2f:I[703058,["/_next/static/immutable/chunks/3bhq_5eh1d760.js","/_next/static/immutable/chunks/1855-ogyi8eh4.js","/_next/static/immutable/chunks/2pfsjpn6k6zlg.js","/_next/static/immutable/chunks/26c7v3_3uwnwu.js","/_next/static/immutable/chunks/25a3ozcrvi1ff.js","/_next/static/immutable/chunks/2r4wx50nvjh_4.js","/_next/static/immutable/chunks/23fsw06hsi5b1.js","/_next/static/immutable/chunks/06_yt270h41rg.js","/_next/static/immutable/chunks/3ezsiz-7shkna.js","/_next/static/immutable/chunks/20x2y96ldu5wx.js","/_next/static/immutable/chunks/2lxntcm3pd1_h.js","/_next/static/immutable/chunks/00dgco8irq3jw.js","/_next/static/immutable/chunks/00nwe-kq0rboc.js","/_next/static/immutable/chunks/2051ffx3xzio9.js"],"PaperListPageClient"] 30:T695,To describe disease activity and treatments received during the postpartum period, breastfeeding rates and their possible impact on rheumatoid arthritis (RA) and spondyloarthritis (SpA) activity. This ancillary study from the French multicentre prospective cohort (GR2-NCT02450396) included pregnant women with RA and SpA with at least one postpartum visit from October 2014 to October 2022. Disease activity, flares, treatments and breastfeeding rates were described. Factors associated with the occurrence of a flare were evaluated by survival analysis. Disease activity was compared according to breastfeeding duration (never, <6 months and ≥6 months). Ninety-four RA and 124 SpA patients were studied. In RA patients, the proportion of patients presenting with at least one flare was significantly higher during the first 6 months postpartum compared with pregnancy (62.0% vs 43.5%; p=0.02). For SpA patients, there was no difference in disease activity at 6 months postpartum compared with pregnancy (40.7% vs 40.7%; p=0.999). Disease activity in postpartum was similar between the different breastfeeding status in both diseases. 13/91 (14.3%) RA patients and 29/123 (23.6%) SpA patients continued a biologic Disease-Modifying Antirheumatic Drug (bDMARD) during the whole pregnancy and the postpartum. 78/91 RA and 94/123 SpA patients delivered without any DMARDs, and among them, 43/78 (55.1%) and 56/94 (59.6%) (re)started a bDMARD postpartum. RA patients were more likely to flare during early postpartum, while SpA patients remained stable. bDMARD continuation during pregnancy was more frequent in SpA patients, and half of the patients restarted bDMARD during postpartum.31:T9b8, Objective To describe disease activity and treatments received during the postpartum period, breastfeeding rates and their possible impact on rheumatoid arthritis (RA) and spondyloarthritis (SpA) activity. Method This ancillary study from the French multicentre prospective cohort (GR2- NCT02450396 ) included pregnant women with RA and SpA with at least one postpartum visit from October 2014 to October 2022. Disease activity, flares, treatments and breastfeeding rates were described. Factors associated with the occurrence of a flare were evaluated by survival analysis. Disease activity was compared according to breastfeeding duration (never, <6 months and ≥6 months). Results Ninety-four RA and 124 SpA patients were studied. In RA patients, the proportion of patients presenting with at least one flare was significantly higher during the first 6 months postpartum compared with pregnancy (62.0% vs 43.5%; p=0.02). For SpA patients, there was no difference in disease activity at 6 months postpartum compared with pregnancy (40.7% vs 40.7%; p=0.999). Disease activity in postpartum was similar between the different breastfeeding status in both diseases. 13/91 (14.3%) RA patients and 29/123 (23.6%) SpA patients continued a biologic Disease-Modifying Antirheumatic Drug (bDMARD) during the whole pregnancy and the postpartum. 78/91 RA and 94/123 SpA patients delivered without any DMARDs, and among them, 43/78 (55.1%) and 56/94 (59.6%) (re)started a bDMARD postpartum. Conclusion RA patients were more likely to flare during early postpartum, while SpA patients remained stable. bDMARD continuation during pregnancy was more frequent in SpA patients, and half of the patients restarted bDMARD during postpartum. 32:T6f3,Osteoporosis causes fractures that further increase the disease burden of rheumatoid arthritis (RA); however, osteoporosis treatment rates remain low. Although several studies have reported that biologic or targeted synthetic disease-modifying antirheumatic drugs (b/tsDMARDs) can prevent or improve osteoporosis in RA, our large-scale, real-world study showed that one-year b/tsDMARDs use did not arrest osteoporosis progression. This study aimed to examine longer-term changes in bone mineral density (BMD). BMD was observed for up to five years in patients receiving b/tsDMARDs for active RA. The primary endpoint was change in BMD (T score), and the secondary endpoint was change in T score-related factors. In total, 797 patients (antiosteoporosis-, n = 645; antiosteoporosis+, n = 152) were included, with a median 3.1-year follow-up (2,489 patient-years). Clinical Disease Activity Index (CDAI) improved in both groups (antiosteoporosis- 26.0 to 6.6; antiosteoporosis+ 24.4 to 6.8). T scores decreased significantly in the femoral neck and radius in the antiosteoporosis- group but not in the antiosteoporosis+ group (antiosteoporosis-: mean change -0.11 to -0.33, both P < 0.001; antiosteoporosis+ -0.01 to -0.10, P = 0.830 and 0.071, respectively). Overall, 460 patients (58%) experienced a decrease in T score. A high baseline T score correlated with a subsequent decrease, whereas longer osteoporosis treatment duration correlated with an increase. Unexpectedly, the duration of b/tsDMARD use and mean CDAI during observation were not associated with BMD maintenance. Even when RA activity was controlled with b/tsDMARDs, BMD still decreased. This study emphasizes the importance of considering osteoporosis as an independent aspect of RA, beyond inflammation control.33:Tbfd, Objective Osteoporosis causes fractures that further increase the disease burden of rheumatoid arthritis (RA); however, osteoporosis treatment rates remain low. Although several studies have reported that biologic or targeted synthetic disease‐modifying antirheumatic drugs (b/tsDMARDs) can prevent or improve osteoporosis in RA, our large‐scale, real‐world study showed that one‐year b/tsDMARDs use did not arrest osteoporosis progression. This study aimed to examine longer‐term changes in bone mineral density (BMD). Methods BMD was observed for up to five years in patients receiving b/tsDMARDs for active RA. The primary endpoint was change in BMD (T score), and the secondary endpoint was change in T score–related factors. Results In total, 797 patients (antiosteoporosis–, n = 645; antiosteoporosis+, n = 152) were included, with a median 3.1‐year follow‐up (2,489 patient‐years). Clinical Disease Activity Index (CDAI) improved in both groups (antiosteoporosis– 26.0 to 6.6; antiosteoporosis+ 24.4 to 6.8). T scores decreased significantly in the femoral neck and radius in the antiosteoporosis− group but not in the antiosteoporosis+ group (antiosteoporosis–: mean change –0.11 to –0.33, both P < 0.001; antiosteoporosis+ –0.01 to –0.10, P = 0.830 and 0.071, respectively). Overall, 460 patients (58%) experienced a decrease in T score. A high baseline T score correlated with a subsequent decrease, whereas longer osteoporosis treatment duration correlated with an increase. Unexpectedly, the duration of b/tsDMARD use and mean CDAI during observation were not associated with BMD maintenance. Conclusion Even when RA activity was controlled with b/tsDMARDs, BMD still decreased. This study emphasizes the importance of considering osteoporosis as an independent aspect of RA, beyond inflammation control.

image

25:[[["$","script","0",{"type":"application/ld+json","dangerouslySetInnerHTML":{"__html":"{\"@context\":\"https://schema.org\",\"@type\":\"CollectionPage\",\"name\":\"Biologic Disease-Modifying Antirheumatic Drug: modality Research & Clinical Takeaways\",\"description\":\"Explore peer-reviewed papers on Biologic Disease-Modifying Antirheumatic Drug (modality). Clinician-written summaries and actionable practice insights. Updated daily.\",\"url\":\"https://www.reachrx.ai/hub/tag/modality/Biologic%20Disease-Modifying%20Antirheumatic%20Drug\",\"breadcrumb\":{\"@type\":\"BreadcrumbList\",\"itemListElement\":[{\"@type\":\"ListItem\",\"position\":1,\"name\":\"Home\",\"item\":\"https://www.reachrx.ai\"},{\"@type\":\"ListItem\",\"position\":2,\"name\":\"Research Hub\",\"item\":\"https://www.reachrx.ai/hub\"},{\"@type\":\"ListItem\",\"position\":3,\"name\":\"Modalities\",\"item\":\"https://www.reachrx.ai/hub/tag/modality\"},{\"@type\":\"ListItem\",\"position\":4,\"name\":\"Biologic Disease-Modifying Antirheumatic Drug\",\"item\":\"https://www.reachrx.ai/hub/tag/modality/Biologic%20Disease-Modifying%20Antirheumatic%20Drug\"}]}}"}}]],["$","$L2f",null,{"title":"Biologic Disease-Modifying Antirheumatic Drug: Research & Clinical Takeaways","description":"Review evidence by treatment modality: Biologic Disease-Modifying Antirheumatic Drug — concise summaries and practical next steps.","papers":[{"doi":"10.1016/j.ard.2026.06.021","pmid":"42443018","title":"Influence of national socioeconomic status on treatment retention and disease activity in psoriatic arthritis and axial spondyloarthritis: evidence over 2 years in 13 European countries","journal_title":"Annals of the Rheumatic Diseases","journal_issn":"0003-4967","published_at":"2026-07-13T00:00:00.000Z","url":"https://doi.org/10.1016/j.ard.2026.06.021","source_score":26,"is_retracted":false,"is_open_access":false,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-08-12T13:26:20.276Z","updated_at":"2026-08-12T13:26:20.276Z","tags":[{"paper_doi":"10.1016/j.ard.2026.06.021","tag_type":"age_group","value":"adult","value_numeric":null},{"paper_doi":"10.1016/j.ard.2026.06.021","tag_type":"category","value":"Rheumatology","value_numeric":null},{"paper_doi":"10.1016/j.ard.2026.06.021","tag_type":"condition","value":"Axial Spondyloarthritis","value_numeric":null},{"paper_doi":"10.1016/j.ard.2026.06.021","tag_type":"condition","value":"Psoriatic Arthritis","value_numeric":null},{"paper_doi":"10.1016/j.ard.2026.06.021","tag_type":"impact_flag","value":"practice_changing","value_numeric":null},{"paper_doi":"10.1016/j.ard.2026.06.021","tag_type":"level_of_evidence","value":"3","value_numeric":null},{"paper_doi":"10.1016/j.ard.2026.06.021","tag_type":"modality","value":"Biologic