{
  "abstract": "Objectives Whether treatment response differs across affected joints in rheumatoid arthritis (RA) remains unclear. We sought to determine whether responses to tumour necrosis factor inhibitors (TNFi) and other biologic/targeted synthetic disease-modifying antirheumatic drugs (b/tsDMARDs) vary across individual joints in a large cohort of patients with RA.Methods Patients with RA from the Swiss Clinical Quality Management in Rheumatic Diseases registry with ≥1 swollen joint at treatment initiation of a b/tsDMARD (abatacept, interleukin-6 receptor inhibitor (IL-6Ri), Janus kinase inhibitor (JAKi), rituximab and TNFi) were included. Time to resolution of swollen joints was evaluated over a 2-year follow-up using mixed effects models accounting for interval-censored data. The analyses compared the speed of improvement of individual joints within the 28-joint count to that of the wrist. The primary analysis focused on bio-naïve patients initiating TNFi treatment, while secondary analyses included all b/tsDMARD classes, irrespective of treatment line.Results A TNFi was initiated in 598 patients with ≥1 swollen joint, while 1942 patients with ≥1 swollen joint started a b/tsDMARD (abatacept: 242, IL-6Ri: 317, JAKi: 333, rituximab: 176, TNFi: 874). Compared with the wrist, all joints demonstrated higher rates of resolution, except for the second and third metacarpophalangeal (MCP2/3) joints and, in some analyses, the knee. This pattern of joint-specific response was consistent across all b/tsDMARDs.Conclusions The wrist, MCP2 and MCP3 joints resolve more slowly than other joints following treatment with b/tsDMARDs, indicating that a longer evaluation period of treatment response and/or bridging intra-articular steroid injections may be required when these joints are affected.",
  "authors": [
    {
      "affiliations": [
        "Department of Rheumatology, University Hospital Zurich, University of Zurich, Zürich, Switzerland"
      ],
      "name": "Annik Steimer"
    },
    {
      "affiliations": [
        "Swiss Clinical Quality Management in Rheumatic Diseases Foundation, Zurich, Switzerland"
      ],
      "name": "Andrea Götschi"
    },
    {
      "affiliations": [
        "Swiss Clinical Quality Management in Rheumatic Diseases Foundation, Zurich, Switzerland"
      ],
      "name": "Jonas Brändli"
    },
    {
      "affiliations": [
        "Division of Rheumatology, Geneva University Hospital, Geneva, Switzerland",
        "Geneva Center for Inflammation Research, University of Geneva, Geneva, Switzerland"
      ],
      "name": "Kim Lauper"
    },
    {
      "affiliations": [
        "Department of Rheumatology, University Hospital Basel, University of Basel, Basel, Switzerland"
      ],
      "name": "Diego Kyburz"
    },
    {
      "affiliations": [
        "Department of Rheumatology and Immunology, Inselspital, Bern University Hospital, University of Bern, Berne, Switzerland"
      ],
      "name": "Burkhard Möller"
    },
    {
      "affiliations": [
        "Department of Rheumatology and Immunology, Inselspital, Bern University Hospital, University of Bern, Berne, Switzerland",
        "Department of Rheumatology, Cantonal Hospital Aarau, Aarau, Switzerland"
      ],
      "name": "Sabine Adler"
    },
    {
      "affiliations": [
        "Department of Rheumatology, Cantonal Hospital St. Gallen, St. Gallen, Switzerland"
      ],
      "name": "Frauke Förger"
    },
    {
      "affiliations": [
        "Department of Rheumatology, Lausanne University Hospital (CHUV), University of Lausanne, Lausanne, Switzerland"
      ],
      "name": "Diana Dan"
    },
    {
      "affiliations": [
        "Division of Rheumatology, La Chaux-de-Fonds Hospital, La Chaux-de-Fonds, Switzerland"
      ],
      "name": "Laure Brulhart Bletsas"
    },
    {
      "affiliations": [
        "Patient Research Partner, Canton Aargau, Switzerland"
      ],
      "name": "Penelope Timpert-Argust"
    },
    {
      "affiliations": [
        "Private Rheumatology Practice, Uster, Switzerland"
      ],
      "name": "Michael Andor"
    },
    {
      "affiliations": [
        "Department of Rheumatology, University Hospital Zurich, University of Zurich, Zürich, Switzerland"
      ],
      "name": "Oliver Distler"
    },
    {
      "affiliations": [
        "Department of Rheumatology, University Hospital Zurich, University of Zurich, Zürich, Switzerland"
      ],
      "name": "Raphael Micheroli"
    },
    {
      "affiliations": [
        "Division of Rheumatology, Geneva University Hospital, Geneva, Switzerland",
        "Geneva Center for Inflammation Research, University of Geneva, Geneva, Switzerland"
      ],
      "name": "Axel Finckh"
    },
    {
      "affiliations": [
        "Department of Rheumatology, University Hospital Zurich, University of Zurich, Zürich, Switzerland"
      ],
      "name": "Caroline Ospelt"
    },
    {
      "affiliations": [
        "Department of Rheumatology, University Hospital Zurich, University of Zurich, Zürich, Switzerland"
      ],
      "name": "Adrian Ciurea"
    }
  ],
  "title": "Site-specific articular responses to b/tsDMARDs in rheumatoid arthritis: a longitudinal observational study from the Swiss Clinical Quality Management Registry",
  "uid": "837a1b1b-55a1-54dd-9bf7-40627188be25"
}