Bah Humbug Vitamin D (12.20.2024)
Dr. Jack Cush reviews the news and journal reports from this past week on RheumNow.com.
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Tocilizumab Efficacy in Giant Cell Arteritis Phenotypes
A Spanish Collaborative Group study of Tocilizumab (TCZ) in Giant Cell Arteritis (GCA) demonstrated high efficacy regardless of the different vascular phenotypes treated.
Multicentre study of 471 GCA patients treated with TCZ, assessed outcomes according to vascular
Don’t Buy Guitars (12.6.2024)
This year at ACR24, the RheumNow faculty and reporters were prolific, generating >800 Tweets, 56 written articles, 117 Videos and 28 podcasts – all in 4 days! You can best review and learn ACR24 by A) Rheumatology Roundup; b) Topic Panel videos; and c) Topic podcasts.
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RA-ILD in the Spotlight at ACR 2024
Over the past 5 years, there has been growing interest in RA-ILD due to its relative prevalence and severity. This seems to be one of the few RA outcomes not improving much, even with the advent of expanded treatment options. There is also a shocking lack of trial data. This year, there were two
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JAKs and Other Drugs in PMR
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
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
Links:
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
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
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
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
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
Links:
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
Links:
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
Links:
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
sheila @RHEUMarampa( View Tweet )
Biosimilar Slow Growth in USA
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
Dr. John Cush @RheumNow( View Tweet )
Dr. Quotes (11.8.2024)
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
Dr. John Cush @RheumNow( View Tweet )
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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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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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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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
Dr. John Cush @RheumNow( View Tweet )
Recent Blogs
How would you manage a patient with Overlap (anti-synthetase) syndrome, ILD, polyarthritis and myositis?
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