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FDA Approves Avacopan for ANCA-Associated Vasculitis

Jack Cush, MD

October 8, 2021 the U.S.

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RheumNow Podcast – I Wanna New Drug.V2 (9.24.2021)

Jack Cush, MD

Almost three years ago to the day, I did a podcast entitled, "I wanna new drug." As I go over this week's podcast, I want to say it again. I want a new drug safe enough to use during pregnancy, for PMR, for GVHD, and more. I'm going to cover these, and other topics including lupus, COVID breakthrough infections, and statin use and the risk of RA, as I review the news and journal articles from the past week on RheumNow.

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TNF Inhibitor Induced IgA Vasculitis in IBD

Jack Cush, MD

A new descriptive series shows an uncommon association between IgA vasculitis (IgAV) and inflammatory bowel diseases (IBD), with most cases interestingly arising after  or during anti-TNF-α therapy.

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RheumNow Podcast – Booster Shots for COVID (8.13.2021)

Jack Cush, MD

Dr. Jack Cush reviews the news and journal reports from the past week on RheumNow.com.

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Mepolizumab Dosing in Eosinophilic Granulomatosis with Polyangiitis

Jack Cush, MD

A new European real world experience study shows that mepolizumab is effective at both 100 or 300mg every 4 weeks in patients with the rarely encountered eosinophilic granulomatosis with polyangiitis (EGPA; or Churg-Strauss Syndrome). 

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RheumNow Podcast – Saphnelo (Anifrolumab) Approved for Lupus (8.6.2021)

Jack Cush, MD

It was a banner week at the FDA; a new drug approval you should know about; a lot of information about pregnancy and safety; and an interesting case plus a question from one of our readers submitted via Back Talk. This and more in this week's podcast. Let's dive in.

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ACR/Vasculitis Foundation Guideline for Giant Cell Arteritis and Takayasu Arteritis

Jack Cush, MD

The ACR and the Vasculitis Foundation have published their evidence-based recommendations and expert guidance for the management of GCA and Takayasu arteritis. These recommendations address a variety of clinical questions and scenarios including diagnostic testing, imaging, treatments, and surgical interventions. Recommendations for GCA and TAK include support for the use of glucocorticoid-sparing immunosuppressive agents and the use of imaging to identify large vessel involvement. Recommendations for TAK include the use of glucocorticoids as initial therapy.

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FDA Approves Avacopan for ANCA-Associated Vasculitis https://t.co/L7UwhYBaVY #RheumNow https://t.co/0cGN5eyfCl

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Dr. John Cush RheumNow ( View Tweet)
Encouraging DBRPCT of Rituximab in #PMR: 116 screened, 49 enrolled, 47 completed: 23 on RTX vs 24 on PBO. Steroid-free remission at 21 wks seen with 11/23 (48%) RTX pts vs 5/24 (21%) on PBO (p=0·049). Infusion Rxns: 10 RTX vs 3 PBO); 1 SAE (PE) on RTX https://t.co/U2ZGNrpi0i

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The EMA has recommended Nucala (mepolizumab) as an add-on treatment for patients aged 6 years and older with relapsing-remitting or refractory eosinophilic granulomatosis with polyangiitis (EGPA) https://t.co/0aVoDpaTPT

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Dr. John Cush RheumNow ( View Tweet)

Metanalysis of long-term steroid (GC) in PMR (24 studies) 77%, 51%, & 25% PMR pts still GC respectively 1, 2, & 5 yrs. 1st Yr pooled relapse rate =43%. Prolonged GC use/relapse moreso in Females, Hi ESR, periph arthritis, starting dose, tapering speed https://t.co/n0gGlik1hO https://t.co/WBqdfUW2RS

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Dr. John Cush RheumNow ( View Tweet)
Cochrane review finds only 2 studies showing tocilizumab to be beneficial in GCA (sustained remission, relapse-free survival, need for escape therapy). https://t.co/sQjIBAiWKN

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Dr. John Cush RheumNow ( View Tweet)

Article in press: Can ANCA titers predict relapse in patients with GPA? Cohort study by @UofT_DoM - microscopic hematuria and MPO ab at month 12 predicted increased risk of relapse https://t.co/ks3Gj5iSLR

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Seminars in Arthritis and Rheumatism seminarthrheum ( View Tweet)

ICYMI: One of our top June videos WATCH: Is blindness with Tocilizumab in GCA a worry? Dr. David Liew ( @drdavidliew ) weighs in. #EULAR2021 https://t.co/eFrmbkW9Gy https://t.co/4tY3hEDj2j

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Dr. John Cush RheumNow ( View Tweet)
ICYMI: Drugs capable of inducing drug-associated ANCA vasculitis - mirabegron (Myrbetriq), sofosbuvir (Sovaldi, antiviral), nintedanib (Ofev), hydralazine, propylthiouracil, thiamazole, minocycline, carbimazole, allopurinol, influenza vax.... https://t.co/KhK2w0IGAx

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Dr. John Cush RheumNow ( View Tweet)

ICYMI: EULAR guidelines rec starting prednisone dose in #PMR to be between 12.5-25mg/d. A cross sectional study of 138 pts (63M, 75F, age 73.4 yes) saw the mean starting dose to be 19.2±7.7 mg.  https://t.co/Yf3yqRRMCK

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Dr. John Cush RheumNow ( View Tweet)

ICYMI While myeloperoxidase (MPO) Abs are seen in idiopathic pulmonary fibrosis (IPF), only 7–23% develop vasculitis. Study of 58 pts w/ IPF & MPO Abs - UIP most frequent ILD pattern, 13 had rheumatic dz; MPO Abs did not change survival of UIP/IPF pts https://t.co/RXXIPUBMBT https://t.co/sJpbzIbBJt

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Dr. John Cush RheumNow ( View Tweet)
While myeloperoxidase (MPO) Abs are seen in idiopathic pulmonary fibrosis (IPF), only 7–23% develop vasculitis. Study of 58 pts w/ IPF & MPO Abs - UIP most frequent ILD pattern, 13 had rheumatic dz; MPO Abs did not change survival of UIP/IPF pts https://t.co/RXXIPUBMBT https://t.co/v3KhEaefZD

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Dr. John Cush RheumNow ( View Tweet)
Drugs capable of inducing drug-associated ANCA vasculitis - mirabegron (Myrbetriq), sofosbuvir (Sovaldi, antiviral), nintedanib (Ofev), hydralazine, propylthiouracil, thiamazole, minocycline, carbimazole, allopurinol, influenza vax.... https://t.co/KhK2w10hs5

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Dr. John Cush RheumNow ( View Tweet)

ACR/Vasculitis Foundation 2021 Guidelines for ANCA–Associated Vasculitis Chung et al have published the 2021 treatment guidelines for the management of antineutrophil cytoplasmic antibody–AAV, including GPA, MPA, and EGPA. https://t.co/234OQ7klRd https://t.co/33sWq1U55T

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Dr. John Cush RheumNow ( View Tweet)
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