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Remission in Axial Spondyloarthritis Unrelated to Gut Inflammation

MedPage Today

Most patients with early, active axial spondyloarthritis (axSpA) who quickly received a tumor necrosis factor (TNF) inhibitor experienced remission, and it didn't matter whether or not they had intestinal inflammation at baseline, a small single-arm study found.

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What would it take for JAKs to ROCK the boat? JAK inhibitors have taken a beating over the last three years. The excitement and potential has been tempered by mounting cardiovascular safety concerns, but specifically in at-risk patients, compared to TNF inhibitors. https://t.co/tgfsU3uFVo
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post hoc MRI study from Osteoarthritis Initiative (OAI) of 210 knee OA pts (mean age 64) Rx w/ either IA corticosteroids or hyaluronate (HA). Bboth reduced pain post-injx (WOMAC -5.2 CS & -2.1 HA), CS had worse progression (cartilage, BM lesions, meniscus) vs controls & HA https://t.co/pbb1ePXob1
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Lichenoid rash vs SCLE? JAMA Dermatology case - 60yoM w/ https://t.co/xl11CwB1AJ problems & meds has pink-red papules (central hypopigmentation) on arms, chest, back (no fungus). Bx= lichenoid dermatitis. Rash worsened, red & annular; Dx now SCLE +ANA/Ro/La) from diltiazem. SCLE
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Increasing costs of biologics. X-sectional study of 76 781 psoriasis pts on biologics (TNFi, IL12/23, IL-17i, IL-23i) saw annual treatment cost increase from $21 236 in 2007 to $47 125 in 2021. AVG cost could have been 44% lower if lowest-cost Rx in same class was used https://t.co/IOaK75zsgg
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UK study of 17472 newly Dx #RA pts (10997 MTX, 4,540 csDMARDs; 13680 steroids-CS) w/ 1307 Serious Infx (SI) (3/100PY) & 311 SI deaths. MTX signif decr. SI (adj HR 0.72) & CS no effect HR 0.99. SI assoc w/ age, smoker, comorbidity, seropositive, high DAS28. 1 DAS unit incr SI https://t.co/Zmsuaf7Rw3
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What would it take for JAKs to ROCK the boat? JAK inhibitors have taken a beating over the last three years. The excitement and potential has been tempered by mounting cardiovascular safety concerns, but specifically in at-risk patients, compared to TNF inhibitors. Once the https://t.co/JgmfxGa6TY
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EMA has published a concept paper about the need for guidance to inform the development of systemic sclerosis (SSc) treatments. They have identified study designs & endpoints; exploratory and confirmatory trials, and assessments of safety and efficacy. See draft here: https://t.co/WADBrw2uXe

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Persistent Burden in Early RA Despite Disease Control: insights from CareRA Trials Advances in the treatment of rheumatoid arthritis (RA), particularly the treat-to-target strategy and the introduction of effective disease-modifying antirheumatic drugs (DMARDs), have improved https://t.co/cMiF6POKGS
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Survey of 154 Saudi established #RA pts on MTX >3mos; 64% claiming #MTX intolerance & 36% w/ MTX Intolerance Severity Score (MISS) >6. But MTX intolerance was NOT related to dose or route of administration, meal or time of day. These were not new MTX starters https://t.co/6KWGcZvx4o
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Full read overview of MDA-5 Dermatomyositis (DM) - pathogenesis, findings, & Rx. MDA-5 DM is a rare, aggressive amyopathic form with distinctive skin findings & rapidly progressive interstitial lung dz. Rx includes Hi dose steroids, calcineurin inhib & IV CTX (maybe JAKi, MMF)
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Add-on certolizumab in pregnant women with APS Women with antiphospholipid syndrome and lupus anti-coagulant are at high risk of developing adverse pregnancy outcomes (APO). Usual care includes low molecular weight heparin (LMWH) and low dose aspirin (LDA). https://t.co/qnnkFlhtiS
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Methotrexate and Leflunomide combination in RA/PsA: Is it safe? Save I asked the EULAR Twitter community about the combination of Methotrexate (MTX) and Leflunomide (LEF). Opinions are split, with 50% prescribing it often and 50% concerned about side effects. In my practice, https://t.co/SZjLaEH1h2
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Psoriatic Arthritis: Hit hard and Early Two studies found no significant benefit of early biologics over standard methotrexate treatment, but they did not focus on poor prognosis cases. The SPEED trial, funded by the NIHR, aimed to compare disease activity in 192 PsA patients https://t.co/pS9DdOOVCV
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