Arthralgia with risk of progression to psoriatic arthritis: role of clinical assessments and ultrasound as prognostic factors

A comprehensive evaluation of the transition to a biosimilar of adalimumab in rheumatoid arthritis and psoriatic arthritis: a single-center experience with a focus on imaging outcomes

OBJECTIVE

Limited data in Latin America exists regarding the efficacy of switches from original biologicals to biosimilars in real-life scenarios. Currently, no studies assess this switch using imaging. The objective of this study was to evaluate clinical, functional, ultrasonographic, and radiological responses in a group of patients with rheumatoid arthritis (RA) and psoriatic arthritis (PsA) switched from original adalimumab (oADA) to biosimilar (bADA) (GP2017).

METHODS

A prospective cohort study included diagnosed RA and PsA patients undergoing oADA treatment. At the baseline visit, blood analysis, X-rays, ultrasound, and an interview for sociodemographic and clinical data were conducted. Evaluators were unaware of each other's data. Patients switched to bADA during follow-up and were assessed in the same program within 3 to 12 months post-switch (only including patients with all evaluations).

RESULTS

Out of 270 RA cohort patients, 35 met the criteria for complete pre-and-post control post-switch to bADA (GP2017), along with 15 PsA patients. The mean time between the switch and the second evaluation was 4.1 months (interquartile range 7). No statistical differences were observed in disease activity or functional capacity. Regarding imaging, no difference was found in X-ray erosion number; however, ultrasonography revealed decreased power Doppler (PD) activity, but not grayscale findings. No differences in acute phase reactants, joint count, or patient visual analog scale were observed between controls.

CONCLUSIONS

In this analysis of the switch between oADA and bADA, no differences were found in disease activity, functional capacity, or radiographic progression. Ultrasonography indicated improvement of PD findings.

Prevalence and clinical features of early axial spondyloarthritis according to ASAS definition: a cross-sectional analysis from the reuma-check cohort

Objectives to estimate the prevalence at diagnosis of early axial spondyloarthritis in Argentinian Reuma-Check cohort, according to ASAS definition (early axSpA) and to identify clinical, laboratory, and imaging features associated with this group in a Latin American cohort. This single-center, observational, cross-sectional study included consecutive adult patients diagnosed with axSpA. Early axSpA was defined as ≤ 2 years of axial symptoms at diagnosis. Clinical, laboratory, and imaging assessments were performed following standardized protocols. A primary analysis was conducted on the entire cohort of diagnosed patients, followed by two subgroup analyses: one including only those fulfilling the ASAS 2009 criteria and another excluding patients with psoriasis. Logistic regression was conducted to identify factors independently associated with early axSpA. Among 124 patients, 38% (n = 47) had early axSpA at diagnosis. Significant differences between early and established axSpA included smoking habit (30 vs. 51%, p = 0.02), NSAID response (58 vs. 74%, p = 0.06), family history (38 vs. 23%, p = 0.04), and radiographic sacroiliitis (37 vs. 71%, p = 0.03). Logistic regression identified family history (OR: 2.4) as an independent risk factor, whereas smoking was inversely associated (OR: 0.4). Similar patterns were observed in the ASAS-fulfilling (33%) and psoriasis-excluded (36%) subgroups. At diagnosis, approximately one third of patients meet the ASAS definition of early axSpA. These patients are characterized by a higher frequency of family history, less smoking and structural damage. These results support the feasibility and relevance of future studies including patients with early axSpA to provide further scientific evidence at earlier stages of the disease.