Novartis has announced the results of the EXCEED trial that pitted its IL-17 inhibitor, Cosentyx (secukinumab - SEC) against Humira (adalimumab - ADA) in patients with active psoriatic arthritis. The trial demonstrated that SEC was not non-inferior to ADA, but failed to meet its primary endpoint of superiority over ADA as far as drug efficacy.

Yesterday, AbbVie reported the top-line study results showing the efficacy of Rinvoq (upadacitinib - UPAD) adult patients with active psoriatic arthritis who previously had an inadequate response to a biologic DMARD.

Dr. Jack Cush reviews recent journal articles and info bits from the past week on RheumNow.com. 

The Global Burden of Diseases, Injuries, and Risk Factors study (GBD) from 2017 analyzed the burden of rheumatoid arthritis (RA) for 195 countries between 1990 to 2017 and surmised that RA is a major global public health challenge, with increasing prevalence and incidence rates.

A Canadian population-based study shows that pregnant women with rheumatoid arthritis (RA) frequently discontinue their DMARD medications, especially in the first trimester.

Rheumatology has a comprehensive overview of methotrexate (MTX) and the risk of lung injury, MTX-related pneumonitis and interstitial lung disease (RA-ILD) with rheumatoid arthritis (RA). Past reports suggest the frequence of MTX-pneumonitis to be between 0.3 and 11.6%; recent studies suggest it may be much lower.

JAMA has an article this week on the shift from biologic drugs to less expensive therapeutic biosimilar agents. The impact of biosimilars can be easily represented by the shift from adalimuamb - a biologic with nearly $19 billion in sales in 2018 - to any one of the four FDA approved biosimilars for adalimumab (see the daily download for slides on new adalimumab and other biosimilars).

Dr. Jack Cush reviews the news and journal articles from the past week on RheumNow.com.

The U.S. Food and Drug Administration has issued a new draft guidance document calling for a boxed warning and delineation of risks with breast implants.

Despite the well known, well publicized treat-to-target (T2T) goal of a serum uric acid (SUA) level 6 mg/dl, this goal is seldom achieved ( 40%) in clinical practice and patient adherence has been unacceptably low. A recent study shows that nurse-led care led to better outcomes in gout including patient acceptability, long-term adherence, and less flares.

Sanofi has initiated a voluntary recall of all Zantac OTC (over-the-counter) products in the United States. This includes Zantac 150®, Zantac 150® Cool Mint, and Zantac 75®.

Ustekinumab (Stelara) is now FDA-approved to treat moderately to severely active ulcerative colitis, said drugmaker Janssen on Monday, in addition to its indications for psoriasis, psoriatic arthritis, and Crohn's disease.

Control of pain in patients with rheumatoid arthritis (RA) often focuses on control of inflammation as a means to better control pain.

A prospective study of birth outcomes to mothers exposed to adalimumab (ADA) between 2004 and 2016 was conducted by Organization of Teratology Information Specialists (OTIS) Research Center at the University of California San Diego, and showed that ADA exposure was not associated with an increase

A systematic review of the literature shows that, compared to placebo, the use of non-TNF, interleukin inhibitor biologics may be associated with significantly higher rates of serious infections, opportunistic infections, and cancer.

Dr. Jack Cush reviews the news and journal articles from the past week on RheumNow.com.

A prospective analysis of newly diagnosed, inflammatory arthritis (IA) patients suggests that perceived distress (stress) increases the odds of incident IA.

The National Rheumatoid Arthritis Society's (NRAS) annual audit has identified significant treatment delays for patients with suspected early inflammatory arthritis could result in unnecessary harm. 

Intra-articular sprifermin given to patients with symptomatic and radiographic knee osteoarthritis has been shown to significantly improve total femorotibial joint cartilage thickness after 2 years, but without significant clinical benefits. Which begs the question, why is there a disconnect between radiographic disease modification (cartilage thickness) and symptomatic improvement?

Even though oral bisphosphonates are widely used, there is an inordinate concern over the risk of osteonecrosis of the jaw (ONJ). A new UK study suggests that the risk of ONJ is elevated six fold by the use of biphosphonates.