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Cost-Effective Use of Biological and Targeted Synthetic DMARDs
An international task force of 13 European experts have developed evidence-based points to consider regarding the cost-effective use of biological and targeted synthetic disease-modifying antirheumatic drugs (b/tsDMARDs) in the treatment of inflammatory rheumatic diseases (including rheumatoid arthritis, psoriatic arthritis and axial spondyloarthritis).
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NSAIDs in Pregnancy (3.3.2023)
Dr. Jack Cush reviews the lastest journal articles, news, and FDA announcements from the past week on RheumNow. This week, the importance of IFNa, Subclinical PsA and NSAID safety during Pregnancy.
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The Late Edition (2.24.2023)
Dr. Jack Cush reviews the news and journal articles from the past week on RheumNow.com
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Atul Deodhar's "3-4-5" Rule for MRI Sacroiliac Jts (SIJ)
Erosion in 3+ SIJ quadrants
Bone marrow edema 4+ SIJ quadrants
Fat lesion in 5+ SI joint
@Rheumnow #RNL2023 https://t.co/AHZUhhEmmC
Eric Dein ericdeinmd ( View Tweet)
Dr. Deodhar reminds us of his "3,4,5 rule" for diagnosing AS.
*Erosions in 3 or more SIJ quadrants
*BME in 4 or more SIJ quadrants
*Fat lesions in 5 of more SIJ quadrants
#RNL2023 @RheumNow https://t.co/2m8TmkQo0A
Dr. Rachel Tate uptoTate ( View Tweet)
Dr. Atul Deodhar on AxSpA
- 5-40% of nr-axSpA progress to r-axSpA over 2-10 years
- is non-radiographic axSpA a misnomer?
@RheumNow #RNL2023 https://t.co/bhwlbg6eWN
Robert B Chao, MD doctorRBC ( View Tweet)
Risk factors for radiographic progression:
Men ♂️
Smoking 🚬
Active inflammation🔥
Blue collar workers 💪
HLA-B27+ 💉
Pre-existing syndesmophyte 🩻
Atul Deodhar at #RNL2023 @RheumNow https://t.co/9ibHTEhi9k
Eric Dein ericdeinmd ( View Tweet)
No significance difference in radiographic progression in patients with IL17-TNF , BY Atul Deodhar #RNL2023 @RheumNow https://t.co/S3NQ4mWgjt
Nouf Al hemmadi NoufAhmedAlham2 ( View Tweet)
SURPASS: SEC vs ADA for axSpA
Outcome: %pts with no radiographic progression
Not benefit- Secukinumab not better than adalimumab
Though negative study, in all groups the progression was very low (<1 mSASS) - both interventions did well!
@RheumNow #RNL2023 https://t.co/Vt58jSXCMd
Eric Dein ericdeinmd ( View Tweet)
First Head-to-Head bDMARD study in axSpA to assess radiographic progression
- secukinumab vs. adalimumab biosimilar
- 66% of either arm prevented radiographic progression
- no difference between two arms but good news is radiographic progression is low!
@RheumNow #RNL2023 https://t.co/xq8GhN7kzr
Robert B Chao, MD doctorRBC ( View Tweet)
Late breaking ACR abstract '22 SURPASS study (H2H TNFi vs IL17 in AS radiographic progression.) Primary endpoint was not met.
However, Dr. Deodhar's take away: spinal radiographic progression over 2 years is very low despite high disease activity in both txs! #RNL2023 @RheumNow https://t.co/TsukRs29pC
Dr. Rachel Tate uptoTate ( View Tweet)
Bimekizumab is a dual IL-17A and IL-17F inhibitor, for nr-axSpA and AS
- it works but is it different from existing IL-17i?
- appears to work well in TNFi-inadequate responders
- are TNFi-IR pts immunologically different? niche category for IL-17A and F use?
@RheumNow #RNL2023 https://t.co/dWkakahHAi
Robert B Chao, MD doctorRBC ( View Tweet)
Dennis Poddubnyy #RNL2023
MRI sequences for axSpA:
Semi-coronal- T1 weighted, T2 STIR, T1 weighted w fat suppression
Semi-axial- T2 STIR
@RheumNow https://t.co/ySk4hU5lMY
Eric Dein ericdeinmd ( View Tweet)
To differentiate mechanical from inflammatory lesion:
1-Site matters
2-Structural changes matter
Denis Poddubnyy #RNL2023 @RheumNow https://t.co/iQ1gHPnkqO
Nouf Al hemmadi NoufAhmedAlham2 ( View Tweet)
@RheumNow's review of new drug approvals during 2022 at #RNL2023 https://t.co/IgndlG6lOI
Dr. Rachel Tate uptoTate ( View Tweet)
Dr. Stanley Cohen on JAKinibs:
Very concise and informative timeline on the multiple JAKinibs approved for multiple conditions
@RheumNow #RNL2023 https://t.co/3ZZHr0akrR
Robert B Chao, MD doctorRBC ( View Tweet)
Swedish registry of Axial SpA pregnancies, 1580 births (matched 1:10), saw improved Preg outcomes & incr biologic use. SpA pts had signif. incr in preterm (RR 1·43), preeclampsia (1·44), C-Sect (1·59), infant SIE (1·29) - Each decreased by annually 0.5% https://t.co/EAUwxNsgzH https://t.co/tmNi3dQtMK
Links:
Dr. John Cush RheumNow ( View Tweet)
32 men w/ B27+ #AS (Rx NSAIDs, BASDAI ~5.3) underwent exercise training (10d, 60min) w/ or w/o Pre-Rx w/ whole-body cryotherapy (WBC). WBC had significant drops in hsCRP, sP-Selectin, sVCAM-1, neopterin & signif decreases in BASDAI, BASFI, pain intensity https://t.co/8bmjTS4VOk https://t.co/ajrD8Z7C8v
Links:
Dr. John Cush RheumNow ( View Tweet)
Enthesitis-related arthritis compared in kids - 105 ERA (57 axial vs 48 peripheral). Axial ERA pts were older @onset (12 vs. 11yrs), longer Dx delay(10 vs. 5 mos), higher inflammatory markers, more Hip Dz (53% vs 27%), more biologic Rx (67% vs 21%) https://t.co/KTYn1kv3qO https://t.co/eWbvMSBLxm
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Dr. John Cush RheumNow ( View Tweet)
New Guideline: Vaccinations OK With Few Tweaks for Rheum Patients
Nearly all available vaccines can be given to people with rheumatologic diseases, according to a new, detailed guideline from the ACR.
https://t.co/514mIylgzj https://t.co/9Zq9pGcujV
Links:
Dr. John Cush RheumNow ( View Tweet)
