Best of 2021: Tofacitinib Safety Concerns Save

Dr. Jack Cush reviews and discusses the news and journal reports from the past week on RheumNow.com.

1. Metanalysis of 3 cross-sectional & 2 case-control studies shows that the risk of developing #RA is elevated in patients with Crohns colitis (RR = 3.14; 95% CI: 2.46–4.01) and ulcerative colitis (RR = 2.29; 95% CI: 1.76–2.97) https://t.co/TIpd6lh5IZ
2. Vagal Nerve Stimulation in Rheumatoid Arthritis Lancet Rheumatology has reported the results of a proof of concept trial, wherein vagal nerve stimulation was shown to ameliorate rheumatoid arthritis (RA) disease activity. https://t.co/AuoeDLM5rF https://t.co/8Mv7EYlVWZ
3. More on Vagal Nerve Stimulation in RA (https://bit.ly/3cHvMPb) The device used was an earbud, designed to deli)ver electrical pulse sequences to target the cholinergic anti-inflammatory pathway. They called this neural input methodology, e-mmunotherapy https://bit.ly/36FWnbx
4. One-Third Rheumatoid Risk from Lifestyle Analysis of the NHANES data suggests that 1/3 of the risk of developing RA in the USA is attributable smoking, obesity and alcohol intake. https://t.co/jLLmEvXg2O https://t.co/ZG1hcJ7QVJ
5. Abbvie has released data from KEEPsAKE-1 and KEEPsAKE-2 studies (1407 pts) showing Risankizumab (IL--23 inhibitor) is effective in Psoriatic arthritis; RIS Rx pts achieved ACR20 of 57% and 51% at week 24 (vs PBO 34% and 27%; p<0.001) https://t.co/wPQMqLnhOO
6. Metanalysis of 24 studies finds pregnant women, w/ inflammatory disease, exposed to biologics had NO increased risk of congenital anomalies (adj OR 1.18; 0.88, 1.57), but had increased preterm births (OR 1.61; 1.37, 1.89) & low birth weight (OR 1.68) https://t.co/KqTDmfFf9H
7. French study of 782 men (50-85 years) with DISH found DISH was associated with increased vertebral fractures (OR 2.89; 95% CI, 1.15-7.28; P <.05), but Nonvertebral fractures were not associated with DISH (HR 0.72; 0.33-1.56).https://t.co/YoQ8r62pns
8. Multiple intraarticular steroid injxs NO better than placebo. Analysis of 6 RCTs show no diff in pain than PBO (−0.47, 95% CI −0.62, 0.31). 14 RCTs + 2 Observ. studies show IA steroids may cause mor cartilage loss or risk of joint replacement (HR 2.54) https://t.co/jCLq4jWn4Y
9. Low Persistence of Biologics in Psoriatic Arthritis 
10. OpenSAFELY analysis shows that NSAIDs safe w/ COVID. Study 1: 1/2 million NSAID users vs ~2 mill non-users found no difference in COVID-19 death (HR 0.96); Study 2: 1.7 million RA/OA pts, 10% on NSAIDs had a lower risk of COVID-19 death (HR 0.78)  https://bit.ly/3aPHzZx
11. Adverse Events with Anti-malarials during the COVID Pandemic
12. Hydroxychloroquine Fails to Prevent COVID-19
13. Cardiac and Cancer Signals Tofacitinib Safety Alert from FDA 

Editor's note: This podcast appeared February 5, 2021 and is being published again today as part of RheumNow's Best of 2021.