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Concomitant ILD negatively affects clinical remission in RA
Key clinical point: Concomitant interstitial lung disease (ILD) is a significant factor associated with failure to achieve clinical remission and an increased risk for unfavorable clinical events in patients with rheumatoid arthritis (RA).
Major finding: The presence of ILD was significantly associated with failure to achieve Disease Activity Score in 28 Joints remission (adjusted hazard ratio [aHR] 0.71; P = .002) and increased risk for death (aHR 3.24; P < .001), hospitalized infections (aHR 2.60; P < .001), major adverse cardiac events (aHR 3.40; P < .001), and lung cancer (aHR 16.0; P < .001).
Study details: This study analyzed the data of 1522 patients with RA (ILD group n = 287; non-ILD group n = 1235) from the observational IORRA cohort.
Disclosures: This study was supported by the Ministry of Health, Labour, and Welfare of Japan and other sources. Some authors declared serving as consultants for or receiving research grants, research funding, or lecture, speaker, or consulting fees from various sources.
Source: Sugano E et al. Impact of interstitial lung disease on clinical remission and unfavourable events of rheumatoid arthritis: Results from the IORRA cohort. Rheumatology (Oxford). 2023 (Jun 28). Doi: 10.1093/rheumatology/kead317
Key clinical point: Concomitant interstitial lung disease (ILD) is a significant factor associated with failure to achieve clinical remission and an increased risk for unfavorable clinical events in patients with rheumatoid arthritis (RA).
Major finding: The presence of ILD was significantly associated with failure to achieve Disease Activity Score in 28 Joints remission (adjusted hazard ratio [aHR] 0.71; P = .002) and increased risk for death (aHR 3.24; P < .001), hospitalized infections (aHR 2.60; P < .001), major adverse cardiac events (aHR 3.40; P < .001), and lung cancer (aHR 16.0; P < .001).
Study details: This study analyzed the data of 1522 patients with RA (ILD group n = 287; non-ILD group n = 1235) from the observational IORRA cohort.
Disclosures: This study was supported by the Ministry of Health, Labour, and Welfare of Japan and other sources. Some authors declared serving as consultants for or receiving research grants, research funding, or lecture, speaker, or consulting fees from various sources.
Source: Sugano E et al. Impact of interstitial lung disease on clinical remission and unfavourable events of rheumatoid arthritis: Results from the IORRA cohort. Rheumatology (Oxford). 2023 (Jun 28). Doi: 10.1093/rheumatology/kead317
Key clinical point: Concomitant interstitial lung disease (ILD) is a significant factor associated with failure to achieve clinical remission and an increased risk for unfavorable clinical events in patients with rheumatoid arthritis (RA).
Major finding: The presence of ILD was significantly associated with failure to achieve Disease Activity Score in 28 Joints remission (adjusted hazard ratio [aHR] 0.71; P = .002) and increased risk for death (aHR 3.24; P < .001), hospitalized infections (aHR 2.60; P < .001), major adverse cardiac events (aHR 3.40; P < .001), and lung cancer (aHR 16.0; P < .001).
Study details: This study analyzed the data of 1522 patients with RA (ILD group n = 287; non-ILD group n = 1235) from the observational IORRA cohort.
Disclosures: This study was supported by the Ministry of Health, Labour, and Welfare of Japan and other sources. Some authors declared serving as consultants for or receiving research grants, research funding, or lecture, speaker, or consulting fees from various sources.
Source: Sugano E et al. Impact of interstitial lung disease on clinical remission and unfavourable events of rheumatoid arthritis: Results from the IORRA cohort. Rheumatology (Oxford). 2023 (Jun 28). Doi: 10.1093/rheumatology/kead317
Exposure to volatile organic compounds raises risk for RA
Key clinical point: Exposure to volatile organic compounds (VOC) significantly increased the risk for rheumatoid arthritis (RA), highlighting environmental pollutants as a risk factor for RA.
Major finding: Patients with RA had a significantly higher urine concentration of seven VOC than those without arthritis (all P < .05). The risk for RA was significantly higher among those in the highest vs lowest concentration quantile of AMCC (adjusted odds ratio [aOR] 2.173; 95% CI 1.021-4.627) and 3HPMA (aOR 2.663; 95% CI 1.288-5.508), with the parent compounds being N,N-Dimethylformamide and acrolein, respectively.
Study details: This cross-sectional study included 9536 participants with complete information on 15 urine VOC, of whom 618 participants had RA and 8918 did not have arthritis.
Disclosures: This study was supported by the Fundamental Research Funds for the Central Universities of Central South University, the National Natural Science Foundation of China, and other sources. The authors declared no conflicts of interest.
