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| Fleischmann RM, et al. ArthritisRheumatol. 2014 Nov 10. |
| In this study, the investigators assessed the efficacy and safety of oral VX-509 (decernotinib) monotherapy in a 12-week, double-blind, placebo-controlled, randomized, dose-ranging study of patients with rheumatoid arthritis (RA). A total of 204 adults with active RA who had failed treatment with ≥1 disease-modifying anti-rheumatic drugs were administered VX-509 25, 50, 100 or 150 mg BID or placebo tablets. At week 12, the ACR20 response rates were 39% (25 mg BID), 61% (50 mg BID), 65% (100 mg BID) and 65.9% (150 mg BID) and were significantly higher than placebo (29.3%) in the 50, 100 and 150 mg BID groups.… |
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| Grazio S, et al. Am J Med Sci. 2014 Oct 10. |
| In a cross-sectional study, 120 adult patients with established diagnosis of psoriatic arthritis (PsA), RA and osteoarthritis (OA) were consecutively enrolled. Serum 25-hydroxyvitamin D and intact parathyroid hormone were determined in these patients. Serum vitamin D insufficiency (≤75 nmol/L) was found in 74% of patients with PsA, 94% of patients with RA and 97% of patients with OA; whereas vitamin D deficiency (≤25 nmol/L) was found in 13% of patients with PsA, 39% of patients with RA and in 38% of patients with OA. Compared with RA, patients with PsA had significantly higher serum vitamin D levels and when controlling for age and gender, their serum vitamin D level was significantly associated with disease activity and functional activity. The authors found a high prevalence of serum vitamin D insufficiency/deficiency regardless of the type of arthritis. They concluded that prophylactic supplementation with vitamin D might be recommended for all rheumatic patients… |
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| Savage EM, et al. Rheumatol Int. 2014 Oct 24. |
| The aim of the study was to determine whether rheumatoid arthritis disease activity correlates with changing weather conditions. A longitudinal analysis was performed, which included 133 participants with a diagnosis of RA and were receiving subcutaneous anti-tumor necrosis factor (TNF) therapy (adalimumab or etanercept) for a period of >6 months. The investigators found a significant correlation between low DAS-28 and increased hours of sunshine. Sunny conditions were associated with a DAS28 reduction of 0.037. A significant correlation between humidity and DAS28 was also observed (p=0.016). Increased humidity was associated with an increased DAS28 of 0.007. Higher temperatures were associated with a non-significant decrease in DAS28… |
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| Chen J, et al. Arthritis Rheumatol. 2014 Oct 9. |
| Rheumatoid arthritis-associated interstitial lung disease (RA-ILD) is a relatively common extra-articular manifestation of RA that contributes significantly to disease burden and excess mortality. Peripheral blood biomarkers of RA-ILD are therefore needed to facilitate earlier diagnosis and to provide insight regarding pathogenesis of this potentially devastating disease complication. In this study, the authors did multiplex ELISAs employing Luminex xMAP technology to assess 36 cytokines/chemokines, matrix metalloproteinases (MMPs), and acute-phase proteins in the identification cohort. The investigators found elevated MMP-7 and IP10/CXCL10 in the serum of patients with different stages of RA-ILD, supporting their value as pathogenically relevant biomarkers.… |
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| Emery P, et al. N Engl J Med. 2014;371(19):1781–1792. |
| In this study, the investigators assessed the effects of reduction and withdrawal of treatment in patients with RA who had a remission while receiving etanercept plus methotrexate therapy. The investigators concluded that in patients with early RA who had a remission while receiving full-dose etanercept plus methotrexate therapy, continuing combination therapy at a reduced dose resulted in better disease control than switching to methotrexate alone or placebo, but no significant difference was observed in radiographic progression… |
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| Emery P, et al. Ann Rheum Dis. 2014 Nov 3. |
| In this study, the investigators evaluated the clinical remission with subcutaneous abatacept plus methotrexate (MTX) and abatacept monotherapy at 12 months in patients with early RA, and maintenance of remission following the rapid withdrawal of all RA treatments.
