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What is Colchicine Worth? (6.23.2023)

Jun 22, 2023 9:37 pm

Dr. Jack Cush reviews the news and reports from the past week on This week a new colchicine FDA approval, rising rate of IgG4 related disease and what's the safest biologic?

  1. An RCT of 1136 newly COVID test positive pts compared long term outcomes if immediately given METFORMIN or Placebo. Cumulative incidence of long COVID at day 300 was 6.3% w/ metformin vs 10.4% w/ placebo (HR 0.59; HR 037 if given w/in 3d)

  2. Study of 28,360 #PsA pts shows blacks have signif more HTN (59 v 52%), DM (31 v 23%), obesity (47 v 30%), gout (12 v 8%); while whites have more cancer (20 v 16%), anxiety (28 v 23%) & OP (14 v 12). Rx (NSAIDs, TNFi, DMARDs) also unequal by race.

  3. Arborviral infx w/ rituximab? 21 RTX pts dx w/ arboviral neuroinvasive Dz, (encephalitis, acute flaccid myelitis); 79% died. B cell depletion impairs immunity & spread of West Nile Virus, serologic Ab Dx tests; thus if suspected, order RT-PCR tests

  4. Small study 57 EGPA pts shows using MTX or AZA to be equipotent as 1st or 2nd line therapy in EGPA. MTX pts used more cumulative steroids (6 g vs 10.7 g @5 yrs) & more AE (66% vs 30%); AZA had fewer asthma/ENT relapses (23% vs 64%, p= 0.04)

  5. Predictors of DAPSA28 remission in #PsA starting 1st TNF-inhibitor (13 369 bio-naive pts from 13 Euro registries) showed 6 mo remission 25% and 12 mo retention 63%. Remission predictors: younger age, Dz duration, males (OR 1.85), CRP >10 (OR 1.52)

  6. Using Optum claims data from 2009 to 2021, they identified 524 IgG4-RD pts (mean age 56 yrs), incidence increased over time 0.78 to 1.39/100K Pt Yrs 2015 and 2019. Prevalence in 2019 was 5.3/100K Pt-Yrs, w/ mortality rate 3.42/100 Pt-Yrs (HR 2.51)vs age/sex matched comparators

  7. Higher Genetic Loads Linked to Worse Systemic Lupus A study of a large SLE cohort shows by genomic analysis, that higher wGRS is associated with earlier SLE onset, higher anti–Sm antibody positivity, lupus nephritis and more diverse lupus manifestations.

  8. 275 early RA pts and after 2 years, 32% reported unacceptable pain (UP). Predictors of UP best seen at 3 mos FUV (not baseline) and included #Tender Jts (not swollen), overall pain, patient global assessment, and HAQ.

  9. BIOSIMILARS (93 in EU, 40 in US) are approaching a tipping point with 8 new adalimumab biosimilars in 2023. Humira sales are down ~26% in 2023. Biosimilar sales expected - $129 billion in next 5 yrs, with estimated savings of $181 billion

  10. FDA Approves Colchicine for CV Prevention

  11. Abatacept Safety Outcomes Across 7 European Registries

  12. 2023 EULAR Recommendations on Imaging in Crystal-Induced Arthritis

  13. #ACA: Ask Cush Anything: Dr. Bruce Hoffman – how to treat ACPA+ arthralgias


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