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ILD Begins (8.29.2025)
Dr. Jack Cush reviews the news and journal reports from RheumNow.com. This week news on vaccines, safety of acetaminophen and more.
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Uncertainty with immunosuppressive for idiopathic inflammatory myopathies
A current Cochrane review suggests a continued unmet need regarding the status and utility of targeted immunosuppressant and immunomodulatory treatments for the idiopathic inflammatory myopathies (IIM). Overall there has been little progress since the previous Cochrane review (2012) that found little or no evidence to guide treatment.
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TNF Inhibitors in Takayasu's Arteritis
A large, retrospective, multicenter study demonstrated the efficacy of intravenous infliximab and subcutaneous adalimumab in patients with Takayasu arteritis.
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Rheums Speak: Changing Rheumatology Practices & Choices
RheumNow surveyed clinicians worldwide on how their rheumatology practice, treatment decisions, and career outlooks have changed over the past 20 years. 242 respondents (68% from the USA) shared their perspectives on the changing landscape of rheumatoid arthritis care, practice patterns, and professional development.
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Repurposing & Pipeline (8.8.2025)
Dr. Jack Cush reviews the news, reports, pipeline and drug repurposing on this week’s podcast.
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J&J announced it has halted its combination biologic study in difficult to treat RA. Phase 2a DAISY proof-of-concept studied the combo of nipocalimab and TNFi in refractory RA, but 12 wk results failed to evidence of efficacy. https://t.co/T4n4GNqtVC v https://t.co/eSAwrEIYHc
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Celltrions tocilizumab biosimilar, tocilizumab-anoh (Avtozma, CT-P47), had similar efficacy when switching from reference tocilizumab (Actemra; Genentech) in a study of 444 RA patients x 52 wks. https://t.co/7aAyuUkZJ9 https://t.co/kJUrRkhstb
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New IDSA recommendation: In hospitalized on systemic steroids w/ severe, critical, progressing COVID-19, when baricitinib or tocilizumab are not available, IDSA guideline panel suggests infliximab. https://t.co/ZCkkZXUDpi https://t.co/gbgkvj5R8Y
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Claims data study of 82 399 PsA pts - 542 on combo targeted Rx >3 mos (200 > 6mos). 2 most common combos of apremilast w/ TNFi or IL-17i. Use of combo targeted Tx was not assoc. w/ more serious infxn (RRs 0.53; 0.17-1.63) or opportunistic infx (RR 1.00; 0.09-11.02) @ 3 or 6 mos https://t.co/mkvq1lqt9Y
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TNF Inhibitors in Takayasu's Arteritis
A large, retrospective, multicenter study demonstrated the efficacy of intravenous infliximab and subcutaneous adalimumab in patients with Takayasu arteritis.
https://t.co/lJbvaYnylO https://t.co/uRBruhW2Fd
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There's a transient (1 yr) increase in New Abx Rx among 399 PsA pts after starting a TNF inhibitor. Pre-TNFi, PsA pts were more likely to recv Abx vs controls (1.26 vs. 0.60/yr; p<0.001). Post TNFi Abx use incr to 1.64/yr (p<0.001) but returned to baseline thereafter. https://t.co/LHXn5d7oC9
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Difficult to manage SpA (D2M-axSpA) defined as failure ≥ 2 b/tsDMARDs (diff MOAs). Study of 129 axSpA pts, 8.5% were D2M, & 3% were treatment refractory (more inflammation- TR). D2M had signif higher BASFI (4.2 vs. 2.9), BASDAI (5.1 vs. 3.5), ASDAS (3.7 vs. 2.8). Predictors: https://t.co/4qdHEFxr3J
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945 consecutive severe psoriasis pts Rx TNFi or nbUVB phototherapy (2005-2010) w/ median F/U > 9 yrs. After propensity matching, incidence of future PsA was 1.18/100 w/ TNFi vs 2.48/100 w/ nbUVB (IRR 2.1; 1.37–2.98, P = 0.0002). TNFi lowered PsA risk (HR = 0.32). PsA predictors https://t.co/aBsXs6RpCY
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Full read review of DMARD effects on CV Risks. Strongest CV protective effects for MTX & TNF inhibitors. Potentially beneficial are sulfasalazine, hydroxychloroquine, & leflunomide. More info needed on IL-6, IL-17/23 inhibitors. Concerns over NSAIDs & JAKi https://t.co/0BW4StS15N
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Large metanalysis of TNFi use in immune-mediated inflammatory diseases (45 studies, 150K pts) shows no increased risk of de novo heart failure (HF), and no significant risk of HF worsening w/ TNFis. https://t.co/9sRVsMZ1kv https://t.co/igCdcQMVK3
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COVID Vaccine study in rheum pts on JAKi (n 22) or TNFi (n 16) Showing 50% response in JAKi and 81% w/ TNFi Rx. Pt PBMCs were stim by SAR-CoV2 spike proteins & CD4+ T cells IFNγ production as Pos. response. Do JAKi impair COVID-19 Vax responses? https://t.co/dZAktwrytf https://t.co/mjkBfcGcfD
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Retrospective review of 9 #RA pts w/ elevated liver enzymes who were Rx w/ TNF inhibitor (4 adalimumab, 5 etanercept; 78% female, median BMI 37). Over 3 yrs F/U, LFTs declined, fibrosis scores (FIB-4) signif decreased; albumin & bilirubin remained stable https://t.co/Hcwa3qaupv https://t.co/OwGY5jxxyZ
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Full read review of DMARD effects on CV Risks. Strongest CV protective effects for MTX & TNF inhibitors. Potentially beneficial are sulfasalazine, hydroxychloroquine, & leflunomide. More info needed on IL-6, IL-17/23 inhibitors. Concerns over NSAIDs & JAKi https://t.co/INEdCt0pxa
Dr. John Cush RheumNow ( View Tweet)
Large metanalysis of TNFi use in immune-mediated inflammatory diseases (45 studies, 150K pts) shows no increased risk of de novo heart failure (HF), and no significant risk of HF worsening w/ TNFis. https://t.co/9sRVsMZ1kv https://t.co/Kapg9ZwVGf
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MTX or TNFi use in elderly #RA pts w/in a year of Dx of melanoma was not associated with increased mortality. This included melanoma in situ (48%), localized (47%) and regional (5%) melanoma. Steroid use however was assoc w/ reduced survival. https://t.co/QOXfEf51S1 https://t.co/GZ5dedEMfM
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