
Axel FinckhUniversity of Geneva | UNIGE · Faculty of Medicine
Axel Finckh
MD, PD
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414
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Introduction
Skills and Expertise
Additional affiliations
September 2002 - August 2005
July 2002 - August 2005
October 2000 - September 2002
Publications
Publications (414)
Background:
Potential associations between targeted therapies and a new cancer in patients with inflammatory arthritis (IA) and a previous malignancy are a frequent concern in daily rheumatology practice.
Objectives:
To develop points to consider (PTC) to assist rheumatologists when initiating a targeted therapy in the context of a previous mali...
Coronavirus disease 2019 (COVID-19) caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has had a profound global impact. The emergence of several variants during the pandemic has presented numerous challenges in preventing and managing this disease. The development of vaccines has played a pivotal role in controlling the pa...
Objectives
To validate the prognostic accuracy of anti-apolipoprotein A-1 IgG (AAA1) for incident major adverse cardiovascular (CV) events (MACE) in rheumatoid arthritis (RA) and study their associations with the lipid paradox at a multicentric scale.
Methods
Baseline AAA1 -, lipid profile, atherogenic indexes, and cardiac biomarkers were measured...
Objective:
Baricitinib is an oral, reversible and selective inhibitor of Janus kinase (JAK)1 and JAK2 that is approved as monotherapy or in combination with methotrexate for the treatment of adults with moderate-to-severe active rheumatoid arthritis (RA) who have responded inadequately to disease-modifying antirheumatic drugs. Evidence supporting...
Introduction
Axial spondyloarthritis (axSpA) is a chronic inflammatory disease characterised by inflammatory low back pain. Non-steroidal anti-inflammatory drugs (NSAIDs) are recommended as a first treatment in axSpA. In case of inadequate response to NSAIDs, biological disease-modifying antirheumatic drugs (bDMARDs) should be introduced according...
Objectives
To describe antibiotic use in patients with inflammatory arthritis (IA) and in the background population (BP) within one year before and after IA diagnosis.
Methods
Using data from Danish nationwide registries, we identified all adults with a first-time diagnosis of RA, PsA, or AS/spondyloarthritis (AS/SpA) from 2010 through 2018. For e...
Analysing complex diseases such as chronic inflammatory joint diseases (CIJDs), where many factors influence the disease evolution over time, is a challenging task. CIJDs are rheumatic diseases that cause the immune system to attack healthy organs, mainly the joints. Different environmental, genetic and demographic factors affect disease developmen...
Purpose
To evaluate the characteristics, efficacy, and retention of tofacitinib monotherapy in patients with rheumatoid arthritis using data from randomized controlled trials (RCTs) and real-world data (RWD).
Patients and Methods
Three patient groups receiving tofacitinib 5 mg twice daily (BID) monotherapy were defined for post hoc RCT/long-term e...
Background
The use of TNF inhibitors (TNFi) during pregnancy shows very reassuring evidence regarding adverse pregnancy outcomes. However, transplacental transfer of most TNFi occurs in the second half of pregnancy and may result in detectable drug levels of in-utero exposed infants. This raises concerns about a potential impact on neonatal immunit...
Background
Counselling patients with rheumatic and musculoskeletal diseases (RMD) in the phase of reproduction, pregnancy and lactation is a challenging task. In women, the potential risk of drug therapy needs to be weighed against the risk of untreated maternal RMD and associated risks for the mother and the child. In men, the safety of antirheuma...
Background
The safety profile of Janus kinase inhibitors (JAKi), particularly concerning infection risks, remains a critical concern in patients with rheumatoid arthritis (RA). Initial pivotal trials and subsequent safety trials[1] showed increased incidences of opportunistic infections and herpes zoster (HZ). However, real-world data on the incide...
Background
Systemic antibiotic exposure and subsequent changes in the composition of the human microbiota have been suggested to be a potential risk factor contributing to development of inflammatory arthritis (IA) including rheumatoid arthritis (RA), psoriatic arthritis (PsA), and ankylosing spondylitis/spondyloarthritis (AS/SpA). However, large-s...
Background
At present, there are limited data on characteristics of non-responders to antirheumatic treatments for rheumatoid arthritis (RA).
Objectives
To characterize patients who were responders/non-responders to assigned treatment for RA.
