Nov 25th, 2019 - NEW YORK (Reuters Health) - Patients with rheumatic diseases who are on tumor-necrosis-factor inhibitor (TNFi) therapy can safely receive the live varicella zoster vaccine, without risking vaccine-related infection, a new study suggests. "Because patients with rheumatic diseases are at higher risk for reactivation of herpes zoster, also known as shingles, prevention of this painful condition is...

Nov 21st, 2019 - ATLANTA — "Immunotherapy operates on this very simple principle: a patient's cancer can be eradicated if we can just instruct the immune system to eradicate it," said Ryan Sullivan, MD, associate director of the melanoma program at Massachusetts General Hospital in Boston. "But for patients with autoimmune disease, it comes with a catch." Immunotherapy helps a patient's immune system locate and...

Nov 19th, 2019 - NEW YORK (Reuters Health) - Changes in atmospheric and environmental factors may contribute to organ-specific disease exacerbation in patients with systemic lupus erythematosus (SLE), according to a new study. The study found "strong associations between atmospheric variables and fine particulate matter concentration over the 10 days prior to a patient visit and organ-specific lupus flares at t...

Nov 18th, 2019 - ATLANTA — Virtual reality can help patients with movement issues, but only if it is done correctly and tailored to individual patients, said Robert Ferguson, a neurorehabilitation clinical specialist who focuses on such therapy. Clinicians "are reading the research and they are applying it wrong," he explained. "The evidence suggests that it's not about the virtual reality, it's about how you u...

Nov 18th, 2019 - NEW YORK (Reuters Health) - Children born to mothers with chronic inflammatory diseases who took non-tumor-necrosis-factor inhibitor (TNFi) biologics or tofacitinib while pregnant appear to be at low risk of developing serious infections, a new analysis suggests. "Our findings help to address the important knowledge gap in biologic and small-molecule drug safety in pregnancy and our data are re...

Nov 17th, 2019 - The prevalence of arthritis in children with Down syndrome is at least two times greater than previously reported, findings from a new study suggest, but the diagnosis is often missed or significantly delayed. There are several reasons for this, including a lack of awareness on the part of clinicians and parents that children with Down syndrome can be at high risk for what's known as arthropath...

Nov 17th, 2019 - Congress has appropriated almost a billion dollars in 2018 and 2019 so that the National Institutes of Health (NIH) can address the opioid epidemic. About half of that money is to address pain management, reported Charles Helmick, MD, who works on the NIH Helping to End Addiction Long-term (HEAL) initiative, which supports research into pain. "Reducing prescribed opioids means addressing arthri...

Nov 14th, 2019 - ATLANTA — A first look at new guidelines for the treatment of gout was presented here at the American College of Rheumatology (ACR) 2019 Annual Meeting. A key update is to use a treat-to-target strategy with urate-lowering therapy for all patients with gout. The draft guidelines recommend starting patients on a low-dose urate-lowering medication, then increasing the dose to reach and maintain a...

Nov 14th, 2019 - ATLANTA — Young adults with chronic illnesses are not being asked the right questions on surveys of patient-reported outcome measures, warns an international focus group. Younger adults saw the outcomes on daily functioning as outdated, said Erika Mosor, MSc, from the Center for Medical Statistics, Informatics, and Intelligent Systems at the Medical University of Vienna, who is president-elect ...

Nov 13th, 2019 - Background/Purpose: Knee OA is a disabling condition affecting over 14 million adults in the US. NSAIDs provide only short-term pain relief, creating the need for additional pain management. Growing evidence indicates that chronic knee OA pain is associated with centralized pain pathways. Based on these considerations, ACR and OARSI recommend or conditionally recommend the use of duloxetine. Th...

Nov 13th, 2019 - Background/Purpose: The goal of RA treatment is to achieve clinical remission or, at minimum, low disease activity (LDA). Modification of initial csDMARD therapy with the addition of a biologic (b) DMARD, such as a tumor necrosis factor inhibitor (TNFi), or Janus Kinase inhibitor (JAKi) may be needed following an inadequate response (IR).1 Switches in mechanism of action have been advocated in ...

Nov 13th, 2019 - Background/Purpose: Legalization of cannabis use is rapidly increasing worldwide, raising the need to evaluate trends and medical implications. A systematic literature review showed inconsistent results on tolerability and safety of cannabis-based medicines for any chronic pain [1]. Additionally, little is known about the use and effectiveness of cannabis in rheumatic diseases [2]. We sought to...

Nov 13th, 2019 - Background/Purpose: DLE is a rare, disfiguring disorder in children. Small retrospective studies suggest 20-25% of patients progress to SLE. Progression risk factors are poorly understood, but DLE has been associated with delay in SLE diagnosis and reduced access to care. This multicenter retrospective cohort study aimed to describe baseline characteristics and clinical phenotypes of pediatric ...

