A better understanding of rheumatic immune-related adverse event phenotypes beyond inflammatory arthritis has been furthered by work from three abstracts presented at EULAR 2019 in Madrid.

Hydroxychloroquine (HCQ) will decrease SLE flares improve lipids, decrease clots, improve survival, augment the response to mycophenolate and are the cornerstone of treatment as per the SLE EULAR guidelines presented at EULAR 2019 in Madrid and also published in ARD.

EULAR 2019 begins today in Madrid and features over 2000 presentations.  After an initial review of titles and abstracts, I’ve compiled a hit list of presentations of interest to me and hopefully other practicing rheumatologists.  

Reuters has reported that Mallinckrodt Plc has tentatively agreed to pay $15.4 million to resolve a US Justice Department investigation into company promotional practices for Acthar gel.

Dr. Jack Cush presents the news and best of rheumatology and medicine from the past week on RheumNow.com

Rituximab (Rituxan) may be an option for maintenance therapy in patients with difficult-to-treat systemic lupus erythematosus (SLE), European researchers reported.

A EULAR task force has reviewed the medical literature and developed evidence-based recommendations for the management of antiphospholipid syndrome (APS) in adults. They note that a high-risk antiphospholipid antibody (aPL) profile is associated with greater risk for thrombotic and obstetric APS.

The risk of serious infectious events (SIE) with rituximab (RTX) is similar to that seen in other biologics (e.g., RA: 2% or 4.3/100PY), but with prolonged use the risk may change. Recent research says that low IgG levels, RTX induced neutropenia, prior SIE and comorbidities can significantly augment this risk.

A retrospective longitudinal single center study of 700 rheumatic and musculoskeletal diseases (RMDs) treated monitored serum immunoglobulins (at baseline and 4–6 months after each cycle), clinical outcomes and SIE over time.

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

A lupus registry from San Francisco County analyzed racial/ethnic differences in lupus manifestations and found significant differences in SLE manifestations among racial/ethnic groups. Researchers found that Blacks, Asians/Pacific Islanders (API), and Hispanics are more likely to develop severe manifestations following a diagnosis of SLE.

From their database, they identified 724 SLE patients, and identified specific features in different subgroups.

The NEJM reports a randomized placebo controlled trial of nintedanib, a tyrosine kinase inhibitor, in systemic sclerosis patients with interstitial lung disease (ILD) resulted in less pulmonary decline, but had no effect on other features of systemic sclerosis. 

A combination risk score helped predict recurrent thrombosis -- particularly arterial -- among patients with antiphospholipid syndrome (APS), an international study found.

A Morbidity and Mortality Weekly Report on a registry of systemic lupus erythematosus (SLE) patients from two Georgia counties (Fulton and Dekalb) shows SLE mortality was 2-3 times higher compared to the general population, especially amongst blacks; notably deaths occurred sooner after diagnosis

A pilot treatment study of patients with anti-aminoacyl-tRNA synthetase antibody–positive polymyositis/dermatomyositis-associated interstitial lung disease (anti-ARS-PM/DM-ILD) shows therapy with glucocorticoids and calcineurin inhibitors (CNI) to be highly effective. 

A composite risk score that included three biomarkers predicted thrombotic events among patients with systemic lupus erythematosus (SLE), a cross-sectional study found.

Systemic lupus erythematosus (SLE) is an autoimmune disease with a propensity to develop glomerulonephritis (47-70%) or end-stage kidney disease despite therapy.

A national database reveals that patients with granulomatosis with polyangiitis (GPA) have 22.3% risk of hospital readmissions within 30 days of discharge. 

From a total of 9749 hospital admissions with GPA, there were 2173 readmissions within 30 days of discharge.

A small prospective study has shown that ustekinumab is safe and effective in Behçet's disease (BD) with recurrent oral ulcers (OU).

A longitudinal study of systemic lupus erythematosus (SLE) from the Toronto Lupus Clinic has shown that mortality has decreased over time.