Proceedings of the National Academy of Sciences (PNAS) has published new research on the mechanistic link between the rheumatoid arthritis (RA) "shared epitope" (SE) risk alleles and environmental triggers such as cigarette smoke that leads to joint inflammation and bony destruction. 

SOBI has announced that Kineret (anakinra) has been approved by the European Commission (EC) for the treatment of Still’s disease (Systemic Juvenile Idiopathic Arthritis [SJIA] and Adult-Onset Still’s Disease [AOSD]), in all 28 European Union (EU) member states.

Dr. Jack Cush reviews the news and journal reports from the past week on RheumNow.com. Highlights includes manpower shortfalls, comorbidities in AA Lupus, certolizumab pregnancy safety, which Shingles vaccine is best and the power of combination biologics in severe refractory  SLE.

One of the driving pathogenic mechanisms in systemic lupus erythematosus (SLE) is the generation of immune complexes capable of inducing netosis (NET formation) and NET-derived DNA that may be an amplifying autoantigen and give rise to anti-nuclear autoantibodies (ANAs). 

Clowse and colleagues have published an extensive review of the certolizumab pegol (CZP) in pregnancy database, and found no evidence that CZP has a teratogenic effect or contributes to fetal harm when compared to the general population. 

The German Autoinflammatory Disease (AID) registry has studied the effects of the IL-6 inhibitor tocilizumab (TCZ) in systemic juvenile idiopathic arthritis (sJIA) patients and shown a clinical response rate of 35% during the first 12 weeks, and inactive disease and/or remission (with medication)

Dr. Jack Cush reviews the news and journal reports from the past week on RheumNow.com. News on drug regulatory decisions, fenofibrate and gout, Still's disease, TB and infection rates, SpA and hidradenitis suppurativa, and predicting methotrexate non-responders.

Stopping methotrexate for 2 weeks after the administration of flu vaccine led to improved immunogenicity without increasing disease activity among patients with rheumatoid arthritis (RA), a prospective Korean study showed.

I spent this past week seeing hepatitis C patients with our hepatologists, and being a rheumatologist, I was looking forward to seeing extra-hepatic manifestations of HCV that we read about in text-books - cryoglobulinemic vasculitis, sicca syndrome, porphyria cutanea tarda and many others. I suppose I should not be surprised that the week passed without seeing a single one of these. 

Dr. Jack Cush reviews the highlights from the news, journals and major meetings. New announcements and approval from the FDA; novel associations between ANCA vasculitis and thyroid disease; flare rates after arthroplasty; and pregnancy outcomes for men and women.

Researchers at Northwestern University have used ultrasound-guided tissue biopsy from the joints to analyze the genes of tissue macrophages with the hope that transcriptional profiling of synovial macrophages may be correlated with clinical parameters or drug responsiveness in rheumatoi

Dr. Jack Cush reviews the highlights from the news, journals and major meetings. Bigtime rheumatologic lessons with tales from intestinal crypts, the friendly skies & the hips of hockey players. Also the microbiome and lupus, benefits of ENT findings with GPA and rare risk of opportunistic infections with biologics.

A large cohort study of pregnant and non-pregnant women with systemic lupus erythematosus has shown that lupus flares are increased during pregnancy and in the 3  months follwing delivery.

Yesterday a FDA advisory panel voted 15-0 in favor of approving Xeljanz (tofacitinib) 10 mg bid for patients with moderate to severe ulcerative colitis.

Capelli and colleagues have studied patients treated with ICIs and found two variants of inflammatory arthritis (IA) - a reactive arthritis like large joint arthritis with combination ICI therapy or a small joint IA with ICI monotherapy.

Gabay and colleagues have reported the results of a novel new recombinant human IL-18 binding protein, tadekinig alfa, demonstrating its effectiveness in an open-label dose escalating study in patients with adult-onset Still's disease (AOSD).

Pisetsky and colleagues have reported in the Annals of Rheumatic Disease that ANA tests done on established SLE patients may yield surprisingly disparate results.

While ANA negative lupus was a problem of old assays and the loss of ANA positivity may be seen with chronicity or age, most rheumatologists believe that ANA positivity is an absolute requirement for the diagnosis of systemic lupus erythematosus.

New guidelines have been developed by the American Society of Clinical Oncology (ASCO) and the National Comprehensive Cancer Network (NCCN) on how to assess and manage of immune checkpoint inhibitor side effects that are often autoimmune in nature.

Listen in on the proceedings from the 2018 RWCS meeting in Maui, with excerpts from leading teachers in rheumatology. This podcast features presentations from Drs.

Dr. Jack Cush reviews highlights, news and recent research published this week on RheumNow.com. This week's report includes news and education from the RWCS meeting in Maui.