The study found that a polygenic risk score (PRS) for rheumatoid arthritis (RA) does not predict progression to RA in a population that is already anti-cyclic citrullinated peptide (ACPA) positive. Traditional factors like rheumatoid factor (RF) IgM level, body mass index (BMI), and shared epitope (SE) were more effective in predicting RA progression
The study investigates how age, seropositivity, and inflammation influence the risk versus benefit of endogenous estrogens on coronary atherosclerosis in patients with rheumatoid arthritis (RA). The findings suggest that higher levels of estrone (E1) are associated with greater plaque burden in older patients (over 55 years) and fewer plaques in ACPA-negative patients. However, increasing E1 levels over time were linked to more new plaques in patients with higher inflammation (TA-CRP), indicating a complex interaction between these factors.
The study investigates the association between body mass index (BMI) and the persistence of non-TNF-targeted biologics in patients with rheumatoid arthritis (RA). It found that patients with a higher BMI had lower treatment continuation rates and less improvement in disease activity compared to those with a lower BMI. This suggests that obesity may impact the effectiveness and persistence of non-TNF-targeted treatments in RA patients
Findings reveal that later onset of Rheumatoid Arthritis leads to higher odds of joint erosion and radiographic changes, suggesting distinct RA phenotypes based on age.
The study investigates the association between the Systemic Immune-Inflammatory Index (SII) and all-cause mortality in critically ill patients with rheumatoid arthritis (RA). The findings indicate that higher SII levels are significantly associated with an increased risk of all-cause mortality, suggesting that SII could be a useful biomarker for assessing the prognosis of critically ill RA patients.
The study explores clinical conditions associated with genetic predisposition to rheumatoid arthritis (RA) in real-world settings. Using data from large biobanks, the researchers constructed a polygenic risk score (PRS) to estimate individuals’ genetic risk for RA. They found that the PRS was associated with RA and several comorbidities in both RA patients and non-RA controls. This suggests that genetic factors may influence the presence of certain conditions alongside RA
The study investigates how systemic inflammation and transcriptional reprogramming contribute to the progression of active rheumatoid arthritis (RA) in individuals who are anti-cyclic citrullinated peptide (ACPA) positive. Using a multi-omics approach, the researchers analyzed plasma proteomes, peripheral blood mononuclear cell (PBMC) transcriptomes, and surface phenotypes. They found that certain proteins and gene expression patterns were associated with the progression to clinical RA, highlighting potential molecular targets for early intervention.
The study examines the association between patient-reported non-articular pain (NAP) and musculoskeletal pain diagnoses and RA disease activity in a prospective real-world cohort of patients with early rheumatoid arthritis (RA). The findings suggest that NAP is common among early RA patients and is often associated with specific musculoskeletal pain diagnoses. Additionally, the presence of NAP was linked to higher RA disease activity, highlighting the importance of addressing non-articular pain in RA management.
The study investigates the association between central pain mechanisms and physical function in patients with early rheumatoid arthritis (RA). It examines how dysregulation in the central nervous system (CNS) pain processing can lead to heightened pain perception and widespread pain sensitivity, potentially limiting physical function. The study found that abnormalities in CNS pain regulation, higher pain intensity, and a greater number of painful body sites were associated with lower physical function in early RA patients.
The study investigates the impact of cartilage damage or subluxation of finger joints on the physical function of patients with rheumatoid arthritis (RA). Using ultrasound and radiographic examinations, the study evaluated the joint space narrowing (JSN) score and the presence of dislocation or subluxation in the metacarpophalangeal (MCP) and proximal interphalangeal (PIP) joints. The findings suggest that subluxation of small joints has a more significant impact on physical function than cartilage damage alone.
The study investigates whether treatment expectations or actual treatment with disease-modifying antirheumatic drugs (DMARDs) can improve illness perceptions (IPs) in patients with arthralgia suspicious for progression to rheumatoid arthritis (RA). The findings suggest that both the prospect of treatment and receiving DMARD treatment led to more positive IPs, particularly in cognitive domains such as understanding the disease, treatment effectiveness, and the impact on life. This indicates a potential “psychological window of opportunity” to improve disease outcomes by addressing patients’ perceptions early on.
