EULAR 2018 - Day 4 Report

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The EULAR 2018 wound down on Saturday with fewer oral presentations but many posters.  In my last report I put together a collection of impressions and some thematic highlights not covered in previous reports.

EULAR 2018 - Day 3 Report

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Day 3 highlights include Behcet’s responds to apremilast and that biologics do not differentially affect TKR/THR post-operative infection rates. Be sure to check out today's podcast as well. 

JAK Inhibition in Autoinflammatory Syndromes Interferonopathies

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While many autoinflammatory syndromes are driven and managed with select inhibition of IL-1, IL-18 or IL-6, a subset are driven by type I interferon and are referred to as interferonopathies. These monogenic IFN–mediated disorders present in infancy with fevers, systemic inflammation, an IFN response gene signature, inflammatory organ damage, and high mortality.

TNF Inhibitors Don't Increase Cancer Risk in Children

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While the risk of neoplasia with tumour necrosis factor inhibitor (TNFi) use has been largely nullified in most inflammatory disorders, this risk in children is less certain. However a recent study shows no risk of increased cancer in children treated with TNFi for juvenile idiopathic arthritis (JIA), pediatric inflammatory bowel disease (pIBD) and pediatric plaque psoriasis (pPsO).

SPAR Predicts ILD Progression in Systemic Sclerosis

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The development and progression of interstitial lung disease in systemic sclerosis can be an ominous finding.

Ustekinumab: A Novel Intervention in Giant Cell Arteritis

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Treatment of refractory giant cell arteritis (GCA) with ustekinumab (Stelara) showed therapeutic promise as a steroid-sparing agent in a small, open-label study, Irish researchers reported.

MPO Antibodies Predict Relapses in MPO-ANCA-Associated Vasculitis

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A study of MPO-ANCA positive patients followed serially over 2 years shows that reappearance of MPO‐ANCA may predict  relapse in patients with MPO‐ANCA positive AAV and that routine MPO‐ANCA monitoring is warranted. 

Autoinflammatory Syndromes Show Dramatic Response to Canakinumab

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The New England Journal of Medicine reports that the anti-interleukin (IL)-1β monoclonal antibody canakinumab (Ilaris) was effective in the treatment of three distinct autoinflammatory recurrent fever syndromes (FMF, TRAPS, HIDS) with responses that were far superior to what was see

The RheumNow Week in Review - Nonadherence and Astronomic Costs (5.11.18)

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Dr. Jack Cush reviews highlights, news and journal articles from the past week on RheumNow.com.

60 Minutes Drills Acthar - A Financially Crippling Drug

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Acthar is in the news again. Previously a New York Times article lambasted the drug as the "single most expensive drug per patient", based on it costing Medicare  $16,2371 per patient for nearly 3100 patients. Overall, costing Medicare a half-billion US dollars per year. 

The RheumNow Week in Review – Why Comorbidity is Like the Weather (5.3.18)

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Dr. Jack Cush discusses the news and journal articles from the past week on RheumNow.com.

Genetic Breakthrough in Systemic JIA

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The identification of a genetic susceptibility locus for systemic juvenile idiopathic arthritis (sJIA) has important implications for treatment of this severe, poorly understood illness, researchers reported.

Tick, Mosquite-Borne Diseases Triple Since 2004

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The Centers for Disease Control and Prevention has a new report showing that from 2004 to 2016, the number of Americans infected by mosquitoes, ticks or fleas tripled from 27,388 in 2004, to 96,075 in 2016. 

From 2015 to 2016, these infections rose by 73 percent. This included new Zika and chikungunya virus infections, (41,680 in 2016), followed by Lyme disease (36,429 cases). This may be an underestimation as as many infections are not reported.

Fixed and Tailored Rituximab Regimens Equal in ANCA Associated Vasculitis

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The French Vasculitis Study Group has published the results of the MAINRITSAN2 trial designed to  compare individually tailored versus fixed-schedule rituximab (RTX) reinfusion for remission maintenance in patients with antineutrophil cytoplasm antibody (ANCA)-associated vasculitides (AAVs).

The RheumNow Week in Review – Vitamin D Snark Report (4.20.18)

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Dr. Jack Cush reviews the news and journal reports from the past week on RheumNow.com.  A second life for Syk kinase, Vitamin D talk, VTE, regulatory hearings and the Lupus clinic edge.

Kineret Approved for Still's Disease in EU

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SOBI has announced that Kineret (anakinra) has been approved by the European Commission (EC) for the treatment of Still’s disease (Systemic Juvenile Idiopathic Arthritis [SJIA] and Adult-Onset Still’s Disease [AOSD]), in all 28 European Union (EU) member states.

SynBioSe: Combo Rituximab and Belimumab Succeeds in Severe Refractory Lupus

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One of the driving pathogenic mechanisms in systemic lupus erythematosus (SLE) is the generation of immune complexes capable of inducing netosis (NET formation) and NET-derived DNA that may be an amplifying autoantigen and give rise to anti-nuclear autoantibodies (ANAs). 

Uveitis in JIA: Screen All, Treat Early

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A European group of experts has formulated consensus-based recommendations for the treatment of juvenile idiopathic arthritis (JIA)-associated uveitis, focusing on screening, monitoring, and treatment of this potentially devastating extra-articular manifestation of JIA.

IL-6 Inhibition Most Effective in Polycyclic Systemic JIA

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The German Autoinflammatory Disease (AID) registry has studied the effects of the IL-6 inhibitor tocilizumab (TCZ) in systemic juvenile idiopathic arthritis (sJIA) patients and shown a clinical response rate of 35% during the first 12 weeks, and inactive disease and/or remission (with medication)

Rituximab May Halt ILD in Antisynthetase Syndrome Myositis

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A multicenter study assessed patients with the antisynthetase syndrome (AS) and interstitial lung disease (ILD) and found that rituximab (RTX) therapy was associated with either improved or stable pulmonary outcomes in most.