IL-1 and IL-6 Inhibition Preferred in Systemic JIA

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Since 2000, the German Biologics register (BiKeR) has prospectively enrolled children with juvenile idiopathic arthritis to assess outcomes with biologic therapies.  A new report evaluates the efficacy and safety of etanercept (ETA), tocilizumab (TOC) and the interleukin-1 inhibitors (anakin

The RheumNow Week in Review - 12 January 2018

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Dr. Jack Cush reviews a dozen highlights from the past week on RheumNow.com.

B Cell Changes Predict Autoimmunity with Checkpoint Inhibitors

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The Journal of Clinical Investigation reports results of a study showing that increases in CD21lo B cells and plasmablasts following that combination checkpoint blockade preceded the onset of immune-related adverse events.

While some have postulated that IRAEs are thought to be T cell mediated, B cells have also been implicated. Investigators studied 39 melanoma patients undergoing treatment with either anti-CTLA4 or anti-PD1, or combination CCB therapy. They analyzed changes in circulating B cells before and after the first cycle of therapy of immune checkpoint blockade (23 received combination therapy, 8 received anti-CTLA4, and 8 received anti-PD1).

2018 Predictions for Rheumatology

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MedPage Today Editors surveyed a few rheumatologists for their major news predictions in 2018. Read on for predictions regarding drug pricing, biosimilars, autoimmunity and checkpoint inhibitors, and thrombotic events and JAK inhibition.

The RheumNow Week in Review - 5 January 2018

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

Stem Cell Transplant Succeeds in Scleroderma

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Myeloablative autologous stem cell transplantation was significantly more effective than 12 months of cyclophosphamide among patients with severe scleroderma, an open-label multicenter study found.

Sorting Out the Complexities of Autoimmunity with Immune Checkpoint Inhibitor Therapy

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An editorial and systematic review of complications seen when checkpoint inhibitor (CPI) therapies are given to patients with immune mediated inflammatory disorders (IMIDs) and cancer shows that nearly 75% manifest autoimmune and inflammatory immune-related adverse events (irAEs).

Despite Increasing Metric Use, They Are Not Widespread in Rheumatoid Care

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The Journal of Rheumatology has published a nationwide survey of US rheumatologists and shown that despite trends for increasing metric assessments, nearly half of rheumatoid arthritis (RA) patients are not routinely assessed with a disease activity metric and the evidence they

MEASURE 3 Study - Anti-IL17 Benefits Persist in Spine Disease

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Patients with ankylosing spondylitis (AS) have shown rapid and sustained responses to secukinumab (Cosentyx) in a third phase III trial that includes a higher dose of this anti-interleukin-17A monoclonal antibody, researchers reported.

New BSR 2017 Gout Guidelines (Best of 2017)

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The British Society for Rheumatology/British Health Professionals in Rheumatology first published a guideline for the management of gout in 2007. They have just updated and published their new guideline, largely because of new therapies, an increasing incidence of gout, low penetrance of urate lowering therapies, and the inability to achieve a target serum uric acid level.

Therapeutic Update: 5 Questions on FDA Hearing for Tofacitinib in PsA (Best of 2017)

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In this Therapeutic Update, Drs. Mease, Gibofsky and Cush answer five questions regarding the August 3rd FDA Arthritis Advisory Committee meeting that reviewed the potential approval of tofacitinib (Xeljanz) in patients with active psoriatic arthritis. The panel was nearly unanimous (10-1) in favor of the efficacy and safety profile of of tofacitinib, and similarly voted 10-1 to approve this drug for use in PsA. Final decisions on these recommendations from the AAC panel will be made at a later date by the FDA. 

Allopurinol Dose Escalation is Safe with Severe CKD

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Hypertension, nephrolithiasis and chronic kidney disease (CKD) commonly associates with gout.  While there is a clear need to dose adjust NSAIDs and colchicine in those with CKD, there is some debate about the need to dose adjust when using allopurinol with CKD.

Risk of Gout Onset and Flare Linked to Urate Levels

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Serum uric acid (SUA) levels are clearly linked to gout. Researchers from Harvard have systemically reviewed the literature to quantify the risk of onset and flare with varying levels of SUA.

Registry Efficacy of Rituximab in Refractory SLE

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Despite large randomized trials failing to show the efficacy of RTX in SLE (LUNAR, EXPLORER), uncontrolled observational data suggests possible efficacy and safety of RTX in refractory SLE.

Baseline Risk Score Predicts Serious Infection Risk in TNF-Treated RA Patients

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Curtis and colleagues have analyzed the certolizumab (CZP) RAPID1 and RAPID2 trials to assess the risk of serious infectious events (SIEs), and shown that steroids combined with an age-adjusted comorbidity index (AACI) yields a 2-3 fold predictable risk for SIE.

FDA Approves Xeljanz for Use in Psoriatic Arthritis

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Pfizer Inc.

2017 Update of Treat to Target Recommendations for SpA/PsA

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A 2017 international committee of experts met to assess and revise its earlier 2012 recommendations regarding treating to target in patients with psoriatic arthritis (PsA) and axial peripheral spondyloarthritis (SpA). 

Do JAK Inhibitors Increase the Risk of Venous Thromboembolic Events?

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Drug Safety has published a systematic review of the FDA’s Adverse Event Reporting System (FAERS) and finds numerous reports of thromboembolic adverse events (AEs) associated with two currently marketed Janus kinase (JAK) inhibitors, tofacitinib (Xeljanz) and ruxolitinib (Jakafi).

PRECISION Subanalyses Question Aspirin Use

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The PRECISION trial reported last year that celecoxib appears to be safer than the NSAIDs naproxen or ibuprofen in treating osteoarthritis (OA) and rheumatoid arthritis patients who are at increased cardiovascular risk. New data suggests that adding aspirin may nullify this advantage, according to a study presented at the annual American Heart Association meeting and reported by Medscape.

Ixekizumab (Taltz) FDA Approved for Psoriatic Arthritis

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On Friday, December 1st, the FDA approved Lilly's drug Taltz (ixekizumab) for use in adult patients with moderate-to-severe plaque psoriasis who are candidates for systemic therapy or phototherapy. 

Taltz, an IL-17 inhibitor, has previously been approved for plaque psoriasis where it has shown high level PASI75 and PASI100 responses.