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JAK/TYK2

RA Associated Cancer Risk

Sep 19, 2023

A large cohort analysis of insured rheumatoid arthritis (RA) patients reveals that RA patients have a 1.69 to 2.08 fold higher risk of developing cancer, especially lymphoma or lung cancer, within 1 year of RA diagnosis.  



The analysis included nationwide health insurance claims data

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Oral Surveillance Changes in Advanced Therapy Use in #RA The safety of tofacitinib and TNF inhibitors was studied in high risk RA patients in the ORAL Surveillance study. Read more.... https://t.co/2ZyB0xow6B https://t.co/mB5R0HfaWq

Oral Surveillance Changes in Advanced Therapy Use in RA

Sep 06, 2023

The safety of tofacitinib and TNF inhibitors was studied in high risk rheumatoid arthritis (RA) patients in the ORAL Surveillance study, which culminated in an FDA warning in January 2021 on the cardiovascular, cancer and VTE risks associated with JAK inhibitor use. These safety concerns and

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Biologic Adherence and Drug Survival in RA Patients

Aug 24, 2023

A real-world rheumatoid arthritis (RA) cohort study from Israel shows significant variability of drug survival using biologic disease-modifying anti-rheumatics drugs (bDMARDs) and targeted synthetic DMARDs (tsDMARDs).



A total of 753 RA patients were drawn from in a large Israeli

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Pizza and Rheumatoid Arthritis (8.11.2023)

Aug 11, 2023

Dr. Jack Cush reviews the news and journal reports from the wonderful wide world of Rheumatology. This week:




  1. Swedish study of 325 #AAV pts saw CVA in 35 pts (8%); CVA incidence=11.3/1000 PYs - this was higher than gen population [SIR 1.85). AAV CVA risk factors included age

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Italian JAKi study, 685 pts Rx w/ BARI (48%), TOFA (31%), UPA (14%), filgotinib (7%), had half (47%) Rx JAKi as 1st line, prior to a biologic. AE of special interest (1137 PYs FU) in 18%, including 1 CVA, 3 deaths/infx. High CV risk pts = Hi AESI(23%) https://t.co/0NN60tvokZ https://t.co/Dzc7OG9Mmv
Tofacitinib in Polymyalgia Rheumatica (EAST PMR Study) An open-label, uncontrolled pilot trial has shown that JAK signaling is involved in the pathogenesis of PMR and that tofacitinib is as effective as glucocorticoids (GC) in patients with PMR. https://t.co/sJcq9lMP1l https://t.co/zvmPs3SdCw

Tofacitinib in Polymyalgia Rheumatica (EAST PMR Study)

Aug 01, 2023

An open-label, uncontrolled pilot trial has shown that JAK signaling is involved in the pathogenesis of PMR and that tofacitinib is as effective as glucocorticoids (GC) in patients with polymyalgia rheumatica (PMR).

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EULAR/ACR Guidance on Haemophagocytic Lymphohistiocytosis/Macrophage Activation Syndrome

Jul 26, 2023

A EULAR/American College of Rheumatology task force has established evidence based, up-to-date guidance and expert opinion on the evaluation, management and monitoring of patients with Haemophagocytic lymphohistiocytosis (HLH) and macrophage activation syndrome (MAS), with the primary intent to 

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Have a rheumatology question or case for Jack Cush? Record it here and we may feature it on an upcoming podcast. Tell us your name and where you practice rheumatology. https://t.co/vGt12ul6iy https://t.co/044BScmSYc

Tofactitinib in PsA & RA: Nine Year Safety Data

Jul 20, 2023

Tofacitinib is FDA approved for psoriatic arthritis and rheumatoid arthritis, but long term safety outcomes beyond a year are limited. A real-world, post-marketing surveillance of tofacitinib in PsA and RA shows a consistent pattern of safety with no new safety concerns identified.

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Filgotinib Effects on Semen and Sex Hormones The oral Janus kinase 1 inhibitor filgotinib is available worldwide, but not in the USA, where the FDA held up its approval for use in RA due to unfinished studies of filgotinib's effects on sperm cells. https://t.co/SrwInSY45G https://t.co/TD54PXNFbi

Anti-Drug Antibodies with Biologics (7.14.2023)

Jul 14, 2023

Dr. Jack Cush Reviews the news and journal reports on CVA, TKA, PJP, ADA, and more!

