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Consequences of TNF inhibition (3.18.2022)
This week we're going to talk about the downside of TNF inhibitors, a few interesting observations in gout, and yes, kids do get COVID. We're also going to preview what's coming in April (hint: it's about PsA). This and more as Dr. Jack Cush reviews the news and journal articles from the past week on RheumNow.com.
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Environmental Pollutants Ups Autoimmune Disease Risk
An Italian environmental study shows that air pollution increases the risk of autoimmune diseases, in particular rheumatoid arthritis, connective tissue diseases (CTDs) and inflammatory bowel diseases (IBD).
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One shortcoming in determining axial disease activity is the BASDAI itself. And yet, this study by Dr. @AlexisOgdie shows that the BASDAI scores were similar in those w and w/o axial disease in PsA. Dr. Mease. And yet not all drugs work equally in PsA/axSpA. #RNL2022 @RheumNow https://t.co/h1PYfNgEV3
Dr. Rachel Tate uptoTate ( View Tweet)
Does IL23i work in axial #PsA? No. Yes. Maybe. Phil Mease #RNl2022 @RheumNow https://t.co/4bSDXCdHl2
Janet Pope Janetbirdope ( View Tweet)
Are AxSpA and axial PsA the same? #RNL2022 @RheumNow
Dr. Rachel Tate uptoTate ( View Tweet)
How to evaluate for Axial PsA?
Philip Mease @RheumNow #RNL2022 https://t.co/Zig3K69P78
Nouf Al hemmadi NoufAhmedAlham2 ( View Tweet)
Ok 💩 results #ClinivalPearl one fecal transplant in active #PsA did WORSE than sham Rx. Those doing high colonics - no idea why one would- likely also a waste {pun intended} Dr Jose Scher presented RCT #RNL2022 @RheumNow https://t.co/FDlOvPdzvl
Janet Pope Janetbirdope ( View Tweet)
Why do we love to hate #guidelines in #rheumatology - maybe for example in #PsA we really don’t know the BEST Rxas 1st line advanced therapy & beyond. I say: Take a guess or do a pragmatic trial to figure it out. A Kavanaugh #RNL2022 @RheumNow https://t.co/lVIno6FBqJ
Janet Pope Janetbirdope ( View Tweet)
Dr. Bruce Kirkham
Drug Targeting in Psoriatic Arthritis
SEAM PsA study - MTX monotherapy not AS efficacious as MTX and TNFi combo therapy, but STILL effective
@RheumNow #RNL2022 https://t.co/qsSGgD9bq7
Robert B Chao, MD doctorRBC ( View Tweet)
Excellent graphic on mechanisms of action of PsA and their effects on specific cytokines
@RheumNow #RNL2022 https://t.co/B0ZT6qlpbE
Robert B Chao, MD doctorRBC ( View Tweet)
Enthesitis in PsA is multi-faceted.
Environmental triggers, microbiome, microdamage in combination with innate immune response in genetically susceptible patients can active the IL-23 and IL-17 pathway
Leading to cartilage damage and degradation
@RheumNow #RNL2022 https://t.co/hvkCmJ0V1S
Robert B Chao, MD doctorRBC ( View Tweet)
PSA management:
MTX can be used alone
TNF and MTX are more effective
Other agents
Bruce Kirkham @RheumNow #Rnl2022 https://t.co/rgdylgYDSb
Nouf Al hemmadi NoufAhmedAlham2 ( View Tweet)
Dr. Kavanaugh reviews the 2018 ACR/National Psoriasis Foundation PsA treatment guidelines. #RNL2022 @RheumNow @RWCSmtg https://t.co/AI3kL6HGxr
Dr. Rachel Tate uptoTate ( View Tweet)
New GRAPPA Guidelines , Cant wait for the final draft to be released!!
They added other associated features like IBD and eye involvement as well as comorbidities!! cool stuff🤓 smart move.
Arthur Kavanaugh @RheumNow #Rnl2022 https://t.co/CYfEc8j4xX
Nouf Al hemmadi NoufAhmedAlham2 ( View Tweet)
GRAPPA: the 2015 guidelines and the initial draft (still in revision) of the purposed 2021 guidelines. Dr. Kavanaugh We've been busy getting approved treatments options for our PsA patients over the past few years!
@RWCSmtg #RNL2022 @RheumNow https://t.co/CJGrNbg6MA
Dr. Rachel Tate uptoTate ( View Tweet)
POD 3 on Psoriatic Arthritis Advances will begin at 2pm ET and Dr. Artie Kavanaugh will lead the first presentation of the pod titled PsA Guidelines: The Good, Bad & Ugly. #RNL2022 https://t.co/cx3XBSWbNr
Dr. John Cush RheumNow ( View Tweet)
Study of 338 psoriatic pts assessed carotid total plaque area (TPA) and cardiac troponin I (cTnI) & NT-proBNP. TPA was associated with troponin 1 (β coefficient 0.52) and NT-proBNP (β coefficient 0.24); both p<0.001. https://t.co/NXUBByAD37 https://t.co/ZQMFiqTzDF
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Dr. John Cush RheumNow ( View Tweet)
RheumNow Live is Coming to Town!
Have you signed up for RheumNow Live yet? We still have space available.
https://t.co/FBCQRu32gO
https://t.co/KoGR8An6af https://t.co/qtwPbMzqSO
Dr. John Cush RheumNow ( View Tweet)
ICYMI: COMPLETE-PsA Trial studied MTX vs MTX + leflunomide in 78 active untreated PsA pts. MTX+LEF was superior to MTX alone at wk 16 (PASDAS 3·1 vs 3·7; p=0·025). Combo group had more N/V (44% v 28%), ^ALT (31% vs 18%). https://t.co/tg5eETiMO4 https://t.co/bC45AAnP3h
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Dr. John Cush RheumNow ( View Tweet)
Psoriatic Arthritis Responds to Tyk2 inhibition with Deucravacitinib
Deucravacitinib, a selective tyrosine kinase 2 (TYK2) inhibitor, was studied in a phase II trial of active psoriatic arthritis (PsA) patients and shown to be effective and safe.
https://t.co/XYK02MRMp6 https://t.co/LgToS5NCaa
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Dr. John Cush RheumNow ( View Tweet)
