ILD Begins (8.29.2025)
Dr. Jack Cush reviews the news and journal reports from RheumNow.com. This week news on vaccines, safety of acetaminophen and more.
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A case–time-control study of French National Health Insurance database w/ 34 241pts Rx w/ IL-17(R)A inhibitor (2016-2021) (for PsO, PsA, AS, JIA) found no significant association betw IL-17(R)A inhibitors & MACEs over 6 months compared to TNFi Rx pts. https://t.co/fJuPFYKnSr https://t.co/Vscnsq0DTA
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LTBI risk in rheumatic pts is high (22%). Metanalysis 18 studies, 12,167 rheum pts shows LTBI signif. incr w/ current smoking (OR 1.50), golimumab(OR 2.90), Chloroquine (OR 1.27), age >40 (OR 1.84), prior TB OR 3.26). LTBI not increased w/ RF, ADA, ETN, BCG, Pred, smoking, DM https://t.co/0PayHJqwDn
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J&J announced it has halted its combination biologic study in difficult to treat RA. Phase 2a DAISY proof-of-concept studied the combo of nipocalimab and TNFi in refractory RA, but 12 wk results failed to evidence of efficacy. https://t.co/T4n4GNqtVC v https://t.co/eSAwrEIYHc
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Celltrions tocilizumab biosimilar, tocilizumab-anoh (Avtozma, CT-P47), had similar efficacy when switching from reference tocilizumab (Actemra; Genentech) in a study of 444 RA patients x 52 wks. https://t.co/7aAyuUkZJ9 https://t.co/kJUrRkhstb
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New IDSA recommendation: In hospitalized on systemic steroids w/ severe, critical, progressing COVID-19, when baricitinib or tocilizumab are not available, IDSA guideline panel suggests infliximab. https://t.co/ZCkkZXUDpi https://t.co/gbgkvj5R8Y
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Claims data study of 82 399 PsA pts - 542 on combo targeted Rx >3 mos (200 > 6mos). 2 most common combos of apremilast w/ TNFi or IL-17i. Use of combo targeted Tx was not assoc. w/ more serious infxn (RRs 0.53; 0.17-1.63) or opportunistic infx (RR 1.00; 0.09-11.02) @ 3 or 6 mos https://t.co/mkvq1lqt9Y
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TNF Inhibitors in Takayasu's Arteritis
A large, retrospective, multicenter study demonstrated the efficacy of intravenous infliximab and subcutaneous adalimumab in patients with Takayasu arteritis.
https://t.co/lJbvaYnylO https://t.co/uRBruhW2Fd
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Uncertainty with immunosuppressive for idiopathic inflammatory myopathies
A current Cochrane review suggests a continued unmet need regarding the status and utility of targeted immunosuppressant and immunomodulatory treatments for the idiopathic inflammatory myopathies (IIM). Overall there has been little progress since the previous Cochrane review (2012) that found
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TNF Inhibitors in Takayasu's Arteritis
A large, retrospective, multicenter study demonstrated the efficacy of intravenous infliximab and subcutaneous adalimumab in patients with Takayasu arteritis.
