Allergic Drug-Induced Arthritis (5.19.2023) Save

Dr. Jack Cush reviews the news and journal reports from this past week on RheumNow.com.  This week we delve into some odd associations, repeat drug warnings and the consequences of antirheumatic therapies.

1. Subanalysis of the tofacitinib ORAL Surveillance study shows the JAK "at-risk" population are patients Age ≥65 years or ever smoker who exhibited the excess adverse events (malignancies, MACE, MI, VTE, all-cause death) comparedd to TNFi (HRs 1.41–5.19) https://t.co/k78WsPR1Mv

2. TNF Inhibitors and Acne?  A literature review found 47 refractory acne pts Rx w/ TNFi; noting partial improvement (94%) or clearance (40%) & only 6% w/ adverse events. 17 pts had new-onset acne after Rx w/ TNFi for a different inflamm Dx. Odd! https://bit.ly/3ocyOmO

3. Lit review of 2236 articles found only 28 reports of 28 pts  w/ Post-COVID autoimmune Dx (64% F; age 51 yrs) - that included 11 (39%) IIM (w/ 4 DM); 7 (25%) SLE; 4 (14%) anti-synthetase syndrome; 4 (14%) SSc; 1 lupus/MCTD overlap. Mean onset 23.7 d post COVID https://bit.ly/3MrcZt6

4. IL-6 for PMR SPARE and SEMAPORE (Toci), SAPHYR (Sari) 2/2023: FDA approves sarilumab for PMR for inadequate response to corticosteroids or unable to taper off Robert Spiera @RheumNow #RNL2023 https://t.co/VtzW01Ez7D

5. Metanalysis of 38 studies(458,256 pts). Diabetes was seen in 19% of hyperuricemic and 16.7% of gout pts - an even higher DM prevalence was seen in North America (20.7%) https://t.co/AYVWaditxG

6. Matched cohort study of 67,598 German primary care Pts shows gout have incr risk of breast cancer (4.5% gout vs 3.7% non-gout; HR: 1.17; 1.05-1.31). Association only seen under age 50 (HR: 1.58; 1.10-2.27), but not in women over 50 yrs https://t.co/pl6gH2GyZQ

7. Chinese study of 4091 SLE pts, 3% (106) dx w/ osteonecrosis (AVN). AVN risk factors included: - SLE onset age ≤ 30 (HR 1.6) - Arthritis (HR 1.6) - Organ damage (HR 2.6) - RNP+ (HR 1.7) - High steroid doses (HR 1.7) https://t.co/DnqhEIWztY

8. Peresolimab's Potential in Rheumatoid Arthritis 

9. Swedish registry review of #MTX initiation in early #PsA vs #RA (n 3642each). 2 years after MTX start, 71% of PsA vs 76% of patients with RA remained on MTX & the majority (66%/60%) had not started another DMARD, or a biologic (77%/74%) https://t.co/nTJO04sn65

10. RCT of 122 active plaque Psoriasis pts (38F, 55M) with low vitamin D (~15). Rx w/ either PBO or Vit D (100K IU, followed by 20K IU/wk x 4 mos). Vitamin D supplementation had no effect on psoriasis severity (but pts had mild PSO). https://t.co/JXtEBaop3c

11. MSK Symptoms from Dupilimab, an IL-4/13 Inhibitor

12. Register for Tuesday Nite Rheumatology Replay of RNL23 session on "Spondyloarthritis Innovations"