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Dr. Jack Cush reviews the news and journal reports from this past week - some obvious, other new thoughts and some - hmmm, reallly?
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A pooled analysis of 25 randomized clinical trials affirms the safety of ixekizumab (IXE) when used to treat patients with psoriasis (PsO), psoriatic arthritis (PsA), or axial spondyloarthritis (axSpA).
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Patients with autoimmune skin diseases (ASDs) with cancer had significantly better cancer survival outcomes than those without ASD, suggesting coexistant autoimmune or inflammatory disease does not adversely affect a cancer prognosis.
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Tumor necrosis factor (TNF) inhibitor therapy was effective in reducing the likelihood that psoriasis would progress to psoriatic arthritis (PsA), a retrospective study indicated.
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Mease et al has published the results of a cohort study showing early initiation of disease-modifying antirheumatic drugs (DMARDs) in patients with psoriatic arthritis (PsA) resulted in better outcomes compared to late initiation.
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Autoimmune hepatitis (AIH) is a chronic, progressive inflammatory liver disease driven by autoimmune mechanisms, characterized by elevated serum aminotransferases, hypergammaglobulinemia, and interface hepatitis on histology.
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BMJ has published a clinical practice guideline resulting from the work of an international, multidisciplinary panel addressing chronic spine pain (≥3 months duration) not associated with cancer or inflammatory arthropathy. This is a chronic (not acute) spine pain guideline.
Dr. John Cush
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Swedish Medical Birth Register study of pregnancy in systemic sclerosis (SSc) shows increased risk of preeclampsia (RR 3.8; 1.8-7.8), preterm birth (3.3; 1.8-6.1), & caesareans (2.5; 1.8-3.5) esp w/ 1st pregnancy -- but not incr. maternal or neonatal death, nor stillbirth https://t.co/SNSK5947zO
Dr. John Cush
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Despite 2024 HHS proposal to reschedule CANNABIS to Schedule III, it remains Schedule I -having "no accepted medical use" and "high abuse potential".There's lots of use (legal in 24 states, DC, decriminalized in 7 states), but no evidence, research or guidelines. https://t.co/KumpvMHdhC
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1 yr study of falls studied in 100 RA & 80 PsA pts. 33% of RA & 46% of PsA reported falls, w/ a higher frequency in PsA Pts (p=0.02). Falls associated w/ disease duration and HAQ score. As falls are assoc w/ high morbidity & mortality risk, pts should be questioned about FALLS https://t.co/tP7zmGCZcw
Dr. John Cush
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Case–control study RA pts > 65yrs in US. SEER (cancer) database (2014–2019). Overall cancer risk not associated with use of JAKi (adjOR 1.04), TNFi (0.98) or other bDMARDs (0.98). But, JAKi use was assoc w/ incr risk of lung CA (OR 1.40), esp in Males (2.12) & >2 yrs JAKi. Lower https://t.co/u2psafyN1I
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Biologic experienced ankylosing spondylitis patient show better retention on TNF compared to IL-17 inhibitors. 148 AS pts (F/U 31 mos), IL-17i drug survival trended better but only signif after 3yrs. More D/C w/ higher BASDAI (HR: 1.3) & ^# prior biologics (HR 1.62) https://t.co/5HXGsV4xol
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Granzyme expression is upregulated in RA, esp early RA. Blood & synovium from early arthritis & TNFi nonresponders (R4RA RCT) gene expression five granzymes, perforin, & serglycin determined by bulk RNA-sequencing data. GZM A, B, H, K, M, PRF-1, SRGN was higher in lymphoid https://t.co/v1rdFZHuuh
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RABBIT (German biologics register) study shows overall small increase in malignancy w/ JAKi vs bDMARDs. Risks greatest in those ≥ 60 yrs, w/ Hi Dz activity, on ≥3 prior csDMARDs. 2285 JAKi vs 4259 bDMARDs: 88 vs 135 malignancies CAs (IRs 11.6 vs 8.9; adj HR 1.40). JAKi risk https://t.co/AlK2SWn6UR
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#RA linked to 40% incr risk of serious dental Infx. National Inpatient Sample (2016-2022) retrospective study of ~15 million adult inpatient records, 10.7K (0.07%) had oral Infx Hosp. Risk factors included RA (1.9%; OR 1.4, male (1.79), Black (1.23), smoking (1.33) https://t.co/pr4Uf6ywJ7
Dr. John Cush
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Review of 104 irAE pts rx w/ JAK inhib. (82% tofacitinib). Checkpoint inhib was for Lung (20%), gastric (17%) & melanoma (16%). JAKi indications: myocarditis (70%), myositis (33%), hepatitis (24%). JAKi potentially effective esp in irAE pts unresponsive to cytokine Rx. https://t.co/8ezpAOzpRh
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Efficacy and safety of deucravacitinib up to week 52 in the POETYK PsA-2 study
•ACR20 at W16: 54.2% (deucravacitinib) vs 39.4% (placebo), p=0.0002
•PASI75: 40.9% vs 15.4%, p<0.0001
•MDA: 25.6% vs 14.7%, p=0.0007
•FACIT-F: +2.5 vs +1.8
•SAE: 1.9% (low)
TYK2 inhibition shows https://t.co/PLJytueZDt
Dr. John Cush
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🎩REGENCY: Obinutuzumab + standard therapy improved renal outcomes in #lupus nephritis across all tested response definitions (REGENCY, BLISS-LN, AURORA-1). Week 76 CRR consistently 13–16% higher vs placebo. Results hold despite variable thresholds.
@RheumNow #EULAR2025 #OP0006
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What happens in pre-RA when you stop #abatacept after 1 yr Rx
At 6 yrs approx 60% on #Placebo
V
50% who initially got #ABA
Prolonged damped effect of development of #RA
NNT for 1 yr is ~10 with a range as low as 6
#EULAR2025 @RheumNow @eular_org
Abst#OP0004 https://t.co/eCXEWQhvWM
Dr. John Cush
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Early intensive therapy in PsA.
STAMP RCT in early PsA:
•ACR50 at 3mo: 43% (early secukinumab) vs 22% (SoC)
•MDA at 3mo: 48% vs 25%
•PASI90 at 3mo: 60% vs 22%
By 12months: outcomes similar, but early secukinumab led to faster control and fewer therapy escalations. https://t.co/Mn0uW3cckf