Source: Lei T et al. The exposure to volatile organic chemicals associates positively with rheumatoid arthritis: A cross-sectional study from the NHANES program. Front Immunol. 2023;14:1098683 (Jun 19). Doi: 10.3389/fimmu.2023.1098683
Key clinical point: Exposure to volatile organic compounds (VOC) significantly increased the risk for rheumatoid arthritis (RA), highlighting environmental pollutants as a risk factor for RA.
Major finding: Patients with RA had a significantly higher urine concentration of seven VOC than those without arthritis (all P < .05). The risk for RA was significantly higher among those in the highest vs lowest concentration quantile of AMCC (adjusted odds ratio [aOR] 2.173; 95% CI 1.021-4.627) and 3HPMA (aOR 2.663; 95% CI 1.288-5.508), with the parent compounds being N,N-Dimethylformamide and acrolein, respectively.
Study details: This cross-sectional study included 9536 participants with complete information on 15 urine VOC, of whom 618 participants had RA and 8918 did not have arthritis.
Disclosures: This study was supported by the Fundamental Research Funds for the Central Universities of Central South University, the National Natural Science Foundation of China, and other sources. The authors declared no conflicts of interest.
Source: Lei T et al. The exposure to volatile organic chemicals associates positively with rheumatoid arthritis: A cross-sectional study from the NHANES program. Front Immunol. 2023;14:1098683 (Jun 19). Doi: 10.3389/fimmu.2023.1098683
Key clinical point: Exposure to volatile organic compounds (VOC) significantly increased the risk for rheumatoid arthritis (RA), highlighting environmental pollutants as a risk factor for RA.
Major finding: Patients with RA had a significantly higher urine concentration of seven VOC than those without arthritis (all P < .05). The risk for RA was significantly higher among those in the highest vs lowest concentration quantile of AMCC (adjusted odds ratio [aOR] 2.173; 95% CI 1.021-4.627) and 3HPMA (aOR 2.663; 95% CI 1.288-5.508), with the parent compounds being N,N-Dimethylformamide and acrolein, respectively.
Study details: This cross-sectional study included 9536 participants with complete information on 15 urine VOC, of whom 618 participants had RA and 8918 did not have arthritis.
Disclosures: This study was supported by the Fundamental Research Funds for the Central Universities of Central South University, the National Natural Science Foundation of China, and other sources. The authors declared no conflicts of interest.
Source: Lei T et al. The exposure to volatile organic chemicals associates positively with rheumatoid arthritis: A cross-sectional study from the NHANES program. Front Immunol. 2023;14:1098683 (Jun 19). Doi: 10.3389/fimmu.2023.1098683
Small and favorable changes in body composition with low-dose prednisolone in elderly patients with active RA
Key clinical point: In patients with established rheumatoid arthritis (RA) age ≥ 65 years, an add-on low-dose prednisolone administration for 2 years led to a marginal weight gain, which appeared mostly as a beneficial increase in lean mass.
Major finding: At 2 years, the body weight increased slightly with 5 mg/day prednisolone (mean change +0.9 kg; 95% CI 0.3-1.6 kg), whereas there was a non-significant decrease with placebo (between-treatment difference 1.3 kg; P < .01). The change in body weight with prednisolone was mostly due to increased lean mass rather than fat mass and was not significantly related to disease activity.
Study details: This substudy of the phase 4 GLORIA trial included 449 patients aged ≥65 years with active RA who were randomly assigned to receive placebo (n = 225) or 5 mg/day prednisolone (n = 224) along with standard care for 2 years.
Disclosures: The GLORIA study was funded by the European Union’s Horizon 2020 research and innovation program. M Boers and MR Kok declared ties with various sources. The other authors declared no competing interests.
Source: Güler-Yüksel M et al. Changes in body weight and body composition in patients with active rheumatoid arthritis aged 65+ treated with 2-year low-dose add-on prednisolone in the randomised double-blind placebo-controlled GLORIA trial. RMD Open. 2023;9:e002905 (Jun 22). Doi: 10.1136/rmdopen-2022-002905
Key clinical point: In patients with established rheumatoid arthritis (RA) age ≥ 65 years, an add-on low-dose prednisolone administration for 2 years led to a marginal weight gain, which appeared mostly as a beneficial increase in lean mass.
Major finding: At 2 years, the body weight increased slightly with 5 mg/day prednisolone (mean change +0.9 kg; 95% CI 0.3-1.6 kg), whereas there was a non-significant decrease with placebo (between-treatment difference 1.3 kg; P < .01). The change in body weight with prednisolone was mostly due to increased lean mass rather than fat mass and was not significantly related to disease activity.
Study details: This substudy of the phase 4 GLORIA trial included 449 patients aged ≥65 years with active RA who were randomly assigned to receive placebo (n = 225) or 5 mg/day prednisolone (n = 224) along with standard care for 2 years.
