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No Increase in Cardiovascular Events with JAK Inhibitors in IBD Patients
UMKC researchers have compared the use of JAK inhibitors versus tumor necrosis factor (TNF) blockers in inflammatory bowel disease (IBD) patients, but failed to see an increase in major adverse cardiovascular events (MACE) in JAKi vs TNFi use in IBD.
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Weight Loss from Anti-Obesity Medications Prevents Gout
A population based study looked at the effect of the weight loss drug, Orlistat, in obese individuals. Compared to those untreated, orlistat over 1 year was associated with significant weight loss and significantly lower risks of incident gout and recurrent gout flares among overweight or obese people.
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Like we've seen in many parts of the world, RA prescribing in Germany is moving away from JAKi, in response to regulatory safety warnings.
Whether all of this is appropriate or not, we'll have to see...
#ACR24 ABST0503 @RheumNow https://t.co/VSqdCz6zc5
David Liew drdavidliew ( View Tweet)
#ACR24 Year in Review: 💡GLP1i significantly decreased knee OA pain over time (or was it the wt loss itself?🤨) 💡CD19 CAR T-Cell therapy has potential to treat/cure many autoimmune diseases (are risks and $ worth the benefit?) 💡 High risk of CV events within 30 days of gout… https://t.co/XF63zr6lk4 https://t.co/oRNri66Il9
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Adela Castro AdelaCastro222 ( View Tweet)
EGPA: To RTX or not to RTX?
French MAINRITSEG trial underway to determine utility of RTX vs. AZA maintenance therapy
Huge anticipation for these results, hopefully next year!
#ACR24 @RheumNow https://t.co/POelLpirrI
Brian Jaros, MD Dr_Brian_MD ( View Tweet)
Hot off the racks:
The MITIGATE trial is the 1st RCT for IgG4-RD showing that Inebilizumab significantly reduced flare rates vs PbO by depleting CD19-targeted B cells
Game changer?
Year in review.
@RheumNow #ACR24 @rheumarhyme @marklagacmd @idatan @ljdado https://t.co/CZvdrymIyr
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sheila RHEUMarampa ( View Tweet)
Year in review:
The MANDARA trial showed benralizumab was non-inferior to mepolizumab for #EGPA
@RheumNow #ACR24 @rheumarhyme @doktora_ging https://t.co/k5azGQOECB
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sheila RHEUMarampa ( View Tweet)
Looking forward to this Plenary - upadacitinib vs plbo in GCA
Similar to GiACTA, 26wk taper w/UPA better than 52wk taper w/PLBO. Too small for safety, but no new rsks
Strong argument for DMARDs upfront in GCA... but doesn't help with which 😉
#ACR24 @RheumNow Abstr#0770 https://t.co/MZY4QUazhI
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Mike Putman EBRheum ( View Tweet)
MANDARA
Mepolizumab v benralizumab for EGPA
BEN is non-inferior
Secondary outcomes- less eosinophils and more pts completely off GCs
Now approved for EGPA
Year in Review #ACR24 Pillinger
@RheumNow https://t.co/ThLziABvzu
Eric Dein ericdeinmd ( View Tweet)
Abatacept for GPA?
Tx with Abacept did NOT significantly reduce rates of treatment failure compared to GC + PBO (background DMARD allowed) in non-severe, relapsing GPA
Continued need for tx options in non-severe relapsing dz
@RheumNow #ACR24 Abstract #0823 https://t.co/7GfprUzoL7
Brian Jaros, MD Dr_Brian_MD ( View Tweet)
RA pearls from #ACR24 review course:
1. Remission is DRUG maintained-Ok to reduce MTX dose while on TNFi.
2. Multimorbidity=Poor outcomes, High risk for mortality.
3. Can RA be truly prevented or we are delaying the inevitable? https://t.co/111w1Myqrg
Links:
Adela Castro AdelaCastro222 ( View Tweet)
No Increase in Cardiovascular Events with JAK Inhibitors in IBD Patients
UMKC researchers have compared the use of JAK inhibitors versus tumor necrosis factor (TNF) blockers in inflammatory bowel disease (IBD) patients, but failed to see an increase in major adverse… https://t.co/XY0UVDTAI6 https://t.co/b09FB3niNP
Dr. John Cush RheumNow ( View Tweet)
Risk for atypical femoral fracture:
🚨Asian race - 4-6x higher risk
Duration of use is greater risk than older age
Higher risk when given for osteoporosis than cancer treatment
- Compare: osteonecrosis of jaw more common with cancer Rx
#ACR24 Review Course
@RheumNow https://t.co/V8cD5QWNGp
Eric Dein ericdeinmd ( View Tweet)
T cell study of bronchoalveolar lavage fluid, blood & synovium from 17 early RA ACPA+ pts (TCR sequencing & immunophenotyping) found shared lung/joint T cell repertoires driven by smoking. The RA TCR repertoire shaped by MHC predisposition, smoking leading to autoimmunity… https://t.co/0lEVwEbKcW https://t.co/YrhV79AvX4
Dr. John Cush RheumNow ( View Tweet)
AMA report says..... " More than one in three physicians, 34 percent, have had a medical liability lawsuit filed against them at some point in their careers"
- Nearly half of physicians >55 have been sued (vs 6% in MDs <40yrs)
- Female physicians are less likely to be sued than… https://t.co/hIUH7Tx85L https://t.co/V2sHyac3XH
Dr. John Cush RheumNow ( View Tweet)
Systematic review suggests (although not provn) that audiovestibular dysfunction may be from APS. Anti-phospholipid & HSP-70 Abs found 25-33% w/idiopathic sudden sensorineural hearing loss,. ACL Abs seen in up to 27% w/ sensorineural hearing loss https://t.co/GTcLoM0SCZ https://t.co/afFntYnPPG
Dr. John Cush RheumNow ( View Tweet)
Early Rx doesnt prevent Difficult to Tx RA (D2TRA). Propective study of 722 early RA pts Rx w/ MTX found after 73 mos 29% were D2TRA. 21.5% Rx w/ b/tsDMARD after 19 mos, yet 70% were uncontrolled. 5 yr retention rates were 40%. D2T predicted by pain & swollen joints… https://t.co/veaspuCHIE https://t.co/zjlTWQn4GQ
Dr. John Cush RheumNow ( View Tweet)
Peptic ulcer disease is still assoc w/ signif. hospitalization & mortality (10K deaths in USA/Yr). PUD affects 10% of outpts w/ Upper GI pain. 42% are due to H.pylori, 36% from ASA NSAIDs. Complications bleeding (73%), perforation (9%), pyloric obstruction (3%)- JAMA review… https://t.co/1bgagFVlYN https://t.co/8i2j3r1puf
Dr. John Cush RheumNow ( View Tweet)
Korean database of 43,502 #AS pts found CV events based on Rx exposure. CV event rates were: No bDMARDS (18.66/10K PYs), TNFi (8.92), & IL-17i (12.87). TNFi significantly lowered rate of CVE (aHR 0.69), but IL-17i did not (0.96) https://t.co/LMzPodWI5v https://t.co/rQ0aq1ALgW
Dr. John Cush RheumNow ( View Tweet)
Genes Linking RA and Osteoporosis
People with rheumatoid arthritis often develop osteoporosis, a more serious condition, as a result of the bone damage caused by immune cells and as a side effect of certain medications.
https://t.co/hEJc77gcln https://t.co/bmsV70riUc
Dr. John Cush RheumNow ( View Tweet)
