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Alotaibi M, Coras R, Pappas DA, Kremer JM, Thiele G, Mikuls T, Jain M, Guma M. POS0506 DIFFERENT BIOACTIVE LIPID PROFILES PREDICT RESPONSE TO TNF OR IL6 INHIBITORS IN RHEUMATOID ARTHRITIS: RESULT OF THE CorEvitas CERTAIN COMPARATIVE EFFECTIVENESS STUDY. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.692] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BackgroundCirculating bioactive lipids can provide information about the pathogenesis of specific diseases and potentially help predict therapeutic response. Choosing the right biological therapy earlier in the course of rheumatoid arthritis (RA) could help reach the goal of remission.ObjectivesWe hypothesized that circulating bioactive lipids at baseline would identify specific metabolic profiles that predict patient response to therapy and define elements of metabolic pathobiology in arthritis.MethodsBioactive lipids were measured in plasma from two cohorts of RA patients from the CorEvitas (formerly known as Corrona) CERTAIN registry (1) at baseline prior to treatment with TNF inhibitors (all biologic naïve, N=102) or anti-IL6 (all previously exposed to biologics, N=114). Response to treatment was categorized by minimal clinically important difference (MCID) in Clinical Disease Activity Index (CDAI) (2) at 6 months after treatment initiation. Patients had to have a 6 month follow up visit and plasma available at both the baseline and the f/u time points. Liquid chromatography (LC) system coupled with high resolution QExactive orbitrap mass spectrometer (LC/MS) was used for bioactive lipids profiling. Around 300 spectral features were identified as potential oxylipins by searching against an in-house MS/MS library. Logistic regression analyses adjusted for gender, age and BMI was perfomed using R software.Results102 patients (average age 54, standard deviation [SD] 12.6, 82% female [83], average BMI 29.7, SD 6.7, average CDAI 27.1, SD 13.7) starting anti-TNF therapy and 114 patients (average age 57, SD 13, 90% female [102], average BMI 30.5, SD 7.4, average CDAI 28.7, SD 13.8) starting tocilizumab were analyzed. Twenty-five bioactive metabolites discriminated between RA patients classified as anti-TNF responders (R, n = 74) and non-responders (NR, n = 28). Among these, the anti-inflammatory oxylipin maresin 2 was higher in R while the pro-inflammatory oxylipins 15d PGJ2 and 5,6-diHETE were higher in NR. Twenty different metabolites discriminated anti-IL6 R (n=73) and NR (n=41) as shown in Figure 1. The anti-inflammatory oxylipin 14-15EET was higher in R while the pro-inflammatory oxylipins 16-HETE and 5S-HpETE were higher in NR.Figure 1.Volcano plots visualizing baseline metabolites associated with responders vs. non responders in a) anti-TNF and b) anti IL-6 therapy groups. Results are derived from multivariate logistic regression analysis of baseline metabolites and response to treatment categorized by MCID. Data plotted as the metabolite against its statistical significance, respectively reported as odds ratio (OR) and -log10(pvalue).ConclusionCirculating bioactive lipid analysis using LC/MS provided a rapid analysis of a wide range of metabolites and can be used to describe metabolic signatures that predict response to therapies. These results lay the groundwork for more deliberate investigations novel metabolic-based interventions to predict response to therapy and reduce arthritis morbidity.References[1]Pappas DA, Kremer JM, Reed G, Greenberg JD, Curtis JR. Design characteristics of the CORRONA CERTAIN study: a comparative effectiveness study of biologic agents for rheumatoid arthritis patients. BMC Musculoskeletal Disord 2014; 15: 113[2]Curtis JR, Yang S, Chen L, Pope JE, Keystone EC, Haraoui B, Boire G, Thorne JC, Tin D, Hitchon CA, Bingham CO 3rd, Bykerk VP. Determining the Minimally Important Difference in the Clinical Disease Activity Index for Improvement and Worsening in Early Rheumatoid Arthritis Patients. Arthritis Care Res (Hoboken). 2015 Oct;67(10):1345-53. doi: 10.1002/acr.22606. PMID: 25988705; PMCID: PMC4580563.Disclosure of InterestsMona Alotaibi: None declared, Roxana Coras: None declared, Dimitrios A Pappas Speakers bureau: Sanofi, Novartis, Paid instructor for: Novartis, Consultant of: Roche, Sanofi, Joel M Kremer Speakers bureau: Pfizer, Consultant of: BMS, Geoffrey Thiele: None declared, Ted Mikuls Consultant of: Pfizer, Gilead, BMS, Sanofi, Mohit Jain Employee of: Sapient Bio, Monica Guma Grant/research support from: Pfizer, Novartis.
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Kremer JM, Tundia N, McLean R, Blachley T, Maniccia A, Pappas DA. POS0435 CHARACTERISTICS AND 6-MONTH OUTCOMES AMONG REAL-WORLD PATIENTS WITH RHEUMATOID ARTHRITIS INITIATING UPADACITINIB: ANALYSIS FROM THE CORRONA REGISTRY. Ann Rheum Dis 2021. [DOI: 10.1136/annrheumdis-2021-eular.170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background:Upadacitinib (UPA) has demonstrated efficacy in randomized controlled trials1-3; however, few data are available from patients with rheumatoid arthritis (RA) who have been treated with UPA in real-world clinical practice.Objectives:Describe the characteristics and 6-month outcomes in patients with RA initiating UPA in a real-world setting.Methods:We identified adults with RA enrolled in the Corrona RA Registry through October 31, 2020 who initiated UPA during or after August 2019 and had a follow-up visit 6 (±3) months after initiation of UPA. Descriptive statistics were used to summarize characteristics in all patients initiating UPA who had a 6-month follow-up visit. Outcomes (CDAI, modified HAQ-DI, pain, and fatigue) were described at the 6-month visit for all UPA initiators regardless of UPA use at 6 months and for the subset of patients who continued UPA through the 6-month visit. Patients who discontinued UPA before the 6-month visit were considered non-responders for dichotomous variables and were assigned the value at the time of discontinuation for continuous variables. Mean change from baseline in continuous variables was analyzed with one-sample t tests or one-sample Wilcoxon rank sum tests. Minimum clinically important difference (MCID) in HAQ-DI is defined as an improvement of 0.22 units or more. MCID in CDAI is an improvement of at least 2, 7, and 13 units for patients in low, moderate and severe disease at initiation, respectively. MCID for 100-point VAS is an improvement of ≥10 points. Percentages of patients achieving MCID thresholds were calculated.Results:We identified 181 patients who initiated UPA and had a 6-month follow-up visit. Mean±SD age was 58.6±12.1 years, 81% were female. Patients had RA for a mean of 11.5±9.8 