The RheumNow Week n Review - 29 April 2017 Save
The RheumNow Week n Review - 29 April 2017 by Dr. Cush
Transcription
Hey now, I'm Jack Cush, executive editor of roomnow.com. It's the 04/28/2017. This is the room now we can review. I'm coming to you this week from the ACR state of the art meeting here in Chicago. Yesterday I was at the Clinical Congress Rheumatology meeting in Destin.
Two very good meetings occurring on the same weekend. At the top of the news, you should follow the Twitter feed for RheumNow over the weekend. We have got a ton of tweets from meeting content given and the tweets are coming out from RheumNow from great speakers like Bingham and Calabrese and Otis and Gabriel and Alan Steers lecturing right now. It goes on and on and on. Peter Merkel later, we'll be tweeting all week, all weekend from the SOTA meeting, so stay tuned.
Announcements that you should be aware of, the ACR abstract site is open and will close with a deadline of June 19. They've also published the dates for their late breaking abstracts. Congratulations goes out to Jim O'Dell, a big shot and a leader in rheumatology, also a big shot and leader in the ACP where he has been voted in as an ACP master. Congratulations, Jim. This week the EU has been busy in the approval of certain drugs.
Although the drugs are not yet approved, they've been recommended for approval. The EMA's committee that looks at that is called the CHMP and the CHMP has actually recommended that the IL-six drug approved in Canada called Kevzara, also known as sorrelimab, has been recommended for approval in moderate to severe RA in The EU. They wait decision by the EMA hopefully in the next few months. Also the CHMP has been busy and actually has recommended the approval of two new biosimilars both coming from Sandoz, the etanercept biosimilar and the rituximab biosimilar from Sandoz being recommended by the CHMP. And lastly, the big news this week is the FDA approval of a fourth biosimilar in The United States called Renflexis.
This is the previously known as the SP2 antibody from Samsung Bioepis. It is now improved. It's been approved in other countries under the similar a name. It's approved like in 22 countries in Europe and whatnot. This is the fourth biosimilar, the second infliximab biosimilar and actually it's the fourth TNF inhibitor, the second infliximab biosimilar and then the fifth biosimilar overall to be approved by the FDA.
That will be on the market in months to come. A report from the last week, there was the British Society of Rheumatology meeting going on in The UK and a study of over 19,000 patients on biologics showed that the risk of opportunistic infections is, guess what, one in a thousand. I keep using that number. The really rare, the really ugly, the really dangerous stuff that freaks everybody out is a one in one thousand risk. In fact, their number was like one in a thousand and fifty three.
So that's what five years of follow-up looking at multiple biologics and looking at the risk of opportunistic infections. The National Psoriasis Foundation has a scientific committee that actually has come up with some guidelines. It's called the Medical Board of the NPF and they say that DMARDs including methotrexate, cyclosporine and even TNF inhibitors should be continued perioperatively in patients with psoriasis who are on those drugs. These guidelines sort of mirror the guidelines coming from the ACR presented at the last ACR meeting by Singh and Goodman. So again there's ample evidence going forward.
A lot of it is expert opinion based on some data that is okay to continue on DMARD and biologic therapy in patients undergoing surgery. A nice review of aortitis looked at the causes of aortitis. This is in the literature we put it on Twitter and on the website. Non infectious clinically isolated aortitis should make you think that this is the presentation of another autoimmune disease like giant cell arteritis, IgG4 related disease and infections and or GPA granulomatosis, granulomatous polyangiitis with granulomatous polyangiitis. Good news on the forefront of RA management, we're doing really well.
The Mayo Clinic has shown that there's a reduction in mortality in RA patients for the first time in a few decades with the use of newer drugs. A worldwide review done by the WHO from 31 countries shows that mortality rates in RA have declined significantly, forty eight percent, from 1987 to twenty eleven. Very good news for our RA patients. An interesting review comes from the study of an animal model of osteoarthritis showing that senescent chondrocytes have an important regulatory role inside a joint and in fact when they actually use the compound designed to eliminate chondrocytes that the development of post traumatic osteoarthritis was far less suggesting that these senescent chondrocytes could be a potential target for future therapies. An interesting news article appeared in the New York Times and in fact was a review, a lot of interviews from orthopedists in the field that looked at the utility of inpatient rehab versus home rehab in patients undergoing hip or knee replacements showing that there's an ample amount of data these days suggesting that home rehab actually is better than inpatient rehab.
It's certainly less costly and a lot of the experts in the field point out that the total cost of joint arthroplasty is what happens after the surgery in the aftercare, especially if there's going to be inpatient management. It turns out the patients who go home also have less toxicities and complications of surgery. So again, that might be the advice you might want to give your patients going forward. A recent study from Monica Ostensen who studies pregnancy looked at patients with RA and spondylitis and showed that those patients who actually were on a TNF inhibitor for either disease who stopped a TNF inhibitor at their first pregnancy test being positive, when they followed them prospectively it turns out that about thirty percent of them flared and had to go back on therapy. It may not be the smartest thing to do and I'll remind you that in IBD it is standard fare for patients who are on either a thiopurine or a TNF inhibitor to continue that throughout the pregnancy so that the patient doesn't flare with regard to their disease.
