B-cells play a major role in the pathogenesis of primary Sjogren’s syndrome (pSS) through antibody-dependent and antibody-independent functions, as well as evident by progression to B-cell malignancies/lymphoma. Hence, targeting B-cell is attractive. Despite efficacy of B-cell depleting therapy with rituximab in Phase II trials and case series, it failed to meet its primary endpoint when investigated in two Phase III trials. It is worth noting that the primary endpoint used in both trials was a subjective measure. Post-hoc analyses however showed greater improvement in objective measures such as salivary flow rate and salivary gland ultrasound score in RTX-treated group vs placebo.
Therefore, do B-cell targeted therapies still have a place for the treatment of pSS?
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Multiple studies compared effectiveness, retention and/or safety of biological DMARDs (bDMARDs) and JAK inhibitors (JAKi) at EULAR 2021.
It's been nearly two weeks since EULAR 21 ended. There were several presentations on the last day; notably, the late breaking abstracts and others. Here are a few of my favorites from Day 4, the final day of the meeting.
"While the Food and Drug Administration decision on new drugs usually follows the recommendations of the advisory committee..."; this oft used proviso is used to either indicate a pending FDA decision or an FDA decision that is contrary to the recommendation of the advisory committee co
Psoriatic arthritis (PsA) is a chronic condition with manifold clinical presentations. Health issues may be far beyond the classical associated conditions like uveitis, enthesitis etc. The current study of Tillett et al (OP0231) assessed comorbidities and patient characteristics comparing psoriasis patients with or without PsA.
All of us are extremely cautious with lupus patients when it comes to pregnancy. Presentation 6888 (Common issues in pregnancy management in lupus and anti-phospholipid syndrome by Dr. Rebecca Fischer-Betz) was an excellent overview of our current approach to lupus and pregnancy.
Dr. Jack Cush reviews and highlights his favorite abstracts and presentations from last week's virtual EULAR 2021 meeting.
Combination disease modifying antirheumatic drug (DMARD) therapy may not be only for rheumatoid arthritis; combining disease modifying agents may be the path to better renal response.
Dr. Philip Mease et al presented results of a phase II trial (OP0227) at EULAR 2021 that shows the efficacy and safety of an oral tyrosine kinase inhibitor (TYKi), deucravacitinib, for treatment of active psoriatic arthritis (PsA).
In RA, the two most common peaks of incidence are thirties and fifties; however a significant percentage of patients above the age of 70 present with active RA -of early or later onset- and require adapted treatment.


