Tocilizumab Risk of Diverticulitis and GI Perforation

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A French registry analysis compared the risk of diverticulitis and gastrointestinal perforation (GIP) in rheumatoid arthritis (RA) patients treated with biologics and found a greater risk of both in patients receiving tocilizumab (TCZ) compared with those on rituximab (RTX) or abatacept (ABA

Total Ankle Arthroplasty vs. Arthodeisis?

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 The Journal of Bone & Joint Surgery reports the findings of a 4-year trial comparing outcomes of total ankle arthroplasty (TAA) versus ankle arthrodesis (AA) in patients with severe ankle arthritis; finding that while both groups improved, TAA was associated with less pain and better function after 4 years.

IL-23 Inhibitor Tildrakizumab Effective in Psoriatic Arthritis

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Tildrakizumab, a monoclonal antibody targeting interleukin-23p19 studied in adults with psoriatic arthritis (PsA), was found to be superior to placebo and well tolerated without reports of uveitis, systemic fungal infections, inflammatory bowel disease, major cardiac events or death. 

RheumNow Live 2021 Now Available for All

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RheumNow Live (RNL) for 2021 was held March 20 - 21 in Fort Worth, TX, and now all can partake in the meeting - by video, podcast or by signing up for Tuesday Nite Rheumatology (TNR).

Risk Factors for Rheumatoid Arthritis-associated Interstitial Lung Disease

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Sparks and colleagues have published a matched cohort analysis demonstrating risk factors that may augment the risk of rheumatoid arthritis (RA)-associated interstitial lung disease (ILD), especially the combination of obesity, high CRP, high MD-HAQ and >30 pack-year smoking h

Insurers Bet Big on Bribing Patients

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Last month, psoriasis patients covered by Cigna received a curious letter from the insurance giant's pharmacy management division.

AURORA-1: Voclosporin Efficacy in Lupus Nephritis

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Lancet has published the results of the AURORA-1 trial, wherein the calcineurin inhibitor, voclosporin, was tested in a placebo controlled trial of lupus nephritis and shown to be effective at inducing a complete renal response.

FDA Advisors Split on Avacopan for Vasculitis

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Members of an FDA advisory panel were sharply divided as to whether avacopan, an oral small molecule inhibitor of the C5a receptor, was sufficiently safe and effective for treating antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis.

Higher Hydroxychloroquine Blood Levels Reduces Thrombosis Risk in Lupus

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Petri and colleagues have published that measuring hydroxychloroquine (HCQ) blood levels can be useful in systemic lupus erythematosus (SLE), as low levels are associated with an increased thrombotic risk in SLE.

RheumNow Podcast – Falling or Falling in Love?

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

Drug Monitoring Ineffective with Infliximab Treatment

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The predictive value of therapeutic drug monitoring (TDM) while on biologics is debateable; gastroenterology routinely relies on TDM, while rheumatologists do not.

Childhood Lupus May Hamper Adult Careers

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Long-term outcomes of kids with childhood-onset systemic lupus erythematosus (cSLE) are uncommon, but this cSLE cohort analysis suggests that SLE significantly impacts their future education, vocation, and employment as they reach adulthood.

Results Disappoint for Fecal Transplant in Arthritis

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Fecal microbiota transplantation (FMT) showed disappointing results among patients with active psoriatic arthritis, a small randomized trial found.

Higher Cardiovascular Risks with Systemic Lupus Erythematosus

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The Journal of the American College of Cardiology has published the results of a study showing that patients with systemic lupus erythematosus (SLE) have an increased risk of heart failure (HF) and other long-term cardiovascular outcomes. 

Predictors of Methotrexate Toxicity

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A metanalysis showed that while adverse events (AEs) are common when methotrexate is used in rheumatoid arthritis or inflammatory arthritis patients, serious AEs ranged from 2.1 to 9.5% and drug discontinuations ranged from 6.7% to 15.5%, mostly due to gastrointestinal events. 

Seven Year Delay in Diagnosing Spondyloarthritis

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A large patient cohort study suggests that the mean diagnostic delay (DD) in European axial spondyloarthritis (axSpA) patients is 7.4 years, moreso in women and younger patients.

Tofacitinib in Ankylosing Spondylitis

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A phase III trial assessing the efficacy and safety of tofacitinib in adults with with active ankylosing spondylitis (AS) shows that JAK inhibitiion was superior to placebo in a 48 week study.

Psoriatic Pregnancies Pose Risks to the Mother, Not Child

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A metanalysis of pregnancy outcomes in women with psoriasis and psoriatic arthritis finds an excess risk of adverse maternal events, but not adverse neonatal events.

This systematic review included 16 studies meeting inclusion criteria. 

Dual IL-17 Targeting is Effective but has More Candidiasis

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Bimekizumab (BIM) is a monoclonal antibody that targets both interleukin-17A and interleukin-17F, which as a biologic target has worked well in the management of psoriatic disease. The current issue of the NEJM has two reports wherein BIM was shown to be more effective than secukinumab and adalimumab in treating patients with moderate-to-severe plaque psoriasis; however, safety concerns arise. 

Little Effect with Multimodal Treatment of CMC1 Osteoarthritis

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A randomized clinical trial of patients with CMC1 osteoarthritis shows modest benefits when a combination of conservative treatments (education, splinting, hand exercises, 1% diclofenac sodium gel) was used compared to education alone. While there were small to medium benefits with regard to hand function, there was no benefit in pain outcomes.