Methods
RA-BE-REAL is a 3-year, multinational, prospective, observational study of adult patients with RA...
Background
The management of women with musculoskeletal disorders during pregnancy and lactation presents many challenges. Since the first EULAR points to consider for the use of antirheumatic drugs before pregnancy, and during pregnancy and lactation published in 2016[1], new relevant data has emerged.
Objectives
To inform the EULAR task force on...
Background
The increasing availability of biosimilars has strongly reduced bDMARD costs, although drug prices vary considerably across countries. The introduction of biosimilars can be seen as an opportunity to reduce costs and improve access to bDMARDs, particularly for countries with lower socioeconomic status. However, it is unknown whether ther...
Objective
To validate the prognostic accuracy of anti-apolipoprotein A-1 (AAA1) IgG for incident major adverse cardiovascular (CV) events (MACE) in rheumatoid arthritis (RA) and study their associations with the lipid paradox at a multicentric scale.
Method
Baseline AAA1 IgG, lipid profile, atherogenic indexes, and cardiac biomarkers were measured...
Objective
To investigate the clinical phenotype and treatment response in patients with rheumatoid arthritis (RA) with and without concomitant Sjögren’s disease (SjD).
Methods
In this observational cohort study, patients with RA from the Swiss Clinical Quality Management in Rheumatic Diseases registry were categorised according to the presence or...
Objectives
This observational study compares the effectiveness of baricitinib (BARI), a targeted synthetic disease-modifying antirheumatic drug (tsDMARD), with alternative biological DMARDs (bDMARDs) in patients with rheumatoid arthritis (RA), from a prospective, longitudinal cohort.
Methods
We compared patients initiating a treatment course (TC)...
Objectives
Obesity is associated with lower treatment response in patients with rheumatoid arthritis (RA). In patients with obesity, abatacept was suggested as a preferable option to tumour necrosis factor-alpha inhibitors. We aimed to assess the comparative effectiveness of etanercept, infliximab and abatacept, compared with adalimumab, in patient...
Background
Faecal Prevotellaceae, and other microbes, have been associated with rheumatoid arthritis (RA) and preclinical RA. We have performed a quantitative microbiome profiling study in preclinical stages of RA.
Methods
First-degree relatives of patients with RA (RA-FDRs) from the SCREEN-RA cohort were categorised into four groups: controls, he...
In rheumatology, this year has been characterized by a broader knowledge of the pathogenesis of rheumatoid arthritis and mechanisms involved in the onset and persistence of low back pain. Studies relevant to the management of of gout, axial spondyloarthritis, autoinflammatory diseases and systemic vasculitides were published. New data on the safety...
Objectives
To assess the relationship between self-reported and serologic evidence of prior chlamydial infection, rheumatoid arthritis (RA)-related autoantibodies and risk of RA-development.
Methods
This is a nested study within a prospective Swiss-based cohort including all first-degree relatives of RA patients (RA-FDR) who answered a question on...
Background
In a clinical trial setting, patients with rheumatoid arthritis (RA) taking the Janus kinase inhibitor (JAKi) tofacitinib demonstrated higher adverse events rates compared with those taking the tumour necrosis factor inhibitors (TNFi) adalimumab or etanercept.
Objective
Compare treatment discontinuations for adverse events (AEs) among s...
Analysing complex diseases such as chronic inflammatory joint diseases (CIJDs), where many factors influence the disease evolution over time, is a challenging task. CIJDs are rheumatic diseases that cause the immune system to attack healthy organs, mainly the joints. Different environmental, genetic and demographic factors affect disease developmen...
Recently, serious infections related to the use of tofacitinib (TOF) for treatment of rheumatoid arthritis (RA) have raised considerable interest. This study aimed to compare the risk for serious infections in patients with RA upon receiving TOF versus biologic disease-modifying antirheumatic drugs (bDMARDs) by age at treatment initiation. We ident...
Objectives:
Treatment response is worse in obese patients with rheumatoid arthritis (RA), including patients on weight-adjusted therapies like infliximab. We aimed to assess the association between body mass index (BMI) and changes in RA disease activity and radiographic progression over time.
Methods:
We included infliximab users with an RA dia...
Objective: To investigate the clinical phenotype and treatment response in patients with rheumatoid arthritis (RA) with and without concomitant Sjögren’s disease (SjD).
