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

Jack Cush, MD

Jun 26, 2020 12:40 pm

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

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. https://bit.ly/3dCasaN
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. https://bit.ly/3dAJgco
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) https://bit.ly/2YJcJvs
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). https://bit.ly/3hVrlR0
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]). https://bit.ly/3dgnMBy
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. https://bit.ly/37Mf0tY
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. https://bit.ly/2AMCSBH
Mortality in Lupus Declines between 2006 and 2016
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. https://bit.ly/3fI8FlW
Hydroxychloroquine Fails as Postexposure Prophylaxis for Covid-19
Protective Benefit of Colchicine in COVID-19 Infection