The study examines the burden of emergency department (ED) visits and their outcomes among patients with rheumatoid arthritis (RA), using data from the Nationwide Emergency Department Sample (NEDS). It found that RA patients had a higher proportion of ED visits compared to non-RA patients, with 46% of RA ED visits resulting in inpatient admission. The study also highlighted disparities in ED visits by race and income, with Black and Hispanic RA patients more likely to visit the ED at younger ages and from lower-income backgrounds
The study investigates behavioral factors and chronic conditions associated with rheumatoid arthritis (RA) using data from the Korea National Health and Nutrition Examination Survey (KNHANES) between 2010 and 2021. The analysis included 35,137 adults aged 20 to 79. Multivariate logistic regression showed that stress, depression, osteoporosis, and cardiovascular disease were significantly associated with RA. Additionally, higher education levels were inversely associated with RA
The study conducts a cross-state comparative assessment of the burden of rheumatoid arthritis (RA) in the United States from 1990 to 20211. Using data from the Global Burden of Disease Study, the researchers analyzed the incidence, prevalence, mortality, and disability-adjusted life years (DALYs) due to RA across different states. The findings show a significant increase in RA burden over the three decades, with notable disparities among states. For example, Tennessee experienced the highest increase in age-standardized incidence rate (ASIR), while Mississippi had the greatest increase in age-standardized DALYs rate (ASDALR).
The study investigates whether autoantibodies to joint-related proteins can predict severe joint destruction in patients with difficult-to-treat rheumatoid arthritis (D2T RA). Using data from the Swedish BARFOT cohort, the researchers analyzed early untreated RA patients for autoantibodies to joint-related proteins (JointIDs). They found that a higher proportion of D2T patients were female, younger, and positive for anti-CCP. The presence of these autoantibodies was associated with more severe disease outcomes at 24 months follow-up, including higher disease activity scores and radiographic progression
The study investigates the associations between discordance of disease activity indices and quantitative sensory testing (QST) measures of nociplastic pain in patients with early rheumatoid arthritis (RA). The researchers hypothesized that higher discordance between subjective and objective components of disease activity measures would correlate with worse QST measures of nociplastic pain. The study used measures such as tender minus swollen joint count (TSJ), proportion of subjective components over total DAS28 (DAS28-P), and patient global assessment minus assessor global assessment (PtGA-AsGA) to evaluate discordance. QST measures included pressure pain thresholds (PPT) at the trapezius, temporal summation (TS), and conditioned pain modulation (CPM). The findings suggest that higher discordance is indeed associated with worse QST measures, indicating the presence of nociplastic pain in early RA patients.
The study explores the differential effect of comorbidities on the clinical evolution of early arthritis by sex. It found that comorbidities significantly influence disease progression, with a more pronounced effect observed in women compared to men. Women with early arthritis and comorbidities showed higher disease activity and disability over time
This study explores the barriers patients with rheumatoid arthritis (RA) face when considering changes to their treatment, aiming to understand their concerns and satisfaction with current disease control. It included 26,377 RA patients, of whom 73% were satisfied with their current disease control. Among the less satisfied patients, 34% were somewhat interested and 23% were very interested in discussing treatment changes. Common barriers included fear of new medication not working, current treatment being “good enough,” and lack of better medication options. Overall, the study highlights the need for better communication and reassurance for RA patients considering treatment changes.
This study examines the long-term outcomes of seronegative rheumatoid arthritis (RA) and undifferentiated arthritis (UA) over a median of 11.8 years. Among the 176 patients followed, 15.1% had their diagnosis changed to other conditions such as spondyloarthropathy or seropositive RA. Additionally, 26.9% achieved drug-free remission, and 18.9% began treatment with biologic or targeted synthetic DMARDs. Overall, the study underscores the variability in long-term outcomes for patients with seronegative RA and UA.
This study examines the link between pesticide use and the development of rheumatoid arthritis (RA) among spouses of pesticide applicators in the Agricultural Health Study. It included 32,345 spouses (mostly female) from North Carolina and Iowa. Key findings show positive associations between RA and the use of certain insecticides, herbicides, and fungicides, but not all pesticides examined. Strong associations were found for specific pesticides like DDT, glyphosate, and maneb/mancozeb. Overall, the study suggests that exposure to certain pesticides may increase the risk of developing RA among spouses of pesticide applicators.
This study investigates how patients with rheumatic diseases perceive mistreatment and its impact on their well-being. Involving 372 patients, 50.3% reported experiencing mistreatment, with psychological mistreatment being the most common (75.9%), followed by neglect (51.3%). The study found that mistreatment was associated with poorer quality of life and increased emotional distress. Overall, it highlights the significant impact of perceived mistreatment on patients with rheumatic diseases.
