Publications by authors named "Heijde D"
Objectives: To compare the construct validity, including discrimination between known groups, of three pain and three morning stiffness (MS) measurement instruments.
Methods: Patients with radiographic axial spondyloarthritis with 8-year data from the Outcome in Ankylosing Spondylitis International Study cohort were assessed cross-sectionally. Three instruments for pain and three for MS, all self-reported and scored 0-10, were compared.
Background: The efficacy and safety of upadacitinib in patients with ankylosing spondylitis (AS) and inadequate response/intolerance to biologic disease-modifying antirheumatic drugs (bDMARD-IR) were evaluated through 1 year in the SELECT-AXIS 2 study. Here, we assess 2-year efficacy, safety, and imaging outcomes in SELECT-AXIS 2.
Methods: Patients who received continuous upadacitinib, and those who switched from placebo to upadacitinib at week 14, could enter the open-label extension (OLE).
Objectives: To evaluate the impact of using Simplified Disease Activity Index (SDAI)-LDA (low disease activity) versus different definitions of remission as a treatment target in established rheumatoid arthritis.
Methods: A meta-epidemiological study of individual patient data from eight randomised controlled trials was performed. Four definitions of the target were considered at 6 months: (1) SDAI-LDA: SDAI≤11; (2) SDAI-Remission: SDAI≤3.
Objective: To compare spinal symptoms and spinal/hip mobility at baseline and 2 years in early axial spondyloarthritis (axSpA) and non-axSpA chronic back pain (BP) patients.
Methods: Baseline and 2 years data of the SPondyloarthritis Caught Early cohort were analysed. Outcomes assessed: overall BP, BP at night, morning stiffness (MS) intensity, MS duration, occiput-to-wall distance (OWD), cervical rotation, chest expansion, lateral spinal flexion (LSF), modified Schober test (mSchober), intermalleolar distance (IMD) and Bath Ankylosing Spondylitis Metrology Index (BASMI).
Article Synopsis
- Uveitis is a common complication in patients with Spondyloarthritis (SpA), and this study examined how frequently it occurs, its geographical variations, and whether it has changed since the introduction of biologic treatments.
- A total of 3984 patients across 22 countries were assessed, revealing that the likelihood of experiencing uveitis increases significantly over time, with various factors like HLA-B27 positivity and a family history of uveitis linked to a higher risk.
- Results indicated a drastic reduction in the prevalence and incidence of uveitis in patients who started treatment after 2000, suggesting that biologic therapies may help mitigate this condition.
Article Synopsis
- The study looked at four different groups of people with chronic back pain to see if their conditions changed over 2 years.
- They used information from doctors and tests to understand if people might switch from one group to another.
- After 2 years, the results showed that most people stayed in the same group, meaning it's unlikely for someone to suddenly develop new signs of their condition after being checked initially.
Objectives: To explore the agreement between patient-reported flare status and clinically significant flare status in patients with rheumatoid arthritis (RA) in sustained remission.
Method: Patients with RA in remission for ≥12 months on stable treatment were included in the ARCTIC REWIND tapering trials and pooled 12-month data used in current analyses. Patient-reported flare status was assessed according to the Outcome Measures in Rheumatology flare questionnaire; 'Are you having a flare of your RA at this time?' (yes/no).
Objective: To test trial and longitudinal known group discrimination of thresholds of meaning for improvement and health states of the ASAS Health Index (ASAS HI) in patients with active axSpA treated in a randomized study.
Methods: Data from baseline and week 48 from the tight-controlled, treat-to-target trial TICOSPA study were used. The performance of different thresholds to assess change or health states of the ASAS HI were evaluated between arms and against changes in patients' relevant outcomes and various external responder criteria.
Objective: To compare health-related quality of life (HRQoL) and work productivity in axial spondyloarthritis (axSpA) and non-axSpA patients with chronic back pain of < 2 years (2 y).
