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I Can't Treat Ugly (9.20.2024)
Dr. Jack Cush reviews the news, journal articles and a new FDA approval for EGPA, this week on the Podcast.
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TREAT EARLIER - Methotrexate in Clinically Suspect Arthralgia Patients
Lancet Rheumatology has published the results of the TREAT EARLIER trial, showing the prevention of rheumatoid arthritis may be enhanced by risk stratification, particularly in anti-citrullinated protein antibody (ACPA)-negative people with clinically suspect arthralgia.
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Moving Forward on RA Prevention Trials
Now that multiple prevention clinical trials for rheumatoid arthritis (RA) have been completed, a group of investigators have reviewed the results and published their recommendations for future trial designs and drug development to assess interventions that may alter disease development.
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TREAT EARLIER - Methotrexate in Clinically Suspect Arthralgia Patients
Lancet Rheumatology has published the results of the TREAT EARLIER trial, showing the prevention of rheumatoid arthritis may be enhanced by risk stratification, particularly in anti-citrullinated protein… https://t.co/1NYgYtYKIr https://t.co/fMMy2DzSxN
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Metanalysis of JAKi in ILD (7 studies, 183 pts) showed increases in FVC (2 %), DLCO (3.1%) & improved Thoracic HRCT of 11%; only 5% had worsening of their ILD. Risk of ILD w/ JAKi was low ( 0.20/1000 PY) w rates similar to abatacept & rituximab https://t.co/UDJ1ZvtGhh https://t.co/WTQS67yDyl
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Retrospective analysis of 63K Alopecia areata pts shows a higher risk of developing psychiatric (aHR 1.3) & autoimmune Dz (aHR 2.7), including SLE (aHR 5.7), atopic dermatitis (4.3), vitiligo (3.8), Sjogrens (3.7), Morphea (3.6), PsO (2.8), RA (1.8) https://t.co/gnEm9TsyoV https://t.co/XWA98sbRLp
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IMPORTANT: Cost effectiveness analysis of the TREAT EARLIER RCT shows 88% probability that 1 yr of MTX in 236 pts w/ clinically suspect arthralgia was cost-effective. Results shows MTX Rx increased quality adjusted life years & reduced costs https://t.co/1BVxs77vo8 https://t.co/uQSQL5Eww9
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Cancer presenting as Inflammatory low back pain? 34 Cases presenting as SpA over 10 yrs often w/ higher ESR/CRP/LDH levels. CA included myeloma, leukemia, lymphoma, CA of breast/lung/prostate & bone tumors. https://t.co/YYKYx39tbD https://t.co/m9uCbJBsnU
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So You've Got RA and Want to Get Pregnant?
Dr. David Liew reviews abstract POS0436 presented at Eular 2024 in Vienna, Austria.
https://t.co/vG9l7kOReq https://t.co/xhumOCisOM
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2612 BSRBR-RA Registry pts on tocilizumab - increasing Body weight was associated with reduced DAS28 response to SC tocilizumab. But the DAS28 difference was small, and did not change drug persistence https://t.co/eR7kmjRaEE https://t.co/vFKYC1I3pV
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Retrospective Taiwan's Health claims: studied 6408 RA pts, half HCQ users vs non-users. No higher risk of osteoporosis in HCQ users vs non-users (aHR=0.99; 95% CI: 0.82–1.196). Why study this? HCQ may suppress both bone formation/resorption https://t.co/xShLXMElnH https://t.co/lkvihaYuAd
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1,717 Chinese rheumatologists (92% response) surveyed on Steroid use in RA. 60% admit to infrequent use of GC cotherapy. Bridging GC use was supported (35%), opposed (27%), but 38% were inconclusive & 67% said long-term low-dose GC use depends on the pt https://t.co/7qe1aRsZx8 https://t.co/D0RoYxPohY
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Animal model shows Aggregatibacter actinomycetemcomitans periodontitis can trigger macrophage/caspase-11/inflammasome activation leading to paw swelling in mice anti-collagen antibody-induced arthritis (CAIA) model https://t.co/f41r28g5yr https://t.co/61NeXgfzmB
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Norwegian Registry study compared risk of stroke in 2750 RA vs 158 879 w/o RA pts. 7.3 vs 5% (HR 1.36; 1.13, 1.62). RA pts with atrial fibrillation was also elevated (HR 1.25; 1.05, 1.5). RA pts less likely to Rx w/ oral anticoagulants (adj OR 0.88) than non-RA… https://t.co/uprHZbsqkR https://t.co/edjoN2vzc0
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Moving Forward on RA Prevention Trials
Now that multiple prevention clinical trials for rheumatoid arthritis (RA) have been completed, a group of investigators have reviewed the results and published their recommendations for future trial designs and drug development to assess… https://t.co/ppmWa27tgd https://t.co/lQEtBNRZRm
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In elderly onset rheumatoid arthritis, Treg cells are increased, but have decr suppressor activity. Maybe due to elevated Type I IFN with IFN-β suppressing old Tregs and increasing PD-1 expression. https://t.co/51ww481FkJ https://t.co/8EA1fENaFm
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Linger on the Fingers (9.6.2024)
Dr. Jack Cush reviews the news and journal reports from the past week on RheumNow. This week with a focus on fingers and better prescriptive follow through.
https://t.co/c9yvRjE9av https://t.co/mdN37AWHjX
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Does Rheumatoid Factor Influence Anti-TNF Responses in RA?
Smolen and colleagues have published a subanalysis of the EXXELERATE study that showed while certolizumab pegol [CZP] concentrations and efficacy was unaffected by high titers of rheumatoid factor (RF), patients treated… https://t.co/Ux9gHXcGbv https://t.co/gpcuWrqVHi
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EMA Updated overview of leflunomide (Arava) https://t.co/LbuqzDdTvf https://t.co/npfsRDdFiP
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Difficult to treat RA Approach
https://t.co/2rmlv0kspP https://t.co/6yb5xj8jrn
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