Burnout #10 (2.3.2023) Save

Dr. Jack Cush reviews the past week of news on RheumNow.com.

1. Swiss RA registry assessed outcomes after 1st JAKi. 400 RA pts starting/failing JAKi were switched to 2nd JAKi or TNFi or other MOA biologic. ~40% had prior bDMARDs. Retention was higher w/ 2nd JAK (918d)i vs other options. TNFi (335d) or OMA (918d). https://t.co/3A3KwVcTCN
2. Is JAKi therapy safe in RA-ILD pts? Italian retrospective study (2018-June 2022) w/ 43 RA pts & HRCT proven ILD (med age 69yrs) & Rx w/ JAKi. After 19 mos F/U, the FVC was stable in 79%, improved in 11%, & worse in 11%. DLCO & HRCT trend was similar. https://t.co/bAqa5wKIYE
3. PNAS has a novel approach to #RA Tx; bioengineered probiotic (Lactobacillus reuteri) orally delivers a peptide Kv1.3 channel blocker to RxRA. Kv1.3 is expressed on CCR7− effector memory T cells. Blocking Kv1.3 improves RA & PSO in rat models. https://t.co/DyyXi2GUH2
4. The EMAs CHMP has recommended granting a marketing authorisation for Sotyktu (deucravacitinib) for the treatment of moderate to severe plaque psoriasis in adults. https://t.co/WztKcNDFl1
5. Retroperitoneal fibrosis Tx is fraut-steroids, tamoxifen, MMF, B cell therapy? OL trial in 8 RPF pts used steroids & mTOR inhibitor sirolimus (2mg/d x 3d; 1mg/d); 12 & 48wks - decr in fibrous tissue 50%, ESR 70%, IgG4 50% w/ normalized renal funct. https://t.co/9BJchCctDi
6. Studies in 76 systemic sclerosis (SSc) pts (& animal models of SSc) show fibroblast A20 (enzyme) is downregulated and promotes fibrosis in SSc; but is repressed by DREAM, an A20 negative transcriptional regulator. https://t.co/30PuO4XRuq
7. US population mortality rates compared dermatomyositis (DM) vs polymyositis (PM) in 1981 (12,249) & 2020 (23,608). Downward trend in DM/PM mortality (<7%); plus PM/DM was 2X more likely to be one of mult causes, instead of, sole cause of death. https://t.co/9KZKr8JxUE
8. Systematic review of MRI confirm degenerative meniscus tears compared arthroscopic meniscectomy (APM) vs non-surgical or sham Rx. Results: 10 trials, 605 patients showed at 24 mos F/U, no advantage in Function or QOL favoring APM - rec conservative Rx https://t.co/4CwicQ9Jac
9. Amgen launched its adalimumab biosimilar - Amjevita ( FDA approved in 2016), has 2 different discounts— 55% or 5% below Humira's (list $6,922/mo). Another report says Amjevita 40mg given q 2wk will cost $40,497 - $85,494 annually https://t.co/iGtJUa991N
10. 1st there was combined Rheum-Derm or Rheum-Pulm clinics. Medscape reports new Rheum-Cardiology clinics at Cleveland Clinic, NYU, Brigham, Stanford. Useful in research, managing Rheum pts a) at hi CV risk, B) having procedures/surgery, c) risk reduction https://t.co/9AqujArSMT
11. FDA has approved the 1st BTK (Bruton’s tyrosine kinase) inhibitor (Jaypirca™ or pirtobrutinib) for adults with refractory mantle cell lymphoma. BTK inhibitors are also being developed for use in MS, RA, SLE, pemphigus & more https://t.co/gDHbcDpNnT
12. Study of 58 pediatric patients with Kikuchi-Fujimoto disease saw 15 (26%) with Macrophage Activation Syndr. KFD-MAS+ pts had signif. more skin rash (27%), Steroid Rx(80%), Dz recurrence (33%), lower cell counts (WBC, plt, lymphs) & higher LDH. https://t.co/GINlAJlEHi
13. ANCA assoc Vasculitis pts in RAVE - treated w/ RTX or CTX, thenAZA. 18/22 severe infections occurred within 6 months. Predictors of severe infx included higher baseline CD19+B cells & PJP prophylaxis w/ TMP/SMX (both groups Rx RTX or CYC/AZA) https://t.co/YhNDCdJuof
14. Herpes Zoster with JAK Inhibitors
15. Physician Burnout Remains, Less So in Rheumatology
16. RheumNow.Live - register now for our hybrid meeting March 18th & 19th