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Heavy Metal Rheumatology (9.23.2022)

Jack Cush, MD

Below are this week’s highlights from RheumNow, as discussed by Dr. Jack Cush. Thanks to all of you for your kind comments and great reviews of our weekly podcast. Please let us know how we can improve by emailing me or recording your suggestion using the "Ask Cush Anything" link on our website.

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Is PMR the Next Indication for Tocilizumab?

MedPage Today

About half of patients with steroid-dependent polymyalgia rheumatica (PMR) were able to get off steroids altogether when they were started on tocilizumab (Actemra) infusions, which also improved disease control in most cases, a randomized phase III trial showed.

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Genetic Testing for Autoinflammatory Disease

Jack Cush, MD

Not all patients with periodic fevers fit neatly into diagnostic categories. Some can be diagnosed as Still’s disease (based on criteria) while others can be classified as autoinflammatory diseases (AID) and some may be unclassifiable, clinically or genetically.

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Olokizumab, another IL-6 Inhibitor for RA

Jack Cush, MD

This week's NEJM has published the efficacy results of a large phase 3 trial of olokizumab, a humanized monoclonal antibody that directly targets IL-6 in patients with rheumatoid arthritis.

This is in contrast to two other marketed IL-6 inhibitors (sarilumab, tocilizumab) that bind to the IL-6 receptor.

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Increased Mortality in Giant Cell Arteritis

Jack Cush, MD

A population-based study from Ontario, Canada suggests an increased mortality risk in patients with giant cell arteritis (GCA), according to a recent report in Arthritis Care & Research.

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ACR guidance

ACR Updated Guideline on Vaccinations for Rheumatic Patients

Jack Cush, MD

The ACR has posted a new ACR Clinical Practice Guideline Summary providing recommendations on the use of vaccinations for children and adults with rheumatic and musculoskeletal diseases (RMDs).

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The Approach to Difficult to Treat Rheumatoid Arthritis

Jack Cush, MD

Tan and Buch have reviewed the approach to difficult to treat rheumatoid arthritis (D2T-RA), with a new EULAR definiation of D2T-RA to foster an approach rationale and concideration of treatment options.

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Social Media Questions (7.29.2022)

Jack Cush, MD

Dr. Jack Cush reviews the news, journal reports and rheumatologist cases from the past week on RheumNow.com. This podcast is brought to you by StillsNow.com - be sure to sign up for our monthly StillsNow email and Monthly StillsNow Podcast.

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Follow us for real time coverage #ACR2022 https://t.co/5CBdiKWdKM
Dr. John Cush RheumNow ( View Tweet)
Rheumatology Salaries and Career Choices A recent Doximity report shows how rheumatology salaries increase by years in practice. Rheumatologists tend to earn their highest salaries after gaining 30-39 years of experience. https://t.co/wxWQruIlu9 https://t.co/gUsIffoHn6

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Record a Question or Comment... Rheums: Have a Rheumatology question or case for Jack Cush? Record it here and we'll feature it on an upcoming podcast. Tell us your name and where you practice rheumatology. https://t.co/rICbSJzPbk https://t.co/VIjlR6xlwQ

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IL-6i in Behcets? Lit Review finds 25 articles papers, 74 pts (31 TNFi naive, 45 TNFi prior Rx). Pts Rx w/ tocilizumab IV. TCZ given for vascular, CNS , ocular & mucocutaneous. TCZ was effective in 87% TNF naive & 80% in TNFi Experienced pts. https://t.co/u1jnR9gb1L https://t.co/Rkqch4MVWi

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Dr. John Cush RheumNow ( View Tweet)
Worldwide, IL-6 inhibitors are approved for RA, poly JIA, systemic JIA, AOSD, GCA, Takayasu arteritis, Castleman’s dz, CAR-T-cell-induced cytokine release syndrome, neuromyelitis optica spectrum disorder and severe COVID-19 https://t.co/SRPjerXnGS

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Dr. John Cush RheumNow ( View Tweet)

IL-6i in Behcets? Lit Review finds 25 articles papers, 74 pts (31 TNFi naive, 45 TNFi prior Rx). Pts Rx w/ tocilizumab IV. TCZ given for vascular, CNS , ocular & mucocutaneous. TCZ was effective in 87% TNF naive & 80% in TNFi Experienced pts. https://t.co/jdJ9H04lnE https://t.co/yoxrKiIVW2

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Dr. John Cush RheumNow ( View Tweet)
The 2022 ACR abstracts are published and posted for you. Let the Learning begin! https://t.co/ZqMAc8jV3U https://t.co/3iCGnzsPI5

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Dr. John Cush RheumNow ( View Tweet)
Rheums! Have a Rheumatology question or case for Jack Cush? Record it here and we may feature it on an upcoming podcast. Tell us your name and where you practice rheumatology. https://t.co/1aSrRsLkel https://t.co/gmh155ty6w

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Dr. John Cush RheumNow ( View Tweet)
Olokizumab, another IL-6 Inhibitor for RA This week's NEJM has published the efficacy results of a large phase 3 trial of olokizumab, a humanized monoclonal antibody that directly targets interleukin-6 (IL-6) in patients with rheumatoid arthritis (RA). https://t.co/VMz8xzffiZ https://t.co/eaA4CUWvrv

Links:

Dr. John Cush RheumNow ( View Tweet)
JAK-pot study of 19 registries, 31,846 RA pts Rx w/ new drugs shows equal CDAI efficacy for TNFi (54%), ABA (50%), IL-6i (55%), & JAKi (56%). Most D/C for LOE. Compared to TNFi, JAKi and IL-6i were d/c more for adverse events, less for ineffectiveness https://t.co/FlqPUVdWaC https://t.co/BZnpwtB8SY

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Dr. John Cush RheumNow ( View Tweet)
Rheums! Do you have a rheumatology question or case for Jack Cush? Record it here and we may feature it on an upcoming podcast. Tell us your name and where you practice rheumatology. https://t.co/cvmbzknQqA https://t.co/6mX5eRUNuU

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Dr. John Cush RheumNow ( View Tweet)
Have you checked out our new sister-site, Still's Now? A new site for Still's disease, autoinflammatory & febrile disorders. https://t.co/oWEugnOB6k https://t.co/5jwiP2Xqrz

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