Dr. Jack Cush reviews the news, tweets and journal articles from the past week on RheumNow. Let's dig into this week's 14 highlights.

The current issue of NEJM reports a novel cell type that may be used to identify rheumatoid arthritis (RA) patients who may flare. 

Investigators prospectively collected blood samples from 4 patients for longitudinal RNA sequencing (RNA-seq) for discovery of moleculartranscripts that were differentially expressed before flares.

Hydroxychloroquine (HCQ) helped reduce recurrent maternal autoantibody-mediated congenital heart block (CHB) in fetuses, an open-label study suggested.

Since the onset of the COVID-19 pandemic numerous anti-rheumatic therapies have been proposed as being potentially beneficial. The mechanistic effects of these agents, either presumed antiviral, anti-inflammatory and anti-thrombotic effects, may benefit mitigate the damage seen with COVID-19 infection.

This review will examine the potential benefits and existing evidence for treating suspected or proven COVID-19 infection with antimalarials, inhibitors of interleukin-6 (IL-6) or interleukin-1 (IL-1) Janus kinase (JAK) inhibitors, TNF inhibitors or colchicine. There are many other antirheumatic and immunosuppressive therapies that are in clinical trials that will not be reviewed here including IVIG, rituximab, calcineurin inhibitors (sirolimus, etc.), apremilast, emapalumab (anti-IFN gamma), etc.

The oral Janus kinase (JAK) inhibitor upadacitinib (Rinvoq) given as monotherapy was more effective than methotrexate alone in methotrexate-naive patients with active rheumatoid arthritis (RA) in a multinational phase III trial.

A one year head-to-head (H2H) trial has shown ixekizumab (IXE) to be superior to adalimumab (ADA) in psoriatic arthritis (PsA); for both skin and articular outcomes.

The SPIRIT H2H study was a 52-week trial of 566 biologic DMARD naive, PsA patients, randomized to received either IXE or ADA. The primary end point was at Wk 24, but the newly published data shows week 52 results for ACR50 and Psoriasis Area and Severity Index 100 responses.