Mono- and Oligo- are Different (8.18.2023) Save

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

1. Glucocorticoid Affects Weight, but not Blood Pressure in RA A pooled analysis of 5 RCTs shows that the effects of 2 years of low-dose glucocorticoid (GC) treatment in RA can significantly increase increase body weight, but not blood pressure. https://t.co/GyUVlfMxq6

2. Do TNF inhibitors work in cardiac sarcoid (CS)? PET scan study of 31 CS pts Rx w/ infliximab 13, adalimumab 15, adalimumab 3. Mean pred dose dropped 18.6 to 7.7mg, p = 0.018) & PET improved w/ TNFi and only 4 pts had CV hospitalization during F/U https://t.co/WjAiSVXJWI

3. Tildrakizumab, IL-23 mAb) was well tolerated in ankylosing spondylitis (AS) pts but did NOT improve ASAS20 responses vs PBO. 101 pts given TIL or PBO. ASAS20 response was 74% TIL vs 80% PBO. Study was terminated at week 24 for lack of efficacy. https://t.co/gje5hGAyOV

4. A review of Myositis-associated ILD prevalance is 50% (Asia), 23%(N. Amer) & 26% (EU) & is increasing. ILD is more common/severe w PL-7/-PL-12 Abs (vs Jo1). MDA5 Abs higher in Asians (11-60%), assoc w/ rapidly progressive ILD https://t.co/gDg3EHfOPn

5. Retrospective cohort study (2009-2022) found that #SLE is a risk factor for myelodysplastic syndrome (MDS) among RMD pts. Found 64 MDS in 55 841 PYs F/U (1.15/1000 PY). SLE was risk factor for MDS (adj HR 2.61). Lower Hgb could be an early clue! https://t.co/lALbyUz1xP

6. Nailfold videocapillaroscopy (NVC) in 1356 #SSc registry pts classified as early, active or‘late. Late pattern seen in 40%: signific. assoc w/ dcSSc (OR=1.96), ILD (OR=1.29), renal crisis (OR=3.46), digital ulcer (OR=1.29), & topoisomerase I Abs (OR=1.39) https://t.co/5CjWnFCfT5

7. UK study of 1,.3 million RMD (RA, PsA, FM) pts looked at opioid Rx 2006-2021. New opioid Rx incr 2006 to 2019, but incr most (4.5 fold) in FM from 3.4/10K in 2006 to 8.7 in 2018/2019 (falling to 5.9 in 2021). Overall less opioid use during the pandemic https://t.co/rNmk6AGMAX

8. Monoarticular JIA - a Distinct Clinical Entity Monoarticular Juvenile Idiopathic Arthritis (monoJIA) is typically classified under oligoarticular JIA, but a recent study suggests it is a separate entity. https://t.co/l5OqZsWVJi

9. 10% of a Single center cohort (n 38) Systemic JIA pts developed MAS. Only1 had recurrent MAS(3 times), mostly Male (3M:1F) w/ mean Dx age=8 ± 6 yrs. Stills w/ MAS had less arthritis (51 v 91%), more Rash (75 v 55%), HSM (50 v 5%), serositis (25 v 5%) https://t.co/QgdSJW03wj

10. Both Lupus Nephritis and Cutaneous lupus erythematosus (CLE) show evidence of tissue infiltrating T cells expressing hi amouts of hypoxia-inducible factor-1 (HIF-1); HIF-1 inhibition improves skin/systemic disease & decreases T cell cytotoxic activity https://t.co/V0JaSKWC0k

11. Lung is involved in pre-clinical ACPA+ RA! Lung-resident B cells from BAL of 12 untreated at-risk or Dx early RA pts found T cell–driven B cell differentiation resulting in local class switching and somatic hypermutation B cells, esp w/ ACPA+ https://t.co/h0eNjzw9Aq

12. The Adalimumab Biosimilar Glut

13.  Miracle Larry Podcast