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Heavy Metal Rheumatology (9.23.2022)

Jack Cush, MD

Below are this week’s highlights from RheumNow, as discussed by Dr. Jack Cush. Thanks to all of you for your kind comments and great reviews of our weekly podcast. Please let us know how we can improve by emailing me or recording your suggestion using the "Ask Cush Anything" link on our website.

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Is PMR the Next Indication for Tocilizumab?

MedPage Today

About half of patients with steroid-dependent polymyalgia rheumatica (PMR) were able to get off steroids altogether when they were started on tocilizumab (Actemra) infusions, which also improved disease control in most cases, a randomized phase III trial showed.

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First In Class, TYK2 Inhibitor FDA Approved for Psoriasis

Jack Cush, MD

Deucravacitinib (Sotyktu), a first-in-class, oral, selective, allosteric tyrosine kinase 2 (TYK2) inhibitor, is the only approved TYK2 inhibitor worldwide and the first innovation in oral treatment for moderate-to-severe plaque psoriasis in nearly 10 years.

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Does Fibromyalgia Need B12? (9.9.2022)

Jack Cush, MD

Can we predict the bad outcomes? Like when ITP evolves into SLE; or when psoriasis will develop arthritis; or if Sjogren's will develop lymphoma? Let's dive in and review these journal reports and this past week's news from RheumNow.com.

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Goofy But True

Jack Cush, MD

Dr. Jack Cush discusses declining survival rates in the USA, FDA approvals of new COVID subvariant boosters and other odd and possibly true new research reports from the past week on RheumNow.com.

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Olokizumab, another IL-6 Inhibitor for RA

Jack Cush, MD

This week's NEJM has published the efficacy results of a large phase 3 trial of olokizumab, a humanized monoclonal antibody that directly targets IL-6 in patients with rheumatoid arthritis.

This is in contrast to two other marketed IL-6 inhibitors (sarilumab, tocilizumab) that bind to the IL-6 receptor.

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Managing JDM with Calcinosis

Jack Cush, MD

Dr. Jack Cush reviews the news and journal reports from this past week on RheumNow and discusses a case of refractory juvenile dermatomyositis with calcinosis.

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Rituximab Efficacy in Systemic Sclerosis

Jack Cush, MD

The DESIRES trial studied rituximab (RTX) in patients with systemic sclerosis (SSc) and showed clinically significant improvement in skin and lung outcomes after a subsequent 24-week open-label extension phase.

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RINOMAX Trial studied single dose of 500 mg rituximab IV in myasthenia gravis - 47 MG pts randomized to RTX or PBO, after 4 mos RTX response (71% vs 29%) superior to PBO. Further studies are needed https://t.co/ffko7uMpk7

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Is PMR the Next Indication for Tocilizumab? About half of patients with steroid-dependent PMR were able to get off steroids altogether when they were started on tocilizumab (Actemra) infusions, a randomized phase III trial showed. https://t.co/LUMG4NnZzs https://t.co/zdFacyYyud

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Dr. John Cush RheumNow ( View Tweet)
EMA has approved 86 biosimilar medicines since 2006 and has issued a harmonizing statement for EU countries that biosimilars are interchangeable with their reference medicine or with an equivalent biosimilar. https://t.co/ajsP1ulZTQ

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534 PsA & 470 AS pts (SERENA study) on Secukinumab for avg of ~88wks - 5.8% PsA & 8.9% AS pts had sudden stop of SEC (for avg ~25wks) (reasons? Mostly AE 58% or pt decision 10%). While TJC & SJC increased, dz control returned w/ restarting SEC https://t.co/GFxj3b06Ra https://t.co/B2ubakq8Ql

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The 2022 ACR abstracts are published and posted for you. Let the Learning begin! https://t.co/ZqMAc8jV3U https://t.co/3iCGnzsPI5

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Dr. John Cush RheumNow ( View Tweet)
FDA has approved SPEVIGO® (spesolimab-sbzo) an IV injection - the first-approved treatment option for generalized pustular psoriasis (GPP) FLARES. Spesolimab is an interleukin-36 receptor antagonist. https://t.co/zmuB1tyw9W https://t.co/bJiQB5qJNl

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Dr. John Cush RheumNow ( View Tweet)
Rheums! Have a Rheumatology question or case for Jack Cush? Record it here and we may feature it on an upcoming podcast. Tell us your name and where you practice rheumatology. https://t.co/1aSrRsLkel https://t.co/gmh155ty6w

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STARTER study looked at US in 256 RA pts completed the study & were Rx w/ biologics csDMARDS or combination DMARDs. Pts w/ US grey scal or power doppler tenosynovitis better controlled in combination DMARDs than csDMARDs alone (p:0.025) https://t.co/MXLVoIxzmw https://t.co/8N5aV3vAA0

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Nintedinib has been studied in 39 children (6–17 yrs) with fibrosing ILD demonstrating pharmacokinetics (wt based dosing) and safety. Adjusted mean changes in FVC % at week 24 were 0.3 with nintedanib and −0.9 with placebo https://t.co/yQ7OREzpTR https://t.co/iylG9BZiz4

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Dr. John Cush RheumNow ( View Tweet)
FDA has approved SPEVIGO® (spesolimab-sbzo) an IV injection - the first-approved treatment option for generalized pustular psoriasis (GPP) FLARES. Spesolimab is an interleukin-36 receptor antagonist. https://t.co/izmExVCvfQ https://t.co/FELKR70UMv

Links:

Dr. John Cush RheumNow ( View Tweet)
Rituximab Efficacy in Systemic Sclerosis The DESIRES trial studied rituximab (RTX) in patients with systemic sclerosis (SSc) and showed clinically significant improvement in skin and lung outcomes after a subsequent 24-week open-label extension phase. https://t.co/8wWrt8GQ5v https://t.co/CIQKUyngN5

Links:

Dr. John Cush RheumNow ( View Tweet)
Rheums! Do you have a rheumatology question or case for Jack Cush? Record it here and we may feature it on an upcoming podcast. Tell us your name and where you practice rheumatology. https://t.co/cvmbzknQqA https://t.co/6mX5eRUNuU

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Dr. John Cush RheumNow ( View Tweet)
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