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Sex Disparities in PsA/SpA
Dr. Eder delivered an illuminating talk at RheumNow Live 2024 on sex differences in psoriatic arthritis; the disease may manifest differently in men and women, and therapeutic responses may differ between the sexes.
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Co-management of Psoriatic Disease
It is a common clinical scenario to see someone with both severe psoriatic arthritis and skin psoriasis. In an ideal world this would involve a combined clinic with our local friendly dermatologist. For many of us, however, this is not practical for many reasons. The excellent Saturday morning session on choosing systemic therapies in psoriatic disease at RheumNow Live 2024 from dermatologist extraordinaire Dr. April Armstrong was therefore hugely insightful.
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NJ leads on prior authorization legislation:
- Prior auth turnaround time is 24 hrs urgent requests
- Peer-to-peers for denials involves same specialty MD
- Transparency: companies have to share data on denials/reasons.
(29 states w/ active bills/reforms) https://t.co/pZlyW68DDL https://t.co/uc251qj2Gf
Dr. John Cush RheumNow ( View Tweet)
JAKi Safety and Efficacy in bDMARD-IR Patients With RA
This ACR 2023 poster shows SELECT-CHOICE outcomes through Week 204 from bDMARD-IR patients with RA, including TNFi-IR subgroup outcomes.
Sponsored by AbbVie US Medical Affairs. https://t.co/3fJsZ4IMjG https://t.co/xaKlZPmDkC
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Tonix is developing a drug, TNX-102 SL, that targets poor sleep quality for fibromyalgia. Phase 3 trial in FM (457 pts) showed TNX-102 SL was better (vs PBO) & improved sleep quality (p=0.0000001 & improved daily pain (p=0.00005) https://t.co/QpgET61Vec https://t.co/zphVycL3rg
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Taiwan National Health claims data looked at drugs & gout flares. Signif increase flares were seen w/ ASA, thiazides, loop diuretics, ethambutol, pyrazinamide (1.15-3.35) & metformin (SR=1.14). Lower risk w/ fenofibrate (SR=0.60) & losartan (0.92) https://t.co/1RUw1Q2EBz https://t.co/D2E68kuuwN
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Microbiome study (stool- & saliva) in 144 DMARD-naïve RA pts. Samples 6 wks after DMARD Rx. In those achieving MCID, stool microbes decreased (Prevotella, Streptococcus). Baseline microbiota in DMARD-naïve pts indicated future response https://t.co/PQJEp3bNBE https://t.co/jV5SeNd21z
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85 Chinese SLE pts study of Dz activity & depression/ anxiety assessed by PHQ-9 & GAD-7. Good correlation betw SLEDAI-2K & SLE-DAS (r=0.76);also w/ mod-high activity (r=0.79), but less w/ mild Dz/remission (r=0.45). Anxiety/Depresion did not affect scores https://t.co/eyhgiYxf3P https://t.co/5LHg3HO21v
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Retro study of 1,169 pts (age 66 yrs) receiving intra-articular steroids & changes on A1C. A1C increases were assoc w/ higher baseline A1C (OR 1.84) for A1C 7–8 (vs <7%) or A1C >8% (OR 4.8 ). YET most patients do not experience increase A1C after IACS https://t.co/t3OWYeT1gr https://t.co/qi5qIUZQdZ
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14d study of 30 #RA pts collected data from iPhone + Apple smartwatch +PROs showed that AI analysis of sensor data augmented PRO data (by 10%) regarding RA status & severity. Sensor + PRO correlated well w/ RAPID3 status (r2, 0.692) https://t.co/3izpHiqRHG https://t.co/vMvtqOZCjF
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VITAL Info on Autoimmune Disease
Dr. Jack Cush reviews the journal reports from the past week on https://t.co/V10S4oVFsv. Highlights are summarized by three songs: "Stairway to Heaven", "You're No Good", and "How Long (has this been going on)".
https://t.co/2553GYCfui https://t.co/y1seBTYk5u
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Brazilian registry of 1316 RA pts on bDMARDs or JAKi-Added use of antimalarials reduced SAEs & total AEs, & incr survival. 19% were on HCQ, & had signif less SAEs (mIRR: 0.49); AEs (0.68); serious infections (0.53); hepatic AEs (0.21); & mortality (P=.003) https://t.co/cOeg3KL8Z3 https://t.co/pPRqD7PkXB
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JAKi Rx pts w/ H.Zoster who continue JAKi are not at higher risk for recurrent HZ. 3947 (RA>UC pts on JAKi, 611 had HZ (8.38/100PY). 460 continued JAKi, 78 D/C. Recurrent HZ reactivation. after median 1.1 yrs was 5.3/100 vs. 5.9/100 PY; P = 0.52) https://t.co/FH0ysEkGiA https://t.co/lOHyaXzAn3
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Inflammatory Arthritis in Systemic Sclerosis is Problematic
Inflammatory arthritis (IA) is a common manifestation in systemic sclerosis (SSc), affecting nearly one-third of patients.
https://t.co/rhR5mi3dBh https://t.co/a1ezUJHUJl
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Poly-Refractory Rheumatoid Arthritis
Refractory of difficult to treat (D2T-RA) rheumatoid arthritis (RA) comprises a minority of patients that can be categorized by clinical and imaging parameters to formulate a better therapeutic approach.
https://t.co/IKAojQFdaw https://t.co/paBwWw2nmh
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Full read overview of SJOGRENS SYNDROME, which can be Primary SS or Secondary (15% in SLE, 20% RA, & 30% systemic sclerosis). SS Organ involvement:
- CNS 2-17%
- Renal <=10%
- ILD 10-20%
-MSK 45-56%
https://t.co/RElOFfP2xr https://t.co/aJI041VCuE
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Favorable Survival w/ MDA-5 Ab+. 154 pts w/ MDA5+DM; 40 died (26%) Rx induction (mostly resp. failure). 114 survived, w/ 5-yr survival of 97% & relapse-free survival 77%. Survival improved w/ JAKi use (P=.03). 8% achieved complete drug-free remission. https://t.co/QkqM9IztEG https://t.co/yBCH85CpUN
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Systematic review of 44 studies looking at treatment of Stills Dz (AOSD), showing that tocilizumab, anakinra & canakinumab therapy are effective in AOSD. Complete remission:
- TCZ 80% (57% Steroid D/C)
- ANAK 73% (47% GC DC)
- CAN 77% (34% GC DC)
https://t.co/bFil81GGlJ https://t.co/F5NJ6m1gVF
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Full read, review of COLCHICINE, a, w/ narrow therapeutic index, & assoc. w/ overdose & fatalities. Discuss Interactions, unauthorized access, overdoses, inappropriate dosing. No dose adjustments w/ Liver dz, but modest changes w/ severe CKD, dialysis https://t.co/53aOA4uqdY https://t.co/fuEwWsXMZG
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JAMA Clinical Challenge - Recurrent Fever, Rash, and Shortness of Breath in a 69-Year-Old. Admited with fever, fatigue, rash, right periorbital swelling, SOB, Palpable purpural, Serositis previously - whats your diagnosis? https://t.co/j6aSGffpPv https://t.co/du6pEo74xp
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