Best of 2021: Potential Birth Defects with Hydroxychloroquine

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HCQ is one of the safest meds used in rheumatology, but new claims data suggests a small increase in the risk of malformations associated with first-trimester HCQ use. The March 2021 issue of the American Journal of Obstetrics and Gynecology studied the risk of major congenital malformations during the first trimester of pregnancy in women with rheumatic disease taking HCQ.

Indications Awaiting (12.17.21)

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There's good news and bad news in rheumatology fellowship matching for 2022.  There's also new FDA approvals and indications, but a new serious safety warning has arisen from the CDC about the J&J COVID-19 vaccine. 

Dr. Jack Cush reviews the latest news, journal reports, regulatory approvals, plus 3 new cases from rheumatologists.

Certain Cancers Increased with Autoimmune Diseases

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Rheumatologists are well aware that inflammation and immune dysregulation are prime contributors to cancer risk, but do oncologists carry the same impressions? A large study from JAMA Oncology shows that patients with immune-mediated diseases (IMD) have an overall increased risk of cancer, especially in organ-specific immune-mediated diseases. 

Rinvoq FDA Approved for Active Psoriatic Arthritis

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The FDA has approved upadacitinib (Rinvoq) today for use in the treatment of adults with active psoriatic arthritis (PsA) who have had an inadequate response or intolerance to one or more tumor necrosis factor (TNF) blockers.

T2T Debate - A Prologue with Dr. Marty Bergman

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Drs. Jack Cush and Martin Bergman review the topic of treat-to-target (T2T) management in rheumatology.

Both will debate the pro's and con's of the T2T strategy at the upcoming RWCS meeting on Feb. 17, 2022.

Monitoring Infliximab Drug Levels Improves Efficacy

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Should we start considering therapeutic drug monitoring when prescribing TNFi for treatment of our rheumatologic conditions?

FDA Puts Boxed Warnings on JAK Inhibitors

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Based on the safety review of tofacitinib in Pfizer's Oral Surveillance (1133) study, the FDA has added serious boxed warnings to all three marketed JAK inhibitors (for inflammatory diseases) and formalized the recommendation that patients should be started on a TNF inhibitor (TNFi) before trying a JAK inhibitor. These recommendations apply to tofacitinib, baricitinib and upadacitinib.

New Insights into Uveitis in Spondyloarthritis

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Uveitis is the most frequent extra-musculoskeletal manifestation (EAM) in Axial Spondyloarthritis (axSpA). The prevalence of uveitis in axSpA is between 25-30%. Up to 50% of patients with an acute episode of uveitis develop recurrent anterior uveitis or iritis.

Risankizumab for Active Psoriatic Arthritis

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The arsenal of therapeutics for psoriatic arthritis continues to increase. Risankizumab is an IL-23 inhibitor to the p19 subunit, currently being investigated for treatment of psoriatic arthritis.

Safety of Psoriatic Biologics in Pregnancy

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Little is known about the safety of newer biologic use during pregnancy, especially in patients who either conceive while on a biologic or must remain on a biologic during pregnancy (often the case with IBD and inflammatory arthritis).