IL-6

Not all patients with periodic fevers fit neatly into diagnostic categories. Some can be diagnosed as Still’s disease (based on criteria) while others can be classified as autoinflammatory diseases (AID) and some may be unclassifiable, clinically or genetically.

This week's NEJM has published the efficacy results of a large phase 3 trial of olokizumab, a humanized monoclonal antibody that directly targets IL-6 in patients with rheumatoid arthritis. This is in contrast to two other marketed IL-6 inhibitors (sarilumab, tocilizumab) that bind to the IL-6 receptor.

A population-based study from Ontario, Canada suggests an increased mortality risk in patients with giant cell arteritis (GCA), according to a recent report in Arthritis Care & Research. A health administrative data study looked at 22,677 GCA patients (≥50 years of age) compared to an age matched population for mortality rates between 2000 and 2018. Standardized mortality ratios (SMRs) were estimated.

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.

Tan and Buch have reviewed the approach to difficult to treat rheumatoid arthritis (D2T-RA), with a new EULAR definiation of D2T-RA to foster an approach rationale and concideration of treatment options.

Dr. Jack Cush reviews the news, journal reports and rheumatologist cases from the past week on RheumNow.com. This podcast is brought to you by StillsNow.com - be sure to sign up for our monthly StillsNow email and Monthly StillsNow Podcast.

Dr. Jack Cush covers the news and journal reports from the past week on RheumNow.com. This week we have Insights NAFLD, overdose deaths, septic arthritis, refractory stills, & when MTX doesn’t work.

What is the classic 'triad' of Still's disease? Does it affect males and females equally? What are typical lab findings? Which drugs are effective at treating Still's, and as importantly, which ones are not? What about complications? Read on for these and other FAQs regarding Still's disease.

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

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.

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…

For autoimmune patients with a history of malignancy, the initiation of biologic or targeted synthetic disease modifying agents (bDMARD/tsDMARDs) may provoke concern. While data for biologic medications and malignancy risk has been largely reassuring, clinical trials have often excluded patients with history of cancer.

Infiltrating macrophages expressing IL-6 and GM-CSF may drive the subacromial bursitis often seen in polymyalgia rheumatica, according to new research (abstract OP0015) presented on the first day of EULAR 2022 in Copenhagen.