Latest news with #rheumatoidArthritis
Medscape
4 days ago
- Business
- Medscape
Tocilizumab, Alone or With Methotrexate, Potent in Active RA
Subcutaneous tocilizumab, either as monotherapy or in combination with methotrexate, demonstrated greater efficacy than methotrexate alone and was well tolerated in patients with active rheumatoid arthritis (RA) who had an inadequate response to conventional synthetic disease-modifying antirheumatic drugs (csDMARDs). METHODOLOGY: Researchers conducted a phase 3 trial at 19 sites in China between July 2017 and August 2022 to evaluate the efficacy of subcutaneous tocilizumab, administered either as monotherapy or in combination with methotrexate, in 340 patients with moderate to severe active RA (mean age, 47.5 years; 86.5% women). The patients had a diagnosis of RA for ≥ 6 months, had received methotrexate for ≥ 12 weeks, experienced treatment failure with at least one csDMARD (including methotrexate), had at least six swollen joints and at least eight tender joints, and had either a high-sensitivity C-reactive protein level ≥ 4 mg/L or an erythrocyte sedimentation rate ≥ 28 mm/h. Patients were randomly assigned to receive tocilizumab-methotrexate combination therapy (n = 136), tocilizumab monotherapy with placebo (n = 136), or methotrexate monotherapy with placebo (n = 68) for 24 weeks. Tocilizumab (162 mg) was administered subcutaneously once every 2 weeks, and methotrexate (10-25 mg) was administered orally once every week. Patients achieving a Disease Activity Score in 28 joints of ≤ 3.2 after 24 weeks continued their randomly assigned treatment, whereas those with a score > 3.2 switched to unblinded tocilizumab-methotrexate treatment. The primary efficacy endpoint was the proportion of patients who achieved a ≥ 20% improvement in the American College of Rheumatology (ACR20) response criteria at 24 weeks, with long-term efficacy analyzed at 48 weeks and safety monitored for 56 weeks. TAKEAWAY: The ACR20 response rate at 24 weeks was higher in the tocilizumab-methotrexate combination therapy (52.9%) and tocilizumab monotherapy (50.0%) groups than in the methotrexate monotherapy group (25.0%), with significant differences of 27.9 and 25.0 percentage points, respectively ( P < .001 for both). < .001 for both). Long-term efficacy analysis at 48 weeks showed maintained or improved efficacy in patients continuing tocilizumab monotherapy or tocilizumab-methotrexate combination therapy, with an improved disease status in those who switched to unblinded tocilizumab-methotrexate treatment at 24 weeks. Tocilizumab was well tolerated as both monotherapy and in combination with methotrexate, with no new safety signals. IN PRACTICE: 'Subcutaneous tocilizumab, both as monotherapy and in combination with methotrexate, had clinically significant efficacy compared with methotrexate monotherapy in Chinese patients with moderate to severe active RA,' the authors wrote. SOURCE: This study was led by Tian Liu, MD, Peking University People's Hospital in Beijing, China. It was published online on May 19, 2025, in JAMA Network Open . LIMITATIONS: Only Chinese patients were included, thus limiting the generalizability of the findings. Researchers did not include imaging analysis. The recruitment was extended over a period of 4 years owing to the COVID-19 pandemic, which resulted in missing the efficacy assessments and tocilizumab administration in some patients. DISCLOSURES: This study received funding from and was conducted in collaboration with F. Hoffmann-La Roche Ltd. Three authors reported receiving grants from various pharmaceutical companies, including Roche. Two authors reported being employed by Roche (China) Holding.
