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Immunosuppression Increasing (2.23.2024)
Dr. Jack Cush reviews the news and journal reports from the past 2 weeks on RheumNow.com; but begins with a discussion of what constitutes "immunosuppression" and how it applies to our patients.
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No clear link between weather and MSK symptoms
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EurekAlert!
There is a longstanding belief that changes in weather conditions, such as impending rain or temperature, can trigger or worsen muscle and joint pain but Australian researchers have found no clear pattern between the two.
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CD19 CAR T-Cell Therapy in Autoimmune Disease
The NEJM has published the results of CD19 B cell depletion (by CAR-T cell therapy) in autoimmune disease patients, demonstrating it to be feasible, safe, and efficacious.
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Top 5 Clinical Pearls in RA Management
#RNL2024 provided a wealth of clinical insights, particularly in the realm of rheumatoid arthritis (RA) management. Here are the top five clinical pearls from the event's opening session, "Success in RA."
https://t.co/DUalEZbfJB https://t.co/RZsW0SKc4J
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Five Takeaways in PsA/SpA at RNL 2024
Continuing with the theme of clinical pearls, the PsA and SpA speakers also provided a wealth of information. Click the link to read our five key takeaways and clinical pearls.
https://t.co/ekKUl5WelF https://t.co/IdPXd7LR65
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The ARIAA trial tested the utility of IV abatacept in individuals ACPA+ arthralgia patients with subclinical inflammation and showed abatacept to decrease MRI inflammation, clinical symptoms, and risk of future RA development.
https://t.co/PdYLKwT0z9 https://t.co/O8uHxzleIK
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Gabapentinoid use in COPD pts assoc w/ signif increased risk of severe exacerbation. Compared with nonuse, GABA use incr risk of COPD exacerbation when used for epilepsy (HR 1.58), neuropathic pain (HR 1.35), chronic pain (HR 1.49) https://t.co/EyONh9sASh https://t.co/Sr2FyJQzBj
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Immune-Related Adverse Events of Immune Checkpoint Inhibitors - FULL READ overview in Annals of Internal Medicine. irAEs occur from few days to 1 year after ICI initiation; w/ 3-fold higher risk 1st 4 wks & only 7% starting 1 year after ICI https://t.co/jxEAl3rlCd https://t.co/IlmvV5kNfP
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ACR 2023 Poster Available on RheumNow: JAKi Safety and Efficacy Through Week 204 in bDMARD-IR Patients with RA
View long-term extension outcomes from the SELECT-CHOICE study in bDMARD-IR patients with RA.
Sponsored by AbbVie US Medical Affairs. https://t.co/3zEn9a2eml https://t.co/P7QXAmqJ2x
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BC, Canada study of 149,902 new rheumatology referrals showed 31% more referrals 2019–2020 (vs 2010–2011). New inflammatory arthritis increased (28% to 51%), delays decr by 22 days; but time to 1st DMARD in RA decreased by only 4 days (6%) to 62 days https://t.co/LEyWcI6ojn https://t.co/QdL8VP1C6q
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MMPs play pathogenic role in RA-ILD. Multicenter VA study of 2,312 RA pts, 96 had prevalent ILD & Incident ILD developed in 130 (IR 7.5/1,000PY). High MMP-7 increased ILD (adj OR 3.78) & incident ILD (adj HR 2.33). Higher MMP-9 did same https://t.co/W8IuDJCH8e https://t.co/UdiyyUt7jJ
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UK Clinical Practice Research Datalink matched cohort study compared Gout (152K) to controls (709K) - CV devlopment higher in gout (21% vs 15%; HR 2.58). Moreso in women (HR 1.88). Gout pt had more CKD, HTN, obesity dyslipidaemia, & NIDDM https://t.co/BXCawnuIfa https://t.co/ZMuK9Msesb
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2021 NHIS Survey data suggests the prevalence of immunosuppression in the USA is 6.6% (4.4% immunosuppressive Dz; 3.9% immunosuppressive meds; 1.8% both); higher in women 7.9% ages 60-69 (9.5%) & Alaskan/Native indian (8.4%) https://t.co/phFPRqpCbJ https://t.co/non7zpQVOL
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FDA has issued new draft guidance on the "Use of Data Monitoring Committees in Clinical Trials", updating its 2006 guidance document. "..the DMC should have access to safety results as well as comparative efficacy results." https://t.co/F0vKOxCLq9 https://t.co/xBa4Q1ukqo https://t.co/KeBUsYIl6u
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Serial plasma samples assayed for 92 inflammation-related proteins, during and after gout attacks. 21 were differentially expressed. Gout flares assoc w/ increased IL-6, CSF-1, VEGF-A & tumour necrosis factor superfamily 14 (TNFSF14 was highest) https://t.co/mhIFaljKHv https://t.co/o45Zzn0g9A
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EMG fibrillation potentials (insertional activity) & positive sharp waves (Fib/PSW) are found in 95% study of 75 pts dx w/ idiopathic inflammatory myositis (44 PM, 17 DM, 7 ADM, 11 IBM); but also in 4 pts not meeting EULAR criteria https://t.co/VsrNjDMGnC https://t.co/OQYnUPJD5o
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False positive COVID tests (+Rapid Ag; neg PCR) are rare, 1.7% of 11,297 tests; Persistent false positives seen in 13/191 and usually in women, with autoimmune dz (6/13; RA, SLE etc) & using the Quidel QuickVue rapid antigen test https://t.co/Pqkk7uBVcO https://t.co/m6ylQz00Ih
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Join our experts, Drs Liebowitz and Mehta, as they provide insights on the differential diagnosis and management concepts in autoinflammatory diseases.
https://t.co/r5WjYIdmaT https://t.co/gGdhyDKqtC
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Week 52 outcomes of 180 lupus nephritis pts (IV, VI, III) from AMP academic centers (rx w/ standard of care) showed 22% complete resp, 22% partial resp, 42% non-responder& 14% undetermined. 8/180 (4.4%) had CR sustained Wk 12 to 52; 10% PR. An unmet need! https://t.co/UfYDKqHq1D https://t.co/zUIgvsZY6m
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Cochrane Review: How Good is Ultrasound Diagnosing GCA?
Is temporal artery ultrasound (US) equivalent or superior to the reference standard of temporal artery biopsy (TAB) when diagnosing giant cell arteritis (GCA)?
https://t.co/BWzP3K8dCo https://t.co/DMu19sPMQv
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