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Risk of Uveitis with Spondyloarthritis

A retrospective registry study shows that uveitis may be seen in 10% with the diagnosis of axial spondyloarthritis (axSpA) but becomes more common (47%) over the next 30 years of disease. The good news is that biologic therapy can significantly lower the risk of uveitis in (SpA).

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🌟 ACUTE OPTIC NEURITIS - Differentials https://t.co/eE1Kbnmqc1
Dr. Akhil 🇮🇳 @DrAkhilX( View Tweet )

Linger on the Fingers (9.6.2024)

Dr. Jack Cush reviews the news and journal reports from the past week on RheumNow.com. This week with a focus on fingers and better prescriptive follow through.

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Immunomodulatory Prevention of Uveitis Relapse in Behçet's The results of a randomised, open-label, head-to-head trial shows that adalimumab was superior to ciclosporin in preventing uveitis relapses in patients with severe Behçet's disease. https://t.co/12fpuIZFmA https://t.co/iDJJq29JMA
Dr. John Cush @RheumNow( View Tweet )
Pooled data from BE MOBILE 1 & 2 RCTs shows Bimekizumab (dual-IL-17A/F inhib) may protect against uveitis in axSpA pts. N=349 pts - 0.6% BKZ vs 4.6% placebo developed uveitis (1.8 vs 15.4/100 PYs); even in pts w/ Hx of uveitis (6.2 vs 70/100 PYs; p=0.004) https://t.co/f8Uk0rEg86 https://t.co/mY1ikcGCNP
Dr. John Cush @RheumNow( View Tweet )

Running with Data (8.30.2024)

Dr. Jack Cush reviews the news and journal reports from the past week on RheumNow.com - including tips on steroids, MAS, and myositis testing.

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Finding Spondylitis Among Psoriasis, Uveitis and Colitis Patients Maksymowych and colleagues have shown that screening patients with either psoriasis, iritis, or colitis may yield a surprising percentage meeting ASAS criterial for axSpA. https://t.co/lVCdGnMVaT https://t.co/jFILeHrQXj
Dr. John Cush @RheumNow( View Tweet )

Finding Spondylitis Among Psoriasis, Uveitis and Colitis Patients

Maksymowych and colleagues have shown that screening patients with either psoriasis, iritis, or colitis may yield a surprising percentage meeting ASAS criterial for axial spondyloarthritis (axSpA).

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JAK Inhibitors Reduce Macular Degeneration Insurance claims data showed that patients with autoimmune disorders who took JAK inhibitors had lower rates of AMD, hinting that the drugs might treat the common eye disease. https://t.co/MuJpbGPqe8 https://t.co/hcp4W3wP8a
Dr. John Cush @RheumNow( View Tweet )
JAK Inhibitors Reduce Macular Degeneration Insurance claims data showed that patients with autoimmune disorders who took JAK inhibitors had lower rates of AMD, hinting that the drugs might treat the common eye disease. https://t.co/bx0UCp0o3r https://t.co/FXSlcFHYXI
Dr. John Cush @RheumNow( View Tweet )

JAK Inhibitors Reduce Macular Degeneration

Mepage Today

Insurance claims data showed that patients with autoimmune disorders who took Janus kinase (JAK) inhibitors had lower rates of age-related macular degeneration (AMD), hinting that the drugs might treat the common eye disease.

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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
Dr. John Cush @RheumNow( View Tweet )

Factors Affecting Hydroxychloroquine Adherence

A study from the University of British Columbia has evaluated the trajectories of hydroxychloroquine (HCQ) use in patients with incident RA and SLE between1997 and 2021, and identified factors associated with high adherence. 

From a total of 27,510 RA/SLE patients taking

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The Window of Opportunity (5.24.2024)

Dr. Jack Cush reviews the journal reports and news from the past week on RheumNow.com. This week: blockbuster drugs, opioids in rheumatology and nontreatment of inflammatory arthritis?

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Risk Factors for Hydroxychloroquine Retinopathy

A long-term hydroxychloroquine users study found that 2.7% developed retinopathy, and identified risk factors as  increasing age, female sex, chronic kidney disease stage 3+ and tamoxifen use.

This Kaiser Permanente cohort study of 4677 patients initiating hydroxychloroquine, and

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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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Autoimmune dz pts have higher risk of macular degeneration. Cleveland Clinic study of 200K AMD vs controls, finds: - SLE (RR 1.73) - Scleroderma (1.65) - Psoriasis (1.48) - Vasculitis (1.48) - RA (1.4) - UC &CD (~1.42) - Sarcoid (1.42) https://t.co/RrXaaqz3Aw https://t.co/9dGoGRCBYu
Dr. John Cush @RheumNow( View Tweet )
Retrospective cohort compared 6147 new PsA pts vs 23,999 contros PsA. The uveitis risk was significantly higher in PsA (adj HR 2.38). Uveitis risk in PsA higher with prior uveitis (adj OR 136.4) and etanercept Rx (aOR 2.57). 106/107 Rx w/ topical steroids https://t.co/YVzIzSOaiB https://t.co/YORU8cQrAx
Dr. John Cush @RheumNow( View Tweet )
Anti-TNF mAbs, JAKi & anti-IL17 Rx appear protective against anterior Uveitis in AxSpA pts. Network Metanalysis of 44 trials, AU IR -TNF mAb: 4.1, ETN: 5.4, IL17i: 2.8, JAKi: 1.5, & placebo: 10.8. AU risk: TNFi < JAKi < IL-17i < ETN << PBO https://t.co/3zIcvuIaBV https://t.co/UseZ6t00EB
Dr. John Cush @RheumNow( View Tweet )

New Year's Resolutions (1.5.2024)

Dr. Jack Cush imparts his new New Year's Resolutions for 2024 and also reviews the news and journal reports from the past week on RheumNow.com.

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ICYMI: Reduction of AxSpa-Associated Acute Anterior Uveitis with Certolizumab

Acute anterior uveitis is the most common extra-musculoskeletal manifestation in axial spondyloarthritis (axSpA) affecting up to 50% of patients in some age groups. AAU can have a significant impact on quality of life with risk of permanent visual deficits if not adequately treated. 

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Rheumatology Roundup - ACR 2023

Drs. Jack Cush and Arthur Kavanaugh discuss highlights and key takeaways from ACR 23.

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My takeaways from #ACR23 #ReviewCourse session on Inflammatory Eye Disease - Dr. Laura Kopplin: 1. Systemic therapy has better long term outcomes than topical treatments, but many/most ophthalmologists are uncomfortable with prescribing there. 2. FAST Trial: Methotrexate better… https://t.co/eoSeWVHsf0

Paul Sufka, MD @psufka( View Tweet )

Reduction of AxSpa-Associated Acute Anterior Uveitis with Certolizumab

Acute anterior uveitis is the most common extra-musculoskeletal manifestation in axial spondyloarthritis (axSpA) affecting up to 50% of patients in some age groups. AAU can have a significant impact on quality of life with risk of permanent visual deficits if not adequately treated. 

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HCQ and risk of retinopathy 👁️ DoD database HCQ 44000+ females & 10000+ males Risk retinopathy HR 1.5 Variations according to diagnosis SLE higher risk vs. RA, more so in males HR 2, females HR 1.7 No adjustment on HCQ dose @RheumNow #ACR23 ABST2452 https://t.co/TtTu6ixb45
Aurelie Najm ( View Tweet )