Paul Emery

• University of Leeds

Objective The tapering of biologic disease‐modifying antirheumatic drug (b‐DMARD) therapy for patients with rheumatoid arthritis (RA) in stable remission is frequently undertaken, but specific guidance on how to successfully taper is lacking. The objective of this study is to identify predictors of flare in patients in stable b‐DMARD–induced clinic...

Objective This study aimed to identify peripheral and salivary gland (SG) biomarkers of response/resistance to B cell depletion based on the novel concise Composite of Relevant Endpoints for Sjögren Syndrome (cCRESS) and candidate Sjögren Tool for Assessing Response (STAR) composite endpoints. Methods Longitudinal analysis of peripheral blood and...

Objective To investigate the prevalence of poly‐refractory rheumatoid arthritis (RA) defined as failure of all biological (b)/targeted synthetic (ts)‐disease‐modifying drugs (DMARDs). To further investigate whether patients with persistent inflammatory refractory RA (PIRRA) and noninflammatory refractory RA (NIRRA), determined by objective ultrasou...

To assess cigarette smoking’s effects on efficacy of the preferential Janus kinase (JAK) 1 inhibitor filgotinib and drug persistence in patients with rheumatoid arthritis (RA). Efficacy in non-smokers, former smokers, and current smokers from phase 3 filgotinib trials was analyzed, including patients with inadequate response (IR) to methotrexate (M...

Objective Recent advances imply that early events triggering rheumatoid arthritis (RA) occur at mucosal surfaces. We aimed to evaluate whether intestinal permeability is altered in patients at increased risk of RA, and/or predicts the development of clinical arthritis, by measuring serum zonulin family peptides (ZFP) levels, which are shown to refl...

Objectives This study aimed to develop a novel whole-body MRI protocol capable of assessing inflammatory arthritis at an early stage in multiple joints in one examination. Materials and methods Forty-six patients with inflammatory joint symptoms and 9 healthy volunteers underwent whole-body MR imaging on a 3.0 T MRI scanner in this prospective stu...

Objectives To investigate, in anti-CCP antibody–positive individuals with musculoskeletal symptoms but no clinical synovitis (CCP+ at-risk), the additional value of US for the prediction of inflammatory arthritis. Furthermore, to define a concise US protocol for feasible risk prediction. Methods Demographic and clinical data were collected in 417...

Biomarkers for the classification of rheumatoid arthritis (RA), and particularly for anti-citrullinated peptide antibody (ACPA)-negative patients, remain an important hurdle for the early initiation of treatment. Taking advantage of DNA-methylation patterns specific to early RA, quantitative methylation-specific qPCR (qMSP) offers a robust technolo...

Objective In 2015, the European Alliance of Associations for Rheumatology (EULAR) published recommendations for the use of imaging for the diagnosis and management of spondyloarthritis in clinical practice. These recommendations included the use of ultrasound in patients with psoriatic arthritis (PsA), but the management was not clearly distinguish...

Objectives: Inflammatory arthritis (IA) is considered the last stage of a disease continuum, where features of systemic autoimmunity can appear years before clinical synovitis. Time to progression to IA varies considerably between at-risk individuals, therefore the identification of biomarkers predictive of progression is of major importance. We p...

Objectives To compare the use of glucocorticoids (GC) over time in patients with rheumatoid arthritis (RA) who were or were not treated initially with GC bridging therapy. Methods Data from the BeSt, CareRA and COBRA trials were combined in an individual patient data (IPD) meta-analysis. We compared GC use between bridgers and non-bridgers at 12,...

Objectives Periodontitis and underlying bacteria have been linked to the development of rheumatoid arthritis (RA). One suggested pathogen is Aggregatibacter actinomycetemcomitans (A.a.), which expresses leukotoxin A (LtxA) that can citrullinate human proteins, providing a possible trigger for the production of anti-citrullinated protein antibodies...

