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MTX Fails Knee OA (6.6.2025)
Dr. Jack Cush reviews the news and journal reports from this past week on RheumNow.com
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Should You Add MTX to a TNF Inhibitor in Psoriasis?
Target emulation trial shows adding methotrexate (MTX) to adalimumab (ADA) does not augment the effectiveness and persistence of adalimumab alone in treating plaque psoriasis in adults.
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Methotrexate Fails in Knee Osteoarthritis
MedPage Today
We'll be blunt: methotrexate flopped in a randomized placebo-controlled trial among patients with osteoarthritis (OA) of the knee.
Contrary to results from a previous trial in hand OA, the old-line disease-modifying anti-rheumatic drug (DMARD) failed to bring any improvement relative to placebo in either pain or an objective measure of joint inflammation after a year of treatment, according to Changhai Ding, PhD, MD, of Southern Medical University in Guangzhou, China, and colleagues.
Belimumab in SLE with Mucocutaneous or Vasculitis Findings
A post hoc analysis of a belimumab (BEL) inn systemic lupus erythematosus (SLE) study showed lupus mucocutaneous and vasculitic manifestations improve with BEL and standard care.
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2025 ACR Guideline for the Treatment of SLE
The ACR has released its 2025 Systemic Lupus Erythematosus (SLE) treatment guidelines and consensus-based good practice statements, applicable to children and adults with SLE.
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IMPACT Study - Certolizumab Efficacy in APS Pregnancies
A pilot trial assessed the safety and value of tumour necrosis factor α inhibitor treatment with certolizumab in patients with high-risk pregnancies with antiphospholipid syndrome (APS).
SLE Treatment Landscape: Abundance or Overload?
Imagine a world where the multiple drugs in Phase 2 and 3 trials actually get approved, and we get access to them? I know you may be thinking that I am overly optimistic, but there are so many drugs in development in lupus that we https://t.co/xLgSU4ZLgP
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Systematic review of JAK inhibitor use in systemic sclerosis - 18 articles/87 SSc pts (80%F; ages 13–78 yrs). JAKi (83% tofa) mostly used for ILD & Skin Dz (45%) or GI+Skin Dz (39%). 87.5% improved, w/ 6% relapsed. Adverse events in 50% (20% infx). We need RCTs! This could be a https://t.co/lNFEX08Vn3
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Positive results from Phase 2b RENOIR RCT of Rosnilimab, an agonist targeting PD-1+ T cells. 432 RA pts on MTX or csDMARDs, Rx w/ 6 mos of PBO vs ROS (100 or 200 mg q4wk or 600 mg q2wk). All 3 doses of rosnilimab achieved significant reductions DAS-28 CRP at Wk 12 https://t.co/6nF8KPRK2f
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Target trial emulation study data from British Dermatologists Biologics & Immunomodulators Register, compared 231 PSO Rx w/ MTX + Adalimumab against 1553 PSO on ADA. @1Yr MTX did not augment ADA only responses based on Rx survival (79% vs 78%) or PASI75 (49% vs 52%). https://t.co/DSYNd9P5Om
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Systematic review of JAK inhibitor use in systemic sclerosis - 18 articles/87 SSc pts (80%F; ages 13–78 yrs). JAKi (83% tofa) mostly used for ILD & Skin Dz (45%) or GI+Skin Dz (39%). 87.5% improved, w/ 6% relapsed. Adverse events in 50% (20% infx). We need RCTs! This could be a https://t.co/VXFuHGpDjB
Dr. John Cush RheumNow ( View Tweet)
SLE Treatment Landscape: Abundance or Overload?
Imagine a world where the multiple drugs in Phase 2 and 3 trials actually get approved, and we get access to them? I know you may be thinking that I am overly optimistic, but there are so many drugs in development in lupus that we https://t.co/1SsSMqfZWz
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MMWR: 1994 the U.S. Vaccines for Children program has covered the cost of vaccines for US children. Since 1994 routine child vaccinations will have prevented ~508 million illness, 32 million hospitalizations, & 1,129,000 deaths,; direct savings of $540 billion & societal savings https://t.co/CBUojpR3Q8
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Lupus Unlocked: Pregnancy and SLE
In this webinar, panelists discussed issues such as congenital heart block, lupus nephritis treatment, teratogenic risks including conception on mycophenolate, antiphospholipid syndrome, hypertension management including the differential https://t.co/0RfAH7jW0J
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Are PSO pts also Rx for PSA? Registry study of 17,310 PSO pts (19% also w PsA). @ baseline Biologics used in 44% of PSO, but higher rate in PSO+PsA (66% vs 39% PSO). 9.4% of PSO+PsA pts on Rx approved for PSO, but not explicitly for PsA. https://t.co/jMqk6gm1RR https://t.co/CQnwYO9yRO
Links:
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IMPACT Study - Certolizumab Efficacy in APS Pregnancies
A pilot trial assessed the safety and value of tumour necrosis factor α inhibitor treatment with certolizumab in patients with high-risk pregnancies with antiphospholipid syndrome (APS). Certolizumab (CZP) was shown to https://t.co/776CTvvGfb
Dr. John Cush RheumNow ( View Tweet)
JAMA CME review of Immune Thrombotic Thrombocytopenic Purpura (iTTP) - thrombotic microangiopathy w/ hemolytic anemia (MAHA) & thrombocytopenia. iTTP incidence is 2-6 per million. Caused by Abs to ADAMTS13), w/ low ADAMTS13 activity vWF multimers bind platelets https://t.co/bvCexDPBmq
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Moving Targets in Lupus and Lupus Trials
In the 1990s, developing lupus treatments became a priority, but success was elusive for 20 years. Belimumab was approved by showing only small differences from placebo in trials with 867 patients globally. Its efficacy was confirmed by https://t.co/TekxzTJjwC
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Biologics in Pregnancy Patients With Autoimmune Disease
A large cohort, claims data study shows that among pregnant women receiving biologic therapies for autoimmune conditions, 72% continued their biologics pregnancy, more so among inflammatory bowel disease (IBD) patients https://t.co/fjtUNaYtp9
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Biologics in Pregnancy Patients With Autoimmune Disease
A large cohort, claims data study shows that among pregnant women receiving biologic therapies for autoimmune conditions, 72% continued their biologics pregnancy, more so among inflammatory bowel disease (IBD) patients https://t.co/CH60gShlH0
Dr. John Cush RheumNow ( View Tweet)
