BEAT LUPUS - Belimumab after Rituximab in SLE

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A recent trial published in Annals of Internal Medicine analyzed the effects of B-cell depletion (rituximab) followed by B-cell suppression (belimumab) and showed effective lowering of anti-dsDNA titers and and fewer severe flare in patients with systemic lupus erythematosus (SLE).

2021 Rheumatology Year in Review

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Our top 10 list of advances, game-changers, worries and those better medical practices that evolved during 2021.

Comorbidities Drive Risk of Severe Outcomes with COVID-19

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The current edition of the MMWR from the CDC shows that among those vaccinated against COVID-19, there is a low risk of severe outcomes (hospitalization and death); the highest risk is seen in those with multiple comorbidities.

COVID Breakthrough Infections with Arthritis and HIV

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Among immunocompromised individuals vaccinated against COVID-19, solid organ transplant recipients as well as those with HIV and rheumatoid arthritis (RA) were significantly more likely to experience breakthrough infections versus people without immune dysfunction, a retrospective study found.

Clinical Practice Guidelines for Multisystem Inflammatory Syndrome in Children

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Multisystem inflammatory syndrome in children (MIS-C) is new and serious complication of COVID-19 that preferentially affects adolescents. A review of proposed management guidelines is compiled in this report, suggesting a unified approach to therapeutic management of MIS-C.

Autoantibody Associations in Systemic Sclerosis

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Analysis of two large cohorts of systemic sclerosis (SSc) patients shows a signfiicant minority of patients to have autoantibodies typical of rheumatoid erosive arthrits, but their presence in SSc patients was associated with unique manifestations of SSc. 

Spesolimab, an IL-36 Blocker, in Pustular Psoriasis

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The NEJM has published the results of a phase 2 randomized trial showing that the use of an interleukin-36 receptor inhibitor, spesolimab, resulted in rapid improvement of generalized pustular psoriasis (at 1 week), but that adverse events and infections were of concern with 12 weeks of foll

Safety of COVID-19 Vaccines in Rheumatic Patients

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Since the introduction of COVID-19 vaccines in January 2021, rheumatologists have fully advocated the protective benefits of their use - yet many have rarely noted flares and reactive side effects worrisome to patients.  Now a multinational study shows that the use of COVID vaccination in rheumatic and musculoskeletal disease is safe, well-tolerated with very rare serious adverse events.

Best of 2021: Jack of All Subspecialties

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It's great to be a rheumatologist, but boy, it's getting harder and harder. You have to be a jack of all trades. You have to be good at cardiovascular disease, osteoporosis, vaccination, inflammatory bowel disease - it just never ends. This and more, as Dr. Cush summarizes more than a dozen journal articles, news reports and questions + cases.

Best of 2021: FDA Puts Boxed Warnings on JAK Inhibitors

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Based on the safety review of tofacitinib in Pfizer's Oral Surveillance (1133) study, the FDA has added serious boxed warnings to all three marketed JAK inhibitors (for inflammatory diseases) and formalized the recommendation that patients should be started on a TNF inhibitor (TNFi) before trying a JAK inhibitor. These recommendations apply to tofacitinib, baricitinib and upadacitinib.

Best of 2021: Comparison of Three Coronavirus Vaccines

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On Feb. 27, the Food and Drug Administration announced it has issued an emergency use authorization for Johnson & Johnson’s one-dose Covid vaccine, making it the third COVID-19 vaccine to be commercially available.  We've compiled a comparison table and some key information relevant to your delivering patient guidance henceforth. 

Best of 2021: FDA Approves Anifrolumab in SLE

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AstraZeneca announced today that anifrolumab (Saphnelo or anifrolumab-fnia) was approved by the the Food and Drug Administration (FDA) for that treatment of adult patients with moderate to severe systemic lupus erythematosus (SLE) who are receiving standard therapy.  

Indications Awaiting (12.17.21)

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There's good news and bad news in rheumatology fellowship matching for 2022.  There's also new FDA approvals and indications, but a new serious safety warning has arisen from the CDC about the J&J COVID-19 vaccine. 

Dr. Jack Cush reviews the latest news, journal reports, regulatory approvals, plus 3 new cases from rheumatologists.

CDC Panel Recommends mRNA COVID Vaccines Over J&J Vaccine

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The U.S.

Certain Cancers Increased with Autoimmune Diseases

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Rheumatologists are well aware that inflammation and immune dysregulation are prime contributors to cancer risk, but do oncologists carry the same impressions? A large study from JAMA Oncology shows that patients with immune-mediated diseases (IMD) have an overall increased risk of cancer, especially in organ-specific immune-mediated diseases. 

Serious Adverse Events Associated with Tocilizumab in COVID-19 Patients

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Safety analysis of over 1000 adverse events associated with the use of tocilizumab in the treatment of COVID‐19 infection shows both rare expected and some unexpected AE.

Adherence to Medication - Predictive Factors in RA

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The numbers on treatment adherence is disappointingly low in RA, with a number of psychological, communication and logistical factors that outweigh the potentially negative influence of sociodemographic or clinical factors.

When to Stop Biologics in Systemic JIA?

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Systemic onset juvenile idiopathic arthritis (sJIA) is a dramatic onset inflammatory condition marked by spiking fevers, intermittent rash, polyarthritis and a host of other hyperinflammatory manifestations.

T2T Debate - A Prologue with Dr. Marty Bergman

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Drs. Jack Cush and Martin Bergman review the topic of treat-to-target (T2T) management in rheumatology.

Both will debate the pro's and con's of the T2T strategy at the upcoming RWCS meeting on Feb. 17, 2022.

Genes and Obesity Tied to Higher Gout Risk in Women

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Excess adiposity and genetic predisposition both contributed to risk of gout among U.S. women, with the risks being highest when both factors are present, a large prospective study found.