У пациентов с ревматоидным артритом отек кисти и средних фаланг пальцев 2-3 пальцев заживает медленнее других суставов

TOPLINE Swelling in the wrist and second and third metacarpophalangeal (MCP) joints resolved more slowly than that in other joints among patients with rheumatoid arthritis (RA) receiving biologic or targeted synthetic disease-modifying antirheumatic drugs (b/tsDMARDs), regardless of the treatment class used. METHODOLOGY - Researchers conducted a longitudinal observational study using data from a Swiss registry to determine whether treatment response differed by the location of joints in patients with RA initiating b/tsDMARDs. - The primary analysis included 598 patients with RA (mean age, 55.8 years; 71% women) who had not received any biologic therapy previously and had at least one swollen joint at the initiation of their first TNF inhibitor. - Another analysis included 1942 patients treated with any b/tsDMARDs — TNF inhibitors, abatacept, interleukin-6 receptor inhibitors, JAK inhibitors, and rituximab — regardless of prior biologic use. - The researchers compared how quickly swelling resolved across individual joints, with the wrist serving as the reference joint. The primary outcome was the time to the first resolution of swelling over 2 years in bio-naive patients starting TNF inhibitors. - Secondary outcomes included the time to the resolution of joint swelling and tenderness across other treatment groups. TAKEAWAY - Most joints had higher rates of swelling resolution after starting TNF inhibitors than the wrist joint, with hazard ratios (HRs) ranging from 1.46 for the knee to 3.84 for the fifth finger's middle joint. - Swelling in the wrist resolved more slowly than that in other joints, and MCP2 and MCP3 joints did not show a significantly faster resolution of swelling than the wrist. - Right-sided joints were associated with a slower rate of swelling resolution than left-sided joints (HR, 0.77; 95% CI, 0.66-0.89) after adjustments. A similar pattern was observed for joint tenderness. - Across all b/tsDMARD classes, a consistent pattern emerged. Swelling in most joints resolved faster than that in the wrist, except for MCP2 and MCP3 joints and, in some cases, the knee. IN PRACTICE "The wrist, MCP2 and MCP3 joints respond more slowly than other joints following initiation of a b/tsDMARD, indicating that overall treatment response should be evaluated at a later time point when these joints are involved," the authors wrote. "In addition, bridging intra-articular steroid injections targeting these specific joints may be considered at treatment initiation of a b/tsDMARD to help manage persistent local inflammation," they added. SOURCE This study was led by Annik Steimer, University Hospital Zurich, University of Zurich, Zürich, Switzerland. It was published online on June 23, 2026, in RMD Open. LIMITATIONS The researchers did not have ultrasound or MRI data to confirm joint inflammation. They included only patients who remained on their initial treatment. Patients who improved slowly may have been more likely to be lost to follow-up. DISCLOSURES The study received support from the MLR Foundation. Several authors reported receiving grants, speaking fees, or consulting fees; serving on advisory boards; or having other financial ties with multiple pharmaceutical companies and other organisations. Detailed disclosures are mentioned in the original article. This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.