This study examines the long-term outcomes of seronegative rheumatoid arthritis (RA) to understand its progression and prognosis. Over a median of 11.8 years, 176 patients were followed. It was found that 15.1% of patients had their diagnosis changed to other conditions like spondyloarthropathy or seropositive RA. Furthermore, 26.9% of patients achieved drug-free remission, and 18.9% started on biologic or targeted synthetic DMARDs. Overall, the study highlights the variability in long-term outcomes for seronegative RA and emphasizes the need for personalized treatment approaches.
Summary: This study looks at how well patients with difficult-to-treat rheumatoid arthritis (D2T RA) respond to advanced therapy. Researchers used both patient-reported symptoms and ultrasound scans to measure disease activity before and after treatment. They found that while both subjective (patient-reported) and objective (ultrasound) measures showed improvement, the subjective measures were less responsive compared to the objective ones.
This study explores whether patients with rheumatoid arthritis (RA) are more likely to receive statin therapy compared to those with osteoarthritis (OA). The research found that RA patients were actually 24% less likely to receive statins despite their higher cardiovascular risk due to chronic inflammation.
This study explores the potential of small molecule metabolites as disease-specific biomarkers for predicting treatment response in rheumatoid arthritis (RA). By analyzing plasma metabolomic profiles, researchers aim to identify biomarkers that can help predict how well patients will respond to treatments
This study investigates the association between the number of teeth and both all-cause and cardiovascular mortality among patients with rheumatoid arthritis (RA), utilizing data from the National Health and Nutrition Examination Survey (NHANES) from 1999 to 2004. Key findings reveal that participants with more than eight missing teeth had the highest risk of all-cause mortality (Hazard Ratio [HR] 4, 95% Confidence Interval [CI] 1.66, 9.67) compared to those with no missing teeth. Furthermore, complete tooth loss was associated with the highest risk of cardiovascular mortality (HR 39.01, 95% CI 5.52-274.89). The study suggests a dose-dependent relationship between the number of teeth and mortality in RA patients, emphasizing the importance of oral health in this population.
This study investigates the association between genetic variation in the PTPN22 gene (specifically the R620W variant) and disease activity in rheumatoid arthritis (RA) patients. The PTPN22 gene is known to be a risk factor for autoimmune diseases, including RA. Key findings include higher disease activity in RA patients with the R620W variant compared to those without it. The R620W variant results in increased downstream signaling from the T cell receptor, potentially leading to higher disease activity. Additionally, the study found that the combination of the R620W variant and the HLA DRB1 shared epitope (SE) was associated with even higher disease activity.
This study explores the association between patient-reported non-articular pain (NAP) and musculoskeletal pain diagnoses and disease activity in a cohort of patients with early rheumatoid arthritis (RA). Key findings include that NAP was frequently reported by early RA patients and often co-located with areas of joint inflammation. Additionally, musculoskeletal pain diagnoses were more common in patients who reported NAP compared to those who did not. The study suggests that NAP may impact RA remission and disease activity.
This study examines whether post-fracture survival for rheumatoid arthritis (RA) patients has improved over time, using data from the West Australian Rheumatic Disease Epidemiology Register. It compares RA patients with a control group without rheumatic diseases. Key findings include that five-year post-fracture survival in RA patients was 34.8%, compared to 43.9% in controls, and one-year post-fracture survival decreased from 79.6% (1990-2000) to 72.6% (2000-2010). Fractures within one year of RA diagnosis were associated with worse survival (HR 3.17, 95% CI 1.08-9.29). Despite advances in RA treatment, post-fracture survival for RA patients has not improved and may have worsened due to more severe illnesses not accounted for in the Charlson Comorbidity Index (CCI).Overall, the study highlights that post-fracture survival for RA patients remains a significant concern.
This study evaluates the benefits of treating rheumatoid arthritis (RA) patients to remission after achieving low disease activity (LDA) in clinical practice. The research aims to understand the incremental benefits of achieving remission in patients who initially reached LDA. Key findings include improved clinical outcomes, with patients in remission having better overall health and lower disease activity compared to those who only reached LDA. Additionally, remission was associated with significant improvements in quality of life, including reduced pain and fatigue. Patients in remission also required fewer medical interventions, had lower healthcare costs, and experienced better productivity with fewer work absences. Overall, the study highlights the substantial benefits of treating RA patients to remission beyond achieving LDA.
