Friday, 03 Apr 2020

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RheumNowLive On Demand: Development & Use of JAK Inhibitors - Dr. John O'Shea

 

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ACR Infusion Guidance During COVID-19 Crisis

The American College of Rheumatology (ACR) has published a guidance document on infusions and office based therapies.

Infusions in the Time of Coronavirus

As they say, necessity is the mother of invention. After years of bemoaning the challenges of telemedicine, our rheumatology clinic transition entirely to a remote clinic in the space of a week. One of the few good things to come out of this crisis is that we may learn that in-person visits are not as critical as we thought, which may in turn help our specialty’s access issues.

Earlier Anakinra Initiation Warranted in Still's Disease

An Italian study examined the outcomes in adult onset Still's disease (AOSD) based on whether they received early or delayed treatment with anakinra (ANK). 

A total of 141 AOSD patients were retrospectively studied.

Overall, they found no differences in efficacy if ANK was started within 6 (or 12 mos) vs. thereafter.  

Switching Biologics in JIA

While there are numerous agents approved for use in juvenile idiopathic arthritis, little is know about actual use biological disease-modifying antirheumatic drug (DMARD) use or switching in the biologic era. A cohort comparison study has shown that after an unsuccessful trial of a first biologic, changing to a second TNFi is as effective as switching to a non-TNFi biologic.

Tofacitinib Effective in Refractory Still's Disease

Fourteen cases reported from mainland China suggest that tofacitinib (TOFA) may be effective in patients with refractory adult-onset Still’s disease (AOSD), further adding to a growing list of potential use of JAK inhibition in managing inflammatory, and now autoinflammatory, disease.