American College of Rheumatology, Oct. 24-29

The annual meeting of the American College of Rheumatology was held this year from Oct. 24 to 29 in Chicago, drawing more than 13,000 participants from around the world, including rheumatology specialists, physicians, scientists, and other health care professionals. The conference featured presentations focusing on the latest advances in the diagnosis and treatment of arthritis as well as other rheumatic and musculoskeletal diseases.In one study, Sinead Maguire, Ph.D., of Our Lady's Hospital Navan in Dublin, and colleagues found that pregnancies in women with axial spondyloarthritis (axSpA) face an increased prevalence of certain complications, including severe maternal morbidity (SMM), gestational diabetes, antepartum hemorrhage, and preterm birth.Using the MOMBABY database, the authors evaluated information for women aged 10 to 55 years with a live birth recorded between April 1, 2002, and March 31, 2020. They found that compared with pregnancies in women of the general population, pregnancies among women with axSpA demonstrated a concerning trend toward an increased prevalence of complications.SMM, a major adverse pregnancy-related physical or psychological event that negatively affects maternal health, confers a high risk for maternal death if left untreated or undetected. SMM has been well documented in the general population but never previously captured in pregnancies among women with axSpA."These results highlight the need for further work to recognize SMM in pregnancies of women with axSpA and create an evidence basis for the development of strategies for prevention," Maguire said.Several authors disclosed financial ties to AbbVie, Abbott, Novartis, Janssen, and Eli Lilly.Abstract No. 2200In another study, Shreya Sakthivel, D.O., of the Anne Arundel Medical Center in Washington, D.C., and colleagues found a potential benefit for certain cardiometabolic agents, including glucagon-like peptide-1 (GLP-1) receptor agonists, in patients with rheumatoid arthritis that goes beyond the well-documented glycemic or weight-management effects.According to the study results, the patient group receiving GLP-1 receptor agonists had a higher flare composite score compared with the disease-modifying antirheumatic drug (DMARD)-only group and the DMARD + sodium-glucose cotransporter-2 (SGLT2) inhibitor group.The authors looked further by comparing the before and after treatment periods for each patient group and found that patients with rheumatoid arthritis taking SGLT2 inhibitors experienced a statistically significant reduction in rheumatoid arthritis flares compared with their pretreatment period. The use of GLP-1 receptor agonists also showed a trend toward flare reduction, although the effect was smaller."While the study is observational and cannot prove causation, the notable improvement in disease activity between these two medications suggests that they may play a beneficial role in reducing inflammatory disease activity in rheumatoid arthritis," Sakthivel said. "The observed reduction in flare activity for both SGLT2s and GLP-1s suggests potential immunomodulatory benefits beyond metabolic control and may have implications for disease activity. On the other hand, improvement in comorbidities may also contribute to decreased inflammatory burden and, in turn, lower rheumatoid arthritis disease activity. Further research is needed to clarify mechanisms, identify nonresponders, and determine whether these agents could eventually complement DMARD therapy in select patients."Abstract No. 1369David Felson, M.D., of Boston University, and colleagues found that SGLT2 inhibitor users exhibit a greater reduced risk of osteoarthritis compared with GLP-1 receptor agonist users.The authors aimed to estimate the effect of long-term GLP-1 receptor agonist use on the five-year risk for osteoarthritis, taking treatment adherence into account. SGLT2 inhibitors were selected as an active comparator. Like GLP-1 receptor agonists, SGLT2 inhibitors have potent anti-inflammatory effects, which might help prevent osteoarthritis outcomes, but they do not cause major weight loss. The researchers found that the five-year risk for osteoarthritis was 16 percent greater in GLP-1 receptor agonist users versus SGLT2 inhibitor users."SGLT2 inhibitor users showed a reduced risk of osteoarthritis outcomes when compared to GLP-1 receptor agonists. However, when looking at only semaglutide, which causes a lot of weight loss, the risk of OA was comparable in both groups. Thus, SGLT2 inhibitor drugs may be effective treatments for osteoarthritis," Felson said. "We need additional evidence for the beneficial effects of SGLT2 inhibitors for osteoarthritis."Abstract 0165.Sign up for our weekly HealthDay newsletter