Disease-Modifying Antirheumatic Drug","value_numeric":null},{"paper_doi":"10.1016/j.ard.2026.06.021","tag_type":"modality","value":"Targeted Synthetic Disease-Modifying Antirheumatic Drug","value_numeric":null},{"paper_doi":"10.1016/j.ard.2026.06.021","tag_type":"sample_size","value":"n=38911","value_numeric":38911},{"paper_doi":"10.1016/j.ard.2026.06.021","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1016/j.ard.2026.06.021","tag_type":"study_design","value":"Longitudinal Cohort Study","value_numeric":null},{"paper_doi":"10.1016/j.ard.2026.06.021","tag_type":"warning","value":"Age distribution of the cohort is not specified in the abstract; 'adult' age group is assumed based on typical spondyloarthritis registry populations.","value_numeric":null},{"paper_doi":"10.1016/j.ard.2026.06.021","tag_type":"warning","value":"No specific biologic or targeted synthetic agents are named in the abstract; brand and generic drug tags could not be assigned.","value_numeric":null},{"paper_doi":"10.1016/j.ard.2026.06.021","tag_type":"warning","value":"The 'practice_changing' impact flag is applied with caution — while findings are novel and policy-relevant, the ecological study design limits direct clinical translation at the individual patient level.","value_numeric":null}],"summaries":{"what_studied":"This study examined how national socioeconomic indicators (GDP per capita, HDI, gross national income, health expenditure, out-of-pocket expenditure) relate to b/tsDMARD treatment retention at 6, 12, and 24 months and disease activity at treatment initiation in 38,911 patients with PsA (n=17,296) or axSpA (n=21,615) across 13 European countries from 2015–2021.","key_result":"Higher national wealth was paradoxically associated with **earlier** b/tsDMARD discontinuation — retention was significantly lower in high-GDP countries vs. medium/low-GDP countries at 6, 12, and 24 months (log-rank P<.001 for all). Conversely, patients in lower-GDP countries started treatment with **worse disease activity**, especially in PsA. The strongest socioeconomic effects on retention were seen with GDP per capita and HDI, and were most pronounced in women with axSpA.","limitations":"- Country-level (ecological) socioeconomic indicators were used rather than individual patient-level socioeconomic data, limiting causal inference.\n- Registry data may reflect variation in prescribing practices, access policies, and drug availability across countries rather than purely socioeconomic effects.\n- The 2015–2021 timeframe may not reflect more recent changes in drug access or health policy across Europe.","practice_takeaway":"In lower-income European countries, patients with PsA and axSpA tend to start biologics with higher disease burden and stay on them longer — possibly due to restricted switching options rather than better drug performance. Clinicians and health policy makers in these settings should actively monitor disease activity at treatment initiation and ensure timely access to treatment optimization."}},{"doi":"10.1093/rheumatology/keag281","pmid":"42216248","title":"Cycling versus swapping strategies for treatment of psoriatic arthritis after primary tumor necrosis factor inhibitors failure: a systematic review and meta-analysis","journal_title":"Rheumatology","journal_issn":"1462-0324","published_at":"2026-05-29T00:00:00.000Z","url":"https://doi.org/10.1093/rheumatology/keag281","source_score":13,"is_retracted":false,"is_open_access":false,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-06-03T13:44:34.183Z","updated_at":"2026-06-03T13:44:34.183Z","tags":[{"paper_doi":"10.1093/rheumatology/keag281","tag_type":"age_group","value":"adult","value_numeric":null},{"paper_doi":"10.1093/rheumatology/keag281","tag_type":"category","value":"Rheumatology","value_numeric":null},{"paper_doi":"10.1093/rheumatology/keag281","tag_type":"condition","value":"Psoriatic Arthritis","value_numeric":null},{"paper_doi":"10.1093/rheumatology/keag281","tag_type":"impact_flag","value":"confirms_prior","value_numeric":null},{"paper_doi":"10.1093/rheumatology/keag281","tag_type":"level_of_evidence","value":"3","value_numeric":null},{"paper_doi":"10.1093/rheumatology/keag281","tag_type":"modality","value":"Biologic Disease-Modifying Antirheumatic Drug","value_numeric":null},{"paper_doi":"10.1093/rheumatology/keag281","tag_type":"modality","value":"Tumor Necrosis Factor Inhibitor","value_numeric":null},{"paper_doi":"10.1093/rheumatology/keag281","tag_type":"sample_size","value":"n=2300","value_numeric":2300},{"paper_doi":"10.1093/rheumatology/keag281","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1093/rheumatology/keag281","tag_type":"study_design","value":"Systematic Review and Meta-Analysis","value_numeric":null},{"paper_doi":"10.1093/rheumatology/keag281","tag_type":"warning","value":"Disease duration range (3.7–12 years) across studies suggests heterogeneous patient populations that may affect generalizability.","value_numeric":null},{"paper_doi":"10.1093/rheumatology/keag281","tag_type":"warning","value":"Heterogeneity was very high (I²=71–94%) for all pooled outcomes, meaning the meta-analytic estimates should be interpreted with caution.","value_numeric":null},{"paper_doi":"10.1093/rheumatology/keag281","tag_type":"warning","value":"No RCTs were identified; all 5 included studies were observational, and confounding by indication is likely (e.g., clinicians may preferentially cycle or swap based on reason for TNFi failure).","value_numeric":null},{"paper_doi":"10.1093/rheumatology/keag281","tag_type":"warning","value":"Specific bDMARD classes used in the 'swapping' arm (e.g., IL-17i, IL-12/23i, CTLA4-Ig) are not detailed in the abstract, limiting granularity of clinical guidance.","value_numeric":null}],"summaries":{"what_studied":"This systematic review and meta-analysis of 5 observational studies (n=2,300 PsA patients) compared **cycling** (switching to a second TNFi) versus **swapping** (switching to a bDMARD with a different mechanism) after primary TNFi failure, evaluating lack of response, 12- and 24-month drug retention, and adverse events.","key_result":"No significant differences were found between cycling and swapping for any outcome: lack of response (RR 0.99; 95% CI 0.70–1.41), 12-month retention (RR 0.91; 95% CI 0.75–1.10), 24-month retention (RR 0.96; 95% CI 0.53–1.75), or adverse events (RR 0.94; 95% CI 0.38–2.34). However, heterogeneity was very high across all outcomes (I²=71–94%).","limitations":"- All 5 included studies were observational (no RCTs found), limiting causal inference.\n- Extremely high heterogeneity (I²=71–94%) across all outcomes undermines pooled estimates.\n- Definitions of 'lack of response' varied by study, making comparisons less reliable.","practice_takeaway":"After a TNFi fails in PsA, cycling to another TNFi or swapping to a different biologic class appears to yield similar drug retention and safety at 1–2 years. Clinicians can reasonably individualize the choice based on patient characteristics, comorbidities, and preference."}},{"doi":"10.1136/rmdopen-2025-006593","pmid":"42049394","title":"Impact of postpartum on patients with rheumatoid arthritis and spondyloarthritis: an ancillary analysis of the GR2 prospective cohort","journal_title":"RMD Open","journal_issn":"2056-5933","published_at":"2026-04-29T00:00:00.000Z","url":"https://doi.org/10.1136/rmdopen-2025-006593","source_score":17,"is_retracted":false,"is_open_access":true,"raw_metadata":{"ooir":{"day":"2026-04-30","doi":"10.1136/rmdopen-2025-006593","days":"14","issn":"2056-5933","rank":"6","field":"Clinical Medicine","score":"17","category":"Rheumatology","categories":["Rheumatology"],"_categories":["Rheumatology"]},"pubmed":{"doi":"10.1136/rmdopen-2025-006593","title":"Impact of postpartum on patients with rheumatoid arthritis and spondyloarthritis: an ancillary analysis of the GR2 prospective cohort.","journal":"RMD open","methods":"This ancillary study from the French multicentre prospective cohort (GR2-NCT02450396) included pregnant women with RA and SpA with at least one postpartum visit from October 2014 to October 2022. Disease activity, flares, treatments and breastfeeding rates were described. Factors associated with the occurrence of a flare were evaluated by survival analysis. Disease activity was compared according to breastfeeding duration (never, <6 months and ≥6 months).","results":"Ninety-four RA and 124 SpA patients were studied. In RA patients, the proportion of patients presenting with at least one flare was significantly higher during the first 6 months postpartum compared with pregnancy (62.0% vs 43.5%; p=0.02). For SpA patients, there was no difference in disease activity at 6 months postpartum compared with pregnancy (40.7% vs 40.7%; p=0.999). Disease activity in postpartum was similar between the different breastfeeding status in both diseases. 13/91 (14.3%) RA patients and 29/123 (23.6%) SpA patients continued a biologic Disease-Modifying Antirheumatic Drug (bDMARD) during the whole pregnancy and the postpartum. 