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Which One is the Loneliest Number (9.27.2024)

d Jack Cush, MD

Dr. Jack Cush reviews the regulatory approvals, announcements, guidelines and interesting journal articles from the past week on RheumNow.com. When not to use muscle relaxants, how frequent is loneliness in RA/PsA/SpA, and when to refer patients with Still's disease.

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Stratified Cancer Screening in Dermatomyositis

d Jack Cush, MD

The International Myositis Assessment and Clinical Studies Group (IMACS) have published  evidence and consensus based cancer screening guidelines for patients with idiopathic inflammatory myopathies, including dermatomyositis. 

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pneumocystis,PJP

Pneumocystis Jirovecii Pneumonia Complicating Systemic Vasculitis

d Jack Cush, MD

A retrospecitive analysis of 62 patients with systemic vasculitis complicated by Pneumocystis jirovecii pneumonia (PJP) showed those with microscopic polyangiitis (MPA) had a higher mortality risk, possibly due to a higher prevalence of interstitial lung disease (ILD) in MPA.

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Stills,continuum

EULAR/PReS Still's Disease Management Recommendations

d Jack Cush, MD

Since 2022, EULAR and the Paediatric Rheumatology European Society (PReS) have been working to establish clinical practice guidelines for the diagnostics and management of systemic juvenile idiopathic arthritis (sJIA) and adult-onset Still’s disease (AOSD). 

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Pain Relief with JAK Inhibitors or Anti-TNFs ?

d MedPage Today

Targeted drugs for rheumatoid arthritis (RA) are not created equal when it comes to pain relief, a retrospective study from Sweden indicated, although the differences appeared to be modest.

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British Society Guidelines for Managing Behçet’s Disease

d Jack Cush, MD

An exhaustive, full read guideline from the British Association of Dermatologists (BAD) and the British Society for Rheumatology (BSR) on the management and treatment of Behçet’s disease (BD) in 2024 has been published in Rheumatology.

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INVIGORATE-2 Study - IV Secukinumab in Active Psoriatic Arthritis

d Jack Cush, MD

The INVIGORATE-2 trial reports that intravenous secukinumab is both effective and safe in patients with active psoriatic arthritis, demonstrating improvements on par with subcutaneous secukinumab.

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Lupus nephritis & CKD considerations: - Non-immune factors: obesity, HTN, Na- or protein-diets, NIDDM, pregnancy, mephrotoxic meds, smoking can add to CKD - use inhibitors renin–angiotensin & SGLT2 inhibitor w/ proteinuria & low GFR https://t.co/IgL4hpixOm https://t.co/FvmLhf7tQq

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NOR-Gout study shows Non-adherence to urate lowering therapy after 5 years is related to poor gout outcomes. 5-year Observational study of 163 patients showed overall good ULT adherence but nonadherent had more flares (33 vs 10%) & less at target (45 vs 87%)… https://t.co/wHQIRbIoBu https://t.co/eBKL4uRfZc
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UCB & Biogen report positive topline results of Phase 3 RCT of Dapirolizumab Pegol (anti-CD40L) in #SLE & will launch a 2nd Ph 3 RCT in 2024. Phase 3 PHOENYCS GO study was 48 wks of DAP vs PBO in mod-severe SLE w/ BILAG improvement by wk 48 https://t.co/G1DJf31T6t https://t.co/DgpTObIXrB

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Genentech announced top line results of the REGENCY Phase III study of obinutuzumab (Gazyva) in lupus nephritis. 271 LN (class III or IV; +/- V) taking MMF & steroids were given placebo or OBIN for 76 wks. OBIN was superior @ complete renal resp at 76 wks… https://t.co/Um9du7fgxE https://t.co/RRWumnbTuy
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NEJM Clinical Images: DLE - A 42-year-old woman presented with a 2-year history of a facial rash. A skin examination after removal of her makeup showed an indurated plaque, areas of hyperpigmentation and hypopigmentation, and scattered nodules. https://t.co/dcmLEwV359 https://t.co/XIjZblDSC3

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Dr. John Cush RheumNow ( View Tweet)
INVIGORATE-2 Study - IV Secukinumab in Active Psoriatic Arthritis The INVIGORATE-2 trial reports that intravenous (IV) secukinumab (SEC) is both effective and safe in patients with active psoriatic arthritis (PsA), demonstrating improvements on par with subcutaneous SEC.… https://t.co/I1TVGIHByN https://t.co/WwSRQxrKAE
Dr. John Cush RheumNow ( View Tweet)
Limited Efficacy of Muscle Relaxants for Chronic Pain A systematic review of long-term muscle relaxant use for chronic pain suggests they may be effective in treating trigeminal neuralgia, cramps, and neck pain, but not fibromyalgia, low back pain, and other pain syndromes.… https://t.co/sReBxhSpWH https://t.co/tQGWKPwokn
Dr. John Cush RheumNow ( View Tweet)
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. https://t.co/mSI16Ug4iR https://t.co/arCx6yo5p6

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Dr. John Cush RheumNow ( View Tweet)
TUDOR study looked at the incidence of PsA by serially following primary care psoriasis pts. At 1 year, 14/511 developed PsA (incidence 2.74 per 100 p-yrs) and at 2 years 7/444 developed PsA (1.58/100 p-yrs). Combined incidence @2 yrs - 2.2 per 100 p-yrs https://t.co/pbHBWt0pXn https://t.co/tHMhQs1cqN

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Dr. John Cush RheumNow ( View Tweet)
ACR 2024 Abstracts are available. Let the fun begin..... https://t.co/uNLZBqjEX0 Search by term, title or abstract # here: https://t.co/Du1eN4gA9D or Search by sessions and topics here >> https://t.co/R7NH1jeHPj https://t.co/OCoTPr03nG

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Korean Epidemiologic study shows the prevalence of Psoriatic arthritis has increased fbetween 2008 and 2020. Prevalence was 6/1000 in 2008 & 19/1000 in 2020. PsA incidence also incr from 3.35 to 5.01/1000 in the same era https://t.co/d20zETK2q2 https://t.co/WAuqoHFDfu

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Danish cross-sectional survey 12 713 Inflam arthritis (RA, PsA, SpA) pts & found lonliness in one-third (RA 32%; 36% in PsA & SpA) and highest in SpA w/ depression (66%). Loneliness was correlated w/ disease activity. https://t.co/Q3IswbIwe6 https://t.co/GNohOkkmEw

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Full read overview of ILD & its Clinical Course inRheumatoid Arthritis. Metanalysis of 22 reports shows 6-19% of RA have ILD on HRCT. Article discusses early onset, progression and the monitoring and management of RA-ILD https://t.co/mqexPcruni https://t.co/One7XYn4wX

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