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T2T Lowers Mortality in Gout
A Spanish prospective cohort of active, uncontrolled gout patients were followed and showed that failure to reach a target serum uric acid (sUA) level of 6 mg/dl (0.36 mmol/L) or less was associated with a 2-3 fold increase in mortality.
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Most Psoriatics Go on Biologics
A cohort study of 97 patients with psoriatic arthritis (PsA) examined the prescribing practices in PsA, and found biologics are commonly initiated as the primary mode of therapy in outpatients with PsA. However, treatment modifications can be made regarding patients who are managed with apremilast alone.
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New EMA Warnings for Tofacitinib in Patients at Risk for Clots
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.
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Mallinckrodt Receives SEC Subpoena
Reuters reports that Mallinckrodt Plc has received a subpoena from the U.S. Securities and Exchange Commission for documents related to the drugmaker’s lawsuit against the U.S. Department of Health and Human Services (HHS).
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Year in Review - Psoriatic Arthritis 2019
Major new insights into the treatment of psoriatic arthritis dominated the headlines during the past year, with a head-to-head trial comparing IL-17A inhibition with tumor necrosis factor blockade, another study considering whether methotrexate can improve outcomes with anti-TNF therapy in PsA, and an investigation into the effects of biologic therapy on bone.
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Physical Activity Lowers Fracture Risk in Post-Menopausal Women
An analysis from the Women’s Health Initiative study shows that postmenopausal women who participate in vigorous physical activity have a statistically lower risk of total and site-specific fractures
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EXCEED Study: Cosentyx Equals Humira in Psoriatic Arthritis
Novartis has announced the results of the EXCEED trial that pitted its IL-17 inhibitor, Cosentyx (secukinumab - SEC) against Humira (adalimumab - ADA) in patients with active psoriatic arthritis. The trial demonstrated that SEC was not non-inferior to ADA, but failed to meet its primary endpoint of superiority over ADA as far as drug efficacy.
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Rinvoq (upadacitinib) Effective in Psoriatic Arthritis
Yesterday, AbbVie reported the top-line study results showing the efficacy of Rinvoq (upadacitinib - UPAD) adult patients with active psoriatic arthritis who previously had an inadequate response to a biologic DMARD.
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RheumNow Podcast – Ghastly, Ghoulish News (10.31.19)
Dr. Jack Cush reviews recent journal articles and info bits from the past week on RheumNow.com.
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Outcomes in Juvenile Idiopathic Arthritis
Arthritis Research & Therapy reports on a prospective cohort of children with juvenile idiopathic arthritis (JIA) shows that the incidence has held steady at 12.8/100,000 children, but that the frequency uveitis and the need for orthopedic surgery has decreased in the last 20 years.
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Frequent DMARD Discontinuations During Rheumatoid Pregnancies
A Canadian population-based study shows that pregnant women with rheumatoid arthritis (RA) frequently discontinue their DMARD medications, especially in the first trimester.
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Psoriasis Risk Increased with TNF Inhibitors in Juveniles
Children with inflammatory diseases who were treated with tumor necrosis factor (TNF) inhibitors had a higher rate of incident psoriasis than those not exposed to these biologics, a single-center retrospective study found.
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Methotrexate and the Risk of Lung Disease
Rheumatology has a comprehensive overview of methotrexate (MTX) and the risk of lung injury, MTX-related pneumonitis and interstitial lung disease (RA-ILD) with rheumatoid arthritis (RA). Past reports suggest the frequence of MTX-pneumonitis to be between 0.3 and 11.6%; recent studies suggest it may be much lower.
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Novel Inhibition of MSU Crystal Inflammation
Researchers from Washington State University have shown that inhibition of tumor growth factor-β (TGF-β)-activated kinase 1 (TAK1) can effectively downregulate inflammatory mediators and suppress inflammation caused by gout.
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The Shame Behind Adalimumab Biosimilars
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).
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RheumNow Podcast – The Shoes Maketh the Doctor (10.25.19)
Dr. Jack Cush reviews the news and journal articles from the past week on RheumNow.com.
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FDA Issues Boxed Warning and Recommendations for Breast Implant Use
The U.S. Food and Drug Administration has issued a new draft guidance document calling for a boxed warning and delineation of risks with breast implants.
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Patients Prefer Nurse Led Care for their Gout
Despite the well known, well publicized treat-to-target (T2T) goal of a serum uric acid (SUA) level 6 mg/dl, this goal is seldom achieved ( 40%) in clinical practice and patient adherence has been unacceptably low. A recent study shows that nurse-led care led to better outcomes in gout including patient acceptability, long-term adherence, and less flares.
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Voluntary Recall of Zantac by Sanofi/FDA
Sanofi has initiated a voluntary recall of all Zantac OTC (over-the-counter) products in the United States. This includes Zantac 150®, Zantac 150® Cool Mint, and Zantac 75®.
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FDA Approves Ustekinumab for Ulcerative Colitis
Ustekinumab (Stelara) is now FDA-approved to treat moderately to severely active ulcerative colitis, said drugmaker Janssen on Monday, in addition to its indications for psoriasis, psoriatic arthritis, and Crohn's disease.
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