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ICYMI: Channeling Bias and Cancer Risk with Biologic or Targeted Synthetic DMARDs

Jack Cush, MD

A retrospective US administrative claims cohort study of RA patients on tumor necrosis factor inhibitors (TNFis), non-TNFi biologics, or Janus kinase inhibitors (JAKis) found a statistically significantly higher risk of incident cancer in patients receiving rituximab, abatacept, or JAKis (compared with TNFis).

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ICYMI: AGA Guideline: Prevention and Treatment of Hepatitis B Virus Reactivation in At-Risk Individuals

Jack Cush, MD

The American Gastroenterology Association has published its revised clinical practice guidelines for the prevention and treatment of hepatitis B virus (HBV) reactivation in at-risk patients, particularly those with immune-mediated disease, receiving immunomodulatory therapy and steroids.

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ICYMI: Axial Involvement in Psoriatic Arthritis

Jack Cush, MD

Analysis of a Greek Psoriatic Arthritis (PsA) cohort shows that nearly one quarter of patients have axial involvement, and among them, ∼30% have isolated spinal axPsA and nr-axSpA, respectively.

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PCR: Prevalence, Cost, & Risk (6.27.2025)

Jack Cush, MD

Dr. Jack Cush reviews the news and journal reports from last week on RheumNow.com

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Remission in Axial Spondyloarthritis Unrelated to Gut Inflammation

MedPage Today

Most patients with early, active axial spondyloarthritis (axSpA) who quickly received a tumor necrosis factor (TNF) inhibitor experienced remission, and it didn't matter whether or not they had intestinal inflammation at baseline, a small single-arm study found.

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Secukinumab fails in GCA phase 3 RCT. Novartis announced top-line results from the GCAptAIN study evaluating secukinumab in adults with newly diagnosed or relapsing GCA. In a steroid taper RCT, the endpoint was sustained remission at Wk 52 compared to placebo https://t.co/JuMDPvznCn
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First FcRn inhibitor in #IIM: In #ALKIVIA, SC efgartigimod PH20 improved TIS vs placebo at 24wks (50.45 vs 35.65, p=0.0004), with faster time to TIS≥20 (30 vs 71.5d) & TIS≥40 (113d vs NE). More major responders too (TIS>60: 34% vs 9.5%). #EULAR2025 #OP0002 https://t.co/ulxtL1NX2Y
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Rheumatologists can’t ignore hypereosinopilic syndrome anymore, not when it borders on our diseases and therapies. Great takeaways on subtypes and therapies from Giacomo Emmi in an elegant talk #EULAR2025 @RheumNow https://t.co/yzQVt1fLKW https://t.co/kiX6kPPQP5

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PCR: Prevalence, Cost, & Risk (6.27.2025) Dr. Jack Cush reviews the news and journal reports from last week on RheumNow. https://t.co/zt0OxwQ2BO https://t.co/eFqHwROQOj

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ARD's Impact Factor The 2024 Impact Factor for ARD is 20.6 – an increase from 20.3 in 2023. This retains the journal’s position as second of 58 titles in the rheumatology category and confirms its status as the top-ranking journal for the publication of original research in both https://t.co/dtMTejkhcc
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TONIX pharm presented two phase 3 RCTs at #EULAR2025 demonstrating efficacy of sublingual cylcobenzaprine at bedtime in w/ significant reductions in Fibromyalgia pain scores. TNX-102 SL could be the 1st new FM drug to be FDA approved in >15 yrs. PDUFA (decision) date is 8.15.25. https://t.co/XNd8uYLQsJ
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Upcoming Lupus Nephritis Pipeline 1. Gazyva (obinutuzumab) – due for FDA/EMA decision 2. Saphnelo IV (anifrolumab) – now in Phase III (new indication for LN 3. Ianalumab SC (Dual-action B-cell inhibitor) – now in Phase III https://t.co/mTInV8JXzq https://t.co/jEv2uvhkqK

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JAK Inhibitors: The Latest from the JAK-pot Study Dr. David Liew reports on abstract POS0150 - Evolution of Janus Kinase Inhibitors (JAKi) Prescriptions Since 2015 In An International Collaboration of Rheumatoid Arthritis Registers (The 'JAK-pot' Study): Effect of Regulatory https://t.co/KiOZuphQTx
Dr. John Cush RheumNow ( View Tweet)
Full read overview of MDA-5 Dermatomyositis (DM) - pathogenesis, findings, & Rx. MDA-5 DM is a rare, aggressive amyopathic form with distinctive skin findings & rapidly progressive interstitial lung dz. Rx includes Hi dose steroids, calcineurin inhib & IV CTX (maybe JAKi, MMF)

Dr. John Cush RheumNow ( View Tweet)

Trends and Innovations from Barcelona (6.20.2025) Dr. Jack Cush reviews highlights, trends and novel studies from EULAR 2025 in Barcelona from last week. https://t.co/iEiQI8GACt https://t.co/X27CuZb5wH

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Dr. John Cush RheumNow ( View Tweet)
Upcoming Lupus Nephritis Pipeline 1. Gazyva (obinutuzumab) – due for FDA/EMA decision 2. Saphnelo IV (anifrolumab) – now in Phase III (new indication for LN 3. Ianalumab SC (Dual-action B-cell inhibitor) – now in Phase III https://t.co/mTInV8JXzq https://t.co/3qg1FWzZRI

Links:

Dr. John Cush RheumNow ( View Tweet)
Increasing costs of biologics. X-sectional study of 76 781 psoriasis pts on biologics (TNFi, IL12/23, IL-17i, IL-23i) saw annual treatment cost increase from $21 236 in 2007 to $47 125 in 2021. AVG cost could have been 44% lower if lowest-cost Rx in same class was used https://t.co/IOaK75zsgg
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By March 2025, the FDA has approved 71 biosimilars (15 interchangeable). The US & EU biosimilars markets spent $22.58 billion in 2024 & is projected to increase by 25% to $171.79 billion by 2033 https://t.co/fsqGTzWuhC https://t.co/ZLYSIwRqI4

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EMA has published a concept paper about the need for guidance to inform the development of systemic sclerosis (SSc) treatments. They have identified study designs & endpoints; exploratory and confirmatory trials, and assessments of safety and efficacy. See draft here: https://t.co/WADBrw2uXe

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A new mechanism of action in SARD-ILD Nerandomilast, an inhibitor of phosphodiesterase 4B, orally administered, is a new mechanism of action to treat lung fibrotic diseases. FIBRONEER-ILD, the Phase 3 RCT of Nerandomilast in patients with progressive pulmonary fibrosis, was https://t.co/goikCwJa2x
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