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Dr. Jack Cush muses on the news, journal reports, FDA announcements and the 2024 BSR abstracts just released.
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A cohort analysis of dermatomyositis (DM) patients starting immunomodulators finds that methotrexate use was not associated with an increased risk of interstitial lung disease (ILD).
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In an open-label, randomized, non-inferiority trial, rheumatoid arthritis patients in remission were subject to tapering of disease-modifying antirheumatic drugs (DMARDs), and while maintenance of remission was seen in some, many DMARD tapering patients did flare and were unable to maintain flare-free survival compared to those on stable conventional synthetic DMARDs.
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An investigational Toll-like receptor (TLR) antagonist was effective in reducing biomarkers and clinical symptoms of systemic lupus erythematosus (SLE) in a pilot trial, evidence that the innate immune system may hold the key to lupus pathophysiology.
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Dr. Jack Cush reviews this past week’s news and journal articles from RheumNow.com.
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An observational cohort study suggests that proteinuria levels in lupus nephritis (LN) patients did not predict their histologic class.
A multicentre observational study of patients with biopsy-proven LN; either proliferative (PLN) or membranous (MLN) lupus nephritis were compared regarding clinical and laboratory presentation and long-term outcomes. The primary outcome was progression to chronic kidney disease (CKD).
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Dr. Jack Cush reviews regulatory reports, news and novel journal articles - this week focusing on Sjogren's, ILD, Gout and Uveitis.
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A population-based cohort has demonstrated that sodium-glucose cotransporter-2 inhibitors (SGLT2i) use in gout patients is superior to sulfonylurea therapy in lowering the risk of incident gout and recurrent flares among patients with type 2 diabetes (T2D).
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Dr. Eder delivered an illuminating talk at RheumNow Live 2024 on sex differences in psoriatic arthritis; the disease may manifest differently in men and women, and therapeutic responses may differ between the sexes.
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The management and outcomes of neuropsychiatric systemic lupus erythematosus (NPSLE) can be challenging as there is limited data.
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Drs. Caroline Siegel and Lisa Sammaritano (from HSS in NYC) have published an impressive overview of systemic lupus erythematosus (SLE) in JAMA. This timely, well-written review covers the many complexities of this multi-organ disorder that affects nearly 3.4 million people worldwide.
Dr. John Cush
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FDA issued a drug safety warning linking thiopurine (AZA, 6MP) use in pregnancy & a rare risk of intrahepatic cholestasis of pregnancy (ICP). ICP has been reported in pts w/ CD, UC, or SLE; however thiopurines are not FDA approved for these Dx https://t.co/s37eRuAtQx
Dr. John Cush
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ARCTIC Rewind: Can You Taper DMARDs with Remission?
https://t.co/5Mkdyt4DIK https://t.co/0Z2gVpjIgX
Dr. John Cush
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Is Colchicine Rx a problem? Retrospective study of UK Clinical Practice registry, 13945 gout initiated allopurinol with colchicine (64yrs; 78% male). 26% on 1+ meds interacting w/ colchicine. Diarrhea & MI more freq w/ comorbidities & more severe CKD https://t.co/ZkhpzaTjjI https://t.co/e3BO813b30
Dr. John Cush
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'Drug Rediscovery for Rare Immune Mediated Inflammatory Diseases’ - a 6 center consortium will study if JAKi (filgotinib) is effective and safe in 3 rare disorders -- Behcets, inflammatory myositis & IgG4 related disease. https://t.co/UyZM4VNSY2 https://t.co/D2D1tdygS4
Dr. John Cush
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Hyperpigmentation from Hydroxychloroquine. From 316 HCQ pts, 26% got hyperpigmentation; delayed onset of 12 mos (6–30mos) after median cum. dose of 108 g. Seen on face (602%), Legs (36%) & hands (20%). Daily sun exposure decrease in the incidence (P=0.02) https://t.co/6B6Z0suXB4
Dr. John Cush
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High risk medications for pregnancy:
MTX- 40% pregnancy loss, 6-10% birth defects
MMF/CYC - 40% pregnancy loss, 25% birth defects
Recommend 2 forms contraception on MMF
Change meds slowly to safe Rx and monitor disease activity at least 3 mos before pregnancy
#RNL2024 @RheumNow
Dr. John Cush
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Hyperpigmentation from Hydroxychloroquine. From 316 HCQ pts, 26% got hyperpigmentation; delayed onset of 12 mos (6–30mos) after median cum. dose of 108 g. Seen on face (602%), Legs (36%) & hands (20%). Daily sun exposure decrease in the incidence (P=0.02) https://t.co/UX8hnwJjhs https://t.co/xU9RWCcr9C
ACR_Journals
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This study examined the risk of neuroinflammatory disease after initiation of b/tsDMARDs
Overall risk of neuroinflammatory events among new users of TNF inhibitors did not differ substantially as compared to new users of other b/tsDMARDs
In AC&R
https://t.co/8rGgZmpq9c https://t.co/5gxuWBctBL
Dr. John Cush
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Korean National Insurance claims study (2010-18) of NSAID use and CV events found among 19,775 RA pts (F/U 98290 PYs); there were 1663 cases of CV evens. Increasing NSAID doses incr incident CVD(adjHR 1.10); including CVA (aHR 1.09). CHF (aHR 1.12) https://t.co/mdRKYMQq1s https://t.co/36i2KT4j5A
