Adverse Events With Rheum Biologics Rise With Age

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Among patients with rheumatic diseases, age and female sex were important factors associated with the development of a first adverse event after initiating biologic treatment, Spanish researchers reported.

Hydroxychloroquine Fails as Postexposure Prophylaxis for Covid-19

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Add this to the list of hydroxychloroquine (HCQ) letdowns in managing COVID-19 treatment or risk - prophylaxis with HCQ fails to prevent COVID-19 infection in those exposed to the SARS-CoV-2 virus.  NEJM has reported a prospective, randomized, double-blind, placebo-controlled trial from the US and Canada wherein adults with household or occupational exposure to someone with confirmed Covid-19 were treated with either placebo or HCQ within 4 days of exposure.

Upside Down with Tocilizumab in COVID-19

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Several recent reports offer conflicting views on the potential benefits and adverse outcomes of IL-6 inhibition with tocilizumab (TCZ) therapy in patients with severe COVID-19 infection. An Italian study grabbed the headlines yesterday with a press release stating TCZ did not improve respiratory symptoms, ICU admissions or mortality rates when given to 126 COVID patients with early disease. The study, supported by the Italian Medicines Agency (Aifa), stopped enrollment (about 1/3 of projections) after an interim analysis found insufficient evidence that TCZ would be effective.  This report has not been published or undergone critical review.

RheumNow Podcast – Enough Already with Weaning (6.19.20)

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Dr. Jack Cush reviews the news and journal reports from the past week on RheumNow.com.

Cosentyx FDA Approval for Non-Radiographic Axial Spondyloarthritis

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Yesterday the FDA approved secukinumab (Cosentyx) for the treatment of patients with active non-radiographic axial spondyloarthritis (nr-axSpA). There are now three agents that are FDA approved for nr-axSpA: certolizumab, ixekizumab and now, secukinumab. 

Voclosporin Beats Standard of Care in Lupus Nephritis

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The high potency calcineurin inhibitor voclosporin plus standard of care was superior to standard of care alone in a phase III study of lupus nephritis known as AURORA.

Canakinumab First FDA-Approved Therapy for Adult-Onset Still's Disease

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Yesterday, the FDA approved canakinumab (Ilaris) as treatment for adult-onset Still's disease (AOSD), the first ever FDA approved drug for AOSD. Canakinumab, an interleukin-1 inhibitor, was FDA approved in 2013 for use children (aged 2 years and older) with systemic juvenile idiopathic arthritis and has since been approved for use in other periodic fever disorders (e.g., FMF, CAPS, TRAPS, Hyper IgD syndrome).

Dexamethasone Reduces Mortality in Severe COVID

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Preliminary results released today shows dexamethasone (DEX), given to hospitalized, severly ill, COVID-19 patients, is capable of reducing mortality rates by one-third, with researchers calling this a “major breakthrough” in coronavirus management. The results stem from a UK trial, called the RECOVERY trial, launched in March 2020, compared outcomes of around 2100 patients who were randomly assigned to DEX treatment compared with 4,300 patients not on DEX. 

Atherosclerotic Events on the Decline in SLE

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The prevalence of atherosclerotic vascular events among patients with systemic lupus erythematosus (SLE) today is considerably lower than in the past, analysis of multicenter data found. Among patients enrolled in an inception cohort from 1999 to 2017, only 3.6% of patients had an atherosclerotic vascular event, at a rate of 4.6 per 1,000 patient-years, according to Murray B. Urowitz, MD, of the University of Toronto in Canada, and colleagues.

Methotrexate May Enhance Pegloticase Response in Gout

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For patients with gout exacerbations while on pegloticase (Krystexxa), adding methotrexate may help reduce uric acid levels, researchers suggested at the European League Against Rheumatism (EULAR) virtual meeting. In a small open-label study of 14 patients experiencing acute gout attacks, use of the pegloticase/methotrexate combination reduced uric acid levels to near undetectable levels in 11 patients, reported John Botson, MD, medical director of Orthopedic Physicians Alaska in Anchorage. He noted that this was far below the 5 mg/dL level recognized as the threshold for development of inflammation that causes gout attacks.

EULAR 2020 - Top 5 Abstracts

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In no particular order, these are my top 5 presentations from this year's EULAR 2020 meeting. Congratulations to EULAR for pulling off the educational coup of the year by transforming their world class gigantic Frankfurt meeting into a worldwide virtual meeting in less than 8 weeks – KUDOS!

Virtual EULAR 2020 Round Up

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In this week's podcast, Drs. Artie Kavanaugh and Jack Cush present highlights from the virtual EULAR2020 meeting held June 3-6, 2020. Featured reports include the SELECT-CHOICE study, the EXCEED trial, Avacopan in AAV, BeST mortality outcomes, BLISS-LN study, biosimilars and tofa in systemic sclerosis.