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Co-management of Psoriatic Disease
It is a common clinical scenario to see someone with both severe psoriatic arthritis and skin psoriasis. In an ideal world this would involve a combined clinic with our local friendly dermatologist. For many of us, however, this is not practical for many reasons. The excellent Saturday morning session on choosing systemic therapies in psoriatic disease at RheumNow Live 2024 from dermatologist extraordinaire Dr. April Armstrong was therefore hugely insightful.
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Oral IL-23 Inhibitor Effective in Psoriasis
The NEJM has published the results of the FRONTIER 1 trial demonstrating the efficacy of JNJ-77242113, an oral interleukin-23 (IL-23) receptor antagonist peptide, in patients with psoriasis (PSO).
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VITAL Info on Autoimmune Disease (2.9.2024)
Dr. Jack Cush reviews the journal reports from the past week on RheumNow.com. Highlights are summarized by three songs: "Stairway to Heaven", "You're No Good", and "How Long (has this been going on)".
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Poly-Refractory Rheumatoid Arthritis
Refractory of difficult to treat (D2T-RA) rheumatoid arthritis (RA) comprises a minority of patients that can be categorized by clinical and imaging parameters to formulate a better therapeutic approach.
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Systematic review of 44 studies looking at treatment of Stills Dz (AOSD), showing that tocilizumab, anakinra & canakinumab therapy are effective in AOSD. Complete remission:
- TCZ 80% (57% Steroid D/C)
- ANAK 73% (47% GC DC)
- CAN 77% (34% GC DC)
https://t.co/bFil81GGlJ https://t.co/F5NJ6m1gVF
Dr. John Cush RheumNow ( View Tweet)
Full read, review of COLCHICINE, a, w/ narrow therapeutic index, & assoc. w/ overdose & fatalities. Discuss Interactions, unauthorized access, overdoses, inappropriate dosing. No dose adjustments w/ Liver dz, but modest changes w/ severe CKD, dialysis https://t.co/53aOA4uqdY https://t.co/fuEwWsXMZG
Dr. John Cush RheumNow ( View Tweet)
JAMA Clinical Challenge - Recurrent Fever, Rash, and Shortness of Breath in a 69-Year-Old. Admited with fever, fatigue, rash, right periorbital swelling, SOB, Palpable purpural, Serositis previously - whats your diagnosis? https://t.co/j6aSGffpPv https://t.co/du6pEo74xp
Dr. John Cush RheumNow ( View Tweet)
Determinants of Gout Flares
Approximately 12 million US adults in the US have gout. Two recent literature reports highlight contributors to gout flares.
https://t.co/F2eiWXOTkF https://t.co/YFftaITmnQ
Dr. John Cush RheumNow ( View Tweet)
J&J announced the results of Phase 2 DAHLIAS study of nipocalimab in Sjögren’s; w/ a signif reduction in clinESSDAI at week 24 vs placebo. Nipocalimab is an investigational anti-FcRn treatment being studied in RA, & myasthenia gravis https://t.co/mroLPx0BnH https://t.co/7IqlY1K6di
Dr. John Cush RheumNow ( View Tweet)
Acute CPPD at significantly higher risk of fractures. 1148 acute CPPD pts matched to 3730 comparators(mean 73 yrs old); Steroids and OP more in CPPD pts. Fx risk was twice as high in the acute CPPD pts (HR 1.8;1.3, 2.3). Fx risk highest forwrist (HR, 3.6) https://t.co/RkuzGKzoPv https://t.co/IHZBIfEmms
Dr. John Cush RheumNow ( View Tweet)
Racial and Ethnic Determinants of Psoriatic Arthritis
A study from a large metropolitan registry of psoriatic arthritis (PsA) patients showed several racial and/or ethnic groups are underrepresented and demonstrate differences in disease activity.
https://t.co/uJD5DWZEwM https://t.co/5dg0ubQzvL
Dr. John Cush RheumNow ( View Tweet)
Danish registries study shows maternal Autoimmune Dzs (all) were assoc w/ incr risk of childhood cancers (OR=1.25, 95% CI 1.06, 1.47), acute lymphoblastic leukemia (OR =1.52), Burkitt lymphoma (OR=2.6) & CNS tumors (OR=1.45); same seen for RA mothers https://t.co/HQO972ch9R https://t.co/dDEJUo8unq
Dr. John Cush RheumNow ( View Tweet)
SeXXist Reason for More Women with Autoimmune Disease
Somewhere between 24 and 50 million Americans have an autoimmune disease, a condition in which the immune system attacks our own tissues. As many as 4 out of 5 of those people are women.
https://t.co/OCHNNhAgF2 https://t.co/7tfttSherh
Dr. John Cush RheumNow ( View Tweet)
Full read overview of SJOGRENS SYNDROME, which can be Primary SS or Secondary (15% in SLE, 20% RA, & 30% systemic sclerosis). SS Organ involvement:
- CNS 2-17%
- Renal <=10%
- ILD 10-20%
-MSK 45-56%
https://t.co/0sfQdZAeGg https://t.co/3lSoGan1h9
Dr. John Cush RheumNow ( View Tweet)
Full read, review of COLCHICINE, a, w/ narrow therapeutic index, & assoc. w/ overdose & fatalities. Discuss Interactions, unauthorized access, overdoses, inappropriate dosing. No dose adjustments w/ Liver dz, but modest changes w/ severe CKD, dialysis https://t.co/fx7G3MYArN https://t.co/azSHyBfPoi
Dr. John Cush RheumNow ( View Tweet)
In Jan 2024 Drug prices rose for more than 900 meds, w/ average price increase ~4.7% (slightly lower vs prior 5 yrs). Main Rheum Drugs included Autoimmune disease medications rose 5% for Enbrel, 6% for Xeljanz and ~4.8% for Stelara https://t.co/cnMxhvBKKd https://t.co/DqF4IaXRWW
Dr. John Cush RheumNow ( View Tweet)
Resolvin (RvT)4 - orchestrates macrophage responses to limit atherosclerosis during inflammatory arthritis. (RvT)4 negatively correlates w/ vascular lipid load in inflammatory arthritis; RvT4 can be used to reduce blood vessel inflammation. https://t.co/H38cFvDcvE https://t.co/ptZpjWf1F6
Dr. John Cush RheumNow ( View Tweet)
VITAL Study - Autoimmune Prevention Requires Continued Supplements
https://t.co/jXTq11R8fE https://t.co/QaCGBdAMAj
Dr. John Cush RheumNow ( View Tweet)
JAMA Clinical Challenge - Recurrent Fever, Rash, and Shortness of Breath in a 69-Year-Old. Admited with fever, fatigue, rash, right periorbital swelling, SOB, Palpable purpural, Serositis previously - whats your diagnosis? https://t.co/AP0Df8vIWx https://t.co/57UtHqXjAf
Dr. John Cush RheumNow ( View Tweet)
Many #RA pts remain on Steroids despite b/tsDMARD use! Study 228 #RA pts, 68% Rx low-dose GCs (32% no GCs). After 3 yrsof b/tsDMARDs, 32% still on GCs, 23% D/C GCs, & 20% go on & off, 25% never took GCs. GCs use assoc w/ HTN (20 v 11%) & MI (2.3% vs 0) https://t.co/lWVfvJrAyp https://t.co/uTIWqDAjRG
Dr. John Cush RheumNow ( View Tweet)
