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Upadacitinib Outcomes in High Risk RA Patients

d Jack Cush, MD

A safety analysis of six phase III SELECT trials showed that higher-risk rheumatoid arthritis (RA) patients had an increased risk of MACE, malignancy (excluding NMSC) and venous thromboembolic events (VTE) regardless of being treated with either upadacitinib (UPA) or adalimumab (ADA).

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ICYMI: ChatGPT - A Boon or Threat to Scientific Publication?

d Jack Cush, MD

ChatGPT is a new, artificial intelligence chatbot that has dramatically changed the digital worlds of education, research, graphic design, statistics and more. While this AI driven platform has the untold potential in generating written content, there is considerable concern in assuring that human-generated content of research, education and publishing has veracity.

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ICYMI: LAVLI - A New Autoinflammatory Disorder

d Jack Cush, MD

NIH researchers have have described a novel autoinflammatory disorder called "Lyn kinase-associated vasculopathy and liver fibrosis" (LAVLI), based on a mutation in the LYN gene (that encodes the Lyn kinase protein). They discovered that increased Lyn kinase activity promotes systemic inflammation, by altering microvascular permeability and neutrophil recruitment, while at the same time promoting hepatic fibrosis.

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Vedolizumab (VED) doesnt help SpA. Study of 39 IBD, half on VED, 17 w/ SpA (7 axial). 14 w/ periph. arthritis before VED, only 3 improved w/ VED. 3 pts on VED developed new arthritis/aglas. 6 Pts stopped for SpA (2) or IBD (4) worsening. https://t.co/uKArtikNMu

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RT @drdavidliew : Autoimmune disease diagnoses slowly on the rise, despite reduced smoking - but that’s now 10% of the population, & many patients have more than one. Most are lifelong. Surely this needs more investment?? CPRD data from the UK https://t.co/RuPZ0ys0xW

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RT @bella_mehta : An interesting biomarker in #sJIA- helps differentiate it from other diseases, including infections and other inflammatory diseases! - kids with fever! serum calprotectin (MRP8/14) particle enhanced immuno-turbidimeteic assay (sCAL Turbi). 650 pts #EULAR2023

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RT @Janetbirdope : What would you do? A middle aged woman has pain and impaired hand function with her PIP&DIP erosive hand #osteoarthritis? Exam - jts are tender w soft tissue swelling? #NSAIDs, #denosumab, #methotrexate? 🤷‍♀️ A +RCT of #MTX in #erosive #hand #OA at #EULAR2023

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RT @Yuz6Yusof : #EULAR2023 #OP0143 Promising therapy. A Phase 2 RCT of Dazodalidep (CD40L-i) in #Sjogren showed significantly more patients on DAZ group met reduction in ESSDAI vs placebo. Interesting to see higher hurdle ESSDAI favored DAZ Group. Phase 3 RCTs are underway

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Long-Term Efficacy and Safety of a JAKi in RA How might long-term efficacy and safety data from a study of a JAKi in TNFi-IR patients with RA influence clinical decision making? Watch Dr. Stan Cohen discuss. Sponsored by AbbVie US Medical Affairs https://t.co/mvVtlMJTc2 https://t.co/YJX3nymDuU

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RT @Yuz6Yusof : #EULAR2023 #POS0116 How does Voclosporin fare in #lupus pts w/heavy proteinuria (=>2g/day)? Pooled Analyses from Phase 2&3 RCTs showed consistent improvement in renal response regardless of demographics or clinical characteristics. An option this resistant group

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RT @drdavidliew : Tapering pred in RA - this just rings true from everyday clinic life. Some patients just seem to hit a wall at PNL 2.5. Sometimes it’s GC withdrawal arthralgias/tertiary adrenal insufficiency, but often it’s genuine inflammation. I still wonder why? POS0050

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RT @synovialjoints : • Erdheim-Chester disease (ECD) is associated with Langerhans cell histiocytosis (LCH) • Bone pain, xanthelasma, hairy kidney • Differential diagnoses of LCH • BRAF mutation associated with cardiac and neurological phenotype of ECD Haroche J, Papo M

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#EULAR2023 #POS0112 Consistent with clinical response, Post-hoc analyses of Phase 2 RCT of Deucravacitinib (Tyk2-i) showed this therapy suppressed both IFN and B cell pathways - a broader mode of action in reducing #SLE pathophysiology. Look forward to Phase 3 results

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RT @AurelieRheumo : The risk of osteoarticular infection following Staph aureus bacteremia is twice higher in RA (1/4) than non RA pop (1/8) Use of TNFi & orthopedic implants associated w/ OAI risk Mortality however similar in RA and non RA groups #EULAR23 POS0033

Dr. John Cush RheumNow ( View Tweet)

RT @bella_mehta : Obesity in #AOSD – predicted the development of a chronic disease course and biologic DMARD failure, 139 pts with AOSD- 19% Obese (BMI>30) observational study. abst#AB1503 #EULAR2023

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RT @drdavidliew : Men trying to conceive were prev told to avoid MTX. Another myth busted Why? Spermatozoa lack the FPGS enzyme responsible for MTX-PG metabolism, the tiny amount of MTX-PG in sperm isn’t active. No quality issues! OP0224 #EULAR2023 https://t.co/i4WGmoWOwU)

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RT @Yuz6Yusof : #EULAR2023 #POS1075 Which biologics have the lowest retention rate in Elderly patients (=>65 yrs) in Rheumatoid Arthritis? Data from Italian registry showed 1/3 discontinued biologics at 2 yrs. IL6-i: lowest persistence; Abatacept: highest

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RT @Janetbirdope : #ClinicalPearl Rx of #scleroderma #ILD -add another drug. MMF, then Cyclo, Rituximab, ?tocilizumab; if progressive fibrosis then #Nintedanib ?Pirfenidone Small RCT of MMF v Tacrolimus - looked the same -helpful if MMF fails, future pregnancy OP0240 #EULAR2023

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RT @Janetbirdope : A shame. Pts with #scleroderma are dying waiting for organ transplant- we should list and work them up for Tx earlier. PAH Pts May do worse @eular_org #EULAR2023 @RheumNow OP0241

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RT @Yuz6Yusof : #EULAR2023 #POS1207 Promising therapy for dermatomyositis. Data from Stage One of Phase 2 RCT (N=18) showed Anti-IFN Beta mAb improved clinical, PROs, extra-muscular activity and reduced CK levels vs Placebo. No cases of HZV. One to watch out in the next few year

Dr. John Cush RheumNow ( View Tweet)

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