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RheumNow Podcast – Modern Treatment of RA Pregnancy (6.25.2021)

Jun 25, 2021 5:48 pm

Dr. Jack Cush reviews this week’s news and journal reports featured on

  1. The FDA has informed Abbvie that their supplemental application for new indications (PsA and AS) for upadacitinib (Rinvoq) has been delayed; the FDA citing its ongoing review of tofacitinibs safety concerns stemming from the ORAL Surveillance RA study
  2. FDA has granted emergency use authorization (EUA) for Actemra (tocilizumab) us in treating hospitalized COVID-19 (adults and kids) patients on steroids and who require, supplemental oxygen, mechanical ventilation, or ECMO
  3. Tofacitinib Efficacy in COVID-19 Pneumonia
  4. Danish population study shows that all cause mortality in GCA is increased 49%,(RR 1.49; CI1.36-1.64) after 1 year but less so at 10 years (RR 1.03: 1.00-1.05). Deaths usually due to infectious, endocrine, cardiovascular, GI diseases
  5. The Swedish Rheumatology Quality Register looked at risk of ant. uveitis (AU). From 4851 starting secukinumab (456) or TNFinhibitor (4395), there was higher AU risk w/ SEC (adj HR 2.32; 1.16-4.63) & ETN (1.82;1.13-2.93) (ADA as referent)
  6. Metanalysis shows no clear association between allopurinol use and a lowered all-cause mortality in gout patients, but the number of studies was small
  7. Italian survey foud 82% of MSK healthcare workers willing to receive COVID-19 vaccine, but only 55% of their rheumatic Dz patients were as willing, even if they perceived they were at risk. Not out of fear or distrust. more education needed
  8. French Vasculitis registry studied 354 GPA patients- 25% had hypereosinophilia (HE) ≥ 500; mostly male (73%) w/ most skin dz (49%) peripheral neuropathy (32%) & higher BVAS (21 vs 18, p= 0.01): severe HE had more baseline renal dysfunction
  9. Mouse model of psoriasis; 10 week exposure of western diet (high sugar & fat) induced dysbiosis and increased skin psoriasis & PsA , with increased IL-17A γδ T cells and helper type 17 cytokines. Treatment w/ Abx reduced IL-23 mediated dz.
  10. Progression from Psoriasis to Psoriatic Arthritis
  11. Better Outcomes with Modern T2T in Pregnancy 
The author has received compensation as an advisor or consultant on this subject

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