Joel M Kremer

• MD
• Managing Director at Albany Medical College

Background Circulating bioactive lipids can provide information about the pathogenesis of specific diseases and potentially help predict therapeutic response. Choosing the right biological therapy earlier in the course of rheumatoid arthritis (RA) could help reach the goal of remission. Objectives We hypothesized that circulating bioactive lipids...

Background Upadacitinib (UPA) has demonstrated efficacy in randomized controlled trials¹⁻³; however, few data are available from patients with rheumatoid arthritis (RA) who have been treated with UPA in real-world clinical practice. Objectives Describe the characteristics and 6-month outcomes in patients with RA initiating UPA in a real-world sett...

Background Understanding the durability of response to biologics and factors associated with failure to maintain response in a real-world setting can inform treatment decisions for patients with rheumatoid arthritis (RA). Objectives To evaluate the durability of response and identify factors associated with decreased durability in US patients with...

Background Clinical studies have demonstrated the efficacy of tocilizumab (TCZ) administered with methotrexate (MTX) in improving rheumatoid arthritis (RA) disease activity in patients who have had an inadequate response to tumor necrosis factor inhibitors (TNFis). Objectives To compare the effectiveness of TCZ + MTX with that of TNFis + MTX in pa...

Background Understanding the persistence of biologic therapies and factors associated with discontinuation can help inform treatment decisions for patients with rheumatoid arthritis (RA). Objectives To evaluate the persistence of tocilizumab (TCZ) therapy and identify factors associated with its discontinuation among US patients with RA in routine...

Background Anti-citrullinated protein antibody (ACPA) is a highly specific biomarker for RA¹ and ACPA-seropositive patients have a tendency toward severe erosive disease and more rapid disease progression.2–4 Little is known regarding the impact of poor prognostic factors, such as ACPA and erosive disease, on healthcare resource utilisation (HCRU)....

Background Methotrexate (MTX) remains the cornerstone of the treatment of rheumatoid arthritis (RA). However, MTX is frequently underutilized in terms of suboptimal dosage, insufficient duration of treatment, and route of administration. Objectives To evaluate the tolerability and the safety of higher-dose, subcutaneous methotrexate (MTX) in patie...

Background Specific patient demographics or disease characteristics may be associated with switching from one therapy to another for patients with RA. Identifying these predictive factors may help inform prospective treatment decisions. Objectives To examine factors predicting switching among patients with RA from a TNF inhibitor (TNFi) to a subse...

Background Although previous studies have established the efficacy of tocilizumab (TCZ) initiated as monotherapy (MONO) for the treatment of rheumatoid arthritis (RA),1,2 changes in active intra-articular inflammation after discontinuation of methotrexate (MTX) in patients achieving good clinical control with TCZ + MTX have not been evaluated. Magn...

Background Many patients with RA do not achieve guideline-recommended treat-to-target (T2T) goals in clinical practice. Little is known about the challenges that patients and rheumatologists face when attempting to achieve better control of RA disease activity. Objectives To identify and prioritise patient- and rheumatologist-perceived barriers to...

Background Few real-world studies have evaluated the impact of comorbidity burden or obesity on the effectiveness of tocilizumab (TCZ) for the improvement of rheumatoid arthritis (RA) disease activity. Objectives To compare the effectiveness of TCZ in treating RA in patients with high vs low comorbidity burden and in obese vs nonobese patients in...

Background Upadacitinib (UPA) is an oral, selective JAK-1 inhibitor in development for the treatment of patients (pts) with moderate to severe rheumatoid arthritis (RA) and other immune-mediated diseases. Methods This Phase 3 study in pts with inadequate response (IR) to csDMARDs included a double-blind placebo (PBO)-controlled period (Period 1, r...

Background Patients with rheumatoid arthritis (RA) often receive methotrexate (MTX) in combination with biologics; however, MTX may be discontinued due to intolerance or to reduce the medication burden once disease control is achieved. Whereas previous studies have established the efficacy of tocilizumab (TCZ) initiated as monotherapy (MONO) for th...

Background: The implementation of treat-to-target principles in rheumatoid arthritis (RA) has not been fully investigated in patients with inadequate response to tumor necrosis factor (TNF) inhibitor treatment. Objectives: To evaluate the prevalence of an inadequate response to initial TNF inhibitor treatment at 6 and 12 months among patients wi...

