Publications

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213 Publications visible to you, out of a total of 213
Corrigendum to: Obesity reduces the real-world effectiveness of cytokine-targeted but not cell-targeted disease-modifying agents in rheumatoid arthritis

Abstract

Not specified

Authors: M. Schafer, Y. Meissner, J. Kekow, S. Berger, S. Remstedt, B. Manger, J. Listing, A. Strangfeld, A. Zink

Date Published: 2020

Publication Type: Journal

Obesity reduces the real-world effectiveness of cytokine-targeted but not cell-targeted disease-modifying agents in rheumatoid arthritis

Abstract (Expand)

OBJECTIVES: The effectiveness of TNF inhibitors in RA has been shown to be affected by obesity. No such effect has been found for abatacept and rituximab, while for tocilizumab results are ambiguous. … Additionally, it remains unresolved whether sex is an effect modifier for obesity. We investigated the impact of obesity on the drug effectiveness of conventional synthetic or biologic DMARDs, taking into account potential sex-specific differences. METHODS: Data from 10 593 RA patients included in the German observational cohort study Rheumatoid Arthritis: oBservation of BIologic Therapy (RABBIT) since 2009 were analysed. Patients had to have a BMI >/=18.5 kg/m2, at least one follow-up and 6 months of observation time. The influence of obesity on drug effectiveness was investigated by regression analysis, adjusting for potential confounders. RESULTS: Obesity had a negative impact on improvement in the DAS with 28 joints using ESR as an inflammation marker of -0.15 (95% CI: -0.26; -0.04) units for women receiving conventional synthetic DMARDs, -0.22 (95% CI: -0.31; -0.12) units for women receiving TNF inhibitors, -0.22 (95% CI: -0.42; -0.03) units for women receiving tocilizumab and -0.41 (95% CI: -0.74; -0.07) units for men receiving tocilizumab. Overall, no negative obesity effects on the effectiveness of rituximab and abatacept were found. CONCLUSION: Obesity has a negative impact on the effectiveness of cytokine-targeted but not cell-targeted therapies in daily practice, affecting more outcomes and therapies in women than in men. Overall, no effects of obesity on treatment effectiveness were found for rituximab and abatacept.

Authors: M. Schafer, Y. Meissner, J. Kekow, S. Berger, S. Remstedt, B. Manger, J. Listing, A. Strangfeld, A. Zink

Date Published: 2020

Publication Type: Journal

EULAR recommendations for the management of rheumatoid arthritis with synthetic and biological disease-modifying antirheumatic drugs: 2019 update

Abstract (Expand)

OBJECTIVES: To provide an update of the European League Against Rheumatism (EULAR) rheumatoid arthritis (RA) management recommendations to account for the most recent developments in the field. METHODS: … An international task force considered new evidence supporting or contradicting previous recommendations and novel therapies and strategic insights based on two systematic literature searches on efficacy and safety of disease-modifying antirheumatic drugs (DMARDs) since the last update (2016) until 2019. A predefined voting process was applied, current levels of evidence and strengths of recommendation were assigned and participants ultimately voted independently on their level of agreement with each of the items. RESULTS: The task force agreed on 5 overarching principles and 12 recommendations concerning use of conventional synthetic (cs) DMARDs (methotrexate (MTX), leflunomide, sulfasalazine); glucocorticoids (GCs); biological (b) DMARDs (tumour necrosis factor inhibitors (adalimumab, certolizumab pegol, etanercept, golimumab, infliximab), abatacept, rituximab, tocilizumab, sarilumab and biosimilar (bs) DMARDs) and targeted synthetic (ts) DMARDs (the Janus kinase (JAK) inhibitors tofacitinib, baricitinib, filgotinib, upadacitinib). Guidance on monotherapy, combination therapy, treatment strategies (treat-to-target) and tapering on sustained clinical remission is provided. Cost and sequencing of b/tsDMARDs are addressed. Initially, MTX plus GCs and upon insufficient response to this therapy within 3 to 6 months, stratification according to risk factors is recommended. With poor prognostic factors (presence of autoantibodies, high disease activity, early erosions or failure of two csDMARDs), any bDMARD or JAK inhibitor should be added to the csDMARD. If this fails, any other bDMARD (from another or the same class) or tsDMARD is recommended. On sustained remission, DMARDs may be tapered, but not be stopped. Levels of evidence and levels of agreement were mostly high. CONCLUSIONS: These updated EULAR recommendations provide consensus on the management of RA with respect to benefit, safety, preferences and cost.

