) from the prospective observational multicentre NORwegian-Disease Modifying Anti-Rheumatic Drug study (6 months follow-up) and general population controls (n=2323)...
June 6, 2018: Annals of the Rheumatic Diseases
Faith Matcham, James Galloway, Matthew Hotopf, Emmert Roberts, Ian C Scott, Sophia Steer, Sam Norton
Rheumatoid Arthritis (RA) pharmacotherapy may impact mental health (MH) outcomes by improving pain and stiffness; and potentially via targeting inflammatory processes common to RA and depression. The objectives of this review were to i) ascertain the frequency of MH assessment in RA pharmacotherapy trials; ii) quantify the efficacy of RA pharmacotherapy efficacy on MH outcomes; iii) explore the clinical and demographic factors related to MH outcomes. CENTRAL, PsychINFO, Web of Science, Medline, Embase and CINAHL were systematically searched from inception to March 2017 for randomised trials of disease-modifying anti-rheumatic drugs (DMARDs) in adult RA patients...
June 6, 2018: Arthritis & Rheumatology
Alessandro Giollo, Lesley-Anne Bissell, Maya H Buch
Rheumatoid arthritis (RA) is associated with a heightened risk of cardiovascular disease (CVD), with both traditional CV risk factors and inflammation contributing to this risk. Areas covered: This review highlights the burden of CVD in RA and associated traditional CV risk factors, including the complexity of dyslipidaemia in RA and the so-called 'lipid paradox'. Furthermore, the recognised RA disease specific factors associated with higher risk of CVD and the role of systemic inflammation in the pathogenesis of CVD in RA will be addressed...
June 6, 2018: Expert Opinion on Drug Safety
Signe Rifbjerg-Madsen, Anton Wulf Christensen, Mikael Boesen, Robin Christensen, Bente Danneskiold-Samsøe, Henning Bliddal, Lene Dreyer, Henning Locht, Kirstine Amris
BACKGROUND: Evidence is emerging that pain in rheumatoid arthritis (RA) exists without underlying inflammation. Our objective was to evaluate the prognostic value of pain classification at treatment initiation using the painDETECT questionnaire (PDQ). Outcomes were change in DAS28-CRP and RAMRIS synovitis score. METHODS: RA patients initiating a disease-modifying anti-rheumatic drug (DMARD) or initiating/ switching a biological agent were included. Follow-up time was 4 months...
May 30, 2018: Arthritis Research & Therapy
David M Kern, Lawrence Chang, Kalyani Sonawane, Cynthia J Larmore, Natalie N Boytsov, Ralph A Quimbo, Joseph Singer, John T Hinton, Sze-Jung Wu, Andre B Araujo
INTRODUCTION: To describe treatment patterns in newly diagnosed rheumatoid arthritis (RA) patients in a large, nationally representative managed-care database. METHODS: Newly diagnosed RA patients were identified from 07/01/2006-08/31/2014. Patients had ≥ 1 RA diagnosis by a rheumatologist, or ≥ 2 non-rheumatologist RA diagnoses ≥ 30 days apart, or RA diagnosis followed by a disease-modifying antirheumatic drug (DMARD) prescription fill within 1 year. Patients were ≥ 18 years old at index (earliest date fulfilling diagnostic criteria) and had ≥ 6 and 12 months of pre- and post-index health plan enrollment, respectively...
May 30, 2018: Rheumatology and Therapy
Eun Ha Kang, Katherine P Liao, Seoyoung C Kim
PURPOSE OF REVIEW: Increased cardiovascular (CV) risk and associated mortality in rheumatoid arthritis (RA) are not fully explained by traditional CV risk factors. This review discusses the epidemiology and mechanisms of increased CV risk in RA and treatment effects on CV risk focusing on biologic disease-modifying anti-rheumatic drugs (DMARDs) and JAK inhibitors. RECENT FINDINGS: Intermediary metabolic changes by inflammatory cytokines are observed in body composition, lipid profile, and insulin sensitivity of RA patients, leading to accelerated atherosclerosis and increased CV risk...
May 30, 2018: Current Rheumatology Reports
Jeffrey A Sparks, Tamara Lesperance, Neil A Accortt, Daniel H Solomon
OBJECTIVES: To examine disease-modifying antirheumatic drug (DMARD) treatments and estimate risk of a subsequent cardiovascular (CV) event following an initial CV event in patients with rheumatoid arthritis (RA), psoriatic arthritis (PsA), or psoriasis (PsO). METHODS: We analyzed data from MarketScan® claims databases (1/1/2006-6/30/2015) for adults with RA, PsA, or PsO and initial/index CV event (acute myocardial infarction, stroke, or coronary revascularization) while receiving DMARDs (tumor necrosis factor inhibitor [TNFi] biologic DMARDs [bDMARDs], conventional synthetic DMARDs [csDMARDs], or non-TNFi bDMARDs)...
