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Best Treatments for COVID-Related MIS-C
The RECOVERY trial focused on pediatric MIS-C patients treated with immunomodulators and anti-cytokine therapy demonstrated the benefits of first-line therapy with intravenous methylprednisolone or second-line tocilizumab in children refractory to initial treatment.
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ACR Applauds Prior Authorization Rule
ACR
The American College of Rheumatology (ACR), on behalf of over 9,100 rheumatologists and rheumatology professional team members, applauds the Centers for Medicare and Medicaid Services (CMS) for finalizing its Advancing Interoperability and Improving Prior Authorization Processes for Medicare Adva
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Rituximab Efficacy in MAINRITSAN Long-Term Studies
The original randomized controlled, prospective MAINRITSAN study of 115 patients (87 with granulomatosis with polyangiitis, 23 with microscopic polyangiitis, and 5 with renal-limited ANCA-associated vasculitis [AAV]) demonstrated superiority of rituximab (RTX) over azathioprine (AZA) for maintenance of remission at 22 months in ANCA-associated vasculitis patients after CYC remission induction.
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Many #RA pts remain on Steroids despite b/tsDMARD use! Study 228 #RA pts, 68% Rx low-dose GCs (32% no GCs). After 3 yrsof b/tsDMARDs, 32% still on GCs, 23% D/C GCs, & 20% go on & off, 25% never took GCs. GCs use assoc w/ HTN (20 v 11%) & MI (2.3% vs 0) https://t.co/lWVfvJrAyp https://t.co/uTIWqDAjRG
Dr. John Cush RheumNow ( View Tweet)
Pre-Treatment Testing with Biologics Falls Short
US commercial insurance claim analysis of lab screening and monitoring practices in CISD patients shows that < 60% received the reco pretreatment testing when starting systemic immunomodulatory treatment.
https://t.co/WdI3xfMyng https://t.co/xxKVkag60o
Dr. John Cush RheumNow ( View Tweet)
Dupilumab (IL-4/13 Inhib) may cause MSK Sxs. Study of 470 Atopic Dermatitis pts on dupilumab; 36 referred to rheum consult, 26 pts (14M/12F) had US/MRI proven enthesitis, arthritis, or tenosynovitis (16 mild, 4 severe). All responded to NSAID or DUP D/C https://t.co/S3ACOC4xUZ https://t.co/juAYbIxNZ6
Dr. John Cush RheumNow ( View Tweet)
Rituximab is superior to cyclophosphamide in relapsing AAV. Provided you are relapsing after having cyclophosphamide as your first agent of course... @EBRheum @RheumNow #RNL2024 https://t.co/JfbcKH2zCG
Richard Conway RichardPAConway ( View Tweet)
Remission maintenance in AAV. First 2 years is clear - fixed dose RTX is superior. After that it is clear that following ANCA is suboptimal, could consider either B-cell return dosing or ongoing fixed dosing @anisha_dua @RheumNow #RNL2024 https://t.co/0Elir88L9U
Richard Conway RichardPAConway ( View Tweet)
Rheumatology drugs in pregnancy. Just missing leflunomide in that big no no section @DrCassySims @RheumNow #RNL2024 https://t.co/ZPtTGRqPki
Richard Conway RichardPAConway ( View Tweet)
@reumacia @RheumNow You are absolutely right. The point was not generally used for psoriasis ( not PsA). I was surprised my self 🤕.
Here is the slide again by Dr. Armstrong , great talk by the way. Let me know if you want the handout. https://t.co/C11Gkn2jho
Nouf Al hemmadi NoufAhmedAlham2 ( View Tweet)
The panel addresses the question about using combination biologics and combo tsDMARDS + biologic. These combos are being studied. The panel noted combo apremilast +biologic is pretty commonly used appears to be effective and safe. #RNL2024 @rheumnow https://t.co/EeIlhJiDZU
TheDaoIndex KDAO2011 ( View Tweet)
Nice summary of data as to why IL-17 or IL-23 are generally favoured by dermatology for psoriasis @_AprilArmstrong @RheumNow #RNL2024 https://t.co/qfAn2AHilX
Richard Conway RichardPAConway ( View Tweet)
Considerations in choosing a biologic in psoriatic disease from dermatology viewpoint @_AprilArmstrong @RheumNow #RNL2024 https://t.co/PHg0CBjTkC
Richard Conway RichardPAConway ( View Tweet)
#RNL2024 @RheumNow
@_AprilArmstrong
Choosing a biologic in Psoriasis
TNF - great in PsA, pregnancy. Avoid in demyelinating, hep B
IL-17 - robust skin, PsA (axial too). Avoid in IBD
IL-23 - robust skin, PsA evidence, fewer injections https://t.co/9Xt7Nx1tKq
Eric Dein ericdeinmd ( View Tweet)
How/when to choose biologics in pts with active psoriasis from Dr April Armstrong #rnl2024
Dr. John Cush RheumNow ( 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
Dr. John Cush RheumNow ( View Tweet)
Japanese retrospective study compared RA pts on JAK inhib vs bDMARDs (n=62 ea) having orthopedic surgery; JAKi- pts had more postoperative flares (29% v 12%, P=.01), esp if JAKi held >11d (p.04). No diff in other postop complications https://t.co/NVY1Oajdve https://t.co/fwc9KWYZ9l
Links:
Dr. John Cush RheumNow ( View Tweet)
Excited to be talking at https://t.co/hposbnLVdD!!
As usual, @RheumNow screen-grabbed me at an opportune moment 🤣😆
Highly recommend the conference; register live/online at the link above! https://t.co/XewJXRASi8
Mike Putman EBRheum ( View Tweet)
European ustekinumab (Stelara) biosimilar Uzpruvo® (AVT04) was granted marketing authorisation by European Commission & will be available in July 2024. US FDA approved Wezlana (ustekinumab-auub) in 11/2023. https://t.co/Wv2Z7P5xAu https://t.co/PdGEUpyRU6
Dr. John Cush RheumNow ( View Tweet)
Real-world data of 5070 RA pts (1816 Rx w/ b/tsDMARDs) showed the use of tsDMARD considerably increased from 2012 to 2021. All b/tsDMARDs pts improved Dz activity & function/ 10 yr effiicacy best for IL6Ri in switch pts and ABA in bNAIVE pts https://t.co/h9j8Pk03if https://t.co/gC7Wloujm0
Dr. John Cush RheumNow ( View Tweet)