years. At UPA initiation, 45% of patients were on monotherapy. Prior use of one or more TNFi and JAKi was 79% and 52%, respectively. Seventy-two percent of patients (n=130) initiated UPA as the third or higher line of therapy. Mean CDAI was 18.7±11.6 and mean HAQ-DI was 1.1±0.8 at initiation. Based on CDAI (n=155), 29%, 52%, and 15% of patients had high, moderate, and low disease activity, respectively; 4.5% were in remission at initiation. At 6 months (n=158), 22%, 39%, and 28% had high, moderate, and low disease activity, respectively; 11% were in remission. Among 138 initiators with valid CDAI measures at initiation and 6 months, mean change in CDAI was –4.8±11.8, P<0.01. At 6 months, 46% (63/138) maintained and 39% (54/138) achieved improvement in any CDAI category. Improvements in other outcomes were significantly different from zero. Improvements >=MCID in CDAI, HAQ-DI, pain, and fatigue were achieved in 36–44% of UPA initiators. Improvements were similar, but larger in the subset of patients (n=122) who continued UPA through the 6-month visit (Table 1).Conclusion:Among patients in the Corrona RA Registry, UPA is frequently started in those who failed multiple previous therapies. UPA initiators responded to therapy in the first 6 months with improvements in several disease activity measures including CDAI and HAQ-DI, as well as patient-reported pain and fatigue.References:[1]Fleischmann R. Arthritis Rheumatol. 2019;71:1788–800.[2]Smolen JS. Lancet. 2019;393:2303–11.[3]Burmester GR. Lancet. 2018;382:2505–12.Outcomes at 6-month follow-upAll initiators(n=181)Subset remainingon UPA (n=122)nValueanValueaRemission (CDAI <2.8)15818 (11)10512 (11)Low (CDAI >=2.8 and <10)15844 (28)10538 (36)Moderate (CDAI >=10 and <22)15862 (39)10536 (34)High (CDAI >=22)15834 (22)10519 (18)Improvement in any CDAI category13854 (39)8940 (45)Maintenance of CDAI category13863 (46)10539 (44)Mean change in CDAI138–4.8±11.8*89–7.1±12.0* HAQ-DI154–0.1±0.5*101–0.2±0.5* Pain154–9.3±25.1*101–13.5±25.8* Fatigue153–7.6±27.3*100–12.5±27.5*MCID achievement in CDAI13857 (41)8943 (48) HAQ-DI15455 (36)10139 (39) Pain15468 (44)10153 (52) Fatigue15365 (42)10049 (49)aMean±SD or n (%).*P<0.01 for improvement significantly different from zero.Acknowledgements:This study was sponsored by Corrona, LLC. Corrona has been supported through contracted subscriptions in the last 2 years by AbbVie, Amgen, Boehringer Ingelheim, Bristol Myers Squibb, Celgene, Crescendo, Eli Lilly and Company, Genentech, Gilead, GSK, Janssen, Merck, Momenta Pharmaceuticals, Novartis, Pfizer, Regeneron, Roche, Sun, UCB, and Valeant. The design, study conduct, and financial support for the study were provided by AbbVie. AbbVie participated in the interpretation of data, review, and approval of the abstract. No honoraria or payments were made for authorship.Medical writing services were provided by Joann Hettasch of Fishawack Facilitate Ltd., part of Fishawack Health, and funded by AbbVie.Disclosure of Interests:Joel M Kremer Shareholder of: Corrona, Consultant of: AbbVie, Grant/research support from: AbbVie, Employee of: Corrona, Namita Tundia Shareholder of: AbbVie, Employee of: AbbVie, Robert McLean Employee of: Corrona, Taylor Blachley Employee of: Corrona, anna maniccia Shareholder of: AbbVie, Employee of: AbbVie, Dimitrios A Pappas Shareholder of: Corrona, Consultant of: AbbVie, Genentech, Novartis, Regeneron, and Roche Hellas, Employee of: Corrona
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Kremer JM, Winkler A, Anatale-Tardiff L, Mclean R, Shan Y, Moore P, Tundia N, Suboticki J, Tesser J. FRI0100 COMPARISON OF PATIENTS (PTS) WITH RHEUMATOID ARTHRITIS (RA) AMONG DISEASE ACTIVITY CATEGORIES AFTER 6 MONTHS OF TREATMENT WITH A TUMOUR NECROSIS FACTOR INHIBITOR (TNFI): RESULTS FROM THE CORRONA® RA REGISTRY. Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.1698] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background:Targeting remission (REM) or low disease activity (LDA) is a widely accepted treatment strategy for RA. However, there are limited data on the proportion of pts who achieve these targets, or remain in moderate (MDA) or high disease activity (HDA) following advanced therapy.Objectives:To estimate the proportion of RA pts in disease activity states (REM, LDA, MDA, and HDA) who were biologic-naïve at initiation and had continuous treatment with a TNFi for 6–12 months in the Corrona RA registry.Methods:Eligible pts were aged ≥18 years, biologic-naïve, initiated TNFi treatment between January 1, 2010 and July 31, 2019, and had continuous use of a TNFi for 6–12 months. Disease activity was defined based on Clinical Disease Activity Index (CDAI) at the visit closest to 6-month follow-up: REM, ≤2.8; LDA, >2.8–10; MDA, >10–22; and HDA, >22. Disease characteristics, disease activity measures, and pt-reported outcomes (PROs) were reported at TNFi initiation and at the 6-month follow-up visit.Results:2586 biologic-naïve pts who initiated a TNFi and had continuous use for 6–12 months were included. At TNFi initiation, 167 (6%) were in REM, 479 (19%) had LDA, 907 (35%) had MDA, and 1033 (40%) had HDA. After 6–12 months of treatment, 563 (21.8%) were in REM, 923 (35.7%) had LDA, 674 (26.1%) had MDA, and 426 (16.5%) had HDA. Pts with HDA/MDA at 6–12 months were more likely to have a history of hypertension (32.7% HDA; 34.0% MDA; vs 23.6% REM) and had higher mean body mass index (BMI) (30.9 HDA; 31.1 MDA; vs 29.0 REM) at baseline compared with pts in REM. Disease activity measures and PROs were worse in pts with MDA and HDA vs LDA and REM after 6–12 months (Table). Pt Global Assessment was higher than Physician Global Assessment across all groups.Conclusion:While 57.4% of pts who initiated a TNFi experienced a favorable outcome, >40% required additional or alternative intervention to achieve REM/LDA. Pts who remained in MDA/HDA continued to have an inadequate response to TNFi (as measured by disease activity measures and PROs) after 6–12 months of treatment compared with those who achieved REM/LDA.TableSummary of disease activity measures and PROs in previously biologic-naïve pts at the 6–12-month follow-up visit, stratified by disease activity category at the 6–12-month follow-up visitCharacteristics at 6–12 months, mean (standard deviation)Disease activity category at 6–12 monthsREM (n=563)LDA (n=923)MDA (n=674)HDA (n=426)CDAI1.2 (0.8)6.2 (2.1)15.4 (3.4)32.7 (9.2)Tender joint count (28)0.1 (0.3)1.0 (1.3)4.3 (3.3)13.4 (7.0)Swollen joint count (28)0.1 (0.3)1.1 (1.6)4.0 (3.6)9.1 (5.9)C-reactive protein6.4 (22.7)7.0 (10.6)11.1 (19.9)12.6 (22.1)Modified health assessment questionnaire0.1 (0.2)0.3 (0.4)0.5 (0.5)0.8 (0.5)Pt global assessment6.6 (6.8)28.6 (20.9)43.7 (25.7)58.0 (22.7)Physician global assessment3.6 (4.3)12.1 (10.4)27.4 (15.9)44.9 (19.8)Pt pain assessment8.7 (11.0)30.3 (23.5)46.1 (27.0)59.9 (24.4)Pt fatigue assessment15.7 (19.2)34.5 (26.6)48.3 (28.0)59.4 (27.5)Morning stiffness (min)16.5 (36.5)55.4 (146.3)96.9 (197.5)143.6 (260.0)Disclosure of Interests:Joel M Kremer Shareholder of: May own stocks and opinions, Grant/research support from: Research and consulting fees from AbbVie Inc., Consultant of: AbbVie, Amgen, BMS, Genentech, Inc., Gilead, GSK, Lilly, Pfizer, Regeneron and Sanofi, Employee of: Corrona, LLC employee, Anne Winkler Consultant of: AbbVie, Pfizer, and Novratis, Speakers bureau: AbbVie, Janssen, Sanofi, Genentech, Celgene, Eli Lilly, and Novartis., Laura Anatale-Tardiff Employee of: Corrona, LLC employee, Robert McLean Employee of: Corrona, LLC, Ying Shan Employee of: Corrona, LLC employee, Page Moore Employee of: Corrona, LLC employee, Namita Tundia Shareholder of: May own stocks and options, Employee of: AbbVie employee, Jessica Suboticki Shareholder of: AbbVie Inc., Employee of: AbbVie Inc., John Tesser Consultant of: Sanofi/Regeneron, Speakers bureau: Sanofi/Regeneron
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Pappas DA, Blachley T, Best JH, Zlotnick S, Emeanuru K, Kremer JM. FRI0104 PERSISTENCE OF TOCILIZUMAB THERAPY AMONG PATIENTS WITH RHEUMATOID ARTHRITIS: DATA FROM THE US-BASED CORRONA RHEUMATOID ARTHRITIS REGISTRY. Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.708] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Background:Understanding the persistence of biologic therapies and factors associated with discontinuation can help inform treatment decisions for patients with rheumatoid arthritis (RA).Objectives:To evaluate the persistence of tocilizumab (TCZ) therapy and identify factors associated with its discontinuation among US patients with RA in routine clinical practice.Methods:Eligible participants were TCZ-naïve patients enrolled in the Corrona RA registry who initiated TCZ after January 1, 2010 and had ≥ 1 follow-up visit. Persistence of therapy was defined as maintaining continuous TCZ treatment with no interruptions; patients were considered no longer persistent upon the first discontinuation of TCZ. Persistence was calculated using Kaplan-Meier survival analysis for the overall population; secondary analyses evaluated persistence excluding patients who stopped TCZ with no reported reason for discontinuation (patients with non-medical reasons for discontinuation [eg, insurance] were censored) and in only those patients who initiated intravenous (IV) TCZ. Cox proportional hazards modeling was used to identify factors associated with persistence.Results:A total of 1789 TCZ initiators were included; 81.0% were female, 85.0% were white and 75.4% were overweight or obese. The mean (SD) age was 58.5 (12.6) years and mean (SD) disease duration was 12.0 (9.6) years. Most patients (93.4%) had prior biologic use and 67.4% had received ≥ 2 prior biologics. Overall, 28.8% initiated TCZ as monotherapy. Among all TCZ initiators, the median (95% CI) duration of persistence was 20 (18 to 22) months (Fig 1). Factors associated with an increased hazard of TCZ discontinuation included smoking and higher baseline CDAI, whereas prior tumor necrosis factor inhibitor (TNFi) use was associated with a reduced hazard (Fig 2A). After excluding patients with no reported reason for discontinuation (remaining n = 1303), the median (95% CI) duration of persistence was 46 (38 to 55) months (Fig 1); smoking, use of 1 prior non-TNFi and higher baseline patient pain score were associated with an increased hazard of discontinuation (Fig 2B). Among the 1284 patients who initiated TCZ IV, median (95% CI) duration of persistence was 22 (19 to 25) months (Fig 1); smoking, lack of insurance and higher baseline patient fatigue score were associated with an increased hazard of discontinuation, whereas use of 1 prior TNFi was associated with a decreased hazard (Fig 2C).Conclusion:In this real-world population of US patients with RA, TCZ was most frequently initiated after an inadequate response to ≥ 2 biologics. Overall median duration of persistence was approximately 20 months and was higher (46 months) when patients with no reported reason for TCZ discontinuation were excluded. As expected, factors indicative of higher baseline disease activity were associated with shorter persistence.Acknowledgments:This study was sponsored by Corrona, LLC. Corrona is supported through contracted subscriptions with multiple pharmaceutical companies. The abstract was a collaborative effort between Corrona and Genentech, Inc., with financial support provided by Genentech, Inc.Disclosure of Interests:Dimitrios A Pappas: None declared, Taylor Blachley Employee of: Corrona, LLC, Jennie H. Best Shareholder of: Genentech, Inc., Employee of: Genentech, Inc., Steve Zlotnick Shareholder of: Genentech, Inc., Employee of: Genentech, Inc., Kelechi Emeanuru Employee of: Corrona, LLC – employment, Joel M Kremer Shareholder of: May own stocks and opinions, Grant/research support from: Research and consulting fees from AbbVie Inc., Consultant of: AbbVie, Amgen, BMS, Genentech, Inc., Gilead, GSK, Lilly, Pfizer, Regeneron and Sanofi, Employee of: Corrona, LLC employee
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Pappas DA, Blachley T, Zlotnick S, Best JH, Emeanuru K, Kremer JM. SAT0118 COMPARATIVE EFFECTIVENESS OF TOCILIZUMAB IN COMBINATION WITH METHOTREXATE VERSUS TUMOR NECROSIS FACTOR INHIBITORS (TNFIS) IN COMBINATION WITH METHOTREXATE IN PATIENTS WITH RHEUMATOID ARTHRITIS WITH PRIOR EXPOSURE TO TNFIS. Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.588] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background:Clinical studies have demonstrated the efficacy of tocilizumab (TCZ) administered with methotrexate (MTX) in improving rheumatoid arthritis (RA) disease activity in patients who have had an inadequate response to tumor necrosis factor inhibitors (TNFis).Objectives:To compare the effectiveness of TCZ + MTX with that of TNFis + MTX in patients with RA who had prior exposure to TNFis in routine clinical practice.Methods:Eligible participants were TCZ-naïve patients from the Corrona RA registry who initiated TCZ + MTX or a TNFi + MTX after January 1, 2010 and had a 6-month follow-up visit. Patients in both groups must have used ≥ 1 TNFi, had a Clinical Disease Activity Index (CDAI) score available at initiation (baseline) and 6 months and had a CDAI score > 10 at baseline. The primary outcome was mean change in CDAI from baseline to 6 months. Secondary outcomes included achievement of low disease activity (LDA; CDAI ≤ 10) and mean change in modified Health