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Cardiovascular and Venous Thromboembolic Risk With JAK Inhibitor Treatment of Skin Disorders
A JAMA systematic review and meta-analysis has showed the use of JAK inhibitors (JAKi) in immune-mediated inflammatory skin diseases was not associated with increased risk of all-cause mortality, major adverse cardiovascular events (MACE), or venous thromboembolism (VTE) (compared to the placebo
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Optimal Management of de Quervain Tenosynovitis
The treatment of de Quervain tenosynovitis (DQT) was examined by systematic review in JAMA, suggesting that local (US-guided) corticosteroid injection plus a thumb spica immobilization was associated with significant pain-relieving and functional benefits.
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Study of TNFi tapering in 108 axSpA patients in remission. Gradual tapering over 2 yrs resulted in flares in 99% (108).
- 27% flared at 2/3 dose
- 20% at 1/2 dose
- 27% at 1/3 dose
- 25% w/ discontinuation
WHY WOULD YOU DO THIS? I DONT! https://t.co/mIJKaK3LK5 https://t.co/SMGJVfepTl
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256 Early RA pt cohort followed 10yrs showed SDAI sustained remission(n 48) had less 10 yr Xray progression (mTSS 4.06), vs sustained LDA (14.6) or MDA/HDA (21.04). Sustained remission pts were younger, lower HAQ & mTSS scores; less need for GC & bDMARDs https://t.co/92L7RTCx82 https://t.co/4uZBydcfRM
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Steroid (GC) use is increasing - Claims data from (US, Taiwan, Denmark; n=54,630,437; 2009-2018), GC use increased from 6.4 to 7.7% USA, 16.6 to 18.7% Taiwan, & 1.7 to 2.9% Denmark. Most Rx by PCP to healthy adults; 20-25% Rx for URI. https://t.co/GkQR0hcys1 https://t.co/5fpBv2Kyo8
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National Health Information Survey 2022 shows that 41.5% of US adults used the Internet to communicate with a doctor’s office; highest in metropolitan areas and decreasing in urban areas https://t.co/utU2YT7mt5 https://t.co/Y4U8ohy71s
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BMJ State of the Art (full read) review of ADVANCES in LUPUS THERAPY (Morand EF, et al).
- Recent SLE RCTs
- Pathogenesis, genetics, epigenetics
- Phenotypes
- Emerging treatments
- Guidelines on Rx
https://t.co/OVJRVA8hoz https://t.co/6Srmo5vNjF
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Analysis of German RABBIT registry did not show more MACE events in pts w/ JAK inhibitors compared to other DMARDs. 154 MACE w/ 14203 Rx episodes (21218 Pt-Yrs). IRs were 0.68 JAKi, 0.62 TNFi, 0.76 bdMARDs and 0.95 csDMARDs; higher in CV risk pts https://t.co/2UZh4zQFEM https://t.co/VRX2Z8YBrC
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FDA has approved another ustekinumab biosimilar (Wezlana) as being interchangeable for use in adults with plaque psoriasis, psoriatic arthritis, Crohn’s disease and ulcerative colitis. https://t.co/zbQKjmKgZh https://t.co/UuTDRgCBIV
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FDA has approved secukinumab (Cosentyx) for use in adults w/ moderate to severe hidradenitis suppurativa. Recommended dose is 300 mg SC @ wk 0, 1, 2, 3 and 4 and then every 4 weeks thereafter. https://t.co/Pi6RbDbroG https://t.co/AWhbVj2QGa
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FDA has approved Abatacept to Treat Juvenile Psoriatic Arthritis (JPsA) in patients aged 2 to 17 years. (JPsA) in patients aged 2 to 17 years. This expands the current indications for ABA use in RA, poly JIA, PsA, and GVHD. https://t.co/eAc8Dsyc3b https://t.co/uHJqhEvuPG
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RheumNow Live registration is NOW OPEN! Early bird pricing through 11/30/2023. Register today!
https://t.co/1SjBiM7Daj https://t.co/w2cFcj85r5
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Choosing steroid sparing therapies in #PMR
We have no evidence-based alternative treatment to glucocorticoids in PMR. Few disease-modifying anti-rheumatic drugs, such as methotrexate and leflunomide, are used in daily clinical practice in PMR.
https://t.co/zvfAwc7t1z https://t.co/pAJFHF6hOn
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Blinkers and the Unseen Information Gap in #PMR
https://t.co/uZ9qCPmRw9 https://t.co/lrXRdVGNk2
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#PMR Mythbusters: PMR Gets 100% Better Within 72 hours
https://t.co/lezwD0J8pL https://t.co/QluGHHnH3X
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Why should rheumatologists discuss exercise in #PMR?
https://t.co/DBnXetbu2K https://t.co/hfjugw661u
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Metanalysis of 26 studies (2252) pts w/ HBsAg-/HBcAb+ RA treated with b/tsDMARDs, shows the pooled HBV reactivation rate was 2.0%
HBV reactivation higher w/ RTX (9%), ABA (6%), JAKi (1%); none w/ IL-6i or TNF-i
More reactivation if pt is HBsAb- (OR=4.56) https://t.co/fSqvkEGbw3 https://t.co/WGCoZ4nQ3d
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FDA Approves Infliximab Biosimilar for Subcutaneous Use
Another infliximab biosimilar has been FDA approved, but this new version of Inflectra can be given subcutaneously for patients with inflammatory bowel disease.
https://t.co/YnbisOzf0L https://t.co/9AyxEBpasb
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Ph 3 360 pt RCT of sarilumab in #GCA was terminated early (COVID). 83 pts Rx'd, only 35%(29) completed. Sustained remission @wk 52:
- SAR 200: 6/13
- SAR 150: 3/7
- PBO: 0/6
All had 26wk GC taper
Sm sample size & COVID ruined RCT interpretation https://t.co/axOvJGpUti #PMR https://t.co/Xpabxn1IjZ
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Subcutaneous Biosimilars?
Dr. Cush reviews RheumNow's top entries the #PMR Campaign, news, journal reports and regulatory actions.
https://t.co/BkKFbv0I64 https://t.co/EABeZxCKYZ
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