RHEUMATOID ARTHRITIS ADVISOR

Rheumatoid Arthritis Advisor

Feature

The Search for Preventive Strategies for Rheumatoid Arthritis

The EULAR has proposed 6 distinct phases (A-F) of RA, characterized by the presence of genetic risk factors (phase A), environmental factors (phase B), systemic autoimmunity associated with RA (phase C), arthralgias without clinical arthritis (phase D), unclassified arthritis (phase E), and established RA (phase F).
Skeletal Muscle Disease and Cardiometabolic Dysfunction in Rheumatoid Arthritis

Skeletal muscle alterations in rheumatoid arthritis are often overlooked despite their important role in disability and cardiometabolic disease development.
Genetics, Environment, and Lifestyle: How Does Each Affect Risk for Rheumatoid Arthritis?

Various combinations of genes, environmental factors, and chance may affect early immune activation and symptom onset in rheumatoid arthritis.
Is It Time to Stop Using DAS28-Defined Remission in Rheumatoid Arthritis?

Although DAS28 metrics represent the gold standard in defining RA outcomes, they may not accurately capture a state of true remission.
Nonpharmacologic Management of Fatigue in Rheumatoid Arthritis: A Review

Nonpharmacologic management of fatigue in rheumatoid arthritis may alter causal pathways of fatigue and provide significant benefits.

News

Clinician examining the hand of a patient with rheumatoid arthritis

Assessing Drug Bioavailability or Anti-Drug Antibody to Guide Use of TNF Inhibitors

September 3, 2020

Monitoring drug and anti-drug antibodies (ADAb) may assist in adjusting the dosage of tumor necrosis factor alpha (TNF) inhibitors or switching to a different drug in patients with chronic inflammatory arthritis.

Assessing the Comorbidity Burden in Antiphospholipid Syndrome vs Rheumatoid Arthritis

Emily Pond

September 3, 2020

The comorbidity burden of APS is comparable to that of RA where prevalence rates of diabetes mellitus, COPD, and neoplasms were similar between both groups.

Positive Squeeze Test Supports the Diagnosis of Subclinical Synovitis

Amit Akirov, MD

September 3, 2020

In patients with arthralgia suspicious for progression of rheumatoid arthritis, a positive squeeze test doubles the probability of presence of subclinical synovitis.

Serum Interleukin-6 Levels Can Predict Response to Sarilumab in Rheumatoid Arthritis

Amit Akirov, MD

September 3, 2020

Interleukin-6 may be a prognostic marker of rheumatoid arthritis disease progression and severity, but may also be a potential predictor of a better response to sarilumab.

$It is unclear whether disease control prevents RA-related bone loss, but data suggest it does in patients with early RA and high disease activity.1 Two systemic analyses of RA studies concluded that biologic DMARDs reduce generalized and localized bone loss.2,19 However, few studies were phase 3 trials, and most measured markers of bone turnover.2,19 High-quality trials that measure BMD change or fracture risk are needed. Bisphosphonates, denosumab, and parathyroid hormone are agents approved for osteoporosis and glucocorticoid-induced osteoporosis. Bisphosphonates and denosumab appear to have similar efficacy at preserving BMD.1 In some RA studies, denosumab also prevented and repaired erosions.2 The ACR guidelines for glucocorticoid-induced osteoporosis categorize patients as having low, moderate, or high fracture risk.18 They recommend calcium (1000 to 1200 mg/d) and vitamin D (600 to 800 IU/d) supplements for all patients, plus an osteoporosis agent (preferably an oral bisphosphonate) for patients with moderate to high fracture risk.$

Adalimumab Serum Levels Not Predictive of Response to Next Anti-Rheumatic Drug

Emily Pond

September 3, 2020

Results from this diagnostic test accuracy study suggest that adalimumab serum levels may not be reliable indicators of response to other bDMARDs after adalimumab failure.