Assessment Questionnaire (mHAQ) at 6 months. Patients were grouped by baseline MTX dose (≤ 10 mg; > 10 to ≤ 15 mg; > 15 to ≤ 20 mg; > 20 mg); outcomes were compared between patients initiating TCZ and those initiating a TNFi overall and within each MTX dose group using propensity score (PS)-trimmed populations. As a sensitivity analysis, TCZ and TNFi initiators in each group were PS-matched 1:1 and outcomes were assessed in the matched populations. Linear and logistic regression models were estimated in the trimmed and matched populations, adjusting for covariates not balanced after PS trimming or matching, respectively.Results:A total of 415 TCZ + MTX initiators and 725 TNFi + MTX initiators met the inclusion criteria prior to PS trimming or matching. The overall trimmed population included 402 TCZ + MTX initiators and 703 TNFi + MTX initiators. In the trimmed population, patient demographics were generally comparable between TCZ + MTX and TNFi + MTX initiators; the mean age was 57.1 years in the TCZ + MTX group and 57.7 years in the TNFi + MTX group, the majority of patients in both groups were female (≥ 80%) and white (≥ 82%) and the mean duration of RA was 11.8 and 10.5 years in the TCZ + MTX and TNFi + MTX groups, respectively. Higher proportions of patients initiating TCZ had received ≥ 2 prior biologics (66.0% to 76.3%) compared with those initiating a TNFi (33.2% to 42.2%) across all MTX dose groups. Patients initiating TCZ had higher mean baseline CDAI scores (26.5 to 29.3) than those initiating a TNFi (24.7 to 27.5). Patients in both cohorts had improvements in CDAI and mHAQ scores and achieved LDA in similar proportions at 6 months regardless of baseline MTX dose (Fig 1). Results were comparable between TCZ and TNFi initiators across all MTX groups in the trimmed population after adjustment for potential confounding variables. Similar results were observed in the PS-matched cohorts.Conclusion:In this real-world population of US patients with RA who had prior TNFi exposure, there was no statistically significant or clinically meaningful difference in the effectiveness of therapy in patients who initiated TCZ + MTX compared with TNFi + MTX.Acknowledgments :This study was sponsored by Corrona, LLC. Corrona is supported through contracted subscriptions with multiple pharmaceutical companies. The abstract was a collaborative effort between Corrona and Genentech, Inc., with financial support provided by Genentech, Inc.Disclosure of Interests: :Dimitrios A Pappas: None declared, Taylor Blachley Employee of: Corrona, LLC, Steve Zlotnick Shareholder of: Genentech, Inc., Employee of: Genentech, Inc., Jennie H. Best Shareholder of: Genentech, Inc., Employee of: Genentech, Inc., Kelechi Emeanuru Employee of: Corrona, LLC – employment, Joel M Kremer Shareholder of: May own stocks and opinions, Grant/research support from: Research and consulting fees from AbbVie Inc., Consultant of: AbbVie, Amgen, BMS, Genentech, Inc., Gilead, GSK, Lilly, Pfizer, Regeneron and Sanofi, Employee of: Corrona, LLC employee
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de los Santos-Villalobos S, Kremer JM, Parra-Cota FI, Hayano-Kanashiro AC, García-Ortega LF, Gunturu SK, Tiedje JM, He SY, Peña-Cabriales JJ. Draft genome of the fungicidal biological control agent Burkholderia anthina strain XXVI. Arch Microbiol 2018; 200:803-810. [DOI: 10.1007/s00203-018-1490-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2017] [Revised: 01/30/2018] [Accepted: 02/01/2018] [Indexed: 01/12/2023]
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Ocon A, Peredo-Wende R, Kremer JM, Bhatt BD. Significant symptomatic improvement of subacute cutaneous lupus after testosterone therapy in a female-to-male transgender subject. Lupus 2017; 27:347-348. [PMID: 28992799 DOI: 10.1177/0961203317734921] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
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Kremer JM. Let's re-examine these MTX points once again. Ann Rheum Dis 2016; 75:e54. [DOI: 10.1136/annrheumdis-2016-209834] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2016] [Accepted: 05/14/2016] [Indexed: 11/03/2022]
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Solomon DH, Greenberg J, Kremer JM, Etzel CJ. Reply. Arthritis Rheumatol 2015; 67:3327-8. [DOI: 10.1002/art.39413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2015] [Accepted: 08/25/2015] [Indexed: 11/10/2022]
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Solomon DH, Reed GW, Kremer JM, Curtis JR, Farkouh ME, Harrold LR, Hochberg MC, Tsao P, Greenberg JD. Disease activity in rheumatoid arthritis and the risk of cardiovascular events. Arthritis Rheumatol 2015; 67:1449-55. [PMID: 25776112 DOI: 10.1002/art.39098] [Citation(s) in RCA: 203] [Impact Index Per Article: 22.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2014] [Accepted: 02/26/2015] [Indexed: 01/19/2023]
Abstract
OBJECTIVE Use of several immunomodulatory agents has been associated with reduced numbers of cardiovascular (CV) events in epidemiologic studies of rheumatoid arthritis (RA). However, it is unknown whether time-averaged disease activity in RA correlates with CV events. METHODS We studied patients with RA whose cases were followed in a longitudinal US-based registry. Time-averaged disease activity was assessed during followup using the area under the curve of the Clinical Disease Activity Index (CDAI), a validated measure of RA disease activity. Age, sex, presence of diabetes mellitus, hypertension, or hyperlipidemia, body mass index, family history of myocardial infarction (MI), use of aspirin or nonsteroidal antiinflammatory drugs (NSAIDs), presence of CV disease, and baseline use of an immunomodulator were assessed at baseline. Cox proportional hazards regression models were examined to determine the risk of a composite CV end point that included MI, stroke, and death from CV causes. RESULTS A total of 24,989 patients who had been followed up for a median of 2.7 years were included in these analyses. During followup, we observed 534 confirmed CV end points, for an incidence rate of 7.8 per 1,000 person-years (95% confidence interval [95% CI] 6.7-8.9). In models adjusted for variables noted above, a 10-point reduction in the time-averaged CDAI was associated with a 21% reduction in CV risk (95% CI 13-29). These results were robust in subgroup analyses stratified by the presence of CV disease, use of corticosteroids, use of NSAIDs or selective cyclooxygenase 2 inhibitors, and change in RA treatment, as well as when restricted to events adjudicated as definite or probable. CONCLUSION Our findings showed that reduced time-averaged disease activity in RA is associated with fewer CV events.
