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TNF Inhibitor Associated Infectious Risk Greatest in First 6 Months
The risk of serious infections (SIE) in RA patients given anti-TNF (TNFi) therapy is not static, instead it has been shown to be greatest in the first 6 months of use according to a recent report in Rheumatology.
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Lots of JAK safety studies in #ACR20. Abst#0237 pooled 5 RCTs on UPA. Good safety numbers and low VTE rates, but watch out for herpes zoster trend, elevated in UPA (30>15mg) compared to MTX and ADA. @RheumNow
Eric Dein ejdein1 ( View Tweet)
Dr. L Calabrese excellent review of irAEs and a proposed personalized algorithm for mgmt of irAE #ACR20 @LCalabreseDO @rheumnow
He believes there should be more studies combining TNFi or IL-6 with CPI https://t.co/GbvgXtNJnI
k dao KDAO2011 ( View Tweet)
Dr. Noha Abdel-wahab on timing for grade 3/4 irAE fastest with the skin after exposure to CPI #ACR20 @rheumnow https://t.co/sc5c6Zn3Uq
k dao KDAO2011 ( View Tweet)
#hydroxychloroquine is not a ‘cutie’ drug. E Park et al showed that HCQ does not increase QT interval in RA & SLE patients including if on other meds that may affect QT but known heart disease excluded from study #ACR20 #ACR2020 @RheumNow abstr#432 @CRASCRRheum https://t.co/FGVPknmj5q
Janet Pope Janetbirdope ( View Tweet)
More UPA safety studies Abst#0215 shows balanced VTE event rates across UPA doses and comparator groups. Evidence for Dr. Strand to use in #ACR20 Great Debate that VTE may be safe TNF alternative @RheumNow. https://t.co/hByttIxiuX
Eric Dein ejdein1 ( View Tweet)
JAKs are no longer new, Winthrop et al presents 8.4 year BARI data in Abst#0202 at #ACR20. VTE risk stable over time, again shows reason to vaccinate patients for zoster before starting. @RheumNow https://t.co/OSIvHl2f7Y
Eric Dein ejdein1 ( View Tweet)
MTX & liver fibrosis:
71% pts w/low FIB-4i of<1.45
No correlation bet FIB-4 values & cumulative MTX dose
Cumulative MTX dose not sig. ⬆ in pts with FIB-4i >1.45 @RheumNow #ACR20 Abstr#0205 https://t.co/RmyAz9M5fw
sheila RHEUMarampa ( View Tweet)
DVT/PE has been the sticking point for baricitinib in RA.
DVT/PE risk in integrated safety analysis >8y: incidence doesn't increase, but also doesn't decrease. No diff with dose either.
Every drug has pros/cons; it's how we manage risk that counts...
#ACR20 ABST0202 @RheumNow https://t.co/V88tQjcXSJ
David Liew drdavidliew ( View Tweet)
Dr Choi et al case control study of methotrexate in RA. No increased risk of NAFLD seen. Increased trigs and BMI associated NAFLD @rheumnow #ACR20 Abstr#0181 https://t.co/WLPuf6Ga1D
Richard Conway RichardPAConway ( View Tweet)
Dr. Izuka talks about drug rxn with TMP-STX in SLE, particularly in anti-Sm at #ACR20 press conference. @HopkinsRheum avoids Bactrim in SLE due to flares. Whats your practice for PJP PPx in SLE? @RheumNow
Eric Dein ejdein1 ( View Tweet)
What do you do with pharmacist drug alert for antimalarial cardiac safety &/or drug interactions @RheumNow #ACR2020 @CRASCRRheum
Janet Pope Janetbirdope ( View Tweet)
@JYazdanyMD @UWRheum @r_burmester Black, et al - cont'd
277 atypical femur fx events
Risk increased w longer duration of bisphosphonate use
Risk decreased after bisphosphonate discontinuation
Asians had a higher risk than Whites.
#ACR20 #ACRambassador
Rheum Cat rheum_cat ( View Tweet)
4.CIRT: low dose MTX 15 mg/week: transaminitis NNH 6,
cirrhosis NNH 1000
5.LoDoCo2: colchicine prevents MACE: NNT 36
6.ENTRACTE: TCZ vs ETN: for bowel perforation TCZ:
NNH 600
k dao KDAO2011 ( View Tweet)
Year in Review by @JYazdanyMD: #Cardiovascular #Inflammation Reduction Trial provided "unique opportunity to learn about side-effects" of a drug we commonly use.
Low-dose MTX assoc. with small-mod. elevated risk of transaminitis, infection, anaemia & skin cancer.
#ACR20 @RheumNow https://t.co/hNS600Pndr
Mrinalini Dey DrMiniDey ( View Tweet)
How do you monitor HCQ on patients with chronic QTc prolonging medications (ex psychiatric meds)? @JYazdanyMD Year-in-Review #ACR20 @rheumnow
Eric Dein ejdein1 ( View Tweet)
Mavrilimumab (anti GM-CSF Receptor α Monoclonal Antibody) Reduces Time to Flare and Increases Sustained Remission in a Phase 2 Trial of Patients with Giant Cell Arteritis https://t.co/1kqWeBcEDq #gca #GmCSFinh Novel MOA , big unmet need
Peter Nash drpnash ( View Tweet)
Efficacy & Safety Deucravacitinib (BMS-986165), Oral, Selective TyK2 Inhib in Patients with Active PsA Results from a Phase 2, RDBPC Trial https://t.co/s3V5NtRpuW results-from-a-phase-2-randomized-double-blind-plac/ #psa #tyk2inhib Efficacy in PsA ?top of dose response
Peter Nash drpnash ( View Tweet)
Long Term Cardiovascular Safety of Febuxostat and Allopurinol in Patients with Chronic Gout: The Febuxostat versus Allopurinol Streamlined Trial (on Behalf of the FAST Investigators) https://t.co/LGERY3mpe5 #febuxostat #allopurinol #CVS some cardiac reassurance feboxustat
Peter Nash drpnash ( View Tweet)
#ACR20 year in review @JYazdanyMD CIRT trial showing that MTX pneumonitis occurs but is very (very) rare. @RheumNow @jeffsparks @DanielHSolomon https://t.co/UbD4mhHBzq
Richard Conway RichardPAConway ( View Tweet)
