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TNF Dose Reduction Succeeds in PsA, Axial Spondyloarthritis

MedPage Today

Patients with psoriatic arthritis (PsA) or axial spondyloarthritis (axSpA) who were doing well on treatment with tumor necrosis factor (TNF) inhibitors were able to successfully taper the therapy when guided by disease activity, a retrospective cohort study found.

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Hepatitis B Reactivation with Rituximab and Abatacept

Jack Cush, MD

Hepatitis B reactivation is an uncommon complication of biologic therapy use. Now, a serologic study of  rheumatoid arthritis patients shows that HBV reactivation is seen with rituximab, and less so with abatacept, especially in patients without hepatitis B antibody (HBsAb) positiv

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RETRO - Taper or Not: You Decide

Jack Cush, MD

A prospective, phase 3 trial of rheumatoid arthritis (RA) patients in sustained remission has shown more than half will flare if disease-modifying antirheumatic drugs (DMARD) therapy is tapered or discontinued and that remission is best maintained by continued DMARD therapy.

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FDA Approves Avacopan for ANCA-Associated Vasculitis

Jack Cush, MD

October 8, 2021 the U.S.

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Lupus Frailty Index Predicts Organ Damage

MedPage Today

Patients with longstanding systemic lupus erythematosus (SLE) who were considered frail were more likely to accrue disease damage over time, a secondary analysis of data from a Chicago lupus cohort found.

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AAOS Clinical Practice Guideline for Knee Osteoarthritis

Jack Cush, MD

The American Academy of Orthopaedic Surgeons has published their Clinical Practice Guideline for Management of Osteoarthritis of the Knee (Non-Arthroplasty); updating 19 of the 29 evidence-based recommendations and focuses on nonsurgical treatmentss to provide pain and patient function.

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RheumNow Podcast – Jack of All Subspecialties (10.1.2021)

Jack Cush, MD

Dr. Jack Cush reviews the news and journal articles from the past week on RheumNow.com

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CDC Advises COVID-19 Vaccines for Pregnant Women

CDC

Today, CDC issued an urgent health advisory to increase COVID-19 vaccination among people who are pregnant, recently pregnant (including those who are lactating), who are trying to become pregnant now, or who might become pregnant in the future to prevent serious illness, deaths, and adverse

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Start #MTX & escalate 5mg q2wk (usual) or 5mg q4wk (fast): open RCT 178 #RA pts - equal EULAR resp (28 v 23%), DAS28-CRP (-1.3 v -1.3) - same at wk8 & 24. No diff in MTX polygluts., cell #s, LFTs, D/C - but more GI sx w/ fast wk8 (40 vs 27%) https://t.co/MbuFoA5HFp

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Dr. John Cush RheumNow ( View Tweet)

Metanalysis of NSAIDs & opioids in Knee/Hip #OA - 192 RCTs (102829 pts). AE dropouts & adverse events were ZERO w/ topical NSAIDs; highest w/ opioids (83% & 90%). Pronounced Rx benefit more likely w/ oral & topical NSAIDs (99 & 93% probability) https://t.co/376uAzMcpH

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Dr. John Cush RheumNow ( View Tweet)

RETRO - Taper or Not: You Decide A prospective, phase 3 trial of RA patients in sustained remission has shown more than half will flare if DMARD therapy is tapered or discontinued and that remission is best maintained by continued DMARD therapy. https://t.co/KDqGrujGMT https://t.co/8HqSS74PqL

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Dr. John Cush RheumNow ( View Tweet)
Upadacitinib was shown to be effective in two Phase 3 SELECT-AXIS trials. 1st trial: in bDMARD-IR AS pts the ASDAS resp was 44% vs 10% PBO at wk 14). 2nd trial: in nr-axSpA, the ASDAS response at wk 14: 42% vs 18% PBO. https://t.co/rnv9VVITeE

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Dr. John Cush RheumNow ( View Tweet)

We are reviewing cases from Ask Cush Anything and almost a dozen news items and reports on this week’s podcast. Download today. https://t.co/Xb81eWEZ1q https://t.co/K6zPKtwAD7

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Dr. John Cush RheumNow ( View Tweet)
ICYMI: Upadacitinib RA program (5306 pts) the risk of H. zoster by Rx and dose (HZ/100PYs) MTX = 0.8/100PY ADA+MTX= 1.1/100PY UPA 15 mg= 3.0/100PY UPA 30 mg = 5.3/100PY Hence there is a 4-5X risk of HZ w/ JAKinhibitors https://t.co/wo9ih5PJ77 #RheumNow https://t.co/h1GoGzADdv

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Dr. John Cush RheumNow ( View Tweet)
MEDWATCH (FAERS) data on venous thromboembolic (VTE) risk with JAK inhibitors from 2010-2019 https://t.co/oKkTYcRsxL

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Dr. John Cush RheumNow ( View Tweet)

2125 RA pts in RCTS w/ baricitinib entered a long term F/U study. baricitinib pts had less XRay damage over 5 yrs; 5 yr No Xray progression was 60% on baricitinib 4 mg; 66% baricitinib 4 mg+MTX; vs 41% on just MTX monotherapy. https://t.co/pLuQCDSf6g https://t.co/wFs3G0DrJ7

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Dr. John Cush RheumNow ( View Tweet)
Lessebo effect: 31 RCT comparing Biologic originator to a biosimilar or to PBO: Lessebo effx =better responses in Biosimilar vs PBO (ACR20=70%) than w/ originator vs PBO (ACR20=59%). ? due to PBO effx in active comparator, nocebo in PBO trials https://t.co/kvANomTHrb

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Dr. John Cush RheumNow ( View Tweet)

Drug Safety Risk Communication- The 800 lb Gorilla Approach https://t.co/6iSJjvlFF8 https://t.co/mPeJfWi1hY

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Dr. John Cush RheumNow ( View Tweet)
A placebo controlled RCT of canakinumab in 31 Adult Stills pts with arthritis showed responders (by DAS28) had signif reductions in calprotectin, IL-1RA, IL-18, IL-at wk 4. Unfortunately: didnt look at fever, rash, serositis, etc. https://t.co/p4Fohos2iU

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Dr. John Cush RheumNow ( View Tweet)

A population based Swedish study of birth records shows that antibiotic exposure in first three years of life to be associated with a future risk of JIA, although infections during fetal life or childhood did not increase risk of JIA. #RheumNow https://t.co/aXFOxoOyF1 https://t.co/Md0zBm5Txl

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Dr. John Cush RheumNow ( View Tweet)
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