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Solomon DH, Greenberg J, Curtis JR, Liu M, Farkouh ME, Tsao P, Kremer JM, Etzel CJ. Derivation and Internal Validation of an Expanded Cardiovascular Risk Prediction Score for Rheumatoid Arthritis: A Consortium of Rheumatology Researchers of North America Registry Study. Arthritis Rheumatol 2015; 67:1995-2003. [DOI: 10.1002/art.39195] [Citation(s) in RCA: 97] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2014] [Accepted: 05/12/2015] [Indexed: 12/19/2022]
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Kremer JM, Robinson DR. Studies of dietary supplementation with omega 3 fatty acids in patients with rheumatoid arthritis. World Rev Nutr Diet 2015; 66:367-82. [PMID: 2053351 DOI: 10.1159/000419305] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
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Lillegraven S, Greenberg JD, Reed GW, Saunders K, Curtis JR, Harrold L, Hochberg MC, Pappas D, Kremer JM, Solomon DH. OP0161 Use of TNF Inhibitors is Associated with a Reduced Risk of Diabetes in RA Patients. Ann Rheum Dis 2014. [DOI: 10.1136/annrheumdis-2013-eular.366] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Strand V, Williams S, Miller PSJ, Saunders K, Grant S, Kremer JM. OP0064 Discontinuation of Biologic Therapy in Rheumatoid Arthritis (RA): Analysis from the Consortium of Rheumatology Researchers of North America (CORRONA) Database. Ann Rheum Dis 2014. [DOI: 10.1136/annrheumdis-2013-eular.269] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Kaushik P, Ghate K, Nourkeyhani H, Farber MG, Kremer JM. Pure ocular mucous membrane pemphigoid in a patient with axial spondyloarthritis (HLA-B27 positive). Rheumatology (Oxford) 2013; 52:2097-9. [DOI: 10.1093/rheumatology/ket157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Pappas DA, Lampl K, Kremer JM, Nyberg F, Gibofsky A, Ho M, Horne L, Saunders K, Onofrei AU, Greenberg JD. THU0138 The Corrona International Rheumatoid Arthritis Registry: Variations in Disease Activity and Management Across Participating Regions. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2013-eular.666] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Pritchard CH, Greenwald MW, Kremer JM, Gaylis NB, Zlotnick S, Chung C, Jaber B, Reiss W. AB0302 Results from the rate-ra study: a multicenter, open-label, single-arm study to evaluate the safety of administering rituximab at a more rapid infusion rate in patients with rheumatoid arthritis. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2013-eular.2624] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Mehta P, Holder S, Fisher B, Vincent T, Nadesalingam K, Maciver H, Shingler W, Bakshi J, Hassan S, D'Cruz D, Chan A, Litwic AE, McCrae F, Seth R, McCrae F, Nandagudi A, Jury E, Isenberg D, Karjigi U, Paul A, Rees F, O'Dowd E, Kinnear W, Johnson S, Lanyon P, Bakshi J, Stevens R, Narayan N, Marguerie C, Robinson H, Ffolkes L, Worsnop F, Ostlere L, Kiely P, Dharmapalaiah C, Hassan N, Nandagudi A, Bharadwaj A, Skibinska M, Gendi N, Davies EJ, Akil M, Kilding R, Ramachandran Nair J, Walsh M, Farrar W, Thompson RN, Borukhson L, McFadyen C, Singh D, Rajagopal V, Chan AML, Wearn Koh L, Christie JD, Croot L, Gayed M, Disney B, Singhal S, Grindulis K, Reynolds TD, Conway K, Williams D, Quin J, Dean G, Churchill D, Walker-Bone KE, Goff I, Reynolds G, Grove M, Patel P, Lazarus MN, Roncaroli F, Gabriel C, Kinderlerer AR, Nikiphorou E, Hall FC, Bruce E, Gray L, Krutikov M, Wig S, Bruce I, D'Agostino MA, Wakefield R, Berner Hammer H, Vittecoq O, Galeazzi M, Balint P, Filippucci E, Moller I, Iagnocco A, Naredo E, Ostergaard M, Gaillez C, Kerselaers W, Van Holder K, Le Bars M, Stone MA, Williams F, Wolber L, Karppinen J, Maatta J, Thompson B, Atchia I, Lorenzi A, Raftery G, Platt P, Platt PN, Pratt A, Turmezei TD, Treece GM, Gee AH, Poole KE, Chandratre PN, Roddy E, Clarson L, Richardson J, Hider S, Mallen C, Lieberman A, Prouse PJ, Mahendran P, Samarawickrama A, Churchill D, Walker-Bone KE, Ottery FD, Yood R, Wolfson M, Ang A, Riches P, Thomson J, Nuki G, Humphreys J, Verstappen SM, Chipping J, Hyrich K, Marshall T, Symmons DP, Roy M, Kirwan JR, Marshall RW, Matcham F, Scott IC, Rayner L, Hotopf M, Kingsley GH, Scott DL, Steer S, Ma MH, Dahanayake C, Scott IC, Kingsley G, Cope A, Scott DL, Dahanayake C, Ma MH, Scott IC, Kingsley GH, Cope A, Scott DL, Wernham A, Ward L, Carruthers D, Deeming A, Buckley C, Raza K, De Pablo P, Nikiphorou E, Carpenter L, Jayakumar K, Solymossy C, Dixey J, Young A, Singh A, Penn H, Ellerby N, Mattey DL, Packham J, Dawes P, Hider SL, Ng N, Humby F, Bombardieri M, Kelly S, Di Cicco M, Dadoun S, Hands R, Rocher V, Kidd B, Pyne D, Pitzalis C, Poore S, Hutchinson D, Low A, Lunt M, Mercer L, Galloway J, Davies R, Watson K, Dixon W, Symmons D, Hyrich K, Mercer L, Lunt M, Low A, Galloway J, Watson KD, Dixon WG, Symmons D, Hyrich KL, Low A, Lunt M, Mercer L, Bruce E, Dixon W, Hyrich K, Symmons D, Malik SP, Kelly C, Hamilton J, Heycock C, Saravanan V, Rynne M, Harris HE, Tweedie F, Skaparis Y, White M, Scott N, Samson K, Mercieca C, Clarke S, Warner AJ, Humphreys J, Lunt M, Marshall T, Symmons D, Verstappen S, Chan E, Kelly C, Woodhead FA, Nisar M, Arthanari S, Dawson J, Sathi N, Ahmad Y, Koduri G, Young A, Kelly C, Chan E, Ahmad Y, Woodhead FA, Nisar M, Arthanari S, Dawson J, Sathi N, Koduri G, Young A, Cumming J, Stannett P, Hull R, Metsios G, Stavropoulos Kalinoglou A, Veldhuijzen van Zanten JJ, Nightingale P, Koutedakis Y, Kitas GD, Nikiphorou E, Dixey J, Williams P, Kiely P, Walsh