Great and Not So Great (9.30.2022)

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This week it's the great and not-so-great on gout, chondrocalcinosis, osteoporosis and misdiagnosis. We are good at many of those things - what's not so great? Let's review the news and journal reports from the past week on RheumNow.

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Efficacy and Safety of JAK Inhibitors in Psoriatic Disease

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There is a growing body of evidence demonstrating efficacy and safety of JAK inhibitors in patients with moderate-to-severe psoriasis and psoriatic arthritis, according to a systematic review in BMC Rheumatology.

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VTE Risk from Swedish Rheumatology Quality Register - VTE Prevalnce/1000PY TNFi 5.15; JAKi 11.33; Gen Pop 3.3. VTE adj HR JAKi vs TNFi =1.73 (1.24, 2.42); PE HR 3.21 (2.11, 4.88) and DVT HR 0.83 (0.47,1.45) https://t.co/WclcFpX3aI https://t.co/r1FXSZNcYJ

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

TYK2 Inhibitor FDA Approved for Psoriasis BMS made a mega bet on deucravacitinib, an in-house experimental TYK2 drug, in the leadup to the big Celgene buyout, keeping it while auctioning off Celgene’s top-selling Otezla to Amgen for $13.4 billionhttps://t.co/wPN62jBIvL https://t.co/Cj6svOoiaJ

First In Class, TYK2 Inhibitor FDA Approved for Psoriasis

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Deucravacitinib (Sotyktu), a first-in-class, oral, selective, allosteric tyrosine kinase 2 (TYK2) inhibitor, is the only approved TYK2 inhibitor worldwide and the first innovation in oral treatment for moderate-to-severe plaque psoriasis in nearly 10 years.

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FDA has approvef deucravacitinib (Sotyktu), an oral TYK2 inhibitor, for use in adults with Moderate-to-Severe Plaque Psoriasis. Approval was based on pivotal Phase 3 POETYK PSO clinical trials demonstrated superior efficacy over PBO & apremilast https://t.co/mkRgVZ0Crh https://t.co/833jGV1yO4

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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JAKi inhibit Vaccine responses some - study of 113 RA fully vaccinated pts assess 6wks post 2nd jab - 51 on JAKi and 62 not on JAKi. Pts not on JAK 77.4% had humoral response; 29% less (54.9%) in thos on JAK inhibitors; even more if on MTX + JAKi https://t.co/NtN4XEa2nE https://t.co/0Msto77iUK

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

STING/IFN Activation Promotes ANCA-Associated Vasculitis Progression

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Research presented in the Journal of Experimental Medicine shows that ANCA-associated vasculitis (AAV) may be propagated by pathogenic mechanisms triggering cGAS/STING/IRF3-dependent IFN-I release.

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Review of VTE risk with JAK inhibitors - Tofacitinib: 10mg or 5 mg bid - PE rates 0.5 & 0.3/100PY; higher w/ risk factors, VTE 0.35/100PY - Baricitinib: IR of DVT/PE was 0.5/100PY - Filgotinib: 200mg VTEs 0.2/100PY Most VTE occured in LT extension of RCT https://t.co/xvf0kQUMel https://t.co/Bj6fmkktP7

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

JAK-pot study of 19 registries, 31,846 RA pts Rx w/ new drugs shows equal CDAI efficacy for TNFi (54%), ABA (50%), IL-6i (55%), & JAKi (56%). Most D/C for LOE. Compared to TNFi, JAKi and IL-6i were d/c more for adverse events, less for ineffectiveness https://t.co/FlqPUVdWaC https://t.co/BZnpwtB8SY

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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Rheums! Do you 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/cvmbzknQqA https://t.co/6mX5eRUNuU

Hit Parade Review (8.12.2022)

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We've got a lot to discuss this week: psoriasis; fatigue; sleep; sural nerve biopsies; uveitis and SpA; diet and RA; tofacitinib and the ORAL surveillance study; what not to take with mycophenolate - and more. In what order should these items be discussed? This week the run down is based on popularity, measured by rheumatologist engagements on the website and social media.

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JAK Inhibitors in Difficult Still’s Disease A small retrospective study suggests that patients with difficult to treat AOSD or sJIA may respond well to JAKi agents - presumable by blocking pro-inflammatory cytokines, notably IL-6 and IFN. https://t.co/cH9wb8bPTX https://t.co/Xm7DUC5okk