#DidYouKnow Sir #WilliamOsler died ☠️ of what he called “the old man’s friend” (#pneumonia)? Learn more about the “father of #InternalMedicine” during the 💯th anniversary of his death https://t.co/0O61Qctouq. #IMProud @mcgillu @UniofOxford @JohnsHopkins @Penn @RoySocMed https://t.co/1ZS79pZrhx

Best of 2019 - The Shame Behind Adalimumab Biosimilars

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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).

Best of 2019 - SEAM-PsA Study - Does Monotherapy MTX Win Despite Losing to Etanercept in Psoriatic Arthritis?

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The SEAM-PsA study examined the efficacy of methotrexate monotherapy, etanercept monotherapy or the combination of MTX and ETN in psoriatic arthritis patients, and found that ETN monotherapy was equivalent to combination therapy - and that both were superior to MTX alone in clinical (ACR and MDA) and radiographic responses.

Best of 2019 - New EMA Warnings for Tofacitinib in Patients at Risk for Clots

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The European Medicines Agency safety committee (PRAC) has concluded that Xeljanz (tofacitinib - TOFA) could increase the risk of blood clots in the lungs and in deep veins in patients who are already at high risk for venous thromboembolic events. The PRAC is recommending that TOFA should be used with caution in patients at high risk of blood clots (VTE), regardless of dose used.

Best of 2019 - ACR/SPARTAN Recommendations for the Treatment of Ankylosing Spondylitis and Nonradiographic Axial Spondyloarthritis

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The American College of Rheumatology (ACR), in partnership with the Spondylitis Association of America (SAA) and the Spondyloarthritis Research and Treatment Network (SPARTAN), released the 2019 Update of the Recommendations for the Treatment of Ankylosing Spondylitis (AS) and Nonradiographic Axi

Best of 2019 - Upadacitinib (RINVOQ) FDA Approved for Rheumatoid Arthritis

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The US Food and Drug Administration (FDA) on Friday, August 16, approved AbbVie JAK1 inhibitor, Rinvoq (upadacitinib) for adults with  rheumatoid arthritis with moderately to severely active disease either not responding to, or intolerant of, methotrexate (MTX). 

Best of 2019 - New EULAR/ACR Classification Criteria for SLE

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The European League Against Rheumatism (EULAR) and the American College of Rheumatology (ACR) have jointly developed new classification criteria for systemic lupus erythematosus (SLE); prompted by the need for criteria that were both highly sensitive and specific. The net result is improved sensitivity and specificity, but the use of positive ANA requirement along with a longer list of weighted criteria ensures its utility in SLE research (including early or latent SLE), but not clinical practice.

Gilead Submits Filgotinib NDA to the FDA

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Gilead has submitted a New Drug Application (NDA) to the U.S. Food and Drug Administration (FDA) for filgotinib, an investigational, oral, selective JAK1 inhibitor for the treatment of adults who are living with moderate-to-severe rheumatoid arthritis (RA).

Upadacitinib Effective in Ankylosing Spondylitis

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Lancet reports that the selective JAK1 inhibitor, upadacitinib, was effective when given to patients with active ankylosing spondylitis.

Belimumab in Lupus Nephritis

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Belimumab has been studied in an active lupus nephritis, phase 3 trial call BLISS-LN and shown to be effective as measured by  trial of belimumab for the treatment of active lupus nephritis in adult patients.

Is Anifrolumab Good Enough for Systemic Lupus Erythematosus?

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The NEJM published favorable results of a phase 3 trial of the alpha interferon inhibitor, anifrolumab, showing it to be superior to placebo in active systemic lupus erythematosus (SLE) patients studied for 48 weeks.

Fewer Lupus Flares on Low Dose Steroids

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French researchers have shown that patients with systemic lupus erythematosus (SLE) and inactive disease are less likely to flare while taking a 5 mg prednisone maintenance dose.

Obesity Not Discussed by Doctors and Patients

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Reuters -  Doctors rarely talk about weight concerns with patients who are overweight or obese, and when they do, patients’ experiences tend to be negative, according to a new review of research based on interviews.

Domestic Abuse Linked to Fibromyalgia and Chronic Fatigue

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Domestic violence was found to predispose to a higher risk of fibromyalgia and those developing chronic fatigue syndrome.

No Cancer Risk with Systemic Necrotizing Vasculitis

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The French Vasculitis Study Group has published that patients with systemic necrotizing vasculitis do not have an increased risk of malignancy; in fact they have a risk that is similar to the general population.

Predicting Inpatient Gout Flares

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Analysis of New Zealand hospitalized patients revals nine predictors of inpatient flare for people with comorbid gout.

This retrospective cohort study of hospitalised patients with comorbid gout included 625 hospitalised patients, 87 experienced inpatient gout flare.

RheumNow Podcast - The Elusive Hand OA Problem (12.13.19)

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Dr. Jack Cush recaps the news and journal reports from the past week on RheumNow.com.

Short-term Benefit with Prednisolone in Hand Osteoarthritis

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Lancet reports that prednisolone 10 mg daily for 6 weeks can effectively control the pain of hand osteoarthritis (OA), according to results from the Hand Osteoarthritis Prednisolone Efficacy (HOPE) study.

This was a double-blind, randomized, placebo-controlled trial aimed to assess the short-term effects of prednisolone in painful hand OA and synovial inflammation. Patients were required to have hand OA and signs of inflammation in their distal and proximal interphalangeal (DIP/PIP) joints and > 4 DIP/PIP osteoarthritic nodes and at least one DIP/PIP joint with soft swelling/erythema or evidence of synovitis on power Doppler ultrasound. The primary endpoint was finger pain.

CRP in SSc: Identifying a Severe Phenotype

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Patients with systemic sclerosis (SSc) who have persistent inflammation -- characterized by consistently elevated levels of C-reactive protein (CRP) -- have more severe disease and worse outcomes, a retrospective study confirmed.