Objective Interstitial lung disease (ILD) is an important cause of mortality in some patients with rheumatoid arthritis (RA). Patient-level factors may predict which patients with RA are at the highest risk of developing ILD and are therefore candidates for screening for this complication of the underlying disease. Methods A systematic literature r...

Background Palindromic rheumatism (PR) is a recognised precursor of rheumatoid arthritis (RA) and is characterised by episodic flares of pain and swelling in and around joints [1]. Up to 50% of PR patients will progress to persistent arthritis (PA) [1]. However, PR is challenging to identify and study longitudinally and risk factors for progression...

Background In the treatment of RA, JAK inhibitors are a valuable option to meet remission or low disease activity (LDA) treatment targets following an inadequate response (IR) or intolerance to ≥1 conventional synthetic disease-modifying antirheumatic drug (DMARD). FIL is a JAK1 preferential inhibitor available in two doses for the treatment of mod...

Background RA autoimmunity may be initiated at mucosal sites, including the periodontium. Anti-CCP positive at-risk individuals without synovitis (CCP+ at-risk) have an increased prevalence of periodontal disease (PD) and Porphyromonas gingivalis and an oral dysbiosis [1]. P gingivalis preferentially citrullinates C-terminal peptides by virtue of i...

Background Upadacitinib (UPA), an oral JAK inhibitor, was shown to be safe and effective in improving the signs and symptoms of moderate-to-severe RA through 84 weeks (wks) when administered as monotherapy in patients (pts) with a prior inadequate response to MTX in the phase 3 SELECT-MONOTHERAPY trial ( NCT02706951 ). [1] Objectives To evaluate t...

Background Refractory rheumatoid arthritis (refRA) persists in the targeted therapy era with up to 20% of patients failing multiple classes of biologic (b) and/or targeted synthetic (ts) DMARDs.[1,2] Currently, there is limited understanding of the immune composition of refRA. Objectives To characterise the peripheral immune landscape of patients...

Background In an age of dose optimization and drug tapering due to excellent conventional (c), biological (b) or targeted synthetic (ts) disease-modifying anti-rheumatic drugs (DMARDs), the fact remains that many patients still have active disease, being therapy refractory, sometimes to multiple DMARDs. In 2021, EULAR defined the term “Difficult-to...

Background In anti-CCP positive individuals at-risk of developing rheumatoid arthritis (CCP+ at-risk), ultrasound (US) sub-clinical inflammation and bone erosions (BE) are associated with progression to clinical arthritis [1] . However, the additional value of US in predicting progression to inflammatory arthritis (IA) when compared with routinely...

Background Subclinical synovitis is a relatively common ultrasound (US) finding in individuals at-risk of rheumatoid arthritis (RA) (33%) [1]. It is associated with the development of inflammatory arthritis (IA); which often results in physicians prescribing disease modifying anti-rheumatic drugs (DMARDs) in the absence of clinical inflammation. Pr...

Background While genetic and epidemiological factors have been used traditionally to evaluate the risk of developing rheumatoid arthritis (RA), the definition of higher risk states has been refined in more recent years through inclusion of serum autoantibodies and symptom complexes, such as inflammatory joint pain. Data from at risk cohorts have re...

Background Glucocorticoid (GC) ‘bridging’ therapy as temporary part of the initial treatment in rheumatoid arthritis (RA) helps to rapidly suppress disease activity. It has been proposed that patients treated with GC bridging (bridgers) may continue to use more GC later in the disease course than patients who did not receive GC bridging (non-bridge...

Background Anti-CCP+ at-risk individuals with musculoskeletal (MSK) symptoms and subclinical synovitis on ultrasound (US) are at high risk of developing inflammatory arthritis (IA). The accepted standard practice is to initiate treatment at progression rather than in the pre-rheumatoid arthritis (RA) phase when they do not have clinical synovitis [...

Background DARWIN 3 ( NCT02065700 ) is a long-term extension (LTE) study assessing the safety and efficacy of filgotinib (FIL) in patients with rheumatoid arthritis (RA) and an inadequate response to methotrexate (MTX). [1] In the DARWIN 1 ( NCT01888874 ) and DARWIN 2 ( NCT01894516 ) parent studies, patients received FIL in combination with MTX or...

