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Article

Polymyalgia rheumatica: more than just steroids at ACR22

David Liew, FRACP Nov 11, 2022

After decades of having little else proven apart from glucocorticosteroids with which to treat polymyalgia rheumatica (PMR), evidence for steroid-sparing options has grown in recent years, and this crescendo is set to continue at ACR Convergence 2022 in Philadelphia, PA.

Article

Heavy Metal Rheumatology (9.23.2022)

Jack Cush, MD Sep 23, 2022

Below are this week’s highlights from RheumNow, as discussed by Dr. Jack Cush. Thanks to all of you for your kind comments and great reviews of our weekly podcast. Please let us know how we can improve by emailing me or recording your suggestion using the "Ask Cush Anything" link on our website.

Article

Is PMR the Next Indication for Tocilizumab?

MedPage Today Sep 21, 2022

About half of patients with steroid-dependent polymyalgia rheumatica (PMR) were able to get off steroids altogether when they were started on tocilizumab (Actemra) infusions, which also improved disease control in most cases, a randomized phase III trial showed.

Article

CD19 CAR T Cell Therapy in SLE (9.16.2022)

Jack Cush, MD Sep 16, 2022

The big news this week: the approval of deucravacitinib (a new class of drug?) for psoriasis; the 2022 ACR guidance on glucocorticoid-induced osteoporosis; a national poll of older adults over the age of 50 who claimed self-reported or doctor-diagnosed arthritis; and much more. Let's review these and other news, journal reports and announcements from this past week.

Froehlich et al. MRI superior to US in GCA. For all GCA sensitivity 73% vs 45%. For supra-aortic GCA sensitivity 73% vs 59%. Both 100% specificity. @rheumnow #ACR22 Abstr#0493 https://t.co/vf2r0h5zUd https://t.co/mlSCcpy2uK

MRI Is Superior to Ultrasound of Supraaortic Arteries in Detecting Giant Cell A…

@MayoClinic data for bari in relapsing GCA caused waves at #ACR21 Spanish data looking at real-world practice: slightly longer, slower GCA, but equally encouraging outcomes waiting for SELECT-GCA with interest! @EBRheum ABST0464 #ACR22 @RheumNow https://t.co/pVRPXAohhc https://t.co/FgNNfPSWk3

https://twitter.com/drdavidliew/status/1457688108338606083

Study of IV tocilizumab for GCA that led to FDA approval of intravenous TCZ this year (2/2022) -one of Dr. C Langford's pick for #YearinReview @rheumnow #ACR22 https://t.co/luxDDluddM

Effect of Tocilizumab on Disease Activity in Patients With Active Polymyalgia R…

TCZ in GCA: what does it mean for diabetes? post-hoc GiACTA: HbA1c obvs better with TCZ (PNL dosing) but then: even after adjusting for PNL dose, apparent benefit Is there protective effect? Interesting observation worth investigating ABST0461 @MGHrheumatology #ACR22 @RheumNow https://t.co/CF1as5y7Yy

Exciting time to be doing research in GCA! Over half a dozen ongoing RCTs Challenging to recruit enough patients given (1) competing trials (2) reticence to join a trial when tocilizumab (standard of care) is available #ACR22 #Vasculitis22 @RheumNow https://t.co/mJm69gH4N9

Nice summary slide of the recently published 2022 Classification Criteria for GCA and TAK! Avalable free! TAK: https://t.co/0aMVPvKgyE GCA: https://t.co/s1aiFpq3r2 #ACR22 #Vasculitis22 @RheumNow https://t.co/x9ufxi7aco

Abbvie launching another upadacitinib phase 3 trial w/essentially zero preliinary data I personally love this strategy; I think Phase 2's are an expensive waste of time Better to go big and answer the question? COI: I participate in SELECT-GCA #ACR22 @RheumNow #Vasculitis22 https://t.co/fSs3xt8baA

12 pts w/ new onset IgA vasculitis (IgAV) post COVID- 19 vaccination (5F; age 52 yrs) - 10 had mRNA & 2 viral vector Vax. Time from Vax to Sxs=11.5 d; 8/12 had vasculitis w/ 1st dose; all skin (7 Jts, 4GI, 2 renal). All Rx w/ steroids https://t.co/eCcUkGeAwV https://t.co/VU1LwFxITC

https://bit.ly/3FVT2ry

Chest CT Airway Dz compared betw GPA (n26) & relapsing polychondritis (n19). Subglottic involvement favors GPA (OR 28.6) & Extensive airway Dz favor of RP (GP OR 0.02). Lesser RP assoc w/ Posterior tracheal sparing & tracheal calcifications. https://t.co/TaaEjpPm76 https://t.co/mwljLYIymH

https://bit.ly/3NnJjfp

Highlights from the @ACRheum Kawasaki Disease Guidelines 🥇IVIG is mainstay therapy (2 g/kg) 👶🏼 Use ASA in acute KD 🗣Refractory cases may require steroids or additional immunosuppression 🫀Get echos on all patients to assess for coronary aneurysms

NEJM: 70 yoWM w/ 3-wk temporal headaches, jaw pain with chewing, temporal artery tender and thickened, but NO vision Sxs. a 15, CRP 24 mg/L. and Doppler US showed “halo sign” . Temp art Bx confirmed the Dx of GCA https://t.co/ayPcVKctEA https://t.co/g3iP0Akbzs

https://bit.ly/3rYTz3S

IL-6i in Behcets? Lit Review finds 25 articles papers, 74 pts (31 TNFi naive, 45 TNFi prior Rx). Pts Rx w/ tocilizumab IV. TCZ given for vascular, CNS , ocular & mucocutaneous. TCZ was effective in 87% TNF naive & 80% in TNFi Experienced pts. https://t.co/u1jnR9gb1L https://t.co/Rkqch4MVWi

https://bit.ly/3fjUoRK

Worldwide, IL-6 inhibitors are approved for RA, poly JIA, systemic JIA, AOSD, GCA, Takayasu arteritis, Castleman’s dz, CAR-T-cell-induced cytokine release syndrome, neuromyelitis optica spectrum disorder and severe COVID-19 https://t.co/SRPjerXnGS

https://bit.ly/3BDHwx4

Is PMR the Next Indication for Tocilizumab? About half of patients with steroid-dependent PMR were able to get off steroids altogether when they were started on tocilizumab (Actemra) infusions, a randomized phase III trial showed. https://t.co/LUMG4NnZzs https://t.co/zdFacyYyud

https://bit.ly/3f8AVmT

A longitudinal study of 506 ANCA-associated vasculitis (AAV) pts showed pts w/ negative ANCA serologies within 180 days of induction had signif lower risk of relapse (HR 0.55; 0.38 to 0.81) but not for ESRD or death within 5 years. https://t.co/qFb2Usov8L https://t.co/faogbabc2W

https://bit.ly/3QQfxzU

Mayo study of 3817 temporal artery biopsies performed on 2539 pts (1994-2004) - 681 (27%) +Bx on one side. Biopsy length HAD NO significant effect BX positivity. If 1-side initially Bx-, then Bx of the contralateral side yielded an added 7% Bx positivity https://t.co/Lr8hYHIlG7 https://t.co/alIpklPtsw

https://bit.ly/3RT9ZWs

Topics

All News

Polymyalgia rheumatica: more than just steroids at ACR22

Heavy Metal Rheumatology (9.23.2022)

Is PMR the Next Indication for Tocilizumab?

CD19 CAR T Cell Therapy in SLE (9.16.2022)

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