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Dr. Jack Cush reviews the news, FDA approvals, and journal articles. In this episode: HMGCR Abs, FDA approvals and Cush eats crow.
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Whole-body MRI (wbMRI) reviews have increasingly appeared in the medical literature, owing to better scanners, faster imaging times and reduced costs. Used of such non-oncologic musculoskeletal imaging provides high-contrast resolution images of the entire body or selected regions screening, diagnosis, staging, and surveillance purposes.
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NEJM has reviewed the common hematologic/immunologic finding of "monoclonal gammopathy of undetermined significance" (MGUS) - a common premalignant plasma-cell proliferative disorder found in approximately 5% of those over age of 50 years.
Dr. John Cush
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Review of GLP-1 agonist use in rheumatology - with benefits beyond DM, obesity, improved survival, reduced major cardiovascular and renal events. Anti-inflammatory & chondroprotective effx shown benefit in knee OA & pain. GLP-1RAs do not prevent gout attacks. More research https://t.co/8zh18mlYDh
Dr. John Cush
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FDA has approved nerandomilast (PDE4b inhibitor) for treatment of adults with idiopathic pulmonary fibrosis (IPF). Approval is based on 2 RCTs, FIBRONEER-IPF & FIBRONEER-ILD, that show slowing of lung function decline IP & progressive pulmonary fibrosis (PPF) pts. https://t.co/pIQwyLUBoj
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Sequencing DNA to find new lupus treatments
MUSC geneticist Betty Tsao, Ph.D., will lead a five-year project to identify rare mutations associated with childhood-onset SLE, or lupus, with more than $3.5 million in funding from the National Institute of Arthritis and https://t.co/1vfQ4fK6FX
Dr. John Cush
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Systematic review of obesity management meds - 56 RCTs (60,307 pts). All OMMs were better at total weight loss than PBO (P < 0.0001), >10% semaglutide & tirzepatide (both effective at NIDDM CHF). Semaglutide effective reducing pain in knee osteoarthritis https://t.co/4MX2IiDC2X
Dr. John Cush
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Activity Trackers Can Predict RA Flares
People with rheumatoid arthritis (RA) who experienced disease flares often showed changes in heart rate and physical activity captured by popular wearable devices 4 weeks before they became clinically apparent, a small study indicated. https://t.co/LjE0LkJTrB
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Taiwan study of HBV or HCV reactivation w/ bDMARD use in PsO & PsA - among 5527 treatment episodes (3197 ts/bDMARDs) found a 10% risk of reactivation of HBVr (10.6%) & HCV (9.9%), highest w/ TNFi. Reactivation assoc w/ TNFi, HBsAg+, HBeAg+, immunosuppressant use without antiviral https://t.co/AwpmRpfJUT
Dr. John Cush
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NY Times on Osteoporosis in Men
The NY Times has addressed the problem of osteoporosis in men noting a need for increased awareness and screening...
Read more: https://t.co/SzNtuPllY6 https://t.co/13EcEfv4ab
Dr. John Cush
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Gender Complexities in Psoriatic Arthritis Treatment Outcomes
Analysis of a German psoriatic arthritis (PsA) patients registry demonstrates sex-specific differences regarding clinical manifestation and treatment outcomes, especially with regard to drug discontinuations. https://t.co/zGtfpndod9
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From the plenary to posters, RheumNow is your companion for ACR Convergence 2025. Expect:
• KOL videos
• Clinical trial highlights
• Daily faculty recaps
• Live streaming
#ACR25 #Rheumatology #ClinicalTrials https://t.co/M5sxhWz2EK
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HMGCR Abs is assoc w/ necrotizing myopathy. Review of 78 pts w/ HMGCR IMNM. 31 had overlap w/ higher MMT-score, less muscle weakness, more ILD, arthralgia, wt loss & rash. 12 had musc. dystrophy like dz w/ earlier onset, longer duration, less myalgia & extramuscular Sxs https://t.co/RpzZI0zI7E
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Prediction of D2T-RA. Model was trained on BRASS pts (700; 16% w/ D2T-RA) & validated on CERTAIN pts (2,070; 28% D2TRA). PRO's were strongest predictors. Moderate predictive accuracy (C-index of 0.64 & 0.62) w/ functional status, pain, fatigue, and global Dz activity https://t.co/uv3uGYIRFb
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Sonelokimab (SLK) is a nanobody that inhibits IL-17 A&F. Phase 2 ARGO trial 207 active PsA pts Rx w/ SLK 120-mg or 60-mg q4wks or PBO or adalimumab. ACR50 at wk 12 was 60-mg WI=46%; 120-mg WI=46%; PBO 20%. PASI90: 60mg 77% vs 120mg 59% vs PBO 15% https://t.co/ra0NqvUEru https://t.co/FXT6kkXUzH
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Osteoporosis Screening in High-Risk Men
A VA Health Systems study of older male veterans found benefits of a remote model of screening that significantly improved osteoporosis screening, treatment, and adherence compared with usual care, with high patient and clinician https://t.co/Kt3mJLahdq
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Retrospective study of 42 adult Still' pts Rx after 2010 w/ IL‐1 inhib if given < 6 mos (early) or > 6mos of Sxs. Early IL-1i had more inactive dz (CID)(67% vs 38%; P = 0.17) & steroid d/c w/in 6 mos. 10 major flares observed (62% after IL‐1i suspension or spacing) https://t.co/uD1meQuYvj
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Not all difficult-to-treat RA will have rapid radiographic progression
A study of radiographic outcomes in difficult-to-treat rheumatoid arthritis (D2T RA) and poly-refractory RA (pr-RA) show a subset in whom damage is rapid and in need of more aggressive therapy. https://t.co/WrwyeW5qsj
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Systematic review of Still's Dz (240 articles, 95 sJIA, 134 AOSD, 23,136 pts); sJIA Dx by ILAR in 78% & AOSD used Yamaguchi criteria 98%. While clinical and lab findings were matched betw AOSD & sJIA, there was variability in MAS , outocmes & trajectory. Standarization needed
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Optimizing DMARD Therapy in Rheumatoid Arthritis
A phase IV trial from Spain demonstrates that optimization of therapy by lessening biological DMARDs in rheumatoid arthritis (RA) may be feasible, with a low risk of flare.
https://t.co/37O3mAulGy https://t.co/y7OkkzRZUg
