Stop Counting Bugs (10.4.2024)
Dr. Jack Cush reviews the news and journal articles from the past week on RheumNow.com.This week’s rants include the microbiome, PsA treatment choices and fishing for P-values in research.
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Pneumocystis Jirovecii Pneumonia Complicating Systemic Vasculitis
A retrospecitive analysis of 62 patients with systemic vasculitis complicated by Pneumocystis jirovecii pneumonia (PJP) showed those with MPA had a higher mortality risk, possibly due to a higher prevalence of… https://t.co/yWjWOXtMwR https://t.co/2aD3EIsi7z
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JAMA metaanalysis of psoriasis pts (40 RCTs, 21 438 pts) Rx w/ biologics: a >=90% PASI (skin) response was less likely with older age, prior biologics, higher BMI, and smoking https://t.co/v5EpOpYVYt https://t.co/wXTXP76Emu
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Long Term Antibiotics Increase Risk of RA
JAMA has published a population-based retrospective cohort study showing a possible association between the long-term use of antibiotics and the risk of rheumatoid arthritis (RA).
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NOR-Gout study shows Non-adherence to urate lowering therapy after 5 years is related to poor gout outcomes. 5-year Observational study of 163 patients showed overall good ULT adherence but nonadherent had more flares (33 vs 10%) & less at target (45 vs 87%)… https://t.co/xuIjBiuFHF https://t.co/fmqkCOYayP
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Declining Menopausal Hormone Therapy in Postmenopausal Women
A two decade cross-sectional population study has shown a marked downward trend in menopausal hormone therapy (MHT), with an over 80% reduction, especially in women aged 52 - 65 years.
Menopausal hormone therapy (MHT) may be the treatment of choice for menopausal symptoms, but
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In utero exposure to upadacitinib review w/ 128 maternal exposures & known outcomes; 80 from RCTs & 48 Postmarketing Pregs. From RCTs - 54-46% live births, 24-38% spont. abortions, 21-15% elective Ab, 1-2% ectopics from RCTs & Postmarketing. No evidence of teratogenicity… https://t.co/s3VJspI59V https://t.co/tV48sKyF8x
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Adult (133,216) vs Pediatric (955) pts on JAKi - analysis of FAERS shows both @ incr risk for infections & GI AEs. Pediatric pts had more blood and lymphatic disorders, while adults had more CNS and MSK/CTD disorders https://t.co/SKjzANYPSq https://t.co/S6JPYuvSlf
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Which One is the Loneliest Number (9.27.2024)
Dr. Jack Cush reviews the regulatory approvals, announcements, guidelines and interesting journal articles from the past week on RheumNow.com. When not to use muscle relaxants, how frequent is loneliness in RA/PsA/SpA, and when to refer patients with Still's disease.
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INVIGORATE-2 Study - IV Secukinumab in Active Psoriatic Arthritis
The INVIGORATE-2 trial reports that intravenous (IV) secukinumab (SEC) is both effective and safe in patients with active psoriatic arthritis (PsA), demonstrating improvements on par with subcutaneous SEC.… https://t.co/I1TVGIHByN https://t.co/WwSRQxrKAE
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Stratified Cancer Screening in Dermatomyositis
The International Myositis Assessment and Clinical Studies Group (IMACS) have published evidence and consensus based cancer screening guidelines for patients with idiopathic inflammatory myopathies, including dermatomyositis.
They proposed 18 final recommendations - 13 were
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Limited Efficacy of Muscle Relaxants for Chronic Pain
A systematic review of long-term muscle relaxant use for chronic pain suggests they may be effective in treating trigeminal neuralgia, cramps, and neck pain, but not fibromyalgia, low back pain, and other pain syndromes.… https://t.co/sReBxhSpWH https://t.co/tQGWKPwokn
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EULAR/PReS Still's Disease Management Recommendations
Since 2022, EULAR and the Paediatric Rheumatology European Society (PReS) have been working to establish clinical practice guidelines for the diagnostics and management of systemic juvenile idiopathic arthritis (sJIA) and adult-onset Still’s disease (AOSD).
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Pain Relief with JAK Inhibitors or Anti-TNFs ?
MedPage Today
Targeted drugs for rheumatoid arthritis (RA) are not created equal when it comes to pain relief, a retrospective study from Sweden indicated, although the differences appeared to be modest.
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I Can't Treat Ugly (9.20.2024)
Dr. Jack Cush reviews the news, journal articles and a new FDA approval for EGPA, this week on the Podcast.
https://t.co/mSI16Ug4iR https://t.co/arCx6yo5p6
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British Society Guidelines for Managing Behçet’s Disease
An exhaustive, full read guideline from the British Association of Dermatologists (BAD) and the British Society for Rheumatology (BSR) on the management and treatment of Behçet’s disease (BD) in 2024 has been published in Rheumatology.
This guideline provides up-to-date,
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INVIGORATE-2 Study - IV Secukinumab in Active Psoriatic Arthritis
The INVIGORATE-2 trial reports that intravenous secukinumab is both effective and safe in patients with active psoriatic arthritis, demonstrating improvements on par with subcutaneous secukinumab.
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Analysis of 5 Nordic registries & 29,478 RA & 10,919 PsA pts initiating 1st bDMARD,s
(& 362,087 pop controls). Incident ILD was higher in RA (HR 9.7) & PsA (4.4). but MTX co-use (vs non-use) did not incr ILD in RA (HR 0.9; 0.7, 1.2) or PsA (HR 1.0) https://t.co/xY8COh85Bw https://t.co/weJGirfhDX
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Antidepressants for Pain are Weakly Effective
University of Sydney research has found people over 65 are being prescribed antidepressants as pain treatment based on international guidelines that use limited evidence.
https://t.co/ln5UguleUv https://t.co/CwZeHi3xWK
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Bimekizumab FDA Approved for Psoriatic Arthritis, Non-radiographic Axial Spondyloarthritis and Ankylosing Spondylitis
UCB announced today that the U.S. Food and Drug Administration (FDA) has approved bimekizumab-bkzx (Bimzelx) for the treatment of 3 chronic inflammatory disorders.
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FDA decision explained on why they modified its rule on #Biosimilar interchangeability. Approved 15 yrs ago, now there are 50 Biosimilars in USA. Switching (interchangeability) studies are no longer needed based on the FDA experience over last 8 years. https://t.co/vpmgdVeDwz https://t.co/UAWnFQxugl
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Limited Efficacy of Muscle Relaxants for Chronic Pain
A systematic review of long-term muscle relaxant use for chronic pain suggests they may be effective in treating trigeminal neuralgia, cramps, and neck pain, but not fibromyalgia, low back pain, and other pain syndromes.
The importance of this issue has grown with stricter opioid
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Metanalysis of JAKi in ILD (7 studies, 183 pts) showed increases in FVC (2 %), DLCO (3.1%) & improved Thoracic HRCT of 11%; only 5% had worsening of their ILD. Risk of ILD w/ JAKi was low ( 0.20/1000 PY) w rates similar to abatacept & rituximab https://t.co/UDJ1ZvtGhh https://t.co/WTQS67yDyl
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Dr. John Cush @RheumNow( View Tweet )
I Can't Treat Ugly (9.20.2024)
Dr. Jack Cush reviews the news, journal articles and a new FDA approval for EGPA, this week on the Podcast.
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Mycophenolate in New-Onset SLE
How aggressively do you treat newly diagnosed new-onset systemic lupus erythematosus (SLE), or should you wait for organ involvement? A trial of early use of mycophenolate mofetil (MMF), in addition to prednisone and hydroxychloroquine, decreased severe flares and the development of renal
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