Effects of 1-year tofacitinib therapy on angiogenic biomarkers in rheumatoid arthritis
ConclusionsDecreasing production of bFGF, PlGF or IL-6 by 1-year tofacitinib therapy potentially inhibits synovial and aortic inflammation. Although NT-proBNP, CXCL8 and CathK were associated with ccIMT, their role in RA-associated atherosclerosis needs to be further evaluated. (Source: Rheumatology)
Source: Rheumatology - October 23, 2023 Category: Rheumatology Source Type: research

The prevalence and impact of polypharmacy in rheumatology
AbstractPolypharmacy is increasingly common in rheumatology due to the complex nature of managing chronic autoimmune diseases. To date there has been limited research into the impact of polypharmacy on rheumatology patients. In this article we reviewed the literature to characterize the prevalence of polypharmacy and its effect on patients. In addition, we have highlighted some key drug –drug interactions to consider involving DMARDs as well as complementary and alternative medicines. There is emerging evidence demonstrating that polypharmacy contributes to adverse outcomes and alters treatment response. This association...
Source: Rheumatology - October 23, 2023 Category: Rheumatology Source Type: research

Comorbidities in RA: bringing them to the limelight
It is invigorating, to say the least, witnessing rheumatology live through an unprecedented era of ground-breaking innovations, bringing new hope to people living with chronic and often debilitating rheumatic and musculoskeletal diseases (RMDs). The importance of accurate and early diagnosis and treatment is now well-recognised across the community and core to new and more effective treatment approaches including treat-to-target strategies, as first described in rheumatoid arthritis (RA) [1]. An important advancement in our understanding of disease pathogenesis is the recognition that many conditions co-existing with RA, w...
Source: Rheumatology - October 23, 2023 Category: Rheumatology Source Type: research

Viewpoint: how to measure comorbidities in patients with rheumatoid arthritis – clinical and academic value
AbstractGiven the high prevalence and the enormous impact on key outcomes, comorbidities are important to consider, especially in patients with RA. Comorbidity indices are tools to quantify the impact of the overall burden of coexisting diseases on a specific outcome of interest. Until now, no gold standard exists on how to measure comorbidities. A large variety of indices have been developed using different settings and therefore leading to conceptual differences. Choosing the right tool clearly depends on the intention (clinical or research purpose) and the specific research question. The current article will address the...
Source: Rheumatology - October 23, 2023 Category: Rheumatology Source Type: research

Neuropathologic evaluation of cerebrovascular disease in patients with rheumatoid arthritis
ConclusionIn this small series of autopsies, patients with and without RA had largely similar cerebrovascular pathology when controlling for neurodegenerative proteinopathies, although patients with RA exhibited more pronounced cerebrovascular disease in the basal ganglia. (Source: Rheumatology)
Source: Rheumatology - October 23, 2023 Category: Rheumatology Source Type: research

Viewpoint: Could better understanding of risk factors for comorbidities pave the way towards personalized therapy in rheumatoid arthritis?
AbstractIn addition to joints, several organs can be affected in rheumatoid arthritis. Coexisting conditions with different pathomechanisms all contribute to disease activity, treatment efficacy, mortality and quality of life. The wide selection of treatment options makes it possible for rheumatologists to personalize treatment for their patients, which in present practice mainly includes the consideration of established comorbidities and contraindications. We suggest that further research can enable clinicians to take into account the individual risk of the future development of comorbidities, when making therapeutic deci...
Source: Rheumatology - October 23, 2023 Category: Rheumatology Source Type: research

Multimorbidity in rheumatoid arthritis: common mechanistic links and impact and challenges in routine clinical practice
We describe how the comorbidity burden in people with RMDs impacts on disease outcome and treatment response. The importance of addressing comorbidity at an early stage and adopting a patient centred approach is critical in modern practice. (Source: Rheumatology)
Source: Rheumatology - October 23, 2023 Category: Rheumatology Source Type: research

