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ICYMI: VITAL Info on Autoimmune Disease (2.9.2024)
Dr. Jack Cush reviews the journal reports from the past week on RheumNow.com. Highlights are summarized by three songs: "Stairway to Heaven", "You're No Good", and "How Long (has this been going on)".
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Best of 2024: Upside/Downside of Steroids in Lupus Nephritis
A systematic review of randomized clinical trials of patients with biopsy-proven lupus nephritis demonstrates both the benefits and harms to early glucocorticoid regimens on lupus outcomes.
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Best of 2024: SGLT2 Inhibitor Protective Effects in Lupus
Systemic lupus erythematosus (SLE) outcomes were assessed based on whether they received sodium-glucose co-transporter 2 inhibitors (SGLT2i), in the setting of comorbid type 2 diabetes (T2D).
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Best of 2024: Good Clinical Practice Recommendations on Glucocorticoid Withdrawal and Adrenal Insufficiency
https://t.co/Fkn26crcNX https://t.co/LJVa0TApid
Dr. John Cush RheumNow ( View Tweet)
Zhang @jeffsparks et al. Even more evidence that MTX does not cause ILD, and in fact prevents ILD, in RA, OR 0.48 in meta-analysis. @RheumNow #ACR24 Abstr#1384 https://t.co/w5G1dEF7Vm https://t.co/cyiQqGBf01 https://t.co/r909qqIh4V
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Dr. John Cush RheumNow ( View Tweet)
post-hoc analysis 48 pts w/ SSc-ILD in the DESIRES trial (DBRPCT) showed that RTX efficacy on lung outcomes (FVC change) at 24 weeks was only seen in those with CRP levels ≥0.055 mg/dl, ΔppFVC was significantly higher w RTX vs PBO [difference 8%) https://t.co/92yfWEU1d8 https://t.co/tB9sd9VS1K
Dr. John Cush RheumNow ( View Tweet)
JAK inhibitors are effective at repigmentation in vitiligo. 5 RCTs, 1,550 pts showed >50% improvement (TVASI50; RR 2.67) or >75% (FVASI75; RR 3.97_ JAKi increased skin AE, but not significantly different from placebo pts. https://t.co/zIreYlUyLt https://t.co/pCWKL2vSVs
Dr. John Cush RheumNow ( View Tweet)
Antiviral prophylaxis is essential for HBsAg+ patients receiving cytokine inhibitors, given the high risk of reactivation. Metanalysis of 10 studies shows reactivation in 21% of HBsAg+ patients without prophylaxis vs 4.4% in HBsAg−/HBcAb+ patients. https://t.co/eHzIeA8uJK https://t.co/CmZw8C8ibn
Dr. John Cush RheumNow ( View Tweet)
Outcomes Comparison study of late-onset RA (LORA) vs younger-onset RA (YORA) showed similar Dz activity assessments over 5 years but Late onset RA had worse functional outcomes and more adverse events (adj HR 4.7 for death & 2.6 for malignancy). https://t.co/b58zJG1OuA https://t.co/WZa12O06Rf
Dr. John Cush RheumNow ( View Tweet)
Best of 2024: SGLT2 Inhibitor Protective Effects in Lupus
https://t.co/zLxEOnWjpB https://t.co/I8jBcxO6rH
Dr. John Cush RheumNow ( View Tweet)
Best of 2024: Good Clinical Practice Recommendations on Glucocorticoid Withdrawal and Adrenal Insufficiency
https://t.co/atoMR1YChT https://t.co/OeaF9QUGEz
Dr. John Cush RheumNow ( View Tweet)
FDA has approved Eli Lilly’s GLP-1 drug Zepbound [tirzepatide] to treat moderate to severe obstructive sleep apnea in adults with obesity in combination with increased physical activity and a reduced-calorie diet.” https://t.co/rYiM6JzmDX https://t.co/hO6CgH9pVs
Dr. John Cush RheumNow ( View Tweet)
Zhang @jeffsparks et al. Even more evidence that MTX does not cause ILD, and in fact prevents ILD, in RA, OR 0.48 in meta-analysis. @RheumNow #ACR24 Abstr#1384 https://t.co/w76dY29bwe https://t.co/1LBevDunjH https://t.co/Ix3UxeGUe2
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Dr. John Cush RheumNow ( View Tweet)
"If you want an argument, put two rheumatologists in a room and ask them about steroid tapers. Add a third and you'll have a fight"
-P. Merkel at UPA plenary session
#ACR24 @RheumNow
Dr. John Cush RheumNow ( View Tweet)
Upadacitinib in GCA. Merkel et al. SELECT-GCA study. Sustained remission week 52 Upa (+26 week steroid) 46% vs PBO (+52 week steroid) 29%. Reduced flare rates with UPA (see picture). Similar to GiACTA results. @RheumNow #ACR24 Abstr#0770 https://t.co/f7OwxAggaf… https://t.co/PUuwo0MLso https://t.co/JBzokT9icx
Dr. John Cush RheumNow ( View Tweet)
Should you worry about giving TNFi to RA pts after a cancer diagnosis?
Medicare data with colorectal, lung, prostate Ca:
TNFi pts survival no worse (numerically better) than csDMARDs
Cancer pts deserve good RA treatment!
#ACR24 ABST0202 Suarez-Almazor @MDAndersonNews @RheumNow… https://t.co/aR75hJQ6YK https://t.co/ptDYCsOpXN
Dr. John Cush RheumNow ( View Tweet)
ANA neg, but ENA pos
should we care about that result?
PPV 5.5% here
(similar to 6% prev @EricFMorand: https://t.co/7Lo0DgHtXT)
and how many really needed the serology? Anxiety?
Surely pos ENA w neg ANA might be more hassle than help. So what to do?⬇️
#ACR24 ABST1930 @RheumNow… https://t.co/lZ1TJxTqhs https://t.co/itx0TCFFjl
Dr. John Cush RheumNow ( View Tweet)
Great table re:side effects of even low dose steroids in RA
Likely generalizes to other diseases ie PMR, SLE
P in prednisone stands for poison!
#ACR24 @RheumNow https://t.co/2bFy6dwl96 https://t.co/YDtjSX054I
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Dr. John Cush RheumNow ( View Tweet)
TAPIR study of continuing vs stopping steroids in ANCA vasculitis in remission. Relapse at month 6 in 16% vs 4%. OR 4.22, but low rate in either group. If treated Rituximab, no difference! Merkel et al. @RheumNow #ACR24 Abstr#0774 #ACRbest https://t.co/F9DOBLrjVq https://t.co/BtphAuEopA
Dr. John Cush RheumNow ( View Tweet)
54K Peptic Ulcers Annually (12.13.2024)
https://t.co/18FiQx1YQA https://t.co/32UZi9XafS
Dr. John Cush RheumNow ( View Tweet)
