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RheumNow Podcast – As Good As I Ever Was (7.2.2021)
Dr. Jack Cush reviews the news and journal reports from this past week on RheumNow.com.
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Neuropsychiatric Events Common in Lupus
Neuropsychiatric (NP-SLE) or CNS lupus events range from mild to severe; several recent studies have noted that NPS lupus is common and should be screened for.
A metanalysis of the literature finds 22 studies wherein the mean frequency of NPSLE ranged from 10.6% to 96.4%. When researchers with the Swiss SLE cohort study looked at their population, NPSLE was found in 28.1%. This included cerebrovascular insults, seizures and psychosis.
New ACR Rheumatoid Arthritis Guideline: Emphasis on Methotrexate
The American College of Rheumatology (ACR) has issued new guidelines on the treatment of rheumatoid arthritis, addressing questions about initial treatment with methotrexate and minimizing reliance on glucocorticoids.
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The Potential of Rituximab Efficacy in Systemic Sclerosis
Rituximab (RTX) has been in the news a lot lately; more surprisingly for its potential benefits in progressive systemic sclerosis (SSc).
Ebata and colleagues have published the results of a double-blind, randomised, placebo-controlled trial comparing intravenous RTX to placebo in 56 SSc patients. Patients had to have a modified Rodnan Skin Score (mRSS) of 10 or more. The primary endpoint was the change in mRSS at 24 weeks.
ACR Stands Against Insurer Mandated Infusion Locations
The American College of Rheumatology (ACR) has released an updated position statement on patient safety and site of service for biologics outlining several reasons why the ACR strongly believes infusions should be administered in a monitored health care setting with onsite supervision by a provid
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RheumNow Podcast – Modern Treatment of RA Pregnancy (6.25.2021)
Dr. Jack Cush reviews this week’s news and journal reports featured on RheumNow.com.
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Dr. John Cush RheumNow ( View Tweet)
Knee Replacement in Obese OA is Cost Effective
Debates over ideal candidates for total knee replacement (TKR) in osteoarthritis patients often excludes those who are obese, but a recent article in the Annals of Internal Medicine suggests that TKR is both effective and cost-effective in obese patients (BMI >40 kg/m2) with
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Pain Persists in RA, Even Without Inflammation
One-third of patients with rheumatoid arthritis had unacceptably high levels of pain 5 years after diagnosis, often despite low levels of inflammation, Swedish researchers found.
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Better Outcomes with Modern T2T in Pregnancy
With the expansion of knowledge regarding the safety of newer agents in pregnancy comes the PreCARA study showing that when pregnancy is planned and patients with rheumatoid arthritis (RA) are treated with a modified treat-to-target (T2T) approach, superior outcomes can be anticipated.
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Progression from Psoriasis to Psoriatic Arthritis
The question of whether psoriasis is a state or pre-clinical psoriatic arthritis has been addressed by several studies; with one suggesting that biologic use in psoriasis may aver the future development of psoratic arthritis (PsA).
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FINCH 1 Trial Filgotinib in Rheumatoid Arthritis
The Annals of Rheumatic Disease has published the results of a head-to-head trial showing that the Janus kinase-1 (JAK1) preferential inhibitor filgotinib was superior to a tumour necrosis factor-α inhibitor (adalimumab) in active rheumatoid arthritis (RA) on methotrexate (MTX).
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Treatment of MIS-C COVID in Kids
The NEJM has published results of a real-world efficacty trial showing that COVID infected children with the multisystem inflammatory syndrome in children (MIS-C) respond better to initial IVIG plus glucocorticoids (than IVIG alone) which was associated with less subsequent cardiovascular co
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Tofacitinib Efficacy in COVID-19 Pneumonia
NEJM has published the results of an observational trial wherein tofacitinib given to patients hospitalized with Covid-19 pneumonia, was shown to significantly lower risk of death or respiratory failure.
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Do B-cell targeted therapies still have a place for the treatment of Sjogren’s?
B-cells play a major role in the pathogenesis of primary Sjogren’s syndrome (pSS) through antibody-dependent and antibody-independent functions, as well as evident by progression to B-cell malignancies/lymphoma. Hence, targeting B-cell is attractive. Despite efficacy of B-cell depleting therapy with rituximab in Phase II trials and case series, it failed to meet its primary endpoint when investigated in two Phase III trials. It is worth noting that the primary endpoint used in both trials was a subjective measure. Post-hoc analyses however showed greater improvement in objective measures such as salivary flow rate and salivary gland ultrasound score in RTX-treated group vs placebo.
Therefore, do B-cell targeted therapies still have a place for the treatment of pSS?
EULAR 2021 – Day 4 Report
It's been nearly two weeks since EULAR 21 ended. There were several presentations on the last day; notably, the late breaking abstracts and others. Here are a few of my favorites from Day 4, the final day of the meeting.
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Problems at the FDA
"While the Food and Drug Administration decision on new drugs usually follows the recommendations of the advisory committee..."; this oft used proviso is used to either indicate a pending FDA decision or an FDA decision that is contrary to the recommendation of the advisory committee co
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