Nov 13th, 2019 - Background/Purpose: To assess the cost-effectiveness of various combinations of urate lowering therapy (ULT) and anti-inflammatory treatment in the management of newly diagnosed gout patients, from the Dutch societal perspective.  Methods: The Anakinra versus Treatment as usual in the Treatment of ACute Gout (ATTACG) study was the  primary data source for  this study.  Since only patients with ...

Nov 13th, 2019 - Background/Purpose: We analyzed a phase 2 study designed to assess the efficacy of abatacept in patients with diffuse Systemic Sclerosis (SSc). In this work, we analyze data from ASSET and seek to confirm the hypothesis that patients in the inflammatory subset on abatacept show a significant decline in modified Rodnan Skin Score (mRSS), which is correlated to modulation of pathways related to t...

Nov 13th, 2019 - Background/Purpose: Giant cell arteritis (GCA) is an autoimmune vasculitis that causes aortic arch syndrome, blindnesss, and stroke. Embedded in granulomatous infiltrates, CD4 T cells persist over long periods in the inflamed vessel wall where they drive wall remodeling, intramural neoangiogenesis, intimal hyperplasia and luminal occulsion. To survive and function in a nonlymphoid tissue enviro...

Nov 13th, 2019 - Background/Purpose: Rheumatoid arthritis (RA) is an inflammatory disorder characterized by synovial hyperplasia, inflammatory cell infiltration and pannus formation. We have shown that soluble CD13 (sCD13) induces angiogenesis, monocyte and lymphocyte chemotaxis and arthritis through G protein-coupled receptors (GPCRs). However, the receptor for sCD13 is not yet defined. Methods: A GPCR screeni...

Nov 13th, 2019 - Background/Purpose: Systemic autoimmunity associated with RA precedes the onset of inflammatory arthritis (IA) by several years. In particular, the presence of systemic anti-cyclic citrullinated peptide (CCP) antibody is a strong predictor of developing classified RA in the future. However, the mechanisms involved in the transition from systemic anti-CCP to IA classifiable as RA are unknown. Ou...

Nov 13th, 2019 - Background/Purpose: There is a need for clinically useful measures of cardiovascular (CV) risk in pediatric-onset SLE (pSLE). Nocturnal blood pressure (BP) non-dipping (loss of the physiologic nocturnal decline in BP) is a reversible marker of CV risk and potential treatment target that can be reproducibly measured by ambulatory blood pressure monitoring (ABPM). We assessed the frequency of non...

Nov 13th, 2019 - Background/Purpose: Musculoskeletal injury is a known risk factor for osteoarthritis (OA). Cumulative effects of comorbid conditions on the association of injury and OA have not been previously examined. The purpose of this study was to clarify associations between knee injury and radiographic knee osteoarthritis (rKOA) and determine whether associations vary by sex, race, body mass index (BMI)...

Nov 13th, 2019 - Background/Purpose: Systemic sclerosis (SSc), or scleroderma, is a heterogeneous disease that is divided into limited cutaneous (lcSSc) and diffuse cutaneous (dcSSc) forms based on the extent of skin involvement, and internal organ involvement also adds to phenotypic variability. The three main internal organ complications are interstitial lung disease (ILD), pulmonary arterial hypertension (PA...

Nov 13th, 2019 - Background/Purpose: Population mortality studies in the United States have previously reported a progressive increase in the scleroderma (SSc) mortality rates from 1959 to 2002. Identification of areas with clusters of higher mortality rates is important to implement targeted interventions and may provide clues about possible etiology factors, especially environmental. In this study, we aimed t...

Nov 13th, 2019 - Background/Purpose: Psoriatic arthritis (PsA) dactylitis is associated with an increased risk of erosions and higher disease activity. Dactylitis treatment strategies are however controversial due to the absence of evidence from randomized controlled trials studying dactylitis as a primary outcome. The objective of this trial was to assess the efficacy of golimumab in combination with methotrex...

Nov 13th, 2019 - Background/Purpose: Recently we have shown that both malondialdehyde-acetaldehyde adducts (MAA) and citrullinated proteins (CIT) are co-localized in joint and lung tissues of patients with rheumatoid arthritis (RA). Therefore, to investigate the possibility that these post-translational modifications pose a synergistic pathogenic role in RA, human synovial fibroblasts and lung epithelial cells ...

Nov 13th, 2019 - Background/Purpose: The United States (US) knee osteoarthritis (OA) population has low levels of physical activity (PA), despite its well-defined health benefits. Interventions to promote PA are often stymied by concerns of lack of sustainability of intervention efficacy. We sought to evaluate lifetime benefits and cost-effectiveness of a short term (3-year) PA intervention in this population. ...

