Rheumatology

Tapering bDMARDs halves flare risk versus stopping in RA remission

In RA patients in sustained remission, complete discontinuation of bDMARDs more than doubled flare risk versus dose reduction (Pooled RR 2.13). Early RA (<2 years) had smaller flare risk increases with stopping than established disease (RR 1.62 vs 2.31). Upon re‑starting therapy, pooled capture rate was 87.5%, with median clinical recovery around 12.4 weeks. Radiographic progression was minimal and correlated with cumulative disease activity during flares, not tapering per se. 1

Data‑driven nutrient risk score strongly predicts incident RA

In 161,725 UK Biobank adults followed median 13.4 years, each unit higher nutrient risk score associated with HR 1.96 for incident RA. The association persisted after GPS and IPW adjustment and was stronger with short sleep, low activity, and high genetic susceptibility. Participants at high genetic risk with highest NRS had about 3.28-fold risk versus low‑risk low‑NRS participants. Obesity indicators mediated a modest portion of the effect (approximately 3.8–13.6%). 2

Consensus candidate core domains for SSc‑RP and digital ulcers

An international 3‑round Delphi (patients and clinicians) identified core candidate domains for SSc‑associated Raynaud’s and digital ulcers. For SSc‑RP, nine domains reached consensus across Pathophysiology and Life Impact areas; for SSc‑DUs, 16 domains reached consensus including Resource Use. Results will inform a final Core Domain Set to standardize outcome measurement in clinical trials. 3