The RheumNow Week in Review - 6 October 2017

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The RheumNow Week in Review discusses the past week's news, journal articles and highlights from RheumNow.com. In this week's report, Dr. Jack Cush discusses when to hold the biologic, lymphoma risk with tofacitinib, early clues to the diagnosis of RA, biologic use in pregnancy, what's killing psoriasis patients and the 2016 top 5, best selling drugs in rheumatology.

Patterns of Biologic Use During Autoimmune Pregnancy

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While it is highly desirable to avoid medications during conception and pregnancy, statistics show that >90% of women take at least one drug during pregnancy and nearly half will take 3 or more medications during pregnancy.

IBD Associated with Increased risk of Autoimmune and Inflammatory Diseases

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A registry based study has shown higher rates of immune mediated diseases (IMD) in patients with inflammatory bowel disease (IBD).

Alcohol Related Deaths Increased in Psoriasis

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JAMA Dermatology has published a report showing psoriasis carries a 60% greater risk alcohol-related death compared with those without psoriasis. (Citation source: https://buff.ly/2galDwr)

29 September 2017 The RheumNow Week in Review

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The RheumNow Week in Review discusses the past week's news, journal articles and highlights from RheumNow.com. This week's report discusses regulatory actions by NICE and FDA, higher death rates in RA and psoriasis, increased risk of RA with Asthma, rising numbers for OA, RA, and STDs.

Psoriasis Increases Risk of Major Adverse Cardiovascular Events

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A report in the Journal of the American Academy of Dermatology shows that psoriasis duration and inflammation may result in cardiovascular inflammation and an increased risk of major adverse CV events.

Safety of Long-Term PPI Use

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The current issue of JAMA reviews the safety of long-term use of proton pump inhibitors (PPI). The following is a collection of the evidence about these purported risks.

Fractures

No Cancer Risk With Biologic Use

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A polulation-based study from Sweden has shown that treatment with tocilizumab, abatacept, rituximab, or tumor necrosis factor (TNFi) inhibitors does not affect the risk of malignant neoplasms among patients with rheumatoid arthritis. Specifically, use of a first or second TNFi or biologic DMARDs (bDMARD) does confer a different cancer risk when compared to conventional DMARDS in biologic–naive RA patients.

FDA Panel Backs New Zoster Subunit Vaccine

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GlaxoSmithKline has announced that the Vaccines and Related Biological Products Advisory Committee (VRBPAC) of the US Food and Drug Administration (FDA) voted unanimously in support of the efficacy, safety and approval of its herpes zoster subunit (HZ/su) vaccine (called Shingrix) for the prevention of herpes zoster (shingles) in adults ages 50 and over.

Sirukumab Turned Down by FDA

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On Friday the U.S. Food and Drug Administration announced that will not approve Johnson & Johnson’s rheumatoid arthritis drug sirukumab, stating further data and study would be needed to establish its safety. 

22 September 2017 The RheumNow Week in Review

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The RheumNow Week in Review discusses the past week's news, journal articles and highlights from RheumNow.com. This week's report discusses survey results on membranous nephritis and patient perceptions of steroids, nonadherence, celebrity arthritis and IgG4 treatment.

Rituximab Efficacy in IgG4 Related Disease

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PLOS reports  greater than 90% efficacy when rituximab (RTX) is used to treat patients with IgG4-related disease (IgG4-RD). 

Romosuzumab Followed by Alendronate is Best in Fracture Prevention

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The NEJM reports that in high risk post-menopausal women, romosozumab for 12 months followed by alendronate resulted in a significantly lower fracture than alendronate alone. 

Half of Takayasu's Arteritis Relapse

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A French retrospective study of 318 Takayasu's arteritis (TA) patients shows that 50% of patients will relapse and experience a vascular complication ≤10 years from diagnosis. 

New Zoster Vaccine Recommended by FDA Panel

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Reuters reports that the FDA advisory panel has voted 11-0 in favor of the safety and efficacy and ultimate approval of GlaxoSmithKline’s Shingrix shingles vaccine for use in adults aged 50 and over.

Jak Inhibition May Ameliorate Pruritus

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Interleukin-4 has been shown to activate sensory neurons involved in pruritus, and that inhibition of IL-4 with Jak inhibition significantly alleviates itching.

Past Infection, Lung Disease Raise Risk for Myopathy

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Infections and noninfectious pulmonary disease were associated with an increased risk for idiopathic inflammatory myopathies (IIM), a Swedish study found.

Biologic Use in Adult-Onset Still's Disease

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 Adult-onset Still's disease (AOSD) is the adult continum of systemic-onset juvenile idiopathic arthritis (SoJIA). Treatment of this febrile polyarticular systemic disorder can be complex, but has been relieved by several specific biologic therapies.

New Recommendations on Biosimilar Use

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The introduction of a growing number of biosimilars into the market poses a substantial change in cost of care for patients with inflammatory rheumatologic disorders.  

Rheumatoid Arthritis Augments Cardiovascular Risk

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A large multi-center study of cardiovascular (CV) risk factors in rheumatoid arthritis (RA) has shown, after nearly 6 years follow-up, more CV events in males than females (21% vs. 11%, respectively) and that RA itself accounts for 30% of the attributable CV risk.