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Medicina
Special Issues
Therapy in Rheumatoid Arthritis: Current Evidence and Future Directions
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Therapy in Rheumatoid Arthritis: Current Evidence and Future Directions

A special issue of Medicina (ISSN 1648-9144).

Deadline for manuscript submissions: closed (31 March 2022) | Viewed by 7599

Special Issue Editor

Prof. Dr. Codrina Ancuta

E-Mail Website
Guest Editor
Rheumatology Department, University of Medicine and Pharmacy “Grigore T Popa”, 700115 Iasi, Romania
Interests: immune-mediated inflammatory rheumatic disorders; rheumatoid arthritis, spondyloarthritis; connective tissue diseases; systemic sclerosis, systemic lupus erythematosus, poli/dermatomyositis; biological therapies
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Rheumatoid arthritis (RA) represents a chronic immune-mediated inflammatory disease characterized by progressive and irreversible tissue destruction, functional disability, and altered quality of life; it is a complex and dynamic condition, extremely heterogeneous, especially from clinical, serological, and therapeutic outlooks.

Choosing a realistic target, depending on the clinical scenario and prognostic factors, has become the actual standard of care in RA, with remission or low-activity disease being the major therapeutic goals. Furthermore, the multistep therapeutic algorithm of the disease clearly emphasizes the true significance of earlier (in the so-called “window of opportunity”), aggressive, dynamic, as well as individualized RA treatment, frequently adapted to disease activity and therapeutic response.

Over time, TNF and non-TNF biologics and targeted synthetic small molecules (JAK inhibitors) have expanded our knowledge and radically changed the outcomes of AR; regardless of their mechanism of action and irrespective of the clinical and therapeutic scenario (early vs. advanced RA, naïve vs. experienced patients, difficult-to-treat disease, refractory to multiple therapeutic options), biologics and JAKinibs have demonstrated comparable efficacy, without any preference or hierarchy in administration. Therefore, the choice of optimal medication remains a challenge in daily practice, for reasons of safety and comorbidities.

The purpose of this Special Issue is to explore and debate a range of issues around personalized RA management taking into account different RA settings. This is an opportunity for both physicians and researchers at the forefront of the evolving RA therapeutic landscape to contribute to this exciting field, looking beyond remission and into the future of RA management.

Prof. Dr. Codrina Ancuta
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Medicina is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 1800 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • rheumatoid arthritis
  • biologics
  • TNF inhibitors
  • non-TNF inhibitors
  • targeted synthetic DMARDs
  • JAK inhibitors
  • conventional synthetic DMARDs
  • remission

Published Papers (3 papers)

