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Allergic Drug-Induced Arthritis (5.19.2023)

Jack Cush, MD

Dr. Jack Cush reviews the news and journal reports from this past week on RheumNow.com.  This week we delve into some odd associations, repeat drug warnings and the consequences of antirheumatic therapies.

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Peresolimab's Potential in Rheumatoid Arthritis

Jack Cush, MD

Peresolimab is a humanized IgG1 monoclonal antibody that acts as a programmed cell death protein 1 (PD-1) agonist (stimulator). The NEJM reports that PER met its efficacy primary endpont in treating patients with active rheumatoid arthritis (RA). 

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B-Cell Stimulating Factors Tied to Lymphoma in Sjogren's

MedPage Today

Genetic blood tests indicated that Bruton's tyrosine kinase (BTK) and a cytokine called APRIL were overexpressed in patients with primary Sjögren's syndrome who subsequently developed lymphoma, French researchers reported, suggesting that BTK inhibitors might be useful in this population.

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National Population Insights (4.28.2023)

Jack Cush, MD

Dr. Jack Cush reviews the news and journal reports and addresses 3 viewer case questions.

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Immune Checkpoint Inhibitor Safety with Pre-existing Rheumatoid Arthritis

Jack Cush, MD

Lancet Rheumatology has published a retrospective analysis showing patients receiving immune checkpoint inhibitors (ICI) for cancer have the same outcomes (mortality and severe immune-related adverse events (irAEs)) even when they have pre-existing rheumatoid arthritis (RA).

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The Match Game (4.14.2023)

Jack Cush, MD

Dr. Jack Cush reviews the news and journal articles from the past week on RheumNow.com, including Rheumatology success in the NRMP MATCH, Cocaine vasculitis and worrisome safety risks with Biologics and tsDMARDs.

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Best Treatments for Immune Checkpoint Inhibitor-associated Arthritis

Jack Cush, MD

A retrospective study of cancer patients who developed immune checkpoint inhibitor-associated inflammatory arthritis (ICI-IA) shows that biologic DMARDs were more effective than conventional synthetic DMARDs (csDMARDs) in rapid control of arthritis.

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EMA Final Update on JAK Inhibitors and MACE, Malignancy & VTE Risks

Jack Cush, MD

The EMA has updated recommendations regarding the use of JAK inhibitors by issuing a direct healthcare professional communication summarizing the data and warnings regarding an increased risk of malignancy, major adverse cardiovascular events (MACE), serious infections, VTE, and mortality in some patients receiving JAKi for the treatment of chronic inflammatory disorders.

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Big Time Vasculitis (3.10.2023)

Jack Cush, MD

Dr. Jack Cush Reviews the News and Journal articles from the past week on RheumNow. This weeks highlights includes insights on scleroderma, myositis, vasculitis and answers the question - does aggressive biologic treatment of psoriasis prevent future psoriatic arthritis?

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Beydon et al., french registry study 255000+ RA patients 2010-2020 Increase ⬆️ overall malignancy by 20% vs. general pop ⬆️lung 40%, ENT 40%, cervix 80%, prostate 8%, melanoma 37% Pancreatic cancer 10% less frequent in ♂ Breast 9% & Uterine body 23% less frequent in ♀

Aurelie Najm AurelieRheumo ( View Tweet)

EULAR PtoC management of targeted therapies in pts w/ IA & Hx cancer 1) If remission, initiate targeted therapy w/out delay 2) Prefer anti-cytokine bDMARDs if Hx solid cancer 3) B cell depleting therapy if Hx lymphoma 4) Use JAK inhibitors and abatacept with caution 🛑 https://t.co/cKhQVZwGh1
Aurelie Najm AurelieRheumo ( View Tweet)
Dr. Anisha Dua on Imaging in PMR: - US of shoulders to eval for bursitis can increase specificity - MRI better for pelvic girdle, but expensive - Consider PET if lack of response to steroids, r/o malignancy #RNL2023 @RheumNow https://t.co/tjhGlJPDWZ https://t.co/9h1FwfM0CP

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Dr. John Cush RheumNow ( View Tweet)
Matched cohort study of 67,598 German primary care Pts shows gout have incr risk of breast cancer (4.5% gout vs 3.7% non-gout; HR: 1.17; 1.05-1.31). Association only seen under age 50 (HR: 1.58; 1.10-2.27), but notin women over 50 yrs https://t.co/pl6gH2GyZQ https://t.co/VR8kuumhNv

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Dr. John Cush RheumNow ( View Tweet)
Review of the etiology of Polyserositis (14 pts, 23 articles): most common - neoplasia (26.3%; Lung Lymphoma; ovarian; pancreatic), autoimmune (16.7% - SLE, AOSD) & infections (12.3%; coxackie, CMV, mTB). https://t.co/Bubd99ETgu https://t.co/VbiPB0y7pv

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Dr. John Cush RheumNow ( View Tweet)
A Danish national registry study compared RA pts taking JAKi (n 875) and bDMARDs (n 4247). They found similar rates of subsequent cancers (14.4 vs 12.9/ per 1000 PYRS); with a nonsignificant risk (HR1.41; CI 0.76, 2.37) https://t.co/wfrlAcij8x https://t.co/OvqKrHw5Wu

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Dr. John Cush RheumNow ( View Tweet)
Immune Checkpoint Inhibitor Safety with Pre-existing Rheumatoid Arthritis Lancet Rheumatology has published a retrospective analysis showing patients receiving ICI for cancer have the same outcomes even when they have pre-existing RA. https://t.co/aFNZX5YaLD https://t.co/ZY9Ie8TOPc

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Dr. John Cush RheumNow ( View Tweet)
Japanese cohort study shows Lung cancer is more common in males w/ elder-onset dermatomyositis - risk increased by Smoking, anti-TIF1-γ-Abs and elevated MLR (monocyte to lymphocyte ratio) https://t.co/C7BTAV5gCj https://t.co/YGq6sUbLOh

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Dr. John Cush RheumNow ( View Tweet)
Retrospective of 28,360 #PsA pts saw more comorbidities by race - AAs had signif. more HTN (59% vs 52%), DM (31% vs 23%), obesity (47% vs 30%) & gout (12% vs 8%); but whites more cancer (20% vs 16%), anxiety (28% vs 23%), OP(14% vs 12%), more biologic use https://t.co/YwGjVowO3G https://t.co/3BUXFX11rh

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Dr. John Cush RheumNow ( View Tweet)
Japanese cohort study shows Lung cancer is more common in males w/ elder-onset dermatomyositis - risk increased by Smoking, anti-TIF1-γ-Abs and elevated MLR (monocyte to lymphocyte ratio) https://t.co/LlTkiWp7pb https://t.co/Bu9atnI8je

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Dr. John Cush RheumNow ( View Tweet)
Ccancer detection study in idiopathic inflammatory myositis: found w/in 3 yrs of onset 9/1011 (0.9%) CT chest & 12/657(1.8%) CT Dx cancer. Yield best w/ DM, TIF1γ pos. Yield very low age<40 yrs; high false(+) w/ antisynthetase synd & necrotizing myositis https://t.co/FCBwEYW1eT https://t.co/DAEj83xmam

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Dr. John Cush RheumNow ( View Tweet)
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