Canary in a Coal Mine (4.19.2024)
Dr. Jack Cush reviews regulatory reports, news and novel journal articles - this week focusing on Sjogren's, ILD, Gout and Uveitis.
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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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Epigenetics and Autoimmune Skin Disease
The central dogma proposed that genetic information predominantly transfers from DNA to RNA during gene expression to make a functional product protein.
https://t.co/VgQE2yYYmq https://t.co/fAWBifCyWv
Dr. John Cush @RheumNow( View Tweet )
Epigenetics and Autoimmune Skin Disease
EurekAlert!
The central dogma proposed that genetic information predominantly transfers from DNA to RNA during gene expression to make a functional product protein. This absolute theory has been debunked because of the influence of the environment on how genes are transcribed. According to the human
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Window of Opportunity in Psoriatic Arthritis
A Dutch Early Psoriatic Arthritis cohort study shows that psoriatic arthritis (PsA) patients treated early (referred and diagnosed within in less than 12 weeks) had the best clinical outcomes.
2023 EULAR Psoriatic Arthritis Recommendations
EULAR has updated its treatment recommendations from the prior 2019 guidelines, since which 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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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
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Lyme Disease 2022
The CDC has updated its Lyme disease surveillance report based on a new case definition. Compared to 2017–2019, the number of cases in 2022 rose by 69%.
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Sniffles & Arthritis (3.1.2024)
Dr. Jack Cush reviews the news and journal reports from the past week on RheumNow.com. Are these associations with infection, biomarkers and weather real or imaginary? Linked or luck? Causal or casual? You decide....
No clear link between weather & MSK symptoms
Immunosuppression Increasing (2.23.2024)
Dr. Jack Cush reviews the news and journal reports from the past 2 weeks on RheumNow.com; but begins with a discussion of what constitutes "immunosuppression" and how it applies to our patients.
2021 NHIS Survey data suggests the prevalence of immunosuppression in the USA
Oral IL-23 Inhibitor Effective in Psoriasis
The NEJM has published the results of the FRONTIER 1 trial demonstrating the efficacy of JNJ-77242113, an oral interleukin-23 (IL-23) receptor antagonist peptide, in patients with psoriasis (PSO).
https://t.co/NRK8LnM5zp https://t.co/FnWEze976O
Dr. John Cush @RheumNow( View Tweet )
Ixekizumab Safety from 25 RCTs (17 PsO, 4 PsA, 4 axSpA) w/ 9225 pts (22371 PYs use). Long-term safety c/w earlier reports/PI. SAEs in 1204 (13%); 45 deaths); ISRs 5.9-11.6/100PYs; IBD ≤ 0.8/100PY; depression, CVA, Cancer : ≤ 1.6/100PY https://t.co/p7N6ZMVvqh https://t.co/22WYkevhaf
Dr. John Cush @RheumNow( View Tweet )
Curbside Consults (2.16.2024)
Dr. Jack Cush answers audience clinical case questions sent by email or "ask Cush anything". Cases and questions from:
- Dr. William Hong - RA management in the setting of active TB or latent TB (LTBI)
- Dr. Vrishali Dalvi - relapsing polychondritis monitoring
Some takeways from JAK inhibitors in dermatology talk by Bruce Strober.
Great talk.
#RNL2024
@RheumNow https://t.co/fuRsSnnsha
Nouf Al hemmadi @NoufAhmedAlham2( View Tweet )
Alopecia aerate and JAK
Bruce Strober
#RNL2024
@RheumNow https://t.co/lGig1Vpf5x
Links:
Nouf Al hemmadi @NoufAhmedAlham2( View Tweet )
Examples from the world of dermatology on JAK inhibitor success stories.
Bruce storber.
#RNL2024
@RheumNow https://t.co/S01lEIqjbR
Links:
Nouf Al hemmadi @NoufAhmedAlham2( View Tweet )
Dermatology colleagues are using JAKis with success for wide range of dermatological diseases.
Note the beauty of this slide with further elaboration on domain inhibition, cool stuff 🤓
Bruce Strober
#RNL2024
@RheumNow https://t.co/2yHHcOgTC8
Nouf Al hemmadi @NoufAhmedAlham2( View Tweet )
I am jealous of the derms who have topical JAKi!
Dr. Strober flaunts all the different JAKi he has at his disposal to treat derm diseases #RNL2024 @rheumnow https://t.co/qdMWCSA5I1
TheDaoIndex @KDAO2011( View Tweet )
Dr. B Strober emphasizes that #AtopicDermatitis is not just found in children. A large proportion of patients are over 50 years of age when they are diagnosed. #RNL2024 @rheumnow
TheDaoIndex @KDAO2011( View Tweet )
Dr. Strober's JAKi in dermatology takeaways!
- Consider this for AD
- Dose matters in terms of both efficacy and toxicity
- Consider combination tx
- Topical JAKi option for vitiligo, especially head and neck involvement (harder in hands and other areas)
#RNL2024 @RheumNow https://t.co/ZrPfpUF4Hz
Dr. Rachel Tate @uptoTate( View Tweet )
JAKi are being used in inflammatory skin disease other than psoriasis:
#HydradenitisSuppurativa, #alopecia, #AtopicDermatitis and #vitiligo
- Dr. B Strober #RNL2024 @rheumnow https://t.co/FzPyATPB93
TheDaoIndex @KDAO2011( View Tweet )
Face and neck vitiligo also responds to topical ruxolitinib. Dr. Strober #RNL2024 @RheumNow https://t.co/6N6A3Yq7RE
Dr. Rachel Tate @uptoTate( View Tweet )
Impressive results for alopecia totalis with baricitinib – Dr. Bruce Strober #RNL2024 @rheumnow https://t.co/OA0tpdRum2
Links:
TheDaoIndex @KDAO2011( View Tweet )
Clinical pearl! Consider topical ruxolitinib for your AD patients. Dr. Strober at #RNL2024 @RheumNow https://t.co/Sxwvn1lAXB
Dr. Rachel Tate @uptoTate( View Tweet )
Deucravacitinib takes longer to work for PsO compared to UPA, IL-17i or IL23i; it’s better than apremilast. Side effects w/TYK2i: acne, mild⬆️CK, but zoster & lipid issues aren't seen much, & no CV risk warnings; Dr. Strober doesn't follow labs w/TYK2i. #RNL2024 @rheumnow https://t.co/05jKqL4wdx
TheDaoIndex @KDAO2011( View Tweet )
Recent Blogs
With their publication in June 2022 (1), the 3rd iteration of the Group for Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA) Treatment recommendations for Psoriatic Arthritis (PsA) may have set a record or sorts.
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