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A New RA Approval (8.1.2025)
Dr. Jack Cush reviews the news, journal reports and a new treatment for RA from the FDA.
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FDA Approves Vagal Nerve Stimulator for RA
SetPoint Medical announced that the FDA has approved the company’s SetPoint System, a first-in-class neuroimmune modulation innovation for treatment of moderate-to-severe rheumatoid arthritis (RA) for those who are not adequately managed by—or cannot tolerate—existing advanced RA therapies, such as biological and targeted synthetic DMARDs.
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Options for Refractory axSpA or PsA
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MedPage Today
Although most patients with axial spondyloarthritis (axSpA) or psoriatic arthritis (PsA) didn't respond adequately to the interleukin-17 (IL-17) inhibitor ixekizumab (Taltz), enough did that it should still be considered in such cases, a Danish registry study indicated.
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TriNetX study of E-health record study of ~53k transcatheter aortic valve intervention (TAVI) pts. 705 were on preoperative colchicine - these had signif reduction of post-TAVI heart block and AV/LBBB (RR 0.867 [95% CI, 0.756–0.994]) @ 1 month, but not at 6 months https://t.co/9tI2KFY7u7
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“There are a terrible lot of lies going about the world, and the worst of it is that
half of them are true.” – Winston Churchill
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HCQ Preserves Renal Function in Lupus Nephritis
Lupus nephritis (LN) patients on long-term therapy with hydroxychloroquine (HCQ) showed significantly less decline in renal function, compared with patients treated otherwise, a 10-year retrospective study indicated. https://t.co/YpJGpAysUQ
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Top 20 Best Rheumatology Hospitals - 2025
Each year, U.S. News ranks hospitals in 15 specialties and for the 8th year in a row Johns Hopkins Hospital in Baltimore has been named the top hospital for rheumatology by U.S. News & World Report.
https://t.co/gBA49giwX7 https://t.co/sObhLxgrBf
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MTX or TNFi use in elderly #RA pts w/in a year of Dx of melanoma was not associated with increased mortality. This included melanoma in situ (48%), localized (47%) and regional (5%) melanoma. Steroid use however was assoc w/ reduced survival. https://t.co/QOXfEf51S1 https://t.co/GZ5dedEMfM
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Rituximab is not Superior in EGPA
A cohort study of Eosinophilic Granulomatosis With Polyangiitis (EGPA) patients from the French Vasculitis Study Group failed to show superiority of rituximab compared to conventional strategy with glucocorticoids (GS) alone or in combination https://t.co/h4B20Ngamj
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FDA is evaluating the safety of Vyvgart Hytrulo, ((efgartigimod) used to treat AChR Ab positive generalized myasthenia gravis (gMG). But in clinical trials there are reports of "severe worsening of chronic inflammatory demyelinating polyradiculoneuropathy (CIDP)” https://t.co/KN7ZZ2LWPW
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PMR & GCA not assoc w/ increased mortality, Norway study of 274 isolated PMR (mean age 72 yrs) & 63 GCA (age 72 yrs) pts. After mean F/U 13.7 yrs 96% were deceased. Standardized mortality ratio was Not incr for PMR (0.97)or GCA (1.10), but men w/ PMR had , lower all-cause https://t.co/wbiVhjCimk
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Pregnant Women on TNFi more likely to use throughout gestation, w/ less steroids. 3711 preg on TNFi in 49,925 F (w/ RA, AS, PsA, PsO, IBD) -- 64% had 3 trimester TNFi use. 89% exposed preconception & 68% cont postpartum. TNFi use incr from 55% to 73% i(20111-21) https://t.co/DVvbwx6MoW
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TriNetX study of E-health record study of ~53k transcatheter aortic valve intervention (TAVI) pts. 705 were on preoperative colchicine - these had signif reduction of post-TAVI heart block and AV/LBBB (RR 0.867 [95% CI, 0.756–0.994]) @ 1 month, but not at 6 months https://t.co/wuwlzE22q2
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Rheumatology Salaries Remain Low
The annual Medscape Physician Compensation report was published and shows only modest salary gains for most specialists.
https://t.co/NcmwrMxpKr https://t.co/mxFbqtUQv2
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CARRA registry study of 2,956 JIA pts (activity: 71% inactive/minimal, 25% persistent moderate/high, 2% “improving”, 2% “flaring”). In 12 mos, Only 10% had DMARD escalation & only 15% escalation despite 2 consecutive visits w/ persistent moderate/high disease activity. This is https://t.co/Gviwgfcdrk
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Mild cognitive impairment (MCI), (a reversible precursor to dementia) is increased in elderly RA (n=378) and is signif. assoc w/ course of disease(OR 1.07), DAS28 (OR 1.31), high CRP (OR 1.01) & osteoporosis (OR 1.88) as independent risk factors. https://t.co/45DY03sD23 https://t.co/kdX9TnykVK
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Plant extracts, C. longa & B. serrata extracts (CBTIL) studied in hand OA in 3 mos, DBRPCT of 162 HOA pts given CBTIL (n83) or PBO (n 79). Also signif were decreased Pt global, acceptable symptom status (PASS), SF-36 pain, SF36 health change (no AE diff) https://t.co/vqhqnEZIsz https://t.co/XuCX0zc4qD
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RA & GOUT? S. Korean study of 34,356 new RA pts vs 103,068 controls. RA had 2.7 X higher risk of gout vs non-RA. Seropos & Seroneg equal incr risk (aHR 2.8 & 2.6), slightly higher in SPRA(aHR 1.07). RA on b/tsDMARDs had lower risk (aHR, 1.93) vs Untreated (aHR, 2.78). https://t.co/P0oqq5bVnq
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Danish childhood vaccination registry study (1997-2020) found among 1,224,176 children w/ vaccination before age 5, w/ aluminum containing vaccines against an DPT, poliovirus, Hib (DTaP-IPV/Hib), PCV, etc found no increased risk of autoimmune dz by 8 yrs of https://t.co/9IR6AmlIT9
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HCQ Preserves Renal Function in Lupus Nephritis
Lupus nephritis (LN) patients on long-term therapy with hydroxychloroquine (HCQ) showed significantly less decline in renal function, compared with patients treated otherwise, a 10-year retrospective study indicated. https://t.co/dB6G34c6Mw
Dr. John Cush RheumNow ( View Tweet)
