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Pre-Treatment Testing with Biologics Falls Short

d Jack Cush, MD

US commercial insurance claim analysis of laboratory screening and monitoring practices in chronic inflammatory skin disease (CISD) patients shows that < 60% received the recommended pretreatment testing when starting systemic immunomodulatory treatment.

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#RNL2024 @RheumNow @_AprilArmstrong Bimekizumab: IL-17A and IL-17F dual efficacy, unlike the prior IL-17i drugs - Fast onset - High efficacy with 2/3 PASI 100 by wk 16 (BE READY) https://t.co/cKh7j4KBs9

Links:

Eric Dein ericdeinmd ( View Tweet)
IL-17 pathway as a target in giant cell arteritis - full read review of pathogenic role of IL-17 and Th17 cells, in #GCA; backed up by the phase II proof-of-principle TiTAIN study showing potential efficacy of secukinumab in GCA pts https://t.co/MThzw2joGO https://t.co/PmrJjf9C3a

Links:

Dr. John Cush RheumNow ( View Tweet)
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Methotrexate Nodulosis (1.19.2024)

d Jack Cush, MD

Dr. Jack Cush reviews the news and journal reports from this past week on RheumNow.com. How good (or not) are rheumatologists and what to do about MTX nodulosis?

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2023

2023 Rheumatology Year in Review

d Jack Cush, MD

Dr. Jack Cush reviews highlights, advances and hot topics in rheumatology from 2023 and the RheumNow website.  



2023 was a year of growth and new horizons while returning to operational and practice standards (in care and education) established before the pandemic.  

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2023, Year, Wordle

2023 Rheumatology Year in Review

d Jack Cush, MD

Here is my top 10 list (in no particular order) of 2023 advances, game-changers, and developments that changed, or will soon change, rheumatologic practices.

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Anti-TNF mAbs, JAKi & anti-IL17 Rx appear protective against anterior Uveitis in AxSpA pts. Network Metanalysis of 44 trials, AU IR -TNF mAb: 4.1, ETN: 5.4, IL17i: 2.8, JAKi: 1.5, & placebo: 10.8. AU risk: TNFi < JAKi < IL-17i < ETN << PBO https://t.co/3zIcvuIaBV https://t.co/UseZ6t00EB

Links:

Dr. John Cush RheumNow ( View Tweet)
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Enthesitis, Synovitis, and Tenosynovitis in Psoriatic Arthritis

d Jack Cush, MD

An ultrasound study suggests that enthesitis is associated with both synovitis and tenosynovitis in patients with Psoriatic arthritis (PsA).

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Best of 2023: Does Biologic Treatment in Psoriasis Reduce the Risk of Psoriatic Arthritis?

d Jack Cush, MD

Retrospective claims analysis shows that psoriasis patients treated with either an IL-12/23 inhibitor or an IL-23 inhibitor had a lower risk of developing incident psoriatic arthritis, compared to TNF inhibitors or IL-17 inhibitors.

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ICYMI: Bimekizumab is Coming…in Third Place

d Michael Putman, MD, MSCI

Of the many exciting advancements for patients with psoriatic arthritis at ACR Convergence, one upcoming therapy stood out: the dual IL-17A/F inhibitor bimekizumab. Nearly two dozen bimekizumab abstracts will be featured at this year’s meeting and it recently received authorization in Europe and the U.S. for psoriasis. That makes this the year I plan to figure out where this drug will be useful for my patients with PsA. 

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UK Dermatology Registry of 13 699 Psoriasis pts on biologics (25K biologic exposures) found 1% risk of paradoxical eczema. Biologics included inhibitors of TNF, IL-17, IL12/23, IL-23. Lowest risk w/ IL-23i (0.56/100kPY), and higher w/ IL-17i (1.22) https://t.co/fOX6VGJQLk https://t.co/u1p1sidCte

Links:

Dr. John Cush RheumNow ( View Tweet)
Greigert et al. IL17 in GCA. Increases vascular inflammation. Synergistic effect on myofibroblasts with IFN-γ - increases IL-1B, IL-6, GM-CSF, CCL20 (recruits T cells), CCL2 (recruits monocytes), VEGF (neoangiogenic). Abstr#2599 #ACR23 @RheumNow https://t.co/p4GumZStAZ https://t.co/zZv0TF4fmn
Richard Conway  ( View Tweet)
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IV Secukinumab for AxSpa

d Eric Dein, MD

The FDA recently announced approval for intravenous secukinumab (Cosentyx) for adults with psoriatic arthritis, ankylosing spondylitis, and non-radiographic spondylitis. Data for this new approval will be presented at ACR Convergence on November 14th by Dr. Atul Deodhar.

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Anterior uveitis incidence across different axSpA treatments Large review and meta-analysis on TNFi, IL-17i, JAKi Immunomodulatory therapy protective against uveitis flare Greatest in TNFi and JAKi @RheumNow #ACR23 Abs# 2550 https://t.co/l3BTL3GuRt
Robert B Chao, MD  ( View Tweet)
Persistence of IL-17i vs. TNFi in PsA treatment Large database study Persistence of IL-17i slightly greater than TNFi over 12 months Are IL-17i a better longterm strategy for PsA pts? @RheumNow #ACR23 Abs# 2240 https://t.co/9km5XgXcLE
Robert B Chao, MD  ( View Tweet)
A#2545 IV SEC for SpA #ACR23 @Rheumow Approved by FDA, though diff dose Who: Medicare/cost/QoL benefit for IV or obese (wt based dose) W16: 41% ASAS40 v 23% PBO W16, PBO switched to SEC. Efficacy W52 (SEC 67%, PBO/Sec 75%) SAE 6%, discontinuation 3.5% #ACRBest https://t.co/ruW0ys49gk
Eric Dein  ( View Tweet)
Very cool meta analysis of IL17i RCTs in PsA No change in MACE in DMARD naieve pts initiating IL17i across RCTs A skosh underpowered but worthwhile question & useful data @RheumNow #ACR23 Abstr2254 https://t.co/ZN8QYgSA1A
Mike Putman EBRheum ( View Tweet)
Another day, another bimekizumab (IL17i) study Across 2 trials, improved PsA specific QOL ("PsAID") metrics Nice to see focus on PROs & I always love a good spidergram @RheumNow #ACR23 Absr2249 https://t.co/dsLXstPzt2
Mike Putman EBRheum ( View Tweet)
Later today at #ACR23 at 4pm See Ab#2545 on IV secukinumab for AxSpA Read about it now on @RheumNow: https://t.co/s9IinpVxgR

Eric Dein  ( View Tweet)

TNF AND IL17 was equally effective in Axial SpA! #ACR23 #Reviewcourse https://t.co/oofQkvsJ3f
Nouf Al hemmadi  ( View Tweet)

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