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Rituximab Induction and Maintenance in Older ANCA–Associated Vasculitis Patients

d Jack Cush, MD

A cohort study suggests that rituximab (RTX) use among patients 75 years and older with antineutrophil cytoplasmic antibody (ANCA)–associated vasculitis (AAV) is efficacious but also has a high risk of serious adverse events, likely related to associated steroid use and the advanced age of the po

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Viscosupplementation Ineffective in Knee Osteoarthritis

d Jack Cush, MD

The BMJ has published the results of a metanalysis showing strong conclusive evidence that viscosupplementation in knee osteoarthritis (kOA) has minimal effects on kOA pain, and also reveals strong evidence of an increased risk of serious adverse events. 

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Achilles,ankle,heel

Steroid Injection for Chronic Achilles Tendinopathy

d MedPage Today

Adding a corticosteroid shot to exercise therapy significantly improved symptoms of chronic Achilles tendinopathy, a 100-person randomized trial found.

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ICYMI: 2021 Rheumatology Year in Review

d Jack Cush, MD

For 2022, let's look our top 10 list of advances, game-changers, worries and those better medical practices that evolved during 2021.

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virus,injection,COVID,vaccine

Two Week Methotrexate Hold with COVID-19 Vaccination

d Jack Cush, MD

A cohort study of rheumatoid arthritis (RA) patients evaluated immunogenicity of COVID vaccination with and without holding methotrexate (MTX) for and 2-weeks and showed better immunogenicity, but more RA flares with the second MTX withdrawal. 

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JAK Janus

JAK/STAT pathway in pyoderma gangrenosum: a new therapeutic highway?

d Aurelie Najm, MD, PhD

Pyoderma gangrenosum (PG) is rare, but often associated with different forms of arthritis, in particular rheumatoid arthritis and inflammatory bowel diseases. 

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GLORIA Study Pred vs PBO in >65yrs RA x 2 years. 451 Pts & DAS28 4.5. 79% on DMARDs (14% biologics) Upside: Lower DAS28 -0.37 & less Xray progression -1.7 Sharp units Downside: 24% more AE (mild infxns), signif.small lowering of lumbar BMD -1% You Decide https://t.co/RRq0WcFsXz https://t.co/xLxjPPSMhh

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Dr. John Cush RheumNow ( View Tweet)
EULAR recommendations for management of #RheumatoidArthritis 6️⃣Glucocorticoids should be tapered & discontinued as soon as clinically feasible 8️⃣JAKi can be used but consider risk factors via Prof Smolen #EULAR2022 https://t.co/7cocPSpgkH
Dr Ai Lyn Tan DrAiLynTan ( View Tweet)
Positive study NUT when to use the Rx? PMR RCTof 1 g #rituximab once. Over 1 yr with more steroid free remission - curves separate by 21 weeks (steroids off) POS0269 @RheumNow @eular_org #EULAR2023 when to use it-COVID risk, ?prefer IL6i

Janet Pope Janetbirdope ( View Tweet)

#LB0006 #EULAR2022 Therapy for relapsing polymyalgia rheumatica. 118/280 recruited re:COVID impact. Phase 3 RCT of Sarilumab+14Wk Steroid taper showed more pts had sustained remission at Wk52 vs PBO+52Wk Steroid Taper(28% vs 10%) even if CRP excluded. PRO improved too! @RheumNow https://t.co/P11iXIAfGn
Md Yuzaiful Md Yusof Yuz6Yusof ( View Tweet)
SAPHYR phase 3 RDBPCT study: #sarilumab vs PCB for relapsing #PMR on pred 7.5+ mg/d. Study met endpoints (whether of or not CRP was included). Time to first flare was longer w/SARI, less steroid use, and also better PROs. AE: #EULAR2022 LB0006 @rheumnow 1/2 https://t.co/lIspLKlveb
TheDaoIndex KDAO2011 ( View Tweet)
Novel ePROMS use. Use of ePROMS RAPID3/PASS and asking patients if they had a flare had high diagnostic accuracy identifying those not needing DMARD or steroid intensification up and eligible to skip their next outpatient clinic visit. Seppen et al #EULAR2022 @RheumNow POS0381

Dr. Antoni Chan synovialjoints ( View Tweet)

EULAR,poster

EULAR 2022 – Day 3 Report

d Jack Cush, MD

By now, those of us attending the meeting know how to find a free coffee or sprite, have found comfortable meeting nooks and know our way around! PAnd congrats to you virtual Rheums for mastering the multi-screen, multitask simultaneous consumption posters, tweets and oral abstract presentations.

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Palmowski et al. Glucocorticoids and bone density in GCA/PMR/other vasculitis from Rh-GIOP. Weird one, no increase in osteoporosis, no association with current or cumulative steroid dose and osteoporosis. Low BMI, vert #, PPIs were assoc osteoporosis. @RheumNow #EULAR2022 POS1139 https://t.co/n3d6YArXmU
Richard Conway RichardPAConway ( View Tweet)
More from GLORIA. Tapering pred 5mg after 2 years. Some minor increase in disease activity (DAS28 0.26) with no evidence of adrenal insufficiency. Can successfully withdraw long term steroids! @RheumNow #EULAR2022 OP0270 https://t.co/IV9iJLY22v https://t.co/ZXdwxlXorK

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Richard Conway RichardPAConway ( View Tweet)
In case there was doubt: - steroid toxicity is real in GCA - giving steroid-sparing therapies (TCZ, MTX) early makes a difference just something to not forget when your next new GCA patient rolls in the door? POS0805 #EULAR2022 @RheumNow https://t.co/2wGV3M8wZD
David Liew drdavidliew ( View Tweet)
Boers et al. GLORIA trial of long term 5mg pred in RA. Titled as "favourable balance of benefit and harm". I cannot agree. 24% increase adverse events, NNH 9, for DAS28 0.37 better at 1 year, and really no difference after that. @RheumNow #EULAR2022 OP0263 https://t.co/eO4f1CjH5q https://t.co/VyyZm1QvYy

Links:

Richard Conway RichardPAConway ( View Tweet)
Long-term low-dose steroids for RA: can it be weaned? Weaning after 2y of blinded add-on in RA: either PNL 5mg/d or placebo No substantial evidence of adrenal insufficiency - symptoms same - cortisol/ACTH same It's never too late to wean the pred! OP0270 #EULAR2022 @RheumNow https://t.co/jp2ZOlAEnb
David Liew drdavidliew ( View Tweet)
Yoshimura et al. 10 year findings of TOMORROW study. Glucocorticoid use of even 2mg/day is fracture risk in RA! @RheumNow #EULAR2022 POS0631 https://t.co/c8uCdPzUiE
Richard Conway RichardPAConway ( View Tweet)
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Babies! Safety and Outcomes Data on Pregnancies

d Kathryn H. Dao, M.D.

EULAR Congress 2022 highlighted several posters on pregnancy, an important subject as most rheumatic diseases afflicts women during their childbearing years.

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