D, Carpenter L, Young A, Perry E, Kelly C, de-Soyza A, Moullaali T, Eggleton P, Hutchinson D, Veldhuijzen van Zanten JJ, Metsios G, Stavropoulos-Kalinoglou A, Sandoo A, Kitas GD, de Pablo P, Maggs F, Carruthers D, Faizal A, Pugh M, Jobanputra P, Kehoe O, Cartwright A, Askari A, El Haj A, Middleton J, Aynsley S, Hardy J, Veale D, Fearon U, Wilson G, Muthana M, Fossati G, Healy L, Nesbitt A, Becerra E, Leandro MJ, De La Torre I, Cambridge G, Nelson PN, Roden D, Shaw M, Davari Ejtehadi H, Nevill A, Freimanis G, Hooley P, Bowman S, Alavi A, Axford J, Veitch AM, Tugnet N, Rylance PB, Hawtree S, Muthana M, Aynsley S, Mark Wilkinson J, Wilson AG, Woon Kam N, Filter A, Buckley C, Pitzalis C, Bombardieri M, Croft AP, Naylor A, Zimmermann B, Hardie D, Desanti G, Jaurez M, Muller-Ladner U, Filer A, Neumann E, Buckley C, Movahedi M, Lunt M, Ray DW, Dixon WG, Burmester GR, Matucci-Cerinic M, Navarro-Blasco F, Kary S, Unnebrink K, Kupper H, Mukherjee S, Cornell P, Richards S, Rahmeh F, Thompson PW, Westlake SL, Javaid MK, Batra R, Chana J, Round G, Judge A, Taylor P, Patel S, Cooper C, Ravindran V, Bingham CO, Weinblatt ME, Mendelsohn A, Kim L, Mack M, Lu J, Baker D, Westhovens R, Hewitt J, Han C, Keystone EC, Fleischmann R, Smolen J, Emery P, Genovese M, Doyle M, Hsia EC, Hart JC, Lazarus MN, Kinderlerer AR, Harland D, Gibbons C, Pang H, Huertas C, Diamantopoulos A, Dejonckheere F, Clowse M, Wolf D, Stach C, Kosutic G, Williams S, Terpstra I, Mahadevan U, Smolen J, Emery P, Ferraccioli G, Samborski W, Berenbaum F, Davies O, Koetse W, Bennett B, Burkhardt H, Weinblatt ME, Fleischmann R, Davies O, Luijtens K, van der Heijde D, Mariette X, van Vollenhoven RF, Bykerk V, de Longueville M, Arendt C, Luijtens K, Cush J, Khan A, Maclaren Z, Dubash S, Chalam VC, Sheeran T, Price T, Baskar S, Mulherin D, Molloy C, Keay F, Heritage C, Douglas B, Fleischmann R, Weinblatt ME, Schiff MH, Khanna D, Furst DE, Maldonado MA, Li W, Sasso EH, Emerling D, Cavet G, Ford K, Mackenzie-Green B, Collins D, Price E, Williamson L, Golla J, Vagadia V, Morrison E, Tierney A, Wilson H, Hunter J, Ma MH, Scott DL, Reddy V, Moore S, Ehrenstein M, Benson C, Wray M, Cairns A, Wright G, Pendleton A, McHenry M, Taggart A, Bell A, Bosworth A, Cox M, Johnston G, Shah P, O'Brien A, Jones P, Sargeant I, Bukhari M, Nusslein H, Alten R, Galeazzi M, Lorenz HM, Boumpas D, Nurmohamed MT, Bensen W, Burmester GR, Peter HH, Rainer F, Pavelka K, Chartier M, Poncet C, Rauch C, Le Bars M, Lempp H, Hofmann D, Adu A, Congreve C, Dobson J, Rose D, Simpson C, Wykes T, Cope A, Scott DL, Ibrahim F, Schiff M, Alten R, Weinblatt ME, Nash P, Fleischmann R, Durez P, Kaine J, Delaet I, Kelly S, Maldonado M, Patel S, Genovese M, Jones G, Sebba A, Lepley D, Devenport J, Bernasconi C, Smart D, Mpofu C, Gomez-Reino JJ, Verma I, Kaur J, Syngle A, Krishan P, Vohra K, Kaur L, Garg N, Chhabara M, Gibson K, Woodburn J, Telfer S, Buckley F, Finckh A, Huizinga TW, Dejonckheere F, Jansen JP, Genovese M, Sebba A, Rubbert-Roth A, Scali JJ, Alten R, Kremer JM, Pitts L, Vernon E, van Vollenhoven RF, Sharif MI, Das S, Emery P, Maciver H, Shingler W, Helliwell P, Sokoll K, Vital EM. Case Reports * 1. A Late Presentation of Loeys-Dietz Syndrome: Beware of TGF Receptor Mutations in Benign Joint Hypermobility. Rheumatology (Oxford) 2013. [DOI: 10.1093/rheumatology/ket197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Yazici Y, Moniz Reed D, Klem C, Rosenblatt L, Wu G, Kremer JM. Greater remission rates in patients with early versus long-standing disease in biologic-naive rheumatoid arthritis patients treated with abatacept: a post hoc analysis of randomized clinical trial data. Clin Exp Rheumatol 2011; 29:494-499. [PMID: 21722499] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2010] [Accepted: 01/26/2011] [Indexed: 05/31/2023]
Abstract
OBJECTIVES Current aim of rheumatoid arthritis (RA) treatment is to achieve remission in as many patients as possible. Rates of remission and clinical outcomes after treatment with abatacept in biologic-naive rheumatoid arthritis (RA) patients with early disease and an inadequate response to methotrexate (MTX) versus patients with ≥ 10 years of disease were assessed. METHODS Data from two trials assessing the efficacy of abatacept in MTX inadequate responders were pooled for this exploratory post hoc analysis. Patients with disease duration of ≤ 2 years at baseline (early disease), originally assigned to an abatacept approximately 10 mg/kg treatment arm and entered into a long-term extension (LTE), were compared with patients with ≥ 10 years of disease (long-standing RA). Remission, DAS28-CRP, ACR 70 responses and the Routine Assessment of Patient Index Data 3 (RAPID3), improvement in physical function as measured by the Health Assessment Questionnaire Disability Index (HAQ-DI). RESULTS Twenty-three percent of these patients (n=108) had early disease. A higher percentage of patients with early disease achieved DAS28-CRP remission versus patients with long-standing disease (35.2% vs. 19.4% at year 1, p<0.01; 46.0% vs. 30.9% at year 3, p<0.05). In addition, a higher percentage of the subgroup with early RA achieved ACR70 responses. More patients with early RA had a meaningful improvement in their HAQ-DI (75.2% vs. 60.4%; p<0.05) and RAPID3 scores at one year (mean changes from baseline of -9.6 vs. -8.1; p=0.009). CONCLUSIONS These data provide additional support for the possible use of abatacept in biologic-naive patients who have had inadequate response to MTX, earlier in their disease course.
