New Findings on COVID-19 Vaccination, Race & More Shared in 1st Plenary Session

The study had 49 patients in the abatacept treatment arm, who received treatment for six months, and 49 in a placebo arm. The average patient age was 51 years in the abatacept arm and 49 years in the placebo arm. The study met its primary end point, with 30 patients in the treatment arm achieving significant improvement in magnetic resonance imaging (MRI) inflammation scores—an assessment of synovitis, tenosynovisits and osteitis—compared with 15 patients in the placebo group (P=0.0043).

Only four patients in the abatacept arm progressed to arthritis, compared with 17 in the placebo group (P=0.0025).

“Abatacept is superior to placebo in inhibiting the progression to arthritis at six months,” Dr. Rech said. “Follow-up results at 18 months will reveal whether the effect of a time-limited intervention of abatacept has a sustained effect on inhibition of progression to arthritis.”

Imaging in Cognitive Impairment & SLE

Dr. John Hanly

Patients with SLE and cognitive impairment have abnormalities in brain function detected by resting state functional MRI and enhanced permeability of the blood-brain barrier,⁵ said John Hanly, MD, professor of medicine and pathology at Dalhousie University, Halifax, Nova Scotia, Canada, adding that the observations may open a new avenue for treatment.

In 78 people with SLE and 71 healthy controls, researchers performed cognitive function tests, as well as neuroimaging with resting state functional MRI and contrast imaging to assess blood-brain-barrier leakage. Forty-seven of the patients with SLE were found to have cognitive impairment in at least one area, including information-processing speed, executive ability—such as multi-tasking—or other categories.

Researchers found the total number of brainwide connections in specific brain regions decreased and the usual functional connectivity between brain regions was altered in patients with SLE and cognitive impairment (P=0.01), as well as in individuals with higher blood-brain barrier permeability (P=0.011).

“Future studies,” Dr. Hanly said, “should investigate the mechanisms underlying blood-brain-barrier-mediated cognitive impairment and the potential of targeting the blood-brain barrier as a therapeutic strategy in SLE patients.”

Thomas Collins is a freelance medical writer based in Florida.

References

1. Paley M, Deepak P, Kim W, et al. Immunosuppression attenuates antibody and neutralization titers in patients with chronic inflammatory disease following SARS-CoV-2 vaccination [abstract 0457]. Arthritis Rheumatol. 2021;73(suppl 10).
2. Ostor A, Papp K, Moreno M, et al. Efficacy and safety of risankizumab for active psoriatic arthritis: 24-week integrated results from the phase 3, randomized, double-blind KEEPsAKE 1 and 2 trials for csDMARD-IR and bio-IR patients [abstract 0453]. Arthritis Rheumatol. 2021;73(suppl 10).
3. Yen E, Rajkumar S, Sharma R, et al. Lupus nephritis mortality in the United States, 1999–2019: Disparities by race/ethnicity and place of residence and a recent worsening trend [abstract 0454]. Arthritis Rheumatol. 2021;73(suppl 10).
4. Rech J, Ostergaard M, Tascilar, et al. Abatacept reverses subclinical arthritis in patients with high-risk to develop rheumatoid arthritis—Results from the randomized, placebo-controlled ARIAA study in RA-at risk patients [abstract 0455]. Arthritis Rheumatol. 2021;73(suppl 10).
5. Hanly J, Robertson J, Kamintsky L, et al. Functional connectivity, enhanced blood-brain barrier leakage and cognitive impairment in systemic lupus erythematosus [abstract 0456]. Arthritis Rheumatol. 2021;73(suppl 10).