Disclosures: The GLORIA study was funded by the European Union’s Horizon 2020 research and innovation program. M Boers and MR Kok declared ties with various sources. The other authors declared no competing interests.
Source: Güler-Yüksel M et al. Changes in body weight and body composition in patients with active rheumatoid arthritis aged 65+ treated with 2-year low-dose add-on prednisolone in the randomised double-blind placebo-controlled GLORIA trial. RMD Open. 2023;9:e002905 (Jun 22). Doi: 10.1136/rmdopen-2022-002905
Key clinical point: In patients with established rheumatoid arthritis (RA) age ≥ 65 years, an add-on low-dose prednisolone administration for 2 years led to a marginal weight gain, which appeared mostly as a beneficial increase in lean mass.
Major finding: At 2 years, the body weight increased slightly with 5 mg/day prednisolone (mean change +0.9 kg; 95% CI 0.3-1.6 kg), whereas there was a non-significant decrease with placebo (between-treatment difference 1.3 kg; P < .01). The change in body weight with prednisolone was mostly due to increased lean mass rather than fat mass and was not significantly related to disease activity.
Study details: This substudy of the phase 4 GLORIA trial included 449 patients aged ≥65 years with active RA who were randomly assigned to receive placebo (n = 225) or 5 mg/day prednisolone (n = 224) along with standard care for 2 years.
Disclosures: The GLORIA study was funded by the European Union’s Horizon 2020 research and innovation program. M Boers and MR Kok declared ties with various sources. The other authors declared no competing interests.
Source: Güler-Yüksel M et al. Changes in body weight and body composition in patients with active rheumatoid arthritis aged 65+ treated with 2-year low-dose add-on prednisolone in the randomised double-blind placebo-controlled GLORIA trial. RMD Open. 2023;9:e002905 (Jun 22). Doi: 10.1136/rmdopen-2022-002905
Joint tenderness at 3 months post-diagnosis predicts long-term pain in early RA
Key clinical point: A substantial proportion of patients with early rheumatoid arthritis (RA) had unacceptably high levels of pain with or without low inflammation at 2 years after diagnosis, with joint tenderness at the 3-month follow-up predicting long-term pain despite low inflammation.
Major finding: Nearly one third of patients with early RA had unacceptable pain levels after 2 years of follow-up, with almost 80% of them also having low inflammation. At the 3-month follow-up, the difference between tender and swollen joint counts predicted the 2-year risk for unacceptable pain (odds ratio [OR] 2.00; P < .05) and unacceptable pain with low inflammation (OR 2.02; P < .05).
Study details: Findings are from a retrospective study including 275 patients with early RA.
Disclosures: This study was supported by The Swedish Research Council, The Swedish Rheumatism Association, and Lund University. Some authors declared working as a medical solution lead in rheumatology or receiving consulting fees, speaking fees, and unrestricted grant from various sources. Three authors declared no conflicts of interest.
Source: Eberhard A et al. Joint tenderness at 3 months follow-up better predicts long-term pain than baseline characteristics in early rheumatoid arthritis patients. Rheumatology (Oxford). 2023 (Jun 14). Doi: 10.1093/rheumatology/kead278
Key clinical point: A substantial proportion of patients with early rheumatoid arthritis (RA) had unacceptably high levels of pain with or without low inflammation at 2 years after diagnosis, with joint tenderness at the 3-month follow-up predicting long-term pain despite low inflammation.
Major finding: Nearly one third of patients with early RA had unacceptable pain levels after 2 years of follow-up, with almost 80% of them also having low inflammation. At the 3-month follow-up, the difference between tender and swollen joint counts predicted the 2-year risk for unacceptable pain (odds ratio [OR] 2.00; P < .05) and unacceptable pain with low inflammation (OR 2.02; P < .05).
Study details: Findings are from a retrospective study including 275 patients with early RA.
Disclosures: This study was supported by The Swedish Research Council, The Swedish Rheumatism Association, and Lund University. Some authors declared working as a medical solution lead in rheumatology or receiving consulting fees, speaking fees, and unrestricted grant from various sources. Three authors declared no conflicts of interest.
Source: Eberhard A et al. Joint tenderness at 3 months follow-up better predicts long-term pain than baseline characteristics in early rheumatoid arthritis patients. Rheumatology (Oxford). 2023 (Jun 14). Doi: 10.1093/rheumatology/kead278
Key clinical point: A substantial proportion of patients with early rheumatoid arthritis (RA) had unacceptably high levels of pain with or without low inflammation at 2 years after diagnosis, with joint tenderness at the 3-month follow-up predicting long-term pain despite low inflammation.
