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The art of talking about risks with our patients
On the first day of EULAR 2024, I am debating Janet Pope.
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Humira Clobbers Biosimilars in Battle for Part D Coverage
Medpage Today
Just about every Medicare Part D prescription drug plan on offer this year covers the original version of adalimumab (Humira), whereas only about half will pay for any of the several biosimilar versions currently approved, researchers found.
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Is Cannabis Safe? (6.7.2024)
Dr. Jack Cush reviews FDA approval, news and journal articles -- and it’s the week before EULAR 2024 in Vienna!!
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Molecular Profile for Cardiovascular Risk in Rheumatoid Arthritis
A new study led by the University of Córdoba, the Maimonides Institute for Biomedical Research and the Rheumatology Department at the Reina Sofía University Hospital in Córdoba has managed to establish, for the first time, the molecular profile of those patients with rheumatoid arthritis who have a higher risk of suffering cardiovascular events.
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JAK or TNF Inhibitor as First Drug for Rheumatoid Arthritis?
Medpage Today
A Janus kinase (JAK) inhibitor outperformed tumor necrosis factor (TNF) blockers for substantially reducing rheumatoid arthritis (RA) symptoms in patients for whom conventional anti-rheumatic drugs had failed, a pragmatic head-to-head trial found.
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Nordic country analysis of mortality in RA (n 1145), RA-ILD (239), population ILD (378) & nl controls (1890) shows most mortality in pop ILD (HR 8.3), but less in RA-ILD (HR 3.6). Why is death less in latter; could it be RA therapies? Abstr #POS0022 # EULAR2025 https://t.co/wFZq49rIiW
Dr. John Cush RheumNow ( View Tweet)
More data from Jak-pot, the real-world multinational RA study, this time looking at infection in 14 national registries
JAKi (vs TNFi) had no signal for general/serious infection (excluding HZ)
Somewhat reassuring post-ORAL Surveillance infection data
#EULAR2024 OP0092 @RheumNow https://t.co/ocAbc4NiV2
David Liew drdavidliew ( View Tweet)
Nice idea from Erlangen: B cell then T cell suppression for ACPA+ RA. A tolergenic reset of sorts. Sounds interesting…
small study, but sadly no difference over ritux only. Does seem broadly safe though - maybe will be a strategy for another disease!
#EULAR2024 OP0069 @RheumNow https://t.co/mXUS4kpRCK
Links:
David Liew drdavidliew ( View Tweet)
OP0053 #EULAR2024 @RheumNow #EULARBest
Effect of #RTX in preclinical #RheumatoidArthritis
RA-risk pts given 1 dose PBO or 1000mg RTX
RTX in RA-risk pts delayed onset of RA by 1yr; no benefit on QoL
Pts developing RA: RTX didn't alter PROs or disease severity when developing RA
Mrinalini Dey DrMiniDey ( View Tweet)
Shingrix in upadacitinib + MTX RA, in SELECT-COMPARE RCT:
data now out to 60w
good humoral and cellular response in most, even without MTX withheld
(& good safety too)
Important for our JAKi-treated patients to get the protection they need #EULAR2024 OP0020 @RheumNow https://t.co/FqVCCwUJOg
Links:
David Liew drdavidliew ( View Tweet)
AMPLIFIED study:
abatacept vs adalimumab in RF+ACPA+ early RA
Not a single blink of difference.
Maybe for high CCP titre but the inverse for low CCP.
Sadly, theoretical mechanistic benefit doesn’t always wash out. We’ll keep on looking for predictors #EULAR2024 OP0007 @RheumNow https://t.co/IswCub9lLn
David Liew drdavidliew ( View Tweet)
@Janetbirdope @RheumNow #EULAR2024 JAK-i Debate
@drdavidliew (NOT in support of regulation)
- is the signal real? Query about replicability & data came from N. America. Not reflected on real-world data of enriched cohorts
- is the warning justified?
- are there unintended consequences?
@RheumNow https://t.co/TXUf90fqwN
Links:
Md Yuzaiful Md Yusof Yuz6Yusof ( View Tweet)
Asking the quintessential Australian question at #EULAR24 by @drdavidliew - does the ORAL surveillance study for JAKi *truly* pass the pub test?
@eular_org @Janetbirdope @RheumNow
What does #MedTwitter think? https://t.co/bqwPU8XX5S
Links:
Benjamin Sutu benjaminsutu ( View Tweet)
#EULAR2024 JAK-i Debate.
@Janetbirdope [Pro Regulatory Safety Measures]
- to do no harm esp since there are other alternatives
- supported by RCT
- although JAK-i have different structures, data from individual RCT + LTE showed similar rates of malignancy & MACE @RheumNow https://t.co/jQKQmHE9Fg
Links:
Md Yuzaiful Md Yusof Yuz6Yusof ( View Tweet)
CATCH cohort study of 547 Early RA pts shows higher Tender > Swollen joint differences is assoc. w/ worse n patient-reported outcomes (PROs) in all domains (phys function, social , pain, sleep problems, fatigue, anxiety, depression) -- Isnt this FM ? https://t.co/4Bk8VGQNB6 https://t.co/K7kO5q990v
Dr. John Cush RheumNow ( View Tweet)
Medicare & Optum claims data study of 2851 #RA pts w/ breast cancer (BC). In 3 mos before BC 27028% received bDMARDs. W/in 1st 3 yrs post-BC Dx 24-26% were receiving bDMARDs. 70% of RA pts on steroids without change w/ time https://t.co/51NcXv0xyc https://t.co/461NZiFvDO
Dr. John Cush RheumNow ( View Tweet)
Molecular Profile for Cardiovascular Risk in Rheumatoid Arthritis
A new study led has managed to establish, for the first time, the molecular profile of those patients with rheumatoid arthritis who have a higher risk of suffering cardiovascular events.
https://t.co/VVKR2G91VQ https://t.co/ZZNLJpoyNA
Dr. John Cush RheumNow ( View Tweet)
JAK or TNF Inhibitor as First Drug for Rheumatoid Arthritis?
A JAK inhibitor outperformed TNF blockers for substantially reducing RA symptoms in patients for whom conventional anti-rheumatic drugs had failed, a pragmatic head-to-head trial found.
https://t.co/7BhFSwb1Ns https://t.co/Hf31OPgE0M
Dr. John Cush RheumNow ( View Tweet)
TriNetX US claims study of 7580 RA pts Rx w/ tofacitinib or adalimumab found Tofa signif. more likely to cause dyslipidemia (HR 1.250), but no difference betw TOFA & ADA in MACE (HR 0.995; 0.76–1.3) or all-cause mortality (HR 1.4; 0.89–2.2) https://t.co/83CGng2R9e https://t.co/QfD4ePuTER
Dr. John Cush RheumNow ( View Tweet)
Save the date! We are covering #EULAR24! We'll be sharing recaps, videos, and more. https://t.co/NMWtHB94Pi https://t.co/ok43pnagFg
Links:
Dr. John Cush RheumNow ( View Tweet)
