RheumNow Podcast – Quackademia (10.15.2021) Save

Jack Cush, MD

Oct 14, 2021 10:02 pm

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

Risk of anterior uveitis w/ secukinumab is equal to etanercept; but both inferior to mAb TNFi (infliximab, adalimumab) ~ 5000 Rx starts, AU risk/100PY = SEC 6.8; ETA 7.5; INFLIX 2.9; ADA 4. SEC has a 2.3 fold greater risk than ADA/INFX https://bit.ly/2YNGa3h
CXCL13 predicts worse Xray status in early #RA. Study of 158 pts, followed 11-years. Baseline CXCL13 correlated with Xray progression (ΔTSS) at 11 years. CXCL13 was superior to CRP, DAS28CRP, SJC28, CCP predicting 11-yr Xray damage https://bit.ly/3FGcgyG
Among 2359 RA & PsA pts (3169 TNFi courses 1778/1391), serious infection (SIE) rates were higher in RA 4.17/100PY vs PsA 2.16/100PY. PsA had 41% lower SIE risk (HR 0.59, p=0.004) - Registry data from the NOR-DMARD study https://bit.ly/3BXgEr3
Retrospective study hospitalized new-onset systemic JIA (2008-19):52 children’s hospitals & 534 sJiAshows 29% rx w/ biologics & 58% steroids. Over time Biologic use increased & MTX decreased. Biologic correlated w/ Hi hospital volume, ICU stay, later years https://bit.ly/3aBhOfA
Comparative study of 46 AOSD, 9 MAS & 31 adult HLH pts, shows that serum IL-18 was signif higher in AOSD than HLH (closely correlates w/ ferritin, sIL-2R). IL-18, sIL-2R, ‘arthralgia or arthritis’ independently distinguished AOSD from HLH https://t.co/ZW6e78nEkh
Smoking worsens adult-onset Still’s disease. 185 AOSD pts, found 45 smokers who had higher risk of pericarditis (36 vs 16%), pleuritis (33 vs 14%), abd pain (18% vs 6%), higher systemic score (6.4 vs 5.4 ), More MAS (29% vs 6%), lung disease (18% vs 13%) https://t.co/ZKKhw1EbnD
Catastrophic Still's dz occurs early; compares 20 AOSD w/ organ failure vs 40 AOSD without. CAT-AOSD had shorter Dz duration, earlier Rx need; risks: younger; splenomegaly, liver, cardiac,lung involvement; ferritin level, no arthralgia https://t.co/8WIMd0JxZr
Anakinra appears to lower mortality risk (OR 0·32 vs historic controls) in hospitalized severe COVID-19 pneumonia (esp w/ hyperinflammation, CRP >100 mg/L). Metanalysis of nearly 2000 pts; better resp if given w/ dexamethasone (OR 0·23) https://t.co/7nFAkLgpGK
Still’s Disease Following COVID-19 Vaccination
Hepatitis B Reactivation with Rituximab and Abatacept
Cancer Risk in Systemic Lupus Erythematosus
Decline in the incidence of Behcets Dz? Between 2004 to 2017 Korea has seen BD decreased from 8.15/100K (2004) to 1.51/100K (2017), an 81.5% decrease, greater for women and middle-aged people, but no change survival or mortality https://t.co/tvZSSGMOH7
FDA Approves Avacopan for ANCA-Associated Vasculitis
RETRO - Taper or Not: You Decide
Triple DMARD Rx - MSH vs MLH (Lef). 136 active #RA pts given OL MTX/SSZ/HCQ vs MTX/HCQ/LEF. Equal efficacy (EULAR-Good) was seen at wk 12 (54% vs 59%) and wk 24 (65% vs 62%) - hence LEF substitution was noninferior. https://t.co/F5CGj0w7Bh
Low dose #methotrexate in primary cardiac prevention #CIRT. Trial had LESS decline in GFR in those with mild renal impairment than placebo. ?meaningful or a fluke. Either way MTX can be used safely in mild CRF! Just follow creatinine/GFR. #ClinicalPearl @RheumNow https://t.co/SyfsxZEeUH
Upadacitinib was shown to be effective in two Phase 3 SELECT-AXIS trials. 1st trial: in bDMARD-IR AS pts the ASDAS resp was 44% vs 10% PBO at wk 14). 2nd trial: in nr-axSpA, the ASDAS response at wk 14: 42% vs 18% PBO. https://t.co/rnv9VVITeE
498 axSpA (62%M: 38% F): Compared to men, women had higher Dz activity, joint counts, enthesitis scores (all P ≤ 0.01), more pain, worse fatigue and Functional scores; all P < 0.05), less full time work, More DMARDs/pred, Depression & FM https://t.co/kPY9YDpA9J
A case of reactive arthritis following COVID-19 infection; manifest as dactylitis, psoriatic skin/nail lesions, painful oral & vaginal ulcers, subungual hyperkeratosis, but no oligoarthritis, or lumbar pain. https://t.co/nobMHGgKfZ
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