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Canakinumab Fails to Improve COVID-19 Survival

d Jack Cush, MD

JAMA has published the findings of trial wherein the anti–interleukin-1β antibody canakinumab (CAN) failed to improve survival in patients hospitalized with severe COVID-19.

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ACR/Vasculitis Foundation Guideline for Giant Cell Arteritis and Takayasu Arteritis

d Jack Cush, MD

The ACR and the Vasculitis Foundation have published their evidence-based recommendations and expert guidance for the management of GCA and Takayasu arteritis. These recommendations address a variety of clinical questions and scenarios including diagnostic testing, imaging, treatments, and surgical interventions. Recommendations for GCA and TAK include support for the use of glucocorticoid-sparing immunosuppressive agents and the use of imaging to identify large vessel involvement. Recommendations for TAK include the use of glucocorticoids as initial therapy.

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ICYMI: 263 RA patients with ILD were treated w/ Abatacept (ABA mono, ABA+MTX or ABA+nonMTX) - all improved their DAS28, stabilized their FVC, DLCO, Chest CT; Only difference was that steroid sparing best when ABA used in combo. https://t.co/1dGufcsRpC

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National Inpatient study (2000-2014) shows increased risk of vertebral compression fractures (VCF) in Ankylosing spondylitis (2.7%), compared to RA 0.77% & gen population 0.35%. VCF Hosp increased over time in AS, but decr in RA pts https://t.co/ugV44XJf8a

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152 Israeli pts w/ Breakthrough COVID infx >7d after 2nd Pfizer vax; all hospitalized, 38 w/ Poor outcome & 22% (34/152) died. All were older, most males, w/ comorbidities, 40% immunocompromised; high risk w/ RTX & low anti-spike IgG titers https://t.co/x1Uuyo7qim

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Study of 33 RCTs, 4544 pts Rx w/ either IL-17 or TNF inhibitors finds lower risk of UVEITIS with anti-TNF mAb (vs PBO OR = 0.46; vs IL-17i OR = 0.34. IL-17 inhibitors are not protective against uveitis https://t.co/AIxgI2qhq9

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Study of 647 RA pts wanting to get pregnant finds only 3.9% SSA+ & 1.1% SSB+ (higher in RF+ pts); ~1/2 had SSA titre of >240 units/mL - but No cases of neonatal lupus or heart block seen. In a French register, SSA related CHB was 1.5% https://t.co/FmZzPpmB7D

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Can you refuse to see unvaccinated pts? NY Times letter reviews options for “vaccine hesitant” or “vaccine refusing” 1. Ask if vaccinated 2. Offer telehealth 3. Require masks & distancing 4. Minimize contact betw vax & no-vax pts 5. Address pt concerns https://t.co/LEJLDMIDyF https://t.co/stoUpzzK02

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Botanical extract, Chrysanthemum zawadskii var. latilobum (GCWB) studied in 112 w/ mild-mod. knee OA. Randomized, double-blind, placebo-controlled study finds GCQB signif better than placebo in WOMAC total & function scores https://t.co/xyKlrL2CG7

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Sweets Syndrome (Acute Febrile Neutrophilic Dermatosis) in NEJM. A 46-year-old woman with erythematous painful raised lesions on her thumb, arms and other areas. https://t.co/Tggz1lLULR

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Do Women or Men make the best doctors? https://t.co/HTtZd9GHRH+

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Carpal Tunnel Syndrome has an annual incidence of 0.4%. Population based study shows more likely in women, 50-59 years, w/ obesity, gout, rheumatoid arthritis or a prior hx of wrist injury. https://t.co/X7U5yh0R3l

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Impact of Nail Psoriasis on Psoriatic Arthritis Mease and colleagues have shown that psoriatic arthritis (PsA) patients with nail involvement have worse disease and outcomes than those without nail psoriasis. https://t.co/fOiso0EGAK https://t.co/6YREBE2mHg

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Top Tweet Last Week: Potential Birth Defects with Hydroxychloroquine HCQ is one of the safest meds used in rheumatology, but there is new claims data suggesting a small increase in the risk of malformations associated with first-trimester HCQ use. https://t.co/IHNKjHVXaU https://t.co/Oay2ayVr9m

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ICYMI: News: EULAR Guidelines on Intraarticular Therapy EULAR has published evidence-based recommendations on the use of intra-articular therapies (IAT) based on the literature review and recommendations of a multidisciplinary international task force. https://t.co/Z6vC0x9zY1 https://t.co/dKpjpo50YT

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ICYMI: Hands-Down Rheumatology - Sarcoidosis usually presents as a monarthritis or oligoarthritis. Late sarcoid arthritis affects knees, ankles, fingers (dactylitis). Bony lesions show honeycomb trabecular pattern). https://t.co/lmXBbJz6ts https://t.co/qqSEmm4lNI

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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/wzNmOzH4VE https://t.co/kKoBTHWX6z

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ICYMI: New ACR Rheumatoid Arthritis Guideline: Emphasis on Methotrexate https://t.co/J9wmcZr17D https://t.co/9fUNrdVWuP

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Osteonecrosis in Lupus A single center analysis of systemic lupus erythematosus (SLE) patients found symptomatic osteonecrosis (ON) in nearly 10%. https://t.co/PoVsm6TYT1 https://t.co/MTeTiUXDS4

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Arthritis as a Harbinger of Pediatric Cancer Lancet Rheumatology has published a cohort analysis showing that a small but significant subset of children presenting with arthralgia or arthritis may have a pediatric malignancy. https://t.co/jospgTxqBd https://t.co/eewDj5rQgL

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