78/91 RA and 94/123 SpA patients delivered without any DMARDs, and among them, 43/78 (55.1%) and 56/94 (59.6%) (re)started a bDMARD postpartum.","abstract":"$30","keywords":["Arthritis, Rheumatoid","Axial Spondyloarthritis","Biological Therapy"],"pubmed_id":"42049394","conclusions":"RA patients were more likely to flare during early postpartum, while SpA patients remained stable. bDMARD continuation during pregnancy was more frequent in SpA patients, and half of the patients restarted bDMARD during postpartum.","publication_date":"2026-04-29T00:00:00"},"crossref":{"DOI":"10.1136/rmdopen-2025-006593","URL":"https://doi.org/10.1136/rmdopen-2025-006593","ISSN":["2056-5933"],"link":[{"URL":"https://syndication.highwire.org/content/doi/10.1136/rmdopen-2025-006593","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"page":"e006593","type":"journal-article","issue":"2","score":1,"title":["Impact of postpartum on patients with rheumatoid arthritis and spondyloarthritis: an ancillary analysis of the GR2 prospective cohort"],"author":[{"given":"Marie","family":"Hornez","sequence":"first","affiliation":[{"name":"Service de Rhumatologie, Université de Lille, CHU Lille, Lille, France"}]},{"given":"Anna","family":"Molto","sequence":"additional","affiliation":[{"name":"Centre for Research in Epidemiology and Statistics, Université Paris Cité; Université Sorbonne Paris Nord; INSERM; INRAE, Paris, France"},{"name":"Service de Rhumatologie, Hôpital Bichat, APHP, Paris, France"}]},{"given":"Maxime","family":"Leroy","sequence":"additional","affiliation":[{"name":"Department of Biostatistics, CHU Lille, Lille, France"}]},{"given":"Béatrice","family":"Banneville","sequence":"additional","affiliation":[{"name":"Service de Rhumatologie, Sorbonne Université and Pitié Salpêtrière Hospital, Paris, France"}]},{"given":"Rakiba","family":"Belkhir","sequence":"additional","affiliation":[{"name":"Service de Rhumatologie, Université Paris-Saclay, Assistance Publique-Hôpitaux de Paris, Hôpital Bicêtre, Le Kremlin-Bicetre, France"}]},{"given":"Elodie","family":"Chauvet","sequence":"additional","affiliation":[{"name":"Service de Médecine Interne, CHU Montpellier, Montpellier, France"}]},{"given":"Marion","family":"Couderc","sequence":"additional","affiliation":[{"name":"Service de Rhumatologie, CHU Gabriel Montpied, Clermont-Ferrand, France"}]},{"given":"Emmanuelle","family":"Dernis","sequence":"additional","affiliation":[{"name":"Service de Rhumatologie, CHU Caen, Caen, France"}]},{"given":"Valérie","family":"Devauchelle-Pensec","sequence":"additional","affiliation":[{"name":"Service de Rhumatologie, UMR1227, Lymphocytes B et Autoimmunité, Université de Bretagne occidentale, Inserm, CHU Brest, LabEx IGO, Brest, France"},{"name":"Rheumatology Unit, Centre National de Référence des Maladies Auto-Immunes Rares (CERAINOM), CHU, Brest, France"}]},{"given":"Aline","family":"Frazier","sequence":"additional","affiliation":[{"name":"Service de Rhumatologie, Université Paris Cité, AP-HP, Hôpital Lariboisière, Paris, France"}]},{"given":"Laure","family":"Gossec","sequence":"additional","affiliation":[{"name":"Service de Rhumatologie, Sorbonne Université and Pitié Salpêtrière Hospital, Paris, France"}]},{"given":"Elisabeth","family":"Gervais","sequence":"additional","affiliation":[{"name":"Service de Rhumatologie, CHU Poitiers, Poitiers, France"}]},{"given":"Hubert","family":"Marotte","sequence":"additional","affiliation":[{"name":"Service de Rhumatologie, Université Jean Monnet Saint-Étienne, CHU Saint-Etienne, Mines Saint-Etienne, INSERM, SAINBIOSE U1059, Saint-Étienne, France"}]},{"given":"Christophe","family":"Richez","sequence":"additional","affiliation":[{"name":"Service de Rhumatologie, National Reference Center for Systemic Autoimmune Rare Diseases, Bordeaux University Hospital, Hôpital Pellegrin, Bordeaux, France"},{"name":"CNRS, Immunoconcept, UMR 5164, Bordeaux University, Bordeaux, France"}]},{"given":"Jérémie","family":"Sellam","sequence":"additional","affiliation":[{"name":"Service de Rhumatologie, Hôpital Saint-Antoine; Assistance Publique–Hôpitaux de Paris (AP-HP); Sorbonne Université, Paris, France"}]},{"given":"Raphaele","family":"Seror","sequence":"additional","affiliation":[{"name":"Service de Rhumatologie, Université Paris-Saclay, Assistance Publique-Hôpitaux de Paris, Hôpital Bicêtre, Le Kremlin-Bicetre, France"}]},{"given":"Véronique","family":"Le Guern","sequence":"additional","affiliation":[{"name":"Service de Médecine Interne, Centre de Référence Maladies Autoimmunes et Systémiques Rares Île de France, APHP Hôpital Cochin, Paris, France"}]},{"given":"Gaëlle","family":"Guettrot-Imbert","sequence":"additional","affiliation":[{"name":"Service de Médecine Interne, Centre de Référence Maladies Autoimmunes et Systémiques Rares Île de France, APHP Hôpital Cochin, Paris, France"}]},{"given":"Nathalie","family":"Costedoat-Chalumeau","sequence":"additional","affiliation":[{"name":"Service de Médecine Interne, Centre de Référence Maladies Autoimmunes et Systémiques Rares Île de France, APHP Hôpital Cochin, Paris, France"}]},{"given":"René-Marc","family":"Flipo","sequence":"additional","affiliation":[{"name":"Service de Rhumatologie, Université de Lille, CHU Lille, FHU PRECISE, Lille, France"}]},{"given":"Jean-Guillaume","family":"Letarouilly","sequence":"additional","affiliation":[{"name":"Service de Rhumatologie, Université de Lille, CHU Lille, FHU PRECISE, U1286 - INFINITE - Institute for Translational Research in Inflammation, Lille, France"}]}],"funder":[{"name":"the Association Prix Veronique Roualet"},{"id":[{"id":"10.13039/100011110","id-type":"DOI","asserted-by":"publisher"}],"DOI":"10.13039/100011110","name":"UCB","doi-asserted-by":"publisher"},{"name":"AFM-Telethon"},{"name":"Cochin Hospital"},{"name":"Association Francophone contre la Polychondrite chronique atrophiante"},{"id":[{"id":"10.13039/100020799","id-type":"DOI","asserted-by":"publisher"}],"DOI":"10.13039/100020799","name":"Association des Sclérodermiques de France","doi-asserted-by":"publisher"},{"id":[{"id":"10.13039/501100014034","id-type":"DOI","asserted-by":"publisher"}],"DOI":"10.13039/501100014034","name":"Foundation for Research in Rheumatology","doi-asserted-by":"publisher"},{"name":"the French Society of Internal Medicine and Rheumatology"},{"name":"Association Gougerot Sjogren"},{"name":"The French Health Ministry"},{"name":"Lupus France"}],"issued":{"date-parts":[[2026,4]]},"member":"239","prefix":"10.1136","source":"Crossref","volume":"12","created":{"date-time":"2026-04-28T13:25:21Z","timestamp":1777382721000,"date-parts":[[2026,4,28]]},"indexed":{"date-time":"2026-04-29T12:21:56Z","timestamp":1777465316482,"date-parts":[[2026,4,29]]},"license":[{"URL":"https://creativecommons.org/licenses/by-nc/4.0/","start":{"date-time":"2026-04-28T00:00:00Z","timestamp":1777334400000,"date-parts":[[2026,4,28]]},"delay-in-days":27,"content-version":"unspecified"}],"subject":[],"abstract":"$31","accepted":{"date-parts":[[2026,3,31]]},"language":"en","relation":{},"resource":{"primary":{"URL":"https://rmdopen.bmj.com/lookup/doi/10.1136/rmdopen-2025-006593"}},"subtitle":[],"deposited":{"date-time":"2026-04-28T13:25:26Z","timestamp":1777382726000,"date-parts":[[2026,4,28]]},"issn-type":[{"type":"electronic","value":"2056-5933"}],"published":{"date-parts":[[2026,4]]},"publisher":"BMJ","reference":[{"DOI":"10.1016/j.jbspin.2021.105289","key":"2026042806251264000_12.2.e006593.1","year":"2022","issue":null,"author":"Fakih","volume":"89","first-page":"105289","unstructured":null,"article-title":"Differences in distribution by department of prevalence and incidence of spondyloarthritis and inflammatory bowel diseases declared to the French National Health Insurance and their evolution between 2008 and 2018","journal-title":"Joint Bone Spine","doi-asserted-by":"crossref"},{"DOI":"10.1016/j.jbspin.2022.105460","key":"2026042806251264000_12.2.e006593.2","year":"2023","issue":null,"author":"Pina Vegas","volume":"90","first-page":"105460","unstructured":null,"article-title":"Prevalence, mortality, and treatment of patients with rheumatoid arthritis: A cohort study of the French National Health Data System, 2010-2019","journal-title":"Joint Bone Spine","doi-asserted-by":"crossref"},{"DOI":null,"key":"2026042806251264000_12.2.e006593.3","year":null,"issue":null,"author":null,"volume":null,"first-page":null,"unstructured":"Hench PS . The ameliorating effect of pregnancy on chronic atrophic (infectious rheumatoid) arthritis, fibrositis, and intermittent hydrarthrosis. In: Classic Papers in Rheumatology. CRC Press, 2001.","article-title":null,"journal-title":null,"doi-asserted-by":null},{"DOI":"10.1002/1529-0131(199906)42:6<1219::AID-ANR19>3.0.CO;2-G","key":"2026042806251264000_12.2.e006593.4","year":null,"issue":null,"author":null,"volume":null,"first-page":null,"unstructured":null,"article-title":null,"journal-title":null,"doi-asserted-by":"publisher"},{"DOI":"10.1002/art.24003","key":"2026042806251264000_12.2.e006593.5","year":null,"issue":null,"author":null,"volume":null,"first-page":null,"unstructured":null,"article-title":null,"journal-title":null,"doi-asserted-by":"publisher"},{"DOI":"10.3899/jrheum.180226","key":"2026042806251264000_12.2.e006593.6","year":null,"issue":null,"author":null,"volume":null,"first-page":null,"unstructured":null,"article-title":null,"journal-title":null,"doi-asserted-by":"publisher"},{"DOI":"10.1007/s10067-021-05588-9","key":"2026042806251264000_12.2.e006593.7","year":"2021","issue":null,"author":"Mokbel","volume":"40","first-page":"3465","unstructured":null,"article-title":"Pregnancy outcomes in women with ankylosing spondylitis: a scoping literature and methodological review","journal-title":"Clin Rheumatol","doi-asserted-by":"crossref"},{"DOI":"10.1136/ard.2003.016881","key":"2026042806251264000_12.2.e006593.8","year":null,"issue":null,"author":null,"volume":null,"first-page":null,"unstructured":null,"article-title":null,"journal-title":null,"doi-asserted-by":"publisher"},{"DOI":"10.1093/rheumatology/key047","key":"2026042806251264000_12.2.e006593.9","year":"2018","issue":null,"author":"Ursin","volume":"57","first-page":"1064","unstructured":null,"article-title":"Disease activity during and after pregnancy in women with axial spondyloarthritis: a prospective multicentre study","journal-title":"Rheumatology (Sunnyvale)","doi-asserted-by":"crossref"},{"DOI":"10.3899/jrheum.180805","key":"2026042806251264000_12.2.e006593.10","year":null,"issue":null,"author":null,"volume":null,"first-page":null,"unstructured":null,"article-title":null,"journal-title":null,"doi-asserted-by":"publisher"},{"DOI":"10.3899/jrheum.181067","key":"2026042806251264000_12.2.e006593.11","year":null,"issue":null,"author":null,"volume":null,"first-page":null,"unstructured":null,"article-title":null,"journal-title":null,"doi-asserted-by":"publisher"},{"DOI":"10.1002/art.1780370605","key":"2026042806251264000_12.2.e006593.12","year":null,"issue":null,"author":null,"volume":null,"first-page":null,"unstructured":null,"article-title":null,"journal-title":null,"doi-asserted-by":"publisher"},{"DOI":"10.1002/1529-0131(200005)43:5<1010::AID-ANR8>3.0.CO;2-O","key":"2026042806251264000_12.2.e006593.13","year":null,"issue":null,"author":null,"volume":null,"first-page":null,"unstructured":null,"article-title":null,"journal-title":null,"doi-asserted-by":"publisher"},{"DOI":"10.1136/ard.2007.084707","key":"2026042806251264000_12.2.e006593.14","year":null,"issue":null,"author":null,"volume":null,"first-page":null,"unstructured":null,"article-title":null,"journal-title":null,"doi-asserted-by":"publisher"},{"DOI":"10.1002/art.20621","key":"2026042806251264000_12.2.e006593.15","year":null,"issue":null,"author":null,"volume":null,"first-page":null,"unstructured":null,"article-title":null,"journal-title":null,"doi-asserted-by":"publisher"},{"DOI":"10.1007/s10067-018-04415-y","key":"2026042806251264000_12.2.e006593.16","year":"2019","issue":null,"author":"Vieira