An Epidural Letdown (4.4.2025) Dr. Jack Cush reviews the news and journal reports from this past week on https://t.co/V10S4oVFsv. https://t.co/YDxQWukJ5U https://t.co/Pr7tG5rU0R

Danish registry study of 1431 AAV pts ((median age: 69 yrs, 52M; F/U 4.8 yrs) shows AAV had more LVH (17% vs 12%), ST-T (10% vs 7%), aFib (9.6% vs 7.5%), QTc prolong (6% vs 3.6%). Only AAV w/ major ECG abnls had incr risk of CV mortality [HR 1.99; 1.49-2.65) https://t.co/OB8b9pC6kw

EMA's EudraVigilance (safety) database study of 10,319 MTX reports (age: 62 yrs, 73% F). Adverse rxns (ADR): 365 kidney & 1,082 liver related. MTX renal ADRs were older, w/ comeds (NSAIDs, Tylenol, metamizole, steroids). More deaths w/ renal ADRs than liver(21% vs 6%); mostly w/ https://t.co/sZYZla0q1X

JAMA Staphylococcus aureus Review - s. aureus bacteremia leads to septic arthritis (7%), vertebral osteomyelitis (≈4%) - bacteremia (≥48 hs) has 39% 90-day mortality risk https://t.co/atao3mF32L https://t.co/oMSJVNKvJN

Topline results from Phase 3b APEX study, comparing guselkumab to placebo in biologic naive #PsA pts - showed significant improvement by ACR20 and significantly less Xray progression of structural damage (vs PB) at Week 24 https://t.co/YkUspqd92h https://t.co/cmAUWaScri

FDA announced approval of Inebilizumab (Uplizna; Amgen), 1st approved Rx for IgG4-related disease (targets CD19+ B cells). IG4-related Dz is estimated to affect 20,000 in the USA. List price is $140,248.50 per dose, After two initial loading doses it is given q 6 mos. https://t.co/aD9yBVJukQ

Matched cohort study of 83,811 #RA pts showed RA had a 12% increased risk of avoidable hospitalizations (CHF, pulmonary edema; (IRR 1.12). Predictors of ACSC hosp. were age, Steroids, ambulatory comorbid Dxs. ambulatory care access & ^ primary care may reduce this risk. https://t.co/Tx7LO59RbP

12-month community trial 770 adults w/ opioid-treated chronic low back pain (CLBP). Found that opioid dosage decreased with both mindfulness-based therapy & cognitive behavioral therapy (CBT) at 6 & 12 mos.(noninferior) - Why dont we use these? https://t.co/9VhqJEHlhc https://t.co/GWnL66nbvY

NORD-STAR RCT: Rx -naïve pts w/ early #RA found triple (MSH) Rx w/ prn IA steroid injx was superior to MTX + Pred (w/ taper) - w/ better clinical outcomes, fewer withdrawals, fewer AEs, & less steroid use BUT slightly worse Xray outcomes https://t.co/YN6Om2xdIP https://t.co/a7G8WFZSK7

JAK-pot Collaboration of 15 registries looked at MACE risk in RA pts and found NO incr CV risk during 1st 2 yrs of JAKi (vs TNFi) use. 51233 pts; 828 incident MACE; in 73008 Rx courses (16K JAKi, 35K TNFi, & 21K OMA bDMARDs). JAK adj IRR: 0.89;0.63 to 1.25 (vs TNFi); bDMARD-OMA https://t.co/MAZrGfCNrU

French REGATE registry study examined RA pts (n 1496) & Safety of tocilizumab (exposure 3991 PYs). 63 (4.2%) developed 75 cancers (35 solid, 11 Heme, 3 melanomas, 26 NMSC). CA incidence rate (excluding NMSC) was 7.5 /1000 PY. Independ Risk factors for solid CA = age (HR=1.05), https://t.co/3q8HIPa6qf

Vamorolone: a New Steroid on the Horizon? Vamorolone is a potentially new alternative to traditional glucocorticoids for use in inflammatory diseases. It is a dissociated steroidal compound with reduced side effects, and in an animal model of inflammation has shown effective https://t.co/zHDyJbU23q