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Best Rheumatologists (7.19.2024)

Jack Cush, MD

This week on the RheumNow Podcast, Dr. Jack Cush reviews the news and journal reports of interesting, including irAE, pollution and Psoriasis, microwave therapy, scleroderma without scleroderma that only the best rheumatologists could discern.

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JAK Inhibitors Reduce Macular Degeneration

Mepage Today

Insurance claims data showed that patients with autoimmune disorders who took Janus kinase (JAK) inhibitors had lower rates of age-related macular degeneration (AMD), hinting that the drugs might treat the common eye disease.

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Updated EULAR Recommendations on the Treatment of Systemic Sclerosis

Medscape

Medscape has published an overview to the 2024 updated recommendations for the treatment of systemic sclerosis (SSc) presented in Vienna at EULAR 2024 by Professor Francesco Del Galdo, MD, PhD on behalf of a 27 member task force.

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Systemic sclerosis sine scleroderma

Jack Cush, MD

Systemic sclerosis sine scleroderma (ssSSc), which accounts for nearly 10% of systemic sclerosis (SSc) patients and was first described in 1962, is a subset of SSc.

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Pollution and Autoimmunity (7.12.2024)

Jack Cush, MD

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

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Efficacy of Biologics in Patients with Chronic KIdney Disease

Jack Cush, MD

A retrospective cohort study of biological disease-modifying antirheumatic drugs (bDMARDs) persistence in rheumatoid arthritis (RA) patients with chronic kidney disease (CKD), shows the 3 year survicval to be under 50% but that all studied biologics were nearly equivalent

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ICYMI: Can Mycophenolate be Stopped in Stable SLE?

Jack Cush, MD

In patients with clinically stable systemic lupus erythematosus (SLE) and lupus nephritis, the withdrawal of mycophenolate mofetil was not significantly inferior to mycophenolate maintenance, but MMF withdrawal had numerically more reactivations, while MMF maintenance had more infections.

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ICYMI: 2023 EULAR Psoriatic Arthritis Recommendations

Jack Cush, MD

EULAR has updated its treatment recommendations from the prior 2019 guidelines, since there have been several newly developed agents. The updated guidance includes 7 overarching principles and 11 recommendations regarding treatment strategy and pharmacological therapies.

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Study of 478 CA pts Rx w. anti-PD-(L)1 Ab or anti-CTLA4 Ab - 28 (6%) had pre-existing Autoimmune Dz (AI). irAE (w/ checkpoint inhib) were higher w/ preexisting AI (57% vs 35%), but activity of AI was not related to irAEs occurrence. https://t.co/CHIdaH91qR https://t.co/XuaLk4D205

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192 RA pts on MTX: GI Sxs studied w/ MISS (MTX intolerance severity score). GI intolerance seen in 56%, Nausea & pain post-MTX most common. More in afro-descendants, w/ FM, Steroids, or JAKi. MISS results unrelated to Route, Gi Dz, age, MTX dose https://t.co/EROmZQo1Zs https://t.co/SOMzzXXj0b

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Febuxostat is assoc w/ a reduced risk of kidney events and slower decline in eGFR. Metanalysis of 16 RCTs, shows febuxostat w/a reduced risk of kidney events (RR=0.56) & slower decline in eGFR; & reduced urine albumin to creatinine ratio https://t.co/GQ8UopbA88 https://t.co/WQskc1yZ02

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Efficacy of Biologics in Patients with CKD A retrospective cohort study of biological bDMARDs persistence in RA patients w/CKD, shows the 3 year survival to be > 50% but all studied biologics were nearly equivalents with regard to safety and efficacy. https://t.co/rL2ZondUsE https://t.co/1hM237Jl83

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FDA adverse event study of JAKi in #RA assoc w/ signif more VTE, ischemic heart Dz, & tachyarrhythmias. 75,407 on JAKi vs 303,278 on biologics (TNFi, RTX, TCZ); JAK had more VTE (ROR=2.11), CVA (ROR=1.25), IHD (1.23), arrhythmias (1.15 ), esp in 1st yr. https://t.co/IVsGwqpiJK https://t.co/4epOHdNHbO

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MTX was tapered or D/C in 30% of RA pts w/in 2 yrs of b/tsDMARD Rx. Of 889 pts, MTX (19 mg/wk) tapered in 13.8% & D/C 16.5% (planned taper(37%); pt decision (27.2%). In 582 (66%) MTX unchanged, 4.25 increased MTX after b/tsDMARD initiation https://t.co/yc8exMbeD1 https://t.co/b3L3Fha7xU

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ICYMI: Can Mycophenolate be Stopped in Stable SLE? https://t.co/WJv2CajgW9 https://t.co/AU8X5bVSJQ

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CHANCE-3 DBR-PCT of 8343 adults (>40yrs) w/ CVA or TIA & hsCRP ≥2 mg/L showed that colchicine (0.5mg) x 90d did not prevent (6.3% vs 6.5%; HR 0.98; 0.83 to 1.16) subsequent stroke within 90 days compared with placebo https://t.co/APiMYVkBTV https://t.co/VgFiCKfMqB

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FDA adverse event study of JAKi in #RA assoc w/ signif more VTE, ischemic heart Dz, & tachyarrhythmias. 75,407 on JAKi vs 303,278 on biologics (TNFi, RTX, TCZ); JAK had more VTE (ROR=2.11), CVA (ROR=1.25), IHD (1.23), arrhythmias (1.15 ), esp in 1st yr. https://t.co/BmNPk6zN6o https://t.co/fbzHQmPmH5

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EULAR 2024 Recommendations on Reproductive Health https://t.co/QuXQlpQv8O https://t.co/nHC7LOLLl8

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ICYMI: 9 Facts about Leflunomide Medscape has published an informative review of leflunomide, drawn from Dr. Eric Ruderman’s recent lecture on the subject at the February RWCS meeting in Maui. https://t.co/WseVa589Fg. https://t.co/K4u00MbwEb

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RT @drdavidliew I have to say: upadacitinib looks very decent for GCA. Not a panacea, but it definitely does something & good safety during trial. Would love to eventually see: - H2H comparative effect vs toci, secukinumab - structural outcomes - long-term safety #EULAR2024

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