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Giant Cell Arteritis: A Systematic Review and Meta-Analysis of Test Accuracy and Benefits and Harms of Common Treatments
Anisha B. Dua,Nedaa M. Husainat,Mohamad A. Kalot,Kevin Byram,Jason M. Springer,Karen E. James,Yih Chang Lin,Marat Turgunbaev,Alexandra Villa-Forte,Andy Abril,Carol Langford,Mehrdad Maz,Sharon A. Chung,Reem A. Mustafa
doi : 10.1002/acr2.11226
Volume 3, Issue 7 p. 429-441
This systematic review compares treatment options for patients with giant cell arteritis (GCA) and evaluates the test accuracy of studies used in diagnosing and monitoring GCA. These studies were used to inform evidence-based recommendations for the American College of Rheumatology (ACR)/Vasculitis Foundation (VF) vasculitis management guidelines. A systematic review and search of articles in English in Ovid Medline, PubMed, Embase, and the Cochrane Library was conducted. Articles were screened for suitability, and studies presenting the highest level of evidence were given preference. Three hundred ninety-nine full-text articles addressing GCA questions were reviewed to inform 27 Population, Intervention, Comparison, and Outcome questions. No benefit was found with intravenous glucocorticoids (GCs) compared with high-dose oral GCs in patients with cranial ischemic symptoms (27.4% vs 12.3%; odds ratio [OR] 2.39 [95% confidence interval (CI) 0.75-7.62], [very low certainty of evidence]). Weekly tocilizumab with a 26-week GC taper was superior to a 52-week GC taper in patients achieving remission (risk ratio 4.00 [95% CI 1.97-8.12], [low certainty of evidence]). Non-GC immunosuppressive therapies with GCs compared with GCs alone showed no statistically significant in relapse at 1 year (OR 0.87 [95% CI 0.73-1.04], [moderate certainty of evidence]) or serious adverse events (OR 0.81 [95% CI 0.54-1.20]; [moderate certainty of evidence]). Temporal artery biopsy has a sensitivity of 61% (95% CI 38%-79%) and a specificity of 98% (95% CI 95%-99%) in patients with a clinical diagnosis of suspected GCA. This comprehensive systematic review synthesizes and evaluates the benefits and harms of different treatment options and the accuracy of commonly used tests for the diagnosis and monitoring of GCA.
Renal Mononuclear Phagocytes in Lupus Nephritis
Anne Davidson
doi : 10.1002/acr2.11269
Volume 3, Issue 7 p. 442-450
Renal mononuclear phagocytes are a highly pleiotropic group of immune cells of myeloid origin that play multiple protective and pathogenic roles in tissue homeostasis, inflammation, repair, and fibrosis. Infiltration of kidneys with these cells is a hallmark of lupus nephritis and is associated with more severe disease and with increased risk of progression to end-stage renal disease. This review presents current knowledge of the diversity of these cells and their involvement in kidney inflammation and resolution and describes how they contribute to the chronic inflammation of lupus nephritis. A better understanding of the subset heterogeneity and diverse functions of mononuclear phagocytes in the lupus nephritis kidney should provide fertile ground for the development of new therapeutic approaches that promote the differentiation and survival of protective subsets while targeting pathogenic cell subsets that cause inflammation and fibrosis.
Environmental Air Pollution Is a Predictor of Poor Response to Biological Drugs in Chronic Inflammatory Arthritides
Giovanni Adami,Maurizio Rossini,Ombretta Viapiana,Giovanni Orsolini,Eugenia Bertoldo,Marco Pontalti,Camilla Benini,Elena Fracassi,Alessandro Giollo,Davide Gatti,Angelo Fassio
doi : 10.1002/acr2.11270
Volume 3, Issue 7 p. 451-456
There is increasing evidence that environmental air pollution is associated with the development of chronic inflammatory arthritides (CIA). The role of air pollutants on the biological treatment (biological disease-modifying antirheumatic drugs [bDMARDs]) response of CIA is still unclear.
What Is the Persistence to Methotrexate in Rheumatoid Arthritis, and Does Machine Learning Outperform Hypothesis-Based Approaches to Its Prediction?
Helga Westerlind,Mateusz Maciejewski,Thomas Frisell,Scott A Jelinsky,Daniel Ziemek,Johan Askling
doi : 10.1002/acr2.11266
Volume 3, Issue 7 p. 457-463
The objectives of this study were to assess the 1-year persistence to methotrexate (MTX) initiated as the first ever conventional synthetic disease-modifying antirheumatic drug in new-onset rheumatoid arthritis (RA) and to investigate the marginal gains and robustness of the results by increasing the number and nature of covariates and by using data-driven, instead of hypothesis-based, methods to predict this persistence.
Clinical Image: Pseudogout of the temporomandibular joint
Mithu Maheswaranathan,Jessica L. Houk,Danielle Elliott Range,Jennifer Rogers
doi : 10.1002/acr2.11268
Volume 3, Issue 7 p. 464-465
Inorganic Dust Exposure During Military Service as a Predictor of Rheumatoid Arthritis and Other Autoimmune Conditions
David Ying,Gabriela Schmajuk,Laura Trupin,Paul D. Blanc
doi : 10.1002/acr2.11273
Volume 3, Issue 7 p. 466-474
Rheumatoid arthritis (RA) and other autoimmune (AI) conditions are associated with inorganic dust exposure. Many military activities are likely to entail inorganic dust exposures. We wished to identify associations between prior military dust exposure and RA and other AI conditions.
Tough Choices: Exploring Medication Decision-Making During Pregnancy and Lactation Among Women With Inflammatory Arthritis
Mehret Birru Talabi,Amanda M. Eudy,Malithi Jayasundara,Tayseer Haroun,W. Benjamin Nowell,Jeffrey R. Curtis,Rachelle Crow-Hercher,Whitney White,Seth Ginsberg,Megan E. B. Clowse
doi : 10.1002/acr2.11240
Volume 3, Issue 7 p. 475-483
This study explored how women’s beliefs about drug safety and interactions with their health care providers influenced their decisions to continue arthritis medications during pregnancy and lactation.
Comparison of Two Rituximab Induction Regimens for Antineutrophil Cytoplasm Antibody–Associated Vasculitis: Systematic Review and Meta-Analysis
Valérie Bénard,Cynthia Farhat,Melissa Zarandi-Nowroozi,Madeleine Durand,Pierre Charles,Xavier Puéchal,Loic Guillevin,Christian Pagnoux,Jean-Paul Makhzoum
doi : 10.1002/acr2.11274
Volume 3, Issue 7 p. 484-494
The objective of this study was to compare the efficacy and safety of two rituximab (RTX) regimens for the induction of remission in severe antineutrophil cytoplasm antibody–associated vasculitis (AAV): the four-dose (375 mg/m2 intravenously weekly) versus the two-dose (1000 mg intravenously biweekly) regimen.
Clinical Images: Extensive tumoral periarticular metastatic calcification in a patient on hemodialysis
Cindy Flower
doi : 10.1002/acr2.11291
Volume 3, Issue 7 p. 495-495
Clinical Images: Medullary nephrocalcinosis in Sj?gren syndrome
Yi-Ning Yen,Hsien-Tzung Liao
doi : 10.1002/acr2.11288
Volume 3, Issue 7 p. 496-496
Clinical Images: A Case of Takayasu Arteritis Initially Presented With Pulmonary Capillaritis
Ting-Yuan Lan,Song-Chou Hsieh
doi : 10.1002/acr2.11294
Volume 3, Issue 7 p. 497-497
