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Anti-Drug Antibodies with Biologics (7.14.2023)
Dr. Jack Cush Reviews the news and journal reports on CVA, TKA, PJP, ADA, and more!
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Filgotinib Effects on Semen and Sex Hormones
The oral Janus kinase 1 inhibitor filgotinib is available worldwide, but not in the USA, where the FDA held up its approval for use in RA due to unfinished studies of filgotinib's effects on sperm cells. The results of 2 phase two studies (MANTA and MANTA-RAy) confirm that filgotinib has no measurable impact on semen parameters or sex hormones in men with active IBD or inflammatory rheumatic diseases.
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Remembering Dr. Naomi F. Rothfield - As one of UConn School of Medicine’s first women faculty, legendary internationally-renowned rheumatologist Dr. had a nearly 50 year career at UConn Health retiring in 2016. She passed away on Sunday, July 2. https://t.co/D3vJzXQCnz https://t.co/YajGbGWpKf
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Scary Outcomes with Systemic Sclerosis Sine Scleroderma
The hallmark of SSc is scleroderma, but less than 10% of SSc patients have ssSSc. A EUSTAR database review compared the manifestations and outcomes of ssSSC to lcSSc and dcSSc.
https://t.co/DMZTLKwmHv https://t.co/2bXqMt7H1z
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Review of DMARDs on the immunogenicity of vaccines by Winthrop:
- reduced by B cell depletion, MMF, CTX, AZA, ABA
- no effect: IL-6 inhibitors & HCQ
- MTX & steroids: gen suppressed by depends on dose & vaccine type https://t.co/mh8xDnwpim https://t.co/44HJjPq0BS
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Multicenter open label trial of 30 refract. Behcets (BD) pts treated w/ tocilizumab (TCZ) x 6 mos; TCZ was effective in 83% (18 complete & 7 partial resp). Complete responses seen w/ uveitis 67%, CNS 60%, mucosal 42%, articular 21%; plus steroid sparing https://t.co/PfrAoQxC2F https://t.co/ocAFv0Y2kr
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Metanalysis 62 RCTs & 16 LTE RCTs looks at neoplasia risk in JAKi, TNFi, MTX, PBO. Total CA rate=1.15/100PYs in RCTs. No diff in all CA between JAKi vs PBO or JAKi vs MTX (IRR 0.77); but JAKi had more CA than TNFi (1.50; 1.16, 1.94) https://t.co/uRLJdO8A2j https://t.co/brNX6ZSfqq
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Pre-Clinical RA - Clinical Trial Outcomes
https://t.co/EIG1eam31h https://t.co/6rYcGmgJG5
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JAMA: Prophylaxis for Pneumocystis Pneumonia - indications and Rx
- Immuncompromised and Immunodeficient
- Pts on Hi Dose Steroids
- ANCA–associated vasculitis
https://t.co/GjtkgeZE8b https://t.co/1I1jjrI5s8
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988 -- the new 3 digit Suicide and Crisis Lifeline (available since July 2022). You don't need to be in crisis or suicidal to call 988 and speak with a counselor. It is a free service available at all hours, day or night, for anyone who needs support. https://t.co/RfTfmHbvxJ https://t.co/JPihu6XOyu
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A double-blind, sham-controlled RCT of auricular vagus nerve stimulation (VNS) showed NO meaningful improvement in 101 RA completers. @week 12, ACR20 was 25% for VNS vs 27% for sham (NS). Also NS was change in DAS28-CRP (–0.95 vs –0.66)(p 0.06) https://t.co/ZvsfB0Pjqh https://t.co/oFmbQXVbct
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Full read review of "Treatments for Lupus Nephritis" from Isenberg et al - discussing:
- Pathogenesis, outcomes
- Conventional Rx
- B cell targeting: BEL, RTX, Obintuzumab, Atacicept & more
- Sequential Rx: Synviose, BEAT, BLISS-Believe
- JAKi & more https://t.co/TiHyK4ffms https://t.co/dmFXbMxKsE
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Full read review of clinical trials in CTD-ILD, specifically looking at:
- Frequency of ILD in RA, SLE, SSc, Sjogr, PM/DM & Rx outcomes
- Results w/ RTX, MMF, CYC, IL-6i, nintedinib, pirfenidone, Stem cell transplant
https://t.co/HyCsrzejLU https://t.co/ejJKOtXupC
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Bringing pivotal clinical trials to you: announcing RheumNow’s Poster Hall, featuring previously presented, sponsor-generated clinical trial posters designed to educate and inform.
https://t.co/4c4oQwY9G6 https://t.co/iRa7wG5yOv
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Watch: Zoster Management and Vaccination
Drs. Janet Pope and Kevin Winthrop at EULAR 2023 in Milan, Italy.
https://t.co/JcZNaeYuqh https://t.co/WF1PdlIbTO
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Pegloticase Plus Methotrexate in Refractory Gout - MIRROR Study 12 mos. Results
The 12-month safety and efficacy of pegloticase + methotrexate (MTX) in the MIRROR trial shows continued efficacy and tophi resolution after 12 months of therapy.
https://t.co/8Jhy7gebMD https://t.co/ihZddj7b36
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Biologics Keep Early RA in Check for at Least One Year
Treatment with at least some biologic drugs significantly reduced 1-year progression of early rheumatoid arthritis (RA) relative to classical small-molecule agents, researchers reported.
https://t.co/FBFX53lZfp https://t.co/l1RapKWlFk
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Metanalysis of 8 RCT, 188751 pts assessed mortality risk & FM. Overall, all-cause mortality increased in FM (HR 1.27, 1.04 to 1.51), but not in subgroup Dx by 1990 criteria. Increased SMR for accidents, infxn, suicide & decreased for cancer (0.82) https://t.co/Ujv8KP8FJK https://t.co/lNGUM0wB3O
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ICYMI: RA Disease Activity and Alcohol Use
https://t.co/tXuAJ4GRl4 https://t.co/3ieVw8BcIs
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35 SLE pts Rx w/ RTX x 3 ys-anti-RTX antibodies found @3 yrs in 64%, higher if previously RTX treated (vs naive). ADA+ had signif lower median RTX levels at 6 mos (P = 0.0018) and increased relapse rates. In vitro showed neutralizing capacity these Abs https://t.co/oV7nHxiS4s https://t.co/p55MvcLDFn
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