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Consequences of TNF inhibition (3.18.2022)

d Jack Cush, MD

This week we're going to talk about the downside of TNF inhibitors, a few interesting observations in gout, and yes, kids do get COVID. We're also going to preview what's coming in April (hint: it's about PsA). This and more as Dr. Jack Cush reviews the news and journal articles from the past week on RheumNow.com.

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Iberdomide in Systemic Lupus Erythematosus

d Jack Cush, MD

The NEJM reports that systemic lupus erythematosus (SLE) patients treated with iberdomide, a cereblon modulator, was effective at yielding a significant SRI-4 clinical response after 24 weeks. 

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Seropositivity Linked to Bronchiectasis in Rheumatoid Arthritis

d Jack Cush, MD

Rheumatoid arthritis associated bronchiectasis (RA-BR) is uncommon, and is unrelated to interstitial lung disease (ILD), but like ILD, can substantially impact RA outcomes.

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RheumNow Live is kicking off with a pod on Rheumatoid Arthritis - Future Improvements. Dr. Cush will lead the first presentation on Treatment Choices in Refractory RA. #RNL2022 https://t.co/H3RbDPZxM1
Dr. John Cush RheumNow ( View Tweet)
RheumNow Live is HERE. Welcome everyone! What pod are you looking forward to the most? Anyone out there who is still on the fence--virtual registration is still open. Join us! https://t.co/3wKgCKqvfD #RNL2022 https://t.co/W2hUpZ2Y8N

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Dr. John Cush RheumNow ( View Tweet)
Seropositivity Linked to Bronchiectasis in Rheumatoid Arthritis Bronchiectasis in rheumatoid arthritis-associated (RA-BR) is uncommon, is unrelated to interstitial lung disease (ILD), but like ILD can substantially impact RA outcomes. https://t.co/xm8HWJkI5C https://t.co/JztHlzGw65

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Dr. John Cush RheumNow ( View Tweet)
Disappointment Behind Acute Gout Hospitalizations https://t.co/Hd1g5Kvwwr https://t.co/jYFVVOQOZX

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Dr. John Cush RheumNow ( View Tweet)
Environmental Pollutants Ups Autoimmune Disease Risk An Italian environmental study shows that air pollution increases the risk of autoimmune diseases, in particular rheumatoid arthritis, CTDs and inflammatory bowel diseases (IBD). https://t.co/LVCn8zgdpG https://t.co/wzi2GzSmGY

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Dr. John Cush RheumNow ( View Tweet)
Medscapes 2022 Physician Suicide report. Sadly 10% of MDs have considered suicide. Highest in pathology (13%), surgery (12%), oncology (12%), ID (11%), EM(11%). LOWEST in Rheumatology (5%), nephrology (2%) https://t.co/ER8kNfcPEh https://t.co/cWQobpIO97

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Dr. John Cush RheumNow ( View Tweet)
Happy Match Day to all newly matched doctors! We can't wait to see who becomes a rheumatologist in a few years. Enjoy your residency and celebrate your amazing accomplishment today! https://t.co/Yuhu7ksmog
Dr. John Cush RheumNow ( View Tweet)
Among 98 women with axSpA, there were 335 pregnancies & 279 live births - 52% uncomplicated and 48% complicated (13%) multiple complications. axSpA had more Preterm birth (13 vs 5%), pre-eclampsia (7 vs 3%), Low birth Wt (8 vs 3%) https://t.co/i43HKduAgu https://t.co/XHbtH9YMrt

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Dr. John Cush RheumNow ( View Tweet)
Baricitinib has been studied in 15 relapsing GCA pts - prospective, open-label, BARI 4 mg/d w/ GC taper. 14/15 completed 52 wks; 13/15 went into remission and d/c steroids. There was 1 Bari D/C for adverse event & 1 pt w/ serious AE. 1 pt relapsed. https://t.co/J5bjdPAFdm https://t.co/LsuSVP8L0R

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Dr. John Cush RheumNow ( View Tweet)
Psoriasis RCT studied ADA+MTX (31) vs ADA (30); after 12 mos, a (non-significant) better drug survival w/ ADA-MTX (74 vs 59%; p=0.15). Also favoring, but not signif was PASI 75 (58 vs 37%). Fewer anti-ADA Abs seen w/ ADA-MTX (23 vs 60%; p<0.01) https://t.co/9CAQrpl6hU https://t.co/mr0ZaJ9mbW

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Dr. John Cush RheumNow ( View Tweet)
Frailty: a decline in the physiologic reserve & function of several systems, leading to increased vulnerability and adverse health outcomes. Not just age; increased in RA (33%) more than AS or PsA. Frailty is dynamic & potentially reversible https://t.co/82hkGKoRxV https://t.co/7d9sycC6S2

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Dr. John Cush RheumNow ( View Tweet)
Infants and children do get COVID; all races, 35% w/ comorbidities. CDC study from 99 counties in 14 US states shows betw 3/20 & 2/22 there were 2,637 hospitalized infants & children 0–4 yrs old; 24% went to ICU; there were 18 deaths https://t.co/mWyXAj2GbT https://t.co/MYN37JKziD

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Dr. John Cush RheumNow ( View Tweet)

Abbvie announced that the FDA has approved Rinvoq (upadacitinib) for use in adults with active ulcerative colitis (after failing TNFi); approval based on 3 endoscopic UC trials. Starting dose is 45 mg/d, then maintain w/ 15 mg (some can get 30 mg) https://t.co/ZUbnkR7LMY https://t.co/dE1JkxzkSz

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Dr. John Cush RheumNow ( View Tweet)
Another Rx for #PsA #psoriaticarthritis Deucravacitinib is shown to be effective. Good news but this adds to the dilemma of what to use in PsA Rx and in what order. Rational Rx may need #personalized Rx for best bang for buck! https://t.co/JQs7BlQwos

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Janet Pope Janetbirdope ( View Tweet)

Individualized Therapy in Ankylosing Spondylitis Whether patients with AS would improve substantially with TNF inhibitor therapy was predicted with moderate to high accuracy based on a lab test and two measures of disease activity, researchers reported. https://t.co/hbbYqTiWGE https://t.co/Hx2U4y2e0F

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Dr. John Cush RheumNow ( View Tweet)
Intravenous (IV) form of tramadol (Schedule IV) went in front of the FDA Drug Safety & Risk and Anesthetic/Analgesic Advisory Committees yesterday. They voted 14-8 against approval of IV tramadol (now available as tabs, liquid) https://t.co/AP2G7w8z1h https://t.co/lr9aLJSKi6

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Dr. John Cush RheumNow ( View Tweet)
Low Dose IL-2 Efficacy in Rheumatoid Arthritis A novel biologic intervention trial has shown that subcutaneous, intermittent therapy with low-dose interleukin-2 (Ld-IL2) is potentially effective and safe in rheumatoid arthritis (RA). https://t.co/ycDgLT9EAA https://t.co/NJi48FZzAa

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Dr. John Cush RheumNow ( View Tweet)

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