Background Autoimmune connective tissue disease (AI-CTD) arise from a common “At-Risk” ANA-positive population in which clinical phenotype does not reliably predict progression. We previously showed that higher IFN-Score-B and family history were predictive of progression to meeting classification criteria at 12-months[1]. However, classification c...

Background Anti-cyclic citrullinated peptide (CCP) antibody positive individuals with musculoskeletal (MSK) symptoms but no clinical synovitis are at elevated risk of developing rheumatoid arthritis (RA) [1]. Whilst risk stratification is possible, specific immunological changes underpinning the transition from pre-RA to clinical arthritis remain u...

Background The pre-clinical phase of inflammatory arthritis (IA) can be prolonged. Although many baseline biomarkers have shown predictive value for progression to IA, their evolution during the disease continuum remains unclear. Objectives To investigate which biomarkers change before progression to IA and assess their predictive value in the nex...

Background Rheumatoid autoimmunity may be initiated at mucosal sites such as the periodontium. Patients with RA and anti-CCP+ at-risk individuals have an increased prevalence of periodontal disease (PD) [1]. PD is often asymptomatic and diagnosed by clinical examination. We hypothesised that comprehensive periodontal assessment of CCP+ at-risk indi...

Background ILD is a significant complication of RA, but diagnosis of RA-ILD is often delayed as respiratory symptoms do not develop until the disease is advanced. Several risk factors for the development of ILD in patients with RA have been identified. Screening tools are required to facilitate earlier detection of RA-ILD in clinical practice. Obj...

Background Peresolimab is a humanized immunoglobulin G1 monoclonal antibody that stimulates human programmed cell death protein 1 (PD-1). We hypothesized that peresolimab binding to PD-1, a checkpoint inhibitory receptor, could stimulate physiological immune inhibitory pathways to restore immune homeostasis; this represents a novel approach to trea...

Biomarkers for the classification of rheumatoid arthritis (RA), and particularly of anti-citrullinated peptide antibody (ACPA) negative patients, remains an important hurdle for the early initiation of treatment despite the use of 2010 classification criteria. Taking advantage of DNA-methylation patterns specific to early RA, quantitative methylati...

Background/Aims When the COVID-19 pandemic began, steps were taken to minimise risk to those vulnerable to severe outcomes. For immunosuppressed patients with rheumatoid arthritis (RA), consideration was given to reducing risk whilst mindful of compromising control of their underlying condition. At Leeds Teaching Hospitals NHS Trust, patients recei...

Background/Aims Anti-CCP positive individuals with musculoskeletal (MSK) symptoms and subclinical synovitis on ultrasound (US) are at high risk of developing inflammatory arthritis (IA). Treatment initiation in these individuals is not accepted practice as they do not have clinical synovitis. We aimed to determine whether imaging characteristics ch...

Background/Aims In rheumatoid arthritis (RA) disease assessment, SDAI and Boolean remission criteria are known to be more stringent in comparison to DAS28-ESR. Comparing remission rates across multiple assessment indices provides a more comprehensive evaluation of disease control. In an early RA trial cohort, we aimed to investigate stringent and m...

Background: AVERT-2 (a phase IIIb, two-stage study) evaluated abatacept + methotrexate versus methotrexate alone, in methotrexate-naive, anti-citrullinated protein antibody-positive patients with early (≤ 6 months), active RA. This subanalysis investigated whether individual patients who achieved the week 24 Simplified Disease Activity Index (SDAI...

Objective: Some patients with rheumatoid arthritis (RA) who persist in remission may decide to stop their therapy. We evaluated baseline characteristics associated with remaining in remission or low disease activity (LDA) following medication withdrawal. Methods: SEAM-RA was a phase 3, multicenter, randomized withdrawal, double-blind, controlled...

