Novel Rx

DBRPCT of Krill oil (4 g/d;KOC) vs PBO in 78 #SLE pts for 24 wks. KOC Rx pts had signif increase in Omega-3 Index 4.3% to 7.17% (4wks) to 8.05% (24wks) w/ no change SLEDAI-2K. But 9pts w/ hi activity (SLEDAI≥9) showed signif Dz activity improvements https://t.co/ODLqqZzGQx https://t.co/tehHk4MhbZ

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Dr. John Cush @RheumNow( View Tweet )
alveolar hemorrhage acute

PEXIVAS: Diffuse Alveolar Hemorrhage in ANCA-Associated Vasculitis Patients

Jack Cush, MD

A secondary analysis of the PEXIVAS study showed antineutrophil cytoplasmic antibody–associated vasculitis (AAV) patients complicated by diffuse alveolar hemorrhage (DAH) may have improved with plasma exchange and glucocorticoids, the results did not achieve significance. 

Diffuse

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Biologics Prevent AA amyloidosis progression to ESRD

MedPage Today

One of the most serious complications of rheumat0logic and autoimmune diseases can be prevented with biologic drugs, a single-center chart review suggested, and some such products may be more effective than others.

Among 83 patients receiving biologic agents for their underlying

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Patients with Financial Limits Struggle with Medication Adherence

Jack Cush, MD

Analysis of the National Health Interview Survey shows that nearly 1 in 5 patients with rheumatologic disease in the United States struggled economically, suffering from food insecurity and cost related medication (CRM) nonadherence.

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Inspirations About RA-ILD Dr. Jonathan Kay discusses abstracts POS0070, POS0043 and POS0022 presented at the Eular 2024 meeting in Vienna, Austria. https://t.co/sKwr7yMUcX https://t.co/UBTYD5SioS

Links:

Dr. John Cush @RheumNow( View Tweet )
SLE Topic Panel: EULAR 2024 Dr.Jack Cush moderates this topic panel on SLE with Drs. Yuz Yusof and Andrea Fava. https://t.co/nBTiIeGd99 https://t.co/5BK72vbR5V

Links:

Dr. John Cush @RheumNow( View Tweet )
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Best Rheumatologists (7.19.2024)

Jack Cush, MD

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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IL-17 inhibitor Brodalumab is not often talked about, but its approved for PsO & PsA. German study of 227 PsO w/ 37 PsA pts Rx w/ BRO - good, rapid response by 3 mos. 1 year drug survival rate was 76.2%, (mean discontinuation=8.3 mos. https://t.co/4byFoc96Zs https://t.co/sPomX0s8aa

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Dr. John Cush @RheumNow( View Tweet )
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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Dr. John Cush @RheumNow( View Tweet )
IRIS-RA, a failed phase 2 study of Nipocalimab, an anti-FcRn mAb severe active RA not responding to TNFi. 53 seropos. RA pts did not achieve primary endpt of better DAS28-CRP at Wk 12 (but Nipo was numerically better & signif lowered RF, CCP, but not CRP) https://t.co/52HLsfpKLS https://t.co/eEifXA6MpP

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Dr. John Cush @RheumNow( View Tweet )
PSS.scleroderma.arthritis.contractures

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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Does B Cell Depletion Matter? Dr. Yuz Yusof interviews Dr. Ed Vital regarding abstract OP0077 at Eular 2024 in Vienna, Austria. https://t.co/SX7BkX3w1T https://t.co/H1rD0n8GnK

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Dr. John Cush @RheumNow( View Tweet )
AbbVie has submitted regulatory applications to both the FDA and the European Medicines Agency for Rinvoq (upadacitinib) to treat adult patients with giant cell arteritis (GCA) https://t.co/LqRcm2FEFV https://t.co/XEjjSNnOGt

