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RA Prevention through Deep Immunophenotyping
Researchers at the University of Colorado have identified pathogenic immune phenotypes in at-risk populations for rheumatoid arthritis (RA).
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Uveitis Risk with Slow Adalimumab Weaning
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MedPage Today
Patients with pediatric non-infectious uveitis (NIU) who achieved remission on adalimumab (Humira) had lower recurrence rates when the drug was withdrawn more gradually, a retrospective cohort analysis indicated.
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ACP: Best Practice Advice on Cannabis or Cannabinoids Use for Chronic Noncancer Pain
The American College of Physicians published a best practice advisory on cannabis or cannabinoids in the Annals of Internal Medicine.
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Mindfulness and CBT improve chronic low back pain
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EurekAlert!
Behavioral interventions were associated with reduced pain and daily opioid use and improved function and quality of life for up to 12 months among adults with opioid-treated chronic low back pain, according to a new randomized clinical trial.
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Danish registry study of 1431 AAV pts ((median age: 69 yrs, 52M; F/U 4.8 yrs) shows AAV had more LVH (17% vs 12%), ST-T (10% vs 7%), aFib (9.6% vs 7.5%), QTc prolong (6% vs 3.6%). Only AAV w/ major ECG abnls had incr risk of CV mortality [HR 1.99; 1.49-2.65) https://t.co/OB8b9pC6kw
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EMA's EudraVigilance (safety) database study of 10,319 MTX reports (age: 62 yrs, 73% F). Adverse rxns (ADR): 365 kidney & 1,082 liver related. MTX renal ADRs were older, w/ comeds (NSAIDs, Tylenol, metamizole, steroids). More deaths w/ renal ADRs than liver(21% vs 6%); mostly w/ https://t.co/sZYZla0q1X
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JAMA Staphylococcus aureus Review
- s. aureus bacteremia leads to septic arthritis (7%), vertebral osteomyelitis (≈4%)
- bacteremia (≥48 hs) has 39% 90-day mortality risk
https://t.co/atao3mF32L https://t.co/oMSJVNKvJN
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Topline results from Phase 3b APEX study, comparing guselkumab to placebo in biologic naive #PsA pts - showed significant improvement by ACR20 and significantly less Xray progression of structural damage (vs PB) at Week 24 https://t.co/YkUspqd92h https://t.co/cmAUWaScri
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FDA announced approval of Inebilizumab (Uplizna; Amgen), 1st approved Rx for IgG4-related disease (targets CD19+ B cells). IG4-related Dz is estimated to affect 20,000 in the USA. List price is $140,248.50 per dose, After two initial loading doses it is given q 6 mos. https://t.co/aD9yBVJukQ
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Matched cohort study of 83,811 #RA pts showed RA had a 12% increased risk of avoidable hospitalizations (CHF, pulmonary edema; (IRR 1.12). Predictors of ACSC hosp. were age, Steroids, ambulatory comorbid Dxs. ambulatory care access & ^ primary care may reduce this risk. https://t.co/Tx7LO59RbP
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12-month community trial 770 adults w/ opioid-treated chronic low back pain (CLBP). Found that opioid dosage decreased with both mindfulness-based therapy & cognitive behavioral therapy (CBT) at 6 & 12 mos.(noninferior) - Why dont we use these? https://t.co/9VhqJEHlhc https://t.co/GWnL66nbvY
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NORD-STAR RCT: Rx -naïve pts w/ early #RA found triple (MSH) Rx w/ prn IA steroid injx was superior to MTX + Pred (w/ taper) - w/ better clinical outcomes, fewer withdrawals, fewer AEs, & less steroid use BUT slightly worse Xray outcomes https://t.co/YN6Om2xdIP https://t.co/a7G8WFZSK7
Links:
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JAK-pot Collaboration of 15 registries looked at MACE risk in RA pts and found NO incr CV risk during 1st 2 yrs of JAKi (vs TNFi) use. 51233 pts; 828 incident MACE; in 73008 Rx courses (16K JAKi, 35K TNFi, & 21K OMA bDMARDs). JAK adj IRR: 0.89;0.63 to 1.25 (vs TNFi); bDMARD-OMA https://t.co/MAZrGfCNrU
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French REGATE registry study examined RA pts (n 1496) & Safety of tocilizumab (exposure 3991 PYs). 63 (4.2%) developed 75 cancers (35 solid, 11 Heme, 3 melanomas, 26 NMSC). CA incidence rate (excluding NMSC) was 7.5 /1000 PY. Independ Risk factors for solid CA = age (HR=1.05), https://t.co/3q8HIPa6qf
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Vamorolone: a New Steroid on the Horizon?
Vamorolone is a potentially new alternative to traditional glucocorticoids for use in inflammatory diseases. It is a dissociated steroidal compound with reduced side effects, and in an animal model of inflammation has shown effective https://t.co/zHDyJbU23q
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Steroids, Prophylaxis and Pneumocystis Pneumonia
A case-control study has shown that glucocorticoids and tapering glucocorticoids are risk factors for the development of Pneumocystis jirovecii pneumonia (PJP). The authors provide guidance on the optimal timing for prophylaxis https://t.co/0nKVEKOEex
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Upadacitinib for Giant-Cell Arteritis - A Phase 3 Trial
The NEJM has published a randomized controlled trial in giant-cell arteritis (GCA) patients, demonstrating significant efficacy and safety of upadacitinib (UPA), given as 15 mg daily, as compared to placebo. https://t.co/Njmg2PKAbq
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Diagnostic delays and Undertreatment of Psoriatic Arthritis
New research from the University of Bath in the UK reveals delayed diagnosis and undertreatment of psoriatic arthritis often results in irreversible damage to joints.
https://t.co/AyaxUXJs8n https://t.co/9x9GhnTR1Y
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1st Line Biologics vs. csDMARDs in Adult Still's Disease
A German multicentre, retrospective study assessed the first-line efficacy of biologics and conventional synthetic DMARD therapy in patients with adult-onset Still's disease (AOSD) and found biologic agents were https://t.co/NaxACbmyxl
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Consensus Against Interventional Injections for Chronic Spinal Pain
BMJ has published a clinical practice guideline resulting from the work of an international, multidisciplinary panel addressing chronic spine pain (≥3 months duration) not associated with cancer or https://t.co/mCsz88JACh
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