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The art of talking about risks with our patients
On the first day of EULAR 2024, I am debating Janet Pope.
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Is Cannabis Safe? (6.7.2024)
Dr. Jack Cush reviews FDA approval, news and journal articles -- and it’s the week before EULAR 2024 in Vienna!!
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JAK or TNF Inhibitor as First Drug for Rheumatoid Arthritis?
Medpage Today
A Janus kinase (JAK) inhibitor outperformed tumor necrosis factor (TNF) blockers for substantially reducing rheumatoid arthritis (RA) symptoms in patients for whom conventional anti-rheumatic drugs had failed, a pragmatic head-to-head trial found.
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The Window of Opportunity (5.24.2024)
Dr. Jack Cush reviews the journal reports and news from the past week on RheumNow.com. This week: blockbuster drugs, opioids in rheumatology and nontreatment of inflammatory arthritis?
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Biomarkers Predictive of a Deucravacitinib Response in Psoriatic Arthritis
A phase II trial demonstrating the clinical efficacy of deucravacitinib, a TYK2 inhibitor, in psoriatic arthritis (PsA) suggests specific biologic effects identified by biomarkers may predict clinical responses.
"Don't You Know Who I am?" (5.17.2024)
Dr. Jack Cush reviews the news and journal reports from the past 2 weeks. This week's question: can we prevent gout, ILD or psoriasis?
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OP0048 Impressive CLASI (lupus skin index score) with #deucravacitinib - data presented by Dr C Arriens #EULAR24 @RheumNow #WiR https://t.co/EuQdwuolN6
TheDaoIndex KDAO2011 ( View Tweet)
Substudy of SELECT-COMPARE trial
Week 60 immunogenicity RZV RA treated UPA 15 mg + MTX
✔️ HUmorale response 71%
✔️ Cellular response 65%
✔️ No serious AEs
✔️ One event of HZ occurred during follow up
Abstr#OP0020 #EULAR2024 @RheumNow https://t.co/8OMwGuIZFx
Aurelie Najm AurelieRheumo ( View Tweet)
I chaired great debate at #EULAR2025 - JAK Inhibitor Special Warnings: can observational data debunk an RCT? Drs Janet Pope(NO) vs David Liew(YES). Voting suggests most are concerned about JAK warnings, but Liew won by converting a minority his way @janetbirdope @Drdavidliew https://t.co/bV1JdO7c4e
Dr. John Cush RheumNow ( View Tweet)
EULAR 2024 kicked off with a fantastic debate between Janet Pope and David Liew - ‘JAK inhibitor special warnings: Can observational data debunk an RCT?’
A thought-provoking discussion summarising all aspects of the ongoing conversation on JAKi use in high-risk patients! https://t.co/MzW3jSSCfr
Links:
The Immune-Mediated Inflammatory Disease Forum IMIDforum ( View Tweet)
More data from Jak-pot, the real-world multinational RA study, this time looking at infection in 14 national registries
JAKi (vs TNFi) had no signal for general/serious infection (excluding HZ)
Somewhat reassuring post-ORAL Surveillance infection data
#EULAR2024 OP0092 @RheumNow https://t.co/ocAbc4NiV2
David Liew drdavidliew ( View Tweet)
Shingrix in upadacitinib + MTX RA, in SELECT-COMPARE RCT:
data now out to 60w
good humoral and cellular response in most, even without MTX withheld
(& good safety too)
Important for our JAKi-treated patients to get the protection they need #EULAR2024 OP0020 @RheumNow https://t.co/FqVCCwUJOg
Links:
David Liew drdavidliew ( View Tweet)
@Janetbirdope @RheumNow #EULAR2024 JAK-i Debate
@drdavidliew (NOT in support of regulation)
- is the signal real? Query about replicability & data came from N. America. Not reflected on real-world data of enriched cohorts
- is the warning justified?
- are there unintended consequences?
@RheumNow https://t.co/TXUf90fqwN
Links:
Md Yuzaiful Md Yusof Yuz6Yusof ( View Tweet)
Asking the quintessential Australian question at #EULAR24 by @drdavidliew - does the ORAL surveillance study for JAKi *truly* pass the pub test?
@eular_org @Janetbirdope @RheumNow
What does #MedTwitter think? https://t.co/bqwPU8XX5S
Links:
Benjamin Sutu benjaminsutu ( View Tweet)
#EULAR2024 JAK-i Debate.
@Janetbirdope [Pro Regulatory Safety Measures]
- to do no harm esp since there are other alternatives
- supported by RCT
- although JAK-i have different structures, data from individual RCT + LTE showed similar rates of malignancy & MACE @RheumNow https://t.co/jQKQmHE9Fg
Links:
Md Yuzaiful Md Yusof Yuz6Yusof ( View Tweet)
#EULAR2024 Eular Debate Showdown between @Janetbirdope vs @drdavidliew
Topic: can observational study debunk RCT?
This stemmed from Oral Surveillance = an increased risk of malignany & MACE with tofacitinib compared with TNF-i. Regulatories extrapolated to all JAK-i @RheumNow https://t.co/hg6xJZDHiA
Md Yuzaiful Md Yusof Yuz6Yusof ( View Tweet)
The great debate on JAKi risk and special warnings
And who better than @RheumNow to keep score between @Janetbirdope & @drdavidliew
Get the popcorn ready 🍿
#EULAR2024 https://t.co/z50Ob8q0i0
Aurelie Najm AurelieRheumo ( View Tweet)
JAK or TNF Inhibitor as First Drug for Rheumatoid Arthritis?
A JAK inhibitor outperformed TNF blockers for substantially reducing RA symptoms in patients for whom conventional anti-rheumatic drugs had failed, a pragmatic head-to-head trial found.
https://t.co/7BhFSwb1Ns https://t.co/Hf31OPgE0M
Dr. John Cush RheumNow ( View Tweet)
FAERS retrospective, safety study of JAKi use in 75K RA pts (52K Tofa; 21K Upa, 2.2K Bari vs bDMARDs) found JAKi had incr risk of VTE (adj ROR=2.11), CVA (ROR=1.25), IHD (1.23), edema(1.22), & tachyarrhythmias (1.15) https://t.co/Bvds4C66Nq https://t.co/Xmu8g35MXR
Links:
Dr. John Cush RheumNow ( View Tweet)
Metanalysis of 26 reports and 195 juvenile Dermatomyositis pts (age 4.9 yrs) treated w/ JAK inhib (tofa, rux, & bari); Good improvement in 90%, 69% & 93%, respectively. JAK indication refractory skin dz (35%) or muscle involvement (29%). TIME FOR RCTs!! https://t.co/Vtm2n9BWV1 https://t.co/1bXZokW1AO
Links:
Dr. John Cush RheumNow ( View Tweet)
