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On this week's podcast, Dr. Jack Cush reviews the news: Steroids are easy to start and hard to stop; hold the MTX but not the biologic or JAK, weighing in on avacopan, and age-old messages for old-age patients.
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Close to 90% of patients with rheumatoid arthritis (RA) well controlled on targeted therapies were able to take 50% dosage reductions without experiencing worsened disease activity in a randomized trial, South Korean researchers said.
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A randomized clinical trial in inflammatory arthritis arthritis shows that temporarily holding biologic or Janus kinase (JAK) inhibitor therapy at the time of COVID-19 vaccination is not warranted.
Dr. John Cush
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Danish national study (2003-2024) of 51,401 #PMR pts (24K PCPs, 27K secondary MDs): PMR incidence = 112/100K. PMR decr 53% in primary care & incr 30% in secondary care (overall 12% decline). Among PMR, GCA rate was 5.4/1,000 PYs, w/ median 68 days from PMR Dx. 28% & 22% were https://t.co/s168riRRLB
Dr. John Cush
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Italian retrospective study of 36 difficult #GCA pts (89% relapsed; 72% prev TCZ) showed Clinical remission 85%, 81%, & 83% at 3, 6, & 12 mos. GC-free remission increased to 15%, 28%, & 40% at 3, 6, & 12 mos. GCs d/c in 43%. Results at odds w/ ph III GCAptAIN RCT where SEC https://t.co/VnMSCPwMrn
Dr. John Cush
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Don't Hold the Biologic or JAK with COVID-19 Vaccination
A randomized clinical trial in inflammatory arthritis arthritis shows that temporarily holding biologic or Janus kinase (JAK) inhibitor therapy at the time of COVID-19 vaccination is not warranted. https://t.co/moQIE09lvi
Dr. John Cush
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Steroids are easy to start and hard to stop. Hold the MTX, but not the biologic or JAK. And what’s the latest on avacopan?
This week, Dr. Jack Cush reviews the rheumatology news you don’t want to miss: from new approvals and promising trial results to sobering Sjögren’s data, https://t.co/UC4RdHMaFS
Dr. John Cush
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Predicting and Preventing Psoriatic Arthritis
Psoriatic arthritis is often underdiagnosed in those with psoriasis (PsO), leading to diagnostic delays an undertreatment. While certain factors in PsO portend a future PsA risk, a predictive profile and early intervention algorithm https://t.co/yvJr293MHs
Dr. John Cush
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Funny! Dr. Glaucomflecken explains the REPLENISH trial -secukinumab for the treatment of polymyalgia rheumatica https://t.co/7JDoMDJzeD https://t.co/ZBMcheSeCv
Dr. John Cush
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Retrospective Kuwait registry study of 2629 RA pts- 2326 (88.5%) w/ early (EORA) vs 303 (11.5%) late(LORA). LORA had more age related comorb. Dz (2 vs. 0.9), similar DAS28/CDA, but signif higher ESR (41 vs 33). T2T applies regardless of age!! https://t.co/MK8SfjcxCA https://t.co/ZxHwt8qxvT
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FDA has approved rembrutinib (Rhapsido - BTK inhibitor from Novartis)as 1st Rx for adults with dermographism not controlled by H1 antihistamines (expanding its use beyond chronic spontaneous urticaria) https://t.co/wytr6veoZJ https://t.co/czFmLHFuL3
Dr. John Cush
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Agenx announced it will discontinue its phase 3 UNITY study -efgartigimod SC in adults with mod-to-severe Sjögren's dz, based on not meeting its primary endpoint (clinESSDAIwk 48) & rec from DSMB. ""Sjögren's Disease is one of the most heterogeneous and complicated diseases in https://t.co/fmuzxvaCGx
Dr. John Cush
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Retrospective cohort study of 387 ANCA-assoc. vasculitis pts Rx w/ GC +/- avacopan (AVA 52 vs 335 not Rx AVA). AVA use assoc w/ signif less severe infx (adj HR 0.22), & less pred use - but no diff in relapse risk was observed. https://t.co/GTtAf7KiqB https://t.co/ElipLLBm63
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POETYK PsA-1 - Efficacy and Safety of Deucravacitinib in Psoriatic Arthritis
van der Heijde et al have published the results of the phase 3 POETYK PsA-1 trial demonstrating that deucravacitinib was superior to placebo in clinical responses, patient-reported outcomes, and https://t.co/ovASDqLeWK
Dr. John Cush
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Giant Cell Arteritis market size was valued approximately $960 million USD in 2023 - read for interesting drug developments in GCA arena https://t.co/pEZ95je7r0 https://t.co/Dz8D5ieDQp
Dr. John Cush
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EBR Journal Club: Brepocitinib in Dermatomyositis (VALOR)
The EBR Journal Club Companion applies my adapted version of the JAMA approach to critical appraisal. Each review covers four domains: Does this apply to my patients? What is the risk of bias? How great are the benefits https://t.co/KUB7fpmdbf
Dr. John Cush
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Exercise Can Improve Pain
A pooled meta-analyses (n=197,392) shows that exercise reduced pain versus control immediately after the intervention (SMD −0.59; 95% CI −0.65 to −0.53; P<0.001). The benefit held across musculoskeletal, inflammatory, neurologic and cancer pain, and https://t.co/rbZlyfrCOW
Dr. John Cush
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Study of 64 Stills related #MAS pts (55 sJIA; 9 AOSD). All Rx GCs; 75% anakinra, 52% ciclosporin. Complete remission in 7, partial Rem in 64%; GCs tapered in 78% in median 40d. MAS recurred in 31%; 11% died; 1-year survival probability 93.75% https://t.co/HxhhpRsSMO https://t.co/IQHLRlULcP
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Retrospective real world avacopan (AVCP) safety data from UK vasculitis center looked at AAV pts (RTX or CTX) rx w/ AVCP (n 133) or not AVCP (n 458). @1 yr AVCP had nonsignif incr in ALT >2xULN (15.8% v 11.4%) or >3xULN (11.3% v 6.3%; P 0.064) No diff in Alk phos, Bili, Hy's law https://t.co/ZZhpxdKhQl
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43 biopsy-proven Giant cell arteritis in Black Caribbeans - GCA incidence rate 1.76/100K pY (1/2 rate of whites) w/ 4 fold incr betw 1993 & 2014. Mean Age 76; F:M ratio 4.4. Initial Sxs HA (65%), jaw claud (33%), scalp tender (37%), anterior ischemic optic neuropathy (26%) & PMR https://t.co/lHAeNdOqbj
