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ICYMI: Cardiac and Cancer Signals Tofacitinib Safety Alert from FDA

d Jack Cush, MD

The FDA has notified healthcare professionals of a safety alert concerning tofacitinib (Xeljanz), noting that preliminary results from a long-term safety clinical trial show an increased risk of serious heart-related problems and cancer with tofacitinib (compared to adalimumab) when given to at-risk rheumatoid arthritis patients. These findings are in addition to the thrombotic risks (added to the label), potential risks including blood clots in the lungs and death.

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ICYMI: JAK Inhibitor Misses Endpoint in Safety Study. Now What?

d MedPage Today

Pfizer announced results Wednesday from its FDA-mandated postmarketing safety study of tofacitinib (Xeljanz), and they don't bode well for the drug and possibly others in its class.

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RheumNow Podcast – As Good As I Ever Was (7.2.2021)

d Jack Cush, MD

Dr. Jack Cush reviews the news and journal reports from this past week on RheumNow.com.

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Gender Trends in Rheumatology

d Jack Cush, MD

A study of rheumatologists in Ontario, Canada has shown an increasing percentage of women in rheumatology; unfortunately they have lower salaries but see fewer patients than do their older, male colleagues.

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Neuropsychiatric Events Common in Lupus

d Jack Cush, MD

Neuropsychiatric (NP-SLE) or CNS lupus events range from mild to severe; several recent studies have noted that NPS lupus is common and should be screened for.

A metanalysis of the literature finds 22 studies wherein the mean frequency of NPSLE ranged from 10.6% to 96.4%. When researchers with the Swiss SLE cohort study looked at their population, NPSLE was found in 28.1%. This included cerebrovascular insults, seizures and psychosis.

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Psoriasis has greatest risk of MTX liver dz - a Danish Population study of PsO, PsA & RA pts taking MTX. Risk of liver Dz was most in PsO, followed by PsA, then RA. PsO had 1.6-3.4 fold risk (mild-severe) liver dz (vs RA). PsA was 1.3-1.6x higher) https://t.co/pAo9KFr5fO

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1/3 of patients with rheumatoid arthritis had unacceptably high levels of pain 5 years after diagnosis, often despite low levels of inflammation, Swedish researchers found. Read more: https://t.co/K8zf1pE9jM https://t.co/eu2Byo6dx4

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The ACR has a new position on patient safety and site of service for biologics— it strongly believes infusions should be given in a monitored health care setting with onsite supervision by a provider w/ training in biologic infusions. https://t.co/NONozoIIq6 https://t.co/PQMvUZqnMW

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A study of rheumatologists in Ontario, Canada has shown an increasing percentage of women in rheumatology; unfortunately they have lower salaries but see fewer patients than do their older, male colleagues. Read more: https://t.co/JM0345p8f1 https://t.co/y95LQ6lX5i

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Download this week’s podcast titled “Good as I Ever Was”. You can find us on SoundCloud and wherever you download your podcasts. https://t.co/hVMf8X5Dx3 https://t.co/uUDCXzO2eU

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New ACR Rheumatoid Arthritis Guideline: Emphasis on Methotrexate https://t.co/J9wmcZr17D

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How risky are family gatherings, birthday parties and informal social gatherings? Read more… https://t.co/jyGHakndUt https://t.co/7eps0EFVWy

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Brand new RheumNow podcast up titled “As Good As I Ever Was” Download now. https://t.co/hVMf8X5Dx3 https://t.co/2R2kq7dwp5 https://t.co/5mahn4D46M

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Therapeutic Drug Monitoring for Infliximab: Might it Actually Work? https://t.co/Onl6cijKbb https://t.co/jnwx4ZZvhz

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Ten Things to Tell Patients About Diet and Rheumatic Disease https://t.co/DpBAJwCJCY https://t.co/AVlgHfdP08

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With the expansion of knowledge regarding the safety of newer agents in pregnancy comes the PreCARA study showing that when pregnancy is planned and patients with RA are treated with a modified T2T approach, superior outcomes can be anticipated. Read on: https://t.co/sV5hJRzPJW https://t.co/ADppVd3CmZ

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The ACR has released an updated position statement on patient safety and site of service for biological. https://t.co/NONozoIIq6 https://t.co/CSbSuXBb8n

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Health care utilization by knee OA pts varies. In nearly 1 million Knee OA (Medicare), 33% ended up with TKR. TKR/arthroplasty assoc w/ more clinic visits; PT, specialist care & intraarticular Rx assoc. w/ less TKR. TKR range 26% to 42% by region https://t.co/d1EQTTie8X

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CDC: as of 5/15/2021; the rates of flu test positivity was 0.051-0.18% for the 2020-21 flu season - compared to usual rate of 10%-19% before COVID. Actual influenza hospitalizations dropped from 44.2 to 0.8/100 000 population https://t.co/N8b1sQWWIh

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Higher rate of Parkinsonism in Osteoarthritis? Taiwan Health Insurance claims analysis of 33,360 OA pts (age 50-64 yrs) vs age matched non-OA - found incr risk of Parkinsons in OA pts (aHR=1.41), esp in knee or hip OA (aHR 1.55) group. https://t.co/SHudF5NnwH

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