This guideline provides evidence-based recommendations for the safe use of biologic therapies in adults. It covers the safety aspects of all biologic therapies approved by the National Institute for Health and Care Excellence (NICE) as of June 2016, for the treatment of RA, PsA and axial spondyloarthritis (SpA) including AS. This group of conditions are referred to as inflammatory arthritis (IA) in the guideline. Therapies approved by NICE after June 2016, such as secukinumab (Cosentyx), are not included.
The guideline highlights several specific safety areas including recommendations for screening before a biologic is started, recommendations for monitoring, the implications of other conditions and ageing, vaccinations and the management of biologic therapies in specific situations such as infection, malignancy and surgery.
Factors associated with ASDAS remission in a long-term study of ankylosing spondylitis patients under tumor necrosis factor inhibitors
The objective of this study was to determine the clinical and demographic factors associated with disease remission and drug survival in patients with ankylosing spondylitis (AS) on anti TNF therapy on an electronic database. Results indicated that that ASDAS-CRP remission is an achievable goal not only for people on their first anti TNF, but also for those on a second anti-TNF. This was particularly notable in younger patients and those with a lower BASDAI at baseline. Non-smokers also seemed to do better.
Researchers evaluated the educational quality of 56 YouTube videos offering exercises for people with AS. Of the 56 videos evaluated, 27 were high quality, 10 were intermediate quality, and 19 were low quality. They conclude YouTube can be considered as an important source of high-quality videos as nearly half of the videos were of high quality. Physicians should inform patients about the importance of video resources during the use of YouTube and should guide patients to the accurate sources of information. Don’t forget NASS have some great exercise videos on YouTube.
Vitamin D serum concentration is not related to the activity of spondyloarthritis – preliminary study
Vitamin D plays an important role in mineral turnover and bone remodelling and there are increasing data about its immunomodulatory potential in different rheumatologic disorders. Deficiency of vitamin D is frequent in people with spondyloarthritis (SpA) and some data suggest its association with increased disease activity and structural damage. However, its exact role in the pathogenesis of SpA and its association with disease activity are still a matter of debate so researchers carried out a preliminary study of 63 patients.
The researchers concluded that their data showed no correlation between the concentration of 25(OH)D in the serum and disease activity in SpA. However, they noted that this does not exclude the potential role of vitamin D in pathogenesis of SpA. They highlight further studies are required.