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“You Can Have it All” (4.7.2023)

Dr. Jack Cush reviews the news and highlights from our "Women in Rheumatology" Campaign from last week on

  1. AMA survey shows 94% MD report delays in Pt care assoc w/ prior authorization. MDs spend 2d/wk on PA &1/3 hire added staff for PA. 4/5 PAs result in abandoned Rx. CMC has a proposed rule to speed up PA approval.  Congress needs to act on this PA problem!

  2. Steroid-Sparing Rituximab in Polymyalgia Rheumatica BRIDGE-PMR proof-of-concept trial assessed the efficacy of RTX in patients with PMR and showed that a single 1000 mg dose of lead to a significant number of glucocorticoid-free remissions after 1 year.

  3. Open-label Trial of 14 pts with MAS due to steroid refractory systemic JIA or adult-onset Still’s demonstrated the efficacy of IV emapalumab, an anti-IFNγ mAb. Demonstrated signif reductions in LDH, sIL-2R, Ferritin, CXCL9, & steroid dose

  4. Inflammasome inhibitors in development: RRx-001 in cancer, ALS, parkinsons - OLT1177 in OA knee, gout, Schnitzlers - DFV890 in CAPs, knee OA - IZD174/334 in CAPS - ZYIL1  CAPS

  5. Among 182 adult #RA pts - half (50%) had Depression and 25% had anxiety. Patients with depression or anxiety had higher HAQ and DAS28 scores. Depression was more prevalent in females, housewives, & low education. Anxiety more in blue-collar workers

  6. Abbvie has completed a phase II upadacitinib vs combo elsubrutinib/upadacitinib (ABBV-599) in active #SLE - M19-130 (SLEek) Phase 2 trial met the primary endpoint SRI-4 response and pred dose<=10 mg qd. No new safety signals - Phase III trial planned

  7. Antiphospholipid Antibodies With Incident Cardiovascular Events

  8. EMA Final Update on JAK Inhibitors and MACE, Malignancy & VTE Risks

  9. DESIR - early SpA Cohort study of 494 pts (half F); w/ 6 yrs F/U, Women had higher ASDAS-CRP & PtGA (P < 0.0001; vs men), yet CRP was similar and structural damage more frequent in men (P < 0.0001).

  10. Analysis of 886 SpA pts in the Ankylosing Spondylitis Registry of Ireland shows women have worse BASDAI (4.57 vs 3.83, p < 0.01) & ASQoL (7.51 vs 6.12, p < 0.01) scores than males. higher scores in females due to all 6 BASDAI components

  11. Pooled data from 3 RCTs in PsA compared tofacitinib vs. adalimumab in 816 pts. Baseline, women had higher TJC, enthesitis, HAQ-DI, FACIT-F (Males more dactylitis). Sexes had equal ACR20/50/70, PASI75, ∆HAQ-DI, & persistence, but females less achieved MDA

  12. US MD survey shows # active MDs grew 33% to 923 419 (2001-2021). But AVG weekly work hrs declined 7.6% (53 to 49 hrs/wk). Decline driven by MD males/Fathers (-12%), rural MDs, 45-54 yrs old MDs. Only MD mothers had signif. increase in work hours (+3%)

  13. Aug 2022 Ann Int Med reports a Compensation study of 1435 matched male (881) & female (554) PCPs; Shows that despite being a growing share of the workforce, Women PCPs earned median of $58 829 less than male PCPs.

  14. 962 #RA pts from Leiden early arthritis clinic shows that in 2005 was a significant delay (~5wks) in referral of females vs male pts. The longer referral delays in female pts has since been eliminated. By 2020 the referral delay is same 4.7 vs 5.4 wks.

  15. "You can have it all... ... but not all at the same time ... or all the time."- @UnaMakris @rheumnow Tuesday Night Rheumatology

  16. Our next Tuesday Night Rheumatology addresses Contract Negotiations, featuring Andrea Liberatore, JD, Gwenesta Melton, MD, and Kathryn Dao, MD. Sign up to attend this and all of our Tuesday Night Rheumatology series.


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