Viewpoint: Supporting mental health in the current management of rheumatoid arthritis: time to act!
AbstractAlthough clinical outcomes of RA have vastly improved in recent years, the disease ’s mental health impact has seemingly not decreased to the same extent. Even today, learning to live with RA is an active process involving several psychological, cognitive, behavioural and emotional pathways. Consequently, mental health disorders are more common in the context of RA than in the g eneral population, and can be particularly detrimental both to patients’ quality of life and to clinical outcomes. However, mental health is a spectrum and represents more than the absence of psychological comorbidity, and supporting pa...
Source: Rheumatology - October 23, 2023 Category: Rheumatology Source Type: research

The Multimorbidity Web in rheumatoid arthritis
AbstractMultimorbidity, the presence of multiple chronic conditions, is highly prevalent in people with RA. An essential characteristic of multimorbidity is the interrelatedness of the different conditions that may develop in a multimorbid person. Recent studies have begun to identify and describe the Multimorbidity Web by elucidating unique multimorbidity patterns in people with RA. The primary multimorbidity patterns in this web are cardiopulmonary, cardiometabolic, and mental health and chronic pain multimorbidity. Once caught in the Multimorbidity Web, the consequences can be devastating, with reduced quality of life, ...
Source: Rheumatology - October 23, 2023 Category: Rheumatology Source Type: research

Prevalence and mortality associations of interstitial lung abnormalities in rheumatoid arthritis within a multicentre prospective cohort of smokers
ConclusionsIn this cohort of smokers, RA was associated with ILAs and this persisted after adjustment for current/past smoking and genetic/lifestyle risk factors. RA with ILAs in smokers had a 3-fold increased all-cause mortality, emphasizing the importance of further screening and treatment strategies for preclinical ILD in RA. (Source: Rheumatology)
Source: Rheumatology - October 23, 2023 Category: Rheumatology Source Type: research

HBV reactivation in patients with rheumatoid arthritis treated with anti-interleukin-6: a systematic review and meta-analysis
ConclusionOverall, anti-IL-6 treatment comes with a significant risk of HBVr in RA patients with CHB; risk is diminished when antiviral prophylaxis is used. In contrast, in RA patients with resolved HBV infection, the risk of HBVr seems to be extremely low. Large, well-designed studies (either controlled trials or multicentre/international observational studies) are warranted to further validate these results. (Source: Rheumatology)
Source: Rheumatology - October 23, 2023 Category: Rheumatology Source Type: research

Preferences for preventive treatments for rheumatoid arthritis: discrete choice survey in the UK, Germany and Romania
ConclusionEffective preventive pharmacological treatments for RA were acceptable to most participants. The relative importance of treatment attributes and likely uptake of fixed treatment profiles were predicted by participant characteristics. (Source: Rheumatology)
Source: Rheumatology - September 7, 2022 Category: Rheumatology Source Type: research

Clinical and therapeutic diversity in adult chronic nonbacterial osteomyelitis (CNO) of the sternocostoclavicular region: a meta-analysis
ConclusionCNO/SCCH literature proves heterogeneous regarding diagnostics and treatment. Timely diagnosis is challenging and mainly follows from increased isotope uptake on nuclear examination. Biopsies, autoantibodies and HLA status are non-contributory, and biochemical inflammation only variably detected. Based on reported data, bisphosphonates and biologicals seem reasonably effective, but due to limitations in design and heterogeneity between studies the precise magnitude of their effect is uncertain. Fundamentally, international consensus seems imperative to advance clinical care for CNO/SCCH. (Source: Rheumatology)
Source: Rheumatology - August 12, 2022 Category: Rheumatology Source Type: research

Tapering belimumab in patients with systemic lupus erythematosus: a single-centre experience
Rheumatology key messageBelimumab tapering seems to be safe and not associated with a worsening of disease activity. (Source: Rheumatology)
Source: Rheumatology - August 10, 2022 Category: Rheumatology Source Type: research

Risk of adverse pregnancy outcomes prior to the onset of an autoimmune rheumatic disease: a systematic review
ConclusionOur findings of an increased risk of APO in certain pre-ARDs highlights the relevance of taking an obstetric history during the first rheumatology appointment and the need for novel screening strategies for the prediction of APOs. Further research is required to elucidate the immune basis of APOs in preclinical and clinical ARD. (Source: Rheumatology)
Source: Rheumatology - August 5, 2022 Category: Rheumatology Source Type: research