Medscape
5 days ago
- General
- Medscape
Fibrosis-4 Index Finds New Role in Rheumatoid Arthritis
Up to 20% of patients with rheumatoid arthritis (RA) had abnormal fibrosis-4 (FIB-4) index values, reflecting an indeterminate to high risk for liver fibrosis; a significant correlation was seen with insulin resistance but not with disease activity. METHODOLOGY: Researchers conducted a cross-sectional study to calculate FIB-4 index values in patients with RA and assess their relationship with disease characteristics and cardiovascular comorbidities. They recruited 465 adults with RA (mean age, 55 years; 81% women) between 2019 and 2021, all of whom had a disease duration of at least 1 year and were taking ≤ 10 mg/day of prednisone or an equivalent dose. The FIB-4 index was calculated using an equation considering age, platelet count, and alanine aminotransferase and aspartate aminotransferase levels, with the risk for fibrosis classified as low, indeterminate, or high on the basis of defined cutoff values. Participants underwent evaluations for disease activity, complete lipid profiles, the presence of metabolic syndrome, anthropometric parameters, and insulin resistance using the Homeostatic Model Assessment, as well as carotid ultrasound to detect subclinical carotid atherosclerosis. Cardiovascular risk was estimated using t he Systematic Coronary Risk Evaluation-2 (SCORE2) tool. TAKEAWAY: SCORE2 classified 66% of patients with RA as having low cardiovascular risk, 28% as having moderate cardiovascular risk, and 6% as having high cardiovascular risk; the prevalence of cardiovascular risk factors was generally high. FIB-4 values indicated an indeterminate risk for fibrosis in 18% of patients with RA and a high risk in 1%, whereas 81% had a low risk. Several factors, including age ( P < .001), cardiovascular risk measured by SCORE2 ( P < .001), and metabolic syndrome ( P = .008), showed positive correlations with FIB-4 values; however, in multivariable analysis, the presence of hypertension, insulin resistance indices, and statin use maintained significant positive associations. < .001), cardiovascular risk measured by SCORE2 ( < .001), and metabolic syndrome ( = .008), showed positive correlations with FIB-4 values; however, in multivariable analysis, the presence of hypertension, insulin resistance indices, and statin use maintained significant positive associations. Disease activity (measured by multiple scores), acute phase reactants, and the presence of rheumatoid factor or anti–citrullinated protein antibodies showed no significant association with FIB-4 values, whereas the presence of erosions at recruitment was associated with FIB-4 ( P = .044). IN PRACTICE: "This index may serve as a surrogate marker for CV [cardiovascular] risk and insulin resistance in patients with RA," the authors concluded. SOURCE: This study was led by Iván Ferraz-Amaro, Hospital Doctor Negrín, Las Palmas de Gran Canaria, Spain. It was published online on May 21, 2025, in Rheumatology . LIMITATIONS: The cross-sectional design of this study prevented the establishment of causal relationships between variables. Data on hepatic ultrasound or liver biopsy were lacking. Information on cumulative methotrexate use was not collected. DISCLOSURES: This study was supported by a grant from Instituto de Salud Carlos III and additional funds from the European Union. Two authors reported receiving grants or research support and consultation fees from speaker bureaus associated with several pharmaceutical and healthcare companies, including AbbVie, Roche, and GSK.