In the Assessing Very Early Rheumatoid arthritis Treatment (AVERT) phase 3b trial, patients with early active RA were randomized to double-blind, weekly, subcutaneous abatacept 125 mg plus MTX, abatacept 125 mg monotherapy, or MTX for 12 months. Patients with low disease activity DAS28 CRP <3.2 at month 12 entered a 12-month period of withdrawal of all RA therapies. For abatacept plus MTX vs. MTX, DAS28 (CRP) <2.6 was achieved in 60.9% vs. 45.2% at 12 months, and following treatment withdrawal, in 14.8% vs. 7.8% at both 12 and 18 months, respectively. DAS28 (CRP) <2.6 was achieved for abatacept monotherapy in 42.5% (month 12) and 12.4% (both months 12 and 18)… |
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| Windschall D, et al. Rheumatol Int. 2014 Sep 11. |
| The aim of the present study was to evaluate the efficacy and safety of treatment with etanercept in children with juvenile idiopathic arthritis (JIA) younger than 2 years. The prospective long-term observational BIKER registry documents baseline demographics, clinical characteristics, disease activity parameters and safety issues. Efficacy was determined using the PedACR response criteria, the JADAS-10 and the proposed criteria for inactive disease and remission after 3, 6, 12, 18 and 24 months. Between January 2001 and June 2013, a total of 13 patients, including 4 patients with systemic JIA (sJIA), 4 patients with extended oligoarthritis, 1 patient with persistent oligoarthritis and 4 patients with RF-negative polyarthritis, were treated with etanercept… |
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| Deodhar A, et al. Ann Rheum Dis. 2014 Nov 11. |
| A total of 356 patients with ankylosing spondylitis (AS) were randomly assigned to placebo, golimumab 50 mg or 100 mg every 4 weeks. At week 16, patients with inadequate response early escaped with blinded dose adjustments (placebo to 50, 50–100 mg). At week 24, all patients receiving placebo crossed over to 50 mg. Blinded active therapy continued through week 104; from week 104 to week 252, the golimumab dose could be adjusted. At week 256, and with >4.5 years of golimumab treatment, overall intent-to-treat Assessment in SpondyloArthritis international Society criteria for 20% improvement (ASAS20) and ASAS40 response rates were 66.0% (235/356) and 57.0% (203/356), respectively; Bath AS Disease Activity Index 50% improvement response was 55.9% (199/356)… |
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| Geetha D, et al. J Am Soc Nephrol. 2014 Nov 7. |
| This is a post hoc analysis of patients enrolled in the Rituximab for ANCA-Associated Vasculitis (RAVE) Trial who had renal involvement (biopsy-proven pauci-immune GN, red blood cell casts in the urine, and/or a rise in serum creatinine concentration attributed to vasculitis). Remission-induction regimens were RTX at 375 mg/m2×4 or CYC at 2 mg/kg/day. Cyclophosphamide (CYC) was replaced by AZA (2 mg/kg/day) after 3–6 months. Both groups received glucocorticoids. No differences in remission rates or increases in eGFR at 18 months were evident when analysis was stratified by Anti-neutrophil cytoplasmic antibodies (ANCA) type, ANCA-associated vasculitis (AAV) diagnosis (granulomatosis with polyangiitis vs. microscopic polyangiitis) or new diagnosis (vs. relapsing disease) at entry. There were no differences between treatment groups in relapses at 6, 12 or 18 months. No differences in adverse events were observed… |
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| Guillevin L, et al. N Engl J Med. 2014;371(19):1771–1780. |
| Patients with newly diagnosed or relapsing granulomatosis with polyangiitis, microscopic polyangiitis, or renal-limited ANCA-associated vasculitis in complete remission after a cyclophosphamide–glucocorticoid regimen were randomly assigned to receive either 500 mg of rituximab on days 0 and 14 and at months 6, 12 and 18 after study entry or daily azathioprine until month 22. The 115 enrolled patients (87 with granulomatosis with polyangiitis, 23 with microscopic polyangiitis, and 5 with renal-limited ANCA-associated vasculitis) received azathioprine (58 patients) or rituximab (57 patients). At month 28, major relapse had occurred in 17 patients in the azathioprine group (29%) and in 3 patients in the rituximab group (5%). The frequencies of severe adverse events were similar in the two groups... |
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| Amato AA, et al. Neurology 2014 Nov 7. |
| To study activin signaling and its blockade in sporadic inclusion body myositis (sIBM) through translational studies and a randomized controlled trial. The authors measured transforming growth factor β signaling by SMAD2/3 phosphorylation in muscle biopsies of 50 patients with neuromuscular disease (17 with sIBM). They tested inhibition of activin receptors IIA and IIB (ActRII) in 14 patients with sIBM using one dose of bimagrumab (n=11) or placebo (n=3). The primary outcome was the change in right thigh muscle volume by MRI at 8 weeks. Muscle SMAD2/3 phosphorylation was higher in sIBM than in other muscle diseases studied. Eight weeks after dosing, the bimagrumab-treated patients increased thigh muscle volume and lean body mass. Subsequently, bimagrumab-treated patients had improved 6-minute walking distance… |
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| London J, et al. Medicine (Baltimore) 2014;93(21):e121. |
| In this study, the authors described the clinical, biological, and radiological characteristics and outcome of 39 patients presenting with sarcoidosis following lymphoproliferative disease, including 14 previously unreported cases and 25 additional patients, after performing a literature review. Hodgkin’s lymphoma and non-Hodgkin’s lymphoma were equally represented. The median delay between lymphoma and sarcoidosis was 18 months… |
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| Guleria R, et al. Lung India 2014;31(4):323–330. |