Major finding: Nearly one third of patients with early RA had unacceptable pain levels after 2 years of follow-up, with almost 80% of them also having low inflammation. At the 3-month follow-up, the difference between tender and swollen joint counts predicted the 2-year risk for unacceptable pain (odds ratio [OR] 2.00; P < .05) and unacceptable pain with low inflammation (OR 2.02; P < .05).
Study details: Findings are from a retrospective study including 275 patients with early RA.
Disclosures: This study was supported by The Swedish Research Council, The Swedish Rheumatism Association, and Lund University. Some authors declared working as a medical solution lead in rheumatology or receiving consulting fees, speaking fees, and unrestricted grant from various sources. Three authors declared no conflicts of interest.
Source: Eberhard A et al. Joint tenderness at 3 months follow-up better predicts long-term pain than baseline characteristics in early rheumatoid arthritis patients. Rheumatology (Oxford). 2023 (Jun 14). Doi: 10.1093/rheumatology/kead278
Joint involvement starts earlier and more severely in hands than in feet in RA
Key clinical point: Functional disabilities involving the hands started earlier and were more frequent and severe than those involving feet in patients with clinically suspect arthralgia (CSA) who progressed toward rheumatoid arthritis (RA) or clinical inflammatory arthritis (IA).
Major finding: In patients with RA development, hand disabilities occurred earlier and were more frequent and severe (mean difference over time 0.41 units; P < .001) than foot disabilities. The evaluation of tender joints and subclinical joint inflammation showed similar findings for hand and foot involvement.
Study details: This study longitudinally assessed 600 patients with CSA who developed clinical IA or had at least 1 year of follow-up.
Disclosures: This study was supported by the European Research Council and the Dutch Arthritis Society. AHM van der Helm-van Mil declared being an Editorial Board Member for RMD Open. The other authors did not report any conflicts of interest.
Source: Khidir SJH et al. Joint involvement in RA starts predominantly in the hands: Functional, clinical and imaging studies in clinically suspect arthralgia and during progression to RA. RMD Open. 2023;9:e003107 (Jun 16). Doi: 10.1136/rmdopen-2023-003107
Key clinical point: Functional disabilities involving the hands started earlier and were more frequent and severe than those involving feet in patients with clinically suspect arthralgia (CSA) who progressed toward rheumatoid arthritis (RA) or clinical inflammatory arthritis (IA).
Major finding: In patients with RA development, hand disabilities occurred earlier and were more frequent and severe (mean difference over time 0.41 units; P < .001) than foot disabilities. The evaluation of tender joints and subclinical joint inflammation showed similar findings for hand and foot involvement.
Study details: This study longitudinally assessed 600 patients with CSA who developed clinical IA or had at least 1 year of follow-up.
Disclosures: This study was supported by the European Research Council and the Dutch Arthritis Society. AHM van der Helm-van Mil declared being an Editorial Board Member for RMD Open. The other authors did not report any conflicts of interest.
Source: Khidir SJH et al. Joint involvement in RA starts predominantly in the hands: Functional, clinical and imaging studies in clinically suspect arthralgia and during progression to RA. RMD Open. 2023;9:e003107 (Jun 16). Doi: 10.1136/rmdopen-2023-003107
Key clinical point: Functional disabilities involving the hands started earlier and were more frequent and severe than those involving feet in patients with clinically suspect arthralgia (CSA) who progressed toward rheumatoid arthritis (RA) or clinical inflammatory arthritis (IA).
Major finding: In patients with RA development, hand disabilities occurred earlier and were more frequent and severe (mean difference over time 0.41 units; P < .001) than foot disabilities. The evaluation of tender joints and subclinical joint inflammation showed similar findings for hand and foot involvement.
Study details: This study longitudinally assessed 600 patients with CSA who developed clinical IA or had at least 1 year of follow-up.
Disclosures: This study was supported by the European Research Council and the Dutch Arthritis Society. AHM van der Helm-van Mil declared being an Editorial Board Member for RMD Open. The other authors did not report any conflicts of interest.
Source: Khidir SJH et al. Joint involvement in RA starts predominantly in the hands: Functional, clinical and imaging studies in clinically suspect arthralgia and during progression to RA. RMD Open. 2023;9:e003107 (Jun 16). Doi: 10.1136/rmdopen-2023-003107
Certolizumab pegol and abatacept show superiority over conventional therapy in early RA
Key clinical point: First-line therapy with biologics, including abatacept and certolizumab pegol but not tocilizumab, all in combination with methotrexate, was clinically superior to conventional therapy with bridging glucocorticoids in patients with moderate-to-severe early rheumatoid arthritis (RA).
Major finding: Compared with active conventional therapy, the Clinical Disease Activity Index-based remission rates at week 48 were significantly higher with abatacept (adjusted difference +20.1%; P < .001) and certolizumab pegol (adjusted difference +13.1%; P = .021) but not with tocilizumab, whereas the radiographic progression was low and lacked between-group differences.