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Nishikawa M, Owaki H, Fuji T, Soliman MM, Ashcroft DM, Watson KD, Lunt M, Symmons D, Hyrich KL, Atkinson F, Malik S, Heycock C, Saravanan V, Rynne M, Hamilton J, Kelly C, Burmester G, Kary S, Unnebrink K, Guerette B, Oezer U, Kupper H, Dennison E, Jameson K, Hyrich K, Watson K, Landewe R, Keystone E, Smolen J, Goldring M, Guerette B, Patra K, Cifaldi M, van der Heijde D, Lloyd LA, Owen C, Breslin A, Ahmad Y, Emery P, Matteson EL, Genovese M, Sague S, Hsia EC, Doyle MK, Fan H, Elashoff M, Kirkham B, Wasco MC, Bathon J, Hsia EC, Fleischmann R, Genovese MC, Matteson EL, Liu H, Fleischmann R, Goldman J, Leirisalo-Repo M, Zanetakis E, El-Kadi H, Kellner H, Bolce R, Wang J, Dehoratius R, Decktor D, Kremer J, Taylor P, Mendelsohn A, Baker D, Kim L, Ritchlin C, Taylor P, Mariette X, Matucci Cerenic M, Pavelka K, van Vollenhoven R, Heatley R, Walsh C, Lawson R, Reynolds A, Emery P, Iaremenko O, Mikitenko G, Smolen J, van Vollenhoven R, Kavanaugh A, Luijtens K, van der Heijde D, Curtis J, van der Heijde D, Schiff M, Keystone E, Landewe R, Kvien T, Curtis J, Khanna D, Luijtens K, Furst D, Behrens F, Koehm M, Scharbatke EC, Kleinert S, Weyer G, Tony HP, Burkhardt H, Blunn KJ, Williams RB, Young A, McDowell J, Keystone E, Weinblatt M, Haraoui B, Guerette B, Mozaffarian N, Patra K, Kavanaugh A, Khraishi M, Alten R, Gomez-Reino J, Rizzo W, Schechtman J, Kahan A, Vernon E, Taylor M, Smolen J, Hogan V, Holweg C, Kummerfeld S, Teng O, Townsend M, van Laar JM, Gullick NJ, De Silva C, Kirkham BW, van der Heijde D, Landewe R, Guerette B, Roy S, Patra K, Keystone E, Emery P, Fleischmann R, van der Heijde D, Keystone E, Genovese MC, Conaghan PG, Hsia EC, Xu W, Baratelle A, Beutler A, Rahman MU, Nikiphorou E, Kiely P, Walsh DA, Williams R, Young A, Shah D, Knight GD, Hutchinson DG, Dass S, Atzeni F, Vital EM, Bingham SJ, Buch M, Beirne P, Emery P, Keystone E, Fleischmann R, Emery P, Dougados M, Williams S, Reynard M, Blackler L, Gullick NJ, Zain A, Oakley S, Rees J, Jones T, Mistlin A, Panayi G, Kirkham BW, Westhovens R, Durez P, Genant H, Robles M, Becker JC, Covucci A, Bathon J, Genovese MC, Schiff M, Luggen M, Le Bars M, Becker JC, Aranda R, Li T, Elegbe A, Dougados M, Smolen J, van Vollenhoven R, Kavanaugh A, Fichtner A, Strand V, Vencovsky J, van der Heijde D, Davies R, Galloway J, Watson KD, Lunt M, Hochberg M, Westhovens R, Aranda R, Kelly S, Khan N, Qi K, Pappu R, Delaet I, Luo A, Torbeyns A, Moreland L, Cohen R, Gujrathi S, Weinblatt M, Bykerk VP, Alvaro-Gracia J, Andres Roman Ivorra J, Nurmohamed MT, Pavelka K, Bernasconi C, Stancati A, Sibilia J, Ostor A, Strangfeld A, Eveslage M, Listing J, Herzer P, Liebhaber A, Krummel-Lorenz B, Zink A, Haraoui B, Emery P, Mozaffarian N, Guerette B, Kupper H, Patra K, Keystone E, Genovese MC, Breedveld FC, Emery P, Cohen SB, Keystone E, Matteson EL, Burke L, Chai A, Reiss W, Sweetser M, Shaw T, Ellis SD, Ehrenstein MR, Notley CA, Yazici Y, Curtis J, Ince A, Baraf H, Malamet R, Chung CY, Kavanaugh A, Hughes C, Faurholm B, Dell'Accio F, Manzo A, Seed M, Eltawil N, Marrelli A, Gould D, Subang C, Al-Kashi A, De Bari C, Winyard P, Chernajovsky Y, Nissim A, van Vollenhoven R, Emery P, Bingham C, Keystone E, Fleischmann RM, Furst DE, Macey KM, Sweetser MT, Lehane P, Farmer P, Long SG, Kremer JM, Furst DE, Burgos-Vargas R, Dudler J, Mela CM, Vernon E, Fleischmann RM, Wegner N, Lugli H, Quirke AM, Guo Y, Potempa J, Venables P. Rheumatoid arthritis - treatment: 180. Utility of Body Weight Classified Low-Dose Leflunomide in Japanese Rheumatoid Arthritis. Rheumatology (Oxford) 2011. [DOI: 10.1093/rheumatology/ker031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Lloyd M, Makadsi R, Ala A, Connor P, Gwynne C, Rhys Dillon B, Lawson T, Emery P, Mease PJ, Rubbert-Roth A, Curtis JR, Muller-Ladner U, Gaylis N, Armstrong GK, Reynard M, Tyrrell H, Joshi N, Loke Y, MacGregor A, Malaiya R, Rachapalli SM, Parton T, King L, Parker G, Nesbitt A, Schiff M, Sheikzadeh A, Formosa D, Domanska B, Morgan D, van Vollenhoven R, Cifaldi M, Roy S, Chen N, Gotlieb L, Malaise M, Langtree M, Lam M, Malipeddi A, Hassan W, El Miedany Y, El Gaafary M, Palmer D, Dutta S, Breslin A, Ahmad Y, Morcos PN, Zhang X, Grange S, Schmitt C, Malipeddi AS, Neame R, Isaacs JD, Olech E, Tak PP, Deodhar A, Keystone E, Emery P, Yocum D, Hessey E, Read S, Blunn KJ, Williams RB, McDowell JA, Rees DH, Young A, Marks JL, Westlake SL, Baird J, Kiely PD, Ostor AJ, Quinn MA, Taylor PC, Edwards CJ, Vagadia V, Bracewell C, McKay N, Collini A, Kidd E, Wright D, Watson K, Williams E, Mossadegh S, Ledingham J, Combe B, Schwartzman S, Massarotti E, Keystone EC, Luijtens K, van der Heijde D, Mariette X, Kivitz A, Isaacs JD, Stohl W, Tak PP, Jones R, Jahreis A, Armstrong G, Shaw T, Westhovens R, Strand V, Keystone EC, Purcaru O, Khanna D, Smolen J, Kavanaugh A, Keystone EC, Fleischmann RM, Emery P, Dougados M, Baldassare AR, Armstrong GK, Linnik M, Reynard M, Tyrrell H, McInnes IB, Combe B, Burmester G, Schiff M, Keiserman M, Codding C, Songcharoen S, Berman A, Nayiager S, Saldate C, Aranda R, Becker JC, Zhao C, Le Bars M, Dougados M, Burmester GR, Kary S, Unnebrink K, Guerette B, Oezer U, Kupper H, Dougados M, Keystone EC, Guerette B, Patra K, Lavie F, Gasparyan AY, Sandoo A, Stavropoulos-Kalinoglou A, Kitas GD, Dubash SR, Linton S, Emery P, Genovese MC, Fleischmann RM, Matteson EL, Hsia EC, Xu S, Doyle MK, Rahman MU, Keystone E, Curtis J, Fleischmann R, Mease P, Khanna D, Smolen J, Coteur G, Combe B, van Vollenhoven R, Smolen J, Schiff M, Fleischmann R, Combe B, Goel N, Desai C, Curtis J, Keystone E, Emery P, Choy E, Van Vollenhoven R, Keystone E, Furie R, Blesch A, Wang CD, Curtis JR, Hughes LD, Young A, Done DJ, Treharne G, van Vollenhoven RF, Emery P, Bingham CO, Keystone EC, Fleischmann RM, Furst DE, Macey K, Sweetster MT, Lehane