Methods: In this observational cohort study, patients with RA from the Swiss Clinical Quality Management in Rheumatic Diseases registry were categorised according to the presence or...
Immune-mediated inflammatory diseases (IMIDs) are a highly heterogeneous group of diseases that share a common etiology of immune dysregulation, such as rheumatoid arthritis, inflammatory bowel disease, and psoriasis, among others. It is estimated that the prevalence of IMIDs ranges between 5% and 7% in developed countries. As current management of...
Objectives
To investigate the association between severe acute respiratory syndrome-associated coronavirus-2 (SARS-CoV-2) infection and subsequent development of autoimmunity or pre-clinical manifestations associated with rheumatoid arthritis (RA) in at risk population.
Methods
This is a nested study within a prospective cohort of first-degree rel...
Baricitinib, an oral selective Janus kinase (JAK)1/JAK2 inhibitor, is approved as monotherapy or in combination with methotrexate for treating adults with moderate-to-severe active rheumatoid arthritis (RA) and provides improvements in clinical signs, symptoms and patient-reported outcomes. Currently, baricitinib is approved for treating RA in more...
Background
Patients with rheumatoid arthritis (RA) have an increased risk of infection and malignancy compared with the general population. Infection risk is increased further with the use of disease-modifying antirheumatic drugs (DMARDs), whereas evidence on whether the use of biologic DMARDs increases cancer risk remains equivocal. This single-ar...
Objective:
As anaemia represents a biomarker for increased radiographic damage in rheumatoid arthritis, we aimed to investigate whether it independently predicts spinal radiographic progression in axial spondyloarthritis (axSpA).
Methods:
AxSpA patients with available haemoglobin levels from the prospective Swiss Clinical Quality Management Regi...
Background
We recently performed a long-term, model-based comparison of the humoral immunogenicity following two-dose vaccination with BNT162b2 and mRNA-1273 in individuals from SCQM, the Swiss cohort for patients with inflammatory rheumatic diseases (IRD). Vaccination with mRNA-1273 resulted in higher humoral immunogenicity compared to BNT162b2 th...
Background
Results of the “ORAL Surveillance” trial showed higher risk of major adverse cardiovascular (CV) events (MACE) for Janus kinase inhibitors (JAKi) than for TNF-inhibitors (TNFi). Currently, there is limited evidence of the real-world cardiovascular safety of JAKi.
Objectives
To assess the incidence of MACE in rheumatoid arthritis (RA) pa...
Background
Potential associations between targeted therapies and a new cancer in patients with an inflammatory arthritis (IA) and a history of malignant disease are a frequent concern in daily rheumatology practice. IA and/or immunomodulatory drugs might confer a specific risk of malignancy. No evidence-based framework has been proposed to guide cl...
Background
The development of biologic and targeted synthetic (b/ts)DMARDs contributed to improved treatment outcomes in rheumatoid arthritis (RA). However, high medications costs may limit their use. Previously we showed that in countries with a lower socioeconomic status (SES), b/tsDMARDs were prescribed to fewer patients than in countries with h...
Background
EULAR recommendations suggest that use of interleukin-6 inhibitors and Janus kinase (JAK) inhibitors are preferred in rheumatoid arthritis (RA) when combination therapy with conventional synthetic disease modifying antirheumatic drugs (csDMARDs) is not indicated due to intolerance of csDMARDs. Monotherapy data for the JAK1/JAK2 inhibitor...
Background
Potential associations between targeted therapies in patients with an inflammatory arthritis (IA)and malignancy are a frequent concern in daily rheumatology practice. No specific framework has been proposed to evaluate the benefit/risk balance of initiating or reinitiating a targeted therapy (bDMARDs/tsDMARDs) in patients with IA and a h...
Objectives
To investigate the impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV2) infection on anti-apolipoprotein A-1 IgG (AAA1) humoral response in immunosuppressed inflammatory rheumatic diseases (IRD) patients.
Methods
This is a nested cohort study from the prospective Swiss Clinical Quality Management registry. A total of 36...
Aims of the study:
To assess current practices in diagnosing, treating, and following-up giant-cell arteritis by specialists in Switzerland and to identify the main barriers to using diagnostic tools.
