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JAK/TYK2

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More Bad Safety News for Xeljanz

MedPage Today
Aug 08, 2022

Another analysis of the mandatory postmarketing safety study for tofacitinib (Xeljanz) has confirmed what most observers expected: that rates of infection with the drug in rheumatoid arthritis are higher than with tumor necrosis factor (TNF) inhibitors.

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Upadacitinib in non-radiographic Axial Spondyloarthritis The janus kinase inhibitor, upadacitinib, has been shown to significantly improve the signs and symptoms of nr-AxSpA, extending the efficacy of UPA beyond classic ankylosing spondylitis. https://t.co/IqKdvRkcgZ https://t.co/cieXqJABTL
Dr. John Cush @RheumNow( View Tweet )
Aug 07, 2022
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JAK Inhibitors in Difficult Still’s Disease

Aug 05, 2022

A small retrospective study suggests that patients with difficult to treat adult-onset Still's disease (AOSD) or sytemic juvenile idiopathic arthritis (sJIA) may respond well to JAK inhibitor (JAKi) agents - presumable by blocking pro-inflammatory cytokines, notably IL-6 and IFN.



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The Great Unknowns (8.5.2022)

Aug 05, 2022

Dr. Jack Cush reviews the news, FDA approvals, journal articles from the past week on RheumNow; plus viewer questions. This week great hopes for vitamin D, the great unknows of CSA and the great big mess that is the gout.




  1. 521 clinically suspect arthralgia (CSA) pts were

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Oral surveillance - tofacitinib vs TNFi in high risk pts: more infections, serious infection (SIEs) & non-serious infx with Tofa vs TNFi. SIE risk 17%-48% higher; SIE higher w/ high dose Tofa, esp in pts aged≥65. Usual risk factors - age, pred, comorbid. https://t.co/gjD8xqtfgp https://t.co/doMd4E9ClL
Dr. John Cush @RheumNow( View Tweet )
Aug 04, 2022
ACR guidance

ACR Updated Guideline on Vaccinations for Rheumatic Patients

Aug 04, 2022

The ACR has posted a new ACR Clinical Practice Guideline Summary providing recommendations on the use of vaccinations for children and adults with rheumatic and musculoskeletal diseases (RMDs).



This guideline builds on past

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The Approach to Difficult to Treat Rheumatoid Arthritis

Aug 03, 2022

Tan and Buch have reviewed the approach to difficult to treat rheumatoid arthritis (D2T-RA), with a new EULAR definiation of D2T-RA to foster an approach rationale and concideration of treatment options.



D2T-RA is defined by failure of at least two different mechanism of action

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Risk of incident & recurrent H.Zoster higher after tofacitinib - Korean claims analysis of 11,720 seropos. RA pts Rx w/ bDMARD or tofacitinib (2011-19). 14% got HZ. Compared to other biologics (ABA), Tofa incr HZ (HR 2.5) & recurrence (HR 3.69) https://t.co/lDuqdtkIjR https://t.co/zJ3ArS3gGs
Dr. John Cush @RheumNow( View Tweet )
Aug 02, 2022
EMA in Europe has approved Rinvoq (upadacitinib 45 mg and 15 mg and 30 mg) for the treatment of adult patients with moderately to severely active ulcerative colitis who are DMARD-IR or biologic-IR. Based on 3 phase III trials. https://t.co/CbRQGzxJEr https://t.co/SlJNprUay3
Dr. John Cush @RheumNow( View Tweet )
Jul 30, 2022
EMA in Europe has approved Rinvoq (upadacitinib 45 mg and 15 mg and 30 mg) for the treatment of adult patients with moderately to severely active ulcerative colitis who are DMARD-IR or biologic-IR. Based on 3 phase III trials. https://t.co/BjvUm0wPNk https://t.co/IVisAgD1wZ
Dr. John Cush @RheumNow( View Tweet )
Jul 27, 2022
Have you checked out our new sister-site, Still's Now? A new site for Still's disease, autoinflammatory & febrile disorders.https://t.co/oWEugnOB6k https://t.co/5jwiP2Xqrz
Dr. John Cush @RheumNow( View Tweet )
Jul 26, 2022
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Treatment Options for Still's Disease

Jul 22, 2022

Are you treating “systemic” or “articular” (arthritis) Still’s disease? Most Still’s patients have a dominance of one or the other. With certainty, the right therapy for the right symptoms can be chosen. What about patients who have an incomplete or no response, or who become unresponsive to a

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Rheums: Got a Rheumatology question or case for Jack Cush? Record it here and we'll feature it on an upcoming podcast. Tell us your name and where you practice rheumatology.https://t.co/QUTIbK3r89 https://t.co/FZcTLREida
Dr. John Cush @RheumNow( View Tweet )
Jul 22, 2022
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Early, Aggressive and Seropositive (7.22.2022)

Jul 22, 2022

Dr. Jack Cush covers the news and journal reports from the past week on RheumNow.com. This week we have Insights NAFLD, overdose deaths, septic arthritis, refractory stills, & when MTX doesn’t work.

