Teaching You How to Think… (8.15.2025) Save

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.

1. Novartis announced top line results of its ianalumab (VAY736;B cell inhibitor) in primary Sjögren’s dz. 2 RCTs, NEPTUNUS-1 and NEPTUNUS-2, met met primary endpoints w/ statistically significant improvements in disease activity in Sjögren’s patients. https://t.co/cIBhF3YJh3
2. 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
3. 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: smoking, PSO, SI, Xray damage. https://buff.ly/vSsdSeU
4. Study of 94 children w/ Enthesitis-related arthritis (ERA) - 45 Tunisian, 49 Turkish. While similar demographics, Turkish ERA had signif. more heel pain (61% vs 9%), enthesitis (69% v 40%), &biologics (50 vs 9%); but Tunisian ERA had more sacroiliitis (91% v 55%), Axial Dz (98% v https://t.co/AKNEYoO0C6
5. 945 consecutive severe psoriasis pts Rx TNFi or nbUVB phototherapy (2005-2010) w/ median F/U > 9 yrs. After propensity matching, incidence of future PsA was 1.18/100 w/ TNFi vs 2.48/100 w/ nbUVB (IRR 2.1; 1.37–2.98, P = 0.0002). TNFi lowered PsA risk (HR = 0.32). PsA predictors https://t.co/aBsXs6RpCY
6. Nailfold videocapillaroscopy (NVC) in Dx of systemic sclerosis - study of 258 NVCs found giant capillaries (specificity 98%) & capillary density to be best at defining a scleroderma pattern (39%). Density ≤8 capillaries/mm best defined dropout (AUC 0.911); having both = 91% accuracy https://t.co/WQx6fbQiAB
7. French OL trial of PCV13 vaccination in 248 early, DMARD Naive RA pts starting MTX @ same time or after 1 month delay. 1 mo delay in MTX resulted in significantly higher responses (46%, 65%) vs. pts vax while taking MTX. Signif responses seen 1 yr later. RA activity equal betw. https://t.co/AnqK89ZJtE
8. PT in RA - Metanalysis of 17 RCTs, 1362 pts Rx w/ aerobic/resistance exercise, hydrotherapy, manual Rx, electrotherapy, multimodal Rx. 5 RCTs (n 307) signif reduced pain (SMD −0.347; interpreted as a small to medium effect favoring PT. https://t.co/UJGSGrgMV0
9. Mayo study of 659 incident RA pts finds Multimorbidity predicted 29% (OR:1.29) higher odds of RA flare, & 34% lower (OR:0.66) odds of remission. RA Flares assoc w/ female, smoking, younger age shorter Dz duration, but not seropositivity. Remission assoc w/ male, not smoking, https://t.co/yEwkQ63zIh
10. 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 stats.https://buff.ly/adrDlNq
11. The Patient Journey with Rheumatic Disease  
12. Wisdom of Medical Aphorisms