RheumNow Live is Coming to Town (3.11.2022) Save

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

1. Go to RheumNow.live to register for next week's RheumNow Live 2022 (join us virtually or in person)

2. 6780 nonspecific MSK pts (no synovitis) saw 3% w/ CCP+, 45% progressed to IA (RA). Progression seen w/ high CCP (OR 9.4), hand (OR 2.7) & foot pain (OR 4.1). CCP- progress if pain in hands (OR 2.5) or knees. 96% NPV for CCP- w/o hand/foot pain https://bit.ly/3MJlIoH

3. Study of 177 PsA pts, those with dactylitis had more severe disease with signif. greater SJC, CRP, US-detected synovitis and bone erosions in DMARD-naive early PsA. Dactylitis could be useful in early risk stratification. https://bit.ly/3t20jz7

4. anti-IL-23 therapy is not effective in Axial Spondyloarthritis. While ustekinumab, guselkumab and risankizumab are approved in psoriasis (& PsA for GUS, RIZ), studies of Ustekinumab and risankizumab failed to show efficacy in axSpA https://t.co/Idlqidy04d

5. Single center study of individualized anakinra use in 47 autoinflammatory pts (32 kids; 43% MAS; 40% systemic JIA). Off-label use in 38%, higher doses in 21 kids (5-29mg/kg); & 5 given IV anakinra; such doses were well tolerated without major AE. https://t.co/wQgw3YAPKX

6. Juvenile CADM: JAMA Case - 6 yoF with 4 yrs of rash on hands, feet, elbows, knees. No Resp to topicals. ROS rare cough & SOB; no weakness. Gottrons over hands, knee. Bx +, ANA+ 1:320, nl enzymes, MSA- See how she was Rx https://t.co/l26Y666JKZ

7. Good review of Diagnosis and Treatment of Pulmonary Sarcoidosis in JAMA. - Lung progression (in only 10%) assoc w/ 12-18% 5yr mortality - Sx Sarcoid w/ Lung: start Pred 20 to 40 mg/d for 2 -6 wks - Steroid sparing w/ MTX, AZA or TNFi https://t.co/ylF8KR47gc

8. Study of 155 adult patients (PsA 61/AS 94) looked at labs & CV risk factors; found IL-18 elevated in peripheral PsA more than axial PsA & AS. Elevations were higher in PsA pts w/ ischemic heart disease correlated w/ atherogenic index & TG levels https://t.co/PQ3fBi8Qdo

   COMPLETE-PsA Trial studied MTX vs MTX + leflunomide in 78 active untreated PsA pts. MTX+LEF was superior to MTX alone at wk 16 (PASDAS 3·1 vs 3·7; p=0·025). Combo group had more N/V (44% v 28%), ^ALT (31% vs 18%). https://t.co/Hc4rNrlQzP

9. COREVITAS RA registry shows poor biologic responses in Severe obesity (BMI >35) & underweight (<18.5) w/ no diff between 2891 TNFi vs 3010 non-TNFi users. Severe obesity lower odds of LDA, MCID, CDAI ~10-20%; UnderWt ~50-70% https://t.co/iMvlyo4UKx

10. Undifferentiated Arthritis Does Not Follow an RA Course 

11. Could Anifrolumab Work in Lupus Nephritis?