Objective Gene expression profiles are associated with the clinical heterogeneity of systemic lupus erythematosus (SLE) but are not well studied as biomarkers for therapy. We studied gene expression and response to rituximab in a multiethnic UK cohort who were refractory to standard therapy. Methods We evaluated baseline expression levels of trans...

Introduction: One target of rheumatoid arthritis (RA) treatment is to achieve early sustained remission; over the long term, patients in sustained remission have less structural joint damage and physical disability. We evaluated Simplified Disease Activity Index (SDAI) remission with abatacept + methotrexate versus abatacept placebo + methotrexate...

Background Concerns have been raised regarding the reduced immunogenicity of vaccines against COVID-19 in patients with autoimmune diseases treated with rituximab. However, the incidence and severity of breakthrough infections in unbiased samples of patients with specific rheumatic and musculoskeletal diseases are largely unknown. We aimed to asses...

Objective To investigate correlations between biomarkers of bone remodelling and extracellular matrix turnover with baseline disease activity and treatment response in patients with early rheumatoid arthritis (RA). Methods A ssessing V ery E arly R heumatoid arthritis T reatment-2 (AVERT-2; NCT02504268 ) included disease-modifying antirheumatic dr...

Background Predicting progression to clinical arthritis in individuals at-risk of developing rheumatoid arthritis is a prerequisite to developing stratification groups for prevention strategies. Selecting accurate predictive criteria is the critical step to define the population at-risk. While positivity for anti-citrullinated protein antibodies (A...

Treatment with immune checkpoint blockade (ICB) frequently triggers immune-related adverse events (irAEs), causing considerable morbidity. In 214 patients receiving ICB for melanoma, we observed increased severe irAE risk in minor allele carriers of rs16906115, intronic to IL7 . We found that rs16906115 forms a B cell-specific expression quantitati...

Objectives To investigate whether patients with rheumatoid arthritis (RA) can discontinue glucocorticoids (GC) after GC ‘bridging’ in the initial treatment step and to identify factors that may affect this. Methods Data from 7 clinical trial arms (with 1653 patients) that included a GC bridging schedule, previously identified in a systematic liter...

Background Rituximab is widely used to treat autoimmunity but clinical response varies. Efficacy is determined by the efficiency of B-cell depletion, which may depend on various Fc gamma receptor (FcγR)-dependent mechanisms. Study of FcγR is challenging due to the complexity of the FCGR genetic locus. We sought to assess the effect of FCGR variants...

ABSTRACT NUMBER: L03 A Phase 2 Trial of Peresolimab for Adults with Rheumatoid Arthritis Jay Tuttle1, Edit Drescher2, Jesus Abraham Simón-Campos3, Paul Emery4, Maria Greenwald5, Alan Kivitz6, Hyungmin Rha1, Pia Yachi1, Christina Kiley1 and Ajay Nirula7, 1Eli Lilly and Company, Indianapolis, IN, 2Csolnoky Ferenc Hospital, Veszprém, Hungary, 3Köhler...

Background/objective: The effect of treatment withdrawal on patient-reported outcomes (PROs) in patients with rheumatoid arthritis (RA) whose disease is in sustained remission has not been well described. This analysis aimed to compare PRO changes in patients with RA following medication withdrawal and disease worsening. Methods: SEAM-RA (Study...

Background: Targeting interleukin (IL)-6 has become a major therapeutic strategy in the treatment of immune-mediated inflammatory disease. Interference with the IL-6 pathway can be directed at the specific receptor using anti-IL-6Rα antibodies or by directly inhibiting the IL-6 cytokine. This paper is an update of a previous consensus document, ba...

Objectives To evaluate the proportion of RA patients that are refractory to multiple targeted therapies in a real-world cohort of patients in a tertiary rheumatology referral centre. To describe patterns of drug sequencing associated with the development of RefRA. To identify if there is a subgroup of RefRA patients in whom successive drugs have sh...

