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Phase 3 Trials of Baricitinib Disappoint in SLE
Despite the encouraging phase II trial results of baricitinib in systemic lupus erythematosus (SLE) patients, two parallel phase III trials have failed to redemonstrate the efficacy of baricitinib in active SLE, thereby halting development of baricitinib in SLE.
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Half the Experts are Wrong (2.17.2023)
Dr. Jack Cush reviews the news and tries to stump the expert panel this week on the podcast.
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New Laboratory Insights for the ANA+ Consult
A new study suggests that use of ELISA assays for CXCL-10 and IFN-α can predict which ANA+ individuals may progress to developing a systemic autoimmune rheumatic disease (SARD).
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Older Lupus Patients Need Follow-Up After Hospital Discharge
MedPage Today
Medicare beneficiaries 65 and older with lupus faced dramatically higher mortality when they received no follow-up care during the month after a hospital stay, researchers found.
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51 Juvenile SLE (j-SLE) studied for neuropsychiatric Dz (j-NPSLE)- 39% presented with jNPSLE. While no clear biomarker/imaging of j-NPSLE identified, they found CSF neopterin (& IFN-α) levels signif higher w/ active j-NPSLE & CNS involvement (p=0.0008) https://t.co/QM8yJGrBJu https://t.co/4hj1eE2JIC
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Dr. John Cush RheumNow ( View Tweet)
While anifrolumab targets IFN alfa in SLE, its unclear how much IFNa is needed for Rx response. A study of 40 pts shows Rx naive SLE has signif higher serum IFN activity; this is assoc w/ fever, leukopenia, ALE rash and oral ulcers & more organ damage https://t.co/RtI9ulurB1 https://t.co/wMl5DOyGB6
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Dr. John Cush RheumNow ( View Tweet)
Metanalysis of 25 studies, betw 1985 - 2021, showed US average annual visits for RA=5.25 for US rheums (vs 3.3 ex-US) & 4.8 US non-rheums. SLE=3.24 & 12.3 for US non-Rheums. FM=1.8 for US rheums & 0.4 vs ex-US Rheums. Rheum Visits Decreased 1982 to 2019 https://t.co/WIXDXUCG60 https://t.co/s7W9gcd5dd
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Dr. John Cush RheumNow ( View Tweet)
A retrospective study from a Taiwan health insurance claims data analysis looked at the association between Hashimoto's thyroiditis and lupus.
https://t.co/159JNLY6tf https://t.co/JxR88a84MN
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Dr. John Cush RheumNow ( View Tweet)
Metanalysis of 25 studies, betw 1985 - 2021, showed US average annual visits for RA=5.25 for US rheums (vs 3.3 ex-US) & 4.8 US non-rheums. SLE=3.24 & 12.3 for US non-Rheums. FM=1.8 for US rheums & 0.4 vs ex-US Rheums. Rheum Visits Decreased 1982 to 2019 https://t.co/5ugk34MJ3b https://t.co/NDMYZT7pil
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Dr. John Cush RheumNow ( View Tweet)
Toxic Epiderman Necrolysis vs Acute Cutaneous Lupus Erythematosus
https://t.co/wKX3v01RUb https://t.co/SWwnH7ph04
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Dr. John Cush RheumNow ( View Tweet)
Steroids assisting options - CTX, LEF or RTX @anisha_dua @RWCSmtg @RheumNow #RWCS23 https://t.co/gVw2tGKYNG https://t.co/ItIKB8MFTI
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Dr. John Cush RheumNow ( View Tweet)
Case reports of anifrolumab use in 2 pts w/ chronic, scarring discoid lupus unresponsive to steriods, HCQ, immunosuppressants & CTX. Case 1 SLEDAI from 13 to 2 in 24 weeks & CLASI-A from 26 to 3 in 20wks. Cs 2 CLASI-A decr 24 to 5 after 1 infusion https://t.co/Qe2rF4Avxe
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Dr. John Cush RheumNow ( View Tweet)
Deucravacitinib - Effective in Systemic Lupus Erythematosus
A Phase II, multicenter study has demonstrated the efficacy and safety of deucravacitinib, an oral, selective, allosteric inhibitor of TYK2, in adults with active SLE.
https://t.co/YS8n02BEsk https://t.co/4sBd88AhtK
Links:
Dr. John Cush RheumNow ( View Tweet)
Have you heard of nipocalimab? It prevents IgG-FcRn by binding to the FcRn IgG binding site. This is one to watch in our diseases (RA, Sjogren’s, SLE, myopathies.) Dr. Postolova #RWCS23 @RheumNow @RWCSmtg https://t.co/qMGA6IdtUE
Dr. Rachel Tate uptoTate ( View Tweet)
Older Lupus Patients Need Follow-Up After Hospital Discharge
Medicare beneficiaries 65 and older with lupus faced dramatically higher mortality when they received no follow-up care during the month after a hospital stay, researchers found.
https://t.co/4mFctXGQH9 https://t.co/2Q1z03myud
Links:
Dr. John Cush RheumNow ( View Tweet)
Study of 232 pediatric #SLE pts. Over 12 mos 47% achieved LLDAS & Damage seen in 40% after 6.2 yrs F/U. Getting to LLDAS w/in 12 mos is assoc w less damage. LLDAS w/in 12 mos more likely in Absence of renal involvement. https://t.co/pGethJCw4e https://t.co/eYpVueIKbf
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Dr. John Cush RheumNow ( View Tweet)
Deucravacitinib - Effective in Systemic Lupus Erythematosus
A Phase II, multicenter study has demonstrated the efficacy and safety of deucravacitinib, an oral, selective, allosteric inhibitor of TYK2, in adults with active SLE.
https://t.co/0g2VM6TJt6 https://t.co/f6wylPc5ep
Links:
Dr. John Cush RheumNow ( View Tweet)
Retrospective cohort study of Taiwan Health Insurance Database looked at risk of #SLE in pts w/ Hashimoto’s thyroiditis (HT). Compared 15K HTvs 31K controls. SLE was incr in HT pts (IRR 3.58; p < 0.01). Several sensitivity analyses aHR 4.35 to 5.11 https://t.co/QaWEN4Chw9 https://t.co/bD8zrCJEXY
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Dr. John Cush RheumNow ( View Tweet)
NLRP12 is a negative regulator of innate immune activation and type I interferon production. SLE PBMCs have low levels NLRP12 (inverse correl w/ IFNa & Hi Dz activity. NLRP12 knockouts or deficiency Incr autoAbs, inflammation & renal damage https://t.co/VICAqKmK9r https://t.co/MxqcNzh6BQ
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Dr. John Cush RheumNow ( View Tweet)
Meta-analysis (21 studies, 3948 pregnant pts) HCQ may reduce risk of preeclampsia (OR 0.45) & premature delivery (OR 0.84) in pregnant autoimmune pts. HCQ may also reduce risk of gestational HTN (OR 0.42) & pre-term birth (OR 0.63) in pregnant SLE pts https://t.co/riQDRN9r1A https://t.co/uR8Nem4Ndx
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Dr. John Cush RheumNow ( View Tweet)