Borba","volume":"38","first-page":"1263","unstructured":null,"article-title":"Prolactin, autoimmunity, and motherhood: when should women avoid breastfeeding?","journal-title":"Clin Rheumatol","doi-asserted-by":"crossref"},{"DOI":"10.1093/rheumatology/kev404","key":"2026042806251264000_12.2.e006593.17","year":"2016","issue":null,"author":"Flint","volume":"55","first-page":"1693","unstructured":null,"article-title":"BSR and BHPR guideline on prescribing drugs in pregnancy and breastfeeding—Part I: standard and biologic disease modifying anti-rheumatic drugs and corticosteroids: Table 1","journal-title":"Rheumatology (Sunnyvale)","doi-asserted-by":"crossref"},{"DOI":"10.1136/annrheumdis-2015-208840","key":"2026042806251264000_12.2.e006593.18","year":null,"issue":null,"author":null,"volume":null,"first-page":null,"unstructured":null,"article-title":null,"journal-title":null,"doi-asserted-by":"publisher"},{"DOI":"10.1002/art.41191","key":"2026042806251264000_12.2.e006593.19","year":"2020","issue":null,"author":"Sammaritano","volume":"72","first-page":"529","unstructured":null,"article-title":"2020 American College of Rheumatology Guideline for the Management of Reproductive Health in Rheumatic and Musculoskeletal Diseases","journal-title":"Arthritis Rheumatol","doi-asserted-by":"crossref"},{"DOI":null,"key":"2026042806251264000_12.2.e006593.20","year":null,"issue":null,"author":null,"volume":null,"first-page":null,"unstructured":"European Network of Pregnancy Registers in Rheumatology (EuNeP) . An overview of procedures and data collection. Arthritis Research & Therapy. Available: https://arthritis-research.biomedcentral.com/articles/10.1186/s13075-019-2019-3 [Accessed 03 May 2023].","article-title":null,"journal-title":null,"doi-asserted-by":null},{"DOI":"10.1186/s13075-019-2019-3","key":"2026042806251264000_12.2.e006593.21","year":"2019","issue":null,"author":"Meissner","volume":"21","first-page":null,"unstructured":null,"article-title":"European Network of Pregnancy Registers in Rheumatology (EuNeP)-an overview of procedures and data collection","journal-title":"Arthritis Res Ther","doi-asserted-by":"crossref"},{"DOI":"10.1136/annrheumdis-2020-218356","key":"2026042806251264000_12.2.e006593.22","year":null,"issue":null,"author":null,"volume":null,"first-page":null,"unstructured":null,"article-title":null,"journal-title":null,"doi-asserted-by":"publisher"},{"DOI":"10.1016/S2665-9913(23)00099-1","key":"2026042806251264000_12.2.e006593.23","year":"2023","issue":null,"author":"de Frémont","volume":"5","first-page":"e330","unstructured":null,"article-title":"Pregnancy outcomes in women with primary Sjögren’s syndrome: an analysis of data from the multicentre, prospective, GR2 study","journal-title":"Lancet Rheumatol","doi-asserted-by":"crossref"},{"DOI":"10.1016/S2665-9913(22)00308-3","key":"2026042806251264000_12.2.e006593.24","year":"2022","issue":null,"author":"Murarasu","volume":"4","first-page":"e842","unstructured":null,"article-title":"Characterisation of a high-risk profile for maternal thrombotic and severe haemorrhagic complications in pregnant women with antiphospholipid syndrome in France (GR2): a multicentre, prospective, observational study","journal-title":"Lancet Rheumatol","doi-asserted-by":"crossref"},{"DOI":null,"key":"2026042806251264000_12.2.e006593.25","year":"2014","issue":null,"author":"van Riel","volume":"32","first-page":"65","unstructured":null,"article-title":"The development of the disease activity score (DAS) and the disease activity score using 28 joint counts (DAS28)","journal-title":"Clin Exp Rheumatol","doi-asserted-by":null},{"DOI":"10.1016/j.jbspin.2022.105505","key":"2026042806251264000_12.2.e006593.26","year":"2023","issue":null,"author":"Valero","volume":"90","first-page":"105505","unstructured":null,"article-title":"Evaluating remission and low disease activity from the perspective of the patient with axial spondyloarthritis: The cross-sectional ConREspAx study","journal-title":"Joint Bone Spine","doi-asserted-by":"crossref"},{"DOI":"10.4103/ijmr.IJMR_701_15","key":"2026042806251264000_12.2.e006593.27","year":"2017","issue":null,"author":"Kumar","volume":"146","first-page":"S57","unstructured":null,"article-title":"Comparison of Disease Activity Score in 28 joints with ESR (DAS28), Clinical Disease Activity Index (CDAI), Health Assessment Questionnaire Disability Index (HAQ-DI) & Routine Assessment of Patient Index Data with 3 measures (RAPID3) for assessing disease activity in patients with rheumatoid arthritis at initial presentation","journal-title":"Indian J Med Res","doi-asserted-by":"crossref"},{"DOI":null,"key":"2026042806251264000_12.2.e006593.28","year":null,"issue":null,"author":null,"volume":null,"first-page":null,"unstructured":"Partial residuals for the proportional hazards regression model. ResearchGate; 2025. Available: https://www.researchgate.net/publication/30941900_Partial_Residuals_for_The_Proportional_Hazards_Regression_Model [Accessed 16 Sep 2025].","article-title":null,"journal-title":null,"doi-asserted-by":null},{"DOI":"10.1136/annrheumdis-2021-eular.420","key":"2026042806251264000_12.2.e006593.29","year":null,"issue":null,"author":null,"volume":null,"first-page":null,"unstructured":null,"article-title":null,"journal-title":null,"doi-asserted-by":"publisher"},{"DOI":"10.3389/fimmu.2021.722118","key":"2026042806251264000_12.2.e006593.30","year":"2021","issue":null,"author":"Wirestam","volume":"12","first-page":null,"unstructured":null,"article-title":"Plasma C-Reactive Protein and Pentraxin-3 Reference Intervals During Normal Pregnancy","journal-title":"Front Immunol","doi-asserted-by":"crossref"},{"DOI":"10.1136/ard-2022-222641","key":"2026042806251264000_12.2.e006593.31","year":null,"issue":null,"author":null,"volume":null,"first-page":null,"unstructured":null,"article-title":null,"journal-title":null,"doi-asserted-by":"publisher"},{"DOI":"10.1016/j.autrev.2018.08.008","key":"2026042806251264000_12.2.e006593.32","year":null,"issue":null,"author":null,"volume":null,"first-page":null,"unstructured":null,"article-title":null,"journal-title":null,"doi-asserted-by":"publisher"},{"DOI":"10.1136/rmdopen-2022-002194","key":"2026042806251264000_12.2.e006593.33","year":"2022","issue":null,"author":"Kemper","volume":"8","first-page":null,"unstructured":null,"article-title":"Active counselling and well-controlled disease result in a higher percentage of women with rheumatoid arthritis that breast feed: results from the PreCARA study","journal-title":"RMD Open","doi-asserted-by":"crossref"},{"DOI":"10.1007/s00404-022-06463-x","key":"2026042806251264000_12.2.e006593.34","year":"2022","issue":null,"author":"Allen","volume":"306","first-page":"1929","unstructured":null,"article-title":"Pregnant women with immune mediated inflammatory diseases who discontinue biologics have higher rates of disease flare","journal-title":"Arch Gynecol Obstet","doi-asserted-by":"crossref"},{"DOI":"10.3389/fphar.2022.887462","key":"2026042806251264000_12.2.e006593.35","year":"2022","issue":null,"author":"Gerardi","volume":"13","first-page":null,"unstructured":null,"article-title":"Stopping bDMARDs at the beginning of pregnancy is associated with disease flares and preterm delivery in women with rheumatoid arthritis","journal-title":"Front Pharmacol","doi-asserted-by":"crossref"},{"DOI":"10.1186/s13075-017-1269-1","key":"2026042806251264000_12.2.e006593.36","year":"2017","issue":null,"author":"van den Brandt","volume":"19","first-page":null,"unstructured":null,"article-title":"Risk factors for flare and treatment of disease flares during pregnancy in rheumatoid arthritis and axial spondyloarthritis patients","journal-title":"Arthritis Res Ther","doi-asserted-by":"crossref"},{"DOI":"10.3899/jrheum.171152","key":"2026042806251264000_12.2.e006593.37","year":null,"issue":null,"author":null,"volume":null,"first-page":null,"unstructured":null,"article-title":null,"journal-title":null,"doi-asserted-by":"publisher"},{"DOI":"10.1016/S0140-6736(15)01024-7","key":"2026042806251264000_12.2.e006593.38","year":null,"issue":null,"author":null,"volume":null,"first-page":null,"unstructured":null,"article-title":null,"journal-title":null,"doi-asserted-by":"publisher"},{"DOI":null,"key":"2026042806251264000_12.2.e006593.39","year":"2021","issue":null,"author":"Coulm","volume":"20","first-page":"10","unstructured":null,"article-title":"Allaiter en France aujourd’hui","journal-title":"Sages-Femmes","doi-asserted-by":null},{"DOI":"10.1016/j.jgyn.2015.09.026","key":"2026042806251264000_12.2.e006593.40","year":"2015","issue":null,"author":"Chantry","volume":"44","first-page":"1071","unstructured":null,"article-title":"Breastfeeding (part one): Frequency, benefits and drawbacks, optimal duration and factors influencing its initiation and prolongation. Clinical guidelines for practice","journal-title":"J Gynecol Obstet Biol Reprod (Paris)","doi-asserted-by":"crossref"},{"DOI":"10.1136/lupus-2021-000491","key":"2026042806251264000_12.2.e006593.41","year":"2021","issue":null,"author":"Ikram","volume":"8","first-page":null,"unstructured":null,"article-title":"Breastfeeding in women with rheumatic diseases","journal-title":"Lupus Sci Med","doi-asserted-by":"crossref"},{"DOI":"10.3389/fimmu.2017.00720","key":"2026042806251264000_12.2.e006593.42","year":"2017","issue":null,"author":"Tang","volume":"8","first-page":null,"unstructured":null,"article-title":"Insight into the Endocrine System and the Immune System: A Review of the Inflammatory Role of Prolactin in Rheumatoid Arthritis and Psoriatic Arthritis","journal-title":"Front Immunol","doi-asserted-by":"crossref"}],"short-title":[],"journal-issue":{"issue":"2","published-print":{"date-parts":[[2026,4]]},"published-online":{"date-parts":[[2026,4,28]]}},"update-policy":"https://doi.org/10.1136/crossmarkpolicy","alternative-id":["10.1136/rmdopen-2025-006593"],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"original-title":[],"container-title":["RMD Open"],"published-print":{"date-parts":[[2026,4]]},"reference-count":42,"published-online":{"date-time":null,"timestamp":null,"date-parts":[[2026,4,28]]},"references-count":42,"clinical-trial-number":[{"registry":"10.18810/clinical-trials-gov","clinical-trial-number":"nct02450396"},{"registry":"10.18810/clinical-trials-gov","clinical-trial-number":"nct02450396"}],"short-container-title":["RMD Open"],"is-referenced-by-count":0},"unpaywall":{"doi":"10.1136/rmdopen-2025-006593","is_oa":true,"title":"Impact of postpartum on patients with rheumatoid