Nov 13th, 2019 - Background/Purpose: Systemic sclerosis (SSc) is a highly heterogeneous disease orphan of effective disease modifying agents. The diffuse cutaneous clinical subset (dcSSc) is currently targeted in most clinical trials. Nevertheless, there is still high variability in clinical outcome within dcSSc, which is limiting effective clinical trial design and interpretation. Global Ranked Composite Score...

Nov 13th, 2019 - Background/Purpose: Real-world evidence (RWE) is key to understanding post-approval long-term safety of medications. Tofacitinib is an oral Janus kinase inhibitor for the treatment of RA. A prospective observational 5-year study, embedded within the US Corrona RA registry, was initiated to evaluate the safety of tofacitinib after US Food and Drug Administration approval on Nov 6, 2012. The obje...

Nov 13th, 2019 - Background/Purpose: Lupus nephritis (LN) is a leading cause of morbidity and mortality in Systemic lupus erythematosus (SLE) patients. However, the pathogenesis of renal disease in lupus patients is not yet fully understood. CD6 is a co-stimulatory receptor, predominantly expressed on T cells, that binds to activated leukocyte cell adhesion molecule (ALCAM), a ligand expressed on antigen presen...

Nov 13th, 2019 - Background/Purpose: Targeting the interleukin(IL)-1 pathway with anti-IL-1 drugs is a treatment option in patients with autoinflammatory diseases like monogenic periodic fever syndromes. The study aims to gain further insights into long-term effectiveness and safety of canakinumab (CAN), an anti-IL1 inhibitor, under routine clinical practice conditions in pediatric and adult patients with CAPS ...

Nov 13th, 2019 - Background/Purpose: Fatigue is very common in SLE patients. We aim to: 1) determine if different trajectories of fatigue associate with specific latent classes of disease activity and 2) define the patient characteristics and associated factors in different latent classes. Methods: This is a retrospective analysis on a prospectively collected dataset from an inception cohort and followed from 1...

Nov 13th, 2019 - Background/Purpose: Giant cell arteritis (GCA) is a clinically heterogeneous disease.  Disease subsets based upon cranial versus extracranial artery involvement have been proposed.  The study objective was to determine if GCA subsets are associated with distinct clinical profiles or merely reflective of differential diagnostic assessment. Methods: Patients were included from a large internation...

Nov 13th, 2019 - Background/Purpose: Nephritis is a severe manifestation of systemic lupus erythematosus (SLE) that develops in 30 to 50 percent of the patients. At the time of diagnosis, it is not possible to predict which patients will develop nephritis. CL-K1 (collectin kidney-1, collectin-11) is a soluble C-type lectin, with collagenous stalks like C1q, that through recognition of suitably spaced patterns o...

Nov 13th, 2019 - Background/Purpose: Structural changes, increased tissue citrullination, signs of local inflammation and anti-citrullinated protein autoantibodies (ACPA) are present in the pulmonary compartment of early untreated seropositive rheumatoid arthritis (RA). These findings provide evidence of a potential role for the lungs in generation and initiation of RA-associated autoimmunity. Here we aimed to ...

Nov 13th, 2019 - Background/Purpose: Current classification criteria differentiate between Takayasu’s arteritis (TAK) and giant cell arteritis (GCA), the two most common forms of large-vessel vasculitis, based primarily on clinical assessment, yet patients with TAK and GCA may differ in patterns of arterial disease.  This study aimed to use computer-based algorithms to determine if patterns of arterial disease ...

Nov 13th, 2019 - Background/Purpose: Cell-bound complement activation products (CB-CAPs) are stable forms of classical complement activation ex-vivo, with high sensitivity and specificity for systemic lupus erythematosus  (SLE). We sought to compare the performance of CB-CAPs to the gold standard low complement C3 or C4 in distinguishing SLE from other rheumatic diseases and healthy individuals. Methods: Multip...

Nov 13th, 2019 - Background/Purpose: Osteoarthritis (OA) is a major source of disability worldwide yet dietary exposures that might be associated with its progression have not received significant research attention. We aimed to examine the prospective association of major dietary patterns derived by principal component analysis (PCA) with symptomatic progression of knee OA. Methods: From the Osteoarthritis Ini...

Nov 13th, 2019 - Background/Purpose: The ultimate goal of therapy in patients with psoriatic arthritis (PsA) is clinical remission, defined as ‘the absence of clinical and laboratory evidence of significant inflammatory disease activity’.1,2 Since many patients with PsA may not achieve clinical remission, treatment recommendations recognise minimal or low disease activity as an important alternative treatment t...

Nov 13th, 2019 - Background/Purpose: Slow walking speed (WS) is a risk factor for mortality in well-functioning older adults and speeds slower than (< ) 1.22 meters per second (m/s) are a risk factor for poor health outcomes in knee osteoarthritis (OA). WS is known to decline with age, with some declining faster than other, though it is unclear if the rate of decline in WS is additionally relevant for mortality...

