AS/Spondyloarthritis

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.

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.

A cohort analysis from Toronto suggests that axial psoriatic arthritis (PsA) is distinctly different from axial ankylosing spondylitis (AS) with psoriasis. Researchers examined two PsA and AS cohorts -  patients with PsA with axial disease and isolated axial patients with AS with psoriasis. 

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.

Pregnancy often occurs in women with axial spondyloarthritis (axSpA), and a recent cohort study suggests outcomes are generally better than what had been reported in the literature. Data was collected from axSpA patients from 4 registries who were pregnant. This included a total of 332 pregnancies from 304 axSpA women (mean age 31 years; disease duration 5 years).  Recorded outcomes included:

Global age-standardized mortality rate (ASMR) for 1000000 was for 0.13 for AS, 0.04 for PsA, 0.86 for CD and 0.76 for UC. Using mortality data from the World Health Organisation (WHO), researchers showed that over time, while there has been no change in age-standardized mortality rates (ASMR) for patients with ankylosing spondylitis (AS), ASMR were decreased for IBD patients (Crohn's disease [CD] and ulcerative colitis [UC]).

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.

Patient-reported fatigue is high in patients with psoriatic arthritis (PsA) and often goes under-recognized by physicians. Fatigue importantly impacts physical functioning, work productivity, and health related quality of life (HRQoL).

Dr. Jack Cush reviews the news, FDA approvals, journal articles from the past week on RheumNow; plus viewer questions. This week great hopes for vitamin D, the great unknows of CSA and the great big mess that is the gout.

The ACR has posted a new ACR Clinical Practice Guideline Summary providing recommendations on the use of vaccinations for children and adults with rheumatic and musculoskeletal diseases (RMDs). This guideline builds on past ACR vaccination guidance, last published in 2021.

The janus kinase inhibitor, upadacitinib, has been shown to significantly improve the signs and symptoms of non-radiographic axial spondyloarthritis (nr-AxSpA), extending the efficacy of UPA beyond classic ankylosing spondylitis.

For about one in six people considered healthy with no reports of back pain, lesions were visible on MRI in the lower spinal column and sacroiliac joint, researchers said -- a sign that rheumatologists should be cautious about diagnosing spondyloarthritis (SpA) on the basis of imaging.

Adding a corticosteroid shot to exercise therapy significantly improved symptoms of chronic Achilles tendinopathy, a 100-person randomized trial found.

For 2022, let's look our top 10 list of advances, game-changers, worries and those better medical practices that evolved during 2021.

This year at EULAR 2022, there were important and interesting topics in Axial Spondyloarthritis (AxSpA). These are my picks of abstracts from the conference.