arthritis and spondyloarthritis: an ancillary analysis of the GR2 prospective cohort","updated":"2026-05-09T14:24:07+00:00","published_date":"2026-04-01","best_oa_location":{"url":"https://doi.org/10.1136/rmdopen-2025-006593","pmh_id":null,"url_for_pdf":null,"url_for_landing_page":"https://doi.org/10.1136/rmdopen-2025-006593"}}},"created_at":"2026-05-14T13:22:56.018Z","updated_at":"2026-05-14T15:13:26.918Z","tags":[{"paper_doi":"10.1136/rmdopen-2025-006593","tag_type":"age_group","value":"adult","value_numeric":null},{"paper_doi":"10.1136/rmdopen-2025-006593","tag_type":"category","value":"Rheumatology","value_numeric":null},{"paper_doi":"10.1136/rmdopen-2025-006593","tag_type":"condition","value":"Rheumatoid Arthritis","value_numeric":null},{"paper_doi":"10.1136/rmdopen-2025-006593","tag_type":"condition","value":"Spondyloarthritis","value_numeric":null},{"paper_doi":"10.1136/rmdopen-2025-006593","tag_type":"generic","value":"adalimumab","value_numeric":null},{"paper_doi":"10.1136/rmdopen-2025-006593","tag_type":"generic","value":"certolizumab pegol","value_numeric":null},{"paper_doi":"10.1136/rmdopen-2025-006593","tag_type":"generic","value":"etanercept","value_numeric":null},{"paper_doi":"10.1136/rmdopen-2025-006593","tag_type":"generic","value":"golimumab","value_numeric":null},{"paper_doi":"10.1136/rmdopen-2025-006593","tag_type":"generic","value":"infliximab","value_numeric":null},{"paper_doi":"10.1136/rmdopen-2025-006593","tag_type":"generic","value":"methotrexate","value_numeric":null},{"paper_doi":"10.1136/rmdopen-2025-006593","tag_type":"generic","value":"sulfasalazine","value_numeric":null},{"paper_doi":"10.1136/rmdopen-2025-006593","tag_type":"impact_flag","value":"confirms_prior","value_numeric":null},{"paper_doi":"10.1136/rmdopen-2025-006593","tag_type":"level_of_evidence","value":"2","value_numeric":null},{"paper_doi":"10.1136/rmdopen-2025-006593","tag_type":"level_of_evidence","value":"3","value_numeric":null},{"paper_doi":"10.1136/rmdopen-2025-006593","tag_type":"modality","value":"Biologic Disease-Modifying Antirheumatic Drug","value_numeric":null},{"paper_doi":"10.1136/rmdopen-2025-006593","tag_type":"modality","value":"Biologic DMARD","value_numeric":null},{"paper_doi":"10.1136/rmdopen-2025-006593","tag_type":"modality","value":"TNF Alpha Inhibitor","value_numeric":null},{"paper_doi":"10.1136/rmdopen-2025-006593","tag_type":"sample_size","value":"n=218","value_numeric":218},{"paper_doi":"10.1136/rmdopen-2025-006593","tag_type":"sex","value":"female","value_numeric":null},{"paper_doi":"10.1136/rmdopen-2025-006593","tag_type":"study_design","value":"Prospective Cohort","value_numeric":null},{"paper_doi":"10.1136/rmdopen-2025-006593","tag_type":"study_design","value":"Prospective Cohort Study","value_numeric":null},{"paper_doi":"10.1136/rmdopen-2025-006593","tag_type":"warning","value":"Certolizumab pegol is classified here under TNF alpha inhibitors and listed by generic name; no brand-level data were reported in the paper.","value_numeric":null},{"paper_doi":"10.1136/rmdopen-2025-006593","tag_type":"warning","value":"Definitions of flare and the specific disease activity measures are not provided in the abstract.","value_numeric":null},{"paper_doi":"10.1136/rmdopen-2025-006593","tag_type":"warning","value":"Disease activity scores were frequently missing, especially CRP, which may have reduced sensitivity to detect objective changes in activity.","value_numeric":null},{"paper_doi":"10.1136/rmdopen-2025-006593","tag_type":"warning","value":"Observational ancillary cohort analysis without randomized comparisons; causal inferences are limited.","value_numeric":null},{"paper_doi":"10.1136/rmdopen-2025-006593","tag_type":"warning","value":"Self-reported flare definitions may overestimate true flare rates compared to validated score-based definitions.","value_numeric":null},{"paper_doi":"10.1136/rmdopen-2025-006593","tag_type":"warning","value":"The association between bDMARD resumption and postpartum flare is likely reverse causation (flare prompts treatment restart) rather than treatment causing flare—authors acknowledge this.","value_numeric":null},{"paper_doi":"10.1136/rmdopen-2025-006593","tag_type":"warning","value":"Treatment denominators (e.g., 91/123) differ from total enrolled (94/124), suggesting missing data or exclusions.","value_numeric":null}],"summaries":{"what_studied":"An ancillary analysis of a French multicentre prospective cohort (GR2) followed pregnant women with rheumatoid arthritis (RA) or spondyloarthritis (SpA) who had at least one postpartum visit (2014–2022) to describe disease activity, flares, breastfeeding, and treatments. Postpartum disease activity was compared with pregnancy, flares were examined with survival analysis, and outcomes were explored by breastfeeding duration (never, <6 months, ≥6 months).","key_result":"In RA, the proportion with at least one flare in the first 6 months postpartum was higher than during pregnancy (62.0% vs 43.5%; p=0.02). In SpA, disease activity at 6 months postpartum was unchanged versus pregnancy (40.7% vs 40.7%; p=0.999); postpartum activity did not differ by breastfeeding status in either disease; 13/91 (14.3%) RA and 29/123 (23.6%) SpA continued a bDMARD through pregnancy and postpartum, and among those delivering without any DMARDs (RA 78/91; SpA 94/123), 43/78 (55.1%) and 56/94 (59.6%) (re)started a bDMARD postpartum.","limitations":"Only patients with at least one postpartum visit were included, and denominators varied across analyses (e.g., 91/123 vs totals 94/124), indicating missing data or exclusions. The abstract does not specify flare definitions or disease activity measures, and adjusted analyses are not reported.","practice_takeaway":"Plan closer monitoring of women with RA in the first 6 months after delivery, when flares were more frequent than during pregnancy; SpA activity appeared stable. Breastfeeding did not change postpartum activity, and many who stopped DMARDs in pregnancy restarted bDMARDs after delivery."}},{"doi":"10.1093/rheumatology/keag240","pmid":"42033784","title":"Clinical outcomes in psoriatic arthritis patients with rheumatoid factor positivity","journal_title":"Rheumatology","journal_issn":"1462-0324","published_at":"2026-04-25T00:00:00.000Z","url":"https://doi.org/10.1093/rheumatology/keag240","source_score":12,"is_retracted":false,"is_open_access":true,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-05-10T13:20:40.711Z","updated_at":"2026-05-10T13:20:40.711Z","tags":[{"paper_doi":"10.1093/rheumatology/keag240","tag_type":"age_group","value":"adult","value_numeric":null},{"paper_doi":"10.1093/rheumatology/keag240","tag_type":"category","value":"Rheumatology","value_numeric":null},{"paper_doi":"10.1093/rheumatology/keag240","tag_type":"condition","value":"Psoriatic Arthritis","value_numeric":null},{"paper_doi":"10.1093/rheumatology/keag240","tag_type":"impact_flag","value":"practice_changing","value_numeric":null},{"paper_doi":"10.1093/rheumatology/keag240","tag_type":"level_of_evidence","value":"3","value_numeric":null},{"paper_doi":"10.1093/rheumatology/keag240","tag_type":"modality","value":"Biologic Disease-Modifying Antirheumatic Drug","value_numeric":null},{"paper_doi":"10.1093/rheumatology/keag240","tag_type":"sample_size","value":"n=1074","value_numeric":1074},{"paper_doi":"10.1093/rheumatology/keag240","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1093/rheumatology/keag240","tag_type":"study_design","value":"Prospective Cohort Study","value_numeric":null},{"paper_doi":"10.1093/rheumatology/keag240","tag_type":"warning","value":"RF positivity in PsA may overlap with or suggest concomitant rheumatoid arthritis in some patients — this distinction is not fully addressed in the abstract.","value_numeric":null},{"paper_doi":"10.1093/rheumatology/keag240","tag_type":"warning","value":"The 'practice_changing' impact flag is applied cautiously; while results are clinically meaningful, this is observational data from a single cohort.","value_numeric":null},{"paper_doi":"10.1093/rheumatology/keag240","tag_type":"warning","value":"The study does not specify which bDMARDs were used, so drug-specific discontinuation rates cannot be inferred.","value_numeric":null}],"summaries":{"what_studied":"This cohort study (n=1,074 PsA patients enrolled after 1996) examined the frequency of rheumatoid factor (RF) positivity and its association with minimal disease activity (MDA) achievement and biologic DMARD (bDMARD) discontinuation, using multivariable generalized estimating equations.","key_result":"RF positivity (found in 16.1% overall; 5.1% at baseline) was linked to lower odds of achieving MDA (MV OR 0.53, 95% CI 0.37–0.77), driven by worse pain, global scores, and physical function. RF positivity also nearly tripled the odds of bDMARD discontinuation (ever positive: OR 2.65, 95% CI 1.34–5.24; newly positive: OR 2.78, 95% CI 1.57–4.92), independent of joint and skin disease activity.","limitations":"- RF was defined as 'ever' or 'newly' positive, which may introduce time-varying classification bias.\n- Observational cohort design limits causal inference.\n- Generalizability may be restricted given enrollment from a single large PsA cohort.","practice_takeaway":"Screen PsA patients for RF positivity, as even newly detected RF signals worse treatment response and higher bDMARD discontinuation risk — independent of joint or skin activity. Consider closer monitoring and earlier treatment adjustment in RF-positive PsA patients on biologics."