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Rheumatology Round-Up with Drs. Kavanaugh & Cush
The Annual Review of Best ACR 2020 abstracts featuring Drs. Cush and Kavanaugh filmed on the last day of Virtual ACR 2020 Nov. 9, 2020. Watch now!
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FAST, FREED, CARES, & CONFIRMS: A Run-Down on the Black-Box Blues of Febuxostat
Febuxostat, a nonpurine xanthine oxidase inhibitor used in the treatment of chronic gout to lower serum urate levels, received bad press in 2019 after the US Food and Drug Administration (FDA) placed a black-box warning on the medication’s label suggesting that it increases the risk of cardiovasc
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The #ACR20 convergence highlighted a shift in gout management and uric acid lowering therapy (ULT). Read more about mitigating immunogenicity when using uricase therapies as ULT in an article by Dr. Alexa Meara ( @lexmeara)
https://t.co/MmO224139q https://t.co/iPcf7yENWf
Links:
Dr. John Cush RheumNow ( View Tweet)
New podcast out now on our site #ACR20
Mid-Meeting Recap: Psoriatic Arthritis, Gout Patient Outcomes on Low-Dose Steroids, Giant Cell Arteritis Panel Vaccination w/ Shingrix: Does it work for patients on JAKi? Is it safe?
https://t.co/roc1Qjec5R https://t.co/gSkkj2Kl0m
Links:
Dr. John Cush RheumNow ( View Tweet)
Latebreaking at #ACR20—Febuxostat was non-inferior to allopurinol with regard to the occurrence of major cardiovascular outcomes in patients with gout: finding from FAST, multicentre, prospective, randomised, open-label, non-inferiority trial https://t.co/cpoNi7zjwi https://t.co/uQyeyepPmj
Links:
The Lancet TheLancet ( View Tweet)
The folly of dietary restriction in contemporary gout? by @RichardPAConway
Dr. Conway discusses the abstracts presented at #ACR20
https://t.co/bJBKXKdftO https://t.co/Y5MXcNJQmS
Links:
Dr. John Cush RheumNow ( View Tweet)
@RheumNow #ACR20 abs1921 single center baseline & follow-up PET/CT scan study in pts w/ refractory LVV-GCA on TCZ: while 83.33%pts achieved clincial remission only 10% experiences normalization of Total vascular score. https://t.co/sQK4L7Zu76
Olga Petryna DrPetryna ( View Tweet)
The FAST trial had 33% of pts with CVD and pts w/class III/IV CHF were not allowed in this study (vs. CARES trial where all subjects had baseline CVD); I am still cautious prescribing febuxostat to pts who have severe CVD until we have more data. @RheumNow https://t.co/fJ9bLcXpR2
k dao KDAO2011 ( View Tweet)
IN GOUT: CARES study said febuxostat increases CV risk; Todays FAST study says No incr CV risk w/ FEB. In your Gout pt w/ CV hx, would you use febuxostat? #ACR2020
Dr. John Cush RheumNow ( View Tweet)
Following the results of the FAST trial, would you have any concerns about prescribing febuxostat if clinically indicated?
#ACR20 @RheumNow
David Liew drdavidliew ( View Tweet)
GOUT: CARES study says febuxostat has high CV risk, new FAST study says no incr risk. Would you give FEB to a gout pt w/ CV risk?
Dr. John Cush RheumNow ( View Tweet)
Gout has more comorbidities than RA & PsA #1466 Half of respondents are correct @RheumNow @CRASCRRheum #ACR20 https://t.co/hjwYvCFJPk
Janet Pope Janetbirdope ( View Tweet)
@RheumNow #ACR20 Abs L08 Prospective 4 year PROBE trial of Febuxostat vs allopurinol long term CV safety: febuxostat was not associated w/increased risk of death compared w/allopurinol. 222 (7·2%) pts died in the febuxostat group compared to 263 (8·6%) in the allopurinol group
Olga Petryna DrPetryna ( View Tweet)
FAST trial: allopurinol vs febuxostat on safety
(for gout pts on allopurinol, with ≥1 CV RF, TTT dosing)
febuxostat non-inferior for CV events
Well, that's a relief.
gout flare similar, good follow-up, colchicine did not influence
out in Lancet today?
#ACR20 ABSTL08 @RheumNow https://t.co/5LeXV5mgu9
David Liew drdavidliew ( View Tweet)
Results of the FAST trial presented at #ACR20
- Safety study required by the EMA
- Febuxostat non-inferior to allopurinol for any outcomes
- Long-term use of febuxostat is not associated with an increased risk of death
Published in @TheLancet today https://t.co/EvJGPpDCR8
Links:
NatRevRheumatol NatRevRheumatol ( View Tweet)
Dr MacDonald presents Febuxostat versus Allopurinol Streamlined Trial. 6128 patients. HR 0·89 [95% CI 0·75-1·06] for cardiovascular events in febuxostat vs allopurinol. Mortality 7.2% vs 8.6%. Reassuring re cardiovascular safety of febuxostat @rheumnow #ACR20 Abstr#L08 #ACRbest
Richard Conway RichardPAConway ( View Tweet)
FAST trial (Plenary) showed opposite of CAREs study. Febuxostat vs PBO in 6128 Gout pts, showed little dropout (~6%) in a 4 year study. Febuxostat (mean 81mg) had similar, flare rates, MACE/cardiac endpoints and CV death vs allopurinol #ACR20 Abstr#L08 https://t.co/FkdDtPB4Oi https://t.co/J9KonQHpT2
Dr. John Cush RheumNow ( View Tweet)
Read my #ACR20 article on diet as a mechanism to control gout @rheumnow https://t.co/nEWJqt8eXx
Richard Conway RichardPAConway ( View Tweet)
Poll results are in! Most would like to wait for a phase III before prescribing MMF with pegloticase in refractory gout. @RheumNow #ACR20 https://t.co/45MpFliDkE
Meral K. El Ramahi, MD MeralElRamahiMD ( View Tweet)
Dr McCormick presents on causal association between hyperuricaemia and diabetes. Insulin resistance causal for high urate. Target insulin resistance to prevent gout. @rheumnow #ACR20 Abstr#1472 https://t.co/OSr3ktIXSS
Richard Conway RichardPAConway ( View Tweet)
