On a JAK inhibitor for RA, the week-12 CDAI predicted the year ahead

The edition in brief

In 843 patients with rheumatoid arthritis starting a JAK inhibitor in a multicentre registry, four trajectories emerged over a year, from rapid responders (65%) to persistent non-responders (4%). The absolute CDAI at week 12 sharply improved prediction of who would follow a favourable course, and the rate of change added little; a CDAI of 9.3 or below at week 12 was the best threshold. In the randomised TOGETHER-PsA trial (271 adults with psoriatic arthritis and overweight or obesity), adding tirzepatide to ixekizumab raised ACR50 at 36 weeks from 20.4% to 33.5%, alongside weight loss. A model built from 649 PEXIVAS participants with severe ANCA vasculitis estimates two-year relapse risk from sex, induction agent, ANCA type, respiratory or mucosal involvement and eGFR at remission (C statistic 0.71), but needs external validation. A meta-analysis of 19 studies (445 patients) found rituximab as rescue or add-on therapy in relapsing or refractory lupus nephritis gave complete renal response in about 40% at 12 to 24 months, from mostly uncontrolled data.