I recently overheard a very good practicing rheumatologist complain, “why do I need yet another drug for psoriatic arthritis? I have more treatment choices than I have actual PsA patients who need a new or better drug”.

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.