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English for the Biologically-Challenged (8.4.2023)
Dr. Jack Cush reviews the news and journal articles from the past week on RheumNow.com. This week highlights Veterans, Vegetarians and Antenatal Corticosteroids.
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Predicting Inflammatory Arthritis in At-Risk Persons
The Annals of Internal Medicine has published a predictive score to distinguish low-risk from high-risk inflammatory arthritis (IA) and who may benefit from risk stratification and preventive measures.
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IL-23 Inhibitor Performance in Psoriatic Disease
IL-23 inhibitors are approved for the treatment of psoriasis and psoriatic arthritis; a single center real-world observational study shows three commercially available IL-23 inhibitors have high and similar drug survival and effectiveness in difficult-to-treat psoriasis and PsA.
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EULAR/ACR Guidance on Haemophagocytic Lymphohistiocytosis/Macrophage Activation Syndrome
A EULAR/American College of Rheumatology task force has established evidence based, up-to-date guidance and expert opinion on the evaluation, management and monitoring of patients with Haemophagocytic lymphohistiocytosis (HLH) and macrophage activation syndrome (MAS), with the primary intent to halt disease progression and prevent life-threatening complications from HLH/MAS.
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WHO Safety Study of Five TNF Inhibitors
Large scale analysis of adverse events (AEs) in World Health Organization (WHO) VigiAccess database showed no new safety signals associated with long-standing use of five TNFα inhibitors.
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SGLT2 Inhibitors Reduce Gout Flares and CV Events
A cohort analysis shows that gout patients initiating sodium–glucose cotransporter-2 inhibitors (SGLT2is) had lower serum urate levels and fewer gouty flares requiring emergency department (ED) visits or hospitalizations.
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Infectious Risk with B Cell Therapies in Lupus
A UK registry study of moderate to severe systemic lupus erythematosus (SLE) patients showed that treatment with rituximab or belimumab was not associated with a greater risk of serious infection, when compared to standard of care therapy.
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RNase Treatment of Autoimmune Disorders
U1RNP complex, Ro/SSA and La/SSB are major RNA-containing autoantigens associated with autoimmune disorders. Immune complexes (ICs) composed of RNA-containing autoantigens and autoantibodies are suspected to be involved in the pathogenesis of some systemic autoimmune diseases.
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Hold the Methotrexate for One Week
In 2018, Park et al showed optimal responses to influenza vaccination in RA patients was best achieved by holding methotrexate for 2 weeks following immunization, with improved humoral responses. Now, a followup trial suggests that equivalent results are had by holding MTX for only 1 week with the "flu" vaccine.
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EULAR Points to Consider in Progressing Psoriasis to Psoriatic Arthritis
The transition from psoriasis to PsA – and the early diagnosis of PsA – is of considerable scientific and clinical interest. People typically have psoriatic skin disease for a decade or more before they begin to experience the joint involvement of PsA.
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Anti-Drug Antibodies with Biologics (7.14.2023)
Dr. Jack Cush Reviews the news and journal reports on CVA, TKA, PJP, ADA, and more!
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Filgotinib Effects on Semen and Sex Hormones
The oral Janus kinase 1 inhibitor filgotinib is available worldwide, but not in the USA, where the FDA held up its approval for use in RA due to unfinished studies of filgotinib's effects on sperm cells. The results of 2 phase two studies (MANTA and MANTA-RAy) confirm that filgotinib has no measurable impact on semen parameters or sex hormones in men with active IBD or inflammatory rheumatic diseases.
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Antidrug Antibodies Impair Response to Biologic Drugs
Monitoring for antidrug antibodies with biologic has not been routine in rheumatology but a new study suggests that antidrug antibodies correlate with nonresponse to bDMARDs in rheumatoid arthritis (RA) patients.
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Biologics Keep Early RA in Check for at Least One Year
Treatment with at least some biologic drugs significantly reduced 1-year progression of early rheumatoid arthritis (RA) relative to classical small-molecule agents, researchers reported.
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RA Biologics Lower COVID-19 Deaths, but Not Recovery Time
Do abatacept, cenicriviroc, or infliximab improve time to recovery for patients hospitalized with COVID-19 pneumonia compared with standard care?
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Baricitinib Effective in JIA Subsets
A phase 3 trial assessed a selective Janus kinase 1/2-inhibitor, baricitinib, in patients with juvenile idiopathic arthritis (JIA), demonstrating it's efficacy and safety compared to placebo.
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GCA and the Risk of Cerebrovascular Ischemic Events
Cerebrovascular ischemic events (CIE) can be one of the most severe complications of giant cell arteritis (GCA), but is seen in 4-5% of GCA patients according to a recent French University Hospital.
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Upadacitinib Outcomes in High Risk RA Patients
A safety analysis of six phase III SELECT trials showed that higher-risk rheumatoid arthritis (RA) patients had an increased risk of MACE, malignancy (excluding NMSC) and venous thromboembolic events (VTE) regardless of being treated with either upadacitinib (UPA) or adalimumab (ADA).
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ICYMI: Drug Safety Differences with New Novel Therapies in RA
Safety outcomes for targeted synthetic or biological disease-modifying antirheumatic drugs (b/ts DMARDs) used to treat RA were studied using data from the Anti-Rheumatic Therapies in Sweden (ARTIS) registry, showing that these newer agents are largely similar, but still have particular differences for specific infection or other adverse event risks.
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