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RheumNow Podcast – Believe in Vitamin D or Rituximab? (9.20.19)
Dr. Jack Cush reviews the news and journal articles from the past week on RheumNow.com.
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NSAID Use Linked With Hypertension in Ankylosing Spondylitis
Continuous use of nonsteroidal anti-inflammatory drugs (NSAIDs) among patients with ankylosing spondylitis (AS) was associated with the development of incident hypertension, a prospective cohort study found.
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FDA Grants Breakthrough Status for Potential Lupus Nephritis Drug
Obinutuzumab (Gazyva) has been granted Breakthrough Therapy Designation (BTD) by the U.S. Food and Drug Administration (FDA) for use in adults with lupus nephritis (LN). The drug made by Genentech, is going forward based on the Phase II NOBILITY study in adult patients with proliferative lupus nephritis (LN). Currently, there are no FDA-approved medicines for lupus nephritis.
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Anakinra Shows Benefits in Cytokine Storm
The interleukin (IL)-1 receptor antagonist anakinra (Kineret) showed promise in critically ill children who develop the often-lethal condition known as secondary hemophagocytic lymphohistiocytosis (sHLH)/macrophage activation syndrome (MAS), a retrospective single-center study found.
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Medical Use of Cannabis in 2019
JAMA has published an overview of cannabis and its medical uses. Although nearly 10% of cannabis users in the United States report using it for medicinal purposes, there is insufficient evidence to support the use of medical cannabis for most conditions for which its use is advocated or advised. Nevertheless, there is increase in favoring the public availability of cannabis, largely for the management of more than 50 medical conditions.
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Prior Authorizations Delay Care in Rheumatology
Physicians who believe their patients' health is negatively affected by insurers' demands for prior authorization, and the delays that often result, will find that opinion vindicated by a new study of rheumatology care: when permission had to be sought from insurers to provide intravenous drugs,
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RheumNow Podcast – The End of Arthritis (9.13.19)
Dr. Jack Cush reviews the news and journal articles from the past week on RheumNow.com.
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Two vs. Four Weeks of Antibiotic Therapy in Septic Arthritis
A prospective trial has shown that 2 weeks of antibiotic therapy is as effective as 4 weeks of antibiotic therapy, with similar outcomes but shorter hospital stays.
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Bimekizumab Add-on Therapy in Rheumatoid Arthritis
Bimekizumab is a dual inhibitor of IL-17A and IL-17F that has been shown to be effective in psoriasis and psoriatic arthritis. A proof-of-concept study shows that giving bimekizumab to rheumatoid arthritis patients not adequately controlled by certolizumab pegol resulted in a rapid decrease in disease activity achieved after 12 weeks of treatment. These findings are novel as anti-IL-17 monoclonal antibody therapy has previously been shown to be ineffective in RA.
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74 Percent of Rheumatoid Arthritis Patients Dissatisfied with Treatment
CreakyJoints has completed a 258 patient survey showing that nearly three-fourths of people with rheumatoid arthritis (RA) have expressed dissatisfaction with their treatments, including conventional (csDMARDs) and biologic Disease Modifying Antirheumatic Drugs (bDMARDs).
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Steroid Sparing Effects of Methotrexate and Mycophenolate in Uveitis
Patients with noninfectious uveitis (intermediate, posterior uveitis, or panuveitis) often require high dose corticosteroids and therefore may need steroid-sparing DMARD therapy. The FAST study investigated the corticosteroid-sparing effect of methotrexate or mycophenolate mofetil in adults with noninfectious uveitis.
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Riociguat Fails in Systemic Sclerosis-Associated Digital Ulcers
Riociguat is an oral, selective soluble guanylate cyclase stimulator that has been studied in patients with digital ulcers (DU) due to systemic sclerosis (SSc) but study results show that short term (16 weeks) riociquat therapy does not sufficiently reduce the DU burden in SSc patients.
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Anti-IL-23 Beats IL-17 in Plaque Psoriasis
Lancet reports a head-to-head trial of antibodies against interleukin (IL)-23 and IL-17A in patients with moderate-to-severe psoriasis favored guselkumab with superior PASI 90 responses at week 48 (compared to secukinumab).
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Nintedanib FDA Approved for Scleroderma Lung Disease
Last Friday, the US Food and Drug Administration approved Ofev (nintedanib) to slow the rate of decline in pulmonary function in adults with interstitial lung disease associated with systemic sclerosis or scleroderma, called SSc-ILD.
ILD as a complication of SSc may lead to progressive loss of lung function and may be associated with a significant mortality risk. Prior to the approval of Olev, there were no FDA approved drugs for SSc-ILD.
RA Women are Less Likely to Breastfeed
A large pregnancy registry has published their results showing rheumatoid arthritis (RA) patients who become pregnant are less likely to breastfeed compared to non-RA women from the general population, with many women stopping breastfeeding so that they could start medication, even though many of
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Respiratory Risks Not Increased in RA Patients with COPD
An insurance claims based study of RA patients with COPD shows that biologics do not have an increased rate of respiratory events compared to those on conventional DMARDs.
A real world cohort of RA patients with COPD was drawn from US-based MarketScan databases. Patients on biologic DMARDs and/or targeted synthetic DMARDs (tsDMARDs) were propensity matched to those on conventional synthetic DMARDs (csDMARDs).
Influenza Vaccination Update
FDA's Vaccines and Related Biological Products Advisory Committee met in Silver Spring, Maryland, on March 6 and 22, 2019, to select the influenza viruses for the composition of the influenza vaccine for the 2019-2020 U.S. influenza season.
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Tocilizumab Shows No Increase in Cardiovascular Risk
The ENTRACTE trial examined the risk for major adverse cardiovascular events (MACE) in RA patients and found no increased risk of MACE in patients treated with tocilizumab (TCZ) versus etanercept (ETN).
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Number of Prior DMARDs Portends Poorer Outcomes
Detailed analysis of two clinical trials in RA has shown that clinical responses decrease as the disease duration and number of prior DMARDs increase.
The associations between disease duration and number of prior DMARDs and response to therapy were assessed using data from two randomised controlled trials in patients with established RA (mean duration, 11 years) receiving adalimumab+methotrexate.
Metanalysis of 16 studyes Systemic Sclerosis pregnancies have a higher risk of miscarriages (OR 1.6), IUGR (OR 3.2), preterm births (OR 2.4) and low birth weight (OR 3.8). SSc pts have 2.8 fold higher rate of gestational HTN & 2.3x more C- sections. https://t.co/FuM0DZFR4k
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