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RheumNow Podcast – Rheumatologist Smoke-Enders (10.22.2021)
Today I have a few questions: Is tramadol really a weak narcotic? Should we really still be doing placebo-controlled trials? What are we going to do about our patients who are smokers? This and more, in this week's review of the news and journal articles.
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Smoking Impairs Methotrexate Efficacy
The Journal of Rheumatology reports that current smoking significantly reduces the clinical efficacy of methotrexate (MTX)-based therapy, as studied in an early rheumatoid arthritis (RA) cohort.
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Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis Insights
Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are among the most severe drug reactions, as they come with substantial mortality and morbidity. A review of European centers dealing with SJS and TEN shows that despite best treatment practices, the 6-week mortality rate was 21%.
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Heart Failure in RA: Inflammation Matters
Patients with rheumatoid arthritis (RA) who had high levels of inflammation at baseline were at increased risk for later heart failure, a large cohort study found.
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Is It OK to Continue TNF Inhibitors with COVID-19 Infection?
Registry level data of patients with immune-mediated inflammatory diseases (IMIDs) diagnosed with COVID-19 should continue their TNF inhibitor (TNFi) therapy as such patients were less likely to experience adverse COVID-19 outcomes (compared to other immunomodulatory treatments).
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NOBILITY: a Trial of Obinutuzumab in Proliferative Lupus Nephritis
B-cell depletion therapy with obinutuzumab, a type II anti-CD20 monoclonal antibody, in lupus nephritis patients was shown to be effective in in combination with standard lupus therapies.
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TICOSPA - Does Treat to Target Work in Spondyloarthritis?
Tight-control or treat-to-target (T2T) strategy is advocated in several diseases, but the recent TICOSPA trial in axial spondyloarthritis (axSpA) showed that T2T was not superior to usual care (UC).
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Are You a High or Low Glucocorticoid Prescriber?
A recent analysis shows thta glucocorticoids (GCs), usually recommended for short-term use in rheumatoid arthritis (RA), are variably used by rheumatologists, and that provider preference is a strong predictors of long-term glucocorticoid use.
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RheumNow Podcast – Quackademia (10.15.2021)
Dr. Jack Cush reviews the FDA approvals, news and the latest journal articles from the past week on RheumNow.com.
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2021 Update to EULAR Points on Immunomodulatory Use in COVID-19
EULAR has updated its recommendations (points to consider - PtC) for rheumatologists managing patients during COVID-19; now with 2 overarching principles and 12 PtC.
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Still’s Disease Following COVID-19 Vaccination
Both systemic onset juvenile idiopathic arthritis (sJIA) and adult-onset Still’s disease are acquired autoinflammatory disorders of uncertain etiology. Yet recent reports of AOSD onset and flare following COVID-19 vaccinations may have important mechanistic implications.
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Cancer Risk in Systemic Lupus Erythematosus
Bernatsky and colleagues have shown cancer risk factors in incident systemic lupus erythematosus (SLE).
Researchers analyzed an SLE cohort of 1,668 patients, over an average of 9 years follow-up and found 65 cancers: 15 breast; 10 nonmelanoma skin; 7 lung; 6 hematologic; 6 prostate; 5 melanoma; 3 cervical; 3 renal; 2 each gastric, head and neck, and thyroid; and, 1 each rectal, sarcoma, thymoma, and uterine cancers.
Abatacept After Ustekinumab Withdrawal in Active Plaque Psoriasis
A randomized controlled trial has shown that treatment of plaque psoriasis via costimulatory blockade ( CD28/B7) with abatacept did not prevent psoriasis relapse after withdrawal of ustekinumab.
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Dr. John Cush RheumNow ( View Tweet)
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TNF Dose Reduction Succeeds in PsA, Axial Spondyloarthritis
Patients with psoriatic arthritis (PsA) or axial spondyloarthritis (axSpA) who were doing well on treatment with tumor necrosis factor (TNF) inhibitors were able to successfully taper the therapy when guided by disease activity, a retrospective cohort study found.
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Hepatitis B Reactivation with Rituximab and Abatacept
Hepatitis B reactivation is an uncommon complication of biologic therapy use. Now, a serologic study of rheumatoid arthritis patients shows that HBV reactivation is seen with rituximab, and less so with abatacept, especially in patients without hepatitis B antibody (HBsAb) positivity.
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