“[P]harmacokinetic results suggest that elsubrutinib achieved adequate target engagement with no exposure-dependent increases in efficacy response rates,” indicating that “the absence of clinical effects with elsubrutinib alone was likely not caused by inadequate exposure or BTK target engagement,” they add.

A monthly selection of topical peer-reviewed articles from the Adis journals, curated by the editors.

How can rheumatologists respond to the challenges associated with rituximab use during the pandemic?

The study advances knowledge of the features to be addressed and included in patient decision aids to enhance engagement, acceptability, and relevance for Indigenous patients.

3–9 November: Keep up with the latest news and interviews from the conference.

Perspective on the approval of anifrolumab and the importance of endpoints in lupus trials.

5 – 9 November: Preview the conference with session recommendations and updates on upcoming coverage.

How will the FAST trial results impact regulatory guidance & clinical practice?

The researchers say that “factors associated with the superiority of the internet-based program vs self-management in this study are not clear,” and speculate that “daily delivery of individualized treatment, together with support, engagement, and nudging from health care professionals, may have played a role.” medwireNews is an independent medical news service provided by Springer Healthcare Ltd. © 2021 Springer Healthcare Ltd, part of the Springer Nature Group JAMA Netw Open 2021; 4 : e210012

Experts discuss the increasing use of telemedicine in rheumatology during the COVID-19 pandemic.

McKernan LC et al. Arthritis Care Res 2018. doi: 10.1002/acr.23748

They acknowledge that the improvements in WOMAC score seen in the trial were “on the lower end of clinically relevant improvement for WOMAC scores,” and suggest that limited engagement with the intervention may have reduced its impact.

However, questionnaires completed remotely online necessitate patient engagement in care, which may lessen over time.

Genovese and team report that average serum concentrations of otilimab–GM-CSF complex – indicating target engagement – increased weekly to a maximum of 138.4 ng/L at week 4 but subsequently decreased during fortnightly dosing, suggesting “that full target engagement was not achieved with this dosing regimen.”

They say it will be “critical” to consider “the factors underlying engagement in sedentary behaviours” when developing such interventions, and add that “[t]o date, few studies have sought to identify determinants of sedentary behaviour in RA, which—due to the pathophysiology of this disease—are likely to be complex and multifactorial.”

Writing in Rheumatology , they say that future versions of iCanCope will be designed to boost engagement with the library, goal setting, and community features, which were used by less than half of participants.

Risk for adverse events There is now a large body of data from clinical trials representing many thousands of patient-years of exposure to both tofacitinib and baricitinib , as well as emerging real-world data.

In addition, MIV-711 treatment significantly reduced biomarkers of bone resorption (serum type I and urine type II collagen C-telopeptide levels) relative to placebo, which Conaghan and team say provides “convincing evidence for target engagement.”

SMILE, an individualized and culturally tailored patient decision aid, has been shown to reduce decisional conflict regarding choice of immunosuppressive treatment in a randomized trial involving a diverse group of women with lupus nephritis.

How can the patient, parents, or guardians reach a conclusion, when we as physicians do not know the answer?