Findings from a proof-of-concept trial provide preliminary evidence to suggest that the JAK inhibitor baricitinib is well tolerated and may have efficacy for the treatment of relapsing giant cell arteritis.

They tested the potential of these candidates relative to the T-cell activation inhibitor abatacept in the current analysis using data for 22,569 propensity score–matched pairs of individuals with RA aged 65 years and older who were treated as Medicare fee-for-service patients between 2007 and 2017.

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?

They stress that a number of questions about rituximab and COVID-19 vaccination still need to be addressed, including the impact of booster doses, the importance of T cell-mediated immunity, and the optimal timing of rituximab therapy.

In addition, responders had a median decrease in circulating plasmoblast levels of around 50%, whereas nonresponders experienced a median increase of approximately 60%, and there was a “consistent and significant decline” in type 2 T follicular helper cells from baseline in responders versus nonresponders, say Stone and team in The Lancet Rheumatology .

For many of the drugs – including TNF inhibitors, interleukin inhibitors, low-dose glucocorticoids (prednisone-equivalent dose <20 mg/day), sulfasalazine, hydroxychloroquine, and leflunomide – no modifications to either immunomodulatory therapy or vaccination timing are recommended.

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.

They say that pooled seroconversion rates were “excellent” (>90%) in people taking tumor necrosis factor (TNF) inhibitors, interleukin inhibitors, and anti-integrin therapies, but “slightly lower” (70–90%) with other drugs including mycophenolate mofetil, methotrexate, hydroxychloroquine, and Janus kinase (JAK) inhibitors.

A comparison of different treatments for rheumatoid arthritis suggests that Janus kinase inhibitors are associated with the highest risk for herpes zoster, while some biologic DMARDs may also be linked to an increased risk.

Bonfa et al note that their study was limited by the absence of data on disease activity in the RMD group, as well as “lack of assessment of vaccine T cell responses.” medwireNews is an independent medical news service provided by Springer Healthcare Ltd. © 2021 Springer Healthcare Ltd, part of the Springer Nature Group 2 August 2021: The coronavirus pandemic is affecting all healthcare professionals across the globe.

They therefore say: “When taking into account functional humoral immunity and T-cell responses, our data suggest that targeted biologics do not impair vaccine responses and provide some reassurance to this vulnerable population.”

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

Study findings from the COVID-19 Global Rheumatology Alliance suggest that rheumatoid arthritis patients taking rituximab or JAK inhibitors are more likely to experience poor outcomes following SARS-CoV-2 infection than those taking TNF inhibitors.

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

Findings from the R4RA trial suggest that tocilizumab may be a more appropriate second-line biologic choice than rituximab for rheumatoid arthritis patients with a low or absent B-cell expression signature based on synovial tissue RNA sequencing.

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

They note that clinical efficacy of tocilizumab “is usually observed rapidly, within a few weeks of treatment” in patients with rheumatoid arthritis or giant cell arteritis, and “[t]herefore, a longer-term evaluation of the primary endpoint (after 6 months) would not have changed the overall results.” medwireNews is an independent medical news service provided by Springer Healthcare Ltd. © 2020 Springer Healthcare Ltd, part of the Springer Nature Group Ann Rheum Dis 2020; doi:10.1136/annrheumdis-2020-218467

“This suggests that PI3K-[delta] inhibition affects cell aggregation in the salivary glands, compromising the process of T/B cell activation, as reflected in the observed decrease in immunoglobulins,” Barone and team remark.