Dr. Jack Cush reviews the news and journal articles from the past week on RheumNow.com. Regulatory approvals, update on global rheumatology alliance, smoking and psoriasis, gabapentin let down and defining difficult RA.

‘Difficult-to-treat RA’ is an oft-used term that carries various clinical qualities and therapeutic disappointments. A EULAR Task Force was established to develop recommendations for the management of difficult-to-treat rheumatoid arthritis and as a first step, have put forth their definition of this rheumatoid arthritis (RA) subset.

TB reactivation and latent tuberculosis infection (LTBI) are warned against with biologic agents, especially TNF inhibitors; yet clinical trial data now shows that the risk of LTBI with IL-17 inhibition via secukinumab is uncommon.

The interstitial lung disease that develops in a subset of patients with systemic sclerosis tends to be heterogeneous, with the majority of patients experiencing a slow pattern of decline in lung function, analysis of outcomes in the European Scleroderma Trials and Research (EUSTAR) database found.

Numerous previous studies have questioned the efficacy or protection afforded by hydroxychloroquine (HCQ) for COVID-19 and studies have show that HCQ has failed when given as post-exposure prophylaxis to health care workers (HCWs).  A new randomized controlled trial has shown that HCQ failed when given as 8 weeks of pre-exposure prophylaxis in hospital-based HCWs exposed to patients with COVID-19 patients. 

The anti-interleukin agent romilkimab showed significant benefits on skin fibrosis among patients with systemic sclerosis in a phase II trial, researchers reported.