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An Epidural Letdown (4.4.2025)
Dr. Jack Cush reviews the news and journal reports from this past week on RheumNow.com.
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Vamorolone: a New Steroid on the Horizon?
Vamorolone is a potentially new alternative to traditional glucocorticoids for use in inflammatory diseases.
Steroids, Prophylaxis and Pneumocystis Pneumonia
A case-control study has shown that glucocorticoids and tapering glucocorticoids are risk factors for the development of Pneumocystis jirovecii pneumonia (PJP).
Topline results from Phase 3b APEX study, comparing guselkumab to placebo in biologic naive #PsA pts - showed significant improvement by ACR20 and significantly less Xray progression of structural damage (vs PB) at Week 24 https://t.co/0Ra8eUeBOi https://t.co/0dwOSxjVxs
Dr. John Cush RheumNow ( View Tweet)
Matched cohort study of 83,811 #RA pts showed RA had a 12% increased risk of avoidable hospitalizations (CHF, pulmonary edema; (IRR 1.12). Predictors of ACSC hosp. were age, Steroids, ambulatory comorbid Dxs. ambulatory care access & ^ primary care may reduce this risk. https://t.co/AxQVoXoxxx
Dr. John Cush RheumNow ( View Tweet)
Topline results from Phase 3b APEX study, comparing guselkumab to placebo in biologic naive #PsA pts - showed significant improvement by ACR20 and significantly less Xray progression of structural damage (vs PB) at Week 24 https://t.co/7sY1sX9B3O https://t.co/EislRI5WAy
Dr. John Cush RheumNow ( View Tweet)
FDA announced approval of Inebilizumab (Uplizna; Amgen), 1st approved Rx for IgG4-related disease (targets CD19+ B cells). IG4-related Dz is estimated to affect 20,000 in the USA. List price is $140,248.50 per dose, After two initial loading doses it is given q 6 mos. https://t.co/zHD2Yv3PjI
Dr. John Cush RheumNow ( View Tweet)
#RheumTwitter—Heading to the highly anticipated State-of-the-Art Clinical Symposium (SOTA), April 4-6, in Chicago? Share your meeting experience on social & be sure to include #SOTA25 in your posts. We can’t wait to see you there! https://t.co/HZTZUm2UfG
American College of Rheumatology ACRheum ( View Tweet)
📢 Federal funding for lupus research and the Lupus Research Program within the Department of Defense hang in the balance as Congress debates spending priorities.
🔬 Investing in lupus research – and all medical research – is one of the wisest investments we can make. That’s why https://t.co/OgWo5z0fMB
Lupus Research LupusResearch ( View Tweet)
🎉 Today's Annual Scientific Conference kicked off with The CARRA Registry Retreat! The retreat brought together physician-PIs, research coordinators, research managers and patients/caregivers involved with the CARRA Registry. 💙 #CARRA2025 #pedsrheum https://t.co/GYYHAjsIdK
CARRA carrainc ( View Tweet)
Systematic review 21 studies showed potential of RTX with IVIg in autoimmune Dz - 10 studies on pemphigus (85 pts) - all Positive outcomes except 1 paraneoplastic pemphigus. Infections (eg, P. jirovecii pneumonia) seen in 3. 11 studies (24 pts) Rx'd neuropathies, CND lupus& https://t.co/o0RRUBIqmS
Dr. John Cush RheumNow ( View Tweet)
Commemorating the 15th Anniversary of the Biologics Price Competition and Innovation Act (by Dr. Sara Yim, FDA)
- BPCIA enacted March 23, 2010
- created pathway for biosimilar approvals
- Now ~70 FDA approved biosimilars; 18 in 2024
https://t.co/dhST5vAJyT https://t.co/BWefr7k9hh
Dr. John Cush RheumNow ( View Tweet)
South Korean nationwide cohort study of 888,909 newly diagnosed #OA pts compared NSAID safety. Nephrotoxicity varied: lowest w/ meloxicam (aHR=1.22 [0.68–2.19]), higher w/ loxoprofen (aHR=3.9 [1.56–10.00]), celecoxib (aHR=2.4 [1.68–3.53]), naproxen (aHR=4.7 [2.16–10.24]) https://t.co/wfWIdoRQGO
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Congrates to Arthritis Research & Therapy on their 25th anniversay - 25 years of research and therapy in arthritis. Started 25 yrs ago by Drs. Peter Lipsky and Ravinder Maini https://t.co/4GFj9qktzr https://t.co/bUz0Ms0y6M
Dr. John Cush RheumNow ( View Tweet)
An estimated 118,000 people throughout the world have EGPA. Steroids & immunosuppressants have been the mainstay; but for managing EGPA. Mepolizumab (2015) & Benralizumab (2024) are FDA approved for EGPA. The latter (Fasenra) approval based on the MANDARA trial https://t.co/84W4sOig9d
Dr. John Cush RheumNow ( View Tweet)
To promote broader avail. of biosimilars in EU, EMA has proposed a new path for new biosimilars, omitting comparative clinical trial data, as long as biosimilar shows structural & functional comparability, w/ pharmacokinetic & interaction data (relative to reference product) https://t.co/24aTCuDwdO
Dr. John Cush RheumNow ( View Tweet)
Joint Implant Metals May Be Leaking
Patients with metal-containing joint replacements had significantly higher concentrations of cobalt in their cerebrospinal fluid (CSF) relative to patients without arthroplasties, researchers reported.
https://t.co/ubDhWqtTSL https://t.co/GjMnog8mcJ
Dr. John Cush RheumNow ( View Tweet)
1st Line Biologics vs. csDMARDs in Adult Still's Disease
A German multicentre, retrospective study assessed the first-line efficacy of biologics and conventional synthetic DMARD therapy in patients with adult-onset Still's disease (AOSD) and found biologic agents were https://t.co/EeSuBiYx5Q
Dr. John Cush RheumNow ( View Tweet)
Review article shows that in psoriasis pts, adding #MTX to TNFi increases efficacy, but there is limited data on adding MTX to either IL-17 or IL-23. But in Psoriatic Arthritis (PsA), adding MTX provides no added efficacy compared to biologic monotherapy https://t.co/FiSFIjpsXo https://t.co/ComFg253u9
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NIH Complimentary Medicine overview of Music Therapy - preliminary research suggests that music interventions may be helpful for anxiety, depression, pain control, dementia, multiple sclerosis, Parkinson’s disease, etc https://t.co/UGsfT7lITQ https://t.co/DrJm4JdEuY
Dr. John Cush RheumNow ( View Tweet)