The Annals of Internal Medicine reports that targeting B-cells in refractory systemic lupus erythematosus (SLE) with sequential belimumab after rituximab may significantly reduce dsDNA antibody titers and lessen the number of future severe flares.

RA patients have an increased risk of venous thromboembolism (VTE) related to disease activity and inflammation, yet a large real-world study of older RA patients shows methotrexate to be associated with a 2-fold increased VTE risk (compared to hydroxychloroquine).

A controlled trial of intra-articular platelet-rich plasma (PRP) injections into the ankle of osteoarthritis (OA) patients failed to improve ankle symptoms and function when compared to placebo injections - yet another trial showing that intraarticular injections are seldom beneficial.

Today, Lilly and Pfizer announced their global clinical development of the NGF inhibitor, tanezumab, has been discontinued due to recent negative opinions from the EMA and FDA advisory committee.

The current issue of the NEJM has two articles on nonalcoholic fatty liver disease (NAFLD also called NASH - nonalcoholic steatohepatitis), one dealing with the prognoses, outcomes and mortality of NAFLD and another prospective and promising interventional trial in NASH patients. 

Healthcare is a personal and individualized relationship between a provider and patient. Each patient is treated according to their particular symptoms and personal health characteristics.

Pregnancy outcomes may be affected by psoriatic arthritis or antirheumatic treatment; registry cohort study shows that preterm birth and cesarean delivery were mostly increased by antirheumatic treatment, especially biologics.

Today I have a few questions: Is tramadol really a weak narcotic? Should we really still be doing placebo-controlled trials? What are we going to do about our patients who are smokers? This and more, in this week's review of the news and journal articles.

The Journal of Rheumatology reports that current smoking significantly reduces the clinical efficacy of methotrexate (MTX)-based therapy, as studied in an early rheumatoid arthritis (RA) cohort.

Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are among the most severe drug reactions, as they come with substantial mortality and morbidity.  A review of European centers dealing with SJS and TEN shows that despite best treatment practices, the 6-week mortality rate was 21%.

Patients with rheumatoid arthritis (RA) who had high levels of inflammation at baseline were at increased risk for later heart failure, a large cohort study found.

Registry level data of patients with immune-mediated inflammatory diseases (IMIDs) diagnosed with COVID-19 should continue their TNF inhibitor (TNFi) therapy as such patients were less likely to experience adverse COVID-19 outcomes (compared to other immunomodulatory treatments).

B-cell depletion therapy with obinutuzumab, a type II anti-CD20 monoclonal antibody, in lupus nephritis patients was shown to be effective in in combination with standard lupus therapies.

Tight-control or treat-to-target (T2T) strategy is advocated in several diseases, but the recent TICOSPA trial in axial spondyloarthritis (axSpA) showed that T2T was not superior to usual care (UC).