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Infections & Lupus (10.28.2022)
Dr. Jack Cush discusses the news and journal reports from the past week on RheumNow. This week more lupus nephritis, more drug induced lupus and more lupus infections that may kill.
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Growing Confidence in Biosimilars?
MediaSource
Today, Cardinal Health released its third edition of Rheumatology Insights, a research report based on surveys with more than 100 rheumatologists nationwide that focuses on key trends
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Are We Overcautious With TNF Inhibitors in Pregnancy?
MedPage Today
What may seem like a prudent approach to treatment of inflammatory bowel disease (IBD) in pregnant women actually represents an overabundance of caution, suggested researchers who found no increased risk from tumor necrosis factor (TNF) inhibitors.
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BIOBADASER registry study of 969 axSpA pts (315 females, 654 males; 2000-2019) who initiated a TNFi shows nonresponse (BASDAI50) was more likely in women (p=0.018), older age at the start of TNFi therapy. https://t.co/Zp7PWhEMav https://t.co/1XY0dC0QCW
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TNF inhibitors Dont Increase Cancer Risk! 4592 RA pts:TNFi Rx (2296) vs matched DMARD Rx (2296) pts. TNFi had a lower cancer risk than DMARD Rx (IR 6.5 vs. 15.6 /1000PYs]). TNFi had Lower HR GI CA (0.432), breast CA (0.146), GU CA (0.220) https://t.co/mf1g0LwjXR
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Will we see you there? #ACR2022
What are you most looking forward to on the agenda? https://t.co/KQGHJtwboe
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TNF inhibitors Dont Increase Cancer Risk! 4592 RA pts:TNFi Rx (2296) vs matched DMARD Rx (2296) pts. TNFi had a lower cancer risk than DMARD Rx (IR 6.5 vs. 15.6 /1000PYs]). TNFi had Lower HR GI CA (0.432), breast CA (0.146), GU CA (0.220) https://t.co/F5ToHLJULn
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Follow us for real time coverage #ACR2022 https://t.co/5CBdiKWdKM
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Rheumatology Salaries and Career Choices
A recent Doximity report shows how rheumatology salaries increase by years in practice. Rheumatologists tend to earn their highest salaries after gaining 30-39 years of experience.
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A retrospectively cohort study of 147 r-AxSpA patients looked at secukinumab retention, which was 55% at 12 mos. Obesity was assoc w/ a lower rate of SEC D/C (29% v 50%, p = 0.013). Yet multiple TNFi had higher rate of SEC D/C [HR 1.99] https://t.co/OZIZoTROZS https://t.co/M99ANDGzv9
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VTE Risk from Swedish Rheumatology Quality Register - VTE Prevalnce/1000PY TNFi 5.15; JAKi 11.33; Gen Pop 3.3. VTE adj HR JAKi vs TNFi =1.73 (1.24, 2.42); PE HR 3.21 (2.11, 4.88) and DVT HR 0.83 (0.47,1.45) https://t.co/WclcFpX3aI https://t.co/r1FXSZNcYJ
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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/jdJ9H04lnE https://t.co/yoxrKiIVW2
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Open label, noninferiority study TNFi withdrawal in 64 PsA & 58 axSpA pts. 2/3 tapered by dz activity T2T strategy (N=81) & 1/3 continued TNFi. At 12 mos. LDA seen in 69% w/ Tapering (~avg 53% dose) vs 73% no-tapering group (91% dose) https://t.co/K6WFaesyRt https://t.co/zqo6nVGtqW
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The 2022 ACR abstracts are published and posted for you. Let the Learning begin! https://t.co/ZqMAc8jV3U https://t.co/3iCGnzsPI5
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Risk of TNFi-related psoriasis in 5088 TNFi Rx children w/ IBD, JIA, or CNO. Compared to non-TNFi exposed, kids on TNFi had an increased PSO risk w/ ADA (IRR 2.70; 1.53-4.75), infliximab (2.34) or etanercept (2.21) & not incr w/ DMARD use https://t.co/Y1Vn9kjk5N https://t.co/5CCxa5kMcU
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JAK-pot study of 19 registries, 31,846 RA pts Rx w/ new drugs shows equal CDAI efficacy for TNFi (54%), ABA (50%), IL-6i (55%), & JAKi (56%). Most D/C for LOE. Compared to TNFi, JAKi and IL-6i were d/c more for adverse events, less for ineffectiveness https://t.co/FlqPUVdWaC https://t.co/BZnpwtB8SY
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