Background Rheumatoid arthritis (RA) is a systemic, inflammatory disease and its burden extends beyond joint disease. In recent years, there has been significant advances in treating joint disease but we need a greater understanding of physical and especially psychosocial comorbities to improve quality of life in RA patients. In particular, patient...

Background RA is associated with pulmonary comorbidity and lung function decline over time, but longitudinal assessment of pulmonary abnormalities in the context of RA treatment needs further characterisation. Mavrilimumab, an investigational human monoclonal antibody, inhibits GM-CSF by binding to the GM-CSF receptor α subunit. Objectives To inve...

Background Biologics in combination with methotrexate (MTX) are associated with improved outcomes versus monotherapy. However, few data exist regarding the use of non-MTX conventional synthetic disease modifying rheumatic drugs (csDMARDs) with biologics. Objectives To assess the effectiveness and safety of adalimumab (ADA) in combination with MTX...

Background Combination therapy of methotrexate (MTX) with biologics results in superior outcomes vs. monotherapy. Recent clinical trials have shown that lower MTX doses may be sufficient in patients with rheumatoid arthritis (RA) to achieve similar clinical and patient reported outcomes (PROs)1,2. Objectives To evaluate whether high MTX dose in co...

Background Clinical studies have shown that the efficacy of TCZ monotherapy (TCZ mono) is superior to that of TNFi monotherapy and comparable to that of TCZ in combination with MTX. Objectives To compare the effectiveness of TCZ mono vs TNFi plus varying doses of MTX in patients with rheumatoid arthritis (RA) and prior exposure to TNFi in routine...

Background TNF inhibitors (TNFi) can be used as monotherapy (mono) or in combination (combo) with conventional DMARDS (cDMARDS). Data from randomized clinical trials and European registries suggest there is evidence of better effectiveness of TNFi combo therapy than mono. Effectiveness of TNFi mono vs combo in US clinical practice, in particular am...

Background Combination therapy of methotrexate (MTX) with biologics results in superior outcomes vs. monotherapy. However, little is known on the effectiveness of adalimumab (ADA) combination therapy with non-MTX conventional synthetic disease modifying anti-rheumatic drugs (csDMARD). Objectives To evaluate whether ADA in combination with non-MTX...

Background Tofacitinib is an oral JAK inhibitor for the treatment (tx) of rheumatoid arthritis (RA). Studies have shown diminishing response to tx in RA patients (pts) when cycling through TNF inhibitors. Prior analyses assessed tofacitinib in csDMARD-inadequate response (IR) pts vs overall bDMARD-IR pts. Objectives To compare tofacitinib safety a...

Background We examined models to predict disease activity transitions from moderate to low or severe and associated factors in patients with rheumatoid arthritis (RA). Methods Data from RA patients enrolled in the Corrona registry (October 2001 to August 2014) were analyzed. Clinical Disease Activity Index (CDAI) definitions were used for low (≤10)...

Objectives: The primary objective is to prospectively study the comparative safety and effectiveness of older and newer classes of nonbiologic DMARDs (Disease-modifying antirheumatic drugs), biologic DMARDs and targeted synthetic therapies approved for rheumatoid arthritis (RA) in a real-world patient population in Japan. Methods: Prospective, m...

Background To characterize the differences between women and men with gout. Methods We analyzed a US national cohort of gout patients cared for by rheumatologists. ResultsCompared with the 1012 men with gout, women with gout (n = 262) were older (71 vs. 61 years, p < 0.001) and had a greater burden of comorbid conditions (p < 0.001 for hypertension...

The objective of the study was to examine whether disease duration independently predicts treatment response among biologic-naïve patients with rheumatoid arthritis (RA) initiating abatacept in clinical practice. Using the Corrona RA registry (February 2006–January 2015), biologic-naïve patients with RA initiating abatacept with 12-month (±3 months...

Objectives Despite the therapeutic value of current rheumatoid arthritis (RA) treatments, agents with alternative modes of action are required. Mavrilimumab, a fully human monoclonal antibody targeting the granulocyte–macrophage colony-stimulating factor receptor-α, was evaluated in patients with moderate-to-severe RA. Methods In a phase IIb study...

