Different biologics for biological-naïve patients with psoriatic arthritis: a systematic review and network meta-analysis.

Aim: To systematically compare the efficacy and safety of biologics [tumor necrosis factor inhibitors (TNFi), interleukin (IL) inhibitors, phosphodiesterase-4 inhibitors (PDE4i), and Janus kinase inhibitors (JAKi)] for biological-naïve patients with psoriatic arthritis (PsA). Methods: PubMed, Web of Science, Embase, and Cochrane Library were comprehensively searched until 12 March 2023. Only head-to-head active comparison studies were included, and placebo-controlled studies without active biologic comparators were excluded. Outcomes included musculoskeletal endpoint [American College of Rheumatology (ACR) 20/50/70, resolution of enthesitis, resolution of dactylitis], function endpoint [Health Assessment Questionnaire-Disability Index (HAQ-DI) change, ∆ HAQ-DI ≥ 0.35], composite index endpoint [ACR 50 + Psoriasis Area Severity Index (PASI) 100], and adverse events. The Jadad scale and Newcastle-Ottawa scale (NOS) were adopted to evaluate the quality of eligible studies. Results: Totally 17 studies with head-to-head comparisons of these biologics were included in this systematic review and network meta-analysis. Compared with IL-17A inhibitors (IL-17Ai), TNFi were associated with a lower rate of achieving ACR 20 response [pooled risk ratios (RR) = 0.92, 95% credibility interval (CrI): 0.86, 0.98]. JAKi had the greatest possibility of achieving ACR 20 (50.25%) and ACR 50 (83.03%). The JAKi group had a higher rate of achieving ACR 70 response than the IL-17Ai group (pooled RR = 1.25, 95%CrI: 1.00, 1.57); TNFi were less effective than JAKi in terms of ACR 70 (pooled RR = 0.77, 95%CrI: 0.64, 0.94). ACR 70 was most likely to be achieved in patients using JAKi (97.48%). The IL-17Ai group had a higher rate of enthesitis resolution than the TNFi group [pooled RR = 1.22, 95% confidence interval (CI): 1.02, 1.47]. Compared with IL-17Ai, TNFi were associated with a lower rate of enthesitis resolution (pooled RR = 0.80, 95%CrI: 0.72, 0.88). Patients receiving IL-17Ai had the highest likelihood of achieving enthesitis resolution (82.76%), dactylitis resolution (58.66%) and the greatest HAQ-DI change (59.74%). IL-17Ai had a similar impact in achieving ∆ HAQ-DI ≥ 0.35 to TNFi (pooled RR = 1.15, 95%CI: 0.93, 1.41). Individuals receiving IL-17Ai had a higher rate of achieving combined ACR 50 and PASI 100 response than those receiving TNFi (pooled RR = 1.56, 95%CI: 1.29, 1.88). Patients receiving PDE4i were least likely to have adverse events (41.59%). Conclusion: In 2023, considering both efficacy and safety, IL-17Ai may be the better treatment option for biological-naïve patients with PsA requiring biological therapy.

Iguratimod efficacy in palindromic rheumatism treatment.

BACKGROUND: As a new immunomodulator for rheumatoid arthritis, iguratimod (IGU) also has therapeutic potential in other immune diseases. In this study, we determined the effects of IGU on disease control in patients with palindromic rheumatism (PR). METHODS: Patients with PR were divided into Control group (Ctrl group) and an IGU treatment (IGU group) groups. Drug efficacy was evaluated according to the frequency of PR attacks (monthly), the visual analog scale (VAS) score of patient pain, and clinical symptoms. RESULTS: The drug positivity and disease control rates of the IGU group (100.00% and 90.91%, respectively) were significantly higher than those of the Ctrl group (61.11% and 5.56%; p = .002 and p < .001, respectively). The median number of PR flares and the VAS score of patients in the Ctrl group decreased from 3.00 (1.00-15.00) to 0.83 (0.00-12.00) and from 5 (4-6) to 4 (1-6), respectively. In the IGU group, the median number of PR attacks decreased from 4.50 (2.00-15.00) to 0.00 (0.00-0.33), and the VAS score decreased from 5 (4-6) to 0 (0-2). The IGU group exhibited a significant reduction in PR flare frequency and improvement in the VAS value (p < .001 and p < .001, respectively). CONCLUSION: Our study is the first to describe the efficacy of IGU in PR treatment. IGU can significantly reduce the number of PR flares and improve the clinical symptoms of patients with PR.

Bi-layered nanofibrous membrane with osteogenic and antibacterial functions for periodontal tissue regeneration.

Guided tissue regeneration (GTR) membranes have great potential to promote periodontal tissue regeneration and reestablishment. However, the regeneration potential and microbial infection resistance of current GTR membranes still need to be improved. Here, a bi-layered nanofibrous membrane on the basis of poly (lactic-co-glycolic acid) (PLGA)/gelatin with osteogenic and antibacterial functions was fabricated for periodontal tissue regeneration. The antimicrobial layer (AL) of the bi-layered nanofibrous membrane was composed of nanofibrous PLGA/gelatin nanofibers loaded with nano-silver (nAg), while the osteoconductive layer (OL) of the nanofibrous membrane consisted of PLGA/gelatin nanofibers loaded with nano-hydroxyapatite (nHA). The bi-layered nanofibrous membrane was examined by scanning electron microscopy (SEM), energy dispersive spectrometer (EDS), transmission electron microscope (TEM), Fourier transform infrared spectroscopy (FTIR), X-ray photoelectron spectrometry (XPS) and X-ray diffractometry (XRD). The results showed that nHA and nAg particles were well evenly loaded or embedded in PLGA/gelatin nanofibers. The cell culture experiments suggested that the bi-layered nanofibrous membrane possessed good cytocompatibility and the OL of the bi-layered nanofibrous membrane possessed an enhanced osteogenic capacity for human osteoblast-like cells (MG63), which was verified by the good cell viability and the increased alkaline phosphatase (ALP) activity, respectively. The results of in vitro antimicrobial study displayed that the AL of the bi-layered nanofibrous membrane possessed an effective antibacterial capability. In conclusion, the prepared bi-layered nanofibrous membrane with osteogenic and antibacterial functions may have great potential for periodontal tissue regeneration and reestablishment.[Formula: see text].

Curcumin promotes the proliferation, invasion of neural stem cells and formation of neurospheres via activating SDF-1/CXCR4 axis.

Curcumin is an active ingredient isolated from the rhizomes of Curcuma longa Linn with remarkably non-toxic bioavailability. This is an in vitro study. In this study, we explored the effects of curcumin on the proliferation, migration and neurogenesis of neural stem cells (NSCs). Primary NSCs were isolated from embryonic day 14 rats and then treated with curcumin and/or stromal derived factor-1 (SDF-1). NSCs showed an SDF-1-dependent proliferation and migration. Further results showed that curcumin and SDF-1 both promoted NSCs proliferation, migration and the formation of neurospheres. In addition, Curcumin up-regulated the expression of SDF-1 and promoted the formation of SDF-1/CXCR4 complex in NSCs. The western blot results showed that the phosphorylation levels of ERK, JNK, MAPK, NF-kB and Akt were up-regulated by curcumin. In contrast, the administration of CXCR4 inhibitor AMD3100 could offset the effect of curcumin. These results suggested that curcumin promoted the NSCs proliferation, migration and formation of neurospheres via SDF-1/CXCR4 in NSCs.