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PMR & Popeye's Spinach (10.6.2023)
Dr. Jack Cush reviews the big PMR reports from this week along with other journal reports from RheumNow.com.
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Sustained Efficacy of Bimekizumab in Psoriatic Arthritis
BE OPTIMAL trial tested the benefits of a dual IL-17 A/F inhibitor, bimekizumab (BKZ), in patients with active psoriatic arthritis and showed superior efficacy over placebo, that was sustained beyond the primary endpoint, from week 16 to 52.
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SAPHYR Trial: Sarilumab Wins in Relapsing Polymyalgia Rheumatica
NEJM reported today that polymyalgia rheumatica (PMR) patients who fail to respond to standard doses of prednisone therapy, were significantly better when given the IL-6 inhibitor sarilumab (than placebo).
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1 in 3 of our pts are on steroids; nice ARD full read review of important papers on steroids 2022-23 written by Prof J Bijlsma, covering:
Mechanisms of action
CV AE
Bone Effects
Infections, COVID-19
Clin trials
Benefit vs Harm
Tapering
GC Guidelines
https://t.co/LnqLk8eKgn https://t.co/5xfvic5YIX
Dr. John Cush RheumNow ( View Tweet)
Pneumothorax in an RA patient is likely from rheumatoid nodules eroding into air spaces in advanced seropositive RA patients. https://t.co/u9rQlKKNKd https://t.co/QKquUngAld https://t.co/e9B3Jx92BW
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Dr. John Cush RheumNow ( View Tweet)
FDA Approves the first Actemra biosimilar- called tocilizumab-bavi (Tofidence) or BIIB800 (during development). This IV FORMULATION is approved for use in active RA, polyarticular JIA and systemic JIA. https://t.co/SSKz6RcR5r https://t.co/fLSNHazFS6 https://t.co/pvfrjkOeyW… https://t.co/ASihH17Phu
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Dr. John Cush RheumNow ( View Tweet)
This Tuesday Night Rheumatology focuses on steroid use in #PMR. Join panelists Dr. Max Yates and Dr. Richard Conway. Moderated by Dr. David Liew.
https://t.co/swGbCcoEc9
@drmaxyates1 @richardpaconway @drdavidliew https://t.co/kZQ2wFbjt9
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Dr. John Cush RheumNow ( View Tweet)
JAKi Safety and Efficacy in bDMARD-IR Patients with RA: Results Through 5 Years
Now in the RheumNow poster hall: Long-term extension outcomes from SELECT-BEYOND through 5 years in bDMARD-IR patients with RA. Sponsored by AbbVie US Medical Affairs.
https://t.co/xltJjADdHz https://t.co/sytZLayxDZ
Dr. John Cush RheumNow ( View Tweet)
Registration is now open! Early bird pricing is available until 11/30/23. See you there!
https://t.co/zEf9KTXYqX https://t.co/eQTQzgJpVF
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Dr. John Cush RheumNow ( View Tweet)
The frequency of demyelinating Dz (DD) studied in 2260 #SpA pts, finging 18 DD events (IR 31 per 100K PYs) DD at 20 yrs was higher in axSpA than PsA (1.30 vs 0.13%, p= 0.01). DD risk w/ smoking (HR 2.9), axSpA (8.8) & IBD (5.7) -- NOT TNFi! https://t.co/IVoCxd6H0D https://t.co/FQtHuUWYUx
Dr. John Cush RheumNow ( View Tweet)
QD Clinic: Steroid Response for a #PMR Diagnosis
Featuring Dr. Jack Cush (Dallas, TX): Exquisite response to prednisone but other red flags!
https://t.co/DCtcZqG5NE https://t.co/Rs9rfds5w0
Dr. John Cush RheumNow ( View Tweet)
TNR: #PMR Diagnosis and Monitoring
Tuesday Night Rheumatology webinar on the diagnosis and monitoring of PMR.
Featuring Panelists, Drs. Claire Owen, Anisha Dua, Stephen Paget and moderated by Jack Cush.
https://t.co/7ewWLAUf4N
@anisha_dua @Rheummd @drceowen https://t.co/GCtYUHBPba
Dr. John Cush RheumNow ( View Tweet)
Multinational study of 47 studies of 11,085 #RA pts showed the prevalence of ANXIETY to range from 2.4% to 77%. Variance due to inconsistent, non-standardized self-report measures and clinical thresholds. Common; but how common? https://t.co/elcxjfSI7N https://t.co/iRNeQy4pEk
Dr. John Cush RheumNow ( View Tweet)
Network metanalysis review of 65 trials (n=5957) looked at Tx effect in Hand #OA. Whereas oral NSAIDs & glucocorticoids’ NMA were effective compared with placebo; intraarticular steroid & hyaluronate, and HCQ and topical NSAIDs were NOT. https://t.co/8CCkfWd80E https://t.co/jpqlq8Xwgp
Dr. John Cush RheumNow ( View Tweet)
QD Clinic: Difficult #PMR Considerations
Featuring Dr. Sarah Mackie (Leeds, UK) Difficulty weaning prednisone leads to consideration of other confounders and conditions QD Clinics are video vignettes with lessons from the clinic.
https://t.co/H6cZaMperr
@Sarah_L_Mackie https://t.co/WtCX6xfWe3
Dr. John Cush RheumNow ( View Tweet)
Gout Flare Prophylaxis - Colchicine or NSAIDs?
A new study suggests that colchicine, more so than non-steroidal anti-inflammatory drug (NSAID) prophylaxis, may increase the odds of adverse events, when initiating allopurinol for gout.
https://t.co/MfVvBy0DsD https://t.co/jP5oiAHaBa
Dr. John Cush RheumNow ( View Tweet)
Subclinical vasculitis in PMR
For a long time #PMR has been an underinvestigated disease. This is changing with new possibilities to make a more accurate diagnosis with imaging as well as new therapies for treatment resistant disease.
https://t.co/t0BRosgMWt https://t.co/bWZzRidqlm
Dr. John Cush RheumNow ( View Tweet)
Subclinical GCA prevalence in newly Dx #PMR ranges from 23 to 29%; best by Vessel imaging or temporal artery Bx. #PMR & GCA share common genetic/pathogenic inflammatory mechanisms & an IL-6 signature; BUT there are differences; further research needed! https://t.co/MhuIs068NG https://t.co/1BeeP3RY0H
Dr. John Cush RheumNow ( View Tweet)
GCA pts w/ prior #PMR Dx had 2 fold more Lg vessel dz & signif more vasculitic stenoses. Study of 311 GCA pts, 16% had prior PMR ~ 31 mos before. prior PMR had more LVV (51 vs 25%) & stenosis(18 vs 3%). Prior PMR incr LVV (OR 7.65) https://t.co/1kqtkPnPaz https://t.co/oVs084NfmV
Dr. John Cush RheumNow ( View Tweet)
JAKi Safety & Efficacy in bDMARD-IR Patients with RA: Results Through 5 Years
This poster shows 5-year outcomes from the SELECT-BEYOND study in bDMARD-IR patients with RA, including TNFi-IR subgroup outcomes. Sponsored by AbbVie US Medical Affairs https://t.co/BRsCMnOnFT . https://t.co/lxfPs12mHb
Dr. John Cush RheumNow ( View Tweet)