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The RheumNow Week in Review - 26 January 2018

The RheumNow Week in Review discusses the past week's news, journal articles and highlights from This week's report covers the price of biologics treatment in psoriasis, comorbidities in myositis, bronchiectasis with MPO antibodies, and the risk of secondary TNF failure with anti-drug antibodies.

  1. EMA has granted marketing authorisation for Taltz (ixekizumab), alone or in combo w/ MTX for active adult psoriatic arthritis not responding to DMARDs.
  2. 0.01% of all Emergency Dept Visits are for Septic Arthritis. Stable rates between 2009-12, ~83% are hospitalized, moreso in those with comorbidities.
  3. According to Rheumatology Network there are 5415 Rheumatology providers (4997 Rheums, 228 NPs, 190 PAs) to manage 54 million with arthritis in the USA
  4. Study of 58 GPA & MPA pts shows bronchiectasis to be independently associated with anti-MPO-ANCA, female gender and more peripheral neuropathy and less renal involvement.
  5. Metanalysis of 6 studies 9,045 PM/DM pts shows inflammatory myositis associated with increased risk of Venous Thromboembolic events (OR =4.31) & risk of DVT (OR =4.85) or PE (OR =4.74)
  6. Inpatient database analyses shows juvenile dermatomyositis pts to have very high rates of comorbidities, including HTN (OR 22.3). obesity [5.87], diabetes [7.95], hyperlipidemia [5.84], lipodystrophy [151], atherosclerosis [10], cerebrovascular Dz [15.5]
  7. Drug induced lupus may be caused by hydralazine, procainamide, isoniazid, minocycline, diltiazem, TNF inhibitors. Drug induced SCLE may be from HCTZ, terbinafine, PPI, TNFi.
  8. Among 286 SLE from the NHS, 42% were dsDNA+ at diagnosis. Current smokers were more likely to be dsDNA+ (HR 1.86) & >10 Pk-yr hx had elevated dsDNA+ SLE risk (HR 1.60)
  9. Offspring to Lupus mothers have lower birth weights. Active SLE assoc w/ 5 fold higher risk preeclampsia, and 8 fold risk of Preterm birth
  10. Only 44% of Scottish patients referred to rheumatology are seen within 12 weeks.
  11. Price of 6 mos of Psoriasis Rx: Guselkumab $29k; Taltz $28.6k; Humira $26.6k; $Enbrel 26.6k; Cosentyx $26.5k; Stelara $19k; Remicade $14k; Inflectra $11.3k; Renflexix $9k
  12. NEJM study shows steroids in septic shock had faster resolution, less mechanical ventilation, fewer transfusions, but no difference in mortalit rates vs placebo.
  13. Anti-Drug Antibodies Partly Explain Secondary TNF Inhibitor Failures  
  14. Cimzia Limits Xray Progression in Axial Spondyloarthritis  
  15. Problems with Biologic Drug Storage  
  16. US Senate Finance Committee voted to approve Alex Azar as next Secretary of the Health and Human Services (HHS). Checkout ACR16 RheumNow interview with Alex Azar, past president of Lilly.


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

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