| The aim of our study was to evaluate the utility of fluorodeoxyglucose-positron emission tomography–computed tomography (FDG-PET–CT) in determining the extent of organ involvement and disease activity in patients of sarcoidosis and to assess its utility in the evaluation of response to therapy. This was a prospective observational study conducted between March 2007 and December 2008 at a tertiary care referral center in north India. Twenty-five symptomatic and histopathologically proven cases of sarcoidosis underwent FDG-PET–CT scanning at baseline and a follow-up scan in 21 patients at 6–9 months post-treatment with glucocorticoids. Fluorodeoxyglucose-positron emission tomography–computed tomography scan detected metabolic disease activity in 24 of the 25 patients with clinically active sarcoidosis… |
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| Christensen R, et al. Arthritis Care Res (Hoboken) 2014 Nov 4. |
| In this study, the authors compared results of obese patients with knee osteoarthritis (OA) who, after an intensive weight loss regimen, received 1 year of either Dietary support (D), knee-Exercise program (E), or Control (C) ‘no attention’. This was a randomized, two-phase, parallel-group trial. A total of 192 obese participants with knee OA were enrolled (mean age: 62.5 years, 81% of women with a mean entry weight of 103.2 kg). In phase 1, all participants were randomly assigned to one of three groups and began a dietary regimen of 400–810 and 1250 kcal/day for 8+8 weeks to achieve a major weight loss. Phase 2: 52-week maintenance in one of three groups D, E or C. All groups had statistically significant pain reduction (D: 6.1 mm; E: 5.6 mm; C: 5.5 mm)… |
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| Bosello SL, et al. Semin Arthritis Rheum. 2014 Sep 8. |
| In this study, the investigators assessed the long-term efficacy and safety of single and multiple courses of rituximab therapy in systemic sclerosis (SSc) patients with and without lung disease. A total of 20 SSc patients with a diffuse disease were treated with rituximab. At baseline and during follow-up, the lung involvement was evaluated with pulmonary function tests (FVC and DLCO) and with lung high-resolution computed tomography (HRCT). The investigators found that the skin score, activity, and severity indices improved significantly after 12 months and at final follow-up compared to baseline. After 12 months, there was a significant increase of FVC and TLC compared to baseline, whereas the mean DLCO value remained stable… |
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| Quartuccio L, et al. Scand J Rheumatol. 2014:1–6. |
| This study was conducted to determine the clinical and laboratory differences between cryoglobulinemic and hypergammaglobulinemic purpura in primary Sjögren’s syndrome (pSS) in a large Italian multicenter cohort. A total of 652 patients were enrolled in this study. Group 1/CV (Cryoglobulinemic Vasculitis) comprised 23/652 (3.53%) patients, group 2/HGV (Hypergammaglobulinemic Vasculitis) comprised 40/652 (6.13%) patients, and group 3/pSS controls comprised 589/652 (90.34%) patients. The three groups were found to be significantly different from each other, thus confirming the different phenotypes of purpura in pSS. Multivariate analyses revealed that peripheral neuropathy, low C4, leukopenia, serum monoclonal component, and the presence of anti-SSB/La antibodies characterized CV; whereas rheumatoid factor, leukopenia, serum monoclonal component, and anti-SSA/Ro antibodies were significantly associated with HGV. Lymphoma was associated only with CV.… |
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| Zickert A, et al. LupusSci Med. 2014;1(1):e000018. |
| A renal biopsy is generally recommended for diagnosis and is necessary for classification of lupus nephritis (LN), but second biopsies after immunosuppressive therapy are seldom a routine procedure. In this study, the investigators studied how repeat biopsies contribute to the evaluation of treatment response and long-term outcome in LN. Sixty-seven patients with active LN were included. Renal biopsies were performed at diagnosis and after standard induction immunosuppressive therapy in all patients (median 8 months), regardless of clinical outcome. Complete response (CR) was demonstrated in 25%, partial response (PR) in 27% and non-response (NR) in 48% of patients. Histopathological remission (HR) was shown in 42% and histopathological non-response (HNR) in 58% of patients. Twenty-nine per cent of CR and 61% of patients with PR had active lesions on repeat biopsies, that is, were HNR.… |
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| Gupta R, et al. Lupus 2014 Oct 10. |
| T cells play an important role in the pathogenesis of lupus nephritis (LN). The investigators in this study studied the role of urinary soluble CD25 (sCD25) as a biomarker of LN disease activity in a cross-sectional and longitudinal study. Patients with systemic lupus erythematosus were classified as active LN (AN), inactive disease (ID) and active non-renal (ANR) based on disease activity and renal involvement at the time of enrolment. Urine and serum samples were collected at baseline from all patients and at 3-month follow-up from patients with AN. Soluble CD25 was measured by ELISA… |
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| Lefèvre G, et al. Rheumatology (Oxford) 2014 Oct 27. |
| In this single-center study, polyarthritis was the first manifestation in 12 of 45 antisynthetase syndrome (ASS) patients (27%). An additional 28 patients were collected for the multicenter study, resulting in a total population of 40 ASS patients who presented with polyarthritis. The mean delay from polyarthritis onset to ASS diagnosis was 27 months. Pulmonary and muscle symptoms were uncommon at ASS diagnosis (40% and 32.5%, respectively) and were dramatically delayed (mean delay after polyarthritis onset of 41 months and 21 months, respectively)… |
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