The 2021 Rheumatology Winter Clinical Symposium launched yesterday as a hybrid meeting. As always, this conference lends itself to data for the practical clinician. Here are my pearls about new developments in RA, checkpoint inhibitors and IV IgG taken from several sessions presented on Day 1.
The American College of Rheumatology has published a draft guidance on the use of COVID-19 vaccination in rheumatic disease and musculoskeletal disease patients, based on the efforts of the North American Task force. The document provides guidance to rheumatology providers on the use of the COVID-19 vaccine and the associated management of RMD patients around the time of vaccination. Here is a summary of the recommendations.
RNA sequencing and classification of RA subsets has proven useful. RNA sequencing-based stratification of RA synovial tissue showed stronger associations with clinical responses compared with histopathological classification. Additionally, for patients with low or absent B-cell lineage expression signature in synovial tissue, tocilizumab is more effective than rituximab.
While comorbidities are associated with severe COVID-19 infection, it appears they also influence severity and survival in rheumatic disease (RMD), according to a a French cohort study,
Analysis of a French RMD cohort with SARS-CoV-2 infection analyzed the effect of inflammatory rheumatic and musculoskeletal diseases (iRMD) and therapies on COVID outcomes.
Among children with multisystem inflammatory syndrome (MIS-C), treatment with IVIG and methylprednisolone vs IVIG alone was associated with a more favorable fever course. MIS-C is a rare but serious pediatric condition associated with COVID-19 where different body parts can become inflamed, including the heart, lungs, kidneys, brain, skin, eyes, or gastrointestinal organs.
Knee osteoarthritis (OA) patients using nonsteroidal anti-inflammatory drugs (NSAIDs) showed greater loss of medial minimum joint space width than did others taking other drugs, registry data indicated.
Medicare beneficiaries were increasingly likely to have long-term opioid therapy stopped in recent years and medication changes often were abrupt, not tapered, an observational study showed.
Dr. Jack Cush reviews and discusses the news and journal reports from the past week on RheumNow.com.
There is a preponderance and mounting evidence that hydroxychloroquine is ineffective in COVID-19 infection; and now the NEJM reports a the results of a trial where HCQ given as post-COVID exposure therapy failed to prevent SARS-CoV-2 infection or symptomatic Covid-19 in healthy persons.
The FDA has notified healthcare professionals of a safety alert concerning tofacitinib (Xeljanz), noting that preliminary results from a long-term safety clinical trial show an increased risk of serious heart-related problems and cancer with tofacitinib (compared to adalimumab) when given to at-risk rheumatoid arthritis patients.
For a variety of reasons, the use of anti-malarials (chloroquine and hydroxychloroquine) rose dramatically in the pandemic; notable was the lack of proven benefit and the dramatic risk in reported adverse drug reactions (ADRs) associated with these drugs being used to treat SARS-CoV-2.
The infliximab biosimilar CT-P13, developed by Celltrion and marketed as Remsima has been approved by HealthCanad for subcutaneous (SC) use in all the indications for infliximab. Last year the EMA approved the subcutaneous use of Celltrions Remsima SC; based on the phase I/III study showing equivalence between SC and IV forms in active rheumatoid arthritis (RA).
A longitudinal observational cohort study of psoriatic arthritis (PsA) patients treated with biologic therapy finds relatively low persistence of selected biologic therapy in PsA patients
Lancet Rheumatology has reported the results of a proof of concept trial, wherein vagal nerve stimulation was shown to ameliorate RA disease activity. The intervention involved non-invasive stimulation of the auricular branch of the vagus nerve using a wearable vagus nerve stimulation device for up to 30 min per day, delivering pulses of 20 kHz.
Analysis of the NHANES (National Health and Nutrition Examination Survey) data suggests that one-third of the risk of developing rheumatoid arthritis (RA) in the USA is attributable smoking, obesity and alcohol intake.
