Annals of the Rheumatic Diseases

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ISSN / EISSN : 0003-4967 / 1468-2060
Current Publisher: BMJ (10.1136)
Former Publisher:
Total articles ≅ 78,581
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, Tatiana Kruglova, Karine Lytkina, Georgy Melkonyan, Elena Prokhorovich, Gleb Putsman, Grigory Rodoman, Arkady Vertkin, Alena Zagrebneva, Justin Stebbing
Published: 7 June 2021
by BMJ
Annals of the Rheumatic Diseases; doi:10.1136/annrheumdis-2021-220049

Na He, Zhenwei Fang, Xiaotong Li,
Published: 7 June 2021
by BMJ
Annals of the Rheumatic Diseases; doi:10.1136/annrheumdis-2021-220819

Scott A Jenks, Chungwen Wei, Regina Bugrovsky, Aisha Hill, Xiaoqian Wang, Francesca M Rossi, Kevin Cashman, Matthew C Woodruff, Laura D Aspey, S. Sam Lim, et al.
Published: 3 June 2021
by BMJ
Annals of the Rheumatic Diseases; doi:10.1136/annrheumdis-2021-220349

The publisher has not yet granted permission to display this abstract.
, Daniela Di Giuseppe, Bénédicte Delcoigne, , , , Manuel Pombo-Suarez, Carlos Sanchez-Piedra, Kari Eklund, Heikki Relas, et al.
Published: 3 June 2021
by BMJ
Annals of the Rheumatic Diseases; doi:10.1136/annrheumdis-2021-220097

Abstract:
Background Comedication with conventional synthetic disease-modifying antirheumatic drugs (csDMARDs) during treatment with tumour necrosis factor inhibitors (TNFi) is extensively used in psoriatic arthritis (PsA), although the additive benefit remains unclear. We aimed to compare treatment outcomes in patients with PsA treated with TNFi and csDMARD comedication versus TNFi monotherapy. Methods Patients with PsA from 13 European countries who initiated a first TNFi in 2006–2017 were included. Country-specific comparisons of 1 year TNFi retention were performed by csDMARD comedication status, together with HRs for TNFi discontinuation (comedication vs monotherapy), adjusted for age, sex, calendar year, disease duration and Disease Activity Score with 28 joints (DAS28). Adjusted ORs of clinical remission (based on DAS28) at 12 months were calculated. Between-country heterogeneity was assessed using random-effect meta-analyses, combined results were presented when heterogeneity was not significant. Secondary analyses stratified according to TNFi subtype (adalimumab/infliximab/etanercept) and restricted to methotrexate as comedication were performed. Results In total, 15 332 patients were included (62% comedication, 38% monotherapy). TNFi retention varied across countries, with significant heterogeneity precluding a combined estimate. Comedication was associated with better remission rates, pooled OR 1.25 (1.12–1.41). Methotrexate comedication was associated with improved remission for adalimumab (OR 1.45 (1.23–1.72)) and infliximab (OR 1.55 (1.21–1.98)) and improved retention for infliximab. No effect of comedication was demonstrated for etanercept. Conclusion This large observational study suggests that, as used in clinical practice, csDMARD and TNFi comedication are associated with improved remission rates, and specifically, comedication with methotrexate increases remission rates for both adalimumab and infliximab.
, Anna-Birgitte Aga, Inge Christoffer Olsen, , , , Tore K Kvien, Espen A Haavardsholm, Siri Lillegraven
Published: 3 June 2021
by BMJ
Annals of the Rheumatic Diseases; doi:10.1136/annrheumdis-2021-220265

Sebastian H Unizony, Min Bao, Jian Han, Yves Luder, Andrey Pavlov,
Published: 28 May 2021
by BMJ
Annals of the Rheumatic Diseases; doi:10.1136/annrheumdis-2021-220347

Abstract:
Objective Identify predictors of treatment failure in patients with giant cell arteritis (GCA) receiving tocilizumab in combination with glucocorticoids and in patients with GCA receiving only glucocorticoids. Methods Posthoc analysis of the Giant-Cell Arteritis Actemra trial including 250 patients who received tocilizumab every week plus a 26-week prednisone taper (n=100), tocilizumab every-other-week plus a 26-week prednisone taper (n=49) or placebo plus a 26-week (n=50) or 52-week (n=51) prednisone taper in the intention-to-treat population. Responders for this analysis were patients who maintained remission (no GCA signs/symptoms and no erythrocyte sedimentation rate elevation) through week 52. Treatment failure was defined as inability to achieve remission by week 12 or relapse between weeks 12 and 52. Predictors investigated in univariate and multivariable analyses included patient characteristics, disease-related and treatment-related factors and patient-reported outcomes (PROs). Results 149 patients received tocilizumab plus prednisone (TCZ/PDN) and 101 received placebo plus prednisone (PBO+PDN). After adjustment for confounders, treatment failure was significantly less likely in the TCZ/PDN group than the PBO/PDN group (OR, 0.2; 95% CI, 0.1 to 0.3; p<0.0001). Risk for treatment failure was significantly higher in women than men in the PBO/PDN group (OR, 5.2; 95% CI, 1.6 to 17.2; p=0.007) but not in the TCZ/PDN group. Predictors of treatment failure in the TCZ/PDN group included lower baseline prednisone doses and worse PROs at baseline. Conclusion The strongest risk factors for treatment failure in GCA are treatment with prednisone alone and female sex. Lower starting prednisone doses and impaired PROs are associated with failure to respond to tocilizumab. Trial registration number NCT01791153.
Keith Colaco, Ker-Ai Lee, Shadi Akhtari, Raz Winer, Paul Welsh, Naveed Sattar, Iain B McInnes, Vinod Chandran, Paula Harvey, Richard J Cook, et al.
Published: 28 May 2021
by BMJ
Annals of the Rheumatic Diseases; doi:10.1136/annrheumdis-2021-220168

The publisher has not yet granted permission to display this abstract.
, , Felix Radny, , , Juliane Greese, Dominik Deppe, , Kay Geert Hermann,
Published: 28 May 2021
by BMJ
Annals of the Rheumatic Diseases; doi:10.1136/annrheumdis-2021-220136

Abstract:
Objective To assess the diagnostic accuracy of radiography (X-ray, XR), CT and MRI of the sacroiliac joints for diagnosis of axial spondyloarthritis (axSpA). Methods 163 patients (89 with axSpA; 74 with degenerative conditions) underwent XR, CT and MR. Three blinded experts categorised the imaging findings into axSpA, other diseases or normal in five separate reading rounds (XR, CT, MR, XR +MR, CT +MR). The clinical diagnosis served as reference standard. Sensitivity and specificity for axSpA and inter-rater reliability were compared. Results XR showed lower sensitivity (66.3%) than MR (82.0%) and CT (76.4%) and also an inferior specificity of 67.6% vs 86.5% (MR) and 97.3% (CT). XR +MR was similar to MR alone (sensitivity 77.5 %/specificity 87.8%) while CT+MR was superior (75.3 %/97.3%). CT had the best inter-rater reliability (kappa=0.875), followed by MR (0.665) and XR (0.517). XR +MR was similar (0.662) and CT+MR (0.732) superior to MR alone. Conclusions XR had inferior diagnostic accuracy and inter-rater reliability compared with cross-sectional imaging. MR alone was similar in diagnostic performance to XR+MR. CT had the best accuracy, strengthening the importance of structural lesions for the differential diagnosis in axSpA.
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