A higher pooled risk of arrhythmia was found in autoimmune patients, with systemic sclerosis and rheumatoid arthritis showing the strongest associations.
Cardiac Arrhythmias in Systemic Autoimmune Diseases
A systematic review and meta-analysis by Juan Sebastian Theran Leon and colleagues (Colombia) assessed the risk of cardiac arrhythmias and conduction disorders in adults with systemic autoimmune diseases compared to the general population. Data from 40 studies, encompassing over 210,000 patients and 800,000 controls, revealed a significantly elevated risk.
Systemic sclerosis and rheumatoid arthritis had the strongest associations with atrial fibrillation, ventricular arrhythmias, and atrioventricular block. The authors suggest that routine ECG and Holter monitoring be considered for these patients.
Comorbidities and Mortality in Juvenile Idiopathic Arthritis (JIA)
Imane Bardan used data from the Norwegian Patient Registry to compare adults with JIA to matched comparators. Results indicated a higher prevalence of ischemic heart disease, hypertension, chronic kidney disease, and other autoimmune conditions (type 1 diabetes, celiac disease, autoimmune thyroiditis, alopecia).
All-cause mortality was higher in JIA (2.4 vs 1.8 per 1,000 person-years). Recent exposure to disease-modifying antirheumatic drugs did not appear to affect these outcomes.
Smartphone-Based Cognitive Assessment in RMD
Alex Kaula and colleagues (Cambridge Cognition) tested a 90-second smartphone cognitive assessment (digit-symbol substitution task) in healthy volunteers and participants with RMD (inflammatory bowel disease, Sjögren's disease, rheumatoid arthritis, or systemic lupus erythematosus) and two neurodegenerative diseases.
The assessment showed good/excellent reliability. Compared to healthy volunteers, total correct items were lower by -3.2 in inflammatory bowel disease and -6.7 in systemic lupus erythematosus. For reference, Parkinson's and Huntington's disease showed differences of -11 and -10.
Proton Pump Inhibitors and Fracture Risk
Cécile Philippoteaux and team analyzed data from the French OSIRIS cohort (1,372,763 matched individuals) on proton pump inhibitor (PPI) exposure and major osteoporotic fractures.
The proportion of patients with at least one fracture was significantly higher in the PPI-exposed group across all sites (hip, vertebrae, humerus, wrist). The highest excess risk was in individuals aged 60-69 years. Longer PPI duration increased risk, particularly for hip and vertebral fractures. Chronic PPI exposure was also associated with increased all-cause mortality.
Venous Thromboembolism Risk with JAK Inhibitors
Using data from the Swedish Rheumatology Quality Register (over 25,000 RA patients), Maxime Raffray and colleagues reported age- and sex-standardized incidence rates of VTE: 8.3 per 1,000 person-years for JAKi, 7.3 for IL-6i, 4.3 for TNFi, 5.9 for rituximab, 4.0 for abatacept, and 2.9 for the general population. The fully adjusted hazard ratio for JAKi versus TNFi was 1.89.
Raffray noted that treating 250 patients with JAKi instead of TNFi for one year would result in approximately one additional VTE case.