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ICYMI: 2021 Rheumatology Year in Review
For 2022, let's look our top 10 list of advances, game-changers, worries and those better medical practices that evolved during 2021.
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ICYMI: Adalimumab Addition vs. Methotrexate Escalation in Psoriatic Arthritis
An interesting study in Lancet Rheumatology shows that psoriatic arthritis patients not responding to methotrexate alone can respond after adding or escalating adalimumab on top of methotrexate to reach minimal disease activity (MDA) response.
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Rheumatic Associated Macrophage Activation Syndrome
Macrophage Activation Syndrome (MAS) is a hyperinflammatory condition that has a significant mortality risk and may arise in patients with rheumatic disease.
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#EULAR2022 Prof Schulze-Koops highlighted a mechanistic study that baricitinib therapy ex vivo suppressed autophagy, increased apoptosis, and reduced expression of adhesion molecules in #sjogren salivary glands. Next step should be randomised controlled trial cc: @Yuz6Yusof https://t.co/1tDBNzTuwQ
Dr. John Cush RheumNow ( View Tweet)
In vitro study shows Upadacitinib inhibits enthesis T cell derived TNFa and IL-17A, disrupting the prominent IL-23/IL-17/TNFa axis driving SpA.
@RheumNow #EULAR2022 ABST#POS0331
cc: @doctorRBC https://t.co/M8YYAOBVat
Dr. John Cush RheumNow ( View Tweet)
#OP0004 #EULAR2022 In line with EULAR President’s preech to go Digital, Prof Mosca highlighted a study which showed assessment of joints in RA could be done by taking photos and analysed their dorsal skin folds using convolutional neural network
cc: @Yuz6Yusof : https://t.co/mn48vXtGad
Dr. John Cush RheumNow ( View Tweet)
Bimekizumab: IL-17A and F inhibitor for tx of PsA - BE OPTIMAL trial reached primary endpoint: ACR50 44% vs. placebo
Efficacy as early as 2 weeks
No MACE, uveitis, IBD, deaths
@RheumNow #EULAR2022 ABST#LB0001 cc:@doctorRBC : https://t.co/wgeBsfdQcL
Dr. John Cush RheumNow ( View Tweet)
Prof Hoi @alberta_hoi Anti-Sm in SLE. Present in 17%. Assoc severe disease activity, "classic" SLE manifestations, specific serologic and proteomic profile. Argues for Sm+ SLE being a specific subset (or even a "different" disease?)
#EULAR2022 POS0774. cc: @RichardPAConway https://t.co/cwp6q4kouz
Dr. John Cush RheumNow ( View Tweet)
#Bestinclass Recurrent #PMR RCT of #sarilumab v placebo. Nearly doubles sustained remission but maybe attenuating effect - flare difference over time? N=118. 🤷♀️ Dunno who I would use it in yet. LB0006 @RheumNow @eular_org #EULAR2022
@Janetbirdope
Dr. John Cush RheumNow ( View Tweet)
SELECT-AXIS 1 trial of upadacitinib in active #AS with an inadequate resp to prior biologic - pivotal phase 2/3 RCT of 420 AS pts (Dz dur 7.7 yrs; 83% B27+) showed better ASAS40 at wk 14 w/ UPA vs PBO (45% vs 18%; P<0.0001) #EULAR2022 POS0306 https://t.co/JmreAOqnqh https://t.co/pTFeAzWUYU
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Dr. John Cush RheumNow ( View Tweet)
Solving Still’s Disease
Still's disease is the most common rheumatic cause of unknown fever in adults. This series covers the definition, history, epidemiology, key manifestations and labs, diagnostic criteria, and more.
https://t.co/YqpSW6T3El https://t.co/vwehTCm4aN
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Dr. John Cush RheumNow ( View Tweet)
Allopurinol Safety in CKD Patients
A study in the Annals of Internal Medicine reports chronic kidney disease (CKD) patients can be safely treated with allopurinol without an increased risk of mortality.
https://t.co/qUQmuZedJq https://t.co/u2Ntjd1oio
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Dr. John Cush RheumNow ( View Tweet)
QD Clinic - Stills (or Not) MAS off of Tocilizumab
https://t.co/YGEifF5X8K https://t.co/719RjYzbE3
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Dr. John Cush RheumNow ( View Tweet)
CDC: Immunocompromised account for 12.2% of all COVID-19 hospitalizations, with an increased risk of ICU (aOR=1.26) and death (aOR = 1.34), even if vaccinated (aOR 1.40; aOR = 1.87). In immunocompromised, death rate was not affected by vaccination. https://t.co/PVRnOPb9gX https://t.co/W2S9eb1cOo
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Dr. John Cush RheumNow ( View Tweet)
Here's a reference for the Salmon-pink skin rashes in adult-onset Still's disease; distinctive in color (faint, salmon-pink), distribution (trunk, neck extremities), and evanescence (comes and goes within the same day). These are not static eruptions! https://t.co/BgzyQeiLyW https://t.co/c3aolVfpav
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Study of 184 #SLE pts shows that major infections in SLE results in a 7 fold increased risk of a major lupus flare. Abst# OP0143 #EULAR2022 #MedTwitter https://t.co/xUkQmwoeni
Dr. John Cush RheumNow ( View Tweet)
Single center comparison of MAS (n 18) to malignancy related mHLH (n = 16). Notable differences seen in platelet (lower in mHLH 29k v 50K), soluble IL-2R (6814 vs 27972), but more hepatomegaly (25% v 0). Less mortality with MAS (22 v 44%, p 0.18) https://t.co/gYdRfxDM2c https://t.co/ekMJfnzElC
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Dr. John Cush RheumNow ( View Tweet)
Getting Real on PMR
Dr. David Liew talks polymyalgia rheumatica and how our understanding has evolved over the years. #EULAR2022
https://t.co/DyVCxDVPE7 https://t.co/PF7zqxX7yk
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Dr. John Cush RheumNow ( View Tweet)
IL-18, Iike IL-1, is a produced by activation of the inflammasome. IL-18 is a potential bioimarker for #AOSD, closely linked to Dz activity & could be a Tx target, either as IL-18 binding protein (Tadekinig alfa) or mAb against IL-18 (phase 1b) https://t.co/ex231f27rg https://t.co/tjsra4blBi
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Dr. John Cush RheumNow ( View Tweet)
Babies! Safety and Outcomes Data on Pregnancies
#EULAR2022 highlighted several posters on pregnancy, an important subject as most rheumatic diseases afflicts women during their childbearing years. I wanted to share with you the ones that caught my eye...
https://t.co/piA1zhGyAA https://t.co/Kb68AGZgA1
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Dr. John Cush RheumNow ( View Tweet)