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Sequential Belimumab and Rituximab in SLE
Could disease control in active systemic lupus erythematosus (SLE) patients be improved by the sequential use of subcutaneous belimumab (BEL) and intravenous rituximab (RTX)? A double blind trial has shown that sequential BEL and RTX was not superior to BEL alone in SLE.
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ACR Applauds Lower Negotiated Prices for Common Arthritis Drugs
The American College of Rheumatology praised the recent announcement from the Centers for Medicare & Medicaid Services (CMS) that their initial drug pricing negotiations have reduced costs for select medications, including significantly lower prices for Enbrel and Stelara, which are frequently used to treat rheumatic diseases.
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Higher Cancer Rates (8.16.2024)
Dr. Jack Cush reviews the news and journal reports from the past week on RheumNow.com, noting his concerns about diet, cancer, ILD, death and dosing challenges.
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ASLeap: Higher Dose Secukinumab in Ankylosing Spondylitis
Ankylosing spondylitis (AS) patients not responding to usual dosing with secukinumab (150 mg) after 16 weeks were dose escalated to secukinumab (SEC) 300 mg, but failed to show improvement by week 52.
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IgG4-related disease
Nearly any organ can be affected
▶️Salivary glands
▶️Lacrimal glands
▶️Orbit
▶️Pancreatobiliary system
▶️Lung
▶️Kidney
▶️Retroperitoneum
👉🏽https://t.co/758F5iuYwT
via @RheumJnl https://t.co/ipONrygHmc
Links:
Dr Ai Lyn Tan DrAiLynTan ( View Tweet)
New! 📣Best Practice Guidelines for the management of Haemophagocytic Lymphohistiocytosis (HLH) aka Macrophage Activation Syndrome (MAS) from @NHSGIRFT @RheumatologyUK Remember the 3Fs Fever, Falling Counts, Ferritin and follow the HLH pathway to guide management… https://t.co/8oDyUbsm9W https://t.co/S0MDi3TkNk
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Dr. Antoni Chan synovialjoints ( View Tweet)
Metanalysis of 50 RCTs (3,231 pts w/ lupus nephritis (LN) related starting pred dose to rates of complete response (CR), serious infections, & death. PO pred 25 mg/D assoc w/ 20%, 3.2% & 0.2%, respectively. Pred 60 mg/day incr rates to 35%, 12% & 2.7% https://t.co/6FH9BWsmaz https://t.co/0cQPAIuvRw
Dr. John Cush RheumNow ( View Tweet)
ASLeap: Higher Dose Secukinumab in Ankylosing Spondylitis
Ankylosing spondylitis (AS) patients not responding to usual dosing with secukinumab (150 mg) after 16 weeks were dose escalated to SEC 300 mg, but failed to show improvement by week 52.
https://t.co/EJvoBlW9or https://t.co/tYb1fIA3pw
Dr. John Cush RheumNow ( View Tweet)
Metanalysis of 12 studies shows that being edentulous (or having < 20 teeth) was associated w/ higher risk (HR 1.66; 1.32–2.09) critical confounders also confirmed that tooth loss as a risk factor for Cardiovascular mortality (HR=1.52, 95% CI: 1.28–1.80) https://t.co/PStGlxmCC3 https://t.co/ZDzaytj9dY
Dr. John Cush RheumNow ( View Tweet)
Metanalysis of 16 RCTs shows febuxostat reduces the risk of kidney events (RR = 0.56, 95% CI 0.37-0.84, p = 0.006) and a slower decline in eGFR (vs controls) https://t.co/9YAxTrHFVQ https://t.co/ZyRE7R6P4a
Dr. John Cush RheumNow ( View Tweet)
Anti-CD40 Therapy in Sjögren's Disease
Iscalimab, a CD40 monoclonal antibody, showed + results in treating Sjögren's disease, an autoimmune condition lacking effective therapy. The TWINSS study demonstrated iscalimab's safety/efficacy in a phase 2 trial.
https://t.co/aanI9K83XP https://t.co/qJhgHDFCVY
Dr. John Cush RheumNow ( View Tweet)
Pregnancy, menopause, contraceptives, hormone replacement, aromatase inhibitors may affect lupus outcomes. Review says hormone therapies are contraindicated w/ antiphospholipid syndr, APL Ab positivity, and uncontrolled SLE or flares https://t.co/bZQr8b871n https://t.co/OmXY04GR4p
Dr. John Cush RheumNow ( View Tweet)
Lung Cancer in Rheumatoid Arthritis and Interstitial Lung Disease
A matched cohort study from the Veterans Health Administration shows that RA patients have a >50% increased risk of lung cancer, a 3-fold higher risk of lung cancer in RA-ILD.
https://t.co/J9FCdkId8H https://t.co/uJylDP3IIp
Dr. John Cush RheumNow ( View Tweet)
Romosozumab vs. Teriparatide in Postmenopausal Osteoporosis
The effectiveness/safety of ROMO and TPTD were compared in a clinical setting, and ROMO showed greater increases in BMD than TPTD after 12 months of therapy, along with a higher completion rate.
https://t.co/iKKLruiiay https://t.co/vPKa8pom7e
Dr. John Cush RheumNow ( View Tweet)
Anti-Inflammatory Diet yields a lower risk of Dementia. UK Biobank study shows patients w/ type 2 diabetes, heart disease, or stroke who were on an anti-inflammatory diet had a 31% lower risk for dementia vs. a pro-inflammatory diet https://t.co/OjHq3BBOfd https://t.co/tG9vO59IEc
Dr. John Cush RheumNow ( View Tweet)
Hispanic Patients With Dermatomyositis
JAMA Dermatology has published a review of dermatomyositis (DM), focusing on similar and different manifestations of DM.
https://t.co/HydzbzTJR4 https://t.co/KJs681ySO7
Dr. John Cush RheumNow ( View Tweet)
Less Mortality with GLP-1 Agonists in Rheumatic Patients
A recent study in PLOS ONE found that treating type 2 diabetes with GLP-1-RAs lowered the risk of mortality and cardiovascular events in patients with IMIDs and type 2 diabetes.
https://t.co/MzCG7WvrDS https://t.co/0RPIfOO0s7
Dr. John Cush RheumNow ( View Tweet)
Rheums! Have a Rheumatology question or case for Jack Cush? Record it here and we'll feature it on an upcoming podcast. Tell us your name and where you practice rheumatology.
https://t.co/GV6WjsqZBH https://t.co/9l9qyJpg3I
Dr. John Cush RheumNow ( View Tweet)
Among the 1st 10 drug prices Negotiated by Medicare - Two are for Rheums:
- Etanercept; original price $7,106/Mo], negotiated price $2,355 (67% decr)
- Ustekinumab: for original price $13,836/mo, negotiated price $4,695 (66% decr) https://t.co/eexr4Acrbi https://t.co/fE0aoD8vA3
Dr. John Cush RheumNow ( View Tweet)
More Noninflammatory Pain in Difficult to Treat RA
A Canadian cohort of difficult-to-treat rheumatoid arthritis (D2T RA) patients shows significantly more non-inflammatory pain in D2T RA compared to patients responding to b/tsDMARDs.
https://t.co/XRH9q0gNyq
Dr. John Cush RheumNow ( View Tweet)