AS/Spondyloarthritis

Chronic low back pain is a common complaint that brings patients to the doctor’s attention. Although the majority of low back pain is mechanical in nature, an important minority is inflammatory in nature. Therefore, prompt referral to a rheumatologist is warranted particularly in the presence of other features suggestive of axial spondyloarthritis (axSpA).

Acute anterior uveitis is the most common extra-musculoskeletal manifestation in axial spondyloarthritis (axSpA) affecting up to 50% of patients in some age groups. AAU can have a significant impact on quality of life with risk of permanent visual deficits if not adequately treated. 

The FDA recently announced approval for intravenous secukinumab (Cosentyx) for adults with psoriatic arthritis, ankylosing spondylitis, and non-radiographic spondylitis. Data for this new approval will be presented at ACR Convergence on November 14th by Dr. Atul Deodhar.

The RheumNow faculty reporters have been scouring the meeting for what they believe to be the best presentations from the first day at ACR 2023 in San Diego.  From hundreds of online presentations, the poster floor and the plenary podium, here are some of the best abstracts from Sunday Nov. 12th. You can spot these on Twitter by looking for the (#ACRbest) hashtag.

Abstract #0494 provides context to our continual search for better understanding of inflammatory bowel disease in patients with AS, nr-AxSpA, and PsA.

A lot of interesting studies will be presented at the poster sessions on Sunday, November 12 and some of them address practical real-world issues such as treatment intensification and the impact of pregnancy on axSpA imaging. 

In clinical practice, pulmonary manifestations of rheumatic medical diseases such as rheumatoid arthritis (RA), psoriatic arthritis (PsA), and peripheral spondyloarthritis (pSpA) are typically not screened for upon diagnosis of a rheumatic disease in patients without any signs or symptoms suggestive of pulmonary involvement.

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). 

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