May 25, 2018: Arthritis Care & Research
Baptiste Louveau, Yann De Rycke, Alexandre Lafourcade, Alain Saraux, Francis Guillemin, Florence Tubach, Bruno Fautrel, David Hajage
Objectives: Several authors have tried to predict the risk of radiographic progression in RA according to baseline characteristics, considering exposure to treatment only as a binary variable (Treated: Yes/No). This study aims to model the risk of 5-year radiographic progression taking into account both baseline characteristics and the cumulative time-varying exposure to corticosteroids or DMARDs. Methods: The study population consisted of 403 patients of the Etude et Suivi des Polyarthrites Indifférenciées Récentes cohort meeting the 1987 ACR or 2010 ACR/EULAR criteria for RA at inclusion and having complete radiographic data at baseline and 5 years...
May 22, 2018: Rheumatology
Slavica Prodanovic, Goran Radunovic, Dragan Babic, Biljana Ristic, Mirjana Sefik-Bukilica, Maja Zlatanovic, Katarina Simic-Pasalic, Srdjan Seric, Nada Vujasinovic-Stupar, Janko Samardzic, Nemanja Damjanov
OBJECTIVE: To investigate the association of high baseline serum levels of metalloproteinases-3 (MMP-3) with structural damage to hand and feet joints, assessed by ultrasonography (US), in patients with early, treatment-naïve rheumatoid arthritis (RA), without initial X-ray-visible erosions, during 24 months follow-up. METHODS: Sixty-three early RA (EULAR/ACR 2010), DMARDs/glucocorticoid naïve patients (mean age 53.4 ± 14.1) with symptom duration ≤ 12 months, had baseline serum levels of MMP-3 tested...
May 24, 2018: Medical Principles and Practice: International Journal of the Kuwait University, Health Science Centre
Marjan Ghiti Moghadam, Femke B G Lamers-Karnebeek, Harald E Vonkeman, Peter M Ten Klooster, Janneke Tekstra, Annemarie M Schilder, Henk Visser, Eric H Sasso, David Chernoff, Willem F Lems, Dirk-Jan van Schaardenburg, Robert Landewe, Hein J Bernelot Moens, Timothy R D J Radstake, Piet L C M van Riel, Mart A F J van de Laar, Tim L Jansen
OBJECTIVE: Successfully stopping or reducing treatment for patients with rheumatoid arthritis (RA) in low disease activity (LDA) may improve cost-effectiveness of care. We evaluated the multi-biomarker disease activity (MBDA) score as a predictor of disease relapse after discontinuation of TNF inhibitor (TNFi) treatment. METHODS: 439 RA patients who were randomized to stop TNFi treatment in the POET study were analyzed post-hoc. Three indicators of disease relapse were assessed over 12 months: 1) restarting TNFi treatment, 2) escalation of any DMARD therapy and 3) physician-reported flare...
2018: PloS One
Dirk Ziebolz, Annegret Rupprecht, Jan Schmickler, Laura Bothmann, Juliane Krämer, Daniel Patschan, Gerhard A Müller, Rainer F Mausberg, Jana Schmidt, Gerhard Schmalz, Susann Patschan
BACKGROUND: The aim of this cross-sectional study was to investigate clinical periodontal findings as well as prevalence of selected potentially periodontal pathogenic bacteria in patients with rheumatoid arthritis (RA) treated with different immunosuppressive rheumatic medications. METHODS: 168 patients with RA undergoing different immunosuppressive medications were included and divided into subgroups according to their medication, which was taken in the past six months, in detail I) non-steroidal anti-inflammatory drugs (NSAID) and glucocorticoids combined, and II-VII) different disease modifying anti-rheumatic drugs (DMARDs): II) Methotrexate (MTX), III) Leflunomide, IV) MTX and TNF-α antagonists combined, V) Interleukin-6 (IL-6) antagonist, VI) MTX and Rituximab combined, and VII) combination therapies of more than two of these DMARDs...
May 22, 2018: Journal of Periodontology
Chinatsu Takai, Daisuke Kobayashi, Satoshi Ito, Akira Murasawa, Yoko Wada, Ichiei Narita, Kiyoshi Nakazono
AIM: To investigate the clinical course of patients with elderly-onset rheumatoid arthritis (RA). METHODS: We compared the characteristics, and clinical course of 55 patients who developed RA at over 80 years of age (elderly-onset [EO] group) with 119 patients who developed RA at 40-59 years of age (non-elderly onset [non-EO] group). We also investigated the characteristics and clinical course of 19 patients who developed RA at over 80 and who received biological disease-modifying anti-rheumatic drugs (bDMARDs)...
2018: Nihon Ronen Igakkai Zasshi. Japanese Journal of Geriatrics
Desirée van der Heijde, Maxime Dougados, Ying-Chou Chen, Maria Greenwald, Edit Drescher, Rena Klar, Li Xie, Inmaculada de la Torre, Terence P Rooney, Sarah L Witt, Douglas E Schlichting, Stephanie de Bono, Paul Emery
Background: Baricitinib was efficacious in a 24-week phase III study in patients with rheumatoid arthritis (RA) and an inadequate response to conventional synthetic disease-modifying anti rheumatic drugs (DMARDs) (csDMARDs) (RA-BUILD). Objectives: To evaluate radiographic progression of structural joint damage in RA-BUILD patients over 48 weeks of baricitinib treatment in the long-term extension study, RA-BEYOND. Methods: In RA-BUILD, patients were randomised to placebo, baricitinib 2 mg or 4 mg once daily, with rescue possible from week 16...
2018: RMD Open
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