Study details: Findings are from the NORD-STAR trial including 812 treatment-naive patients with moderate-to-severe early RA who were randomly assigned to receive methotrexate combined with active conventional therapy, certolizumab pegol, abatacept, or tocilizumab.
Disclosures: This study was funded by the Academy of Finland, Finska Läkaresällskapet, and other sources. Several authors declared chairing the committees of or receiving travel support, research grants, or fees for lectures, speaking, consultancy, advisory roles, or other services from various sources.
Source: Østergaard M et al, on behalf of the NORD-STAR study group. Certolizumab pegol, abatacept, tocilizumab or active conventional treatment in early rheumatoid arthritis: 48-week clinical and radiographic results of the investigator-initiated randomised controlled NORD-STAR trial. Ann Rheum Dis. 2023 (Jul 9). Doi: 10.1136/ard-2023-224116
Key clinical point: First-line therapy with biologics, including abatacept and certolizumab pegol but not tocilizumab, all in combination with methotrexate, was clinically superior to conventional therapy with bridging glucocorticoids in patients with moderate-to-severe early rheumatoid arthritis (RA).
Major finding: Compared with active conventional therapy, the Clinical Disease Activity Index-based remission rates at week 48 were significantly higher with abatacept (adjusted difference +20.1%; P < .001) and certolizumab pegol (adjusted difference +13.1%; P = .021) but not with tocilizumab, whereas the radiographic progression was low and lacked between-group differences.
Study details: Findings are from the NORD-STAR trial including 812 treatment-naive patients with moderate-to-severe early RA who were randomly assigned to receive methotrexate combined with active conventional therapy, certolizumab pegol, abatacept, or tocilizumab.
Disclosures: This study was funded by the Academy of Finland, Finska Läkaresällskapet, and other sources. Several authors declared chairing the committees of or receiving travel support, research grants, or fees for lectures, speaking, consultancy, advisory roles, or other services from various sources.
Source: Østergaard M et al, on behalf of the NORD-STAR study group. Certolizumab pegol, abatacept, tocilizumab or active conventional treatment in early rheumatoid arthritis: 48-week clinical and radiographic results of the investigator-initiated randomised controlled NORD-STAR trial. Ann Rheum Dis. 2023 (Jul 9). Doi: 10.1136/ard-2023-224116
Key clinical point: First-line therapy with biologics, including abatacept and certolizumab pegol but not tocilizumab, all in combination with methotrexate, was clinically superior to conventional therapy with bridging glucocorticoids in patients with moderate-to-severe early rheumatoid arthritis (RA).
Major finding: Compared with active conventional therapy, the Clinical Disease Activity Index-based remission rates at week 48 were significantly higher with abatacept (adjusted difference +20.1%; P < .001) and certolizumab pegol (adjusted difference +13.1%; P = .021) but not with tocilizumab, whereas the radiographic progression was low and lacked between-group differences.
Study details: Findings are from the NORD-STAR trial including 812 treatment-naive patients with moderate-to-severe early RA who were randomly assigned to receive methotrexate combined with active conventional therapy, certolizumab pegol, abatacept, or tocilizumab.
Disclosures: This study was funded by the Academy of Finland, Finska Läkaresällskapet, and other sources. Several authors declared chairing the committees of or receiving travel support, research grants, or fees for lectures, speaking, consultancy, advisory roles, or other services from various sources.
Source: Østergaard M et al, on behalf of the NORD-STAR study group. Certolizumab pegol, abatacept, tocilizumab or active conventional treatment in early rheumatoid arthritis: 48-week clinical and radiographic results of the investigator-initiated randomised controlled NORD-STAR trial. Ann Rheum Dis. 2023 (Jul 9). Doi: 10.1136/ard-2023-224116
Tofacitinib shows marginal edge over adalimumab in real-world patients with RA
Key clinical point: In patients with rheumatoid arthritis (RA), tofacitinib led to a modest yet statistically significant reduction in disease activity at 3 months compared with adalimumab; however, the reduction in disease activity was not significantly different between the treatment groups at 9 months.
Major finding: The difference in the mean Disease Activity Score in 28 Joints using C-reactive protein between patients treated with tofacitinib vs adalimumab was modest yet statistically significant at 3 months (average treatment effect [ATE] −0.2; P = .02), whereas there was no significant difference at 9 months (ATE −0.03; P = .60).
Study details: This observational study emulated a randomized controlled trial using the data of 842 biologic or targeted synthetic disease-modifying antirheumatic drug-naïve patients with RA from the OPAL dataset who initiated adalimumab (n = 569) or tofacitinib (n = 273).
