3- Wednesday Research News – 19th May

1 – Effect of Therapeutic Drug Monitoring vs Standard Therapy During Infliximab Induction on Disease Remission in Patients With Chronic Immune-Mediated Inflammatory Diseases – A Randomized Clinical Trial

• Among patients with chronic immune-mediated inflammatory diseases initiating treatment with infliximab, does proactive therapeutic drug monitoring (TDM) improve clinical remission rates compared with standard therapy?
• In this randomized clinical trial that included 411 patients, the proportion of patients who experienced disease remission after 30 weeks was 50.5% in the TDM group and 53.0% in the standard therapy group, a difference that was not statistically significant.
• These findings do not support routine use of proactive TDM during infliximab induction for improving disease remission rates.

Source: JAMA Network

2- Effect of Half-Dose vs Stable-Dose Conventional Synthetic Disease-Modifying Antirheumatic Drugs on Disease Flares in Patients With Rheumatoid Arthritis in Remission – The ARCTIC REWIND Randomized Clinical Trial

• In patients with rheumatoid arthritis in remission taking conventional synthetic disease-modifying antirheumatic drugs (csDMARDs), is reducing the csDMARDs to half dose noninferior to stable csDMARD dosage for the outcome of rheumatoid arthritis flares?
• In this randomized clinical trial that included 160 patients with rheumatoid arthritis in remission taking csDMARD therapy, treatment with half-dose vs stable-dose csDMARDs resulted in disease flares in 25% vs 6% over 12 months; this did not meet the noninferiority criterion of a 20% difference. There were significantly fewer patients with flares in the stable-dose group.
• These findings do not support the use of half-dose treatment in patients with rheumatoid arthritis in remission taking csDMARDs.

Source: JAMA Network

3- Effect of ivermectin on COVID-19: A multicenter double-blind randomized controlled clinical trial

• This study aimed to evaluate the effect of the widely used antiparasitic drug ivermectin on COVID-19 patient outcomes.
• A single dose of ivermectin was well-tolerated in symptomatic COVID-19 patients and improved important clinical features of COVID-19 patients including dyspnea, cough, and lymphopenia.
• Further studies with larger sample sizes, different drug dosages, dosing intervals and durations, especially in different stages of the disease, may help understanding ivermectin’s potential clinical benefits.

Source: ScieneDirect

4- Six month assessment of low dose rituximab in the treatment of rheumatoid arthritis during coronavirus disease 2019 (COVID-19) pandemic

• This study aims to evaluate the 6-month treatment responses to low dose rituximab (LDR) compared to standard dose rituximab (SDR) in rheumatoid arthritis (RA) patients whose treatments were disrupted due to the pandemic with increased disease activity and to examine the effect of LDR treatment on serum immunoglobulin (Ig) levels
• LDR is an effective treatment option in the treatment of RA.
• In this study, none of our patients developed severe COVID-19 infection requiring hospitalization, and LDR may be preferred during the COVID-19 pandemic period.

Source: ScienceDirect

5- Objective and Subjective COVID-19 Vaccine Reactogenicity by Age and Vaccine Manufacturer

• Several vaccines against SARS-CoV-2 have been granted emergency use authorization from the United States Food and Drug Administration and similar regulatory bodies abroad to combat the COVID-19 pandemic.
• They conducted a retrospective analysis of 50977 subscribers to the WHOOP platform who received either the AstraZeneca, Janssen/Johnson & Johnson), or Pfizer/BioNTech.
• The results confirm the previously observed subjective symptomatology trends, and for the first time show that objectively measured cardiovascular and sleep parameters are altered the night after vaccination.
• Moreover, these results suggest that the response may be different between vaccine manufacturers and may be modified by age and larger after the second dose.

Source: MedRxiv

6- Asymptomatic and Symptomatic SARS-CoV-2 Infections After BNT162b2 Vaccination in a Routinely Screened Workforce

• A 2-dose regimen of the BNT162b2 vaccine (Pfizer-BioNTech) against SARS-CoV-2 was authorized in December 2020 based on reported 94.8% efficacy.
• Although an association between vaccination and a reduction in symptomatic disease has been well described, an association with asymptomatic infection remains unclear.
• This study found an association between vaccination with BNT162b2 in hospital employees and a decreased risk of symptomatic and asymptomatic infections with SARS-CoV-2.

Source: JAMA Network

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