Authors: J. S. Smolen, R. B. M. Landewe, J. W. J. Bijlsma, G. R. Burmester, M. Dougados, A. Kerschbaumer, I. B. McInnes, A. Sepriano, R. F. van Vollenhoven, M. de Wit, D. Aletaha, M. Aringer, J. Askling, A. Balsa, M. Boers, A. A. den Broeder, M. H. Buch, F. Buttgereit, R. Caporali, M. H. Cardiel, D. De Cock, C. Codreanu, M. Cutolo, C. J. Edwards, Y. van Eijk-Hustings, P. Emery, A. Finckh, L. Gossec, J. E. Gottenberg, M. L. Hetland, T. W. J. Huizinga, M. Koloumas, Z. Li, X. Mariette, U. Muller-Ladner, E. F. Mysler, J. A. P. da Silva, G. Poor, J. E. Pope, A. Rubbert-Roth, A. Ruyssen-Witrand, K. G. Saag, A. Strangfeld, T. Takeuchi, M. Voshaar, R. Westhovens, D. van der Heijde

Date Published: 2020

Publication Type: Journal

Methotrexate: what are the true risks of treatment?

Abstract

Not specified

Authors: A. Strangfeld, G. R. Burmester

Date Published: 2020

Publication Type: Journal

[RABBIT-SpA: a new disease register for axial spondyloarthritis and psoriatic arthritis]

Abstract (Expand)

BACKGROUND: The treatment of axial spondyloarthritis (axSpA) and psoriatic arthritis (PsA) has changed enormously in recent years due to market authorization of a number of new biologicals with different … modes of action and the increasing use of biosimilars. Real-world data on long-term safety and efficacy under routine daily conditions is not yet sufficient. Therefore, the German Rheumatism Research Center has initiated a new cohort study covering axSpA and PsA. OBJECTIVE: Presentation of initial results from the new register RABBIT-SpA, which was started in May 2017. MATERIAL AND METHODS: This is a prospective longitudinal cohort study with a similar study design to the German biologics register RABBIT. Patients can be included at the start of a new treatment either in the so-called index drug group or in the comparison group (conventional systemic treatment, including non-steroidal anti-inflammatory drugs, NSAID). Follow-up per patient should be at least 5 years and preferably 10 years. The RABBIT-SpA uses a web-based documentation system. RESULTS: Up to mid-December 2018 a total of 514 axSpA patients had been documented in RABBIT-SpA, 410 with an index drug and 104 with conventional treatment. There are differences between these treatment groups, e. g. in the duration of the disease and in parameters of disease activity. It is also noticeable that in axSpA patients, approximately 5 years lie between the onset of the symptoms and confirmation of the diagnosis. Of the 355 PsA patients, 265 were included with an index drug and 90 with conventional treatment. Of the PsA patients 86% have a dominant peripheral manifestation. The average number of pressure tender joints is 8 and the average number of swollen joints is 4. CONCLUSION: The online register RABBIT-SpA is well-received by the participating rheumatological institutions. The electronic recording of patient data can be carried out in a reasonable time. Participation in the RABBIT-SpA is open to new rheumatological institutions at any time.

Authors: A. C. Regierer, A. Weiss, X. Baraliakos, A. Zink, J. Listing, A. Strangfeld

Date Published: 2020

Publication Type: Journal

Pregnancy outcomes in DMARD-exposed patients with juvenile idiopathic arthritis—results from a JIA biologic registry

Abstract

Not specified

Authors: Paula Drechsel, Katrin Stüdemann, Martina Niewerth, Gerd Horneff, Rebecca Fischer-Betz, Eva Seipelt, Susanna Spähtling-Mestekemper, Peer Aries, Angela Zink, Jens Klotsche, Kirsten Minden

Date Published: 1st Aug 2019

Publication Type: Journal

Time of Disease‐Modifying Antirheumatic Drug Start in Juvenile Idiopathic Arthritis and the Likelihood of a Drug‐Free Remission in Young Adulthood

Abstract

Not specified

Authors: Kirsten Minden, Gerd Horneff, Martina Niewerth, Eva Seipelt, Martin Aringer, Peer Aries, Ivan Foeldvari, Johannes‐Peter Haas, Ariane Klein, Stefanie Tatsis, Klaus Tenbrock, Angela Zink, Jens Klotsche

Date Published: 1st Mar 2019

Publication Type: Journal

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