Objectives This study aimed to demonstrate how to estimate the value of health gain after patients with a multisystem disease achieve a condition-specific composite response endpoint. Methods Data from patients treated in routine practice with an exemplar multisystem disease (systemic lupus erythematosus) were extracted from a national register (B...

Objective: To assess outcomes of repeat rituximab cycles and identify predictors of sustained clinical response in systemic manifestations of primary Sjögren syndrome (pSS). Methods: An observational study was conducted in 40 rituximab-treated patients with pSS. Clinical response was defined as a 3-point or more reduction in the European League...

Background Rituximab is widely used to treat rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE) but clinical response varies. Efficacy is determined by the efficiency of depletion, which may depend on a variety of Fc gamma receptor (FcγR)-dependent mechanisms. Previous research was limited by complexity of the FCGR locus, not integrat...

Background The MSK components of the BILAG and SLEDAI have limited sensitivity, specificity and responsiveness. Objectives To develop a better disease activity tool for MSK lupus. Methods “LAMDA” was derived using data from the multicentre USEFUL study (PMID:33792659); 133 patients with inflammatory MSK pain received intramuscular depomedrone the...

Background The preferential Janus kinase-1 inhibitor FIL is approved for treatment of moderate to severe active RA in Europe and Japan. Objectives Efficacy and safety of FIL were assessed in pts with IR to MTX who completed a Phase 3 trial (NCT02889796)¹ and enrolled in an LTE (NCT03025308). Methods Pts completing the PS¹ on study drug were eligi...

Background Infections are the most commonly reported AE observed in patients with RA treated with immunosuppressive therapies and can be clinically significant. A recent review reported differences in the risk of infection for some biologics such as tocilizumab and TNF inhibitors. ¹ Abatacept selectively modulates T-cell co-stimulation and is appro...

Background A reduction in serum lipids such as total cholesterol (TC) and low-density lipoprotein (LDL) has been associated with increased risk of cardiovascular events in active RA, paradoxical to the general population ¹ . The effect of DMARDs and active inflammation on lipid profiles has been investigated in RA but detailed lipid profiling has b...

Background The TRial for Anti-B-Cell Therapy In patients with pSS (TRACTISS) is the largest multi-centre, placebo-controlled, phase-III trial with the administration of 2 cycles of Rituximab (RTX) or placebo at week 0 and 24, with trial clinical endpoints at week 48. Despite the primary endpoints (30% reduction in fatigue or oral dryness) were not...

jats:sec> Background As rituximab (RTX) is a B-cell depleting agent, there are concerns regarding its safety during the COVID pandemic. Data from registries during pre-vaccination period reported increased risk of poor outcomes in RTX-treated patients vs TNFi. However, registry data could be limited by reporting bias in determining true incidence....

Background Although many predictors of progression to inflammatory arthritis (IA) have been identified at first visit in individuals at risk of developing IA, their fluctuation during follow-up is largely unknown. Objectives To describe the changes in relevant biomarkers, which precede arthritis development in anti-CCP positive at risk individuals...

Background Discordance between DAS28ESR and musculoskeletal ultrasound (MSUS) detected power Doppler synovitis (PDUS) is well-recognised and may lead to under/overtreatment. We hypothesize that clinical and imaging features at diagnosis associate with early discordance of DAS28-PDUS and change in DAS28-PDUS status following DMARD treatment. Object...

Background As rituximab (RTX) is a B-cell depleting agent, there are concerns regarding its safety during the COVID pandemic. Data from registries during pre-vaccination period reported increased risk of poor outcomes in RTX-treated patients vs TNFi. However, registry data could be limited by reporting bias in determining true incidence. There are...

Rheumatoid arthritis (RA) is a chronic inflammatory disorder with poorly defined aetiology characterised by synovial inflammation with variable disease severity and drug responsiveness. To investigate the peripheral blood immune cell landscape of early, drug naive RA, we performed comprehensive clinical and molecular profiling of 267 RA patients an...

