Apremilast’s Rapid Onset in Psoriatic Arthritis

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Monotherapy with apremilast (Otezla) among patients with psoriatic arthritis who were biologic-naive was significantly more effective than placebo as early as week 2 in a phase IIIb study. 

Problems with Biologic Drug Storage

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Is your patient’s refrigerator the problem with the inefficacy of biologic therapies? Studies show most patients don't store their biologics correctly, which may be a source of limited drug efficacy.

Weight Loss Linked to RA Improvement

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By retrospectively reviewing electronic health record (EHR) data, Kreps et al found that rheumatoid arthritis (RA) patients who lost >5 kg of weight were three times more likely to demonstrate improvement in disease activity.

Prevention of HBV Infection: How Are We Doing?

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In 2016 the WHO set out to eliminate HBV infection as a public health threat by 2030. So far, we are far from this goal as vaccine implementation has been suboptimal in a number of important patient populations, including patients with rheumatologic diseases, as well as other immunocompromising diseases like HIV.

IL-1 and IL-6 Inhibition Preferred in Systemic JIA

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Since 2000, the German Biologics register (BiKeR) has prospectively enrolled children with juvenile idiopathic arthritis to assess outcomes with biologic therapies.  A new report evaluates the efficacy and safety of etanercept (ETA), tocilizumab (TOC) and the interleukin-1 inhibitors (anakin

Laparoscopic Gastric Sleeve Compared to Bypass Bariatric Surgery

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JAMA reports the results of a 5 year Finnish study comparing the results of laparoscopic sleeve gastrectomy vs Roux-en-Y gastric bypass and shows that gastric bypass yielded greater weight loss at 5 years, the difference was not statistically significant, in patients with morbid obesity. 

Stroke Risk Confirmed in SLE

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The most common cerebrovascular events (CVEs) seen among a large cohort of patients with systemic lupus erythematosus (SLE) were stroke and transient ischemia, and the majority of these events were attributable to the disease itself, a multinational study determined.

The RheumNow Week in Review - 12 January 2018

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Dr. Jack Cush reviews a dozen highlights from the past week on RheumNow.com.

B Cell Changes Predict Autoimmunity with Checkpoint Inhibitors

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The Journal of Clinical Investigation reports results of a study showing that increases in CD21lo B cells and plasmablasts following that combination checkpoint blockade preceded the onset of immune-related adverse events.

While some have postulated that IRAEs are thought to be T cell mediated, B cells have also been implicated. Investigators studied 39 melanoma patients undergoing treatment with either anti-CTLA4 or anti-PD1, or combination CCB therapy. They analyzed changes in circulating B cells before and after the first cycle of therapy of immune checkpoint blockade (23 received combination therapy, 8 received anti-CTLA4, and 8 received anti-PD1).

Ibuprofen’s Anti-androgenic Effect May Result in Hypogonadism in Males

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PNAS reports use of ibuprofen by males may result in antiandrogen effects that may contribute to adult male reproductive problems.

2018 Predictions for Rheumatology

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MedPage Today Editors surveyed a few rheumatologists for their major news predictions in 2018. Read on for predictions regarding drug pricing, biosimilars, autoimmunity and checkpoint inhibitors, and thrombotic events and JAK inhibition.

Calcium and Vitamin D Supplements Do Not Reduce Hip Fractures

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Recent JAMA study shows metanalysis of 33 clinical trials and 51,145 participants, showed that calcium, vitamin D, or both affords no decreased risk of hip fractures compared with placebo or no treatment and therefore questions their routine widespread use in the elderly.. 

The RheumNow Week in Review - 5 January 2018

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Dr Jack Cush reviews the news and journal articles from the past week on RheumNow.com.  

Sorting Out the Complexities of Autoimmunity with Immune Checkpoint Inhibitor Therapy

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An editorial and systematic review of complications seen when checkpoint inhibitor (CPI) therapies are given to patients with immune mediated inflammatory disorders (IMIDs) and cancer shows that nearly 75% manifest autoimmune and inflammatory immune-related adverse events (irAEs).

Community Screening for Fracture Risk in Older Women is Effective and Feasible

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A UK Study published in Lancet shows that community-based screening programme for fracture risk in older women is feasible, and may reduce hip fractures. 

MEASURE 3 Study - Anti-IL17 Benefits Persist in Spine Disease

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Patients with ankylosing spondylitis (AS) have shown rapid and sustained responses to secukinumab (Cosentyx) in a third phase III trial that includes a higher dose of this anti-interleukin-17A monoclonal antibody, researchers reported.

New BSR 2017 Gout Guidelines (Best of 2017)

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The British Society for Rheumatology/British Health Professionals in Rheumatology first published a guideline for the management of gout in 2007. They have just updated and published their new guideline, largely because of new therapies, an increasing incidence of gout, low penetrance of urate lowering therapies, and the inability to achieve a target serum uric acid level.

Therapeutic Update: 5 Questions on FDA Hearing for Tofacitinib in PsA (Best of 2017)

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In this Therapeutic Update, Drs. Mease, Gibofsky and Cush answer five questions regarding the August 3rd FDA Arthritis Advisory Committee meeting that reviewed the potential approval of tofacitinib (Xeljanz) in patients with active psoriatic arthritis. The panel was nearly unanimous (10-1) in favor of the efficacy and safety profile of of tofacitinib, and similarly voted 10-1 to approve this drug for use in PsA. Final decisions on these recommendations from the AAC panel will be made at a later date by the FDA. 

Death Rates from Lupus Remain Disproportionately High (Best of 2017)

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The Annals of Internal Medicine reports that despite improving trends in mortality, death rates from systematic lupus erythematosus (lupus) remain high compared to those in the general population, and disparities persist between subpopulations and geographic regions.