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Best of 2019 - Ups and Downs with Abatacept
Two recent studies have examined the effect of starting abatacept upon the risk of serious hospitalized infections or cancer, showing divergent results from claims data analyses.
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Best of 2019 - 2019 EULAR Guidelines on Antiphospholipid Syndrome Management
A EULAR task force has reviewed the medical literature and developed evidence-based recommendations for the management of antiphospholipid syndrome (APS) in adults. They note that a high-risk antiphospholipid antibody (aPL) profile is associated with greater risk for thrombotic and obstetric APS.
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RheumNow Podcast - The Elusive Hand OA Problem (12.13.19)
Dr. Jack Cush recaps the news and journal reports from the past week on RheumNow.com.
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ACR/EULAR Classification Criteria for IgG4 Related Disease
IgG4-related disease (IgG4-RD) is a relatively new disorder since 2003, and may present as a diagnostic challenge as it can cause fibroinflammatory pathology in nearly any organ.
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RheumNow Podcast – ACR 2019 Round Up (11.15.19)
Dr. Jack Cush presents his favorite abstracts and presentations from Rheumatology Round Up and ACR 2019.
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Year in Review - Psoriatic Arthritis 2019
Major new insights into the treatment of psoriatic arthritis dominated the headlines during the past year, with a head-to-head trial comparing IL-17A inhibition with tumor necrosis factor blockade, another study considering whether methotrexate can improve outcomes with anti-TNF therapy in PsA, and an investigation into the effects of biologic therapy on bone.
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Novel Inhibition of MSU Crystal Inflammation
Researchers from Washington State University have shown that inhibition of tumor growth factor-β (TGF-β)-activated kinase 1 (TAK1) can effectively downregulate inflammatory mediators and suppress inflammation caused by gout.
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FDA Issues Boxed Warning and Recommendations for Breast Implant Use
The U.S. Food and Drug Administration has issued a new draft guidance document calling for a boxed warning and delineation of risks with breast implants.
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RheumNow Podcast – Fight or Switching (DMARDs) (10.18.19)
Dr. Jack Cush reviews the news and journal articles from the past week on RheumNow.com.
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Warfarin Superior to Xarelto in Antiphospholipid Syndrome
A 3 year, multicenter, European, study shows that rivaroxaban was inferior to warfarin in preventing thrombosis in patients with antiphospholipid syndrome (APS) according to the Annals of Internal Medicine. Thus despite the inconvenience of warfarin, it remains the best option for patients with APS.
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Stress and the Risk of Incident Inflammatory Arthritis
A prospective analysis of newly diagnosed, inflammatory arthritis (IA) patients suggests that perceived distress (stress) increases the odds of incident IA.
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Serum Interferon Predicts Lupus Flares
Elevated serum levels of interferon-α among patients whose systemic lupus erythematosus (SLE) was in remission helped predict future disease flares, European researchers found.
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FUTURE 5 - Secukinumab and Less Radiographic Progression in Psoriatic Arthritis
The FUTURE 5 trial studied the effect of secukinumab (SEC) on radiographic progression through 52 weeks in patients with active psoriatic arthritis (PsA) and found that SEC was clinically and radiographically superior to placebo (PBO).
Patients received s.c. secukinumab 300 mg load (300 mg), 150 mg load (150 mg), 150 mg no load regimens or placebo at baseline, at weeks 1, 2 and 3 and every 4 weeks starting at week 4. The majority (87%) of patients enrolled at baseline remained in the study for 52 weeks.
Anakinra Use in Hospitalized Gout Patients
While the efficacy and safety of interleukin 1 (IL-1) inhibitors (e.g., anakinra) in the acute management of gout and pseudogout has been repeatedly shown, the cost efficacy of such biologic therapy has rendered it impractical for most. A new retrospective study has shown that IL-1 inhibitors may be effective and appropriate for some medically complex, hospitalized patients with acute gout or calcium pyrophosphate crystal arthritis.
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Low Dose IL-2 Effective in Lupus
A double-blind, placebo-controlled clinical trial of low-dose IL-2 in patients with systemic lupus erythematosus (SLE) has shown that low-dose IL-2 induced was clinically effective while expandng regulatory T cells and NK cells, which may benefit immune homeostasis in SLE patients.
Anakinra Shows Benefits in Cytokine Storm
The interleukin (IL)-1 receptor antagonist anakinra (Kineret) showed promise in critically ill children who develop the often-lethal condition known as secondary hemophagocytic lymphohistiocytosis (sHLH)/macrophage activation syndrome (MAS), a retrospective single-center study found.
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Bimekizumab Add-on Therapy in Rheumatoid Arthritis
Bimekizumab is a dual inhibitor of IL-17A and IL-17F that has been shown to be effective in psoriasis and psoriatic arthritis. A proof-of-concept study shows that giving bimekizumab to rheumatoid arthritis patients not adequately controlled by certolizumab pegol resulted in a rapid decrease in disease activity achieved after 12 weeks of treatment. These findings are novel as anti-IL-17 monoclonal antibody therapy has previously been shown to be ineffective in RA.
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Influenza Vaccination Update
FDA's Vaccines and Related Biological Products Advisory Committee met in Silver Spring, Maryland, on March 6 and 22, 2019, to select the influenza viruses for the composition of the influenza vaccine for the 2019-2020 U.S. influenza season.
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Autoantibodies Don't Disappear With Remission in RA
Immunologic remission in rheumatoid arthritis, defined as the disappearance of anti-citrullinated protein antibodies and rheumatoid factor, was seen infrequently among patients achieving sustained clinical remission and did not correlate with the disappearance of symptoms, a long-term Dutch study found.
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Updated CDC Recommendation for Serologic Diagnosis of Lyme Disease
Serologic testing is the principal means of laboratory diagnosis of Lyme disease. Current recommendations include using a sensitive enzyme immunoassay (EIA) or immunofluorescence assay, followed by a western immunoblot assay for specimens yielding positive or equivocal results.
On July 29, 2019, the Food and Drug Administration cleared several Lyme disease serologic assays with new indications for use, allowing for an EIA rather than western immunoblot assay as the second test in a Lyme disease testing algorithm. Thus, serologic assays that utilize a second EIA in place of western immunoblot assay are acceptable alternatives for the serologic diagnosis of Lyme disease.