Rheumatology

Sarilumab shows sustained effectiveness and consistent safety over 52 weeks in Japanese RA practice

In 1998 Japanese RA patients (mean age 66.6 years), sarilumab reduced mean CDAI from 21.2 at baseline to 9.7 by week 12. Mean CDAI change at weeks 24 and 52 was approximately −14 points for both monotherapy and combination therapy. Retention at week 52 was 67.5%, and treatment-emergent adverse events occurred in 44.6% overall. Outcomes and patient-reported measures improved similarly whether sarilumab was given alone or with csDMARDs; no new safety signals were reported. 1

MAS and ILD mark a more aggressive Still's disease course; early anakinra common in severe cases

In a 10-year single-centre cohort of 110 patients with Still's disease/sJIA, macrophage activation syndrome (MAS) occurred in 36.7% and interstitial lung disease (ILD) in 8.2%. MAS often presented at disease onset and associated with serositis at diagnosis and laboratory features of active MAS. ILD was strongly associated with MAS and a polycyclic disease course, which linked to older onset and rash. Early anakinra was used more in severe cases but was not independently associated with improved long-term outcomes. 2

Abatacept for 2 years reduced progression to RA versus hydroxychloroquine in seropositive palindromic rheumatism

In this randomized open-label trial, abatacept-treated patients progressed to RA in 20.6% (7/34) versus 50.0% (18/36) with hydroxychloroquine (P=0.010). Abatacept prolonged time to RA with a hazard ratio of 0.27 and improved symptom remission and attack intensity. Results were consistent in sensitivity analyses using available-data-only, though patient numbers were small. Both drugs were well tolerated in the trial period. 3