Systemic Sclerosis Insights (9.13.2024)

Jack Cush, MD

Sep 13, 2024 7:00 am

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

Guselkumab (Tremfy) receives U.S. FDA approval for adults with moderately to severely active ulcerative colitis, based on pivotal, Phase 2b/3 QUASAR study showing 50% remission at week 44 (vs 19 PBO) for those on GUS 200 mg q 4 wk https://t.co/kvtqXFUezw
Low Placental Transfer Rates with Risankizumab
JAMA: RCT in 101 chronic low back pain pts showed a single nondeceptive placebo injection reduced LBP intensity for 1 month https://t.co/RI9TnvmeMJ
UK Biobank study of 34209 pts w/ Abdominal MRIs found a dose response assoc. between visceral & subcutaneous fat and chronic MSK pain, moreso in women. Is adiposity causal or casual in the pathogenesis of chronic pain? https://t.co/w4ziJf7FQD
Conservative Treatment of Acute Vertebral Fractures A network meta-analysis of pain outcomes in patients with acute osteoporotic vertebral compression fractures (VCFs) showed short-term success with calcitonin and NSAIDs in decreasing pain during activity, but long-term…teriparatide was superior to bisphosphonates. https://t.co/EulO6EGVxq
French retrospective study of 181 hemodialysis pts (97 on urate Rx-90% allopurinol, 9% febuxostat). W/ ULT pts had significantly fewer agout flare (HR:0.42; CI 95: 0.25-0.71). Overall flares 35% (23% ULT vs 50% w/o ULT; p 0.0002) https://t.co/9hTgsR2Kx9
Claims analysis of two datasets showed TNFi treatment in 1st two years after newly Dx breast cancer (n 2216) had no effect on overall survival (OS); but had signif better breast cancer survival (HR 0.28; 0.08–0.98) vs csDMARD Rx. Pts on GC worse OS (HR 2.18)… https://t.co/Kxk7Sy7ahi
CA-125 & PET/CT screening in 1432 myositis. 125 pts had CA-125 w/in 5yrs of onset - 3.1% false-positives (fibroids, endometriosis) & 14.3% false-negatives. 139 had PET done- 5.5% false-positives (LN, lung nodules), 28.6% false-negatives (missed melanoma, breast or prostate CA)… https://t.co/16KSDmp9Kz
Cross-sectional study 69 Systemic Sclerosis Pts: 33% w/ PPI-refractory esophagitis & 2/3 w/ EGD normal esophageal mucosa. PPI-refractory esophagitis was more commonly linked to diffuse SSc subset (43 vs 17%) and GI dysmotility (66 vs 8%; p = <0.001) https://t.co/givt90C0tE
Increasing Incidence of Morphea
Systematic literature review IVIG in systemic sclerosis included 12 studies, 266 pts. A favorable effect was seen for skin thickening, MSK pain, GI Sxs, Steroid use, QOL. But less effect for pulmonary Dz, PFTs (stabilized?). Studies were not of high-quality https://buff.ly/3XJ4i33
Study of 65 myositis pts w/ PM/Scl Abs found ILD as a dominant feature, esp. if double pos. w/ myositis-specific Abs (MSAs 52%). PM/Scl+ more likely women (90 vs 68%), w/ sclerodactyly (16 vs 0%). Double ++ had more ILD (91%) & mortality (21% vs 0) https://buff.ly/47x3npG
Consensus Guidelines on Pediatric Methotrexate Use