This multicentre study enrolled patients from Takayasu's referral centers in France, Italy, Spain, Armenia,
There's a transient (1 yr) increase in New Abx Rx among 399 PsA pts after starting a TNF inhibitor. Pre-TNFi, PsA pts were more likely to recv Abx vs controls (1.26 vs. 0.60/yr; p<0.001). Post TNFi Abx use incr to 1.64/yr (p<0.001) but returned to baseline thereafter. https://t.co/LHXn5d7oC9
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Difficult to manage SpA (D2M-axSpA) defined as failure ≥ 2 b/tsDMARDs (diff MOAs). Study of 129 axSpA pts, 8.5% were D2M, & 3% were treatment refractory (more inflammation- TR). D2M had signif higher BASFI (4.2 vs. 2.9), BASDAI (5.1 vs. 3.5), ASDAS (3.7 vs. 2.8). Predictors: https://t.co/4qdHEFxr3J
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945 consecutive severe psoriasis pts Rx TNFi or nbUVB phototherapy (2005-2010) w/ median F/U > 9 yrs. After propensity matching, incidence of future PsA was 1.18/100 w/ TNFi vs 2.48/100 w/ nbUVB (IRR 2.1; 1.37–2.98, P = 0.0002). TNFi lowered PsA risk (HR = 0.32). PsA predictors https://t.co/aBsXs6RpCY
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Rheums Speak: Changing Rheumatology Practices & Choices
RheumNow surveyed clinicians worldwide on how their rheumatology practice, treatment decisions, and career outlooks have changed over the past 20 years. 242 respondents (68% from the USA) shared their perspectives on the changing landscape of rheumatoid arthritis care, practice patterns, and
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Full read review of DMARD effects on CV Risks. Strongest CV protective effects for MTX & TNF inhibitors. Potentially beneficial are sulfasalazine, hydroxychloroquine, & leflunomide. More info needed on IL-6, IL-17/23 inhibitors. Concerns over NSAIDs & JAKi https://t.co/0BW4StS15N
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Large metanalysis of TNFi use in immune-mediated inflammatory diseases (45 studies, 150K pts) shows no increased risk of de novo heart failure (HF), and no significant risk of HF worsening w/ TNFis. https://t.co/9sRVsMZ1kv https://t.co/igCdcQMVK3
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Repurposing & Pipeline (8.8.2025)
Dr. Jack Cush reviews the news, reports, pipeline and drug repurposing on this week’s podcast.
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COVID Vaccine study in rheum pts on JAKi (n 22) or TNFi (n 16) Showing 50% response in JAKi and 81% w/ TNFi Rx. Pt PBMCs were stim by SAR-CoV2 spike proteins & CD4+ T cells IFNγ production as Pos. response. Do JAKi impair COVID-19 Vax responses? https://t.co/dZAktwrytf https://t.co/mjkBfcGcfD
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Retrospective review of 9 #RA pts w/ elevated liver enzymes who were Rx w/ TNF inhibitor (4 adalimumab, 5 etanercept; 78% female, median BMI 37). Over 3 yrs F/U, LFTs declined, fibrosis scores (FIB-4) signif decreased; albumin & bilirubin remained stable https://t.co/Hcwa3qaupv https://t.co/OwGY5jxxyZ
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Full read review of DMARD effects on CV Risks. Strongest CV protective effects for MTX & TNF inhibitors. Potentially beneficial are sulfasalazine, hydroxychloroquine, & leflunomide. More info needed on IL-6, IL-17/23 inhibitors. Concerns over NSAIDs & JAKi https://t.co/INEdCt0pxa
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Large metanalysis of TNFi use in immune-mediated inflammatory diseases (45 studies, 150K pts) shows no increased risk of de novo heart failure (HF), and no significant risk of HF worsening w/ TNFis. https://t.co/9sRVsMZ1kv https://t.co/Kapg9ZwVGf
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MTX or TNFi use in elderly #RA pts w/in a year of Dx of melanoma was not associated with increased mortality. This included melanoma in situ (48%), localized (47%) and regional (5%) melanoma. Steroid use however was assoc w/ reduced survival. https://t.co/QOXfEf51S1 https://t.co/GZ5dedEMfM
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A New RA Approval (8.1.2025)
Dr. Jack Cush reviews the news, journal reports and a new treatment for RA from the FDA.
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Pregnant Women on TNFi more likely to use throughout gestation, w/ less steroids. 3711 preg on TNFi in 49,925 F (w/ RA, AS, PsA, PsO, IBD) -- 64% had 3 trimester TNFi use. 89% exposed preconception & 68% cont postpartum. TNFi use incr from 55% to 73% i(20111-21) https://t.co/DVvbwx6MoW
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FDA Approves Vagal Nerve Stimulator for RA
SetPoint Medical announced that the FDA has approved the company’s SetPoint System, a first-in-class neuroimmune modulation innovation for treatment of moderate-to-severe rheumatoid arthritis (RA) for those who are not adequately managed by—or cannot tolerate—existing advanced RA therapies, such
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