Pollution and Autoimmunity (7.12.2024) Save

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

1. IV zoledronic acid (ZA) does not prevent future knee replacement (TKR) in symptomatic knee OA without severe joint space narrowing (JSN). In 222 Knee OA pts, after 7 yrs F/U, ZA had more TKR (39% vs 30%; HR 4.2' 1.2-14.7) https://t.co/2cGeqz2Rwu
2. CHANCE-3 DBR-PCT of 8343 adults (>40yrs) w/ CVA or TIA & hsCRP ≥2 mg/L showed that colchicine (0.5mg) x 90d did not prevent (6.3% vs 6.5%; HR 0.98; 0.83 to 1.16) subsequent stroke within 90 days compared with placebo https://t.co/APiMYVkBTV
3. Preliminary results from RESET-RA Study announced; demonstrating ACR20 efficacy of implanted vagal nerve stimulation at 12 wks (p=0.0209). 2-staged, multicenter, randomized, sham-controlled, double-blind pivotal trial, enrolled 242 RA pts https://t.co/dsptP1TLt5
4. In the US CorEvitas registry of 1823 PsA pts; 11.1% fulfilled fibromyalgia definition & 20.6% had widespread pain. FM was assoc w/ female, depression/anxiety, impaired function, increased BMI, comorbidities. cDAPSA, patient pain& TJC https://t.co/IJI5zx0oR6
5. Bimekizumab (dual-IL-17A/F inhib), may prevent uveitis in patients with axSpA. In phase 3 RCTs (MOBILE 1 & 2) double-blind period, uveitis seen in 0.6% on BKZ vs 4.6% on PBO (p=0.001). In pts w/ hx uveitis, again lower w/ BKZ (6.2/100 PYs vs 70.4/100 PYs) https://t.co/v0wMK45chz
6. Paradoxical psoriasis w/ IL-17 inhib? Lit review 35 (SpA) pts, presenting as palmoplantar pustular and plaque PsO; median 11 weeks after IL-17i. one-third continued IL-17i w/ mostly topical Rx; 2/3 D/C IL-17i, switching to other biologic w/ good outcomes https://t.co/q2xqQyiM3b
7. In early arthritis (RA) pts there is no value in measuring for IgA-ACPA or IgA-RF, as there presence doesnt provide more than IgG-ACPA. In tREACH trial IgA-ACPA present in 23% & overlaped w/ IgG-ACPA in 94% (w/ IgM-RF in 90%). https://t.co/d8Xc4GBfEt
8. 5 yr results of 150 difficult-to-treat RA pts - D2T RA resolved in 45%, persisted in 50%, & 5% died. Resolved D2T RA was signif younger, had more Rx changes, & more IL-6i use. Mortality predicted by comorbidity index, steroid escalation (OR 3.50; & 32) https://t.co/cIUNcQ0r3F
9. CT angio in 75 pts w/ Takayasu arteritis (40 w/ cDMARDs, 35 biologics) showed reduced arterial thickness in 73% (31% w/ >25% decr in wall thickness). 1st immunosuppressives (p= 0.012) & bDMARDs(p= 0.026) reduced art. wall thickness (relative to cDMARDs) https://t.co/16eGmgVoWr
10. Study from the UK Biobank (n 459K) shows long-term exposure to air pollutants (PM2.5, PM10, NO2, and NOx) may increase the risk of #SLE. 399 SLE pts (F/U 11.8 yrs) found an 18027% incr SLE risk w/ pollutants; magnified in those with high genetic risk https://buff.ly/3LiKWKO
11. Ultraprocessed Foods Increase Lupus Risk     
12. Cost-Effectiveness of Biosimilars vs Leflunomide