2016 EULAR Guidelines on RA Management

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The management of rheumatoid arthritis (RA) has evolved significantly with time.  Nevertheless, there are still some uncertainties - such as when, what and which biologic or novel therapy should be used.

The RheumNow Week in Review - 6 October 2017

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The RheumNow Week in Review discusses the past week's news, journal articles and highlights from RheumNow.com. In this week's report, Dr. Jack Cush discusses when to hold the biologic, lymphoma risk with tofacitinib, early clues to the diagnosis of RA, biologic use in pregnancy, what's killing psoriasis patients and the 2016 top 5, best selling drugs in rheumatology.

Patterns of Biologic Use During Autoimmune Pregnancy

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While it is highly desirable to avoid medications during conception and pregnancy, statistics show that >90% of women take at least one drug during pregnancy and nearly half will take 3 or more medications during pregnancy.

Alcohol Related Deaths Increased in Psoriasis

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JAMA Dermatology has published a report showing psoriasis carries a 60% greater risk alcohol-related death compared with those without psoriasis. (Citation source: https://buff.ly/2galDwr)

Amgen-Abbvie Settle Humira Biosimilar Patent Dispute

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Amgen's biosimilar version of adalimumab (Humira) was FDA-approved in September 2016 and given the trade name Amjevita (generic: adalimumab-atto). This new TNF inhibitor biosimilar has not yet been to market because of legal wranglings over patent issues by Abbvie's Humira.

29 September 2017 The RheumNow Week in Review

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The RheumNow Week in Review discusses the past week's news, journal articles and highlights from RheumNow.com. This week's report discusses regulatory actions by NICE and FDA, higher death rates in RA and psoriasis, increased risk of RA with Asthma, rising numbers for OA, RA, and STDs.

Psoriasis Increases Risk of Major Adverse Cardiovascular Events

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A report in the Journal of the American Academy of Dermatology shows that psoriasis duration and inflammation may result in cardiovascular inflammation and an increased risk of major adverse CV events.

Safety of Long-Term PPI Use

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The current issue of JAMA reviews the safety of long-term use of proton pump inhibitors (PPI). The following is a collection of the evidence about these purported risks.

Fractures

Increased Deaths in RA, Despite Decreasing Mortality Rates

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Data from the Swedish Rheumatology Quality (SRQ) Register studied death rates in patients with rheumatoid arthritis (RA) between 1997 and 2014.  Holmqvist and colleagues studied 17,512 RA and 78,847 matched controls from the general population, until their death.

No Cancer Risk With Biologic Use

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A polulation-based study from Sweden has shown that treatment with tocilizumab, abatacept, rituximab, or tumor necrosis factor (TNFi) inhibitors does not affect the risk of malignant neoplasms among patients with rheumatoid arthritis. Specifically, use of a first or second TNFi or biologic DMARDs (bDMARD) does confer a different cancer risk when compared to conventional DMARDS in biologic–naive RA patients.

FDA Panel Backs New Zoster Subunit Vaccine

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GlaxoSmithKline has announced that the Vaccines and Related Biological Products Advisory Committee (VRBPAC) of the US Food and Drug Administration (FDA) voted unanimously in support of the efficacy, safety and approval of its herpes zoster subunit (HZ/su) vaccine (called Shingrix) for the prevention of herpes zoster (shingles) in adults ages 50 and over.

Isolated SS-B Not Associated with Connective Tissue Disease

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A one-year prospective study of 624 patients undergoing autoantibody testing for anti-SS-A and/or anti-SS-B autoantibodies finds that isolated anti-SS-B autoantibodies was not associated with features or the diagnosis of any specific connective tissue diseases (CTD).

Rituximab Efficacy in IgG4 Related Disease

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PLOS reports  greater than 90% efficacy when rituximab (RTX) is used to treat patients with IgG4-related disease (IgG4-RD). 

Romosuzumab Followed by Alendronate is Best in Fracture Prevention

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The NEJM reports that in high risk post-menopausal women, romosozumab for 12 months followed by alendronate resulted in a significantly lower fracture than alendronate alone. 

CDC: 40% of U.S Adults Claim to Have Arthritis

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The CDC has reported its 2013 and 2014 prevalence statistics for arthritis and other chronic medical conditions affecting U.S. adults aged ≥18 years. Data is drawn from the ongoing Behavioral Risk Factor Surveillance System (BRFSS), a state-based, telephone survey of noninstitutionalized adults. Data herein is self-reported arthritis (OA, RA, Gout, FM) and is quantified by state and metropolitan areas.

Mortality with Interstitial Lung Disease in Rheumatoid Arthritis

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Annals of Rheumatic Disease has published a Danish population based study demonstrating the high mortality rates seen with interstitial lung disease (ILD).

Sarcoid and Rheumatoid Arthritis Risk Increased by Silica Exposure

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A Swedish study has shown that occupational silica exposure increases the incidence rates of sarcoidosis and rheumatoid arthritis (RA) in those exposed workers in Swedish iron foundries.

New Zoster Vaccine Recommended by FDA Panel

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Reuters reports that the FDA advisory panel has voted 11-0 in favor of the safety and efficacy and ultimate approval of GlaxoSmithKline’s Shingrix shingles vaccine for use in adults aged 50 and over.

Why Rheumatologists Should Do Better Vaccinating this Flu Season

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It is well known that influenza infection is more common in patients with rheumatologic diseases. Blumentals et al.

Jak Inhibition May Ameliorate Pruritus

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Interleukin-4 has been shown to activate sensory neurons involved in pruritus, and that inhibition of IL-4 with Jak inhibition significantly alleviates itching.