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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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Predictive FDG-PET in Newly Diagnosed GCA
Annals of Internal Medicine reports that the use of 18F-fluorodeoxyglucose (FDG) PET imaging at the time of a giant cell arteritis (GCA) diagnosis may help estimate the risk for aortic aneurysm formation.
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TNR: PMR Diagnosis and Monitoring
Panelists Dr. Claire Owen, Stephen Paget, Anisha Dua and Jack Cush discuss diagnosis and monitoring in PMR during this week's Tuesday Night Rheumatology.
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Gout Flare Prophylaxis - Colchicine or NSAIDs?
Flare prophylaxis is the standard when initiating urate-lowering therapy (ULT) in patients with gout. 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.
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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)
Best quote from last nights Tues Night Rheumatology on #PMR , comes from Dr. Stephen Paget (#HSS) who said, "steroids to a new PMR patient are like spinach to Popeye" https://t.co/r7L1cUTJeT
Dr. John Cush RheumNow ( View Tweet)
X-sectional case-cntrl study w/ UK Biobank looked @ comorbidity w #PMR (n=1036) & GCA (102) pts (98% W; age 63 yrs) - pts rated their health as poor. Comorbid Dx included-more hypothyroidism (OR 1.34), HRT use (1.26), HTN (1.21-1.86) & cataract (1.51-3.84) https://t.co/GxpzN5NWug https://t.co/8J0IRMLK5g
Dr. John Cush RheumNow ( View Tweet)
New download on #PMR available now!
https://t.co/C4fCUQ5j8e https://t.co/3Fm5xG8EM7
Dr. John Cush RheumNow ( View Tweet)
Steroid Tapering in #PMR: What's the Gold Standard?
Dr. Anisha Dua, Chicago, discusses the gold standard tapering of glucocorticoids in polymyalgia rheumatica.
https://t.co/WyojhJQkN2 https://t.co/NarFqwNxEj
Dr. John Cush RheumNow ( View Tweet)
Retrospective EHR study of 7,970 gout pts from Singapore finds ~28% are poorly controlled, with only 46% prescribed allopurinol (13% @doses ≥300). Poor control assoc w/ male gender (adj OR 1.66), Malay ethnicity (aOR 1.27), CHF (aOR, 1.64) https://t.co/M8dJFIbZEV https://t.co/aUnLgUmvXN
Dr. John Cush RheumNow ( View Tweet)
Cardiovascular manifestations of monogenic periodic fever syndromes - includes:
- Pericarditis (most common)
- Cardiac Amyloidosis
- Myocarditis
- CV complications of inflammation and steroid
- Premature atherosclerosis
https://t.co/iLfbPq2nzn https://t.co/T7Vtx5q8Y1
Dr. John Cush RheumNow ( View Tweet)
October is #PMR Month
PMR has come a long way from being an occasional referral and often test question, to now being a hot area of drug development and investigation
https://t.co/voVlxuRGZA https://t.co/NwEvws8cD3
Dr. John Cush RheumNow ( View Tweet)
Excited to join @RheumNow for Tuesday Night Rheumatology and contribute to Make Rheum for #PMR this October🤩 https://t.co/8HqAVPDLXS
Claire Owen ( View Tweet)
RA QD Clinic - RA in Deep Remission
If the patient is in Deep Remission - do you suggest DMARD or biologic weaning?
https://t.co/ELV1MTNkrI https://t.co/9wiqvlZUEY
Dr. John Cush RheumNow ( View Tweet)
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/MAErgj8MGz https://t.co/JDnBUU3FLe
Dr. John Cush RheumNow ( View Tweet)
Metanalysis of 17 studies (n=862849 pts) looked at fall risk w/ #OA. OA Hip (OR 1.50 & knee (OR 1.55) assoc w/ signif incr risk recurrent falls, but not FX. Xray knee OA w/ incr risk of falls (OR 1.28); Xray hip OA decr risk recurrent falls (OR 0.70) https://t.co/7iD8CDA1L7 https://t.co/Cn8lUt07WG
Dr. John Cush RheumNow ( View Tweet)
Long-term Safety of a JAKi in Patients with RA With up to 6.5 Years of Exposure
View this poster on the long-term integrated safety data with a JAKi in patients with RA from 6 clinical studies. Sponsored by AbbVie US Medical Affairs
https://t.co/h9hAaF5Q8d. https://t.co/RfhNioxQrm
Dr. John Cush RheumNow ( View Tweet)