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Pulse Steroids with Tocilizumab in Giant Cell Arteritis
A pilot study assessed pulse methoprednisolone with weekly subcutaneous tocilizumab (TCZ) in patients with large vessel-GCA (LV-GCA) and showed that a sizeable minority will relapse after the TCZ is discontinued.
Sequential Belimumab and Rituximab in SLE
Could disease control in active systemic lupus erythematosus (SLE) patients be improved by the sequential use of subcutaneous belimumab (BEL) and intravenous rituximab (RTX)? A double blind trial has shown that sequential BEL and RTX was not superior to BEL alone in SLE.
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Less Mortality with GLP-1 Agonists in Rheumatic Patients
A recent article in PLOS ONE has shown that treatment of type 2 diabetes with glucagon-like peptide-1 receptor agonists (GLP-1-RAs) was associated with a significant lowering of risk of all-cause mortality and major adverse cardiovascular events in patients with immune-mediated inflammatory diseases and type 2 diabetes.
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Relapses with Rituximab Maintenance in ANCA-associated Vasculitis
Real-world, retrospective study of microscopic-polyangiitis (ΜPA) and granulomatosis-with-polyangiitis (GPA) patients shows that rituximab (RTX) maintenance was associated with 25% risk of relapse and that lower relapse rates was seen with RTX plus cyclophosphamide treatment.
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Biologic Rx may be less effective in psoriasis pts who are older, smokers, w/ Hi BMI & prior biologic use. Metanalysis of 40 studies, 21 438 PSO pts, and PASI90 responses. Decr Response w/ age (OR 0.99), Biologics (0.44), BMI 30+ (0.57), smoking (0.81) https://t.co/uhFFIwNKB7 https://t.co/LaznQ0M9UG
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Pulse Steroids with Tocilizumab in Giant Cell Arteritis
A pilot study assessed pulse methoprednisolone with weekly subcutaneous TCZ in patients with large vessel-GCA (LV-GCA) and showed that a sizeable minority will relapse after the TCZ is discontinued.
https://t.co/gGrSY3U1t9 https://t.co/zuspadaY9t
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Overview of Cannabinoids for Rheumatic Pain disappoints because not much is really known or studied well. They may improve pain, but come w/ mild-mod side effects. Conflicting evidence contributes to practitioner and patient uncertainty https://t.co/eI07SXbbem https://t.co/ZDvdFcLXh4
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Metanalysis of 50 RCTs (3,231 pts w/ lupus nephritis (LN) related starting pred dose to rates of complete response (CR), serious infections, & death. PO pred 25 mg/D assoc w/ 20%, 3.2% & 0.2%, respectively. Pred 60 mg/day incr rates to 35%, 12% & 2.7% https://t.co/6FH9BWsmaz https://t.co/0cQPAIuvRw
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ASLeap: Higher Dose Secukinumab in Ankylosing Spondylitis
Ankylosing spondylitis (AS) patients not responding to usual dosing with secukinumab (150 mg) after 16 weeks were dose escalated to SEC 300 mg, but failed to show improvement by week 52.
https://t.co/EJvoBlW9or https://t.co/tYb1fIA3pw
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Metanalysis of 16 RCTs shows febuxostat reduces the risk of kidney events (RR = 0.56, 95% CI 0.37-0.84, p = 0.006) and a slower decline in eGFR (vs controls) https://t.co/9YAxTrHFVQ https://t.co/ZyRE7R6P4a
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Anti-CD40 Therapy in Sjögren's Disease
Iscalimab, a CD40 monoclonal antibody, showed + results in treating Sjögren's disease, an autoimmune condition lacking effective therapy. The TWINSS study demonstrated iscalimab's safety/efficacy in a phase 2 trial.
https://t.co/aanI9K83XP https://t.co/qJhgHDFCVY
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Pregnancy, menopause, contraceptives, hormone replacement, aromatase inhibitors may affect lupus outcomes. Review says hormone therapies are contraindicated w/ antiphospholipid syndr, APL Ab positivity, and uncontrolled SLE or flares https://t.co/bZQr8b871n https://t.co/OmXY04GR4p
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Romosozumab vs. Teriparatide in Postmenopausal Osteoporosis
The effectiveness/safety of ROMO and TPTD were compared in a clinical setting, and ROMO showed greater increases in BMD than TPTD after 12 months of therapy, along with a higher completion rate.
https://t.co/iKKLruiiay https://t.co/vPKa8pom7e
Dr. John Cush RheumNow ( View Tweet)
Favorable results from Vasculitis Pregnancy Registry; enrolled 147 women, 149 pregnancies; data on 78 pregs. 36% had active vasculitis during Preg, 14 hospitalized (4 w/ vasculitis. 74% Rx vasculitis meds during preg & 97% live births, 21% preterm https://t.co/rq2Y4ij0OW https://t.co/wmmFPvlOGY
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Breast CA (BC) & TNFi - study of 2 cohorts (Optum commercial * SEER/Medicare) found that 17% & 16% of BC pts received TNFi. 1 yr overall survival was no different +/- TNFi (HR= 0.77 & 0.84); but BC survival better on TNFi (HR 0.28; 0.08–0.98) vs csDMARDs. https://t.co/cGqT80rGTR https://t.co/n7i5VNFkVT
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Prescription Painkiller Misuse in Chronic Pain Patients
A new scientific review has found that nearly 1 in 10 patients experiences opioid dependence or opioid use disorder and nearly 1 in 3 shows symptoms of dependence and opioid use disorder.
https://t.co/DnUe1l51bS https://t.co/G4RPg8eqqe
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Full Read Overview of the safety of bDMARDs/tsDMARDS - contraindications, precautions, & boxed warnings for treatment of RA, PsA, SpA, JIA - safety checklist for a class of drugs you use and diseases you treat https://t.co/5chrS3sW8i https://t.co/twSv4Zs9r3
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Relapses with RTX Maintenance in ANCA-associated Vasculitis
A real-world study on ΜPA and GPA patients found that RTX maintenance had a 25% relapse risk, with lower rates when combined with cyclophosphamide treatment.
https://t.co/bD6u5JWVqS https://t.co/CSotJt4in1
Dr. John Cush RheumNow ( View Tweet)
EU study of 1052 systemic sclerosis pts failed to show early immunosuppressive use (vs late) lowered ILD risk. Early Rx (Dz Dur < 3yrs) group (n=547, 52%) more male, diffuse Dz, 60% Rx w/ MTX (1.7% biologics); ILD in 47% after3.6yrs (HR 1.13;0.93–1.38) https://t.co/PtQlgyX0TE https://t.co/R7X3zvPvIg
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FDA issued draft guidance, which, if implemented, would remove requirement for a switching study for demonstrating biosimilar interchangeability. Citing research showing no additional safety concerns if pts switched from reference biologics to biosimilars https://t.co/MBvI4yxajW https://t.co/sEE654E2rl
Dr. John Cush RheumNow ( View Tweet)