Nov 13th, 2019 - Background/Purpose: Prednisone is commonly used to treat rheumatic diseases, yet few comparative effectiveness studies on different dosing regimens are available. Electronic health records (EHR) and prescriptions are potential data sources for such research. However, a barrier to this work is organizing non-standardized prednisone “sigs”, or free-text instructions within a prescription, into a ...

Nov 13th, 2019 - Background/Purpose: In rheumatoid arthritis (RA) disease outcomes  have improved enormously in the last  decades. Due to early initiation of therapy, a treat-to-target approach and a growing arsenal of disease-modifying antirheumatic drugs (DMARDs) and biologicals, RA patients are in sustained remission more often. This raises the subsequent questions whether treatment should be continued, tape...

Nov 13th, 2019 - Background/Purpose: In April 2019, FDA approved the first treatment, intravenous (IV) belimumab (BEL), specifically for children 5 to 17 years of age with active, seropositive SLE receiving standard care (SOC). The approval was supported by a single post-marketing required randomized, controlled trial (NCT01649765) that evaluated the efficacy, safety and pharmacokinetics (PK) of 10 mg/kg IV BEL...

Nov 13th, 2019 - Background/Purpose: Factors associated with diagnostic delay in Juvenile Dermatomyositis (JDM) are not known.  We hypothesized that limited access to pediatric rheumatologists can lead to delay in the diagnosis of JDM and worse outcomes. We investigated demographic factors, including access to care, associated with diagnostic delays and clinical outcomes of subjects with JDM in the Childhood Ar...

Nov 13th, 2019 - Background/Purpose: Gut microbiota may be relevant in the regulation of immune processes and in the development of systemic autoimmune diseases (SADs). A reduction of microbiota diversity and a selective decrease of commensal pro-regolatory bacteria have been observed in systemic lupus erythematosus (SLE), Sjogren syndrome (SJS) and primary anti-phosholipid syndrome (PAPS). None studies have be...

Nov 13th, 2019 - Background/Purpose: Severe infections, frequently resulting in hospitalization, are a well-known adverse effects of tumor necrosis factor inhibitors (TNFi). However, studies regarding outpatient treated infections are needed. Our objective was to investigate the use of antimicrobials (antibiotics, antifungals and antivirals; excluding antimycobacterials) in patients with rheumatoid arthritis (R...

Nov 13th, 2019 - Background/Purpose: Sitting is associated with many poor health outcomes, which may include knee osteoarthritis (OA). When the knee is subject to minimal load, knee cartilage becomes thinner and may be more susceptible to damage. Thus, people who spend more time in sitting, whether during leisure time or during work, may be at greater risk for worsening structural damage in the knee. We examine...

Nov 13th, 2019 - Background/Purpose: The aim of this study was to evaluate whether alterations in the splicing machinery of immune cells could influence the development and activity of the disease and the kidney involvement in systemic lupus erythematosus (SLE) patients. Methods: Monocytes, lymphocytes and neutrophils from 43 SLE patients and 34 healthy donors (HD) were purified by immunomagnetic selection. The...

Nov 13th, 2019 - Background/Purpose: To assess the risk of 30-day readmission, mortality, and adverse events among adults with Rheumatoid Arthritis as compared to Osteoarthritis after primary hip or knee arthroplasty. Methods: We identified index hospitalizations with a principal procedure of primary HA or KA using a nationally representative U.S. sample, the Nationwide Readmission Database (2010-2013).  Exclud...

Nov 13th, 2019 - Background/Purpose: The Lupus Low Disease Activity State (LLDAS) is a treatment endpoint for SLE that has been shown in prospective validation studies to be associated with protection against disease flares and damage accrual. In addition to improved physician-measured outcomes, attainment of treatment endpoints should also result in improvement in patient-reported outcomes such as health relat...

Nov 13th, 2019 - Background/Purpose: Recurrent pericarditis (RP) is characterized by the recurrence of pericarditis signs and symptoms after a symptom-free period of ≥4 to 6 weeks and affects 20-30 % of acute pericarditis patients. IL-1α/β, mediators of the inflammatory process, predominate in recurrent pericarditis (RP). Methods: Participants with symptomatic or corticosteroid (CS)-dependent idiopathic or post...

Nov 13th, 2019 - Background/Purpose: Interstitial lung disease (ILD) is the leading cause of mortality and carries significant morbidity in connective tissue disease (CTD). Corticosteroids are often used as first line therapy, yet the use of additional immunosuppressive (IS) agents remains largely empiric. In this study we evaluated the effect of Rituximab (RTX) as rescue therapy on lung function in a cohort of...

Nov 13th, 2019 - Background/Purpose: Current treatment guidelines for rheumatoid arthritis (RA) recommend a treat-to-target approach with early treatment initiation of disease-modifying antirheumatic drugs (DMARDs), most commonly methotrexate (MTX), and treatment escalation in case of insufficient response. In this scenario, similar efficacy of biological DMARDs (bDMARDs)  + MTX compared to conventional triple ...