Methods: Baseline and 2 y data of patients included in the SPondyloArthritis Caught Early cohort were analyzed. HRQoL was assessed by the physical (PCS) and mental component summary (MCS) scores of the 36-Item Short-Form Health Survey; and presenteeism, absenteeism, work productivity loss (WPL) and activity impairment (AI) by the Work Productivity and Activity Impairment questionnaire.
Objective: The objective of this study was to evaluate the impact of protocol violations in the treat-to-target group in the Tight Control in Spondyloarthritis (TICOSPA) trial and to compare the proportion of patients optimally treated according to the Assessment of Spondyloarthritis International Society (ASAS)/EULAR 2016 recommendations for patients with axial spondyloarthritis (axSpA) between the treat-to-target versus usual care (UC) arms.
Methods: This study was a cluster-randomized, controlled 48-week trial including patients with axSpA who fulfilled the ASAS criteria, had an Axial Spondyloarthritis Disease Activity Score >2.1, and were biologic disease-modifying antirheumatic drug naive.
Objectives: To assess the association of posterior element (PE) and facet joint (FJ) inflammation with subsequent new FJ ankylosis (FJA) on MRI, in patients with radiographic axial spondyloarthritis (r-axSpA).
Methods: Patients from the Sensitive Imaging in Ankylosing Spondylitis cohort, inclusion criteria r-axSpA and ≥1 radiographic spinal syndesmophyte, were studied. MRI of the full spinal was performed at baseline, 1 and 2 years.
Objective: Upadacitinib improved the signs and symptoms of non-radiographic axial spondyloarthritis (nr-axSpA) versus placebo over 14 weeks in the primary analysis of the SELECT-AXIS 2 nr-axSpA study. Here, we evaluated the efficacy and safety of upadacitinib through 1 year in patients with nr-axSpA in SELECT-AXIS 2.
Methods: Patients aged at least 18 years diagnosed with nr-axSpA who fulfilled the 2009 Assessment of SpondyloArthritis International Society (ASAS) classification criteria and were receiving stable background therapy were randomized to upadacitinib 15 mg once daily or placebo for the 52-week double-blind period.
Disease modification in axial spondyloarthritis - still a controversy?
Curr Opin Rheumatol
July 2024
Article Synopsis
- This review highlights recent advancements in disease-modifying therapies for axial spondyloarthritis (axSpA).
- It discusses conflicting findings regarding the effectiveness of NSAIDs, TNF inhibitors, IL-17 inhibitors, and JAK inhibitors in slowing structural progression of the disease.
- The review suggests that ongoing research and improved imaging techniques are necessary to better understand the impact of these therapies on disease outcomes over time.
Objective: To assess whether using ultrasound (US) in addition to clinical information versus only clinical information in a treat-to-target (T2T) strategy leads to more clinical remission and to less radiographic progression in RA.
Methods: Patients with RA from the 2-year prospective BIODAM cohort were included. Clinical and US data (US7-score) were collected every 3 months and hands and feet radiographs every 6 months.
Article Synopsis
- A study investigated the long-term effects of tapering disease-modifying antirheumatic drugs (DMARDs) in rheumatoid arthritis patients who were in sustained remission, with a focus on the risks of disease flare-ups over a 3-year period.
- Patients aged 18-80 were randomly assigned to one of three treatment strategies: stable-dose DMARDs, half-dose DMARDs, or a tapering regimen that led to drug withdrawal after a year.
- The trial enrolled 160 patients, with a majority being women, and aimed to assess flare-free survival rates, ultimately finding that most patients maintained remission throughout the follow-up period.
Article Synopsis
- The phase IIIb SURPASS study aimed to compare spinal radiographic progression in patients with radiographic axial spondyloarthritis who were treated with secukinumab (an interleukin-17A inhibitor) versus adalimumab biosimilar (a tumor necrosis factor inhibitor).
- The study involved 859 biologic-naive patients at high risk for progression, assessing outcomes like the proportion with no progression after 104 weeks and the safety of the treatments.
- Results showed no significant difference in radiographic progression between secukinumab and adalimumab biosimilar, with overall low progression rates observed in all treatment groups and no unexpected safety issues reported.
