A recent presentation at the 2024 Society of Cardiovascular Computed Tomography meeting by Brittany Weber MD, PhD (Brigham and Women’s Hospital) has shown that incidental findings of coronary artery calcium on chest CTs in patients with immune-mediated inflammatory diseases may be associated with poorer outcomes, even if they don’t have preexisting atherosclerotic cardiovascular disease.
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A study from the Leiden Early Arthritis Clinic shows that is rheumatoid arthritis (RA) is diagnosed within 12 weeks after symptom onset, treatment costs were lower in both autoantibody-negative and autoantibody-positive RA.
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Dr. Jack Cush reviews the news and journal articles from the past week on RheumNow.com.
UK study of pneumococcal vaccination in UK, shows IMID pts had suboptimal vax against pneumococcus. In 32 277 pts (RA 14151, IBD 13631, SpA 3804, SLE 691) saw 57% vaccinated; lower if <45 yrs (32%), IBD (42%). Vax not associated w/ IMID flare https://t.co/y5JHYaEpA9 https://t.co/zUXfDoqyal
From LG cohort of myeloid neoplasms (861 MDS, 640 AML, 112 MDS/MPN, 89 MPN) autoimmune Rheum Dz (AIRD) found in 7.7% (lit suggests 8-30%), less in AML (4.7% vs 9.5% others). Common: RA (42%), CTD(18%), PMR (14%), vasculitis (12%), AxSpA (7%). https://t.co/ZXxOrZBunZ https://t.co/m5nIgrhohw
Australian Womens survey, from 25 467 responders the prevalence of #RA varies by how defined - 3·9% for self-reported RA, 1·9% based on the medication dispensed, and 0·5% by self-reported medication use definitions. https://t.co/2FUwftajlG https://t.co/4a5CIfw8hS
174 Active RA pts not responding to MTX were started on TCZ. High GM-CSF (> 5 ng/ml and > 10 ng/ml) at baseline were the independent predictors of poor response to TCZ at Wk24. high GM-CSF had signif higher DAS28-ESR & cytokine levels at baseline https://t.co/AreLBseJDq https://t.co/OyIOkiUOT1
Problems With Laboratory Tests in the Management of RA
https://t.co/kUYivP7SHW https://t.co/nFtB75N0jQ
ICYMI: Metrics Used by Rheumatologists in RA
https://t.co/7Qr4cYvqp1 https://t.co/1FnyNpfhqi
Pain in RA: Different Drugs for Different Mechanisms
https://t.co/pOETFkTIkS https://t.co/Vn5zgrYsKR
192 RA pts on MTX: GI Sxs studied w/ MISS (MTX intolerance severity score). GI intolerance seen in 56%, Nausea & pain post-MTX most common. More in afro-descendants, w/ FM, Steroids, or JAKi. MISS results unrelated to Route, Gi Dz, age, MTX dose https://t.co/EROmZQo1Zs https://t.co/SOMzzXXj0b
IRIS-RA, a failed phase 2 study of Nipocalimab, an anti-FcRn mAb severe active RA not responding to TNFi. 53 seropos. RA pts did not achieve primary endpt of better DAS28-CRP at Wk 12 (but Nipo was numerically better & signif lowered RF, CCP, but not CRP) https://t.co/52HLsfpKLS https://t.co/eEifXA6MpP
Does B Cell Depletion Matter?
Dr. Yuz Yusof interviews Dr. Ed Vital regarding abstract OP0077 at Eular 2024 in Vienna, Austria.
https://t.co/SX7BkX3w1T https://t.co/H1rD0n8GnK
174 Active RA pts not responding to MTX were started on TCZ. High GM-CSF (> 5 ng/ml and > 10 ng/ml) at baseline were the independent predictors of poor response to TCZ at Wk24. high GM-CSF had signif higher DAS28-ESR & cytokine levels at baseline https://t.co/vy7czYwv1Z https://t.co/R2cYdNZ3V0
Preliminary results from RESET-RA Study announced; demonstrating ACR20 efficacy of implanted vagal nerve stimulation at 12 wks (p=0.0209). 2-staged, multicenter, randomized, sham-controlled, double-blind pivotal trial, enrolled 242 RA pts https://t.co/gIVJd9F6Pk https://t.co/SNjWIa3raB
Efficacy of Biologics in Patients with CKD
A retrospective cohort study of biological bDMARDs persistence in RA patients w/CKD, shows the 3 year survival to be > 50% but all studied biologics were nearly equivalents with regard to safety and efficacy.
https://t.co/rL2ZondUsE https://t.co/1hM237Jl83
FDA adverse event study of JAKi in #RA assoc w/ signif more VTE, ischemic heart Dz, & tachyarrhythmias. 75,407 on JAKi vs 303,278 on biologics (TNFi, RTX, TCZ); JAK had more VTE (ROR=2.11), CVA (ROR=1.25), IHD (1.23), arrhythmias (1.15 ), esp in 1st yr. https://t.co/IVsGwqpiJK https://t.co/4epOHdNHbO
MTX was tapered or D/C in 30% of RA pts w/in 2 yrs of b/tsDMARD Rx. Of 889 pts, MTX (19 mg/wk) tapered in 13.8% & D/C 16.5% (planned taper(37%); pt decision (27.2%). In 582 (66%) MTX unchanged, 4.25 increased MTX after b/tsDMARD initiation https://t.co/yc8exMbeD1 https://t.co/b3L3Fha7xU
Cost-Effectiveness of Biosimilars vs Leflunomide
An economic evaluation of 25 099 rheumatoid arthritis patients found that treatment with biosimilar DMARDs were cost-effective compared with the conventional DMARD, leflunomide.
https://t.co/lWJB1VL1CL https://t.co/lzra8suVqs
5 yr results of 150 difficult-to-treat RA pts - D2T RA resolved in 45%, persisted in 50%, & 5% died. Resolved D2T RA was signif younger, had more Rx changes, & more IL-6i use. Mortality predicted by comorbidity index, steroid escalation (OR 3.50; & 32) https://t.co/cIUNcQ0r3F https://t.co/rNZaWu3Ocd