PB, Farmer P, Long SG, Kremer JM, Russell AS, Emery P, Abud-Mendoza C, Szechinski J, Becker JC, Wu G, Westhovens R, Keystone EC, Kavanaugh A, van der Heijde D, Sinisi S, Guerette B, Keystone EC, Fleischmann R, Smolen J, Strand V, Landewe R, Combe B, Mease P, Ansari Z, Goel N, van der Heijde D, Emery P, Alavi A, Fitzgerald O, Collins ES, Fraser O, Tarelli E, Ng VC, Breshnihan B, Veale DJ, Axford JS, Aletaha D, Alasti F, Smolen JS, Keystone EC, Schiff MH, Rovensky J, Taylor M, John AK, Balbir-Gurman A, Hughes LD, Young A, John Done D, Treharne GJ, Ezard C, Willott R, Butt S, Gadsby K, Deighton C, Tsuru T, Terao K, Suzaki M, Nakashima H, Akiyama A, Nishimoto N, Smolen J, Wordsworth P, Doyle MK, Kay J, Matteson EL, Landewe R, Hsia E, Zhou Y, Rahman MU, Van Vollenhoven R, Siri D, Furie R, Krasnow J, Alecock E, Alten R, Nishimoto N, Kawata Y, Aoki C, Mima T, van Vollenhoven RF, Nishimoto N, Yamanaka H, Woodworth T, Schiff MH, Taylor A, Pope JE, Genovese MC, Rubbert A, Keystone EC, Hsia EC, Buchanan J, Klareskog L, Murphy FT, Wu Z, Parasuraman S, Rahman MU, Kay J, Wordsworth P, Doyle MK, Smolen J, Buchanan J, Matteson EL, Hsia EC, Landewe R, Zhou Y, Shreekant P, Rahman MU, Smolen JS, Gomez-Reino JJ, Davies C, Alecock E, Rubbert-Roth A, Emery P. Rheumatoid Arthritis: Treatment [151-201]: 151. Should we be Looking More Carefully for Methotrexate Induced Liver Disease? Rheumatology (Oxford) 2010. [DOI: 10.1093/rheumatology/keq725] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Curtis JR, Beukelman T, Onofrei A, Cassell S, Greenberg JD, Kavanaugh A, Reed G, Strand V, Kremer JM. Elevated liver enzyme tests among patients with rheumatoid arthritis or psoriatic arthritis treated with methotrexate and/or leflunomide. Ann Rheum Dis 2010; 69:43-7. [PMID: 19147616 PMCID: PMC2794929 DOI: 10.1136/ard.2008.101378] [Citation(s) in RCA: 151] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
INTRODUCTION Potential hepatotoxicity associated with disease-modifying antirheumatic drugs (DMARDs) requires laboratory monitoring. In patients with rheumatoid arthritis (RA) or psoriatic arthritis (PsA), the incidence of elevated alanine aminotransferase/aspartate aminotransferase (ALT/AST) enzymes associated with methotrexate (MTX), leflunomide (LEF) and MTX+LEF versus other DMARDs was examined. METHODS Patients with RA and PsA enrolled in the Consortium of Rheumatology Researchers of North America (CORRONA) initiating DMARDs were identified. Abnormalities were identified when either was 1- or 2-fold times above the upper limits of normal (ULN). Odds ratios (OR) between MTX/LEF dose and elevated ALT/AST enzymes were estimated using generalised estimating equations. Interaction terms for use of MTX+LEF quantified the incremental risk of the combination compared with each individually. RESULTS Elevated ALT/AST levels (>1x ULN) occurred in 22%, 17%, 31% and 14% of patients with RA receiving MTX, LEF, MTX+LEF or neither, respectively; elevations were 2.76-fold (95% CI 1.84 to 4.15) more likely in patients with PsA. Elevations >2x ULN occurred in 1-2% of patients on MTX or LEF monotherapy compared with 5% with the combination. After multivariable adjustment and compared with either monotherapy, the combination of MTX and LEF was associated with a greater risk according to MTX dose used as part of the combination: MTX 10-17.5 mg/week, OR 2.91 (95% CI 1.23 to 6.90); MTX > or =20 mg/week, OR 3.98 (95% CI 1.72 to 9.24). CONCLUSIONS Abnormal ALT/AST levels developed in 14-35% of patients with RA or PsA initiating DMARD therapy. The risks were incrementally greater in those with PsA and in those receiving MTX (> or =10 mg/day) + LEF. These findings should help inform monitoring for potential hepatotoxicity in these patient populations.
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Macaraeg G, Kremer JM, Russell AS, Emery P, Abud-Mendoza C, Szechinski J, Becker JC, Wu G, Westhovens R. P32 Abatacept demonstrates consistent safety and sustained improvements in efficacy through 5 years of treatment in biologic-naïve patients with RA. INDIAN JOURNAL OF RHEUMATOLOGY 2009. [DOI: 10.1016/s0973-3698(09)60050-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Coombs JH, Bloom BJ, Breedveld FC, Fletcher MP, Gruben D, Kremer JM, Burgos-Vargas R, Wilkinson B, Zerbini CAF, Zwillich SH. Improved pain, physical functioning and health status in patients with rheumatoid arthritis treated with CP-690,550, an orally active Janus kinase (JAK) inhibitor: results from a randomised, double-blind, placebo-controlled trial. Ann Rheum Dis 2009; 69:413-6. [PMID: 19587388 DOI: 10.1136/ard.2009.108159] [Citation(s) in RCA: 108] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
OBJECTIVES To determine the efficacy of CP-690,550 in improving pain, function and health status in patients with moderate to severe active rheumatoid arthritis (RA) and an inadequate response to methotrexate or a tumour necrosis factor alpha inhibitor. METHODS Patients were randomised equally to placebo, CP-690,550 5, 15 or 30 mg twice daily for 6 weeks, with 6 weeks' follow-up. The patient's assessment of arthritis pain (pain), patient's assessment of disease activity, Health Assessment Questionnaire-Disability Index (HAQ-DI) and Short Form-36 (SF-36) were recorded. RESULTS At week 6, significantly more patients in the CP-690,550 5, 15 and 30 mg twice-daily groups experienced a 50% improvement in pain compared with placebo (44%, 66%, 78% and 14%, respectively), clinically meaningful reductions in HAQ-DI (> or =0.3 units) (57%, 75%, 76% and 36%, respectively) and clinically meaningful improvements in SF-36 domains and physical and mental components. CONCLUSIONS CP-690,550 was efficacious in improving the pain, function and health status of patients with RA, from week 1 to week 6.
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