Biosimilars represent a novel category in the world of follow-up medicinal products with the requirement that they are highly similar but not identical to an approved originator biologic medicine, with no clinically meaningful differences in safety, purity, and potency. In this review, we discuss recent pivotal biosimilar developments for anti-infl...

Background/Aims Rituximab is widely used to treat rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE) but clinical response varies. Efficacy is determined by the efficiency of depletion, which may depend on a variety of Fc gamma receptor (FcγR)-dependent mechanisms. Previous research was limited by complexity of the FCGR locus, not int...

Background/Aims Clinical remission is the treatment target in rheumatoid arthritis (RA). In a treatment-naïve, early RA trial (VEDERA: ‘Very early Etanercept and Methotrexate versus Methotrexate with/without Delayed Etanercept in RA’), we previously reported the presence of ultrasound power Doppler synovitis (PDUS) at diagnosis that improved in the...

Background/Aims Randomised controlled trials (RCTs) of rituximab (RTX) in primary Sjogren’s syndrome (pSS) have failed to alleviate glandular symptoms and fatigue. The question remains as to whether B-cell depleting therapies have a place for the treatment of pSS. Post-hoc analyses from RCTs showed greater improvement in objective measures such as...

Background/Aims On average, there is a delay of 6.7 years between symptom onset and diagnosis of axial spondyloarthritis (axSpA). Since traditional approaches to improving early axSpA identification have had limited success, predictive automated analyses using patient records may help alleviate the burden on healthcare providers. We report results...

Background/Aims The preferential Janus kinase (JAK)-1 inhibitor filgotinib (FIL) is approved for treatment of moderately to severely active RA in Europe and Japan. We assessed efficacy and safety of FIL in patients (pts) with inadequate response to MTX (MTX-IR) who completed a Phase 3 trial (NCT02889796) and went on to enroll in a long-term extensi...

Background/Aims Discordance between DAS28-ESR and ultrasound (US)-detected power Doppler synovitis (PDUS) can lead to unnecessary DMARD cycling. Using DAS28-ESR and PDUS in an early RA trial cohort, we aimed to identify and describe concordance and discordance at diagnosis and evaluate their proportional change in response to treatment. Methods Th...

Background/Aims Synovitis and tenosynovitis (TS) are key findings seen in patients with rheumatoid arthritis (RA) on musculoskeletal ultrasound (MSUS). Both power Doppler TS (PDTS) and power Doppler synovitis (PDUS) have also been reported in preclinical-RA. We aimed to describe the prevalence of PDTS and PDUS in a treatment-naïve, new-onset RA tri...

Background/Aims Filgotinib (FIL), an oral janus kinase 1 (JAK1) inhibitor, has been evaluated in three Phase 3 clinical studies (FINCH 1-3) in adults with moderately-to-severely active rheumatoid arthritis (RA). Patients with RA who currently smoke (a predisposing factor for RA) have been reported to be less likely to respond to anti-TNFα treatment...

Although treatment with immune checkpoint blockade (ICB) has transformed outcomes for patients with melanoma (1, 2), it frequently triggers immune related adverse events (irAEs), causing serious morbidity and presenting a major hurdle to immuno-oncology (3, 4). The degree to which germline genetic variation predisposes to irAEs is unknown. Here, st...

Objective To test the ability of machine learning (ML) approaches with clinical and genomic biomarkers to predict methotrexate treatment response in patients with early rheumatoid arthritis (RA). Methods Demographic, clinical, and genomic data from 643 patients of European ancestry with early RA (mean age 54 years; 70% female) subdivided into a tr...

Objectives To assess antibody and T cell responses to SARS-CoV-2 vaccination in patients with rheumatoid arthritis (RA) on disease-modifying antirheumatic drugs (DMARDs). Methods This prospective study recruited 100 patients with RA on a variety of DMARDs for antibody and T cell analysis, pre-vaccination and 4 weeks post-vaccination. Positive anti...

Background Drug-free remission is a desirable goal in rheumatoid arthritis (RA) for both patients and clinicians. The aim of this post hoc analysis was to investigate whether clinical and magnetic resonance imaging (MRI) variables in patients with early RA who achieved remission with methotrexate and/or abatacept at 12 months could predict disease...

