Oh LJ et al. Intern Med J 2018; 48: 408–413. doi: 10.1111/imj.13713

Researchers have validated a blood test involving B-cell receptor clones that could determine which healthy individuals at risk for rheumatoid arthritis are likely to develop the condition in the short term.

MetS was defined by the presence of three or more of its components, which comprise abdominal obesity (waist circumference ≥90 cm); elevated triglyceride levels (≥150 mg/dL); reduced high-density lipoprotein cholesterol (<40 mg/dL); elevated blood pressure (BP; systolic BP ≥130 mmHg and/or diastolic BP ≥85 mmHg); and elevated fasting glucose (≥100 mg/dL).

They say that IFN-γ levels measured in the blood at baseline were significantly higher among people who developed GCA relative to 97 matched controls, at 7.27 versus 7.07 units, giving an odds ratio (OR) of 1.52 per standard deviation increase.

We used machine learning (ML) methods to construct diagnostic models based on blood routine examination, liver function test, and kidney function test of patients with AS.

And in two MIS-C patients with follow-up blood samples, “we observed the disappearance of hyperphosphorylated IL-1Ra, which preceded the disappearance of anti-IL-1Ra antibodies,” say Thurner and team.

“Importantly, no unexpected safety signals occurred for this IL-6 targeted therapy also with respect to changes in blood cell counts, increase of liver enzymes, and lipid levels over the entire observational period,” said Feist.

An S1P gradient (low in tissues, high in blood), maintained by synthetic and degradative enzymes, regulates lymphocyte trafficking.

Overall rates of AEs, serious AEs, and AEs leading to treatment discontinuation in SELECT-PsA 2 Most frequent AEs The most commonly reported treatment-emergent AEs occurring in at least 5% of patients in either upadacitinib group were: upper respiratory tract infection; nasopharyngitis; bronchitis; urinary tract infection; influenza; diarrhea; nausea; and increase in blood creatine phosphokinase levels.

After adjusting for age, sex, obesity, high blood pressure, no glucosamine/chondroitin supplements, and baseline structural disease severity, the researchers found that people who used NSAIDs at baseline were a significant 2.05 times more likely to experience radiographic progression than those who did not.

Carriers of the LARRC55  rs717117G allele had decreased interleukin (IL)-6 production after stimulation of peripheral blood mononuclear cells with Borrelia burgdorferi and Escherichia coli bacteria, which the researchers indicate could suggest impaired IL-6-mediated anti-inflammatory effects.

In total, 93% of FMT and 88% of sham transplantation patients had an AE, with nausea (60 vs 44%), reflux (53 vs 50%), high white blood cell count (>8.80×10 9 /L; 33 vs 38%), and vomiting (40 vs 6%) the most common AEs associated with FMT.

The investigators say that future studies should “test the differentially expressed transcripts identified herein against different drugs in order to elucidate whether they are general markers of response or specific to this class of drug.”

For instance, at the time of writing EULAR recommends that consultations can take place remotely and blood monitoring can be postponed temporarily, provided that the RMD and treatment are stable and there are no signs or symptoms of drug toxicity.

The researchers also looked at the potential for immunogenicity based on lab tests, so see whether “the immune system is changing in a way that suggests people are probably protected,” Curtis explained.

As planned, after a positive pregnancy test, she stopped ramipril and started enoxaparin 4000 IU/day.

Alexis Mathian (University Hospital Pitié Salpêtrière, Paris) and co-authors say that the median duration of hydroxychloroquine treatment was 7.5 years, and the median blood concentration was 648 ng/mL in the eight patients with available measurements.

I undertake routine blood monitoring tests in exactly the same way as for patients taking methotrexate and, in addition, I check fasting blood lipids after 12 weeks of treatment with a JAK inhibitor.

The researchers highlight in ACR Open Rheumatology that their “findings may lead to [the selection of] those patients at higher risk who do not systematically undergo CV assessment and/or echocardiographic examination due to their asymptomatic condition and, often, normal blood pressure values.”

The authors defined the ideal pathway as according to the presence of three indicators: diagnosis with laboratory blood tests, musculoskeletal imaging, and tests for antiphospholipid, extractable nuclear antigen, and antinuclear antibodies; treatment based on no exposure or wash-out from methotrexate and leflunomide, and no exposure to biologic drugs from conception to delivery; and  prenatal follow-up with at least one visit to a rheumatologist.