Background We compared the effectiveness of abatacept (ABA) vs tocilizumab (TCA) in tumor necrosis factor inhibitor (TNFi) experienced patients. Methods We identified rheumatoid arthritis (RA) patients from a large observational US cohort (1 January 2010–31 May 2014) who had discontinued at least one TNFi and initiated ABA or TCZ in moderate or hig...

Supplementary Figure 1. Analysis design. The primary exposure of interest (blue) was the time (in months) from the last rituximab infusion to the start of a subsequent (non‐rituximab) biologic. Patients were categorized by the duration of time between their last rituximab infusion and the switch to a subsequent biologic (≤ 5 months, 6‐11 months, an...

Introduction: Treat to target guidelines recommend achieving remission or low disease activity in rheumatoid arthritis (RA). However, the reduction in adverse events and costs associated with lower disease activity is unclear. Methods: We used Corrona linked to Medicare data to identify RA patients. Time varying disease activity was measured usi...

Objective: To assess the effects of baricitinib on lipid profiles in patients with moderate-to-severe rheumatoid arthritis. Methods: Treatment with once-daily doses of baricitinib (1, 2, 4, or 8 mg) or placebo was studied in 301 randomized patients. Changes in lipid profile and lipoprotein particle size and particle number were assessed at weeks...

Figure S2 Study A3921019 a: ACR20, b: ACR50, and c: ACR70 response rates over time. ACR, American College of Rheumatology; BID, twice daily; FAS, full analysis set; LOCF, last observation carried forward. *P ≤ 0.05; **P < 0.001; ***P < 0.0001 versus placebo.

Figure S3 Study A3921025 a: ACR20, b: ACR50, and c: ACR70 response rates over time. ACR, American College of Rheumatology; BID, twice daily; FAS, full analysis set; LOCF, last observation carried forward; QD, once daily. Owing to reassignment, P values were not added to data post‐Week 12. *P ≤ 0.05; **P < 0.001; ***P < 0.0001 versus placebo.

Figure S4 Study A3921035 a: ACR20, b: ACR50, and c: ACR70 response rates over time. ACR, American College of Rheumatology; BID, twice daily; FAS, full analysis set; LOCF, last observation carried forward. Owing to reassignment, P values were not added to data post week 12. *P ≤ 0.05; **P < 0.001; ***P < 0.0001 versus placebo.

Figure S14 Study A3921035 a: mean HAQ‐DI and b: pain (VAS) over time. (r), reassigned; BID, twice daily; FAS, full analysis set; HAQ‐DI, Health Assessment Questionnaire‐Disability Index; VAS, visual analog scale.

Figure S1 Overview of cytokine signaling through the JAK‐STAT pathway. JAK, Janus kinase; P, phosphate group; STAT, signal transducer and activator of transcription. Reprinted by permission from Macmillan Publishers Ltd: Nature Reviews Immunology; 3: 900–911, copyright 2003.

Figure S5 Study A3921039 a: ACR20, b: ACR50, and c: ACR70 response rates over time. ACR, American College of Rheumatology; BID, twice daily; FAS, full analysis set; LOCF, last observation carried forward. *P ≤ 0.05; **P < 0.001; ***P < 0.0001 versus placebo.

Figure S6 Study A3921040 a: ACR20, b: ACR50, and c: ACR70 response rates over time. ACR, American College of Rheumatology; BID, twice daily; FAS, full analysis set; LOCF, last observation carried forward. *P ≤ 0.05; **P < 0.001; ***P < 0.0001 versus placebo.

Figure S7 Study A3921019 a: mean change from baseline in DAS28‐3(CRP) and b: time course of DAS28‐3(CRP)< 2.6. BID, twice daily; CRP, C‐reactive protein; DAS, disease activity score; FAS, full analysis set. *P ≤ 0.05; **P < 0.001; ***P < 0.0001 versus placebo.

Figure S10 Study A3921039 a: mean change from baseline in DAS28‐3(CRP), b: time course of DAS28‐3(CRP)< 2.6, and c: DAS28‐4(ESR)< 2.6 rates (patients not in remission at baseline). BID, twice daily; CRP, C‐reactive protein; DAS, disease activity score; ESR, erythrocyte sedimentation rate; FAS, full analysis set. *P ≤ 0.05; **P < 0.001; ***P < 0.000...

