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NSAIDs in Pregnancy (3.3.2023)
Dr. Jack Cush reviews the lastest journal articles, news, and FDA announcements from the past week on RheumNow. This week, the importance of IFNa, Subclinical PsA and NSAID safety during Pregnancy.
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VEGA - The Efficacy of Combination Biologics in Ulcerative Colitis
A novel trial has shown that combination biologic therapy (guselkumab plus golimumab) to be more effective in ulcerative colitis than either biologic alone.
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Sarilumab is FDA Approved for PMR
Yesterday, the U.S. Food and Drug Administration (FDA) approved sarilumab (Kevzara) for the treatment of adults with active, refractory polymyalgia rheumatica (PMR), stipulating it is indicated in those patients who have had an inadequate response to corticosteroids or who cannot tolerate corticosteroid taper.
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Triad of Trouble: A case of joint, skin and GI woes
Sara Faghihi Kashani, MD, presents her poster at RWCS 2023
https://t.co/xwT2jV1gJv https://t.co/g63tRHsoQY
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Sarilumab is FDA Approved for PMR
The FDA approved sarilumab for PMR, stipulating it is indicated in those patients who have had an inadequate response to corticosteroids or who cannot tolerate corticosteroid taper.
https://t.co/VjzloCbpBv https://t.co/9dVb6sVbph
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"My eye is swollen": an underrecognized mimic of IgG4-related disease
Artem Minalyan, MD, presenting his poster at RWCS 2023.
https://t.co/1j3FMazdyk https://t.co/K7VoQHhhGz
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Dr. John Cush RheumNow ( View Tweet)
Without head-to-head trials, do we look to metanalyses? 13 trials of TNF inhibitors in JIA pts - Results at 12-14 weeks. While it ADA looks possibly better, that would be an over-interpretation and misuse of trial data that isnt truly comparable https://t.co/k6QcPZZj67 https://t.co/SwwND1VFfT
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51 Juvenile SLE (j-SLE) studied for neuropsychiatric Dz (j-NPSLE)- 39% presented with jNPSLE. While no clear biomarker/imaging of j-NPSLE identified, they found CSF neopterin (& IFN-α) levels signif higher w/ active j-NPSLE & CNS involvement (p=0.0008) https://t.co/QM8yJGrBJu https://t.co/4hj1eE2JIC
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Study of 87 pts with isolated Nail Psoriasis noted that 11% went on to have #PsA (concurrently or within 3 years). NP findings were mainly onycholysis in79% and nail pitting in 70% https://t.co/2NynITxe6B https://t.co/qs4uYySjxp
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Mycobacterium Tuberculosis Osteomyelitis in a Patient on Pembrolizumab
Jourdan Frankovich, MD, presents her poster at RWCS 2023.
https://t.co/198oMm7GRa https://t.co/Qnh1sOOl6s
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Dr. John Cush RheumNow ( View Tweet)
PsA: Depressing News on Second- and Later-Line Treatments
Most patients with PsA failed to achieve low disease activity after switching from one targeted therapy to another, real-world data from Scandinavian registries indicated.
https://t.co/7tSzoNLVoD https://t.co/3oUM4E38b1
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Treat-to-Target Guidelines for GCA and PMR
The Annals of Rheumatic Disease has published updated multinational, T2T recommendations for the treatment of giant cell arteritis (GCA) and polymyalgia rheumatica (PMR).
https://t.co/OQmtqGGNQu https://t.co/eEOTWfdgLI
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Prospective study of 490 mod-to-severe psoriasis compared prospectively by exam & US for PsA - 384 w/o arthritis (Silent PSO), 80 non-PSO & 106 w prodromal or active PsA (12.7%). US synovio-enthesitis in 1.8% of controls & 16.1% of silent PSO (p< 0.001) https://t.co/kUdIwLnfYL https://t.co/dgIaOXaJKR
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CorEvitas registry data shows H2H comparison of 369 CCP+ abatacept & 475 CCP+ tofacitinib treated patients showed equivalent drug responses (reduced CDAI or PRO's); b/tsDMARD naive pts had numerically better ABA response at 6 mos (P = 0.662) https://t.co/36jr7l2DKm https://t.co/PItYrvMUNV
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Granulomatous Myositis? Back to Square One
Samuel Ng, MD, presents his poster at RWCS 2023.
https://t.co/7dcbUbRe8b https://t.co/9lobNJOkJd
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Dr. John Cush RheumNow ( View Tweet)
While anifrolumab targets IFN alfa in SLE, its unclear how much IFNa is needed for Rx response. A study of 40 pts shows Rx naive SLE has signif higher serum IFN activity; this is assoc w/ fever, leukopenia, ALE rash and oral ulcers & more organ damage https://t.co/RtI9ulurB1 https://t.co/wMl5DOyGB6
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Phase 3 Trials of Baricitinib Disappoint in SL
Despite the encouraging phase II trial results of baricitinib in SLE patients, two parallel phase III trials have failed to redemonstrate the efficacy of baricitinib in active SLE.
https://t.co/JjouppdG8k https://t.co/SHATPuTIiP
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Korean study Neonatal/maternal outcomes w/ NSAIDs. 1.8 million pregn assoc w/ early preg NSAIDs exposure - incr risks for major congenital malformations (adjRR 1.14), low birth Wt (1.29) & maternal oligohydramnios (1.09); higher w/ COX-2i or NSAIDs>10d https://t.co/SaRrVOHOt9 https://t.co/b2YqUh91fK
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FDA has approved sarilumab (Kevzara) for the treatment of polymyalgia rheumatica (PMR) in adult patients who have had an inadequate response to corticosteroids or who cannot tolerate corticosteroid taper. Approval is based on Phase 3 SAPHYR study https://t.co/kA9pTauvDP https://t.co/GGlyvQcyat
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Check out last week's podcast--we discuss interesting data on the risk of arthritis comes from a large NHANES study.
https://t.co/w5TNhH7a2f https://t.co/bkKDoWA0ft
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Dr. John Cush RheumNow ( View Tweet)