More Bad Safety News for Xeljanz
MedPage Today
Aug 08, 2022
Recent News
Read ArticleAnother analysis of the mandatory postmarketing safety study for tofacitinib (Xeljanz) has confirmed what most observers expected: that rates of infection with the drug in rheumatoid arthritis are higher than with tumor necrosis factor (TNF) inhibitors.
CDC Reviews Monkeypox
MMWR
Aug 08, 2022
MMWR recently reviewed the epidemiology and characteristics of U.S. monkeypox cases seen between May and July 2022. They found that 99% of cases occurred in men, 94% of whom reported recent male-to-male sexual or close intimate contact. Current outbreak-associated cases are less likely to have a prodrome and more likely to have genital involvement and racial and ethnic minority groups appear to be disproportionately affected.
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Amgen and ChemoCentryx, (maker of newly approved Avacopan)have entered into a definitive agreement wherein Amgen will acquire ChemoCentryx for ~$3.7 billion ($52 per share). https://t.co/8quO9ET8vH https://t.co/AphPizgKo8
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Dr. John Cush @RheumNow ( View Tweet)
Aug 08, 2022
Do not take antacids or PPI with mycophenolate. Magnesium & aluminium hydroxide antacids (Maalox) will lower MMF Cmax 33% & AUC 17% if given simultaneously. PPI also lowers AUC by ~33% https://t.co/IoWISgL3SY https://t.co/JV1Yv5Pg9d https://t.co/b8UoQ4zMUV https://t.co/VwNgVQ5End
Dr. John Cush @RheumNow ( View Tweet)
Aug 08, 2022
Evusheld works & reduces COVID-19 by 77%; yet only 25% of available Rx has been used. Its FREE to the ~7000 immunocompromised pts who might benefit from it. Repeat doses (300 mg) every 6 mos! Time to jump on this! https://t.co/IzcAUvKoW8 https://t.co/h5q25yWCHG
Links:
Dr. John Cush @RheumNow ( View Tweet)
Aug 08, 2022
Study of 57 #RA pts. w/ ILD treated with abatacept. Lung progression in 46% before ABA. After median 27 mos of follow-up, ILD
- 72% improved or stabilized
- 23% worsened
- 5% died.
No significant change in FVC, DLCO
ILD worse assoc w/ DAS28, FVC DLCO https://t.co/kLa61ZS8dt https://t.co/7XhqxcHuCt
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Dr. John Cush @RheumNow ( View Tweet)
Aug 08, 2022
Krill Oil Effective in Knee Osteoarthritis
Krill oil supplements in knee OA was shown to be superior to placebo in reducing knee pain, stiffness and function while increasing the omega-3 index. https://t.co/Tx4UnDf5m3 https://t.co/bsh2DQYGc9
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Dr. John Cush @RheumNow ( View Tweet)
Aug 07, 2022
Plasmacytoid Dendritic Cell Inhibitor in Cutaneous Lupus
Litifilimab, a humanized monoclonal antibody against BDCA2, targets the BDCA2 receptor on plasmacytoid dendritic cells. https://t.co/nmadPUhlyH https://t.co/4UbNPMtxIh
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Dr. John Cush @RheumNow ( View Tweet)
Aug 07, 2022
Upadacitinib in non-radiographic Axial Spondyloarthritis
The janus kinase inhibitor, upadacitinib, has been shown to significantly improve the signs and symptoms of nr-AxSpA, extending the efficacy of UPA beyond classic ankylosing spondylitis. https://t.co/IqKdvRkcgZ https://t.co/cieXqJABTL
Links:
Dr. John Cush @RheumNow ( View Tweet)
Aug 07, 2022
Approach to ILD in Myositis Syndromes
Mehta et al have published a full read review of managing ILD in patients with inflammatory myopathies, a heterogeneous group of syndromes connected by ILD and and increased morbidity and mortality risk.https://t.co/av6fVqASme https://t.co/utHJ9oiyRq
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Dr. John Cush @RheumNow ( View Tweet)
Aug 07, 2022
The FDA has extended its indications for ustekinumab (Stelara) for use in pediatric psoriatic arthritis aged 6 years and older. Pediatric PsA makes up 6% of all pediatric inflammatory arthritis pts. https://t.co/7bGJ0ZCJJl https://t.co/GtuXdHj3Og
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Dr. John Cush @RheumNow ( View Tweet)
Aug 06, 2022
FDA has approved a topical PDE4 inhibitor Roflumilast (Zoryve) a 0.3% cream for use in Plaque Psoriasis (Age 12 and Older) https://t.co/UwDf3UkuZI https://t.co/5l4xE1LaxA https://t.co/PpwiKYUpdN
Dr. John Cush @RheumNow ( View Tweet)
Aug 06, 2022
JAK Inhibitors in Difficult Still’s Disease
Aug 05, 2022
A small retrospective study suggests that patients with difficult to treat adult-onset Still's disease (AOSD) or sytemic juvenile idiopathic arthritis (sJIA) may respond well to JAK inhibitor (JAKi) agents - presumable by blocking pro-inflammatory cytokines, notably IL-6 and IFN.
