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TNR - Controversies in PsA

d Jack Cush, MD

Held on April 19, 2022, Tuesday Night Rheumatology: Controversies in PsA, featured a lively and informative panel discussion, moderated by Dr. Jack Cush.



The PsA Expert panelists included:

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Faith in Exercise Benefit Boosts Actual Benefit in SpA

d MedPage Today

Patients with axial spondyloarthritis (SpA) got more bang for their exercise buck in a randomized trial when they had good opinions about their workout program, with better persistence with exercise at 1 year relative to a control group, researchers said.

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Dietary Improvement in Psoriatic Arthritis

d Jack Cush, MD

The results of the DIETA trial showed that dietary changes may control psoriatic arthritis (PsA) disease activity, independent of weight loss.  

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UK drug safety warning, observational data 2700 pregnancies, 1st trimester pregabalin (Lyrica) use was assoc w/ higher rate of congenital malformations (5.9 vs 4.1%). US PI label says Lyrica use in Pregnancy "May cause fetal harm". https://t.co/GdIitpe8KW

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Dr. John Cush RheumNow ( View Tweet)

Beijing #RA Cohort study compared 102 T2T (CENTRA) vs 271 usual care pt (TARRA) groups for SDAI outcomes at 12 mos. CENTRA had signif lower SDAI than TARRA (2.1 vs 3.4; p<0.001) & more SDAI-defined remission (71% vs 49%; p<0.001) https://t.co/1JBP33eifI https://t.co/RmGny30QAq

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Dr. John Cush RheumNow ( View Tweet)
QD Clinic - PsA Lessons from the Clinic What are the Safe Treatment Options for psoriatics who have HIV? QD Clinic is sponsored by RheumNow's PsA All the Way Campaign in April 2022 https://t.co/fh00ydSYd3 https://t.co/fpDl2tF4cw

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Dr. John Cush RheumNow ( View Tweet)
Miss this blog from earlier in the month? Dr. Eric Ruderman ( @jointMD) weighs in on combined clinics for PsA and its value. https://t.co/4mdjmetGvF https://t.co/nJJXmk0a0t

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Dr. John Cush RheumNow ( View Tweet)
ABP 654 is a Ustekinumab (anti-IL-12/23) biosimilar from Amgen - 563 pt, phase 3 trial shown to be equivalent to originator in mod- severe plaque psoriasis (no meaningful differences). ABP 654 is also being developed for Crohns & UC. https://t.co/vDNfMXCWcC

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Dr. John Cush RheumNow ( View Tweet)

Italian retrospective of Canakinumab in 80 kids w/ Systemic JIA - 12 moved from anakinra to CAN w/ iinactive dz/CID. 58 pts w/ active SoJIA started CAN - CID in 57% at 6mos, 64% 12 mos; MAS 3/100PY; Nonresp assoc w/ MAS, #Jts, Dz duration https://t.co/2YmkukU7Z2

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Dr. John Cush RheumNow ( View Tweet)

Open label, RCT compared triple DMARD Rx adding either LEF (MLH) or SSZ (MSH) to MTX+HCQ in 136 RA pts. Both were equally effective (non-inferior), 61.7% & 64.7% patients (p = 0.8) at wk 24. AE were also equal (15 vs 21 AE). https://t.co/cxdeBfo6XA

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Dr. John Cush RheumNow ( View Tweet)

2 studies from NKF meeting shows gout occurs in 13.5% of CKD on dialysis; and seen in 17-28% of Stg 3,4 CKD pts. CKD w/ Gout has more bone/mineral Dz (40 vs 26%), CHF (21 vs 14%), DJD (17 vs 9%); >1/3 NOT on urate lowering therapy https://t.co/sn40xqxRyg https://t.co/ewb0tpWukw

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Dr. John Cush RheumNow ( View Tweet)

Can IL-22 differentiate between IL-17 & TNF inhibitor #PSA responders? Pilot study 2 cohorts 81 PSA pts showed both biologics worked but somewhat better response in IL-17i Pts w/ low IL- & TNFi responses w/ high IL-22 levels. https://t.co/txyNl2OwTP

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Dr. John Cush RheumNow ( View Tweet)

ICYMI: Copenhagen study of COVID & Rheum disease (AIRD) ▶️ COVID+ AIRD pts have 10x more hospitalizations (7% vs 0.7%) ▶️ Only RTX assoc w/ COVID hosp (adj OR 14.6) ▶️ IgG Abs increased if AIRD pt hospitalized https://t.co/VtERRZsGb8 https://t.co/ZwdfNJaAS7

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Dr. John Cush RheumNow ( View Tweet)
ICYMI: Males respond better than females? Ixekizumab trials in #PSA - 676 pts in Two Phase 3 RCTs - females had lower response rates than males in all measures (ACR20/50/70; MDA; DAPSA) F had ⬆️HAQ, enthesitis, but ⬇️CRP https://t.co/sjVJZ8uQA3 https://t.co/l7B2ICZWaJ

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Dr. John Cush RheumNow ( View Tweet)
ICYMI: SLE study from BC, Canada shows that among 3062 incident #SLE patients 96% received antimalarial (AM) Rx with only 40% adherent. Over a 6.4 yr F/U, 242 (8%) died. AM adherence was assoc w/ a 71% and 83% lower risk of death https://t.co/0uKAKJVxri https://t.co/KuvEA2pzrg

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Dr. John Cush RheumNow ( View Tweet)
In #rheumatology ,the longer you see pts,the more they rely on you for issues related to their disease, including ➡️ Dental/mental Health ➡️ Nutrition/exercise/sleep ➡️ PT/OT/rehab Looking for resources pertaining to rheumatology to self educate. #RheumTwitter #MedTwitter

Tanmayee Bichile, MD BichileT ( View Tweet)

Register for Tuesday Night Rheumatology today! Join us as we discuss the controversies in PsA when it comes to diagnosis, treatment strategies, therapeutics and more. https://t.co/YXAmzvPfeK https://t.co/jtSd0Ig5IT

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Dr. John Cush RheumNow ( View Tweet)
Administrative Claims data from British Columbia studied 100,358 OA pts and compared tramadol v NSAIDs. Tramadol was associated with higher All-cause mortality (HRs,1.2 to 1.5), more VTE (v diclofenac, HR 1.7), more hip Fx (HR 1.6) https://t.co/5Lei6Lgtpf

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Dr. John Cush RheumNow ( View Tweet)

Kids With Psoriasis Maintained with Long Term IL-17A Inhibitor https://t.co/CfAjvc9XWg https://t.co/RaD5qqPM3a

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Dr. John Cush RheumNow ( View Tweet)
No Benefit to More Intensive Urate Lowering in Gout While treat-to-target (T2T) is commonly advocated in gout management, it is unknown if T2T (or more intensive T2T) may result in less bony erosions in gout. https://t.co/uag4fJ4FSi https://t.co/djniwFl491

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Dr. John Cush RheumNow ( View Tweet)
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