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RheumNow Podcast – Upadacitinib Wins in PsA (4.2.2021)

Apr 02, 2021 2:10 pm

Dr Jack Cush reviews the news and Journal reports and takes "Back Talk" questions from viewers.

  1. Comparison of oral and parenteral MTX shows oral MTX in RA is non inferior to subcutaneous MTX treatment (in 640 RA pts) with regard to disease activity, but oral MTX had fewer adverse events than SC ( 41% vs 52%, p= 0.005).
  2. In the UK, NICE has recommended Kineret (anakinra) for use as 1st line biologic Rx in systemic JIA and adult-onset still’s disease (AOSD); but pts must first fail a DMARD - the latter is unfortunate as systemic Sxs of Still's do not respond to usual DMARDs .
  3. Matched cohort Nurses’ Health Study looked at 283 pre‐RA pts (mean 9.7 years before RA Dx) and and 842 controls; 21% pre‐RA were ACPA+. ACPA+ was associated with increased risk of COPD (HR 3.04) that was not seen in ACPA- pts.
  4. 263 RA patients with ILD were treated w/ Abatacept (ABA mono, ABA+MTX or ABA+nonMTX) - all improved their DAS28, stablized their FVC, DLCO, CHest CT; Only difference was that steroid sparing best when ABA used in combo.
  5. Retrospective study of 267 adults w/ Henoch-Schönlein purpura (AKA IgA vasculitis (IgAV) shows more arthritis, enteritis & renal Dz, higher comorbidity scores (2.6 vs1.5) & higher risk of Serious infx (OR 8.4) and death (MRR 2.06) than gen population
  6. Abstract presented 10/20 at American Society Nephrology mtg show IV Pegloticase use in 136 ESRD dialysis pts (Rx by Rheums 68%). Pts were 73% males, avg age 57 years, More on hemodialysis [79%] than peritoneal dialysis [17%]. Pts RCV ~13 infusions.
  7. Metanalysis of 32 studies shows most forms of arthritis assoc w/ incr risk of CVA (ischemic stroke: RR=1.53 or hemorrhagic stroke: RR=1.45), esp for RA (RR=1.38), AS (RR=1.49), PsA (RR=1.33), gout (RR=1.4) --risk higher with age <45 years (RR=1.46)
  8. 2127 suspected myositis patients assayed for myositis Abs, ~1% tested positive for SAE Abs (small ubiquitin-like modifier (SUMO) activating enzyme) - present w/ rash first, followed by myositis, extramuscular involvement, sm risk for coincident cancer
  9. Upadacitinib Clinical Efficacy in Psoriatic Arthritis
  10. Back talk - send in your questions or cases to RheumNow!




The author has no conflicts of interest to disclose related to this subject

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