}},{"doi":"10.1002/art.70125","pmid":"41797301","title":"Biologic and Targeted Synthetic Disease‐Modifying Antirheumatic Drugs Do Not Arrest Bone Loss in Patients With Rheumatoid Arthritis: A Long‐Term Multicenter Observational Study","journal_title":"Arthritis & Rheumatology","journal_issn":"2326-5191","published_at":"2026-03-09T00:00:00.000Z","url":"https://doi.org/10.1002/art.70125","source_score":22,"is_retracted":false,"is_open_access":true,"raw_metadata":{"ooir":{"day":"2026-04-25","doi":"10.1002/art.70125","days":"30","issn":"2326-5191","rank":"8","field":"Clinical Medicine","score":"22","category":"Rheumatology","categories":["Rheumatology"],"_categories":["Rheumatology"]},"pubmed":{"doi":"10.1002/art.70125","title":"Biologic and Targeted Synthetic Disease-Modifying Antirheumatic Drugs Do Not Arrest Bone Loss in Patients With Rheumatoid Arthritis: A Long-Term Multicenter Observational Study.","journal":"Arthritis & rheumatology (Hoboken, N.J.)","methods":"","results":"In total, 797 patients (antiosteoporosis-, n = 645; antiosteoporosis+, n = 152) were included, with a median 3.1-year follow-up (2,489 patient-years). Clinical Disease Activity Index (CDAI) improved in both groups (antiosteoporosis- 26.0 to 6.6; antiosteoporosis+ 24.4 to 6.8). T scores decreased significantly in the femoral neck and radius in the antiosteoporosis- group but not in the antiosteoporosis+ group (antiosteoporosis-: mean change -0.11 to -0.33, both P < 0.001; antiosteoporosis+ -0.01 to -0.10, P = 0.830 and 0.071, respectively). Overall, 460 patients (58%) experienced a decrease in T score. A high baseline T score correlated with a subsequent decrease, whereas longer osteoporosis treatment duration correlated with an increase. Unexpectedly, the duration of b/tsDMARD use and mean CDAI during observation were not associated with BMD maintenance.","abstract":"$32","keywords":[],"pubmed_id":"41797301","conclusions":"Even when RA activity was controlled with b/tsDMARDs, BMD still decreased. This study emphasizes the importance of considering osteoporosis as an independent aspect of RA, beyond inflammation control.","publication_date":"2026-03-09T00:00:00"},"crossref":{"DOI":"10.1002/art.70125","URL":"https://doi.org/10.1002/art.70125","ISSN":["2326-5191","2326-5205"],"link":[{"URL":"https://acrjournals.onlinelibrary.wiley.com/doi/pdf/10.1002/art.70125","content-type":"application/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https://acrjournals.onlinelibrary.wiley.com/doi/full-xml/10.1002/art.70125","content-type":"application/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https://acrjournals.onlinelibrary.wiley.com/doi/pdf/10.1002/art.70125","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"page":null,"type":"journal-article","issue":null,"score":1,"title":["Biologic and Targeted Synthetic Disease‐Modifying Antirheumatic Drugs Do Not Arrest Bone Loss in Patients With Rheumatoid Arthritis: A Long‐Term Multicenter Observational Study"],"author":[{"given":"Takafumi","family":"Aritomi","sequence":"first","affiliation":[{"name":"First Department of Internal Medicine School of Medicine, University of Occupational and Environmental Health Japan Kitakyushu Japan"},{"name":"Department of Laboratory and Transfusion Medicine Hospital of the University of Occupational and Environmental Health Japan Kitakyushu Japan"}]},{"given":"Koshiro","family":"Sonomoto","sequence":"additional","affiliation":[{"name":"First Department of Internal Medicine School of Medicine, University of Occupational and Environmental Health Japan Kitakyushu Japan"},{"name":"Department of Clinical Nursing School of Health Sciences, University of Occupational and Environmental Health Japan Kitakyushu Japan"},{"name":"Department of Rheumatology Shunan Memorial Hospital Kudamatsu Japan"}]},{"given":"Shingo","family":"Nakayamada","sequence":"additional","affiliation":[{"name":"First Department of Internal Medicine School of Medicine, University of Occupational and Environmental Health Japan Kitakyushu Japan"},{"name":"Department of Rheumatology Saiseikai Yahata General Hospital Kitakyushu Japan"}]},{"given":"Hiroaki","family":"Tanaka","sequence":"additional","affiliation":[{"name":"First Department of Internal Medicine School of Medicine, University of Occupational and Environmental Health Japan Kitakyushu Japan"},{"name":"Department of Medical Informatics and Management Hospital of the University of Occupational and Environmental Health Japan Kitakyushu Japan"}]},{"given":"Atsushi","family":"Nagayasu","sequence":"additional","affiliation":[{"name":"First Department of Internal Medicine School of Medicine, University of Occupational and Environmental Health Japan Kitakyushu Japan"},{"name":"Department of Infectious Disease Medicine School of Medicine, University of Occupational and Environmental Health Japan Kitakyushu Japan"}]},{"given":"Satoshi","family":"Kubo","sequence":"additional","affiliation":[{"name":"First Department of Internal Medicine School of Medicine, University of Occupational and Environmental Health Japan Kitakyushu Japan"},{"name":"Department of Rheumatology Kyusyu Rosai Hospital Kitakyushu Japan"}]},{"given":"Ippei","family":"Miyagawa","sequence":"additional","affiliation":[{"name":"First Department of Internal Medicine School of Medicine, University of Occupational and Environmental Health Japan Kitakyushu Japan"},{"name":"Department of Molecular Targeted Therapeutics University of Occupational and Environmental Health Japan, Kitakyushu Japan"},{"name":"Department of Rheumatology Kokura Memorial Hospital Kitakyushu Japan"}]},{"given":"Ayako","family":"Yamaguchi","sequence":"additional","affiliation":[{"name":"First Department of Internal Medicine School of Medicine, University of Occupational and Environmental Health Japan Kitakyushu Japan"},{"name":"Department of Laboratory and Transfusion Medicine Hospital of the University of Occupational and Environmental Health Japan Kitakyushu Japan"},{"name":"Department of Rheumatology Fukuoka Shin Mizumaki Hospital Kitakyushu Japan"},{"name":"Department of Rheumatology Shin‐Kokura Hospital Kitakyushu Japan"}]},{"given":"Naoaki","family":"Ohkubo","sequence":"additional","affiliation":[{"name":"First Department of Internal Medicine School of Medicine, University of Occupational and Environmental Health Japan Kitakyushu Japan"},{"name":"Department of Environmental Epidemiology University of Occupational and Environmental Health Japan Kitakyushu Japan"},{"name":"Department of Rheumatology Obase Hospital Kanda Japan"}]},{"given":"Yasuyuki","family":"Todoroki","sequence":"additional","affiliation":[{"name":"First Department of Internal Medicine School of Medicine, University of Occupational and Environmental Health Japan Kitakyushu Japan"},{"name":"Department of Molecular Targeted Therapeutics University of Occupational and Environmental Health Japan, Kitakyushu Japan"},{"name":"Department of Rheumatology Steel Memorial Yawata Hospital Kitakyushu Japan"}]},{"given":"Yurie","family":"Satoh‐Kanda","sequence":"additional","affiliation":[{"name":"First Department of Internal Medicine School of Medicine, University of Occupational and Environmental Health Japan Kitakyushu Japan"},{"name":"Department of Rheumatology Tochiku Hospital Kitakyushu Japan"}]},{"given":"Masanobu","family":"Ueno","sequence":"additional","affiliation":[{"name":"First Department of Internal Medicine School of Medicine, University of Occupational and Environmental Health Japan Kitakyushu Japan"}]},{"given":"Ryuichiro","family":"Kanda","sequence":"additional","affiliation":[{"name":"First Department of Internal Medicine School of Medicine, University of Occupational and Environmental Health Japan Kitakyushu Japan"}]},{"given":"Yuya","family":"Fujita","sequence":"additional","affiliation":[{"name":"First Department of Internal Medicine School of Medicine, University of Occupational and Environmental Health Japan Kitakyushu Japan"},{"name":"Department of Rheumatology Ashiya Central Hospital Kitakyushu Japan"}]},{"given":"Masashi","family":"Funada","sequence":"additional","affiliation":[{"name":"First Department of Internal Medicine School of Medicine, University of Occupational and Environmental Health Japan Kitakyushu Japan"}]},{"given":"Hidenori","family":"Sakai","sequence":"additional","affiliation":[{"name":"First Department of Internal Medicine School of Medicine, University of Occupational and Environmental Health Japan Kitakyushu Japan"},{"name":"Department of Rheumatology Yamaguchi‐ken Saiseikai Shimonoseki General Hospital Shimonoseki Japan"}]},{"given":"Satsuki","family":"Matsunaga","sequence":"additional","affiliation":[{"name":"First Department of Internal Medicine School of Medicine, University of Occupational and Environmental Health Japan Kitakyushu Japan"},{"name":"Department of Rheumatology Yamaguchi Rosai Hospital Sanyo‐Onoda Japan"}]},{"given":"Hiroaki","family":"Tanaka","sequence":"additional","affiliation":[{"name":"First Department of Internal Medicine School of Medicine, University of Occupational and Environmental Health Japan Kitakyushu Japan"},{"name":"Department of Rheumatology Hagiwara Central Hospital Kitakyushu Japan"}]},{"given":"Masayuki","family":"Shinojima","sequence":"additional","affiliation":[{"name":"First Department of Internal Medicine School of Medicine, University of Occupational and Environmental Health Japan Kitakyushu Japan"},{"name":"Department of Rheumatology Kenai Memorial Hospital Kitakyushu Japan"}]},{"given":"Hiroki","family":"Kawamura","sequence":"additional","affiliation":[{"name":"First Department of Internal Medicine School of Medicine, University of Occupational and Environmental Health Japan Kitakyushu Japan"},{"name":"Department of Rheumatology Ohira Medical Care Hospital Kitakyushu Japan"}]},{"given":"Kazuki","family":"Takahashi","sequence":"additional","affiliation":[{"name":"First Department of Internal Medicine School of Medicine, University of Occupational and Environmental Health Japan Kitakyushu Japan"},{"name":"Department of Rheumatology Hosoe Clinic Shimonoseki Japan"}]},{"given":"Miyabi","family":"Ando","sequence":"additional","affiliation":[{"name":"First Department of Internal Medicine School of Medicine, University of Occupational and Environmental Health Japan Kitakyushu Japan"},{"name":"Department of Rheumatology Sasaki Hospital Kitakyushu Japan"}]},{"given":"Kazuki","family":"Haru","sequence":"additional","affiliation":[{"name":"First Department of Internal Medicine School of Medicine, University of Occupational and Environmental Health Japan Kitakyushu Japan"},{"name":"Department of Rheumatology Yoshino Hospital Kitakyushu Japan"}]},{"given":"Yusuke","family":"Miyazaki","sequence":"additional","affiliation":[{"name":"First Department of Internal Medicine School of Medicine, University of Occupational and Environmental Health Japan Kitakyushu Japan"},{"name":"Department of Rheumatology and Diabetology Wakamatsu Hospital of the University of Occupational and Environmental Health Japan Kitakyushu Japan"}]},{"given":"Kentaro","family":"Hanami","sequence":"additional","affiliation":[{"name":"Department of Rheumatology and Diabetology Kitakyushu General Hospital Kitakyushu Japan"}]},{"given":"Masao","family":"Nawata","sequence":"additional","affiliation":[{"name":"Department of Rheumatology Kokura Rheumatology Clinic Kitakyushu Japan"}]},{"given":"Shunsuke","family":"Fukuyo","sequence":"additional","affiliation":[{"name":"First Department of Internal Medicine School of