Anti-Rheumatic Rx

The American College of Rheumatology (ACR) expressed concern that the conversion factor included in the Centers for Medicare and Medicaid Services (CMS) CY 2024 Medicare Physician Fee Schedule and Quality Payment Program final rule is insufficient to address rising inflation.

A prospective study of first line use anakinra in systemic juvenile idiopathic arthritis (sJIA) proved to be effective and without potentially allergic lung reactions.

Dr. Jack Cush reviews the news, journal reports and regulatory approvals from the past week on RheumNow.com. Study of LATE-onset RA (>65y), shows DMARD initiation is low in LORA;  despite current clinical practice guidelines recommending early aggressive Rx. Among 3,373 LORA pts (age77 yrs),  only 29% initiated on a DMARD. https://bit.ly/47dT6x6

JAK inhibitors are known to increase the risk of herpes zoster infections between between 3-5 fold.  Two recent reports suggest variable efficacy when JAK inhibitor (JAKi) treated patients are vaccinated with the recombinant herpes zoster subunit vaccine (RZV). 

Safety risks found in a postmarketing trial with the Janus-associated kinase (JAK) inhibitor tofacitinib (Xeljanz) appear to have influenced prescribing patterns across the class for rheumatoid arthritis (RA) patients in the Veterans Affairs (VA) health system, researchers found.

A JAMA systematic review and meta-analysis has showed the use of JAK inhibitors (JAKi) in immune-mediated inflammatory skin diseases was not associated with increased risk of all-cause mortality, major adverse cardiovascular events (MACE), or venous thromboembolism (VTE) (compared to the placebo or active comparator cohorts).

The treatment of de Quervain tenosynovitis (DQT) was examined  by systematic review in JAMA, suggesting that local (US-guided) corticosteroid injection plus a thumb spica immobilization was associated with significant pain-relieving and functional benefits. 

Another infliximab biosimilar has been FDA approved, but this new version of Inflectra can be given subcutaneously for patients with inflammatory bowel disease.

Dr. Jack Cush reviews RheumNow's top entries the PMR Campaign, news, journal reports and regulatory actions. #PMR Polymyalgia rheumatica is very common, yet there is little research on the Dx & Management of PMR by #PCPs! Mayo study prevalence 701 per 100,000 (women=870 and men =508 per 100,000 population). https://t.co/7JZFeRPRnn

Among patients with systemic lupus erythematosus (SLE), high titers of anti-phospholipid (aPL) antibodies were most prevalent in whites and Latinos and less so for Black and Asian individuals, researchers found.

The ACR has published its updated recommendations for prevention and treatment of glucocorticoid-induced osteoporosis (GIOP) for patients receiving >3 months treatment with glucocorticoids (GCs) ≥2.5 mg daily. Despite increasing treatment options to prevent and treat GIOP, many GC-treated patients are not evaluated or treated.

Dr. Jack Cush discusses the news, journal articles and regulatory actions. This week we discuss JAKne, DLE and SLE and more.