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Teaching You How to Think… (8.15.2025)
Dr. Jack Cush reviews the news, journal reports and press clippings from the past week on RheumNow. Positive results in a Sjogren's trial, to PT or not to PT, and aphorisms to live by.
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Advances in Still's disease Rx:
- using IL-1 or IL-6 inhibitors 1st line
- New FDA approval of emapalumab (IFNg) for MAS
- unclear if biologics can cause lung probs in Stills https://t.co/zSqTcOSVGE https://t.co/8GhoamkV4N
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JAKne? Study of 2183 IBD pts on JAK inhib, 272 developed acne. Crude prevalence: 16% upadacitinib, 4% tofacitinib, 2% filgotinib (dose-dependent w/ UPA & Tofa). JAKne in pts 30–50 yrs; mild-moderate severity; in 1st 3 mos. Higher risk w/ prior hx acne vulgaris (OR 4.9) https://t.co/G29CvZ6aux
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NEW EULAR POSTER: Real-world treatment patterns across the first 12 months of first-line advanced therapy in patients with PsA
Compare treatment switching across first-line MOAs and treatments. Sponsored by AbbVie Medical Affairs + Health Impact.
https://t.co/9sDxUeFwNt https://t.co/EaOnZE7zla
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Dermatomyositis Reviewed
Researchers from the University of Pennsylvania have published an open-access review of dermatomyositis (DM) - its manifestations, hallmark cutaneous features, etiopathogenesis and treatment options.
https://t.co/Dm85RL99UU https://t.co/SbaVBWC3Wv
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“A physician is judged by the three A’s: ability, availability, and affability.”
- Paul Reznikoff, MD
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NEW EULAR POSTER: Real-world impact of second-line treatment choice in patients with PsA!
🔎View the effectiveness of different PsA treatment patterns: TNFi to JAKi, TNFi to IL-17i, or TNFi to TNFi. Sponsored by AbbVie Medical Affairs + Health Impact.
https://t.co/OVrLuwT4qa https://t.co/G3KFmWsSVQ
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Inefficiencies of ANA Testing
The Journal of Rheumatology has published an analysis of antinuclear antibody (ANA) multiplex testing showing its nonspecific utility and poor rate of return in identifying ANA-associated autoimmune rheumatic disease (ARDs). https://t.co/85B70egGBw
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📊 PRESENTED AT EULAR 2025: Long-term safety of a JAKi! 📊
View safety across ~17,000 patient-years of data from 11 Phase 3 trials in adult patients with RA, PsA, AS, or nr-axSpA. This poster is sponsored by AbbVie Medical Affairs + Health Impact.
https://t.co/a5Ef4SedXU https://t.co/dcMtye01A4
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Wondering what rheumatoid arthritis experts think about the future of treatment?
Dr. Jack Cush moderates a special Tuesday Nite Rheumatology session, live at 7 PM ET on August 26th, where experts will dive into a nationwide survey on the evolution of biologics and DMARDs.
Hear https://t.co/afYRarqjvj
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Biologic Switching in Psoriasis
A systematic review and meta-analysis found that biologic switching was effective in a significant number of psoriasis patients; but there may be a price to pay.
https://t.co/QEv5jx9AIo https://t.co/06keUfXwRT
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There's a transient (1 yr) increase in New Abx Rx among 399 PsA pts after starting a TNF inhibitor. Pre-TNFi, PsA pts were more likely to recv Abx vs controls (1.26 vs. 0.60/yr; p<0.001). Post TNFi Abx use incr to 1.64/yr (p<0.001) but returned to baseline thereafter. https://t.co/LHXn5d7oC9
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Pain Flares in RA are just pain, not inflammation. Study of 195 RA pts (11+ yrs dz dur), 49-89% experienced at least 1 flare (median 2-4 flares/mo), IQR 2.1-5), lasting median of 2 days. Flares preceded by worsening mood, anxiety, sleepiness - but no change in Accelerometer https://t.co/twI6wcxKf7
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Difficult to manage SpA (D2M-axSpA) defined as failure ≥ 2 b/tsDMARDs (diff MOAs). Study of 129 axSpA pts, 8.5% were D2M, & 3% were treatment refractory (more inflammation- TR). D2M had signif higher BASFI (4.2 vs. 2.9), BASDAI (5.1 vs. 3.5), ASDAS (3.7 vs. 2.8). Predictors: https://t.co/4qdHEFxr3J
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Wisdom of Medical Aphorisms
The American Journal of Medicine and Dr. Joseph S. Alpert have curated insightful aphorisms from leading figures in internal medicine, such as Eugene A. Stead, Jr., Francis Peabody, Paul Beeson, and others, including Alpert. These timeless aphorisms https://t.co/IqjPKmlVAk
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Chondrocalcinosis Increases Osteoarthritis Risk
Analysis of data from two large, prospective cohort studies show that knee chondrocalcinosis was associated with an increased risk of incident knee osteoarthritis.
https://t.co/Jd1Wb9lWpT https://t.co/QwXn2ehNie
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Anifrolumab appears effective & safe in refractory Cutaneous LE. OL Study of 15 CLE, on HCQ, topical steroids, failed multiple DMARDs. All Rx w/ ANIF 300 mg IV q4wks. ALL improved, CLASI-A decr from 16 to 1 (p<0.001); CLASI-D decreased from 5 to 4 (p<0.001). DBPCT needed! https://t.co/zj4cYou7hz
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Systematic review of 47 studies covering 1.5 million cases found that Dx of Crohns, SLE, Type I DM positively associated w/ incr risk of pancreatic, esophageal, colon, liver, and hepatobiliary cancers. MS assoc w/ lower risk of pancreatic, esophageal, rectal, & colorectal CA https://t.co/g0N5eHhJYj
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Rheums Speak: Changing Rheumatology Practices & Choices
RheumNow surveyed clinicians worldwide on how their rheumatology practice, treatment decisions, and career outlooks have changed over the past 20 years. 242 respondents (68% from the USA) shared their perspectives on the https://t.co/g714oow71a
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2025 ACR Guidance on Diagnosis and Management of VEXAS
The ACR has published a formal international consensus guidance on VEXAS as a resource for clinicians seeking to understand the disease and its management.
https://t.co/KoNjOiKdTq https://t.co/9bIZgvP8kD
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