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Systemic Sclerosis Insights (9.13.2024)

Jack Cush, MD

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

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pregnancy,embryo,fetal

Low Placental Transfer Rates with Risankizumab

Jack Cush, MD

There are significant concerns about the safety of drug use during pregnancy and lactation, especially newer biologic agents. This is complicated by a lack of research. 

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Methotrexate

Consensus Guidelines on Pediatric Methotrexate Use

Jack Cush, MD

Methotrexate (MTX) is commonly used in the treatment of pediatric inflammatory skin conditions, often for off-label indications. Consensus based recommendations were published to address 5 major subjects.

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Moving Forward on RA Prevention Trials

Jack Cush, MD

Now that multiple prevention clinical trials for rheumatoid arthritis (RA) have been completed, a group of investigators have reviewed the results and published their recommendations for future trial designs and drug development to assess interventions that may alter disease development.

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Linger on the Fingers (9.6.2024)

Jack Cush, MD

Dr. Jack Cush reviews the news and journal reports from the past week on RheumNow.com. This week with a focus on fingers and better prescriptive follow through.

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CAR-T Like Effects with Bispecific Teclistamab

MedPage Today

A new chapter may have begun in the exciting story of "immune reset" therapy for difficult-to-treat autoimmune diseases, with a patient with severe refractory lupus obtaining drug-free remission after treatment with an antibody product normally used in multiple myeloma.

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Does Rheumatoid Factor Influence Anti-TNF Responses in RA?

Jack Cush, MD

Smolen and colleagues have published a subanalysis of the EXXELERATE study that showed while certolizumab pegol [CZP] concentrations and efficacy was unaffected by high titers of rheumatoid factor (RF), patients treated with adalimumab had a blunted response in the face of high RF titers.

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CAR-T Like Effects with Bispecific Teclistamab A new chapter may have begun in the exciting story of "immune reset" therapy for difficult-to-treat autoimmune diseases, with a patient with severe refractory lupus obtaining drug-free remission after treatment with an antibody… https://t.co/FO42QaJaFn https://t.co/5LouAzYeOv
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Consensus Guidelines on Pediatric Methotrexate Use MTX is commonly used in the treatment of pediatric inflammatory skin conditions, often for off-label indications. Consensus based recommendations were published to address 5 major subjects: -indications and contraindications… https://t.co/6JtIMGOAhq https://t.co/OZJLqAyOnF
Dr. John Cush RheumNow ( View Tweet)
A low risk of Candida infections with ixekizumab (IXE); integrated analysis of 25; Candida infx rates - PsO:1.9/100 PY (N  6892); PsA 2.0/100 PY (N 1401); axSpA 1.2/100PY (N 932). Most occured only once, were mild/moderate & were oral or genital Candida https://t.co/ZkkPoSzPMW https://t.co/VysnaQ8rpi

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Claims analysis of two datasets showed TNFi treatment in 1st two years after newly Dx breast cancer (n 2216) had no effect on overall survival (OS); but had signif better breast cancer survival (HR 0.28; 0.08–0.98) vs csDMARD Rx. Pts on GC worse OS (HR 2.18)… https://t.co/Kxk7Sy7ahi https://t.co/PtxRsTifi1
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post hoc analysis of 4432 pt COLCORONA trial, showed colchicine had few drug interactions, none serious. The most common were interactions w/ rosuvastatin & atorvastatin (10-12% of all pts), that MAY nonsignificantly increase colchicine exposure https://t.co/W3JXne0ywH https://t.co/dNz6NVYjUW

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Dr. John Cush RheumNow ( View Tweet)
Does Rheumatoid Factor Influence Anti-TNF Responses in RA? Smolen and colleagues have published a subanalysis of the EXXELERATE study that showed while certolizumab pegol [CZP] concentrations and efficacy was unaffected by high titers of rheumatoid factor (RF), patients treated… https://t.co/Ux9gHXcGbv https://t.co/gpcuWrqVHi
Dr. John Cush RheumNow ( View Tweet)
EMA Updated overview of leflunomide (Arava) https://t.co/LbuqzDdTvf https://t.co/npfsRDdFiP

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Good Clinical Practice Recommendations on Glucocorticoid Withdrawal and Adrenal Insufficiency The European Society of Endocrinology and Endocrine Society have jointly published a clinical guideline on the diagnosis and treatment of glucocorticoid-induced adrenal insufficiency,… https://t.co/GmQ5ypvqWP https://t.co/oab9qHpxSa
Dr. John Cush RheumNow ( View Tweet)
Sustained Hydroxychloroquine and Cardiovascular Outcomes A national cohort study shows that continuous use of hydroxychloroquine (HCQ) protects against cardiovascular (CV) events in patients with systemic lupus erythematosus (SLE). https://t.co/xqB2tyzzYQ https://t.co/dlFjbgbsep

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Dr. John Cush RheumNow ( View Tweet)
Dactylitis is seen in 50% of PsA patients. Dactylitis is frequently associated with more severe PsA phenotype, often representing the initial feature of the disease. Many agents are effective but no b/tsDMARD is distinguished as being superior in dactylitis.… https://t.co/NKOXReiZYd https://t.co/Ake2fixZ40
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Difficult to treat RA Approach https://t.co/2rmlv0kspP https://t.co/6yb5xj8jrn

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Dr. John Cush RheumNow ( View Tweet)
Norwegian Registry study compared risk of stroke in 2750 RA vs 158 879 w/o RA pts. 7.3 vs 5% (HR 1.36; 1.13, 1.62). RA pts with atrial fibrillation was also elevated (HR 1.25; 1.05, 1.5). RA pts less likely to Rx w/ oral anticoagulants (adj OR 0.88) than non-RA… https://t.co/s20wTKafR8 https://t.co/FPxc5VP4Xh
Dr. John Cush RheumNow ( View Tweet)
Claims analysis, shows <0.5% of IBD or RA pts developed an invasive fungal infx within 1 year of TNF therapy initiation (. Histoplasmosis was the most common IBD = 3.3 IFI/100PY RA = 2.8 IFF/100PY https://t.co/ER9YCxecJT https://t.co/T0UNgB4h6R

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