Nov 13th, 2019 - Background/Purpose: Tildrakizumab (TIL), a high-affinity anti–interleukin-23p19 monoclonal antibody, is approved for moderate-to-severe plaque psoriasis treatment and is under investigation for PsA. This study evaluated the 24-week efficacy and safety results from a randomized, double-blind, placebo-controlled, multiple-dose, phase 2b TIL study in patients with active PsA (NCT02980692). Methods...

Nov 13th, 2019 - Background/Purpose: Gout affects >4 million US adults aged ≥ 65 years, but little is known about the scale and drivers of public spending on gout medications, including colchicine.  Used for decades, its price rose drastically after one brand-name form (Colcrys) was granted market exclusivity from 2011-2014, as part of the FDA Unapproved Drugs Initiative. We quantified changes in total spending...

Nov 13th, 2019 - Background/Purpose: Cardiac manifestations of neonatal lupus (NL) have been associated with significant morbidity and mortality, however there has been minimal information on long-term outcomes of affected individuals.  This study was initiated to evaluate the presence of and risk factors associated with cardiac dysfunction in NL after birth in multiple age groups to improve counseling, further...

Nov 13th, 2019 - Background/Purpose: The impact of renal injury in lupus nephritis (LN) is widespread with consequences to resident cells in other tissue beds, even non-lesional, non-sun exposed skin. Faithful reflection of a relevant renal tissue pathway in a more readily accessible compartment would allow for less invasive diagnostic alternatives. While ongoing studies are exploiting single cell RNA sequencin...

Nov 13th, 2019 - Background/Purpose: 18F-flurodeoxyglucose (FDG) positron emission tomography (PET) is one of several imaging modalities used in the assessment of patients with large-vessel vasculitis (LVV).  Conventionally PET images are obtained 1 hour after radiotracer injection; however, delayed imaging may be more sensitive to detect vascular inflammation.    The objectives of this study were to: 1) determ...

Nov 13th, 2019 - Background/Purpose: Cutaneous lupus erythematosus (CLE) is an autoimmune disease with various subsets and clinical manifestations. T lymphocytes are the predominant cell type found in lesional skin, but plasmacytoid dendritic cells (pDCs) and myeloid dendritic cells (mDCs) also play an important role in the pathogenesis. Oral antimalarials, including hydroxychloroquine (HCQ) and quinacrine (QC)...

Nov 13th, 2019 - Background/Purpose: The protein A20, encoded by TNFAIP3, represses signaling upstream of the inflammatory transcription factor nuclear factor (NF)-kB by regulating ubiquitination. Heterozygous loss-of-function mutations in TNFAIP3 cause the systemic autoinflammatory disease Haploinsufficiency of A20 (HA20) [1]. Because no FDA-approved medications directly target NF-kB signaling, current HA20 th...

Nov 13th, 2019 - Background/Purpose: Efficiently identifying eligible patients is an important component of a successful clinical trial.  Billing codes from electronic health record (EHR) data are commonly used to first screen for potential patients, followed by labor-intensive chart review to identify the eligible patients by trial criteria.  The objective of this study was to test whether a machine learning s...

Nov 13th, 2019 - Background/Purpose: Secukinumab (SEC) has provided significant and sustained improvement in the signs and symptoms of active psoriatic arthritis (PsA) and ankylosing spondylitis1. Evidence is limited on the efficacy of biologics in the treatment of patients (pts) with PsA having axial manifestations that affect between 30–70% of pts2, particularly as validated classification criteria for this s...

Nov 13th, 2019 - Background/Purpose: Psoriatic arthritis (PsA) is characterized by peripheral synovitis, enthesitis, dactylitis and spondylitis, and IL-23 is involved in the pathogenesis of these conditions either directly or indirectly. Risankizumab (RZB), a potent humanized IgG1 monoclonal antibody and selective IL23p19 inhibitor, exhibited superior efficacy vs placebo via ACR responses and PASI scores in pat...

Nov 13th, 2019 - Background/Purpose: In prior cross-sectional analyses of African Americans (AA) with RA, we observed that low education, income and home ownership were associated with clinical damage and patient reported outcomes (PROs) among those with mean disease duration of 7.8 years. However, when restricted to those with disease duration of < 2 years, associations with PROs remained, but were no longer o...

Nov 13th, 2019 - Background/Purpose: The main goal of Familial Mediterranean Fever (FMF) treatment is to prevent attacks and subclinical inflammation. Mainstay of treatment is colchicine; however, 5-10% of patients are unresponsive to colchicine even in maximum tolerated dosage. Anakinra has been proven to be effective in controlled trials in terms of attack frequency and subclinical inflammation in colchicine ...