Article Synopsis
- This text outlines a systematic literature review that evaluates the efficacy and safety of various pharmacological treatments for psoriatic arthritis (PsA), focusing on disease-modifying antirheumatic drugs (DMARDs).
- A thorough search of databases like Medline and EMBASE helped to identify relevant studies published between 2019 and 2022, analyzing both treatment effectiveness and potential adverse effects.
- The review found that different classes of drugs, including conventional and biologic DMARDs, were effective in alleviating PsA symptoms and improving quality of life, while also confirming that safety concerns align with previous findings from 2019.
Objective: New modes of action and more data on the efficacy and safety of existing drugs in psoriatic arthritis (PsA) required an update of the EULAR 2019 recommendations for the pharmacological treatment of PsA.
Methods: Following EULAR standardised operating procedures, the process included a systematic literature review and a consensus meeting of 36 international experts in April 2023. Levels of evidence and grades of recommendations were determined.
Objectives: To compare the long-term outcomes of three phenotypes of axial SpA (axSpA).
Methods: Patients with a clinical diagnosis of axSpA from the DESIR cohort were grouped into three phenotypes at baseline: 'Pure axSpA' ('Axial'), 'axSpA with peripheral signs' ('IBP+Peripheral') and 'axSpA at risk' ('At risk') by latent class analysis. Clinical and imaging data were collected up to 5 years.
Objective: To assess which definition of remission best predicts good radiographic outcome (GRO) and good functional outcome (GFO) in rheumatoid arthritis, focusing the updated American College of Rheumatology/European Alliance of Associations for Rheumatology criteria.
Material And Methods: Meta-analyses of individual patient data (IPD) from randomised controlled trials (RCTs). Six definitions of remission were considered: (1) Boolean with Patient Global Assessment (PGA)≤1 (Boolean); (2) Simplified Disease Activity Index (SDAI)≤3.
Objective: To investigate the efficacy of bDMARDs in patients with RA with RF/ACPA compared with patients without these autoantibodies.
Methods: Previous systematic literature reviews performed by EULAR RA management task forces were searched for qualifying RCTs. RCTs investigating the efficacy of bDMARDs and including both autoantibody-positive (≤80% of total population) and -negative RA patients were eligible.
Article Synopsis
- - The study compares the ability of MRI and radiographs to detect erosions in the sacroiliac joint (SIJ) for patients with recent-onset axial spondyloarthritis (axSpA) over a 104-week period, with a focus on the effects of the treatment etanercept. - Results showed that MRI detected more erosions than radiographs at baseline and in changes over time, with a significant number of patients demonstrating improved erosion scores on MRI compared to radiographs after treatment. - The research highlights that MRI may be superior in monitoring SIJ erosions in axSpA, suggesting that further investigation into the clinical significance of these findings is needed.
Objective: The Berlin algorithm was developed to help diagnose axial SpA (axSpA), but new studies suggest some features typical of SpA are less specific than previously assumed. Furthermore, evidence is lacking for other SpA subtypes (e.g.
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- The study aimed to compare the Health Index scores between patients with radiographic axial spondyloarthritis (r-axSpA) and non-radiographic axSpA (nr-axSpA), and to find factors linked to higher scores in both groups.
- A total of 976 patients participated, with findings showing that r-axSpA patients reported worse Health Index scores compared to nr-axSpA patients, though the disease phenotype itself didn’t significantly correlate with these scores in the multivariable analysis.
- Higher Health Index scores were significantly associated with being female, experiencing poorer physical function, higher disease activity, and increased anxiety and depressive symptoms, indicating a similar overall health impact across both disease types.
Background: Despite highly effective targeted therapies for rheumatoid arthritis, about 40% of patients respond poorly, and predictive biomarkers for treatment choices are lacking. We did a biopsy-driven trial to compare the response to rituximab, etanercept, and tocilizumab in biologic-naive patients with rheumatoid arthritis stratified for synovial B cell status.
Methods: STRAP and STRAP-EU were two parallel, open-label, biopsy-driven, stratified, randomised, phase 3 trials done across 26 university centres in the UK and Europe.