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Research

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10 pages, 700 KiB  
Article
Comparison of Efficacy and Safety of Original and Biosimilar Adalimumab in Active Rheumatoid Arthritis in a Real-World National Cohort
by Claudiu Costinel Popescu, Corina Delia Mogoșan, Luminița Enache and Cătălin Codreanu
Medicina 2022, 58(12), 1851; https://doi.org/10.3390/medicina58121851 - 15 Dec 2022
Cited by 5 | Viewed by 1573
Abstract
Background and Objectives: Real-world evidence should reflect the evidence obtained from controlled trials; therefore, the study aimed to compare biosimilar adalimumab (bADA) to original adalimumab (oADA) in terms of efficacy and safety in a real-life national cohort of rheumatoid arthritis (RA) patients. Materials [...] Read more.
Background and Objectives: Real-world evidence should reflect the evidence obtained from controlled trials; therefore, the study aimed to compare biosimilar adalimumab (bADA) to original adalimumab (oADA) in terms of efficacy and safety in a real-life national cohort of rheumatoid arthritis (RA) patients. Materials and Methods: The following study is a prospective observational study in which we analyzed patients treated with reimbursed biologics from the Romanian Registry of Rheumatic Diseases (RRBR). RA cases must fulfill the 2010 classification criteria, as well as specific inclusion and exclusion criteria. The RRBR database was queried for all RA patients starting oADA or bADA (FKB327, GP2017, MSB11022, SB5 available) from 2 May 2019 (the first bADA initiation) until 26 March 2022 (study search date). Results: The study included 441 patients who started oADA (48.3%) or bADA (51.7%) in the same time period. At baseline, patients starting bADA had a significantly higher mean age and lower prevalence of women. After the first six months of treatment, there were no significant differences between the oADA and bADA regarding rates of Boolean (15.0% vs. 12.3%, p = 0.401), DAS28-CRP (32.4% vs. 34.2%, p = 0.686) and SDAI (16.4% vs. 14.0%, p = 0.483) remission rates. There were 107 cases of adverse events (AE): 81.3% on oADA and 18.7% on bADA. Notably, 51.4% of AE were infections. Regarding severity, 49.5% of AEs were mild, 34.6% were moderate, and 15.9% were severe. Conclusion: Biosimilar adalimumab showed similar efficacy and safety to original adalimumab after the first six months of treatment in RA patients from a national registry. Full article
(This article belongs to the Special Issue Therapy in Rheumatoid Arthritis: Current Evidence and Future Directions)
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13 pages, 1444 KiB  
Article
Ultrasound Enthesitis in Psoriasis Patients with or without Psoriatic Arthritis, a Cross-Sectional Analysis
by Mihaela Agache, Claudiu C. Popescu, Liliana Popa and Cătălin Codreanu
Medicina 2022, 58(11), 1557; https://doi.org/10.3390/medicina58111557 - 30 Oct 2022
Cited by 4 | Viewed by 3022
Abstract
Background and objectives: The main objective of the current study was to describe the prevalence of enthesitis at different sites in a group of patients with psoriasis with or without psoriatic arthritis (PsA). Materials and Methods: The study included adult patients with psoriasis [...] Read more.
Background and objectives: The main objective of the current study was to describe the prevalence of enthesitis at different sites in a group of patients with psoriasis with or without psoriatic arthritis (PsA). Materials and Methods: The study included adult patients with psoriasis who underwent clinical examination, laboratory tests and ultrasound examination of the entheses. The enthesitis ultrasound scores (BUSES, MASEI, GUESS) were evaluated; the presence of OMERACT-defined enthesitis was also recorded for each scan site. Results: The study included 16 (57.1%) patients with PsA and 12 (42.9%) patients with psoriasis, with an increased average body mass index (29.3 kg/m2). Compared to psoriasis patients, PsA patients had a higher prevalence of nail psoriasis (68.8% compared to 33.3%; p = 0.063). There were no significant differences regarding the clinical examination of entheses between patients with psoriasis and patients with PsA (p = 0.459). Ultrasound scores, BUSES, GUESS and MASEI proved to have statistically significant higher median values in PsA patients compared to psoriasis patients. Compared to psoriasis patients, PsA patients had a significantly higher prevalence of OMERACT-defined enthesitis of the quadriceps tendon and inferior patellar ligament (both 81.3% compared to 25.0%, p = 0.003). Clinical examination of the lateral epicondyle and of the superior patellar ligament was consistent with their ultrasound examination (κ = 0.357, p = 0.043, respectively, κ = 0.404, p = 0.008). Conclusions: Clinical enthesitis scores do not differ between psoriasis and PsA patients. All analyzed ultrasound scores are significantly higher in patients with PsA. OMERACT-defined enthesitis has the ability to discriminate sonographic enthesitis between the two subgroups for bilateral quadriceps and inferior patellar tendon enthesitis. Bilateral ultrasound damage of entheses can suggest a PsA diagnosis. Full article
(This article belongs to the Special Issue Therapy in Rheumatoid Arthritis: Current Evidence and Future Directions)
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Review

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11 pages, 481 KiB  
Review
Depression in Rheumatoid Arthritis: A Narrative Review—Diagnostic Challenges, Pathogenic Mechanisms and Effects
by Cătălina-Elena Ionescu, Claudiu Costinel Popescu, Mihaela Agache, Georgiana Dinache and Cătălin Codreanu
Medicina 2022, 58(11), 1637; https://doi.org/10.3390/medicina58111637 - 13 Nov 2022
Cited by 11 | Viewed by 2493
Abstract
Depression is one of the most frequent comorbidities in rheumatoid arthritis (RA); it takes an important toll on the quality of life of these patients and also leads to a decrease in life expectancy. The current article is a narrative review on depression [...] Read more.
Depression is one of the most frequent comorbidities in rheumatoid arthritis (RA); it takes an important toll on the quality of life of these patients and also leads to a decrease in life expectancy. The current article is a narrative review on depression in RA, with the objective to emphasize and raise awareness on the high prevalence, pathogenic mechanisms, and effects that depression has on RA patients. In RA, the prevalence of depression has been shown to be 2 to 3 times higher than in the general population, with a meta-analysis reporting that 16.8% of RA patients have a major depressive disorder. Future studies are needed to determine the most accurate self-reported depression questionnaires and their ideal threshold for defining depression as compared to diagnostic interview as gold-standard for patients with RA to allow better comparisons across studies. The pathogenesis of depression remains to be fully understood, but recent specialty literature suggests that immune-mediated processes are involved and that there are similarities between the neural networks recruited in inflammation and those implicated in the pathophysiology of depression. Depression in patients with RA is associated with poor long-term outcomes. Multiple studies have shown that depression in RA is associated with increased pain, fatigue, and physical disability. It alters treatment compliance, causes more comorbidities, and leads to higher mortality, partly through increased suicide risk. Depression in RA also increases health service utilization and healthcare costs directly through hospitalization, but also indirectly through loss of work productivity. Assessing depression could be a significant psychomarker of rheumatological outcome in RA. Full article
(This article belongs to the Special Issue Therapy in Rheumatoid Arthritis: Current Evidence and Future Directions)
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