Nov 13th, 2019 - Background/Purpose: The last 25 years, treatment of rheumatoid arthritis (RA) has changed considerably. Although clinically relevant joint damage has become infrequent, it is less established to what extent other long-term outcomes have improved. Moreover, anti-citrullinated anti-bodies (ACPA)-positive and ACPA-negative disease subsets were discovered and it is unknown they have benefited equal...

Nov 13th, 2019 - Background/Purpose: Although biologic therapies have transformed the outlook for rheumatoid arthritis (RA), the lack of a major treatment response in over 50% of patients, the potential side effects and the high cost of these drugs have highlighted the need to define predictive markers of response and to stratify patients according to therapeutic outcome. B-cells are pivotal to RA pathogenesis,...

Nov 13th, 2019 - Background/Purpose: Systemic lupus erythematosus (SLE) affects various organs and tissues, but whether pathologic processes in each organ are distinct or whether dysregulated molecular functions are found in common in all tissues is not known. We, therefore, conducted a meta-analysis of gene expression profiles in four affected SLE tissues to identify commonly dysregulated pathways. Methods: Ge...

Nov 13th, 2019 - Background/Purpose: Interstitial Lung Disease (ILD) is the most common lung manifestation in Connective Tissue Diseases (CTD). It is present in most types of CTD, such as: Rheumatoid Arthritis (RA), Systemic Sclerosis (SSc), Systemic Lupus Erythematous (SLE), Inflammatory Myositis (IM), Mixed Connective Tissue Disease (MCTD), Sjogren Syndrome and Sarcoid. Despite it being so common, treatment h...

Nov 13th, 2019 - Background/Purpose: Anemia, thrombocytopenia and leukopenia in RA patients treated with non-Janus Kinase 1 (JAK1) selective inhibitors may be due to inhibition of hematopoietic growth factors signaling through JAK2. Therefore, we investigated the extent of anemia, thrombocytopenia and leukopenia in patients with active RA with a prior inadequate response/intolerance to biological DMARD (bDMARD)...

Nov 13th, 2019 - Background/Purpose: Belimumab (BEL) is the first treatment approved for children with systemic lupus erythematosus (SLE) from 5 years of age and older.1 This approval was based on the PLUTO trial (NCT01649765), which was designed to assess the safety and efficacy of BEL in children with SLE.2 Additional evidence to support the consistency of effect of BEL in children included an across-trial co...

Nov 13th, 2019 - Background/Purpose: Psoriatic arthritis (PsA) is a T lymphocytes-mediated inflammatory condition. Although regulatory T cells (Tregs) isolated from blood and psoriatic skin have been showed a functional deficiency in suppressing effector T-cells in PsA, absolute quantitative status of peripheral Treg or Th17 cells is still unclear. On the other hand, recent studies have revealed that low-dose I...

Nov 13th, 2019 - Background/Purpose: Takayasu arteritis (TAK) is a chronic vasculitis which predominantly affects large vessels. Although anti-endothelial cell antibodies (AECA) had been reported to be involved in vascular inflammation in TAK, their target antigens remained unclear. We had constructed an expression cloning system for specific identification of cell-surface antigens, which we named SARF. The aim...

Nov 13th, 2019 - Background/Purpose: Adaptive and innate immune pathways are involved in inflammation and pathogenesis of rheumatoid arthritis (RA). Toll-like receptor (TLR) stimulation activates the innate immune system, and may be involved in the pro-inflammatory response to ACPA protein complexes found in severe RA.1 Interleukin (IL) receptor-associated kinase 4 (IRAK4) is a key signal transducer downstream ...

Nov 13th, 2019 - Background/Purpose: Systemic lupus erythematosus (SLE) is a heterogeneous disease with > 100 known risk alleles. Some of these risk alleles associate with ACR SLE criteria such as renal disease. We examined if nine of these SLE risk alleles would identify autoimmune features in a population without diagnosed autoimmune diseases. Methods: We investigated subjects from BioVU, a databank that link...

Nov 13th, 2019 - Background/Purpose: The direct and indirect effects of rheumatoid arthritis (RA) are difficult to measure in observational studies because: (1) The inflammatory effects of RA are difficult to separate from underlying age-sex related risk of comorbid conditions (2) Long-term large sample follow-up of patients is expensive, arduous, and difficult to standardize (3) Limited methods for selecting a...

Nov 13th, 2019 - Background/Purpose: Autologous hematopoietic stemcell transplantation (HSCT) has shown to improve survival of SSc patients with poor prognosis, but is hampered by treatment related mortality (TRM). Better selection of eligible patients could improve outcomes. Objectives: 1. To evaluate event-free survival, TRM and response after HSCT in SSc and 2. To explore patient characteristics that associa...