Figure S13 Study A3921025 a: mean HAQ‐DI and b: pain (VAS) over time. (r), reassigned; BID, twice daily; FAS, full analysis set; HAQ‐DI, Health Assessment Questionnaire‐Disability Index; QD, once daily; VAS, visual analog scale.

Figure S9 Study A3921035 a: mean change from baseline in DAS28‐3(CRP), b: time course of DAS28‐3(CRP)< 2.6, and c: DAS28‐4(ESR)< 2.6 rates (patients not in remission at baseline). BID, twice daily; CRP, C‐reactive protein; DAS, disease activity score; ESR, erythrocyte sedimentation rate; FAS, full analysis set. *P ≤ 0.05; **P < 0.001; ***P < 0.0001...

Figure S11 Study A3921040 a: mean change from baseline in DAS28‐3(CRP), b: time course of DAS28‐3(CRP)< 2.6, and c: DAS28‐4(ESR)< 2.6 rates (patients not in remission at baseline). BID, twice daily; CRP, C‐reactive protein; DAS, disease activity score; ESR, erythrocyte sedimentation rate; FAS, full analysis set. *P ≤ 0.05; **P < 0.001; ***P < 0.000...

Figure S15 Study A3921039 a: mean HAQ‐DI and b: pain (VAS) over time. BID, twice daily; FAS, full analysis set; HAQ‐DI, Health Assessment Questionnaire‐Disability Index; VAS, visual analog scale.

Figure S8 Study A3921025 a: mean change from baseline in DAS28‐3(CRP) and b: time course of DAS28‐3(CRP)< 2.6. BID, twice daily; CRP, C‐reactive protein; DAS, disease activity score; FAS, full analysis set; QD, once daily. *P ≤ 0.05; **P < 0.001; ***P < 0.0001 versus placebo.

Table S1 Study design Table S2 Patient disposition Table S3 Change from baseline in laboratory values (FAS, no imputation)†

Figure S16 Study A3921040 a: mean HAQ‐DI and b: pain (VAS) over time. BID, twice daily; FAS, full analysis set; HAQ‐DI, Health Assessment Questionnaire‐Disability Index; VAS, visual analog scale.

Figure S12 Study A3921019 a: mean HAQ‐DI and b: pain (VAS) over time. BID, twice daily; FAS, full analysis set; HAQ‐DI, Health Assessment Questionnaire‐Disability Index; VAS, visual analog scale.

Objectives To assess baricitinib on patient-reported outcomes (PROs) in patients with moderately to severely active rheumatoid arthritis, who had insufficient response or intolerance to ≥1 tumour necrosis factor inhibitors (TNFis) or other biological disease-modifying antirheumatic drugs (bDMARDs). Methods In this double-blind phase III study, pat...

Objective: In many rheumatoid arthritis (RA) patients, disease is controlled with anti-tumor necrosis factor (anti-TNF) biologic therapies. However, in a significant number of patients, the disease fails to respond to anti-TNF therapy. We undertook the present study to examine the hypothesis that rare and low-frequency genetic variants might influ...

Nature Communications 7 : Article number: 12460 10.1038/ncomms12460 ( 2016 ); Published: 23 August 2016 ; Updated: 10 October 2016 . The HTML version of this Article incorrectly duplicated the authors S.

Rheumatoid arthritis (RA) affects millions world-wide. While anti-TNF treatment is widely used to reduce disease progression, treatment fails in ∼one-third of patients. No biomarker currently exists that identifies non-responders before treatment. A rigorous community-based assessment of the utility of SNP data for predicting anti-TNF treatment eff...

Supplementary Figures 1-6, Supplementary Tables 1-4, Supplementary Note 1 and Supplementary References

Rheumatoid arthritis (RA) affects millions world-wide. While anti-TNF treatment is widely used to reduce disease progression, treatment fails in ∼one-third of patients. No biomarker currently exists that identifies non-responders before treatment. A rigorous community-based assessment of the utility of SNP data for predicting anti-TNF treatment eff...

