To the Editor: We read the report by Kitajima et al1 with great interest. They demonstrated 4 cases of antimelanoma differentiation-associated gene 5 (anti-MDA5)–positive interstitial lung disease (ILD) manifested following SARS-CoV-2 vaccination and suggested the possibility of the increased incidence of anti-MDA5-associated ILD (anti-MDA5-ILD) due to the vaccination. This study interested us since we also encountered a case of new-onset anti-MDA5 antibody–positive clinically amyopathic dermatomyositis (CADM) with ILD, developed 8 weeks after BNT162b2 vaccination during the SARS-CoV-2 vaccination campaign in Japan. Herein, we briefly describe the case and address several issues to advance basic and clinical research in ILD related to anti-MDA5 antibodies. Written informed consent for publication was obtained from the patient, and the study design was approved by the appropriate ethics review board; ethics approval was not required. A 39-year-old Japanese woman with no significant medical background was referred to our hospital with a 2-month history of gradually deteriorating polyarthralgia and erythema on her fingers, and a 1-month history of face erythema, all of … Address correspondence to Dr. T. Mutoh, Department of Rheumatology, Osaki Citizen Hospital, 3-8-1 Furukawa Honami, Osaki, Miyagi 989-6183, Japan. Email: qma-kyo{at}hotmail.co.jp.
Abstract Objectives To investigate 6‐year drug survival (median: 48.5 months) of golimumab and predictors for lack of efficacy leading to golimumab discontinuation in Japanese patients with rheumatoid arthritis (RA) in routine practice. Methods This retrospective single‐center study included 60 patients with RA treated with golimumab from November 2011 to August 2020. Patients were divided into 2 groups (retention, n = 28; withdrawal due to lack of efficacy, n = 24). The retention rate was assessed using the Kaplan‐Meier method, and variables associated with golimumab discontinuation were identified using the Cox proportional hazard model. Results The prevalence of concomitant methotrexate and no biologics use was significantly higher in the retention than in the withdrawal group. Overall drug survival of golimumab was 66.3%, 48.3%, and 24.5% at 12, 36, and 72 months, respectively. There were statistical differences in retention rates among groups stratified by initiation dose, methotrexate, and biologics use. Multivariate analysis revealed the factor associated with golimumab discontinuation as history of 1 (hazards ratio: 4.42, 95% CI: 1.35‐19.93, P = .012) and ≥2 biologics use (7.49, 1.97‐36.27, P = .003). Conclusions Prior exposure of increasing number of biologics was identified as the most important factor negatively affecting long‐term golimumab retention in Japanese patients with RA.
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