Nov 13th, 2019 - Background/Purpose: Synovial B cell aggregates in patients with early Rheumatoid Arthritis (RA) have been associated with disease severity and radiographic progression. Here, we analysed the presence of B cells and their association with clinical outcomes in matched synovial biopsies pre- and post- treatment with conventional synthetic Disease Modifying anti-Rheumatic Drug (scDMARDs). Methods: ...

Nov 13th, 2019 - Background/Purpose: The heterogeneity of the clinical manifestations of systemic lupus erythematosus (SLE) and lack of a diagnostic test make SLE difficult for epidemiologists to study. The Centers for Disease Control and Prevention (CDC) supported five population-based SLE surveillance registries, using harmonized methodology, to better estimate incidence and prevalence of SLE in diverse areas...

Nov 13th, 2019 - Background/Purpose: The trillions of microorganisms (microbiota) found within the human gut play a critical role in shaping the immune system, yet these complex microbial communities are also highly sensitive to numerous environmental factors. While much of the focus to date has been on dietary intake, emerging data has begun to suggest that the use of pharmaceutical drugs, even those that are ...

Nov 13th, 2019 - Background/Purpose: The very early diagnosis of SSc is a challenge today. The aim of the VEDOSS project was to study in an at-risk population, the clinical signs that could predict the progression toward a definite SSc. Methods: Patients with Raynaud phenomenon (RP), with or without anti-nuclear antibodies (abs) (ANA) were recruited for this longitudinal, observational study. Fulfilling the 201...

Nov 13th, 2019 - Background/Purpose: Rheumatoid arthritis (RA) is a chronic inflammatory autoimmune disease of unknown and complex aetiology with severe detrimental effects for the patient’s quality of life. While autoantibodies have been used extensively for the diagnosis of RA, no clear mechanism of action towards disease pathogenesis and progression has been identified. Importantly, both seropositive and ser...

Nov 13th, 2019 - Background/Purpose: Giant cell arteritis (GCA) is the most common form of vasculitis of large arteries affecting people older than 50 years. Temporal artery biopsy (TAB) is still considered as the gold standard for GCA diagnosis but it is invasive and its sensitivity ranges from 39 to 86%.Color Doppler Ultrasonography and PET-scanner have been proposed as alternative methods for GCA diagnosis b...

Nov 12th, 2019 - ATLANTA — Immune checkpoint inhibitors are safe and effective for patients with rheumatoid arthritis who develop malignancies, report investigators. "In the real world, patients with autoimmune conditions are at a higher risk for malignancies" than people in the general population, said Sabina Sandigursky, MD, from the NYU Langone Medical Center in New York City. Sabina Sandigursky "Our study s...

Nov 12th, 2019 - Background/Purpose: Rheumatoid arthritis (RA) is a chronic autoimmune disorder, characterized by joint inflammation and bone destruction. The fibroblast-like synoviocyte(FLS) contributes to the pathogenesis of RA through cellular proliferation and production of cytokines or chemokines. Recently, blockade of the bromodomain and extra-terminal domain (BET) family protein was reported to be a pote...

Nov 12th, 2019 - Background/Purpose: Early diagnosis for rheumatic conditions is crucial for children to achieve the best functional outcomes. Access to care is difficult due to the volume of referrals and paucity of pediatric rheumatologists. This compelling need to expediently triage dire and complex rheumatology referrals has been painfully demonstrated in our clinic. When this project was initiated there wa...

Nov 12th, 2019 - Background/Purpose: Although a number of genetic factors, including susceptibility alleles, have been identified in rheumatoid arthritis (RA), the concordance rate in monozygotic (MZ) twins is only 15% (Silman AJ et al, Br J Rheumatol 1993). Given this relatively low rate, environmental factors (including smoking, the microbiome and others) likely play a significant role in disease pathogenesis...

Nov 12th, 2019 - Background/Purpose: The Phase IIIb Assessing Very Early Rheumatoid arthritis Treatment (AVERT)-2 trial (NCT02504268) is evaluating SC abatacept (ABA) + MTX versus ABA placebo (PBO) + MTX in adults with early RA.1 AVERT-2 was designed to demonstrate that ABA + MTX could achieve higher rates of SDAI remission versus ABA PBO + MTX and to test a clinically meaningful withdrawal strategy. Identifyin...

Nov 12th, 2019 - Background/Purpose: Skin inflammation can drive systemic disease in SLE, thus it is essential to understand the key regulators of the aberrant inflammatory response in lupus skin. We have previously identified BATF2 as a transcription factor that is highly overexpressed in lupus keratinocytes following type I IFN exposure. The objective of this study was to determine the role of BATF2 in regula...

Nov 12th, 2019 - Background/Purpose: Evidence thus far on the effect of psoriatic arthritis (PsA) on bone mineral density (BMD) has been inconsistent. There is also insufficient guidance surrounding BMD testing in PsA patients. The purpose of this study was to determine BMD in the PsA population, factors associated with having BMD testing performed, and the effect of PsA clinical activity on BMD. Methods: : Thi...

