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Anti-Rheumatic Rx

Best Rheumatologists (7.19.2024)

This week on the RheumNow Podcast, Dr. Jack Cush reviews the news and journal reports of interesting, including irAE, pollution and Psoriasis, microwave therapy, scleroderma without scleroderma that only the best rheumatologists could discern.

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JAK Inhibitors Reduce Macular Degeneration

Mepage Today

Insurance claims data showed that patients with autoimmune disorders who took Janus kinase (JAK) inhibitors had lower rates of age-related macular degeneration (AMD), hinting that the drugs might treat the common eye disease.

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Geography of Arthritis-attributable Pain in the USA

The journal Pain has shown geographic differences in arthritis-attributable pain, arthritis-related outcomes mostly clustered in the Deep South and Appalachia, while severe arthritis pain is more prevalent in the Southwest, Pacific Northwest, Georgia, Florida, and Maine.  

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Updated EULAR Recommendations on the Treatment of Systemic Sclerosis Medscape has published an overview to the 2024 updated recommendations for the treatment of SSc presented in Vienna at EULAR 2024. https://t.co/U0usOgajFQ https://t.co/Hos3mu7rVE
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Retrospective study, biopsy-proven Lupus Nephritis pts - 35 of 115 pts (30%) were ANCA positive. ANCA+ LN pts had higher dz activity, predominantly proliferative LN, require more immunosuppressives (CTX, MMF) to achieve remission. https://t.co/NKPyC7Ri9F https://t.co/DVDES77ect
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Recurrent chronic monarthritis treatment with microwave ablation (MWA). 22 pts, 24 knees requiring median 5 IA aspirations in the last 6 mos.(total 129) decreased to 7 total in 6 mos post MWA ((0.89 vs 0.03/mo, P < 0.001). No complication. https://t.co/M2N0eFFKvL https://t.co/EOKUfudtSS
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Updated EULAR Recommendations on the Treatment of Systemic Sclerosis

Medscape

Medscape has published an overview to the 2024 updated recommendations for the treatment of systemic sclerosis (SSc) presented in Vienna at EULAR 2024 by Professor Francesco Del Galdo, MD, PhD on behalf of a 27 member task force.

The new recommendations (n=20)

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Systemic sclerosis sine scleroderma

Systemic sclerosis sine scleroderma (ssSSc), which accounts for nearly 10% of systemic sclerosis (SSc) patients and was first described in 1962, is a subset of SSc.

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Efficacy of Biologics in Patients with CKD A retrospective cohort study of biological bDMARDs persistence in RA patients w/CKD, shows the 3 year survival to be > 50% but all studied biologics were nearly equivalents with regard to safety and efficacy. https://t.co/rL2ZondUsE https://t.co/1hM237Jl83
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European Research Council has awarded a Proof of Concept Grant to Institute of Bioengineering of Catalonia and their OrthoBots project, to study the treatment of joint diseases using nanorobots to deliver nanoparticle based therapy to synovial tissues https://t.co/JmYQ1727rf https://t.co/k5uZoSwJPo
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Pollution and Autoimmunity (7.12.2024)

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

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MTX was tapered or D/C in 30% of RA pts w/in 2 yrs of b/tsDMARD Rx. Of 889 pts, MTX (19 mg/wk) tapered in 13.8% & D/C 16.5% (planned taper(37%); pt decision (27.2%). In 582 (66%) MTX unchanged, 4.25 increased MTX after b/tsDMARD initiation https://t.co/yc8exMbeD1 https://t.co/b3L3Fha7xU
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ICYMI: Can Mycophenolate be Stopped in Stable SLE? https://t.co/WJv2CajgW9 https://t.co/AU8X5bVSJQ
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Progress in SLE with new mRNA CAR-T cell Trial

Cartesian Therapeutics, has announced their first-in-class mRNA-engineered chimeric antigen receptor T-cell therapy (mRNA CAR-T) therapy has been given to the first systematic lupus erythematosus (SLE). patient in a Phase 2 open-label clinical trial. 

The investigational drug,

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Efficacy of Biologics in Patients with Chronic KIdney Disease

A retrospective cohort study of biological disease-modifying antirheumatic drugs (bDMARDs) persistence in rheumatoid arthritis (RA) patients with chronic kidney disease (CKD), shows the 3 year survicval to be under 50% but that all studied biologics were nearly

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CT angio in 75 pts w/ Takayasu arteritis (40 w/ cDMARDs, 35 biologics) showed reduced arterial thickness in 73% (31% w/ >25% decr in wall thickness). 1st immunosuppressives (p= 0.012) & bDMARDs(p= 0.026) reduced art. wall thickness (relative to cDMARDs) https://t.co/16eGmgVoWr https://t.co/AyNyT7FsYZ
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Cost-Effectiveness of Biosimilars vs Leflunomide

An economic evaluation of 25 099 rheumatoid arthritis patients found that treatment with biosimilar disease-modifying antirheumatic drugs (DMARDs) were cost-effective compared with the conventional DMARD, leflunomide. Does this suggest RA treatment guidelines need to be amended to allow

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ICYMI: 9 Facts about Leflunomide Medscape has published an informative review of leflunomide, drawn from Dr. Eric Ruderman’s recent lecture on the subject at the February RWCS meeting in Maui. https://t.co/WseVa589Fg. https://t.co/K4u00MbwEb
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ICYMI: Can Mycophenolate be Stopped in Stable SLE?

In patients with clinically stable systemic lupus erythematosus (SLE) and lupus nephritis, the withdrawal of mycophenolate mofetil was not significantly inferior to mycophenolate maintenance, but MMF withdrawal had numerically more reactivations, while MMF maintenance had more infections.

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ICYMI: 2023 EULAR Psoriatic Arthritis Recommendations

EULAR has updated its treatment recommendations from the prior 2019 guidelines, since there have been several newly developed agents. The updated guidance includes 7 overarching principles and 11 recommendations regarding treatment strategy and pharmacological therapies.

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ICYMI: Hidradenitis Suppurativa-Related Autoinflammatory Syndromes

Hidradenitis suppurativa (HS) is a suppurative inflammatory skin disorder that is considered to be autoinflammatory by many. HS includes a specturm of disorders, linked by suppurative (or psoriatic) skin disease and potentially genetics. These HS-related disorders may include pyoderma

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ICYMI: 9 Facts about Leflunomide

Medscape has published an informative review of leflunomide, drawn from Dr. Eric Ruderman’s recent lecture on the subject at the February RWCS meeting in Maui. Here are some highpoints from this Medscape article and lecture.

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ICYMI: 2023 EULAR Non-pharmacological Management of Hip and Knee Osteoarthritis: 2023 update

EULAR has published the 2023 updated recommendations for the optimal non-pharmacological management of hip and knee osteoarthritis (OA).

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No Risk of Interstitial Lung Disease with Methotrexate Use JAMA reports a cohort study that investigated the association between methotrexate (MTX) use and Interstitial lung disease (ILD) in patients with dermatomyositis (DM). https://t.co/qauRelAkG0 https://t.co/bhSLYrfzlv
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ICYMI: JAMA: SLE Review

Drs. Caroline Siegel and Lisa Sammaritano (from HSS in NYC) have published an impressive overview of systemic lupus erythematosus (SLE) in JAMA. This timely, well-written review covers the many complexities of this multi-organ disorder that affects nearly 3.4 million people worldwide.

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