Streptococcus pneumonia is a leading cause of morbidity and mortality in adults; including patients with autoimmune diseases who are at particular risk.

Rituximab, a chimeric anti-CD20 monoclonal antibody, has been effectively used in the treatment of multiple autoimmune disorders for over two decades. But the response to rituximab has been shown to not be as effective in SLE as it is in RA. 

It is well-known that patients with systemic autoimmune diseases are at risk for Pneumocystis jirovecii pneumonia (PJP) and although infrequent, it carries a high mortality. A new study shows lymphopenia and steroid use increases the risk of PJP.

Pianta, et al have published their findings in the Journal of Clinical Investigation showing that two novel autoantigens, GNS and FLNA, are highly expressed in synovium and share a sequence homology with gut microbesa; thereby providing a potential link between gut mucosal and joint immunity in rheumatoid arthritis. 

Researchers from Augusta University have examined exosomes from patients with knee osteoarthritis (OA) to enhance our molecular understanding of the pathogenesis of OA. (Citation source http://buff.ly/2tuDZ3v)

Vaccinating our rheumatoid arthritis patients against influenza every year is a safety priorty. However immunosuppressive therapies pose a challenge to vaccine administration as their use can hamper vaccine immunogenicity.

Dr. Jack Cush reviews highlights from the past week on RheumNow.com. 

The NEJM reports success when using mepolizumab (anti-IL-5 monoclonal antibody) in a 52 week study of patients with eosinophilic granulomatosis with polyangiitis (EGPA).

The FDA has approved sarilumab (Kevzara), a new IL-6 inhibitor co-developed by Regeneron and Sanofi's, for use in adults with moderate to severe rheumatoid arthritis (RA).

A retrospective analysis of four European vasculitis trials analyzes the risk venous thromboembolism (VTE) with ANCA-associated vasculitis and shows that CRP, cutaneous and GI involvement and baseline creatinine were most associated with VTE risk.

A study in the April 24 issue of Nature Medicine suggests that senescent cells in the joint contribute to age-related degenerative disease and that their removal can abrogate disease. 

On the 21st of April, the FDA approved another infliximab biosimilar, called Renflexis (Infliximab-abda) following on the biologics license application of the South Korean manufacturer Samsung Bioepis Co. LTD.  In early developmental trials this agent was also called SB2.

Dr. Jack Cush reviews highlights from the news and Advances in Targeted Therapies meeting in Mandelieu, France:

Tweeting this week from Advances in Targeted Therapies #ATT2017 in Mandelieu, France.

A comprehensive review of psoriatic arthritis (PsA) was published this week in the NEJM, authored by leaders in the field, Drs. Ritchlin, Colbert and Gladman.

High points from their review inlcuded:

Dr. Jack Cush reviews highlights in the news from the past week at RheumNow.com.  News on hepatitis C in RA and risk of hepatotoxicity; TNF inhibitor persistence in PsA; unnecessary injections in pre-operative OA knee patients; and a delay in the FDA decision on abaloparatide.

In January 2017, the Food and Drug Administration (FDA) released its draft guidance on the issue of interchangeability between biosimilars and originator biologic drugs. The window for your input will close on May 18, 2017. RheumNow encourages you to participate in this exercise and express your opinion.

The current JAMA has a perspective piece on the role of the oral microbiome in the pathogenesis and references a recent article by Konig et al on "Aggregatibacter actinomycetemcomitans–induced hypercitrullination links periodontal infection to autoimmunity in rheumatoid arthritis (RA)." (Citation

Researchers from Rush University Medical Center have reported in the March 6 issue of the Journal of Clinical Investigation that engagement of the integrin CD11b with a novel compound, may improved outcomes in patients iwth systemic lupus erythematosus (SLE).

The TNF inhibitor drug development trials have indirectly taught us that monoclonal antibody based TNFi was capable of retarding the recurrence of anterior uveitis (AU) in patients with ankylosing spondylitis (AS).

The European Commission has approved Eli Lilly's rheumatoid arthritis drug Olumiant (baricitinib) for use in Europe for RA patients with moderate-to-severe active disease in adults who have not responded one or more disease-modifying antirheumatic drugs.