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RheumNow Podcast – Function Follows Form (10.2.20)

Oct 01, 2020 11:26 pm

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

  1. Today Janssen announced the FDA has approved golimumab (Simponi Aria) for use in children (> 2yrs) with active Polyarticular Juvenile Idiopathic Arthritis and for pediatric Psoriatic Arthritis
  2. Pfizer announced the FDA has approved tofacitinib (Xeljanz) in children (>2yrs) w/ polyarticular JIA. Approval based on a 225 pt, Phase 3, 18 wk Open Run-in followed by 26-wk randomized, withdrawal study of placebo vs tofa 5 mg qd (or wt based oral soln)
  3. Filgotinib Approved by the EMA for Rheumatoid Arthritis 
  4. Latest data Global Rheumatology Alliance COVID Registry -2121 pts (40% RA, 17% SLE, 9% PsA), 64% on DMARDs, 33% biologics, 5% JAKi, 34% steroid,27% HCQ, with only 7.6 deaths and 39% hospitalized and 81% resolved infection.
  5. Swiss cohort of 666 axSpA, RA & PsA pts seen before, during & after COVID; consults dropped 52%, remote visits increased 129%, & non-compliance slightly increased during COVID (axSpA 20% vs 13% before, p=0.003); but no incr in flares(<15%) or Dz activity
  6. Predictors of Remission in SLE? metanalysis of 17270 SLE pts; 42-88% achieved remission x 1 yr, & 21-70% for 5 yrs. Remission associated w/ older age , lower Dz activity & No major organ involvement; Positive serologies negatively associated w/ remission
  7. Complement associations studied by Petri & Durcan in 2399 SLE pts. 55% had low C3 (persistently low 4%); 47% low C4 (3% persistently low). Low C4 is weak marker clinical & serological Dz. Low C3 linked w/ renal & serological Dz, Low C3/C4 linked to ACL Abs, CVA, DVT
  8. Meta-analysis shows smoking increases the risk of psoriasis (OR: 1.84) in the general population, but smoking the risk of PsA among psoriasis patients (OR: 0.70) but was equal to the general population.
  9. 14203 early RA cohort looked at adherence to quality standards of care (DMARD use, steroids, early F/U care) and showed adherence lessened need for future hospitalization (adj HR 0.85); most impact from early DMARDs, worst from steroid use
  10. Study of early axSpA from the DESIR cohort looked at MRIs of the SI joint/spine @baseline, 2 & 5 yrs; showed that bone marrow edema pn MRI‐SIJ and ‐spine at baseline predicted of ‐year damage pm MRI‐SIJ [OR=4.2] and MRI‐spine [OR=10.7]
  11. Low Risk of Latent TB with Secukinumab 
  12. Gabapentin Fails to Lessen Chronic Pelvic Pain    
  13. Defining Difficult Rheumatoid Arthritis    
The author has received compensation as an advisor or consultant on this subject

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