Novel Rx

Mitochondrial constituents and metabolic products may give rise to immune activation; this is especially true for mitochondrial DNA, which can function as damage-associated molecular patterns (DAMPs) leading to inflammasome activation. DAMPs and pathogen-associated molecular patterns (PAMPs) are primary drivers of inflammasome activity.

Placebo responses are to be expected in rheumatoid arthritis (RA) clinical trials, but are such placebo responses affected by continuing background DMARDs like methotrexate (MTX) even though there was an inadequate response (IR) to MTX? 

An open-label, 2 year study evaluated the efficacy and safey (drug retention) of subcutaneous (SC) abatacept (ABA) in active rheumatoid arthritis (RA) and showed superior responses when ABA was given to biologic-naive and seropositive RA patients. 

Dr. Jack Cush reviews the new studies and drug approvals and new insights into febrile disorders from the past week on RheumNow.com Ustekinumab (IL-12/23i) phase 2 study was successful in #SLE; but the phase 3 LOTUS study of 512 pts, UST was NOT superior to PBO (SRI-4 44% v 56%) at 1 year. Study was halted for lack of efficacy (but no safety concerns). https://bit.ly/3RvPzDm

A cohort study suggests that rituximab (RTX) use among patients 75 years and older with antineutrophil cytoplasmic antibody (ANCA)–associated vasculitis (AAV) is efficacious but also has a high risk of serious adverse events, likely related to associated steroid use and the advanced age of the population.

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

Adult-onset Still's presents an interesting and diagnostic challenge when encountered. Here are 5 tips to improve your diagnostic acumen for this febrile disorder.

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

The GRAPPA (Group for Research and Assessment of Psoriasis and Psoriatic Arthritis) treatment recommendations have been updated and the 2021 evidence-based guidance is rich in treatment recommendations based on the key disease "domains" - peripheral arthritis, axial disease, enthesitis, dactylitis, skin and nail psoriasis; with new PsA related domains uveitis and inflammatory bowel disease.

Dr. Jack Cush does a 2-week review of RheumNow Tweets on news and journal citations worth noting, along with some opinions on Telehealth, manpower, monkeypox and the price of drugs. Although Rheumatology currently ranks 2nd or 3rd in specialty use of telemedicine - the vast majority of rheums have given up on telehealth (<15%) https://t.co/iDNesBkOnN

Clear differences were apparent among the three major types of targeted medications for rheumatoid arthritis (RA) in a large European registry study.

The American College of Rheumatology applauds the Federal Trade Commission’s decision to investigate the business practices of pharmacy benefit managers (PBMs), which continue to increase PBM profit margins while placing the burden of skyrocketing drug costs on America’s most vulnerable patients, including those living with chronic and severe rheumatic diseases.

Dr. Jack Cush reviews the top abstracts from EULAR 2022  As chosen by me with the  aid of the RheumNow EULAR faculty. “Top” is relative and subjective, but my criteria for inclusion are based on impact, water cooler talk potential, innovation and social media buzz.  Speaking of social media…

Rheumatologists have long hoped and wondered whether the right type of early intervention could prevent rheumatoid arthritis occurring in at-risk individuals. While it is often a point of substantive discussion at EULAR, this year’s meeting in Copenhagen provided further data on how therapy might useful before patients develop rheumatoid arthritis (RA), particularly for those at particularly high risk.

At the onset of the pandemic, data from the Global Rheumatology Alliance reported increased risk of poor severe COVID outcomes including deaths in patients who were treated with rituximab and baricitinib. With the vaccination program undertaken globally, has this risk been attenuated?