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JAK Inhibitor Succeeds as Monotherapy in Rheumatoid Arthritis
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.
Read ArticleIL-17 Superior to TNF Inhibition in Psoriatic Arthritis
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.
Growing Risk of COVID Among Adolescents
The risk COVID-19 infection and mortality in the U.S. has been closely correlated with increasing age. However, recent data suggests that young adults (aged 18–25 years) have shown an increasing risk of COVID-19 infection since the pandemic began in March 2020.
Read ArticleExtrapulmonary Manifestations of COVID-19
A new article in Nature Medicine delineates how our understanding of COVID-19 infection has evolved over time, such that the infection outomes may be worsened by extrapulmonary manifestations; notably thrombotic, cardiac, renal, gastrointestinal hepatic, neurologic, and other complications.
Read ArticleICYMI: COVID-19 and Thrombotic Complications
Severe and fatal outcomes with coronavirus infection are often the result of the downstream damage that follows the viral infection. Rising high on the list of complications are the hematologic and vascular complications seen in severely affected patients, so much so that many centers are routinely anticoagulating hospitalized (but not ambulatory) COVID patients.
Read ArticleICYMI: The Nine Lives of Hydroxychloroquine (Updated)
Hydroxychloroquine is one of many medications frequently used in rheumatology practice. Its remarkable versatility is attested by its routine use in lupus, in patients with an autoimmune coagulopathy, in patients with rheumatoid arthritis, as well as in those with a low-level inflammatory arthropathy.
Read ArticleICYMI: Outcomes of Critically-Ill COVID Patients in NYC
Lancet has reported COVID outcomes from NewYork-Presbyterian hospitals in NYC during March 2020 showing high rates of hospitalization, ICU admission, mechanical ventilation and death.
A prospective observational cohort study 2 2 NYC hospitals from March 2 to April 1, 2020, looking at laboratory-confirmed COVID-19 and were critically ill with acute hypoxaemic respiratory failure, and collected clinical, biomarker, and treatment data. The primary outcome was in-hospital death.
2020 ACR Gout Management Guideline
In May, the American College of Rheumatology (ACR) released the"2020 Guideline for the Management of Gout"reflecting new clinical evidence since the last guideline published in 2012.
Read ArticleCoexistent Gout and Rheumatoid Arthritis
While it is often said there is a negative association between gout and rheumatoid arthritis (RA), cases of coexistent disorders are uncommonly seen. A recent VA study describes 121 patients whith both RA and gout.
Read ArticleCV Risks Raised in Myopathies
Patients with the idiopathic inflammatory myopathies (IIMs) dermatomyositis and polymyositis are at increased risk for cardiovascular events, with risks similar to what has been documented for rheumatoid arthritis (RA), during the first 5 years after diagnosis, U.K. researchers reported.
Read ArticleLiver Abnormalities in Psoriatic Arthritis
A new report in the Journal of Rheumatology shows that liver abnormalities are common in psoriatic arthritis (PsA) and may be associated with obesity, more severe disease and select therapies.
Read ArticlePremature Atherosclerosis in Autoimmune Rheumatic Diseases
The VITAL study is a VA registry that has shown that both systemic lupus erythematosus (SLE) and rheumatoid arthritis (RA) patients carry higher odds of both premature and extremely premature atherosclerotic cardiovascular disease and its consequences.
Read ArticleCOVID's Multisystem Inflammatory Syndrome in Children
Two recent reports further characterize the newly described, Kawasaki-like, syndrome affecting children with COVID-19 infections.
The NEJM describes the childhood syndrome as having Kawasaki’s disease, fever, toxic shock syndrome, acute abdominal conditions, and encephalopathy; hence the label Childhood Multisystem Inflammatory Syndrome. The disorder emerged in late April 2020, first in the U.K., and then similar cases were reported from many other countries. The CDC named this multisystem inflammatory syndrome in children (MIS-C).
ACR Position Statement on Telemedicine
The American College of Rheumatology (ACR) has released an official position statement supporting the role of telemedicine as a tool with the potential to increase access and improve care for patients with rheumatic diseases.
Read ArticleIs IL-23 Better than IL-17 Inhibition in Psoriasis?
Data presented at the recent American Academy of Dermatology meeting suggests that interleukin (IL)-23 inhibition with risankizumab was more effective than the IL-17 inhibition (secukinumab) based on a 52 week randomized head-to-head trial in moderate to severe psoriasis patients.
Read ArticleTocilizumab May Benefit COVID-19 Pneumonia
A retrospective, observational study published in Lancet Rheumatology has shown that tocilizumab (TCZ) may reduce the risk of death or the need for mechanical ventilation in severe COVID-19 pneumonia. This observational study included adults, with severe COVID-19 pneumonia, who were hospitalized between Feb 21 and March 24, 2020. All were on the standard of care (ie, supplemental oxygen, hydroxychloroquine, azithromycin, antiretrovirals, and low molecular weight heparin), and a non-randomly selected subset of patients also received TCZ.
Read ArticleRheumNow Podcast – Lupus Mortality Declines, But… (6.26.20)
Dr Jack Cush reviews the news and journal articles from the past week on RheumNow.com
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