Rheum Round-up: Comparisons of Early RA, Knee OA, and Shoulder Surgery Treatments

Here are the top stories recently covered by DocWire News in the Rheumatology section. In this edition, read three comparisons: early rheumatoid arthritis (RA) treatments, strategies to treat osteoarthritis of the knee, and three shoulder surgery techniques. Plus, learn how RA still affects absenteeism at work.

A study compared superiority outcomes in very early rheumatoid arthritis (RA) treated with first-line etanercept plus methotrexate (ETN+MTX) versus treat-to-target MTX (MTX-TT), and questioned whether delayed ETN treatment after initial MTX was comparable to first-line ETN-MTX. “In summary, the VEDERA study did not demonstrate the larger than standard effect size (of 30%), which was proposed to exist in a previous exploratory subgroup analysis with first-line TNFi-MTX in very ERA. These data also highlight a ceiling effect in achieving remission in a real life, comorbid ERA cohort. The suggestion that expedient addition of ETN to MTX-TT-IR may not be as effective in a proportion as in treatment-naïve patients requires validation and further investigation,” the researchers concluded.

A retrospective study compared medical care costs, adverse events, and opioid/prescription analgesic use for treatments for osteoarthritis (OA) of the knee. Primary comparisons were made between intra-articular corticosteroids (ICS) and intra-articular hyaluronic acid (IHA), and a secondary comparison was made between combination ICS/IHA versus knee arthroplasty (TKA). “Patients in the IHA cohort had lower total medical care costs, fewer adverse outcomes, and lower use/costs of opioids and prescription analgesics vs patients in the ICS and TKA cohorts. Reducing total medical care costs and minimizing opioid/analgesic use should be a treatment goal when selecting therapies for patients with knee OA,” summarized the researchers.

A systematic review compared complications and revision rates between cemented polyethylene glenoid (PEG) versus three modern designs of metal-backed glenoids (MBG) used in total shoulder arthroplasty. “The modern MBG component, especially TM glenoid, seems to be a promising alternative to cemented PEGs, based on subgroup revision rates according to the follow-up duration and overall results of ROM and clinical scores. All polyethylene glenoids tend to increase loosening and failure over time,” the study authors concluded. They called for future studies to conduct longer-term analyses.

A new study evaluated how patients living with RA who are commencing methotrexate treatment fared in terms of work loss, absenteeism, and presenteeism over a one-year period. The researchers concluded that the disease continues to pose a significant professional burden. They further suggested that a holistic disease management strategy should be employed in conjunction with disease activity control in order to improve work-related outcomes for RA patients.