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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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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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Antidepressants for Pain are Weakly Effective
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EurekAlert!
University of Sydney research has found people over 65 are being prescribed antidepressants as pain treatment based on international guidelines that use limited evidence. The study found that in the last 40 years there have been only 15 trials globally focusing on the benefit of antidepressants for pain in older people. This study fills a much-needed gap in research by bringing together the information from these trials to look at the efficacy and harms of antidepressants for acute and chronic non-cancer pain in those over 65 years old.
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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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Study extended - People with #lupus #SLE: We'd love to hear about your experiences. Either use the link below or scan the QR code with another device. https://t.co/gbmn8PWbwd https://t.co/MHLbDdCGbf
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Julia Simard, ScD RheumEpi ( View Tweet)
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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Voclosporin and Steroids in Lupus Nephritis
Dr. Jack Cush reports on abstract OP0059 presented at Eular 2024 in Vienna, Austria.
https://t.co/4CilABzEjm https://t.co/hgyDqG1fPR
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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
Dr. John Cush RheumNow ( View Tweet)