IL-6

PMR spotlight

JAKs and Other Drugs in PMR

Richard Conway, MBBChBAO, PhD

This has been an interesting ACR meeting in terms of PMR updates. I would argue that we are still far too wedded to glucocorticoids only in the management of PMR. Yes, some patients will do fine with just glucocorticoids but we persist far too long with a glucocorticoid only strategy in others

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I've shared some thoughts on @RheumNow on methotrexate, tocilizumab, and baricitinib in PMR based on #ACR24 https://t.co/WXiW1nLN4k

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Richard Conway @RichardPAConway( View Tweet )

A#2531 @AlisaMueller CRISPR deletion of fibroblasts, gave cytokine activation to mimic inflamm Are there gene depletions that affect inflamm pathways? 👉SIX1 reduces inflamm potentiation 👉NFIL3 deletion promotes inflamm, degradation @RheumNow #ACR24 https://t.co/Nqghb5UaBR

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Eric Dein @ericdeinmd( View Tweet )
Comparison of infection risk across b/tsDMARDs in IA in real-world study Treatment with ➡️Rituximab ➡️JAKi ➡️Anti-IL6 assoc with ⬆️⬆️ risk of severe infection compared to TNFi A reminder to consider comorbidities & infection risk in selecting b/tsDMARDs Ab1716 #ACR24 @RheumNow

Mrinalini Dey @DrMiniDey( View Tweet )

Chevet et al. What happens when you withdraw tocilizumab after 6 months in PMR? Follow up of SEMAPHORE study. 80.8% relapsed! Median time to relapse 15 weeks. @RheumNow #ACR24 Abstr#1698 https://t.co/9pJ88C05V2

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Richard Conway @RichardPAConway( View Tweet )
Is #IL1 inhibition for 4 months a winner in #GCA —NOPE Anakinra daily 100mg sc 4/12 Underpowered but equal relapses and d/c #steroids not different #relapses esp after d/c #anakinra N=30 d/c due to #COVIDpandemic #1699 #ACR24 @RheumNow @ACRheum https://t.co/1TgloS5x8O

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Janet Pope @Janetbirdope( View Tweet )
When you stop 🛑 #TCZ #tocilizumab at 6 months of #Rx in #PMR RELAPSES are V high DON’T stop #Toci in PMR too Early Rapid and frequent flares #ACR24 @RheumNow @ACRheum #1698 https://t.co/IX5EJOcIY5

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Janet Pope @Janetbirdope( View Tweet )
Race of b/tsDMARDs in RA, the “JAK-pot” study. JAKi and TNFi with more rapid early improvement in CDIA, HAQ, and pain compared to ABA or IL-6 inhibitors…..although effects blunted after adjusting for patient and RA characteristics #ACR24 @RheumNow ABST#0501 https://t.co/8M4wX3LAbW

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Jiha Lee @JihaRheum( View Tweet )
Harkins @DrTrishHarkins et al. 1 year outcomes of 65 PMR patients treated in FTC. 32.7% experienced relapse, 28% still on GCs, 21% on tocilizumab. @RheumNow #ACR24 Abstr#0739 https://t.co/uYBYhPqGQE https://t.co/n9x9BDTPKg

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Richard Conway @RichardPAConway( View Tweet )
Courvoisier et al. JAK-pot study analysis. Which therapies work quicker in RA? JAKi (as expected) and TNFi (what!?) faster than IL6 and abatacept. @RheumNow #ACR24 Abstr#0501 https://t.co/7DPPwHlqpP https://t.co/3mOJ62hZhp

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Richard Conway @RichardPAConway( View Tweet )
Quinn @KQuinnRheum @petercgrayson et al. FDG-PET is not particularly useful in monitoring GCA on tocilizumab. Toc reduces but often not eliminate PET inflammation. PET activity does not predict relapse or vascular progression @RheumNow #ACR24 Abstr#0742 https://t.co/1qcJCGV118 https://t.co/6mBCgcbYo6

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Richard Conway @RichardPAConway( View Tweet )
#obesity causes a lot of diseases including #arthritis. How? ⬆️ IL-6 ⬆️ leptin ⬆️ TNF-a @RheumNow #ACR24 @rheumarhyme https://t.co/qeqTZUOEZy

