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Drug Safety

SATISFACTION (2.27.2026)

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

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FDA has approved tocilizumab-anoh (Avtozma; Celltrion), a biosimilar to Actemra, for intravenous and subcutaneous use in rheumatoid arthritis (RA), giant cell arteritis, polyarticular juvenile idiopathic arthritis, systemic juvenile idiopathic arthritis, and COVID-19. https://t.co/qw7SJ7ZCK9
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Taiwan National retrospective study (2001-20) of 8732 newly Dx, biologic-naïve RA pts initiating b/tsDMARDs. Found no difference in malignancy event rates between DMARDs. 2.16% over 5-yr & 2.89% over 18yrs. (6384 Rx w/ TNFis, 667 w/ TCZ, 656 w/ ABA, 1025 on tsDMARDs) https://t.co/54ZMPywEYI
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UK Retrospective analysis of 2 RA cohorts, 2,701 pts (F/U 6 yrs) = 101 (3.7%) Dx with ILD. (12 @ baseline, 46 w/ F/U, 43 @ death). ILD Dx signif. assoc w/ onset age (aOR 1.03), seropositivity (aOR 2.58), ever smoking (aOR 1.7). https://t.co/Zvkb1Wjpa4 https://t.co/YMkWDc3rMr
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Danish DERMBIO registry of psoriasis pts Rx w/ biologics. Among 3790 bionaive pts ustekinumab had best 1-5 yr survival vs (ADA & SEC). In 3403 bioexperienced pts, bimekizumab, guselkumab, & risankizumab had highest 2-year drug survival rate. https://t.co/TInyLPMYkb https://t.co/UTPqa9erPU
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FDA Commissioner Marty Makary is seeking to make more drugs available without a prescription; and has stated “everything should be over-the-counter” unless the drug is addictive, unsafe, or requires monitoring. https://t.co/CGurlOWO8m https://t.co/bFwkpZ3kbn
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Full read review of JAK inhibitors. JAK inhibitors have a reasonably rapid onset of action and a short half-life, which facilitates management of any adverse effects. The half-life of Tofacitinib, Baricitinib & Upadacitinib is 3 hrs, 13 hrs. & 9-14hrs. https://t.co/jKO2LL2TVC
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3 Months of Romosozumab in Postmenopausal Osteoporosis A report in The Lancet Diabetes & Endocrinology suggested that 3 months of romosozumab (ROMO) followed by denosumab is as effective at increasing hip bone mineral density (BMD) as the standard 12-month course. https://t.co/6HfGFZqavF
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July 2024 survey of 143 women (18-45 yrs) with rheumatic disease shows only 63% used effective contraception. In those previously pregnant, 33% experienced an unplanned pregnancy, highlighting contraceptive failure. https://t.co/tR6976vmJp https://t.co/1XRkQfWL5r
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Early vs Delayed Belimumab in Lupus An economic evaluation of early vs delayed use of the Blys inhibitor, belimumab (BEL), in systemic lupus erythematosus (SLE) has shown both cost-effectiveness and clinical utility of early BEL initiation in active lupus patients. https://t.co/m6NvAWbNjr
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Real-world study of 1202 #PsA pts shows that secukinumab retention rates were lower w/ smoking (79%/73%/72% in never/former/current smokers) but not w/ obesity (72%/77%/77% in normal/overweight/obese), Adh HR signif. higher w/ former (1.32) & current smokers (1.27) https://t.co/1REWmod73W
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Review of Calcinosis Cutis - Surgical intervent. most effective (excision, curettage, laser ablation, etc). Medical measures inconsistently, partially effective, best if used early & localized (CCB, TCN, probenecid, immunomodulation, biologics, colchicine, NA thiosulfate, & JAKi https://t.co/rv0hQBv6nX
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Referral Rules to Live By (2.20.2026) Dr. Jack Cush reviews the news and journal reports from this past week on RheumNow. Highlights include referral rules, combination biologics in psoriasis, and don't use JAK inhibitors in pregnancy. https://t.co/thzetw5jwa https://t.co/HTjWyqFqDZ
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3 Months of Romosozumab in Postmenopausal Osteoporosis

A report in The Lancet Diabetes & Endocrinology suggested that 3 months of romosozumab (ROMO) followed by denosumab is as effective at increasing hip bone mineral density (BMD) as the standard 12-month course.

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Paradoxical Reactions, Target Selection & the Future of Imaging in Psoriatic Care At RheumNow Live, Dr. Joseph Merola presented a compelling discussion on paradoxical immune reactions in psoriatic disease. He began with a case of a 60-year-old woman with mild psoriasis who, https://t.co/AVIOO42vfP
Dr. John Cush @RheumNow( View Tweet )

Early vs Delayed Belimumab in Lupus

An economic evaluation of early vs delayed use of the Blys inhibitor, belimumab (BEL), in systemic lupus erythematosus (SLE) has shown both cost effectiveness and clinical utility of early BEL initiation in active lupus patients.

While most would advocate for using your best therapy

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RT @gibson_rheumPAC Given rising resistance, effective first-line regimens and adequate duration (14 days) are critical. PPI-based quadruple regimens remain highly effective when patients can adhere. #RNL26 https://t.co/bxqMbPFegt
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RT @richardPAConway Data from Scott Matson's group showing that immunosuppressing RA-ILD (agnostic to agent) results in stabilisation of the previous downward trajectory of pulmonary function tests. #RNL26 https://t.co/TMNeCsPDep
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RT @RichardPAConway UIP pattern RA-ILD is where the big problem is. We are less good at treating this. Perhaps the newer agents such as nerandomilast will change this? #RNL26 https://t.co/lzKFulaomD
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Can I Use JAK Inhibitors During Pregnancy? Short answer: Not yet. https://t.co/E9yrWR5zTG https://t.co/NLy6OibkYH
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A Modern Approach to Osteoporosis Management

Currently, fewer than half of patients diagnosed with osteoporosis receive appropriate pharmacologic therapy. This treatment gap reflects several challenges in osteoporosis management, including limited disease awareness, barriers to medication access, clinician discomfort with therapy selection

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RT @richardPAConway Target trial emulation from Dr Sparks group in RA-ILD. Abatatacept and JAKi seem to be better than RTX. TNFi and IL-6i appear similar to RTX. Thought provoking! #RNL26 https://t.co/vmg7ot9m8b
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RT @richardPAConway Data from Scott Matson's group showing that immunosuppressing RA-ILD (agnostic to agent) results in stabilisation of the previous downward trajectory of pulmonary function tests. #RNL26 https://t.co/MoYoM0K1cs
Dr. John Cush @RheumNow( View Tweet )

Together PSO Trial - Combination Ixekizumab and Tirzepatide

Today Lilly announced top line results of the TOGETHER-PsO open-label, Phase 3b trial demonstrating the significant benefits of concomitant ixekizumab (IXE: an IL-17A inhibitor) and tirzepatide (TIR: GLP-1agonist) over IXE alone.

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Can I Use JAK Inhibitors During Pregnancy?

In 2020, the ACR Recommendations on Reproductive Health notably avoided firm guidance on the use of JAK inhibitors (JAKi) during pregnancy stating, "There is no available evidence regarding use or safety of the new small- molecule agents, tofacitinib, baricitinib, and apremilast, during

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