Running with Data (8.30.2024)

Jack Cush, MD

Aug 30, 2024 7:00 am

Dr. Jack Cush reviews the news and journal reports from the past week on RheumNow.com - including tips on steroids, MAS, and myositis testing.

Pooled data from BE MOBILE 1 & 2 RCTs shows Bimekizumab (dual-IL-17A/F inhib) may protect against uveitis in axSpA pts. N=349 pts - 0.6% BKZ vs 4.6% placebo developed uveitis (1.8 vs 15.4/100 PYs); even in pts w/ Hx of uveitis (6.2 vs 70/100 PYs; p=0.004) https://buff.ly/4g6wUdG
Retrospective study of 58 pts w/ #SLE concurrent with PJP infx, showed that 39% died, with many of these having diabetes and invasive ventilation. A 4 fold incr Mortality seen risk factorsHyperglycemia/DM, decreased C3, & thrombocytopenia https://buff.ly/4g1MPd9
MDs: How long must you be on Pred 40 mg/d before you must slowly wean pred (vs stopping abruptly)?

4. It takes >3-4 weeks of steroids (@ any dose >5 mg pred/d) to pose risk of adrenal insufficiency – Hence, Endocrine Society Guideline says short-term glucocorticoid therapy of <3-4 wks, irrespective of dose, DOES NOT require GC tapering https://buff.ly/4e6PGjj

5. RISE registry study shows Prednisone Rx before rheum consult ends up with more long-term Pred. 1,733 RA pts; 715 on GC (41% 0.5-2 mos before rheum care). mean GC use =157 d. GC before rheum care associated with longer GC use https://t.co/UpeK4hwIN0

6. Novel: 2 case reports of refractory macrophage activation syndrome successfully treated w/ an investigational monoclonal Ab (MAS825 ) to IL-1β, and IL-18 https://t.co/ZqC77njbjk

7. Study of 425 RA pts & 36 mo. bDMARD retention rates w/ TNFi, IL-6i & ABA based on renal funct (eGFR: ≥60, 30–60, <30 mL/min) showing little effect of CKD w/ TNFi (45%, 28%, 34%), IL-6i (47%, 67%, 71%) & CTLA-4Ig (50%, 31%, 33%), maybe lower w/ TNFi & higher w/ IL6i… https://t.co/FhXoSnEfG1

8. Renal Impairment in Rheumatoid Arthritis Patients with highly active rheumatoid arthritis (RA) experienced faster declines in kidney function than those whose disease was under better control, analysis of a large registry indicated. https://t.co/yVLZDkt53R

9. New $$$ drugs are NOT usually steroid sparing, but a single center 716 RA pt study compared JAKi (n 156) vs bDMARDs (560) starts; JAKi assoc w/ more rapid GC reduction in1st 6 mos & 60% higher odds of GC D/C (adj OR 1.63) (>50% vs 40% @12 mos) https://t.co/shiDytQeBU

10. Global Rheumatoid Arthritis Market estimated to be worth USD 22.77 billion in 2021 and is predicted to expand to USD 33.30 billion by 2030 https://t.co/J64mVxY4Ia

11. Cohort study shows GERD in 1539/1632 (94%) #SSc patients & 450/469 (96%) of SSc-ILD pts. GERD didnt influence ILD Dx or severity. But GERD Rx (PPI, H2RA) assoc w/ improved survival in those Scleroderma pts with ILD (p = 0.002) https://t.co/stQkpbmBCP

12. Myositis (IIM) pts w/ ILD have higher mortality. Study of IIM (n 190) vs myositis-mimics (414) shows ILD risk incr by myositis-specific antibody (MSA) 6 fold; Ro-52 8 fold; or 20 fold with dual positivity (MSA + Ro-52 antibodies) https://t.co/UrrN28FXfz

13. Diagnosing Seronegative Sjogren's Disease

14. Antibiotics May Increase Inflammatory Arthritis Risk