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Dr. H. Ralph Schumacher (1933-2017)
Dr. H. Ralph Schumacher passed away from ALS in July 30, 2017. The current issues of The Rheumatologist and the Journal of Clinical Rheumatology have beautiful tributes written by Dr. Simon Helfgott and past ACR president Dr.
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Treat-to-Target a Bust with Rheumatologists
Treat-to-target strategy is widely advocated as an important means of optimizing treatment responses in patients with rheumatoid arthritis. Even though T2T is encouraged by most guidelines, a current report shows that US Rheumatologists fail to implement T2T in their daily practice.
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Therapeutic Update: 5 Questions on FDA Hearing for Tofacitinib in PsA
In this Therapeutic Update, Drs. Mease, Gibofsky and Cush answer five questions regarding the August 3rd FDA Arthritis Advisory Committee meeting that reviewed the potential approval of tofacitinib (Xeljanz) in patients with active psoriatic arthritis. The panel was nearly unanimous (10-1) in favor of the efficacy and safety profile of of tofacitinib, and similarly voted 10-1 to approve this drug for use in PsA. Final decisions on these recommendations from the AAC panel will be made at a later date by the FDA.
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Rheumatoid Arthritis Increases Risk of Repeat Coronary Events and Mortality
Studies have shown that rheumatoid arthritis (RA) patients have increased risk of acute coronary syndrome (ACS) and may suffer from poorer short-term outcomes after ACS. The long-term outcomes in patients with RA with ACS was shown to be worse than matched non-RA patients also with ACS.
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Pegloticase Infusion Reactions Largely Seen in Non-Responders
The introduction of intravenous pegloticase (PEG) in 2010 was felt by many to be a major advance in the treatment of patients with severe, refractory tophaceous gout. But for some, concerns over infusion reactions and safety have limited its use.
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No Evidence to Support Use of Gabapentinoids in Low Back Pain
Management of chronic low back pain (CLBP) is often complex, requiring multiple modalities and meds to control pain. An analysis of studies shows that Gabapentinoids, including pregabalin and gabapentin, have little to no benefits but significant risk of adverse effects.
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Psoriatic Arthritis Patients with Comorbidities have Worse Disease and Poor Responses
A population-based cohort study shows that comorbidities in psoriatic arthritis patients (PsA) were associated with higher disease activity, shorter persistence and reduced clinical response to TNF inhibitors (TNFi).
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Kids with Crohn's have Profound MSK Deficits - but No Increase in Fractures
Crohn’s disease (CD), a chronic inflammatory condition of the gastrointestinal tract, is also known for its propensity to affect the musculoskeletal system.
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Therapeutic Update: 5 Questions on Sirukumab FDA Hearing
Drs. Cush and Gibofsky answer 5 questions about the August 2, 2017 FDA Arthritis Advisory Committee meeting that reviewed the NDA for sirukumab use in rheumatoid arthritis. The panel voted against (1-12) the approval of sirukumab.
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MSK Ultrasound Now Standard for Rheumatology Training
In the United States, musculoskeletal ultrasound (MSUS) in rheumatology has grown significantly in the last few decades. Ten years ago, more than half of rheumatology fellows had training or exposure to MSUS. A current survey of training programs shows that 94% provide MSUS training.
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FDA Arthritis Advisory Panel Endorses Tofacitinib Approval for Psoriatic Arthritis
On Thursday, August 3, the FDA Arthritis Advisory Committee (AAC) met to consider tofacitinib for use in patients with psoriatic arthritis. The panel voted 10-1 in favor of approval.
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The RheumNow Week in Review – 4 August 2017
Dr. Jack Cush reviews new FDA decisions on sirukumab and tofacitinib as well as other news items from the past week on RheumNow.com.
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Arthritis Advisory Panel Votes Down Sirukumab
On Wednesday, August 2, the FDA convened the Arthritis Advisory Committee (AAC) to evaluate the safety and efficacy of Janssen’s anti-IL-6 monoclonal antibody, sirukumab.
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Pediatric Consensus on Comorbidity Assessments
Comorbidity is a serious consequence or confounder in patients with inflammatory diseases. This has been well described in both psoriatic and rheumatoid disease.
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No Increase in Malformations with Etanercept Use During Pregnancy
While there are several reports detailing uncontrolled, observational results of biologic use during pregnancy, most are hampered by low numbers, incomplete data and too small a sample to make reliable judgements regarding the teratogenicity. A company sponsored claims data analysis has shown that etanercept exposure during pregnancy was not associated with an increase in major congenital malformations (MCMs).
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Romosuzumab Outperforms Teriparatide in Post-Bisphosphonate Osteoporosis
The STRUCTURE trial results have been reported in Lancet and have shown that after 12 months of therapy, romosozumab (ROMO) had superior gains in bone mineral density (BMD) compared to teriparatide (TER) in women with postmenopausal osteoporosis who have previously taken bisphosphonate therapy.
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One-Third of Americans Took Opioids in 2015
In the wake of the well-publicized "opioid epidemic", researchers report in the Annals of Internal Medicine (online July 31) that more than one third of U.S.
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August 2nd AAC Meeting: FDA Concerns Over Sirukumab Deaths
On August 2, the US Food and Drug Administration (FDA) will convene a hearing of the Arthritis Advisory Committee (AAC) to review the safety of the novel IL-6 inhibitor, sirukumab, being developed by Janssen (Johnson & Johnson).
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Tubulointerstitial Damage in Lupus Predicts ESRD Progression
The presence of tubulointerstitial damage (TID) may provide a potential window for early intervention in lupus nephritis (LN) to ward off end-stage renal disease (ESRD), according to a data analysis.
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Baricitinib Derailed by FDA Review
Eli Lilly and Co disclosed today that upon further discussions with the US Food and Drug Administration (FDA) there would be a delay in further regulatory decisions regarding baricitinib, a JAK inhibitor, that is being developed for use in rheumatoid arthritis (RA).
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