Objective Tofacitinib is an oral Janus kinase inhibitor for the treatment of rheumatoid arthritis (RA). We compared patient‐reported outcomes (PROs) in patients with RA treated with tofacitinib or placebo in combination with conventional disease‐modifying antirheumatic drugs (DMARDs). Methods In a 12‐month, phase III randomized controlled trial (O...

Tofacitinib is an oral Janus kinase inhibitor for the treatment of rheumatoid arthritis (RA). Here, the safety and efficacy data from five Phase 2 studies of tofacitinib in patients with RA are summarized. Tofacitinib 1–30 mg twice daily was investigated, as monotherapy and in combination with methotrexate, in patients with RA. Tofacitinib 20 mg on...

Duran et al may have missed my point. If so, this is my fault in that I must not have made it clearly enough. I detected a clear implication of industry bias in the thrust and premise of their findings. To support this position, they extrapolate from studies which purport to illustrate the wisdom of the implications of their review. They correctly...

Objective To describe changes in immune parameters observed during long-term methotrexate (MTX) therapy in patients with active rheumatoid arthritis (RA) and explore correlations with simultaneously measured MTX pharmacokinetic (PKC) parameters. Design Prospective, open-label, long-term mechanism of action study. Setting University clinic. Methods...

Objective: To compare the efficacy and safety of ABT-494, a novel selective Janus kinase 1 inhibitor, with placebo, in patients with moderate-to-severe rheumatoid arthritis (RA) and an inadequate response or intolerance to ≥1 anti-tumor necrosis factor (TNF) therapy. Methods: In this 12-week, double-blind, placebo-controlled, dose-ranging study,...

Background Biologic agents can help achieve low disease activity or remission in patients with rheumatoid arthritis (RA) who do not respond adequately to therapy with one or two conventional synthetic disease modifying anti-rheumatic drugs (csDMARDs) (1). Objectives To understand the prevalence of RA patients with inadequate response to therapy wi...

Background Comparative effectiveness research (CER) can inform decisions regarding the choice of biologics for the treatment of RA. Objectives To compare the efficacy of tumor necrosis factor inhibitors (TNFis) and non-TNFis (nTNFis) in real-world patients with RA previously treated with ≥1 TNFi. Methods CERTAIN was a CER study nested within the...

Background While some treatment options for psoriatic arthritis (PsA) are similar to those initially developed for rheumatoid arthritis (RA), their introduction to the clinic has generally increased in the recent years. Also, there has been a perception among some that RA is perhaps associated with greater disease burden compared to PsA. Objective...

Background Some studies have suggested that efficacy of triple non-biologic disease modifying anti-rheumatic drug (nbDMARD) therapy for Rheumatoid Arthritis (RA) is similar to biologic combination therapy (1). Objectives To examine the difference in need to advance therapy after treatment with triple nbDMARD (Group 1) or TNF inhibitors in combinat...

Background TNF inhibitors (TNFi) can be used as monotherapy (mono) or in combination (combo) with conventional DMARDS (cDMARDS). Clinical trial data and European registry data have shown evidence of better effectiveness of TNFi combo therapy than mono. Effectiveness of mono vs combo in US clinical practice, in particular among biologic naïve and ex...

Background Limited data are available about infliximab (IFX) dose escalation. Objectives This analysis examines the frequency of dose escalation among IFX patients using data from the US CORRONA RA registry and describes the characteristics of patients who dose escalate vs those who do not. Methods RA patients initiating IFX at a dose of ≤5 mg/kg...

Background ABT-494 is a novel selective JAK1 inhibitor. Objectives The safety, efficacy, and dose response of ABT-494 were characterized vs placebo (PBO) in patients (pts) with moderately to severely active RA and an inadequate response to ≥1 anti-TNF biologic therapy (TNF-IR). Methods This was a phase 2b, 12-week, double-blind PBO-controlled stu...

Background Mavrilimumab, a fully human monoclonal antibody, which targets granulocyte-macrophage colony-stimulating factor receptor-α, has demonstrated efficacy and an acceptable safety profile in prior 12- and 24-week studies.1,2 Objectives This analysis evaluated all long-term (LT) safety and efficacy, through 74 weeks of treatment, of mavrilimu...