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The Great Unknowns (8.5.2022)
Aug 05, 2022
Dr. Jack Cush reviews the news, FDA approvals, journal articles from the past week on RheumNow; plus viewer questions. This week great hopes for vitamin D, the great unknows of CSA and the great big mess that is the gout.
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#RA disease activity drives risk of hospitalized infections (SIE). Study of 3,254 RA pts w/ 529 hospitalized infx. SIE seen 3.8/100 person Yrs in remission, 6.6/100PY w/ low Dz activity & 8/100PY w/ moderate Dz activity. HR was 1.60 w/ LDA and 1.83 w/ MDA https://t.co/i4bSsnRiHk https://t.co/kcN9ZvpSOn
Links:
Dr. John Cush @RheumNow ( View Tweet)
Aug 05, 2022
PsA Females: more likely to have Peripheral arthritis, have more pain, fatigue, poor function, lower QOL and less likely to have xray damage (than men)
Males: more axial dz & severe psoriasis
PsA Women may need more psychosocial support & pain management https://t.co/ZYWYu1K3jW https://t.co/xZX913vGdX
Dr. John Cush @RheumNow ( View Tweet)
Aug 05, 2022
QD Clinic - Still's (or Not): an FUO Evaluation
A young man with fever up to 104F, has a complex history.
Is this Still's disease or not? https://t.co/k47Kz3onCn https://t.co/UVMaaU1uPO
Links:
Dr. John Cush @RheumNow ( View Tweet)
Aug 05, 2022
521 clinically suspect arthralgia (CSA) pts were assessed - Low educational attainment was associated with increased risk of developing inflammatory arthritis (HR = 2.35), independent of BMI & smoking https://t.co/h1bXDfxaQk https://t.co/g2ign0HDmj
Links:
Dr. John Cush @RheumNow ( View Tweet)
Aug 05, 2022
Evusheld works & reduces COVID-19 by 77%; yet only 25% of available Rx has been used. Its FREE to the ~7000 immunocompromised pts who might benefit from it. Repeat doses (300 mg) every 6 mos! Time to jump on this! https://t.co/BSi7EtJytf https://t.co/GafjXXZ2ny
Links:
Dr. John Cush @RheumNow ( View Tweet)
Aug 05, 2022
Durkan's Carpal Tunnel Compression Test is more sensitive (0.71) than Tinel's (0.47), Phalen's test (0.50) to detect #carpaltunnelsyndrome. - @rheumnow #RheumGR https://t.co/05U1a0HR2q
UTSWRheum @UTSWRheum ( View Tweet)
Aug 04, 2022
Oral surveillance - tofacitinib vs TNFi in high risk pts: more infections, serious infection (SIEs) & non-serious infx with Tofa vs TNFi. SIE risk 17%-48% higher; SIE higher w/ high dose Tofa, esp in pts aged≥65. Usual risk factors - age, pred, comorbid. https://t.co/gjD8xqtfgp https://t.co/doMd4E9ClL
Links:
Dr. John Cush @RheumNow ( View Tweet)
Aug 04, 2022
From the blog
Still's disease: paediatrics to adults, a continuum or not?
Dr. Ilenia Di Cola and Dr. Piero Ruscitti
Jul 25, 2022
Still’s disease is a rare inflammatory disorder, affecting less than 1 person per 2000 people. This disease may occur in both children and adults, namely as systemic juvenile idiopathic arthritis (sJIA) and adult-onset Still’s disease (AOSD).
The paediatric form was described by George Still in 1896, whereas the adult variant later by Eric Bywaters in 1971. However only the adult disease is identified by the name of Still.
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Podcasts
The Great Unknowns (8.5.2022)Aug 05, 2022
QD Clinics - Still's Or Not - Part 2Jul 29, 2022- Social Media Questions (7.29.2022)Jul 29, 2022
TNR Still's Now Journal Club - Pivotal Trials in SJIA & AOSD Approved MedsJul 27, 2022- Early, Aggressive & Seropositive (7.22.2022)Jul 22, 2022
Therapeutic Updates
JAK Inhibitor Treatment in Patients with Rheumatoid Arthritis (RA) and an Inadequate Response or Intolerance to TNF Inhibitors (TNFi-IR)
Sponsored by AbbVie Medical Affairs
Jul 01, 2022
Read for an overview of post hoc subgroup analysis results from TNF-IR RA patients in SELECT BEYOND, COMPARE, and CHOICE clinical trials of upadacitinib in RA patients…
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