Nov 12th, 2019 - Background/Purpose: In rheumatoid arthritis (RA), it has been reported that osteoclast are activated by immune complexes, anti-CCP antibodies (ACPAs), and inflammatory cytokines. The purpose of this study was to investigate the relationship between bone microstructure and joint involvement by imaging the distal radius using HR-pQCT. Methods: Subjects were 127 female patients with RA, who were e...

Nov 12th, 2019 - Background/Purpose: Certolizumab pegol (CZP) is an anti-TNF drug approved for rheumatoid arthritis (RA), axial spondyloarthritis (axSpA), psoriatic arthritis (PsA), psoriasis (PSO) and Crohn’s disease (CD). Older age, comorbidities and corticosteroid (CS) use have been linked to increased risk of serious infectious events (SIEs) in CZP-treated patients (pts) with RA.1 However, the impact of ove...

Nov 12th, 2019 - Background/Purpose: To evaluate alterations of bone mineral density and microarchitecture in patients with rheumatoid arthritis (RA). We also aimed to identify potential factors associated with these alterations. Methods: In this case-control study, patients with RA were recruited from the PUMC Hospital site of the Chinese Registry of rhEumatoiD arthrITis (CREDIT). The primary outcomes were hig...

Nov 12th, 2019 - Background/Purpose: Biologic disease modifying antirheumatic drugs (b-DMARDs) have revolutionized the management of Rheumatoid Arthritis (RA). Despite this success, a high percentage of the patients undergoing biologic treatment respond insufficiently. There is thus an urgent need to identify effective biomarkers to guide treatment selection. The aim of this study was to identify several specif...

Nov 12th, 2019 - Background/Purpose: An association between low bone mineral density (BMD) and cardiovascular events has been shown. The calcification process observed in atherosclerosis and bone mineralization have a common pathogenesis pathway. Bone health parameters are not yet incorporated in the cardiovascular risk assessment scale. The objective of our study was to look for an association between standard...

Nov 12th, 2019 - Background/Purpose: The anti-BAFF monoclonal belimumab is approved for the treatment of systemic lupus erythematosus (SLE) since 2011. Effects of belimumab on anti-double stranded (ds)DNA levels, as well as serum levels of B cell activating factor (BAFF) and a proliferation-inducing ligand (APRIL), both belonging to the tumour necrosis factor (TNF) ligand superfamily, have been demonstrated in ...

Nov 12th, 2019 - Background/Purpose: Macrophage activation syndrome (MAS), also known as secondary hemophagocytic lymphohistiocytosis (HLH), is a life threatening condition that commonly presents with unremitting fever and shock like multi-organ dysfunction (MOD). Laboratory studies show pancytopenia, elevated liver enzymes, elevated ferritin, and hemophagocytosis. Familial forms of HLH result from homozygous d...

Nov 12th, 2019 - Background/Purpose: Rheumatoid Arthritis (RA) is an autoimmune inflammatory disease causing erosive and disabling joint damage. We recently found that mitochondria are extruded upon formation of neutrophil extracellular traps (NETs). The extruded mitochondria can be a source of danger-associated molecular patterns (DAMPs) that include highly unmethylated CpG motif content, oxidized mitochondria...

Nov 12th, 2019 - Background/Purpose: The course of systemic sclerosis-associated interstitial lung disease (SSc-ILD) is heterogeneous; some patients may experience rapid decline in lung function, while others have relatively stable disease. Large patient registries, such as The European Scleroderma Trials and Research (EUSTAR) database, can assist in mapping the trajectory of SSc-ILD and identifying patients at...

Nov 12th, 2019 - Background/Purpose: In IgG4-related disease (IgG4-RD), both activated B cells and CD4+ cytotoxic T lymphocytes (CD4+CTLs) expand clonally, accumulate in tissues, likely recognize distinct epitopes on the same protein antigens, and thus, work together to contribute to fibrosis. We have previously reported that CD4+CTLs synthesize IL-1β and TGF-β in disease tissues, indicating that they are react...

Nov 12th, 2019 - Background/Purpose: In the double-blind, placebo-controlled 16-week pilot including 10 systemic sclerosis (SSc) patients with upper and lower gastrointestinal (GI) symptoms we found that fecal microbiota transplantation (FMT) with commercially-available anaerobic cultivated human intestinal microbiota (ACHIM) reduced lower GI symptoms. Here, we aimed to determine relative abundance of gut micro...

Nov 12th, 2019 - Background/Purpose: Background/Purpose:  Immune checkpoint inhibitors have demonstrated durable benefit in some cancer patients.  However, checkpoint inhibitors are also associated with new onset autoimmune adverse events.  The link between checkpoints and autoimmune disease suggests that activating immune checkpoint receptors might be useful in treating autoimmune diseases like SLE.  As the ro...