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RheumNow Podcast – High Science and Future Treatments (9.10.2021)
This week: high science that affect future treatments; breakthrough infections in our patients, and what's up with that; and soon your radiologist is going to be replaced by AI. This and more in our review of the news and journal articles from the past week.
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FDA Review of Vaping Products Extended
The FDA has again extended its decision on whether the manufacturers of vaping products can market their e-cigarettes in the United States.
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Lymphoma in RA: Disease Activity Matters
Among patients with rheumatoid arthritis (RA), the strongest risk factors for the development of lymphoma were disease activity and severity, French researchers found.
In a multivariate analysis, having a high Disease Activity Score in 28 joints (DAS28) at baseline conferred twice the risk for lymphoma, with an odds ratio of 2.09 (95% CI 1.41-3.38), according to Gaetane Nocturne, MD, of Hôpital Bicêtre in Ile-de-France, and colleagues.
COVID Breakthrough Infections in Rheumatic Patients
Analysis of records from the Mass General Brigham healthcare system in the Boston area, shows that breakthrough infections (after receiving SARS-CoV-2 vaccines) in patients with systemic autoimmune rheumatic diseases (SARDs) are not uncommon, and may be severe or fatal.
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Diagnostic Delay in Half of Psoriatic Arthritis Patients
A Mayo Clinic/ Olmsted County study of psoriatic arthritis (PsA) patients has shown that more than half (55%) of PsA patients had a diagnostic delay of > 2 years, and that this delay has not improved over time.
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Not All Immunosuppression Alters Vaccine Immunogenicity
Chronic inflammatory disease (CID) patients are urged to receive the COVID-19 vaccines; but when a cohort of CID patients treated with immunosuppressive medications were given an mRNA-based SARS-CoV-2 vaccination, only those treated with glucocorticoids and B cell depleting therapies (B
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Expert Panel: Initial Views on FDA Warnings for JAK Inhibitors
Dr. Jack Cush is joined by Drs. Roy Fleischmann (Dallas), Allan Gibofsky (NYC), and Artie Kavanaugh (San Diego) to discuss the 9/2/21 FDA Drug Safety Communication regarding the cardiovascular and cancer risks arising from the Pfizer 1133 (ORAL Surveillance) tofacitinib study, but also applied to baricitinib and upadacitinib.
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FDA: New Cardiac and Cancer Warnings for All JAK Inhibitors
Today, Sept.1st, the FDA announced its decision regarding tofacitinib's safety concerns from the Oral Surveillance study - handing down warnings for not only Pfizer's JAK inhibitor, but also for other marketed JAK inhibitors from AbbVie and Eli Lilly & Co.
These safety concerns arise from the Oral Surveillance study - a large, post-marketing, safety trial of tofacitinib versus adalimumab in high risk patients. New warnings about the risks of cardiac events, death and cancer will appear as a revision to the "boxed warnings" in the product label (package insert) for all JAK inhibitors - tofacitinib, baricitinib and upadacitinib.
Predictors of Inflammatory Arthritis
Data from 4 parallel case-control studies within The Health Improvement Network looked at risk factors for developing psoriatic arthritis (PsA), psoriasis, rheumatoid arthritis (RA), and ankylosing spondylitis (AS) showed both shared and differentiating risk factors, but statin use was protective in all 4 conditions.
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Drug Choices After First TNF Inhibitor in RA
TNFi are frequently used first line in RA patients; and a new analysis shows that repeat use of TNFi dominates over the use of non-TNFi biologics when the initial TNFi therapy has failed. This retrospective analysis of commercial insurance records analyzed the patterns of drug use in adult RA patients who switched to their second biologic or targeted disease-modifying antirheumatic drug.
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RheumNow Podcast – COVID Marching Amidst the Madness (8.27.2021)
We have a lot of news, information and approvals to review and discuss, though I need to begin with what's weighing heavily on my mind. After, we'll dive into what we learned this week.
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ACR Guidance on Timing of 3rd Dose Booster with Immunomodulatory Drugs
The American College of Rheumatology has issued an updated version of its COVID-19 Vaccine Clinical Guidance for Patients with Rheumatic and Musculoskeletal Diseases following recent recommendations from the CDC that certain immunocompromised patients receive a third dose of an availabl
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Rheumatic Events With Checkpoint Inhibitors: Tumor Type Matters
Among the factors that were associated with an increased risk for the development of rheumatic immune-related adverse events following cancer treatment with immune checkpoint inhibitors (ICIs) was the type of malignancy involved, a large case-control study found.
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Biologic Therapy of Psoriasis May Prevent Psoriatic Arthritis
Another retrospective cohort study has shown that biologic treatment of psoriasis may reduce the subsequent incidence of psoriatic arthritis (PsA).
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Passive Smoke Exposure and Rheumatoid Risk
A current report in Arthritis & Rheumatology examined the Nurses Health Study II data set and shows that parental smoking, and passive exposure to children, can later lead to an increased risk of adult-onset incident seropositive rheumatoid arthritis (RA).
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RheumNow Podcast – Driving in Pain (8.20.2021)
You know, I'm a very good driver. We all think we're great drivers - but consider what it's like to drive in pain: would you be a good driver? Also, I want you to consider the diagnosis of calcium pyrophosphate dihydrate disease (CPPD). But first, let's look at a study out of Scotland, looking at military service and greater risk of hip and knee replacement.
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Oligoarticular vs. Polyarticular Psoriatic Arthritis
A psoriatic arthritis (PsA) cohort analysis reveals many similarities and few distinctions between those who present with oligoarticular and polyarticular PsA.
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Sustained Effectiveness of mRNA Vaccines Against COVID-19 Hospitalizations
The CDC has reported that mRNA vaccine effectiveness against COVID-19–associated hospitalizations was sustained over 24 weeks; but there is evidence of waning protection amongst the immunosuppressed.
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EULAR Points on Managing Difficult Rheumatoid Arthritis
A EULAR task force has promulgated several points to consider in managing difficult-to-treat RA. These "points" are unique in directing the rheumatologist's attention to the potential for misdiagnosis and the impact of comorbid conditions on what is perceived as poorly controlled RA.
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