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IL-1 Inhibition in CPPD

Jack Cush, MD

Controlled clinical trials in patients with calcium Pyrophosphate Deposition Disease (CPPD) are scant. Now a metanalysis provides evidence that anakinra, an interleukin-1 inhibitor, is a promising alternative for patients with acute CPPD flares.

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DAHLIAS study - Nipocalimab in Sjögren's Disease

Jack Cush, MD

Nipocalimab, a neonatal Fc receptor blocker that reduces circulating IgG and autoantibodies, was shown to be effective in a phase 2 trial in patients with severe Sjögren's disease.

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Genetic Risks and Severe Cutaneous Reactions to Allopurinol

Jack Cush, MD

A matched cohort study shows that HLA-B*58:01 and HLA-A*34:02 are strongly associated with allopurinol-induced severe cutaneous adverse reactions (SCARs), these alleles were absent in more than one-third of those affected, suggesting these are strong but incomplete indicators of SCAR risk. 

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ACR, guidance, guidelines

New ACR 2025 Guidelines for Non-Renal Lupus

MedPage Today

Written by Lisa Sammaritano, MD, of the Hospital for Special Surgery in New York City, and a committee of nearly 50 other experts, the new guideline also stipulates that corticosteroids are OK for gaining symptom control in newly diagnosed patients and when flares erupt, but the duration should be kept as short as possible.

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syringe, pill, DMARD, Treatment, therapy

What should head-to-head studies in inflammatory arthritis teach us?

Janet Pope, MD, MPH, FRCPC

The multimillion dollar question for inflammatory arthritis prescriptions is: which drug should I use next?

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CART

Beyond malignancy, look out for LICATS with CAR-T

Md Yuzaiful Md Yusof, MRCP(UK), PhD

CAR T cell therapy took the centre stage in 2022 where data pertaining to a successful case series of 5 patients with refractory SLE were published by Prof Schett’s group. Since then, this area of therapeutic has expanded exponentially. Our growing enthusiasm was slightly dampened though when the FDA required all six approved CAR T-cell therapies in oncology to include a black box warning regarding the risk of second primary malignancies in January 2024. At ACR25, Prof Schett’s group described a new form of toxicity in patients with autoimmune disease receiving CAR T-cell therapy, most likely due to the cleansing of immune cells from the affected organs.

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Biologic use in 5008 IBD pts finds higher serious infxn (SIE) rates (vs, RA or PsO). In UC the SIE rate was 5.5/100PY w/ vedolizumab & 7/100PY w/ other biologics. In Crohns the SIE rate was 7.9/100PY w/ vedolizumab vs 6.5/100PY w/ other biologics (adj HR 1.15; 0.95–1.40) (P .16) https://t.co/R7YC220NnO
Dr. John Cush RheumNow ( View Tweet)
Genetic Risks and Severe Cutaneous Reactions to Allopurinol A matched cohort study shows that HLA-B*58:01 and HLA-A*34:02 are strongly associated with allopurinol-induced severe cutaneous adverse reactions (SCARs), these alleles were absent in more than one-third of those https://t.co/NLpHVhr9Ww
Dr. John Cush RheumNow ( View Tweet)
Swedish Birth Registry study of adverse preg outcomes (APOs) after SSc Dx [n=941] or w/in 3 yrs [39] or > 3yrs pre-Dx [839]. SSc women have incr APOs post-Dx, including preeclampsia (RR 3.8), preterm (3.3), C-section (2.5); but also incr APO risk w/in 3 yrs of Dx

Dr. John Cush RheumNow ( View Tweet)

NHANES study of 4,622 adults, including 296 w/ RA, shows volatile organic compounds (VOCs) & metabolites (mVOCs) exposures increases the risk of #RA (OR: 1.23 - 1.37), especially in females. https://t.co/pBNLTRkyLn https://t.co/L6nVbYlBhD

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Dr. John Cush RheumNow ( View Tweet)
Genentech announced positive results from the phase III DBRPCT ALLEGORY trial showin safety & efficacy of obinutuzumab in ~300 SLE pts on SOC. Results have yet to be presented publicly. https://t.co/4hoT9dBtPq

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Dr. John Cush RheumNow ( View Tweet)

Systematic review of 10 studies showed TNFi exposure in utero not assoc w/ incr risk of infant severe infxn (4 RCTs); same for breast milk exposure (2 RCTs). Infant vaccination outcomes unaffected by TNFi use, but rec delaying BCG vaccination if TNFi exposed https://t.co/02Nn6TuzR3
Dr. John Cush RheumNow ( View Tweet)
In 2024, 77 pts referred to Rheum for possible PMR were ultimately Dx w/ B19 viral infx. 96% had arthralgia & 7% had PMR-like features (5/5 w/ BL shoulder/neck. prolonged AM stiff, fever & Hi CRP/ESR - none had hip pain. 4/5 were male, w/ mean age of 55 yrs. None were RF/CCP+ https://t.co/AiK2K9whBH
Dr. John Cush RheumNow ( View Tweet)
Stopping therapy in GCA At #ACR25 we saw the SELECT-GCA extension data presented in the first plenary session, looking at the second year after the 52 week original study, comparing upadacitinib versus placebo in GCA. In this second year, patients in remission on upadacitinib https://t.co/GaYNWr3Sjq
Dr. John Cush RheumNow ( View Tweet)
Upadacitinib: revisiting safety data in RA and GCA For the last several years, conversations about JAK inhibitors have often started and ended with safety. The shadow cast by ORAL Surveillance has made clinicians more cautious and regulators more restrictive. Yet in practice, https://t.co/6Wes2npkFd
Dr. John Cush RheumNow ( View Tweet)
If We Can’t Prevent RA, Can We at Least Prevent Difficult-to-Treat RA? Despite major advances in RA management, some patients develop difficult-to-treat RA (D2TRA), characterized by ongoing inflammation and impairment despite multiple therapies. While understanding of the https://t.co/FcF0V82KdT
Dr. John Cush RheumNow ( View Tweet)
Marketscan claims study of 62,813 IMID women w/ 70,529 pregnancies & 69,412 births, 4,485 (7.1%) were exposed to at least one TNFi during pregnancy & 3,559 postpartum. TNFi use NOT assoc w/ SIE risk during Preg (HR 1.39; 0.95-2.05) or postpartum (HR 1.22; https://t.co/NsxOLpT0ds
Dr. John Cush RheumNow ( View Tweet)
Topline results of ALLEGORY study (Genentech) - 300 pt. phase 3 DBRPCT obinuntuzumab vs PBO in active SLE w/ SRI-4 primary outcome at wk 52. The anti-CD20, B-cell depleter, Rx met all efficacy endpoints primary and all key secondary endpoints. Gazyva was FDA approved last wk https://t.co/Wd6EFEjvGP
Dr. John Cush RheumNow ( View Tweet)
FDA is going to "fast-track" biosimilars to curtail the costs of expensive biologics https://t.co/h5NBsUaM97

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Dr. John Cush RheumNow ( View Tweet)

🍼 “Stop breastfeeding if on methotrexate” — that’s what we’ve always heard. But here’s the news 👇 📊 Latest EULAR lactation: Methotrexate = LoE 4 / C ➡️ May be considered in breastfeeding if no safer alternative exists. 💡Not first-line, not forbidden — just evidence-limited. https://t.co/IJEpZYMaFV

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Dr Abhilasha Manwatkar (AIIMS Nagpur) Abhilasha21822 ( View Tweet)
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