Medicine, University of Occupational and Environmental Health Japan Kitakyushu Japan"},{"name":"Department of Rheumatology and Diabetology Wakamatsu Hospital of the University of Occupational and Environmental Health Japan Kitakyushu Japan"}]},{"given":"Keisuke","family":"Nakatsuka","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Japan Community Health care Organization Fukuoka Yutaka Central Hospital Nogata Japan"}]},{"given":"Mikiko","family":"Tokunaga","sequence":"additional","affiliation":[{"name":"Hakataeki Minami Tokunaga Clinic Fukuoka Japan"}]},{"given":"Kazuyoshi","family":"Saito","sequence":"additional","affiliation":[{"name":"Department of Clinical Immunology and Rheumatology Tobata General Hospital Kitakyushu Japan"}]},{"given":"Yoshiya","family":"Tanaka","sequence":"additional","affiliation":[{"name":"First Department of Internal Medicine School of Medicine, University of Occupational and Environmental Health Japan Kitakyushu Japan"},{"name":"Department of Molecular Targeted Therapeutics University of Occupational and Environmental Health Japan, Kitakyushu Japan"}]}],"funder":[{"id":[{"id":"10.13039/100016239","id-type":"DOI","asserted-by":"publisher"}],"DOI":"10.13039/100016239","name":"University of Occupational and Environmental Health","award":["19K17919"],"award-info":[{"award-number":["19K17919"]}],"doi-asserted-by":"publisher"}],"issued":{"date-parts":[[2026,4,21]]},"member":"311","prefix":"10.1002","source":"Crossref","volume":null,"archive":["Portico"],"created":{"date-time":"2026-03-09T05:51:10Z","timestamp":1773035470000,"date-parts":[[2026,3,9]]},"indexed":{"date-time":"2026-04-21T11:10:42Z","timestamp":1776769842503,"date-parts":[[2026,4,21]]},"license":[{"URL":"http://onlinelibrary.wiley.com/termsAndConditions#vor","start":{"date-time":"2026-04-21T00:00:00Z","timestamp":1776729600000,"date-parts":[[2026,4,21]]},"delay-in-days":0,"content-version":"vor"},{"URL":"http://doi.wiley.com/10.1002/tdm_license_1.1","start":{"date-time":"2026-04-21T00:00:00Z","timestamp":1776729600000,"date-parts":[[2026,4,21]]},"delay-in-days":0,"content-version":"tdm"}],"subject":[],"abstract":"$33","language":"en","relation":{},"resource":{"primary":{"URL":"https://acrjournals.onlinelibrary.wiley.com/doi/10.1002/art.70125"}},"subtitle":[],"assertion":[{"name":"received","group":{"name":"publication_history","label":"Publication History"},"label":"Received","order":0,"value":"2025-10-06"},{"name":"accepted","group":{"name":"publication_history","label":"Publication History"},"label":"Accepted","order":2,"value":"2026-02-24"},{"name":"published","group":{"name":"publication_history","label":"Publication History"},"label":"Published","order":3,"value":"2026-04-21"}],"deposited":{"date-time":"2026-04-21T10:28:55Z","timestamp":1776767335000,"date-parts":[[2026,4,21]]},"issn-type":[{"type":"print","value":"2326-5191"},{"type":"electronic","value":"2326-5205"}],"published":{"date-parts":[[2026,4,21]]},"publisher":"Wiley","reference":[{"DOI":"10.3390/jcm10061241","key":"e_1_2_7_2_1","year":null,"issue":null,"author":null,"volume":null,"first-page":null,"unstructured":null,"article-title":null,"journal-title":null,"doi-asserted-by":"publisher"},{"DOI":"10.1007/s00198-017-4170-5","key":"e_1_2_7_3_1","year":null,"issue":null,"author":null,"volume":null,"first-page":null,"unstructured":null,"article-title":null,"journal-title":null,"doi-asserted-by":"publisher"},{"DOI":"10.1002/1529-0131(200003)43:3<522:AID-ANR7>3.0.CO;2-Y","key":"e_1_2_7_4_1","year":null,"issue":null,"author":null,"volume":null,"first-page":null,"unstructured":null,"article-title":null,"journal-title":null,"doi-asserted-by":"publisher"},{"DOI":"10.1038/nrendo.2014.125","key":"e_1_2_7_5_1","year":null,"issue":null,"author":null,"volume":null,"first-page":null,"unstructured":null,"article-title":null,"journal-title":null,"doi-asserted-by":"publisher"},{"DOI":"10.1016/j.berh.2022.101773","key":"e_1_2_7_6_1","year":null,"issue":null,"author":null,"volume":null,"first-page":null,"unstructured":null,"article-title":null,"journal-title":null,"doi-asserted-by":"publisher"},{"DOI":"10.1002/acr.22988","key":"e_1_2_7_7_1","year":null,"issue":null,"author":null,"volume":null,"first-page":null,"unstructured":null,"article-title":null,"journal-title":null,"doi-asserted-by":"publisher"},{"DOI":"10.1007/s00296-020-04593-6","key":"e_1_2_7_8_1","year":null,"issue":null,"author":null,"volume":null,"first-page":null,"unstructured":null,"article-title":null,"journal-title":null,"doi-asserted-by":"publisher"},{"DOI":"10.7759/cureus.17519","key":"e_1_2_7_9_1","year":null,"issue":null,"author":null,"volume":null,"first-page":null,"unstructured":null,"article-title":null,"journal-title":null,"doi-asserted-by":"publisher"},{"DOI":"10.1136/annrheumdis-2022-eular.329","key":"e_1_2_7_10_1","year":null,"issue":null,"author":null,"volume":null,"first-page":null,"unstructured":null,"article-title":null,"journal-title":null,"doi-asserted-by":"publisher"},{"DOI":"10.3899/jrheum.2025-0314.135","key":"e_1_2_7_11_1","year":null,"issue":null,"author":null,"volume":null,"first-page":null,"unstructured":null,"article-title":null,"journal-title":null,"doi-asserted-by":"publisher"},{"DOI":"10.1136/annrheumdis-2015-207524","key":"e_1_2_7_12_1","year":null,"issue":null,"author":null,"volume":null,"first-page":null,"unstructured":null,"article-title":null,"journal-title":null,"doi-asserted-by":"publisher"},{"DOI":"10.1002/art.41752","key":"e_1_2_7_13_1","year":null,"issue":null,"author":null,"volume":null,"first-page":null,"unstructured":null,"article-title":null,"journal-title":null,"doi-asserted-by":"publisher"},{"DOI":"10.1136/ard.2003.017780","key":"e_1_2_7_14_1","year":null,"issue":null,"author":null,"volume":null,"first-page":null,"unstructured":null,"article-title":null,"journal-title":null,"doi-asserted-by":"publisher"},{"DOI":"10.1093/rheumatology/kei082","key":"e_1_2_7_15_1","year":null,"issue":null,"author":null,"volume":null,"first-page":null,"unstructured":null,"article-title":null,"journal-title":null,"doi-asserted-by":"publisher"},{"DOI":"10.1196/annals.1351.040","key":"e_1_2_7_16_1","year":null,"issue":null,"author":null,"volume":null,"first-page":null,"unstructured":null,"article-title":null,"journal-title":null,"doi-asserted-by":"publisher"},{"DOI":"10.1136/ard.2005.044198","key":"e_1_2_7_17_1","year":null,"issue":null,"author":null,"volume":null,"first-page":null,"unstructured":null,"article-title":null,"journal-title":null,"doi-asserted-by":"publisher"},{"DOI":"10.1186/ar2219","key":"e_1_2_7_18_1","year":null,"issue":null,"author":null,"volume":null,"first-page":null,"unstructured":null,"article-title":null,"journal-title":null,"doi-asserted-by":"publisher"},{"DOI":"10.1136/ard.2007.076604","key":"e_1_2_7_19_1","year":null,"issue":null,"author":null,"volume":null,"first-page":null,"unstructured":null,"article-title":null,"journal-title":null,"doi-asserted-by":"publisher"},{"DOI":"10.1136/ard.2008.091611","key":"e_1_2_7_20_1","year":null,"issue":null,"author":null,"volume":null,"first-page":null,"unstructured":null,"article-title":null,"journal-title":null,"doi-asserted-by":"publisher"},{"DOI":"10.1186/1471-2474-12-54","key":"e_1_2_7_21_1","year":null,"issue":null,"author":null,"volume":null,"first-page":null,"unstructured":null,"article-title":null,"journal-title":null,"doi-asserted-by":"publisher"},{"DOI":"10.1007/s10067-012-2128-8","key":"e_1_2_7_22_1","year":null,"issue":null,"author":null,"volume":null,"first-page":null,"unstructured":null,"article-title":null,"journal-title":null,"doi-asserted-by":"publisher"},{"DOI":"10.1093/rheumatology/kes320","key":"e_1_2_7_23_1","year":null,"issue":null,"author":null,"volume":null,"first-page":null,"unstructured":null,"article-title":null,"journal-title":null,"doi-asserted-by":"publisher"},{"DOI":"10.1093/rheumatology/ket468","key":"e_1_2_7_24_1","year":null,"issue":null,"author":null,"volume":null,"first-page":null,"unstructured":null,"article-title":null,"journal-title":null,"doi-asserted-by":"publisher"},{"DOI":"10.1016/j.jbspin.2014.10.015","key":"e_1_2_7_25_1","year":null,"issue":null,"author":null,"volume":null,"first-page":null,"unstructured":null,"article-title":null,"journal-title":null,"doi-asserted-by":"publisher"},{"DOI":"10.1371/journal.pone.0188454","key":"e_1_2_7_26_1","year":null,"issue":null,"author":null,"volume":null,"first-page":null,"unstructured":null,"article-title":null,"journal-title":null,"doi-asserted-by":"publisher"},{"DOI":"10.1007/s00296-017-3922-z","key":"e_1_2_7_27_1","year":null,"issue":null,"author":null,"volume":null,"first-page":null,"unstructured":null,"article-title":null,"journal-title":null,"doi-asserted-by":"publisher"},{"DOI":"10.3389/fimmu.2021.783030","key":"e_1_2_7_28_1","year":null,"issue":null,"author":null,"volume":null,"first-page":null,"unstructured":null,"article-title":null,"journal-title":null,"doi-asserted-by":"publisher"},{"DOI":"10.1007/s00198-021-05871-0","key":"e_1_2_7_29_1","year":null,"issue":null,"author":null,"volume":null,"first-page":null,"unstructured":null,"article-title":null,"journal-title":null,"doi-asserted-by":"publisher"},{"DOI":"10.1007/s00774-025-01598-8","key":"e_1_2_7_30_1","year":null,"issue":null,"author":null,"volume":null,"first-page":null,"unstructured":null,"article-title":null,"journal-title":null,"doi-asserted-by":"publisher"},{"DOI":"10.1007/s00198-021-05824-7","key":"e_1_2_7_31_1","year":null,"issue":null,"author":null,"volume":null,"first-page":null,"unstructured":null,"article-title":null,"journal-title":null,"doi-asserted-by":"publisher"},{"DOI":"10.1093/rheumatology/kead579","key":"e_1_2_7_32_1","year":null,"issue":null,"author":null,"volume":null,"first-page":null,"unstructured":null,"article-title":null,"journal-title":null,"doi-asserted-by":"publisher"},{"DOI":"10.1007/s40744-025-00762-w","key":"e_1_2_7_33_1","year":null,"issue":null,"author":null,"volume":null,"first-page":null,"unstructured":null,"article-title":null,"journal-title":null,"doi-asserted-by":"publisher"},{"DOI":"10.1111/1756-185X.70232","key":"e_1_2_7_34_1","year":null,"issue":null,"author":null,"volume":null,"first-page":null,"unstructured":null,"article-title":null,"journal-title":null,"doi-asserted-by":"publisher"},{"DOI":"10.1002/art.27584","key":"e_1_2_7_35_1","year":null,"issue":null,"author":null,"volume":null,"first-page":null,"unstructured":null,"article-title":null,"journal-title":null,"doi-asserted-by":"publisher"},{"DOI":"10.1016/j.jocd.2019.09.001","key":"e_1_2_7_36_1","year":null,"issue":null,"author":null,"volume":null,"first-page":null,"unstructured":null,"article-title":null,"journal-title":null,"doi-asserted-by":"publisher"},{"DOI":null,"key":"e_1_2_7_37_1","year":"1994","issue":null,"author":null,"volume":"843","first-page":"1","unstructured":null,"article-title":"Assessment