Disclosures: This study did not declare any specific funding source. Four authors declared being a director of, serving on advisory boards or speakers’ bureaus for, or receiving personal fees for consultancy from various sources.
Source: Deakin CT et al, for the OPAL Rheumatology Network. Comparative effectiveness of adalimumab vs tofacitinib in patients with rheumatoid arthritis in Australia. JAMA Netw Open. 2023;6(6):e2320851 (Jun 29). Doi: 10.1001/jamanetworkopen.2023.20851
Key clinical point: In patients with rheumatoid arthritis (RA), tofacitinib led to a modest yet statistically significant reduction in disease activity at 3 months compared with adalimumab; however, the reduction in disease activity was not significantly different between the treatment groups at 9 months.
Major finding: The difference in the mean Disease Activity Score in 28 Joints using C-reactive protein between patients treated with tofacitinib vs adalimumab was modest yet statistically significant at 3 months (average treatment effect [ATE] −0.2; P = .02), whereas there was no significant difference at 9 months (ATE −0.03; P = .60).
Study details: This observational study emulated a randomized controlled trial using the data of 842 biologic or targeted synthetic disease-modifying antirheumatic drug-naïve patients with RA from the OPAL dataset who initiated adalimumab (n = 569) or tofacitinib (n = 273).
Disclosures: This study did not declare any specific funding source. Four authors declared being a director of, serving on advisory boards or speakers’ bureaus for, or receiving personal fees for consultancy from various sources.
Source: Deakin CT et al, for the OPAL Rheumatology Network. Comparative effectiveness of adalimumab vs tofacitinib in patients with rheumatoid arthritis in Australia. JAMA Netw Open. 2023;6(6):e2320851 (Jun 29). Doi: 10.1001/jamanetworkopen.2023.20851
Key clinical point: In patients with rheumatoid arthritis (RA), tofacitinib led to a modest yet statistically significant reduction in disease activity at 3 months compared with adalimumab; however, the reduction in disease activity was not significantly different between the treatment groups at 9 months.
Major finding: The difference in the mean Disease Activity Score in 28 Joints using C-reactive protein between patients treated with tofacitinib vs adalimumab was modest yet statistically significant at 3 months (average treatment effect [ATE] −0.2; P = .02), whereas there was no significant difference at 9 months (ATE −0.03; P = .60).
Study details: This observational study emulated a randomized controlled trial using the data of 842 biologic or targeted synthetic disease-modifying antirheumatic drug-naïve patients with RA from the OPAL dataset who initiated adalimumab (n = 569) or tofacitinib (n = 273).
Disclosures: This study did not declare any specific funding source. Four authors declared being a director of, serving on advisory boards or speakers’ bureaus for, or receiving personal fees for consultancy from various sources.
Source: Deakin CT et al, for the OPAL Rheumatology Network. Comparative effectiveness of adalimumab vs tofacitinib in patients with rheumatoid arthritis in Australia. JAMA Netw Open. 2023;6(6):e2320851 (Jun 29). Doi: 10.1001/jamanetworkopen.2023.20851
Bruton tyrosine kinase inhibitors improve outcomes in CLL when combined with anti-CD20 mAb
Key clinical point: Compared with Bruton tyrosine kinase inhibitors (BTKi) alone, BTKi + anti-CD20 monoclonal antibodies (mAb) demonstrated better efficacy in patients with untreated, relapsed, or refractory chronic lymphocytic leukemia (CLL) without causing safety concerns.
Major finding: The BTKi + anti-CD20 mAb therapy vs BTKi monotherapy group had significantly improved progression-free survival (hazard ratio 0.70; 95% CI 0.51-0.97), complete response rate (relative risk [RR] 2.03; 95% CI 1.01-4.06), and undetectable minimal residual disease rate (RR 6.43; 95% CI 3.54-11.67) and a similar risk for grade ≥3 adverse events (RR 1.08; 95% CI 0.80-1.45).
Study details: Findings are from a meta-analysis of 4 randomized controlled trials including 1056 patients who received a BTKi + anti-CD20 mAb or BTKi monotherapy for untreated, relapsed, or refractory CLL.
Disclosures: This study was supported by grants from the National Science and Technology Council in Taiwan and the industry-academia cooperation program. The authors declared no conflicts of interest.
Source: Nguyen TT et al. Efficacy and safety of add-on anti-CD20 monoclonal antibody to Bruton tyrosine kinase inhibitor treatment for chronic lymphocytic leukemia: A meta-analysis. Sci Rep. 2023;13:9775 (Jun 16). Doi: 10.1038/s41598-023-36279-x
Key clinical point: Compared with Bruton tyrosine kinase inhibitors (BTKi) alone, BTKi + anti-CD20 monoclonal antibodies (mAb) demonstrated better efficacy in patients with untreated, relapsed, or refractory chronic lymphocytic leukemia (CLL) without causing safety concerns.
