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EMR Messaging Woes (4.11.2025)
Dr. Jack Cush reviews the news, journal reports and regulatory approvals from this past week on RheumNow.com
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Should Lupus Nephritis Receive PJP Prophylaxis?
A current review article suggests that the need for Pneumocystis jirovecii pneumonia (PJP) prophylaxis in patients with systemic lupus erythematosus (SLE) and lupus nephritis will need to be individualized based on therapies and risk factors.
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Pregnancy-Related Deaths in the US
A CDC cross-sectional national study showed an increase in pregnancy-related deaths in the US from 2018 to 2022, with highest rates among American Indian, Alaska Native women, and non-Hispanic Black women.
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Uveitis Risk with Slow Adalimumab Weaning
MedPage Today
Patients with pediatric non-infectious uveitis (NIU) who achieved remission on adalimumab (Humira) had lower recurrence rates when the drug was withdrawn more gradually, a retrospective cohort analysis indicated.
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Bimekizumab efficacy and safety in patients with psoriatic arthritis who had skin and nail psoriasis at baseline: Up to 2-year results from two phase 3 studies
Sponsored by UCB
https://t.co/461bFRZwjw
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Metanalysis showed no increased risk of serious infx (SIE) w/ JAK inhibitors use in pts w/ immune-mediated inflammatory skin diseases -- 32 RCTs, 11,917 pts found SIE in 0.62% on JAKi vs 0.51% controls. Meta-analysis found no significant increase in risk of serious infection https://t.co/ugH72nk8bZ
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Korean insurance claims study (2008–2021) 183,212 psoriasis & PsA pts, found Biologic Rx assoc w/ lower risk of new-onset & recurrent MACEs vs phototherapy (adj HR, 0.45 & 0.34). Nonbiologic systemic Rx lowered MACE risk (v photoRx) only in pts w/ prior Hx MACE (0.79) https://t.co/1RC8bMSZJ3
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Does DMARD Rx affect neurocognitive function in older pts? bDMARDs targeting TNF-α & IL-6 may mitigate neuroinflammation & preserve cognitive function. But, cognitive impact of csDMARDs (MTX) is complex, w/ conflicting reports on its role in vascular dementia. https://t.co/u3kSKHRvpI
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MMWR: While PRE-overdose opioid prescribing is a risk marker for fatal overdose from opioids alone, stimulants alone, or both; PRE-overdose stimulant prescribing might not be a risk marker for fatal overdose attributable to stimulants. https://t.co/ReVbpligeT https://t.co/PnjeqaCySX
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Inebilizumab, an anti-CD19+ (B cell)mAb was tested in myasthenia gravis in phase 3, 238 pt trial and shows to signif. improv function and reduce disease severity in acetylcholine recpt Ab+ or muscle-specific kinase Ab+ myasthenia gravis pts. https://t.co/vBBjf8AUug https://t.co/cUbK4PJEvf
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EMA's EudraVigilance (safety) database study of 10,319 MTX reports (age: 62 yrs, 73% F). Adverse rxns (ADR): 365 kidney & 1,082 liver related. MTX renal ADRs were older, w/ comeds (NSAIDs, Tylenol, metamizole, steroids). More deaths w/ renal ADRs than liver(21% vs 6%); mostly w/ https://t.co/tQ9PSOTtyx
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EMA has approved upadacitinib (Rinvoq) for use in the EU to treat adult patients with giant cell arteritis (GCA) - approval is based on data from the Phase 3 SELECT-GCA trial demonstrating sustained remission and key secondary endpoints https://t.co/Y2tyZPC9Et https://t.co/SHPz2Q94Vs
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JAMA Staphylococcus aureus Review
- s. aureus bacteremia leads to septic arthritis (7%), vertebral osteomyelitis (≈4%)
- bacteremia (≥48 hs) has 39% 90-day mortality risk
https://t.co/1UQoz7JDPU https://t.co/xTAkakv2he
Dr. John Cush RheumNow ( View Tweet)
Does DMARD Rx affect neurocognitive function in older pts? bDMARDs targeting TNF-α & IL-6 may mitigate neuroinflammation & preserve cognitive function. But, cognitive impact of csDMARDs (MTX) is complex, w/ conflicting reports on its role in vascular dementia. https://t.co/6uMmOOdRoF
Dr. John Cush RheumNow ( View Tweet)
Danish registry study of 1431 AAV pts ((median age: 69 yrs, 52M; F/U 4.8 yrs) shows AAV had more LVH (17% vs 12%), ST-T (10% vs 7%), aFib (9.6% vs 7.5%), QTc prolong (6% vs 3.6%). Only AAV w/ major ECG abnls had incr risk of CV mortality [HR 1.99; 1.49-2.65) https://t.co/OB8b9pC6kw
Dr. John Cush RheumNow ( View Tweet)
EMA's EudraVigilance (safety) database study of 10,319 MTX reports (age: 62 yrs, 73% F). Adverse rxns (ADR): 365 kidney & 1,082 liver related. MTX renal ADRs were older, w/ comeds (NSAIDs, Tylenol, metamizole, steroids). More deaths w/ renal ADRs than liver(21% vs 6%); mostly w/ https://t.co/sZYZla0q1X
Dr. John Cush RheumNow ( View Tweet)
JAMA Staphylococcus aureus Review
- s. aureus bacteremia leads to septic arthritis (7%), vertebral osteomyelitis (≈4%)
- bacteremia (≥48 hs) has 39% 90-day mortality risk
https://t.co/atao3mF32L https://t.co/oMSJVNKvJN
Dr. John Cush RheumNow ( View Tweet)
Topline results from Phase 3b APEX study, comparing guselkumab to placebo in biologic naive #PsA pts - showed significant improvement by ACR20 and significantly less Xray progression of structural damage (vs PB) at Week 24 https://t.co/YkUspqd92h https://t.co/cmAUWaScri
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FDA announced approval of Inebilizumab (Uplizna; Amgen), 1st approved Rx for IgG4-related disease (targets CD19+ B cells). IG4-related Dz is estimated to affect 20,000 in the USA. List price is $140,248.50 per dose, After two initial loading doses it is given q 6 mos. https://t.co/aD9yBVJukQ
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NORD-STAR RCT: Rx -naïve pts w/ early #RA found triple (MSH) Rx w/ prn IA steroid injx was superior to MTX + Pred (w/ taper) - w/ better clinical outcomes, fewer withdrawals, fewer AEs, & less steroid use BUT slightly worse Xray outcomes https://t.co/YN6Om2xdIP https://t.co/a7G8WFZSK7
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