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Lupus

A Pilot Trial of Anifrolumab in Discoid Lupus

Mar 15, 2023

A research report in JAMA Dermatology describes the use of the type 1 interferon receptor inhibitor anifrolumab in patients with chronic discoid lupus erythematosus (DLE). 

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Itaconate - A Potential New Immunosuppressive

EurekAlert!
Mar 15, 2023

Researchers have revealed the modulatory effect of the anti-inflammatory metabolite itaconate (ITA) on T helper and T regulatory cells, which may lead to new therapeutic approaches to treating some autoimmune diseases.

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Cost-Effective Use of Biological and Targeted Synthetic DMARDs

Mar 14, 2023

An international task force of 13 European experts have developed evidence-based points to consider regarding the cost-effective use of biological and targeted synthetic disease-modifying antirheumatic drugs (b/tsDMARDs) in the treatment of inflammatory rheumatic diseases (including rheumatoid

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Big Time Vasculitis (3.10.2023)

Mar 10, 2023

Dr. Jack Cush Reviews the News and Journal articles from the past week on RheumNow. This weeks highlights includes insights on scleroderma, myositis, vasculitis and answers the question - does aggressive biologic treatment of psoriasis prevent future psoriatic arthritis?




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Higher Rehospitalization Rates in Younger SLE Patients

Mar 08, 2023

A Medicare study shows that young adults with systemic lupus erythematosus (SLE) exhibit very high 30-day rehospitalization rates (36%) that are significantly higher than older SLE patients and age matched non-SLE patients.



This study was drawn from a 20% national Medicare sample from

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Serum beta-2 microglobulin (B2M) in 100 #SLE pts - strong correlations betw B2M & 24 hr urinary protein, BUN, creatinine, disease activity, & damage score (p < 0.001), & negatively correlated with GFR, C3, C4 (p < 0.001). B2M predicted lupus LN https://t.co/XujdKvjjoS https://t.co/vl8XXQDhXM
Phase 3 Trials of Baricitinib Disappoint in SL Despite the encouraging phase II trial results of baricitinib in SLE patients, two parallel phase III trials have failed to redemonstrate the efficacy of baricitinib in active SLE. https://t.co/SwU7ujZnsP https://t.co/IgpCTtyDNA
While anifrolumab targets IFN alfa in SLE, its unclear how much IFNa is needed for Rx response. A study of 40 pts shows Rx naive SLE has signif higher serum IFN activity; this is assoc w/ fever, leukopenia, ALE rash and oral ulcers & more organ damage https://t.co/nhqg0ky7RT https://t.co/kBuqvJYFYE

NSAIDs in Pregnancy (3.3.2023)

Mar 03, 2023

Dr. Jack Cush reviews the lastest journal articles, news, and FDA announcements from the past week on RheumNow.  This week, the importance of IFNa, Subclinical PsA and NSAID safety during Pregnancy.




  1. Study of 87 pts with isolated Nail Psoriasis noted that 11% went on to have

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51 Juvenile SLE (j-SLE) studied for neuropsychiatric Dz (j-NPSLE)- 39% presented with jNPSLE. While no clear biomarker/imaging of j-NPSLE identified, they found CSF neopterin (& IFN-α) levels signif higher w/ active j-NPSLE & CNS involvement (p=0.0008) https://t.co/QM8yJGrBJu https://t.co/4hj1eE2JIC
While anifrolumab targets IFN alfa in SLE, its unclear how much IFNa is needed for Rx response. A study of 40 pts shows Rx naive SLE has signif higher serum IFN activity; this is assoc w/ fever, leukopenia, ALE rash and oral ulcers & more organ damage https://t.co/RtI9ulurB1 https://t.co/wMl5DOyGB6

Phase 3 Trials of Baricitinib Disappoint in SLE

Feb 27, 2023

Despite the encouraging phase II trial results of baricitinib in systemic lupus erythematosus (SLE) patients, two parallel phase III trials have failed to redemonstrate the efficacy of baricitinib in active SLE, thereby halting development of baricitinib in SLE. 



