The Window of Opportunity (5.24.2024) Save

Dr. Jack Cush reviews the journal reports and news from the past week on RheumNow.com. This week: blockbuster drugs, opioids in rheumatology and nontreatment of inflammatory arthritis?

1. No Link Between Autoimmune Diseases and Monoclonal Gammopathy of Undetermined Significance Annals of Internal Medicine reports a study of more than 75,000 persons screened for MGUS and found no association between AIRD and MGUS. https://t.co/cTuIWU7eoa
2. Lille Univ Hosp study of 485 systemic sclerosis pts, found osteoporosis in 23% (18% w/ fragility Fx). OP independently linked to age (OR1.06), topoisomerase I Ab+ positivity (OR 2.22) & GC treatment (OR 4.48) https://t.co/9KN5VQnl4A
3. Australian multicenter KARAOKE RCT of 262 adults w/ Knee OA (w/ MRI effusion/synovitis) Rx w/ placebo vs , 2 g/d of krill oil showed no significant benefit in pain VAS score, −19.9 [krill oil] vs −20.2 [placebo]. https://t.co/8QSZyzIVh9
4. Best Selling US Drugs in 2023 11 Skyrizi $10.1 billion 10 Dupixent $11.5 b 9 Biktarvy $13.15 b 8 Mounjaro $13.16 b 7 Keytruda $15.4 b 6 Stelara $15.87 b 5 Jardiance $15.89 b 4 Trulicity $16.3 b 3 Eliquis $22.1 b 2 Humira $35.3 b 1 Ozempic $38.6 b https://t.co/tiEwqyTB6D
5. 384 Psoriasis pts followed mean 33 mos, 56 (14.6%) developed new-onset PsA. 311/384 (81%) had arthralgia (subclinical PsA) & 9.4% got PsA within 12 mos (23% by 36%). Subclinical more likely than PSO to get PsA (OR 11.7) https://t.co/D7n3ZpJURH
6. Brazilian Registry of Spondyloarthritis study of 1096 SpA pts, found 73% HLA-B27 positivity. B27+ signif assoc w/ males, earlier onset/Dx, uveitis, +FHx. B27 negativity assoc w/ psoriasis, higher peripheral arthritis/disease activity, worse QOL, mobility https://t.co/ousSetEnrt
7. MarketScan Claims & Medicaid study of incident AS, PsA, or RA (2010–2017) that Opioid use was highly prevalent in AS (36%), PsA (30%), & RA (44%) in the year prior to Dx & during the 1st Yr. Is this PCP or Rheumatologist mismanagement? https://t.co/YsCOLZUCfS
8. NON-treatment of 18,318 VA pts (RA, SpA, PsA) = 41% not Rx DMARDs w/in 12 mos of Dx. Signif higher odds if Black (HR 1.13), Hispanic (1.14), Charlson Comorbidity ≥2 (1.15), opiate use (1.09). DMARD use ^ if married, w/ erosions, female MD, Rheum Dx https://t.co/TaYC27oIOz
9. Insurance claims data studied 7580 newly Dx RA (2018-2020) - 1998 tofacitinib vs 5582 adalimumab. After propensity matching, dyslipidemia was signif. higher w/ TOFA (HR 1.25), BUT no differences in MACE (HR 0.995) or all-cause mortality (HR, 1.4; NS) https://t.co/ZJ7uHWTycS
10. FAERS retrospective, safety study of JAKi use in 75K RA pts (52K Tofa; 21K Upa, 2.2K Bari vs bDMARDs) found JAKi had incr risk of VTE (adj ROR=2.11), CVA (ROR=1.25), IHD (1.23), edema(1.22), & tachyarrhythmias (1.15) https://t.co/Bvds4C66Nq
11. Disparities in SLE care: adult Medicare cohort study of 1,036 SLE pts found 39% saw a rheumatologist q 6 mos & 28% had serologic tests. Least disadvantaged quintile had higher visit-based retention, but decreased serologic testing (aOR 0.80) https://t.co/lGoriPIMqV
12. Greek cohort study of 570 SLE pts; lupus nephritis was initial presentation in 59, w/ another 66 LN during F/U (total LN= 22%). Predictors of LN: male sex (adjHR 4.31), Dx age <26yrs (3.71), Hi dsDNA (2.48), low C3/C4 (NS 2.24) https://t.co/lGmZlBpaPq
13. SLE Cost of Care and Disease Activity 
14. Window of Opportunity in Psoriatic Arthritis 

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