Are We Overcautious With TNF Inhibitors in Pregnancy?

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What may seem like a prudent approach to treatment of inflammatory bowel disease (IBD) in pregnant women actually represents an overabundance of caution, suggested researchers who found no increased risk from tumor necrosis factor (TNF) inhibitors.

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ACR's State-by-State Report Cards for Rheumatic Disease

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New report examines access, affordability, and activity and lifestyle factors in all 50 states and the District of Columbia, evaluating how easy it is to live with a rheumatic disease in your state. No state scored an "A" or "F", and only two states improved their 2018 grades.

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Spanish SpA Registry (REGISPONSER) - 18.3% had psoriasis; w/ 3/4 of these (76%) having PSO before MSK Sxs. Pts w/ PSO before MSK Sxs had shorter dz duration, lower BMI, Less B27 & anterior uveitis, more dactylitis and ^risk PsA dx (78% vs 56%) https://t.co/sz9nKkDoEX https://t.co/B0TmMqZpoY

CD19 CAR T Cell Therapy in SLE (9.16.2022)

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The big news this week: the approval of deucravacitinib (a new class of drug?) for psoriasis; the 2022 ACR guidance on glucocorticoid-induced osteoporosis; a national poll of older adults over the age of 50 who claimed self-reported or doctor-diagnosed arthritis; and much more. Let's review these and other news, journal reports and announcements from this past week.

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Open label, noninferiority study TNFi withdrawal in 64 PsA & 58 axSpA pts. 2/3 tapered by dz activity T2T strategy (N=81) & 1/3 continued TNFi. At 12 mos. LDA seen in 69% w/ Tapering (~avg 53% dose) vs 73% no-tapering group (91% dose) https://t.co/K6WFaesyRt https://t.co/zqo6nVGtqW

534 PsA & 470 AS pts (SERENA study) on Secukinumab for avg of ~88wks - 5.8% PsA & 8.9% AS pts had sudden stop of SEC (for avg ~25wks) (reasons? Mostly AE 58% or pt decision 10%). While TJC & SJC increased, dz control returned w/ restarting SEC https://t.co/GFxj3b06Ra https://t.co/B2ubakq8Ql

The 2022 ACR abstracts are published and posted for you. Let the Learning begin! https://t.co/ZqMAc8jV3U https://t.co/3iCGnzsPI5

Nice table from the Poddubny et al., (2021) study which looks at some of the different characteristics between Axial SpA vs Axial PsA. Axial PsA tends to have; - Less frequent IBP - Less HLAB27 +‘ve - More frequent C-spine involvement https://t.co/XXQKBSfSQq

The ACR is developing a new clinical practice guideline for systemic autoimmune rheumatic disease with interstitial lung disease (ILD). The Call for Public Comment is open until September 29, 2022. https://t.co/UxXDbGEQlh https://t.co/zGoBpbKLTC

Spanish SpA Registry (REGISPONSER) - 18.3% had psoriasis; w/ 3/4 of these (76%) having PSO before MSK Sxs. Pts w/ PSO before MSK Sxs had shorter dz duration, lower BMI, Less B27 & anterior uveitis, more dactylitis and ^risk PsA dx (78% vs 56%) https://t.co/xchK5ETmg3 https://t.co/F9klsUE5er

Does Fibromyalgia Need B12? (9.9.2022)

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Can we predict the bad outcomes? Like when ITP evolves into SLE; or when psoriasis will develop arthritis; or if Sjogren's will develop lymphoma? Let's dive in and review these journal reports and this past week's news from RheumNow.com.

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How to predict IBD in AS/SpA? Study of 82 SpA pts undergoing colonoscopy showed: Rectal bleeding, diarrhea, abdominal pain, high Dz activity and calprotectin levels were suggestive of abnormal ileum inflammation and risk of IBD https://t.co/10PKp7uwmx https://t.co/tnU5tu6Ffp

Spanish SpA Registry (REGISPONSER) - 18.3% had psoriasis; w/ 3/4 of these (76%) having PSO before MSK Sxs. Pts w/ PSO before MSK Sxs had shorter dz duration, lower BMI, Less B27 & anterior uveitis, more dactylitis and ^risk PsA dx (78% vs 56%) https://t.co/b9Qa6fL9eM https://t.co/6nRu0iuP1a

Rheums! Have a Rheumatology question or case for Jack Cush? Record it here and we may feature it on an upcoming podcast. Tell us your name and where you practice rheumatology. https://t.co/1aSrRsLkel https://t.co/gmh155ty6w

✅ Probably one of my most important slides ⬇️ WHY IS MY #TREATMENT NOT WORKING (or not working enough) 😭 This is really a question we're dealing with everyday in #rheumatology when taking care of patients with #autoimmune and other rheumatic diseases 👍 https://t.co/osUPYSvuWf

Axial Psoriatic Arthritis and Ankylosing Spondylitis with Psoriasis A cohort analysis from Toronto suggests that axial psoriatic arthritis (PsA) is distinctly different from axial ankylosing spondylitis (AS) with psoriasis.https://t.co/8bAoqp79Mg https://t.co/K2Z1LwPTiS

NICE has approved upadacitinib (Rinvoq) for availability in England & Wales for use in adults w/ active ankylosing spondylitis not controlled with conventional therapy, only after TNF inhibitors are tried or not suitable https://t.co/MV47NPb2EF https://t.co/9Le2Sj5aNI

Axial Psoriatic Arthritis and Ankylosing Spondylitis with Psoriasis

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A cohort analysis from Toronto suggests that axial psoriatic arthritis (PsA) is distinctly different from axial ankylosing spondylitis (AS) with psoriasis.

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Favorable Pregnancy Outcomes in Spondyloarthritis Pregnancy often occurs in women with axial spondyloarthritis (axSpA), and a recent cohort study suggests outcomes are generally better than what had been reported in the literature. https://t.co/piAjx1Ugsu https://t.co/N6SGYOM6F1

Managing JDM with Calcinosis

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Dr. Jack Cush reviews the news and journal reports from this past week on RheumNow and discusses a case of refractory juvenile dermatomyositis with calcinosis.

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