Major finding: The BTKi + anti-CD20 mAb therapy vs BTKi monotherapy group had significantly improved progression-free survival (hazard ratio 0.70; 95% CI 0.51-0.97), complete response rate (relative risk [RR] 2.03; 95% CI 1.01-4.06), and undetectable minimal residual disease rate (RR 6.43; 95% CI 3.54-11.67) and a similar risk for grade ≥3 adverse events (RR 1.08; 95% CI 0.80-1.45).
Study details: Findings are from a meta-analysis of 4 randomized controlled trials including 1056 patients who received a BTKi + anti-CD20 mAb or BTKi monotherapy for untreated, relapsed, or refractory CLL.
Disclosures: This study was supported by grants from the National Science and Technology Council in Taiwan and the industry-academia cooperation program. The authors declared no conflicts of interest.
Source: Nguyen TT et al. Efficacy and safety of add-on anti-CD20 monoclonal antibody to Bruton tyrosine kinase inhibitor treatment for chronic lymphocytic leukemia: A meta-analysis. Sci Rep. 2023;13:9775 (Jun 16). Doi: 10.1038/s41598-023-36279-x
Key clinical point: Compared with Bruton tyrosine kinase inhibitors (BTKi) alone, BTKi + anti-CD20 monoclonal antibodies (mAb) demonstrated better efficacy in patients with untreated, relapsed, or refractory chronic lymphocytic leukemia (CLL) without causing safety concerns.
Major finding: The BTKi + anti-CD20 mAb therapy vs BTKi monotherapy group had significantly improved progression-free survival (hazard ratio 0.70; 95% CI 0.51-0.97), complete response rate (relative risk [RR] 2.03; 95% CI 1.01-4.06), and undetectable minimal residual disease rate (RR 6.43; 95% CI 3.54-11.67) and a similar risk for grade ≥3 adverse events (RR 1.08; 95% CI 0.80-1.45).
Study details: Findings are from a meta-analysis of 4 randomized controlled trials including 1056 patients who received a BTKi + anti-CD20 mAb or BTKi monotherapy for untreated, relapsed, or refractory CLL.
Disclosures: This study was supported by grants from the National Science and Technology Council in Taiwan and the industry-academia cooperation program. The authors declared no conflicts of interest.
Source: Nguyen TT et al. Efficacy and safety of add-on anti-CD20 monoclonal antibody to Bruton tyrosine kinase inhibitor treatment for chronic lymphocytic leukemia: A meta-analysis. Sci Rep. 2023;13:9775 (Jun 16). Doi: 10.1038/s41598-023-36279-x
A lymph node diameter > 56.5 mm strongly predicts progression during venetoclax treatment in CLL
Key clinical point: The presence of one or more lymph nodes >56.5 mm before starting venetoclax is an independent risk factor for early progression during venetoclax therapy in patients with relapsed or refractory chronic lymphocytic leukemia (CLL).
Major finding: After a median follow up of 14.3 months, the median progression-free survival (PFS) was not reached and the estimated 3‐year PFS rate was 54%. Multivariable analysis revealed a >56.5 mm diameter of at least one lymph node before therapy initiation to be a significant predictive factor for progression (adjusted hazard ratio 1.01; P =.005).
Study details: Findings are from a multicenter retrospective study including 128 patients with relapsed or refractory CLL treated with ibrutinib, idelalisib, or both who switched to venetoclax due to progression or adverse events, of which 28 patients experienced progressive disease.
Disclosures: This study did not receive any specific funding. The authors declared no conflicts of interest.
Source: Autore F et al. Lymphadenopathy as a predictor of progression during venetoclax treatment in chronic lymphocytic leukemia. A campus chronic lymphocytic leukemia study. Hematol Oncol. 2023 (Jul 1). Doi: 10.1002/hon.3199
Key clinical point: The presence of one or more lymph nodes >56.5 mm before starting venetoclax is an independent risk factor for early progression during venetoclax therapy in patients with relapsed or refractory chronic lymphocytic leukemia (CLL).
Major finding: After a median follow up of 14.3 months, the median progression-free survival (PFS) was not reached and the estimated 3‐year PFS rate was 54%. Multivariable analysis revealed a >56.5 mm diameter of at least one lymph node before therapy initiation to be a significant predictive factor for progression (adjusted hazard ratio 1.01; P =.005).
Study details: Findings are from a multicenter retrospective study including 128 patients with relapsed or refractory CLL treated with ibrutinib, idelalisib, or both who switched to venetoclax due to progression or adverse events, of which 28 patients experienced progressive disease.