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Filgotinib Effects on Semen and Sex Hormones

Jul 13, 2023

The oral Janus kinase 1 inhibitor filgotinib is available worldwide, but not in the USA, where the FDA held up its approval for use in RA due to unfinished studies of filgotinib's effects on sperm cells.  The results of 2 phase two studies (MANTA and MANTA-RAy) confirm that filgotinib has no

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Metanalysis 62 RCTs & 16 LTE RCTs looks at neoplasia risk in JAKi, TNFi, MTX, PBO. Total CA rate=1.15/100PYs in RCTs. No diff in all CA between JAKi vs PBO or JAKi vs MTX (IRR 0.77); but JAKi had more CA than TNFi (1.50; 1.16, 1.94) https://t.co/aiJHQ5oPqt https://t.co/8MjJv728sh

Baricitinib Effective in JIA Subsets

Jul 11, 2023

A phase 3 trial assessed a selective Janus kinase 1/2-inhibitor, baricitinib, in patients with juvenile idiopathic arthritis (JIA), demonstrating it's efficacy and safety compared to placebo.

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Upadacitinib Outcomes in High Risk RA Patients

Jul 10, 2023

A safety analysis of six phase III SELECT trials showed that higher-risk rheumatoid arthritis (RA) patients had an increased risk of MACE, malignancy (excluding NMSC) and venous thromboembolic events (VTE) regardless of being treated with either upadacitinib (UPA) or adalimumab (ADA).

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ICYMI: Drug Safety Differences with New Novel Therapies in RA

Jul 06, 2023

Safety outcomes for targeted synthetic or biological disease-modifying antirheumatic drugs (b/ts DMARDs) used to treat RA were studied using data from the Anti-Rheumatic Therapies in Sweden (ARTIS) registry, showing that these newer agents are largely similar, but still have particular

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ICYMI: GRAPPA Recommendations for Treating Enthesitis in Psoriatic Arthritis

Jul 05, 2023

GRAPPA has provided new, evidence based updates to the management of enthesitis in patients with psoriatic arthritis (PsA), affecting at least 30% of PsA patients and is associated with more severe disease, x-ray damage, and poorer outcomes. 

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Metanalysis of 62 RCTs, 16 LTEs, 82 366 Pt-Yrs JAK exposure. JAKi malignancy incid rate = 1.15/100 PYs in RCTs (1.26/100PYs overall). Network meta-analyses show no diff betw JAK & PBO or MTX in NMSC, but signif increased malignancy risk (IRR 1.50) https://t.co/ANa7zYmhPx
JAK inhibitors have been effective in refractory inflammatory myositis, all open label, but no controlled trials. #EULAR2023

Scleroderma – Thick and Thin (6.30.2023)

Jun 30, 2023

Dr. Jack Cush reviews the news, journal articles and regulatory decisions from the past week from RheumNow.com. This week focuses on parodoxical psoriasis, scleroderma outcomes and subsets, and alopecia areata therapy.

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FDA has approved a 2nd JAK inhibitor for Alopecia areata - Pfizers Ritlecitinib (Litfulo) is approved for Adults and Adolescents (>12 yrs) With Severe Alopecia Areata (based on ALLEGRO trial, pub in Lancet) https://t.co/VmjhQOnZyS https://t.co/VmjhQOnZyS https://t.co/oUZfckt6DX
Indian study of 943 AIRD patients (43% RA) starting biologics or JAKi, had TB screening with IGRA assay. 125 pts were IGRA pos. and had LTBI; 124/125 received anti-TB prophylaxis. IGRA Accuracy in predicting absence of TB reactivation = 99.6% https://t.co/KI9vGWpS59 https://t.co/Ne33P51koD

Treatment Sequences Define Subphenotypes in RA Patients

Jun 21, 2023

An analysis of a large rheumatoid arthritis cohort sheds light on biologic disease-modifying anti-rheumatic drugs (bDMARDs) clustering that may be used in management, as certain clusters of b/tsDMARD correlated with disease activity over time. 

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