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Rheumatologist Survey: What do you rely on MOST in diagnosing Still’s disease? Sxs? Labs? Both? Criteria? Fever? Vote here:https://t.co/oANKpKqJA5 https://t.co/LIjRSBHNBi
Dr. John Cush @RheumNow( View Tweet )
Jul 21, 2022
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Treating Enthesitis in Psoriatic Arthritis Patients

Jul 20, 2022

A large prospective psoriatic arthritis (PsA) study examined the enthesitis outcomes when PsA patients received conventional (cDMARDs) or targeted disease-modifying antirheumatic drugs (tDMARDs) and showed an overall 86% response rates, regardless of the medication used.

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Metanalysis (48 pubs, 145 refract pts) of JAK inhibitors in myositis (DM, JDM) shows significant improvement in skin lesions, muscle weakness, and ILD. https://t.co/cYZ1YEGBOr https://t.co/MDNTSje6a2
Dr. John Cush @RheumNow( View Tweet )
Jul 17, 2022
Tofacitinib had faster and larger impact on improvement of fatigue compared to placebo in treatment of ankylosing spondylitis pts. Note 100% fatigue resolution roughly same vs. placebo @RheumNow #EULAR2022 ABST#POS0305 cc: @doctorRBC : https://t.co/sodp75Nblw
Dr. John Cush @RheumNow( View Tweet )
Jul 10, 2022
#EULAR2022 Prof Schulze-Koops highlighted a mechanistic study that baricitinib therapy ex vivo suppressed autophagy, increased apoptosis, and reduced expression of adhesion molecules in #sjogren salivary glands. Next step should be randomised controlled trial cc: @Yuz6Yusof https://t.co/1tDBNzTuwQ
Dr. John Cush @RheumNow( View Tweet )
Jul 10, 2022
In vitro study shows Upadacitinib inhibits enthesis T cell derived TNFa and IL-17A, disrupting the prominent IL-23/IL-17/TNFa axis driving SpA. @RheumNow #EULAR2022 ABST#POS0331 cc: @doctorRBC https://t.co/M8YYAOBVat
Dr. John Cush @RheumNow( View Tweet )
Jul 09, 2022
SELECT-AXIS 1 trial of upadacitinib in active #AS with an inadequate resp to prior biologic - pivotal phase 2/3 RCT of 420 AS pts (Dz dur 7.7 yrs; 83% B27+) showed better ASAS40 at wk 14 w/ UPA vs PBO (45% vs 18%; P<0.0001) #EULAR2022 POS0306 https://t.co/JmreAOqnqh https://t.co/pTFeAzWUYU
Dr. John Cush @RheumNow( View Tweet )
Jul 09, 2022
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ICYMI: 2021 Rheumatology Year in Review

Jul 08, 2022

For 2022, let's look our top 10 list of advances, game-changers, worries and those better medical practices that evolved during 2021.

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The EMA's CHMP has positively recommended upadacitinib for use in Non-radiographic axial spondyloarthritis (nr-axSpA) based on Phase 3 SELECT-AXIS 2 study showing superior ASAS40 responses at week 14 https://t.co/uc7oOKglLX https://t.co/yz7M8U3rkk
Dr. John Cush @RheumNow( View Tweet )
Jul 02, 2022
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What Worries You, Masters You (7.1.2022)

Jul 01, 2022

Dr. Jack Cush reviews recent news, regulatory and guideline updates from the past week on RheumNow.com.  Studies on methotrexate use, COVID vaccination, Supplements and vitamins, and arthrocentesis despite anticoagulation are discussed.




  1. FDA approved Abbvies risakizumab-rzaa

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New Updated GRAPPA Psoriatic Arthritis Recommendations

Jun 29, 2022

The GRAPPA (Group for Research and Assessment of Psoriasis and Psoriatic Arthritis) treatment recommendations have been updated and the 2021 evidence-based guidance is rich in treatment recommendations based on the key disease "domains" - peripheral arthritis, axial disease, enthesitis,

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