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RheumNow Podcast – Lupus Mortality Declines, But… (6.26.20)

Jun 26, 2020 12:40 pm

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

  1. High uric acid is associated with a higher risk of kidney cancer, especially in women; Data from a UK biobank of 444 462 without cancer w/ 6.5 yrs F/U. Highest Urate quartile had increased risk of renal cancer (HR 1.45, 95%CI 1.08 to 1.93), only in women.
  2. J&J announced that is discontinuing its phase 3 trial of ustekinumab in #SLE. An interim analysis of the 516 pt LOTUS trial showed no new safety concerns. Study was halted for lack of efficacy. A subsequent LOTUS-C trial in China has been suspended.  
  3. Tocilizumab may be effective in refractory ocular-, neuro-, vasculo-Behcet's. Study of 47 Behcet's pts Rx w/ TCZ - good at ocular (24/25), CNS (6/6), vascular (7/7) & amyloidosis(2/2) but less effective w/ oral/genital (8/21), skin (6/14) or joints (4/11)  
  4. Metanalysis of 8 studies and >130,000 patients shows that IBD (Crohns & UC) have a significantly higher risk of developing #RA (RR = 2.59; 95% CI: 1.93–3.48).  
  5. NGF inhibitor Tanuzemab (TNZ) phase III study in patients with low back pain - H2H against placebo and tramadol. At 16 wks, ≥50% improvement in LBP was 37% in PBO, 43% TNZ 5mg and 46% TNZ 10mg (Odds ratio [95% CI] vs placebo = 1.45 [1.09, 1.91; P=0.0101]).  
  6. 35 pregnant women w/ baseline & postpartum MRI-SIJ. 27/35 (77%) had SI bone marrow edema postpartum, 60% met ASAS definition of +MRI. 6 and 12 mos after, 46% and 12% still showed BM edema. Findings assoc w/ short labor & no epidural.  
  7. WHO global safety database shows increased risk of DVT & PE with tofacitinib & baricitinib, who were likely to be older with preexisting VTE risk. In EU, TOFA risk for DVT/PE was OR 2.3; BARI risk was OR 3.4. No VTE risk for BARI in US, TOFA 2.0 VTE risk.  
  8. Mortality in Lupus Declines between 2006 and 2016     
  9. Early COVID 1255 patients In Wuhan, China - median age 64 yrs; 53 male: 63% w/ chronic comorbidities. There were 17 autoimmune pts w/ COVID  - median age 64; 83% female; only 1 admitted to ICU and one died. 10 stopped DMARDS & 5 their Dz worsened.  
  10. Hydroxychloroquine Fails as Postexposure Prophylaxis for Covid-19  
  11. Protective Benefit of Colchicine in COVID-19 Infection

The author has received compensation as an advisor or consultant on this subject

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