Abatacept is a selective T-cell co-stimulation modulator that has demonstrated efficacy for the treatment of rheumatoid arthritis in patients who have failed treatment with methotrexate. Until recently, abatacept was only available as a monthly intravenous infusion. In August 2011, the FDA approved the use of subcutaneous abatacept for the treatment of moderate to severe rheumatoid […]
The development of antidrug antibodies to biologic therapies, notably drugs that consist of monoclonal antibodies (such as adalimumab and infliximab) has been reported in patients with rheumatoid arthritis. However, the clinical significance of these antidrug antibodies in the long-term follow up of RA patients is unknown.
Vaccinations are a critical component of RA clinical management, and their importance in preventing infection cannot be stressed enough. The majority of patients with RA are on immunosuppressive treatment, and a data driven approach to vaccinations in this high-risk population is essential.
Belimumab is a fully human IgG1λ antibody. It binds to the soluble cytokine, B-lymphocyte stimulator (BLyS) inhibiting its action. BLyS is important for the survival of B lymphocytes, but in patients with systemic lupus erythematosus (SLE) it is overexpressed.
Spleen tyrosine kinase (Syk) is an important mediator of inflammatory signals from extracellular receptors to the nucleus of immune cells. Inhibiting Syk with the oral, small-molecule inhibitor fostamatinib has shown efficacy compared to placebo in a short term study of RA patients on background methotrexate. Here, Weinblatt et al (NEJM 2010; published online ahead of […]
The dosage of rituximab commonly used in clinical practice (1000 mg infused twice, separated by two weeks) is largely empirically based. It is unclear whether lower doses will result in reduced efficacy or improved safety. Here, Emery et al (Ann Rheum Dis 2010; 69: 1629) explore patient outcomes in RA patients treated with 2 x […]
Ingestion of dairy products has been associated with a lower risk of gout in observational studies. However, the mechanism underlying this protective effect is unstudied. In addition, the association could be related more to health behaviors associated with milk drinking, such as better general health and less consumption of alcohol and red meat, rather than […]
Inflammatory cytokines are implicated in the painful symptoms of sciatica, a common form of lumbar radiculopathy associated with intense pain and dysfunction. Case reports have suggested that TNF inhibitors may improve pain in individuals with sciatica. However, since sciatica is often self-limited, uncontrolled reports of efficacy may be misleading. Here, Genevay et al (Arthritis Rheum […]
Antioxidants may protect tissues against damage, reduce systemic inflammation, and modulate antigen presentation by inflammatory cells. However, no large-scale investigation on whether dietary and/or supplement intake of antioxidants is protective against the development of autoimmune rheumatic disease. Here, Costenbader et al (American Journal of Epidemiology 2010; 172(2): 205) explore antioxidant intake and the risk of […]
The epidemiology of rheumatoid arthritis (RA) is influenced by a number of factors, including survival, changes in diagnostic tools, and temporal trends in environmental factors that may promote or protect from disease. Here, Myasoedova et al (Arthritis Rheum 2010; 62(6): 1576) explore the trends in RA incidence and prevalence over 50 years in a population-based […]