Measures of Rheumatoid Arthritis Disease Activity

Johnson, Tate M.; Michaud, Kaleb; England, Bryant R.

doi:10.1002/acr.24336

Cited by 11 publications

(6 citation statements)

References 136 publications

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“…DAS28-ESR was categorised into remission/low (<3.2), moderate (3.2–5.1) and high (>5.1), and DAS28-CRP into remission/low (<2.9), moderate (2.9–4.6) and high (>4.6). 36 Additionally, systemic inflammation measured by ESR/C reactive protein (CRP) and disease activity in the joints defined as swollen and tender joint count (0–28) were analysed separately. Elevated systemic inflammation was defined as ESR >21 mm/hour and CRP ≥5 mg/L, and high systemic inflammation as ESR >50 mm/hour and CRP >30 mg/L.…”

Section: Methodsmentioning

confidence: 99%

Impact of DMARD treatment and systemic inflammation on all-cause mortality in patients with rheumatoid arthritis and interstitial lung disease: a cohort study from the German RABBIT register

Rudi,

Zietemann,

Meissner

et al. 2024

RMD Open

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ObjectivesTo investigate the impact of disease activity and treatment with disease-modifying antirheumatic drugs (DMARDs) on all-cause mortality in patients with rheumatoid arthritis and prevalent interstitial lung disease (RA-ILD).MethodsPatients with RA-ILD were selected from the biologics register Rheumatoid Arthritis: Observation of Biologic Therapy (RABBIT). Using time-varying Cox regression, the association between clinical measures and mortality was investigated. The impact of DMARDs was analysed by (1) Cox regression considering cumulative exposure (ie, treatment months divided by total months) and (2) time-varying Cox regression as main approach (treatment exposures at monthly level).ResultsOut of 15 566 participants, 381 were identified as RA-ILD cases with 1258 person-years of observation and 2.6 years median length of follow-up. Ninety-seven patients (25.5%) died and 34 (35.1%) of these were not receiving DMARD therapy at the time of death. Higher inflammatory biomarkers but not swollen and tender joint count were significantly associated with mortality. Compared with tumour necrosis factor inhibitors (TNFi), non-TNFi biologic DMARDs (bDMARDs) exhibited adjusted HRs (aHRs) for mortality below 1, lacking statistical significance. This finding was stable in various sensitivity analyses. Joint aHR for non-TNFi biologics and JAKi versus TNFi was 0.56 (95% CI 0.33 to 0.97). Receiving no DMARD treatment was associated with a twofold higher mortality risk compared with receiving any DMARD treatment, aHR 2.03 (95% CI 1.23 to 3.35).ConclusionsInflammatory biomarkers and absence of DMARD treatment were associated with increased risk of mortality in patients with RA-ILD. Non-TNFi bDMARDs may confer enhanced therapeutic benefits in patients with RA-ILD.

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Section: Methodsmentioning

confidence: 99%

Impact of DMARD treatment and systemic inflammation on all-cause mortality in patients with rheumatoid arthritis and interstitial lung disease: a cohort study from the German RABBIT register

Rudi,

Zietemann,

Meissner

et al. 2024

RMD Open

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“…IMID treatment was subcategorised as anti-inflammatories and immunomodulators such as 5-aminosalicylic acid (5-ASA), sulfasalazine, hydroxychloroquine, glatiramer and interferon therapies; traditional immunosuppressants such as methotrexate, leflunomide, azathioprine and mycophenolate; biologic or advanced therapies such as antitumour necrosis factor (anti-TNF) agents, B cell-depleting agents, vedolizumab, fingolimod, anticytokine therapies, other biologics and Janus kinase inhibitors; and corticosteroids (online supplemental table 1). Self-reported IMID disease activity/status was assessed with disease-relevant validated measures (IA: Routine Assessment of Patient Index Data 3 and Rheumatoid Arthritis Flare Core domain indices; SARD: Systemic Lupus Activity Questionnaire; IBD: Inflammatory Bowel Symptoms Severity Index-Short Form and Manitoba IBD Flare Question; MS: self-report disease activity and Expanded Disability Status Scale) 16–20. These disease-related questionnaires were fully completed for IBD (248/255, 97% visits), IA (208/215, 97% visits), SARDs (239/260, 92% visits) and MS (291/327, 89% visits).…”

Section: Methodsmentioning

confidence: 99%

Immunogenicity and safety of mixed COVID-19 vaccine regimens in patients with immune-mediated inflammatory diseases: a single-centre prospective cohort study

