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Relapses with Rituximab Maintenance in ANCA-associated Vasculitis
Real-world, retrospective study of microscopic-polyangiitis (ΜPA) and granulomatosis-with-polyangiitis (GPA) patients shows that rituximab (RTX) maintenance was associated with 25% risk of relapse and that lower relapse rates was seen with RTX plus cyclophosphamide treatment.
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CARRA Consensus Treatment for Refractory Juvenile Dermatomyositis
CARRA has developed consensus treatment plans for the use of biologic disease-modifying antirheumatic drugs (bDMARDs) in patients with refractory, moderately severe juvenile dermatomyositis. Juvenile dermatomyositis is the most common form of idiopathic, inflammatory myositis in childhood, with an estimated incidence of 3.2 per million children per year in the United States.
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Lead with Lupus (8.2.2024)
Dr. Jack Cush reviews the news and journal reports from this past week on RheumNow.com - leading with lupus because everyone wants to know about lupus!
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NSAIDs Used Despite Contraindications
EurekAlert!
Osteoarthritis affects 600 million people worldwide, making it a leading cause of disability.
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Arthritis drugs may relieve long COVID lung symptoms
EurekAlert!
University of Virginia School of Medicine researchers have identified a potential treatment for the respiratory symptoms of long COVID after discovering an unknown cause of the condition inside the lungs.
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Breast CA (BC) & TNFi - study of 2 cohorts (Optum commercial * SEER/Medicare) found that 17% & 16% of BC pts received TNFi. 1 yr overall survival was no different +/- TNFi (HR= 0.77 & 0.84); but BC survival better on TNFi (HR 0.28; 0.08–0.98) vs csDMARDs. https://t.co/cGqT80rGTR https://t.co/n7i5VNFkVT
Dr. John Cush RheumNow ( View Tweet)
Prescription Painkiller Misuse in Chronic Pain Patients
A new scientific review has found that nearly 1 in 10 patients experiences opioid dependence or opioid use disorder and nearly 1 in 3 shows symptoms of dependence and opioid use disorder.
https://t.co/DnUe1l51bS https://t.co/G4RPg8eqqe
Dr. John Cush RheumNow ( View Tweet)
Full Read Overview of the safety of bDMARDs/tsDMARDS - contraindications, precautions, & boxed warnings for treatment of RA, PsA, SpA, JIA - safety checklist for a class of drugs you use and diseases you treat https://t.co/5chrS3sW8i https://t.co/twSv4Zs9r3
Links:
Dr. John Cush RheumNow ( View Tweet)
Relapses with RTX Maintenance in ANCA-associated Vasculitis
A real-world study on ΜPA and GPA patients found that RTX maintenance had a 25% relapse risk, with lower rates when combined with cyclophosphamide treatment.
https://t.co/bD6u5JWVqS https://t.co/CSotJt4in1
Dr. John Cush RheumNow ( View Tweet)
EU study of 1052 systemic sclerosis pts failed to show early immunosuppressive use (vs late) lowered ILD risk. Early Rx (Dz Dur < 3yrs) group (n=547, 52%) more male, diffuse Dz, 60% Rx w/ MTX (1.7% biologics); ILD in 47% after3.6yrs (HR 1.13;0.93–1.38) https://t.co/PtQlgyX0TE https://t.co/R7X3zvPvIg
Dr. John Cush RheumNow ( View Tweet)
FDA issued draft guidance, which, if implemented, would remove requirement for a switching study for demonstrating biosimilar interchangeability. Citing research showing no additional safety concerns if pts switched from reference biologics to biosimilars https://t.co/MBvI4yxajW https://t.co/sEE654E2rl
Dr. John Cush RheumNow ( View Tweet)
Full Read Overview of the safety of bDMARDs/tsDMARDS - contraindications, precautions, & boxed warnings for treatment of RA, PsA, SpA, JIA - safety checklist for a class of drugs you use and diseases you treat https://t.co/TIdCtJjF21 https://t.co/UE0nGbESDB
Links:
Dr. John Cush RheumNow ( View Tweet)
Melatonin doesnt work! 172 pts w/ unilateral TKA for Rx in DBRPCT trial of qhs 5 mg melatonin vs. 125 mg vit C placebo for 6 weeks. No differences in PSQI or other sleep measures @6wks. Poor sleep assoc w/ worse pt function and pain. https://t.co/b1gfnyB7Qw https://t.co/nT589CItIF
Dr. John Cush RheumNow ( View Tweet)
Guselkumab maintenance dose is 100 mg sc q8wks. GUIDE ph 3b trial treated 297 PSO super responders (PASI <3) w/ q8wk or extended q16wk GUS & demonstrated noninferiority of q16 wk dosing w/ disease control (91.9 vs 92.6%) https://t.co/31DPTmcVD2 https://t.co/qHMsyYCH4J
Dr. John Cush RheumNow ( View Tweet)
NSAIDs Used Despite Contraindications
https://t.co/elhnmB3N52 https://t.co/VgIqKvkfVJ
Dr. John Cush RheumNow ( View Tweet)
TRUST: 10 Yr Japanese study of tacrolimus in 1355 SLE nephritis pts; half on TAC x 10yrs. TAC use assoc w/ signif reduction corticosteroid use (~16 mg/d @4wks to 7.2 mg/d @ 1Yr(P < 0.001). 9.7% w/ serious AEs. https://t.co/PsfCVZF4tk https://t.co/l3HkTRc4oC
Dr. John Cush RheumNow ( View Tweet)
Literature review - Glucocorticoid use in elderly to be problematic. GC use may be assoc w/ remission, but GC increases AE rates, & there is difficulty w/ GC discontinuation. Goal: D/C GC early, but some may require for up to yrs to control Dz activity https://t.co/6liN0mubIv https://t.co/PiGKGSYrof
Dr. John Cush RheumNow ( View Tweet)
In the UK, estimated cost of hardardous NSAID use is £31.43million (pounds) (£9.28m to £67.11m) over 10 yrs. High risk = Elderly >65y without gastroprotection, pts on anticoagulants; & Pts w/ heart failure, chronic kidney Dz , or Hx of peptic ulcer. https://t.co/bPXnQbQnNV https://t.co/aDLGHjLmhB
Dr. John Cush RheumNow ( View Tweet)
Polypharmacy Doubled in 20 Years. Polypharmacy (5+ Rx last month) went from 24% in 2000 to > 40% in 2020 https://t.co/2czI4DxlVm https://t.co/VAZkbxKrJP
Dr. John Cush RheumNow ( View Tweet)
NEW VIEWPOINT—Arthritis complicating inflammatory bowel disease—the future is now https://t.co/FyojGF6Pvx @DrLauraCoates #GITwitter https://t.co/kMewGTDQTc
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The Lancet Rheumatology TheLancetRheum ( View Tweet)
