Ten years after tight control, 82% of early RA patients followed up were in remission

The edition in brief

Today's rheumatology edition opens on lupus nephritis. A five-centre Chinese study of 443 patients with biopsy-proven lupus nephritis built a seven-variable model from routine tests, including lymphocyte percentage, haematuria, leukocyturia, eGFR, uric acid, anti-dsDNA and C3, that identified proliferative nephritis with an AUC of 0.895 in external validation, a possible aid where biopsy is delayed or unsafe. A double-blind trial of a multispecies probiotic in 66 patients with moderately active psoriatic arthritis found no benefit over placebo (43% vs 65% reaching low disease activity). A EUSTAR analysis of 301 patients with systemic sclerosis-associated pulmonary arterial hypertension linked sustained initial therapy with lower mortality in as-treated analyses, but not in intention-to-treat, a reminder of the limits of observational comparisons. The FDA recorded a supplement to the etanercept licence, an administrative record without a stated new indication. The pearl covers the urine and serology checks for lupus nephritis at every visit. The edition closes on 10-year follow-up of the ARCTIC trial of strict treat-to-target therapy in 230 patients with early rheumatoid arthritis: 82% of those assessed were in DAS remission, radiographic progression was minimal, function approached population norms, survival matched the general population, and sustained remission at two years predicted better outcomes at ten.