RheumNow Podcast – Uppers and Downers

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

ACR Updates COVID-19 Vaccine Guidance- April 2021

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The ACR COVID-19 Vaccine Clinical Guidance was originally published on February 8, 2021 and updated on March 4, 2021. On April 28, 2021, new recommendations were added regarding mycophenolate, methotrexate, acetaminophen, and NSAID timing considerations,  

Predictors of Methotrexate Toxicity

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A metanalysis showed that while adverse events (AEs) are common when methotrexate is used in rheumatoid arthritis or inflammatory arthritis patients, serious AEs ranged from 2.1 to 9.5% and drug discontinuations ranged from 6.7% to 15.5%, mostly due to gastrointestinal events. 

Seven Year Delay in Diagnosing Spondyloarthritis

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A large patient cohort study suggests that the mean diagnostic delay (DD) in European axial spondyloarthritis (axSpA) patients is 7.4 years, moreso in women and younger patients.

Tofacitinib in Ankylosing Spondylitis

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A phase III trial assessing the efficacy and safety of tofacitinib in adults with with active ankylosing spondylitis (AS) shows that JAK inhibitiion was superior to placebo in a 48 week study.

Psoriatic Pregnancies Pose Risks to the Mother, Not Child

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A metanalysis of pregnancy outcomes in women with psoriasis and psoriatic arthritis finds an excess risk of adverse maternal events, but not adverse neonatal events.

This systematic review included 16 studies meeting inclusion criteria. 

Dual IL-17 Targeting is Effective but has More Candidiasis

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Bimekizumab (BIM) is a monoclonal antibody that targets both interleukin-17A and interleukin-17F, which as a biologic target has worked well in the management of psoriatic disease. The current issue of the NEJM has two reports wherein BIM was shown to be more effective than secukinumab and adalimumab in treating patients with moderate-to-severe plaque psoriasis; however, safety concerns arise.