Articles By Md Yuzaiful Md Yusof, MRCP(UK), PhD
Dual target blockade may be better than one in SLE
Inhibition of B-cell Activating Factor (BAFF) has revolutionised the treatment of patients with systemic lupus erythematosus. However, outcomes of therapies within the same class (i.e. BAFF-inhibitor) when evaluated in randomised controlled trials have been inconsistent.
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Does Evusheld shield people living with rheumatic diseases?
While COVID vaccination and subsequent booster remain the cornerstone, pre-exposure prophylaxis such as Evusheld (tixagevimab and cilgavimab) has been approved by FDA in December 2021 and EMA in March 2022 for people immunocompromised either due to a medical condition or receiving treatment with immunosuppressants and may not mount an adequate immune response to COVID vaccination. How does this therapy fare in RMD patients?
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What do our lupus patients think about treat-to-target?
In SLE, two targets that are increasingly used are the DORIS 2021 Remission and the Lupus Low Disease Activity (LLDAS). T2T is more likely to be successful if the treating clinicians and the patients set the treatment goals together. What do our patients think about T2T and do they have any say/concern?
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The Safety of Rituximab and JAK Inhibitors with post-COVID Vaccination
At the onset of the pandemic, data from the Global Rheumatology Alliance reported increased risk of poor severe COVID outcomes including deaths in patients who were treated with rituximab and baricitinib. With the vaccination program undertaken globally, has this risk been attenuated?
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SLE trials update
Translating targeted therapy from bench to bedside has been more problematic in SLE than other autoimmune diseases, with many theoretically well-founded agents appearing to have failed in clinical trials as a result of inefficacy, problem with trial design and/or safety issues.
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Risks associated with mortality in VEXAS
Vacuoles, E1 enzyme, X-linked, autoinflammatory, somatic syndrome (VEXAS) took the centre stage when it was first introduced at ACR20 last year. It got everyone’s thinking that they might have encountered one or two patients in their rheumatology lifetime who might have this condition.
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Update on Safety, Effectiveness of SARS-CoV-2 vaccines in SLE
It is almost a year since the Pfizer-BioNTech SARS-CoV-2 vaccine has been made available by the FDA under emergency use authorization (EUA). The question still being asked is whether the vaccine is safe for people with lupus?
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Emapalumab for the treatment of macrophage activation syndrome
Macrophage activation syndrome (MAS) is a term commonly used by rheumatologists to describe a potentially life-threatening complication of systemic inflammatory disorders, most commonly occurring in people with systemic juvenile idiopathic arthritis (sJIA) and systemic lupus erythematosus (SLE).
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Risks associated with mortality in VEXAS
Vacuoles, E1 enzyme, X-linked, autoinflammatory, somatic syndrome (VEXAS) took the centre stage when it was first introduced at ACR20 last year. It got everyone’s thinking that they might have encountered one or two patients in their rheumatology lifetime who might have this condition.
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Do B-cell targeted therapies still have a place for the treatment of Sjogren’s?
B-cells play a major role in the pathogenesis of primary Sjogren’s syndrome (pSS) through antibody-dependent and antibody-independent functions, as well as evident by progression to B-cell malignancies/lymphoma. Hence, targeting B-cell is attractive. Despite efficacy of B-cell depleting therapy with rituximab in Phase II trials and case series, it failed to meet its primary endpoint when investigated in two Phase III trials. It is worth noting that the primary endpoint used in both trials was a subjective measure. Post-hoc analyses however showed greater improvement in objective measures such as salivary flow rate and salivary gland ultrasound score in RTX-treated group vs placebo. Therefore, do B-cell targeted therapies still have a place for the treatment of pSS?
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