Repurposing & Pipeline (8.8.2025) Save

Dr. Jack Cush reviews the news, reports, pipeline and drug repurposing on this week’s podcast.

1. Metanalysis of 35 studies, 887 participants, shows 3 consecutive nights of sleep deprivation (~4.3hr/hs) assoc w/ signif. increase in IL-6 (p < 0.01) and C-reactive protein (p = 0.03) in blood. This was not seen w/ a single night of total or partial sleep deprivation https://buff.ly/MVJRRUcfasdf
2. DID YOU KNOW? >30% of Systemic Sclerosis pts present without Raynauds!. Data from 2 large US cohorts, of SSc dx with puffy fingers/hands or other symptoms. Such patients presented with more severe skin and musculoskeletal disease. https://buff.ly/t6mFdB9
3. Pipeline of drugs being developed for Scleroderma by these companies - Bayer, Novartis, GSK, Boehringer Ingelheim, Celgene Corp., Johnson & Johnson, Prometic, Cytori arGentis - either as fusion proteins, peptides, small molecule, mAb, Polymers & Gene therapy https://t.co/dWRcQ1a3GU
4. Retrospective study of 63 pts w/ Cryoglobulinemia (essential mixed [EM], CTD-related) vasculitis (CryoVas) in remission post RTX induction. W/ 58 mos F/U Relapse rates were 23%, 42%, 71% (@ 1yr, 2yrs, 5yrs). Relapse risk w/ purpura [HR 2.2] & prior CryoVas flare (HR 1.9). https://t.co/6zGgSN8Wfe
5. COVID Vaccine study in rheum pts on JAKi (n 22) or TNFi (n 16) Showing 50% response in JAKi and 81% w/ TNFi Rx. Pt PBMCs were stim by SAR-CoV2 spike proteins & CD4+ T cells IFNγ production as Pos. response. Do JAKi impair COVID-19 Vax responses? https://t.co/dZAktwrytf
6. AMN Healthcare report on MD salaries -- high demand for specialist MDs w/ RHEUM the 7th Most In-Demand. 2024/205 Rheum were low of $214K, a high of $450K, median of $341,000. Avg salary for NPs is $180K up from $164,000 last year, a 9.6% increase. https://t.co/NcmwrMxpKr
7. Survey of 39 Spanish rheumatologists (mean age 50 yrs, 9.6 yrs in practice) finds that while 79% agreed on the importance of using Patient-Reported Outcome Measures (PROMs), only 28% use them routinely (mostly pain, VAS, HAQ) - reason? Time! https://t.co/YnZBXlK24M
8. Potentially novel RA vaccine of recombinant HLA-DRB1 04:01 bound to type II collagen (COL2) peptide COL2259-273 that was chemically modified at glycine position 265 & shows to suppress collagen induced arthritis in human DRB1 04:01-expressing mice https://t.co/TtBt49DQDa
9. Japan IORRA study of 10,613 RA pts (2007-21) - 915 deaths from cancer (28%), lung Dz (22%), CV Dz (16%). Protective Rx were MTX and bDMARDs, while even low-dose glucocorticoids showed increased mortality risk. https://t.co/lV5WmC5l1X
10. Large metanalysis of TNFi use in immune-mediated inflammatory diseases (45 studies, 150K pts) shows no increased risk of de novo heart failure (HF), and no significant risk of HF worsening w/ TNFis. https://t.co/9sRVsMZ1kv
11. Retrospective review of 9 #RA pts w/ elevated liver enzymes who were Rx w/ TNF inhibitor (4 adalimumab, 5 etanercept; 78% female, median BMI 37). Over 3 yrs F/U, LFTs declined, fibrosis scores (FIB-4) signif decreased; albumin & bilirubin remained stable https://t.co/Hcwa3qaupv
12. Study of 110 #SLE pts found 41% w/ osteoporosis, 35% of whom had Lupus nephritis (LN). SLE w/ lower BMD assoc w/ LN classes III & IV, U1-RNP Abs, high CRP, & longer Dz duration, also w/ higher age, HAQ, C3 levels. 86% were on glucocorticoids, mean age 48 yrs. https://t.co/dqutqbvnjB
13. French retrospective observational study of Bx/CT/PET Dx of 380 #GCA pts found 7.6% (29) w/ Nl baseline CRP < 10 mg/L at Dx. GCA w/ low CRP had less fever, more ocular Dz (ant ischemic optic neuropathy 28 vs 13%), & limb claudication (24 vs. 8%) but equal relapse rates https://t.co/fPy92NjJzS
14. CCL17 is a downstream mediator of GM-CSF. Drug repurposing review of FDA approved Rx shows 5 Rx w/ anti-CCL17 effects - fluoxetine, ractopamine, ponesimod, terbutaline & etravirine, w/ inhibition of STAT5, IRF4 & CCL17 & shows antiinflamm effects in RA animal model https://t.co/2aTyZMWPJn
15. Inefficiencies of ANA Testing