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Best of 2022: EULAR 2022 Top 10 Abstracts
Dr. Jack Cush reviews the top abstracts from EULAR 2022 As chosen by me with the aid of the RheumNow EULAR faculty. “Top” is relative and subjective, but my criteria for inclusion are based on impact, water cooler talk potential, innovation and social media buzz. Speaking of social media…
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Best of 2022: Acne with JAK Inhibitors
JAK inhibitors have become enormously popular and while their side effect profile has been delineated and reviewed, little mention is made of acne – an adverse event that may affect up to one-quarter of patients taking JAK inhibitors (JAKi). Dermatologists often refer to this side effect as "JAKne".
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New Hope for Hand Osteoarthritis
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EurekAlert!
The drug talarozole – which increases retinoic acid – could be a promising new treatment for hand osteoarthritis.
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Best of 2022: Acne with JAK Inhibitors
https://t.co/ul0CJUTFZE https://t.co/dahLh04k4u
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Infection in lupus is suggested by very high CRP, PMN-lymph ratio (NLR) Plt-lymph ratio(PLR). Study of 104 hospitalized SLE found all very high w/ infx & Combined cutoffs of CRP >20 mg/L, NLR >3.5, PLR >151 had 87 sensitivity & 81% specificity for infx https://t.co/2ycSGhnHeK https://t.co/VZsGAK2hFs
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NEJM has published results of 2 phase 3 trials (BRAVE-AA1, BRAVE-AA2) demonstrating the efficacy of Baricitinib in aduls with severe alopecia areata - BARI was superior to placebo in hair regrowth by week 36 https://t.co/eTP2d107ti https://t.co/BMKrL5NLyg
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New Hope for Hand Osteoarthritis
The drug talarozole – which increases retinoic acid – could be a promising new treatment for hand osteoarthritis.
https://t.co/jVMLiJLnch https://t.co/0nk8WA2k1S
Links:
Dr. John Cush RheumNow ( View Tweet)
Best of 2022: Methotrexate in PsA
Until the publication of the SEAM trial1, evidence in the medical literature for the efficacy of the most commonly used drug for PsA worldwide, MTX, has been lukewarm at best.
https://t.co/vl2u9JENpt https://t.co/SHHAfkFX9k
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anti-IL-23 therapy is not effective in Axial Spondyloarthritis. While ustekinumab, guselkumab and risankizumab are approved in psoriasis (& PsA for GUS, RIZ), studies of Ustekinumab and risankizumab failed to show efficacy in axSpA https://t.co/hjXEopji6r https://t.co/FwzBa2YNzb
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On Wednesday 12/21 the FDA approved tocilizumab (Actemra; 8 mg/kg, 60-min IV infusion ) for hospitalized COVID-19 on steroids, supplemental O2 & req ventilation, or ECMO; 1st MAb approved for COVID-19; Prev EUA issued in June 2021 https://t.co/BswLu4ZY5O https://t.co/7gpPkeoPZ4
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Deucravacitinib, TYK2 inhib, studied in phase II trial 203 active PsA pts randomised to PBO, or DEUC 6 mg or 12 mg qd. At wk 16 ACR-20 responses were significantly higher with DEUC 6mg (53%, p=0.0134) and 12 mg (63%, p=0.0004) vs PBO. https://t.co/0zCcYXMQOD
#BestOf2022
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213 #SLE pts were screened for Cryoglobulinemia (2013 -2017); CG is frequent in SLE (66%), but mostly asymptomatic. Mean levels 40mg/L (0-228). Cryo Vasculitis in 15% w/ purpura, ulcers, digit ischemia, arthritis, GN (5%) or CNS (19%) https://t.co/rBNDHrb3sh #BestOf2022
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Lit review of MDA5 antibody-positive clinically amyopathic dermatomyositis w/ ILD - shows limited data from 15 studies, 388 pts, 1 RCT: ? best survival with high-dose steroids + immunosuppressive (CTX or CyA/tacrolimus). Refractory dz Rx w/PLEX, Tofa, RTX https://t.co/8yE4B3SfRg
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Allopurinol Use Does Not Increase Mortality in Gout w/ Chronic Kidney Disease
A trial has shown that allopurinol use dose escalation and achieving target uric acid levels, was not associated w/ increased mortality in patients with gout and concurrent CKD.
https… https://t.co/IIBo3aOLio
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Lumbar spinal stenosis affects 103 million worldwide (11% of older adults in US). 1st line Rx is activity modification, analgesia, PT. Benefits of epidural steroids havent been established. Decompressive surgery only for selected pts w/ pain & limitation https://t.co/zye3p5j2Hn https://t.co/HzVGLT8Qgl
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Hyperuricemia as a biomarker of severe #PsA? Study of 242 PsA pts 30% had hyperuricemia & 6% had gout. Hyperuricemia was significantly associated with age, comorbidity, perph polyarthritis, Jt destruction, less response to treatment. https://t.co/6uUWYPyFKf https://t.co/9nVj0lYwMO
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Study of 119 SLE pts (30 w CKD) shows urinary galectin-3 binding protein as a biomarker, increased w/ active LN, significantly (p<0.001)correlating w/ SLEDAI, SLICC RAS, histologic activity; higher in proliferative vs membranous LN (p=0.04) https://t.co/DlJzREdj0h https://t.co/peqZzpQrWk
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JAKi not yet safe in pregnancy - theyre fetotoxic at high doses (animals). JAKi do cross placenta. ACR Guidelines: no position due to no data. 47 tofa Rheum & 15 UC maternal exposures - no signif probs. Paternal use of JAKi is ok.
https://t.co/o4zqwwHwU9 https://t.co/NfFu3rb3gD https://t.co/72bJgfC6zx
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Spanish SpA Registry (REGISPONSER) - 18.3% had psoriasis; w/ 3/4 of these (76%) having PSO before MSK Sxs. Pts w/ PSO before MSK Sxs had shorter dz duration, lower BMI, Less B27 & anterior uveitis, more dactylitis and ^risk PsA dx (78% vs 56%)
https://t.co/Kc1n4RVe3v
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Nailfold Capillaroscopy doesnt have to be expensive: use handheld Carson Microbrite (~$10) 10x or 20 x handheld microscope (w/ KY gel) to evaluate #Raynauds #scleroderma https://t.co/aJ6K6JeVCp https://t.co/0aUBnqxhic https://t.co/54s66sWvyv #RWCS2022
#BestOf2022
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