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KNOW YOUR NUMBERS! (2.10.2023)

d Jack Cush, MD

Dr. Jack Cush reviews the news, journal articles and the numbers, from the past week on RheumNow.com.

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TSR Shoulder replacement

Without DMARDS, Shoulder Arthroplasty Increasing in Rheumatoid Arthritis

d Jack Cush, MD

The need for total shoulder arthroplasty (TSA) in rheumatoid arthritis (RA) patients appears to depend on the use of disease modifying antirheumatic drugs (DMARDs), according to Seminars in Arthroplasty.

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Skin,cancer,squamous,cell

Does Methotrexate Increase Skin Cancer Risk?

d Jack Cush, MD

There are several reports suggesting a link between methotrexate (MTX) use and certain skin cancers, yet these are confounded by a higher risk of skin cancers with inflammatory conditions like rheumatoid arthritis of which MTX is the most common treatment.

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Cutaneous.lupus.SLE.Face.dermnetnz

Deucravacitinib - Effective in Systemic Lupus Erythematosus

d Jack Cush, MD

A Phase II, multicenter study has demonstrated the efficacy and safety of deucravacitinib, an oral, selective, allosteric inhibitor of TYK2, in  adults with active systemic lupus erythematosus (SLE).

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infx.pneumonia.jpg

Serious Infection Risk in Pediatric Psoriasis with Ustekinumab, Etanercept, or Methotrexate

d Jack Cush, MD

Etanercept was FDA approved for use in pediatric psoriasis (PsO) in 2016 and ustekinumab was similarly approved  in 2020.  This comparative analysis looks at the risk of serious infections (SIE) requiring hospitalization in pediatric PSO patients treated with ustekinumab, etanercept, or

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The FDA has added a new indication to the oral JAK inhibitor Cibinqo (abrocitinib) - now approved to treat atopic dermatitis in adolescents 12 to under 18 years old. (Approval is based on a phase 3 JADE TEEN trial. https://t.co/DsQj3BfPmZ https://t.co/0bpb2FAwpg

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An open-label trial of 170 adults w/ IgA Nephropathy (proteinuria >1 g/d) evaluated addition of mycophenolate to standard care (SC). MMF (1.5g/d) associated w/ less renal worsening - 7.1% MMF + SC vs. 21% SC alone (aHR 0.23; 95% CI, 0.09-0.63) https://t.co/FlcafoZi3U https://t.co/tQkZE8RRyy

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Meta-analysis (21 studies, 3948 pregnant pts) HCQ may reduce risk of preeclampsia (OR 0.45) & premature delivery (OR 0.84) in pregnant autoimmune pts. HCQ may also reduce risk of gestational HTN (OR 0.42) & pre-term birth (OR 0.63) in pregnant SLE pts https://t.co/riQDRN9r1A https://t.co/uR8Nem4Ndx

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Benlysta granted Orphan Drug Designation by US FDA as potential Rx of systemic sclerosis, such status facilitates eval in rare diseases. GSK is planning a trial of belimumab for SSc-associated interstitial lung disease in the first half of 2023 https://t.co/kWItB7NEvn https://t.co/eVbQtKy98H

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Enthesitis-related arthritis compared in kids - 105 ERA (57 axial vs 48 peripheral). Axial ERA pts were older @onset (12 vs. 11yrs), longer Dx delay(10 vs. 5 mos), higher inflammatory markers, more Hip Dz (53% vs 27%), more biologic Rx (67% vs 21%) https://t.co/KTYn1kv3qO https://t.co/eWbvMSBLxm

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211 Adult Crohn's pts w/ steroid-free remission >6mo on Combo infliximab & immunosuppressant either cont combo or W/D IFX or Immsup. 2-yr relapse rates: 14% Combo vs, 36% IFX vs 10% Immunosup. WD of IFX had 3.45-4.76 fold incr rsk of flare https://t.co/6EbM3Vx0Ei https://t.co/5ZOE2oxCl0

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Did you have a chance to listen to last week's RheumNow podcast? Dr. Cush covers rheumatology news from the last week. Make sure to tune in before we release our next episode tomorrow! https://t.co/uRRg2K2K1a https://t.co/MjWF3Zl05i

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Treatment failures studied in 718 RA pts - csDMARDs D/Cs intolerance (22%), inefficacy (20%), acute Rxns (5%), severe infx(0.6%) - bDMARDs D/Cs inefficacy (29%), intolerance (10%), acute Rxns (6%), severe infx (1.5%) - Multi-drug ifailure 5.7-8.4% https://t.co/FdoP77uELe https://t.co/dQjTNncABc

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NLRP12 is a negative regulator of innate immune activation and type I interferon production. SLE PBMCs have low levels NLRP12 (inverse correl w/ IFNa & Hi Dz activity. NLRP12 knockouts or deficiency Incr autoAbs, inflammation & renal damage https://t.co/PjTQNHhduB https://t.co/m0erNXMkUC

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GRAPPA Recommendations for Treating Enthesitis in PsA GRAPPA has provided new updates to the mgmt of enthesitis in patients with PsA, affecting at least 30% of PsA patients and is associated with more severe disease, x-ray damage, and poorer outcomes. https://t.co/AC6KHGMeo0

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New 5 Peptide Autoantibody Panel Complements RA Diagnosis Antibodies to peptides not currently used for rheumatoid arthritis (RA) diagnosis helped identify patients with untreated early disease that conventional biomarkers missed, researchers said. https://t.co/twgULvokPY https://t.co/O0I4i81RAN

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Systemic Sclerosis cohort study of 506 SSc pts with saw 5.3 with Degos-like lesions (89% in fingers). Degos lesions more assoc w/ diffuseSSc & acro-osteolysis, digital ulcers, and calcinosis (but not renal crisis, ILD, or pulmonary HTN https://t.co/Usrfr0XcCJ https://t.co/pmwkHsaJOx

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ChatGPT - A Boom or Threat to Scientific Publication? ChatGPT is a new, AI chatbot that has dramatically changed the digital worlds of education, research, statistics and more. Recently there were reports of ChatGPT passing the LSAT, USMLE, and more. https://t.co/CZd0WjOas5 https://t.co/Nx49SqXoHG

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High- Versus Low-Dose Exercise Therapy for Knee Osteoarthritis The Annals of Internal medicine has reported the results of high-dose versus low-dose exercise therapy demonstrating no benefits from more intense exercise. https://t.co/BtqeYWKG34 https://t.co/ngyM1DshDz

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Multicenter study of 80 AOSD & 60 controls used to develop AOSD criteria: - 3 pts rash - 3pts fever ≥ 39C - 2 pts pharyngitis - 2 pts arthritis - 2 pts NLR ≥ 4 - 1 pt glycosyl ferritin ≤ 20% 7 pts = Dx (sens 92.5%) vs Yamaguchi(79%), Fautrel (76%) https://t.co/Amew1RHaA1 https://t.co/dnJ6zVyfOW

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