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Dr. Jack Cush reviews the news and journal reports from this past week - some obvious, other new thoughts and some - hmmm, reallly?
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A pooled analysis of 25 randomized clinical trials affirms the safety of ixekizumab (IXE) when used to treat patients with psoriasis (PsO), psoriatic arthritis (PsA), or axial spondyloarthritis (axSpA).
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Patients with autoimmune skin diseases (ASDs) with cancer had significantly better cancer survival outcomes than those without ASD, suggesting coexistant autoimmune or inflammatory disease does not adversely affect a cancer prognosis.
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Is there a higher risk of cancer that comes with the disease? Or with the treatments? So many confounding parameters, such as disease duration, disease state, and disease activity come into play. A promising session explored comorbidities in Rheumatoid Arthritis, in particular cancer and cardiovascular events. Here are my takeaways.
Dr. John Cush
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Case–control study RA pts > 65yrs in US. SEER (cancer) database (2014–2019). Overall cancer risk not associated with use of JAKi (adjOR 1.04), TNFi (0.98) or other bDMARDs (0.98). But, JAKi use was assoc w/ incr risk of lung CA (OR 1.40), esp in Males (2.12) & >2 yrs JAKi. Lower https://t.co/u2psafyN1I
Dr. John Cush
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RABBIT (German biologics register) study shows overall small increase in malignancy w/ JAKi vs bDMARDs. Risks greatest in those ≥ 60 yrs, w/ Hi Dz activity, on ≥3 prior csDMARDs. 2285 JAKi vs 4259 bDMARDs: 88 vs 135 malignancies CAs (IRs 11.6 vs 8.9; adj HR 1.40). JAKi risk https://t.co/AlK2SWn6UR
Dr. John Cush
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Review of 104 irAE pts rx w/ JAK inhib. (82% tofacitinib). Checkpoint inhib was for Lung (20%), gastric (17%) & melanoma (16%). JAKi indications: myocarditis (70%), myositis (33%), hepatitis (24%). JAKi potentially effective esp in irAE pts unresponsive to cytokine Rx. https://t.co/8ezpAOzpRh
Dr. John Cush
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Clinical determinants of multiple drug failure in D2T RA
2000+ RA cohort 250+ refractory
-Low financial status
-Cancer Hx
-CV comorbidities
-Chronic use of NSAID or GCs
Protective: Regular participation in leisure activities
#POS0030 @RheumNow #EULAR2025 https://t.co/mdePGkHU82
Dr. John Cush
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Cancer risk in rheumatoid arthritis: anything new?
There is still a question I have a hard time answering with certainty when people living with rheumatoid arthritis ask me: Is there a higher risk of cancer that comes with the disease? Or with the treatments? So many https://t.co/6rbZg5Fr2k
Antoni Chan MD (Prof)
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Key summary slide of research in the use of CD19 CAR T cells in rheumatology indications
Dinesh Khanna @RheumNow #EULAR2025 https://t.co/CoFHqaE1L1
Antoni Chan MD (Prof)
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Autologous CAR T cell production, administration and monitoring
Dinesh Khanna @RheumNow #EULAR2025 https://t.co/zrXjxSCRgl
Janet Pope
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Should we screen for #lung #cancer in #SSc high risk Pts? When >10 yrs?
Greek cohort of SSc since 1995
Disease duration 12 yrs,
smoking lung ca group ⬆️58% vs 29%
⬆️dcSSc
⬆️immunosuppression
OR >4X lung ca if dcSSc, IS
Less #DU
#PO0940 @RheumNow @eular_org #EULAR2025 https://t.co/L2zEkP8pAc
David Liew
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Should we still be worried about lymphoma developing in RA patients?
Incidence has plummeted with modern therapy, although still a small risk. TNFi and other bDMARDs don’t seem to confer any real risk.
So what should our approach be?
Karin Hellgren #EULAR2025 @RheumNow https://t.co/9ZodpojSaz
Antoni Chan MD (Prof)
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The definition of MAS. MAS is secondary HLH. Other causes of secondary HLH are infections, malignancy and iatrogenic.
Georgin-Lavialle S @RheumNow #EULAR2025 https://t.co/CpB78JBlVJ
Bella Mehta
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Clinical Pearl's for #MAS
Infections are still the most common cause.
Next is malignancy...
Then other causes like autoimmunity..
Ask a detailed history ! Sometimes check with the family when the pt can't give history..
#EULAR2025 @RheumNow https://t.co/fepercz5Af
Jiha Lee
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JAKi: expanding RMD indications—but important safety concerns to consider
⚠️ Cancer: Neutral vs MTX/placebo, ↑ risk vs TNF
⚠️ Infection: ↑ with age, disease activity & GC use—not uniformly higher with JAKi
🗣️ Patients rank infection risk as top concern
@rheumnow #EULAR2025 https://t.co/RJRDWQjqNC
Janet Pope
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#Cancer is not ⬆️in JAKi vs #bDMARDs in
#rheumatoid #arthritis
When adjusted for #confounders
#JAKPOT data
Now you see it (unadjusted ⬆️risk)
Now you don’t (adjusted =#malignancy)
JAKi vs bDMARDs in RA
EULAR2025 @RheumNow @eular_org
#JAK it out! new perspective on JAKi https://t.co/wCQ3dHNAVa
Janet Pope
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Would you use #CAR-T in #polyrefractory #RA
#EULAR2025 @RheumNow @eular_org
Aurelie Najm
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Clinical determinants of multiple drug failure in D2T RA
2000+ RA cohort 250+ refractory
-Low financial status
-Cancer Hx
-CV comorbidities
-Chronic use of NSAID or GCs
Protective: Regular participation in leisure activities
#POS0030 @RheumNow #EULAR2025 https://t.co/qNHQoHCb80
Jiha Lee
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#OP0066 Danish registry study finds no increased risk of cancer recurrence with bDMARDs vs csDMARDs in RA patients with prior solid tumor in remission. IPTW-adjusted HR for any bDMARD: 0.92 (95% CI 0.38–2.21).
📉 TNFi, ,RTX also not associated with recurrence
@RheumNow #EULAR2025