This study investigates the associations between genetic factors and rheumatoid arthritis (RA) treatment patterns using data from the Veteran Affairs Million Veteran Program (MVP) and a multihospital healthcare system Biobank. Key findings include the identification of similar treatment patterns in both healthcare systems, with clusters of biologic Disease-Modifying Antirheumatic Drugs (bDMARDs) use categorized as TNFi persisters, TNFi to abatacept switchers, and multi-bDMARD cyclers. Additionally, the study calculated genetic risk scores for inflammatory arthritis and found that TNFi persisters had a higher genetic risk for RA compared to those who cycled through multiple bDMARDs.
This study evaluates the discontinuation and effectiveness of sequential advanced therapy (AT) in rheumatoid arthritis (RA) patients using real-world data from the Ontario Best Practice Research Initiative (OBRI). It aims to describe the pattern of sequential AT use and assess the survival rate and effectiveness of each line of therapy. The patient cohort included 2,449 adult RA patients initiating their first AT between June 1, 2008, and January 1, 2023. Key findings revealed that TNF inhibitors (Etanercept and Adalimumab) were the most common first-line AT. However, subsequent lines showed lower TNFi usage. The risk of discontinuation increased in later lines, even after adjustments for confounders. Effectiveness was evaluated using the Clinical Disease Activity Index (CDAI) change, the proportion of patients reaching the minimally clinically important difference (MCID), CDAI low disease activity (LDA), and remission at 6 months. A pre- and post-2010 comparison showed significant differences in first-line AT retention, with quicker switches post-2010 (median survival 12.2 vs. 7.6 years). Overall, the study highlights the patterns of sequential AT use and the importance of understanding treatment effectiveness and discontinuation rates in RA patients.
This study evaluates the discontinuation and effectiveness of sequential advanced therapy (AT) in rheumatoid arthritis (RA) patients, using data from the Ontario Best Practice Research Initiative (OBRI). It included 2,449 adult RA patients who started their first AT between June 1, 2008, and January 1, 2023. Key findings revealed that TNF inhibitors were the most common first-line AT, but the risk of discontinuation increased with later lines. The effectiveness was measured by changes in the Clinical Disease Activity Index (CDAI), the proportion of patients reaching the minimally clinically important difference (MCID), CDAI low disease activity (LDA), and remission at six months. Post-2010, there were quicker switches in first-line AT (median survival 12.2 vs. 7.6 years), highlighting the importance of understanding treatment effectiveness and discontinuation rates in RA patients.
This study investigates how the effect of inflammation on cardiovascular risk in rheumatoid arthritis (RA) patients varies according to their sex and anti-citrullinated protein antibody (ACPA) status. Key findings include that the impact of inflammation on cardiovascular risk may differ between male and female RA patients, and that the presence of ACPA antibodies can influence this relationship. These findings suggest that sex and ACPA status should be considered when assessing cardiovascular risk in RA patients, potentially leading to more personalized treatment strategies.
This study provides a systematic review and meta-analysis of the global prevalence of interstitial lung disease (ILD) in patients with rheumatoid arthritis (RA). The global pooled prevalence of RA-associated ILD (RA-ILD) was found to be 21.38% (95% CI: 0.1542 – 0.2886), with significant heterogeneity among the studies (I² value of 98%). The prevalence estimates for specific ILD patterns were 11.01% for usual interstitial pneumonia and 6.86% for non-specific interstitial pneumonia. Geographic variations showed Africa with the highest RA-ILD prevalence at 38.15% (95% CI: 2.29 – 94.2), while Europe had the lowest at 10.15% (95% CI: 2.86 – 30.23). These findings highlight the need for standardized diagnostic criteria and further research to understand the high prevalence of RA-ILD in different regions.
This study examines how body mass index (BMI) affects cardiovascular risk in rheumatoid arthritis (RA) patients, considering anti-citrullinated protein antibody (ACPA) status and biologic use. Key findings include that the impact of BMI on cardiovascular risk varies depending on ACPA status and biologic use. RA patients with positive ACPA status may experience different cardiovascular risk profiles compared to those who are ACPA-negative. Additionally, the use of biologic treatments can influence the relationship between BMI and cardiovascular risk. These findings suggest that personalized approaches considering ACPA status and biologic use may be necessary for managing cardiovascular risk in RA patients.
This study investigates the impact of lipid profile parameters on the incidence of major adverse cardiovascular events (MACE) in patients with rheumatoid arthritis (RA). Key findings include that higher HDL-c (High-Density Lipoprotein Cholesterol) levels are significantly associated with a reduced risk of MACE (RR: 0.64, 95% CI: [0.49, 0.82]; I²=62%). However, BMI, LDL-c (Low-Density Lipoprotein Cholesterol), triglycerides (TAG), and total cholesterol (TC) did not show significant correlations with MACE incidence. These findings suggest that while HDL-c levels may have a protective effect, other lipid parameters did not significantly impact MACE incidence in RA patients.