Well, that's it from the SOTA meeting here in Chicago. Be sure to follow our Twitter feed and what we put on the website about SOTA. Go to the website to find these citations and more information on these articles. We'll see you next week.
Two very good meetings occurring on the same weekend. At the top of the news, you should follow the Twitter feed for RheumNow over the weekend. We have got a ton of tweets from meeting content given and the tweets are coming out from RheumNow from great speakers like Bingham and Calabrese and Otis and Gabriel and Alan Steers lecturing right now. It goes on and on and on. Peter Merkel later, we'll be tweeting all week, all weekend from the SOTA meeting, so stay tuned.
Announcements that you should be aware of, the ACR abstract site is open and will close with a deadline of June 19. They've also published the dates for their late breaking abstracts. Congratulations goes out to Jim O'Dell, a big shot and a leader in rheumatology, also a big shot and leader in the ACP where he has been voted in as an ACP master. Congratulations, Jim. This week the EU has been busy in the approval of certain drugs.
Although the drugs are not yet approved, they've been recommended for approval. The EMA's committee that looks at that is called the CHMP and the CHMP has actually recommended that the IL-six drug approved in Canada called Kevzara, also known as sorrelimab, has been recommended for approval in moderate to severe RA in The EU. They wait decision by the EMA hopefully in the next few months. Also the CHMP has been busy and actually has recommended the approval of two new biosimilars both coming from Sandoz, the etanercept biosimilar and the rituximab biosimilar from Sandoz being recommended by the CHMP. And lastly, the big news this week is the FDA approval of a fourth biosimilar in The United States called Renflexis.
This is the previously known as the SP2 antibody from Samsung Bioepis. It is now improved. It's been approved in other countries under the similar a name. It's approved like in 22 countries in Europe and whatnot. This is the fourth biosimilar, the second infliximab biosimilar and actually it's the fourth TNF inhibitor, the second infliximab biosimilar and then the fifth biosimilar overall to be approved by the FDA.
That will be on the market in months to come. A report from the last week, there was the British Society of Rheumatology meeting going on in The UK and a study of over 19,000 patients on biologics showed that the risk of opportunistic infections is, guess what, one in a thousand. I keep using that number. The really rare, the really ugly, the really dangerous stuff that freaks everybody out is a one in one thousand risk. In fact, their number was like one in a thousand and fifty three.
So that's what five years of follow-up looking at multiple biologics and looking at the risk of opportunistic infections. The National Psoriasis Foundation has a scientific committee that actually has come up with some guidelines. It's called the Medical Board of the NPF and they say that DMARDs including methotrexate, cyclosporine and even TNF inhibitors should be continued perioperatively in patients with psoriasis who are on those drugs. These guidelines sort of mirror the guidelines coming from the ACR presented at the last ACR meeting by Singh and Goodman. So again there's ample evidence going forward.
A lot of it is expert opinion based on some data that is okay to continue on DMARD and biologic therapy in patients undergoing surgery. A nice review of aortitis looked at the causes of aortitis. This is in the literature we put it on Twitter and on the website. Non infectious clinically isolated aortitis should make you think that this is the presentation of another autoimmune disease like giant cell arteritis, IgG4 related disease and infections and or GPA granulomatosis, granulomatous polyangiitis with granulomatous polyangiitis. Good news on the forefront of RA management, we're doing really well.
The Mayo Clinic has shown that there's a reduction in mortality in RA patients for the first time in a few decades with the use of newer drugs. A worldwide review done by the WHO from 31 countries shows that mortality rates in RA have declined significantly, forty eight percent, from 1987 to twenty eleven. Very good news for our RA patients. An interesting review comes from the study of an animal model of osteoarthritis showing that senescent chondrocytes have an important regulatory role inside a joint and in fact when they actually use the compound designed to eliminate chondrocytes that the development of post traumatic osteoarthritis was far less suggesting that these senescent chondrocytes could be a potential target for future therapies. An interesting news article appeared in the New York Times and in fact was a review, a lot of interviews from orthopedists in the field that looked at the utility of inpatient rehab versus home rehab in patients undergoing hip or knee replacements showing that there's an ample amount of data these days suggesting that home rehab actually is better than inpatient rehab.
It's certainly less costly and a lot of the experts in the field point out that the total cost of joint arthroplasty is what happens after the surgery in the aftercare, especially if there's going to be inpatient management. It turns out the patients who go home also have less toxicities and complications of surgery. So again, that might be the advice you might want to give your patients going forward. A recent study from Monica Ostensen who studies pregnancy looked at patients with RA and spondylitis and showed that those patients who actually were on a TNF inhibitor for either disease who stopped a TNF inhibitor at their first pregnancy test being positive, when they followed them prospectively it turns out that about thirty percent of them flared and had to go back on therapy. It may not be the smartest thing to do and I'll remind you that in IBD it is standard fare for patients who are on either a thiopurine or a TNF inhibitor to continue that throughout the pregnancy so that the patient doesn't flare with regard to their disease.
Well, that's it from the SOTA meeting here in Chicago. Be sure to follow our Twitter feed and what we put on the website about SOTA. Go to the website to find these citations and more information on these articles. We'll see you next week.
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