An Epidural Letdown (4.4.2025)

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

**Correction: a Tweet from 3/18 podcast, had incorrect information. Late Breaking abstract from 2025 Amer. Acad. Dermatology (AAD) on the Phase 3 ICONIC-LEAD study showed J&J's oral IL-23 inhibitor (icotrokinra) was superior to PLACEBO (not deucravacitinib as reported) in skin clearance (65% vs 8%) & PASI90 (50% v 4%) at Wk 16 (NOT 15) in 684 moderate-to-severe plaque PsO pts https://buff.ly/dMbTbML

  1. Matched cohort study of 83,811 #RA pts showed RA had a 12% increased risk of avoidable hospitalizations (ambulatory care sensitive conditions (ACSCs) grand mal seizures, chronic lower respiratory diseases, asthma, diabetes, heart failure CHF, pulmonary edema; (IRR 1.12). Predictors of ACSC hosp. were age, Steroids, ambulatory comorbid Dxs. ambulatory care access & ^ primary care may reduce this risk. https://buff.ly/9OfLaEq
  2. South Korean nationwide cohort study of 888,909 newly diagnosed #OA pts compared NSAID safety. Nephrotoxicity varied: lowest w/ meloxicam (aHR=1.22 [0.68–2.19]), higher w/ loxoprofen (aHR=3.9 [1.56–10.00]), celecoxib (aHR=2.4 [1.68–3.53]), naproxen (aHR=4.7 [2.16–10.24]) https://t.co/wfWIdoRQGO
  3. EMA approved a record 28 biosimilars in 2024 for cancer, osteoporosis, macular degeneration, and immune-related diseases like plaque psoriasis, ulcerative colitis, and Crohn’s disease https://t.co/NNzKRalLvF
  4. To promote broader avail. of biosimilars in EU, EMA has proposed a new path for new biosimilars, omitting comparative clinical trial data, as long as biosimilar shows structural & functional comparability, w/ pharmacokinetic & interaction data (relative to reference product) https://t.co/24aTCuDwdO
  5. Review article shows that in psoriasis pts, adding #MTX to TNFi increases efficacy, but there is limited data on adding MTX to either IL-17 or IL-23. But in Psoriatic Arthritis (PsA), adding MTX provides no added efficacy compared to biologic monotherapy https://t.co/FiSFIjpsXo
  6. NIH Complimentary Medicine overview of Music Therapy (Performing or listening to music  )  - preliminary research suggests that music interventions may be helpful for anxiety, depression, pain control, dementia, multiple sclerosis, Parkinson’s disease, etc https://t.co/UGsfT7lITQ
  7. A study in Alberta, Canada, examining the travel burdens for rheumatoid arthritis patients, found a median travel time of 13 minutes to reach general practitioners and 34 minutes to see rheumatologists. The research highlighted significant disparities between rural and urban areas, with rural patients experiencing travel times four times longer for GP visits and 8.7 times longer for rheumatologist consultations. Despite these differences, the travel duration had minimal effect on the utilization of healthcare services. https://t.co/Dp2m2M1HP7
  8. Diagnosing PMR is easy before Pred initiation; but after steroids NO SO. Before Pred, PMR Dx from non-PMR (median probabilities 7.8 vs 2.8) w/ 86% sensitivity/83% specificity. After Pred Dx probability of PMR dropped to 1.0 w/ sensitivity 3.5%; not much better w/ Pred D/C https://t.co/q4TceeFByc
  9. Vamorolone, a promising alternative to traditional glucocorticoids for inflammatory diseases. ◦ #Vamorolone is a dissociated steroid compound with reduced side effects. ◦ Unlike conventional #glucocorticoids, vamorolone lacks the hydroxyl or ketone groups and is resistant to https://t.co/yvDWqcbXbn
  10. 1st Line Biologics vs csDMARDs in Adult Still's Disease  
  11. Consensus Against Interventional Injections for Chronic Spinal Pain 
  12. Upadacitinib for Giant-Cell Arteritis - A Phase 3 Trial 
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The author has no conflicts of interest to disclose related to this subject
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