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The RheumNow Week in Review – 24 February 2017

Dr. Jack Cush reviews highlights from the past week on

  1. Study of >43K Psoriasis, Psoriatic Arthritis, and Ankylosing Spondylitis patients show a 14-34% increase risk for depression; but not for suicide or suicidal ideation.
  2. Scleroderma Renal Crisis Criteria include HTN, Acute Kidney Injury, encephalopathy, seizures, microangiopathic hemolytic anemia
  3. 183 SLE Patients in a Phase II trial showed no benefit with IL-6 inhibition(PF-04236921) for 6 mos. The highest dose was D/C for safety.
  4. #RWCS17 Dr Bergman shows incredibly poor adherence to drug therapy. Suggests you need time and a plan to combat
  5. Analysis 26 studies failed to show any predictors of mycohenolate mofetil responses in Lupus. More research needed.
  6. Metanalysis shows no Cancer risk with Inflx (OR 1.68), ETN (0.79), ADA (0.93), ABA (1.04), RTX (0.58), TCZ (0.60), Tofa (1.15)
  7. Prior Authorizations is a problem for GI docs too - 63% use >25% FTE to do PA and 73% make > 5 calls (37% >10 calls) per day to payors
  8. CDC reports seasonal Influenza peaked in 2nd week Feb 2017 & will continue for weeks. No antiviral resistance seen thus far.
  9. Dr Mahadevan #RWCS17 shows data that there is a 1/2000 risk of bone fractures with chronic PPI use
  10. Dr Mahadevan #RWCS17 shows that PPI chronic use yields a 1/4000 risk of PPI induced C. ridicule diarrhea
  11. #rwcs2017 Dr Kavanaugh shows RCT where apemilast does well against etanercept in psoriasis.
  12. Dr Kevin Winthrop at #RWCS2017 reviews DMARD/Biologic effects on vaccine responses. Most effected by RTX, least by MTX.
  13. ORAL strategy trial shows Xeljanz +MTX = Humira +MTX; but was inferior as monoRx Xeljanz in 1152 RA pts over 12 mos
  14. FDA approves the IL-17 inhibitor “Siliq” (brodalumab; from Valeant) for moderate-severe plaque psoriasis.Comes with a black box warning for suicide.
  15. Baricitinib (trade name “Olumiant” ) approved by EMA for use in EU for moderate-to-severe RA as monotherapy or combo with MTX.
  16. Higher Hip and Knee Replacement Revision Rates in Younger Patients 
  17. Sirukumab shows moderate efficacy in Rheumatoid Arthritis
  18. Abatacept shows modest efficacy in Giant Cell Arteritis
The author has received compensation as an advisor or consultant on this subject

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