Background Anti-citrullinated protein antibodies (ACPA) are associated with more severe, erosive rheumatoid arthritis (RA), but the extent to which ACPA status predicts response to therapy is not known.1,2 Objectives To evaluate in a real-world, observational RA cohort whether baseline ACPA status is associated with response to biologics among pat...

Background Mavrilimumab, a fully human monoclonal antibody targeting the granulocyte-macrophage colony-stimulating factor receptor-α, has demonstrated efficacy and safety in disease-modifying antirheumatic drug (DMARD)-inadequate responder (IR) patients (pts) with rheumatoid arthritis (RA).¹ Objectives Few head-to-head studies in tumor necrosis fa...

Background Patients with long-standing RA may have more treatment-resistant disease than those with shorter disease duration. Objectives To examine whether disease duration is an independent predictor of treatment response among biologic-naïve patients with RA initiating abatacept in a US national, observational cohort. Methods Using the Corrona...

Background There is a growing emphasis on treating patients to a target level of low disease activity (LDA) or remission in order to improve outcomes associated with rheumatoid arthritis (RA). Objectives Our objective was to examine trends in the achievement of LDA over the past decade among RA patients receiving their first, second and third or m...

Background Little is known about the relationship between adherence to the treat-to-target (T2T) paradigm and clinical outcomes in US patients with rheumatoid arthritis (RA). Objectives To evaluate the relationship between adherence to T2T care and achievement of low disease activity (LDA) using a post hoc analysis of a cluster-randomized behavior...

Background Patients with rheumatoid arthritis (RA) experience diminished quality of life, including increased disability and RA-related comorbidities. Patient-reported outcomes (PROs) are increasingly being recognized as important measures in determining response to therapy in patients with RA. Objectives To examine the impact of rituximab on PROs...

Background It is unclear whether anti-cyclic citrullinated peptide (anti-CCP) and rheumatoid factor (RF) status are predictive of response to rheumatoid arthritis (RA) therapy. Objectives To assess whether baseline anti-CCP/RF status is associated with treatment response in patients with RA initiating abatacept (ABA) or a tumour necrosis factor-al...

Objective: Rheumatologists have limited tools to assess medication adherence. The extent to which methotrexate (MTX) adherence is overestimated by rheumatologists is unknown. Methods: We deployed an Internet survey to patients with rheumatoid arthritis (RA) participating in a US registry. Patient self-report was the gold standard compared to MTX...

Objective. To analyze prophylaxis using the CORRONA (COnsortium of Rheumatology Researchers Of North America) Gout Registry according to the American College of Rheumatology (ACR) guidelines, and to evaluate whether differences in disease characteristics influenced prophylaxis. Methods. All patients with gout in the CORRONA Gout Registry between No...

Objectives: Tofacitinib is an oral Janus kinase inhibitor for the treatment of rheumatoid arthritis (RA). Here we investigated the effects of tofacitinib on patient-reported outcomes (PRO) in patients with active RA. Methods: Two, 6-month, double-blind, placebo-controlled Phase 2b studies were performed. The combination study evaluated patients...

Background Factors associated with care concordant with the American College of Rheumatology (ACR) recommendations for the use of disease-modifying antirheumatic drugs (DMARDs) in rheumatoid arthritis (RA) are unknown. Methods We identified a national cohort of biologic-naive patients with RA with visits between December 2008 and February 2013. Tr...

Objective: To assess whether the time between the last rituximab infusion and initiation of a different biologic influenced infection risk in patients with rheumatoid arthritis (RA). Methods: Patients with RA who newly initiated rituximab within the Corrona registry were included if they switched to a non-rituximab biologic and had ≥ 1 follow-up...

Duran et al 1 present the results of a literature search performed on a very large number of publications comparing methotrexate (MTX) with a biologic agent. Their literature review eventually yielded 13 published trials for their analysis. The authors were particularly interested in the dose, and route of administration, of MTX. As the efficacy of...

Objectives: To report 5-year efficacy and safety in rheumatoid arthritis (RA) patients with active disease treated with tocilizumab. Methods: LITHE was a 2-year, randomised, placebo-controlled study of tocilizumab in RA patients (ClinicalTrials.gov, NCT00106535), with an additional 3-year, open-label extension. Patients were randomly assigned to...

