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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.
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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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Mycophenolate in New-Onset SLE
How aggressively do you treat newly diagnosed new-onset systemic lupus erythematosus (SLE), or should you wait for organ involvement?
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FDA decision explained on why they modified its rule on #Biosimilar interchangeability. Approved 15 yrs ago, now there are 50 Biosimilars in USA. Switching (interchangeability) studies are no longer needed based on the FDA experience over last 8 years. https://t.co/vpmgdVeDwz https://t.co/UAWnFQxugl
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Neoself-antigens are targeted by autoreactive T cells clonally expanded in SLE. Neoself-antigen presentation results in clonally expanded neoself-reactive T cells, leading to the development of lupus-like disease in mice. https://t.co/iFXNLNRxO5 https://t.co/9TEJUqfEbo
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Fasenra (benralizumab, an anti-IL-5 mAb) has been FDA approved in the US for the treatment of adult patients with eosinophilic granulomatosis with polyangiitis (EGPA); approval based on MANDARA trial - H2H noninferior to mepolizumab at remission https://t.co/5tAPolUItK https://t.co/VHCNjACThw
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FOREMOST: Apremilast in Early Oligoarticular Psoriatic Arthritis
A controlled trial has shown that apremilast is effective in patients with early, oligoarticular psoriatic arthritis (PsA).
https://t.co/i2w4RbGd5f https://t.co/5PD6pYB5vm
Dr. John Cush RheumNow ( View Tweet)
Full read review of Neonatal lupus syndrome - caused by pathogenic maternal autoAbs (SSA, SSB) in fetal circulation. Mild Sxs in 25%, severe Sxs are rare; Heart block in up to 2% of neonates born to mothers with positive antibodies. https://t.co/iH4MBRGvg1 https://t.co/kXxIeQC47m
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BSR Guidelines for Systemic Sclerosis Management
The BSR has updated its 2015 guidelines for the management of patients with SSc based on published evidence, systematic literature review and expert opinion.
https://t.co/HdQrK4TKGI https://t.co/O6FeaelWZV
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Different Autoantibody Phenotypes in Juvenile and Adult Myositis
A Kyoto University study compared juvenile-idiopathic inflammatory myopathy (IIM) and adult-IIM patients, demonstrating different autoantibody profiles and a more favorable outcome for n juvenile-IIM patients.… https://t.co/4fgkNJeO4i https://t.co/Z2lDloBzrI
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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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Increasing Incidence of Morphea
A large EMR cohort study of over 10,000 patients with morphea (localized scleroderma) sheds light on the increasing prevalence of morphea.
https://t.co/ISqv4y0Pkp https://t.co/KM3gbt2iWd
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Exploratory analysis from an academic center showed SLE pts w/ higher odds of positive ANA vs. other ANA-asso diseases (OR 2.10). Over 20 yrs, ANA titers are more dynamic than expected; & average titers being higher in early disease and decreasing over time.… https://t.co/iQXN0nPSIG https://t.co/viMTGen34K
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Pipeline drugs and trials intended for Interstitial Lung Disease - including studies with nintedinib, Efzofitimod, BI 1015550, AD-214, Abatacept, ATYR1923, Pirfenidone inhalation, RO-0220912, Lung stem cells...Riociguat, Treprostinil and more https://t.co/fpMjjubPVx https://t.co/ketFP0N9jk
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Yes you can space out Guselkumab injx in controlled Psoriasis. Phase 3b RCT of 149 GUS pts w/ PASI <4 were cont on GUS q8 wks or spaced to q16wks. Noninferiority was shown w/ maintenance of "super-responders" in > 90% w/ both https://t.co/4Y9quetoJn https://t.co/zP9ywFKpvY
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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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PEDIALUP registry includes 138 childhood-onset SLE (cSLE) pts.w/ 15.4 yrs median F/U, showed signif increase in SLICC-damage index (DI) scores. 34% cSLE pts had active dz w/ SLEDAI ≥6. sub-Saharan African ethnicity 7-fold incr risk of active cSLE https://t.co/iLz7DMTQuf https://t.co/tJpEvst7p4
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40 postmenopausal F Rx w/ Blackcurrant (BC) vs PBO. @6 mos BC lowered IL-1β (P .056) & RANKL (P .052) & BMD inversely correlated w/ RANKL change. BC bone protective may also be through enhancing gut microbial balance https://t.co/wy9VR3fwvJ https://t.co/cRCjSb5XDQ
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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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Study of 115 systemic sclerosis (SSc) pts followed 4 yrs. modified Rodnan skin score @ 4 yrs correlated w/ baseline mRSS & finger-to-palm distance (length from the distal tip of the fourth finger to the distal palmar crease) https://t.co/TwMy5Mh68r https://t.co/4qhhBS9yOH
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