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ICYMI: Drug Survival Differences in RA, PsA, SpA and PsO

d Jack Cush, MD

Drug survival may be the best measure of efficacy and safety. A study of novel therapy durability (survival) in patients with RA, axial spondyloarthritis, PsA, and psoriasis shows that while all these drugs are approved for said conditions, drug survival varies by condition, suggesting an ongoing need for individualized treatment.

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What Worries You, Masters You (7.1.2022)

d Jack Cush, MD

Dr. Jack Cush reviews recent news, regulatory and guideline updates from the past week on RheumNow.com.  Studies on methotrexate use, COVID vaccination, Supplements and vitamins, and arthrocentesis despite anticoagulation are discussed.

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Novel Anti-TNF Shines in Rheumatoid Arthritis Trial A new way of inhibiting tumor necrosis factor (TNF) for treating rheumatoid arthritis showed strong results in a phase II/III clinical trial, researchers said. https://t.co/fTmWeIrVD5 https://t.co/LPk2Ok2gac

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Placebo Works Best in Combination Analysis of two large clinical trial datasets shows that placebo response rates in randomised controlled trials (RCTs) of patients with rheumatoid arthritis are better when the patient continued background MTX. https://t.co/JmNGRQWv6L https://t.co/77LdcTwCvl

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Video: Post Hoc Analysis of the ORAL Surveillance Study https://t.co/PVzfYlzdQa https://t.co/0RpA3CfTEE

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Novel Anti-TNF Shines in Rheumatoid Arthritis Trial

d MedPage Today

A new way of inhibiting tumor necrosis factor (TNF) for treating rheumatoid arthritis showed strong results in a phase II/III clinical trial, researchers said.

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Study of new onset #RA & undiff arthritis pts starting Rx 2005-2010; mean F/U 104 mos, 11% died. Steroids (<7.5/d) given to 44% initially, ultimately 57% w/ 20% recv >7.5/d. Steroids did not increase mortality (HR 1.35 ; 0.74, 2.47) or hospitalization https://t.co/KNpobs1UwH https://t.co/sjddMBKOeE

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It's time to exonerate methotrexate in causing or exacerbating fibrotic interstitial lung disease in #RA patients https://t.co/AuEIWn8Pc4 https://t.co/razVTF6fFX

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Metanalysis of 7 studies shows that oral anticoagulants need not be discontinued for joint injections or aspiration. Only pts w/ hemorrhage after 5427 procedures, over 32-yrs. INR values of 3 bleeding cases was 1.9, 2.3, and 3.4. https://t.co/pCxDqzXGHQ https://t.co/ExZkXSliFo

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Modest Benefits of Diet on Arthritis A EULAR taskforce reviewed the literature on the effects of diet and lifestyle behaviors in RMDs, and found little evidence suggesting dietary factors can substantially affect the outcomes in people with RMDs. https://t.co/D31l7dlq9v https://t.co/Kt80Yp74ro

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Two Week Methotrexate Hold with COVID-19 Vaccination

d Jack Cush, MD

A cohort study of rheumatoid arthritis (RA) patients evaluated immunogenicity of COVID vaccination with and without holding methotrexate (MTX) for and 2-weeks and showed better immunogenicity, but more RA flares with the second MTX withdrawal. 

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Japanese claims data study looked at hospitalizable infections (SIE) in RA pts based on age: young (16-64 y), old (65-74y), very old (>75y) and showed age related increase in SIE - 3.2, 5.0, and 10.1 SIE/100PY, respectively. (#s unaffected by biologic use)https://t.co/deaGy3g0Ai https://t.co/2A5mB8n4FK

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Military biobank of serial serum samples was used to identify biomarkers of imminent RA (vs reactive arthritis or healthy controls). Soluble programmed cell death receptor-1 (sPD-1) best predicted seropos. RA w/in 6mos of Dx. Specif >89%; sensitivity 48% https://t.co/djOGhLeCIi https://t.co/DzKqwteQku

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Burnout Threatens the Rheumatology Workforce Conundrum

d Jack Cush, MD

There is a shortage of rheumatologists in Canada and the recent 2020 Canadian Rheumatology Association (CRA) Workforce and Wellness study shows that the shortage may be compounded by rheumatologist burnout, especially among young and female physicians. 

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CC Genotype and Thiopurine Toxicity

d Jack Cush, MD

Annals of Internal Medicine reports that thiopurine toxcicity risk is associated with the "CC" genotype and that azathioprine discontinuation was associated with hematopoietic toxicity and lower thiopurine doses. 

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#EULAR2022 has concluded but you can find all our coverage here https://t.co/s62OVJPQ86 https://t.co/QAvPQYCABj

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Two Week Twitter (6.17.2022)

d Jack Cush, MD

Dr. Jack Cush does a 2-week review of RheumNow Tweets on news and journal citations worth noting, along with some opinions on Telehealth, manpower, monkeypox and the price of drugs.

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Not All RA Drug Classes Are Created Equal

d MedPage Today

Clear differences were apparent among the three major types of targeted medications for rheumatoid arthritis (RA) in a large European registry study.

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Balance and falls studied in 228 #RA pts (24-85 yrs) followed x 1yr; 20% had at least one fall; risks included Age (OR 1.04), HAQ (OR 1.62), low FICSIT-4 score (OR 2.38) & 1-leg standing (OR  2.14). 1-leg stand is a good screening tool https://t.co/u9v8unC0gA https://t.co/oD0sgFxiQm

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Small study 34 biologic-naive RA pts starting abatacept. Remission achieved 47.1% of early and 23.5% established RA. Remission @ 6 mos predicted by Baseline LOWER IL-6 levels ≤ 8.4 pg/ml, (66.7%) and CD4+CD25+FoxP3+ cells ≥ 6% (83.3%) https://t.co/N93E9M4M15

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