Rheum Round-up: Five RA Drugs Compared, Two THA Approaches, and more

Here are the top stories recently covered by DocWire News in the Rheumatology section. In this edition, read about a comparison of five monotherapies for rheumatoid arthritis (RA), two approaches for total hip arthroplasty (THA), disease-modifying antirheumatic drug- (DMARD) free remission for RA patients, and the correlation between serological markers and comorbidities in psoriatic patients.

There are many existing medication options for RA, but which ones come out on top when it comes to safety and efficacy? Researchers recently compared five Janus kinase inhibitors (JAK inhibitors) to find the answer: tofacitinib, baricitinib, upadacitinib, filgotinib, and peficitinib. The authors concluded, “All five JAK inhibitors—tofacitinib, baricitinib, upadacitinib, filgotinib and peficitinib—were efficacious monotherapy interventions for active RA, and differences were noted in their efficacy and safety in monotherapy.”

Researchers recently reviewed clinical, functional, and radiographic outcomes between THA patients treated with the direct anterior approach (DAA) versus the posterior approach (PA). DAA patients had a longer surgery duration by a mean 13.74 minutes. Postoperative early functional outcomes were significantly better in the DAA group versus PA group, including the visual analog scale scores postoperative days one and two and Harris Hip Score at six weeks postoperatively. Late functional outcomes and radiographic outcomes did not largely differ between the groups. Length of the incision, length of hospital stay, blood loss, transfusion rates and complication rates also did not significantly differ.

A study evaluated two strategies for gradual tapering toward DMARD-free remission for patients with established RA. Two tapering strategies were explored. One strategy first tapered the conventional synthetic DMARD (csDMARD)—in most cases, methotrexate—and then tapered the tumor necrosis factor (TNF) inhibitor. The other strategy first tapered the TNF-inhibitor then the csDMARD. “[DMARD-free remission] was achievable in a small proportion of patients and was seen slightly more frequent in patients that tapered their csDMARDs first. Because of similar effects from a clinical perspective, financial arguments may influence the decision to taper TNF-inhibitors first,” the researchers concluded.

Early psoriatic arthritis detection can pose a challenge for rheumatologists—especially in the presence of psoriasis. A study assessed the correlation between serological markers and comorbidities in psoriatic patients. “Clinicians should be particularly aware of such manifestations as gout, hyperlipidemia, axial spondylopathy (inflammatory back pain), and allergic rhinitis in [psoriasis] PSO in order to ensure the early diagnosis of [psoriatic arthritis] PSA among psoriasis patients. Moreover, miR-210-3p could be a marker that differentiates between PSO and PSA and also between before and after biologics treatment,” the researchers summarized.