Medscape
28-05-2025
- Health
- Medscape
Poor Sleep Tied to Greater Pain Interference in Early RA
Patients with early rheumatoid arthritis (RA) who experienced higher levels of sleep disturbances were more likely to have greater difficulties with daily activities because of pain 6 months later. METHODOLOGY: Researchers analyzed data from the Canadian Early Arthritis Cohort study between 2016 and 2023 to examine the association between sleep disturbances and pain interference with daily functioning in patients with early RA. They included 502 patients (mean age, 56 years; 68% women; mean duration of disease, 5.4 months) who presented with joint symptoms for a maximum duration of 12 months. Participants completed Patient-Reported Outcomes Measurement Information System measures at baseline and at subsequent follow-ups to assess sleep disturbance and pain interference they experienced over the past 7 days. The sleep disturbance domain included questions regarding perceptions of sleep quality, depth, and restoration, and the pain interference domain included questions about how pain affected physical, mental, and social functioning. TAKEAWAY: At baseline, 80% and 44% of patients with early RA reported having mild to severe scores for pain interference and sleep disturbance, respectively. Those who reported higher sleep disturbance reported greater subsequent pain interference at the 6-month follow-up, even after adjusting for covariates (adjusted β coefficient, 0.76; 95% CI, 0.44-1.09). These findings were consistent across several sensitivity analyses, including adjustments for time-varying symptoms of depression and concurrent pain interference at baseline. IN PRACTICE: 'Identification and early intervention in problematic sleep patterns may contribute to enhanced long-term pain outcomes,' the authors wrote. SOURCE: This study was led by Burcu Aydemir, PhD, Northwestern University Feinberg School of Medicine, Chicago. It was published online on May 12, 2025, in Arthritis Care and Research . LIMITATIONS: This study relied on patient-reported assessments for sleep and pain interference, which may have introduced bias. Although the study accounted for several important confounders, it likely did not eliminate all potential sources of bias from unmeasured confounding. Additionally, the study did not assess the impact of the duration of sleep disturbances, so it's unclear how persistent or temporary sleep issues can affect pain interference outcomes. DISCLOSURES: The Canadian Arthritis Cohort study received funding from Pfizer, AbbVie, Hoffman La Roche, and other sources. Some authors reported receiving research support, grants, consulting fees, payments, or honoraria from; holding stocks of; or having other ties with various sources, including the funding agencies.
Medscape
26-05-2025
- Health
- Medscape
Gender Gaps Found in Timing of RA Treatment Initiation
Gender-based differences were identified in the clinical characteristics and time to initiation of the first biologic or targeted synthetic disease-modifying antirheumatic drug (b/ts DMARD) among patients with rheumatoid arthritis (RA), with women experiencing a longer disease duration before treatment initiation than men. METHODOLOGY: Researchers conducted a multicenter observational study using data from a Spanish registry to assess gender differences in clinical characteristics and in the timing of b/tsDMARD initiation in patients with RA. They included 3384 patients with RA (78.1% women) who started their first b/tsDMARD between January 2000 and October 2023. The main outcomes included the time from RA diagnosis to initiation of the first b/tsDMARD and disease activity at treatment initiation, which were compared by sex. The analysis stratified treatment initiation periods according to the emergence and marketing of different drugs during the study: Up to December 2006, January 2007-December 2016, and after January 2017. TAKEAWAY: Women had a lower mean age at treatment initiation than men (54.8 vs 57.0 years; P < .001) but a longer disease duration (mean, 7.3 vs 6.7 years; P = .031). < .001) but a longer disease duration (mean, 7.3 vs 6.7 years; = .031). Men had a higher body mass index and more comorbidities, whereas women were more likely to have Sjögren syndrome and osteoporosis. At treatment initiation, women had a higher Disease Activity Score 28–Erythrocyte Sedimentation Rate than men; however, no difference was observed in Disease Activity Score 28–C-reactive protein. Gender differences in disease duration before treatment initiation were especially notable in women from 2017 onward (hazard ratio, 0.9; P = .026). A longer RA duration before treatment was observed in women, older patients, and those on other conventional synthetic DMARDs (excluding methotrexate), whereas smokers, individuals with obesity, and those receiving methotrexate or glucocorticoids began treatment earlier. IN PRACTICE: "The delay in treatment initiation in women despite a higher activity rate merits reflection," the authors of the study wrote. SOURCE: This study was led by Paloma Vela-Casasempere, Alicante Institute for Health and Biomedical Research (ISABIAL), Alicante, Spain. It was published online on May 14, 2025, in Arthritis Research & Therapy . LIMITATIONS: Only the covariates available in the registry were included in this study, potentially missing other confounding factors. Sex was recorded as a dichotomous variable (male/female), without accounting for self-identified gender. DISCLOSURES: The registry was supported by the Spanish Agency of Drugs and Medical Devices, Biogen, Bristol-Myers and Squibb, and others. Several authors reported receiving grants or contracts, consulting fees, honoraria, or travel support from various pharmaceutical companies, including Novartis and Pfizer.