et al. 2023

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ObjectiveAmong persons with immune-mediated inflammatory diseases (IMIDs) who received SARS-CoV-2 vaccines, we compared postvaccine antibody responses and IMID disease activity/states.DesignSingle-centre prospective cohort study.SettingSpecialty ambulatory clinics in central Canada.ParticipantsPeople with inflammatory arthritis (n=78; 77% rheumatoid arthritis), systemic autoimmune rheumatic diseases (n=84; 57% lupus), inflammatory bowel disease (n=93; 43% Crohn’s) and multiple sclerosis (n=72; 71% relapsing-remitting) (female 79.4%, white 84.7%, mean (SD) age 56.0 (14.3) years) received COVID-19 vaccinations between March 2021 and September 2022.Primary outcomePostvaccination anti-spike, anti-receptor binding domain (anti-RBD) and anti-nucleocapsid (anti-NC) IgG antibodies tested by multiplex immunoassays compared across vaccine regimens and with responses in 370 age-matched and sex-matched vaccinated controls.Secondary outcomesCOVID-19 infection and self-reported IMID disease activity/state.ResultsMost (216/327, 66.1%) received homologous messenger RNA (mRNA) (BNT162b2 or mRNA1273) vaccines, 2.4% received homologous ChAdOx1 and 30.6% received heterologous vaccines (23.9% ChAdOx1/mRNA, 6.4% heterologous mRNA) for their first two vaccines (V1, V2). Seroconversion rates were 52.0% (91/175) for post-V1 anti-spike and 58.9% (103/175) for anti-RBD; 91.5% (214/234) for post-V2 anti-spike and 90.2% (211/234) for anti-RBD; and were lower than controls (post-V2 anti-spike 98.1% (360/370), p<0.0001). Antibody titres decreased 3 months after V2 but increased 1 month after the third vaccine (V3) and 1 month after the fourth vaccine (V4) (BAU/mL median (IQR), anti-spike 1835 (2448) 1 month post-V2, 629.1 (883.4) 3 months post-V2, 4757.5 (7033.1) 1 month post-V3 and 4356.0 (9393.4) 1 month post-V4; anti-RBD 1686.8 (2199.44) 1 month post-V2, 555.8 (809.3) 3 months post-V2, 4280.3 (6380.6) 1 month post-V3 and 4792.2 (11 673.78) 1 month post-V4). If primed with a vector vaccine, an mRNA vaccine increased antibody titres to those comparable to homologous mRNA vaccines. Anti-RBD and anti-spike titres were higher in anti-NC seropositive (n=31; 25 participants) versus seronegative samples (BAU/mL median (IQR) anti-RBD 11 755.3 (20 373.1) vs 1248.0 (53 278.7); anti-spike 11 254.4 (15 352.6) vs 1313.1 (3106.6); both p<0.001). IMID disease activity/state and rates of self-reported moderate or severe IMID flare were similar across vaccinations.ConclusionHeterologous COVID-19 vaccination improves seroconversion rates following a vector vaccine and does not lead to IMID disease flare. IMIDs benefit from at least three vaccines.

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“…For classification, the patients with RA were subdivided into two groups: patients with RA in remission (disease activity score using 28 joint counts [DAS28] ≤2.6) and patients with active RA (DAS28 >2.6), and patients with active RA were further categorized into three types: patients with active RA with high (DAS28 >5.1), moderate (3.2 <DAS28 ≤5.1), or low (2.6 <DAS28 ≤3.2) disease activity. Classifications were based on the DAS28 score system, which were evaluated by a rheumatologist according to the following formula (24): DAS28 = 0.56 × sqrt(tender joint count) + 0.28 × sqrt(swollen joint count) + 0.36 × Ln(C‐reactive protein + 1) + 0.014 × visual analogue scale + 0.96, sqrt = square root. The clinical characteristics of all participants were collected and summarized in Supplementary Tables 1 and 2 (available on the Arthritis & Rheumatology website at https://doi.org/10.1002/art.42629).…”

Section: Methodsmentioning

confidence: 99%

METTL14‐Mediated m6A Modification of TNFAIP3 Involved in Inflammation in Patients With Active Rheumatoid Arthritis

Tang

Xia

et al. 2023

Arthritis & Rheumatology

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ObjectiveThe aim of the study was to investigate the role of N6‐Methyladenosine (m6A) modification in the progression of rheumatoid arthritis (RA).MethodsPeripheral blood mononuclear cells (PBMCs) from RA patients and healthy controls were collected. The expression of m6A‐modification related proteins and m6A levels were detected using PCR, western blot and m6A ELISA. The roles of methyltransferase‐like 14 (METTL14) in the regulation of inflammation in RA was explored using MeRIP‐sequencing and RNA immunoprecipitation assays. Collagen antibody‐induced arthritis (CAIA) mice were used as an in vivo model to study the role of METTL14 in the inflammation progression of RA.ResultsWe found that m6A writer METTL14 and m6A levels were decreased in PBMCs of active RA patients, and correlated negatively with the disease activity score using 28 joint counts (DAS28). Knockdown of METTL14 down‐regulated m6A, and promoted the secretion of inflammatory cytokines IL‐6 and IL‐17 in PBMCs of RA patients. Consistently, METTL14 knockdown promoted joint inflammation accompanied by upregulation of IL‐6 and IL‐17 in CAIA mice. MeRIP‐sequencing and functional studies confirmed that tumor necrosis factor alpha induced protein 3 (TNFAIP3), a key suppressor of NF‐κB inflammatory pathway, was involved in m6A‐regulated PBMCs. Mechanistic investigations revealed that m6A affected TNFAIP3 expression by regulation of mRNA stability and translocation in TNFAIP3 protein‐coding regions (CDS).ConclusionsOur study highlights the critical roles of m6A on regulation of inflammation in RA progression. Treatment strategies targeting m6A modification may represent a new option for management of RA.This article is protected by copyright. All rights reserved.image

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Measures of Rheumatoid Arthritis Disease Activity

Cited by 11 publications

References 136 publications

Impact of DMARD treatment and systemic inflammation on all-cause mortality in patients with rheumatoid arthritis and interstitial lung disease: a cohort study from the German RABBIT register

Impact of DMARD treatment and systemic inflammation on all-cause mortality in patients with rheumatoid arthritis and interstitial lung disease: a cohort study from the German RABBIT register

Immunogenicity and safety of mixed COVID-19 vaccine regimens in patients with immune-mediated inflammatory diseases: a single-centre prospective cohort study

METTL14‐Mediated m6A Modification of TNFAIP3 Involved in Inflammation in Patients With Active Rheumatoid Arthritis

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