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sheila @RHEUMarampa( View Tweet )
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Biosimilar Slow Growth in USA

Jack Cush, MD

A recent Forbes article, "Biosimilars Are Making Inroads In U.S., But It’s Still A Bumpy Ride", reviews the current state and reasons for slowish uptake of these significant cost-savings alternatives to biologic therapy in treating cancer and autoimmune disorders. The following are takeaway

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Overview of Uveitis management of adult & pediatric rheumatology. - Uveitis accounts for 10% of visual impairment globally - TNF inhib are effective; w/ IL-6 inhib as 2nd line options https://t.co/CmGuA7W4Ag https://t.co/p5aEQlV7p6

Links:

Dr. John Cush @RheumNow( View Tweet )
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Dr. Quotes (11.8.2024)

Jack Cush, MD

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

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FDA's perspective on the use of artificial intelligence in drug development. - FDA is committed to a risk-based regulatory framework that promotes innovation & protects Pt safety - Est. CDER AI Council to coordinate, develop, & support internal & external AI-related activities… https://t.co/BLCYmBBJMY https://t.co/fMie3oOfmn
Dr. John Cush @RheumNow( View Tweet )
Study of 168 patients with MDA5-positive Dermatomyositis finds that elevated IL-6 (≥ 13.41pg/m), lymphopenia (< 0.5 × 109) older age and high LDH predicted 6-month all-cause mortality in DM https://t.co/eHYrUtvsI9 https://t.co/SAy27Om2zu

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Dr. John Cush @RheumNow( View Tweet )
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Pain Relief in RA: JAK Better than TNF Inhibitors?

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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Stills,continuum

EULAR/PReS Still's Disease Management Recommendations

Jack Cush, MD

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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I Can't Treat Ugly (9.20.2024)

Jack Cush, MD

Dr. Jack Cush reviews the news, journal articles and a new FDA approval for EGPA, this week on the Podcast.

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2612 BSRBR-RA Registry pts on tocilizumab - increasing Body weight was associated with reduced DAS28 response to SC tocilizumab. But the DAS28 difference was small, and did not change drug persistence https://t.co/eR7kmjRaEE https://t.co/vFKYC1I3pV

Links:

Dr. John Cush @RheumNow( View Tweet )
Chinese study of 62 Systemic JIA pts Rx w/ IV Tocilizumab (34 12 mg/kg; 28 8 mg/kg). Wk12 87% responded (JIA ACR 30w/ no fever); Week 52 results were similar. No deaths or macrophage activation syndrome occurred. https://t.co/qGgMCt597x https://t.co/lFDxAgDHfW

Links:

Dr. John Cush @RheumNow( View Tweet )
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Running with Data (8.30.2024)

Jack Cush, MD

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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Study of 425 RA pts & 36 mo. bDMARD retention rates w/ TNFi, IL-6i & ABA based on renal funct (eGFR: ≥60, 30–60, <30 mL/min) showing little effect of CKD w/ TNFi (45%, 28%, 34%), IL-6i (47%, 67%, 71%) & CTLA-4Ig (50%, 31%, 33%), maybe lower w/ TNFi & higher w/ IL6i… https://t.co/FhXoSnEfG1 https://t.co/N29nLBOoUj
Dr. John Cush @RheumNow( View Tweet )
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Lipids and Inflammation in Rheumatoid Arthritis

EurekAlert!

In the realm of chronic inflammation, lipid abnormalities are well-recognized as pivotal contributors to the progression and clinical manifestations of atherosclerosis. Particularly in rheumatoid arthritis (RA), a systemic autoimmune disorder, the immune response leads to the generation of

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Recent Blogs

Overlap Syndrome with ILD

Jack Cush, MD
Cush RheumThought ILD

How would you manage a patient with Overlap (anti-synthetase) syndrome, ILD, polyarthritis and myositis?

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Advancing PMR

Eric L. Matteson, MD, MPH
Dr. Eric Matteson
Even though polymyalgia rheumatica is not perceived by many physicians as a severe diagnosis, its diagnosis and management actually propose significant challenges. I'd like to talk about those challenges, and what directions our path forward can include to advance our understanding and improve the treatment of patients who have PMR. Read Post

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