of fracture risk and its application to screening for postmenopausal osteoporosis. Report of a WHO Study Group","journal-title":"World Health Organ Tech Rep Ser","doi-asserted-by":null},{"DOI":"10.1016/j.bone.2007.11.001","key":"e_1_2_7_38_1","year":null,"issue":null,"author":null,"volume":null,"first-page":null,"unstructured":null,"article-title":null,"journal-title":null,"doi-asserted-by":"publisher"},{"DOI":"10.1016/j.cca.2016.06.036","key":"e_1_2_7_39_1","year":null,"issue":null,"author":null,"volume":null,"first-page":null,"unstructured":null,"article-title":null,"journal-title":null,"doi-asserted-by":"publisher"},{"DOI":"10.1001/jama.280.24.2077","key":"e_1_2_7_40_1","year":null,"issue":null,"author":null,"volume":null,"first-page":null,"unstructured":null,"article-title":null,"journal-title":null,"doi-asserted-by":"publisher"},{"DOI":"10.1001/jama.282.14.1344","key":"e_1_2_7_41_1","year":null,"issue":null,"author":null,"volume":null,"first-page":null,"unstructured":null,"article-title":null,"journal-title":null,"doi-asserted-by":"publisher"},{"DOI":"10.1007/s00198-009-1077-9","key":"e_1_2_7_42_1","year":null,"issue":null,"author":null,"volume":null,"first-page":null,"unstructured":null,"article-title":null,"journal-title":null,"doi-asserted-by":"publisher"},{"DOI":"10.1007/s00198-020-05488-9","key":"e_1_2_7_43_1","year":null,"issue":null,"author":null,"volume":null,"first-page":null,"unstructured":null,"article-title":null,"journal-title":null,"doi-asserted-by":"publisher"},{"DOI":"10.1016/j.amjmed.2022.01.017","key":"e_1_2_7_44_1","year":null,"issue":null,"author":null,"volume":null,"first-page":null,"unstructured":null,"article-title":null,"journal-title":null,"doi-asserted-by":"publisher"},{"DOI":"10.1136/rmdopen-2023-003919","key":"e_1_2_7_45_1","year":null,"issue":null,"author":null,"volume":null,"first-page":null,"unstructured":null,"article-title":null,"journal-title":null,"doi-asserted-by":"publisher"},{"DOI":"10.1007/s00198-009-1102-z","key":"e_1_2_7_46_1","year":null,"issue":null,"author":null,"volume":null,"first-page":null,"unstructured":null,"article-title":null,"journal-title":null,"doi-asserted-by":"publisher"},{"DOI":"10.1001/jama.2013.277817","key":"e_1_2_7_47_1","year":null,"issue":null,"author":null,"volume":null,"first-page":null,"unstructured":null,"article-title":null,"journal-title":null,"doi-asserted-by":"publisher"},{"DOI":"10.1210/jc.2014-3777","key":"e_1_2_7_48_1","year":null,"issue":null,"author":null,"volume":null,"first-page":null,"unstructured":null,"article-title":null,"journal-title":null,"doi-asserted-by":"publisher"},{"DOI":"10.1001/jamainternmed.2020.2986","key":"e_1_2_7_49_1","year":null,"issue":null,"author":null,"volume":null,"first-page":null,"unstructured":null,"article-title":null,"journal-title":null,"doi-asserted-by":"publisher"},{"DOI":"10.1056/NEJMoa1107142","key":"e_1_2_7_50_1","year":null,"issue":null,"author":null,"volume":null,"first-page":null,"unstructured":null,"article-title":null,"journal-title":null,"doi-asserted-by":"publisher"},{"DOI":"10.1007/s00198-016-3703-7","key":"e_1_2_7_51_1","year":null,"issue":null,"author":null,"volume":null,"first-page":null,"unstructured":null,"article-title":null,"journal-title":null,"doi-asserted-by":"publisher"},{"DOI":"10.1007/s00198-021-05900-y","key":"e_1_2_7_52_1","year":null,"issue":null,"author":null,"volume":null,"first-page":null,"unstructured":null,"article-title":null,"journal-title":null,"doi-asserted-by":"publisher"},{"DOI":"10.1016/S0969-8043(98)00026-8","key":"e_1_2_7_53_1","year":null,"issue":null,"author":null,"volume":null,"first-page":null,"unstructured":null,"article-title":null,"journal-title":null,"doi-asserted-by":"publisher"},{"DOI":"10.1093/rheumatology/kez655","key":"e_1_2_7_54_1","year":null,"issue":null,"author":null,"volume":null,"first-page":null,"unstructured":null,"article-title":null,"journal-title":null,"doi-asserted-by":"publisher"},{"DOI":"10.1136/rmdopen-2024-004564","key":"e_1_2_7_55_1","year":null,"issue":null,"author":null,"volume":null,"first-page":null,"unstructured":null,"article-title":null,"journal-title":null,"doi-asserted-by":"publisher"},{"DOI":"10.1007/s00198-017-4230-x","key":"e_1_2_7_56_1","year":null,"issue":null,"author":null,"volume":null,"first-page":null,"unstructured":null,"article-title":null,"journal-title":null,"doi-asserted-by":"publisher"},{"DOI":"10.1007/s00198-019-04844-8","key":"e_1_2_7_57_1","year":null,"issue":null,"author":null,"volume":null,"first-page":null,"unstructured":null,"article-title":null,"journal-title":null,"doi-asserted-by":"publisher"},{"DOI":"10.1007/s11657-020-00871-9","key":"e_1_2_7_58_1","year":null,"issue":null,"author":null,"volume":null,"first-page":null,"unstructured":null,"article-title":null,"journal-title":null,"doi-asserted-by":"publisher"},{"DOI":"10.1001/jama.288.15.1889","key":"e_1_2_7_59_1","year":null,"issue":null,"author":null,"volume":null,"first-page":null,"unstructured":null,"article-title":null,"journal-title":null,"doi-asserted-by":"publisher"},{"DOI":"10.1007/s11657-022-01061-5","key":"e_1_2_7_60_1","year":null,"issue":null,"author":null,"volume":null,"first-page":null,"unstructured":null,"article-title":null,"journal-title":null,"doi-asserted-by":"publisher"},{"DOI":"10.1016/j.bonr.2020.100","key":"e_1_2_7_61_1","year":null,"issue":null,"author":null,"volume":null,"first-page":null,"unstructured":null,"article-title":null,"journal-title":null,"doi-asserted-by":"publisher"}],"short-title":[],"update-policy":"https://doi.org/10.1002/crossmark_policy","alternative-id":["10.1002/art.70125"],"article-number":"art.70125","content-domain":{"domain":["acrjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"original-title":[],"container-title":["Arthritis & Rheumatology"],"reference-count":60,"published-online":{"date-time":null,"timestamp":null,"date-parts":[[2026,4,21]]},"references-count":60,"short-container-title":["Arthritis & Rheumatology"],"is-referenced-by-count":1},"unpaywall":{"doi":"10.1002/art.70125","is_oa":true,"title":"Biologic and Targeted Synthetic Disease‐Modifying Antirheumatic Drugs Do Not Arrest Bone Loss in Patients With Rheumatoid Arthritis: A Long‐Term Multicenter Observational Study","updated":"2026-04-22T09:11:45+00:00","published_date":"2026-03-09","best_oa_location":{"url":"https://doi.org/10.1002/art.70125","pmh_id":null,"url_for_pdf":null,"url_for_landing_page":"https://doi.org/10.1002/art.70125"}}},"created_at":"2026-05-07T22:49:26.774Z","updated_at":"2026-05-14T15:13:26.918Z","tags":[{"paper_doi":"10.1002/art.70125","tag_type":"age_group","value":"adult","value_numeric":null},{"paper_doi":"10.1002/art.70125","tag_type":"category","value":"Rheumatology","value_numeric":null},{"paper_doi":"10.1002/art.70125","tag_type":"condition","value":"Osteoporosis","value_numeric":null},{"paper_doi":"10.1002/art.70125","tag_type":"condition","value":"Rheumatoid Arthritis","value_numeric":null},{"paper_doi":"10.1002/art.70125","tag_type":"impact_flag","value":"practice_changing","value_numeric":null},{"paper_doi":"10.1002/art.70125","tag_type":"level_of_evidence","value":"3","value_numeric":null},{"paper_doi":"10.1002/art.70125","tag_type":"modality","value":"Anti-Osteoporosis Therapy","value_numeric":null},{"paper_doi":"10.1002/art.70125","tag_type":"modality","value":"Biologic Disease-Modifying Antirheumatic Drug","value_numeric":null},{"paper_doi":"10.1002/art.70125","tag_type":"modality","value":"Targeted Synthetic Disease-Modifying Antirheumatic Drug","value_numeric":null},{"paper_doi":"10.1002/art.70125","tag_type":"sample_size","value":"n=797","value_numeric":797},{"paper_doi":"10.1002/art.70125","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1002/art.70125","tag_type":"study_design","value":"Multicenter Observational Cohort Study","value_numeric":null},{"paper_doi":"10.1002/art.70125","tag_type":"warning","value":"Sex distribution and glucocorticoid use data are not reported in the abstract, though these are key BMD confounders in RA populations.","value_numeric":null},{"paper_doi":"10.1002/art.70125","tag_type":"warning","value":"Specific b/tsDMARD agents and anti-osteoporosis drug classes are not detailed in the abstract, limiting modality-level granularity.","value_numeric":null},{"paper_doi":"10.1002/art.70125","tag_type":"warning","value":"The observational design means confounding by indication (sicker patients more likely receiving anti-osteoporosis treatment) cannot be excluded.","value_numeric":null}],"summaries":{"what_studied":"This multicenter observational study examined long-term BMD changes (up to 5 years) in 797 RA patients on b/tsDMARDs, comparing those with and without anti-osteoporosis treatment, using T-score as the primary endpoint.","key_result":"Despite disease control (CDAI improved from ~25 to ~7 in both groups), BMD declined significantly in the femoral neck and radius in patients without anti-osteoporosis therapy (mean T-score change −0.11 to −0.33, P < 0.001), but not in those on anti-osteoporosis treatment (P = 0.830 and 0.071). Overall, 58% of patients (460/797) experienced a T-score decrease. Duration of b/tsDMARD use and mean CDAI were **not** associated with BMD maintenance.","limitations":"- Observational design limits causal inference; anti-osteoporosis treatment was not randomized.\n- Anti-osteoporosis therapy group was much smaller (n=152 vs. n=645), risking imbalance.\n- Fracture outcomes were not reported as an endpoint.","practice_takeaway":"Even with well-controlled RA on b/tsDMARDs, bone loss continues — clinicians should screen for and treat osteoporosis independently of inflammation management. Anti-osteoporosis therapy, not DMARD use alone, was associated with BMD preservation."}}],"initialOffset":5,"fetchConfig":{"kind":"tags","tags":[{"tag_type":"modality","value":"Biologic Disease-Modifying Antirheumatic Drug"}]},"breadcrumbItems":[{"name":"Home","href":"/"},{"name":"Research Hub","href":"/hub"},{"name":"Modalities","href":"/hub/tag/modality"},{"name":"Biologic Disease-Modifying Antirheumatic Drug"}],"hrefConfig":{"basePath":"/hub/papers","webViewQueryParams":{"hub_ctx":"tag","hub_tag_type":"modality","hub_tag_value":"Biologic Disease-Modifying Antirheumatic Drug"}}}]]