FDA Panel Votes to Favor High Dose Xeljanz in Ulcerative Colitis

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Yesterday a FDA advisory panel voted 15-0 in favor of approving Xeljanz (tofacitinib) 10 mg bid for patients with moderate to severe ulcerative colitis.

Inflammatory Arthritis Variants with Checkpoint Inhibitors

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Capelli and colleagues have studied patients treated with ICIs and found two variants of inflammatory arthritis (IA) - a reactive arthritis like large joint arthritis with combination ICI therapy or a small joint IA with ICI monotherapy.

IL-18 Binding Protein Effective in Adult-Onset Still's Disease

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Gabay and colleagues have reported the results of a novel new recombinant human IL-18 binding protein, tadekinig alfa, demonstrating its effectiveness in an open-label dose escalating study in patients with adult-onset Still's disease (AOSD).

Are ANA Tests Unreliable?

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Pisetsky and colleagues have reported in the Annals of Rheumatic Disease that ANA tests done on established SLE patients may yield surprisingly disparate results.

While ANA negative lupus was a problem of old assays and the loss of ANA positivity may be seen with chronicity or age, most rheumatologists believe that ANA positivity is an absolute requirement for the diagnosis of systemic lupus erythematosus.

ASCO/NCCN Guidelines for Checkpoint Inhibitor Immune-Related Adverse Events

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New guidelines have been developed by the American Society of Clinical Oncology (ASCO) and the National Comprehensive Cancer Network (NCCN) on how to assess and manage of immune checkpoint inhibitor side effects that are often autoimmune in nature.

RWCS Day 4 Podcast

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Listen in on the proceedings from the 2018 RWCS meeting in Maui, with excerpts from leading teachers in rheumatology. This podcast features presentations from Drs.

The RWCS - RheumNow Week in Review - 9 February 2018

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Dr. Jack Cush reviews highlights, news and recent research published this week on RheumNow.com. This week's report includes news and education from the RWCS meeting in Maui.

Methotrexate May Help in Chronic Chikungunya Arthritis

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Methotrexate may provide benefits in treatment of the chronic arthritis that can persist following acute chikungunya virus infection, but definitive evidence remains lacking, researchers reported.

Poor Prognosis of the MDA-5 Antibody in Dermatomyositis

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Researchers from Hong Kong assessed the clinical associations seen with the anti-melanoma differentiation-associated gene 5 antibody (anti-MDA5 Ab) assay in consecutive patients with dermatomyositis (DM) and polymyositis (PM).

ACIP Guidelines on H. Zoster Vaccination Updated

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The ACIP has discussed and analyzed its VZV vaccination policy to ensure safety and reduce disease burden. This report serves as a supplement to the 2008 Prevention of Herpes Zoster Recommendations.

ESRD Death Declines in Vasculitis Patients

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In the past 2 decades, mortality from end-stage renal disease (ESRD) among U.S. patients with granulomatosis with polyangiitis (GPA) has declined significantly, a nationwide study found.

Obesity Outweighs Psoriasis in Comorbidity Risk with Children

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Like their adult counterparts, psoriasis in children is an independent risk factor for comorbidity, but not as much as  obesity.

Anti-Drug Antibodies Partly Explain Secondary TNF Inhibitor Failures

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An observational study of patients with active rheumatoid arthritis (RA) or spondyloarthritis (SpA) experiencing secondary failure to TNF inhibitor (TNFi) therapy showed that (secondary) loss of efficacy to a TNFi was associated with anti-drug antibodies in less than 30% of patients. 

Problems with Biologic Drug Storage

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Is your patient’s refrigerator the problem with the inefficacy of biologic therapies? Studies show most patients don't store their biologics correctly, which may be a source of limited drug efficacy.

Two Types of Osteoarthritis Based on Cartilage Studies

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A report from Annals of Rheumatic Diseases suggests that osteoarthritis (OA) may be two distinct diseases based on genetic studies of articular cartilage. (Citation source: https://buff.ly/2mNtUsL).

IL-1 and IL-6 Inhibition Preferred in Systemic JIA

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Since 2000, the German Biologics register (BiKeR) has prospectively enrolled children with juvenile idiopathic arthritis to assess outcomes with biologic therapies.  A new report evaluates the efficacy and safety of etanercept (ETA), tocilizumab (TOC) and the interleukin-1 inhibitors (anakin

Salt Drives Gut-Brain Connection via IL-17

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A study from Nature Neuroscience shows that a high salt diet may mediate neurovascular disease by altering microbiome and the expansion of TH17 cells in the small intestine, thereby increasing plasma interleukin-17 (IL-17) and its subsequent effects on endothelium in the brain.

Stroke Risk Confirmed in SLE

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The most common cerebrovascular events (CVEs) seen among a large cohort of patients with systemic lupus erythematosus (SLE) were stroke and transient ischemia, and the majority of these events were attributable to the disease itself, a multinational study determined.

B Cell Changes Predict Autoimmunity with Checkpoint Inhibitors

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The Journal of Clinical Investigation reports results of a study showing that increases in CD21lo B cells and plasmablasts following that combination checkpoint blockade preceded the onset of immune-related adverse events.

While some have postulated that IRAEs are thought to be T cell mediated, B cells have also been implicated. Investigators studied 39 melanoma patients undergoing treatment with either anti-CTLA4 or anti-PD1, or combination CCB therapy. They analyzed changes in circulating B cells before and after the first cycle of therapy of immune checkpoint blockade (23 received combination therapy, 8 received anti-CTLA4, and 8 received anti-PD1).

Ibuprofen’s Anti-androgenic Effect May Result in Hypogonadism in Males

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PNAS reports use of ibuprofen by males may result in antiandrogen effects that may contribute to adult male reproductive problems.