This study aims to validate the Expanded Risk Score for Rheumatoid Arthritis (ERS-RA) in a multicenter Italian cohort. The ERS-RA is a disease-specific cardiovascular risk prediction score designed to assess the 10-year risk of cardiovascular disease (CVD) in RA patients. The study included RA patients aged 40-69 years from multiple centers across Italy and compared the performance of ERS-RA with traditional cardiovascular risk prediction scores, such as the European Systemic Coronary Risk (SCORE-2), the Italian “Progetto Cuore” algorithm (PCA), and the updated SCORE-2 algorithm. The researchers evaluated the ability of these algorithms to predict fatal and non-fatal cardiovascular events over a follow-up period from 2019 to 2023. This validation effort underscores the potential of ERS-RA as a tailored tool for improving cardiovascular risk assessment in RA patients, offering insights into the need for personalized treatment strategies.
This study investigates the use of lung ultrasound (LUS) as a screening tool for rheumatoid arthritis-associated interstitial lung disease (RA-ILD). Key findings indicate that LUS shows promise in detecting RA-ILD by identifying sonographic characteristics such as B-lines and pleural irregularities. While high-resolution computed tomography (HRCT) remains the gold standard, LUS offers a non-invasive, non-ionizing alternative with good sensitivity and specificity. Furthermore, LUS can aid in the early detection of RA-ILD, potentially allowing for earlier treatment and improved patient outcomes.
This study examines the trends in the initiation of disease-modifying antirheumatic drugs (DMARDs) for rheumatoid arthritis (RA) among commercially insured US adults from 2001 to 2021. It identified 407,728 DMARD initiation episodes among 229,365 unique patients with RA (median age: 50 years; 79.4% female). Over the 21-year period, there was a notable shift in DMARD utilization: conventional synthetic DMARDs (csDMARDs) use declined from 79.7% of initiations in 2001 to 54.7% by 2021, biologic DMARDs (bDMARDs) initiations increased from 20.3% to 33.1%, and targeted synthetic DMARDs (tsDMARDs) initiations rose from 0.1% in 2014 to 12.2% in 2021. Despite the decline, methotrexate remained the most initiated DMARD, though its use decreased from 28.7% to 15.0%. Adalimumab was the most frequently initiated bDMARD, while tofacitinib use peaked in 2019 and then declined, with upadacitinib use increasing in the same period. These findings highlight the evolving landscape of RA treatment and the increasing adoption of newer DMARDs over time.
This study examines trends in disease activity in rheumatoid arthritis (RA) patients from 2009 to 2023 using the DAS28-CRP score, inferred from electronic health records (EHR). The DAS28-CRP score incorporates the number of tender and swollen joints, patient global assessment, and C-reactive protein (CRP) levels. Data was collected from two large academic medical centers, utilizing a neural network model to infer disease activity from structured EHR data and natural language processing of clinical notes. The RA population included 9,620 patients with a median age of 65 years, 78% female, and 81% White. The analysis was also stratified by seropositivity status (RF or anti-CCP positive) among patients who had these labs checked.
Researchers investigated the risk of Acute Coronary Syndrome (ACS) in patients with both Rheumatoid Arthritis (RA) and Interstitial Lung Disease (ILD). The researchers analyzed data from 864,724 RA patients, identifying 25,064 with ILD. They found that RA patients with ILD have a higher risk of developing ACS and face increased mortality compared to those without ILD. The study also highlights significant gender and racial disparities, with African Americans and females at higher risk. The findings underscore the need for tailored interventions to address these disparities and improve outcomes for this patient group.
The study investigates the link between early heart inflammation and future coronary plaque buildup in people with rheumatoid arthritis (RA). Researchers found that RA patients often have a higher risk of heart disease. They looked at specific markers like coronary flow reserve (CFR) and high sensitivity cardiac troponin (hs-cTnT) to identify early signs of heart issues. The study showed that these markers could predict future plaque buildup in the arteries, which is a risk factor for heart disease.
The study examines the risk of major adverse cardiovascular events (MACE) like heart attacks and strokes associated with common rheumatology medications. Researchers analyzed data from the FDA Adverse Event Reporting System (FAERS) to see how often these events occurred with different drugs used to treat conditions like rheumatoid arthritis. They found that some medications, such as prednisone and rituximab, were linked to a higher risk of these serious heart-related events, while others like methotrexate and certain TNF inhibitors had a lower risk.
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