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DMARD,trends,2021

US Trends in RA DMARD Use 2017-2021

d Jack Cush, MD

A trend analysis of DMARDs shows that only half of rheumatoid arthritis (RA) patients are taking DMARDs, and that the COVID-19 pandemic substantially affected DMARD use. Despite numerous DMARD advances and evolving treatment guidelines since 1990, older therapies are still commonly used and the latest agents make up a small percentage of overall DMARD use.

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Long-term safety of Ixekizumab (IXE) - 26 RCTs (22k PYs) in PSO, PsA, AS & nr-axSpA - nasopharyngitis most common AE; AEs did not incr over time - D/C from AE 3-5/100Pys - ISRs: 5.9-11.6/100PYs - Candida 1.2-2/100PYs - IBD: 0.1 PsO - 0.8/100PY for axSpA https://t.co/nOoCE3VOxD https://t.co/F4gP1yR1Je

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Dutch study of 586 RA pts on bDMARDs found more nonserious infections (NSIE) (77/100PYs) than serious infx (SIE)(1.3/100Pys). Upper respiratory tract infections were most frequent with recurrence rate that remained stable over time https://t.co/zwELL2yevG https://t.co/GLbidGvjp3

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Depression and RA Dr. Jack Cush reviews the news, journal reports and regulatory approvals from the past week. https://t.co/nJZD4D2ByC https://t.co/ET3Xp9cK62

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syringe, pill, DMARD, Treatment, therapy

JAMA Review of DMARD Use in Rheumatoid Arthritis

d Jack Cush, MD

JAMA has reviewed the "2022 EULAR Recommendations for the Management of Rheumatoid Arthritis With Synthetic and Biological Disease-Modifying Antirheumatic Drugs". 

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Frensius-Kabi has announced that the FDA has approved the tocilizumab biosimilar, Tyenne (tocilizumab-aazg); the first TCZ biosimilar with both IV and subcutaneous formulations https://t.co/F3d8DKxpkU https://t.co/NSEqAcoBBo

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Sandoz has announced FDA approval for their two interchangeable biosimilars of denosumab - Wyost (denosumab-bddz) and Jubbonti (denosumab-bddz) based on reference products Xgeva and Prolia https://t.co/Spb0ABOMMm https://t.co/wkMurvB0G3

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Depression and RA (3.8.2024)

d Jack Cush, MD

Dr. Jack Cush reviews the news, journal reports and regulatory approvals from the past week.

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An assessment of screening for latent tuberculosis in patients initiating b/tsDMARD therapy found over 1 in 3 new b/tsDMARD users did not receive TB screening within recommended time window, as well as variation in screening between drug classes In AC&R https://t.co/MGsWNZCiPW https://t.co/QRFq1lqWt6

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An assessment of screening for latent tuberculosis in patients initiating b/tsDMARD therapy found over 1 in 3 new b/tsDMARD users did not receive TB screening within recommended time window, as well as variation in screening between drug classes In AC&R https://t.co/MGsWNZCiPW https://t.co/QRFq1lqWt6

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Neonatal Fc receptor mAb (lowers Igs) development: 2021 FDA approved efgartigimod (Vyvgart) for myasthenia gravis 2023 FDA approved rozanolixizumab (Rystiggo) for MG 2023 nipocalimab promising efficacy in RA, Sjogrens, hemolytic anemia, MG INTERESTING? https://t.co/HB1fJet3Bo https://t.co/OBrd2Y3nye

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FDA approves 10th adalimumab biosimilar - called Simlandi (adalimumab-ryvk), from Alvotech and Teva. Unique in that it's the 1st high-concentration, citrate-free & interchangeable ADA biosimilar.https://t.co/Kg7Dqr54dg https://t.co/X25SKggJzN

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As of 11/23, FDA has approved 44 biosimilars to 14 different reference products. FDA systematic review on biosimilars found no differences in the risk of death, serious adverse events, or treatment discontinuations between the switch and no-switch arms.https://t.co/yVScZnP559 https://t.co/feswD1gJz9

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EGPA: Benralizumab or Mepolizumab

d Jack Cush, MD

A multicenter, double-blind, phase 3, randomized, active-controlled trial has shown that Benralizumab (BEN) was noninferior to mepolizumab (MEP) for the induction of remission of patients with relapsing or refractory Eosinophilic granulomatosis with polyangiitis (EGPA).

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RA BIOBADASER registry study of 1128 patients going on ts/bDMARD found 107 (9.3%) w/ multimorbidity (Charlson Comorbidity index ≥ 3). Multimorbid RA were older, more SJC & signif higher DAS28; ts/bDMARD retention rate equal groups https://t.co/am4Uoccla9 https://t.co/P7Ae2Jal2e

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Feb 2024 EMA meeting approved biosimilar ustekinumab (Pyzchiva) for adult/pediatric psoriasis; psoriatic arthritis; UC/Crohn's. & also approved generic Apremilast Accordfor the treatment of psoriatic arthritis, psoriasis, and Behçet disease https://t.co/Cu9f4qQjgP https://t.co/qmH3ZkfReN

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Immunosuppression Increasing (2.23.2024)

d Jack Cush, MD

Dr. Jack Cush reviews the news and journal reports from the past 2 weeks on RheumNow.com; but begins with a discussion of what constitutes "immunosuppression" and how it applies to our patients.

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CD19 CAR T-Cell Therapy in Autoimmune Disease

d Jack Cush, MD

The NEJM has published the results of CD19 B cell depletion (by CAR-T cell therapy) in autoimmune disease patients, demonstrating it to be feasible, safe, and efficacious.

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Orismilast is a novel oral phosphodiesterase-4 (PDE4) B/D inhibitor studied in phase 2b RCT in 202 moderate-to-severe psoriasis pts vs PBO. At wk 16, Orismilast was better at PASI 75 (40%-49% vs PBO 16.5%; P <.05) and PASI90 (22%-28% vs 8%; P <.05) https://t.co/wSmiO2Hr5W https://t.co/gMiQUfT6EG

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ARIAA Trial: Abatacept Delays the Onset of RA

d Jack Cush, MD

The ARIAA trial tested the utility of IV abatacept in individuals ACPA+ arthralgia patients with subclinical inflammation and showed abatacept to decrease MRI inflammation, clinical symptoms, and risk of future rheumatoid arthritis (RA) development.

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