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Dr. John Cush @RheumNow( View Tweet )
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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Dr. John Cush @RheumNow( View Tweet )
FDA adverse event study of JAKi in #RA assoc w/ signif more VTE, ischemic heart Dz, & tachyarrhythmias. 75,407 on JAKi vs 303,278 on biologics (TNFi, RTX, TCZ); JAK had more VTE (ROR=2.11), CVA (ROR=1.25), IHD (1.23), arrhythmias (1.15 ), esp in 1st yr. https://t.co/IVsGwqpiJK https://t.co/4epOHdNHbO

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Dr. John Cush @RheumNow( View Tweet )
Sobi has submitted a biologics license application to FDA for SEL-212 (pegadricase a uricase enzyme that breaks down uric acid) based on DISSOLVE I & II RCTs. SEL-212 was given FDA FDA’s Fast Track designation in March 2024 https://t.co/TPcUnCJOxT https://t.co/X1DrFDJZeK

Links:

Dr. John Cush @RheumNow( View Tweet )
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

Links:

Dr. John Cush @RheumNow( View Tweet )
Progress in SLE with new mRNA CAR-T cell Trial Cartesian Therapeutics, has announced their first-in-class mRNA CAR-T therapy has been given to the first SLE. patient in a Phase 2 open-label clinical trial. https://t.co/7SYNtjIn9F https://t.co/a5LJn8QLT3

Links:

Dr. John Cush @RheumNow( View Tweet )
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Pollution and Autoimmunity (7.12.2024)

Jack Cush, MD

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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Dr. John Cush @RheumNow( View Tweet )
Bimekizumab (dual-IL-17A/F inhib), may prevent uveitis in patients with axSpA. In phase 3 RCTs (MOBILE 1 & 2) double-blind period, uveitis seen in 0.6% on BKZ vs 4.6% on PBO (p=0.001). In pts w/ hx uveitis, again lower w/ BKZ (6.2/100 PYs vs 70.4/100 PYs) https://t.co/v0wMK45chz https://t.co/CVPdg1k41V

Links:

Dr. John Cush @RheumNow( View Tweet )
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PNAS & Nature Insights into Lupus Pathogenesis

Jack Cush, MD

Two prominent medical journals this week published new insights into the pathogenesis of systemic lupus erythematosus (SLE), with both inidicating promient roles for T cells in what is a classically viewed as a humoral (B cell) disorder. 

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Cost-Effectiveness of Biosimilars vs Leflunomide An economic evaluation of 25 099 rheumatoid arthritis patients found that treatment with biosimilar DMARDs were cost-effective compared with the conventional DMARD, leflunomide. https://t.co/lWJB1VL1CL https://t.co/lzra8suVqs

Links:

Dr. John Cush @RheumNow( View Tweet )
Paradoxical psoriasis w/ IL-17 inhib? Lit review 35 (SpA) pts, presenting as palmoplantar pustular and plaque PsO; median 11 weeks after IL-17i. one-third continued IL-17i w/ mostly topical Rx; 2/3 D/C IL-17i, switching to other biologic w/ good outcomes https://t.co/q2xqQyiM3b https://t.co/6hSE6NLHWw

Links:

Dr. John Cush @RheumNow( View Tweet )
kidneys

Efficacy of Biologics in Patients with Chronic KIdney Disease

Jack Cush, MD

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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Recent Blogs

Best of 2023: New ACR RA-ILD Treatment Guidelines – What Were They Smoking!?

Richard Conway, MBBChBAO, PhD
Lungs ILD
Rheumatoid arthritis related interstitial lung disease (RA-ILD) is common, with symptomatic RA-ILD affecting approximately 8% of RA patients. There is a very limited evidence base supporting treatment and therefore the recent release of ACR guidelines is to be welcomed. However, the published guidelines appear discordant with the best available evidence base.  Read Post

Choice Overload (and the Way Out)

Jack Cush, MD
paint,choice,overload,color
I recently overheard a very good practicing rheumatologist complain, “why do I need yet another drug for psoriatic arthritis? I have more treatment choices than I have actual PsA patients who need a new or better drug”. Read Post

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