Objectives: Specific guidelines for managing RA patients in clinical remission for ≥6 months on cs-DMARDs are lacking. Tapering of treatment is encouraged, however, without validated biomarkers for success. We aimed to assess the rate of sustained remission after 12 months in patients who either (i) followed structured cs-DMARD tapering or (ii) co...

Background Musculoskeletal (MSK) symptoms are among the commonest reasons for primary care assessments; however, few individuals will be diagnosed with an inflammatory arthritis (IA) within the following year. The purpose of this study was to investigate, in individuals with new MSK symptoms, the association between patient factors and risk of prog...

Introduction : Rheumatoid arthritis (RA) affects 1% of the population and is principally associated with joint inflammation. It is suggested however that muscle involvement may be one of the earliest clinical features of RA. It is therefore important that techniques exist to accurately assess muscle health in those with RA to enable successful trea...

Introduction Rheumatoid arthritis (RA) affects 1% of the population and is principally associated with joint inflammation. It is suggested however that muscle involvement may be one of the earliest clinical features of RA. It is therefore important that techniques exist to accurately assess muscle health in those with RA to enable successful treatm...

Background Time to relapse after rituximab for the treatment of antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) is variable, and optimal retreatment strategy has remained unclear. In AAV following rituximab induction, the study objective was to evaluate clinical and B-cell predictors of relapse in order to develop a retreatme...

Objectives: This study aimed to demonstrate how to estimate the value of health gain after patients with a multisystem disease achieve a condition-specific composite response endpoint. Methods: Data from patients treated in routine practice with an exemplar multisystem disease (systemic lupus erythematosus) were extracted from a national register (...

Objectives: Biologic disease-modifying anti-rheumatic drugs (b-DMARDs) have qualitatively improved the management of axial spondyloarthritis (axSpA), but up to 30-40% of patients do not respond. Although lymphocytes are clearly implicated in the pathology of SpA, circulating lymphocyte subsets (LS) dynamics has been poorly studied. The objective o...

Secreted Frizzled Receptor Protein 4 (SFRP4) has been shown to be increased in Scleroderma (SSc). To determine its role in immune-driven fibrosis, we analysed SSc and sclerotic Chronic Graft Versus Host Disease (sclGVHD) biosamples; skin biopsies (n = 24) from chronic GVHD patients (8 with and 5 without sclGVHD), 8 from SSc and 3 healthy controls (...

Objective To characterise the impact of dactylitis in disease-modifying antirheumatic drug (DMARD)-naive early psoriatic arthritis (PsA). Methods Patients with early PsA meeting the classification criteria for PsA (CASPAR) were recruited. Clinical outcomes were recorded, and ultrasonography was conducted to assess grey scale (GS) and power Doppler...

Introduction Filgotinib (FIL), un inhibiteur préférentiel de JAK1 per os, a été évalué dans 3 études cliniques de phase 3 (FINCH 1-3) chez des adultes atteints de polyarthrite rhumatoïde (PR) active modérée à sévère. Les patients (pts) PR fumeurs actifs, facteur de prédisposition à la PR, sont moins susceptibles de répondre au traitement par anti-T...

Introduction Ankylosing spondylitis (AS) is a chronic inflammatory disease whose main hallmark is involvement of the axial skeleton. Non-steroidal anti-inflammatory drugs (NSAIDs) are the first line treatment; however, their use is limited because of side-effects. Tumour necrosis factor inhibitors (TNFi) are a safe and effective therapy, and they h...

Objectives To investigate whether anti-CCP2 positive at-risk individuals with MSK symptoms, but without clinical synovitis (CCP2+ at-risk), develop ultrasound (US) subclinical synovitis before inflammatory arthritis (IA), and if US subclinical synovitis can be predicted. Methods First, US scans of CCP2+ at-risk who developed IA (‘progressors’) wer...