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Peresolimab's Potential in Rheumatoid Arthritis
Peresolimab is a humanized IgG1 monoclonal antibody that acts as a programmed cell death protein 1 (PD-1) agonist (stimulator). The NEJM reports that PER met its efficacy primary endpont in treating patients with active rheumatoid arthritis (RA).
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MSK Symptoms from Dupilimab, an IL-4/13 Inhibitor
A new MSK syndrome of inflammatory enthesitis/arthritis/tenosynovitis has been described in atopic dermatitis (AD) patients treated with the IL-4 receptor antagonist, dupilumab.
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Brepocitinib in Active Psoriatic Arthritis
Brepocitinib is a novel tyrosine kinase 2/Janus kinase 1 inhibitor and has been studied in patients with moderately-to-severely active psoriatic arthritis (PsA), showing impressive efficacy at both 16 weeks and 52 weeks.
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IL-6 for PMR
SPARE and SEMAPORE (Toci), SAPHYR (Sari)
2/2023: FDA approves sarilumab for PMR for inadequate response to corticosteroids or unable to taper off
Robert Spiera @RheumNow #RNL2023 https://t.co/VtzW01Ez7D https://t.co/P6oUQvmDXH
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Dr. John Cush RheumNow ( View Tweet)
Swedish registry review of #MTX initiation in early #PsA vs #RA (n 3642each). 2 years after MTX start, 71% of PsA vs 76% of patients with RA remained on MTX & the majority (66%/60%) had not started another DMARD, or a biologic (77%/74%) https://t.co/nTJO04sn65 https://t.co/gLjKzj2c74
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Evidence-Based Guidelines for EGPA
Eosinophilic granulomatosis with polyangiitis (EGPA) is a rare form of anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis, affecting between 10 and 14 cases per million globally.
https://t.co/VixECcPv4R https://t.co/XgEHRgDiPj
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Dr. John Cush RheumNow ( View Tweet)
RELIEF Trial: Sublingual Cyclobenzaprine in Fibromyalgia
https://t.co/a6KUPcfmxM https://t.co/ToRJQVsZSu
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Dr. John Cush RheumNow ( View Tweet)
RCT of 122 active plaque Psoriasis pts (38F, 55M) with low vitamin D (~15). Rx w/ either PBO or Vit D (100K IU, followed by 20K IU/wk x 4 mos). Vitamin D supplementation had no effect on psoriasis severity (but pts had mild PSO). https://t.co/JXtEBaop3c https://t.co/ScGtBUIrm0
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Dr. John Cush RheumNow ( View Tweet)
Subanalysis of the tofacitinib ORAL Surveillance study shows the JAK "at-risk" population are patients Age ≥65 years or ever smoker who exhibited the excess adverse events (malignancies, MACE, MI, VTE, all-cause death) comparedd to TNFi (HRs 1.41–5.19) https://t.co/k78WsPR1Mv https://t.co/JmTDSctIa0
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Juvenile and Adult-onset Scleroderma Differ
A retrospecitve cohort comparision of juvenile (jSSc) and adult-onset (aSSc) systemic sclerosis (SSc) are both rare but present differently.
https://t.co/57OrgaUNqj https://t.co/Y2puN18ux0
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Dr. John Cush RheumNow ( View Tweet)
Black Tongue discoloration in 80 yr old w/ 5 d of fever & shoulder pain, Dx as septic arthritis from Staph. aureus (Rx/ IV cefazolin). Black tongue from Abx? (cephalosporins, PCN, tetracyclines, erythromycins, doxycycline, metronidazole moxifloxacin) https://t.co/lJ91yXOvQ9 https://t.co/mYqwCj3VEL
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ICYMI: Our old friend, hydroxychloroquine
https://t.co/NouJayD0T3 https://t.co/lRBl0UQuY3
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Dr. John Cush RheumNow ( View Tweet)
Conaghan shares unpublished data from PROMOTE study at #RNL2023
Early data shows MTX benefits pain in patients w/ OA, particularly more metabolically active. Looking forward to more data on this--
https://t.co/Zfh7CbqvPi https://t.co/kIYKRFtUX2
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Dr. John Cush RheumNow ( View Tweet)
Metanalysis of 38 studies(458,256 pts). Diabetes was seen in 19% of hyperuricemic and 16.7% of gout pts - an even higher DM prevalence was seen in North America (20.7%) https://t.co/AYVWaditxG https://t.co/T4fedCSpx1
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Matched cohort study of 67,598 German primary care Pts shows gout have incr risk of breast cancer (4.5% gout vs 3.7% non-gout; HR: 1.17; 1.05-1.31). Association only seen under age 50 (HR: 1.58; 1.10-2.27), but notin women over 50 yrs https://t.co/pl6gH2GyZQ https://t.co/VR8kuumhNv
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Dr. John Cush RheumNow ( View Tweet)
What happens to PsA in pregnancy?
1/3 with mod-severe disease
Little evidence of change of disease activity in pregnancy
Disease may increase post-partum
Christina Chambers @mothertobaby
#RNL2023 @RheumNow https://t.co/0QAxhHb45u https://t.co/zb0YSaqiOf
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Dr. John Cush RheumNow ( View Tweet)
DMARDs/TNF for PMR:
MTX- initial benefit, but no 5 year steroid sparing effect
Infliximab - no benefit
Lef - some benefit in case series
Robert Spiera #RNL2023 @RheumNow https://t.co/d7BpmxFfct https://t.co/jLJDPuMtD3
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Dr. John Cush RheumNow ( View Tweet)
Is there role for MTX in GCA
Favorable results in a meta-analysis with NNT 11 to prevent 1 cranial relapse
BUT: limitations of meta-analysis, short follow-up, dose response not evaluated
Robert Spiera at #RNL2023 @RheumNow https://t.co/lucAWypvr7 https://t.co/W604xXesaI
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Dr. John Cush RheumNow ( View Tweet)
#RNL2023
Rob Spiera: I often use aspirin a day, especially if cranial complications and no contra-indications"
No prospective studies, 2 large retrospective studies suggesting benefit
@RheumNow https://t.co/V8C43LN5wl https://t.co/2focIzWhPP
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Dr. John Cush RheumNow ( View Tweet)
Lit review of 2236 articles found only 28 w/ Post-COVID autoimmune Dx (64% F; age 51 yrs) - that included 11 (39) IIM (w/ 4 DM); 7 (25%) SLE; 4 (14%) anti-synthetase syndrome; 4 (14%) SSc; 1 lupus/MCTD overlap. Mean onset 23.7 d post COVID https://t.co/jtRaqIBGH1 https://t.co/WilcRFNAL9
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Dr. John Cush RheumNow ( View Tweet)
