Multisystem inflammatory syndrome in children (MIS-C) is new and serious complication of COVID-19 that preferentially affects adolescents. A review of proposed management guidelines is compiled in this report, suggesting a unified approach to therapeutic management of MIS-C.

The NEJM has published the results of a phase 2 randomized trial showing that the use of an interleukin-36 receptor inhibitor, spesolimab, resulted in rapid improvement of generalized pustular psoriasis (at 1 week), but that adverse events and infections were of concern with 12 weeks of foll

Since the introduction of COVID-19 vaccines in January 2021, rheumatologists have fully advocated the protective benefits of their use - yet many have rarely noted flares and reactive side effects worrisome to patients.  Now a multinational study shows that the use of COVID vaccination in rheumatic and musculoskeletal disease is safe, well-tolerated with very rare serious adverse events.

It's great to be a rheumatologist, but boy, it's getting harder and harder. You have to be a jack of all trades. You have to be good at cardiovascular disease, osteoporosis, vaccination, inflammatory bowel disease - it just never ends. This and more, as Dr. Cush summarizes more than a dozen journal articles, news reports and questions + cases.

Safety comparisons of JAKi (tofacitinib) vs. TNFi from Oral Surveillance showed that, in patients with active RA on MTX and aged >50 years with one or more CV risk factors, that there was numerically more MACE events, malignancies, and VTE especially in higher dose.

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

This is the #1 question I get from new consults: “How did I get arthritis?”

But as the aching are asking, they are really thinking these joint complaints must be due to something.

AstraZeneca announced today that anifrolumab (Saphnelo or anifrolumab-fnia) was approved by the the Food and Drug Administration (FDA) for that treatment of adult patients with moderate to severe systemic lupus erythematosus (SLE) who are receiving standard therapy.  

HCQ is one of the safest meds used in rheumatology, but new claims data suggests a small increase in the risk of malformations associated with first-trimester HCQ use. The March 2021 issue of the American Journal of Obstetrics and Gynecology studied the risk of major congenital malformations during the first trimester of pregnancy in women with rheumatic disease taking HCQ.

Genentech announced March 4th that the US Food and Drug Administration approved tocilizumab (Actemra) for the treatment of Systemic Sclerosis-associated Interstitial Lung Disease (SSc-ILD), specifically indicated for slowing the rate of decline in pulmonary function in adults S

There's good news and bad news in rheumatology fellowship matching for 2022.  There's also new FDA approvals and indications, but a new serious safety warning has arisen from the CDC about the J&J COVID-19 vaccine. 

Dr. Jack Cush reviews the latest news, journal reports, regulatory approvals, plus 3 new cases from rheumatologists.

The U.S.

Rheumatologists are well aware that inflammation and immune dysregulation are prime contributors to cancer risk, but do oncologists carry the same impressions? A large study from JAMA Oncology shows that patients with immune-mediated diseases (IMD) have an overall increased risk of cancer, especially in organ-specific immune-mediated diseases. 

The FDA approved tofacitinib (Xeljanz, Xeljanz XR) for treating active ankylosing spondylitis in adults, Pfizer announced on Tuesday.

The numbers on treatment adherence is disappointingly low in RA, with a number of psychological, communication and logistical factors that outweigh the potentially negative influence of sociodemographic or clinical factors.