Methods:
We performed a national survey of specialists potentially caring for patients with giant-cell arteritis. The survey was sent by email to...
The improvement of our knowledge about the pathogenic mechanisms, the identification of the risks factors and the development of new antirheumatic drugs have enabled significant progress in the management of patients suffering of Rheumatoid Arthritis (RA). We know now that the disease develops long before the first clinical signs appear (immunologi...
Background
The pathogenesis of rheumatoid arthritis (RA) is believed to initiate at mucosal sites. The so-called ‘mucosal origin hypothesis of RA’ postulates an increased intestinal permeability before disease onset. Several biomarkers, including lipopolysaccharide binding protein (LBP) and intestinal fatty acid binding protein (I-FABP), have been...
Introduction
The characterization of the influence of the microbiota on the development and drug responses during rheumatic diseases has intensified in recent years. The role of specific bacteria during disease development has become a central research question. Notably, several lines of evidence point to distinct microbes, e.g., Prevotella copri (...
Background: Comparative safety assessments are important for informed treatment decisions. Recently, serious infections related to tofacitinib (TOF) have raised considerable interest. This study aims to compare the risk for serious infections in patients with rheumatoid arthritis (RA) upon receiving TOF versus biologic disease-modifying antirheumat...
Background
Patients with rheumatoid arthritis (RA) have an increased risk of infection and malignancy compared with the general population. Infection risk is increased further with the use of disease-modifying antirheumatic drugs (DMARDs), whereas evidence on whether the use of biologic DMARDs increases cancer risk remains equivocal. This single-ar...
Objectives
To provide an update of the EULAR rheumatoid arthritis (RA) management recommendations addressing the most recent developments in the field.
Methods
An international task force was formed and solicited three systematic literature research activities on safety and efficacy of disease-modifying antirheumatic drugs (DMARDs) and glucocortic...
Objective
To compare the likelihood of achieving remission between men and women with rheumatoid arthritis (RA) after starting their first biologic or targeted synthetic disease-modifying anti-rheumatic drug (b/tsDMARD).
Methods
This cohort study in the Swiss Clinical Quality Management in Rheumatic Diseases (SCQM) registry included RA patients st...
Patients with inflammatory rheumatic diseases (IRD) are at increased risk for worse COVID-19 outcomes. Identifying whether mRNA vaccines differ in immunogenicity and examining the effects of immunomodulatory treatments may support COVID-19 vaccination strategies. We aimed to conduct a long-term, model-based comparison of the humoral immunogenicity...
Background: Obesity is associated with lower treatment response in patients with rheumatoid arthritis (RA). Among obese patients, abatacept was suggested as a preferable option to tumour necrosis factor alpha (TNF) inhibitors. Sex and gender differences in RA were described.
Objectives: To assess the comparative effectiveness of etanercept, inflixi...
Objective
There is a need to better define symptom characteristics associated with arthritis development in individuals at risk of rheumatoid arthritis (RA). We investigated whether reported symptoms in at-risk individuals could predict arthritis development and whether predictive symptoms differed between seropositive and seronegative at-risk indi...
Objectives
The expanded therapeutic arsenal in rheumatoid arthritis (RA) raises new clinical questions. The objective of this study is to compare the effectiveness of cycling Janus kinase inhibitors (JAKi) with switching to biologic disease-modifying antirheumatic drug (bDMARD) in patients with RA after failure to the first JAKi.
Methods
This is a...
Rheumatoid arthritis (RA) is a systemic autoimmune disease that predominantly affects the joints. The prevalence of RA varies globally, with generally a higher prevalence in industrialized countries, which may be explained by exposures to environmental risk factors, but also by genetic factors, differing demographics and under-reporting in other pa...
Background
Sex and gender can play a role in rheumatoid arthritis; thus, we aimed to compare the likelihood of reaching remission in men and women with rheumatoid arthritis.
Methods
This observational cohort study was done using the Swiss Clinical Quality Management in Rheumatic Diseases (SCQM) registry (1997–2019). The study included adults (olde...
While physical activity provides substantial health benefits, cardiac rehabilitation patients do not reach the recommended physical activity levels after discharge from clinics (1, 2). Traditional interventions providing knowledge about theses expected health benefits do not appear to be sufficient (3). Recent research on automatically activated pr...
