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ICYMI: GRAPPA Recommendations for Treating Enthesitis in Psoriatic Arthritis

d Jack Cush, MD

GRAPPA has provided new, evidence based updates to the management of enthesitis in patients with psoriatic arthritis (PsA), affecting at least 30% of PsA patients and is associated with more severe disease, x-ray damage, and poorer outcomes. 

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RT @drdavidliew : Dazodalibep is the next CD40L inhibitor being tested in Sjogren’s - we need better therapies reducing symptom burden. Nice phase 2 data analyses so far of subjective measures, and plenty will be happy if we see this kind of result in phase 3 LB0003 #EULAR2023

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RT @Janetbirdope : #SLE #EULAR recommendations What is new - use LESS #glucocorticoids, aim for none or 5 mg/d or less, use #biologics early if needed to prevent damage, #lupus #nephritis consider less pulse dose if using, voclosporin vs Belimumab ? it depends #EULAR2023

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Scleroderma – Thick and Thin (6.30.2023)

d Jack Cush, MD

Dr. Jack Cush reviews the news, journal articles and regulatory decisions from the past week from RheumNow.com. This week focuses on parodoxical psoriasis, scleroderma outcomes and subsets, and alopecia areata therapy.

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Study of FDA review times for New Indication Approvals of Drugs and Biologics (2017 - 2019) finds FDA approved 107 drugs for 146 new indications [99 small molecules (68%) & 47 biologics (32%)]. Median regulatory review time was 6 mos (IQR, 6-10) https://t.co/3P6T4R4FCF https://t.co/avl65W3kvr

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Belimumab in adult inflamm myositis (IIM)? Small study 15 IIM pts recv ≥ 5 doses of belimumab or placebo; Treatment success (TIS ≥ 40) was more common with BEL (55% vs 33%) as was defined improvement (DOI: 33% vs 17%); not signif, but interesting! https://t.co/CG9ClLHEW6 https://t.co/DPekHWjTsP

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Why Patients Don't Take Medicines This report examines the characteristics of adults aged 18–64 who took prescription medication in the past 12 months and did not take medication as prescribed due to cost. https://t.co/zuPgMjKYbh https://t.co/62cG9LDYWi

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Indian study of 943 AIRD patients (43% RA) starting biologics or JAKi, had TB screening with IGRA assay. 125 pts were IGRA pos. and had LTBI; 124/125 received anti-TB prophylaxis. IGRA Accuracy in predicting absence of TB reactivation = 99.6% https://t.co/KI9vGWpS59 https://t.co/Ne33P51koD

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Are bDMARDs, tsDMARDs and biosimilar DMARDs cost effective? The use of methotrextate with either bDMARDs, tsDMARDs or bsDMARDs was not shown to be cost effective, even though reduced disease activity and improved patient quality of life. Read more--https://t.co/4nBp0ML8Kl https://t.co/5YXCotHlYK

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What is Colchicine Worth? (6.23.2023)

d Jack Cush, MD

Dr. Jack Cush reviews the news and reports from the past week on RheumNow.com. This week a new colchicine FDA approval, rising rate of IgG4 related disease and what's the safest biologic?

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FDA,approved,stamp,blue

FDA Approves Colchicine for CV Prevention

d Jack Cush, MD

The FDA has approved colchicine (Lodoco) for cardiovascular prevention in adults with established atherosclerotic disease or multiple risk factors, making it the first anti-inflammatory medicine with such an indication.

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Study of 28,360 #PsA pts shows blacks have signif more HTN (59 v 52%), DM (31 v 23%), obesity (47 v 30%), gout (12 v 8%); while whites have more cancer (20 v 16%), anxiety (28 v 23%) & OP (14 v 12). Rx (NSAIDs, TNFi, DMARDs) also unequal by race. https://t.co/Ok7vhTdS8g https://t.co/ozFIg9HNuy

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Arborviral infx w/ rituximab? 21 RTX pts dx w/ arboviral neuroinvasive Dz, (encephalitis, acute flaccid myelitis); 79% died. B cell depletion impairs immunity & spread of West Nile Virus, serologic Ab Dx tests; thus if suspected, order RT-PCR tests https://t.co/yQiXI2IYqd https://t.co/dZX2CQJs0L

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Are bDMARDs, tsDMARDs and biosimilar DMARDs cost effective?

d Jack Cush, MD

Treatment advances with new biologic disease-modifying antirheumatic drugs (bDMARDs), targeted synthetic DMARDs (tsDMARDs) and biosimilar DMARDs (bsDMARDs) have proven efficacy and safety; but does their increased cost yield commensurate benefits in patients with rheumatoid arthritis (RA) and high disease activity?

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Rheums! Have a rheumatology question or case for Jack Cush? Record it here and we may feature it on an upcoming podcast. Tell us your name and where you practice rheumatology. https://t.co/3atPdJwb1m https://t.co/MKbgzEi9pd

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computer screen safety

Abatacept Safety Outcomes Across 7 European Registries

d Jack Cush, MD

A multinational registry analysis of rheumatoid arthritis (RA) receiving abatacept (ABA) has shown that the safety profile of ABA remains unchanged with no new or increased risks of infection or malignancy.

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Biosimilars Match Biologic Originators in RA A JAMA review shows that biosimilars of adalimumab, infliximab, and etanercept were associated w/clinically equivalent treatment effects compared with their ref biologics for treatment of RA. https://t.co/EO22ThFL5C https://t.co/wlK0e2Cg5l

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BIOSIMILARS (93 in EU, 40 in US) are approaching a tipping point with 8 new adalimumab biosimilars in 2023. Humira sales are down ~26% in 2023. Biosimilar sales expected - $129 billion in next 5 yrs, with estimated savings of $181 billion https://t.co/HMOYaSaIBQ https://t.co/6jOujr4JXQ

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Novel drug in development, LY3361237, is a BTLA (B & T lymphocyte attenuator) agonistic antibody to treat autoimmune Dz (eg SLE) - augments immune responses by activating checkpoint inhibitory receptors (CIRs). https://t.co/3iYq9UwHww https://t.co/RwrhqRO8cm https://t.co/tl8qVIXqjc

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Novel drug in development, LY3361237, is a BTLA (B & T lymphocyte attenuator) agonistic antibody to treat autoimmune Dz (eg SLE) - augments immune responses by activating checkpoint inhibitory receptors (CIRs). https://t.co/3iYq9UwHww https://t.co/RwrhqRO8cm https://t.co/tl8qVIXqjc

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