Pizza and Rheumatoid Arthritis (8.11.2023) Save

Dr. Jack Cush reviews the news and journal reports from the wonderful wide world of Rheumatology. This week:

1. Swedish study of 325 #AAV pts saw CVA in 35 pts (8%); CVA incidence=11.3/1000 PYs - this was higher than gen population [SIR 1.85). AAV CVA risk factors included age <65 yrs (SIR 3.19) & Hi platelet count (HR 1.14), but no effx on survival https://bit.ly/3OSrOWW

2. Anti-gephyrin autoantibodies (AGA) have been tied to lower GI dysfunction. Johns Hopkins study of 188 scleroderma pts found 8.5% w/ anti-gephyrin Abs (1/4 it was only autoAb). AGA+ assoc w/ severe constipation (46 vs 15%) & bloating (54 vs 25%) https://t.co/z1KQjhCU21

3. Retrospective study of 1,516 MIS-C pts at 44 sites: 13% received anakinra alone or with other agents as initial treatment. Variable effx w/ anakinra - which was not equivalent to IVIG or steroids vs. IVIG plus steroids (re: vasopressors, LVEF, or CRP https://t.co/pGCHa4VmlB

4. Network Meta-Analysis of Perioperative Pain Control compared gabapentin & pregabalin; finds GABA 900-1200mg/daily before spine surgery assoc w/ lowest pain scores & least opioid use. GABA 3 fold better than pregabalin (75-300). (27 RCTs, 1861 pts) https://t.co/6gmjYuwMle

5. Prospective, open-label study compared 19 Takayasu pts on secukinumab vs 34 pts on TNFi . SEC response (Complete/partial) was 53% & the TNFi response was 59% at 3 mos. SEC had 4 pts relapse by wk 48 (median 31 wks(, TNFi had 12 pts relapse. https://t.co/IQDFDmbdBR

6. Study of 3082 pts w/ muscle disease; 14 had adult IIM w/ myocarditis. Mean: 54 yrs, 71% black,  Antisynthetase syndrome in 64% (Jo1=4, PL12=3); 79% w/ active myositis, 93% hosp); 5 yr myocarditis survival 53% (6 died; all w/ LVEF < 40%) https://t.co/HChGMU2nBv

7. IMMpulse study - 1 yr OL, phase 4 trial of risankizumab (150 mg, wk 0, 4) vs apremilast (30 mg bid) in 352 pts w/ moderate plaque psoriasis. RIZ had superior efficacy at wk 16 w/ PASI90 score of 55.9% vs 5.1% for APR. https://t.co/dSLJA9Tsmx

8. Cross-sectional study 365 RA pts showed eating half a pizza >1 time/wk (vs. ≤2 times/mo) was assoc w/ 70% less Dz activity; esp w/ more severe RA (80%) (benefit likely due to mozzarella & olive oil). YES, this was an italian study... https://t.co/6xKMIFdEWf

9. Italian JAKi study, 685 pts Rx w/ BARI (48%), TOFA (31%), UPA (14%), filgotinib (7%), had half (47%) Rx JAKi as 1st line, prior to a biologic. AE of special interest (1137 PYs FU) in 18%, including 1 CVA, 3 deaths/infx. High CV risk pts = Hi AESI(23%) https://t.co/0NN60tvokZ

10. Chinese study of 5530 RA pts found 546 (9.9%) who developed diabetes. DM risk was significantly lower w/ bDMARD (HR 0.51), MTX (HR 0.50) and HCQ (HR 0.52). TNF inhibitors were also protective (HR 0.69). https://t.co/hdkyqFXbbu

11. Metanalysis of remote Pt monitoring w/ electronic Outcome Measures (ePROMs) in #RA (4,473 pts, 7 studies) showed lower disease activity & higher remission rates in ePROM group (OR 1.65) & fewer F2F visits were needed in ePROM grp https://t.co/Va2Psx6zSc

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14. "Ask Cush Anything" 

15. RheumNow’s Poster Hall