Background: JAK-inhibitors (JAKi), recently approved in rheumatoid arthritis (RA), have changed the landscape of treatment choices. We aimed to compare the effectiveness of four current second-line therapies of RA with different modes of action, since JAKi approval, in an international collaboration of 19 registers.
Methods: In this observational...
Background
Current hypotheses for the ethiopathogenesis of rheumatoid arthritis (RA) postulate an infectious agent initiating autoimmunity, which is thought to be at the mucosal level. Chlamydiae infections have been previously associated to development of an acute inflammatory arthritis, which can become chronic in some patients. Chlamydia trachom...
Background
Rheumatoid arthritis (RA) affects women three time more frequently than men. However, compared to men, women may have a lower likelihood of achieving clinical response, but data related to this topic are controversial.
Objectives
We aimed to compare the likelihood of achieving remission across men and women with RA, who started their fi...
Background
The recently presented “ORAL Surveillance Study” has suggested increased risk of serious adverse events (AEs) with tofacitinib, a JAK-inhibitor (JAKi), compared to a comparator TNF-inhibitor (TNFi). Currently, there is limited real world evidence for the tolerability and safety of JAKi (1).
Objectives
To assess the safety of JAKi compar...
Background
Management guidelines of RA suggest to administer biological or targeted synthetic DMARD (b/tsDMARD) in combination with conventional synthetic DMARD (csDMARD). Limited data exists about the impact of such csDMARD combination therapy (co-therapy) in real life settings, in particular for baricitinib use compared to other types of b/tsDMAR...
Background
Drug maintenance is a common outcome measure of real world effectiveness studies, because it combines a measure of drug effectiveness and its tolerance / safety. Major hurdles of observational studies are potential selection biases and confounding. Cox proportional hazard ratio models address this issue by adjusting for potential confoun...
Background
Evidence about the influence of microbes in autoimmune diseases such as rheumatoid arthritis (RA) has grown in recent years. However, the precise role of specific bacteria remains largely unknown. Previous investigations identified several oral pathobionts to be specifically targeted by serum antibodies in RA patients.¹ In addition, Pian...
Background
Patients on immunomodulatory treatments mount an attenuated immune response following mRNA COVID-19 vaccination, yet long-term studies of vaccine-induced anti-SARS-CoV-2 antibody (Ab) kinetics are missing.
Objectives
In this prospective observational study, we mapped the humoral antibody response to mRNA COVID-19 vaccines up to 24 weeks...
Objectives
JAK Inhibitors (JAKi) are recommended DMARDs for patients with moderate-to severe rheumatoid arthritis (RA) who failed first-line therapy with methotrexate. There is a lack of data allowing an evidence-based choice of subsequent disease modifying anti-rheumatic drug (DMARD) therapy for patients who had discontinued JAKi treatment. We aim...
Periodontal disease (PD) and rheumatoid arthritis (RA) are chronic inflammatory diseases with a bi-directional relationship. Both share common genetic and environmental risk factors and result in the progressive destruction of bone and connective tissue. First degree relatives of patients with RA (FDR-RA) are one of the at-risk populations for RA....
Meta-analysis of randomized controlled trials is generally considered the most reliable source of estimates of relative treatment effects. However, in the last few years, there has been interest in using non-randomized studies to complement evidence from randomized controlled trials. Several meta-analytical models have been proposed to this end. Su...
Background/Aims
Previous research has suggested that switching between b/tsDMARDs with different mode of action may be more effective than switching agents within the same mechanism of action. Limited data exists about the impact of an inadequate response to a previous JAK-inhibitor (JAKi) on subsequent JAKi effectiveness.
Methods
This is a nested...
Patients with inflammatory rheumatologic diseases are at increased risk for infectious complications, including SARS-CoV-2, which represent one of the leading causes of death in this population. This risk is due to both the numerous comorbidities of this patient's group and the immunosuppressive therapies they receive. Vaccination reduces the incid...
Objectives
To identify differing patient characteristics at the time of stop and restart of biological or targeted synthetic disease-modifying antirheumatic drugs (b/tsDMARDs) in rheumatoid arthritis (RA), stratified by stop reason.
Design
Explorative descriptive cohort study.
Setting
Swiss Clinical Quality Management in Rheumatic Diseases (1999–...