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The RheumNow Week in Review - 23 March 2018

Dr. Jack Cush reviews the highlights from the news, journals and major meetings. New announcements and approval from the FDA; novel associations between ANCA vasculitis and thyroid disease; flare rates after arthroplasty; and pregnancy outcomes for men and women.

  1. FDA Arthritis Advisory Committee will meet on April 23rd to discuss the NDA for Eli Lilly's JAK inhibitor - baricitinib in moderate to severe RA. Discussion will be around risk:benefit assessment, dose selection & the risk of venous thromboembolic events. https://t.co/dQ4AdYZyQx
  2. FDA Approves Ilumya (tildrakizumab) for Moderate-to-Severe Plaque Psoriasis. It binds p19 subunit of IL-23, inhibiting binding to IL-23 receptor. Given as 100 mg sc at Wk 0, 4 & q 12wks; this is the2nd IL-23 inhib approved for Pso. https://t.co/q9bQTVqN0t
  3. Norfolk registry study of 431 inflammatory arthritis pts shows 82% still on MTX after 2 years. Early MTX failure associated with RF+, younger onset age, high DAS-28. MTX discontinuations for AE less likely if RF-positive https://t.co/kOrfaCnZaf
  4. In a RCT of 106 hip osteoarthritis patients, intramuscular glucocorticoid injection shown to be significantly better than placebo injx in all outcomes for up to 12-weeks https://t.co/csGXkQQwjh
  5. Study from German RABBIT Registry of 885 RA patients treated with tocilizumab finds that treatment success with TCZ similar in pts with no, 1 or 2 prior bDMARD failures, but less with with ≥ 3 bDMARD failures. https://t.co/jAriEaPruP
  6. Study of 279 patients with ANCA Associated vasculitis shows a high prevalence of thyroid disease - 21.5% - mostly females with MPO Abs and renal disease. https://t.co/7QGZrcSnLJ
  7. Flares are frequent in patients in 120 RA undergoing arthroplasty (THA, TKA); by 6 wks 63%. Flare more freq with higher disease activity (OR=2), ESR, CRP, Pain; but not affected by biologic use. https://t.co/4hdn5nTQZO
  8. Pregnancy study from Quebec finds 51 Pregs exposed to leflunomide during 1st trimester; 21 during the 2nd/3rd trimesters but was not associated with an increased risk of congenital malformations, Spont Ab, low birth weight or prematurity https://t.co/WiqyOkg3L2
  9. Danish/Swedish study of 8097 births in 6103 psoriasis women & 964 births in 753 PsA women shows increased number of maternal gestational DM, HTN & preeclampsia; and more cesarean delivery, pre-term birth & low birth weight infants; moreso with severe psoriasis https://t.co/DjrNqiRlgA
  10. Risk of Paternal Exposure to Anti-Rheumatic Drugs  
  11. Shoe Inserts Disappoint with Plantar Heel Pain  
  12. mTOR Inhibition with Sirolimus Effective in Lupus  

 

Disclosures: 
The author has received compensation as an advisor or consultant on this subject

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