SLE-BRAVE I and SLE-

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Metanalysis of 25 studies, betw 1985 - 2021, showed US average annual visits for RA=5.25 for US rheums (vs 3.3 ex-US) & 4.8 US non-rheums. SLE=3.24 & 12.3 for US non-Rheums. FM=1.8 for US rheums & 0.4 vs ex-US Rheums. Rheum Visits Decreased 1982 to 2019 https://t.co/WIXDXUCG60 https://t.co/s7W9gcd5dd
A retrospective study from a Taiwan health insurance claims data analysis looked at the association between Hashimoto's thyroiditis and lupus. https://t.co/159JNLY6tf https://t.co/JxR88a84MN
Metanalysis of 25 studies, betw 1985 - 2021, showed US average annual visits for RA=5.25 for US rheums (vs 3.3 ex-US) & 4.8 US non-rheums. SLE=3.24 & 12.3 for US non-Rheums. FM=1.8 for US rheums & 0.4 vs ex-US Rheums. Rheum Visits Decreased 1982 to 2019 https://t.co/5ugk34MJ3b https://t.co/NDMYZT7pil
Toxic Epiderman Necrolysis vs Acute Cutaneous Lupus Erythematosus https://t.co/wKX3v01RUb https://t.co/SWwnH7ph04
Steroids assisting options - CTX, LEF or RTX @anisha_dua @RWCSmtg @RheumNow #RWCS23 https://t.co/gVw2tGKYNG https://t.co/ItIKB8MFTI
Case reports of anifrolumab use in 2 pts w/ chronic, scarring discoid lupus unresponsive to steriods, HCQ, immunosuppressants & CTX. Case 1 SLEDAI from 13 to 2 in 24 weeks & CLASI-A from 26 to 3 in 20wks. Cs 2 CLASI-A decr 24 to 5 after 1 infusion https://t.co/Qe2rF4Avxe
Deucravacitinib - Effective in Systemic Lupus Erythematosus A Phase II, multicenter study has demonstrated the efficacy and safety of deucravacitinib, an oral, selective, allosteric inhibitor of TYK2, in adults with active SLE. https://t.co/YS8n02BEsk https://t.co/4sBd88AhtK

Half the Experts are Wrong (2.17.2023)

Feb 17, 2023

Dr. Jack Cush reviews the news and tries to stump the expert panel this week on the podcast.

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Have you heard of nipocalimab? It prevents IgG-FcRn by binding to the FcRn IgG binding site. This is one to watch in our diseases (RA, Sjogren’s, SLE, myopathies.) Dr. Postolova #RWCS23 ⁦@RheumNow⁩ ⁦@RWCSmtg⁩ https://t.co/qMGA6IdtUE
Older Lupus Patients Need Follow-Up After Hospital Discharge Medicare beneficiaries 65 and older with lupus faced dramatically higher mortality when they received no follow-up care during the month after a hospital stay, researchers found. https://t.co/4mFctXGQH9 https://t.co/2Q1z03myud

New Laboratory Insights for the ANA+ Consult

Feb 15, 2023

A new study suggests that use of ELISA assays for CXCL-10 and IFN-α can predict which ANA+ individuals may progress to developing a systemic autoimmune rheumatic disease (SARD).



Assays for cytokines (serum IFN-α or selected IFN-induced cytokines) were performed by nanoString, ELISA or

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Study of 232 pediatric #SLE pts. Over 12 mos 47% achieved LLDAS & Damage seen in 40% after 6.2 yrs F/U. Getting to LLDAS w/in 12 mos is assoc w less damage. LLDAS w/in 12 mos more likely in Absence of renal involvement. https://t.co/pGethJCw4e https://t.co/eYpVueIKbf
Deucravacitinib - Effective in Systemic Lupus Erythematosus A Phase II, multicenter study has demonstrated the efficacy and safety of deucravacitinib, an oral, selective, allosteric inhibitor of TYK2, in adults with active SLE. https://t.co/0g2VM6TJt6 https://t.co/f6wylPc5ep
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