Publications

Kanda et al. investigated the efficacy of second-line b/tsDMARDs in RA patients unresponsive to first-line b/tsDMARDs. Using data from the FIRST registry, the study assessed 687 patients with RA treated with TNFis, IL-6 receptor inhibitors, cytotoxic T-lymphocyte-associated protein 4 immunoglobulin, or JAKis. After propensity score-based adjustment, JAKi showed the highest persistence rate, greatest improvement in CDAI, and highest remission rates at 24 weeks. Among JAKi, UPA was most effective in achieving remission, with a safety profile comparable to other b/tsDMARDs.

Heutz et al. found that patients requiring bDMARDs rarely achieved DMARD-free remission, while 15–37% of those on non-bDMARDs reached this milestone, underscoring significant differences based on treatment type. This suggests the EULAR recommendation against DMARD cessation may be too generalised.

Edwards et al. report on real-world data for baricitinib monotherapy in rheumatoid arthritis, showing significant disease activity reduction across multiple registries and observational studies. These findings reinforce the viability of baricitinib monotherapy in clinical practice for RA patients, complementing existing guidelines.

The 2023 EULAR recommendations provided an updated consensus on the pharmacological management of PsA with a new overarching principle and recommendation for 2023. Recent MOA safety data emphasised the importance of patient-specific benefit-risk profiling in JAKi therapy, and extra-musculoskeletal (MSK) manifestations related to PsA should be considered during drug selection.

As part of the GBD 2021, the authors provide updated estimates for the global burden of RA. In 2020, approximately 17.6 million people worldwide had RA, with a 14.1% increase in prevalence since 1990. Mortality decreased by 23.8% from 1990 to 2020. The study forecasts an increase in cases to 31.7 million by 2050.

Comparing the alignment of European national recommendations for patients with PsA and axSpA with EULAR and ASAS-EULAR treatment recommendations found that only a minority of national treatment recommendations were completely aligned.

Smolen, et al. provide a 2022 update of the EULAR recommendations for the management of RA with synthetic and biological DMARDs.