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What is JAKne? (5.6.2022)

May 06, 2022 2:31 pm

Dr. Jack Cush reviews the news, journal reports, FDA actions, new side effects and changing prevalence of Gout.

  1. Gout affects >10 million (4%) in USA, but now w/ more ethnicity, with highest risk in Native Hawaiians (HR 2.21), followed by Black (1.34) and Japanese (1.14); but lower in Latinos (HR 0.78) compared to whites.

  2. Hyperuricemia as a biomarker of severe #PsA? Study of 242 PsA pts 30% had hyperuricemia & 6% had gout. Hyperuricemia was significantly associated with age, comorbidity, perph polyarthritis, Jt destruction, less response to treatment.

  3. Canadian study of 6012 Pregnancies w/ +COVID-19 PCR test shows Preg pts increased risk of hospitalization (RR 2.65) & ICU adm (RR 5.46) vs gen population and higher risk of preterm birth vs preg women without COVID (RR 1.63)

  4. Danish case-control registry of 491,274 women shows Psoriasis assoc w/ increased risk of ectopic pregnancy (EP) (OR 1.34), highest in women w/ moderate-to-severe psoriasis (OR 2.77). EP risk was 2.5x higher for women w/ mod--severe PSO

  5. Phase 2b DBRPCT of Intranodular injections of adalimumab in 140 pts w/ Dupuytrens contracture showed signif reduction nodule size and hardness (−4·6 vs −2·2; p=0·0002) at 12 months

  6. Neural networks of high-res quantitative CT (HR-pQCT) scans allowed for 3D imaging of MCP2 to differentiate normals from #RA & #PsA. 932 of 617 ppts correct AuROC for HC 82%, RA 75%, PsA 68%. UA pts read as 86% RA,11% PsA, & 3% HC

  7. Retrospective study of 71 adult-onset Still’s disease pts Rx 1st w/ High-dose glucocorticoids shows 41% failed to respond (poor outcome) by week4 w/ WBC as best predictor. If WBC < 13K 60% responded; if ≥13K only 23.5%

  8. An increasing incidence of RA is driven by increasing # of ACPA-negative RA (but not ACPA-positive RA), partly explained by an ageing population (thus making ACPA-negative RA more prevalent in coming years)

  9. Leflunomide responses in #RA assoc w/ high metabolite levels (A77 1726). In 115 LEF Rx Pts, 40% had LDAS/remission. A77 1726 levels neg correlation w/ DAS28-ESR (r = − 0.42, p < 0.001). Levels >10µg/mL & LDAS PPV 70%; NPV 93%

  10. Study of 33 #RA pts finds nearly half had peripheral neuropathy (48.5%); sensorimotor in 64.7%, motor in 17.6%. Neuropathy was NOT associated with age, gender, disease activity, functionality, or falls

  11. Upadacitinib FDA Approved for Ankylosing Spondylitis 

  12. Acne with JAK Inhibitors 

  13. Efficacy of Subsequent b/tsDMARD Use in Rheumatoid Arthritis

The author has received compensation as an advisor or consultant on this subject

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