Update on Checkpoint Inhibitor Safety

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“Autoimmunity is the Achilles heel of onco-immunotherapy” per Dr. Leonard Calabrese, which leaves a dilemma for rheumatologists.

Onco-immunotherapy induces immune dysregulation to allow patients to develop an immune response to their cancer cells. An unfortunate side effect for patients taking onco-immunotherapy is often autoimmune-like diseases referred to as immune adverse reactions (irAEs). Studies in France and the United States have shown that irAEs can be a good prognostic sign, suggesting these therapies are working. Rheumatology is faced with new problems as onco-immunotherapies may induce new chronic diseases in multiple different forms secondary to the treatment.

'These Results Are Astonishing': What We Heard at ACR 2018

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"If radiation was a drug that could improve survival in the metastatic setting like that it would be millions and millions of dollars." -- James B. Yu, of Yale Cancer Center, discussing aggressive use of stereotactic body radiation therapy in oligometastatic cancer.

RheumNow ACR Week in Review: ACR Wrap-Up (10.26.18)

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This past week in Chicago gave us a plethora of new and eye-opening research, people, KOLs, exhibits, sessions, guidelines, posters and a never-ending supply of coffee served in small paper cups.  ACR 2018 highlights for me included:

Update on Myositis

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The ACR/ARHP 2018 national meeting in Chicago presented us with opportunities to learn more about inflammatory myositis. A particularly interesting lecture was HOT topics in myositis. There were a few abstracts on MDA-5 related disease and a few on new or repurposed medications for dermatomyositis which will be covered here.

ACR 2018 - Day 4 Report

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Highlights from Tuesday and Wednesday (days 3 and 4) from the ACR annual meeting include: the important and impactful abstracts covered by the Rheumatology Roundup session; upadacitinib clinical trials; and the baricitinib CV and VTE safety analysis.

Checkpoint Inhibitor-related Myositis – Something Different

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As expected, this year’s ACR meeting saw an upswing in the number of abstracts on immune related adverse events from checkpoint inhibitor therapy compared to last year.

Early Promise for Steroid-free Approach for Giant Cell Arteritis

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A very small study presented at ACR18 looking at tocilizumab monotherapy in patients with a new diagnosis of giant cell arteritis has nevertheless given hope to the tantalising idea that some GCA patients might achieve drug-free remission without steroids, although broader data are requ

Pregnancy and Contraception in Patients with Rheumatic Diseases

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A number of abstracts at this year’s ACR in Chicago highlighted issues around pregnancy and contraception advice in routine clinical practice.

ACR 2018 Podcast - Day 3

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Audio Highlights and Interviews from Day 3 at the ACR 2018 meeting  LISTEN HERE

ACR 2018 - Day 3 Report

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Highlights from Tuesday, day 3 of the ACR Annual meeting in Chicago, included:

The PEXIVAS Study –  2x2 Trial of Plasma Exchange and Reduced Steroids in ANCA-Associated Vasculitis (AAV) - Abstract #2788

Axial Spondylitis Abstracts Roundup

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There have been a number of interesting posters and presentations covering the field of axial spondyloarthropathy. I’ve picked out a few points that I found particularly relevant.

Classification Criteria

NK cells and a Potential Role in the Development of PsA vs PsC (Cutaneous Psoriasis)

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Human NK cells express multiple receptors that interact with HLA class I molecules which, in turn, suppy peptides that bind HLA-E to form CD94/NKG2A NK receptor ligands.

What is the Future of MTX for Psoriatic Arthritis?

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Like most rheumatologists, I retain a deep and abiding love for methotrexate.

Autoimmunity in the Setting of Primary Immunodeficiency

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There are many avenues for interdisciplinary collaboration within rheumatology, as our specialty encompasses every organ system and diseases with protean manifestations.

ACR 2018 Podcast - Day 1B

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Audio Highlights and Interviews from Day 1 at the ACR 2018 meeting - LISTEN HERE

ACR 2018 Podcast - Day 2A

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Audio Highlights and Interviews from Day 2 at the ACR 2018 meeting - LISTEN HERE

Technology Tools for the Rheumatologist

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Four years ago, the genesis of this session (technology tools for rheumatologists) was from the frustration of the archaic technologies we have been using in our medical practices (including user hostile EHRs), compared to the rapid advancing pace of the consumer technologies we use at home. So came the struggle to adapt affordable and usable consumer technology products in the office that would save time (or at least be time neutral) and impact patient management.

Several Studies Addressed Treatment of Axial Spondylitis

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Monday afternoon's session on the treatment of Axial Spondyloarthritis presented us with a great selection of studies addressing important issues in modern treatment paradigm of AxSpA.

TRIPLE Trial Results

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Pegloticase has become an excellent option for management of patients with chronic refractory gout, although treatment may be limited by the development of anti-drug antibodies that lead to loss of serum urate (sUA) lowering effect.

Emerging Trends in the Treatment of Rheumatoid Arthritis

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