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Half the Experts are Wrong (2.17.2023)

Feb 17, 2023 11:54 am

Dr. Jack Cush reviews the news and tries to stump the expert panel this week on the podcast.

  1. Case reports of anifrolumab use in 2 pts w/ chronic, scarring discoid lupus unresponsive to steriods, HCQ, immunosuppressants & CTX. Case 1 SLEDAI from 13 to 2 in 24 weeks & CLASI-A from 26 to 3 in 20wks. Cs 2 CLASI-A decr 24 to 5 after 1 infusion
  2. Study of 232 pediatric #SLE pts. Over 12 mos 47% achieved LLDAS & Damage seen in 40% after 6.2 yrs F/U. Getting to LLDAS w/in 12 mos is assoc w less damage. LLDAS w/in 12 mos more likely in Absence of renal involvement.
  3. On Dec. 19, 2022, the U.S. Food & Drug Administration (FDA) approved subcutaneous abaloparatide (Tymlos) for the treatment of men with osteoporosis at high risk of fracture
  4. Lg vessel US study compared 44 LV-GCA vs 42high-risk atherosclerosis pt.Intima-media thickness (IMT) was signif. higher w/ GCA. IMT ≥ 1 mmseen in 31/44 axillary, 30/44 subclavian in GCA; but only in 2/42 axillary & 3//42 subclavian in atherosclerosis grp.
  5. Retrospective study of 64 gout pts having orthopedic surgery - perioperative flares more likely with Incr SUA, DM, tophi and diuretics. In 12 mos following surgery, recurrent gout more if ^SUA (45% vs 11%) & those w/ topic ((RR = 4.8; P = 0.029)
  6. NOVESA trial ziritaxestat (an autotaxin inhibitor) in 33 early diffuse systemic sclerosis pts. After 24 wks, ziritaxestat showed signif reduction in mRSS (–8.9 vs. –6.0 PBO; P=0.04). It was well tolerated & showed biologic effect w/ reduced LPA C18:2
  7. Metanalysis of HBV reactivation in HBsAg−/HBcAb+ RA ( 26 studies 2252 pts) Rx w/ b/tsDMARDs. Pooled HBV reactivation = 2%. Reactivation higher w/ RTX (esp if HBsAb−) RTX 9% (p .03) ABA 6% JAKi 1% IL‐6i 0% TNFi 0% Safe to use TNFi, JAKi, IL6 mAbs
  8. Retrospective cohort study of Taiwan Health Insurance Database looked at risk of #SLE in pts w/ Hashimoto’s thyroiditis (HT). Compared 15K HTvs 31K controls. SLE was incr in HT pts (IRR 3.58; p < 0.01). Several sensitivity analyses aHR 4.35 to 5.11
  9. New Laboratory Insights for the ANA+ Consult 
  10. Ask Cush Anything - Elevated CRP in Obesity
  11. Join us at RheumNow Live this March!


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