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RheumNow Podcast – Upadacitinib Wins in PsA (4.2.2021)

d Jack Cush, MD

Dr Jack Cush reviews the news and Journal reports and takes "Back Talk" questions from viewers.

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US Senate Introduces the Safe Step Act

d ACR

The American College of Rheumatology (ACR) today commended leaders in the United States Senate for introducing the bipartisan Safe Step Act of 2021 (S. 464), new legislation that would place reasonable limits on insurer use of step therapy.

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Upadacitinib Clinical Efficacy in Psoriatic Arthritis

d Jack Cush, MD

McInnes and colleagues have published the results of the SELECT - PsA trial in NEJM showing updacitinib (UPA) to be superior to placebo in active psoriatic arthritis (PsA) patients, with 15 mg UPA equal to adalimumab (ADA) and 30 mg UPA qd being superior to ADA.

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Inflammatory Conditions Up the Risk of Premature Myocardial Infarction

d Jack Cush, MD

The European Journal of Preventive Cardiology reports that younger patients with their first myocardial infarction before age 50 yrs have a higher risk of having a systemic inflammatory disease (SIDs) and higher rates all-cause mortality.

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News Feature: HLA B27 Iritis - RNL 2021 Highlights by Dr. Rachel Tate ( @uptoTate ) #RNL2021 #RheumNow https://t.co/SlftHnhD6z https://t.co/utjOU0rfBP

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News Feature: Inflammatory Conditions Up the Risk of Premature Myocardial Infarction https://t.co/gbPpAYJGFg https://t.co/ValdJWGyxl

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News Feature: Aortic Calcification and Lumbar Fracture Risk in Older Men https://t.co/6gcoP9EFey #RheumNow https://t.co/BTTrYAoyNp

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In the UK, NICE has recommended Kineret (anakinra) for use as 1st line biologic Rx in systemic JIA and adult-onset still’s disease (AOSD); but pts must first fail a DMARD - the latter is unfortunate as systemic Sxs of Still's do not respond to usual DMARDs.https://t.co/BNdqhLy9jg

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From @doctorRBC #RNL2021 coverage "Avoid the lawsuit... “warty” appearing skin lesions in a lupus can be confused as skin cancer on shave biopsy when in fact it could be VERRUCOUS LUPUS which can be treated with HCQ. Perform a deeper biopsy. - Dr. Clay Cockrell " #RheumNow

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Comparison of oral and parenteral MTX shows oral MTX in RA is non inferior to subcutaneous MTX treatment (in 640 RA pts) with regard to disease activity, but oral MTX had fewer adverse events than SC ( 41% vs 52%, p= 0.005). https://t.co/828kcG53iz

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Matched cohort Nurses’ Health Study looked at 283 pre‐RA pts (mean 9.7 years before RA Dx) and and 842 controls; 21% pre‐RA were ACPA+. ACPA+ was associated with increased risk of COPD (HR 3.04) that was not seen in ACPA- pts. https://t.co/HNB11eAiva

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Dr. Olga Petryna ( @drpetryna) weighing the future Rx in RA by Dr. Fleischmann: -CD22, new IL6i & GM-CSF show promises but far form being available -bDMARD or tsDMARD after MTX but work better wMTX -JAKS better choice for mono-therapy but safety is a concern #RNL2021

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#RNL2021 coverage from @doctorRBC ACR’s conditional recommendations for tx of specific RA populations #RheumNow https://t.co/3uo9x42bPX
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Retrospective study of 267 adults w/ Henoch-Schönlein purpura (AKA IgA vasculitis (IgAV) shows more arthritis, enteritis & renal Dz, higher comorbidity scores (2.6 vs1.5) & higher risk of Serious infx (OR 8.4) and death (MRR 2.06) than gen population https://t.co/ihK6JPbLFm

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News Feature: Hypertension Unaffected by Urate Lowering Therapy Does uric acid contribute to the risk of hypertension (HTN)? A recent cohort trial shows that allopurinol in young adults does not sufficiently lower blood pressure (BP). https://t.co/PAMkgCc2DS #RheumNow https://t.co/ar7OiWKVQj

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263 RA patients with ILD were treated w/ Abatacept (ABA mono, ABA+MTX or ABA+nonMTX) - all improved their DAS28, stablized their FVC, DLCO, CHest CT; Only difference was that steroid sparing best when ABA used in combo. https://t.co/11vJCWOdSG https://t.co/yMF6imuFMV

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Abstract presented 10/20 at American Society Nephrology mtg show IV Pegloticase use in 136 ESRD dialysis pts (Rx by Rheums 68%). Pts were 73% males, avg age 57 years, More on hemodialysis [79%] than peritoneal dialysis [17%]. Pts RCV ~13 infusions. https://t.co/SFO8duqiy8

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Great coverage of #RNL2021 from Dr. Robert Chao @doctorRBC Fascinating talk by Dr. Robert Wang on uveitis. Pearls: -Anterior uveitis with hypopyon, will be B27+ -Hypopyon can be 2/2 Behcets and endopthalmitis -work up for Uveitis: B27, ACE/CXR, syphilis test #RNL2021 https://t.co/9DdNaAt7lx
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News Feature: Psoriatic Disease Management - #RNL2021 Highlights This year’s coverage of psoriatic arthritis included an overview of the latest therapeutic options, a discussion on psoriasis specifically, and the epidemiology of psoriatic arthritis. https://t.co/wJ0pFgANhy https://t.co/SJezq1O7T4

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The Reflecting Rheum: Top Publications from 2020 Covering SpA and Still’s Disease Sponsored by Novartis Medical Affairs Listen to a panel of experts share their views on top spondyloarthritis and Still’s disease publications from 2020. View Now: https://t.co/Kp2drDS1x3 https://t.co/Y1PilF0Syg

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