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Scleroderma – Thick and Thin (6.30.2023)

d Jack Cush, MD

Dr. Jack Cush reviews the news, journal articles and regulatory decisions from the past week from RheumNow.com. This week focuses on parodoxical psoriasis, scleroderma outcomes and subsets, and alopecia areata therapy.

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frank,austin

Dr. K. Frank Austen (1928-2023)

d Jack Cush, MD

Rheumatology mourns the loss of a historic leader in the field, Dr. K. Frank Austen, who died at his home in Maine on June 23, 2023, at the age of 95.

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ild.jpg

Scary Outcomes with Systemic Sclerosis Sine Scleroderma

d Jack Cush, MD

The hallmark of systemic sclerosis is scleroderma, but less than 10% of SSc patients have sine scleroderma (ssSSc). A EUSTAR database review compared the manifestations and outcomes of ssSSC to limited cutaneous SSc and diffuse cutaneous SSc.

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back, LBP, spine, AS

Opioids Ineffective in Acute Lower Back and Neck Pain

d EurekAlert!

A randomised controlled trial including 347 participants with lower back or neck pain found there was no benefit of taking opioid pain relievers compared to placebo. 

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RheumNow’s new Poster Hall features sponsor-generated clinical trial posters designed to educate and inform. Posters addressing vasculitis, AxSpa and nrAxSpa, and PMR now available. https://t.co/38foNET3j4 https://t.co/8CjXwzyGab

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In pts seeking care for MSK pain cannot assume that improving pain/function will result in improved depression, but substantial improvements are required to effect anxiety. Study of 11 236 Ortho pts in JAMA https://t.co/5vvoPs31GU https://t.co/gEwZNW35xB

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Study of FDA review times for New Indication Approvals of Drugs and Biologics (2017 - 2019) finds FDA approved 107 drugs for 146 new indications [99 small molecules (68%) & 47 biologics (32%)]. Median regulatory review time was 6 mos (IQR, 6-10) https://t.co/3P6T4R4FCF https://t.co/avl65W3kvr

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UK MHRA reminder that NSAIDs are: - contraindicated in the 3rd trimester of pregnancy (>28wks) - >20 wks - assoc w/ increased risk of oligohydramnios & fetal renal dysfunction MDs should avoid NSAIDs in pregnancy after wk 20 https://t.co/u3fTnuoF17 https://t.co/b2b5XThe1i

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Predictors of Cardiovascular Events in ANCA-Associated Vasculitis A large, retrospective, multinational study of patients with ANCA-AAV shows they may be at risk for CVEs. https://t.co/k9XPolEXKc https://t.co/0nxai3Eqe2

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Check SSc-ILD Patients on Nintedinib for Malnutrition During nintedanib treatment for interstitial lung disease associated with SSc-ILD, clinicians prescribing the drug should be watchful for an unusual, indirect side effect, trial data suggested. https://t.co/5Q3xCwLvPa https://t.co/mGD3DCYZR0

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RheumNow LIVE VOTE Survey: What do you need to better manage pre-clinical (at-risk) Rheumatoid arthritis? Please vote here >>https://t.co/lt38vJMEIA

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Comprehensive, full-read overview of SLE treatment with Tyk2 vs JAK inhibitors https://t.co/KjLEYGfxAY https://t.co/btvoBQjboi

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2022 of fibromyalgia Year in review discusses possible causes (inflammation, gut dysbiosis, neuroinflammation), new Rx (kinin antagonists, neurostimulation, mind-body Rx; but more needed on ketamine, vitamin D, and hormonal therapy https://t.co/IovNztH1kP https://t.co/fEVjO6ZW67

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Mirikizumab, an anti-IL-23 MAb, shown to be effective in phase 2 trial in ulcerative colitis. 1281 Pts: mirikizumab > placebo group w/ remission at wk 12 (24% vs 13%, P<0.001) & after re-randomization & maintenance @wk 40l (50% vs 25%, P<0.001) https://t.co/9ZPsRCDhJc https://t.co/jrJvzAhyWY

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Metanalysis of JAK inhib in Alopecia Areata: 7 RCTs &1710 patients shows JAK inhibitors yielded > 50% hair regrowth (OR 5.28) or > 90% improvement (OR 8.15) vs PBO. Oral JAK inhibitors were better than topical (latter = PBO). https://t.co/J9kGh89aEi https://t.co/QbMY1m4NQe

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Congratulations to Dr Stephan Maier who has been appointed as the Executive Director of EULAR. https://t.co/K7LCWT8Q6l https://t.co/xXV9ROFXqq

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A 35 yr old daughter of one of your Seropos. #RA patients shows up with finger arthralgias, +ACPA 200 IU and questions about if will she get RA. Here's a Survey for Rheumatologists and what you would do:https://t.co/lt38vJM6T2

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FDA Delays Bimekizumab Decision, Again UCB, the maker of the IL-17 A/F inhibitor bimekizumab (BMK), has announced that the FDA decision on BMK use in adults with moderate to severe plaque psoriasis has been delayed until the 3rd quarter of 2023. https://t.co/u3wZp2xain https://t.co/pEldK1grb9

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Gut Microbiome Alterations in Lupus Patients Recurrent bouts of systemic lupus erythematosus, marked by the body’s immune system attack of its own tissues, closely tracked with measurable upticks in growth in the gut of a certain species of bacteria. https://t.co/eGk4EQsVES https://t.co/PiFKxJWD13

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Taiwan claims data analysis of 1,830 scleroderma (SSc) pts & 27,981 controls showed increased incidence of SSc hospitalized w/ heart failure of 3.5%, 5.3%, & 9.7% (at 3, 5, 10 yrs). SSc patients had an increased risk of HF (adjusted HR 3.26) https://t.co/4WcHfiTJVF https://t.co/rW3J5aQdlS

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