Disclosures: This study did not receive any specific funding. The authors declared no conflicts of interest.
Source: Autore F et al. Lymphadenopathy as a predictor of progression during venetoclax treatment in chronic lymphocytic leukemia. A campus chronic lymphocytic leukemia study. Hematol Oncol. 2023 (Jul 1). Doi: 10.1002/hon.3199
Key clinical point: The presence of one or more lymph nodes >56.5 mm before starting venetoclax is an independent risk factor for early progression during venetoclax therapy in patients with relapsed or refractory chronic lymphocytic leukemia (CLL).
Major finding: After a median follow up of 14.3 months, the median progression-free survival (PFS) was not reached and the estimated 3‐year PFS rate was 54%. Multivariable analysis revealed a >56.5 mm diameter of at least one lymph node before therapy initiation to be a significant predictive factor for progression (adjusted hazard ratio 1.01; P =.005).
Study details: Findings are from a multicenter retrospective study including 128 patients with relapsed or refractory CLL treated with ibrutinib, idelalisib, or both who switched to venetoclax due to progression or adverse events, of which 28 patients experienced progressive disease.
Disclosures: This study did not receive any specific funding. The authors declared no conflicts of interest.
Source: Autore F et al. Lymphadenopathy as a predictor of progression during venetoclax treatment in chronic lymphocytic leukemia. A campus chronic lymphocytic leukemia study. Hematol Oncol. 2023 (Jul 1). Doi: 10.1002/hon.3199
Soluble CD163 holds prognostic value in chemoimmunotherapy- and targeted therapy-treated MCL
Key clinical point: High serum levels of the M2 macrophage marker soluble CD163 could be used as an independent negative prognostic marker in patients with newly diagnosed or relapsed mantle cell lymphoma (MCL).
Major finding: Above-median levels of soluble CD163 (>3000 ng/mL) were significantly associated with shorter progression-free survival (adjusted hazard ratio [aHR] 3.48; P =.006) and overall survival (aHR 4.33; P =.016).
Study details: This study analyzed serum samples from 131 patients with newly diagnosed or relapsed MCL who received immunochemotherapy or targeted treatments (mainly rituximab, ibrutinib, and lenalidomide), respectively.
Disclosures: This study was supported by grants from the Swedish Cancer Society and others. Some authors declared serving as advisory board members or scientific advisors or receiving research funding or honoraria from various organizations.
Source: Nikkarinen A et al. Soluble CD163 predicts outcome in both chemoimmunotherapy and targeted therapy-treated mantle cell lymphoma. Blood Adv. 2023 (Jun 30). Doi: 10.1182/bloodadvances.2023010052
Key clinical point: High serum levels of the M2 macrophage marker soluble CD163 could be used as an independent negative prognostic marker in patients with newly diagnosed or relapsed mantle cell lymphoma (MCL).
Major finding: Above-median levels of soluble CD163 (>3000 ng/mL) were significantly associated with shorter progression-free survival (adjusted hazard ratio [aHR] 3.48; P =.006) and overall survival (aHR 4.33; P =.016).
Study details: This study analyzed serum samples from 131 patients with newly diagnosed or relapsed MCL who received immunochemotherapy or targeted treatments (mainly rituximab, ibrutinib, and lenalidomide), respectively.
Disclosures: This study was supported by grants from the Swedish Cancer Society and others. Some authors declared serving as advisory board members or scientific advisors or receiving research funding or honoraria from various organizations.
Source: Nikkarinen A et al. Soluble CD163 predicts outcome in both chemoimmunotherapy and targeted therapy-treated mantle cell lymphoma. Blood Adv. 2023 (Jun 30). Doi: 10.1182/bloodadvances.2023010052
Key clinical point: High serum levels of the M2 macrophage marker soluble CD163 could be used as an independent negative prognostic marker in patients with newly diagnosed or relapsed mantle cell lymphoma (MCL).
Major finding: Above-median levels of soluble CD163 (>3000 ng/mL) were significantly associated with shorter progression-free survival (adjusted hazard ratio [aHR] 3.48; P =.006) and overall survival (aHR 4.33; P =.016).
Study details: This study analyzed serum samples from 131 patients with newly diagnosed or relapsed MCL who received immunochemotherapy or targeted treatments (mainly rituximab, ibrutinib, and lenalidomide), respectively.
Disclosures: This study was supported by grants from the Swedish Cancer Society and others. Some authors declared serving as advisory board members or scientific advisors or receiving research funding or honoraria from various organizations.
Source: Nikkarinen A et al. Soluble CD163 predicts outcome in both chemoimmunotherapy and targeted therapy-treated mantle cell lymphoma. Blood Adv. 2023 (Jun 30). Doi: 10.1182/bloodadvances.2023010052