RheumNow Podcast – Quackademia (10.15.2021)

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Dr. Jack Cush reviews the FDA approvals, news and the latest journal articles from the past week on RheumNow.com.

TNF Dose Reduction Succeeds in PsA, Axial Spondyloarthritis

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Patients with psoriatic arthritis (PsA) or axial spondyloarthritis (axSpA) who were doing well on treatment with tumor necrosis factor (TNF) inhibitors were able to successfully taper the therapy when guided by disease activity, a retrospective cohort study found.

Prevalence of Arthritis Rising in the USA

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The latest CDC estimates of the national prevalence of arthritis and arthritis-attributable activity limitations (AAAL) show a continued increase in absolute number: 58.5 million (23.7%) U.S. adults have arthritis, 25.7 million (43.9%) of whom have AAAL. 

Pathways to a Psoriatic Arthritis Diagnosis

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Ogdie and colleagues have retrospectively analyzed a longitudinal cohort of psoriatic arthritis (PsA) patients, showing that only two-thirds of PsA are diagnosed by rheumatologists, PCPs and dermatologists, with significant differences in what preemptive symptoms were noted by different subspecialties.

RheumNow Podcast – I Wanna New Drug.V2 (9.24.2021)

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Almost three years ago to the day, I did a podcast entitled, "I wanna new drug." As I go over this week's podcast, I want to say it again. I want a new drug safe enough to use during pregnancy, for PMR, for GVHD, and more. I'm going to cover these, and other topics including lupus, COVID breakthrough infections, and statin use and the risk of RA, as I review the news and journal articles from the past week on RheumNow.

ACR Comments on JAK Inhibitors and FDA Announcement

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Following is a statement from ACR President David Karp, MD, PhD, on JAK inhibitors and FDA drug safety communication.

Lymphoma in RA: Disease Activity Matters

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Among patients with rheumatoid arthritis (RA), the strongest risk factors for the development of lymphoma were disease activity and severity, French researchers found.

In a multivariate analysis, having a high Disease Activity Score in 28 joints (DAS28) at baseline conferred twice the risk for lymphoma, with an odds ratio of 2.09 (95% CI 1.41-3.38), according to Gaetane Nocturne, MD, of Hôpital Bicêtre in Ile-de-France, and colleagues.

COVID Breakthrough Infections in Rheumatic Patients

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Analysis of records from the Mass General Brigham healthcare system in the Boston area, shows that breakthrough infections (after receiving SARS-CoV-2 vaccines) in patients with systemic autoimmune rheumatic diseases (SARDs) are not uncommon, and may be severe or fatal.

Expert Panel: Initial Views on FDA Warnings for JAK Inhibitors

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Dr. Jack Cush is joined by Drs. Roy Fleischmann (Dallas), Allan Gibofsky (NYC), and Artie Kavanaugh (San Diego) to discuss the 9/2/21 FDA Drug Safety Communication regarding the cardiovascular and cancer risks arising from the Pfizer 1133 (ORAL Surveillance) tofacitinib study, but also applied to baricitinib and upadacitinib.

FDA: New Cardiac and Cancer Warnings for All JAK Inhibitors

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Today, Sept.1st, the FDA announced its decision regarding tofacitinib's safety concerns from the Oral Surveillance study - handing down warnings for not only Pfizer's JAK inhibitor, but also for other marketed JAK inhibitors from AbbVie and Eli Lilly & Co.

These safety concerns arise from the Oral Surveillance study - a large, post-marketing, safety trial of tofacitinib versus adalimumab in high risk patients. New warnings about the risks of cardiac events, death and cancer will appear as a revision to the "boxed warnings" in the product label (package insert) for all JAK inhibitors - tofacitinib, baricitinib and upadacitinib. 

The #1 question I get from new consults: “How did I get arthritis?” Here is my list of 11 drugs (or drug classes) known to cause arthritis or rheumatic disorders (as an unintended consequence). #RheumNow https://t.co/GsV0Qj9ENr https://t.co/IrTkY5yFdY