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Dot the "i", Cross the "t" (10.11.2024)

Jack Cush, MD

Dr. Jack Cush reviews the news and journal articles from the past week on RheumNow.com. Today’s reports suggest where to look for help, especially with regard to pain.

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I Can't Treat Ugly (9.20.2024)

Jack Cush, MD

Dr. Jack Cush reviews the news, journal articles and a new FDA approval for EGPA, this week on the Podcast.

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Running with Data (8.30.2024)

Jack Cush, MD

Dr. Jack Cush reviews the news and journal reports from the past week on RheumNow.com - including tips on steroids, MAS, and myositis testing.

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All in the Family (8.23.2024)

Jack Cush, MD

Dr. Jack Cush picks highlight reports from the past week on RheumNow.com, with reports on the challenge of lupus nephritis, perplexing skin issues, you don't know JAK (about Tyk) and the value of a good family history.

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Sequential Belimumab and Rituximab in SLE

Jack Cush, MD

Could disease control in active systemic lupus erythematosus (SLE) patients be improved by the sequential use of subcutaneous belimumab (BEL) and intravenous rituximab (RTX)? A double blind trial has shown that sequential BEL and RTX was not superior to BEL alone in SLE.

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CARRA Consensus Treatment for Refractory Juvenile Dermatomyositis

Jack Cush, MD

CARRA has developed consensus treatment plans for the use of biologic disease-modifying antirheumatic drugs (bDMARDs) in patients with refractory, moderately severe juvenile dermatomyositis. Juvenile dermatomyositis is the most common form of idiopathic, inflammatory myositis in childhood, with an estimated incidence of 3.2 per million children per year in the United States.

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Lead with Lupus (8.2.2024)

Jack Cush, MD

Dr. Jack Cush reviews the news and journal reports from this past week on RheumNow.com - leading with lupus because everyone wants to know about lupus!

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Upadacitinib safety across in RA, PsA, AS, atopic dermatitis >15000 Pt-Yrs exposure. Rates (per 100PYs) of Hzoster (1.6–3.6), NMSC (0–0.8) & incr CPK (4.4–7.9) higher w/ UPA vs comparators (RA, PsA); Deaths (0–0.8), SIE (0–3.9), MACE (0–0.4), VTE (<0.1–0.4), CA, malignancies… https://t.co/OoJ5OX7JyL https://t.co/vaMVFmldEB
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In utero exposure to upadacitinib review w/ 128 maternal exposures & known outcomes; 80 from RCTs & 48 Postmarketing Pregs. From RCTs - 54-46% live births, 24-38% spont. abortions, 21-15% elective Ab, 1-2% ectopics from RCTs & Postmarketing. No evidence of teratogenicity… https://t.co/s3VJspI59V https://t.co/tV48sKyF8x
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Pain Relief with JAK Inhibitors or Anti-TNFs ? Targeted drugs for rheumatoid arthritis (RA) are not created equal when it comes to pain relief, a retrospective study from Sweden indicated, although the differences appeared to be modest. https://t.co/oIgNxBF518 https://t.co/L9g9MJQbQx

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Adult (133,216) vs Pediatric (955) pts on JAKi - analysis of FAERS shows both @ incr risk for infections & GI AEs. Pediatric pts had more blood and lymphatic disorders, while adults had more CNS and MSK/CTD disorders https://t.co/SKjzANYPSq https://t.co/S6JPYuvSlf

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Metanalysis of JAKi in ILD (7 studies, 183 pts) showed increases in FVC (2 %), DLCO (3.1%) & improved Thoracic HRCT of 11%; only 5% had worsening of their ILD. Risk of ILD w/ JAKi was low ( 0.20/1000 PY) w rates similar to abatacept & rituximab https://t.co/UDJ1ZvtGhh https://t.co/WTQS67yDyl

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Dr. John Cush RheumNow ( View Tweet)
All in the Family (8.23.2024) Dr. Jack Cush picks highlight reports from the past week on RheumNow, with reports on the challenge of lupus nephritis, perplexing skin issues, you don't know JAK (about Tyk) and the value of a good family history. https://t.co/gwM77mJCnr https://t.co/HOGnymjhSZ

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Dr. John Cush RheumNow ( View Tweet)
New $$$ drugs are NOT usually steroid sparing, but a single center 716 RA pt study compared JAKi (n 156) vs bDMARDs (560) starts; JAKi assoc w/ more rapid GC reduction in1st 6 mos & 60% higher odds of GC D/C (adj OR 1.63) (>50% vs 40% @12 mos) https://t.co/shiDytQeBU https://t.co/dCjyw21uLd

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Dr. John Cush RheumNow ( View Tweet)
Tyk2 inhibitor/Zasocitinib (TAK-279) effective in Psoriasis. Ph II RDBPCT of 259 pts w/ mod- severe plaque PsO showed 12 week PASI 75 success in 68% & 67% on 15 - 30 mg zasocitinib qd vs Placebo (18%). https://t.co/yyZwBYAP3H https://t.co/TvSSlEAKtR

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HBV reactivation w/ Anti-IL17, IL12/23, IL23 & JAKi. Metanalysis of pts w/ chronic HBV infection (HBsAg+ or detectable HBV-DNA) and prior HBV infection (HBcAb+, HBsAg neg) shows more reactiv w/ chronic HBV (14% vs 5%), similar betw classes (0-4%) https://t.co/5Jgehb5gNg https://t.co/o0TuLEsMm9

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JAKi an option for Still's Dz, especially refractory AOSD? Metanlysis of 9 studies (35 pts), Rx w/ either Tofa (17), Bari (14), Ruxo (4), Upa 1. Half had complete remission, 1/3 partial remission, 1/5 loss effect. Ruxolitinib 100% effective in AOSD w/ MAS https://t.co/3TKFNsj4v9 https://t.co/3yAXlcJ2sX

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Dr. John Cush RheumNow ( View Tweet)
Severe Alopecia Areata or Universalis - if you stop the JAK inhibitor, Hair loss occurs quickly, but can be recaptured. Severe Alopecia Areata. Substudy of the baricitinib BRAVE-AA1 RCT, 80% of those who D/C vs 8% of those continuing, lost BARI benefits https://t.co/YcfmegdvK6 https://t.co/GIwVy4ac6U

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FIRST registry of 1424 #RA pts found 732 achieving HAQ-DI <0.5 & 454 w/ pain VAS <4/10. Achieiing LDA in 1st 6mos predicted by seropositivity & JAKi use. Less likely were: older, failin ≥ 2 b/tsDMARDs, hi baseline HAQ& steroid use (not comorbidities) https://t.co/7y0uMV414j https://t.co/6aLPTzf5fm

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JAK Inhibitors Reduce Macular Degeneration Insurance claims data showed that patients with autoimmune disorders who took JAK inhibitors had lower rates of AMD, hinting that the drugs might treat the common eye disease. https://t.co/MuJpbGPqe8 https://t.co/hcp4W3wP8a

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Dr. John Cush RheumNow ( View Tweet)
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