Background In phase 2 studies, baricitinib, an oral Janus kinase 1 and 2 inhibitor, reduced disease activity in patients with rheumatoid arthritis who had not previously received treatment with biologic disease-modifying antirheumatic drugs (DMARDs). Methods In this phase 3 study involving 527 patients with an inadequate response to or unacceptabl...

In chronic inflammatory rheumatic diseases, comorbidities such as cardiovascular diseases and infections are suboptimally prevented, screened for and managed. The objective of this European League Against Rheumatism (EULAR) initiative was to propose points to consider to collect comorbidities in patients with chronic inflammatory rheumatic diseases...

Introduction In the United States, the recommended starting dose of intravenous tocilizumab (TCZ) is 4 mg/kg every 4 weeks, with an increase to 8 mg/kg based on clinical response for patients with moderate to severe rheumatoid arthritis; however, data on how TCZ dose is escalated in real life are missing. The objective of this analysis was to descr...

I read with interest the article by Hill et al ,1 with the accompanying editorial by Felson and Bischoff-Ferrari.2 The point made by the editorialists was that the absence of a difference in osteoarthritis outcomes could have been due to the comparator group, which was high in oleic acid. Hill et al chose sunola oil for the comparator with fish oil...

Background and objectives Baricitinib is an oral, reversible inhibitor of Janus kinase (JAK)1/JAK2 being developed as treatment for patients with RA. Previous studies have shown transient increases in total lymphocyte count within hours of dosing and return to baseline prior to the next dose. We examined changes over time in lymphocyte subsets in R...

In this issue of The Journal a Japanese group reports an overall diminished incidence of total knee arthroplasty (TKA) in a group of patients with longstanding rheumatoid arthritis (RA) receiving methotrexate (MTX) plus tumor necrosis factor (TNF) inhibitor, versus another group receiving TNF inhibitor but not MTX1. If true, the findings are certa...

Objectives To characterise the comparative effectiveness of combination therapy (a tumour necrosis factor inhibitor (TNFi) and a conventional synthetic disease-modifying antirheumatic drug (csDMARD) such as methotrexate) and monotherapy (TNFi only) for psoriatic arthritis (PsA) from a large US registry. Methods The analysis included adult patients...

Introduction Tofacitinib is an oral Janus kinase inhibitor for the treatment of rheumatoid arthritis. Method In this 6-month, phase 3, randomized, placebo-controlled trial, 611 patients with inadequate response to disease-modifying anti-rheumatic drugs (DMARD-IR) were randomized 4:4:1:1 to receive: tofacitinib 5 mg BID or tofacitinib 10 mg BID for...

Objective: We conducted a longitudinal observational study of biological disease-modifying antirheumatic drugs (bDMARD) to describe the proportions of patients with rheumatoid arthritis in remission who discontinued these agents, and to assess the potential predictors of the decision to discontinue. Methods: We used data from the US COnsortium o...

Introduction: The goal of this study was to evaluate how frequently rheumatoid arthritis (RA) therapy is instituted promptly and to describe the characteristics of patients who are not treated early upon diagnosis. Methods: The percentage of patients who at the time of enrollment in the Corrona registry were not receiving any RA-directed therapy...

Patients with active rheumatoid arthritis (RA) despite anti–tumor necrosis factor(anti-TNF)agent treatment can switch to either a subsequent anti-TNF agent or a biologic with an alternative mechanism of action, such as rituximab; however, there are limited data available to help physicians decide between these 2 strategies. The objective of this an...

Subcutaneous nodules are the most common conspicuous extra-articular manifestation of rheumatoid arthritis (RA). Cardiovascular disease (CVD) is the leading cause of death in patients with RA. The objective of this study is to examine the possibility of a relationship between subcutaneous nodules and "first ever" cardiovascular disease event, i.e.,...

Background Tabalumab is a human monoclonal antibody that neutralises B-cell activating factor. Objectives To evaluate tabalumab efficacy and safety in patients with rheumatoid arthritis (RA). Methods This phase 3, randomised, double-blind, placebo-controlled study evaluated 456 patients with active RA after 24-week treatment with subcutaneous tabal...