Yahoo
22-05-2025
- Health
- Yahoo
Alina creates welcoming shop for traders to sell their wares
IN 2018 I was diagnosed with rheumatoid arthritis and also discovered I have some degenerative issues at the bottom of my spine. I started looking into alternative options to help me change my lifestyle and manage pain. I spent many hours investigating alternative medicine, holistic therapy, herbalism, Ayurvedic herbalism and skincare. Skincare was something I looked into from 2011, when I had to see several doctors and dermatologists for my skin. Unfortunately some of the products they prescribed made my situation worse. I stopped using anything fragranced or perfumed. In 2022 I had my son and stopped working. When he was nine months-old I decided to create an online page and start practising what I had learned. With little money left after getting divorced, I bought some materials, ingredients and paid for cosmetic assessments to start making and selling my own skincare products. There's a good variety of products in the shop Aromatherapy oils Alina in her shop Online interest and following took a while to build up so I started taking part in events and markets. Some refused my attendance because I had to bring my son along, while others took a lot of effort and money. Even with my son starting nursery, returning to work as a single mum is not an option as I have nobody to look after him if the nursery is closed or he's poorly. Also, I wanted him too much to work just to pay for childcare and rarely see him. Through events and networking I met some amazing people with similar issues that led them to run their business from home. Many had closed due to lack of sales and related mental health issues. That's how the idea of opening a small business collective came to me - what if I bring several businesses under one roof so we can help each other? I applied for a loan and also reached out to different people with businesses I've bought from or met through my social events. I offered them a space in the shop for a small fee. Their payments go towards paying bills and any other related shop expenses. Many agreed to join me months before I even got the keys. I came across the shop in Shipley, where I had lived for ten years. When I saw it I got a good feeling. The street is nice with mainly female-run businesses and as a spiritual person it called to me. Colourful scarves in the shop Trader Susan Brophy with a crocheted shawl she made Alina in her shop When I finally got accepted for the loan I only received half of the requested and required amount, which meant most of the work I had to do myself. A couple of friends and my nephew came to help for a few hours, which made it easier. However, the loan got me into debt, especially as I had to limit my expenses. My eldest brother sent me some money to help but it has been a struggle. At the moment I'm looking into grants and maybe another loan to finish the work and display of the shop . Even so I am proud of myself and what I've achieved so far. I make a variety of skincare products such as soap, body butters, face and body oils, hemp and magnesium balms and aromatherapy oils. Most of my ingredients come from The Soapery, which is a British supplier of natural ingredients for cosmetics. I have people of all ages, mainly women, and from all over the UK, sending their products to me. People sell bath and body products, jewellery, crystals, scarves, resin and polymer decorations, 3D printing, children's clothing, crochet and many personalised gifts. One of the crafters in the shop is using her stock to raise money for Cancer Research UK. After recovering from breast cancer she started using her talents for the cause and so far she's raised £12000. Another charity we have is the Rotary Club of Shipley - they use their proceeds to help the local community. I have two mothers who have SEN children, who work their business around their care. I have a single mother-of-three who was widowed during her pregnancy with her youngest, so her business had to be designed around caring for them. A display inside the shop Alina's Gifts in Shipley Another look inside Several of us suffer with chronic pain, some have social anxiety and is hard for us to find a job that accepts us with our commitments and issues. The shop is a lifeline for many of us. Some of the people have actually made more sales through the shop than on their own. Some were thinking of closing down before they joined. For some having something to do and creating something is so important for their mental health - they see it as an opportunity to keep creating and not give up. I hope I managed to bring opportunities for everyone involved. The shop is an important part of my life and I want it to succeed. It allows me to work at my own pace, engage and interact with people while still being able to spend time with my son. We also host workshops in crafts such as origami and crochet, which are very popular. Working in the shop is such a joy for me, it has a calming vibe and I really enjoy it. Having my son with me while being able to do something is such a relief too. *Alina's Gifts, 29 Westgate, Shipley BD18 3QX; visit Alina's Gifts on Facebook and Instagram
