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Women with Rheumatic Disease (11.4.2022)

Nov 04, 2022 12:29 pm

Dr. Jack Cush reviews the news and journal articles from this past week on  New regulatory decisions about JAK inhibitors and why do women with rheumatic diseases have unfair outcomes?

  1. Population study shows among vaccinated gout pts, COVID breakthrough infection occurred in @ 4.68/1K Pt-mos vs 3.76/1K Pt-mos in non-Gout persons. Gout w/ Covid had More Hosp (aHR=1.30) & death (aHR=1.36), moreso in Women w/ gout (aHR 1.55 & 2.46)

  2. Multinational cross-sectional survey of 2270 PsA pts shows despite comparable Dz duration, presentation, biologic use (54%), Women had worse QOL, more disability and work activity impairment (but less comorbidities)

  3. BIOBADASER registry study of 969 axSpA pts (315 females, 654 males; 2000-2019) who initiated a TNFi shows nonresponse (BASDAI50) was more likely in women (p=0.018), older age at the start of TNFi therapy.

  4. Single center study from UAB shows 72 gout pts treated & D/C from ED were Rx w/ steroids (64%), opioids (63%), NSAIDs (43%), colchicine (32%). But only 26/72 (36%) had subsequent outpatient clinic visit for gout.

  5. China study of 109 w/ MPO+ vasculitis (MPO-AAV), 23 w/ anti-GBM & 20 Double positive (MPO+ GBM+) (DPP) pts showed DPP pts were older(p=0.007), higher creatinine & lower GFR, & had multi-organ damage (cardiac) outside the kidney

  6. Drug-induced Hepatotoxicity - many Rheum drugs on the list: Tylenol, azathioprine, allopurinol, cyclosporine, dapsone, gold, MTX, 6-MP, NSAIDs, ASA, SSZ, Minocin...

  7. Opportunistic infections in #PsA pts on b/tsDMARDS is low. Metanalysis 47 studies, 17,197 pts - OI risk by MOA:1) JAK inhib 2.72%, 2) anti-IL-17 1.18%, 3) anti-IL-23 0.24% , 4) TNFi 0.01%. H. zoster w/ JAKi= 2.53% & Candida risk w/ IL-17=0.97%

  8. GSK announced they will halt development of Otilimab (anti-GM-CSF mAb) to treat #RA; decisioin based on negative results from phase 3 ContRAst-3 study, that failed to meet ACR20 primary endpoint in RA pts who failed bDMARDs or JAKi

  9. Chest CT Airway Dz compared betw GPA (n26) & relapsing polychondritis (n19). Subglottic involvement favors GPA (OR 28.6) & Extensive airway Dz favor of RP (GP OR 0.02). Lesser RP assoc w/ Posterior tracheal sparing & tracheal calcifications.

  10. EMA Crack Down on JAK Inhibitors

  11. Undiagnosed RA During the Pandemic

  12. SLE T2T - Lupus Low Disease Activity State Predicts Outcomes


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