Best Rheumatologists (7.19.2024) Save

This week on the RheumNow Podcast, Dr. Jack Cush reviews the news and journal reports of interesting, including irAE, pollution and Psoriasis, microwave therapy, scleroderma without scleroderma that only the best rheumatologists could discern.

1. Review of checkpoint inhibitors in 23,897 pts w/ CA & autoimmune Dz. AIRD pts had signif more irAEs (RR 1.3), seen in 61% (36% flares). Most were mild-mod, Rx w/ steroids w/ no impact on cancer response. 32% hospitalized; mortality rate 0.07% https://t.co/xVHhwBATWH
2. Study of 478 CA pts Rx w. anti-PD-(L)1 Ab or anti-CTLA4 Ab - 28 (6%) had pre-existing Autoimmune Dz (AI). irAE (w/ checkpoint inhib) were higher w/ preexisting AI (57% vs 35%), but activity of AI was not related to irAEs occurrence. https://buff.ly/3yfgm1M
3. AbbVie has submitted regulatory applications to both the FDA and the European Medicines Agency for Rinvoq (upadacitinib) to treat adult patients with giant cell arteritis (GCA) https://t.co/LqRcm2FEFV
4. Prospective cohort study from 474 055 participants in UK Biobank, finds long-term exposure to air pollutants, NO2 etc, assoc w/ a 19% to 47% increased risk incident psoriasis. Air pollution and genetic predisposition also significantly incr incident PsO https://buff.ly/3Y9yFjD
5. 192 RA pts on MTX: GI Sxs studied w/ MISS (MTX intolerance severity score). GI intolerance seen in 56%, Nausea & pain post-MTX most common. More in afro-descendants, w/ FM, Steroids, or JAKi. MISS results unrelated to Route, Gi Dz, age, MTX dose https://t.co/EROmZQo1Zs
6. 174 Active RA pts not responding to MTX were started on TCZ. High GM-CSF (> 5 ng/ml and > 10 ng/ml) at baseline were the independent predictors of poor response to TCZ at Wk24. high GM-CSF had signif higher DAS28-ESR & cytokine levels at baseline https://t.co/vy7czYwv1Z
7. Retrospective study, biopsy-proven Lupus Nephritis pts - 35 of 115 pts (30%) were ANCA positive. ANCA+ LN pts had higher dz activity, predominantly proliferative LN, require more immunosuppressives (CTX, MMF) to achieve remission. https://t.co/NKPyC7Ri9F
8. Febuxostat is assoc w/ a reduced risk of kidney events and slower decline in eGFR. Metanalysis of 16 RCTs, shows febuxostat w/a reduced risk of kidney events (RR=0.56) & slower decline in eGFR; & reduced urine albumin to creatinine ratio https://t.co/GQ8UopbA88
9. Recurrent chronic monarthritis treatment with microwave ablation (MWA). 22 pts, 24 knees requiring median 5 IA aspirations in the last 6 mos.(total 129) decreased to 7 total in 6 mos post MWA ((0.89 vs 0.03/mo, P < 0.001). No complication. https://t.co/M2N0eFFKvL
10. Intercurrent infections may be assoc w/ SLE flares. 203 Amsterdam SLE pts, incidence of major & minor infections were 5.3 & 64/100Pys. Intercurrent infections (major & minor) were assoc w/ SLE flares (HR 1.9); major infx lead to major SLE flares (HR 7.4) https://t.co/DSPgi9KrwT
11. Systemic sclerosis sine scleroderma 
12. Updated EULAR Recommendations on the Treatment of Systemic Sclerosis  
13. Top 20 Best Rheumatology Hospitals - 2024